| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96375 |
|
1,456 |
662 |
$108.54 |
| 96365 |
|
599 |
321 |
$73.10 |
| 99213 |
|
2,704 |
991 |
$72.83 |
| 94640 |
|
381 |
89 |
$56.48 |
| J2930 |
Methylprednisolone injection |
710 |
390 |
$17.61 |
| J1100 |
Dexamethasone sodium phos |
1,762 |
752 |
$2.82 |
| J7040 |
Normal saline solution infus |
804 |
412 |
$1.83 |
| 99214 |
|
261 |
192 |
$0.00 |
| 96372 |
|
488 |
346 |
$0.00 |
| 96366 |
|
69 |
37 |
$0.00 |
| J1030 |
Methylprednisolone 40 mg inj |
303 |
247 |
$0.00 |
| J3490 |
Drugs unclassified injection |
585 |
296 |
$0.00 |
| 1125F |
|
26 |
24 |
$0.00 |
| J7060 |
5% dextrose/water |
73 |
38 |
$0.00 |
| J1040 |
Methylprednisolone 80 mg inj |
13 |
13 |
$0.00 |
| J2360 |
Orphenadrine injection |
665 |
373 |
$0.00 |
| 96374 |
|
1,103 |
544 |
$0.00 |
| J7042 |
5% dextrose/normal saline |
33 |
27 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
1,519 |
654 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
254 |
157 |
$0.00 |
| 1126F |
|
111 |
44 |
$0.00 |
| 3074F |
|
106 |
51 |
$0.00 |
| 1170F |
|
172 |
84 |
$0.00 |
| 96361 |
|
52 |
46 |
$0.00 |
| 1157F |
|
101 |
40 |
$0.00 |
| 3079F |
|
34 |
12 |
$0.00 |
| 3008F |
|
118 |
43 |
$0.00 |
| 3075F |
|
39 |
13 |
$0.00 |
| 1159F |
|
261 |
141 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
884 |
258 |
$0.00 |
| J2300 |
Inj nalbuphine hydrochloride |
813 |
233 |
$0.00 |
| 96160 |
|
284 |
144 |
$0.00 |
| 1160F |
|
261 |
141 |
$0.00 |
| 3078F |
|
184 |
94 |
$0.00 |
| J2550 |
Promethazine hcl injection |
109 |
40 |
$0.00 |
| 3077F |
|
83 |
39 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
94 |
86 |
$0.00 |
| 96360 |
|
53 |
46 |
$0.00 |
| 99397 |
|
34 |
31 |
$0.00 |
| G0438 |
Ppps, initial visit |
37 |
14 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
145 |
55 |
$0.00 |