| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
74 |
52 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
27 |
19 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
28 |
16 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20 |
12 |
$940.46 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$513.13 |
| 90651 |
|
16 |
12 |
$324.76 |
| 90734 |
|
19 |
13 |
$121.60 |