| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
216 |
211 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
61 |
61 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$834.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$404.00 |
| 90686 |
|
32 |
30 |
$66.00 |
| 96127 |
|
12 |
12 |
$24.20 |
| 3078F |
|
192 |
190 |
$0.00 |
| G9920 |
Screening performed and negative |
14 |
14 |
$0.00 |
| 3008F |
|
116 |
113 |
$0.00 |
| 1111F |
|
343 |
335 |
$0.00 |
| 3074F |
|
234 |
232 |
$0.00 |