| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
|
16,950 |
7,202 |
$473K |
| 99213 |
|
12,033 |
8,589 |
$339K |
| 96372 |
|
2,284 |
1,102 |
$25K |
| 99202 |
|
427 |
413 |
$20K |
| 99203 |
|
234 |
223 |
$16K |
| 87426 |
|
714 |
553 |
$14K |
| 80305 |
|
1,115 |
711 |
$11K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
244 |
219 |
$5K |
| 99214 |
|
105 |
76 |
$4K |
| 99396 |
|
57 |
41 |
$3K |
| 99308 |
|
198 |
137 |
$3K |
| 87880 |
|
337 |
228 |
$3K |
| 80307 |
|
59 |
27 |
$2K |
| 87804 |
|
168 |
99 |
$2K |
| 90471 |
|
111 |
108 |
$1K |
| 90686 |
|
66 |
65 |
$869.66 |
| 93000 |
|
32 |
28 |
$612.78 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
698 |
580 |
$369.09 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
24 |
16 |
$186.20 |
| 81003 |
|
239 |
210 |
$174.41 |
| 90685 |
|
52 |
51 |
$142.68 |
| Q2035 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria) |
14 |
12 |
$93.61 |
| G0008 |
Administration of influenza virus vaccine |
26 |
24 |
$35.40 |
| 82274 |
|
13 |
12 |
$34.57 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
59 |
54 |
$33.71 |
| 99307 |
|
15 |
12 |
$0.00 |