| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 64635 |
|
13 |
12 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
75 |
69 |
$2K |
| 64493 |
|
30 |
25 |
$2K |
| 64494 |
|
33 |
24 |
$864.06 |
| 36416 |
|
134 |
105 |
$59.16 |
| 82962 |
|
134 |
105 |
$52.93 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
48 |
43 |
$25.22 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
66 |
63 |
$0.83 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
14 |
12 |
$0.70 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
15 |
15 |
$0.00 |