| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
9,978 |
9,647 |
$425K |
| 99284 |
|
7,021 |
6,695 |
$256K |
| 11042 |
|
1,581 |
917 |
$144K |
| 80053 |
|
8,484 |
7,200 |
$73K |
| 87637 |
|
418 |
407 |
$43K |
| 85025 |
|
10,648 |
9,129 |
$39K |
| 96374 |
|
2,261 |
2,171 |
$38K |
| 87633 |
|
77 |
76 |
$26K |
| 96361 |
|
1,338 |
1,267 |
$22K |
| 96375 |
|
692 |
651 |
$18K |
| 99282 |
|
270 |
266 |
$11K |
| 93005 |
|
1,220 |
1,076 |
$10K |
| 83735 |
|
1,525 |
680 |
$9K |
| 83615 |
|
1,476 |
634 |
$9K |
| 99211 |
|
813 |
316 |
$7K |
| 96372 |
|
321 |
291 |
$7K |
| 87502 |
|
63 |
59 |
$5K |
| 31720 |
|
111 |
48 |
$5K |
| 87798 |
|
77 |
76 |
$5K |
| 84484 |
|
535 |
474 |
$4K |
| 71045 |
|
316 |
306 |
$3K |
| 99281 |
|
109 |
107 |
$3K |
| 97110 |
|
113 |
45 |
$3K |
| 87631 |
|
30 |
29 |
$3K |
| 70450 |
|
50 |
47 |
$3K |
| 71046 |
|
261 |
249 |
$3K |
| 74177 |
|
25 |
25 |
$2K |
| 87651 |
|
173 |
171 |
$2K |
| 80048 |
|
515 |
467 |
$2K |
| 83690 |
|
254 |
248 |
$2K |
| 81003 |
|
1,312 |
1,249 |
$1K |
| 97597 |
|
20 |
14 |
$1K |
| 99285 |
|
28 |
26 |
$1K |
| 87581 |
|
77 |
76 |
$997.75 |
| 87486 |
|
77 |
76 |
$997.74 |
| 84443 |
|
119 |
110 |
$980.00 |
| 96360 |
|
28 |
27 |
$939.89 |
| 81001 |
|
347 |
331 |
$908.18 |
| 81025 |
|
108 |
107 |
$786.15 |
| J1885 |
Ketorolac tromethamine inj |
345 |
327 |
$467.25 |
| 94640 |
|
40 |
30 |
$400.48 |
| G0463 |
Hospital outpt clinic visit |
144 |
64 |
$389.09 |
| 87426 |
|
18 |
15 |
$387.58 |
| 87800 |
|
12 |
12 |
$328.29 |
| 83036 |
|
55 |
55 |
$315.11 |
| 82248 |
|
117 |
101 |
$292.88 |
| 80061 |
|
32 |
32 |
$287.20 |
| J7030 |
Normal saline solution infus |
1,081 |
940 |
$202.99 |
| 87086 |
|
34 |
32 |
$186.24 |
| 83880 |
|
12 |
12 |
$167.52 |
| 87186 |
|
29 |
28 |
$166.53 |
| 87075 |
|
31 |
26 |
$146.27 |
| 36415 |
|
5,396 |
3,969 |
$143.85 |
| 87880 |
|
13 |
13 |
$113.46 |
| 87081 |
|
12 |
12 |
$101.93 |
| 87070 |
|
31 |
26 |
$86.13 |
| J7120 |
Ringers lactate infusion |
61 |
50 |
$70.56 |
| 85610 |
|
72 |
38 |
$67.00 |
| 85027 |
|
13 |
13 |
$59.07 |
| 83605 |
|
13 |
12 |
$53.26 |
| 87205 |
|
31 |
26 |
$48.51 |
| J2405 |
Ondansetron hcl injection |
87 |
78 |
$35.05 |
| J3010 |
Fentanyl citrate injection |
82 |
62 |
$32.85 |
| J7050 |
Normal saline solution infus |
38 |
25 |
$12.97 |
| J1100 |
Dexamethasone sodium phos |
36 |
30 |
$11.31 |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
88 |
54 |
$7.63 |
| P9604 |
One-way allow prorated trip |
823 |
663 |
$3.07 |
| A9270 |
Non-covered item or service |
129 |
46 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
52 |
38 |
$0.00 |
| 36416 |
|
42 |
31 |
$0.00 |