| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 36415 |
|
10,447 |
8,363 |
$1.85M |
| 96375 |
|
6,620 |
2,920 |
$1.77M |
| 96372 |
|
3,202 |
1,806 |
$1.38M |
| 80053 |
|
14,991 |
9,931 |
$1.09M |
| 96365 |
|
3,821 |
2,109 |
$723K |
| 96413 |
|
6,530 |
3,062 |
$698K |
| A9552 |
F18 fdg |
696 |
596 |
$474K |
| 36591 |
|
1,778 |
969 |
$239K |
| 96361 |
|
1,004 |
594 |
$165K |
| 82962 |
|
394 |
343 |
$163K |
| J7040 |
Normal saline solution infus |
8,209 |
4,223 |
$82K |
| 96367 |
|
1,726 |
996 |
$76K |
| J1642 |
Inj heparin sodium per 10 u |
1,358 |
518 |
$46K |
| 83735 |
|
6,397 |
3,373 |
$40K |
| 80050 |
|
67 |
51 |
$30K |
| J0897 |
Denosumab injection |
308 |
225 |
$29K |
| J2405 |
Ondansetron hcl injection |
3,666 |
1,658 |
$21K |
| 78815 |
|
813 |
725 |
$20K |
| 82784 |
|
1,657 |
1,098 |
$17K |
| J7050 |
Normal saline solution infus |
7,098 |
3,236 |
$14K |
| 86900 |
|
438 |
317 |
$13K |
| 84439 |
|
572 |
504 |
$11K |
| 85025 |
|
15,837 |
10,208 |
$5K |
| 99211 |
|
173 |
139 |
$5K |
| 81001 |
|
91 |
85 |
$5K |
| 82728 |
|
3,828 |
3,501 |
$4K |
| 82306 |
|
774 |
705 |
$4K |
| 77336 |
|
40 |
12 |
$2K |
| 96374 |
|
261 |
131 |
$2K |
| 82607 |
|
1,412 |
1,300 |
$996.13 |
| 84443 |
|
827 |
659 |
$796.47 |
| 83615 |
|
1,609 |
1,291 |
$757.59 |
| G0463 |
Hospital outpt clinic visit |
27 |
25 |
$709.27 |
| 84238 |
|
157 |
142 |
$642.55 |
| 82378 |
|
712 |
503 |
$588.61 |
| 86850 |
|
72 |
53 |
$419.81 |
| J1439 |
Inj ferric carboxymaltos 1mg |
641 |
371 |
$222.60 |
| 96360 |
|
19 |
12 |
$191.48 |
| 83020 |
|
15 |
12 |
$151.35 |
| 85610 |
|
86 |
66 |
$75.90 |
| 83883 |
|
258 |
196 |
$31.64 |
| 82746 |
|
811 |
737 |
$12.63 |
| 83550 |
|
3,232 |
2,964 |
$5.08 |
| 83540 |
|
3,260 |
2,988 |
$5.08 |
| J1100 |
Dexamethasone sodium phos |
4,212 |
1,761 |
$2.43 |
| 85046 |
|
2,241 |
1,998 |
$1.44 |
| J7030 |
Normal saline solution infus |
2,616 |
1,405 |
$0.78 |
| J3490 |
Drugs unclassified injection |
1,553 |
531 |
$0.00 |
| 86901 |
|
437 |
317 |
$0.00 |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
656 |
553 |
$0.00 |
| 85652 |
|
871 |
783 |
$0.00 |
| 86880 |
|
89 |
82 |
$0.00 |
| 96415 |
|
564 |
338 |
$0.00 |
| 96366 |
|
212 |
144 |
$0.00 |
| 83521 |
|
172 |
93 |
$0.00 |
| 86300 |
|
56 |
38 |
$0.00 |
| 84703 |
|
91 |
53 |
$0.00 |
| 85660 |
|
88 |
74 |
$0.00 |
| Q0138 |
Ferumoxytol, non-esrd |
27 |
13 |
$0.00 |
| A9609 |
F18 fdg, 15 millicuries |
96 |
95 |
$0.00 |
| 87389 |
|
39 |
37 |
$0.00 |
| 83021 |
|
89 |
75 |
$0.00 |
| 85730 |
|
14 |
14 |
$0.00 |
| 86141 |
|
14 |
13 |
$0.00 |
| 86334 |
|
967 |
823 |
$0.00 |
| 84165 |
|
954 |
818 |
$0.00 |
| 84550 |
|
401 |
337 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
2,554 |
1,160 |
$0.00 |
| J1756 |
Iron sucrose injection |
102 |
53 |
$0.00 |
| J1453 |
Fosaprepitant injection |
195 |
116 |
$0.00 |
| 86038 |
|
178 |
162 |
$0.00 |
| 84100 |
|
1,259 |
935 |
$0.00 |
| 96417 |
|
1,577 |
753 |
$0.00 |
| A4216 |
Sterile water/saline, 10 ml |
415 |
166 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
49 |
28 |
$0.00 |
| 80074 |
|
14 |
12 |
$0.00 |
| J9271 |
Inj pembrolizumab |
35 |
24 |
$0.00 |