| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
27,721 |
3,875 |
$725K |
| 99283 |
|
16,406 |
5,794 |
$525K |
| 99213 |
|
17,435 |
8,607 |
$507K |
| 99214 |
|
14,835 |
4,124 |
$319K |
| J3490 |
Drugs unclassified injection |
1,586 |
460 |
$265K |
| 99391 |
|
2,452 |
1,937 |
$141K |
| 99282 |
|
3,471 |
2,158 |
$115K |
| 99392 |
|
1,445 |
1,279 |
$85K |
| 93010 |
|
3,799 |
209 |
$75K |
| 99212 |
|
3,430 |
1,913 |
$64K |
| 99238 |
|
1,967 |
476 |
$54K |
| 87428 |
|
1,095 |
996 |
$41K |
| 90472 |
|
2,157 |
1,932 |
$36K |
| 85025 |
|
3,117 |
2,651 |
$35K |
| 90471 |
|
3,703 |
3,325 |
$34K |
| 36415 |
|
6,310 |
4,735 |
$26K |
| A9270 |
Non-covered item or service |
2,373 |
664 |
$23K |
| 99211 |
|
406 |
26 |
$23K |
| 99393 |
|
297 |
283 |
$21K |
| 90460 |
|
479 |
455 |
$18K |
| 76815 |
|
328 |
219 |
$16K |
| J7040 |
Normal saline solution infus |
49 |
12 |
$15K |
| 87491 |
|
523 |
443 |
$14K |
| 87591 |
|
524 |
442 |
$14K |
| 84443 |
|
1,200 |
1,028 |
$14K |
| 99215 |
Prolong outpt/office vis |
467 |
121 |
$14K |
| 80053 |
|
862 |
758 |
$13K |
| 99281 |
|
442 |
215 |
$13K |
| W0037 |
|
3,801 |
3,801 |
$11K |
| 76816 |
|
204 |
161 |
$11K |
| 87651 |
|
335 |
307 |
$11K |
| 80050 |
|
148 |
137 |
$9K |
| 87400 |
|
332 |
164 |
$8K |
| 99232 |
|
210 |
38 |
$8K |
| 90474 |
|
874 |
792 |
$8K |
| 86780 |
|
715 |
645 |
$7K |
| 88305 |
|
217 |
54 |
$7K |
| 90715 |
|
328 |
298 |
$6K |
| 76805 |
|
28 |
26 |
$6K |
| 87660 |
|
293 |
253 |
$6K |
| 87510 |
|
292 |
252 |
$6K |
| 90677 |
|
528 |
492 |
$6K |
| 87480 |
|
280 |
240 |
$6K |
| 99222 |
|
83 |
70 |
$5K |
| 59025 |
|
118 |
53 |
$5K |
| 87086 |
|
664 |
543 |
$4K |
| 87637 |
|
30 |
27 |
$4K |
| 96372 |
|
436 |
297 |
$4K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
37 |
12 |
$4K |
| 84439 |
|
526 |
469 |
$3K |
| 90686 |
|
1,072 |
976 |
$3K |
| 99394 |
|
41 |
35 |
$3K |
| 87389 |
|
169 |
151 |
$3K |
| 87807 |
|
265 |
244 |
$2K |
| 87801 |
|
76 |
63 |
$2K |
| 97110 |
|
59 |
13 |
$2K |
| 87880 |
|
193 |
183 |
$2K |
| 80061 |
|
279 |
260 |
$2K |
| 86787 |
|
219 |
95 |
$2K |
| 83036 |
|
310 |
277 |
$2K |
| 86803 |
|
167 |
147 |
$2K |
| 20610 |
|
35 |
14 |
$2K |
| 81001 |
|
629 |
542 |
$2K |
| 87481 |
|
122 |
63 |
$1K |
| 88175 |
|
70 |
62 |
$1K |
| 01967 |
|
13 |
12 |
$1K |
| 80306 |
|
119 |
107 |
$1K |
| 86696 |
|
96 |
85 |
$1K |
| 87661 |
|
76 |
62 |
$1K |
| 82728 |
|
112 |
91 |
$1K |
| 99309 |
|
22 |
12 |
$1K |
| 83655 |
|
94 |
85 |
$1K |
| 71046 |
|
44 |
39 |
$971.89 |
| 86762 |
|
105 |
94 |
$964.13 |
| 99460 |
|
16 |
12 |
$938.50 |
| 87210 |
|
179 |
165 |
$925.34 |
| 87340 |
|
119 |
107 |
$805.74 |
| 87653 |
|
27 |
25 |
$701.42 |
| 99223 |
Prolong inpt eval add15 m |
16 |
14 |
$686.48 |
| 87804 |
|
84 |
42 |
$662.00 |
| 86850 |
|
105 |
93 |
$615.51 |
| 81025 |
|
129 |
110 |
$585.48 |
| 90651 |
|
42 |
36 |
$489.15 |
| 87426 |
|
12 |
12 |
$423.96 |
| 90656 |
|
139 |
137 |
$379.90 |
| 87081 |
|
64 |
61 |
$371.94 |
| 83550 |
|
49 |
40 |
$326.06 |
| 99231 |
|
48 |
12 |
$316.16 |
| 82950 |
|
58 |
54 |
$282.71 |
| 81002 |
|
110 |
69 |
$276.46 |
| 86900 |
|
132 |
120 |
$251.16 |
| 87420 |
|
26 |
21 |
$250.38 |
| 90756 |
|
24 |
21 |
$249.30 |
| 86901 |
|
137 |
120 |
$248.17 |
| 83540 |
|
49 |
40 |
$234.92 |
| 86592 |
|
53 |
44 |
$221.50 |
| 96127 |
|
78 |
33 |
$181.16 |
| J3301 |
Triamcinolone acet inj nos |
94 |
74 |
$170.88 |
| 90670 |
|
1,040 |
937 |
$162.16 |
| 90473 |
|
14 |
12 |
$118.52 |
| J7030 |
Normal saline solution infus |
253 |
106 |
$97.92 |
| 85027 |
|
63 |
63 |
$97.05 |
| 85018 |
|
41 |
38 |
$87.69 |
| 82977 |
|
43 |
43 |
$72.00 |
| 90688 |
|
13 |
12 |
$64.98 |
| 96110 |
|
12 |
12 |
$63.78 |
| 80048 |
|
12 |
12 |
$25.38 |
| J1100 |
Dexamethasone sodium phos |
100 |
76 |
$18.94 |
| 82951 |
|
13 |
12 |
$12.87 |
| J0696 |
Ceftriaxone sodium injection |
17 |
12 |
$2.50 |
| J1885 |
Ketorolac tromethamine inj |
20 |
12 |
$2.20 |
| 90680 |
|
979 |
888 |
$0.00 |
| 86140 |
|
27 |
25 |
$0.00 |
| 90723 |
|
1,052 |
954 |
$0.00 |
| 36416 |
|
112 |
93 |
$0.00 |
| 90696 |
|
28 |
27 |
$0.00 |
| G0008 |
Admin influenza virus vac |
24 |
24 |
$0.00 |
| 90697 |
|
31 |
30 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
51 |
26 |
$0.00 |
| 0352U |
|
17 |
12 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
22 |
13 |
$0.00 |
| 90648 |
|
1,366 |
1,248 |
$0.00 |
| 90633 |
|
359 |
337 |
$0.00 |
| 90461 |
|
270 |
260 |
$0.00 |
| J7120 |
Ringers lactate infusion |
25 |
12 |
$0.00 |
| 90710 |
|
49 |
47 |
$0.00 |
| 90662 |
|
34 |
32 |
$0.00 |
| 90734 |
|
37 |
35 |
$0.00 |
| 90700 |
|
14 |
12 |
$0.00 |
| 85048 |
|
44 |
14 |
$0.00 |