| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
172 |
137 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
53 |
41 |
$5K |
| 90686 |
|
61 |
61 |
$1K |
| 90674 |
|
37 |
35 |
$921.92 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
24 |
16 |
$905.79 |
| 90658 |
|
31 |
29 |
$789.88 |
| 0003A |
|
12 |
12 |
$320.00 |
| 36415 |
Collection of venous blood by venipuncture |
164 |
141 |
$103.60 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
143 |
125 |
$0.00 |