| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
706 |
429 |
$6K |
| 93922 |
|
258 |
139 |
$3K |
| 93925 |
|
19 |
14 |
$2K |
| 75710 |
|
23 |
12 |
$772.66 |
| 99152 |
|
112 |
54 |
$455.48 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17 |
12 |
$183.00 |
| 99153 |
Mod sedat endo service >5yrs |
52 |
16 |
$120.31 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
79 |
42 |
$81.73 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
76 |
42 |
$7.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
22 |
13 |
$6.30 |
| J1644 |
Injection, heparin sodium, per 1000 units |
76 |
42 |
$4.48 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
50 |
29 |
$1.60 |
| 1036F |
|
1,148 |
596 |
$0.00 |
| G9197 |
Documentation of order for first or second generation cephalosporin for antimicrobial prophylaxis |
73 |
46 |
$0.00 |