| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,936 |
4,449 |
$317K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,510 |
4,086 |
$153K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
572 |
535 |
$31K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
497 |
451 |
$26K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
123 |
112 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
117 |
97 |
$5K |
| 90686 |
|
283 |
256 |
$3K |
| 90670 |
|
110 |
104 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
12 |
$684.00 |
| 90688 |
|
46 |
45 |
$601.53 |
| 90648 |
|
37 |
37 |
$506.25 |
| 90633 |
|
36 |
34 |
$383.38 |
| 90710 |
|
17 |
15 |
$197.10 |
| 90651 |
|
15 |
13 |
$157.68 |
| 90756 |
|
20 |
17 |
$143.40 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
40 |
29 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
134 |
56 |
$0.00 |