| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
|
8,879 |
8,877 |
$328K |
| D0120 |
|
10,723 |
10,721 |
$252K |
| 43239 |
|
223 |
222 |
$181K |
| D1354 |
|
6,294 |
3,518 |
$148K |
| D2392 |
|
1,970 |
1,699 |
$148K |
| D1206 |
|
5,453 |
5,444 |
$142K |
| D1110 |
|
3,020 |
3,018 |
$130K |
| D7140 |
|
2,230 |
1,917 |
$127K |
| D2391 |
|
2,076 |
1,827 |
$112K |
| D1351 |
|
1,757 |
1,265 |
$95K |
| 99285 |
|
600 |
595 |
$85K |
| D1208 |
|
5,430 |
5,427 |
$68K |
| D2930 |
|
572 |
489 |
$66K |
| D0150 |
|
2,309 |
2,308 |
$58K |
| D0330 |
|
2,007 |
2,007 |
$58K |
| D0272 |
|
3,543 |
3,541 |
$47K |
| D0274 |
|
1,846 |
1,845 |
$42K |
| D0140 |
|
3,126 |
2,992 |
$35K |
| J3490 |
Drugs unclassified injection |
2,640 |
1,469 |
$26K |
| G0378 |
Hospital observation per hr |
62 |
38 |
$26K |
| D0220 |
|
1,796 |
1,769 |
$16K |
| D0210 |
|
684 |
682 |
$15K |
| C1889 |
Implant/insert device, noc |
80 |
78 |
$12K |
| 80053 |
|
254 |
250 |
$12K |
| J3010 |
Fentanyl citrate injection |
631 |
616 |
$10K |
| D3220 |
|
108 |
100 |
$9K |
| J2405 |
Ondansetron hcl injection |
741 |
733 |
$8K |
| D0240 |
|
581 |
581 |
$8K |
| 88305 |
|
599 |
596 |
$7K |
| 99213 |
|
56 |
55 |
$4K |
| 87633 |
|
30 |
30 |
$2K |
| T1013 |
Sign lang/oral interpreter |
104 |
102 |
$2K |
| J2704 |
Inj, propofol, 10 mg |
1,019 |
838 |
$2K |
| 99203 |
|
15 |
15 |
$2K |
| 0225U |
|
28 |
28 |
$1K |
| 85025 |
|
220 |
216 |
$1K |
| J0131 |
Inj, acetaminophen (nos) |
788 |
784 |
$1K |
| 76705 |
|
12 |
12 |
$1K |
| D2393 |
|
13 |
13 |
$924.37 |
| D9920 |
|
65 |
64 |
$692.70 |
| D2330 |
|
14 |
13 |
$647.20 |
| 94760 |
|
102 |
99 |
$632.08 |
| D0251 |
|
37 |
37 |
$425.40 |
| C9399 |
Unclassified drugs or biolog |
103 |
103 |
$343.47 |
| J7030 |
Normal saline solution infus |
145 |
135 |
$185.48 |
| D0230 |
|
16 |
16 |
$151.92 |
| J1100 |
Dexamethasone sodium phos |
708 |
697 |
$104.52 |
| J3480 |
Inj potassium chloride |
21 |
21 |
$87.78 |
| J1885 |
Ketorolac tromethamine inj |
104 |
101 |
$40.98 |
| 82962 |
|
15 |
14 |
$16.43 |
| J0690 |
Cefazolin sodium injection |
37 |
37 |
$14.70 |
| 81025 |
|
24 |
24 |
$5.29 |
| 99080 |
|
209 |
25 |
$0.00 |
| D1330 |
|
133 |
133 |
$0.00 |
| 36000 |
|
13 |
13 |
$0.00 |