| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
6,369 |
5,341 |
$322K |
| 99283 |
|
8,430 |
6,951 |
$241K |
| 99285 |
|
925 |
790 |
$179K |
| 87428 |
|
2,289 |
2,103 |
$110K |
| 80053 |
|
5,672 |
4,943 |
$48K |
| 85025 |
|
5,296 |
4,451 |
$33K |
| 87430 |
|
2,286 |
1,987 |
$31K |
| 87426 |
|
861 |
788 |
$20K |
| 80061 |
|
893 |
865 |
$14K |
| 84443 |
|
554 |
525 |
$7K |
| 99282 |
|
395 |
266 |
$7K |
| 83036 |
|
483 |
467 |
$5K |
| 81001 |
|
1,768 |
1,477 |
$5K |
| 93005 |
|
607 |
502 |
$4K |
| 70450 |
|
98 |
77 |
$4K |
| 71045 |
|
1,095 |
897 |
$4K |
| 87400 |
|
1,088 |
813 |
$4K |
| 99281 |
|
118 |
95 |
$3K |
| 85027 |
|
703 |
658 |
$3K |
| 83735 |
|
431 |
389 |
$2K |
| 84484 |
|
369 |
277 |
$2K |
| 81025 |
|
756 |
628 |
$2K |
| 87086 |
|
139 |
86 |
$2K |
| 84439 |
|
161 |
155 |
$1K |
| 83655 |
|
63 |
59 |
$1K |
| 87804 |
|
114 |
103 |
$1K |
| 71046 |
|
139 |
108 |
$953.94 |
| 83880 |
|
105 |
82 |
$926.75 |
| 81003 |
|
436 |
348 |
$828.40 |
| 80307 |
|
15 |
14 |
$558.70 |
| 74018 |
|
60 |
49 |
$521.64 |
| 83605 |
|
44 |
42 |
$488.40 |
| 80048 |
|
74 |
63 |
$458.03 |
| 87807 |
|
30 |
30 |
$405.55 |
| 82306 |
|
39 |
39 |
$324.93 |
| 94640 |
|
37 |
28 |
$296.56 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
850 |
669 |
$235.99 |
| 74022 |
|
14 |
14 |
$228.33 |
| 86756 |
|
20 |
12 |
$189.90 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
144 |
117 |
$159.80 |
| 82043 |
|
32 |
32 |
$145.04 |
| 82553 |
|
15 |
14 |
$136.08 |
| 82550 |
|
17 |
15 |
$86.40 |
| 84436 |
|
30 |
30 |
$84.42 |
| 83690 |
|
13 |
13 |
$72.72 |
| 85007 |
|
14 |
12 |
$70.98 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
21 |
15 |
$53.16 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
166 |
121 |
$51.65 |
| 96372 |
|
19 |
12 |
$40.00 |
| 85610 |
|
17 |
15 |
$28.85 |
| 85730 |
|
17 |
15 |
$14.60 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
67 |
45 |
$5.33 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
27 |
26 |
$1.98 |
| 36415 |
|
906 |
824 |
$0.00 |