| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
940 |
732 |
$39K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
571 |
470 |
$39K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
432 |
352 |
$14K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
262 |
218 |
$12K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
130 |
89 |
$12K |
| 73630 |
|
430 |
298 |
$5K |
| 20611 |
|
78 |
40 |
$4K |
| 73610 |
|
317 |
217 |
$4K |
| 73560 |
|
355 |
270 |
$4K |
| 73110 |
|
246 |
170 |
$4K |
| 73130 |
|
267 |
172 |
$3K |
| 73565 |
|
241 |
208 |
$3K |
| 20610 |
|
74 |
46 |
$2K |
| 73030 |
|
65 |
54 |
$909.07 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
45 |
38 |
$376.39 |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
13 |
13 |
$348.04 |
| 72100 |
|
14 |
13 |
$260.14 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
27 |
24 |
$72.03 |
| J0670 |
Injection, mepivacaine hydrochloride, per 10 ml |
31 |
26 |
$13.98 |
| 99024 |
|
129 |
94 |
$0.00 |