| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
295 |
246 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
93 |
72 |
$483.80 |
| 95911 |
|
32 |
27 |
$181.03 |
| A4550 |
Surgical trays |
347 |
237 |
$40.52 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
66 |
63 |
$27.68 |
| 95886 |
|
33 |
27 |
$16.65 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
566 |
385 |
$5.02 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
179 |
105 |
$3.07 |
| J3490 |
Unclassified drugs |
33 |
26 |
$1.82 |
| 20552 |
|
37 |
36 |
$1.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
243 |
167 |
$0.00 |