| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
687 |
630 |
$18K |
| 96151 |
|
495 |
494 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
185 |
183 |
$8K |
| 92551 |
|
468 |
466 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
88 |
87 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
53 |
53 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
26 |
$1K |
| 90686 |
|
127 |
127 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
55 |
54 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
15 |
$572.74 |
| 99173 |
|
122 |
121 |
$557.80 |
| 90658 |
|
20 |
20 |
$180.00 |
| 85018 |
|
32 |
30 |
$69.72 |
| 86580 |
|
218 |
212 |
$40.23 |
| 81001 |
|
209 |
203 |
$0.00 |