| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90651 |
|
30 |
30 |
$450.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
465 |
465 |
$62.10 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
811 |
781 |
$40.50 |
| 97803 |
|
499 |
499 |
$24.75 |
| 92552 |
|
646 |
646 |
$16.52 |
| 81002 |
|
643 |
640 |
$1.70 |
| 96160 |
|
955 |
954 |
$0.00 |
| 85014 |
|
659 |
659 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
65 |
65 |
$0.00 |
| 99173 |
|
649 |
649 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
56 |
56 |
$0.00 |
| 90734 |
|
32 |
32 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
98 |
98 |
$0.00 |
| 85018 |
|
12 |
12 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
680 |
652 |
$0.00 |
| 90686 |
|
159 |
159 |
$0.00 |
| 97802 |
|
40 |
40 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |