| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99232 |
|
4,128 |
1,417 |
$125K |
| 99213 |
|
2,695 |
2,126 |
$115K |
| J7050 |
Normal saline solution infus |
7,314 |
2,876 |
$94K |
| 99212 |
|
4,806 |
2,970 |
$78K |
| 96413 |
|
2,662 |
896 |
$71K |
| 99231 |
|
3,881 |
1,604 |
$63K |
| 96365 |
|
1,547 |
657 |
$58K |
| 96375 |
|
5,167 |
1,956 |
$54K |
| J1756 |
Iron sucrose injection |
1,239 |
514 |
$16K |
| 96417 |
|
480 |
187 |
$11K |
| 99204 |
|
111 |
79 |
$11K |
| 36415 |
|
4,838 |
2,260 |
$10K |
| 99214 |
|
128 |
110 |
$9K |
| Q5106 |
Inj retacrit non-esrd use |
163 |
82 |
$8K |
| 96372 |
|
1,817 |
914 |
$8K |
| J2916 |
Na ferric gluconate complex |
269 |
112 |
$2K |
| J2469 |
Palonosetron hcl |
223 |
77 |
$2K |
| 96360 |
|
107 |
64 |
$2K |
| J2780 |
Ranitidine hydrochloride inj |
1,246 |
503 |
$1K |
| 99223 |
Prolong inpt eval add15 m |
41 |
39 |
$1K |
| J1100 |
Dexamethasone sodium phos |
1,953 |
657 |
$808.85 |
| J2405 |
Ondansetron hcl injection |
2,477 |
835 |
$780.97 |
| J1200 |
Diphenhydramine hcl injectio |
2,247 |
841 |
$303.68 |
| J3490 |
Drugs unclassified injection |
171 |
63 |
$159.89 |
| J7040 |
Normal saline solution infus |
796 |
360 |
$22.70 |
| J0885 |
Epoetin alfa, non-esrd |
17 |
12 |
$0.00 |