| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87637 |
|
3,535 |
3,375 |
$302K |
| 80053 |
|
4,775 |
4,263 |
$290K |
| 99282 |
|
2,542 |
2,429 |
$183K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,170 |
1,070 |
$66K |
| 99283 |
|
5,900 |
5,564 |
$61K |
| 97110 |
|
2,888 |
857 |
$59K |
| 80048 |
|
1,283 |
1,083 |
$59K |
| 96372 |
|
2,090 |
1,898 |
$32K |
| 81001 |
|
2,845 |
2,611 |
$29K |
| 87635 |
|
598 |
563 |
$26K |
| 70450 |
|
1,015 |
948 |
$22K |
| 81003 |
|
1,250 |
1,185 |
$21K |
| 99284 |
|
4,702 |
4,435 |
$20K |
| 81025 |
|
2,001 |
1,876 |
$20K |
| 87651 |
|
1,638 |
1,595 |
$18K |
| 77063 |
|
243 |
239 |
$17K |
| 80307 |
|
1,073 |
1,002 |
$15K |
| 73130 |
|
230 |
217 |
$14K |
| 82947 |
|
990 |
699 |
$14K |
| 73630 |
|
477 |
410 |
$13K |
| 73610 |
|
253 |
237 |
$13K |
| 85025 |
|
5,328 |
4,764 |
$11K |
| 73030 |
|
306 |
289 |
$9K |
| 71045 |
|
2,383 |
2,211 |
$9K |
| 87086 |
|
752 |
706 |
$9K |
| 99285 |
|
2,072 |
1,877 |
$8K |
| 97014 |
|
201 |
93 |
$8K |
| 74176 |
|
384 |
360 |
$8K |
| 73560 |
|
298 |
251 |
$7K |
| 71046 |
|
570 |
548 |
$7K |
| 84702 |
|
101 |
91 |
$6K |
| 99281 |
|
52 |
52 |
$6K |
| 96365 |
|
722 |
670 |
$6K |
| 93306 |
|
58 |
56 |
$5K |
| 80061 |
|
249 |
241 |
$5K |
| 72100 |
|
152 |
140 |
$4K |
| 96361 |
|
811 |
745 |
$3K |
| 93005 |
|
2,277 |
2,073 |
$3K |
| 87491 |
|
83 |
82 |
$3K |
| 96375 |
|
1,031 |
909 |
$2K |
| 74018 |
|
122 |
116 |
$2K |
| 87077 |
|
258 |
222 |
$2K |
| 96374 |
|
1,500 |
1,385 |
$2K |
| 73562 |
|
67 |
57 |
$2K |
| 74177 |
|
778 |
736 |
$2K |
| 84484 |
|
2,267 |
1,432 |
$1K |
| 96360 |
|
249 |
240 |
$1K |
| 85379 |
|
341 |
328 |
$1K |
| 73502 |
|
83 |
78 |
$1K |
| 85007 |
|
418 |
391 |
$995.45 |
| 36415 |
|
6,515 |
5,475 |
$948.30 |
| 73110 |
|
53 |
51 |
$884.05 |
| 72040 |
|
26 |
25 |
$842.59 |
| 84439 |
|
229 |
220 |
$719.88 |
| 82077 |
|
513 |
464 |
$529.01 |
| 85610 |
|
651 |
599 |
$483.30 |
| 94640 |
|
677 |
585 |
$460.86 |
| 97161 |
|
303 |
298 |
$408.10 |
| 83036 |
|
373 |
360 |
$388.20 |
| 72125 |
|
97 |
92 |
$367.66 |
| 83880 |
|
546 |
498 |
$325.99 |
| 84443 |
|
640 |
607 |
$305.18 |
| J1170 |
Hydromorphone injection |
258 |
198 |
$220.42 |
| 82550 |
|
170 |
157 |
$152.75 |
| 82248 |
|
116 |
112 |
$148.56 |
| 83735 |
|
2,233 |
1,927 |
$127.32 |
| 87040 |
|
603 |
341 |
$88.01 |
| 97140 |
|
373 |
201 |
$73.21 |
| 97162 |
|
15 |
12 |
$68.23 |
| 97112 |
|
20 |
13 |
$48.61 |
| 97116 |
|
22 |
12 |
$45.87 |
| 85027 |
|
936 |
742 |
$36.26 |
| 83690 |
|
1,269 |
1,180 |
$25.05 |
| J0360 |
Hydralazine hcl injection |
15 |
12 |
$10.22 |
| J0690 |
Cefazolin sodium injection |
280 |
236 |
$7.38 |
| J2704 |
Inj, propofol, 10 mg |
367 |
258 |
$6.92 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
151 |
84 |
$6.46 |
| J1100 |
Dexamethasone sodium phos |
1,092 |
1,017 |
$6.03 |
| J3010 |
Fentanyl citrate injection |
158 |
143 |
$5.78 |
| 85730 |
|
393 |
358 |
$5.34 |
| J2405 |
Ondansetron hcl injection |
1,131 |
1,004 |
$5.00 |
| J2250 |
Inj midazolam hydrochloride |
232 |
214 |
$4.80 |
| J1920 |
Inj, labetalol hcl, 5mg |
22 |
12 |
$4.64 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
82 |
65 |
$0.18 |
| 87591 |
|
55 |
54 |
$0.00 |
| 83605 |
|
811 |
723 |
$0.00 |
| 87661 |
|
69 |
67 |
$0.00 |
| 71260 |
|
169 |
160 |
$0.00 |
| C1725 |
Cath, translumin non-laser |
62 |
56 |
$0.00 |
| G0378 |
Hospital observation per hr |
465 |
117 |
$0.00 |
| J2060 |
Lorazepam injection |
66 |
55 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
1,345 |
1,215 |
$0.00 |
| 96376 |
|
159 |
123 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
668 |
595 |
$0.00 |
| C1769 |
Guide wire |
83 |
68 |
$0.00 |
| 90471 |
|
39 |
36 |
$0.00 |
| 96366 |
|
17 |
13 |
$0.00 |
| 94644 |
|
13 |
12 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
51 |
51 |
$0.00 |
| J2270 |
Morphine sulfate injection |
333 |
291 |
$0.00 |
| 80179 |
|
55 |
52 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
87 |
76 |
$0.00 |
| 77067 |
|
240 |
235 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
48 |
42 |
$0.00 |
| 87186 |
|
103 |
91 |
$0.00 |
| 82805 |
|
15 |
12 |
$0.00 |
| J2930 |
Methylprednisolone injection |
18 |
18 |
$0.00 |
| 80143 |
|
80 |
76 |
$0.00 |
| 87804 |
|
127 |
123 |
$0.00 |
| 36600 |
|
13 |
13 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
118 |
111 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
261 |
190 |
$0.00 |
| 90715 |
|
25 |
24 |
$0.00 |
| 73590 |
|
17 |
12 |
$0.00 |
| J2550 |
Promethazine hcl injection |
12 |
12 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
15 |
12 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
21 |
17 |
$0.00 |
| 97530 |
|
36 |
22 |
$0.00 |