| Code | Description | Claims | Beneficiaries | Total Paid |
| 90960 |
End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits |
381 |
381 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
184 |
184 |
$6K |
| 90961 |
|
49 |
49 |
$2K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
57 |
25 |
$235.29 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$141.40 |