| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92507 |
|
1,572 |
453 |
$292K |
| 99283 |
|
1,118 |
1,079 |
$265K |
| 97110 |
|
1,673 |
548 |
$247K |
| 99284 |
|
950 |
895 |
$239K |
| 99214 |
|
875 |
750 |
$198K |
| 99213 |
|
496 |
421 |
$106K |
| 96361 |
|
255 |
235 |
$93K |
| 99285 |
|
372 |
362 |
$85K |
| 77063 |
|
411 |
411 |
$84K |
| 99212 |
|
326 |
301 |
$68K |
| 80307 |
|
1,222 |
829 |
$59K |
| 97140 |
|
1,140 |
408 |
$50K |
| 99282 |
|
213 |
211 |
$50K |
| 71046 |
|
589 |
577 |
$44K |
| 97010 |
|
207 |
95 |
$36K |
| G0378 |
Hospital observation per hr |
169 |
87 |
$24K |
| H0015 |
Alcohol and/or drug services |
79 |
12 |
$24K |
| 80053 |
|
1,796 |
1,692 |
$24K |
| 74177 |
|
160 |
159 |
$22K |
| 87491 |
|
675 |
665 |
$22K |
| 87591 |
|
660 |
650 |
$21K |
| 88305 |
|
350 |
345 |
$20K |
| 97803 |
|
93 |
92 |
$18K |
| 70450 |
|
176 |
174 |
$18K |
| 59025 |
|
73 |
24 |
$18K |
| 99215 |
Prolong outpt/office vis |
67 |
60 |
$17K |
| G0480 |
Drug test def 1-7 classes |
280 |
227 |
$17K |
| 85025 |
|
1,915 |
1,709 |
$15K |
| 84443 |
|
859 |
855 |
$15K |
| 87502 |
|
195 |
193 |
$15K |
| 97112 |
|
162 |
64 |
$14K |
| 99218 |
|
51 |
33 |
$14K |
| 76705 |
|
85 |
83 |
$14K |
| 82306 |
|
425 |
424 |
$13K |
| 96365 |
|
102 |
89 |
$13K |
| 80061 |
|
1,257 |
1,251 |
$12K |
| 88175 |
|
381 |
380 |
$10K |
| 45380 |
|
27 |
27 |
$10K |
| 87624 |
|
302 |
301 |
$9K |
| 80048 |
|
910 |
843 |
$8K |
| 80050 |
|
420 |
419 |
$7K |
| 85027 |
|
1,084 |
1,041 |
$7K |
| 93005 |
|
610 |
554 |
$7K |
| 83036 |
|
696 |
693 |
$7K |
| 97162 |
|
102 |
102 |
$7K |
| 84702 |
|
437 |
383 |
$7K |
| 87389 |
|
272 |
272 |
$6K |
| 87086 |
|
744 |
704 |
$6K |
| 76642 |
|
69 |
67 |
$6K |
| 96413 |
|
36 |
24 |
$6K |
| 82607 |
|
344 |
343 |
$5K |
| 71260 |
|
45 |
45 |
$5K |
| J3490 |
Drugs unclassified injection |
62 |
47 |
$5K |
| 82728 |
|
326 |
317 |
$5K |
| 73630 |
|
58 |
58 |
$4K |
| 76536 |
|
12 |
12 |
$4K |
| 84153 |
|
199 |
199 |
$4K |
| 73610 |
|
51 |
51 |
$3K |
| 87081 |
|
493 |
489 |
$3K |
| 84484 |
|
244 |
205 |
$3K |
| 84466 |
|
243 |
242 |
$3K |
| 86803 |
|
230 |
230 |
$3K |
| 86618 |
|
181 |
179 |
$3K |
| 86780 |
|
219 |
218 |
$3K |
| 84439 |
|
300 |
298 |
$3K |
| 83516 |
|
72 |
70 |
$3K |
| 76770 |
|
18 |
14 |
$3K |
| 85610 |
|
646 |
480 |
$3K |
| J0131 |
Inj, acetaminophen (nos) |
32 |
31 |
$3K |
| 83690 |
|
372 |
346 |
$3K |
| 81003 |
|
986 |
935 |
$2K |
| 87340 |
|
214 |
213 |
$2K |
| 72100 |
|
12 |
12 |
$2K |
| 87186 |
|
212 |
207 |
$2K |
| 73721 |
|
12 |
12 |
$2K |
| 83735 |
|
303 |
262 |
$2K |
| 87070 |
|
231 |
225 |
$2K |
| 87088 |
|
243 |
233 |
$2K |
| 96374 |
|
529 |
445 |
$2K |
| 73130 |
|
13 |
13 |
$2K |
| 87660 |
|
92 |
88 |
$2K |
| 96360 |
|
32 |
29 |
$2K |
| 87480 |
|
91 |
87 |
$2K |
| 87510 |
|
91 |
87 |
$2K |
| 83540 |
|
264 |
263 |
$2K |
| 87147 |
|
179 |
176 |
$2K |
| 80076 |
|
203 |
199 |
$2K |
| 82248 |
|
609 |
566 |
$2K |
| 84403 |
|
51 |
50 |
$2K |
| 86140 |
|
278 |
249 |
$1K |
| 81025 |
|
225 |
219 |
$1K |
| 96372 |
|
129 |
127 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
371 |
291 |
$1K |
| 73110 |
|
26 |
26 |
$1K |
| 82565 |
|
173 |
145 |
$1K |
| 87077 |
|
133 |
129 |
$1K |
| 97161 |
|
16 |
16 |
$1K |
| 76856 |
|
27 |
26 |
$1K |
| 86762 |
|
73 |
72 |
$1K |
| 85730 |
|
156 |
154 |
$984.75 |
| 87880 |
|
66 |
66 |
$854.51 |
| 82043 |
|
145 |
144 |
$838.75 |
| 74018 |
|
13 |
12 |
$796.52 |
| 88342 |
|
55 |
55 |
$743.19 |
| 71045 |
|
130 |
129 |
$693.70 |
| 82962 |
|
449 |
336 |
$673.50 |
| 82947 |
|
137 |
136 |
$526.00 |
| 85652 |
|
186 |
183 |
$516.04 |
| 87522 |
Neg quan hep c or qual rna |
13 |
13 |
$507.91 |
| 84550 |
|
187 |
161 |
$454.76 |
| 86706 |
|
37 |
37 |
$431.14 |
| 86850 |
|
15 |
15 |
$429.00 |
| 84460 |
|
109 |
92 |
$406.98 |
| 84270 |
|
15 |
15 |
$398.25 |
| 84450 |
|
96 |
81 |
$356.04 |
| 36415 |
|
459 |
410 |
$354.66 |
| 82784 |
|
26 |
26 |
$353.00 |
| 96375 |
|
327 |
289 |
$343.07 |
| J2405 |
Ondansetron hcl injection |
313 |
264 |
$312.29 |
| 85379 |
|
27 |
26 |
$302.14 |
| 83001 |
|
12 |
12 |
$272.40 |
| 90471 |
|
41 |
38 |
$263.47 |
| 87205 |
|
49 |
48 |
$262.94 |
| J7030 |
Normal saline solution infus |
539 |
313 |
$255.92 |
| 84520 |
|
97 |
74 |
$229.40 |
| J2250 |
Inj midazolam hydrochloride |
118 |
113 |
$200.50 |
| J3010 |
Fentanyl citrate injection |
140 |
137 |
$200.50 |
| 86704 |
|
13 |
13 |
$191.49 |
| 87040 |
|
15 |
14 |
$160.41 |
| J7120 |
Ringers lactate infusion |
159 |
94 |
$145.55 |
| 86787 |
|
12 |
12 |
$141.00 |
| G0279 |
Tomosynthesis, mammo |
29 |
29 |
$132.16 |
| 77065 |
Tomosynthesis, mammo |
14 |
13 |
$132.16 |
| J2704 |
Inj, propofol, 10 mg |
233 |
150 |
$109.90 |
| 84100 |
|
40 |
31 |
$101.28 |
| 84156 |
|
18 |
12 |
$80.64 |
| 85018 |
|
12 |
12 |
$33.19 |
| 77067 |
|
418 |
418 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
333 |
323 |
$0.00 |
| 99152 |
|
40 |
39 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
95 |
95 |
$0.00 |
| Q0163 |
Diphenhydramine hcl 50mg |
17 |
13 |
$0.00 |
| J2270 |
Morphine sulfate injection |
17 |
13 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
12 |
12 |
$0.00 |
| J2765 |
Metoclopramide hcl injection |
88 |
83 |
$0.00 |
| J2001 |
Lidocaine injection |
166 |
148 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
146 |
139 |
$0.00 |
| A9585 |
Gadobutrol injection |
120 |
117 |
$0.00 |
| Q0162 |
Ondansetron oral |
41 |
41 |
$0.00 |
| J1170 |
Hydromorphone injection |
21 |
17 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
14 |
14 |
$0.00 |