| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
15,826 |
15,441 |
$9.05M |
| 99283 |
|
33,706 |
32,854 |
$3.48M |
| 87633 |
|
5,694 |
5,454 |
$2.74M |
| G0378 |
Hospital observation per hr |
2,744 |
2,535 |
$1.88M |
| 87631 |
|
6,096 |
5,962 |
$922K |
| 41899 |
|
889 |
875 |
$827K |
| 99212 |
|
12,944 |
10,432 |
$720K |
| 99282 |
|
5,612 |
5,447 |
$467K |
| 99285 |
|
881 |
847 |
$383K |
| 93303 |
|
719 |
668 |
$365K |
| 99202 |
|
3,638 |
3,570 |
$351K |
| 76705 |
|
2,506 |
2,440 |
$240K |
| 80053 |
|
15,248 |
11,009 |
$228K |
| 85025 |
|
17,834 |
13,333 |
$193K |
| 87635 |
|
5,786 |
5,671 |
$186K |
| 95812 |
|
319 |
318 |
$184K |
| 71046 |
|
3,696 |
3,610 |
$160K |
| 93307 |
|
497 |
471 |
$145K |
| 42820 |
|
49 |
31 |
$130K |
| 99000 |
|
8,506 |
6,978 |
$124K |
| 99213 |
|
2,159 |
2,066 |
$118K |
| 43239 |
|
229 |
216 |
$118K |
| 87880 |
|
5,078 |
4,943 |
$115K |
| 99211 |
|
3,554 |
3,226 |
$112K |
| 74018 |
|
2,265 |
2,189 |
$87K |
| 99203 |
|
1,094 |
1,054 |
$81K |
| 0202U |
|
680 |
639 |
$80K |
| 87651 |
|
1,686 |
1,662 |
$57K |
| 93005 |
|
2,407 |
2,298 |
$55K |
| G0463 |
Hospital outpt clinic visit |
567 |
525 |
$53K |
| 93306 |
|
108 |
103 |
$39K |
| 76770 |
|
226 |
223 |
$38K |
| 86710 |
|
3,533 |
1,740 |
$36K |
| 87086 |
|
4,400 |
4,296 |
$36K |
| 69436 |
|
42 |
39 |
$33K |
| 0241U |
|
7,520 |
7,424 |
$32K |
| 73721 |
|
61 |
51 |
$28K |
| 90791 |
|
130 |
127 |
$26K |
| 87798 |
|
3,776 |
3,713 |
$25K |
| 81001 |
|
6,952 |
6,752 |
$24K |
| 82947 |
|
7,046 |
6,010 |
$23K |
| 85046 |
|
2,671 |
2,146 |
$22K |
| G0108 |
Diab manage trn per indiv |
582 |
529 |
$22K |
| 96365 |
|
237 |
191 |
$21K |
| 83735 |
|
2,472 |
1,502 |
$21K |
| 80050 |
|
187 |
182 |
$19K |
| 74019 |
|
358 |
350 |
$17K |
| 82728 |
|
881 |
835 |
$17K |
| 70220 |
|
145 |
145 |
$16K |
| 84439 |
|
950 |
935 |
$14K |
| 99001 |
|
1,820 |
1,633 |
$14K |
| 84100 |
|
2,294 |
1,395 |
$13K |
| 99214 |
|
128 |
109 |
$13K |
| J0131 |
Inj, acetaminophen (nos) |
917 |
751 |
$12K |
| 36415 |
|
14,315 |
12,490 |
$11K |
| 77072 |
|
133 |
132 |
$9K |
| 36591 |
|
285 |
179 |
$9K |
| Q0162 |
Ondansetron oral |
4,743 |
4,624 |
$8K |
| 96409 |
|
77 |
38 |
$8K |
| 80061 |
|
369 |
366 |
$8K |
| J0561 |
Penicillin g benzathine inj |
51 |
49 |
$7K |
| 82330 |
|
503 |
466 |
$7K |
| 92567 |
|
176 |
170 |
$7K |
| 96130 |
|
79 |
77 |
$7K |
| J1100 |
Dexamethasone sodium phos |
1,518 |
1,422 |
$7K |
| 70551 |
|
12 |
12 |
$6K |
| 84443 |
|
212 |
209 |
$6K |
| 96374 |
|
651 |
553 |
$5K |
| 84703 |
|
681 |
614 |
$5K |
| 99204 |
|
31 |
31 |
$5K |
| 94640 |
|
138 |
124 |
$4K |
| 86140 |
|
689 |
655 |
$4K |
| 96375 |
|
134 |
76 |
$4K |
| 70450 |
|
27 |
25 |
$4K |
| 96139 |
|
44 |
41 |
$4K |
| 73090 |
|
65 |
58 |
$4K |
| 73110 |
|
69 |
67 |
$3K |
| 96360 |
|
440 |
430 |
$3K |
| 87040 |
|
245 |
231 |
$3K |
| 73080 |
|
54 |
44 |
$3K |
| 88312 |
|
48 |
41 |
$3K |
| J2405 |
Ondansetron hcl injection |
1,760 |
1,526 |
$3K |
| 76700 |
|
28 |
28 |
$3K |
| 81003 |
|
545 |
534 |
$2K |
| 88305 |
|
26 |
13 |
$2K |
| 80307 |
|
26 |
25 |
$2K |
| 83036 |
|
154 |
153 |
$2K |
| 99201 |
|
55 |
55 |
$2K |
| 85651 |
|
325 |
308 |
$2K |
| 99170 |
|
16 |
16 |
$2K |
| 96137 |
|
41 |
40 |
$2K |
| 81025 |
|
112 |
108 |
$2K |
| 84295 |
|
427 |
389 |
$1K |
| 96136 |
|
40 |
40 |
$1K |
| 90836 |
|
21 |
21 |
$1K |
| 84132 |
|
422 |
386 |
$1K |
| 82435 |
|
420 |
385 |
$1K |
| 87491 |
|
14 |
14 |
$1K |
| 87591 |
|
14 |
14 |
$1K |
| 83003 |
|
58 |
24 |
$1K |
| 82670 |
|
27 |
12 |
$1K |
| 77074 |
|
13 |
13 |
$1K |
| J2704 |
Inj, propofol, 10 mg |
1,831 |
1,755 |
$1K |
| 87807 |
|
87 |
85 |
$1K |
| J2270 |
Morphine sulfate injection |
795 |
745 |
$1K |
| 84145 |
|
36 |
36 |
$1K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
12 |
12 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
435 |
347 |
$968.49 |
| 96138 |
|
45 |
42 |
$947.52 |
| 82652 |
|
32 |
31 |
$839.06 |
| 90686 |
|
30 |
30 |
$756.95 |
| J3010 |
Fentanyl citrate injection |
521 |
496 |
$734.47 |
| 82784 |
|
49 |
40 |
$646.89 |
| J2250 |
Inj midazolam hydrochloride |
457 |
433 |
$644.57 |
| 83001 |
|
24 |
12 |
$600.01 |
| 83002 |
|
24 |
12 |
$549.61 |
| 83516 |
|
27 |
27 |
$512.24 |
| J0690 |
Cefazolin sodium injection |
181 |
149 |
$504.63 |
| 87081 |
|
70 |
70 |
$456.78 |
| 84520 |
|
134 |
129 |
$425.58 |
| 86803 |
|
13 |
12 |
$423.50 |
| 86850 |
|
27 |
24 |
$417.78 |
| J0696 |
Ceftriaxone sodium injection |
57 |
50 |
$338.88 |
| 80076 |
|
27 |
27 |
$333.31 |
| J9370 |
Vincristine sulfate 1 mg inj |
22 |
12 |
$323.42 |
| 87340 |
|
13 |
12 |
$306.56 |
| 85027 |
|
37 |
27 |
$305.33 |
| 90833 |
|
25 |
23 |
$275.56 |
| 83550 |
|
13 |
13 |
$186.07 |
| 96372 |
|
375 |
345 |
$163.74 |
| 85014 |
|
136 |
129 |
$131.54 |
| 86592 |
|
13 |
12 |
$126.79 |
| 86900 |
|
27 |
24 |
$105.32 |
| 83690 |
|
16 |
16 |
$103.95 |
| 86901 |
|
27 |
24 |
$94.36 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
25 |
25 |
$91.45 |
| 83615 |
|
17 |
13 |
$73.53 |
| 82247 |
|
16 |
12 |
$70.76 |
| 85007 |
|
13 |
12 |
$60.30 |
| G0008 |
Admin influenza virus vac |
12 |
12 |
$49.80 |
| J7613 |
Albuterol non-comp unit |
78 |
63 |
$20.37 |
| 36416 |
|
165 |
124 |
$5.42 |
| A9270 |
Non-covered item or service |
3,152 |
3,002 |
$2.89 |
| J7510 |
Prednisolone oral per 5 mg |
27 |
26 |
$0.00 |
| J9201 |
In gemcitabine hcl nos 200mg |
26 |
26 |
$0.00 |
| 96361 |
|
126 |
122 |
$0.00 |
| J1642 |
Inj heparin sodium per 10 u |
252 |
112 |
$0.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
14 |
14 |
$0.00 |