| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 97110 |
|
6,646 |
2,873 |
$146K |
| 96366 |
|
726 |
652 |
$89K |
| 97112 |
|
3,666 |
1,927 |
$80K |
| 80048 |
|
5,826 |
4,837 |
$63K |
| 96365 |
|
757 |
679 |
$63K |
| 97140 |
|
3,037 |
1,341 |
$46K |
| 96368 |
|
442 |
404 |
$32K |
| 85025 |
|
4,215 |
3,330 |
$31K |
| 97162 |
|
804 |
751 |
$30K |
| 80061 |
|
2,657 |
2,420 |
$28K |
| 97530 |
|
1,448 |
884 |
$27K |
| 83036 |
|
1,924 |
1,756 |
$23K |
| 62323 |
|
119 |
114 |
$20K |
| 97163 |
|
686 |
635 |
$20K |
| 80076 |
|
2,424 |
1,846 |
$18K |
| 97113 |
|
388 |
168 |
$15K |
| 81025 |
|
894 |
784 |
$11K |
| 80306 |
|
611 |
565 |
$10K |
| 82947 |
|
1,168 |
842 |
$9K |
| 73721 |
|
81 |
68 |
$6K |
| 62321 |
|
28 |
28 |
$5K |
| 85027 |
|
835 |
753 |
$5K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
857 |
743 |
$5K |
| 81001 |
|
770 |
680 |
$4K |
| 80053 |
|
217 |
190 |
$4K |
| C1776 |
Joint device (implantable) |
154 |
141 |
$4K |
| 97161 |
|
101 |
93 |
$4K |
| 64493 |
|
13 |
12 |
$3K |
| 87635 |
|
93 |
83 |
$3K |
| 85651 |
|
350 |
322 |
$3K |
| 64483 |
|
14 |
12 |
$3K |
| 83735 |
|
391 |
286 |
$2K |
| 82043 |
|
367 |
339 |
$2K |
| 85610 |
|
483 |
317 |
$2K |
| 87631 |
|
15 |
15 |
$2K |
| 84460 |
|
343 |
311 |
$2K |
| 84443 |
|
145 |
126 |
$1K |
| 82570 |
|
383 |
352 |
$1K |
| 87491 |
|
56 |
47 |
$1K |
| 85014 |
|
62 |
54 |
$1K |
| 87591 |
|
56 |
47 |
$1K |
| 82306 |
|
55 |
46 |
$937.53 |
| 82565 |
|
134 |
123 |
$564.73 |
| 72148 |
|
12 |
12 |
$521.14 |
| 86140 |
|
53 |
52 |
$250.47 |
| J2795 |
Ropivacaine hcl injection |
1,317 |
750 |
$246.24 |
| 77002 |
|
26 |
26 |
$239.36 |
| J0171 |
Adrenalin epinephrine inject |
469 |
290 |
$208.30 |
| 81003 |
|
121 |
100 |
$196.68 |
| J1885 |
Ketorolac tromethamine inj |
387 |
232 |
$183.08 |
| J3010 |
Fentanyl citrate injection |
1,854 |
1,523 |
$150.36 |
| 87480 |
|
14 |
12 |
$146.15 |
| 99152 |
|
356 |
282 |
$144.03 |
| 87086 |
|
32 |
27 |
$135.83 |
| 82728 |
|
15 |
13 |
$123.35 |
| J0690 |
Cefazolin sodium injection |
934 |
737 |
$115.65 |
| J2704 |
Inj, propofol, 10 mg |
1,616 |
1,324 |
$110.82 |
| 85018 |
|
62 |
54 |
$101.34 |
| J7120 |
Ringers lactate infusion |
1,128 |
1,000 |
$93.40 |
| 87510 |
|
14 |
12 |
$65.95 |
| J1100 |
Dexamethasone sodium phos |
1,666 |
1,323 |
$62.88 |
| J2405 |
Ondansetron hcl injection |
1,087 |
916 |
$48.29 |
| 87081 |
|
12 |
12 |
$44.29 |
| 36415 |
|
720 |
573 |
$42.89 |
| J1170 |
Hydromorphone injection |
195 |
145 |
$36.16 |
| A9577 |
Inj multihance |
206 |
197 |
$36.08 |
| J7050 |
Normal saline solution infus |
2,034 |
1,375 |
$35.92 |
| 85652 |
|
13 |
13 |
$34.07 |
| J2250 |
Inj midazolam hydrochloride |
1,322 |
1,133 |
$32.76 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
675 |
487 |
$26.91 |
| J2370 |
Phenylephrine hcl injection |
146 |
126 |
$23.33 |
| 73560 |
|
14 |
12 |
$18.86 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
195 |
167 |
$14.55 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
71 |
56 |
$12.85 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
553 |
528 |
$7.73 |
| J3490 |
Drugs unclassified injection |
101 |
91 |
$1.92 |
| J3370 |
Vancomycin hcl injection |
481 |
352 |
$1.44 |
| 76000 |
|
12 |
12 |
$0.32 |
| 36592 |
|
61 |
56 |
$0.13 |
| G1010 |
Cdsm stanson |
826 |
683 |
$0.00 |
| G1004 |
Cdsm ndsc |
625 |
492 |
$0.00 |
| J0688 |
Inj cefazolin sodium, hikma |
334 |
286 |
$0.00 |
| J0670 |
Inj mepivacaine hcl/10 ml |
15 |
14 |
$0.00 |
| J2002 |
Inj, lidocaine in d5w, 1 mg |
111 |
102 |
$0.00 |
| J0697 |
Sterile cefuroxime injection |
19 |
12 |
$0.00 |
| J1010 |
Inj, methylpred acetate 1 mg |
13 |
12 |
$0.00 |
| J1040 |
Methylprednisolone 80 mg inj |
15 |
14 |
$0.00 |