| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 80053 |
|
2,633 |
1,704 |
$710K |
| 96413 |
|
1,788 |
905 |
$677K |
| 99212 |
|
2,027 |
1,454 |
$414K |
| 99214 |
|
1,336 |
1,160 |
$349K |
| 96375 |
|
1,133 |
620 |
$343K |
| 99213 |
|
1,059 |
912 |
$255K |
| 74177 |
|
122 |
122 |
$217K |
| 85025 |
|
3,073 |
2,072 |
$184K |
| 71260 |
|
221 |
221 |
$153K |
| 96411 |
|
612 |
416 |
$151K |
| 80050 |
|
368 |
312 |
$144K |
| 99215 |
Prolong outpt/office vis |
448 |
402 |
$134K |
| 96417 |
|
472 |
293 |
$118K |
| 96409 |
|
440 |
276 |
$96K |
| 96361 |
|
258 |
140 |
$82K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
278 |
275 |
$55K |
| 99233 |
Prolong inpt eval add15 m |
1,290 |
385 |
$55K |
| 83735 |
|
2,042 |
1,197 |
$55K |
| 86850 |
|
530 |
323 |
$49K |
| 96367 |
|
309 |
219 |
$44K |
| 96415 |
|
117 |
62 |
$42K |
| 99232 |
|
903 |
216 |
$39K |
| J2469 |
Palonosetron hcl |
176 |
114 |
$38K |
| 77067 |
|
193 |
193 |
$32K |
| 86900 |
|
570 |
345 |
$30K |
| 99205 |
Prolong outpt/office vis |
80 |
73 |
$28K |
| 84100 |
|
1,487 |
875 |
$28K |
| 86901 |
|
522 |
317 |
$27K |
| 82378 |
|
329 |
239 |
$25K |
| 85027 |
|
823 |
487 |
$24K |
| 96365 |
|
76 |
58 |
$21K |
| J0185 |
Inj., aprepitant, 1 mg |
38 |
26 |
$21K |
| 82248 |
|
1,220 |
749 |
$20K |
| 83615 |
|
707 |
532 |
$17K |
| 82784 |
|
157 |
138 |
$16K |
| 80048 |
|
111 |
63 |
$14K |
| 99223 |
Prolong inpt eval add15 m |
104 |
100 |
$14K |
| J1453 |
Fosaprepitant injection |
19 |
12 |
$12K |
| 85007 |
|
786 |
456 |
$12K |
| J9370 |
Vincristine sulfate 1 mg inj |
458 |
300 |
$9K |
| 80076 |
|
48 |
36 |
$6K |
| 99222 |
|
66 |
66 |
$6K |
| 84439 |
|
130 |
105 |
$6K |
| 82565 |
|
251 |
193 |
$5K |
| 82247 |
|
341 |
195 |
$4K |
| 90686 |
|
111 |
111 |
$4K |
| 84450 |
|
238 |
152 |
$3K |
| G0008 |
Admin influenza virus vac |
107 |
107 |
$2K |
| 80051 |
|
29 |
21 |
$2K |
| J8540 |
Oral dexamethasone |
457 |
239 |
$2K |
| 81001 |
|
109 |
70 |
$2K |
| 99238 |
|
32 |
30 |
$2K |
| J2405 |
Ondansetron hcl injection |
485 |
277 |
$1K |
| A9585 |
Gadobutrol injection |
14 |
13 |
$1K |
| 82310 |
|
50 |
34 |
$1K |
| 84520 |
|
58 |
39 |
$1K |
| J3489 |
Zoledronic acid 1mg |
13 |
12 |
$1K |
| 83516 |
|
29 |
20 |
$1K |
| 81003 |
|
58 |
39 |
$1K |
| 84702 |
|
16 |
14 |
$931.68 |
| 99231 |
|
30 |
17 |
$682.24 |
| 82947 |
|
26 |
17 |
$677.15 |
| J3490 |
Drugs unclassified injection |
23 |
12 |
$667.92 |
| 96372 |
|
15 |
12 |
$647.76 |
| J3475 |
Inj magnesium sulfate |
28 |
12 |
$639.55 |
| Q0162 |
Ondansetron oral |
121 |
69 |
$549.51 |
| 85045 |
|
32 |
29 |
$493.00 |
| 84132 |
|
24 |
16 |
$488.75 |
| 82374 |
|
23 |
15 |
$397.91 |
| 84295 |
|
19 |
12 |
$363.47 |
| 84550 |
|
16 |
12 |
$299.20 |
| J1200 |
Diphenhydramine hcl injectio |
99 |
65 |
$173.92 |
| J9250 |
Methotrexate sodium inj |
43 |
24 |
$134.49 |
| J1100 |
Dexamethasone sodium phos |
40 |
26 |
$60.73 |