| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,188 |
3,139 |
$107K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
238 |
229 |
$5K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
293 |
279 |
$3K |
| 86580 |
|
312 |
295 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
50 |
44 |
$2K |
| 90715 |
|
540 |
531 |
$853.48 |
| 90686 |
|
231 |
229 |
$810.00 |
| 90707 |
|
37 |
37 |
$280.60 |
| 90716 |
|
50 |
50 |
$265.69 |
| 90658 |
|
93 |
87 |
$242.42 |
| 90649 |
|
158 |
157 |
$190.14 |
| 0011A |
|
52 |
51 |
$50.40 |
| 0031A |
|
18 |
17 |
$40.00 |
| 90734 |
|
524 |
517 |
$15.43 |
| 90698 |
|
72 |
72 |
$0.00 |
| 90696 |
|
114 |
112 |
$0.00 |
| 90651 |
|
305 |
302 |
$0.00 |
| 90744 |
|
65 |
65 |
$0.00 |
| 90647 |
|
18 |
16 |
$0.00 |
| 91301 |
|
227 |
219 |
$0.00 |
| 0012A |
|
50 |
50 |
$0.00 |
| 91303 |
|
15 |
15 |
$0.00 |
| 90723 |
|
20 |
18 |
$0.00 |
| 90633 |
|
297 |
293 |
$0.00 |
| 90670 |
|
206 |
203 |
$0.00 |
| 90713 |
|
39 |
39 |
$0.00 |
| 90710 |
|
193 |
188 |
$0.00 |
| 90700 |
|
28 |
28 |
$0.00 |