| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
2,301 |
2,098 |
$590K |
| 99285 |
|
1,398 |
1,255 |
$529K |
| 99283 |
|
2,238 |
2,121 |
$413K |
| 74177 |
|
310 |
296 |
$128K |
| 87631 |
|
992 |
943 |
$116K |
| 70450 |
|
431 |
402 |
$109K |
| 93005 |
|
1,313 |
1,147 |
$102K |
| 96375 |
|
1,273 |
1,095 |
$99K |
| 74176 |
|
317 |
294 |
$88K |
| 96361 |
|
684 |
627 |
$78K |
| 99282 |
|
657 |
627 |
$76K |
| 96365 |
|
557 |
464 |
$66K |
| 71045 |
|
1,016 |
911 |
$61K |
| 96374 |
|
1,517 |
1,298 |
$56K |
| 94640 |
|
259 |
195 |
$34K |
| 80053 |
|
2,652 |
2,282 |
$33K |
| 71250 |
|
136 |
133 |
$29K |
| 71046 |
|
386 |
370 |
$28K |
| 80307 |
|
546 |
493 |
$28K |
| 96372 |
|
885 |
813 |
$27K |
| 73610 |
|
221 |
204 |
$26K |
| 72125 |
|
90 |
86 |
$25K |
| 97110 |
|
416 |
115 |
$24K |
| 85025 |
|
2,977 |
2,526 |
$22K |
| 72100 |
|
119 |
113 |
$13K |
| 36415 |
|
1,752 |
1,557 |
$12K |
| 97530 |
|
198 |
85 |
$12K |
| 83880 |
|
459 |
404 |
$12K |
| 73030 |
|
123 |
105 |
$11K |
| 73562 |
|
112 |
95 |
$11K |
| 73130 |
|
163 |
145 |
$11K |
| 73110 |
|
148 |
132 |
$10K |
| 84484 |
|
905 |
775 |
$10K |
| 96360 |
|
110 |
103 |
$9K |
| 99281 |
|
119 |
113 |
$8K |
| 77067 |
|
50 |
50 |
$7K |
| 87880 |
|
385 |
369 |
$7K |
| 81001 |
|
1,509 |
1,389 |
$7K |
| 96366 |
|
200 |
170 |
$6K |
| 73630 |
|
95 |
88 |
$6K |
| 80320 |
|
395 |
356 |
$6K |
| 83690 |
|
641 |
570 |
$6K |
| 80048 |
|
400 |
359 |
$5K |
| 80143 |
|
170 |
157 |
$5K |
| 80179 |
|
168 |
155 |
$5K |
| 84703 |
|
538 |
513 |
$5K |
| 76700 |
|
37 |
37 |
$4K |
| 87086 |
|
468 |
438 |
$4K |
| 82962 |
|
342 |
259 |
$4K |
| 84443 |
|
292 |
276 |
$4K |
| 87070 |
|
314 |
296 |
$4K |
| 83605 |
|
293 |
257 |
$3K |
| G0480 |
Drug test def 1-7 classes |
37 |
36 |
$3K |
| 70486 |
|
12 |
12 |
$3K |
| 76705 |
|
25 |
25 |
$3K |
| 90471 |
|
119 |
112 |
$3K |
| 87040 |
|
156 |
139 |
$2K |
| 83735 |
|
250 |
206 |
$2K |
| 85610 |
|
425 |
384 |
$2K |
| 82550 |
|
205 |
192 |
$2K |
| 97140 |
|
26 |
12 |
$1K |
| 85379 |
|
149 |
134 |
$1K |
| 73502 |
|
15 |
12 |
$952.18 |
| 83036 |
|
73 |
71 |
$917.70 |
| 77063 |
|
26 |
26 |
$538.19 |
| J7030 |
Normal saline solution infus |
250 |
201 |
$451.53 |
| 82553 |
|
52 |
50 |
$443.93 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
27 |
25 |
$392.75 |
| 96368 |
|
12 |
12 |
$365.68 |
| 87804 |
|
15 |
15 |
$361.52 |
| 82140 |
|
15 |
15 |
$275.04 |
| 80061 |
|
18 |
18 |
$256.47 |
| J0696 |
Ceftriaxone sodium injection |
26 |
25 |
$251.01 |
| 85027 |
|
40 |
39 |
$219.93 |
| J2704 |
Inj, propofol, 10 mg |
53 |
48 |
$213.43 |
| 87186 |
|
29 |
28 |
$212.98 |
| 96376 |
|
212 |
187 |
$210.54 |
| 87077 |
|
29 |
27 |
$162.68 |
| 81003 |
|
83 |
80 |
$157.68 |
| 85730 |
|
12 |
12 |
$50.34 |
| 85652 |
|
13 |
12 |
$35.24 |
| J3010 |
Fentanyl citrate injection |
66 |
56 |
$27.93 |
| J2405 |
Ondansetron hcl injection |
45 |
39 |
$27.87 |
| J1885 |
Ketorolac tromethamine inj |
45 |
42 |
$20.97 |
| J2250 |
Inj midazolam hydrochloride |
22 |
18 |
$13.21 |
| A9270 |
Non-covered item or service |
22 |
14 |
$0.00 |