| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,319 |
1,086 |
$47K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
74 |
53 |
$790.08 |
| 96127 |
|
1,601 |
841 |
$764.59 |
| 80305 |
|
709 |
583 |
$636.70 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
58 |
44 |
$1.17 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
28 |
26 |
$0.00 |
| 99152 |
|
36 |
27 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
18 |
14 |
$0.00 |
| 1170F |
|
205 |
173 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
36 |
27 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
17 |
13 |
$0.00 |