| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99221 |
|
14,000 |
12,056 |
$327K |
| 0450 |
|
4,070 |
3,546 |
$155K |
| 93306 |
|
441 |
437 |
$91K |
| 99281 |
|
1,244 |
1,131 |
$43K |
| 0761 |
|
877 |
808 |
$41K |
| 76815 |
|
777 |
405 |
$33K |
| 99212 |
|
909 |
555 |
$31K |
| 92507 |
|
551 |
218 |
$28K |
| 97799 |
|
924 |
209 |
$27K |
| 93005 |
|
1,106 |
1,053 |
$20K |
| 97139 |
|
630 |
171 |
$18K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
414 |
242 |
$17K |
| 74177 |
|
93 |
85 |
$16K |
| 96374 |
|
405 |
343 |
$15K |
| 97110 |
|
1,232 |
388 |
$15K |
| 71046 |
|
731 |
707 |
$15K |
| G0378 |
Hospital observation service, per hour |
172 |
157 |
$14K |
| 0700 |
|
361 |
301 |
$14K |
| 80053 |
|
1,560 |
1,385 |
$12K |
| 85025 |
|
1,875 |
1,676 |
$11K |
| G0480 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed |
202 |
165 |
$9K |
| 96372 |
|
480 |
437 |
$9K |
| 70450 |
|
81 |
73 |
$8K |
| 59025 |
|
735 |
228 |
$7K |
| 94010 |
|
414 |
408 |
$6K |
| 96375 |
|
232 |
185 |
$5K |
| 97010 |
|
696 |
222 |
$5K |
| 99201 |
|
321 |
197 |
$5K |
| J3490 |
Unclassified drugs |
3,692 |
2,034 |
$5K |
| 97140 |
|
524 |
190 |
$4K |
| 99283 |
|
34 |
32 |
$4K |
| 94640 |
|
272 |
176 |
$4K |
| 96361 |
|
234 |
201 |
$4K |
| A4649 |
Surgical supply; miscellaneous |
2,474 |
1,679 |
$3K |
| J7050 |
Infusion, normal saline solution, 250 cc |
467 |
350 |
$3K |
| 85027 |
|
485 |
454 |
$3K |
| 96365 |
|
62 |
50 |
$3K |
| 81001 |
|
1,143 |
1,061 |
$3K |
| 94729 |
|
39 |
38 |
$3K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
144 |
126 |
$2K |
| 84703 |
|
420 |
385 |
$2K |
| 85730 |
|
395 |
377 |
$2K |
| 87086 |
|
353 |
333 |
$2K |
| 94060 |
|
54 |
53 |
$2K |
| 97750 |
|
41 |
32 |
$2K |
| 71045 |
|
204 |
196 |
$2K |
| 87801 |
|
55 |
50 |
$2K |
| 73610 |
|
93 |
84 |
$2K |
| 94726 |
|
25 |
24 |
$2K |
| Z7502 |
|
39 |
39 |
$2K |
| 85610 |
|
425 |
406 |
$1K |
| 80305 |
|
160 |
142 |
$1K |
| 84484 |
|
218 |
175 |
$1K |
| 76856 |
|
29 |
28 |
$1K |
| 83690 |
|
338 |
299 |
$1K |
| 71020 |
|
59 |
24 |
$1K |
| 86850 |
|
335 |
314 |
$1K |
| 94664 |
|
173 |
150 |
$1K |
| 96360 |
|
43 |
33 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
349 |
302 |
$1K |
| 73630 |
|
67 |
66 |
$1K |
| 86901 |
|
434 |
391 |
$1K |
| 86900 |
|
434 |
391 |
$1K |
| 97112 |
|
33 |
14 |
$953.60 |
| 97162 |
|
44 |
44 |
$882.59 |
| 99213 |
|
64 |
49 |
$844.52 |
| 73562 |
|
41 |
40 |
$831.93 |
| 80048 |
|
112 |
88 |
$770.47 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
197 |
157 |
$735.48 |
| 76830 |
|
12 |
12 |
$735.26 |
| 90658 |
|
44 |
44 |
$674.89 |
| 0760 |
|
17 |
16 |
$658.05 |
| 82947 |
|
195 |
171 |
$646.22 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
228 |
187 |
$610.13 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
67 |
58 |
$500.07 |
| 73130 |
|
26 |
26 |
$421.05 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
90 |
76 |
$399.87 |
| 59430 |
|
24 |
24 |
$302.40 |
| 84702 |
|
30 |
26 |
$226.19 |
| 81025 |
|
102 |
98 |
$203.91 |
| 73110 |
|
12 |
12 |
$190.34 |
| 36415 |
|
169 |
135 |
$185.65 |
| 81003 |
|
99 |
96 |
$183.01 |
| 73030 |
|
13 |
12 |
$176.61 |
| 81002 |
|
79 |
79 |
$161.75 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
71 |
60 |
$139.40 |
| 87210 |
|
39 |
38 |
$106.33 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
15 |
14 |
$77.18 |
| 87088 |
|
14 |
13 |
$61.60 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
58 |
48 |
$51.76 |
| 96376 |
|
25 |
24 |
$46.50 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
15 |
12 |
$40.50 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
25 |
25 |
$30.71 |
| 90471 |
|
12 |
12 |
$28.54 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
27 |
27 |
$13.78 |
| 0270 |
|
33 |
13 |
$11.18 |
| 0515 |
|
177 |
172 |
$0.00 |
| 0324 |
|
19 |
18 |
$0.00 |
| 0514 |
|
146 |
100 |
$0.00 |