| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,390 |
2,377 |
$88K |
| 64635 |
|
226 |
203 |
$37K |
| 64483 |
|
384 |
382 |
$36K |
| 64493 |
|
312 |
287 |
$18K |
| 99152 |
|
837 |
801 |
$7K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
110 |
110 |
$7K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
730 |
712 |
$6K |
| G0480 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed |
60 |
60 |
$4K |
| 95886 |
|
43 |
24 |
$3K |
| G0481 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed |
29 |
29 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
75 |
75 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$1K |
| 64495 |
|
46 |
44 |
$384.78 |
| 77003 |
|
19 |
18 |
$165.96 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
820 |
772 |
$162.79 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
298 |
264 |
$128.88 |
| 64494 |
|
76 |
73 |
$102.87 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
813 |
796 |
$55.22 |