| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 80053 |
|
4,532 |
3,728 |
$160K |
| 99282 |
|
1,042 |
963 |
$126K |
| 99281 |
|
821 |
748 |
$92K |
| 99283 |
|
5,696 |
5,021 |
$85K |
| 87430 |
|
873 |
816 |
$66K |
| 80307 |
|
1,028 |
904 |
$61K |
| 87804 |
|
1,477 |
1,356 |
$57K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
386 |
355 |
$44K |
| 84703 |
|
1,627 |
1,445 |
$43K |
| 84484 |
|
1,468 |
981 |
$43K |
| 84443 |
|
730 |
663 |
$38K |
| 87086 |
|
1,039 |
933 |
$35K |
| 71046 |
|
1,195 |
1,097 |
$31K |
| 81001 |
|
3,428 |
2,964 |
$24K |
| 36415 |
|
6,274 |
4,662 |
$24K |
| 76856 |
|
176 |
167 |
$22K |
| 93306 |
|
272 |
250 |
$21K |
| 99285 |
|
1,424 |
1,220 |
$21K |
| 86756 |
|
399 |
354 |
$20K |
| 86900 |
|
108 |
94 |
$20K |
| 83880 |
|
628 |
528 |
$16K |
| 87070 |
|
1,033 |
955 |
$14K |
| 70450 |
|
677 |
611 |
$14K |
| 99284 |
|
3,637 |
3,153 |
$12K |
| 87040 |
|
479 |
321 |
$12K |
| 74018 |
|
266 |
239 |
$9K |
| 80048 |
|
657 |
475 |
$9K |
| 72100 |
|
307 |
283 |
$8K |
| 74176 |
|
245 |
222 |
$8K |
| 84702 |
|
336 |
261 |
$7K |
| 73630 |
|
191 |
176 |
$6K |
| 85025 |
|
5,265 |
4,173 |
$6K |
| 71045 |
|
1,340 |
1,153 |
$6K |
| 73130 |
|
154 |
141 |
$5K |
| J7120 |
Ringers lactate infusion |
539 |
494 |
$4K |
| 73562 |
|
118 |
110 |
$4K |
| 87077 |
|
513 |
472 |
$4K |
| 87491 |
|
424 |
381 |
$4K |
| 93971 |
|
30 |
26 |
$4K |
| 83655 |
|
175 |
168 |
$4K |
| 78452 |
|
28 |
24 |
$4K |
| 73610 |
|
173 |
159 |
$4K |
| 76700 |
|
43 |
40 |
$3K |
| 96372 |
|
772 |
633 |
$2K |
| G0463 |
Hospital outpt clinic visit |
167 |
109 |
$2K |
| 85610 |
|
425 |
366 |
$2K |
| 76801 |
|
163 |
136 |
$2K |
| 72050 |
|
55 |
49 |
$2K |
| 77067 |
|
42 |
38 |
$1K |
| 93005 |
|
1,688 |
1,398 |
$1K |
| 73502 |
|
27 |
25 |
$1K |
| 85379 |
|
197 |
182 |
$1K |
| J2704 |
Inj, propofol, 10 mg |
386 |
369 |
$1K |
| 73030 |
|
83 |
77 |
$1K |
| 72070 |
|
12 |
12 |
$1K |
| P9612 |
Catheterize for urine spec |
147 |
128 |
$1K |
| 96375 |
|
569 |
451 |
$960.82 |
| 76705 |
|
27 |
26 |
$781.39 |
| 96366 |
|
96 |
67 |
$780.72 |
| 74019 |
|
142 |
122 |
$758.02 |
| 73080 |
|
14 |
14 |
$751.14 |
| 76830 |
|
174 |
166 |
$747.10 |
| 77066 |
Tomosynthesis, mammo |
16 |
14 |
$721.43 |
| 80320 |
|
120 |
117 |
$714.12 |
| 73110 |
|
29 |
28 |
$710.62 |
| 96365 |
|
423 |
356 |
$709.14 |
| G0378 |
Hospital observation per hr |
320 |
245 |
$646.76 |
| 94640 |
|
666 |
522 |
$492.31 |
| 87210 |
|
245 |
221 |
$483.28 |
| 96361 |
|
546 |
448 |
$479.85 |
| 83605 |
|
298 |
229 |
$410.76 |
| 83036 |
|
188 |
175 |
$391.91 |
| 74177 |
|
238 |
220 |
$344.44 |
| J7030 |
Normal saline solution infus |
1,273 |
992 |
$335.08 |
| 94760 |
|
210 |
106 |
$303.82 |
| G0480 |
Drug test def 1-7 classes |
53 |
42 |
$256.86 |
| J1650 |
Inj enoxaparin sodium |
244 |
138 |
$240.92 |
| 76642 |
|
15 |
14 |
$169.02 |
| 80061 |
|
224 |
207 |
$81.88 |
| 83690 |
|
1,023 |
888 |
$56.49 |
| 74022 |
|
149 |
139 |
$44.40 |
| 82962 |
|
72 |
27 |
$35.33 |
| J0696 |
Ceftriaxone sodium injection |
558 |
472 |
$34.46 |
| J2270 |
Morphine sulfate injection |
666 |
533 |
$3.12 |
| J1885 |
Ketorolac tromethamine inj |
866 |
771 |
$0.41 |
| J0171 |
Adrenalin epinephrine inject |
115 |
105 |
$0.00 |
| J7040 |
Normal saline solution infus |
285 |
228 |
$0.00 |
| 84439 |
|
219 |
205 |
$0.00 |
| 96360 |
|
98 |
96 |
$0.00 |
| 85007 |
|
426 |
355 |
$0.00 |
| J2405 |
Ondansetron hcl injection |
857 |
715 |
$0.00 |
| J2550 |
Promethazine hcl injection |
258 |
204 |
$0.00 |
| 87186 |
|
421 |
392 |
$0.00 |
| J2930 |
Methylprednisolone injection |
259 |
225 |
$0.00 |
| 82010 |
|
47 |
38 |
$0.00 |
| 93017 |
|
41 |
36 |
$0.00 |
| J7510 |
Prednisolone oral per 5 mg |
265 |
247 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
19 |
13 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
83 |
72 |
$0.00 |
| 90714 |
|
28 |
27 |
$0.00 |
| 00170 |
|
12 |
12 |
$0.00 |
| Q0163 |
Diphenhydramine hcl 50mg |
13 |
12 |
$0.00 |
| 82550 |
|
796 |
627 |
$0.00 |
| 85730 |
|
355 |
309 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
602 |
539 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
392 |
365 |
$0.00 |
| 82150 |
|
404 |
367 |
$0.00 |
| 82553 |
|
926 |
734 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
310 |
284 |
$0.00 |
| 96374 |
|
556 |
516 |
$0.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
227 |
201 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
166 |
153 |
$0.00 |
| 87205 |
|
204 |
178 |
$0.00 |
| J7050 |
Normal saline solution infus |
139 |
116 |
$0.00 |
| J1170 |
Hydromorphone injection |
79 |
64 |
$0.00 |
| 88304 |
|
94 |
89 |
$0.00 |
| 84436 |
|
159 |
146 |
$0.00 |
| 83735 |
|
594 |
483 |
$0.00 |
| 76817 |
|
146 |
121 |
$0.00 |
| J2060 |
Lorazepam injection |
103 |
80 |
$0.00 |
| 85027 |
|
44 |
39 |
$0.00 |
| 88305 |
|
35 |
32 |
$0.00 |
| A9500 |
Tc99m sestamibi |
12 |
12 |
$0.00 |
| J2360 |
Orphenadrine injection |
16 |
14 |
$0.00 |
| 99291 |
|
20 |
19 |
$0.00 |
| 42820 |
|
15 |
15 |
$0.00 |