| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,970 |
1,409 |
$29K |
| 99199 |
Unlisted special service, procedure or report |
3,136 |
2,146 |
$20K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
228 |
164 |
$15K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
181 |
142 |
$5K |
| 90651 |
|
177 |
166 |
$4K |
| 90734 |
|
185 |
149 |
$3K |
| 90674 |
|
130 |
126 |
$2K |
| 96127 |
|
432 |
394 |
$2K |
| 99384 |
|
20 |
12 |
$2K |
| 96160 |
|
326 |
299 |
$1K |
| 0001A |
|
19 |
18 |
$1K |
| 0002A |
|
18 |
17 |
$1K |
| 90686 |
|
977 |
735 |
$837.41 |
| 90756 |
|
142 |
48 |
$658.35 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17 |
17 |
$483.34 |
| 90715 |
|
82 |
55 |
$316.16 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
16 |
12 |
$280.77 |
| 99173 |
|
420 |
386 |
$192.37 |
| 92551 |
|
350 |
331 |
$114.03 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
68 |
12 |
$113.04 |
| 85018 |
|
155 |
106 |
$73.00 |
| 36415 |
Collection of venous blood by venipuncture |
28 |
14 |
$37.80 |
| 90656 |
|
74 |
74 |
$0.00 |
| 99000 |
|
25 |
19 |
$0.00 |
| 36416 |
|
15 |
13 |
$0.00 |
| 99072 |
|
30 |
30 |
$0.00 |
| 90649 |
|
291 |
129 |
$0.00 |