| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,142 |
2,015 |
$196K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,024 |
2,818 |
$178K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
465 |
427 |
$23K |
| 99215 |
Prolong outpt/office vis |
113 |
102 |
$16K |
| 20553 |
|
224 |
179 |
$11K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
60 |
60 |
$9K |
| 80305 |
|
829 |
806 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
42 |
29 |
$2K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
254 |
247 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
456 |
440 |
$180.25 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
125 |
118 |
$174.56 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$157.86 |
| J1020 |
Injection, methylprednisolone acetate, 20 mg |
52 |
52 |
$106.38 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
203 |
196 |
$39.00 |
| 99000 |
|
31 |
29 |
$4.00 |
| J3490 |
Unclassified drugs |
140 |
133 |
$1.14 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
97 |
93 |
$0.04 |
| A4550 |
Surgical trays |
12 |
12 |
$0.00 |