| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
|
29,464 |
27,109 |
$1.19M |
| 70450 |
|
3,217 |
3,044 |
$314K |
| Z7502 |
|
8,382 |
8,162 |
$311K |
| 96374 |
|
5,689 |
5,398 |
$278K |
| 74176 |
|
2,328 |
2,217 |
$236K |
| 80307 |
|
6,542 |
5,927 |
$235K |
| 99281 |
|
3,508 |
3,163 |
$162K |
| 80053 |
|
15,670 |
14,679 |
$139K |
| 93005 |
|
7,325 |
6,980 |
$138K |
| 96375 |
|
4,302 |
4,091 |
$132K |
| 96365 |
|
2,091 |
2,000 |
$118K |
| 99284 |
|
1,524 |
1,449 |
$109K |
| 99199 |
|
2,570 |
2,318 |
$101K |
| 0206 |
|
25 |
25 |
$101K |
| 96361 |
|
3,516 |
3,301 |
$98K |
| 96372 |
|
4,126 |
3,887 |
$95K |
| 99285 |
|
628 |
604 |
$93K |
| 85025 |
|
15,676 |
14,598 |
$91K |
| 71045 |
|
6,586 |
6,328 |
$84K |
| 99283 |
|
1,417 |
1,358 |
$76K |
| 76805 |
|
1,258 |
1,193 |
$70K |
| 87635 |
|
2,131 |
1,936 |
$66K |
| 0360 |
|
1,112 |
967 |
$66K |
| 94642 |
|
650 |
623 |
$58K |
| J3490 |
Drugs unclassified injection |
8,425 |
5,540 |
$54K |
| 76705 |
|
1,088 |
1,069 |
$46K |
| 45380 |
|
434 |
428 |
$44K |
| 96360 |
|
843 |
827 |
$38K |
| Z7610 |
|
2,912 |
2,497 |
$38K |
| 0270 |
|
4,367 |
3,500 |
$36K |
| 83880 |
|
1,818 |
1,729 |
$34K |
| 84484 |
|
4,380 |
4,057 |
$32K |
| 88305 |
|
969 |
935 |
$31K |
| 0720 |
|
843 |
639 |
$31K |
| 87426 |
|
1,771 |
1,685 |
$31K |
| 0250 |
|
7,480 |
6,819 |
$30K |
| 0272 |
|
2,573 |
2,446 |
$28K |
| 83690 |
|
5,287 |
5,054 |
$27K |
| 87086 |
|
4,548 |
4,407 |
$26K |
| 0636 |
|
2,794 |
2,549 |
$26K |
| 59025 |
|
1,613 |
1,171 |
$26K |
| 0710 |
|
1,680 |
1,616 |
$25K |
| 84703 |
|
4,792 |
4,646 |
$24K |
| 83605 |
|
2,499 |
2,347 |
$23K |
| 81001 |
|
9,334 |
8,994 |
$23K |
| 43239 |
|
356 |
352 |
$23K |
| 87040 |
|
1,763 |
1,705 |
$23K |
| J7050 |
Normal saline solution infus |
4,327 |
4,002 |
$21K |
| 85730 |
|
4,100 |
3,966 |
$17K |
| 76815 |
|
613 |
430 |
$17K |
| 0510 |
|
647 |
571 |
$17K |
| 96366 |
|
379 |
350 |
$16K |
| 85610 |
|
4,426 |
4,272 |
$14K |
| J2405 |
Ondansetron hcl injection |
3,872 |
3,660 |
$14K |
| 0750 |
|
83 |
82 |
$13K |
| J1885 |
Ketorolac tromethamine inj |
2,949 |
2,709 |
$13K |
| 99282 |
|
331 |
302 |
$10K |
| 96368 |
|
414 |
399 |
$8K |
| Z7514 |
|
128 |
94 |
$7K |
| J0696 |
Ceftriaxone sodium injection |
1,625 |
1,524 |
$7K |
| 82948 |
|
2,283 |
1,849 |
$7K |
| J2270 |
Morphine sulfate injection |
1,127 |
1,030 |
$7K |
| 87807 |
|
1,222 |
1,200 |
$7K |
| 76801 |
|
158 |
143 |
$7K |
| 87186 |
|
997 |
961 |
$6K |
| 80320 |
|
2,438 |
2,309 |
$6K |
| 82140 |
|
624 |
596 |
$6K |
| 85027 |
|
1,353 |
1,314 |
$6K |
| 87077 |
|
1,048 |
1,009 |
$5K |
| 80048 |
|
861 |
814 |
$5K |
| 90715 |
|
134 |
133 |
$5K |
| 84702 |
|
316 |
291 |
$4K |
| 72125 |
|
70 |
70 |
$4K |
| 86769 |
|
140 |
139 |
$4K |
| 87430 |
|
546 |
540 |
$3K |
| 0160 |
|
87 |
56 |
$3K |
| 85007 |
|
1,372 |
1,332 |
$3K |
| 88312 |
|
323 |
319 |
$3K |
| 0300 |
|
783 |
712 |
$2K |
| 71046 |
|
180 |
172 |
$2K |
| J2930 |
Methylprednisolone injection |
270 |
241 |
$2K |
| J2704 |
Inj, propofol, 10 mg |
785 |
751 |
$2K |
| V2632 |
Post chmbr intraocular lens |
12 |
12 |
$2K |
| 86328 |
|
65 |
54 |
$2K |
| 72131 |
|
25 |
24 |
$2K |
| 86901 |
|
933 |
897 |
$2K |
| 81003 |
|
1,188 |
1,159 |
$2K |
| 73562 |
|
101 |
99 |
$2K |
| 76856 |
|
39 |
38 |
$2K |
| G0463 |
Hospital outpt clinic visit |
27 |
24 |
$2K |
| 87071 |
|
460 |
455 |
$1K |
| 73630 |
|
72 |
71 |
$1K |
| 86900 |
|
589 |
572 |
$1K |
| 86850 |
|
403 |
390 |
$1K |
| J1200 |
Diphenhydramine hcl injectio |
211 |
207 |
$1K |
| 70486 |
|
13 |
13 |
$1K |
| 36415 |
|
2,510 |
2,309 |
$964.49 |
| J2250 |
Inj midazolam hydrochloride |
112 |
103 |
$912.90 |
| 90471 |
|
235 |
234 |
$809.79 |
| G0480 |
Drug test def 1-7 classes |
12 |
12 |
$767.40 |
| J7040 |
Normal saline solution infus |
28 |
28 |
$676.02 |
| S0164 |
Injection pantroprazole |
94 |
92 |
$668.33 |
| 87400 |
|
194 |
190 |
$659.02 |
| 94640 |
|
44 |
43 |
$655.86 |
| J3010 |
Fentanyl citrate injection |
203 |
201 |
$640.98 |
| 73610 |
|
38 |
38 |
$620.30 |
| A4649 |
Surgical supplies |
608 |
422 |
$582.28 |
| 71010 |
|
34 |
34 |
$506.26 |
| 85379 |
|
84 |
81 |
$485.73 |
| 82009 |
|
116 |
113 |
$466.05 |
| 0258 |
|
113 |
107 |
$384.52 |
| 0324 |
|
55 |
54 |
$341.09 |
| J1100 |
Dexamethasone sodium phos |
83 |
75 |
$294.96 |
| 80329 |
|
73 |
72 |
$291.70 |
| 80354 |
|
361 |
352 |
$262.68 |
| 73130 |
|
16 |
16 |
$262.28 |
| J1815 |
Insulin injection |
55 |
40 |
$245.60 |
| J0690 |
Cefazolin sodium injection |
50 |
40 |
$216.97 |
| J2919 |
Inj, methylpred sod succ 5mg |
78 |
75 |
$199.91 |
| A6451 |
Mod compres band w>=3"<5"/yd |
36 |
36 |
$191.45 |
| 73110 |
|
13 |
13 |
$163.35 |
| 74018 |
|
12 |
12 |
$158.47 |
| 0370 |
|
84 |
82 |
$146.17 |
| 87420 |
|
34 |
34 |
$143.67 |
| 83735 |
|
28 |
27 |
$95.96 |
| 84443 |
|
13 |
13 |
$87.65 |
| 84512 |
|
14 |
13 |
$75.76 |
| J1953 |
Levetiracetam injection |
13 |
12 |
$45.47 |
| 81025 |
|
23 |
22 |
$42.18 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
12 |
12 |
$18.80 |
| A6402 |
Sterile gauze <= 16 sq in |
72 |
69 |
$4.43 |
| 0301 |
|
243 |
240 |
$0.00 |