| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,584 |
4,225 |
$226K |
| 64635 |
|
339 |
270 |
$78K |
| L0637 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
94 |
93 |
$76K |
| 64483 |
|
290 |
278 |
$52K |
| 64493 |
|
350 |
313 |
$51K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
768 |
744 |
$47K |
| 64636 |
|
323 |
258 |
$43K |
| 64633 |
|
107 |
87 |
$29K |
| 64494 |
|
345 |
312 |
$27K |
| 64490 |
|
142 |
133 |
$25K |
| 62321 |
|
170 |
160 |
$25K |
| 64634 |
|
128 |
102 |
$22K |
| 64484 |
|
218 |
208 |
$17K |
| 27096 |
|
99 |
97 |
$16K |
| 99443 |
|
165 |
165 |
$13K |
| 64491 |
|
142 |
133 |
$12K |
| 20553 |
|
199 |
144 |
$9K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
131 |
19 |
$6K |
| 77002 |
|
90 |
89 |
$5K |
| 97760 |
|
153 |
150 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
139 |
131 |
$4K |
| 20610 |
|
54 |
53 |
$3K |
| 96127 |
|
870 |
842 |
$2K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,004 |
1,629 |
$1K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
31 |
29 |
$1K |
| G3002 |
Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs, and desired outcomes; overall treatment management; facilitation and coordination of any necessary behavioral health treatment; medication management; pain and health literacy counseling; any necessary chronic pain related crisis care; and ongoing communication and care coordination between relevant practitioners furnishing care, e.g. physical therapy and occupational therapy, complementary and integrative approaches, and community-based care, as appropriate. required initial face-to-face visit at least 30 minutes provided by a physician or other qualified health professional; first 30 minutes personally provided by physician or other qualified health care professional, per calendar month. (when using g3002, 30 minutes must be met or exceeded.) |
32 |
32 |
$293.22 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
52 |
39 |
$41.54 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
160 |
119 |
$7.39 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
725 |
596 |
$6.43 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
99 |
71 |
$3.41 |
| A4930 |
Gloves, sterile, per pair |
16 |
15 |
$0.00 |