| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
7,518 |
6,948 |
$1.33M |
| 99284 |
|
4,969 |
4,600 |
$1.17M |
| 99285 |
|
3,531 |
3,167 |
$851K |
| 74176 |
|
858 |
798 |
$333K |
| 74177 |
|
744 |
683 |
$318K |
| 70450 |
|
934 |
857 |
$204K |
| 99282 |
|
1,119 |
1,047 |
$121K |
| G0378 |
Hospital observation per hr |
75 |
60 |
$39K |
| 71275 |
|
115 |
108 |
$30K |
| 99291 |
|
25 |
25 |
$17K |
| 72125 |
|
31 |
30 |
$10K |
| 96361 |
|
2,186 |
1,786 |
$9K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,316 |
1,170 |
$8K |
| J3490 |
Drugs unclassified injection |
2,431 |
1,563 |
$5K |
| 99281 |
|
75 |
70 |
$4K |
| 96375 |
|
3,486 |
2,475 |
$3K |
| 96372 |
|
2,269 |
1,938 |
$2K |
| 87637 |
|
2,373 |
2,240 |
$2K |
| 96376 |
|
814 |
496 |
$1K |
| J1815 |
Insulin injection |
14 |
12 |
$1K |
| 71045 |
|
2,480 |
2,207 |
$1K |
| 96374 |
|
3,762 |
3,318 |
$966.72 |
| 80053 |
|
6,289 |
5,288 |
$937.62 |
| 87651 |
|
1,031 |
977 |
$928.84 |
| 96366 |
|
37 |
27 |
$765.63 |
| 87428 |
|
2,072 |
1,880 |
$671.37 |
| 93005 |
|
1,942 |
1,627 |
$474.98 |
| 85025 |
|
6,481 |
5,118 |
$453.19 |
| 96365 |
|
680 |
609 |
$327.57 |
| 84484 |
|
2,193 |
1,657 |
$296.38 |
| A4649 |
Surgical supplies |
1,379 |
1,175 |
$278.10 |
| 93000 |
|
477 |
409 |
$249.97 |
| 71046 |
|
841 |
798 |
$188.01 |
| 83690 |
|
2,118 |
1,870 |
$179.89 |
| 87880 |
|
1,285 |
1,205 |
$160.07 |
| 83880 |
|
500 |
443 |
$142.71 |
| 85004 |
|
1,270 |
995 |
$135.50 |
| A4248 |
Chlorhexidine antisept |
1,068 |
965 |
$134.56 |
| 83605 |
|
1,098 |
871 |
$98.90 |
| 81001 |
|
2,594 |
2,147 |
$87.01 |
| 94640 |
|
822 |
689 |
$83.36 |
| 85379 |
|
653 |
593 |
$75.80 |
| 83735 |
|
1,470 |
1,222 |
$75.31 |
| 84703 |
|
763 |
694 |
$68.96 |
| 81003 |
|
2,556 |
2,344 |
$65.49 |
| 81025 |
|
1,052 |
977 |
$61.22 |
| 36415 |
|
2,845 |
2,573 |
$58.95 |
| 82077 |
|
177 |
167 |
$58.73 |
| 85730 |
|
905 |
833 |
$50.81 |
| A4244 |
Alcohol or peroxide per pint |
68 |
64 |
$48.24 |
| 85610 |
|
1,298 |
1,013 |
$46.58 |
| J1885 |
Ketorolac tromethamine inj |
2,684 |
2,406 |
$43.72 |
| 84443 |
|
192 |
185 |
$40.70 |
| 84702 |
|
558 |
516 |
$40.36 |
| 87426 |
|
181 |
160 |
$35.33 |
| 80305 |
|
655 |
600 |
$35.28 |
| J7030 |
Normal saline solution infus |
2,699 |
2,333 |
$29.32 |
| 82150 |
|
340 |
312 |
$25.32 |
| 87086 |
|
400 |
375 |
$24.64 |
| J8499 |
Oral prescrip drug non chemo |
4,332 |
2,312 |
$22.07 |
| 84100 |
|
288 |
275 |
$20.95 |
| J2270 |
Morphine sulfate injection |
1,076 |
835 |
$20.18 |
| 82550 |
|
75 |
65 |
$19.83 |
| 86140 |
|
308 |
294 |
$19.68 |
| J2405 |
Ondansetron hcl injection |
2,228 |
1,858 |
$19.03 |
| 99001 |
|
349 |
336 |
$18.01 |
| 87040 |
|
126 |
55 |
$17.96 |
| 99053 |
|
97 |
96 |
$12.58 |
| A6257 |
Transparent film <= 16 sq in |
1,135 |
1,013 |
$12.30 |
| 87088 |
|
155 |
141 |
$12.16 |
| A4216 |
Sterile water/saline, 10 ml |
865 |
707 |
$11.11 |
| 84439 |
|
93 |
91 |
$10.82 |
| J0696 |
Ceftriaxone sodium injection |
700 |
549 |
$10.34 |
| J1100 |
Dexamethasone sodium phos |
709 |
616 |
$8.22 |
| J1170 |
Hydromorphone injection |
142 |
86 |
$7.21 |
| 82947 |
|
285 |
148 |
$6.87 |
| J2765 |
Metoclopramide hcl injection |
221 |
200 |
$5.53 |
| A6402 |
Sterile gauze <= 16 sq in |
250 |
242 |
$4.49 |
| A4450 |
Non-waterproof tape |
52 |
47 |
$3.31 |
| J7620 |
Albuterol ipratrop non-comp |
494 |
385 |
$0.17 |
| J7050 |
Normal saline solution infus |
208 |
173 |
$0.00 |
| 80320 |
|
448 |
378 |
$0.00 |
| 36410 |
|
171 |
65 |
$0.00 |
| A4657 |
Syringe w/wo needle |
51 |
49 |
$0.00 |
| J2001 |
Lidocaine injection |
216 |
193 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
62 |
61 |
$0.00 |
| 80048 |
|
228 |
169 |
$0.00 |
| J7613 |
Albuterol non-comp unit |
123 |
94 |
$0.00 |
| Q0162 |
Ondansetron oral |
260 |
222 |
$0.00 |
| 94760 |
|
30 |
30 |
$0.00 |
| J2060 |
Lorazepam injection |
116 |
83 |
$0.00 |
| J3480 |
Inj potassium chloride |
44 |
12 |
$0.00 |
| 99000 |
|
76 |
60 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
17 |
15 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
12 |
12 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
24 |
24 |
$0.00 |
| A9150 |
Misc/exper non-prescript dru |
21 |
13 |
$0.00 |
| J2360 |
Orphenadrine injection |
12 |
12 |
$0.00 |
| 80329 |
|
30 |
12 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
194 |
174 |
$0.00 |
| 80365 |
|
505 |
439 |
$0.00 |
| 87804 |
|
18 |
18 |
$0.00 |
| J2550 |
Promethazine hcl injection |
82 |
63 |
$0.00 |
| J7510 |
Prednisolone oral per 5 mg |
18 |
14 |
$0.00 |
| 73562 |
|
31 |
26 |
$0.00 |
| 96360 |
|
436 |
413 |
$0.00 |
| A6250 |
Skin seal protect moisturizr |
86 |
80 |
$0.00 |
| J7120 |
Ringers lactate infusion |
69 |
57 |
$0.00 |
| 73630 |
|
15 |
14 |
$0.00 |
| 74018 |
|
13 |
13 |
$0.00 |
| A6413 |
Adhesive bandage, first-aid |
15 |
15 |
$0.00 |
| S0164 |
Injection pantroprazole |
64 |
60 |
$0.00 |
| 73130 |
|
12 |
12 |
$0.00 |
| 87400 |
|
150 |
82 |
$0.00 |
| 76705 |
|
28 |
26 |
$0.00 |
| 73030 |
|
13 |
12 |
$0.00 |