| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
134 |
128 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
132 |
126 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
66 |
64 |
$665.94 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
50 |
25 |
$516.50 |
| 90461 |
|
14 |
14 |
$232.07 |
| 94760 |
|
15 |
13 |
$0.00 |
| 90686 |
|
14 |
14 |
$0.00 |
| G9153 |
Mapcp demonstration - physician incentive pool |
18 |
18 |
$0.00 |