| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Y7506 |
|
4,369 |
3,622 |
$36.73M |
| X4006 |
|
2,720 |
2,481 |
$6.81M |
| X4003 |
|
10,989 |
10,329 |
$1.33M |
| G0463 |
Hospital outpt clinic visit |
15,292 |
14,110 |
$679K |
| 27279 |
|
33 |
30 |
$359K |
| G0260 |
Inj for sacroiliac jt anesth |
468 |
431 |
$112K |
| 20610 |
|
707 |
639 |
$109K |
| 64493 |
|
706 |
683 |
$103K |
| 64449 |
|
97 |
92 |
$48K |
| 64635 |
|
32 |
29 |
$32K |
| 64490 |
|
273 |
264 |
$30K |
| 80307 |
|
476 |
470 |
$17K |
| 64418 |
|
30 |
27 |
$10K |
| 72148 |
|
59 |
53 |
$6K |
| 62323 |
|
32 |
26 |
$5K |
| 72110 |
|
146 |
146 |
$4K |
| 64415 |
|
12 |
12 |
$3K |
| J2405 |
Ondansetron hcl injection |
204 |
197 |
$2K |
| 20605 |
|
15 |
12 |
$2K |
| 80305 |
|
220 |
206 |
$2K |
| 72100 |
|
28 |
27 |
$1K |
| 72141 |
|
13 |
13 |
$1K |
| 77002 |
|
120 |
102 |
$790.30 |
| 64494 |
|
31 |
30 |
$407.64 |
| 80048 |
|
48 |
38 |
$309.56 |
| 64491 |
|
14 |
14 |
$288.18 |
| 99213 |
|
289 |
278 |
$254.82 |
| 72050 |
|
12 |
12 |
$209.16 |
| J0131 |
Inj, acetaminophen (nos) |
88 |
85 |
$2.41 |
| J3301 |
Triamcinolone acet inj nos |
222 |
215 |
$0.00 |
| A4619 |
Face tent |
13 |
12 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
48 |
40 |
$0.00 |
| J1040 |
Methylprednisolone 80 mg inj |
115 |
113 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
12 |
12 |
$0.00 |
| J3490 |
Drugs unclassified injection |
67 |
62 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
41 |
40 |
$0.00 |