| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 36415 |
|
8,019 |
6,430 |
$362K |
| 11042 |
|
959 |
377 |
$247K |
| 87804 |
|
6,209 |
3,256 |
$193K |
| 80307 |
|
2,695 |
2,307 |
$104K |
| 99281 |
|
1,328 |
1,231 |
$103K |
| 87070 |
|
441 |
373 |
$99K |
| 99282 |
|
1,527 |
1,452 |
$89K |
| 97110 |
|
2,279 |
586 |
$69K |
| 99283 |
|
7,633 |
6,980 |
$61K |
| 87186 |
|
555 |
499 |
$56K |
| 81025 |
|
2,890 |
2,654 |
$47K |
| 86756 |
|
911 |
862 |
$42K |
| 82948 |
|
1,986 |
995 |
$38K |
| G0463 |
Hospital outpt clinic visit |
1,036 |
478 |
$32K |
| 86900 |
|
429 |
363 |
$31K |
| 88305 |
|
317 |
293 |
$28K |
| 87430 |
|
3,187 |
3,045 |
$28K |
| 59025 |
|
605 |
415 |
$24K |
| 70450 |
|
1,231 |
1,156 |
$23K |
| 81003 |
|
5,904 |
5,293 |
$20K |
| 71046 |
|
1,813 |
1,665 |
$17K |
| 88304 |
|
189 |
186 |
$17K |
| 74176 |
|
551 |
507 |
$15K |
| 70551 |
|
50 |
49 |
$13K |
| 99284 |
|
5,113 |
4,609 |
$12K |
| 73130 |
|
297 |
282 |
$12K |
| 73630 |
|
319 |
302 |
$11K |
| 73564 |
|
364 |
353 |
$10K |
| 96375 |
|
1,478 |
1,330 |
$9K |
| 80053 |
|
5,850 |
4,952 |
$8K |
| 95816 |
|
61 |
59 |
$8K |
| 72100 |
|
329 |
318 |
$8K |
| 87491 |
|
419 |
411 |
$8K |
| 73610 |
|
308 |
297 |
$8K |
| 87086 |
|
725 |
690 |
$8K |
| 73030 |
|
208 |
195 |
$6K |
| 74177 |
|
848 |
800 |
$6K |
| 96360 |
|
568 |
542 |
$6K |
| 96361 |
|
1,466 |
1,357 |
$5K |
| 73110 |
|
142 |
133 |
$4K |
| G0378 |
Hospital observation per hr |
874 |
589 |
$4K |
| 96365 |
|
731 |
674 |
$3K |
| 72125 |
|
378 |
367 |
$3K |
| 80048 |
|
2,119 |
1,910 |
$3K |
| 87077 |
|
365 |
314 |
$3K |
| 93005 |
|
3,124 |
2,626 |
$3K |
| 93306 |
|
146 |
141 |
$3K |
| 93971 |
|
108 |
97 |
$3K |
| 71045 |
|
2,116 |
1,861 |
$2K |
| 82803 |
|
259 |
231 |
$2K |
| 77066 |
Tomosynthesis, mammo |
24 |
24 |
$2K |
| 74022 |
|
561 |
516 |
$2K |
| 76010 |
|
107 |
106 |
$2K |
| 86850 |
|
271 |
253 |
$2K |
| 99285 |
|
1,677 |
1,536 |
$2K |
| 96376 |
|
193 |
173 |
$2K |
| 97162 |
|
111 |
105 |
$2K |
| 70486 |
|
30 |
29 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
744 |
662 |
$2K |
| 97161 |
|
146 |
140 |
$2K |
| 71260 |
|
335 |
316 |
$1K |
| 76641 |
|
43 |
41 |
$1K |
| 82553 |
|
2,009 |
1,600 |
$1K |
| 85610 |
|
2,250 |
1,986 |
$1K |
| 76700 |
|
12 |
12 |
$1K |
| 73502 |
|
83 |
80 |
$1K |
| 74018 |
|
59 |
45 |
$1K |
| 97140 |
|
53 |
27 |
$1K |
| J2930 |
Methylprednisolone injection |
417 |
373 |
$903.04 |
| 97150 |
|
265 |
97 |
$898.71 |
| 96372 |
|
1,659 |
1,446 |
$775.32 |
| J2405 |
Ondansetron hcl injection |
913 |
795 |
$644.08 |
| 81001 |
|
568 |
455 |
$628.10 |
| 83655 |
|
68 |
63 |
$622.75 |
| 76705 |
|
41 |
38 |
$572.22 |
| 93970 |
|
29 |
27 |
$551.44 |
| 77067 |
|
12 |
12 |
$486.68 |
| 76856 |
|
13 |
13 |
$401.01 |
| 84702 |
|
466 |
394 |
$391.30 |
| A9270 |
Non-covered item or service |
2,347 |
1,421 |
$390.35 |
| 84443 |
|
926 |
867 |
$387.53 |
| 76801 |
|
90 |
82 |
$348.40 |
| 85025 |
|
8,194 |
6,693 |
$247.57 |
| 82247 |
|
45 |
28 |
$245.42 |
| 72050 |
|
12 |
12 |
$136.93 |
| 87081 |
|
663 |
610 |
$99.78 |
| 80061 |
|
416 |
390 |
$96.35 |
| 74019 |
|
13 |
12 |
$87.40 |
| 83735 |
|
876 |
697 |
$35.52 |
| 87040 |
|
945 |
636 |
$13.31 |
| 82272 |
|
40 |
39 |
$13.16 |
| 82550 |
|
2,175 |
1,746 |
$9.92 |
| 85027 |
|
212 |
196 |
$8.45 |
| 93880 |
|
13 |
12 |
$7.09 |
| G8979 |
Mobility goal status |
84 |
75 |
$0.00 |
| 84100 |
|
162 |
120 |
$0.00 |
| 36600 |
|
209 |
187 |
$0.00 |
| 85378 |
|
821 |
752 |
$0.00 |
| 87220 |
|
286 |
280 |
$0.00 |
| 84439 |
|
25 |
25 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
62 |
49 |
$0.00 |
| J7510 |
Prednisolone oral per 5 mg |
161 |
155 |
$0.00 |
| G8978 |
Mobility current status |
65 |
61 |
$0.00 |
| J2550 |
Promethazine hcl injection |
114 |
83 |
$0.00 |
| 82248 |
|
18 |
12 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
48 |
42 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
175 |
92 |
$0.00 |
| 82947 |
|
15 |
15 |
$0.00 |
| 99152 |
|
27 |
25 |
$0.00 |
| J0595 |
Butorphanol tartrate 1 mg |
16 |
14 |
$0.00 |
| 82150 |
|
862 |
794 |
$0.00 |
| 87591 |
|
418 |
410 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
475 |
409 |
$0.00 |
| 83690 |
|
1,999 |
1,768 |
$0.00 |
| 87205 |
|
400 |
334 |
$0.00 |
| 83036 |
|
288 |
270 |
$0.00 |
| 83605 |
|
382 |
343 |
$0.00 |
| 85018 |
|
12 |
12 |
$0.00 |
| 83880 |
|
807 |
715 |
$0.00 |
| 96366 |
|
148 |
143 |
$0.00 |
| 85730 |
|
2,143 |
1,897 |
$0.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
284 |
259 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
1,154 |
1,007 |
$0.00 |
| 86901 |
|
430 |
364 |
$0.00 |
| C1769 |
Guide wire |
19 |
13 |
$0.00 |
| 87088 |
|
166 |
162 |
$0.00 |
| 96374 |
|
1,859 |
1,663 |
$0.00 |
| J2765 |
Metoclopramide hcl injection |
234 |
220 |
$0.00 |
| 86140 |
|
31 |
28 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
467 |
436 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
86 |
82 |
$0.00 |
| 84484 |
|
2,719 |
1,846 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
764 |
706 |
$0.00 |
| 97597 |
|
20 |
12 |
$0.00 |
| 94640 |
|
123 |
53 |
$0.00 |
| J2175 |
Meperidine hydrochl /100 mg |
17 |
17 |
$0.00 |
| J1815 |
Insulin injection |
241 |
135 |
$0.00 |
| 76817 |
|
12 |
12 |
$0.00 |
| 90471 |
|
28 |
26 |
$0.00 |
| G0008 |
Admin influenza virus vac |
13 |
13 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
12 |
12 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
15 |
13 |
$0.00 |
| 85651 |
|
52 |
42 |
$0.00 |
| 69436 |
|
13 |
12 |
$0.00 |
| J2060 |
Lorazepam injection |
27 |
25 |
$0.00 |
| J1170 |
Hydromorphone injection |
53 |
46 |
$0.00 |
| 66984 |
|
15 |
15 |
$0.00 |