| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1999 |
Noc retail items andsupplies |
54 |
54 |
$195K |
| 64484 |
|
355 |
348 |
$41K |
| 64483 |
|
359 |
350 |
$39K |
| 99213 |
|
1,082 |
1,063 |
$20K |
| 99214 |
|
523 |
516 |
$12K |
| 99490 |
Ccm add 20min |
352 |
352 |
$1K |
| 99491 |
Ccm add 20min |
93 |
93 |
$1K |
| J3301 |
Triamcinolone acet inj nos |
738 |
716 |
$1K |
| 99439 |
|
87 |
87 |
$878.96 |
| 97110 |
|
105 |
68 |
$596.08 |
| S0020 |
Injection, bupivicaine hydro |
154 |
153 |
$543.29 |
| 97530 |
|
37 |
26 |
$173.24 |
| 20552 |
|
38 |
38 |
$76.82 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
426 |
423 |
$60.37 |
| G2058 |
Ccm add 20min |
248 |
248 |
$8.80 |
| 97010 |
|
12 |
12 |
$3.32 |
| G8418 |
Calc bmi blw low param f/u |
39 |
39 |
$0.00 |
| 1036F |
|
27 |
27 |
$0.00 |
| G8730 |
Pain doc pos and plan |
60 |
60 |
$0.00 |
| 3288F |
|
60 |
60 |
$0.00 |
| G8427 |
Docrev cur meds by elig clin |
93 |
86 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
19 |
18 |
$0.00 |