| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90750 |
|
3,382 |
3,380 |
$544K |
| G0008 |
Administration of influenza virus vaccine |
17,119 |
17,101 |
$177K |
| 90686 |
|
11,236 |
11,225 |
$118K |
| 90732 |
|
634 |
634 |
$66K |
| 90674 |
|
4,178 |
4,177 |
$44K |
| 0001A |
|
979 |
965 |
$33K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,190 |
3,188 |
$33K |
| 0011A |
|
965 |
964 |
$30K |
| 0012A |
|
761 |
760 |
$27K |
| 0002A |
|
739 |
737 |
$26K |
| 0064A |
|
777 |
777 |
$26K |
| 0124A |
|
586 |
586 |
$22K |
| 0003A |
|
475 |
475 |
$17K |
| 0004A |
|
489 |
488 |
$17K |
| 0013A |
|
473 |
473 |
$16K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
362 |
349 |
$12K |
| 0031A |
|
286 |
286 |
$10K |
| 0054A |
|
272 |
272 |
$9K |
| 90688 |
|
778 |
777 |
$8K |
| 90746 |
|
110 |
110 |
$7K |
| G0009 |
Administration of pneumococcal vaccine |
720 |
720 |
$7K |
| 0072A |
|
99 |
97 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
60 |
60 |
$3K |
| 90670 |
|
18 |
18 |
$3K |
| 0134A |
|
71 |
71 |
$3K |
| 0071A |
|
78 |
77 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
72 |
72 |
$2K |
| 90694 |
|
307 |
307 |
$1K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
14 |
13 |
$1K |
| 90682 |
|
18 |
18 |
$830.85 |
| 0034A |
|
17 |
17 |
$528.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$298.79 |
| 0502F |
|
299 |
256 |
$0.00 |