| Code | Description | Claims | Beneficiaries | Total Paid |
| 20611 |
|
920 |
416 |
$23K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
308 |
279 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
78 |
78 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
36 |
36 |
$878.18 |
| 20610 |
|
24 |
14 |
$40.79 |
| J7328 |
Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg |
512 |
204 |
$0.00 |