| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
591 |
586 |
$26K |
| 64483 |
|
192 |
192 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
308 |
308 |
$18K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
59 |
59 |
$5K |
| 64635 |
|
15 |
14 |
$4K |
| 62321 |
|
32 |
32 |
$3K |
| 64636 |
|
29 |
14 |
$3K |
| 99152 |
|
49 |
48 |
$889.37 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
142 |
141 |
$458.72 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
759 |
700 |
$392.44 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
110 |
109 |
$101.21 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$37.80 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
57 |
57 |
$3.25 |