| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77002 |
|
7,713 |
3,101 |
$150K |
| 20610 |
|
6,739 |
2,766 |
$147K |
| J7321 |
Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose |
1,092 |
361 |
$77K |
| J7324 |
Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose |
649 |
224 |
$62K |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
9,848 |
2,195 |
$39K |
| J7320 |
Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg |
1,014 |
354 |
$33K |
| J7323 |
Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose |
562 |
245 |
$32K |
| L1843 |
Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
80 |
31 |
$17K |
| 27369 |
|
1,094 |
456 |
$12K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
4,824 |
927 |
$7K |
| J3304 |
Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg |
51 |
38 |
$5K |
| L2397 |
Addition to lower extremity orthosis, suspension sleeve |
190 |
72 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
156 |
136 |
$2K |
| 73580 |
|
102 |
73 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
60 |
51 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
387 |
200 |
$128.55 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
24 |
14 |
$76.80 |
| 99426 |
|
13 |
12 |
$34.76 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,312 |
384 |
$5.80 |