| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
1,132 |
1,018 |
$300K |
| 99283 |
|
1,141 |
1,065 |
$243K |
| 99285 |
|
531 |
462 |
$122K |
| 74177 |
|
107 |
94 |
$94K |
| 74176 |
|
105 |
98 |
$61K |
| 70450 |
|
204 |
188 |
$57K |
| 72125 |
|
50 |
47 |
$19K |
| G0378 |
Hospital observation per hr |
90 |
44 |
$15K |
| 99282 |
|
88 |
86 |
$10K |
| 99281 |
|
101 |
96 |
$7K |
| 76497 |
|
13 |
13 |
$5K |
| 96361 |
|
384 |
332 |
$4K |
| 96366 |
|
64 |
59 |
$948.82 |
| 96372 |
|
406 |
353 |
$706.86 |
| 87651 |
|
181 |
180 |
$280.59 |
| 96374 |
|
487 |
433 |
$275.29 |
| 96375 |
|
434 |
370 |
$78.56 |
| 87502 |
|
230 |
220 |
$77.00 |
| J1885 |
Ketorolac tromethamine inj |
311 |
271 |
$36.82 |
| 93005 |
|
357 |
306 |
$29.84 |
| 71045 |
|
437 |
385 |
$28.83 |
| 80053 |
|
939 |
769 |
$14.84 |
| 85027 |
|
1,148 |
900 |
$13.71 |
| 84484 |
|
322 |
248 |
$13.55 |
| 81025 |
|
127 |
124 |
$10.28 |
| J8499 |
Oral prescrip drug non chemo |
911 |
550 |
$8.86 |
| J2405 |
Ondansetron hcl injection |
461 |
381 |
$8.00 |
| 81002 |
|
613 |
561 |
$6.35 |
| 80048 |
|
213 |
173 |
$5.82 |
| J2060 |
Lorazepam injection |
267 |
210 |
$5.21 |
| J1200 |
Diphenhydramine hcl injectio |
77 |
63 |
$5.18 |
| 83690 |
|
297 |
262 |
$4.86 |
| 96360 |
|
109 |
99 |
$0.00 |
| 80305 |
|
140 |
127 |
$0.00 |
| J2270 |
Morphine sulfate injection |
294 |
217 |
$0.00 |
| J2550 |
Promethazine hcl injection |
110 |
84 |
$0.00 |
| 76856 |
|
33 |
31 |
$0.00 |
| 80307 |
|
185 |
146 |
$0.00 |
| 71046 |
|
115 |
110 |
$0.00 |
| 76705 |
|
29 |
25 |
$0.00 |
| 84702 |
|
32 |
29 |
$0.00 |
| 85610 |
|
174 |
139 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
12 |
12 |
$0.00 |
| 96367 |
|
14 |
14 |
$0.00 |
| 85730 |
|
103 |
85 |
$0.00 |
| 82553 |
|
113 |
92 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
180 |
150 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
119 |
113 |
$0.00 |
| 83605 |
|
60 |
44 |
$0.00 |
| J1170 |
Hydromorphone injection |
155 |
124 |
$0.00 |
| 83735 |
|
328 |
269 |
$0.00 |
| 84443 |
|
82 |
73 |
$0.00 |
| 85379 |
|
70 |
64 |
$0.00 |
| J2001 |
Lidocaine injection |
105 |
89 |
$0.00 |
| 87807 |
|
63 |
62 |
$0.00 |
| 94640 |
|
163 |
148 |
$0.00 |
| 84703 |
|
242 |
223 |
$0.00 |
| 87040 |
|
81 |
65 |
$0.00 |
| 83880 |
|
35 |
31 |
$0.00 |
| J3490 |
Drugs unclassified injection |
168 |
93 |
$0.00 |
| 82550 |
|
209 |
173 |
$0.00 |
| 96365 |
|
253 |
229 |
$0.00 |
| 82150 |
|
15 |
12 |
$0.00 |
| J7644 |
Ipratropium bromide non-comp |
12 |
12 |
$0.00 |
| 96376 |
|
77 |
66 |
$0.00 |
| Q0162 |
Ondansetron oral |
36 |
34 |
$0.00 |