| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
43 |
43 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
35 |
35 |
$1K |
| 92552 |
|
64 |
64 |
$952.57 |
| 81000 |
|
52 |
52 |
$132.09 |
| 85018 |
|
44 |
42 |
$89.79 |
| 86580 |
|
12 |
12 |
$39.96 |
| 90630 |
|
86 |
86 |
$24.55 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
58 |
56 |
$17.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
45 |
41 |
$15.00 |
| 99215 |
Prolong outpt/office vis |
13 |
12 |
$0.00 |
| 90633 |
|
18 |
18 |
$0.00 |
| 90716 |
|
13 |
13 |
$0.00 |