| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
300 |
274 |
$25K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
76 |
76 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
70 |
70 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
71 |
71 |
$4K |
| 92552 |
|
146 |
142 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
21 |
20 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
40 |
40 |
$617.16 |
| 90658 |
|
70 |
70 |
$475.55 |
| 87430 |
|
30 |
30 |
$418.47 |
| 90655 |
|
21 |
21 |
$179.28 |
| 90633 |
|
12 |
12 |
$78.12 |
| 99173 |
|
136 |
135 |
$69.67 |