| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
8,109 |
2,473 |
$237K |
| 96365 |
|
8,149 |
1,318 |
$172K |
| 99214 |
|
2,952 |
2,381 |
$156K |
| P9047 |
Albumin (human), 25%, 50ml |
5,819 |
944 |
$118K |
| 99212 |
|
5,160 |
841 |
$114K |
| 96361 |
|
9,946 |
1,411 |
$80K |
| 96366 |
|
7,957 |
1,292 |
$54K |
| 96372 |
|
4,553 |
1,328 |
$28K |
| 96367 |
|
1,815 |
438 |
$27K |
| 96360 |
|
2,329 |
355 |
$24K |
| 85025 |
|
12,352 |
3,663 |
$20K |
| P9046 |
Albumin (human), 25%, 20 ml |
678 |
91 |
$11K |
| 96375 |
|
450 |
218 |
$5K |
| J7040 |
Normal saline solution infus |
9,844 |
1,404 |
$3K |
| 36415 |
|
4,316 |
1,513 |
$2K |
| 96374 |
|
129 |
51 |
$2K |
| J2469 |
Palonosetron hcl |
349 |
179 |
$2K |
| 90686 |
|
67 |
67 |
$361.77 |
| 90471 |
|
35 |
32 |
$319.67 |
| J1200 |
Diphenhydramine hcl injectio |
510 |
238 |
$239.97 |
| S0164 |
Injection pantroprazole |
78 |
25 |
$74.10 |
| S0028 |
Injection, famotidine, 20 mg |
23 |
12 |
$15.50 |
| J1100 |
Dexamethasone sodium phos |
22 |
14 |
$13.84 |
| G0008 |
Admin influenza virus vac |
28 |
27 |
$0.00 |