| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
|
24,035 |
21,531 |
$4.13M |
| 74177 |
|
3,309 |
2,808 |
$2.58M |
| 99283 |
|
18,413 |
17,079 |
$2.14M |
| 99285 |
|
5,384 |
4,562 |
$2.02M |
| 87637 |
|
3,854 |
3,663 |
$893K |
| 99282 |
|
11,275 |
10,658 |
$635K |
| 70450 |
|
2,490 |
2,101 |
$612K |
| 96374 |
|
6,423 |
5,445 |
$606K |
| G0378 |
Hospital observation per hr |
937 |
748 |
$586K |
| 96361 |
|
6,083 |
4,901 |
$476K |
| 96365 |
|
3,178 |
2,602 |
$462K |
| 80307 |
|
2,848 |
2,515 |
$448K |
| 80053 |
|
14,872 |
12,150 |
$420K |
| 96375 |
|
5,718 |
4,688 |
$360K |
| 97110 |
|
5,864 |
1,949 |
$350K |
| 85025 |
|
14,641 |
12,075 |
$297K |
| 80050 |
|
3,066 |
2,789 |
$278K |
| 71260 |
|
706 |
571 |
$277K |
| 87631 |
|
1,006 |
974 |
$270K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
98 |
97 |
$224K |
| 93005 |
|
4,810 |
4,155 |
$224K |
| 97140 |
|
4,045 |
1,307 |
$211K |
| 93306 |
|
410 |
399 |
$202K |
| 87651 |
|
2,042 |
1,988 |
$194K |
| 96372 |
|
3,426 |
2,889 |
$182K |
| 96366 |
|
1,203 |
838 |
$172K |
| 72125 |
|
431 |
372 |
$169K |
| 83880 |
|
2,005 |
1,785 |
$157K |
| 83605 |
|
4,993 |
4,064 |
$153K |
| 71045 |
|
5,084 |
3,976 |
$153K |
| 87635 |
|
2,360 |
2,185 |
$144K |
| 59025 |
|
895 |
426 |
$141K |
| 84484 |
|
4,871 |
3,193 |
$140K |
| 96360 |
|
1,267 |
1,178 |
$131K |
| 87491 |
|
1,137 |
1,090 |
$113K |
| 87591 |
|
1,137 |
1,090 |
$111K |
| 74176 |
|
292 |
240 |
$109K |
| 99211 |
|
663 |
507 |
$104K |
| 97530 |
|
1,714 |
704 |
$103K |
| 83690 |
|
5,190 |
4,613 |
$101K |
| 71046 |
|
1,654 |
1,490 |
$95K |
| 92507 |
|
816 |
357 |
$92K |
| 76705 |
|
768 |
704 |
$91K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
2,073 |
1,952 |
$91K |
| 96376 |
|
2,327 |
1,716 |
$87K |
| 36415 |
|
12,118 |
9,630 |
$84K |
| J7120 |
Ringers lactate infusion |
3,334 |
2,805 |
$78K |
| 81025 |
|
3,719 |
3,447 |
$78K |
| 87040 |
|
2,504 |
1,442 |
$72K |
| 82077 |
|
1,636 |
1,371 |
$71K |
| J0131 |
Inj, acetaminophen (nos) |
1,412 |
1,304 |
$68K |
| 87088 |
|
2,879 |
2,712 |
$61K |
| 84145 |
|
977 |
870 |
$59K |
| 83735 |
|
3,501 |
2,950 |
$57K |
| 84443 |
|
1,472 |
1,365 |
$56K |
| 76856 |
|
429 |
408 |
$55K |
| 81003 |
|
7,484 |
6,682 |
$54K |
| 81001 |
|
6,041 |
4,966 |
$53K |
| J2405 |
Ondansetron hcl injection |
5,480 |
4,624 |
$53K |
| 87077 |
|
1,925 |
1,795 |
$52K |
| 85730 |
|
3,445 |
3,145 |
$51K |
| 93041 |
|
2,279 |
2,055 |
$50K |
| 82805 |
|
293 |
224 |
$46K |
| 85610 |
|
4,379 |
3,862 |
$46K |
| 76830 |
|
273 |
262 |
$45K |
| 76801 |
|
294 |
266 |
$45K |
| 94060 |
|
418 |
391 |
$45K |
| 82150 |
|
2,564 |
2,335 |
$44K |
| J0561 |
Penicillin g benzathine inj |
61 |
61 |
$43K |
| J1170 |
Hydromorphone injection |
2,471 |
1,914 |
$42K |
| 71275 |
|
64 |
54 |
$41K |
| 87186 |
|
1,643 |
1,525 |
$41K |
| 73610 |
|
381 |
336 |
$40K |
| J7030 |
Normal saline solution infus |
2,078 |
1,745 |
$39K |
| 73130 |
|
388 |
342 |
$38K |
| 87502 |
|
315 |
312 |
$37K |
| 94640 |
|
693 |
498 |
$34K |
| 85379 |
|
1,270 |
1,200 |
$34K |
| 99281 |
|
1,265 |
1,213 |
$33K |
| 85027 |
|
2,056 |
1,766 |
$33K |
| 83036 |
|
1,297 |
1,248 |
$33K |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
838 |
805 |
$31K |
| 97161 |
|
322 |
309 |
$30K |
| 87070 |
|
1,091 |
977 |
$29K |
| 88305 |
|
387 |
293 |
$29K |
| 86140 |
|
2,088 |
1,898 |
$27K |
| J1885 |
Ketorolac tromethamine inj |
3,395 |
3,095 |
$26K |
| 84702 |
|
620 |
529 |
$26K |
| J3010 |
Fentanyl citrate injection |
2,148 |
1,777 |
$26K |
| 86850 |
|
630 |
361 |
$25K |
| 76816 |
|
202 |
191 |
$25K |
| 77067 |
|
299 |
293 |
$24K |
| 80061 |
|
624 |
603 |
$24K |
| 73110 |
|
200 |
159 |
$23K |
| J2704 |
Inj, propofol, 10 mg |
1,679 |
1,367 |
$23K |
| 0241U |
|
925 |
808 |
$22K |
| 73562 |
|
217 |
201 |
$21K |
| 70553 |
|
33 |
25 |
$20K |
| 94729 |
|
155 |
147 |
$19K |
| 90715 |
|
288 |
286 |
$19K |
| 76817 |
|
138 |
114 |
$18K |
| 76805 |
|
104 |
103 |
$18K |
| 80048 |
|
934 |
766 |
$18K |
| 84703 |
|
729 |
676 |
$17K |
| 82248 |
|
1,223 |
1,057 |
$16K |
| 73030 |
|
178 |
151 |
$15K |
| 87880 |
|
345 |
330 |
$13K |
| A9576 |
Inj prohance multipack |
206 |
204 |
$13K |
| J7040 |
Normal saline solution infus |
637 |
364 |
$12K |
| J2250 |
Inj midazolam hydrochloride |
1,409 |
1,286 |
$12K |
| 70486 |
|
25 |
25 |
$11K |
| 73630 |
|
129 |
111 |
$10K |
| 93017 |
|
114 |
114 |
$10K |
| 82948 |
|
660 |
430 |
$10K |
| 73721 |
|
13 |
13 |
$10K |
| A9579 |
Gad-base mr contrast nos,1ml |
152 |
146 |
$10K |
| J1100 |
Dexamethasone sodium phos |
1,309 |
1,211 |
$10K |
| J0690 |
Cefazolin sodium injection |
866 |
764 |
$9K |
| 82550 |
|
524 |
476 |
$8K |
| J0696 |
Ceftriaxone sodium injection |
965 |
666 |
$7K |
| 87210 |
|
482 |
456 |
$7K |
| 86901 |
|
685 |
630 |
$7K |
| C9113 |
Inj pantoprazole sodium, via |
676 |
589 |
$7K |
| 78452 |
|
12 |
12 |
$7K |
| 86900 |
|
594 |
550 |
$6K |
| 76642 |
|
92 |
83 |
$6K |
| J2270 |
Morphine sulfate injection |
361 |
274 |
$5K |
| 97035 |
|
273 |
124 |
$5K |
| 85651 |
|
552 |
524 |
$5K |
| 87205 |
|
437 |
371 |
$5K |
| 96367 |
|
58 |
54 |
$5K |
| 77063 |
|
272 |
268 |
$5K |
| J7050 |
Normal saline solution infus |
290 |
216 |
$4K |
| 97112 |
|
111 |
43 |
$4K |
| 87420 |
|
87 |
84 |
$4K |
| J2060 |
Lorazepam injection |
387 |
338 |
$4K |
| 71250 |
|
17 |
12 |
$4K |
| 80305 |
|
122 |
111 |
$3K |
| 84439 |
|
148 |
142 |
$3K |
| 76815 |
|
27 |
13 |
$3K |
| 99212 |
|
45 |
37 |
$3K |
| 85007 |
|
271 |
239 |
$2K |
| G0279 |
Tomosynthesis, mammo |
83 |
66 |
$2K |
| 90471 |
|
118 |
118 |
$2K |
| J2710 |
Neostigmine methylslfte inj |
39 |
37 |
$2K |
| J3490 |
Drugs unclassified injection |
89 |
78 |
$2K |
| 73502 |
|
17 |
12 |
$2K |
| 80320 |
|
2,332 |
1,900 |
$2K |
| 94726 |
|
13 |
12 |
$2K |
| 80047 |
|
61 |
56 |
$2K |
| 97162 |
|
15 |
13 |
$2K |
| 99213 |
|
15 |
13 |
$1K |
| J0171 |
Adrenalin epinephrine inject |
76 |
69 |
$1K |
| 82565 |
|
131 |
128 |
$1K |
| 87220 |
|
101 |
91 |
$1K |
| 73560 |
|
16 |
12 |
$1K |
| J2550 |
Promethazine hcl injection |
154 |
127 |
$1K |
| 76000 |
|
12 |
12 |
$1K |
| 82570 |
|
69 |
66 |
$1K |
| 12001 |
|
12 |
12 |
$900.51 |
| 82140 |
|
20 |
15 |
$875.67 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
45 |
38 |
$787.83 |
| 93010 |
|
189 |
178 |
$717.98 |
| 86703 |
|
13 |
12 |
$648.58 |
| 36600 |
|
15 |
14 |
$568.61 |
| J2765 |
Metoclopramide hcl injection |
90 |
76 |
$555.24 |
| 0202U |
|
640 |
617 |
$552.14 |
| 82247 |
|
36 |
12 |
$539.91 |
| J1200 |
Diphenhydramine hcl injectio |
74 |
68 |
$523.03 |
| 85014 |
|
137 |
126 |
$517.41 |
| 87340 |
|
14 |
14 |
$516.24 |
| J3475 |
Inj magnesium sulfate |
32 |
24 |
$350.36 |
| 93016 |
|
32 |
30 |
$253.06 |
| J2470 |
Inj pantoprazole sodium 40mg |
28 |
26 |
$239.72 |
| 82043 |
|
13 |
13 |
$224.16 |
| 99238 |
|
13 |
12 |
$214.70 |
| 36416 |
|
31 |
29 |
$212.94 |
| J2543 |
Piperacillin/tazobactam |
17 |
12 |
$210.49 |
| 93018 |
|
32 |
30 |
$150.92 |
| J2471 |
Inj pantoprazole(hikma) 40mg |
29 |
26 |
$140.48 |
| J2930 |
Methylprednisolone injection |
13 |
12 |
$139.93 |
| 84520 |
|
13 |
13 |
$136.18 |
| J1815 |
Insulin injection |
14 |
12 |
$134.44 |
| J2001 |
Lidocaine injection |
15 |
14 |
$129.91 |
| J2360 |
Orphenadrine injection |
13 |
13 |
$121.51 |
| A4215 |
Sterile needle |
497 |
483 |
$114.68 |
| 93000 |
|
18 |
17 |
$104.23 |
| 84100 |
|
13 |
12 |
$95.94 |
| 81015 |
|
71 |
68 |
$85.93 |
| 80329 |
|
1,596 |
858 |
$63.02 |
| Q0162 |
Ondansetron oral |
12 |
12 |
$31.86 |
| J7620 |
Albuterol ipratrop non-comp |
30 |
26 |
$28.29 |
| 85008 |
|
28 |
25 |
$10.94 |
| J7613 |
Albuterol non-comp unit |
14 |
13 |
$5.64 |
| A9270 |
Non-covered item or service |
752 |
556 |
$0.00 |
| T1015 |
Clinic service |
80 |
72 |
$0.00 |