| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
2,541 |
1,837 |
$102K |
| 99213 |
|
401 |
328 |
$11K |
| 99442 |
|
220 |
192 |
$6K |
| 99233 |
Prolong inpt eval add15 m |
602 |
139 |
$6K |
| 99204 |
|
86 |
86 |
$5K |
| 96372 |
|
912 |
760 |
$4K |
| 99497 |
|
147 |
145 |
$4K |
| 99308 |
|
483 |
140 |
$2K |
| 90674 |
|
116 |
107 |
$2K |
| 99223 |
Prolong inpt eval add15 m |
73 |
56 |
$1K |
| 99396 |
|
12 |
12 |
$1K |
| 90471 |
|
89 |
86 |
$1K |
| 90677 |
|
41 |
40 |
$784.68 |
| 90694 |
|
141 |
134 |
$768.09 |
| 99397 |
|
16 |
16 |
$640.32 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
531 |
465 |
$440.68 |
| G0008 |
Administration of influenza virus vaccine |
166 |
158 |
$315.08 |
| J2010 |
Injection, lincomycin hcl, up to 300 mg |
15 |
12 |
$38.25 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
38 |
30 |
$26.32 |
| 96127 |
|
12 |
12 |
$12.32 |
| A4208 |
Syringe with needle, sterile 3 cc, each |
17 |
14 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
40 |
40 |
$0.00 |