| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
5,113 |
4,418 |
$280K |
| 99203 |
|
3,737 |
3,725 |
$238K |
| 99214 |
|
3,082 |
2,699 |
$214K |
| 87426 |
|
6,434 |
5,868 |
$162K |
| 99204 |
|
1,219 |
1,209 |
$105K |
| 87804 |
|
4,429 |
2,230 |
$45K |
| 96372 |
|
2,127 |
1,882 |
$22K |
| 87880 |
|
1,607 |
1,556 |
$16K |
| 99000 |
|
4,880 |
4,459 |
$15K |
| 71046 |
|
559 |
525 |
$9K |
| M0245 |
Bamlan and etesev infusion |
21 |
21 |
$7K |
| 96365 |
|
205 |
186 |
$6K |
| 87635 |
|
160 |
156 |
$6K |
| 99441 |
|
77 |
67 |
$2K |
| 81002 |
|
781 |
732 |
$2K |
| 81025 |
|
310 |
299 |
$2K |
| J2930 |
Methylprednisolone injection |
320 |
294 |
$1K |
| 96375 |
|
133 |
120 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
831 |
746 |
$1K |
| 87430 |
|
121 |
120 |
$1K |
| J0696 |
Ceftriaxone sodium injection |
1,124 |
1,004 |
$919.80 |
| 94640 |
|
156 |
147 |
$794.46 |
| 36415 |
|
283 |
266 |
$723.16 |
| 86328 |
|
17 |
16 |
$711.55 |
| 99442 |
|
13 |
13 |
$637.08 |
| 96361 |
|
129 |
116 |
$617.46 |
| J1100 |
Dexamethasone sodium phos |
989 |
891 |
$603.61 |
| 87807 |
|
83 |
82 |
$575.05 |
| 87634 |
|
13 |
13 |
$523.17 |
| 99001 |
|
12 |
12 |
$117.63 |
| J7050 |
Normal saline solution infus |
36 |
32 |
$19.74 |
| J2405 |
Ondansetron hcl injection |
57 |
51 |
$11.16 |
| 2010F |
|
433 |
416 |
$0.24 |
| J7644 |
Ipratropium bromide non-comp |
28 |
27 |
$0.05 |
| S9088 |
Services provided in urgent |
1,623 |
1,334 |
$0.02 |
| 4120F |
|
299 |
290 |
$0.00 |
| 99051 |
|
122 |
119 |
$0.00 |
| G8711 |
Pres antibx on/within 3 day |
211 |
209 |
$0.00 |
| G8710 |
Pt pres antibiotic |
223 |
219 |
$0.00 |
| 99070 |
|
65 |
62 |
$0.00 |