| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
1,432 |
1,245 |
$384K |
| 99285 |
|
1,040 |
846 |
$343K |
| 99283 |
|
1,032 |
945 |
$223K |
| 74176 |
|
248 |
225 |
$122K |
| 74177 |
|
174 |
154 |
$109K |
| 99282 |
|
701 |
647 |
$90K |
| 96361 |
|
857 |
702 |
$51K |
| 70450 |
|
376 |
313 |
$35K |
| 72125 |
|
93 |
74 |
$25K |
| 77067 |
|
123 |
106 |
$12K |
| 71046 |
|
586 |
531 |
$11K |
| 45380 |
|
13 |
12 |
$10K |
| 76856 |
|
88 |
85 |
$9K |
| 96372 |
|
510 |
408 |
$9K |
| 76700 |
|
58 |
56 |
$6K |
| 80053 |
|
2,071 |
1,618 |
$5K |
| 96365 |
|
349 |
254 |
$5K |
| 99212 |
|
18 |
12 |
$4K |
| G0378 |
Hospital observation per hr |
305 |
138 |
$4K |
| 96375 |
|
631 |
510 |
$3K |
| 96360 |
|
430 |
338 |
$3K |
| 76805 |
|
39 |
36 |
$3K |
| 80307 |
|
424 |
364 |
$2K |
| 74018 |
|
100 |
93 |
$2K |
| 88305 |
|
191 |
124 |
$2K |
| 76705 |
|
64 |
59 |
$2K |
| 73562 |
|
58 |
58 |
$2K |
| 93005 |
|
984 |
746 |
$2K |
| 73030 |
|
67 |
63 |
$1K |
| 76801 |
|
17 |
12 |
$933.93 |
| 76830 |
|
65 |
61 |
$676.76 |
| 87077 |
|
144 |
107 |
$629.70 |
| 96374 |
|
872 |
736 |
$614.18 |
| 73630 |
|
34 |
31 |
$522.73 |
| 73130 |
|
28 |
26 |
$367.60 |
| 81001 |
|
822 |
676 |
$352.30 |
| 71045 |
|
574 |
489 |
$331.73 |
| 81025 |
|
342 |
305 |
$278.08 |
| 85025 |
|
2,132 |
1,672 |
$277.51 |
| 84702 |
|
34 |
28 |
$238.82 |
| 73610 |
|
31 |
28 |
$204.28 |
| 59025 |
|
67 |
39 |
$196.88 |
| 80048 |
|
245 |
180 |
$171.41 |
| 86850 |
|
24 |
19 |
$169.93 |
| 83690 |
|
529 |
445 |
$164.43 |
| 83605 |
|
374 |
264 |
$161.00 |
| 83880 |
|
129 |
90 |
$105.25 |
| 36415 |
|
240 |
187 |
$55.69 |
| 96376 |
|
159 |
108 |
$50.40 |
| 84443 |
|
78 |
66 |
$38.26 |
| 85027 |
|
209 |
160 |
$30.69 |
| 85730 |
|
168 |
142 |
$22.14 |
| 87086 |
|
468 |
390 |
$20.92 |
| 94640 |
|
320 |
203 |
$18.30 |
| 83735 |
|
361 |
258 |
$17.75 |
| 87088 |
|
328 |
266 |
$13.05 |
| J2405 |
Ondansetron hcl injection |
708 |
584 |
$9.98 |
| J7030 |
Normal saline solution infus |
291 |
229 |
$7.20 |
| J0696 |
Ceftriaxone sodium injection |
177 |
148 |
$7.08 |
| 87186 |
|
108 |
90 |
$6.06 |
| J3010 |
Fentanyl citrate injection |
323 |
259 |
$0.76 |
| J2550 |
Promethazine hcl injection |
30 |
25 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
135 |
103 |
$0.00 |
| 81003 |
|
413 |
354 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
316 |
281 |
$0.00 |
| J2930 |
Methylprednisolone injection |
57 |
43 |
$0.00 |
| 85610 |
|
330 |
275 |
$0.00 |
| 82947 |
|
386 |
205 |
$0.00 |
| J7120 |
Ringers lactate infusion |
123 |
109 |
$0.00 |
| J2270 |
Morphine sulfate injection |
102 |
84 |
$0.00 |
| 86900 |
|
40 |
32 |
$0.00 |
| J8499 |
Oral prescrip drug non chemo |
68 |
33 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
14 |
12 |
$0.00 |
| 90715 |
|
30 |
28 |
$0.00 |
| 87804 |
|
508 |
240 |
$0.00 |
| 87880 |
|
58 |
52 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
14 |
12 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
333 |
293 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
51 |
43 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
195 |
174 |
$0.00 |
| 84484 |
|
752 |
497 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
593 |
503 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
142 |
125 |
$0.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
13 |
13 |
$0.00 |
| 80320 |
|
325 |
286 |
$0.00 |
| J8597 |
Antiemetic drug oral nos |
203 |
170 |
$0.00 |
| A9270 |
Non-covered item or service |
1,150 |
233 |
$0.00 |
| 84703 |
|
68 |
64 |
$0.00 |
| 87807 |
|
47 |
47 |
$0.00 |
| 87040 |
|
215 |
96 |
$0.00 |
| 87081 |
|
74 |
70 |
$0.00 |
| J2060 |
Lorazepam injection |
42 |
37 |
$0.00 |
| 80329 |
|
135 |
127 |
$0.00 |
| 86901 |
|
41 |
32 |
$0.00 |
| J3490 |
Drugs unclassified injection |
71 |
31 |
$0.00 |
| 90471 |
|
30 |
28 |
$0.00 |
| J1170 |
Hydromorphone injection |
19 |
17 |
$0.00 |