| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
367 |
344 |
$35K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
107 |
105 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
57 |
54 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
54 |
52 |
$1K |
| 87428 |
|
14 |
13 |
$393.27 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
15 |
$238.44 |
| 87807 |
|
14 |
12 |
$151.45 |
| 90686 |
|
17 |
17 |
$17.82 |
| 90674 |
|
13 |
12 |
$0.01 |
| 90698 |
|
13 |
13 |
$0.00 |
| 90671 |
|
14 |
14 |
$0.00 |