| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
2,512 |
2,350 |
$27K |
| 99213 |
|
5,528 |
4,574 |
$13K |
| 99212 |
|
93 |
86 |
$503.33 |
| 90471 |
|
426 |
355 |
$306.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
410 |
351 |
$250.82 |
| 36415 |
|
922 |
908 |
$167.64 |
| 99211 |
|
82 |
81 |
$155.56 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,629 |
1,397 |
$148.23 |
| 92551 |
|
180 |
179 |
$42.24 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
67 |
63 |
$19.80 |
| 90658 |
|
16 |
16 |
$18.00 |
| 92081 |
|
188 |
187 |
$15.00 |
| 85018 |
|
216 |
206 |
$2.58 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
15 |
13 |
$0.86 |
| 1036F |
|
567 |
442 |
$0.28 |
| 88150 |
|
12 |
12 |
$0.00 |
| 3008F |
|
526 |
513 |
$0.00 |
| 3074F |
|
457 |
390 |
$0.00 |
| 3075F |
|
14 |
12 |
$0.00 |
| 3079F |
|
58 |
55 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
13 |
13 |
$0.00 |
| 90655 |
|
82 |
82 |
$0.00 |
| 3078F |
|
514 |
432 |
$0.00 |
| 3077F |
|
36 |
30 |
$0.00 |
| 81002 |
|
192 |
179 |
$0.00 |
| 90653 |
|
31 |
31 |
$0.00 |