| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 93925 |
|
524 |
508 |
$44K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
698 |
690 |
$28K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
105 |
105 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
122 |
121 |
$8K |
| 93978 |
|
56 |
56 |
$4K |
| 93922 |
|
199 |
199 |
$4K |
| 99406 |
|
189 |
185 |
$1K |
| 99152 |
|
69 |
67 |
$1K |
| 99153 |
Mod sedat endo service >5yrs |
93 |
67 |
$954.90 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
15 |
$834.52 |
| 76937 |
|
73 |
69 |
$799.25 |
| 75625 |
|
13 |
13 |
$493.93 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
87 |
52 |
$433.40 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
40 |
38 |
$1.42 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
53 |
51 |
$0.00 |