| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J3490 |
Unclassified drugs |
742 |
551 |
$44K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
139 |
123 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
68 |
54 |
$2K |
| 76942 |
|
14 |
12 |
$731.71 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
115 |
76 |
$132.66 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
188 |
165 |
$21.70 |