| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
|
57,672 |
55,888 |
$2.99M |
| 0300 |
|
27,842 |
20,844 |
$958K |
| 0301 |
|
66,288 |
26,178 |
$754K |
| 0636 |
|
23,749 |
12,798 |
$288K |
| 0402 |
|
2,745 |
2,150 |
$170K |
| 0320 |
|
6,395 |
4,959 |
$165K |
| 0305 |
|
26,426 |
18,905 |
$131K |
| 0259 |
|
13,890 |
10,328 |
$118K |
| 0730 |
|
3,971 |
3,906 |
$103K |
| 0762 |
|
184 |
147 |
$98K |
| G0463 |
Hospital outpt clinic visit |
3,534 |
2,316 |
$91K |
| 0750 |
|
2,269 |
1,692 |
$80K |
| 0403 |
|
1,303 |
837 |
$58K |
| 0306 |
|
5,805 |
4,463 |
$51K |
| 80053 |
|
5,486 |
5,258 |
$50K |
| 0312 |
|
1,941 |
1,510 |
$49K |
| 0250 |
|
5,130 |
4,234 |
$49K |
| 85025 |
|
7,380 |
6,979 |
$43K |
| 0352 |
|
179 |
164 |
$37K |
| 0270 |
|
2,297 |
2,173 |
$37K |
| 88305 |
|
736 |
730 |
$33K |
| 99070 |
|
5,766 |
3,922 |
$32K |
| 0260 |
|
799 |
503 |
$28K |
| Z7502 |
|
663 |
642 |
$25K |
| 77067 |
|
335 |
332 |
$24K |
| 0324 |
|
1,354 |
1,340 |
$21K |
| 0279 |
|
2,600 |
2,576 |
$19K |
| 0302 |
|
2,231 |
1,697 |
$19K |
| 0360 |
|
125 |
99 |
$17K |
| 43239 |
|
400 |
393 |
$15K |
| 0307 |
|
6,078 |
5,767 |
$14K |
| 80061 |
|
964 |
959 |
$13K |
| 74177 |
|
70 |
68 |
$12K |
| 99283 |
|
401 |
399 |
$12K |
| 45380 |
|
395 |
390 |
$11K |
| 76856 |
|
75 |
75 |
$6K |
| 0920 |
|
269 |
170 |
$6K |
| 81001 |
|
2,031 |
1,989 |
$5K |
| 83036 |
|
680 |
679 |
$5K |
| 0710 |
|
542 |
540 |
$5K |
| 99284 |
|
94 |
93 |
$4K |
| 83735 |
|
929 |
896 |
$4K |
| 80055 |
|
93 |
92 |
$4K |
| 59025 |
|
204 |
141 |
$4K |
| 0940 |
|
147 |
145 |
$4K |
| 0410 |
|
169 |
157 |
$3K |
| 87086 |
|
414 |
404 |
$3K |
| J2250 |
Inj midazolam hydrochloride |
645 |
636 |
$3K |
| J3010 |
Fentanyl citrate injection |
575 |
568 |
$3K |
| 0351 |
|
15 |
12 |
$3K |
| 83690 |
|
566 |
558 |
$3K |
| 0361 |
|
131 |
126 |
$3K |
| 85610 |
|
901 |
840 |
$3K |
| 82728 |
|
282 |
276 |
$3K |
| 84443 |
|
167 |
167 |
$3K |
| 70450 |
|
36 |
36 |
$2K |
| 72110 |
|
76 |
76 |
$2K |
| 85027 |
|
522 |
501 |
$2K |
| 99282 |
|
39 |
39 |
$2K |
| 99281 |
|
38 |
38 |
$2K |
| 76705 |
|
25 |
25 |
$2K |
| 45378 |
|
37 |
37 |
$1K |
| 83550 |
|
235 |
233 |
$1K |
| 76830 |
|
16 |
16 |
$1K |
| 76700 |
|
26 |
26 |
$1K |
| 72148 |
|
13 |
13 |
$1K |
| 45385 |
|
42 |
40 |
$1K |
| 87880 |
|
168 |
166 |
$1K |
| 73562 |
|
56 |
42 |
$1K |
| 0510 |
|
14 |
13 |
$851.02 |
| 97110 |
|
26 |
12 |
$761.13 |
| 76642 |
|
14 |
12 |
$732.58 |
| 71045 |
|
85 |
85 |
$654.92 |
| 86710 |
|
58 |
58 |
$540.88 |
| 84703 |
|
103 |
102 |
$536.55 |
| J1885 |
Ketorolac tromethamine inj |
96 |
94 |
$515.38 |
| 83655 |
|
190 |
184 |
$492.10 |
| 80164 |
|
41 |
41 |
$488.23 |
| 87491 |
|
13 |
13 |
$485.26 |
| J2405 |
Ondansetron hcl injection |
92 |
88 |
$434.41 |
| J1010 |
Inj, methylpred acetate 1 mg |
110 |
110 |
$390.89 |
| 80048 |
|
44 |
44 |
$380.23 |
| J7050 |
Normal saline solution infus |
43 |
37 |
$344.48 |
| J1200 |
Diphenhydramine hcl injectio |
58 |
55 |
$301.63 |
| 82950 |
|
51 |
51 |
$243.32 |
| 87389 |
|
12 |
12 |
$207.12 |
| 86592 |
|
40 |
40 |
$167.69 |
| 84460 |
|
42 |
42 |
$160.55 |
| 84450 |
|
42 |
42 |
$157.09 |
| 99285 |
|
27 |
26 |
$151.30 |
| S0164 |
Injection pantroprazole |
16 |
15 |
$150.94 |
| J2765 |
Metoclopramide hcl injection |
26 |
24 |
$136.33 |
| 87081 |
|
25 |
25 |
$119.59 |
| 99152 |
|
18 |
18 |
$102.64 |
| 0258 |
|
14 |
12 |
$100.24 |
| Q0162 |
Ondansetron oral |
146 |
143 |
$93.16 |
| J2270 |
Morphine sulfate injection |
12 |
12 |
$86.05 |
| 81003 |
|
42 |
27 |
$62.94 |
| 85018 |
|
37 |
37 |
$62.93 |
| 85730 |
|
14 |
13 |
$48.48 |
| 96372 |
|
19 |
13 |
$0.00 |
| G0500 |
Mod sedat endo service >5yrs |
45 |
43 |
$0.00 |