| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90960 |
|
20,199 |
20,041 |
$438K |
| 99232 |
|
7,658 |
3,214 |
$103K |
| 99233 |
Prolong inpt eval add15 m |
3,138 |
1,271 |
$76K |
| 99214 |
|
4,430 |
3,666 |
$43K |
| 99215 |
Prolong outpt/office vis |
1,232 |
1,012 |
$20K |
| 36902 |
|
1,328 |
1,286 |
$14K |
| 90966 |
|
81 |
81 |
$9K |
| 99223 |
Prolong inpt eval add15 m |
200 |
196 |
$6K |
| 99213 |
|
272 |
261 |
$4K |
| 90935 |
|
241 |
150 |
$3K |
| 92014 |
|
26 |
26 |
$3K |
| 92012 |
|
25 |
25 |
$2K |
| 96374 |
|
388 |
369 |
$2K |
| 92004 |
|
14 |
14 |
$2K |
| 36905 |
|
103 |
89 |
$2K |
| 90961 |
|
88 |
86 |
$1K |
| 78725 |
|
118 |
118 |
$813.98 |
| 92015 |
|
166 |
155 |
$711.64 |
| 77080 |
|
223 |
222 |
$620.18 |
| 99152 |
|
568 |
536 |
$506.60 |
| V2020 |
Vision svcs frames purchases |
15 |
14 |
$350.00 |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
13 |
13 |
$260.00 |
| 76775 |
|
122 |
121 |
$215.33 |
| V2784 |
Lens polycarb or equal |
14 |
14 |
$169.00 |
| 77001 |
|
13 |
12 |
$60.08 |
| 90674 |
|
46 |
46 |
$22.66 |
| G2211 |
Complex e/m visit add on |
357 |
322 |
$16.12 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
287 |
279 |
$0.00 |
| G8907 |
Pt doc no events on discharg |
26 |
26 |
$0.00 |
| 99222 |
|
26 |
26 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
312 |
297 |
$0.00 |
| 36415 |
|
2,307 |
1,803 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
313 |
298 |
$0.00 |
| G0008 |
Admin influenza virus vac |
49 |
49 |
$0.00 |
| 99309 |
|
35 |
12 |
$0.00 |