| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
982 |
775 |
$28K |
| 64635 |
|
436 |
307 |
$23K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
766 |
595 |
$14K |
| 64636 |
|
437 |
307 |
$9K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
1,148 |
763 |
$3K |
| 64633 |
|
18 |
12 |
$1K |
| J3490 |
Unclassified drugs |
1,166 |
773 |
$1K |
| 77003 |
|
1,287 |
836 |
$642.02 |
| 64634 |
|
18 |
12 |
$555.49 |
| 64483 |
|
23 |
12 |
$492.27 |
| 64484 |
|
23 |
12 |
$477.87 |
| 94760 |
|
1,193 |
770 |
$202.14 |
| A4649 |
Surgical supply; miscellaneous |
778 |
601 |
$117.42 |
| A4209 |
Syringe with needle, sterile 5 cc or greater, each |
1,719 |
940 |
$37.97 |
| A4208 |
Syringe with needle, sterile 3 cc, each |
1,390 |
896 |
$34.48 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
160 |
99 |
$17.34 |