| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
219 |
208 |
$29K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
267 |
259 |
$23K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
89 |
86 |
$6K |
| 77002 |
|
41 |
30 |
$2K |
| 80305 |
|
240 |
231 |
$2K |
| 64493 |
|
13 |
13 |
$2K |
| 20610 |
|
43 |
32 |
$1K |
| 64494 |
|
13 |
13 |
$938.69 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
38 |
36 |
$804.40 |
| J3490 |
Unclassified drugs |
15 |
14 |
$747.92 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
91 |
75 |
$186.30 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
58 |
55 |
$129.88 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
133 |
113 |
$25.64 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
54 |
47 |
$0.14 |