| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
10,330 |
9,462 |
$1.02M |
| 41899 |
|
966 |
845 |
$576K |
| 99285 |
|
1,717 |
1,551 |
$511K |
| 99284 |
|
2,956 |
2,712 |
$448K |
| 74176 |
|
693 |
626 |
$315K |
| 87502 |
|
1,205 |
1,124 |
$96K |
| 80053 |
|
11,937 |
10,407 |
$80K |
| J9271 |
Inj pembrolizumab |
16 |
12 |
$68K |
| 96413 |
|
1,006 |
588 |
$66K |
| 87635 |
|
1,414 |
1,311 |
$51K |
| 70450 |
|
278 |
258 |
$51K |
| 80307 |
|
1,076 |
936 |
$50K |
| 36415 |
|
24,468 |
20,638 |
$47K |
| 85025 |
|
9,491 |
8,368 |
$46K |
| 71046 |
|
731 |
662 |
$37K |
| 80050 |
|
695 |
641 |
$24K |
| 80061 |
|
2,244 |
2,127 |
$24K |
| 93005 |
|
1,015 |
904 |
$23K |
| 71045 |
|
686 |
632 |
$21K |
| 83735 |
|
4,265 |
3,634 |
$17K |
| 84100 |
|
4,106 |
3,502 |
$11K |
| 81001 |
|
5,374 |
4,659 |
$10K |
| 96367 |
|
333 |
165 |
$8K |
| 96372 |
|
869 |
670 |
$8K |
| J7030 |
Normal saline solution infus |
963 |
824 |
$5K |
| 99282 |
|
59 |
58 |
$5K |
| J1885 |
Ketorolac tromethamine inj |
909 |
831 |
$5K |
| J7040 |
Normal saline solution infus |
366 |
236 |
$5K |
| 83880 |
|
201 |
181 |
$5K |
| 81025 |
|
668 |
587 |
$4K |
| 82306 |
|
190 |
172 |
$4K |
| 82150 |
|
893 |
810 |
$4K |
| 83036 |
|
530 |
497 |
$4K |
| 96417 |
|
59 |
28 |
$4K |
| 84484 |
|
471 |
394 |
$3K |
| J2405 |
Ondansetron hcl injection |
208 |
134 |
$3K |
| 82553 |
|
455 |
369 |
$3K |
| 82550 |
|
622 |
531 |
$2K |
| 87081 |
|
327 |
299 |
$2K |
| 87086 |
|
319 |
286 |
$2K |
| 96375 |
|
133 |
65 |
$1K |
| 96360 |
|
102 |
58 |
$1K |
| 85730 |
|
342 |
309 |
$1K |
| J2930 |
Methylprednisolone injection |
213 |
193 |
$1K |
| 85027 |
|
294 |
275 |
$850.35 |
| 96365 |
|
30 |
28 |
$837.34 |
| 85610 |
|
334 |
308 |
$801.17 |
| 83605 |
|
157 |
134 |
$788.98 |
| 96374 |
|
183 |
111 |
$788.27 |
| 99281 |
|
12 |
12 |
$627.22 |
| 96361 |
|
95 |
44 |
$613.16 |
| 70220 |
|
17 |
12 |
$538.09 |
| 82077 |
|
46 |
44 |
$479.93 |
| J0780 |
Prochlorperazine injection |
83 |
74 |
$447.95 |
| 84439 |
|
51 |
50 |
$422.47 |
| J1642 |
Inj heparin sodium per 10 u |
363 |
224 |
$388.86 |
| J0702 |
Betamethasone acet&sod phosp |
59 |
53 |
$316.38 |
| 90853 |
|
3,261 |
268 |
$299.46 |
| J1200 |
Diphenhydramine hcl injectio |
56 |
25 |
$259.20 |
| 80164 |
|
19 |
12 |
$166.54 |
| J1100 |
Dexamethasone sodium phos |
330 |
185 |
$153.50 |
| 80048 |
|
19 |
18 |
$152.28 |
| 80143 |
|
12 |
12 |
$140.65 |
| 80179 |
|
12 |
12 |
$140.65 |
| J2704 |
Inj, propofol, 10 mg |
1,459 |
1,183 |
$86.58 |
| J7050 |
Normal saline solution infus |
34 |
25 |
$83.99 |
| J0696 |
Ceftriaxone sodium injection |
12 |
12 |
$67.20 |
| 86140 |
|
12 |
12 |
$62.16 |
| J2175 |
Meperidine hydrochl /100 mg |
158 |
138 |
$59.30 |
| J2919 |
Inj, methylpred sod succ 5mg |
20 |
12 |
$29.77 |
| 85007 |
|
12 |
12 |
$27.45 |
| A9270 |
Non-covered item or service |
212 |
188 |
$22.80 |
| S0028 |
Injection, famotidine, 20 mg |
35 |
28 |
$8.30 |
| J3010 |
Fentanyl citrate injection |
245 |
218 |
$7.40 |
| 90832 |
|
49 |
37 |
$0.00 |
| J7120 |
Ringers lactate infusion |
52 |
51 |
$0.00 |
| 96523 |
|
36 |
12 |
$0.00 |
| J0897 |
Denosumab injection |
15 |
13 |
$0.00 |
| A4217 |
Sterile water/saline, 500 ml |
24 |
14 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
68 |
66 |
$0.00 |
| J7042 |
5% dextrose/normal saline |
224 |
138 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
15 |
13 |
$0.00 |