| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,213 |
930 |
$48K |
| 93978 |
|
179 |
178 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
240 |
226 |
$16K |
| 37252 |
|
12 |
12 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
60 |
49 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$1K |
| 76937 |
|
38 |
36 |
$547.22 |
| 99152 |
|
14 |
13 |
$288.40 |
| 99153 |
Mod sedat endo service >5yrs |
14 |
13 |
$259.16 |
| J7050 |
Infusion, normal saline solution, 250 cc |
37 |
36 |
$9.81 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
24 |
24 |
$7.51 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
12 |
12 |
$0.77 |
| 99072 |
|
108 |
88 |
$0.00 |