| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
24 |
24 |
$3K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
12 |
12 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
14 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
26 |
26 |
$1K |
| 73110 |
|
16 |
13 |
$463.95 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
12 |
12 |
$19.68 |
| A4208 |
Syringe with needle, sterile 3 cc, each |
12 |
12 |
$0.00 |
| A6413 |
Adhesive bandage, first-aid type, any size, each |
12 |
12 |
$0.00 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
12 |
12 |
$0.00 |