| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
438 |
415 |
$12K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
55 |
52 |
$4K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
123 |
80 |
$758.61 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$472.93 |
| A4215 |
Needle, sterile, any size, each |
30 |
27 |
$1.46 |