| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 36902 |
|
15 |
14 |
$6K |
| 93925 |
|
12 |
12 |
$390.14 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
289 |
135 |
$314.72 |
| 75710 |
|
13 |
13 |
$299.81 |
| 99152 |
|
18 |
16 |
$260.33 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
26 |
12 |
$182.96 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
26 |
24 |
$138.68 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
35 |
35 |
$107.47 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$23.58 |
| 99153 |
Mod sedat endo service >5yrs |
12 |
12 |
$16.30 |