| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
408 |
382 |
$5K |
| 90686 |
|
76 |
76 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
265 |
260 |
$679.80 |
| 96127 |
|
87 |
86 |
$612.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
57 |
56 |
$600.00 |
| 99173 |
|
143 |
140 |
$493.20 |
| 90670 |
|
14 |
14 |
$307.44 |
| 90647 |
|
14 |
14 |
$307.44 |
| 90685 |
|
14 |
13 |
$263.52 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$262.40 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
41 |
41 |
$224.80 |
| 96160 |
|
30 |
30 |
$118.80 |
| 99174 |
|
13 |
12 |
$0.00 |