| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
13,733 |
12,716 |
$949K |
| 99285 |
|
3,530 |
3,135 |
$923K |
| 99283 |
|
15,118 |
14,171 |
$653K |
| 87635 |
|
7,437 |
7,105 |
$353K |
| G0463 |
Hospital outpt clinic visit |
7,485 |
6,071 |
$298K |
| 80053 |
|
22,516 |
18,618 |
$233K |
| 85025 |
|
25,737 |
20,807 |
$213K |
| 87502 |
|
3,154 |
3,040 |
$197K |
| J9312 |
Inj., rituximab, 10 mg |
16 |
12 |
$143K |
| 93005 |
|
7,247 |
6,519 |
$88K |
| 96413 |
|
1,119 |
597 |
$82K |
| 87651 |
|
1,465 |
1,414 |
$57K |
| 99282 |
|
1,035 |
976 |
$46K |
| 97602 |
|
1,773 |
749 |
$43K |
| 74177 |
|
246 |
226 |
$42K |
| 81001 |
|
8,551 |
7,953 |
$37K |
| 70450 |
|
331 |
291 |
$29K |
| 87400 |
|
2,146 |
2,029 |
$27K |
| 71046 |
|
1,969 |
1,844 |
$22K |
| 84484 |
|
1,357 |
1,169 |
$17K |
| G0480 |
Drug test def 1-7 classes |
797 |
322 |
$17K |
| 87088 |
|
1,645 |
1,490 |
$16K |
| 96375 |
|
513 |
232 |
$15K |
| 87430 |
|
770 |
743 |
$15K |
| 87634 |
|
195 |
191 |
$12K |
| 96374 |
|
111 |
78 |
$9K |
| 81025 |
|
2,282 |
2,148 |
$8K |
| 83735 |
|
1,272 |
1,043 |
$8K |
| 71045 |
|
1,168 |
1,060 |
$8K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,630 |
842 |
$8K |
| 83605 |
|
747 |
640 |
$6K |
| 83690 |
|
762 |
721 |
$6K |
| 87081 |
|
398 |
386 |
$5K |
| M0243 |
Casirivi and imdevi inj |
50 |
48 |
$3K |
| 87420 |
|
170 |
162 |
$3K |
| 85610 |
|
1,028 |
842 |
$3K |
| 43239 |
|
13 |
12 |
$3K |
| J2469 |
Palonosetron hcl |
16 |
12 |
$3K |
| 74176 |
|
34 |
32 |
$3K |
| 93306 |
|
41 |
29 |
$2K |
| 80048 |
|
223 |
205 |
$2K |
| 86900 |
|
83 |
54 |
$2K |
| 96415 |
|
38 |
25 |
$2K |
| J1885 |
Ketorolac tromethamine inj |
2,223 |
2,085 |
$2K |
| 82553 |
|
122 |
117 |
$1K |
| 86850 |
|
83 |
54 |
$1K |
| 82550 |
|
143 |
130 |
$816.00 |
| 86901 |
|
84 |
54 |
$724.04 |
| 86300 |
|
39 |
37 |
$629.20 |
| 85730 |
|
270 |
218 |
$602.95 |
| 36415 |
|
146 |
94 |
$515.34 |
| J2930 |
Methylprednisolone injection |
91 |
74 |
$504.69 |
| J1100 |
Dexamethasone sodium phos |
464 |
338 |
$461.52 |
| J7030 |
Normal saline solution infus |
270 |
251 |
$364.59 |
| 85027 |
|
121 |
63 |
$355.02 |
| 82962 |
|
1,349 |
1,179 |
$329.45 |
| J7050 |
Normal saline solution infus |
568 |
210 |
$304.05 |
| 84703 |
|
46 |
43 |
$281.26 |
| 87077 |
|
145 |
110 |
$279.40 |
| 73130 |
|
21 |
12 |
$242.25 |
| 73630 |
|
12 |
12 |
$200.10 |
| J2405 |
Ondansetron hcl injection |
821 |
679 |
$178.58 |
| 83615 |
|
34 |
30 |
$168.00 |
| 85379 |
|
17 |
15 |
$148.20 |
| J2270 |
Morphine sulfate injection |
50 |
43 |
$129.81 |
| 87070 |
|
13 |
12 |
$111.93 |
| J0696 |
Ceftriaxone sodium injection |
57 |
52 |
$72.75 |
| J7120 |
Ringers lactate infusion |
78 |
74 |
$55.94 |
| 87205 |
|
13 |
12 |
$49.63 |
| J7040 |
Normal saline solution infus |
16 |
12 |
$18.75 |
| J2765 |
Metoclopramide hcl injection |
14 |
13 |
$12.72 |
| 87186 |
|
106 |
74 |
$10.44 |
| J0690 |
Cefazolin sodium injection |
64 |
62 |
$5.48 |
| J2704 |
Inj, propofol, 10 mg |
178 |
165 |
$2.60 |
| J3010 |
Fentanyl citrate injection |
98 |
88 |
$0.72 |
| J2250 |
Inj midazolam hydrochloride |
40 |
38 |
$0.52 |
| G1004 |
Cdsm ndsc |
192 |
137 |
$0.02 |
| 85018 |
|
19 |
12 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
27 |
25 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
15 |
12 |
$0.00 |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
21 |
12 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
39 |
26 |
$0.00 |
| 85014 |
|
19 |
12 |
$0.00 |