| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,730 |
3,703 |
$211K |
| A6010 |
Collagen based wound filler, dry form, sterile, per gram of collagen |
168 |
140 |
$98K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
284 |
231 |
$87K |
| A6443 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard |
220 |
189 |
$77K |
| A6454 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard |
160 |
136 |
$68K |
| A6449 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
97 |
81 |
$51K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
631 |
559 |
$50K |
| 93922 |
|
1,002 |
895 |
$49K |
| 99215 |
Prolong outpt/office vis |
677 |
450 |
$35K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
55 |
44 |
$34K |
| 76937 |
|
97 |
87 |
$32K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,340 |
1,033 |
$29K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
19 |
17 |
$16K |
| A6197 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
36 |
26 |
$10K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
202 |
151 |
$10K |
| 97597 |
|
155 |
103 |
$8K |
| 36005 |
|
77 |
51 |
$7K |
| 93971 |
|
93 |
85 |
$7K |
| 99205 |
Prolong outpt/office vis |
98 |
84 |
$6K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
36 |
30 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
107 |
94 |
$5K |
| 29581 |
|
204 |
111 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
257 |
200 |
$4K |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
19 |
15 |
$4K |
| 99310 |
Prolong nursin fac eval 15m |
45 |
35 |
$3K |
| 93990 |
|
40 |
37 |
$3K |
| 15271 |
|
146 |
49 |
$3K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
88 |
67 |
$3K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
25 |
22 |
$2K |
| A6243 |
Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
19 |
13 |
$2K |
| 97598 |
|
36 |
27 |
$2K |
| 75820 |
|
14 |
12 |
$1K |
| 99305 |
|
47 |
42 |
$997.62 |
| 99306 |
Prolong nursin fac eval 15m |
15 |
13 |
$902.09 |
| 99222 |
Initial hospital care, per day, moderate complexity |
29 |
24 |
$791.08 |
| A4246 |
Betadine or phisohex solution, per pint |
23 |
20 |
$766.13 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
58 |
43 |
$318.54 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
30 |
15 |
$38.35 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
36 |
16 |
$7.15 |
| A2002 |
Mirragen advanced wound matrix, per square centimeter (add-on, list separately in addition to primary procedure) |
84 |
46 |
$0.00 |