| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
3,310 |
3,183 |
$1.03M |
| 99283 |
|
4,027 |
3,823 |
$789K |
| 99285 |
|
2,889 |
2,731 |
$696K |
| 74177 |
|
555 |
541 |
$329K |
| 74176 |
|
470 |
456 |
$202K |
| 70450 |
|
590 |
567 |
$88K |
| 99282 |
|
503 |
496 |
$57K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
793 |
768 |
$27K |
| 71250 |
|
37 |
37 |
$24K |
| 72125 |
|
56 |
56 |
$19K |
| G0378 |
Hospital observation per hr |
42 |
41 |
$8K |
| 71275 |
|
26 |
25 |
$5K |
| 87637 |
|
2,663 |
2,585 |
$5K |
| 96361 |
|
1,963 |
1,672 |
$899.08 |
| 96374 |
|
1,494 |
1,409 |
$786.13 |
| 96375 |
|
1,656 |
1,162 |
$765.36 |
| 87086 |
|
460 |
433 |
$668.58 |
| 80053 |
|
3,141 |
2,849 |
$546.13 |
| 85025 |
|
3,233 |
2,890 |
$417.13 |
| 96372 |
|
1,980 |
1,672 |
$416.49 |
| A4649 |
Surgical supplies |
567 |
502 |
$307.63 |
| 93005 |
|
1,305 |
1,146 |
$262.12 |
| 96365 |
|
621 |
583 |
$250.40 |
| 87880 |
|
1,485 |
1,455 |
$197.48 |
| 71045 |
|
1,512 |
1,444 |
$194.27 |
| 96360 |
|
576 |
559 |
$166.31 |
| 84484 |
|
1,323 |
1,059 |
$134.87 |
| J7030 |
Normal saline solution infus |
2,288 |
2,091 |
$128.42 |
| 81025 |
|
1,293 |
1,237 |
$120.01 |
| 83690 |
|
1,233 |
1,167 |
$111.64 |
| 83605 |
|
390 |
344 |
$101.50 |
| J1885 |
Ketorolac tromethamine inj |
1,850 |
1,750 |
$96.07 |
| 71046 |
|
287 |
285 |
$82.43 |
| 80305 |
|
510 |
490 |
$70.56 |
| 83735 |
|
934 |
872 |
$63.73 |
| 83880 |
|
294 |
281 |
$60.30 |
| 81003 |
|
1,758 |
1,687 |
$58.54 |
| J3490 |
Drugs unclassified injection |
343 |
306 |
$52.36 |
| 82077 |
|
72 |
66 |
$41.46 |
| J1100 |
Dexamethasone sodium phos |
563 |
543 |
$40.12 |
| 87040 |
|
74 |
39 |
$39.14 |
| 94640 |
|
416 |
396 |
$37.62 |
| 73030 |
|
49 |
48 |
$37.27 |
| 81001 |
|
1,002 |
953 |
$37.16 |
| 73130 |
|
64 |
61 |
$36.05 |
| J2270 |
Morphine sulfate injection |
303 |
281 |
$33.96 |
| 85379 |
|
118 |
111 |
$24.60 |
| 85730 |
|
206 |
204 |
$20.79 |
| J2405 |
Ondansetron hcl injection |
919 |
851 |
$20.20 |
| J0696 |
Ceftriaxone sodium injection |
537 |
516 |
$19.34 |
| 85610 |
|
247 |
243 |
$18.89 |
| J8499 |
Oral prescrip drug non chemo |
1,341 |
808 |
$18.02 |
| 94760 |
|
276 |
270 |
$8.02 |
| 82150 |
|
37 |
36 |
$5.73 |
| J7050 |
Normal saline solution infus |
289 |
282 |
$5.12 |
| 99001 |
|
460 |
443 |
$0.00 |
| 84439 |
|
12 |
12 |
$0.00 |
| A4216 |
Sterile water/saline, 10 ml |
43 |
37 |
$0.00 |
| 73562 |
|
75 |
66 |
$0.00 |
| 73610 |
|
108 |
102 |
$0.00 |
| 82947 |
|
55 |
38 |
$0.00 |
| 96367 |
|
14 |
12 |
$0.00 |
| 74018 |
|
101 |
101 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 73630 |
|
111 |
105 |
$0.00 |
| 84702 |
|
12 |
12 |
$0.00 |
| 73110 |
|
14 |
14 |
$0.00 |
| J7120 |
Ringers lactate infusion |
14 |
12 |
$0.00 |
| 99053 |
|
156 |
154 |
$0.00 |
| A6250 |
Skin seal protect moisturizr |
23 |
21 |
$0.00 |
| A4565 |
Slings |
12 |
12 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
13 |
13 |
$0.00 |
| 72100 |
|
12 |
12 |
$0.00 |
| J7620 |
Albuterol ipratrop non-comp |
168 |
164 |
$0.00 |
| 36415 |
|
2,253 |
2,107 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
47 |
47 |
$0.00 |
| J7613 |
Albuterol non-comp unit |
67 |
66 |
$0.00 |
| 87651 |
|
192 |
190 |
$0.00 |
| J2001 |
Lidocaine injection |
238 |
230 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
48 |
46 |
$0.00 |
| 84443 |
|
84 |
83 |
$0.00 |
| 90471 |
|
12 |
12 |
$0.00 |
| A6448 |
Lt compres band <3"/yd |
28 |
25 |
$0.00 |
| J2360 |
Orphenadrine injection |
13 |
13 |
$0.00 |
| J2765 |
Metoclopramide hcl injection |
13 |
12 |
$0.00 |
| 83874 |
|
14 |
14 |
$0.00 |
| 86140 |
|
13 |
13 |
$0.00 |
| 82553 |
|
14 |
14 |
$0.00 |