| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
95 |
94 |
$4K |
| 92551 |
|
112 |
112 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
59 |
59 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
45 |
43 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
38 |
38 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
22 |
22 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17 |
17 |
$1K |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$1K |
| 90700 |
|
49 |
49 |
$873.18 |
| 83655 |
|
44 |
44 |
$472.56 |
| 85013 |
|
51 |
51 |
$317.22 |
| 90648 |
|
27 |
27 |
$160.38 |
| 90670 |
|
26 |
26 |
$154.44 |
| 90713 |
|
20 |
20 |
$118.80 |
| 90633 |
|
14 |
14 |
$83.16 |
| 81002 |
|
12 |
12 |
$37.08 |