| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
167 |
151 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
136 |
130 |
$3K |
| 90658 |
|
19 |
19 |
$425.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17 |
15 |
$206.46 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
37 |
35 |
$172.78 |
| 94760 |
|
924 |
836 |
$113.00 |
| Q2037 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin) |
18 |
16 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
21 |
18 |
$0.00 |