| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 36415 |
|
10,348 |
7,772 |
$1.34M |
| 99283 |
|
10,776 |
9,494 |
$617K |
| 87804 |
|
5,942 |
3,692 |
$341K |
| 81025 |
|
3,801 |
3,469 |
$324K |
| 99282 |
|
2,823 |
2,622 |
$307K |
| 87880 |
|
2,182 |
2,093 |
$232K |
| 70553 |
|
123 |
112 |
$172K |
| 96372 |
|
2,257 |
1,686 |
$157K |
| 82565 |
|
302 |
280 |
$104K |
| 59025 |
|
900 |
615 |
$99K |
| 82947 |
|
1,828 |
895 |
$88K |
| 99284 |
|
5,891 |
5,211 |
$78K |
| 96365 |
|
734 |
624 |
$58K |
| J2704 |
Inj, propofol, 10 mg |
1,633 |
1,541 |
$55K |
| 88305 |
|
552 |
518 |
$52K |
| 99281 |
|
361 |
335 |
$51K |
| 87491 |
|
394 |
366 |
$47K |
| 97110 |
|
1,631 |
409 |
$43K |
| J0690 |
Cefazolin sodium injection |
759 |
664 |
$41K |
| 74176 |
|
761 |
708 |
$41K |
| 93306 |
|
455 |
399 |
$41K |
| 87086 |
|
2,081 |
1,878 |
$40K |
| 96361 |
|
1,259 |
1,004 |
$40K |
| 71250 |
|
211 |
198 |
$40K |
| 70450 |
|
1,119 |
1,033 |
$36K |
| 81003 |
|
3,134 |
2,863 |
$36K |
| 71046 |
|
1,903 |
1,711 |
$36K |
| 81001 |
|
2,453 |
2,238 |
$33K |
| 88304 |
|
172 |
172 |
$33K |
| 96360 |
|
506 |
445 |
$33K |
| 72100 |
|
508 |
482 |
$31K |
| 74177 |
|
865 |
829 |
$31K |
| 80307 |
|
1,312 |
1,171 |
$29K |
| 80053 |
|
4,856 |
4,077 |
$28K |
| 95813 |
|
138 |
132 |
$28K |
| 87070 |
|
251 |
225 |
$27K |
| J2405 |
Ondansetron hcl injection |
3,892 |
3,060 |
$24K |
| 74018 |
|
392 |
356 |
$23K |
| 73630 |
|
256 |
241 |
$23K |
| 73030 |
|
298 |
280 |
$22K |
| L8699 |
Prosthetic implant nos |
42 |
42 |
$22K |
| 73130 |
|
219 |
210 |
$22K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,818 |
1,627 |
$21K |
| 73610 |
|
193 |
183 |
$21K |
| 96374 |
|
1,531 |
1,346 |
$20K |
| 73562 |
|
244 |
231 |
$18K |
| 76705 |
|
308 |
291 |
$18K |
| 83021 |
|
229 |
192 |
$17K |
| 93971 |
|
88 |
77 |
$16K |
| 73110 |
|
156 |
150 |
$15K |
| 71045 |
|
2,268 |
2,003 |
$15K |
| 11042 |
|
35 |
27 |
$13K |
| 95810 |
|
43 |
43 |
$13K |
| 94726 |
|
29 |
25 |
$12K |
| 80047 |
|
2,518 |
2,275 |
$12K |
| 87077 |
|
608 |
560 |
$11K |
| J1956 |
Levofloxacin injection |
34 |
28 |
$10K |
| 74022 |
|
491 |
453 |
$10K |
| 87807 |
|
985 |
933 |
$10K |
| G0463 |
Hospital outpt clinic visit |
315 |
255 |
$10K |
| 77067 |
|
178 |
178 |
$9K |
| 72040 |
|
320 |
305 |
$9K |
| 78452 |
|
42 |
39 |
$9K |
| 99285 |
|
1,925 |
1,726 |
$8K |
| 96366 |
|
173 |
132 |
$8K |
| G0378 |
Hospital observation per hr |
655 |
593 |
$8K |
| 73564 |
|
84 |
83 |
$7K |
| T5999 |
Supply, nos |
60 |
60 |
$7K |
| 84443 |
|
1,311 |
1,204 |
$6K |
| 93005 |
|
3,268 |
2,719 |
$6K |
| 86850 |
|
269 |
208 |
$6K |
| 71260 |
|
97 |
93 |
$5K |
| C9113 |
Inj pantoprazole sodium, via |
165 |
108 |
$5K |
| 45378 |
|
79 |
77 |
$5K |
| 73502 |
|
107 |
103 |
$5K |
| 97530 |
|
379 |
177 |
$5K |
| 93017 |
|
177 |
155 |
$5K |
| 85730 |
|
1,137 |
1,032 |
$5K |
| 86900 |
|
476 |
399 |
$5K |
| 76815 |
|
101 |
91 |
$4K |
| 80081 |
|
317 |
279 |
$4K |
| 94640 |
|
1,088 |
796 |
$4K |
| 87210 |
|
324 |
302 |
$4K |
| 76817 |
|
35 |
25 |
$4K |
| 83690 |
|
1,727 |
1,565 |
$4K |
| 84484 |
|
2,665 |
1,814 |
$3K |
| 80048 |
|
2,221 |
1,784 |
$3K |
| 97140 |
|
65 |
26 |
$3K |
| 83605 |
|
1,866 |
1,576 |
$3K |
| 83735 |
|
2,951 |
2,467 |
$3K |
| 87081 |
|
327 |
303 |
$3K |
| 95811 |
|
12 |
12 |
$3K |
| 84702 |
|
628 |
502 |
$2K |
| 43239 |
|
50 |
48 |
$2K |
| 45380 |
|
14 |
13 |
$2K |
| 71275 |
|
212 |
199 |
$2K |
| 72125 |
|
105 |
101 |
$2K |
| 82306 |
|
27 |
25 |
$2K |
| 94760 |
|
157 |
87 |
$2K |
| 74019 |
|
49 |
46 |
$2K |
| 87186 |
|
553 |
504 |
$1K |
| 85025 |
|
7,159 |
5,798 |
$1K |
| 73140 |
|
17 |
16 |
$1K |
| 96413 |
|
156 |
79 |
$1K |
| 12001 |
|
12 |
12 |
$1K |
| J2060 |
Lorazepam injection |
272 |
219 |
$1K |
| 85610 |
|
1,281 |
1,139 |
$1K |
| 96375 |
|
1,815 |
1,207 |
$1K |
| 97161 |
|
139 |
128 |
$1K |
| 96367 |
|
116 |
57 |
$960.90 |
| Q0162 |
Ondansetron oral |
1,161 |
1,100 |
$895.12 |
| 84146 |
|
226 |
208 |
$865.81 |
| 84466 |
|
44 |
39 |
$853.00 |
| J1650 |
Inj enoxaparin sodium |
413 |
195 |
$824.04 |
| 84145 |
|
603 |
548 |
$803.74 |
| 73080 |
|
13 |
13 |
$716.46 |
| 84439 |
|
695 |
648 |
$689.53 |
| J2550 |
Promethazine hcl injection |
336 |
279 |
$637.78 |
| 85027 |
|
1,801 |
1,591 |
$547.46 |
| J2765 |
Metoclopramide hcl injection |
62 |
51 |
$486.13 |
| 86592 |
|
108 |
92 |
$467.83 |
| 43235 |
|
71 |
68 |
$451.86 |
| J2270 |
Morphine sulfate injection |
575 |
477 |
$444.82 |
| 80076 |
|
528 |
489 |
$417.22 |
| 96376 |
|
320 |
264 |
$414.53 |
| J1200 |
Diphenhydramine hcl injectio |
757 |
542 |
$400.90 |
| J3010 |
Fentanyl citrate injection |
1,465 |
1,285 |
$393.84 |
| J2250 |
Inj midazolam hydrochloride |
1,135 |
1,014 |
$393.84 |
| 83036 |
|
450 |
408 |
$367.53 |
| 82607 |
|
194 |
171 |
$355.69 |
| 82550 |
|
939 |
853 |
$288.81 |
| 87205 |
|
201 |
178 |
$248.10 |
| 97116 |
|
64 |
27 |
$225.94 |
| A9270 |
Non-covered item or service |
50 |
13 |
$182.31 |
| 80061 |
|
326 |
303 |
$169.84 |
| 82570 |
|
13 |
12 |
$162.32 |
| 87591 |
|
395 |
367 |
$158.84 |
| 36600 |
|
15 |
12 |
$132.94 |
| 94644 |
|
94 |
75 |
$95.18 |
| J0131 |
Inj, acetaminophen (nos) |
49 |
44 |
$81.98 |
| J7512 |
Prednisone ir or dr oral 1mg |
214 |
136 |
$34.59 |
| 86140 |
|
459 |
432 |
$33.76 |
| 87040 |
|
691 |
418 |
$24.55 |
| 86901 |
|
477 |
399 |
$19.75 |
| 83540 |
|
78 |
66 |
$17.03 |
| 85379 |
|
428 |
396 |
$13.63 |
| G8978 |
Mobility current status |
17 |
12 |
$12.28 |
| 84132 |
|
143 |
130 |
$8.00 |
| 85652 |
|
393 |
358 |
$7.10 |
| 84550 |
|
58 |
51 |
$3.85 |
| 85018 |
|
85 |
54 |
$3.05 |
| 83615 |
|
13 |
12 |
$2.08 |
| J2930 |
Methylprednisolone injection |
209 |
173 |
$0.00 |
| J0692 |
Cefepime hcl for injection |
17 |
12 |
$0.00 |
| 82248 |
|
975 |
892 |
$0.00 |
| 90715 |
|
71 |
68 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
114 |
112 |
$0.00 |
| J2274 |
Inj morphine pf epid ithc |
280 |
250 |
$0.00 |
| 82009 |
|
28 |
26 |
$0.00 |
| 50590 |
|
17 |
14 |
$0.00 |
| 96417 |
|
20 |
13 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
49 |
39 |
$0.00 |
| 84156 |
|
13 |
12 |
$0.00 |
| 99152 |
|
30 |
26 |
$0.00 |
| 82805 |
|
14 |
13 |
$0.00 |
| 84100 |
|
19 |
19 |
$0.00 |
| 85014 |
|
60 |
39 |
$0.00 |
| A9502 |
Tc99m tetrofosmin |
13 |
12 |
$0.00 |
| G8979 |
Mobility goal status |
17 |
12 |
$0.00 |
| 83880 |
|
1,096 |
938 |
$0.00 |
| 82150 |
|
547 |
508 |
$0.00 |
| 94010 |
|
12 |
12 |
$0.00 |
| J2001 |
Lidocaine injection |
701 |
650 |
$0.00 |
| J1170 |
Hydromorphone injection |
1,922 |
1,332 |
$0.00 |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
197 |
185 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
1,436 |
1,311 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
570 |
487 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
204 |
193 |
$0.00 |
| C1769 |
Guide wire |
59 |
57 |
$0.00 |
| 82728 |
|
14 |
14 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
1,868 |
1,607 |
$0.00 |
| J1940 |
Furosemide injection |
94 |
60 |
$0.00 |
| 88342 |
|
28 |
27 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
74 |
65 |
$0.00 |
| J2175 |
Meperidine hydrochl /100 mg |
17 |
15 |
$0.00 |
| 74420 |
|
183 |
174 |
$0.00 |
| C1725 |
Cath, translumin non-laser |
15 |
12 |
$0.00 |
| A9585 |
Gadobutrol injection |
64 |
53 |
$0.00 |
| J3480 |
Inj potassium chloride |
20 |
13 |
$0.00 |
| J0360 |
Hydralazine hcl injection |
12 |
12 |
$0.00 |
| A9579 |
Gad-base mr contrast nos,1ml |
49 |
42 |
$0.00 |
| 82746 |
|
13 |
13 |
$0.00 |