| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Q4131 |
Epifix or epicord, per square centimeter |
581 |
304 |
$591K |
| Q4172 |
Puraply or puraply am, per square centimeter |
210 |
95 |
$434K |
| 17110 |
|
4,585 |
4,058 |
$292K |
| 17004 |
|
2,127 |
1,926 |
$270K |
| Q4195 |
Puraply, per square centimeter (add-on, list separately in addition to primary procedure) |
93 |
54 |
$150K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,476 |
7,280 |
$142K |
| 96910 |
|
5,493 |
1,616 |
$108K |
| Q4186 |
Epifix, per square centimeter (add-on, list separately in addition to primary procedure) |
167 |
57 |
$91K |
| 17000 |
|
2,624 |
2,347 |
$90K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,419 |
1,416 |
$85K |
| Q4145 |
Epifix, injectable, 1 mg |
40 |
28 |
$72K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
972 |
559 |
$57K |
| 95044 |
|
228 |
222 |
$55K |
| 11200 |
|
1,957 |
1,829 |
$42K |
| 11100 |
|
1,356 |
1,245 |
$40K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
1,200 |
778 |
$36K |
| 97597 |
|
1,322 |
984 |
$36K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,770 |
2,479 |
$27K |
| 15271 |
|
570 |
304 |
$26K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
609 |
607 |
$23K |
| 15275 |
|
448 |
205 |
$22K |
| 17003 |
|
1,525 |
1,441 |
$19K |
| 11102 |
|
399 |
385 |
$19K |
| 11043 |
|
245 |
146 |
$14K |
| 10060 |
|
330 |
314 |
$12K |
| 14001 |
|
54 |
50 |
$11K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
717 |
545 |
$10K |
| 11106 |
|
126 |
123 |
$8K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
681 |
220 |
$8K |
| 11900 |
|
215 |
203 |
$3K |
| 11101 |
|
172 |
170 |
$3K |
| 11402 |
|
72 |
69 |
$3K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
276 |
260 |
$2K |
| 99305 |
|
63 |
63 |
$2K |
| 11104 |
|
17 |
17 |
$1K |
| 14021 |
|
15 |
15 |
$1K |
| 11312 |
|
17 |
17 |
$757.25 |
| 11103 |
|
32 |
29 |
$757.08 |
| 17250 |
|
52 |
37 |
$734.29 |
| 11107 |
|
33 |
33 |
$353.85 |
| 99343 |
|
24 |
24 |
$223.42 |
| 99215 |
Prolong outpt/office vis |
14 |
12 |
$0.00 |