| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,250 |
3,062 |
$194K |
| 95886 |
|
824 |
808 |
$138K |
| 64484 |
|
520 |
499 |
$135K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,021 |
1,021 |
$122K |
| 64483 |
|
520 |
499 |
$97K |
| 72275 |
|
918 |
867 |
$67K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
819 |
804 |
$65K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
1,814 |
1,647 |
$37K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
841 |
803 |
$32K |
| 95911 |
|
192 |
192 |
$31K |
| 76942 |
|
291 |
279 |
$24K |
| 20611 |
|
367 |
283 |
$24K |
| 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 |
25 |
25 |
$18K |
| L0631 |
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 item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
12 |
12 |
$5K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
663 |
618 |
$3K |
| 20553 |
|
40 |
38 |
$2K |
| 95912 |
|
12 |
12 |
$2K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
1,207 |
1,098 |
$308.56 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
362 |
320 |
$2.15 |
| 97026 |
|
36 |
12 |
$0.00 |
| 97124 |
|
34 |
12 |
$0.00 |
| 97810 |
|
75 |
24 |
$0.00 |
| 97811 |
|
75 |
24 |
$0.00 |