| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 80053 |
|
1,489 |
1,061 |
$58K |
| 99283 |
|
2,306 |
2,074 |
$51K |
| 11042 |
|
395 |
155 |
$44K |
| G0378 |
Hospital observation per hr |
223 |
121 |
$33K |
| 99282 |
|
541 |
504 |
$27K |
| 99281 |
|
356 |
324 |
$24K |
| 96374 |
|
542 |
454 |
$20K |
| 99284 |
|
1,423 |
1,207 |
$18K |
| 87430 |
|
625 |
590 |
$17K |
| 99285 |
|
596 |
466 |
$15K |
| 96372 |
|
557 |
486 |
$14K |
| 70450 |
|
204 |
186 |
$12K |
| 80048 |
|
326 |
276 |
$10K |
| 96361 |
|
356 |
314 |
$9K |
| 97597 |
|
144 |
85 |
$9K |
| 74176 |
|
285 |
253 |
$8K |
| 36415 |
|
568 |
370 |
$7K |
| G0463 |
Hospital outpt clinic visit |
132 |
78 |
$5K |
| 87086 |
|
572 |
514 |
$5K |
| 71045 |
|
758 |
674 |
$5K |
| 84703 |
|
155 |
141 |
$5K |
| 81025 |
|
558 |
499 |
$5K |
| 71046 |
|
191 |
179 |
$4K |
| 86756 |
|
113 |
110 |
$4K |
| 80306 |
|
219 |
191 |
$4K |
| 74177 |
|
31 |
31 |
$3K |
| 94640 |
|
249 |
185 |
$3K |
| 87804 |
|
1,216 |
818 |
$3K |
| 81003 |
|
557 |
497 |
$3K |
| 87077 |
|
204 |
186 |
$2K |
| 81001 |
|
1,023 |
887 |
$2K |
| 96365 |
|
200 |
170 |
$2K |
| 82962 |
|
420 |
166 |
$2K |
| 96360 |
|
12 |
12 |
$2K |
| 84484 |
|
605 |
417 |
$2K |
| 73562 |
|
38 |
37 |
$2K |
| 87070 |
|
646 |
603 |
$1K |
| 87880 |
|
12 |
12 |
$944.73 |
| 80307 |
|
43 |
37 |
$929.52 |
| 85025 |
|
1,748 |
1,266 |
$561.79 |
| 87635 |
|
34 |
32 |
$464.88 |
| 82947 |
|
72 |
20 |
$423.74 |
| 74018 |
|
13 |
12 |
$405.49 |
| 87186 |
|
166 |
147 |
$296.57 |
| 73030 |
|
15 |
13 |
$281.32 |
| J7030 |
Normal saline solution infus |
675 |
514 |
$241.49 |
| 93005 |
|
734 |
619 |
$230.86 |
| 73630 |
|
16 |
12 |
$203.41 |
| 96375 |
|
382 |
317 |
$179.97 |
| J1885 |
Ketorolac tromethamine inj |
480 |
405 |
$115.75 |
| J2704 |
Inj, propofol, 10 mg |
44 |
38 |
$93.22 |
| J0696 |
Ceftriaxone sodium injection |
295 |
236 |
$78.60 |
| J2274 |
Inj morphine pf epid ithc |
82 |
55 |
$69.98 |
| 72125 |
|
13 |
12 |
$68.92 |
| 83735 |
|
352 |
267 |
$66.45 |
| 87651 |
|
13 |
13 |
$64.86 |
| 94760 |
|
270 |
204 |
$60.57 |
| 83690 |
|
393 |
335 |
$59.45 |
| 87040 |
|
16 |
12 |
$54.12 |
| 84443 |
|
64 |
60 |
$32.59 |
| 87088 |
|
134 |
123 |
$27.06 |
| 83605 |
|
16 |
14 |
$27.06 |
| 85379 |
|
89 |
79 |
$20.19 |
| 83880 |
|
66 |
53 |
$20.19 |
| 85610 |
|
230 |
201 |
$16.90 |
| 85730 |
|
188 |
164 |
$15.64 |
| J2405 |
Ondansetron hcl injection |
407 |
326 |
$13.55 |
| J2270 |
Morphine sulfate injection |
152 |
105 |
$0.00 |
| J7040 |
Normal saline solution infus |
95 |
83 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
67 |
55 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
282 |
240 |
$0.00 |
| Q0162 |
Ondansetron oral |
47 |
43 |
$0.00 |
| 85027 |
|
16 |
12 |
$0.00 |
| 82550 |
|
50 |
43 |
$0.00 |
| 82553 |
|
16 |
14 |
$0.00 |
| 76801 |
|
13 |
12 |
$0.00 |
| J2060 |
Lorazepam injection |
18 |
13 |
$0.00 |