| Code | Description | Claims | Beneficiaries | Total Paid |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
200 |
66 |
$4K |
| 99222 |
Initial hospital care, per day, moderate complexity |
12 |
12 |
$362.33 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$205.68 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
30 |
30 |
$195.88 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28 |
27 |
$185.30 |
| 94060 |
|
16 |
16 |
$131.76 |
| 94727 |
|
16 |
16 |
$20.94 |
| 94729 |
|
16 |
16 |
$13.82 |