| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
15,084 |
7,581 |
$268K |
| 99213 |
|
4,447 |
2,931 |
$133K |
| 99203 |
|
1,495 |
1,199 |
$51K |
| 96372 |
|
5,327 |
3,137 |
$41K |
| 80305 |
|
13,638 |
6,176 |
$26K |
| 99204 |
|
620 |
467 |
$21K |
| 96360 |
|
1,256 |
832 |
$13K |
| J2930 |
Methylprednisolone injection |
3,391 |
2,421 |
$6K |
| 87880 |
|
211 |
155 |
$2K |
| 36415 |
|
1,589 |
1,059 |
$1K |
| 94640 |
|
232 |
194 |
$991.71 |
| J7030 |
Normal saline solution infus |
989 |
678 |
$496.46 |
| J1885 |
Ketorolac tromethamine inj |
4,668 |
3,074 |
$440.86 |
| J7042 |
5% dextrose/normal saline |
196 |
126 |
$79.67 |
| J1030 |
Methylprednisolone 40 mg inj |
35 |
27 |
$61.58 |
| 81003 |
|
274 |
169 |
$52.27 |
| J2405 |
Ondansetron hcl injection |
1,245 |
820 |
$13.00 |
| J1100 |
Dexamethasone sodium phos |
85 |
78 |
$4.50 |
| S0028 |
Injection, famotidine, 20 mg |
1,138 |
738 |
$0.00 |
| 81025 |
|
166 |
133 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
87 |
69 |
$0.00 |
| S9088 |
Services provided in urgent |
18 |
15 |
$0.00 |