| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
11,845 |
9,783 |
$577K |
| 99213 |
|
5,242 |
4,470 |
$187K |
| 87426 |
|
3,904 |
3,150 |
$78K |
| 99204 |
|
795 |
673 |
$57K |
| 87804 |
|
5,577 |
2,418 |
$50K |
| 87880 |
|
2,766 |
2,411 |
$31K |
| 99203 |
|
548 |
457 |
$30K |
| 96372 |
|
2,912 |
2,422 |
$22K |
| 85027 |
|
3,837 |
3,311 |
$15K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,004 |
838 |
$1K |
| 81003 |
|
359 |
266 |
$747.90 |
| 94640 |
|
55 |
41 |
$339.28 |
| 87807 |
|
33 |
30 |
$330.00 |
| 86308 |
|
12 |
12 |
$72.00 |
| 36415 |
|
29 |
26 |
$38.40 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
34 |
27 |
$24.57 |
| 36416 |
|
3,706 |
3,201 |
$2.00 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
42 |
29 |
$0.04 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,577 |
1,325 |
$0.00 |