| Code | Description | Claims | Beneficiaries | Total Paid |
| 99222 |
Initial hospital care, per day, moderate complexity |
115 |
103 |
$12K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
28 |
25 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
42 |
41 |
$6K |
| 99443 |
|
105 |
98 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
15 |
$995.16 |
| 99442 |
|
18 |
18 |
$451.96 |