| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J3300 |
Injection, triamcinolone acetonide, preservative free, 1 mg |
6,795 |
5,242 |
$1.47M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,848 |
7,410 |
$494K |
| L0650 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
327 |
326 |
$255K |
| 64493 |
|
1,311 |
1,215 |
$141K |
| L1690 |
Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment |
123 |
122 |
$82K |
| 64494 |
|
1,341 |
1,242 |
$74K |
| E0731 |
Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patient's skin by layers of fabric) |
425 |
355 |
$73K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
282 |
274 |
$72K |
| 64495 |
|
1,002 |
965 |
$57K |
| 20553 |
|
1,179 |
1,137 |
$33K |
| 64483 |
|
247 |
221 |
$31K |
| 27096 |
|
241 |
240 |
$25K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
280 |
279 |
$24K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
449 |
438 |
$18K |
| 64484 |
|
248 |
228 |
$15K |
| 76000 |
|
2,058 |
1,721 |
$13K |
| 62323 |
|
98 |
95 |
$13K |
| 77002 |
|
227 |
163 |
$12K |
| 97760 |
|
260 |
260 |
$11K |
| 20610 |
|
271 |
224 |
$8K |
| L3960 |
Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment |
14 |
13 |
$6K |
| L0180 |
Cervical, multiple post collar, occipital/mandibular supports, adjustable |
20 |
20 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
576 |
567 |
$5K |
| 99205 |
Prolong outpt/office vis |
30 |
30 |
$3K |
| 72275 |
|
79 |
78 |
$3K |
| 62321 |
|
13 |
13 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
798 |
767 |
$2K |
| 62320 |
|
13 |
13 |
$1K |
| 80305 |
|
43 |
43 |
$258.26 |
| A4215 |
Needle, sterile, any size, each |
484 |
394 |
$151.92 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
55 |
50 |
$90.06 |
| A4649 |
Surgical supply; miscellaneous |
14 |
13 |
$52.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
169 |
161 |
$50.59 |
| A4550 |
Surgical trays |
144 |
123 |
$0.00 |
| 99070 |
|
50 |
50 |
$0.00 |