| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
751 |
724 |
$49K |
| 64483 |
|
135 |
120 |
$21K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
131 |
131 |
$15K |
| 27096 |
|
28 |
24 |
$3K |
| 72110 |
|
66 |
66 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
45 |
43 |
$1K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
45 |
38 |
$353.38 |
| A4215 |
Needle, sterile, any size, each |
448 |
360 |
$60.65 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
202 |
177 |
$28.38 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
12 |
12 |
$1.54 |
| A4550 |
Surgical trays |
447 |
359 |
$0.00 |
| J3490 |
Unclassified drugs |
457 |
371 |
$0.00 |