| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
6,137 |
5,487 |
$6K |
| 99232 |
|
74 |
25 |
$3K |
| 99307 |
|
142 |
79 |
$1K |
| 90686 |
|
121 |
121 |
$1K |
| 99239 |
|
25 |
25 |
$1K |
| 99214 |
|
519 |
484 |
$1K |
| 90471 |
|
178 |
175 |
$808.68 |
| 99223 |
Prolong inpt eval add15 m |
12 |
12 |
$804.52 |
| J7507 |
Tacrolimus, immediate release, oral, 1 mg |
282 |
246 |
$612.78 |
| 99308 |
|
43 |
28 |
$593.79 |
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
595 |
571 |
$357.66 |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
729 |
569 |
$235.76 |
| J7518 |
Mycophenolic acid, oral, 180 mg |
137 |
132 |
$149.90 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
365 |
345 |
$51.24 |
| 87086 |
|
18 |
18 |
$7.15 |
| 83036 |
|
44 |
44 |
$0.00 |
| 85025 |
|
39 |
37 |
$0.00 |
| 36415 |
|
45 |
42 |
$0.00 |
| 81001 |
|
15 |
15 |
$0.00 |
| 80048 |
|
17 |
17 |
$0.00 |
| 84443 |
|
19 |
19 |
$0.00 |
| 80053 |
|
38 |
36 |
$0.00 |
| 84478 |
|
17 |
17 |
$0.00 |
| 99212 |
|
31 |
28 |
$0.00 |
| 83721 |
|
29 |
29 |
$0.00 |
| 83718 |
|
17 |
17 |
$0.00 |