| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92507 |
|
20,335 |
6,331 |
$2.37M |
| 97530 |
|
20,704 |
5,599 |
$1.52M |
| 99283 |
|
7,529 |
6,932 |
$1.32M |
| 97110 |
|
15,772 |
4,485 |
$1.17M |
| 99282 |
|
2,895 |
2,760 |
$455K |
| 99284 |
|
2,293 |
2,116 |
$372K |
| 96361 |
|
780 |
622 |
$272K |
| 99281 |
|
1,649 |
1,562 |
$184K |
| 74177 |
|
423 |
394 |
$132K |
| 97112 |
|
2,717 |
1,048 |
$122K |
| 80050 |
|
7,909 |
4,113 |
$114K |
| 97116 |
|
2,240 |
984 |
$114K |
| 96365 |
|
476 |
261 |
$66K |
| 71046 |
|
1,035 |
998 |
$56K |
| 70450 |
|
191 |
181 |
$55K |
| 97161 |
|
515 |
493 |
$54K |
| J3490 |
Drugs unclassified injection |
6,666 |
2,855 |
$51K |
| 97140 |
|
610 |
151 |
$47K |
| 87502 |
|
551 |
539 |
$42K |
| 87633 |
|
215 |
208 |
$37K |
| 96375 |
|
1,524 |
1,084 |
$34K |
| 93005 |
|
1,786 |
1,520 |
$33K |
| J7120 |
Ringers lactate infusion |
728 |
575 |
$28K |
| 96374 |
|
1,660 |
1,465 |
$24K |
| 87635 |
|
655 |
618 |
$23K |
| 96372 |
|
1,314 |
1,084 |
$17K |
| G0378 |
Hospital observation per hr |
73 |
64 |
$15K |
| 36415 |
|
10,027 |
8,184 |
$15K |
| J7030 |
Normal saline solution infus |
1,577 |
1,209 |
$12K |
| 71045 |
|
1,138 |
1,025 |
$10K |
| 77063 |
|
126 |
124 |
$9K |
| 87651 |
|
409 |
400 |
$8K |
| 99285 |
|
73 |
66 |
$8K |
| 86140 |
|
3,190 |
2,858 |
$7K |
| J8499 |
Oral prescrip drug non chemo |
3,676 |
1,682 |
$7K |
| 97165 |
|
56 |
53 |
$7K |
| J2405 |
Ondansetron hcl injection |
1,854 |
1,548 |
$6K |
| 87086 |
|
1,723 |
1,596 |
$6K |
| 81001 |
|
3,479 |
3,142 |
$5K |
| 80048 |
|
1,541 |
1,242 |
$5K |
| 74018 |
|
72 |
65 |
$5K |
| 85025 |
|
3,699 |
3,036 |
$5K |
| J2704 |
Inj, propofol, 10 mg |
1,013 |
830 |
$5K |
| 87637 |
|
40 |
37 |
$4K |
| 92523 |
|
40 |
39 |
$4K |
| 80053 |
|
2,787 |
2,430 |
$4K |
| 87636 |
|
31 |
31 |
$4K |
| J3010 |
Fentanyl citrate injection |
362 |
321 |
$3K |
| 87798 |
|
304 |
296 |
$3K |
| 83690 |
|
1,676 |
1,488 |
$3K |
| 82150 |
|
1,301 |
1,169 |
$3K |
| 83735 |
|
1,201 |
900 |
$3K |
| 97597 |
|
21 |
12 |
$3K |
| J1885 |
Ketorolac tromethamine inj |
875 |
772 |
$3K |
| 84439 |
|
221 |
211 |
$2K |
| 97164 |
|
14 |
14 |
$2K |
| 87430 |
|
142 |
136 |
$2K |
| 85027 |
|
774 |
705 |
$2K |
| J1100 |
Dexamethasone sodium phos |
437 |
379 |
$2K |
| 94664 |
|
116 |
102 |
$2K |
| 84443 |
|
285 |
276 |
$2K |
| 87081 |
|
132 |
128 |
$2K |
| 84484 |
|
820 |
580 |
$1K |
| 85610 |
|
1,151 |
916 |
$1K |
| 87634 |
|
69 |
67 |
$1K |
| 99212 |
|
15 |
12 |
$1K |
| 87186 |
|
584 |
462 |
$1K |
| S9152 |
Speech therapy, re-eval |
15 |
15 |
$1K |
| 77067 |
|
157 |
151 |
$820.24 |
| 84703 |
|
377 |
354 |
$657.90 |
| 87088 |
|
312 |
264 |
$528.67 |
| 87804 |
|
40 |
19 |
$494.30 |
| J7050 |
Normal saline solution infus |
118 |
84 |
$473.58 |
| 87040 |
|
108 |
69 |
$445.75 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
545 |
477 |
$442.26 |
| 87486 |
|
216 |
209 |
$370.10 |
| 83036 |
|
43 |
43 |
$346.88 |
| 80061 |
|
55 |
54 |
$302.87 |
| 80306 |
|
182 |
156 |
$222.62 |
| 87581 |
|
216 |
209 |
$217.73 |
| 82728 |
|
16 |
16 |
$200.00 |
| 84145 |
|
48 |
39 |
$186.80 |
| 83605 |
|
167 |
124 |
$185.44 |
| 85652 |
|
27 |
24 |
$135.10 |
| J2250 |
Inj midazolam hydrochloride |
12 |
12 |
$104.45 |
| 85379 |
|
69 |
65 |
$90.00 |
| 83540 |
|
14 |
14 |
$88.90 |
| J0131 |
Inj, acetaminophen (nos) |
242 |
200 |
$45.81 |
| J2270 |
Morphine sulfate injection |
135 |
85 |
$39.80 |
| 85730 |
|
101 |
90 |
$13.55 |
| 81025 |
|
12 |
12 |
$3.02 |
| 82077 |
|
107 |
80 |
$0.00 |
| 94761 |
|
20 |
13 |
$0.00 |
| 96376 |
|
21 |
14 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
12 |
12 |
$0.00 |
| J2060 |
Lorazepam injection |
55 |
30 |
$0.00 |
| 94760 |
|
22 |
13 |
$0.00 |