| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
6,183 |
4,702 |
$567K |
| 99284 |
|
3,637 |
2,583 |
$462K |
| 97110 |
|
4,358 |
872 |
$192K |
| 74177 |
|
332 |
271 |
$148K |
| 80053 |
|
10,267 |
7,628 |
$147K |
| 99282 |
|
3,302 |
2,534 |
$146K |
| 99285 |
|
1,902 |
1,315 |
$145K |
| 87635 |
|
4,176 |
2,657 |
$118K |
| 82306 |
|
1,105 |
906 |
$79K |
| 87637 |
|
167 |
150 |
$58K |
| 87502 |
|
563 |
483 |
$26K |
| 87636 |
|
666 |
521 |
$22K |
| 80061 |
|
3,349 |
2,920 |
$20K |
| 80050 |
|
216 |
214 |
$16K |
| 71046 |
|
1,756 |
1,416 |
$16K |
| 80306 |
|
965 |
704 |
$15K |
| 74176 |
|
64 |
55 |
$14K |
| 80048 |
|
2,333 |
1,780 |
$12K |
| 80307 |
|
326 |
264 |
$12K |
| 70450 |
|
145 |
117 |
$11K |
| 96361 |
|
1,121 |
851 |
$10K |
| 96374 |
|
3,020 |
2,047 |
$9K |
| 85025 |
|
12,402 |
8,881 |
$9K |
| 93005 |
|
2,292 |
1,700 |
$8K |
| G0378 |
Hospital observation per hr |
32 |
12 |
$7K |
| 84443 |
|
4,395 |
3,689 |
$7K |
| 87651 |
|
786 |
683 |
$7K |
| 97530 |
|
70 |
12 |
$6K |
| 96375 |
|
2,214 |
1,443 |
$5K |
| 96365 |
|
846 |
433 |
$5K |
| J3010 |
Fentanyl citrate injection |
479 |
315 |
$4K |
| 87633 |
|
355 |
290 |
$4K |
| 84703 |
|
478 |
390 |
$4K |
| 87591 |
|
221 |
174 |
$3K |
| 77067 |
|
51 |
50 |
$3K |
| 83036 |
|
2,954 |
2,565 |
$3K |
| 99281 |
|
229 |
215 |
$3K |
| 87491 |
|
220 |
175 |
$3K |
| 87811 |
|
551 |
192 |
$2K |
| 99213 |
|
41 |
39 |
$2K |
| 87086 |
|
1,499 |
1,171 |
$2K |
| 93306 |
|
26 |
24 |
$2K |
| 85610 |
|
2,782 |
1,922 |
$1K |
| 84466 |
|
426 |
336 |
$1K |
| 96372 |
|
1,644 |
1,205 |
$1K |
| J8499 |
Oral prescrip drug non chemo |
6,177 |
2,939 |
$1K |
| 82607 |
|
519 |
427 |
$794.41 |
| 87798 |
|
198 |
89 |
$745.05 |
| 81003 |
|
3,000 |
2,418 |
$477.90 |
| 84439 |
|
3,025 |
2,542 |
$462.29 |
| 84484 |
|
1,551 |
1,059 |
$441.45 |
| 87186 |
|
109 |
80 |
$423.62 |
| 81001 |
|
2,310 |
1,845 |
$400.87 |
| 87804 |
|
92 |
78 |
$349.44 |
| 97162 |
|
12 |
12 |
$335.49 |
| 85730 |
|
1,751 |
1,305 |
$272.70 |
| 86141 |
|
305 |
259 |
$242.31 |
| 99070 |
|
471 |
343 |
$195.71 |
| 87634 |
|
67 |
63 |
$173.32 |
| 83880 |
|
54 |
43 |
$144.81 |
| J3490 |
Drugs unclassified injection |
1,951 |
912 |
$105.11 |
| 87486 |
|
112 |
87 |
$95.76 |
| 83690 |
|
1,646 |
1,188 |
$95.10 |
| 82043 |
|
218 |
188 |
$79.95 |
| 82728 |
|
502 |
408 |
$72.96 |
| 83735 |
|
2,248 |
1,660 |
$65.43 |
| 84481 |
|
1,678 |
1,476 |
$62.87 |
| 96360 |
|
33 |
24 |
$57.71 |
| 87070 |
|
260 |
229 |
$46.70 |
| 80076 |
|
208 |
184 |
$33.42 |
| 94640 |
|
105 |
60 |
$32.80 |
| 71045 |
|
258 |
181 |
$32.67 |
| 87077 |
|
150 |
118 |
$23.38 |
| J1885 |
Ketorolac tromethamine inj |
1,719 |
1,265 |
$21.05 |
| 85652 |
|
417 |
329 |
$17.67 |
| 82550 |
|
469 |
349 |
$13.32 |
| 84152 |
|
15 |
12 |
$12.55 |
| J2405 |
Ondansetron hcl injection |
1,838 |
1,173 |
$5.18 |
| 83540 |
|
491 |
396 |
$3.89 |
| 84550 |
|
69 |
52 |
$3.08 |
| 86592 |
|
61 |
51 |
$2.91 |
| J2001 |
Lidocaine injection |
126 |
76 |
$1.42 |
| J1100 |
Dexamethasone sodium phos |
84 |
55 |
$1.20 |
| J0696 |
Ceftriaxone sodium injection |
71 |
50 |
$0.57 |
| J2250 |
Inj midazolam hydrochloride |
473 |
340 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
149 |
84 |
$0.00 |
| 83605 |
|
227 |
145 |
$0.00 |
| 82746 |
|
308 |
244 |
$0.00 |
| 86850 |
|
75 |
65 |
$0.00 |
| 80320 |
|
210 |
145 |
$0.00 |
| 83874 |
|
19 |
12 |
$0.00 |
| 87581 |
|
110 |
87 |
$0.00 |
| 82553 |
|
37 |
27 |
$0.00 |
| 96376 |
|
15 |
12 |
$0.00 |
| 87088 |
|
14 |
14 |
$0.00 |
| J1170 |
Hydromorphone injection |
43 |
25 |
$0.00 |
| 88142 |
|
24 |
12 |
$0.00 |
| 85379 |
|
32 |
26 |
$0.00 |
| 86593 |
|
12 |
12 |
$0.00 |
| A4300 |
Cath impl vasc access portal |
54 |
48 |
$0.00 |
| J2060 |
Lorazepam injection |
31 |
12 |
$0.00 |
| 36415 |
|
32 |
25 |
$0.00 |
| 87389 |
|
15 |
13 |
$0.00 |
| T1015 |
Clinic service |
3,001 |
2,217 |
$0.00 |
| A4649 |
Surgical supplies |
36 |
13 |
$0.00 |
| 82570 |
|
164 |
135 |
$0.00 |
| J2270 |
Morphine sulfate injection |
54 |
38 |
$0.00 |
| J7030 |
Normal saline solution infus |
289 |
129 |
$0.00 |
| 86038 |
|
28 |
26 |
$0.00 |
| 87420 |
|
15 |
14 |
$0.00 |
| 86431 |
|
15 |
13 |
$0.00 |