| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,713 |
3,590 |
$288K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,096 |
2,030 |
$223K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
369 |
366 |
$36K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
141 |
137 |
$14K |
| 90686 |
|
710 |
707 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
82 |
82 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
707 |
703 |
$4K |
| 96127 |
|
683 |
646 |
$3K |
| 99215 |
Prolong outpt/office vis |
13 |
12 |
$2K |
| 90656 |
|
107 |
107 |
$763.43 |
| 0072A |
|
13 |
13 |
$546.00 |
| 0071A |
|
13 |
13 |
$546.00 |
| 90671 |
|
26 |
26 |
$511.94 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$485.40 |
| 90670 |
|
37 |
37 |
$475.39 |
| 99173 |
|
255 |
252 |
$435.10 |
| 90648 |
|
37 |
37 |
$343.44 |
| 90633 |
|
12 |
12 |
$114.48 |
| 96161 |
|
12 |
12 |
$39.49 |
| 1160F |
|
465 |
434 |
$0.00 |
| 99072 |
|
503 |
461 |
$0.00 |
| 1159F |
|
529 |
491 |
$0.00 |