| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
4,358 |
2,514 |
$2.20M |
| L0700 |
Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type) |
209 |
179 |
$305K |
| 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 |
407 |
372 |
$295K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
979 |
974 |
$182K |
| 99205 |
Prolong outpt/office vis |
993 |
989 |
$149K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,316 |
967 |
$107K |
| A0130 |
Non-emergency transportation: wheelchair van |
1,450 |
530 |
$106K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
268 |
201 |
$29K |
| 95117 |
|
2,117 |
1,826 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
521 |
513 |
$13K |
| E0731 |
Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patient's skin by layers of fabric) |
77 |
64 |
$12K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
198 |
107 |
$9K |
| 90791 |
Psychiatric diagnostic evaluation |
63 |
60 |
$7K |
| 93790 |
|
396 |
369 |
$6K |
| E0570 |
Nebulizer, with compressor |
51 |
51 |
$5K |
| 94060 |
|
73 |
73 |
$3K |
| E0855 |
Cervical traction equipment not requiring additional stand or frame |
68 |
52 |
$3K |
| 94070 |
|
46 |
46 |
$2K |
| 94200 |
|
107 |
106 |
$2K |
| 93000 |
|
183 |
180 |
$2K |
| 94760 |
|
1,868 |
1,626 |
$2K |
| 94726 |
|
41 |
41 |
$2K |
| 81000 |
|
497 |
492 |
$1K |
| 94375 |
|
46 |
46 |
$892.05 |
| 36415 |
Collection of venous blood by venipuncture |
403 |
386 |
$375.21 |
| 82962 |
|
282 |
252 |
$281.34 |
| 99407 |
|
15 |
14 |
$207.44 |
| 81002 |
|
90 |
90 |
$202.30 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$98.97 |
| 96127 |
|
15 |
15 |
$60.08 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$0.00 |
| 98960 |
|
18 |
18 |
$0.00 |