| Code | Description | Claims | Beneficiaries | Total Paid |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
65 |
55 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
91 |
75 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
28 |
27 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$922.08 |