| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,916 |
6,652 |
$720K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,538 |
3,077 |
$235K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
613 |
590 |
$14K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
85 |
85 |
$14K |
| 0124A |
|
325 |
325 |
$9K |
| 0054A |
|
148 |
148 |
$4K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
65 |
65 |
$1K |
| 0004A |
|
18 |
18 |
$680.00 |
| 0053A |
|
15 |
15 |
$560.00 |
| 90686 |
|
457 |
457 |
$488.13 |
| 0064A |
|
12 |
12 |
$240.00 |
| 90715 |
|
73 |
73 |
$73.66 |
| G0008 |
Administration of influenza virus vaccine |
132 |
132 |
$18.59 |
| 91312 |
|
63 |
63 |
$0.00 |
| 91300 |
|
29 |
29 |
$0.00 |
| 90750 |
|
12 |
12 |
$0.00 |
| 90688 |
|
26 |
26 |
$0.00 |
| 90739 |
|
33 |
33 |
$0.00 |