| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 97110 |
|
3,531 |
860 |
$227K |
| 80053 |
|
3,285 |
2,737 |
$138K |
| 81001 |
|
2,647 |
2,225 |
$91K |
| 36415 |
|
1,896 |
1,352 |
$83K |
| 97530 |
|
2,427 |
725 |
$71K |
| 99283 |
|
2,487 |
2,195 |
$66K |
| 87804 |
|
743 |
602 |
$35K |
| 99282 |
|
520 |
472 |
$33K |
| 92507 |
|
1,577 |
476 |
$27K |
| 80048 |
|
1,061 |
813 |
$25K |
| 87086 |
|
1,417 |
1,219 |
$22K |
| 87880 |
|
296 |
278 |
$19K |
| 86850 |
|
130 |
119 |
$15K |
| 71046 |
|
1,043 |
905 |
$12K |
| 76830 |
|
28 |
26 |
$11K |
| G0463 |
Hospital outpt clinic visit |
372 |
241 |
$10K |
| 80307 |
|
845 |
718 |
$8K |
| 99284 |
|
1,923 |
1,647 |
$8K |
| 70450 |
|
455 |
407 |
$8K |
| 87070 |
|
238 |
206 |
$7K |
| 93306 |
|
81 |
75 |
$7K |
| 87491 |
|
241 |
210 |
$7K |
| 74177 |
|
417 |
373 |
$6K |
| 73630 |
|
102 |
84 |
$6K |
| 96372 |
|
675 |
493 |
$6K |
| 11042 |
|
57 |
26 |
$5K |
| 88305 |
|
132 |
111 |
$5K |
| 85025 |
|
3,802 |
3,002 |
$5K |
| 96374 |
|
1,211 |
1,020 |
$5K |
| 81025 |
|
1,067 |
913 |
$4K |
| 73610 |
|
84 |
75 |
$4K |
| 87077 |
|
525 |
454 |
$4K |
| 80055 |
|
166 |
136 |
$4K |
| 86900 |
|
184 |
160 |
$3K |
| 72100 |
|
79 |
70 |
$3K |
| 84443 |
|
973 |
899 |
$3K |
| 73564 |
|
79 |
71 |
$3K |
| 82950 |
|
152 |
138 |
$2K |
| 84702 |
|
241 |
181 |
$2K |
| 82306 |
|
153 |
148 |
$2K |
| 73130 |
|
41 |
38 |
$2K |
| 73110 |
|
43 |
40 |
$2K |
| 87081 |
|
325 |
309 |
$2K |
| 87210 |
|
119 |
105 |
$1K |
| 76856 |
|
28 |
26 |
$1K |
| 99285 |
|
1,439 |
1,200 |
$1K |
| 74176 |
|
76 |
69 |
$1K |
| 87147 |
|
49 |
39 |
$1K |
| 81003 |
|
59 |
50 |
$1K |
| 83036 |
|
329 |
297 |
$1K |
| 96360 |
|
224 |
199 |
$1K |
| 82105 |
|
19 |
18 |
$950.10 |
| 71045 |
|
681 |
579 |
$863.03 |
| 93005 |
|
1,357 |
1,096 |
$816.21 |
| 97140 |
|
415 |
121 |
$795.16 |
| 80061 |
|
551 |
523 |
$768.14 |
| 84484 |
|
1,219 |
815 |
$732.50 |
| 84439 |
|
202 |
182 |
$659.30 |
| 96361 |
|
660 |
538 |
$610.22 |
| 77067 |
|
12 |
12 |
$516.63 |
| 96365 |
|
271 |
227 |
$451.05 |
| 74022 |
|
30 |
28 |
$368.50 |
| 80076 |
|
41 |
38 |
$359.74 |
| 97161 |
|
17 |
16 |
$284.38 |
| 83880 |
|
405 |
346 |
$235.60 |
| 97162 |
|
32 |
29 |
$200.67 |
| 86780 |
|
37 |
33 |
$77.80 |
| 83735 |
|
661 |
483 |
$73.98 |
| 82607 |
|
27 |
27 |
$43.02 |
| 85610 |
|
412 |
351 |
$33.97 |
| 87186 |
|
464 |
400 |
$31.96 |
| 85651 |
|
67 |
62 |
$29.94 |
| 85027 |
|
443 |
369 |
$20.64 |
| 86703 |
|
229 |
191 |
$19.98 |
| G8978 |
Mobility current status |
82 |
69 |
$16.95 |
| 82150 |
|
15 |
12 |
$16.45 |
| 85018 |
|
146 |
119 |
$9.91 |
| 94664 |
|
596 |
337 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
118 |
104 |
$0.00 |
| J7030 |
Normal saline solution infus |
533 |
414 |
$0.00 |
| 84145 |
|
77 |
72 |
$0.00 |
| J7040 |
Normal saline solution infus |
104 |
88 |
$0.00 |
| 84100 |
|
102 |
84 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
224 |
194 |
$0.00 |
| J2405 |
Ondansetron hcl injection |
667 |
560 |
$0.00 |
| J2270 |
Morphine sulfate injection |
377 |
292 |
$0.00 |
| G8979 |
Mobility goal status |
100 |
83 |
$0.00 |
| J7120 |
Ringers lactate infusion |
315 |
278 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
108 |
39 |
$0.00 |
| J2930 |
Methylprednisolone injection |
32 |
28 |
$0.00 |
| J2550 |
Promethazine hcl injection |
100 |
86 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
16 |
15 |
$0.00 |
| 59025 |
|
15 |
12 |
$0.00 |
| 85007 |
|
16 |
12 |
$0.00 |
| 96375 |
|
579 |
467 |
$0.00 |
| A9270 |
Non-covered item or service |
331 |
266 |
$0.00 |
| G0378 |
Hospital observation per hr |
270 |
246 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
693 |
599 |
$0.00 |
| 82550 |
|
134 |
85 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
160 |
133 |
$0.00 |
| 96376 |
|
302 |
222 |
$0.00 |
| 83605 |
|
381 |
315 |
$0.00 |
| 87040 |
|
224 |
156 |
$0.00 |
| J7050 |
Normal saline solution infus |
30 |
24 |
$0.00 |
| 83690 |
|
796 |
676 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
235 |
212 |
$0.00 |
| 85379 |
|
151 |
140 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
270 |
234 |
$0.00 |
| J1170 |
Hydromorphone injection |
88 |
74 |
$0.00 |
| 86901 |
|
234 |
203 |
$0.00 |
| 87591 |
|
241 |
210 |
$0.00 |
| 94640 |
|
664 |
366 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
13 |
13 |
$0.00 |
| J2765 |
Metoclopramide hcl injection |
82 |
67 |
$0.00 |
| 86762 |
|
45 |
41 |
$0.00 |
| 87205 |
|
42 |
37 |
$0.00 |
| 87389 |
|
48 |
43 |
$0.00 |
| 85730 |
|
44 |
36 |
$0.00 |
| 86140 |
|
32 |
28 |
$0.00 |
| 86592 |
|
13 |
12 |
$0.00 |
| 87340 |
|
46 |
42 |
$0.00 |
| 83874 |
|
95 |
64 |
$0.00 |