| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,249 |
969 |
$40K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
981 |
839 |
$25K |
| 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 |
24 |
18 |
$11K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
146 |
135 |
$9K |
| 20552 |
|
240 |
186 |
$6K |
| 64493 |
|
58 |
29 |
$3K |
| 64494 |
|
58 |
29 |
$1K |
| 99215 |
Prolong outpt/office vis |
23 |
19 |
$995.36 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
87 |
76 |
$660.33 |
| 80305 |
|
430 |
312 |
$189.26 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
81 |
57 |
$25.03 |
| 96127 |
|
114 |
89 |
$3.09 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
65 |
33 |
$1.02 |
| J3490 |
Unclassified drugs |
63 |
41 |
$0.00 |
| 99407 |
|
43 |
32 |
$0.00 |