| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 64635 |
|
733 |
705 |
$12K |
| 64640 |
|
618 |
296 |
$11K |
| 64633 |
|
427 |
415 |
$5K |
| 64483 |
|
145 |
141 |
$2K |
| 64634 |
|
854 |
415 |
$1K |
| 64636 |
|
848 |
409 |
$1K |
| 64625 |
|
30 |
30 |
$945.72 |
| 64484 |
|
145 |
141 |
$44.10 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
94 |
94 |
$22.14 |
| 80305 |
|
244 |
239 |
$20.92 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
223 |
217 |
$0.12 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
29 |
29 |
$0.00 |
| 1101F |
|
93 |
93 |
$0.00 |
| 1036F |
|
40 |
40 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
93 |
93 |
$0.00 |
| G8730 |
Pain assessment documented as positive using a standardized tool and a follow-up plan is documented |
1,299 |
1,255 |
$0.00 |
| G9584 |
Patient evaluated for risk of misuse of opiates by using a brief validated instrument (e.g., opioid risk tool, soapp-r) or patient interviewed at least once during opioid therapy |
93 |
93 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
129 |
123 |
$0.00 |
| G9562 |
Patients who had a follow-up evaluation conducted at least every three months during opioid therapy |
93 |
93 |
$0.00 |
| 4004F |
|
53 |
53 |
$0.00 |
| 1124F |
|
93 |
93 |
$0.00 |
| G9578 |
Documentation of signed opioid treatment agreement at least once during opioid therapy |
93 |
93 |
$0.00 |