| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
3,939 |
2,660 |
$389K |
| 99283 |
|
4,811 |
3,631 |
$290K |
| 99285 |
|
1,720 |
1,156 |
$143K |
| 84443 |
|
2,741 |
2,271 |
$51K |
| 80053 |
|
7,830 |
5,858 |
$36K |
| 99282 |
|
933 |
613 |
$25K |
| 70450 |
|
254 |
188 |
$23K |
| 74177 |
|
64 |
53 |
$23K |
| 82306 |
|
312 |
253 |
$19K |
| 74176 |
|
59 |
50 |
$16K |
| 80050 |
|
201 |
198 |
$11K |
| 96361 |
|
1,137 |
855 |
$8K |
| 71046 |
|
1,222 |
794 |
$6K |
| 85025 |
|
8,132 |
5,963 |
$3K |
| 87086 |
|
770 |
583 |
$3K |
| 93005 |
|
1,995 |
1,469 |
$2K |
| 83036 |
|
1,945 |
1,721 |
$1K |
| 99281 |
|
30 |
28 |
$1K |
| 80061 |
|
2,179 |
1,905 |
$997.48 |
| 96374 |
|
1,353 |
1,012 |
$941.14 |
| 80305 |
|
498 |
392 |
$913.39 |
| 87400 |
|
358 |
271 |
$447.52 |
| 81003 |
|
1,001 |
830 |
$412.02 |
| 80048 |
|
178 |
146 |
$369.70 |
| 85610 |
|
777 |
593 |
$332.45 |
| 96365 |
|
400 |
311 |
$242.66 |
| 81001 |
|
1,843 |
1,478 |
$183.62 |
| 36415 |
|
10,342 |
7,609 |
$169.72 |
| 81025 |
|
327 |
273 |
$168.48 |
| A4223 |
Infusion supplies w/o pump |
3,536 |
2,388 |
$158.05 |
| 82607 |
|
48 |
28 |
$130.94 |
| 71045 |
|
767 |
604 |
$125.76 |
| 87430 |
|
93 |
76 |
$122.70 |
| 83690 |
|
927 |
640 |
$112.64 |
| 83880 |
|
242 |
182 |
$96.29 |
| 84703 |
|
69 |
52 |
$89.20 |
| 87502 |
|
50 |
42 |
$58.05 |
| 87186 |
|
49 |
42 |
$56.82 |
| 81005 |
|
850 |
506 |
$48.60 |
| 85379 |
|
203 |
133 |
$41.35 |
| 83735 |
|
708 |
579 |
$36.98 |
| 94640 |
|
131 |
66 |
$16.49 |
| 84439 |
|
93 |
55 |
$6.15 |
| J1885 |
Ketorolac tromethamine inj |
468 |
352 |
$0.90 |
| J2405 |
Ondansetron hcl injection |
279 |
223 |
$0.00 |
| J2270 |
Morphine sulfate injection |
35 |
28 |
$0.00 |
| S5000 |
Prescription drug, generic |
121 |
109 |
$0.00 |
| 96360 |
|
191 |
105 |
$0.00 |
| A7010 |
Disposable corrugated tubing |
109 |
66 |
$0.00 |
| J7030 |
Normal saline solution infus |
813 |
642 |
$0.00 |
| S8100 |
Spacer without mask |
56 |
26 |
$0.00 |
| J7120 |
Ringers lactate infusion |
19 |
15 |
$0.00 |
| 90678 |
|
14 |
14 |
$0.00 |
| S8120 |
O2 contents gas cubic ft |
20 |
13 |
$0.00 |
| 84100 |
|
35 |
32 |
$0.00 |
| A4215 |
Sterile needle |
2,653 |
1,835 |
$0.00 |
| 82550 |
|
549 |
436 |
$0.00 |
| 96372 |
|
689 |
494 |
$0.00 |
| 84484 |
|
1,598 |
1,133 |
$0.00 |
| 0241U |
|
564 |
493 |
$0.00 |
| 96376 |
|
31 |
27 |
$0.00 |
| 85730 |
|
307 |
259 |
$0.00 |
| J7050 |
Normal saline solution infus |
455 |
299 |
$0.00 |
| 96375 |
|
800 |
602 |
$0.00 |
| A4217 |
Sterile water/saline, 500 ml |
288 |
155 |
$0.00 |
| A9150 |
Misc/exper non-prescript dru |
45 |
38 |
$0.00 |
| 82553 |
|
388 |
308 |
$0.00 |
| 99070 |
|
159 |
133 |
$0.00 |
| J3490 |
Drugs unclassified injection |
159 |
61 |
$0.00 |
| 80320 |
|
33 |
25 |
$0.00 |
| 86140 |
|
12 |
12 |
$0.00 |
| 83605 |
|
37 |
27 |
$0.00 |
| 87088 |
|
15 |
13 |
$0.00 |
| A4556 |
Electrodes, pair |
14 |
12 |
$0.00 |