| Code | Description | Claims | Beneficiaries | Total Paid |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
39 |
24 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
45 |
45 |
$3K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
67 |
43 |
$2K |
| 99223 |
Prolong inpt eval add15 m |
13 |
12 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$930.76 |
| 99222 |
Initial hospital care, per day, moderate complexity |
15 |
13 |
$877.02 |