| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99211 |
|
9,982 |
9,068 |
$126K |
| 72082 |
|
2,795 |
2,652 |
$59K |
| 97110 |
|
1,813 |
764 |
$44K |
| 99202 |
|
1,811 |
1,719 |
$43K |
| OP370 |
|
107 |
99 |
$22K |
| J3490 |
Drugs unclassified injection |
672 |
270 |
$20K |
| 97165 |
|
450 |
421 |
$16K |
| 97161 |
|
469 |
453 |
$15K |
| 97116 |
|
514 |
221 |
$7K |
| 99212 |
|
250 |
202 |
$6K |
| G0463 |
Hospital outpt clinic visit |
1,644 |
1,483 |
$6K |
| OP710 |
|
96 |
85 |
$6K |
| 97530 |
|
299 |
125 |
$5K |
| 73110 |
|
289 |
246 |
$4K |
| J7120 |
Ringers lactate infusion |
497 |
450 |
$2K |
| 73140 |
|
195 |
174 |
$2K |
| J1100 |
Dexamethasone sodium phos |
519 |
466 |
$1K |
| 97760 |
|
32 |
28 |
$1K |
| J2704 |
Inj, propofol, 10 mg |
455 |
408 |
$1K |
| 73521 |
|
140 |
129 |
$1K |
| 72170 |
|
119 |
106 |
$1K |
| 73610 |
|
63 |
55 |
$1K |
| J2405 |
Ondansetron hcl injection |
373 |
334 |
$1K |
| 99201 |
|
72 |
72 |
$684.36 |
| J1885 |
Ketorolac tromethamine inj |
190 |
144 |
$658.83 |
| J2270 |
Morphine sulfate injection |
137 |
115 |
$627.02 |
| J0131 |
Inj, acetaminophen (nos) |
213 |
180 |
$542.12 |
| J0690 |
Cefazolin sodium injection |
166 |
107 |
$519.10 |
| 72081 |
|
26 |
25 |
$515.36 |
| 25600 |
|
13 |
12 |
$472.23 |
| 87635 |
|
12 |
12 |
$425.40 |
| OP272 |
|
29 |
26 |
$382.75 |
| 97542 |
|
12 |
12 |
$329.55 |
| 77073 |
|
12 |
12 |
$210.45 |
| 73630 |
|
30 |
26 |
$138.61 |
| J0134 |
Inj acetaminophen -fresenius |
48 |
40 |
$137.03 |
| 77072 |
|
12 |
12 |
$91.84 |
| 99203 |
|
14 |
13 |
$47.35 |
| 73090 |
|
13 |
12 |
$11.32 |
| J3010 |
Fentanyl citrate injection |
16 |
14 |
$0.00 |