| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
12,131 |
10,327 |
$420K |
| 96372 |
|
4,052 |
3,115 |
$56K |
| 99213 |
|
942 |
821 |
$30K |
| 99203 |
|
155 |
146 |
$6K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
2,352 |
1,955 |
$2K |
| 99442 |
|
122 |
116 |
$904.90 |
| 99497 |
|
31 |
30 |
$825.93 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
1,131 |
947 |
$746.04 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
17 |
16 |
$535.30 |
| 96160 |
|
39 |
36 |
$506.91 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
658 |
561 |
$492.47 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,958 |
1,679 |
$446.27 |
| 81002 |
|
205 |
170 |
$326.70 |
| 1159F |
|
99 |
92 |
$140.00 |
| 1160F |
|
98 |
92 |
$140.00 |
| 0011A |
|
21 |
15 |
$120.03 |
| 99349 |
|
15 |
12 |
$113.39 |
| 90471 |
|
16 |
13 |
$32.46 |
| 3074F |
|
32 |
30 |
$20.00 |
| 3078F |
|
61 |
58 |
$20.00 |
| 36415 |
|
14 |
13 |
$14.52 |
| 1125F |
|
32 |
31 |
$10.00 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
12 |
12 |
$9.50 |
| 99366 |
|
38 |
35 |
$0.00 |
| 3061F |
|
12 |
12 |
$0.00 |