| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
8,716 |
7,457 |
$987K |
| 99283 |
|
8,032 |
7,311 |
$883K |
| 70450 |
|
499 |
431 |
$126K |
| 99285 |
|
855 |
747 |
$100K |
| 74176 |
|
276 |
244 |
$93K |
| 99282 |
|
740 |
654 |
$86K |
| 74177 |
|
192 |
172 |
$58K |
| G0378 |
Hospital observation per hr |
1,331 |
666 |
$58K |
| 80053 |
|
6,802 |
5,736 |
$36K |
| 99281 |
|
697 |
309 |
$32K |
| 96361 |
|
731 |
619 |
$12K |
| 87635 |
|
4,746 |
4,437 |
$10K |
| 71275 |
|
15 |
14 |
$7K |
| 93005 |
|
2,250 |
1,563 |
$5K |
| 96372 |
|
669 |
601 |
$5K |
| 87040 |
|
419 |
364 |
$5K |
| 96374 |
|
3,254 |
2,811 |
$5K |
| 87807 |
|
937 |
899 |
$4K |
| 87070 |
|
1,703 |
1,599 |
$4K |
| J7030 |
Normal saline solution infus |
3,454 |
2,711 |
$3K |
| 96360 |
|
180 |
154 |
$3K |
| 87275 |
|
4,389 |
4,116 |
$3K |
| 71045 |
|
2,310 |
2,053 |
$3K |
| 76801 |
|
423 |
311 |
$3K |
| 76819 |
|
341 |
230 |
$3K |
| 96365 |
|
209 |
189 |
$2K |
| 85027 |
|
8,136 |
6,618 |
$2K |
| 81025 |
|
1,372 |
1,271 |
$2K |
| 76856 |
|
280 |
251 |
$2K |
| 96375 |
|
1,143 |
930 |
$2K |
| 76705 |
|
169 |
151 |
$2K |
| 87276 |
|
4,389 |
4,114 |
$2K |
| 80048 |
|
647 |
499 |
$2K |
| 74022 |
|
37 |
33 |
$1K |
| 72131 |
|
13 |
13 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
1,682 |
1,270 |
$1K |
| 87480 |
|
157 |
143 |
$640.93 |
| 76805 |
|
306 |
264 |
$498.62 |
| 87880 |
|
1,809 |
1,705 |
$378.06 |
| 81001 |
|
3,000 |
2,692 |
$363.96 |
| J2405 |
Ondansetron hcl injection |
1,142 |
881 |
$332.36 |
| 72100 |
|
15 |
12 |
$210.72 |
| 83690 |
|
1,491 |
1,294 |
$208.68 |
| 85610 |
|
711 |
620 |
$181.03 |
| 85730 |
|
675 |
592 |
$181.03 |
| 76830 |
|
34 |
28 |
$142.10 |
| 87077 |
|
196 |
182 |
$131.04 |
| 84703 |
|
1,770 |
1,480 |
$126.76 |
| 84484 |
|
1,166 |
915 |
$122.43 |
| A9270 |
Non-covered item or service |
133 |
26 |
$93.79 |
| 71046 |
|
392 |
345 |
$72.62 |
| 81003 |
|
1,168 |
1,013 |
$60.75 |
| 94640 |
|
217 |
198 |
$40.12 |
| 80307 |
|
160 |
143 |
$39.91 |
| J1200 |
Diphenhydramine hcl injectio |
666 |
467 |
$21.08 |
| 87086 |
|
779 |
700 |
$20.77 |
| 84702 |
|
583 |
417 |
$17.50 |
| 86140 |
|
234 |
205 |
$14.40 |
| 87426 |
|
135 |
111 |
$5.10 |
| J1100 |
Dexamethasone sodium phos |
380 |
269 |
$3.33 |
| 86900 |
|
750 |
649 |
$2.50 |
| J2270 |
Morphine sulfate injection |
559 |
356 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
376 |
316 |
$0.00 |
| 99238 |
|
69 |
41 |
$0.00 |
| 85007 |
|
262 |
200 |
$0.00 |
| J7120 |
Ringers lactate infusion |
275 |
218 |
$0.00 |
| 74018 |
|
71 |
68 |
$0.00 |
| 87660 |
|
157 |
143 |
$0.00 |
| 73562 |
|
29 |
26 |
$0.00 |
| 73630 |
|
40 |
40 |
$0.00 |
| J2930 |
Methylprednisolone injection |
27 |
24 |
$0.00 |
| 73610 |
|
14 |
14 |
$0.00 |
| J1650 |
Inj enoxaparin sodium |
21 |
12 |
$0.00 |
| J7040 |
Normal saline solution infus |
16 |
14 |
$0.00 |
| 80076 |
|
13 |
12 |
$0.00 |
| 86850 |
|
454 |
383 |
$0.00 |
| J2765 |
Metoclopramide hcl injection |
356 |
285 |
$0.00 |
| 86901 |
|
454 |
383 |
$0.00 |
| 83605 |
|
344 |
289 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
415 |
342 |
$0.00 |
| 83735 |
|
68 |
57 |
$0.00 |
| 87487 |
|
159 |
145 |
$0.00 |
| 84443 |
|
44 |
39 |
$0.00 |
| 82550 |
|
79 |
69 |
$0.00 |
| J7050 |
Normal saline solution infus |
394 |
315 |
$0.00 |
| 87591 |
|
159 |
145 |
$0.00 |
| 99460 |
|
56 |
38 |
$0.00 |
| Q0162 |
Ondansetron oral |
92 |
91 |
$0.00 |
| 92650 |
|
1,210 |
895 |
$0.00 |
| 83880 |
|
108 |
91 |
$0.00 |
| 85379 |
|
130 |
119 |
$0.00 |
| 88305 |
|
27 |
26 |
$0.00 |
| 87510 |
|
157 |
143 |
$0.00 |
| 85651 |
|
51 |
42 |
$0.00 |
| 76817 |
|
148 |
119 |
$0.00 |
| J3490 |
Drugs unclassified injection |
76 |
66 |
$0.00 |
| 76811 |
|
19 |
14 |
$0.00 |
| J1170 |
Hydromorphone injection |
55 |
37 |
$0.00 |
| G0480 |
Drug test def 1-7 classes |
15 |
12 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
16 |
12 |
$0.00 |