| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,921 |
2,246 |
$74K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
317 |
300 |
$22K |
| 20610 |
|
360 |
327 |
$7K |
| L1810 |
Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
24 |
24 |
$2K |
| J7324 |
Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose |
22 |
18 |
$975.34 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
293 |
270 |
$246.32 |
| 20553 |
|
15 |
12 |
$47.95 |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
19 |
14 |
$45.10 |
| 20552 |
|
12 |
12 |
$21.93 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
16 |
16 |
$0.00 |