| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
48 |
48 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
50 |
50 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
29 |
29 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
15 |
$306.75 |
| 90686 |
|
15 |
15 |
$160.05 |