| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
6,177 |
2,461 |
$165K |
| 99214 |
|
4,983 |
2,116 |
$164K |
| 96372 |
|
7,054 |
2,612 |
$137K |
| 99215 |
Prolong outpt/office vis |
1,025 |
445 |
$38K |
| 96360 |
|
1,093 |
395 |
$27K |
| J0696 |
Ceftriaxone sodium injection |
5,461 |
2,011 |
$21K |
| 99309 |
|
2,259 |
667 |
$19K |
| J1885 |
Ketorolac tromethamine inj |
7,034 |
2,240 |
$12K |
| 87635 |
|
301 |
237 |
$9K |
| 96361 |
|
1,043 |
379 |
$8K |
| 99310 |
Prolong nursin fac eval 15m |
724 |
279 |
$7K |
| 99212 |
|
350 |
242 |
$6K |
| 87804 |
|
471 |
190 |
$5K |
| J1100 |
Dexamethasone sodium phos |
5,232 |
1,908 |
$5K |
| 94640 |
|
461 |
245 |
$3K |
| 99395 |
|
54 |
52 |
$3K |
| 99396 |
|
45 |
41 |
$3K |
| 87880 |
|
287 |
236 |
$3K |
| 99204 |
|
15 |
14 |
$1K |
| J1110 |
Inj dihydroergotamine mesylt |
148 |
59 |
$948.16 |
| J3420 |
Vitamin b12 injection |
806 |
543 |
$910.48 |
| 99308 |
|
186 |
142 |
$794.00 |
| 81002 |
|
1,317 |
728 |
$702.29 |
| 82962 |
|
364 |
242 |
$683.60 |
| G0452 |
Molecular pathology interpr |
848 |
588 |
$530.16 |
| J7050 |
Normal saline solution infus |
428 |
155 |
$497.96 |
| 36415 |
|
455 |
406 |
$473.69 |
| J7030 |
Normal saline solution infus |
367 |
133 |
$421.18 |
| 94664 |
|
214 |
112 |
$417.56 |
| J1956 |
Levofloxacin injection |
151 |
66 |
$401.83 |
| J7626 |
Budesonide non-comp unit |
164 |
78 |
$197.28 |
| 36410 |
|
332 |
139 |
$43.75 |
| J1836 |
Inj, metronidazole, 10 mg |
38 |
15 |
$0.98 |