| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 36415 |
|
4,517 |
3,300 |
$555K |
| 80053 |
|
4,270 |
3,194 |
$433K |
| 85025 |
|
4,339 |
3,283 |
$367K |
| 99283 |
|
6,527 |
5,180 |
$359K |
| 99284 |
|
4,639 |
3,527 |
$319K |
| 99285 |
|
1,889 |
1,481 |
$308K |
| 93005 |
|
1,843 |
1,439 |
$253K |
| 84484 |
|
1,384 |
1,020 |
$249K |
| J7030 |
Normal saline solution infus |
1,749 |
1,303 |
$240K |
| 71045 |
|
1,651 |
1,326 |
$210K |
| 87804 |
|
2,623 |
2,038 |
$209K |
| 87040 |
|
967 |
532 |
$205K |
| 96361 |
|
1,372 |
974 |
$202K |
| 96375 |
|
1,696 |
1,316 |
$196K |
| 96374 |
|
2,022 |
1,528 |
$184K |
| 70450 |
|
893 |
710 |
$174K |
| 81003 |
|
1,991 |
1,583 |
$141K |
| 94640 |
|
899 |
609 |
$135K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
651 |
528 |
$131K |
| 96365 |
|
847 |
675 |
$121K |
| 83605 |
|
588 |
455 |
$104K |
| 82803 |
|
568 |
436 |
$99K |
| 99282 |
|
1,043 |
881 |
$90K |
| 81001 |
|
1,479 |
1,199 |
$86K |
| 36600 |
|
315 |
247 |
$86K |
| J2405 |
Ondansetron hcl injection |
1,273 |
940 |
$81K |
| 99281 |
|
826 |
698 |
$81K |
| 74176 |
|
450 |
362 |
$78K |
| 83880 |
|
392 |
305 |
$70K |
| 71046 |
|
1,068 |
892 |
$67K |
| 83690 |
|
796 |
617 |
$62K |
| 81025 |
|
1,453 |
1,163 |
$51K |
| 74177 |
|
378 |
310 |
$45K |
| J0696 |
Ceftriaxone sodium injection |
527 |
430 |
$39K |
| 87430 |
|
2,038 |
1,744 |
$37K |
| J1885 |
Ketorolac tromethamine inj |
1,101 |
845 |
$33K |
| 96372 |
|
1,371 |
1,110 |
$32K |
| J2270 |
Morphine sulfate injection |
484 |
373 |
$32K |
| 80306 |
|
543 |
437 |
$30K |
| 87086 |
|
498 |
411 |
$28K |
| 80048 |
|
190 |
130 |
$25K |
| 82550 |
|
76 |
51 |
$23K |
| J2930 |
Methylprednisolone injection |
264 |
213 |
$22K |
| 85378 |
|
161 |
128 |
$22K |
| 94760 |
|
271 |
219 |
$21K |
| 96360 |
|
177 |
137 |
$15K |
| 73630 |
|
190 |
172 |
$14K |
| 82962 |
|
163 |
82 |
$13K |
| 73130 |
|
211 |
183 |
$13K |
| 83735 |
|
80 |
61 |
$12K |
| J2060 |
Lorazepam injection |
171 |
128 |
$11K |
| 74018 |
|
211 |
184 |
$10K |
| 85610 |
|
44 |
40 |
$10K |
| J1170 |
Hydromorphone injection |
204 |
164 |
$10K |
| 85730 |
|
43 |
39 |
$9K |
| 93306 |
|
19 |
18 |
$9K |
| 84443 |
|
46 |
39 |
$8K |
| J1100 |
Dexamethasone sodium phos |
300 |
243 |
$8K |
| J2550 |
Promethazine hcl injection |
97 |
69 |
$8K |
| J7512 |
Prednisone ir or dr oral 1mg |
367 |
324 |
$7K |
| 87186 |
|
173 |
140 |
$7K |
| 72125 |
|
37 |
30 |
$6K |
| 96366 |
|
38 |
28 |
$6K |
| 73610 |
|
109 |
104 |
$6K |
| 80307 |
|
86 |
52 |
$5K |
| 87088 |
|
93 |
78 |
$4K |
| J7050 |
Normal saline solution infus |
35 |
27 |
$4K |
| J7040 |
Normal saline solution infus |
43 |
28 |
$4K |
| 72100 |
|
61 |
56 |
$2K |
| 96376 |
|
31 |
27 |
$2K |
| 73030 |
|
32 |
25 |
$1K |
| 73564 |
|
18 |
15 |
$1K |
| 90714 |
|
17 |
13 |
$716.54 |
| J2765 |
Metoclopramide hcl injection |
53 |
47 |
$563.42 |
| 73110 |
|
16 |
12 |
$541.03 |
| J1940 |
Furosemide injection |
15 |
13 |
$450.34 |
| J1200 |
Diphenhydramine hcl injectio |
60 |
51 |
$153.19 |
| 87807 |
|
318 |
286 |
$109.52 |
| J7510 |
Prednisolone oral per 5 mg |
56 |
49 |
$0.00 |
| J3370 |
Vancomycin hcl injection |
16 |
12 |
$0.00 |