| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 62323 |
|
69 |
67 |
$4K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
286 |
263 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$419.02 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
350 |
329 |
$40.18 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
68 |
67 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
67 |
66 |
$0.00 |