| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,242 |
2,922 |
$90K |
| 0012A |
|
79 |
79 |
$3K |
| 0011A |
|
83 |
81 |
$3K |
| 90632 |
|
41 |
41 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
132 |
129 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
38 |
25 |
$1K |
| 90651 |
|
224 |
203 |
$920.98 |
| 0001A |
|
23 |
23 |
$906.98 |
| 90715 |
|
621 |
557 |
$852.04 |
| 0002A |
|
19 |
19 |
$710.62 |
| 94250 |
|
47 |
39 |
$617.27 |
| 90734 |
|
938 |
835 |
$486.68 |
| 90686 |
|
219 |
215 |
$480.24 |
| 86580 |
|
91 |
58 |
$429.51 |
| 90716 |
|
25 |
25 |
$359.18 |
| 99406 |
|
32 |
25 |
$267.30 |
| 90619 |
|
234 |
230 |
$158.56 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$152.30 |
| 90713 |
|
60 |
50 |
$10.50 |
| 91301 |
|
171 |
160 |
$1.69 |
| 91300 |
|
42 |
42 |
$0.41 |
| 91307 |
|
12 |
12 |
$0.09 |
| 90744 |
|
88 |
72 |
$0.00 |
| 90698 |
|
119 |
99 |
$0.00 |
| 90696 |
|
44 |
32 |
$0.00 |
| 90670 |
|
103 |
85 |
$0.00 |
| 90710 |
|
144 |
122 |
$0.00 |
| 90633 |
|
200 |
180 |
$0.00 |
| 90700 |
|
51 |
43 |
$0.00 |
| 90707 |
|
25 |
25 |
$0.00 |