| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 41899 |
Unlisted procedure, dentoalveolar structures |
953 |
879 |
$2.41M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
3,769 |
1,432 |
$236K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,023 |
3,744 |
$103K |
| 72081 |
|
589 |
474 |
$23K |
| 72082 |
|
301 |
254 |
$15K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
206 |
198 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
272 |
234 |
$8K |
| 99201 |
|
460 |
458 |
$7K |
| 97161 |
|
336 |
279 |
$6K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
59 |
53 |
$3K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
19 |
14 |
$1K |
| 73090 |
|
27 |
25 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$530.07 |
| 73521 |
|
34 |
29 |
$330.81 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
401 |
347 |
$251.12 |
| J3490 |
Unclassified drugs |
2,601 |
1,229 |
$223.74 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,247 |
1,126 |
$141.23 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,448 |
1,303 |
$131.71 |
| 70310 |
|
932 |
859 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
709 |
625 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
457 |
351 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
1,320 |
1,197 |
$0.00 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
60 |
51 |
$0.00 |