| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99309 |
|
792 |
447 |
$25K |
| 99345 |
Prolong home eval add 15m |
199 |
183 |
$17K |
| 0012A |
|
400 |
397 |
$17K |
| 0013A |
|
397 |
389 |
$16K |
| 0003A |
|
282 |
259 |
$10K |
| 0002A |
|
218 |
213 |
$9K |
| 87811 |
|
238 |
126 |
$9K |
| 96127 |
|
283 |
258 |
$9K |
| 0001A |
|
208 |
203 |
$8K |
| 0011A |
|
214 |
213 |
$6K |
| 90662 |
|
54 |
25 |
$4K |
| 99350 |
Prolong home eval add 15m |
49 |
45 |
$3K |
| 0064A |
|
54 |
54 |
$2K |
| 90688 |
|
84 |
38 |
$2K |
| G0008 |
Admin influenza virus vac |
47 |
33 |
$980.65 |
| 99310 |
Prolong nursin fac eval 15m |
15 |
14 |
$882.53 |
| 0031A |
|
19 |
19 |
$800.66 |
| 0004A |
|
27 |
26 |
$649.33 |
| 90686 |
|
23 |
19 |
$376.34 |
| Q2038 |
Fluzone vacc, 3 yrs & >, im |
16 |
13 |
$304.70 |
| 96161 |
|
21 |
21 |
$298.41 |
| 83037 |
|
17 |
16 |
$25.16 |
| 90471 |
|
120 |
54 |
$5.13 |
| G8427 |
Docrev cur meds by elig clin |
312 |
285 |
$3.12 |
| 1159F |
|
312 |
285 |
$3.12 |
| 1160F |
|
311 |
284 |
$3.11 |
| G8510 |
Scr dep neg, no plan reqd |
291 |
266 |
$2.91 |
| 1126F |
|
186 |
175 |
$1.86 |
| 3074F |
|
86 |
81 |
$0.86 |
| 91301 |
|
132 |
130 |
$0.68 |
| 1125F |
|
56 |
50 |
$0.56 |
| 99501 |
|
21 |
20 |
$0.21 |
| G9226 |
3 comp foot exam completed |
16 |
16 |
$0.16 |
| 91300 |
|
13 |
13 |
$0.12 |
| 2023F |
|
12 |
12 |
$0.12 |