| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,957 |
7,352 |
$539K |
| A4550 |
Surgical trays |
1,159 |
718 |
$35K |
| 99152 |
|
2,365 |
1,590 |
$32K |
| 80305 |
|
3,130 |
2,582 |
$27K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
755 |
433 |
$21K |
| 20552 |
|
671 |
362 |
$10K |
| 99153 |
Mod sedat endo service >5yrs |
484 |
292 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
323 |
254 |
$3K |
| J3490 |
Unclassified drugs |
1,579 |
490 |
$2K |
| J2704 |
Injection, propofol, 10 mg |
2,572 |
1,594 |
$1K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
92 |
65 |
$930.99 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
1,229 |
553 |
$438.78 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
346 |
277 |
$408.15 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,364 |
1,549 |
$395.52 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
939 |
668 |
$331.29 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
24 |
15 |
$308.32 |
| 90756 |
|
32 |
16 |
$281.48 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
239 |
175 |
$199.18 |
| H0049 |
Alcohol and/or drug screening |
17 |
17 |
$183.77 |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
21 |
13 |
$109.36 |
| J3360 |
Injection, diazepam, up to 5 mg |
64 |
32 |
$97.74 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
30 |
14 |
$13.36 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
47 |
31 |
$12.21 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
660 |
365 |
$5.83 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
871 |
469 |
$0.20 |