| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
218 |
218 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
269 |
269 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
202 |
202 |
$9K |
| 92552 |
|
629 |
628 |
$8K |
| 92081 |
|
566 |
566 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
173 |
172 |
$5K |
| 90686 |
|
393 |
392 |
$3K |
| 90670 |
|
197 |
197 |
$2K |
| 90648 |
|
189 |
188 |
$1K |
| 99384 |
|
24 |
24 |
$1K |
| 90657 |
|
117 |
117 |
$820.00 |
| 90723 |
|
91 |
91 |
$634.88 |
| 90651 |
|
60 |
60 |
$535.68 |
| 99383 |
|
14 |
14 |
$483.60 |
| 90707 |
|
58 |
58 |
$406.72 |
| 90716 |
|
58 |
58 |
$406.72 |
| 90734 |
|
40 |
40 |
$376.96 |
| 90680 |
|
46 |
46 |
$327.36 |
| 90620 |
|
31 |
31 |
$238.08 |
| 90633 |
|
19 |
19 |
$168.64 |
| 99223 |
Prolong inpt eval add15 m |
13 |
13 |
$87.39 |
| 90700 |
|
12 |
12 |
$59.52 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
13 |
13 |
$41.02 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
449 |
425 |
$28.86 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,140 |
1,003 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
25 |
25 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$0.00 |