| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
8,781 |
7,867 |
$3.46M |
| 99282 |
|
5,773 |
5,228 |
$1.59M |
| 99284 |
|
2,148 |
1,941 |
$1.33M |
| 99285 |
|
503 |
428 |
$504K |
| 97110 |
|
1,629 |
536 |
$69K |
| 74177 |
|
12 |
12 |
$25K |
| 97032 |
|
311 |
125 |
$22K |
| 97140 |
|
661 |
244 |
$12K |
| 87428 |
|
1,318 |
1,200 |
$3K |
| 96361 |
|
486 |
437 |
$1K |
| 87880 |
|
487 |
461 |
$1K |
| 96372 |
|
2,521 |
2,218 |
$702.90 |
| 81025 |
|
671 |
607 |
$661.97 |
| 96374 |
|
788 |
707 |
$331.91 |
| 81002 |
|
1,438 |
1,341 |
$305.86 |
| 93005 |
|
1,123 |
940 |
$297.07 |
| 94640 |
|
147 |
102 |
$143.01 |
| 80305 |
|
12 |
12 |
$110.08 |
| 96375 |
|
375 |
323 |
$106.62 |
| 80047 |
|
1,610 |
1,414 |
$83.51 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
44 |
41 |
$81.98 |
| Q0162 |
Ondansetron oral |
191 |
184 |
$74.82 |
| J7040 |
Normal saline solution infus |
1,342 |
934 |
$50.41 |
| J1100 |
Dexamethasone sodium phos |
1,447 |
1,290 |
$28.39 |
| J1885 |
Ketorolac tromethamine inj |
1,372 |
1,212 |
$27.05 |
| J2405 |
Ondansetron hcl injection |
126 |
119 |
$22.28 |
| 85025 |
|
14 |
13 |
$20.00 |
| 85014 |
|
1,606 |
1,414 |
$17.62 |
| J7030 |
Normal saline solution infus |
216 |
200 |
$13.24 |
| C1751 |
Cath, inf, per/cent/midline |
624 |
547 |
$1.95 |
| 96365 |
|
28 |
25 |
$0.00 |
| J2001 |
Lidocaine injection |
65 |
63 |
$0.00 |
| A9270 |
Non-covered item or service |
33 |
29 |
$0.00 |
| 71045 |
|
179 |
153 |
$0.00 |
| 87426 |
|
118 |
104 |
$0.00 |
| 97035 |
|
63 |
24 |
$0.00 |
| 82803 |
|
30 |
24 |
$0.00 |
| 90471 |
|
13 |
13 |
$0.00 |
| 84484 |
|
89 |
75 |
$0.00 |
| 83605 |
|
30 |
24 |
$0.00 |
| J2270 |
Morphine sulfate injection |
41 |
39 |
$0.00 |
| 71046 |
|
103 |
93 |
$0.00 |
| 90715 |
|
17 |
17 |
$0.00 |