| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
165 |
163 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
40 |
40 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
19 |
19 |
$961.15 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$663.25 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$572.29 |
| 99051 |
|
24 |
24 |
$497.20 |
| 99177 |
|
17 |
17 |
$89.50 |
| 3078F |
|
215 |
211 |
$0.00 |
| 3725F |
|
42 |
42 |
$0.00 |
| 3074F |
|
223 |
219 |
$0.00 |
| 3008F |
|
219 |
215 |
$0.00 |
| 1126F |
|
85 |
83 |
$0.00 |
| 1036F |
|
99 |
97 |
$0.00 |