| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99223 |
Prolong inpt eval add15 m |
378 |
377 |
$14K |
| 99213 |
|
688 |
496 |
$11K |
| 99222 |
|
381 |
377 |
$10K |
| 99221 |
|
170 |
170 |
$3K |
| 99214 |
|
124 |
110 |
$1K |
| 96365 |
|
84 |
39 |
$306.88 |
| J3415 |
Injection, pyridoxine hcl, 100 mg |
80 |
36 |
$180.54 |
| 96372 |
|
55 |
39 |
$105.84 |
| J3411 |
Injection, thiamine hcl, 100 mg |
80 |
37 |
$59.55 |
| 93000 |
|
12 |
12 |
$50.09 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
55 |
38 |
$33.61 |
| 81002 |
|
85 |
84 |
$4.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
83 |
39 |
$0.00 |
| J2724 |
Injection, protein c concentrate, intravenous, human, 10 iu |
80 |
37 |
$0.00 |
| 36415 |
|
107 |
107 |
$0.00 |