| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
|
19,732 |
18,203 |
$1.11M |
| 99283 |
|
17,182 |
16,386 |
$636K |
| D9420 |
|
617 |
592 |
$162K |
| 85025 |
|
19,240 |
17,216 |
$142K |
| 80053 |
|
14,571 |
13,012 |
$128K |
| 87804 |
|
8,254 |
5,516 |
$127K |
| 87430 |
|
3,184 |
3,077 |
$48K |
| 87086 |
|
4,316 |
3,938 |
$41K |
| G0463 |
Hospital outpt clinic visit |
2,545 |
1,506 |
$39K |
| 84443 |
|
2,283 |
2,224 |
$36K |
| 80061 |
|
2,114 |
2,076 |
$32K |
| 83036 |
|
1,607 |
1,564 |
$19K |
| 81003 |
|
7,475 |
6,836 |
$17K |
| 85027 |
|
3,226 |
3,156 |
$17K |
| 93005 |
|
2,497 |
2,020 |
$15K |
| 76816 |
|
411 |
289 |
$13K |
| 82607 |
|
810 |
790 |
$13K |
| 80055 |
|
166 |
162 |
$12K |
| 62323 |
|
150 |
135 |
$12K |
| 71046 |
|
1,384 |
1,265 |
$12K |
| 80305 |
|
1,264 |
1,104 |
$11K |
| 80048 |
|
853 |
832 |
$10K |
| 82746 |
|
778 |
759 |
$9K |
| 99285 |
|
70 |
68 |
$8K |
| 70450 |
|
144 |
130 |
$8K |
| 96413 |
|
139 |
74 |
$8K |
| 87420 |
|
487 |
479 |
$8K |
| 82306 |
|
968 |
954 |
$7K |
| 11042 |
|
395 |
147 |
$7K |
| 83655 |
|
313 |
306 |
$5K |
| 71045 |
|
1,223 |
1,085 |
$4K |
| 86592 |
|
766 |
750 |
$4K |
| 86701 |
|
332 |
320 |
$4K |
| 84484 |
|
859 |
688 |
$4K |
| 80074 |
|
79 |
79 |
$4K |
| 43235 |
|
54 |
39 |
$4K |
| 76805 |
|
132 |
127 |
$3K |
| 94640 |
|
404 |
234 |
$3K |
| 80047 |
|
439 |
419 |
$3K |
| 86850 |
|
525 |
505 |
$3K |
| 59025 |
|
728 |
508 |
$3K |
| 99281 |
|
88 |
81 |
$3K |
| 83735 |
|
393 |
390 |
$3K |
| 87070 |
|
284 |
277 |
$3K |
| 83690 |
|
593 |
543 |
$3K |
| J2469 |
Palonosetron hcl |
22 |
12 |
$3K |
| 96375 |
|
128 |
65 |
$3K |
| 81025 |
|
914 |
868 |
$3K |
| 86762 |
|
131 |
128 |
$3K |
| 99282 |
|
64 |
62 |
$2K |
| 43239 |
|
14 |
12 |
$2K |
| 85610 |
|
710 |
625 |
$2K |
| 87389 |
|
80 |
80 |
$2K |
| 87340 |
|
145 |
142 |
$2K |
| 80307 |
|
58 |
50 |
$2K |
| J0561 |
Penicillin g benzathine inj |
14 |
14 |
$2K |
| 84702 |
|
135 |
123 |
$2K |
| 82550 |
|
404 |
312 |
$2K |
| 82150 |
|
297 |
275 |
$2K |
| 74177 |
|
13 |
13 |
$1K |
| 83880 |
|
91 |
74 |
$1K |
| 74022 |
|
69 |
66 |
$1K |
| 82950 |
|
182 |
179 |
$1K |
| 86706 |
|
79 |
79 |
$1K |
| 97110 |
|
227 |
63 |
$1K |
| 76818 |
|
22 |
12 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
747 |
692 |
$816.97 |
| 75625 |
|
13 |
12 |
$712.95 |
| 70486 |
|
14 |
14 |
$667.20 |
| J0696 |
Ceftriaxone sodium injection |
418 |
389 |
$661.69 |
| 85651 |
|
171 |
157 |
$642.06 |
| 86160 |
|
31 |
25 |
$637.20 |
| 86140 |
|
321 |
308 |
$628.26 |
| 80076 |
|
79 |
75 |
$601.92 |
| 85730 |
|
456 |
392 |
$595.68 |
| 86901 |
|
193 |
182 |
$547.68 |
| 87081 |
|
60 |
55 |
$496.53 |
| 86900 |
|
141 |
135 |
$411.25 |
| 81001 |
|
119 |
104 |
$353.40 |
| 84439 |
|
37 |
36 |
$332.97 |
| 43450 |
|
24 |
14 |
$325.56 |
| 83605 |
|
46 |
43 |
$291.46 |
| 85014 |
|
83 |
82 |
$274.13 |
| 85018 |
|
83 |
82 |
$271.08 |
| 82105 |
|
12 |
12 |
$264.12 |
| 97140 |
|
58 |
12 |
$256.08 |
| 84703 |
|
38 |
37 |
$242.64 |
| 87040 |
|
37 |
26 |
$232.53 |
| 82803 |
|
13 |
12 |
$228.24 |
| J1100 |
Dexamethasone sodium phos |
379 |
339 |
$216.20 |
| 86803 |
|
12 |
12 |
$207.24 |
| 84481 |
|
13 |
12 |
$206.04 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
74 |
71 |
$194.41 |
| 82947 |
|
42 |
41 |
$181.35 |
| 83550 |
|
13 |
13 |
$141.24 |
| 73110 |
|
13 |
12 |
$136.44 |
| 82553 |
|
15 |
14 |
$119.07 |
| 84479 |
|
24 |
24 |
$118.14 |
| 74018 |
|
16 |
14 |
$113.40 |
| 87186 |
|
15 |
12 |
$111.21 |
| J2405 |
Ondansetron hcl injection |
369 |
328 |
$101.12 |
| 83540 |
|
13 |
13 |
$92.76 |
| 84436 |
|
25 |
25 |
$92.46 |
| J0780 |
Prochlorperazine injection |
14 |
12 |
$87.93 |
| 82570 |
|
13 |
13 |
$60.48 |
| A0425 |
Ground mileage |
1,659 |
1,315 |
$57.03 |
| 84156 |
|
13 |
13 |
$40.41 |
| J2765 |
Metoclopramide hcl injection |
41 |
40 |
$30.56 |
| 36415 |
|
2,004 |
1,275 |
$22.40 |
| 96372 |
|
49 |
48 |
$10.00 |
| J1644 |
Inj heparin sodium per 1000u |
28 |
17 |
$4.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
42 |
40 |
$3.20 |
| 93010 |
|
5,798 |
4,494 |
$2.28 |
| J2250 |
Inj midazolam hydrochloride |
37 |
31 |
$1.76 |
| J1040 |
Methylprednisolone 80 mg inj |
59 |
54 |
$0.00 |
| 93018 |
|
33 |
33 |
$0.00 |
| A0427 |
Als1-emergency |
714 |
632 |
$0.00 |
| A0428 |
Bls |
286 |
206 |
$0.00 |
| P9603 |
One-way allow prorated miles |
192 |
185 |
$0.00 |
| A0426 |
Als 1 |
17 |
15 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
33 |
29 |
$0.00 |
| C1769 |
Guide wire |
20 |
15 |
$0.00 |
| 96374 |
|
33 |
26 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
21 |
13 |
$0.00 |
| D2710 |
|
13 |
13 |
$0.00 |
| J7040 |
Normal saline solution infus |
13 |
12 |
$0.00 |
| 76937 |
|
16 |
14 |
$0.00 |