| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
28,076 |
21,937 |
$3.31M |
| 99283 |
|
23,325 |
18,077 |
$2.42M |
| 99285 |
|
11,363 |
9,274 |
$1.67M |
| 96361 |
|
3,477 |
3,106 |
$1.51M |
| 74177 |
|
1,677 |
1,329 |
$665K |
| 99282 |
|
7,793 |
5,948 |
$387K |
| 80053 |
|
23,396 |
17,893 |
$249K |
| 87591 |
|
4,006 |
3,369 |
$178K |
| G0463 |
Hospital outpt clinic visit |
1,481 |
1,074 |
$149K |
| 87635 |
|
2,171 |
1,977 |
$146K |
| 87491 |
|
4,011 |
3,374 |
$145K |
| 70450 |
|
636 |
501 |
$136K |
| 97110 |
|
3,380 |
1,192 |
$112K |
| 85025 |
|
27,727 |
21,288 |
$108K |
| 99211 |
|
1,594 |
945 |
$93K |
| 88305 |
|
1,725 |
1,440 |
$91K |
| 0241U |
|
710 |
664 |
$72K |
| 71046 |
|
1,373 |
943 |
$64K |
| 97802 |
|
527 |
202 |
$58K |
| 92507 |
|
247 |
73 |
$54K |
| 84443 |
|
3,803 |
3,242 |
$51K |
| 71045 |
|
3,277 |
2,656 |
$50K |
| 87086 |
|
3,434 |
2,745 |
$44K |
| 97140 |
|
2,400 |
824 |
$44K |
| 96413 |
|
525 |
298 |
$33K |
| 93005 |
|
4,363 |
3,449 |
$33K |
| 74176 |
|
81 |
63 |
$32K |
| 97804 |
|
339 |
200 |
$30K |
| 42820 |
|
13 |
13 |
$30K |
| 80048 |
|
2,664 |
2,072 |
$28K |
| 36415 |
|
12,157 |
9,347 |
$28K |
| 86780 |
|
1,239 |
1,039 |
$28K |
| 87624 |
|
740 |
717 |
$28K |
| J7120 |
Ringers lactate infusion |
7,909 |
6,196 |
$23K |
| 93010 |
|
3,856 |
3,241 |
$23K |
| 88142 |
|
956 |
740 |
$22K |
| 80061 |
|
1,622 |
1,397 |
$21K |
| 86703 |
|
1,186 |
993 |
$19K |
| 87081 |
|
842 |
757 |
$19K |
| 83605 |
|
1,457 |
1,230 |
$18K |
| 88175 |
|
1,076 |
1,046 |
$18K |
| 99232 |
|
457 |
185 |
$17K |
| T1015 |
Clinic service |
65 |
31 |
$17K |
| J2405 |
Ondansetron hcl injection |
5,931 |
4,326 |
$16K |
| J7030 |
Normal saline solution infus |
5,437 |
3,323 |
$16K |
| 96367 |
|
203 |
107 |
$16K |
| 96360 |
|
69 |
63 |
$16K |
| 84484 |
|
1,131 |
867 |
$16K |
| 83690 |
|
4,855 |
3,811 |
$15K |
| 81001 |
|
4,877 |
3,806 |
$14K |
| 81025 |
|
3,243 |
2,534 |
$14K |
| 83036 |
|
835 |
744 |
$12K |
| 87077 |
|
1,061 |
871 |
$12K |
| 86850 |
|
892 |
737 |
$10K |
| J1885 |
Ketorolac tromethamine inj |
9,871 |
6,175 |
$10K |
| 43239 |
|
14 |
12 |
$10K |
| J3010 |
Fentanyl citrate injection |
2,444 |
1,576 |
$10K |
| 87186 |
|
1,059 |
869 |
$10K |
| 87653 |
|
238 |
183 |
$10K |
| 84439 |
|
1,045 |
893 |
$10K |
| 87340 |
|
645 |
552 |
$9K |
| J2001 |
Lidocaine injection |
2,070 |
1,475 |
$9K |
| 81003 |
|
7,763 |
6,545 |
$9K |
| 85027 |
|
1,471 |
1,117 |
$9K |
| 83735 |
|
1,768 |
1,200 |
$8K |
| J2250 |
Inj midazolam hydrochloride |
1,856 |
1,334 |
$8K |
| 87502 |
|
137 |
103 |
$8K |
| 99223 |
Prolong inpt eval add15 m |
59 |
56 |
$8K |
| J1100 |
Dexamethasone sodium phos |
3,378 |
2,244 |
$8K |
| 87486 |
|
165 |
148 |
$7K |
| 73610 |
|
147 |
99 |
$7K |
| 73130 |
|
173 |
126 |
$7K |
| 76705 |
|
59 |
42 |
$7K |
| 86140 |
|
558 |
511 |
$7K |
| 87633 |
|
165 |
148 |
$7K |
| 87389 |
|
204 |
200 |
$6K |
| 96365 |
|
36 |
26 |
$6K |
| J0131 |
Inj, acetaminophen (nos) |
418 |
321 |
$6K |
| J1170 |
Hydromorphone injection |
1,069 |
683 |
$6K |
| 86762 |
|
276 |
228 |
$5K |
| 97161 |
|
25 |
25 |
$5K |
| J0690 |
Cefazolin sodium injection |
695 |
506 |
$5K |
| 0240U |
|
43 |
43 |
$4K |
| 97530 |
|
200 |
123 |
$4K |
| 74160 |
|
20 |
18 |
$4K |
| 87581 |
|
165 |
148 |
$4K |
| 73630 |
|
111 |
89 |
$4K |
| 86592 |
|
201 |
201 |
$4K |
| 96375 |
|
2,807 |
2,455 |
$3K |
| 87070 |
|
276 |
251 |
$3K |
| G0108 |
Diab manage trn per indiv |
52 |
49 |
$3K |
| 88300 |
|
91 |
86 |
$3K |
| 86900 |
|
973 |
810 |
$3K |
| J7050 |
Normal saline solution infus |
1,208 |
502 |
$3K |
| 86803 |
|
258 |
251 |
$3K |
| 86901 |
|
971 |
808 |
$3K |
| 80306 |
|
295 |
216 |
$3K |
| 82306 |
|
154 |
130 |
$3K |
| 73562 |
|
45 |
29 |
$2K |
| 82728 |
|
141 |
133 |
$2K |
| 97165 |
|
15 |
12 |
$2K |
| 87798 |
|
165 |
148 |
$2K |
| J3490 |
Drugs unclassified injection |
110 |
97 |
$2K |
| 83550 |
|
189 |
177 |
$2K |
| G0481 |
Drug test def 8-14 classes |
13 |
12 |
$2K |
| 85610 |
|
548 |
423 |
$2K |
| 76830 |
|
12 |
12 |
$1K |
| 87804 |
|
36 |
28 |
$1K |
| 83540 |
|
163 |
152 |
$1K |
| 85652 |
|
452 |
417 |
$1K |
| 84703 |
|
155 |
104 |
$1K |
| 99213 |
|
14 |
13 |
$1K |
| 77067 |
|
32 |
24 |
$1K |
| 99460 |
|
12 |
12 |
$1K |
| 84481 |
|
167 |
155 |
$1K |
| 87426 |
|
127 |
125 |
$1K |
| 87210 |
|
77 |
64 |
$900.60 |
| 87430 |
|
329 |
309 |
$847.91 |
| 83880 |
|
44 |
28 |
$836.23 |
| J2704 |
Inj, propofol, 10 mg |
1,497 |
997 |
$773.79 |
| 36591 |
|
58 |
39 |
$757.33 |
| 73030 |
|
28 |
26 |
$716.75 |
| 77063 |
|
12 |
12 |
$685.32 |
| J7040 |
Normal saline solution infus |
527 |
284 |
$667.30 |
| 82565 |
|
146 |
124 |
$648.68 |
| 99231 |
|
24 |
12 |
$619.55 |
| 82947 |
|
145 |
116 |
$612.41 |
| 99238 |
|
13 |
13 |
$474.40 |
| 94060 |
|
12 |
12 |
$470.80 |
| J2270 |
Morphine sulfate injection |
500 |
258 |
$396.81 |
| 84702 |
|
37 |
26 |
$328.22 |
| 94729 |
|
12 |
12 |
$305.39 |
| 80320 |
|
18 |
14 |
$281.56 |
| 82150 |
|
37 |
12 |
$250.50 |
| 84145 |
|
75 |
71 |
$235.40 |
| 94726 |
|
12 |
12 |
$235.40 |
| 82948 |
|
85 |
53 |
$219.06 |
| J1200 |
Diphenhydramine hcl injectio |
400 |
238 |
$97.54 |
| J2550 |
Promethazine hcl injection |
139 |
66 |
$90.94 |
| J2765 |
Metoclopramide hcl injection |
45 |
27 |
$46.96 |
| 88342 |
|
13 |
13 |
$45.58 |
| 84450 |
|
27 |
26 |
$43.92 |
| 84460 |
|
27 |
26 |
$32.11 |
| J2060 |
Lorazepam injection |
46 |
26 |
$18.71 |
| J1642 |
Inj heparin sodium per 10 u |
1,236 |
478 |
$14.04 |
| J0696 |
Ceftriaxone sodium injection |
71 |
52 |
$0.00 |
| 96372 |
|
643 |
577 |
$0.00 |
| Q0162 |
Ondansetron oral |
613 |
481 |
$0.00 |
| 96374 |
|
4,720 |
4,220 |
$0.00 |
| A9270 |
Non-covered item or service |
397 |
99 |
$0.00 |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
413 |
393 |
$0.00 |
| J1790 |
Droperidol injection |
302 |
254 |
$0.00 |
| J2920 |
Methylprednisolone injection |
12 |
12 |
$0.00 |
| 85730 |
|
31 |
28 |
$0.00 |
| A4217 |
Sterile water/saline, 500 ml |
58 |
57 |
$0.00 |
| 94640 |
|
12 |
12 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
394 |
356 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
27 |
25 |
$0.00 |