| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
11,071 |
9,163 |
$196K |
| 64483 |
|
951 |
893 |
$50K |
| 99215 |
Prolong outpt/office vis |
1,647 |
1,310 |
$37K |
| 76942 |
|
1,315 |
1,152 |
$12K |
| 64484 |
|
491 |
463 |
$10K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
2,153 |
1,965 |
$6K |
| 62370 |
|
1,175 |
1,027 |
$5K |
| 99358 |
Prolong nursin fac eval 15m |
435 |
435 |
$4K |
| 20611 |
|
263 |
214 |
$4K |
| 27096 |
|
28 |
27 |
$2K |
| 64493 |
|
28 |
26 |
$2K |
| 99205 |
Prolong outpt/office vis |
42 |
42 |
$2K |
| 62321 |
|
37 |
37 |
$1K |
| 99401 |
|
66 |
56 |
$761.28 |
| 64494 |
|
26 |
24 |
$697.32 |
| 80305 |
|
1,652 |
1,562 |
$408.59 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
863 |
825 |
$276.74 |
| 99441 |
|
40 |
30 |
$62.80 |
| A4248 |
Chlorhexidine containing antiseptic, 1 ml |
109 |
95 |
$5.65 |
| G2142 |
Functional status measured by the oswestry disability index (odi version 2.1a) at one year (9 to 15 months) postoperatively was less than or equal to 22 or functional status measured by the odi version 2.1a within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated an improvement of 30 points or greater |
52 |
44 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
134 |
52 |
$0.00 |
| A4220 |
Refill kit for implantable infusion pump |
12 |
12 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
15 |
14 |
$0.00 |