| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 36415 |
|
27,868 |
26,208 |
$2.24M |
| 88305 |
|
4,410 |
4,290 |
$495K |
| 70553 |
|
332 |
330 |
$480K |
| 77066 |
Tomosynthesis, mammo |
2,663 |
2,609 |
$343K |
| 69436 |
|
3,047 |
2,951 |
$309K |
| 88300 |
|
2,248 |
2,226 |
$266K |
| 76770 |
|
1,841 |
1,833 |
$259K |
| 76642 |
|
7,115 |
5,949 |
$239K |
| 73721 |
|
297 |
293 |
$212K |
| 81025 |
|
1,277 |
1,259 |
$198K |
| 74018 |
|
5,953 |
5,732 |
$172K |
| 42830 |
|
928 |
915 |
$154K |
| 42820 |
|
1,838 |
1,827 |
$148K |
| 77065 |
Tomosynthesis, mammo |
2,636 |
2,429 |
$143K |
| 72148 |
|
151 |
150 |
$76K |
| 87070 |
|
1,246 |
1,211 |
$73K |
| 77072 |
|
2,302 |
2,274 |
$54K |
| 82565 |
|
186 |
183 |
$40K |
| 82657 |
|
310 |
306 |
$39K |
| 70551 |
|
57 |
57 |
$39K |
| 88304 |
|
392 |
387 |
$39K |
| 77067 |
|
1,222 |
1,207 |
$37K |
| 71046 |
|
2,369 |
2,294 |
$36K |
| 87081 |
|
211 |
209 |
$32K |
| 43239 |
|
2,459 |
2,431 |
$26K |
| J7120 |
Ringers lactate infusion |
12,067 |
11,803 |
$25K |
| 77063 |
|
248 |
244 |
$25K |
| 74177 |
|
182 |
181 |
$21K |
| 76775 |
|
218 |
215 |
$20K |
| 76705 |
|
164 |
162 |
$14K |
| 72141 |
|
13 |
13 |
$13K |
| 76700 |
|
70 |
70 |
$11K |
| 87086 |
|
439 |
410 |
$10K |
| 71250 |
|
24 |
24 |
$9K |
| 80053 |
|
9,995 |
9,623 |
$9K |
| 19083 |
|
337 |
306 |
$9K |
| 71260 |
|
25 |
25 |
$7K |
| 76830 |
|
12 |
12 |
$5K |
| D2930 |
|
28 |
27 |
$5K |
| A4648 |
Implantable tissue marker |
484 |
459 |
$4K |
| 73630 |
|
51 |
50 |
$4K |
| 00170 |
|
42 |
42 |
$3K |
| 54161 |
|
114 |
112 |
$3K |
| J0690 |
Cefazolin sodium injection |
3,494 |
3,407 |
$3K |
| 87077 |
|
274 |
265 |
$3K |
| 78264 |
|
12 |
12 |
$3K |
| 81001 |
|
797 |
760 |
$2K |
| 82784 |
|
2,777 |
2,709 |
$1K |
| G1004 |
Cdsm ndsc |
1,489 |
1,402 |
$1K |
| 82570 |
|
1,444 |
1,417 |
$1K |
| A9585 |
Gadobutrol injection |
1,439 |
1,384 |
$1K |
| 72100 |
|
38 |
38 |
$1K |
| 80069 |
|
1,134 |
1,065 |
$957.82 |
| 84443 |
|
7,923 |
7,740 |
$944.31 |
| 93976 |
|
24 |
24 |
$734.51 |
| 00126 |
|
12 |
12 |
$588.49 |
| 80061 |
|
3,045 |
2,998 |
$587.07 |
| 86140 |
|
3,418 |
3,301 |
$562.34 |
| 82785 |
|
1,085 |
1,069 |
$489.23 |
| 82306 |
|
4,143 |
4,046 |
$418.95 |
| 82043 |
|
636 |
635 |
$397.97 |
| 76856 |
|
12 |
12 |
$387.73 |
| 80048 |
|
1,365 |
1,254 |
$343.28 |
| 83036 |
|
2,083 |
2,039 |
$311.98 |
| 83516 |
|
2,037 |
2,001 |
$268.52 |
| 73130 |
|
16 |
16 |
$249.55 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,116 |
1,072 |
$216.00 |
| G0279 |
Tomosynthesis, mammo |
1,918 |
1,878 |
$208.88 |
| 82670 |
|
135 |
134 |
$182.15 |
| 80307 |
|
13 |
12 |
$172.77 |
| 85025 |
|
8,367 |
8,014 |
$149.82 |
| 76942 |
|
83 |
76 |
$138.47 |
| J1100 |
Dexamethasone sodium phos |
6,365 |
6,215 |
$129.21 |
| 82310 |
|
15 |
14 |
$127.36 |
| 80197 |
|
110 |
86 |
$117.03 |
| 84403 |
|
435 |
427 |
$115.88 |
| 86003 |
|
689 |
680 |
$99.18 |
| 84439 |
|
4,366 |
4,260 |
$93.83 |
| 80076 |
|
772 |
736 |
$93.15 |
| 82728 |
|
1,281 |
1,244 |
$69.49 |
| J2405 |
Ondansetron hcl injection |
7,859 |
7,613 |
$59.79 |
| 86255 |
|
964 |
933 |
$48.72 |
| 81003 |
|
99 |
97 |
$35.48 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
900 |
629 |
$29.45 |
| J1885 |
Ketorolac tromethamine inj |
90 |
86 |
$28.41 |
| 85027 |
|
3,495 |
3,333 |
$12.49 |
| J3010 |
Fentanyl citrate injection |
5,259 |
5,176 |
$11.84 |
| J2270 |
Morphine sulfate injection |
1,006 |
968 |
$7.68 |
| 86317 |
|
176 |
172 |
$0.00 |
| 83735 |
|
2,170 |
2,016 |
$0.00 |
| 86800 |
|
429 |
426 |
$0.00 |
| J1170 |
Hydromorphone injection |
2,506 |
2,138 |
$0.00 |
| 83519 |
|
657 |
644 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
751 |
733 |
$0.00 |
| J3490 |
Drugs unclassified injection |
5,027 |
4,108 |
$0.00 |
| 83001 |
|
209 |
204 |
$0.00 |
| 82550 |
|
98 |
94 |
$0.00 |
| 87205 |
|
1,174 |
1,140 |
$0.00 |
| 86160 |
|
121 |
117 |
$0.00 |
| 86376 |
|
674 |
665 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
198 |
196 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
1,914 |
1,839 |
$0.00 |
| 83520 |
|
80 |
80 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
90 |
88 |
$0.00 |
| 85651 |
|
2,937 |
2,867 |
$0.00 |
| 85652 |
|
1,121 |
1,100 |
$0.00 |
| 82607 |
|
240 |
238 |
$0.00 |
| 83002 |
|
258 |
253 |
$0.00 |
| 80177 |
|
13 |
12 |
$0.00 |
| 42821 |
|
25 |
25 |
$0.00 |
| 84480 |
|
42 |
41 |
$0.00 |
| 83498 |
|
26 |
25 |
$0.00 |
| 83880 |
|
28 |
28 |
$0.00 |
| 86364 |
|
79 |
78 |
$0.00 |
| 82533 |
|
13 |
12 |
$0.00 |
| 87340 |
|
12 |
12 |
$0.00 |
| 45380 |
|
39 |
37 |
$0.00 |
| 84134 |
|
27 |
27 |
$0.00 |
| 86341 |
|
15 |
13 |
$0.00 |
| D1206 |
|
25 |
24 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
12 |
12 |
$0.00 |
| 84402 |
|
13 |
13 |
$0.00 |
| 84446 |
|
25 |
25 |
$0.00 |
| 83540 |
|
1,071 |
1,037 |
$0.00 |
| 84305 |
|
1,113 |
1,086 |
$0.00 |
| 84156 |
|
241 |
225 |
$0.00 |
| 82610 |
|
1,252 |
1,197 |
$0.00 |
| 85007 |
|
1,445 |
1,329 |
$0.00 |
| 83970 |
|
1,351 |
1,304 |
$0.00 |
| 84100 |
|
2,181 |
2,041 |
$0.00 |
| 85610 |
|
593 |
551 |
$0.00 |
| 82977 |
|
609 |
579 |
$0.00 |
| 86038 |
|
369 |
349 |
$0.00 |
| 84466 |
|
1,049 |
1,015 |
$0.00 |
| J2272 |
Inj, morphine (fresenius) |
279 |
276 |
$0.00 |
| 87186 |
|
436 |
420 |
$0.00 |
| 80164 |
|
54 |
52 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
43 |
40 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
13 |
13 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
46 |
44 |
$0.00 |
| 86235 |
|
12 |
12 |
$0.00 |
| 86337 |
|
15 |
14 |
$0.00 |
| 82627 |
|
29 |
29 |
$0.00 |
| 86480 |
|
12 |
12 |
$0.00 |
| 86774 |
|
12 |
12 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
28 |
26 |
$0.00 |
| 84146 |
|
12 |
12 |
$0.00 |
| 88312 |
|
27 |
27 |
$0.00 |
| D1120 |
|
16 |
16 |
$0.00 |
| 84590 |
|
12 |
12 |
$0.00 |
| J7030 |
Normal saline solution infus |
27 |
27 |
$0.00 |