| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
318 |
315 |
$23K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
166 |
150 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
13 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
14 |
$381.56 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$314.12 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
28 |
27 |
$296.04 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
81 |
81 |
$0.00 |
| 90648 |
|
13 |
13 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |
| 90686 |
|
32 |
31 |
$0.00 |