| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,388 |
1,215 |
$32K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
473 |
451 |
$18K |
| 93925 |
|
252 |
242 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
138 |
137 |
$7K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
28 |
14 |
$1K |
| 99223 |
Prolong inpt eval add15 m |
13 |
13 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
12 |
$935.61 |
| 99222 |
Initial hospital care, per day, moderate complexity |
12 |
12 |
$826.40 |
| 99233 |
Prolong inpt eval add15 m |
39 |
12 |
$722.48 |
| 93926 |
|
14 |
12 |
$357.56 |
| J2704 |
Injection, propofol, 10 mg |
46 |
44 |
$63.57 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
14 |
12 |
$5.19 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
26 |
24 |
$1.83 |