| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
534 |
500 |
$33K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
12 |
$1K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
80 |
76 |
$173.49 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
124 |
119 |
$151.62 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
74 |
71 |
$62.78 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
17 |
17 |
$28.48 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
91 |
88 |
$12.42 |