| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,057 |
982 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
295 |
258 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
16 |
16 |
$368.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
12 |
12 |
$72.46 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
15 |
12 |
$6.08 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
15 |
13 |
$0.00 |