| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
417 |
407 |
$16K |
| 95816 |
|
105 |
105 |
$14K |
| 93890 |
|
125 |
122 |
$8K |
| 93886 |
|
109 |
108 |
$6K |
| 93880 |
|
116 |
114 |
$5K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
97 |
73 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
26 |
26 |
$1K |
| 95812 |
|
12 |
12 |
$1K |
| J7050 |
Infusion, normal saline solution, 250 cc |
89 |
66 |
$23.45 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
89 |
67 |
$20.61 |