| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
9,263 |
7,912 |
$1.58M |
| 99283 |
|
18,130 |
15,401 |
$1.56M |
| 99285 |
|
2,116 |
1,695 |
$516K |
| 85025 |
|
6,317 |
5,860 |
$189K |
| 99282 |
|
4,138 |
3,771 |
$163K |
| 80053 |
|
3,351 |
3,115 |
$131K |
| 36415 |
|
8,290 |
7,463 |
$74K |
| 97110 |
|
634 |
167 |
$50K |
| 97530 |
|
332 |
146 |
$41K |
| 0241U |
|
624 |
602 |
$38K |
| 86140 |
|
603 |
577 |
$28K |
| J3490 |
Drugs unclassified injection |
664 |
304 |
$28K |
| 80048 |
|
568 |
528 |
$23K |
| J2704 |
Inj, propofol, 10 mg |
1,153 |
846 |
$23K |
| J3010 |
Fentanyl citrate injection |
1,015 |
784 |
$21K |
| 96374 |
|
369 |
343 |
$21K |
| 81001 |
|
1,676 |
1,574 |
$20K |
| 83605 |
|
524 |
485 |
$18K |
| 74177 |
|
235 |
223 |
$13K |
| 96372 |
|
439 |
409 |
$13K |
| 43239 |
|
15 |
12 |
$13K |
| J2250 |
Inj midazolam hydrochloride |
440 |
376 |
$9K |
| 96375 |
|
166 |
151 |
$9K |
| 96361 |
|
218 |
200 |
$8K |
| 71045 |
|
318 |
284 |
$8K |
| 87804 |
|
149 |
75 |
$8K |
| 93005 |
|
90 |
79 |
$8K |
| 85027 |
|
376 |
345 |
$7K |
| 84484 |
|
175 |
158 |
$7K |
| 99213 |
|
225 |
137 |
$6K |
| 99281 |
|
334 |
323 |
$5K |
| J1885 |
Ketorolac tromethamine inj |
231 |
216 |
$5K |
| 71046 |
|
184 |
174 |
$5K |
| J7120 |
Ringers lactate infusion |
154 |
128 |
$4K |
| 87635 |
|
133 |
126 |
$3K |
| J7030 |
Normal saline solution infus |
29 |
25 |
$1K |
| 80076 |
|
32 |
29 |
$1K |
| 93010 |
|
215 |
207 |
$1K |
| 87430 |
|
27 |
26 |
$964.85 |
| 80307 |
|
23 |
12 |
$866.32 |
| J7121 |
5% dextrose in lac ringers |
17 |
15 |
$806.95 |
| A9270 |
Non-covered item or service |
4,538 |
2,010 |
$593.40 |
| 83690 |
|
15 |
13 |
$422.34 |
| 77067 |
|
17 |
15 |
$386.81 |
| 87081 |
|
16 |
13 |
$365.63 |
| 87086 |
|
13 |
13 |
$339.96 |
| 77063 |
|
18 |
15 |
$312.34 |
| J2405 |
Ondansetron hcl injection |
13 |
12 |
$289.79 |
| J7040 |
Normal saline solution infus |
23 |
13 |
$138.81 |
| P9604 |
One-way allow prorated trip |
71 |
43 |
$42.06 |