| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,365 |
9,079 |
$789K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,320 |
3,268 |
$386K |
| 64493 |
|
278 |
277 |
$66K |
| 64494 |
|
264 |
263 |
$32K |
| 99152 |
|
566 |
539 |
$32K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
2,218 |
2,116 |
$28K |
| 64495 |
|
171 |
171 |
$23K |
| 62323 |
|
79 |
76 |
$18K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
488 |
453 |
$13K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
53 |
53 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
70 |
70 |
$9K |
| 64635 |
|
25 |
25 |
$7K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
581 |
577 |
$6K |
| 98967 |
|
123 |
122 |
$4K |
| 64490 |
|
13 |
12 |
$4K |
| 80353 |
|
564 |
560 |
$3K |
| 80356 |
|
564 |
560 |
$3K |
| 64636 |
|
25 |
25 |
$2K |
| 98966 |
|
114 |
111 |
$2K |
| A4209 |
Syringe with needle, sterile 5 cc or greater, each |
1,503 |
1,408 |
$2K |
| 76942 |
|
15 |
12 |
$1K |
| 77002 |
|
29 |
27 |
$1K |
| 80348 |
|
466 |
464 |
$970.14 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
13 |
$748.30 |
| 80359 |
|
466 |
464 |
$747.81 |
| 80365 |
|
466 |
464 |
$742.81 |
| 80361 |
|
466 |
464 |
$742.81 |
| 80346 |
|
465 |
463 |
$742.81 |
| 80324 |
|
466 |
464 |
$742.81 |
| 80358 |
|
466 |
464 |
$742.81 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,907 |
1,789 |
$666.78 |
| 80349 |
|
466 |
464 |
$585.00 |
| 80345 |
|
466 |
464 |
$585.00 |
| 99441 |
|
13 |
13 |
$564.23 |
| 83992 |
|
12 |
12 |
$270.82 |
| 80373 |
|
12 |
12 |
$151.25 |
| 80354 |
|
12 |
12 |
$151.25 |
| 80355 |
|
12 |
12 |
$151.25 |
| 80366 |
|
12 |
12 |
$151.25 |
| 80360 |
|
12 |
12 |
$151.25 |
| 80368 |
|
12 |
12 |
$110.00 |
| 80370 |
|
12 |
12 |
$96.25 |
| 80321 |
|
12 |
12 |
$77.00 |
| 80333 |
|
12 |
12 |
$57.75 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
82 |
77 |
$14.91 |