| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpt clinic visit |
194,045 |
161,579 |
$12.64M |
| X4011 |
|
17,841 |
16,724 |
$8.65M |
| X4003 |
|
94,446 |
81,206 |
$5.98M |
| 99284 |
|
16,956 |
15,260 |
$3.91M |
| 80053 |
|
62,639 |
53,378 |
$3.20M |
| 99283 |
|
19,391 |
17,532 |
$3.09M |
| 94761 |
|
25,225 |
22,612 |
$2.75M |
| 85025 |
|
60,201 |
50,404 |
$2.43M |
| 99285 |
|
7,820 |
6,954 |
$2.28M |
| 81001 |
|
10,269 |
9,429 |
$1.08M |
| Y7506 |
|
934 |
877 |
$979K |
| 0241U |
|
9,149 |
7,979 |
$942K |
| 93005 |
|
13,160 |
10,952 |
$733K |
| D7999 |
|
436 |
394 |
$529K |
| Y7507 |
|
1,297 |
1,174 |
$514K |
| 83690 |
|
4,352 |
3,950 |
$411K |
| 96374 |
|
4,088 |
3,487 |
$386K |
| 87502 |
|
1,880 |
1,688 |
$334K |
| 87804 |
|
1,440 |
1,323 |
$305K |
| 80307 |
|
3,273 |
3,026 |
$304K |
| 87637 |
|
3,186 |
3,017 |
$303K |
| 0202U |
|
981 |
837 |
$287K |
| 71046 |
|
1,722 |
1,558 |
$280K |
| J3490 |
Drugs unclassified injection |
12,360 |
9,587 |
$263K |
| G0480 |
Drug test def 1-7 classes |
1,670 |
1,508 |
$229K |
| 84484 |
|
6,074 |
4,934 |
$217K |
| 71045 |
|
4,225 |
3,733 |
$214K |
| 87651 |
|
7,331 |
6,543 |
$208K |
| 87088 |
|
3,220 |
2,914 |
$207K |
| 84443 |
|
6,323 |
5,780 |
$180K |
| 87880 |
|
7,943 |
7,478 |
$176K |
| 81003 |
|
9,367 |
7,437 |
$173K |
| 83735 |
|
6,886 |
5,513 |
$168K |
| X4006 |
|
115 |
98 |
$160K |
| 96413 |
|
1,035 |
592 |
$158K |
| 84436 |
|
1,823 |
1,663 |
$154K |
| 85610 |
|
2,836 |
2,512 |
$153K |
| 70310 |
|
81 |
78 |
$116K |
| 92567 |
|
2,952 |
2,745 |
$94K |
| 90834 |
|
1,416 |
880 |
$94K |
| 84702 |
|
1,347 |
1,207 |
$86K |
| 99391 |
|
1,321 |
1,139 |
$79K |
| 86140 |
|
498 |
462 |
$75K |
| 81002 |
|
955 |
664 |
$75K |
| 85730 |
|
1,822 |
1,652 |
$71K |
| 88305 |
|
879 |
786 |
$69K |
| 87081 |
|
740 |
726 |
$69K |
| 81025 |
|
888 |
815 |
$68K |
| 99392 |
|
946 |
890 |
$63K |
| D2930 |
|
96 |
96 |
$54K |
| 80048 |
|
581 |
506 |
$50K |
| 73630 |
|
1,592 |
1,181 |
$47K |
| 96361 |
|
1,007 |
847 |
$44K |
| 86900 |
|
616 |
535 |
$42K |
| 87635 |
|
3,339 |
3,169 |
$41K |
| G0378 |
Hospital observation per hr |
93 |
78 |
$35K |
| 82553 |
|
150 |
146 |
$33K |
| 82550 |
|
164 |
158 |
$33K |
| 80061 |
|
3,263 |
3,041 |
$32K |
| 83880 |
|
935 |
816 |
$32K |
| 77067 |
|
328 |
312 |
$30K |
| 96372 |
|
751 |
554 |
$29K |
| 96375 |
|
994 |
816 |
$26K |
| 86850 |
|
829 |
747 |
$24K |
| 85027 |
|
473 |
426 |
$24K |
| J0131 |
Inj, acetaminophen (nos) |
295 |
277 |
$23K |
| 80143 |
|
1,612 |
1,478 |
$22K |
| 80179 |
|
1,611 |
1,479 |
$22K |
| 82077 |
|
1,761 |
1,608 |
$22K |
| 29581 |
|
469 |
119 |
$21K |
| 87591 |
|
395 |
358 |
$20K |
| 87430 |
|
61 |
56 |
$19K |
| 87491 |
|
339 |
307 |
$18K |
| 88312 |
|
277 |
244 |
$18K |
| 43239 |
|
110 |
96 |
$18K |
| 59025 |
|
135 |
112 |
$18K |
| 87426 |
|
1,678 |
1,585 |
$17K |
| 99393 |
|
251 |
247 |
$17K |
| 96365 |
|
168 |
136 |
$16K |
| 83036 |
|
2,076 |
1,946 |
$16K |
| 97597 |
|
288 |
212 |
$15K |
| 82306 |
|
728 |
694 |
$15K |
| 11042 |
|
128 |
103 |
$14K |
| 90870 |
|
80 |
45 |
$14K |
| 86901 |
|
616 |
535 |
$13K |
| 96367 |
|
219 |
103 |
$13K |
| 83655 |
|
1,261 |
1,095 |
$13K |
| 77063 |
|
326 |
310 |
$12K |
| 90471 |
|
561 |
536 |
$12K |
| 84439 |
|
1,854 |
1,710 |
$12K |
| 99282 |
|
106 |
92 |
$12K |
| 90792 |
|
173 |
150 |
$11K |
| 11721 |
|
4,520 |
3,770 |
$11K |
| 76816 |
|
344 |
292 |
$11K |
| 70450 |
|
141 |
124 |
$10K |
| 36415 |
|
14,226 |
10,276 |
$10K |
| 74177 |
|
41 |
36 |
$8K |
| 41899 |
|
69 |
57 |
$8K |
| 94640 |
|
79 |
51 |
$7K |
| 77336 |
|
105 |
50 |
$7K |
| 83605 |
|
607 |
539 |
$7K |
| 87801 |
|
117 |
114 |
$6K |
| 86780 |
|
724 |
699 |
$6K |
| 98941 |
|
675 |
326 |
$6K |
| 82728 |
|
709 |
650 |
$6K |
| 76805 |
|
88 |
80 |
$5K |
| 97602 |
|
128 |
89 |
$5K |
| 99394 |
|
99 |
89 |
$5K |
| 71260 |
|
66 |
61 |
$5K |
| 87660 |
|
310 |
278 |
$5K |
| 36592 |
|
122 |
79 |
$4K |
| 93296 |
|
475 |
450 |
$4K |
| D7140 |
|
24 |
24 |
$4K |
| J0330 |
Succinycholine chloride inj |
244 |
134 |
$4K |
| 80081 |
|
63 |
62 |
$4K |
| 92557 |
|
91 |
80 |
$4K |
| 76820 |
|
141 |
119 |
$4K |
| 87634 |
|
60 |
42 |
$3K |
| 11730 |
|
33 |
25 |
$3K |
| 85007 |
|
42 |
40 |
$3K |
| 0352U |
|
38 |
37 |
$3K |
| J0585 |
Injection,onabotulinumtoxina |
24 |
24 |
$3K |
| 62323 |
|
38 |
29 |
$3K |
| 69210 |
|
178 |
147 |
$3K |
| 83550 |
|
576 |
524 |
$3K |
| 87480 |
|
190 |
177 |
$3K |
| 87040 |
|
153 |
119 |
$3K |
| 87389 |
|
175 |
164 |
$2K |
| 88175 |
|
115 |
103 |
$2K |
| 86803 |
|
201 |
192 |
$2K |
| 83540 |
|
593 |
538 |
$2K |
| 85652 |
|
105 |
94 |
$2K |
| 90837 |
|
40 |
26 |
$2K |
| 93922 |
|
67 |
53 |
$2K |
| 93880 |
|
29 |
25 |
$2K |
| 90715 |
|
59 |
57 |
$2K |
| 90832 |
|
27 |
26 |
$2K |
| 83615 |
|
524 |
419 |
$2K |
| J2405 |
Ondansetron hcl injection |
153 |
121 |
$1K |
| 43249 |
|
13 |
12 |
$1K |
| 20611 |
|
15 |
12 |
$1K |
| 17311 |
|
14 |
12 |
$1K |
| 97032 |
|
161 |
64 |
$1K |
| 90791 |
|
12 |
12 |
$926.00 |
| 82746 |
|
149 |
141 |
$920.22 |
| 96360 |
|
13 |
12 |
$893.67 |
| 87150 |
|
41 |
37 |
$877.49 |
| 82607 |
|
138 |
131 |
$876.93 |
| 94726 |
|
13 |
13 |
$857.08 |
| 87340 |
|
149 |
140 |
$852.91 |
| 99212 |
|
59 |
56 |
$821.22 |
| 95115 |
|
118 |
49 |
$775.59 |
| 94060 |
|
12 |
12 |
$719.52 |
| 92552 |
|
39 |
39 |
$683.12 |
| J7030 |
Normal saline solution infus |
83 |
73 |
$679.17 |
| 86762 |
|
64 |
61 |
$613.09 |
| 87186 |
|
105 |
79 |
$588.13 |
| 87077 |
|
103 |
78 |
$581.34 |
| 87510 |
|
44 |
39 |
$566.35 |
| J2270 |
Morphine sulfate injection |
46 |
45 |
$548.35 |
| 87070 |
|
152 |
133 |
$537.06 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
445 |
364 |
$533.19 |
| J1885 |
Ketorolac tromethamine inj |
47 |
38 |
$517.23 |
| 87075 |
|
121 |
108 |
$502.64 |
| 0071A |
|
32 |
29 |
$480.00 |
| 99213 |
|
62 |
50 |
$412.67 |
| 85018 |
|
311 |
283 |
$374.01 |
| 87205 |
|
161 |
121 |
$373.95 |
| J1050 |
Medroxyprogesterone acetate |
15 |
13 |
$310.31 |
| 0072A |
|
16 |
15 |
$280.00 |
| J2274 |
Inj morphine pf epid ithc |
14 |
12 |
$272.80 |
| 85045 |
|
166 |
157 |
$257.31 |
| A6210 |
Foam drg >16<=48 sq in w/o b |
117 |
38 |
$252.55 |
| J2250 |
Inj midazolam hydrochloride |
37 |
30 |
$237.18 |
| J3010 |
Fentanyl citrate injection |
74 |
61 |
$224.64 |
| 92555 |
|
29 |
28 |
$192.33 |
| J1650 |
Inj enoxaparin sodium |
15 |
12 |
$187.34 |
| 80305 |
|
26 |
25 |
$168.96 |
| 97162 |
|
18 |
12 |
$142.93 |
| 85046 |
|
41 |
40 |
$128.05 |
| 87807 |
|
15 |
14 |
$97.16 |
| 82962 |
|
76 |
53 |
$94.42 |
| J2175 |
Meperidine hydrochl /100 mg |
27 |
25 |
$90.15 |
| 88720 |
|
15 |
12 |
$71.33 |
| 93299 |
|
31 |
28 |
$66.61 |
| A6212 |
Foam drg <=16 sq in w/border |
466 |
360 |
$58.48 |
| 92558 |
|
42 |
28 |
$57.19 |
| 82947 |
|
15 |
12 |
$54.14 |
| 82950 |
|
12 |
12 |
$37.14 |
| J7614 |
Levalbuterol non-comp unit |
15 |
12 |
$34.20 |
| J1040 |
Methylprednisolone 80 mg inj |
14 |
12 |
$12.91 |
| 94729 |
|
12 |
12 |
$11.75 |
| G1010 |
Cdsm stanson |
968 |
613 |
$0.00 |
| J7120 |
Ringers lactate infusion |
13 |
12 |
$0.00 |
| G9920 |
Scrning perf and negative |
16 |
14 |
$0.00 |
| 90833 |
|
14 |
12 |
$0.00 |
| 90686 |
|
58 |
52 |
$0.00 |
| G0008 |
Admin influenza virus vac |
101 |
89 |
$0.00 |
| 80050 |
|
42 |
41 |
$0.00 |
| J1642 |
Inj heparin sodium per 10 u |
14 |
13 |
$0.00 |
| A9270 |
Non-covered item or service |
207 |
26 |
$0.00 |
| 94760 |
|
17 |
12 |
$0.00 |
| 92551 |
|
13 |
13 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
13 |
12 |
$0.00 |