| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,185 |
1,625 |
$90K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
109 |
99 |
$7K |
| 0012A |
|
73 |
69 |
$3K |
| 0502F |
|
63 |
40 |
$3K |
| 0011A |
|
62 |
45 |
$2K |
| 90686 |
|
170 |
116 |
$2K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
41 |
12 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$579.23 |