| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
4,893 |
4,339 |
$851K |
| 99284 |
|
2,812 |
2,428 |
$563K |
| 80053 |
|
4,648 |
4,020 |
$78K |
| 0241U |
|
467 |
446 |
$51K |
| 99282 |
|
350 |
327 |
$42K |
| 85025 |
|
4,977 |
4,260 |
$29K |
| 83605 |
|
651 |
578 |
$19K |
| 96374 |
|
564 |
521 |
$15K |
| 91300 |
|
376 |
313 |
$10K |
| 0002A |
|
191 |
185 |
$9K |
| 99285 |
|
44 |
39 |
$9K |
| 74177 |
|
25 |
24 |
$8K |
| 96361 |
|
66 |
64 |
$8K |
| 87635 |
|
172 |
168 |
$7K |
| 0001A |
|
206 |
194 |
$6K |
| 36415 |
|
1,502 |
1,280 |
$5K |
| 87502 |
|
86 |
83 |
$5K |
| 96375 |
|
133 |
117 |
$4K |
| 81001 |
|
455 |
411 |
$4K |
| 86140 |
|
317 |
279 |
$2K |
| 93005 |
|
47 |
42 |
$1K |
| 84443 |
|
104 |
87 |
$1K |
| 87804 |
|
104 |
94 |
$1K |
| 71046 |
|
15 |
13 |
$778.25 |
| 80061 |
|
38 |
32 |
$557.05 |
| 87651 |
|
14 |
13 |
$352.85 |
| 84484 |
|
28 |
25 |
$234.78 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
14 |
13 |
$196.21 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
86 |
78 |
$186.34 |
| 83690 |
|
18 |
16 |
$167.68 |
| 90832 |
|
45 |
28 |
$125.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
12 |
12 |
$93.04 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
13 |
12 |
$45.68 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
14 |
13 |
$18.29 |