| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpt clinic visit |
27,171 |
18,487 |
$2.07M |
| 96361 |
|
1,083 |
902 |
$230K |
| 99283 |
|
2,800 |
2,572 |
$210K |
| 99284 |
|
2,096 |
1,910 |
$116K |
| 99282 |
|
1,017 |
981 |
$104K |
| 59025 |
|
628 |
358 |
$95K |
| 96360 |
|
425 |
376 |
$71K |
| 96365 |
|
687 |
489 |
$68K |
| 74177 |
|
306 |
297 |
$47K |
| 70450 |
|
450 |
396 |
$42K |
| 93306 |
|
220 |
204 |
$36K |
| 43239 |
|
116 |
107 |
$31K |
| 76815 |
|
388 |
356 |
$23K |
| 76705 |
|
254 |
250 |
$21K |
| 76856 |
|
275 |
273 |
$18K |
| 76811 |
|
280 |
278 |
$18K |
| 74176 |
|
135 |
130 |
$17K |
| 80053 |
|
3,264 |
2,461 |
$16K |
| 76801 |
|
261 |
232 |
$15K |
| 45385 |
|
51 |
43 |
$13K |
| 17110 |
|
112 |
103 |
$12K |
| 76817 |
|
190 |
167 |
$9K |
| 76830 |
|
233 |
231 |
$9K |
| 76819 |
|
143 |
78 |
$8K |
| 97110 |
|
330 |
104 |
$8K |
| 76700 |
|
100 |
99 |
$7K |
| 99285 |
|
221 |
214 |
$7K |
| 77067 |
|
184 |
184 |
$7K |
| 45380 |
|
37 |
34 |
$6K |
| 97127 |
|
37 |
13 |
$6K |
| 76805 |
|
108 |
104 |
$6K |
| 71046 |
|
917 |
851 |
$6K |
| G0108 |
Diab manage trn per indiv |
180 |
159 |
$6K |
| 58300 |
|
57 |
55 |
$5K |
| 11750 |
|
15 |
12 |
$5K |
| 76770 |
|
65 |
64 |
$5K |
| G0378 |
Hospital observation per hr |
303 |
247 |
$5K |
| 11056 |
|
82 |
73 |
$4K |
| 29125 |
|
17 |
17 |
$4K |
| 76642 |
|
42 |
41 |
$3K |
| 94640 |
|
436 |
322 |
$3K |
| 97530 |
|
147 |
81 |
$3K |
| 72148 |
|
28 |
27 |
$3K |
| 97140 |
|
155 |
57 |
$3K |
| 87040 |
|
491 |
254 |
$3K |
| 76536 |
|
40 |
40 |
$3K |
| 85025 |
|
3,890 |
2,948 |
$3K |
| 80048 |
|
404 |
369 |
$3K |
| 80307 |
|
285 |
260 |
$2K |
| 73630 |
|
187 |
167 |
$2K |
| 84484 |
|
672 |
524 |
$2K |
| 87641 |
|
277 |
241 |
$2K |
| 93005 |
|
1,181 |
988 |
$2K |
| 93971 |
|
25 |
24 |
$2K |
| 36415 |
|
3,568 |
2,692 |
$2K |
| 96366 |
|
14 |
12 |
$2K |
| 96413 |
|
26 |
13 |
$2K |
| 97803 |
|
48 |
44 |
$2K |
| 94060 |
|
121 |
116 |
$2K |
| 82553 |
|
354 |
300 |
$2K |
| 71260 |
|
94 |
92 |
$2K |
| 73030 |
|
119 |
115 |
$1K |
| 83880 |
|
468 |
382 |
$1K |
| 73610 |
|
160 |
151 |
$1K |
| 83605 |
|
283 |
241 |
$1K |
| 92507 |
|
25 |
13 |
$1K |
| 11721 |
|
158 |
134 |
$1K |
| 72125 |
|
63 |
62 |
$1K |
| 73130 |
|
121 |
103 |
$997.04 |
| 97535 |
|
163 |
56 |
$976.35 |
| 97162 |
|
20 |
19 |
$833.70 |
| 74018 |
|
135 |
127 |
$833.58 |
| 97112 |
|
28 |
12 |
$824.70 |
| 87420 |
|
39 |
39 |
$819.47 |
| 97802 |
|
13 |
13 |
$819.00 |
| 90715 |
|
46 |
45 |
$806.00 |
| 73560 |
|
39 |
37 |
$805.87 |
| 71045 |
|
674 |
596 |
$797.13 |
| 72110 |
|
30 |
28 |
$744.60 |
| 96372 |
|
1,204 |
895 |
$734.41 |
| 93010 |
|
280 |
236 |
$715.33 |
| 85379 |
|
116 |
115 |
$693.08 |
| 96374 |
|
1,326 |
1,146 |
$691.12 |
| 83735 |
|
798 |
537 |
$680.99 |
| 94729 |
|
43 |
42 |
$658.79 |
| 73562 |
|
90 |
80 |
$534.00 |
| 99213 |
|
16 |
16 |
$530.00 |
| J2704 |
Inj, propofol, 10 mg |
533 |
505 |
$498.87 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
582 |
532 |
$496.91 |
| 96376 |
|
333 |
235 |
$468.16 |
| J0696 |
Ceftriaxone sodium injection |
403 |
306 |
$434.49 |
| 81025 |
|
741 |
701 |
$427.12 |
| 87804 |
|
1,615 |
1,230 |
$403.44 |
| 73110 |
|
48 |
47 |
$359.50 |
| 72100 |
|
59 |
59 |
$352.33 |
| 94726 |
|
41 |
40 |
$339.51 |
| 86850 |
|
170 |
157 |
$338.41 |
| 80329 |
|
107 |
101 |
$336.53 |
| 84443 |
|
214 |
205 |
$335.47 |
| J1642 |
Inj heparin sodium per 10 u |
723 |
255 |
$329.13 |
| 96375 |
|
1,442 |
955 |
$322.21 |
| 81003 |
|
913 |
832 |
$298.29 |
| 70486 |
|
13 |
12 |
$293.01 |
| 86140 |
|
313 |
268 |
$284.85 |
| 85610 |
|
903 |
784 |
$282.76 |
| 71250 |
|
12 |
12 |
$271.08 |
| 86900 |
|
260 |
237 |
$246.59 |
| 85652 |
|
267 |
225 |
$246.48 |
| 87186 |
|
184 |
166 |
$237.69 |
| 83615 |
|
317 |
155 |
$235.82 |
| 73080 |
|
14 |
12 |
$235.27 |
| 87070 |
|
82 |
75 |
$229.76 |
| 73502 |
|
25 |
25 |
$225.36 |
| 72040 |
|
19 |
19 |
$224.44 |
| J7050 |
Normal saline solution infus |
851 |
408 |
$198.26 |
| 84112 |
|
28 |
19 |
$182.18 |
| 88305 |
|
329 |
317 |
$158.96 |
| 82962 |
|
566 |
377 |
$156.95 |
| 87591 |
|
12 |
12 |
$144.93 |
| J7030 |
Normal saline solution infus |
1,888 |
1,585 |
$144.48 |
| 81001 |
|
1,292 |
1,132 |
$142.26 |
| 73140 |
|
13 |
13 |
$137.72 |
| 86901 |
|
259 |
237 |
$132.95 |
| 85730 |
|
720 |
643 |
$128.73 |
| 83690 |
|
905 |
807 |
$128.26 |
| 83036 |
|
590 |
415 |
$127.51 |
| 82150 |
|
606 |
555 |
$118.03 |
| 84145 |
|
13 |
13 |
$114.71 |
| 74022 |
|
132 |
124 |
$109.58 |
| 87086 |
|
435 |
390 |
$107.51 |
| 82550 |
|
460 |
394 |
$105.80 |
| 80306 |
|
275 |
269 |
$90.10 |
| 87880 |
|
536 |
516 |
$81.14 |
| 88312 |
|
133 |
132 |
$80.46 |
| 84703 |
|
70 |
68 |
$68.18 |
| 82728 |
|
15 |
14 |
$66.90 |
| 84100 |
|
223 |
197 |
$59.68 |
| 84702 |
|
117 |
101 |
$54.63 |
| 88304 |
|
49 |
48 |
$51.70 |
| 80061 |
|
18 |
18 |
$51.59 |
| 87430 |
|
214 |
212 |
$48.61 |
| 90471 |
|
44 |
41 |
$43.29 |
| 36591 |
|
68 |
49 |
$40.25 |
| 85027 |
|
19 |
17 |
$37.73 |
| 81002 |
|
311 |
277 |
$36.75 |
| 83550 |
|
14 |
13 |
$33.32 |
| 83540 |
|
14 |
13 |
$33.32 |
| 87081 |
|
206 |
204 |
$31.22 |
| J1170 |
Hydromorphone injection |
725 |
595 |
$30.68 |
| J1100 |
Dexamethasone sodium phos |
703 |
514 |
$24.74 |
| 90686 |
|
19 |
12 |
$22.74 |
| J2405 |
Ondansetron hcl injection |
1,351 |
1,048 |
$21.85 |
| J7120 |
Ringers lactate infusion |
607 |
507 |
$18.13 |
| J1885 |
Ketorolac tromethamine inj |
806 |
722 |
$16.82 |
| J2270 |
Morphine sulfate injection |
188 |
157 |
$14.73 |
| 87205 |
|
90 |
80 |
$8.67 |
| 87807 |
|
82 |
81 |
$7.80 |
| J2930 |
Methylprednisolone injection |
136 |
118 |
$7.18 |
| J7040 |
Normal saline solution infus |
217 |
211 |
$7.08 |
| 87077 |
|
92 |
76 |
$6.79 |
| J3010 |
Fentanyl citrate injection |
427 |
394 |
$5.86 |
| J3301 |
Triamcinolone acet inj nos |
33 |
30 |
$5.84 |
| J2060 |
Lorazepam injection |
179 |
163 |
$4.57 |
| 87088 |
|
133 |
116 |
$2.89 |
| J2250 |
Inj midazolam hydrochloride |
318 |
299 |
$2.63 |
| A4216 |
Sterile water/saline, 10 ml |
54 |
34 |
$2.45 |
| J2550 |
Promethazine hcl injection |
290 |
263 |
$1.92 |
| J1200 |
Diphenhydramine hcl injectio |
263 |
211 |
$1.83 |
| J7512 |
Prednisone ir or dr oral 1mg |
26 |
25 |
$1.29 |
| J7613 |
Albuterol non-comp unit |
123 |
121 |
$0.74 |
| 77063 |
|
184 |
184 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
194 |
176 |
$0.00 |
| A9585 |
Gadobutrol injection |
46 |
46 |
$0.00 |
| 99406 |
|
154 |
130 |
$0.00 |
| J2001 |
Lidocaine injection |
85 |
72 |
$0.00 |
| J7060 |
5% dextrose/water |
37 |
16 |
$0.00 |
| 84436 |
|
13 |
13 |
$0.00 |
| G0008 |
Admin influenza virus vac |
34 |
19 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
13 |
13 |
$0.00 |
| G0009 |
Admin pneumococcal vaccine |
20 |
12 |
$0.00 |
| 88313 |
|
28 |
28 |
$0.00 |
| J0780 |
Prochlorperazine injection |
12 |
12 |
$0.00 |
| 51702 |
|
17 |
15 |
$0.00 |
| A4315 |
Cath w/drainage 2-way silcne |
15 |
15 |
$0.00 |
| 87491 |
|
12 |
12 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
30 |
29 |
$0.00 |
| J1650 |
Inj enoxaparin sodium |
44 |
31 |
$0.00 |
| S0164 |
Injection pantroprazole |
19 |
14 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
83 |
80 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
20 |
14 |
$0.00 |