| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,254 |
3,907 |
$119K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,785 |
1,666 |
$73K |
| 64635 |
|
308 |
233 |
$33K |
| 64636 |
|
308 |
233 |
$14K |
| 99215 |
Prolong outpt/office vis |
99 |
94 |
$6K |
| J3490 |
Unclassified drugs |
2,378 |
1,855 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
30 |
28 |
$2K |
| 64483 |
|
28 |
25 |
$2K |
| 80305 |
|
307 |
284 |
$2K |
| 64484 |
|
28 |
25 |
$2K |
| 64493 |
|
19 |
14 |
$1K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
137 |
109 |
$1K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
1,372 |
989 |
$791.80 |
| 64494 |
|
19 |
14 |
$618.29 |
| 80306 |
|
43 |
41 |
$261.33 |
| 77002 |
|
19 |
15 |
$251.52 |
| A4550 |
Surgical trays |
1,876 |
1,341 |
$124.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
381 |
295 |
$104.77 |
| 94760 |
|
1,009 |
765 |
$53.50 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
12 |
12 |
$4.10 |
| Q9960 |
High osmolar contrast material, 200-249 mg/ml iodine concentration, per ml |
30 |
22 |
$0.65 |
| 77003 |
|
21 |
17 |
$0.00 |