| Code | Description | Claims | Beneficiaries | Total Paid |
| 99214 |
|
28,452 |
26,681 |
$802K |
| 95165 |
|
4,185 |
2,941 |
$707K |
| 99213 |
|
23,515 |
21,988 |
$515K |
| 99204 |
|
5,577 |
5,421 |
$495K |
| 95004 |
|
2,170 |
2,114 |
$250K |
| J2357 |
Omalizumab injection |
172 |
142 |
$245K |
| 87502 |
|
2,547 |
2,517 |
$214K |
| 87635 |
|
4,545 |
4,473 |
$173K |
| 69436 |
|
1,161 |
1,058 |
$162K |
| 95117 |
|
9,542 |
5,646 |
$117K |
| 97110 |
|
5,195 |
2,292 |
$115K |
| 94060 |
|
3,372 |
3,306 |
$112K |
| 99203 |
|
1,759 |
1,715 |
$92K |
| 76816 |
|
1,318 |
1,258 |
$87K |
| 71046 |
|
8,480 |
8,046 |
$83K |
| 76805 |
|
751 |
740 |
$80K |
| 92587 |
|
3,664 |
3,567 |
$75K |
| 99212 |
|
3,261 |
3,133 |
$72K |
| 92567 |
|
4,708 |
4,594 |
$66K |
| 93306 |
|
1,327 |
1,273 |
$51K |
| 87651 |
|
2,293 |
2,259 |
$37K |
| 99202 |
|
873 |
850 |
$36K |
| 20610 |
|
1,087 |
971 |
$35K |
| 80053 |
|
4,473 |
3,831 |
$28K |
| J1439 |
Inj ferric carboxymaltos 1mg |
41 |
31 |
$24K |
| 93000 |
|
2,334 |
2,177 |
$24K |
| 74177 |
|
376 |
357 |
$22K |
| 42820 |
|
100 |
97 |
$21K |
| 96365 |
|
1,100 |
798 |
$20K |
| J0897 |
Denosumab injection |
59 |
57 |
$20K |
| 76819 |
|
262 |
125 |
$19K |
| 85025 |
|
5,971 |
4,984 |
$16K |
| 84443 |
|
1,686 |
1,648 |
$16K |
| 77067 |
|
601 |
596 |
$16K |
| 99205 |
Prolong outpt/office vis |
170 |
164 |
$15K |
| 87661 |
|
948 |
915 |
$15K |
| 87801 |
|
621 |
601 |
$15K |
| 96413 |
|
308 |
206 |
$13K |
| 87804 |
|
467 |
451 |
$11K |
| 96372 |
|
1,705 |
1,267 |
$10K |
| 99201 |
|
402 |
383 |
$10K |
| 90961 |
|
485 |
458 |
$10K |
| 73630 |
|
639 |
568 |
$9K |
| 74018 |
|
713 |
692 |
$9K |
| 87591 |
|
510 |
489 |
$9K |
| 87491 |
|
509 |
489 |
$9K |
| 84439 |
|
1,145 |
1,113 |
$8K |
| 82728 |
|
463 |
453 |
$7K |
| 83036 |
|
1,069 |
1,053 |
$7K |
| J1756 |
Iron sucrose injection |
149 |
89 |
$6K |
| 99391 |
|
89 |
79 |
$6K |
| 87481 |
|
637 |
617 |
$6K |
| 77063 |
|
385 |
384 |
$6K |
| 87660 |
|
301 |
294 |
$6K |
| 99232 |
|
478 |
175 |
$5K |
| 87634 |
|
79 |
79 |
$5K |
| 43239 |
|
27 |
27 |
$4K |
| 70553 |
|
14 |
14 |
$4K |
| J1040 |
Methylprednisolone 80 mg inj |
592 |
567 |
$4K |
| 81001 |
|
1,082 |
844 |
$4K |
| 99215 |
Prolong outpt/office vis |
99 |
94 |
$4K |
| 80069 |
|
1,038 |
996 |
$3K |
| 92588 |
|
58 |
58 |
$3K |
| 92014 |
|
178 |
157 |
$3K |
| 97161 |
|
104 |
94 |
$3K |
| 71250 |
|
46 |
44 |
$3K |
| 85027 |
|
441 |
426 |
$3K |
| 99460 |
|
44 |
44 |
$3K |
| 90471 |
|
204 |
186 |
$3K |
| 17110 |
|
54 |
49 |
$3K |
| 90686 |
|
155 |
144 |
$2K |
| 51798 |
|
373 |
348 |
$2K |
| 87510 |
|
301 |
294 |
$2K |
| 87480 |
|
301 |
294 |
$2K |
| 11721 |
|
1,243 |
1,190 |
$2K |
| 87880 |
|
378 |
366 |
$2K |
| 80048 |
|
388 |
380 |
$2K |
| 96110 |
|
177 |
176 |
$2K |
| 73610 |
|
124 |
116 |
$2K |
| 85652 |
|
1,091 |
1,057 |
$2K |
| 73564 |
|
84 |
71 |
$2K |
| 99392 |
|
25 |
25 |
$2K |
| 83540 |
|
862 |
824 |
$2K |
| 99238 |
|
37 |
36 |
$2K |
| 93296 |
|
124 |
121 |
$2K |
| 83970 |
|
231 |
228 |
$1K |
| 52000 |
|
27 |
26 |
$1K |
| 84702 |
|
165 |
126 |
$1K |
| J1030 |
Methylprednisolone 40 mg inj |
337 |
319 |
$1K |
| 42830 |
|
12 |
12 |
$1K |
| 71045 |
|
446 |
390 |
$1K |
| J1050 |
Medroxyprogesterone acetate |
27 |
26 |
$988.06 |
| 70450 |
|
29 |
26 |
$986.58 |
| 99393 |
|
13 |
13 |
$964.00 |
| 76830 |
|
13 |
13 |
$953.50 |
| 76856 |
|
12 |
12 |
$881.59 |
| 71260 |
|
25 |
24 |
$849.04 |
| 92557 |
|
24 |
24 |
$796.15 |
| 96160 |
|
64 |
63 |
$790.97 |
| 80061 |
|
67 |
67 |
$788.84 |
| 95115 |
|
70 |
38 |
$729.11 |
| 86780 |
|
70 |
69 |
$728.90 |
| 93227 |
|
56 |
37 |
$716.15 |
| 92504 |
|
71 |
57 |
$677.18 |
| 99211 |
|
49 |
48 |
$653.13 |
| 69210 |
|
39 |
39 |
$593.01 |
| 85007 |
|
294 |
281 |
$585.28 |
| 0012A |
|
75 |
75 |
$574.79 |
| 99222 |
|
25 |
24 |
$549.42 |
| 92004 |
|
18 |
16 |
$502.25 |
| 73130 |
|
28 |
26 |
$483.75 |
| 92555 |
|
41 |
40 |
$459.48 |
| 87150 |
|
12 |
12 |
$418.68 |
| 81025 |
|
62 |
60 |
$406.77 |
| 90960 |
|
26 |
26 |
$362.75 |
| 87807 |
|
24 |
24 |
$344.90 |
| 87389 |
|
16 |
16 |
$337.81 |
| J1010 |
Inj, methylpred acetate 1 mg |
107 |
103 |
$298.44 |
| 74176 |
|
13 |
13 |
$280.78 |
| 73110 |
|
15 |
14 |
$267.18 |
| 0011A |
|
83 |
82 |
$256.27 |
| 97802 |
|
14 |
13 |
$255.28 |
| V2020 |
Vision svcs frames purchases |
19 |
12 |
$225.60 |
| 96161 |
|
18 |
14 |
$222.52 |
| 92552 |
|
13 |
13 |
$202.63 |
| 93294 |
|
25 |
25 |
$182.93 |
| 36415 |
|
15,630 |
13,937 |
$179.31 |
| 95251 |
|
30 |
25 |
$175.96 |
| 77080 |
|
25 |
25 |
$160.97 |
| 93010 |
|
29 |
24 |
$133.16 |
| 82746 |
|
12 |
12 |
$123.55 |
| 93017 |
|
15 |
14 |
$111.10 |
| 82607 |
|
13 |
12 |
$108.26 |
| 86850 |
|
14 |
14 |
$74.66 |
| 86762 |
|
13 |
13 |
$74.66 |
| 93016 |
|
16 |
15 |
$68.93 |
| 94729 |
|
13 |
13 |
$68.58 |
| 92015 |
|
19 |
16 |
$63.00 |
| 96127 |
|
28 |
28 |
$61.46 |
| 81003 |
|
44 |
43 |
$60.93 |
| 81002 |
|
27 |
27 |
$24.91 |
| J3301 |
Triamcinolone acet inj nos |
172 |
163 |
$20.91 |
| 20552 |
|
15 |
14 |
$19.91 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
445 |
420 |
$18.09 |
| 1159F |
|
22,296 |
20,961 |
$0.02 |
| 3008F |
|
6,840 |
6,407 |
$0.01 |
| G8510 |
Scr dep neg, no plan reqd |
213 |
204 |
$0.01 |
| 3074F |
|
9,830 |
9,260 |
$0.00 |
| 3075F |
|
337 |
311 |
$0.00 |
| 3017F |
|
154 |
147 |
$0.00 |
| 99000 |
|
24 |
24 |
$0.00 |
| 3079F |
|
385 |
364 |
$0.00 |
| 3014F |
|
32 |
27 |
$0.00 |
| 4274F |
|
6,097 |
5,665 |
$0.00 |
| 3078F |
|
8,957 |
8,420 |
$0.00 |
| 4004F |
|
119 |
112 |
$0.00 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
45 |
44 |
$0.00 |