| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87633 |
|
2,359 |
1,913 |
$803K |
| 99214 |
|
4,632 |
3,144 |
$386K |
| 99204 |
|
4,526 |
3,350 |
$382K |
| 99213 |
|
3,794 |
2,699 |
$200K |
| 99203 |
|
3,551 |
2,790 |
$177K |
| 87486 |
|
2,937 |
2,301 |
$117K |
| 87581 |
|
2,921 |
2,300 |
$116K |
| 91320 |
|
692 |
338 |
$102K |
| 87798 |
|
2,166 |
1,649 |
$96K |
| 87631 |
|
939 |
687 |
$95K |
| 99000 |
|
4,000 |
2,674 |
$89K |
| 87811 |
|
2,211 |
1,447 |
$85K |
| 87804 |
|
2,114 |
1,372 |
$60K |
| 87632 |
|
314 |
284 |
$55K |
| 87880 |
|
3,563 |
2,530 |
$54K |
| 99308 |
|
1,799 |
900 |
$50K |
| 99309 |
|
1,678 |
718 |
$40K |
| 96372 |
|
2,822 |
1,745 |
$33K |
| 91322 |
|
180 |
103 |
$28K |
| 0202U |
|
106 |
102 |
$26K |
| 87634 |
|
448 |
306 |
$22K |
| 90677 |
|
78 |
69 |
$21K |
| 81025 |
|
2,682 |
1,867 |
$14K |
| 90653 |
|
182 |
128 |
$10K |
| 99305 |
|
119 |
102 |
$10K |
| 90658 |
|
491 |
283 |
$9K |
| 87651 |
|
232 |
161 |
$8K |
| 81003 |
|
3,209 |
2,265 |
$7K |
| 99306 |
Prolong nursin fac eval 15m |
154 |
134 |
$6K |
| 11042 |
|
117 |
40 |
$6K |
| 71046 |
|
245 |
179 |
$5K |
| 96373 |
|
352 |
245 |
$4K |
| 99233 |
Prolong inpt eval add15 m |
78 |
26 |
$4K |
| 99384 |
|
37 |
29 |
$4K |
| 87801 |
|
73 |
53 |
$4K |
| 99307 |
|
189 |
117 |
$2K |
| 90732 |
|
18 |
18 |
$2K |
| J1885 |
Ketorolac tromethamine inj |
984 |
563 |
$2K |
| 99205 |
Prolong outpt/office vis |
17 |
13 |
$2K |
| J1100 |
Dexamethasone sodium phos |
948 |
573 |
$2K |
| 94640 |
|
167 |
96 |
$1K |
| J2919 |
Inj, methylpred sod succ 5mg |
163 |
97 |
$966.91 |
| 90686 |
|
43 |
21 |
$837.03 |
| 36415 |
|
633 |
445 |
$715.56 |
| 90661 |
|
20 |
12 |
$643.72 |
| 93000 |
|
48 |
30 |
$626.85 |
| 99239 |
|
12 |
12 |
$622.84 |
| 99326 |
|
14 |
14 |
$452.67 |
| J0696 |
Ceftriaxone sodium injection |
205 |
132 |
$329.96 |
| 90656 |
|
12 |
12 |
$249.39 |
| 99238 |
|
12 |
12 |
$237.20 |
| G0008 |
Admin influenza virus vac |
32 |
27 |
$172.52 |
| 90471 |
|
58 |
51 |
$130.70 |
| J2930 |
Methylprednisolone injection |
19 |
15 |
$90.81 |
| J2405 |
Ondansetron hcl injection |
69 |
42 |
$28.87 |
| J7620 |
Albuterol ipratrop non-comp |
128 |
77 |
$24.41 |
| A9150 |
Misc/exper non-prescript dru |
50 |
48 |
$0.00 |