| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,443 |
1,046 |
$76K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
460 |
335 |
$14K |
| 99205 |
Prolong outpt/office vis |
44 |
37 |
$5K |
| 64483 |
|
141 |
57 |
$3K |
| 64493 |
|
161 |
52 |
$3K |
| 64484 |
|
136 |
56 |
$3K |
| 64495 |
|
161 |
52 |
$2K |
| 64494 |
|
161 |
52 |
$2K |
| J3490 |
Unclassified drugs |
317 |
109 |
$2K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
334 |
125 |
$1K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
371 |
128 |
$121.92 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
418 |
153 |
$99.63 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
332 |
118 |
$47.09 |
| A4215 |
Needle, sterile, any size, each |
438 |
163 |
$26.49 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
291 |
126 |
$19.13 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
465 |
170 |
$0.94 |
| 99408 |
|
33 |
24 |
$0.00 |