| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,889 |
5,376 |
$132K |
| 76881 |
|
1,338 |
1,024 |
$42K |
| 20611 |
|
2,245 |
1,027 |
$41K |
| J7321 |
Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose |
1,241 |
520 |
$39K |
| 97750 |
|
2,976 |
2,524 |
$15K |
| 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 |
14 |
14 |
$13K |
| 76882 |
|
1,116 |
778 |
$9K |
| 98925 |
|
606 |
489 |
$8K |
| 99205 |
Prolong outpt/office vis |
95 |
95 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
108 |
91 |
$4K |
| 20553 |
|
104 |
86 |
$3K |
| J7320 |
Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg |
27 |
13 |
$2K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
275 |
236 |
$239.59 |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$10.30 |