| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
7,731 |
7,055 |
$869K |
| 99283 |
|
7,169 |
6,747 |
$645K |
| 99285 |
|
1,941 |
1,710 |
$164K |
| G0463 |
Hospital outpt clinic visit |
1,715 |
1,336 |
$161K |
| 59025 |
|
1,888 |
1,249 |
$159K |
| 87637 |
|
2,105 |
1,987 |
$94K |
| 96361 |
|
655 |
600 |
$52K |
| 92587 |
|
857 |
810 |
$37K |
| 99282 |
|
187 |
177 |
$20K |
| 76815 |
|
357 |
314 |
$17K |
| 74177 |
|
48 |
42 |
$12K |
| 70450 |
|
56 |
51 |
$8K |
| 96374 |
|
2,410 |
2,161 |
$2K |
| 97597 |
|
43 |
25 |
$2K |
| 80053 |
|
5,089 |
4,533 |
$2K |
| 71045 |
|
845 |
762 |
$2K |
| 87081 |
|
348 |
333 |
$1K |
| 01999 |
|
59 |
51 |
$1K |
| 85025 |
|
5,602 |
4,947 |
$873.63 |
| 93005 |
|
719 |
616 |
$779.83 |
| 96372 |
|
846 |
770 |
$546.86 |
| J1100 |
Dexamethasone sodium phos |
430 |
400 |
$500.02 |
| J1885 |
Ketorolac tromethamine inj |
903 |
804 |
$336.68 |
| 80048 |
|
59 |
58 |
$328.59 |
| 96375 |
|
752 |
674 |
$87.00 |
| 81001 |
|
1,301 |
1,174 |
$83.84 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
93 |
80 |
$66.77 |
| 71046 |
|
142 |
135 |
$66.77 |
| 87086 |
|
161 |
144 |
$45.61 |
| 84703 |
|
400 |
362 |
$40.61 |
| 82274 |
|
18 |
17 |
$37.68 |
| J7510 |
Prednisolone oral per 5 mg |
26 |
26 |
$31.98 |
| 83690 |
|
264 |
230 |
$22.44 |
| J2405 |
Ondansetron hcl injection |
164 |
145 |
$6.23 |
| 81003 |
|
404 |
357 |
$5.20 |
| 87651 |
|
139 |
134 |
$0.00 |
| J2765 |
Metoclopramide hcl injection |
14 |
12 |
$0.00 |
| 76819 |
|
15 |
13 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
32 |
27 |
$0.00 |
| 84484 |
|
102 |
63 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
30 |
13 |
$0.00 |
| 83735 |
|
29 |
27 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
13 |
12 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
19 |
14 |
$0.00 |
| 84702 |
|
14 |
12 |
$0.00 |
| J7120 |
Ringers lactate infusion |
123 |
106 |
$0.00 |