| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
8,015 |
6,692 |
$1.29M |
| 99284 |
|
7,338 |
6,473 |
$898K |
| 99283 |
|
7,381 |
6,631 |
$535K |
| 74177 |
|
437 |
395 |
$290K |
| 96375 |
|
3,458 |
2,819 |
$186K |
| 87502 |
|
2,898 |
2,635 |
$179K |
| 93005 |
|
4,260 |
3,604 |
$143K |
| 96374 |
|
4,254 |
3,665 |
$133K |
| 70450 |
|
721 |
636 |
$123K |
| 87635 |
|
2,127 |
1,785 |
$91K |
| 85025 |
|
13,310 |
11,229 |
$81K |
| 80053 |
|
11,752 |
9,962 |
$80K |
| 71045 |
|
2,254 |
1,879 |
$74K |
| 96361 |
|
2,847 |
2,453 |
$54K |
| 87880 |
|
3,154 |
2,789 |
$38K |
| 71046 |
|
578 |
524 |
$35K |
| 99282 |
|
599 |
570 |
$33K |
| 41899 |
|
13 |
13 |
$31K |
| 36415 |
|
15,733 |
12,998 |
$29K |
| 80307 |
|
426 |
398 |
$29K |
| 96365 |
|
430 |
362 |
$29K |
| 87637 |
|
464 |
363 |
$25K |
| J7030 |
Normal saline solution infus |
3,865 |
3,283 |
$23K |
| 96372 |
|
465 |
423 |
$21K |
| J3490 |
Drugs unclassified injection |
6,475 |
4,484 |
$20K |
| 87651 |
|
437 |
404 |
$15K |
| 66984 |
|
50 |
25 |
$15K |
| 83880 |
|
731 |
612 |
$15K |
| 84484 |
|
2,395 |
1,993 |
$14K |
| 83735 |
|
3,108 |
2,716 |
$13K |
| 83605 |
|
1,728 |
1,492 |
$13K |
| 87804 |
|
1,013 |
902 |
$12K |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
284 |
261 |
$12K |
| 87631 |
|
136 |
133 |
$12K |
| 87798 |
|
269 |
252 |
$10K |
| 80320 |
|
302 |
274 |
$9K |
| 83690 |
|
1,652 |
1,430 |
$8K |
| 74176 |
|
32 |
27 |
$8K |
| 87070 |
|
886 |
817 |
$8K |
| 81001 |
|
3,146 |
2,782 |
$7K |
| 86140 |
|
2,167 |
1,908 |
$7K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
506 |
454 |
$7K |
| 72125 |
|
25 |
25 |
$7K |
| 81003 |
|
2,834 |
2,029 |
$6K |
| 43239 |
|
12 |
12 |
$6K |
| 84443 |
|
482 |
420 |
$5K |
| J2405 |
Ondansetron hcl injection |
2,102 |
1,833 |
$4K |
| 96376 |
|
194 |
127 |
$4K |
| 81025 |
|
537 |
479 |
$4K |
| 97110 |
|
82 |
24 |
$4K |
| G0463 |
Hospital outpt clinic visit |
70 |
52 |
$3K |
| 85730 |
|
938 |
834 |
$3K |
| 96360 |
|
27 |
24 |
$3K |
| 82306 |
|
89 |
71 |
$3K |
| 85027 |
|
326 |
297 |
$3K |
| 94640 |
|
323 |
272 |
$3K |
| 76805 |
|
15 |
15 |
$2K |
| 85610 |
|
943 |
838 |
$2K |
| J7120 |
Ringers lactate infusion |
375 |
355 |
$2K |
| 87086 |
|
373 |
344 |
$2K |
| 97597 |
|
25 |
14 |
$2K |
| 82728 |
|
130 |
108 |
$2K |
| 82150 |
|
443 |
386 |
$1K |
| C1780 |
Lens, intraocular (new tech) |
50 |
25 |
$1K |
| 85007 |
|
315 |
282 |
$1K |
| 87040 |
|
217 |
206 |
$1K |
| 87491 |
|
47 |
43 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
643 |
587 |
$1K |
| J2704 |
Inj, propofol, 10 mg |
337 |
296 |
$1K |
| 59025 |
|
15 |
13 |
$1K |
| 82803 |
|
168 |
150 |
$992.45 |
| 88175 |
|
44 |
39 |
$971.40 |
| 82140 |
|
117 |
96 |
$935.05 |
| J2270 |
Morphine sulfate injection |
400 |
326 |
$909.00 |
| 80048 |
|
136 |
110 |
$885.37 |
| 84439 |
|
86 |
78 |
$869.55 |
| A9270 |
Non-covered item or service |
4,258 |
2,498 |
$840.31 |
| 85379 |
|
181 |
164 |
$834.09 |
| J1170 |
Hydromorphone injection |
333 |
278 |
$803.76 |
| J1100 |
Dexamethasone sodium phos |
156 |
143 |
$687.76 |
| J2930 |
Methylprednisolone injection |
96 |
87 |
$634.52 |
| 36600 |
|
96 |
89 |
$550.28 |
| 80061 |
|
30 |
26 |
$440.31 |
| 84703 |
|
44 |
37 |
$388.88 |
| 87186 |
|
41 |
40 |
$292.42 |
| 99281 |
|
12 |
12 |
$281.43 |
| 82550 |
|
151 |
124 |
$271.43 |
| J7612 |
Levalbuterol non-comp con |
68 |
59 |
$209.12 |
| 86592 |
|
41 |
40 |
$191.16 |
| J3010 |
Fentanyl citrate injection |
88 |
79 |
$187.84 |
| J2060 |
Lorazepam injection |
144 |
93 |
$182.54 |
| J2250 |
Inj midazolam hydrochloride |
62 |
37 |
$147.88 |
| 96366 |
|
12 |
12 |
$125.90 |
| J2550 |
Promethazine hcl injection |
57 |
51 |
$105.33 |
| J7050 |
Normal saline solution infus |
29 |
25 |
$74.59 |
| 87077 |
|
13 |
12 |
$55.68 |
| 82009 |
|
27 |
25 |
$40.66 |
| J7611 |
Albuterol non-comp con |
104 |
95 |
$38.07 |
| J7644 |
Ipratropium bromide non-comp |
169 |
151 |
$31.69 |
| 85652 |
|
15 |
13 |
$26.88 |
| J0696 |
Ceftriaxone sodium injection |
15 |
12 |
$25.21 |
| J2710 |
Neostigmine methylslfte inj |
15 |
14 |
$24.67 |