| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
7,646 |
6,128 |
$477K |
| 99213 |
|
3,889 |
3,146 |
$171K |
| 99203 |
|
1,162 |
1,024 |
$72K |
| 87804 |
|
2,353 |
2,022 |
$49K |
| 96372 |
|
4,674 |
2,801 |
$43K |
| 87880 |
|
3,729 |
3,124 |
$40K |
| 87635 |
|
919 |
807 |
$33K |
| 87811 |
|
1,233 |
1,083 |
$32K |
| G2023 |
Specimen collect covid-19 |
550 |
471 |
$9K |
| 99394 |
|
57 |
57 |
$5K |
| 99204 |
|
35 |
29 |
$3K |
| 87428 |
|
70 |
62 |
$3K |
| 99051 |
|
187 |
157 |
$3K |
| 36415 |
|
842 |
695 |
$1K |
| J0696 |
Ceftriaxone sodium injection |
953 |
759 |
$1K |
| 81003 |
|
795 |
655 |
$1K |
| 90471 |
|
92 |
76 |
$959.22 |
| 94375 |
|
53 |
49 |
$929.88 |
| 99202 |
|
16 |
15 |
$847.59 |
| J0702 |
Betamethasone acet&sod phosp |
81 |
73 |
$719.25 |
| J1885 |
Ketorolac tromethamine inj |
616 |
535 |
$702.67 |
| J1100 |
Dexamethasone sodium phos |
1,507 |
1,252 |
$634.41 |
| 94690 |
|
33 |
30 |
$629.50 |
| 92551 |
|
97 |
84 |
$564.66 |
| 87807 |
|
54 |
53 |
$547.67 |
| 94200 |
|
51 |
47 |
$480.61 |
| 0001A |
|
15 |
13 |
$434.00 |
| J1200 |
Diphenhydramine hcl injectio |
788 |
661 |
$397.14 |
| J1040 |
Methylprednisolone 80 mg inj |
43 |
39 |
$288.71 |
| 96127 |
|
90 |
88 |
$256.75 |
| 82947 |
|
72 |
65 |
$153.48 |
| 85018 |
|
108 |
96 |
$152.09 |
| 99173 |
|
85 |
73 |
$131.97 |
| 93000 |
|
16 |
13 |
$126.81 |
| 86308 |
|
27 |
21 |
$115.90 |
| 90686 |
|
14 |
14 |
$83.93 |
| 96160 |
|
15 |
15 |
$29.07 |
| A4208 |
3 cc sterile syringe&needle |
2,292 |
1,535 |
$14.02 |
| 94760 |
|
116 |
91 |
$10.25 |
| J0945 |
Brompheniramine maleate inj |
29 |
28 |
$0.80 |
| A4206 |
1 cc sterile syringe&needle |
18 |
12 |
$0.00 |
| 91300 |
|
19 |
13 |
$0.00 |
| 36416 |
|
134 |
112 |
$0.00 |
| J1094 |
Inj dexamethasone acetate |
207 |
141 |
$0.00 |