| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
2,785 |
2,636 |
$536K |
| 99284 |
|
1,366 |
1,293 |
$352K |
| 74177 |
|
342 |
335 |
$182K |
| 99282 |
|
451 |
447 |
$40K |
| 74176 |
|
84 |
84 |
$30K |
| 99281 |
|
499 |
488 |
$29K |
| 70450 |
|
137 |
133 |
$6K |
| 96375 |
|
636 |
590 |
$216.81 |
| J0137 |
Inj, acetaminophen (hikma) |
56 |
56 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
454 |
436 |
$0.00 |
| 81003 |
|
1,136 |
1,071 |
$0.00 |
| 87880 |
|
308 |
306 |
$0.00 |
| J2270 |
Morphine sulfate injection |
194 |
176 |
$0.00 |
| J2405 |
Ondansetron hcl injection |
530 |
504 |
$0.00 |
| 81025 |
|
158 |
155 |
$0.00 |
| 93005 |
|
679 |
649 |
$0.00 |
| 0202U |
|
347 |
347 |
$0.00 |
| 71046 |
|
315 |
305 |
$0.00 |
| J7030 |
Normal saline solution infus |
781 |
737 |
$0.00 |
| S0119 |
Ondansetron 4 mg |
273 |
269 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
108 |
101 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |
| 85610 |
|
64 |
63 |
$0.00 |
| Q0163 |
Diphenhydramine hcl 50mg |
16 |
14 |
$0.00 |
| 76705 |
|
46 |
46 |
$0.00 |
| 73130 |
|
12 |
12 |
$0.00 |
| 73562 |
|
12 |
12 |
$0.00 |
| 76856 |
|
12 |
12 |
$0.00 |
| 84100 |
|
14 |
14 |
$0.00 |
| 84702 |
|
12 |
12 |
$0.00 |
| 83690 |
|
724 |
673 |
$0.00 |
| 96365 |
|
176 |
174 |
$0.00 |
| 85730 |
|
29 |
28 |
$0.00 |
| 80053 |
|
1,425 |
1,330 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
638 |
625 |
$0.00 |
| 85027 |
|
436 |
422 |
$0.00 |
| 36416 |
|
85 |
84 |
$0.00 |
| 84484 |
|
543 |
463 |
$0.00 |
| J7611 |
Albuterol non-comp con |
130 |
121 |
$0.00 |
| 83735 |
|
428 |
411 |
$0.00 |
| 83605 |
|
90 |
81 |
$0.00 |
| 71045 |
|
464 |
460 |
$0.00 |
| 83880 |
|
72 |
71 |
$0.00 |
| 87081 |
|
266 |
264 |
$0.00 |
| 96372 |
|
460 |
441 |
$0.00 |
| 87637 |
|
191 |
191 |
$0.00 |
| 96361 |
|
221 |
214 |
$0.00 |
| 96374 |
|
801 |
750 |
$0.00 |
| 94640 |
|
166 |
157 |
$0.00 |
| 36415 |
|
1,643 |
1,527 |
$0.00 |
| 87086 |
|
182 |
179 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
322 |
313 |
$0.00 |
| 82962 |
|
81 |
70 |
$0.00 |
| 85379 |
|
58 |
58 |
$0.00 |
| 85025 |
|
1,126 |
1,069 |
$0.00 |
| 80048 |
|
134 |
130 |
$0.00 |
| J1170 |
Hydromorphone injection |
31 |
27 |
$0.00 |
| J7644 |
Ipratropium bromide non-comp |
110 |
100 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
42 |
41 |
$0.00 |
| 82550 |
|
15 |
15 |
$0.00 |
| 84703 |
|
49 |
49 |
$0.00 |
| 90471 |
|
12 |
12 |
$0.00 |