| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
15,112 |
12,777 |
$909K |
| 99213 |
|
14,038 |
11,286 |
$514K |
| J2357 |
Omalizumab injection |
167 |
77 |
$219K |
| A4305 |
Drug delivery system >=50 ml |
4,050 |
1,415 |
$104K |
| 96375 |
|
3,842 |
882 |
$78K |
| 96365 |
|
1,566 |
484 |
$53K |
| 96372 |
|
4,466 |
2,850 |
$48K |
| 96401 |
|
378 |
291 |
$35K |
| 99204 |
|
241 |
212 |
$13K |
| 96361 |
|
1,453 |
833 |
$11K |
| 96413 |
|
145 |
112 |
$11K |
| 80305 |
|
632 |
573 |
$7K |
| 90471 |
|
443 |
418 |
$5K |
| 96374 |
|
211 |
148 |
$5K |
| 90688 |
|
251 |
241 |
$4K |
| 99212 |
|
94 |
84 |
$4K |
| 99396 |
|
27 |
27 |
$3K |
| 99395 |
|
44 |
39 |
$3K |
| J3420 |
Vitamin b12 injection |
1,997 |
1,221 |
$2K |
| 96366 |
|
100 |
36 |
$1K |
| J7050 |
Normal saline solution infus |
2,144 |
970 |
$1K |
| 90686 |
|
136 |
134 |
$1K |
| A6257 |
Transparent film <= 16 sq in |
1,440 |
803 |
$1K |
| A4212 |
Non coring needle or stylet |
1,511 |
483 |
$894.21 |
| 99203 |
|
27 |
27 |
$853.01 |
| J1642 |
Inj heparin sodium per 10 u |
1,905 |
569 |
$831.01 |
| A4209 |
5+ cc sterile syringe&needle |
4,376 |
1,346 |
$697.77 |
| J7030 |
Normal saline solution infus |
354 |
127 |
$626.63 |
| J1885 |
Ketorolac tromethamine inj |
952 |
378 |
$396.69 |
| 81002 |
|
342 |
261 |
$393.17 |
| 96367 |
|
54 |
12 |
$282.98 |
| 99490 |
Ccm add 20min |
1,798 |
1,764 |
$232.36 |
| J2405 |
Ondansetron hcl injection |
660 |
211 |
$229.40 |
| A4210 |
Nonneedle injection device |
2,526 |
1,226 |
$223.16 |
| J1030 |
Methylprednisolone 40 mg inj |
25 |
24 |
$148.89 |
| J0696 |
Ceftriaxone sodium injection |
29 |
25 |
$34.55 |
| J1100 |
Dexamethasone sodium phos |
198 |
91 |
$25.75 |
| J7040 |
Normal saline solution infus |
27 |
13 |
$14.96 |
| J1200 |
Diphenhydramine hcl injectio |
39 |
14 |
$13.16 |
| 81025 |
|
15 |
15 |
$0.00 |
| S0028 |
Injection, famotidine, 20 mg |
38 |
13 |
$0.00 |