| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
718 |
669 |
$23K |
| 90960 |
End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits |
268 |
255 |
$21K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
851 |
339 |
$15K |
| 36901 |
|
140 |
137 |
$5K |
| 36902 |
|
45 |
45 |
$3K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
517 |
506 |
$360.67 |
| 99152 |
|
150 |
145 |
$350.13 |
| 99222 |
Initial hospital care, per day, moderate complexity |
14 |
13 |
$308.40 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
105 |
105 |
$19.33 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
152 |
147 |
$8.50 |