| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 64483 |
|
1,693 |
1,460 |
$168K |
| 64520 |
|
1,444 |
1,246 |
$168K |
| 99214 |
|
2,296 |
2,079 |
$76K |
| 64484 |
|
1,696 |
1,461 |
$71K |
| 64493 |
|
891 |
840 |
$40K |
| 64445 |
|
866 |
732 |
$26K |
| 64494 |
|
879 |
829 |
$18K |
| J1030 |
Methylprednisolone 40 mg inj |
1,930 |
1,631 |
$5K |
| 99213 |
|
289 |
273 |
$5K |
| J1040 |
Methylprednisolone 80 mg inj |
1,572 |
1,437 |
$5K |
| 96372 |
|
355 |
342 |
$3K |
| 64495 |
|
486 |
461 |
$3K |
| 64479 |
|
22 |
14 |
$2K |
| 77003 |
|
17 |
16 |
$1K |
| 64480 |
|
22 |
14 |
$880.12 |
| 72275 |
|
45 |
37 |
$605.11 |
| J1010 |
Inj, methylpred acetate 1 mg |
201 |
187 |
$546.28 |
| J1100 |
Dexamethasone sodium phos |
1,948 |
1,606 |
$346.99 |
| J1885 |
Ketorolac tromethamine inj |
351 |
337 |
$239.50 |
| 99152 |
|
12 |
12 |
$38.76 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
2,129 |
1,940 |
$34.26 |
| 80305 |
|
88 |
86 |
$9.61 |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
389 |
371 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
12 |
12 |
$0.00 |