| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| X0620 |
|
1,584 |
1,286 |
$274K |
| T1015 |
Clinic service |
3,150 |
1,526 |
$109K |
| L4360 |
Pneumat walking boot pre cst |
166 |
164 |
$37K |
| 73564 |
|
687 |
547 |
$18K |
| 73610 |
|
797 |
730 |
$17K |
| X0592 |
|
369 |
358 |
$15K |
| 72110 |
|
497 |
492 |
$13K |
| 73630 |
|
596 |
518 |
$9K |
| L3908 |
Who cock-up nonmolde pre ots |
178 |
152 |
$9K |
| L1820 |
Ko elas w/ condyle pads & jo |
165 |
152 |
$8K |
| 20611 |
|
179 |
164 |
$7K |
| 73030 |
|
337 |
300 |
$7K |
| 97161 |
|
118 |
115 |
$6K |
| L1902 |
Afo ankle gauntlet pre ots |
96 |
92 |
$6K |
| 73130 |
|
359 |
318 |
$6K |
| 73502 |
|
181 |
176 |
$5K |
| 73110 |
|
282 |
253 |
$4K |
| J1020 |
Methylprednisolone 20 mg inj |
651 |
603 |
$3K |
| L4350 |
Ankle control ortho pre ots |
49 |
49 |
$3K |
| 73590 |
|
113 |
107 |
$2K |
| 97162 |
|
45 |
44 |
$2K |
| G0463 |
Hospital outpt clinic visit |
220 |
197 |
$2K |
| 73100 |
|
110 |
95 |
$2K |
| L3807 |
Whfo w/o joints pre cst |
13 |
12 |
$2K |
| 20610 |
|
229 |
201 |
$2K |
| 72050 |
|
49 |
49 |
$2K |
| 72100 |
|
78 |
76 |
$2K |
| 90686 |
|
86 |
86 |
$1K |
| 73562 |
|
44 |
40 |
$959.70 |
| 76881 |
|
13 |
13 |
$825.98 |
| 20550 |
|
30 |
24 |
$773.44 |
| 97110 |
|
40 |
27 |
$750.58 |
| Q3014 |
Telehealth facility fee |
48 |
48 |
$564.71 |
| 97150 |
|
87 |
51 |
$552.70 |
| 72082 |
|
12 |
12 |
$526.90 |
| 73080 |
|
33 |
31 |
$513.68 |
| 73140 |
|
44 |
42 |
$498.47 |
| J0702 |
Betamethasone acet&sod phosp |
253 |
249 |
$497.66 |
| 73090 |
|
27 |
24 |
$398.48 |
| G0008 |
Admin influenza virus vac |
32 |
32 |
$315.28 |
| 73070 |
|
12 |
12 |
$208.60 |
| 72170 |
|
12 |
12 |
$165.21 |
| 76882 |
|
13 |
13 |
$116.95 |
| J3301 |
Triamcinolone acet inj nos |
1,428 |
1,411 |
$2.40 |
| J2795 |
Ropivacaine hcl injection |
38 |
38 |
$0.00 |
| 90656 |
|
43 |
43 |
$0.00 |