| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
12,741 |
9,629 |
$674K |
| 99284 |
|
4,704 |
3,599 |
$540K |
| 99283 |
|
1,744 |
1,393 |
$316K |
| 99285 |
|
693 |
415 |
$118K |
| 87635 |
|
1,962 |
1,668 |
$97K |
| 99213 |
|
2,826 |
1,639 |
$58K |
| 90460 |
|
1,966 |
1,769 |
$31K |
| 93005 |
|
514 |
400 |
$29K |
| G0463 |
Hospital outpt clinic visit |
3,428 |
1,982 |
$21K |
| 99282 |
|
172 |
120 |
$17K |
| 99392 |
|
231 |
191 |
$16K |
| 99393 |
|
216 |
194 |
$16K |
| 85025 |
|
3,673 |
2,577 |
$13K |
| 97110 |
|
268 |
81 |
$13K |
| 99215 |
Prolong outpt/office vis |
185 |
149 |
$12K |
| 80053 |
|
1,959 |
1,486 |
$11K |
| 84443 |
|
946 |
774 |
$9K |
| 87636 |
|
106 |
85 |
$7K |
| 96361 |
|
67 |
54 |
$6K |
| 99391 |
|
77 |
64 |
$5K |
| 96374 |
|
77 |
65 |
$5K |
| 90471 |
|
589 |
432 |
$4K |
| 99204 |
|
61 |
56 |
$4K |
| 97140 |
|
113 |
37 |
$4K |
| 80061 |
|
427 |
358 |
$4K |
| 80048 |
|
1,000 |
705 |
$4K |
| 71046 |
|
46 |
40 |
$3K |
| 83036 |
|
595 |
486 |
$3K |
| 99394 |
|
37 |
36 |
$3K |
| 87591 |
|
131 |
110 |
$3K |
| 90686 |
|
959 |
881 |
$3K |
| 71045 |
|
56 |
38 |
$3K |
| 87491 |
|
131 |
110 |
$2K |
| G0480 |
Drug test def 1-7 classes |
75 |
43 |
$2K |
| 0002A |
|
58 |
56 |
$2K |
| M0243 |
Casirivi and imdevi inj |
13 |
12 |
$2K |
| 99205 |
Prolong outpt/office vis |
27 |
24 |
$2K |
| 36415 |
|
4,222 |
3,076 |
$2K |
| 0064A |
|
65 |
65 |
$1K |
| 96372 |
|
25 |
13 |
$1K |
| J7120 |
Ringers lactate infusion |
339 |
229 |
$1K |
| 0001A |
|
33 |
33 |
$1K |
| 0004A |
|
59 |
55 |
$1K |
| 80306 |
|
118 |
76 |
$1K |
| 0072A |
|
55 |
54 |
$1K |
| 92004 |
|
16 |
16 |
$1K |
| 96375 |
|
18 |
15 |
$979.65 |
| 87389 |
|
26 |
26 |
$926.20 |
| 0071A |
|
49 |
40 |
$850.00 |
| 99212 |
|
243 |
143 |
$773.58 |
| 87631 |
|
16 |
15 |
$763.58 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
22 |
17 |
$692.26 |
| 81001 |
|
364 |
286 |
$647.08 |
| J1885 |
Ketorolac tromethamine inj |
228 |
152 |
$585.34 |
| 96127 |
|
96 |
92 |
$550.98 |
| 86803 |
|
39 |
39 |
$437.47 |
| 87086 |
|
127 |
109 |
$421.32 |
| 99443 |
|
42 |
22 |
$377.87 |
| 83690 |
|
87 |
69 |
$354.00 |
| 84484 |
|
50 |
41 |
$290.90 |
| 0054A |
|
15 |
14 |
$281.46 |
| 92015 |
|
19 |
19 |
$237.69 |
| 90656 |
|
67 |
66 |
$213.07 |
| 87070 |
|
30 |
25 |
$164.48 |
| 90472 |
|
16 |
16 |
$164.15 |
| J1100 |
Dexamethasone sodium phos |
17 |
12 |
$141.09 |
| 90480 |
|
15 |
14 |
$131.32 |
| 87400 |
|
26 |
12 |
$122.78 |
| 86140 |
|
34 |
28 |
$117.19 |
| 87077 |
|
15 |
14 |
$90.80 |
| 85027 |
|
44 |
25 |
$86.14 |
| J2405 |
Ondansetron hcl injection |
97 |
67 |
$83.53 |
| 83550 |
|
13 |
12 |
$82.28 |
| 87081 |
|
18 |
12 |
$61.32 |
| 83540 |
|
13 |
12 |
$61.06 |
| 81003 |
|
51 |
42 |
$46.45 |
| J7050 |
Normal saline solution infus |
24 |
19 |
$41.22 |
| G0008 |
Admin influenza virus vac |
62 |
46 |
$40.55 |
| J3010 |
Fentanyl citrate injection |
19 |
12 |
$34.50 |
| 85652 |
|
15 |
13 |
$27.68 |
| J2250 |
Inj midazolam hydrochloride |
17 |
12 |
$24.97 |
| J7030 |
Normal saline solution infus |
17 |
12 |
$23.65 |
| 90461 |
|
127 |
111 |
$22.77 |
| 91300 |
|
208 |
186 |
$0.84 |
| 91307 |
|
149 |
137 |
$0.60 |
| 91306 |
|
65 |
65 |
$0.30 |
| 91305 |
|
27 |
24 |
$0.10 |
| 90670 |
|
13 |
13 |
$0.00 |
| 90688 |
|
14 |
13 |
$0.00 |