| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99233 |
Prolong inpt eval add15 m |
796 |
474 |
$26K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
53 |
53 |
$4K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
12 |
12 |
$3K |
| 99222 |
Initial hospital care, per day, moderate complexity |
24 |
24 |
$858.32 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
12 |
$655.26 |
| G8484 |
Influenza immunization was not administered, reason not given |
12 |
12 |
$0.00 |