| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0054A |
|
148 |
146 |
$3K |
| 0124A |
|
101 |
85 |
$3K |
| 91322 |
|
28 |
23 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
45 |
44 |
$1K |
| 90480 |
|
83 |
63 |
$1K |
| 0051A |
|
39 |
38 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
61 |
39 |
$764.97 |
| 90658 |
|
26 |
26 |
$661.54 |
| M0201 |
Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patient's home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patient's home |
43 |
31 |
$574.24 |
| 0074A |
|
13 |
13 |
$514.48 |
| 0071A |
|
13 |
13 |
$350.80 |
| 90686 |
|
19 |
16 |
$243.44 |
| 0052A |
|
15 |
15 |
$118.16 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
30 |
30 |
$0.00 |