| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
18,846 |
15,480 |
$377K |
| 99204 |
|
9,186 |
8,816 |
$228K |
| 99213 |
|
10,918 |
9,905 |
$196K |
| 99203 |
|
6,217 |
6,168 |
$194K |
| 87635 |
|
5,611 |
5,006 |
$145K |
| S9088 |
Services provided in urgent |
11,552 |
8,641 |
$102K |
| 87636 |
|
897 |
884 |
$94K |
| 99051 |
|
8,789 |
7,743 |
$50K |
| 96372 |
|
7,336 |
5,231 |
$34K |
| J0696 |
Ceftriaxone sodium injection |
3,381 |
2,237 |
$17K |
| 99212 |
|
911 |
813 |
$17K |
| 99202 |
|
485 |
479 |
$12K |
| U0002 |
Covid-19 lab test non-cdc |
1,626 |
1,550 |
$8K |
| 87880 |
|
2,227 |
2,167 |
$8K |
| 87804 |
|
1,875 |
921 |
$8K |
| J1885 |
Ketorolac tromethamine inj |
1,298 |
1,165 |
$6K |
| 81003 |
|
2,264 |
2,087 |
$5K |
| 99001 |
|
922 |
866 |
$4K |
| 87811 |
|
110 |
99 |
$2K |
| J8540 |
Oral dexamethasone |
80 |
79 |
$2K |
| 71046 |
|
175 |
158 |
$1K |
| J1100 |
Dexamethasone sodium phos |
91 |
90 |
$1K |
| 94640 |
|
165 |
156 |
$897.33 |
| A9150 |
Misc/exper non-prescript dru |
418 |
414 |
$724.20 |
| 73610 |
|
58 |
58 |
$686.11 |
| 99000 |
|
731 |
695 |
$666.56 |
| 87807 |
|
134 |
133 |
$565.69 |
| J3301 |
Triamcinolone acet inj nos |
52 |
52 |
$468.78 |
| 73630 |
|
31 |
31 |
$449.78 |
| J7613 |
Albuterol non-comp unit |
100 |
96 |
$447.28 |
| S0119 |
Ondansetron 4 mg |
76 |
76 |
$242.98 |
| 29540 |
|
23 |
23 |
$223.49 |
| 73130 |
|
12 |
12 |
$170.46 |
| 93000 |
|
12 |
12 |
$155.53 |
| A6449 |
Lt compres band >=3" <5"/yd |
201 |
198 |
$87.98 |
| S0077 |
Injection, clindamycin phosp |
18 |
12 |
$85.00 |
| 82962 |
|
15 |
15 |
$85.00 |
| 81025 |
|
29 |
29 |
$52.88 |
| J7644 |
Ipratropium bromide non-comp |
26 |
26 |
$46.59 |
| J8499 |
Oral prescrip drug non chemo |
16 |
16 |
$31.50 |
| 99173 |
|
12 |
12 |
$24.18 |
| 73562 |
|
16 |
15 |
$23.38 |
| A6448 |
Lt compres band <3"/yd |
14 |
14 |
$3.00 |
| A7003 |
Nebulizer administration set |
39 |
39 |
$0.00 |