| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 64483 |
|
322 |
321 |
$25K |
| 01936 |
|
184 |
169 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
589 |
566 |
$13K |
| 64484 |
|
323 |
322 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
691 |
663 |
$10K |
| 77002 |
|
148 |
113 |
$3K |
| 20610 |
|
133 |
99 |
$2K |
| 76942 |
|
109 |
104 |
$1K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
494 |
473 |
$1K |
| 20553 |
|
95 |
90 |
$719.60 |
| 01940 |
|
12 |
12 |
$625.56 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
298 |
266 |
$406.18 |
| 99152 |
|
60 |
58 |
$348.81 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
239 |
211 |
$233.54 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
131 |
123 |
$15.42 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
897 |
789 |
$6.72 |
| 01992 |
|
24 |
24 |
$0.00 |
| 80305 |
|
26 |
26 |
$0.00 |