| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
|
17,359 |
15,502 |
$1.04M |
| 74177 |
|
1,951 |
1,798 |
$561K |
| 99499 |
|
9,576 |
8,331 |
$557K |
| 99283 |
|
2,113 |
1,950 |
$399K |
| 70450 |
|
2,113 |
1,939 |
$283K |
| 99284 |
|
1,594 |
1,490 |
$238K |
| 96374 |
|
4,188 |
3,693 |
$202K |
| 80053 |
|
12,854 |
10,635 |
$151K |
| 93005 |
|
7,204 |
6,355 |
$144K |
| 99285 |
|
354 |
303 |
$140K |
| 0272 |
|
1,089 |
945 |
$111K |
| 96361 |
|
2,863 |
2,280 |
$104K |
| 96372 |
|
3,502 |
2,939 |
$83K |
| 85027 |
|
16,162 |
12,777 |
$82K |
| 71045 |
|
6,119 |
5,454 |
$78K |
| 80307 |
|
1,119 |
940 |
$76K |
| 83690 |
|
8,125 |
7,158 |
$55K |
| 96375 |
|
2,009 |
1,637 |
$52K |
| 74176 |
|
103 |
99 |
$52K |
| 84484 |
|
6,061 |
5,043 |
$50K |
| 96360 |
|
577 |
506 |
$37K |
| 76856 |
|
506 |
456 |
$36K |
| 72125 |
|
261 |
245 |
$34K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
3,114 |
1,896 |
$31K |
| 80048 |
|
3,023 |
2,325 |
$29K |
| 84703 |
|
3,127 |
2,726 |
$26K |
| 99282 |
|
38 |
37 |
$22K |
| 76705 |
|
379 |
358 |
$20K |
| 71046 |
|
532 |
486 |
$19K |
| 83880 |
|
1,000 |
885 |
$18K |
| J3490 |
Drugs unclassified injection |
10,180 |
7,093 |
$12K |
| J7120 |
Ringers lactate infusion |
2,257 |
2,016 |
$11K |
| 0250 |
|
5,185 |
2,562 |
$10K |
| 76830 |
|
137 |
131 |
$10K |
| A0429 |
Bls-emergency |
314 |
233 |
$10K |
| J1885 |
Ketorolac tromethamine inj |
3,204 |
1,870 |
$10K |
| 81001 |
|
3,387 |
3,089 |
$9K |
| 87635 |
|
305 |
275 |
$8K |
| 87426 |
|
490 |
469 |
$8K |
| 85610 |
|
2,123 |
1,869 |
$8K |
| G0378 |
Hospital observation per hr |
50 |
40 |
$8K |
| 86850 |
|
604 |
571 |
$7K |
| 85730 |
|
1,414 |
1,175 |
$7K |
| 0270 |
|
2,003 |
1,261 |
$6K |
| 86901 |
|
1,592 |
1,451 |
$5K |
| 86900 |
|
1,588 |
1,448 |
$5K |
| 84702 |
|
324 |
252 |
$4K |
| 0259 |
|
124 |
115 |
$4K |
| 87040 |
|
417 |
311 |
$4K |
| 99281 |
|
74 |
70 |
$4K |
| 87633 |
|
18 |
15 |
$3K |
| 73630 |
|
120 |
105 |
$3K |
| J7030 |
Normal saline solution infus |
862 |
705 |
$3K |
| J0696 |
Ceftriaxone sodium injection |
685 |
613 |
$3K |
| 96365 |
|
67 |
64 |
$3K |
| 87502 |
|
37 |
26 |
$3K |
| J2405 |
Ondansetron hcl injection |
1,397 |
1,185 |
$3K |
| 83605 |
|
377 |
293 |
$2K |
| 73562 |
|
137 |
123 |
$2K |
| 73610 |
|
94 |
91 |
$2K |
| 87631 |
|
34 |
34 |
$2K |
| 76801 |
|
28 |
26 |
$2K |
| 96376 |
|
147 |
79 |
$1K |
| 83735 |
|
661 |
338 |
$1K |
| 82150 |
|
70 |
65 |
$1K |
| 73110 |
|
14 |
14 |
$1K |
| 73130 |
|
54 |
48 |
$919.11 |
| J2270 |
Morphine sulfate injection |
267 |
226 |
$801.69 |
| 90471 |
|
75 |
71 |
$629.26 |
| 84443 |
|
74 |
67 |
$522.60 |
| 93971 |
|
12 |
12 |
$511.52 |
| J1170 |
Hydromorphone injection |
158 |
122 |
$486.82 |
| 73030 |
|
26 |
25 |
$371.08 |
| 87086 |
|
84 |
78 |
$338.46 |
| 87486 |
|
18 |
15 |
$331.68 |
| 87581 |
|
18 |
15 |
$331.68 |
| 87798 |
|
18 |
15 |
$272.53 |
| 80061 |
|
60 |
56 |
$269.86 |
| 94640 |
|
16 |
12 |
$247.39 |
| 83036 |
|
70 |
65 |
$203.92 |
| 86140 |
|
35 |
27 |
$127.44 |
| J1100 |
Dexamethasone sodium phos |
55 |
37 |
$123.80 |
| 84439 |
|
17 |
14 |
$76.22 |
| J3010 |
Fentanyl citrate injection |
35 |
31 |
$36.50 |
| 84100 |
|
41 |
16 |
$31.74 |
| J7050 |
Normal saline solution infus |
40 |
34 |
$30.34 |
| A9270 |
Non-covered item or service |
1,006 |
283 |
$2.68 |
| 0301 |
|
48 |
14 |
$0.00 |
| 0636 |
|
28 |
27 |
$0.00 |
| 0305 |
|
43 |
42 |
$0.00 |
| 0302 |
|
14 |
13 |
$0.00 |
| G1003 |
Cdsm medicalis |
39 |
38 |
$0.00 |