| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14,760 |
11,224 |
$1.01M |
| 64483 |
|
1,616 |
1,433 |
$350K |
| 99215 |
Prolong outpt/office vis |
2,141 |
1,697 |
$172K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,395 |
1,221 |
$95K |
| 64484 |
|
625 |
592 |
$76K |
| 64636 |
|
264 |
147 |
$52K |
| 76942 |
|
1,014 |
882 |
$51K |
| 64635 |
|
153 |
147 |
$44K |
| 62370 |
|
744 |
639 |
$37K |
| 99205 |
Prolong outpt/office vis |
282 |
280 |
$37K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
2,594 |
2,395 |
$27K |
| 80305 |
|
5,229 |
4,935 |
$24K |
| 62321 |
|
113 |
111 |
$18K |
| 27096 |
|
89 |
89 |
$14K |
| 20611 |
|
265 |
229 |
$13K |
| 64493 |
|
83 |
67 |
$12K |
| 64494 |
|
71 |
55 |
$5K |
| 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 |
13 |
13 |
$5K |
| L0631 |
Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the 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 |
15 |
15 |
$2K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,200 |
1,159 |
$1K |
| 64495 |
|
16 |
13 |
$856.39 |
| 99091 |
|
13 |
13 |
$213.51 |
| A4248 |
Chlorhexidine containing antiseptic, 1 ml |
1,316 |
1,161 |
$185.94 |
| A4220 |
Refill kit for implantable infusion pump |
167 |
140 |
$157.50 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
19 |
18 |
$29.24 |
| 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 |
663 |
589 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
54 |
49 |
$0.00 |
| G8539 |
Functional outcome assessment documented as positive using a standardized tool and a care plan based on identified deficiencies is documented within two days of the functional outcome assessment |
31 |
26 |
$0.00 |