| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
9,922 |
9,246 |
$963K |
| 99283 |
|
13,745 |
13,038 |
$951K |
| 99282 |
|
5,717 |
5,499 |
$247K |
| 80053 |
|
13,373 |
11,415 |
$107K |
| 93005 |
|
5,537 |
5,019 |
$106K |
| 85025 |
|
14,249 |
12,120 |
$78K |
| 80050 |
|
1,918 |
1,863 |
$75K |
| 71046 |
|
1,298 |
1,200 |
$57K |
| 71045 |
|
1,941 |
1,718 |
$52K |
| 36415 |
|
25,518 |
21,873 |
$49K |
| 88305 |
|
624 |
593 |
$46K |
| 83735 |
|
7,888 |
7,114 |
$39K |
| 99285 |
|
225 |
205 |
$37K |
| 43239 |
|
67 |
66 |
$27K |
| 80061 |
|
2,151 |
2,068 |
$26K |
| 87400 |
|
3,536 |
1,662 |
$25K |
| 99212 |
|
891 |
429 |
$21K |
| 81025 |
|
2,980 |
2,815 |
$19K |
| 77067 |
|
312 |
303 |
$16K |
| 97110 |
|
623 |
145 |
$15K |
| 83036 |
|
1,499 |
1,451 |
$14K |
| 87086 |
|
2,196 |
2,076 |
$14K |
| 84484 |
|
1,843 |
1,641 |
$13K |
| 83690 |
|
2,158 |
2,041 |
$12K |
| 81001 |
|
4,588 |
4,229 |
$12K |
| 82553 |
|
1,422 |
1,281 |
$10K |
| 70450 |
|
55 |
52 |
$8K |
| 88342 |
|
272 |
262 |
$8K |
| J1885 |
Ketorolac tromethamine inj |
2,671 |
2,546 |
$8K |
| 84443 |
|
500 |
473 |
$7K |
| 82550 |
|
1,674 |
1,495 |
$7K |
| 96413 |
|
86 |
53 |
$7K |
| 43281 |
|
12 |
12 |
$7K |
| 82306 |
|
182 |
173 |
$5K |
| 84436 |
|
1,073 |
1,044 |
$5K |
| 81003 |
|
2,611 |
2,415 |
$5K |
| 87591 |
|
124 |
120 |
$5K |
| 87491 |
|
124 |
120 |
$5K |
| 82728 |
|
305 |
304 |
$4K |
| 94640 |
|
242 |
192 |
$4K |
| 87651 |
|
91 |
84 |
$3K |
| J2405 |
Ondansetron hcl injection |
1,502 |
1,286 |
$3K |
| 80307 |
|
74 |
67 |
$3K |
| 80048 |
|
638 |
541 |
$3K |
| 43775 |
|
44 |
39 |
$3K |
| 83550 |
|
305 |
304 |
$3K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
217 |
197 |
$2K |
| 83540 |
|
305 |
304 |
$2K |
| 84479 |
|
335 |
330 |
$2K |
| J1100 |
Dexamethasone sodium phos |
540 |
507 |
$2K |
| 76700 |
|
16 |
14 |
$2K |
| G0378 |
Hospital observation per hr |
38 |
13 |
$2K |
| 96372 |
|
202 |
112 |
$1K |
| 87420 |
|
102 |
97 |
$1K |
| 95806 |
|
16 |
15 |
$1K |
| 82043 |
|
186 |
184 |
$1K |
| 82570 |
|
187 |
185 |
$1K |
| J7040 |
Normal saline solution infus |
408 |
163 |
$973.61 |
| 72110 |
|
15 |
13 |
$970.75 |
| 84153 |
|
45 |
44 |
$863.52 |
| J2270 |
Morphine sulfate injection |
333 |
271 |
$850.00 |
| 99213 |
|
30 |
25 |
$821.50 |
| 86140 |
|
201 |
181 |
$813.16 |
| 94761 |
|
43 |
14 |
$719.27 |
| 87430 |
|
47 |
43 |
$624.52 |
| 87661 |
|
14 |
14 |
$539.14 |
| 77063 |
|
43 |
39 |
$453.28 |
| J0131 |
Inj, acetaminophen (nos) |
29 |
26 |
$451.87 |
| C1769 |
Guide wire |
14 |
12 |
$422.30 |
| 85651 |
|
132 |
116 |
$368.36 |
| 87081 |
|
46 |
42 |
$309.64 |
| 87806 |
|
12 |
12 |
$283.14 |
| 82962 |
|
147 |
120 |
$261.92 |
| J3490 |
Drugs unclassified injection |
505 |
287 |
$253.91 |
| J2704 |
Inj, propofol, 10 mg |
534 |
509 |
$250.75 |
| 87186 |
|
39 |
37 |
$202.17 |
| 88300 |
|
18 |
16 |
$190.00 |
| J1642 |
Inj heparin sodium per 10 u |
132 |
75 |
$182.78 |
| J0694 |
Cefoxitin sodium injection |
173 |
151 |
$144.62 |
| 83880 |
|
12 |
12 |
$135.29 |
| 87077 |
|
26 |
25 |
$133.80 |
| J3010 |
Fentanyl citrate injection |
322 |
291 |
$121.14 |
| J1170 |
Hydromorphone injection |
171 |
99 |
$119.81 |
| J2360 |
Orphenadrine injection |
14 |
14 |
$119.21 |
| A6257 |
Transparent film <= 16 sq in |
229 |
223 |
$94.24 |
| 85027 |
|
12 |
12 |
$86.76 |
| J2250 |
Inj midazolam hydrochloride |
539 |
471 |
$81.70 |
| J2550 |
Promethazine hcl injection |
110 |
90 |
$68.02 |
| 88307 |
|
14 |
14 |
$61.41 |
| J1200 |
Diphenhydramine hcl injectio |
29 |
27 |
$54.84 |
| 96374 |
|
27 |
25 |
$32.32 |
| C9113 |
Inj pantoprazole sodium, via |
42 |
25 |
$11.00 |
| J2765 |
Metoclopramide hcl injection |
26 |
26 |
$3.51 |
| G0463 |
Hospital outpt clinic visit |
1,073 |
691 |
$0.00 |
| J1040 |
Methylprednisolone 80 mg inj |
14 |
14 |
$0.00 |
| 90853 |
|
7,404 |
739 |
$0.00 |
| 72100 |
|
24 |
24 |
$0.00 |