| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpt clinic visit |
37,041 |
29,015 |
$4.11M |
| 92507 |
|
17,579 |
5,730 |
$1.25M |
| 96110 |
|
5,152 |
3,684 |
$1.19M |
| 97530 |
|
12,262 |
4,071 |
$920K |
| 69436 |
|
486 |
280 |
$673K |
| 42820 |
|
450 |
279 |
$444K |
| 97110 |
|
4,520 |
1,849 |
$349K |
| G0378 |
Hospital observation per hr |
3,162 |
1,094 |
$345K |
| 99392 |
|
4,401 |
3,543 |
$332K |
| 99393 |
|
3,034 |
2,644 |
$249K |
| 96361 |
|
792 |
324 |
$242K |
| 99391 |
|
3,128 |
2,527 |
$238K |
| 95812 |
|
199 |
163 |
$188K |
| 93303 |
|
620 |
490 |
$169K |
| 99394 |
|
1,714 |
1,395 |
$146K |
| 97535 |
|
2,871 |
1,308 |
$138K |
| 92587 |
|
2,009 |
1,595 |
$125K |
| 95714 |
|
91 |
40 |
$87K |
| 94010 |
|
1,509 |
1,041 |
$87K |
| 93325 |
|
1,022 |
754 |
$85K |
| 95816 |
|
401 |
286 |
$73K |
| 93304 |
|
290 |
233 |
$72K |
| 96127 |
|
874 |
681 |
$70K |
| 96161 |
|
512 |
383 |
$63K |
| 90791 |
|
292 |
249 |
$61K |
| 43239 |
|
100 |
79 |
$56K |
| 97116 |
|
1,218 |
514 |
$46K |
| 99211 |
|
366 |
349 |
$42K |
| 92567 |
|
1,040 |
857 |
$32K |
| 99381 |
|
391 |
355 |
$27K |
| 42830 |
|
44 |
25 |
$25K |
| 00170 |
|
925 |
563 |
$24K |
| 99204 |
|
189 |
178 |
$23K |
| 99383 |
|
289 |
260 |
$23K |
| 99202 |
|
188 |
181 |
$20K |
| G0008 |
Admin influenza virus vac |
2,036 |
1,447 |
$20K |
| 97162 |
|
232 |
206 |
$20K |
| 92579 |
|
341 |
278 |
$18K |
| 90670 |
|
1,984 |
1,209 |
$18K |
| 93005 |
|
1,547 |
1,202 |
$17K |
| 92557 |
|
269 |
232 |
$17K |
| 31575 |
|
133 |
116 |
$15K |
| 90471 |
|
3,069 |
1,759 |
$15K |
| 70553 |
|
66 |
38 |
$14K |
| 90633 |
|
2,287 |
1,575 |
$14K |
| 97165 |
|
128 |
116 |
$14K |
| 95700 |
|
90 |
65 |
$13K |
| 99384 |
|
160 |
135 |
$13K |
| 92523 |
|
151 |
125 |
$13K |
| G0009 |
Admin pneumococcal vaccine |
2,007 |
1,220 |
$12K |
| 90698 |
|
1,821 |
1,297 |
$11K |
| 94640 |
|
114 |
51 |
$10K |
| 97802 |
|
118 |
113 |
$10K |
| 97166 |
|
89 |
69 |
$10K |
| 93306 |
|
39 |
27 |
$9K |
| 94664 |
|
355 |
221 |
$9K |
| 90686 |
|
1,860 |
1,339 |
$9K |
| 99203 |
|
68 |
67 |
$9K |
| 96374 |
|
637 |
398 |
$8K |
| 90697 |
|
1,282 |
870 |
$8K |
| 92609 |
|
102 |
31 |
$8K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
754 |
467 |
$7K |
| 97112 |
|
187 |
76 |
$7K |
| 93320 |
|
612 |
489 |
$7K |
| 90651 |
|
1,284 |
898 |
$7K |
| 90460 |
|
5,259 |
4,412 |
$6K |
| 87502 |
|
116 |
87 |
$6K |
| 95711 |
|
76 |
27 |
$6K |
| 90680 |
|
2,043 |
1,433 |
$6K |
| 96360 |
|
367 |
209 |
$6K |
| 96365 |
|
42 |
25 |
$6K |
| 90716 |
|
904 |
620 |
$6K |
| 29065 |
|
51 |
45 |
$5K |
| 90677 |
|
1,811 |
1,506 |
$5K |
| 90696 |
|
980 |
736 |
$5K |
| 90472 |
|
1,950 |
1,123 |
$5K |
| J3590 |
Unclassified biologics |
70 |
15 |
$5K |
| 90710 |
|
1,171 |
849 |
$4K |
| 69210 |
|
334 |
263 |
$4K |
| 90832 |
|
54 |
51 |
$4K |
| 90734 |
|
1,189 |
841 |
$4K |
| J7042 |
5% dextrose/normal saline |
313 |
132 |
$4K |
| 90620 |
|
490 |
344 |
$4K |
| J2704 |
Inj, propofol, 10 mg |
2,338 |
1,278 |
$3K |
| 90707 |
|
889 |
612 |
$3K |
| 90744 |
|
609 |
472 |
$3K |
| 29075 |
|
25 |
25 |
$3K |
| 90700 |
|
732 |
504 |
$3K |
| G0010 |
Admin hepatitis b vaccine |
242 |
142 |
$3K |
| 93321 |
|
120 |
75 |
$3K |
| J3490 |
Drugs unclassified injection |
92 |
36 |
$2K |
| 96372 |
|
418 |
160 |
$2K |
| 90715 |
|
626 |
455 |
$2K |
| 90656 |
|
512 |
503 |
$2K |
| 83036 |
|
718 |
608 |
$2K |
| 90648 |
|
392 |
300 |
$2K |
| 96375 |
|
379 |
213 |
$2K |
| 92652 |
|
12 |
12 |
$2K |
| 97167 |
|
13 |
13 |
$2K |
| 73110 |
|
65 |
45 |
$2K |
| 99382 |
|
46 |
36 |
$2K |
| 90661 |
|
206 |
201 |
$1K |
| 97750 |
|
19 |
12 |
$1K |
| 99395 |
|
12 |
12 |
$1K |
| 80053 |
|
159 |
83 |
$1K |
| 87651 |
|
747 |
670 |
$1K |
| 81003 |
|
806 |
668 |
$1K |
| J7120 |
Ringers lactate infusion |
1,842 |
1,129 |
$942.14 |
| 90674 |
|
125 |
101 |
$927.14 |
| 85025 |
|
303 |
175 |
$871.03 |
| 81001 |
|
357 |
272 |
$639.18 |
| G0379 |
Direct refer hospital observ |
36 |
21 |
$630.64 |
| 96376 |
|
304 |
137 |
$599.64 |
| 90381 |
|
96 |
96 |
$534.24 |
| 87428 |
|
53 |
44 |
$503.05 |
| 97161 |
|
15 |
12 |
$438.20 |
| 90380 |
|
87 |
70 |
$397.43 |
| 36415 |
|
631 |
496 |
$317.81 |
| J1100 |
Dexamethasone sodium phos |
1,790 |
1,106 |
$265.59 |
| 94760 |
|
1,184 |
766 |
$261.59 |
| 73080 |
|
15 |
12 |
$257.12 |
| 82306 |
|
25 |
15 |
$245.52 |
| 00126 |
|
97 |
41 |
$183.43 |
| 85027 |
|
47 |
32 |
$182.42 |
| J3010 |
Fentanyl citrate injection |
2,299 |
1,291 |
$176.19 |
| 90681 |
|
32 |
32 |
$157.08 |
| 81025 |
|
150 |
127 |
$140.58 |
| 92552 |
|
13 |
13 |
$135.01 |
| 85018 |
|
404 |
368 |
$125.38 |
| J2405 |
Ondansetron hcl injection |
1,601 |
964 |
$119.90 |
| 88305 |
|
259 |
151 |
$117.51 |
| 90480 |
|
137 |
120 |
$83.88 |
| 92582 |
|
24 |
15 |
$80.70 |
| J1885 |
Ketorolac tromethamine inj |
310 |
158 |
$55.99 |
| 81002 |
|
200 |
182 |
$54.03 |
| 90658 |
|
15 |
15 |
$36.85 |
| 87804 |
|
34 |
22 |
$34.60 |
| J2270 |
Morphine sulfate injection |
25 |
15 |
$22.31 |
| 87880 |
|
28 |
19 |
$13.69 |
| A9576 |
Inj prohance multipack |
68 |
39 |
$10.76 |
| J2250 |
Inj midazolam hydrochloride |
228 |
163 |
$7.23 |
| J0690 |
Cefazolin sodium injection |
24 |
13 |
$2.76 |
| J7030 |
Normal saline solution infus |
63 |
45 |
$2.70 |
| J7050 |
Normal saline solution infus |
44 |
14 |
$1.36 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
256 |
170 |
$0.21 |
| 91321 |
|
38 |
29 |
$0.05 |
| 94761 |
|
119 |
114 |
$0.00 |
| 87635 |
|
98 |
80 |
$0.00 |
| 92551 |
|
13 |
13 |
$0.00 |
| 87426 |
|
15 |
13 |
$0.00 |
| 00731 |
|
53 |
49 |
$0.00 |
| 92504 |
|
46 |
43 |
$0.00 |