| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,732 |
1,534 |
$128K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,691 |
2,363 |
$127K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
88 |
72 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
89 |
79 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
28 |
24 |
$2K |
| 0011A |
|
52 |
46 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
17 |
17 |
$1K |
| 90686 |
|
164 |
133 |
$1K |
| 90651 |
|
19 |
15 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
76 |
64 |
$994.93 |
| 90688 |
|
66 |
58 |
$962.76 |
| 90674 |
|
18 |
17 |
$553.98 |
| 90734 |
|
20 |
15 |
$522.43 |
| 90715 |
|
17 |
12 |
$372.42 |
| 81003 |
|
16 |
13 |
$35.76 |
| 1160F |
|
197 |
178 |
$0.00 |
| 1159F |
|
123 |
116 |
$0.00 |
| 3078F |
|
102 |
93 |
$0.00 |
| 3008F |
|
162 |
150 |
$0.00 |
| 1036F |
|
41 |
37 |
$0.00 |
| 3074F |
|
91 |
85 |
$0.00 |