| Code | Description | Claims | Beneficiaries | Total Paid |
| 99222 |
Initial hospital care, per day, moderate complexity |
361 |
310 |
$27K |
| 99223 |
Prolong inpt eval add15 m |
215 |
154 |
$16K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,710 |
330 |
$10K |
| 99221 |
|
58 |
53 |
$3K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
449 |
88 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18 |
15 |
$619.39 |
| 1159F |
|
111 |
105 |
$100.78 |
| 1160F |
|
93 |
87 |
$0.00 |