| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99233 |
Prolong inpt eval add15 m |
1,090 |
471 |
$31K |
| 99223 |
Prolong inpt eval add15 m |
207 |
173 |
$12K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
365 |
306 |
$11K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
345 |
150 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
62 |
59 |
$2K |
| 36902 |
|
20 |
16 |
$2K |
| 99152 |
|
35 |
28 |
$147.92 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
103 |
70 |
$9.14 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
15 |
15 |
$7.60 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
19 |
14 |
$6.73 |