| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90472 |
Immunization administration, each additional vaccine (list separately) |
25 |
25 |
$282.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
46 |
46 |
$276.00 |
| 90461 |
|
17 |
17 |
$102.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
35 |
32 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |
| 90734 |
|
13 |
13 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
63 |
60 |
$0.00 |
| 90686 |
|
14 |
14 |
$0.00 |
| 90651 |
|
20 |
20 |
$0.00 |
| 99050 |
|
23 |
23 |
$0.00 |