| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpt clinic visit |
4,197 |
3,764 |
$311K |
| J0585 |
Injection,onabotulinumtoxina |
59 |
50 |
$48K |
| 51705 |
|
333 |
278 |
$30K |
| 51700 |
|
493 |
427 |
$27K |
| 51728 |
|
132 |
120 |
$26K |
| 52287 |
|
24 |
24 |
$20K |
| 97110 |
|
111 |
54 |
$14K |
| 95810 |
|
12 |
12 |
$11K |
| 51600 |
|
42 |
40 |
$6K |
| 51703 |
|
190 |
169 |
$5K |
| 51797 |
|
498 |
457 |
$5K |
| J3490 |
Drugs unclassified injection |
768 |
570 |
$5K |
| 95800 |
|
13 |
13 |
$3K |
| 51784 |
|
426 |
396 |
$3K |
| 76000 |
|
32 |
25 |
$3K |
| 92507 |
|
22 |
12 |
$3K |
| 74430 |
|
27 |
27 |
$2K |
| 92610 |
|
12 |
12 |
$2K |
| 51741 |
|
203 |
192 |
$1K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
52 |
51 |
$882.71 |
| 95873 |
|
25 |
25 |
$586.69 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
95 |
53 |
$524.69 |
| S0020 |
Injection, bupivicaine hydro |
42 |
40 |
$319.04 |
| 95874 |
|
21 |
13 |
$309.82 |
| A4215 |
Sterile needle |
13 |
13 |
$198.76 |
| 87086 |
|
25 |
25 |
$180.90 |
| J8499 |
Oral prescrip drug non chemo |
132 |
127 |
$170.07 |
| 81003 |
|
13 |
13 |
$28.00 |