| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,692 |
4,421 |
$153K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
463 |
387 |
$32K |
| 64493 |
|
458 |
351 |
$24K |
| 64494 |
|
450 |
345 |
$12K |
| 64495 |
|
362 |
274 |
$10K |
| 99152 |
|
587 |
442 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
432 |
334 |
$8K |
| 80305 |
|
1,629 |
1,340 |
$6K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
1,889 |
1,356 |
$6K |
| 64635 |
|
20 |
12 |
$1K |
| 64636 |
|
20 |
12 |
$1K |
| J3490 |
Unclassified drugs |
1,148 |
878 |
$993.92 |
| 99205 |
Prolong outpt/office vis |
15 |
12 |
$991.76 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
125 |
110 |
$417.53 |
| 99442 |
|
18 |
13 |
$109.01 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
17 |
13 |
$99.70 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
518 |
393 |
$50.49 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
258 |
188 |
$41.22 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
32 |
24 |
$13.01 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
51 |
45 |
$2.58 |