| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 27096 |
|
510 |
368 |
$70K |
| 95924 |
|
378 |
258 |
$29K |
| 93923 |
|
482 |
228 |
$25K |
| 95923 |
|
378 |
258 |
$17K |
| J1040 |
Methylprednisolone 80 mg inj |
1,206 |
868 |
$12K |
| 96130 |
|
282 |
249 |
$10K |
| 96132 |
|
219 |
201 |
$6K |
| 99214 |
|
87 |
84 |
$6K |
| J1030 |
Methylprednisolone 40 mg inj |
618 |
409 |
$4K |
| 93040 |
|
317 |
215 |
$2K |
| 99213 |
|
68 |
65 |
$2K |
| J2704 |
Inj, propofol, 10 mg |
3,292 |
2,293 |
$2K |
| 99152 |
|
383 |
274 |
$2K |
| 99203 |
|
38 |
31 |
$1K |
| 62323 |
|
27 |
24 |
$1K |
| 64635 |
|
12 |
12 |
$1K |
| J2250 |
Inj midazolam hydrochloride |
3,107 |
2,166 |
$1K |
| 64636 |
|
12 |
12 |
$290.80 |
| G0396 |
Alcohol/subs interv 15-30mn |
75 |
75 |
$239.37 |
| 96138 |
|
63 |
61 |
$170.70 |
| J1020 |
Methylprednisolone 20 mg inj |
59 |
40 |
$116.83 |
| J1010 |
Inj, methylpred acetate 1 mg |
28 |
25 |
$108.83 |
| G0444 |
Depression screen annual |
16 |
14 |
$62.83 |
| J1100 |
Dexamethasone sodium phos |
16 |
13 |
$9.24 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
178 |
142 |
$3.26 |