| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
6,993 |
6,584 |
$7.38M |
| 99285 |
|
2,159 |
1,974 |
$2.39M |
| 99283 |
|
10,709 |
10,308 |
$870K |
| 87426 |
|
5,444 |
5,233 |
$242K |
| 93005 |
|
1,205 |
1,074 |
$209K |
| 87804 |
|
6,202 |
5,331 |
$166K |
| J7030 |
Normal saline solution infus |
1,376 |
1,249 |
$105K |
| 99282 |
|
1,333 |
1,290 |
$99K |
| 96361 |
|
817 |
712 |
$62K |
| 80053 |
|
5,115 |
4,646 |
$49K |
| 87430 |
|
2,379 |
2,295 |
$43K |
| 85025 |
|
5,352 |
4,877 |
$35K |
| J0696 |
Ceftriaxone sodium injection |
268 |
251 |
$25K |
| J2405 |
Ondansetron hcl injection |
1,592 |
1,479 |
$23K |
| 71046 |
|
518 |
495 |
$20K |
| 70450 |
|
245 |
232 |
$16K |
| 87081 |
|
1,929 |
1,854 |
$14K |
| 71045 |
|
802 |
742 |
$14K |
| 96374 |
|
1,553 |
1,383 |
$14K |
| 81025 |
|
1,629 |
1,484 |
$13K |
| 81003 |
|
4,973 |
4,626 |
$10K |
| J1885 |
Ketorolac tromethamine inj |
494 |
457 |
$8K |
| 87807 |
|
561 |
552 |
$6K |
| 74177 |
|
29 |
27 |
$6K |
| 87088 |
|
851 |
785 |
$5K |
| 96365 |
|
64 |
59 |
$5K |
| 96375 |
|
812 |
722 |
$5K |
| J1100 |
Dexamethasone sodium phos |
263 |
255 |
$5K |
| 84484 |
|
921 |
764 |
$4K |
| 83690 |
|
434 |
385 |
$2K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
63 |
54 |
$2K |
| J7050 |
Normal saline solution infus |
66 |
52 |
$1K |
| S0028 |
Injection, famotidine, 20 mg |
163 |
158 |
$994.37 |
| 96372 |
|
719 |
666 |
$786.40 |
| J7120 |
Ringers lactate infusion |
16 |
14 |
$687.84 |
| 83605 |
|
75 |
61 |
$367.82 |
| J2920 |
Methylprednisolone injection |
14 |
12 |
$243.71 |
| 84702 |
|
13 |
13 |
$199.29 |
| A9270 |
Non-covered item or service |
408 |
342 |
$0.00 |