| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
235 |
207 |
$11K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
98 |
91 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
141 |
134 |
$5K |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
451 |
401 |
$1K |
| A4550 |
Surgical trays |
790 |
689 |
$411.33 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
176 |
164 |
$387.93 |
| 96160 |
|
60 |
53 |
$131.72 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
175 |
148 |
$19.12 |