| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,311 |
1,214 |
$86K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
598 |
562 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
257 |
140 |
$3K |
| 0071A |
|
35 |
31 |
$1K |
| 0072A |
|
26 |
26 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$895.06 |
| 87428 |
|
16 |
15 |
$699.18 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
12 |
$270.64 |
| 96127 |
|
66 |
64 |
$207.63 |
| 90656 |
|
19 |
19 |
$9.50 |
| 90686 |
|
113 |
59 |
$1.09 |