| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,956 |
3,488 |
$333K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,102 |
1,915 |
$95K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
344 |
344 |
$29K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
297 |
296 |
$22K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
90 |
90 |
$7K |
| 90688 |
|
500 |
498 |
$6K |
| 90672 |
|
281 |
281 |
$4K |
| 90734 |
|
72 |
72 |
$2K |
| 69210 |
|
46 |
45 |
$1K |
| 90744 |
|
108 |
107 |
$1K |
| 0071A |
|
35 |
35 |
$1K |
| 90651 |
|
27 |
25 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$943.93 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$517.87 |
| 90700 |
|
40 |
39 |
$490.20 |
| 99173 |
|
116 |
115 |
$266.76 |
| 90687 |
|
18 |
17 |
$221.52 |
| 92587 |
|
45 |
45 |
$181.90 |
| 90647 |
|
12 |
12 |
$132.00 |
| 91307 |
|
36 |
36 |
$0.29 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
38 |
19 |
$0.00 |