| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
|
10,344 |
9,402 |
$906K |
| J3490 |
Drugs unclassified injection |
8,232 |
4,293 |
$478K |
| J7030 |
Normal saline solution infus |
1,390 |
1,305 |
$283K |
| A4649 |
Surgical supplies |
3,305 |
1,677 |
$240K |
| 0360 |
|
2,085 |
1,925 |
$236K |
| 85027 |
|
8,833 |
8,131 |
$193K |
| 81025 |
|
2,912 |
2,715 |
$157K |
| 0160 |
|
453 |
260 |
$139K |
| J7120 |
Ringers lactate infusion |
716 |
688 |
$117K |
| 88305 |
|
778 |
772 |
$100K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
489 |
480 |
$99K |
| 96372 |
|
421 |
410 |
$69K |
| 80053 |
|
7,716 |
7,220 |
$67K |
| 71046 |
|
1,338 |
1,319 |
$66K |
| 87086 |
|
1,699 |
1,598 |
$65K |
| G0480 |
Drug test def 1-7 classes |
790 |
730 |
$64K |
| 87502 |
|
558 |
555 |
$58K |
| 84443 |
|
3,544 |
3,483 |
$58K |
| 96374 |
|
863 |
817 |
$55K |
| 87491 |
|
1,239 |
1,221 |
$52K |
| 87591 |
|
1,237 |
1,220 |
$47K |
| 87880 |
|
754 |
747 |
$41K |
| 45378 |
|
116 |
114 |
$41K |
| 83036 |
|
3,662 |
3,644 |
$39K |
| 0710 |
|
1,754 |
1,749 |
$38K |
| 81000 |
|
1,945 |
1,886 |
$33K |
| 80048 |
|
605 |
577 |
$25K |
| 93306 |
|
86 |
85 |
$24K |
| 83721 |
|
2,390 |
2,383 |
$24K |
| 81002 |
|
352 |
348 |
$22K |
| 83718 |
|
2,478 |
2,468 |
$21K |
| 73562 |
|
343 |
308 |
$18K |
| J7060 |
5% dextrose/water |
164 |
123 |
$18K |
| 74177 |
|
278 |
274 |
$17K |
| 84478 |
|
2,634 |
2,624 |
$16K |
| 70450 |
|
366 |
359 |
$15K |
| J0131 |
Inj, acetaminophen (nos) |
345 |
344 |
$15K |
| 74018 |
|
338 |
335 |
$14K |
| 80069 |
|
166 |
145 |
$14K |
| 82306 |
|
790 |
788 |
$13K |
| 82465 |
|
2,620 |
2,608 |
$13K |
| 0270 |
|
175 |
156 |
$13K |
| C1781 |
Mesh (implantable) |
13 |
13 |
$13K |
| 88175 |
|
509 |
508 |
$13K |
| 73610 |
|
227 |
218 |
$13K |
| 86703 |
|
2,108 |
2,043 |
$12K |
| 76700 |
|
145 |
145 |
$12K |
| 87624 |
|
334 |
334 |
$12K |
| 82746 |
|
667 |
662 |
$11K |
| 73630 |
|
175 |
159 |
$11K |
| 86140 |
|
2,204 |
2,079 |
$9K |
| 86803 |
|
553 |
551 |
$9K |
| 76830 |
|
166 |
166 |
$9K |
| 76856 |
|
125 |
125 |
$8K |
| 86780 |
|
521 |
514 |
$7K |
| J7050 |
Normal saline solution infus |
57 |
54 |
$7K |
| 73110 |
|
118 |
113 |
$7K |
| J2704 |
Inj, propofol, 10 mg |
942 |
913 |
$6K |
| 86850 |
|
361 |
348 |
$6K |
| 71045 |
|
671 |
649 |
$6K |
| J1885 |
Ketorolac tromethamine inj |
1,070 |
1,023 |
$6K |
| 93975 |
|
45 |
43 |
$5K |
| 84439 |
|
536 |
531 |
$5K |
| J3010 |
Fentanyl citrate injection |
1,242 |
1,222 |
$5K |
| 84702 |
|
191 |
140 |
$5K |
| 87340 |
|
405 |
402 |
$4K |
| 87088 |
|
709 |
674 |
$4K |
| 73130 |
|
55 |
51 |
$4K |
| 81003 |
|
276 |
276 |
$4K |
| 82728 |
|
278 |
274 |
$4K |
| 73030 |
|
67 |
64 |
$4K |
| J2250 |
Inj midazolam hydrochloride |
1,284 |
1,266 |
$4K |
| 83655 |
|
509 |
508 |
$4K |
| J0690 |
Cefazolin sodium injection |
481 |
425 |
$4K |
| 82043 |
|
489 |
486 |
$3K |
| 83013 |
|
42 |
42 |
$3K |
| J2405 |
Ondansetron hcl injection |
1,555 |
1,480 |
$3K |
| 86003 |
|
19 |
14 |
$3K |
| J1100 |
Dexamethasone sodium phos |
682 |
564 |
$3K |
| 88304 |
|
300 |
300 |
$3K |
| 87503 |
|
406 |
404 |
$3K |
| J2270 |
Morphine sulfate injection |
870 |
753 |
$3K |
| 96375 |
|
619 |
575 |
$3K |
| 85610 |
|
1,079 |
973 |
$2K |
| 84403 |
|
85 |
84 |
$2K |
| 83550 |
|
283 |
281 |
$2K |
| 83540 |
|
312 |
310 |
$2K |
| 86762 |
|
128 |
126 |
$2K |
| 85730 |
|
784 |
737 |
$2K |
| J7040 |
Normal saline solution infus |
18 |
14 |
$2K |
| 85018 |
|
621 |
619 |
$2K |
| 45380 |
|
70 |
70 |
$2K |
| 86480 |
|
25 |
25 |
$2K |
| 73080 |
|
14 |
14 |
$2K |
| 85014 |
|
595 |
591 |
$2K |
| 76705 |
|
81 |
81 |
$2K |
| 85651 |
|
575 |
557 |
$1K |
| 87186 |
|
324 |
312 |
$1K |
| 83735 |
|
2,975 |
2,697 |
$1K |
| 83880 |
|
191 |
187 |
$1K |
| J2765 |
Metoclopramide hcl injection |
447 |
423 |
$1K |
| 87070 |
|
45 |
41 |
$1K |
| 20610 |
|
41 |
41 |
$1K |
| 73140 |
|
13 |
13 |
$1K |
| 43239 |
|
27 |
27 |
$1K |
| 86901 |
|
398 |
383 |
$1K |
| 83690 |
|
2,887 |
2,677 |
$1K |
| 86705 |
|
83 |
82 |
$996.68 |
| 82550 |
|
912 |
835 |
$941.88 |
| 82950 |
|
130 |
119 |
$927.53 |
| 93005 |
|
1,236 |
1,126 |
$907.52 |
| 86706 |
|
76 |
76 |
$894.00 |
| 96360 |
|
204 |
200 |
$885.51 |
| J3300 |
Triamcinolone a inj prs-free |
28 |
28 |
$880.20 |
| 86900 |
|
398 |
383 |
$760.61 |
| 82947 |
|
164 |
163 |
$685.44 |
| 94640 |
|
257 |
234 |
$655.86 |
| G0481 |
Drug test def 8-14 classes |
12 |
12 |
$651.02 |
| 84153 |
|
29 |
28 |
$619.06 |
| 96361 |
|
278 |
261 |
$530.00 |
| 86787 |
|
37 |
37 |
$497.96 |
| 84481 |
|
25 |
24 |
$463.44 |
| 87040 |
|
138 |
136 |
$434.74 |
| 86038 |
|
28 |
27 |
$385.09 |
| 87081 |
|
52 |
52 |
$356.48 |
| 84484 |
|
822 |
733 |
$329.54 |
| J1170 |
Hydromorphone injection |
95 |
83 |
$289.25 |
| 81015 |
|
12 |
12 |
$271.16 |
| 87205 |
|
109 |
105 |
$262.16 |
| 84550 |
|
51 |
51 |
$254.40 |
| 80076 |
|
26 |
25 |
$206.13 |
| 82785 |
|
20 |
13 |
$205.92 |
| 82570 |
|
30 |
29 |
$163.66 |
| 85007 |
|
87 |
84 |
$157.53 |
| 84100 |
|
46 |
43 |
$93.56 |
| J2780 |
Ranitidine hydrochloride inj |
13 |
13 |
$82.10 |
| 83615 |
|
13 |
13 |
$80.30 |
| 85378 |
|
29 |
29 |
$51.12 |
| J1200 |
Diphenhydramine hcl injectio |
15 |
15 |
$20.97 |
| J2001 |
Lidocaine injection |
27 |
27 |
$11.02 |
| J2060 |
Lorazepam injection |
64 |
58 |
$2.70 |
| J7610 |
Albuterol comp con |
92 |
87 |
$0.00 |
| 90715 |
|
18 |
18 |
$0.00 |
| 82553 |
|
17 |
16 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
28 |
27 |
$0.00 |
| J7644 |
Ipratropium bromide non-comp |
65 |
63 |
$0.00 |
| 83605 |
|
41 |
38 |
$0.00 |