| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,554 |
1,162 |
$94K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
15 |
15 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
15 |
15 |
$1K |
| 81002 |
|
400 |
392 |
$716.05 |
| 90658 |
|
37 |
37 |
$584.38 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
39 |
39 |
$354.95 |
| 93000 |
|
21 |
21 |
$274.20 |
| 36415 |
Collection of venous blood by venipuncture |
377 |
376 |
$76.95 |