| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
738 |
734 |
$42K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
657 |
617 |
$29K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
287 |
278 |
$18K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
132 |
125 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
29 |
29 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
366 |
365 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
100 |
100 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
14 |
14 |
$1K |
| 90648 |
|
57 |
57 |
$631.23 |
| 90474 |
|
14 |
14 |
$608.09 |
| 90686 |
|
264 |
263 |
$550.62 |
| 85018 |
|
13 |
12 |
$387.12 |
| 90670 |
|
82 |
82 |
$0.00 |
| 90723 |
|
14 |
14 |
$0.00 |
| 90680 |
|
14 |
14 |
$0.00 |