| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,134 |
903 |
$29K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
583 |
442 |
$23K |
| 96151 |
|
437 |
436 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
219 |
219 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
111 |
92 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
112 |
98 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
68 |
53 |
$4K |
| 81000 |
|
438 |
437 |
$1K |
| 90686 |
|
128 |
124 |
$1K |
| 81001 |
|
133 |
133 |
$599.28 |
| 96150 |
|
24 |
24 |
$558.24 |
| 90658 |
|
55 |
54 |
$495.00 |
| 90734 |
|
28 |
28 |
$252.00 |
| 90715 |
|
14 |
14 |
$126.00 |
| 90707 |
|
13 |
12 |
$108.00 |
| 94760 |
|
47 |
46 |
$0.00 |
| 99072 |
|
16 |
15 |
$0.00 |