| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
|
5,530 |
5,025 |
$161K |
| 0121 |
|
55 |
27 |
$150K |
| 99285 |
|
688 |
652 |
$62K |
| G0463 |
Hospital outpt clinic visit |
2,527 |
1,969 |
$50K |
| 99283 |
|
892 |
823 |
$34K |
| 0760 |
|
950 |
841 |
$31K |
| 70450 |
|
295 |
285 |
$27K |
| 93005 |
|
2,088 |
1,913 |
$18K |
| 99284 |
|
503 |
471 |
$18K |
| 80053 |
|
3,597 |
3,122 |
$16K |
| 0510 |
|
603 |
541 |
$15K |
| 97110 |
|
335 |
81 |
$13K |
| 96374 |
|
542 |
505 |
$11K |
| 99231 |
|
380 |
323 |
$11K |
| 71046 |
|
711 |
684 |
$11K |
| 80307 |
|
252 |
241 |
$10K |
| 85025 |
|
3,968 |
3,391 |
$10K |
| A4606 |
Oxygen probe used w oximeter |
1,719 |
1,594 |
$10K |
| 0270 |
|
1,185 |
609 |
$9K |
| 74177 |
|
56 |
55 |
$9K |
| J3490 |
Drugs unclassified injection |
3,310 |
1,822 |
$8K |
| 71045 |
|
759 |
713 |
$6K |
| A0429 |
Bls-emergency |
174 |
134 |
$4K |
| 0700 |
|
93 |
79 |
$4K |
| 84484 |
|
822 |
674 |
$4K |
| A4663 |
Dialysis blood pressure cuff |
614 |
570 |
$3K |
| 96372 |
|
208 |
197 |
$3K |
| 0258 |
|
339 |
211 |
$2K |
| 81003 |
|
1,753 |
1,600 |
$2K |
| 93975 |
|
17 |
17 |
$2K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
360 |
335 |
$2K |
| J1885 |
Ketorolac tromethamine inj |
549 |
511 |
$2K |
| J7120 |
Ringers lactate infusion |
367 |
322 |
$2K |
| 87798 |
|
331 |
310 |
$2K |
| 83690 |
|
429 |
406 |
$2K |
| A9270 |
Non-covered item or service |
2,188 |
583 |
$2K |
| 82948 |
|
396 |
320 |
$1K |
| 81025 |
|
218 |
211 |
$1K |
| 0259 |
|
265 |
154 |
$1K |
| G0480 |
Drug test def 1-7 classes |
29 |
27 |
$944.26 |
| 73130 |
|
43 |
40 |
$943.29 |
| 80047 |
|
293 |
279 |
$938.42 |
| 80048 |
|
458 |
391 |
$923.35 |
| 87086 |
|
222 |
212 |
$895.12 |
| 73630 |
|
47 |
43 |
$833.77 |
| 99281 |
|
28 |
25 |
$803.85 |
| 86803 |
|
279 |
268 |
$769.07 |
| 87389 |
|
204 |
193 |
$748.19 |
| 73610 |
|
43 |
42 |
$748.13 |
| A4301 |
Implantable access syst perc |
220 |
160 |
$507.54 |
| 96365 |
|
13 |
12 |
$490.75 |
| 73110 |
|
28 |
28 |
$450.69 |
| A4306 |
Drug delivery system <=50 ml |
250 |
231 |
$447.50 |
| 82947 |
|
111 |
89 |
$417.21 |
| 94760 |
|
102 |
92 |
$361.20 |
| 83605 |
|
76 |
72 |
$336.89 |
| 73030 |
|
17 |
17 |
$329.26 |
| 85610 |
|
179 |
159 |
$271.26 |
| 73562 |
|
16 |
15 |
$252.26 |
| 94640 |
|
16 |
13 |
$243.54 |
| 99221 |
|
13 |
12 |
$236.32 |
| 83036 |
|
93 |
92 |
$191.61 |
| 90656 |
|
12 |
12 |
$174.77 |
| 36415 |
|
1,456 |
1,323 |
$137.94 |
| 84443 |
|
13 |
13 |
$122.35 |
| 96375 |
|
14 |
12 |
$103.82 |
| Q4051 |
Splint supplies misc |
24 |
18 |
$99.20 |
| 85048 |
|
103 |
96 |
$96.91 |
| J2405 |
Ondansetron hcl injection |
43 |
36 |
$90.88 |
| 90471 |
|
15 |
15 |
$81.59 |
| 82550 |
|
16 |
12 |
$62.70 |
| 0271 |
|
58 |
28 |
$60.68 |
| J0696 |
Ceftriaxone sodium injection |
13 |
13 |
$52.12 |
| J1170 |
Hydromorphone injection |
13 |
12 |
$50.96 |
| 0250 |
|
75 |
39 |
$46.45 |
| 86901 |
|
12 |
12 |
$44.34 |
| 87210 |
|
12 |
12 |
$39.08 |
| 86900 |
|
12 |
12 |
$38.98 |
| 85027 |
|
13 |
12 |
$38.46 |
| 83735 |
|
15 |
12 |
$32.74 |
| 85730 |
|
13 |
12 |
$25.08 |
| 99499 |
|
401 |
364 |
$0.00 |
| 0300 |
|
15 |
12 |
$0.00 |
| 0301 |
|
15 |
12 |
$0.00 |
| 0305 |
|
15 |
12 |
$0.00 |
| 0636 |
|
15 |
12 |
$0.00 |