| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 36478 |
|
163 |
115 |
$116K |
| 93970 |
|
328 |
307 |
$18K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
369 |
325 |
$15K |
| 93925 |
|
159 |
150 |
$9K |
| 93971 |
|
191 |
145 |
$8K |
| 93880 |
|
49 |
44 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27 |
27 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
52 |
46 |
$1K |
| 93923 |
|
42 |
42 |
$721.31 |
| A4649 |
Surgical supply; miscellaneous |
58 |
41 |
$605.06 |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
50 |
38 |
$147.43 |
| A4217 |
Sterile water/saline, 500 ml |
56 |
43 |
$34.55 |
| A6448 |
Light compression bandage, elastic, knitted/woven, width less than three inches, per yard |
77 |
56 |
$31.76 |
| A4550 |
Surgical trays |
32 |
24 |
$27.97 |
| A4452 |
Tape, waterproof, per 18 square inches |
70 |
52 |
$1.72 |
| A6204 |
Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
13 |
12 |
$0.00 |