| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90960 |
End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits |
705 |
668 |
$87K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,474 |
633 |
$34K |
| 36902 |
|
48 |
43 |
$4K |
| 99233 |
Prolong inpt eval add15 m |
70 |
38 |
$2K |
| 99223 |
Prolong inpt eval add15 m |
27 |
26 |
$1K |
| 75710 |
|
13 |
13 |
$560.48 |
| 99152 |
|
90 |
70 |
$312.44 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
103 |
52 |
$88.07 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
225 |
199 |
$24.31 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
15 |
13 |
$5.66 |