| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
652 |
619 |
$14K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
48 |
48 |
$2K |
| 99383 |
|
30 |
30 |
$2K |
| 99382 |
|
30 |
30 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
36 |
36 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
45 |
45 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
16 |
16 |
$675.76 |
| 90698 |
|
47 |
47 |
$414.00 |
| 90670 |
|
41 |
41 |
$360.00 |
| 96150 |
|
205 |
152 |
$288.15 |
| 92551 |
|
126 |
126 |
$179.12 |
| 90680 |
|
19 |
19 |
$162.00 |
| 90707 |
|
12 |
12 |
$108.00 |
| 90716 |
|
12 |
12 |
$108.00 |
| 90744 |
|
12 |
12 |
$108.00 |
| 94760 |
|
190 |
183 |
$92.24 |
| 96151 |
|
37 |
37 |
$34.88 |
| 99173 |
|
130 |
130 |
$4.60 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
78 |
78 |
$0.00 |
| 99401 |
|
37 |
37 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 99172 |
|
34 |
34 |
$0.00 |
| 99050 |
|
268 |
263 |
$0.00 |