| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,079 |
3,790 |
$209K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
486 |
454 |
$17K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
63 |
63 |
$2K |
| 01992 |
|
15 |
15 |
$2K |
| 80305 |
|
117 |
116 |
$793.65 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
51 |
49 |
$92.08 |
| J7050 |
Infusion, normal saline solution, 250 cc |
15 |
15 |
$61.60 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
25 |
24 |
$38.02 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
32 |
30 |
$26.29 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
38 |
37 |
$9.25 |
| 99072 |
|
14 |
12 |
$0.00 |