| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,214 |
3,294 |
$20K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
93 |
68 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
653 |
412 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,090 |
677 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
105 |
76 |
$1K |
| 20610 |
|
54 |
26 |
$596.59 |
| 72110 |
|
103 |
49 |
$316.71 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
182 |
139 |
$310.33 |
| 64493 |
|
108 |
71 |
$177.60 |
| 20611 |
|
191 |
79 |
$140.02 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
231 |
155 |
$109.82 |
| A4550 |
Surgical trays |
13 |
12 |
$58.00 |
| 64494 |
|
75 |
53 |
$54.08 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
613 |
436 |
$11.81 |
| 80305 |
|
45 |
24 |
$10.54 |
| J7050 |
Infusion, normal saline solution, 250 cc |
85 |
70 |
$9.39 |
| J3490 |
Unclassified drugs |
87 |
40 |
$0.26 |
| 62323 |
|
12 |
12 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
39 |
27 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
67 |
51 |
$0.00 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
38 |
12 |
$0.00 |