| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90472 |
Immunization administration, each additional vaccine (list separately) |
761 |
755 |
$34K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,509 |
1,481 |
$29K |
| H1000 |
Prenatal care, at-risk assessment |
1,302 |
1,300 |
$22K |
| 99407 |
|
47 |
37 |
$752.36 |
| 90688 |
|
183 |
183 |
$450.00 |
| 90670 |
|
236 |
236 |
$429.95 |
| 90716 |
|
68 |
68 |
$122.02 |
| 90686 |
|
38 |
38 |
$105.00 |
| 90715 |
|
38 |
38 |
$84.28 |
| 90651 |
|
90 |
90 |
$0.00 |
| 90647 |
|
99 |
99 |
$0.00 |
| 90723 |
|
91 |
91 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
30 |
30 |
$0.00 |
| 90480 |
|
12 |
12 |
$0.00 |
| 90619 |
|
14 |
14 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
21 |
21 |
$0.00 |
| 90633 |
|
53 |
53 |
$0.00 |
| 91322 |
|
12 |
12 |
$0.00 |
| 90707 |
|
65 |
65 |
$0.00 |
| 90734 |
|
95 |
95 |
$0.00 |
| 90681 |
|
37 |
37 |
$0.00 |