| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,163 |
1,727 |
$145K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,250 |
931 |
$57K |
| L0648 |
Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
15 |
15 |
$10K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
798 |
706 |
$9K |
| 80305 |
|
1,149 |
842 |
$7K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
66 |
58 |
$3K |
| 77002 |
|
32 |
28 |
$2K |
| 76942 |
|
54 |
54 |
$2K |
| 64493 |
|
16 |
16 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$1K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
684 |
617 |
$896.95 |
| 64494 |
|
16 |
16 |
$845.64 |
| 64495 |
|
16 |
16 |
$845.64 |
| 20610 |
|
14 |
14 |
$531.14 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
78 |
64 |
$122.00 |