| Code | Description | Claims | Beneficiaries | Total Paid |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
1,744 |
526 |
$166K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
3,452 |
1,136 |
$93K |
| 99233 |
Prolong inpt eval add15 m |
1,501 |
564 |
$56K |
| 99223 |
Prolong inpt eval add15 m |
123 |
121 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
176 |
174 |
$6K |
| 94010 |
|
64 |
64 |
$6K |
| 99222 |
Initial hospital care, per day, moderate complexity |
51 |
51 |
$3K |
| A4617 |
Mouth piece |
25 |
25 |
$24.78 |