| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
575 |
560 |
$28K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
288 |
271 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
43 |
42 |
$4K |
| 90686 |
|
26 |
26 |
$570.36 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
26 |
26 |
$149.50 |
| 3008F |
|
449 |
418 |
$0.00 |
| 3074F |
|
318 |
304 |
$0.00 |
| 1036F |
|
420 |
394 |
$0.00 |
| 3079F |
|
28 |
27 |
$0.00 |
| 3725F |
|
294 |
281 |
$0.00 |
| 1159F |
|
465 |
432 |
$0.00 |
| 1160F |
|
465 |
432 |
$0.00 |
| 3078F |
|
227 |
217 |
$0.00 |