| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74176 |
|
1,201 |
889 |
$323K |
| 99285 |
|
1,890 |
1,373 |
$291K |
| 99284 |
|
3,559 |
2,707 |
$278K |
| 99283 |
|
4,084 |
3,214 |
$193K |
| G0378 |
Hospital observation per hr |
916 |
393 |
$181K |
| 85025 |
|
8,146 |
5,701 |
$141K |
| 70450 |
|
987 |
737 |
$126K |
| 36415 |
|
8,823 |
5,024 |
$114K |
| 80053 |
|
6,078 |
4,518 |
$113K |
| 96365 |
|
1,107 |
768 |
$109K |
| 96374 |
|
1,337 |
955 |
$92K |
| 96372 |
|
2,660 |
1,921 |
$91K |
| 94640 |
|
1,392 |
858 |
$83K |
| 96361 |
|
1,241 |
822 |
$69K |
| 84484 |
|
1,767 |
1,120 |
$66K |
| 93005 |
|
2,152 |
1,528 |
$65K |
| 71045 |
|
1,953 |
1,402 |
$65K |
| 96375 |
|
1,640 |
1,026 |
$58K |
| 80048 |
|
2,450 |
1,715 |
$50K |
| 74177 |
|
155 |
73 |
$49K |
| 81001 |
|
2,167 |
1,694 |
$46K |
| 94664 |
|
1,021 |
770 |
$46K |
| 80307 |
|
936 |
637 |
$46K |
| J2550 |
Promethazine hcl injection |
768 |
470 |
$43K |
| 83690 |
|
1,364 |
937 |
$39K |
| J2300 |
Inj nalbuphine hydrochloride |
785 |
446 |
$38K |
| 71046 |
|
1,114 |
922 |
$36K |
| 82150 |
|
913 |
654 |
$35K |
| 72125 |
|
273 |
222 |
$35K |
| 84443 |
|
1,687 |
1,514 |
$34K |
| 80061 |
|
1,450 |
1,324 |
$30K |
| 87430 |
|
1,639 |
1,363 |
$30K |
| 87040 |
|
922 |
626 |
$29K |
| 86710 |
|
1,424 |
1,187 |
$29K |
| 86738 |
|
962 |
769 |
$28K |
| 99282 |
|
591 |
523 |
$27K |
| 83880 |
|
648 |
425 |
$25K |
| 83036 |
|
1,275 |
1,159 |
$25K |
| J2405 |
Ondansetron hcl injection |
1,408 |
799 |
$24K |
| 97110 |
|
608 |
157 |
$24K |
| 87070 |
|
1,674 |
1,368 |
$23K |
| J7030 |
Normal saline solution infus |
2,122 |
1,154 |
$23K |
| 72131 |
|
282 |
214 |
$23K |
| 81003 |
|
908 |
676 |
$20K |
| 84703 |
|
981 |
779 |
$17K |
| 87086 |
|
701 |
552 |
$16K |
| 82607 |
|
579 |
526 |
$16K |
| 97140 |
|
461 |
126 |
$15K |
| 74018 |
|
106 |
82 |
$14K |
| 73630 |
|
339 |
290 |
$13K |
| J0696 |
Ceftriaxone sodium injection |
1,072 |
756 |
$13K |
| 36600 |
|
345 |
247 |
$12K |
| 85610 |
|
1,044 |
694 |
$12K |
| J1885 |
Ketorolac tromethamine inj |
1,161 |
829 |
$12K |
| J2270 |
Morphine sulfate injection |
512 |
309 |
$11K |
| 83735 |
|
619 |
478 |
$11K |
| 85730 |
|
524 |
434 |
$10K |
| 83605 |
|
487 |
311 |
$10K |
| 82306 |
|
299 |
271 |
$9K |
| 82803 |
|
336 |
249 |
$9K |
| 73030 |
|
72 |
59 |
$9K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
204 |
132 |
$9K |
| 97035 |
|
287 |
85 |
$8K |
| 93010 |
|
241 |
148 |
$7K |
| 99281 |
|
314 |
277 |
$7K |
| 87205 |
|
414 |
337 |
$7K |
| 87186 |
|
303 |
246 |
$7K |
| 82043 |
|
245 |
222 |
$7K |
| 85651 |
|
370 |
302 |
$7K |
| 82962 |
|
420 |
133 |
$7K |
| 73610 |
|
219 |
192 |
$6K |
| 82248 |
|
189 |
167 |
$6K |
| 96360 |
|
87 |
63 |
$5K |
| 96376 |
|
182 |
97 |
$5K |
| 87088 |
|
122 |
107 |
$5K |
| 73562 |
|
165 |
136 |
$5K |
| 82652 |
|
104 |
93 |
$4K |
| 72100 |
|
65 |
63 |
$4K |
| 73130 |
|
89 |
83 |
$4K |
| J2930 |
Methylprednisolone injection |
414 |
257 |
$4K |
| 85378 |
|
124 |
98 |
$4K |
| J3490 |
Drugs unclassified injection |
308 |
117 |
$3K |
| 70486 |
|
21 |
12 |
$3K |
| G0480 |
Drug test def 1-7 classes |
32 |
20 |
$2K |
| 96367 |
|
57 |
30 |
$2K |
| 80076 |
|
178 |
145 |
$2K |
| 84439 |
|
85 |
75 |
$2K |
| J1100 |
Dexamethasone sodium phos |
125 |
103 |
$1K |
| 77067 |
|
14 |
14 |
$1K |
| 84702 |
|
41 |
24 |
$1K |
| 80320 |
|
80 |
43 |
$973.45 |
| 82553 |
|
46 |
30 |
$736.96 |
| 80171 |
|
29 |
24 |
$661.88 |
| 81015 |
|
113 |
83 |
$649.55 |
| 84550 |
|
37 |
33 |
$647.97 |
| 86140 |
|
131 |
72 |
$596.10 |
| 82746 |
|
35 |
27 |
$581.35 |
| 85027 |
|
53 |
28 |
$560.53 |
| 86803 |
|
49 |
44 |
$538.63 |
| 87077 |
|
36 |
26 |
$529.72 |
| 94760 |
|
167 |
112 |
$426.68 |
| 99217 |
|
18 |
12 |
$373.29 |
| J2360 |
Orphenadrine injection |
59 |
43 |
$284.57 |
| 86430 |
|
38 |
28 |
$195.69 |
| 73590 |
|
19 |
13 |
$160.31 |
| C9113 |
Inj pantoprazole sodium, via |
38 |
13 |
$130.18 |
| 90471 |
|
12 |
12 |
$96.00 |
| 82550 |
|
18 |
12 |
$61.85 |
| J1170 |
Hydromorphone injection |
22 |
12 |
$60.87 |
| 90714 |
|
12 |
12 |
$17.32 |