| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0360 |
|
407 |
227 |
$32K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
194 |
68 |
$26K |
| 00630 |
|
148 |
143 |
$17K |
| 99199 |
Unlisted special service, procedure or report |
119 |
43 |
$7K |
| 99152 |
|
36 |
26 |
$6K |
| 77003 |
|
202 |
200 |
$5K |
| 0710 |
|
202 |
195 |
$4K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
81 |
67 |
$3K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
207 |
199 |
$1K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
168 |
164 |
$1K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
92 |
92 |
$562.21 |
| 93000 |
|
66 |
66 |
$142.92 |
| 93040 |
|
32 |
32 |
$78.42 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
32 |
32 |
$51.30 |