| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
13,494 |
10,701 |
$659K |
| 99282 |
|
4,243 |
3,587 |
$204K |
| 99284 |
|
4,418 |
2,923 |
$126K |
| 87502 |
|
984 |
922 |
$123K |
| 87635 |
|
2,386 |
2,300 |
$121K |
| 80053 |
|
8,825 |
7,859 |
$104K |
| 85025 |
|
7,812 |
6,890 |
$40K |
| 76816 |
|
312 |
293 |
$19K |
| 99070 |
|
2,384 |
2,060 |
$17K |
| 96374 |
|
636 |
531 |
$15K |
| 96375 |
|
384 |
289 |
$15K |
| 81001 |
|
3,215 |
2,895 |
$13K |
| 96361 |
|
507 |
425 |
$12K |
| 87634 |
|
125 |
117 |
$11K |
| 96372 |
|
200 |
151 |
$7K |
| 97110 |
|
140 |
48 |
$6K |
| 87086 |
|
369 |
318 |
$5K |
| G0378 |
Hospital observation per hr |
73 |
58 |
$5K |
| 93005 |
|
430 |
348 |
$4K |
| 71045 |
|
408 |
351 |
$4K |
| 96365 |
|
75 |
32 |
$3K |
| 71046 |
|
179 |
154 |
$3K |
| 84443 |
|
143 |
136 |
$2K |
| 20610 |
|
21 |
13 |
$2K |
| 87807 |
|
55 |
49 |
$1K |
| 99213 |
|
264 |
181 |
$1K |
| 85027 |
|
123 |
96 |
$1K |
| 86140 |
|
187 |
163 |
$1K |
| 87426 |
|
19 |
19 |
$1K |
| 80048 |
|
112 |
83 |
$910.07 |
| J1885 |
Ketorolac tromethamine inj |
430 |
355 |
$864.73 |
| 84484 |
|
121 |
81 |
$823.65 |
| 96376 |
|
33 |
15 |
$800.20 |
| 59025 |
|
23 |
12 |
$778.20 |
| 96360 |
|
13 |
12 |
$773.38 |
| 94640 |
|
68 |
42 |
$753.39 |
| 77067 |
|
14 |
14 |
$674.65 |
| 86738 |
|
67 |
57 |
$630.97 |
| 83690 |
|
78 |
65 |
$612.63 |
| 86592 |
|
73 |
71 |
$612.49 |
| 87430 |
|
29 |
28 |
$562.64 |
| 87040 |
|
36 |
30 |
$552.25 |
| 87660 |
|
12 |
12 |
$544.14 |
| 87186 |
|
38 |
35 |
$543.07 |
| 84439 |
|
41 |
37 |
$495.64 |
| 74019 |
|
45 |
33 |
$472.90 |
| 87077 |
|
38 |
35 |
$431.34 |
| 80305 |
|
18 |
15 |
$422.73 |
| 81025 |
|
30 |
28 |
$411.53 |
| 86850 |
|
29 |
28 |
$382.38 |
| 80320 |
|
14 |
12 |
$354.71 |
| 83036 |
|
32 |
31 |
$352.96 |
| 83605 |
|
66 |
46 |
$334.42 |
| A0425 |
Ground mileage |
1,666 |
1,325 |
$331.14 |
| 87081 |
|
25 |
25 |
$316.00 |
| 86901 |
|
30 |
28 |
$278.46 |
| 36415 |
|
7,062 |
5,827 |
$264.93 |
| 73564 |
|
14 |
13 |
$248.28 |
| 87071 |
|
19 |
19 |
$238.45 |
| 87510 |
|
12 |
12 |
$231.00 |
| 87480 |
|
12 |
12 |
$231.00 |
| 82247 |
|
21 |
12 |
$221.76 |
| 86900 |
|
30 |
28 |
$218.14 |
| J1170 |
Hydromorphone injection |
60 |
31 |
$207.66 |
| 84481 |
|
15 |
12 |
$202.75 |
| 87205 |
|
30 |
28 |
$193.01 |
| 85007 |
|
69 |
50 |
$179.70 |
| 83735 |
|
51 |
40 |
$168.41 |
| 85379 |
|
14 |
12 |
$149.10 |
| J0690 |
Cefazolin sodium injection |
52 |
48 |
$135.89 |
| 87070 |
|
14 |
13 |
$111.37 |
| J2550 |
Promethazine hcl injection |
18 |
14 |
$104.04 |
| J2405 |
Ondansetron hcl injection |
181 |
142 |
$101.60 |
| 85610 |
|
64 |
41 |
$79.45 |
| 85651 |
|
17 |
13 |
$79.32 |
| J1100 |
Dexamethasone sodium phos |
36 |
29 |
$57.24 |
| J0696 |
Ceftriaxone sodium injection |
17 |
15 |
$48.77 |
| J2704 |
Inj, propofol, 10 mg |
184 |
163 |
$33.56 |
| 99212 |
|
114 |
88 |
$23.59 |
| J3010 |
Fentanyl citrate injection |
60 |
49 |
$19.72 |
| G2211 |
Complex e/m visit add on |
49 |
26 |
$2.74 |
| J3301 |
Triamcinolone acet inj nos |
29 |
25 |
$1.98 |
| J2250 |
Inj midazolam hydrochloride |
16 |
14 |
$0.12 |
| A9270 |
Non-covered item or service |
547 |
161 |
$0.00 |
| A0427 |
Als1-emergency |
604 |
522 |
$0.00 |
| 99000 |
|
12 |
12 |
$0.00 |
| A0429 |
Bls-emergency |
40 |
35 |
$0.00 |