| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99409 |
|
243 |
229 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
204 |
203 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
95 |
95 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
31 |
31 |
$3K |
| 90480 |
|
45 |
45 |
$960.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
38 |
38 |
$4.21 |
| 91320 |
|
23 |
23 |
$0.14 |
| 90656 |
|
15 |
15 |
$0.13 |
| 91322 |
|
22 |
22 |
$0.10 |
| 90653 |
|
27 |
27 |
$0.04 |
| G0008 |
Administration of influenza virus vaccine |
16 |
16 |
$0.00 |