| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
5,467 |
4,457 |
$851K |
| 99199 |
|
2,205 |
2,094 |
$109K |
| 87635 |
|
5,998 |
5,695 |
$81K |
| 0450 |
|
10,799 |
9,928 |
$47K |
| 74177 |
|
699 |
681 |
$26K |
| 99283 |
|
449 |
418 |
$24K |
| 99285 |
|
187 |
175 |
$24K |
| Z7502 |
|
553 |
513 |
$20K |
| 70450 |
|
412 |
395 |
$15K |
| 80053 |
|
4,462 |
4,239 |
$13K |
| 85025 |
|
4,970 |
4,660 |
$12K |
| 87804 |
|
2,994 |
2,890 |
$7K |
| 74176 |
|
307 |
298 |
$7K |
| 80305 |
|
1,629 |
1,500 |
$7K |
| 93005 |
|
1,256 |
1,212 |
$7K |
| 71046 |
|
1,493 |
1,450 |
$5K |
| 83605 |
|
1,299 |
1,245 |
$5K |
| 0250 |
|
2,929 |
2,571 |
$5K |
| 83880 |
|
624 |
602 |
$5K |
| 99282 |
|
141 |
133 |
$4K |
| 99284 |
|
54 |
54 |
$4K |
| 87430 |
|
1,230 |
1,202 |
$3K |
| 87807 |
|
1,297 |
1,249 |
$3K |
| 71250 |
|
37 |
35 |
$3K |
| 71045 |
|
621 |
592 |
$3K |
| 84484 |
|
1,004 |
968 |
$3K |
| 83690 |
|
1,420 |
1,372 |
$2K |
| Z7610 |
|
228 |
202 |
$2K |
| 83735 |
|
852 |
831 |
$2K |
| 81025 |
|
1,434 |
1,398 |
$2K |
| 99281 |
|
463 |
426 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
1,109 |
1,045 |
$1K |
| 0270 |
|
4,611 |
4,097 |
$1K |
| 99214 |
|
1,900 |
1,697 |
$1K |
| 81003 |
|
1,959 |
1,907 |
$1K |
| 99213 |
|
3,596 |
3,066 |
$1K |
| 80048 |
|
399 |
370 |
$1K |
| 87086 |
|
624 |
610 |
$1K |
| 84443 |
|
427 |
421 |
$895.38 |
| 36000 |
|
198 |
198 |
$887.78 |
| 84702 |
|
337 |
326 |
$865.51 |
| J2405 |
Ondansetron hcl injection |
822 |
791 |
$712.09 |
| J0696 |
Ceftriaxone sodium injection |
498 |
488 |
$638.87 |
| 82553 |
|
160 |
155 |
$576.97 |
| 73610 |
|
97 |
90 |
$505.91 |
| 85379 |
|
197 |
190 |
$491.40 |
| 73630 |
|
117 |
102 |
$481.20 |
| J1170 |
Hydromorphone injection |
228 |
199 |
$477.91 |
| 86140 |
|
239 |
237 |
$446.04 |
| J2270 |
Morphine sulfate injection |
170 |
155 |
$438.00 |
| 87040 |
|
81 |
78 |
$372.60 |
| 83874 |
|
92 |
88 |
$361.41 |
| 81001 |
|
334 |
327 |
$321.35 |
| 71101 |
|
14 |
14 |
$287.77 |
| 83036 |
|
291 |
284 |
$230.04 |
| 73562 |
|
93 |
74 |
$224.00 |
| 73130 |
|
64 |
61 |
$197.35 |
| J3490 |
Drugs unclassified injection |
344 |
279 |
$191.40 |
| 73030 |
|
43 |
40 |
$186.60 |
| 80061 |
|
237 |
236 |
$136.46 |
| 85610 |
|
184 |
180 |
$113.89 |
| 84439 |
|
119 |
119 |
$82.81 |
| 99203 |
|
155 |
155 |
$82.05 |
| 90715 |
|
13 |
13 |
$80.37 |
| J1200 |
Diphenhydramine hcl injectio |
57 |
55 |
$75.44 |
| J2765 |
Metoclopramide hcl injection |
42 |
42 |
$55.64 |
| 85730 |
|
36 |
36 |
$53.20 |
| 97530 |
|
82 |
27 |
$31.96 |
| 97110 |
|
81 |
26 |
$31.44 |
| 72100 |
|
25 |
25 |
$27.81 |
| 82306 |
|
15 |
15 |
$24.79 |
| 86901 |
|
12 |
12 |
$15.96 |
| 86900 |
|
12 |
12 |
$10.47 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
17 |
16 |
$8.46 |
| 82043 |
|
12 |
12 |
$8.00 |
| 82570 |
|
12 |
12 |
$5.32 |
| 0258 |
|
528 |
498 |
$3.05 |
| 85018 |
|
21 |
21 |
$2.64 |
| 36415 |
|
2,400 |
2,234 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
13 |
13 |
$0.00 |
| 99202 |
|
37 |
37 |
$0.00 |
| 96374 |
|
12 |
12 |
$0.00 |
| 0521 |
|
107 |
83 |
$0.00 |
| A4649 |
Surgical supplies |
124 |
114 |
$0.00 |
| 99212 |
|
73 |
72 |
$0.00 |
| 99204 |
|
25 |
25 |
$0.00 |
| 99442 |
|
16 |
16 |
$0.00 |
| 73110 |
|
14 |
12 |
$0.00 |