| Code | Description | Claims | Beneficiaries | Total Paid |
| 92004 |
|
587 |
586 |
$35K |
| 99213 |
|
52,976 |
46,178 |
$32K |
| 99204 |
|
3,304 |
3,236 |
$28K |
| 92014 |
|
856 |
843 |
$26K |
| 99214 |
|
46,912 |
40,840 |
$23K |
| 99291 |
|
880 |
522 |
$17K |
| G0500 |
Mod sedat endo service >5yrs |
435 |
426 |
$17K |
| G0483 |
Drug test def 22+ classes |
41 |
41 |
$12K |
| J3490 |
Drugs unclassified injection |
482 |
475 |
$12K |
| 99232 |
|
1,806 |
701 |
$10K |
| 99222 |
|
421 |
385 |
$10K |
| 92551 |
|
895 |
893 |
$10K |
| 99205 |
Prolong outpt/office vis |
429 |
423 |
$8K |
| 92526 |
|
522 |
186 |
$7K |
| 99203 |
|
6,167 |
6,024 |
$7K |
| 92507 |
|
1,201 |
422 |
$7K |
| 99215 |
Prolong outpt/office vis |
3,361 |
3,050 |
$6K |
| 99233 |
Prolong inpt eval add15 m |
1,435 |
466 |
$5K |
| 90651 |
|
1,566 |
1,564 |
$4K |
| 99392 |
|
3,486 |
3,482 |
$4K |
| 90670 |
|
1,862 |
1,855 |
$3K |
| 99152 |
|
209 |
207 |
$3K |
| 90791 |
|
14 |
14 |
$3K |
| 99393 |
|
2,592 |
2,590 |
$3K |
| 43239 |
|
429 |
424 |
$3K |
| J3301 |
Triamcinolone acet inj nos |
1,744 |
1,709 |
$2K |
| 99394 |
|
1,914 |
1,914 |
$2K |
| 90734 |
|
988 |
988 |
$2K |
| 93306 |
|
990 |
966 |
$2K |
| 99223 |
Prolong inpt eval add15 m |
768 |
676 |
$2K |
| 99202 |
|
2,945 |
2,924 |
$2K |
| 59025 |
|
1,000 |
370 |
$2K |
| 99244 |
|
955 |
948 |
$2K |
| 90686 |
|
7,518 |
7,500 |
$2K |
| 90710 |
|
634 |
634 |
$1K |
| 20610 |
|
551 |
492 |
$1K |
| 99391 |
|
1,661 |
1,626 |
$1K |
| 99212 |
|
4,271 |
3,737 |
$1K |
| 45380 |
|
394 |
388 |
$1K |
| 90716 |
|
654 |
653 |
$1K |
| 71046 |
|
1,861 |
1,803 |
$1K |
| 99395 |
|
1,440 |
1,432 |
$997.64 |
| 45385 |
|
131 |
129 |
$961.64 |
| 99239 |
|
514 |
485 |
$948.72 |
| 90620 |
|
511 |
511 |
$888.86 |
| 92557 |
|
13 |
13 |
$858.12 |
| 17110 |
|
614 |
585 |
$857.80 |
| 99243 |
|
604 |
601 |
$833.31 |
| 99285 |
|
1,678 |
1,495 |
$745.76 |
| 99245 |
|
189 |
187 |
$729.72 |
| 99309 |
|
40 |
36 |
$727.99 |
| 74177 |
|
729 |
689 |
$658.36 |
| 94060 |
|
755 |
754 |
$626.56 |
| 93010 |
|
2,867 |
2,304 |
$619.58 |
| 90723 |
|
1,028 |
1,027 |
$615.42 |
| 90707 |
|
649 |
647 |
$610.52 |
| 99385 |
|
313 |
311 |
$599.04 |
| 90633 |
|
1,319 |
1,318 |
$532.05 |
| 90715 |
|
1,796 |
1,793 |
$512.01 |
| 87804 |
|
3,568 |
3,490 |
$506.87 |
| 76700 |
|
619 |
619 |
$494.62 |
| 90696 |
|
599 |
598 |
$486.68 |
| 99283 |
|
1,772 |
1,717 |
$482.14 |
| 93000 |
|
1,829 |
1,791 |
$441.95 |
| 92550 |
|
14 |
13 |
$432.88 |
| 20611 |
|
702 |
569 |
$428.28 |
| 77067 |
|
1,155 |
1,155 |
$426.02 |
| 96372 |
|
2,964 |
2,600 |
$415.22 |
| 94726 |
|
481 |
481 |
$395.59 |
| 94729 |
|
458 |
458 |
$392.53 |
| 92002 |
|
362 |
361 |
$390.06 |
| 97530 |
|
68 |
24 |
$389.90 |
| 90648 |
|
1,569 |
1,566 |
$373.04 |
| 71045 |
|
1,874 |
1,404 |
$372.49 |
| 92012 |
|
1,320 |
1,221 |
$366.87 |
| 95004 |
|
351 |
342 |
$354.79 |
| 76705 |
|
357 |
347 |
$346.39 |
| 76817 |
|
494 |
455 |
$336.90 |
| 94640 |
|
971 |
907 |
$318.79 |
| 87880 |
|
4,122 |
4,011 |
$291.42 |
| 90700 |
|
568 |
566 |
$284.20 |
| 69210 |
|
248 |
213 |
$266.09 |
| 76815 |
|
437 |
387 |
$259.99 |
| 70551 |
|
87 |
85 |
$242.93 |
| 76942 |
|
695 |
684 |
$230.89 |
| 92523 |
|
12 |
12 |
$228.52 |
| 99308 |
|
34 |
29 |
$224.75 |
| 83655 |
|
1,086 |
1,060 |
$223.20 |
| 95144 |
|
4,176 |
1,840 |
$218.96 |
| 74018 |
|
458 |
419 |
$213.38 |
| 93224 |
|
88 |
88 |
$206.36 |
| 76830 |
|
819 |
805 |
$197.26 |
| H1003 |
Prenatal at risk education |
2,041 |
1,516 |
$193.46 |
| 95117 |
|
3,419 |
1,579 |
$186.83 |
| 84443 |
|
3,258 |
3,222 |
$177.11 |
| 80053 |
|
7,326 |
7,054 |
$174.96 |
| 85018 |
|
3,790 |
3,766 |
$173.16 |
| 90681 |
|
410 |
410 |
$169.66 |
| 73610 |
|
612 |
561 |
$164.69 |
| 99238 |
|
192 |
191 |
$164.30 |
| 70450 |
|
599 |
567 |
$159.29 |
| 80061 |
|
5,715 |
5,647 |
$159.28 |
| 92083 |
|
124 |
123 |
$158.65 |
| 99255 |
|
13 |
12 |
$150.94 |
| 76536 |
|
76 |
75 |
$146.38 |
| 66984 |
|
245 |
198 |
$136.65 |
| 73080 |
|
63 |
56 |
$136.41 |
| 83036 |
|
6,362 |
6,255 |
$124.24 |
| 99284 |
|
2,205 |
2,066 |
$119.61 |
| 99241 |
|
14 |
14 |
$117.82 |
| 73630 |
|
761 |
685 |
$117.54 |
| 92133 |
|
202 |
198 |
$112.88 |
| 76519 |
|
290 |
286 |
$107.58 |
| 87491 |
|
4,700 |
4,588 |
$107.54 |
| 87591 |
|
4,701 |
4,591 |
$107.19 |
| 81002 |
|
3,864 |
3,682 |
$101.02 |
| 73140 |
|
394 |
361 |
$100.55 |
| 73110 |
|
637 |
539 |
$99.52 |
| 70553 |
|
40 |
38 |
$98.53 |
| 73564 |
|
270 |
231 |
$96.95 |
| 85025 |
|
5,522 |
5,139 |
$92.83 |
| 76856 |
|
597 |
590 |
$92.00 |
| 20551 |
|
122 |
112 |
$91.86 |
| 99242 |
|
98 |
98 |
$90.86 |
| 73030 |
|
531 |
492 |
$87.92 |
| 92504 |
|
16 |
13 |
$87.42 |
| 11721 |
|
122 |
121 |
$84.12 |
| 73562 |
|
414 |
362 |
$81.84 |
| 69209 |
|
402 |
346 |
$80.80 |
| 95810 |
|
105 |
105 |
$76.64 |
| 92134 |
|
573 |
549 |
$74.97 |
| 73560 |
|
253 |
224 |
$70.37 |
| 59425 |
|
2,497 |
1,593 |
$70.00 |
| 84439 |
|
1,603 |
1,575 |
$68.42 |
| 99221 |
|
70 |
66 |
$66.03 |
| 87070 |
|
1,318 |
1,301 |
$64.59 |
| 81025 |
|
1,568 |
1,508 |
$62.92 |
| 87086 |
|
2,916 |
2,765 |
$62.20 |
| J0696 |
Ceftriaxone sodium injection |
358 |
314 |
$58.41 |
| 72100 |
|
403 |
400 |
$53.01 |
| 87088 |
|
2,282 |
2,183 |
$52.90 |
| 90685 |
|
73 |
72 |
$52.54 |
| 99201 |
|
329 |
327 |
$51.01 |
| 76642 |
|
171 |
151 |
$50.44 |
| 82306 |
|
1,618 |
1,602 |
$42.14 |
| 73590 |
|
32 |
31 |
$41.56 |
| 88304 |
|
296 |
239 |
$41.45 |
| J1885 |
Ketorolac tromethamine inj |
1,284 |
1,162 |
$41.43 |
| 82728 |
|
1,246 |
1,211 |
$41.04 |
| 87186 |
|
949 |
923 |
$39.75 |
| 86580 |
|
774 |
746 |
$34.77 |
| 87389 |
|
1,537 |
1,529 |
$34.44 |
| 99231 |
|
132 |
68 |
$32.48 |
| 87510 |
|
296 |
292 |
$31.59 |
| 87480 |
|
296 |
292 |
$31.55 |
| 87660 |
|
296 |
292 |
$31.41 |
| 64615 |
|
26 |
26 |
$30.41 |
| 87075 |
|
133 |
132 |
$29.20 |
| 73130 |
|
622 |
545 |
$26.84 |
| 82043 |
|
1,408 |
1,397 |
$26.17 |
| 20553 |
|
73 |
61 |
$25.14 |
| 82570 |
|
1,847 |
1,810 |
$24.15 |
| 83550 |
|
1,189 |
1,160 |
$23.42 |
| 86803 |
|
906 |
903 |
$21.37 |
| 86787 |
|
467 |
465 |
$19.92 |
| 82951 |
|
314 |
313 |
$19.72 |
| 85027 |
|
2,319 |
2,297 |
$19.70 |
| 83540 |
|
1,267 |
1,236 |
$19.44 |
| 95115 |
|
757 |
324 |
$17.64 |
| 20550 |
|
133 |
121 |
$16.74 |
| 88305 |
|
1,956 |
1,495 |
$14.35 |
| 81001 |
|
2,416 |
2,340 |
$14.27 |
| 87147 |
|
419 |
416 |
$13.68 |
| 92015 |
|
131 |
131 |
$13.62 |
| 93015 |
|
13 |
13 |
$13.43 |
| 80048 |
|
1,376 |
1,320 |
$12.72 |
| 87077 |
|
784 |
761 |
$12.39 |
| 87205 |
|
174 |
173 |
$11.76 |
| 83690 |
|
224 |
221 |
$10.34 |
| 86140 |
|
939 |
921 |
$8.10 |
| 86592 |
|
1,692 |
1,674 |
$6.72 |
| 85610 |
|
1,973 |
1,627 |
$5.93 |
| J7613 |
Albuterol non-comp unit |
1,681 |
1,610 |
$4.92 |
| 85652 |
|
1,253 |
1,236 |
$4.22 |
| 99211 |
|
177 |
158 |
$4.18 |
| 93793 |
|
814 |
629 |
$2.17 |
| 86708 |
|
12 |
12 |
$0.00 |
| 59409 |
|
34 |
34 |
$0.00 |
| A9552 |
F18 fdg |
82 |
82 |
$0.00 |
| 88175 |
|
1,110 |
1,110 |
$0.00 |
| 86480 |
|
340 |
339 |
$0.00 |
| 76805 |
|
307 |
302 |
$0.00 |
| 80076 |
|
369 |
362 |
$0.00 |
| 83516 |
|
267 |
248 |
$0.00 |
| 86765 |
|
12 |
12 |
$0.00 |
| 81003 |
|
134 |
133 |
$0.00 |
| 99396 |
|
727 |
724 |
$0.00 |
| 83013 |
|
285 |
284 |
$0.00 |
| 84550 |
|
327 |
313 |
$0.00 |
| 86038 |
|
462 |
455 |
$0.00 |
| 20552 |
|
59 |
50 |
$0.00 |
| 87512 |
|
121 |
120 |
$0.00 |
| 72125 |
|
13 |
13 |
$0.00 |
| 87427 |
|
160 |
158 |
$0.00 |
| 80307 |
|
1,067 |
989 |
$0.00 |
| 86900 |
|
450 |
447 |
$0.00 |
| 80074 |
|
96 |
95 |
$0.00 |
| 90750 |
|
37 |
37 |
$0.00 |
| 84156 |
|
317 |
306 |
$0.00 |
| G2012 |
Brief check in by md/qhp |
299 |
273 |
$0.00 |
| 87481 |
|
162 |
128 |
$0.00 |
| 86431 |
|
218 |
216 |
$0.00 |
| 82274 |
|
56 |
56 |
$0.00 |
| 90746 |
|
56 |
56 |
$0.00 |
| 87045 |
|
156 |
154 |
$0.00 |
| 84403 |
|
281 |
275 |
$0.00 |
| 82652 |
|
128 |
128 |
$0.00 |
| 87209 |
|
68 |
66 |
$0.00 |
| 74176 |
|
77 |
76 |
$0.00 |
| 87799 |
|
329 |
135 |
$0.00 |
| 99401 |
|
248 |
248 |
$0.00 |
| 76770 |
|
27 |
27 |
$0.00 |
| 85014 |
|
42 |
40 |
$0.00 |
| 84702 |
|
193 |
152 |
$0.00 |
| 84450 |
|
14 |
14 |
$0.00 |
| 73721 |
|
25 |
25 |
$0.00 |
| 11750 |
|
14 |
12 |
$0.00 |
| 85007 |
|
65 |
63 |
$0.00 |
| 83970 |
|
95 |
93 |
$0.00 |
| 85048 |
|
53 |
53 |
$0.00 |
| 87177 |
|
68 |
66 |
$0.00 |
| J0585 |
Injection,onabotulinumtoxina |
21 |
12 |
$0.00 |
| 86200 |
|
12 |
12 |
$0.00 |
| 78815 |
|
25 |
25 |
$0.00 |
| 84146 |
|
64 |
61 |
$0.00 |
| J7307 |
Etonogestrel implant system |
14 |
14 |
$0.00 |
| 84481 |
|
44 |
44 |
$0.00 |
| 86003 |
|
13 |
13 |
$0.00 |
| 90653 |
|
22 |
22 |
$0.00 |
| 84460 |
|
27 |
27 |
$0.00 |
| 76813 |
|
13 |
13 |
$0.00 |
| 90662 |
|
31 |
31 |
$0.00 |
| 86735 |
|
12 |
12 |
$0.00 |
| J2405 |
Ondansetron hcl injection |
13 |
13 |
$0.00 |
| 72141 |
|
12 |
12 |
$0.00 |
| 93325 |
|
14 |
13 |
$0.00 |
| 10060 |
|
13 |
12 |
$0.00 |
| 90471 |
|
5,559 |
5,443 |
$0.00 |
| 82962 |
|
406 |
388 |
$0.00 |
| 84153 |
|
263 |
258 |
$0.00 |
| 82607 |
|
906 |
896 |
$0.00 |
| 88142 |
|
717 |
717 |
$0.00 |
| J3420 |
Vitamin b12 injection |
352 |
321 |
$0.00 |
| 82784 |
|
242 |
239 |
$0.00 |
| 87046 |
|
158 |
156 |
$0.00 |
| 86317 |
|
39 |
39 |
$0.00 |
| 86850 |
|
421 |
420 |
$0.00 |
| 87340 |
|
852 |
849 |
$0.00 |
| 87522 |
Neg quan hep c or qual rna |
75 |
73 |
$0.00 |
| 88307 |
|
58 |
52 |
$0.00 |
| 87081 |
|
1,277 |
1,275 |
$0.00 |
| 80069 |
|
170 |
164 |
$0.00 |
| 93016 |
|
15 |
15 |
$0.00 |
| 88141 |
|
55 |
55 |
$0.00 |
| 87661 |
|
350 |
347 |
$0.00 |
| 86901 |
|
472 |
469 |
$0.00 |
| 87624 |
|
1,152 |
1,152 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
26 |
24 |
$0.00 |
| 86762 |
|
569 |
559 |
$0.00 |
| 92250 |
|
37 |
37 |
$0.00 |
| 85730 |
|
225 |
220 |
$0.00 |
| 82746 |
|
512 |
507 |
$0.00 |
| 83014 |
|
186 |
185 |
$0.00 |
| 86800 |
|
13 |
13 |
$0.00 |
| 00142 |
|
212 |
174 |
$0.00 |
| 62326 |
|
48 |
48 |
$0.00 |
| 99070 |
|
118 |
100 |
$0.00 |
| H1001 |
Antepartum management |
157 |
131 |
$0.00 |
| 99383 |
|
73 |
72 |
$0.00 |
| 11200 |
|
24 |
24 |
$0.00 |
| 58300 |
|
214 |
212 |
$0.00 |
| 83001 |
|
167 |
163 |
$0.00 |
| 83735 |
|
168 |
146 |
$0.00 |
| J7298 |
Mirena, 52 mg |
37 |
37 |
$0.00 |
| 58100 |
|
16 |
16 |
$0.00 |
| H2000 |
Comp multidisipln evaluation |
67 |
67 |
$0.00 |
| 58301 |
|
28 |
27 |
$0.00 |
| 99406 |
|
39 |
38 |
$0.00 |
| 72040 |
|
74 |
74 |
$0.00 |
| 83002 |
|
42 |
42 |
$0.00 |
| 17000 |
|
13 |
13 |
$0.00 |
| 88342 |
|
45 |
40 |
$0.00 |
| 93971 |
|
12 |
12 |
$0.00 |
| 87521 |
Neg quan hep c or qual rna |
28 |
28 |
$0.00 |
| 76816 |
|
66 |
64 |
$0.00 |
| 72148 |
|
25 |
25 |
$0.00 |
| 95012 |
|
53 |
52 |
$0.00 |
| 82378 |
|
13 |
12 |
$0.00 |
| 73502 |
|
65 |
63 |
$0.00 |
| 93018 |
|
16 |
16 |
$0.00 |
| G0008 |
Admin influenza virus vac |
48 |
48 |
$0.00 |
| 86376 |
|
69 |
68 |
$0.00 |
| 90674 |
|
32 |
32 |
$0.00 |
| 59430 |
|
107 |
107 |
$0.00 |
| 71260 |
|
12 |
12 |
$0.00 |
| 70486 |
|
12 |
12 |
$0.00 |
| 81000 |
|
16 |
16 |
$0.00 |
| 99384 |
|
32 |
32 |
$0.00 |
| 86704 |
|
12 |
12 |
$0.00 |
| 84402 |
|
15 |
15 |
$0.00 |
| 59514 |
|
24 |
13 |
$0.00 |
| 82550 |
|
13 |
12 |
$0.00 |