| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
2,643 |
1,729 |
$428K |
| 99283 |
|
3,102 |
2,430 |
$426K |
| 99213 |
|
8,572 |
7,374 |
$312K |
| 87635 |
|
4,264 |
3,506 |
$207K |
| 99285 |
|
1,306 |
711 |
$199K |
| 97110 |
|
2,895 |
834 |
$142K |
| 99214 |
|
3,238 |
1,973 |
$82K |
| 99282 |
|
878 |
662 |
$73K |
| 87631 |
|
543 |
478 |
$59K |
| 97140 |
|
864 |
294 |
$44K |
| 87636 |
|
546 |
412 |
$42K |
| 71046 |
|
661 |
410 |
$35K |
| 96374 |
|
579 |
413 |
$33K |
| 80053 |
|
5,326 |
3,981 |
$28K |
| 99392 |
|
442 |
407 |
$27K |
| 93005 |
|
1,114 |
774 |
$26K |
| 99393 |
|
412 |
395 |
$25K |
| 85025 |
|
6,819 |
4,813 |
$25K |
| 99211 |
|
1,315 |
1,085 |
$21K |
| 96361 |
|
273 |
197 |
$21K |
| 74177 |
|
19 |
13 |
$21K |
| 84443 |
|
2,156 |
1,837 |
$21K |
| G0463 |
Hospital outpt clinic visit |
1,284 |
824 |
$20K |
| 70450 |
|
57 |
40 |
$19K |
| 96365 |
|
257 |
142 |
$17K |
| 80061 |
|
1,390 |
1,231 |
$15K |
| 90460 |
|
2,421 |
2,136 |
$15K |
| 87651 |
|
469 |
422 |
$13K |
| G0378 |
Hospital observation per hr |
27 |
12 |
$12K |
| 82306 |
|
538 |
458 |
$12K |
| 71045 |
|
197 |
134 |
$11K |
| 99391 |
|
177 |
145 |
$10K |
| 96375 |
|
145 |
90 |
$10K |
| 99394 |
|
137 |
127 |
$8K |
| G0381 |
Lev 2 hosp type b ed visit |
432 |
307 |
$8K |
| 83036 |
|
1,206 |
1,037 |
$8K |
| 87591 |
|
351 |
277 |
$8K |
| 87491 |
|
351 |
277 |
$8K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
253 |
190 |
$7K |
| 99281 |
|
66 |
63 |
$6K |
| 80048 |
|
1,490 |
1,033 |
$6K |
| G0382 |
Lev 3 hosp type b ed visit |
88 |
84 |
$6K |
| 77067 |
|
12 |
12 |
$5K |
| 84439 |
|
706 |
618 |
$5K |
| 97161 |
|
59 |
34 |
$5K |
| 87086 |
|
989 |
792 |
$4K |
| 87804 |
|
404 |
184 |
$4K |
| 97530 |
|
144 |
65 |
$3K |
| 87880 |
|
291 |
274 |
$3K |
| 90471 |
|
472 |
449 |
$2K |
| 84484 |
|
612 |
355 |
$2K |
| 87081 |
|
482 |
446 |
$2K |
| 36415 |
|
7,032 |
5,326 |
$2K |
| 90461 |
|
563 |
496 |
$2K |
| 99212 |
|
57 |
56 |
$2K |
| 82728 |
|
160 |
122 |
$2K |
| 86140 |
|
511 |
363 |
$2K |
| 83690 |
|
437 |
298 |
$2K |
| G0380 |
Lev 1 hosp type b ed visit |
175 |
124 |
$1K |
| 81001 |
|
926 |
667 |
$1K |
| 81025 |
|
276 |
208 |
$1K |
| 86803 |
|
111 |
84 |
$1K |
| 77063 |
|
12 |
12 |
$1K |
| 87502 |
|
42 |
36 |
$1K |
| 96372 |
|
62 |
39 |
$1K |
| 96360 |
|
20 |
12 |
$1K |
| 87389 |
|
29 |
25 |
$823.84 |
| J7030 |
Normal saline solution infus |
408 |
271 |
$767.70 |
| 81003 |
|
540 |
430 |
$670.74 |
| J2405 |
Ondansetron hcl injection |
345 |
199 |
$639.07 |
| 86618 |
|
57 |
52 |
$637.05 |
| J7120 |
Ringers lactate infusion |
201 |
114 |
$608.22 |
| 96127 |
|
216 |
194 |
$547.22 |
| 85652 |
|
255 |
191 |
$437.43 |
| 80050 |
|
52 |
52 |
$404.87 |
| J1885 |
Ketorolac tromethamine inj |
231 |
157 |
$389.70 |
| 85027 |
|
87 |
67 |
$378.82 |
| J7050 |
Normal saline solution infus |
176 |
69 |
$333.63 |
| 87077 |
|
76 |
52 |
$322.14 |
| 84702 |
|
27 |
12 |
$311.94 |
| 90686 |
|
926 |
874 |
$280.85 |
| 85610 |
|
158 |
93 |
$243.19 |
| 87186 |
|
51 |
39 |
$241.95 |
| 83735 |
|
59 |
46 |
$180.65 |
| A0425 |
Ground mileage |
14 |
12 |
$167.33 |
| 90472 |
|
33 |
29 |
$147.22 |
| 93010 |
|
49 |
37 |
$137.43 |
| G2211 |
Complex e/m visit add on |
41 |
38 |
$133.26 |
| 99215 |
Prolong outpt/office vis |
24 |
12 |
$119.47 |
| J2001 |
Lidocaine injection |
19 |
12 |
$29.92 |
| J2250 |
Inj midazolam hydrochloride |
20 |
13 |
$8.64 |
| 90734 |
|
13 |
12 |
$0.00 |
| 90670 |
|
13 |
12 |
$0.00 |
| 90685 |
|
13 |
13 |
$0.00 |
| 90656 |
|
49 |
49 |
$0.00 |