| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,609 |
1,569 |
$136K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,937 |
1,704 |
$105K |
| 29075 |
|
436 |
366 |
$35K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
221 |
208 |
$29K |
| 29425 |
|
39 |
36 |
$3K |
| 73562 |
|
41 |
39 |
$2K |
| 73100 |
|
43 |
37 |
$1K |
| 73610 |
|
32 |
26 |
$1K |
| 73070 |
|
31 |
26 |
$896.80 |
| 73140 |
|
15 |
12 |
$474.20 |
| 73560 |
|
13 |
12 |
$434.67 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
13 |
$301.37 |
| L3265 |
Plastazote sandal, each |
16 |
13 |
$85.00 |
| Q4012 |
Cast supplies, short arm cast, pediatric (0-10 years), fiberglass |
63 |
52 |
$0.00 |
| Q4010 |
Cast supplies, short arm cast, adult (11 years +), fiberglass |
19 |
17 |
$0.00 |