| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
350 |
334 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
18 |
16 |
$824.60 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$678.84 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$626.99 |
| 87430 |
|
29 |
29 |
$158.83 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18 |
15 |
$140.36 |
| 90707 |
|
13 |
12 |
$117.00 |
| 94760 |
|
17 |
17 |
$5.59 |
| 97802 |
|
12 |
12 |
$0.00 |
| 99050 |
|
99 |
93 |
$0.00 |