| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
5,695 |
4,306 |
$555K |
| 99204 |
|
382 |
327 |
$56K |
| 62323 |
|
153 |
152 |
$54K |
| J1030 |
Methylprednisolone 40 mg inj |
693 |
652 |
$8K |
| 64484 |
|
22 |
12 |
$4K |
| 64483 |
|
24 |
13 |
$3K |
| A4215 |
Sterile needle |
1,192 |
1,105 |
$3K |
| A4930 |
Sterile, gloves per pair |
1,044 |
971 |
$900.27 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
995 |
937 |
$836.09 |
| J3301 |
Triamcinolone acet inj nos |
88 |
86 |
$288.50 |
| J1100 |
Dexamethasone sodium phos |
84 |
79 |
$191.60 |
| J2001 |
Lidocaine injection |
704 |
643 |
$72.34 |
| J3490 |
Drugs unclassified injection |
216 |
195 |
$53.46 |
| J1040 |
Methylprednisolone 80 mg inj |
56 |
56 |
$48.27 |
| 94761 |
|
1,114 |
1,037 |
$24.93 |
| A4550 |
Surgical trays |
1,042 |
968 |
$11.23 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
32 |
32 |
$10.32 |
| G8427 |
Docrev cur meds by elig clin |
14 |
13 |
$0.00 |