| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 36475 |
|
628 |
557 |
$1.06M |
| 37252 |
|
829 |
789 |
$563K |
| 36465 |
|
377 |
355 |
$462K |
| 99215 |
Prolong outpt/office vis |
7,101 |
5,121 |
$420K |
| 99214 |
|
9,425 |
8,353 |
$371K |
| 93970 |
|
2,416 |
2,393 |
$326K |
| Q4186 |
Epifix 1 sq cm |
74 |
24 |
$206K |
| 37253 |
|
788 |
731 |
$181K |
| 11043 |
|
1,329 |
702 |
$152K |
| 36905 |
|
155 |
154 |
$120K |
| 93971 |
|
1,746 |
1,570 |
$118K |
| 99205 |
Prolong outpt/office vis |
1,340 |
1,339 |
$109K |
| 99223 |
Prolong inpt eval add15 m |
1,901 |
1,833 |
$106K |
| 93925 |
|
1,141 |
1,139 |
$93K |
| 99233 |
Prolong inpt eval add15 m |
2,701 |
1,164 |
$90K |
| 11042 |
|
1,137 |
596 |
$88K |
| 95924 |
|
913 |
911 |
$88K |
| 99204 |
|
1,091 |
1,088 |
$79K |
| 36907 |
|
224 |
221 |
$70K |
| 93880 |
|
685 |
685 |
$66K |
| 99213 |
|
2,652 |
2,440 |
$64K |
| 93922 |
|
2,071 |
2,030 |
$52K |
| 97610 |
|
239 |
46 |
$50K |
| 99232 |
|
1,812 |
650 |
$49K |
| 93923 |
|
1,045 |
1,033 |
$48K |
| 99203 |
|
802 |
798 |
$40K |
| 11721 |
|
1,179 |
1,175 |
$27K |
| 76937 |
|
1,821 |
1,671 |
$26K |
| 93990 |
|
572 |
566 |
$25K |
| 37246 |
|
61 |
54 |
$24K |
| 36902 |
|
26 |
25 |
$19K |
| 99152 |
|
766 |
731 |
$18K |
| 80048 |
|
464 |
441 |
$18K |
| 20550 |
|
368 |
342 |
$18K |
| 99231 |
|
681 |
195 |
$15K |
| 95923 |
|
406 |
401 |
$14K |
| 96374 |
|
597 |
551 |
$12K |
| 96372 |
|
1,325 |
825 |
$12K |
| 75710 |
|
184 |
164 |
$11K |
| 93040 |
|
932 |
904 |
$10K |
| 15275 |
|
135 |
49 |
$10K |
| 11730 |
|
135 |
108 |
$6K |
| 93978 |
|
55 |
55 |
$5K |
| 11056 |
|
168 |
160 |
$4K |
| 96127 |
|
965 |
767 |
$4K |
| 99354 |
|
70 |
67 |
$3K |
| 11755 |
|
45 |
45 |
$2K |
| A5500 |
Diab shoe for density insert |
79 |
77 |
$1K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,030 |
980 |
$1K |
| J3301 |
Triamcinolone acet inj nos |
401 |
353 |
$795.27 |
| 99212 |
|
48 |
46 |
$755.94 |
| A5513 |
Multi den insert custom mold |
42 |
41 |
$725.20 |
| 20552 |
|
23 |
16 |
$662.81 |
| 20600 |
|
15 |
13 |
$631.71 |
| 29540 |
|
63 |
39 |
$621.30 |
| 93924 |
|
14 |
14 |
$581.07 |
| A5512 |
Multi den insert direct form |
32 |
32 |
$568.89 |
| 11750 |
|
13 |
12 |
$534.64 |
| 99153 |
Mod sedat endo service >5yrs |
112 |
111 |
$519.34 |
| 11055 |
|
39 |
39 |
$473.22 |
| J3010 |
Fentanyl citrate injection |
377 |
354 |
$263.62 |
| 99308 |
|
47 |
47 |
$245.00 |
| J1644 |
Inj heparin sodium per 1000u |
474 |
445 |
$205.47 |
| 93931 |
|
12 |
12 |
$142.23 |
| J2250 |
Inj midazolam hydrochloride |
357 |
334 |
$122.53 |
| 93042 |
|
17 |
16 |
$64.68 |
| 93041 |
|
17 |
16 |
$48.36 |
| 36415 |
|
12 |
12 |
$3.00 |
| 1031F |
|
12 |
12 |
$0.00 |