| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Q4186 |
Epifix, per square centimeter (add-on, list separately in addition to primary procedure) |
25 |
23 |
$47K |
| Q4195 |
Puraply, per square centimeter (add-on, list separately in addition to primary procedure) |
18 |
15 |
$41K |
| 17004 |
|
222 |
212 |
$29K |
| 17110 |
|
275 |
262 |
$23K |
| 11106 |
|
182 |
179 |
$23K |
| 96910 |
|
555 |
195 |
$13K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
193 |
192 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
469 |
405 |
$10K |
| 17000 |
|
183 |
175 |
$9K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
566 |
173 |
$6K |
| 11200 |
|
274 |
252 |
$6K |
| 17003 |
|
143 |
137 |
$3K |
| 10060 |
|
59 |
55 |
$2K |
| 11107 |
|
31 |
31 |
$2K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
20 |
16 |
$2K |
| 15271 |
|
27 |
23 |
$1K |
| 10061 |
|
14 |
13 |
$975.00 |
| 15275 |
|
15 |
12 |
$945.99 |
| 11100 |
|
21 |
20 |
$445.94 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$408.43 |