| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
14,876 |
8,932 |
$196K |
| 99214 |
|
5,840 |
4,074 |
$96K |
| 96372 |
|
4,307 |
2,600 |
$14K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
949 |
691 |
$8K |
| 99203 |
|
249 |
169 |
$6K |
| 99211 |
|
659 |
429 |
$4K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,916 |
1,142 |
$3K |
| 90756 |
|
296 |
237 |
$3K |
| 71046 |
|
265 |
171 |
$2K |
| 90674 |
|
241 |
147 |
$2K |
| 90471 |
|
272 |
224 |
$1K |
| 81003 |
|
988 |
752 |
$834.94 |
| 90732 |
|
13 |
13 |
$801.76 |
| 90694 |
|
125 |
82 |
$518.35 |
| 87636 |
|
25 |
14 |
$427.89 |
| 1160F |
|
956 |
553 |
$345.19 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
745 |
461 |
$338.90 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
116 |
85 |
$282.58 |
| 1125F |
|
956 |
608 |
$280.00 |
| 96127 |
|
137 |
100 |
$221.10 |
| 93000 |
|
38 |
29 |
$216.24 |
| G0008 |
Administration of influenza virus vaccine |
449 |
284 |
$171.68 |
| 36415 |
|
1,085 |
593 |
$160.16 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
17 |
12 |
$134.88 |
| 87804 |
|
17 |
14 |
$122.01 |
| 3074F |
|
1,647 |
1,142 |
$80.00 |
| 3075F |
|
632 |
441 |
$50.41 |
| 3078F |
|
1,440 |
1,023 |
$50.00 |
| 99308 |
|
159 |
81 |
$41.20 |
| 1170F |
|
93 |
61 |
$40.00 |
| G0009 |
Administration of pneumococcal vaccine |
18 |
17 |
$39.39 |
| 1159F |
|
152 |
99 |
$30.00 |
| 3077F |
|
733 |
541 |
$20.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
657 |
322 |
$12.64 |
| 3080F |
|
316 |
259 |
$0.00 |
| 3044F |
|
1,022 |
691 |
$0.00 |
| 1111F |
|
3,590 |
2,390 |
$0.00 |
| 1126F |
|
120 |
66 |
$0.00 |
| 3079F |
|
230 |
172 |
$0.00 |
| 99499 |
|
110 |
99 |
$0.00 |
| 99080 |
|
13 |
12 |
$0.00 |
| 3045F |
|
138 |
95 |
$0.00 |
| 3046F |
|
130 |
86 |
$0.00 |
| 90653 |
|
75 |
52 |
$0.00 |