| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
18,340 |
15,092 |
$363K |
| 99232 |
|
8,713 |
1,572 |
$202K |
| 96413 |
|
2,522 |
1,674 |
$150K |
| 96365 |
|
3,539 |
1,621 |
$90K |
| 80053 |
|
22,986 |
17,897 |
$84K |
| 85025 |
|
23,498 |
18,090 |
$63K |
| J0490 |
Belimumab injection |
19 |
12 |
$47K |
| 96375 |
|
4,625 |
2,126 |
$41K |
| 99214 |
|
3,760 |
3,045 |
$40K |
| 99223 |
Prolong inpt eval add15 m |
755 |
700 |
$39K |
| 96374 |
|
2,157 |
861 |
$37K |
| J1756 |
Iron sucrose injection |
1,191 |
547 |
$36K |
| 96372 |
|
6,390 |
4,046 |
$35K |
| 96367 |
|
2,026 |
1,194 |
$27K |
| 99233 |
Prolong inpt eval add15 m |
471 |
216 |
$21K |
| 86300 |
|
2,559 |
2,475 |
$18K |
| 82728 |
|
2,021 |
1,935 |
$10K |
| J2469 |
Palonosetron hcl |
218 |
140 |
$8K |
| J1100 |
Dexamethasone sodium phos |
3,707 |
2,107 |
$3K |
| 96417 |
|
66 |
51 |
$3K |
| J2930 |
Methylprednisolone injection |
603 |
300 |
$2K |
| 96415 |
|
111 |
80 |
$2K |
| J3420 |
Vitamin b12 injection |
3,013 |
2,045 |
$2K |
| 99212 |
|
71 |
70 |
$2K |
| 81003 |
|
1,335 |
1,267 |
$2K |
| J1885 |
Ketorolac tromethamine inj |
1,628 |
934 |
$980.45 |
| 81001 |
|
1,070 |
743 |
$857.81 |
| 52000 |
|
14 |
14 |
$710.90 |
| 0011A |
|
28 |
28 |
$570.82 |
| J1200 |
Diphenhydramine hcl injectio |
961 |
572 |
$511.54 |
| 0012A |
|
20 |
20 |
$400.00 |
| J0696 |
Ceftriaxone sodium injection |
382 |
174 |
$375.74 |
| 85610 |
|
97 |
63 |
$205.20 |
| J2919 |
Inj, methylpred sod succ 5mg |
74 |
31 |
$201.94 |
| 90674 |
|
30 |
30 |
$185.50 |
| 85651 |
|
76 |
66 |
$175.91 |
| 90688 |
|
16 |
16 |
$144.48 |
| 82378 |
|
38 |
36 |
$143.37 |
| 84436 |
|
26 |
24 |
$86.55 |
| 90686 |
|
25 |
25 |
$70.08 |
| J1626 |
Granisetron hcl injection |
52 |
24 |
$65.62 |
| 36415 |
|
13,804 |
10,415 |
$10.07 |
| G8427 |
Docrev cur meds by elig clin |
21 |
20 |
$0.00 |
| G8731 |
Pain neg no plan |
22 |
22 |
$0.00 |
| 4040F |
|
21 |
20 |
$0.00 |
| G8484 |
Flu immunize no admin |
22 |
21 |
$0.00 |
| 84443 |
|
49 |
44 |
$0.00 |
| G0008 |
Admin influenza virus vac |
40 |
40 |
$0.00 |
| 1123F |
|
22 |
21 |
$0.00 |