| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99215 |
Prolong outpt/office vis |
1,169 |
1,056 |
$97K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
722 |
719 |
$70K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
816 |
715 |
$37K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16 |
16 |
$384.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
13 |
13 |
$214.64 |
| 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 |
32 |
24 |
$153.46 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
30 |
15 |
$8.98 |
| A4550 |
Surgical trays |
70 |
30 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
13 |
13 |
$0.00 |