| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,760 |
4,269 |
$364K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,192 |
3,814 |
$356K |
| 76942 |
|
1,054 |
967 |
$100K |
| 20553 |
|
1,144 |
1,041 |
$57K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
224 |
224 |
$30K |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
672 |
627 |
$9K |
| 0101T |
|
57 |
49 |
$8K |
| L0650 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
12 |
12 |
$7K |
| 99458 |
|
106 |
106 |
$5K |
| 99457 |
|
147 |
146 |
$3K |
| 95886 |
|
18 |
18 |
$3K |
| 76881 |
|
26 |
14 |
$2K |
| 20611 |
|
15 |
15 |
$996.96 |
| 72275 |
|
27 |
27 |
$978.01 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
12 |
12 |
$96.84 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
12 |
12 |
$3.00 |
| 99072 |
|
123 |
110 |
$0.00 |