| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
2,488 |
2,355 |
$535K |
| 99283 |
|
1,779 |
1,709 |
$303K |
| 74177 |
|
382 |
371 |
$190K |
| 99285 |
|
866 |
832 |
$115K |
| 99282 |
|
799 |
742 |
$65K |
| 70450 |
|
207 |
200 |
$41K |
| 74176 |
|
85 |
82 |
$17K |
| 80053 |
|
2,390 |
2,108 |
$750.92 |
| 96374 |
|
1,208 |
1,135 |
$606.84 |
| 87637 |
|
798 |
763 |
$602.93 |
| 85025 |
|
2,371 |
2,142 |
$432.61 |
| 96375 |
|
1,130 |
1,007 |
$193.80 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
622 |
601 |
$150.65 |
| 71045 |
|
302 |
295 |
$135.07 |
| 71046 |
|
527 |
515 |
$117.94 |
| 93005 |
|
1,003 |
887 |
$114.88 |
| 96365 |
|
307 |
293 |
$79.39 |
| 87880 |
|
280 |
274 |
$40.14 |
| 96361 |
|
1,320 |
1,185 |
$36.26 |
| J7030 |
Normal saline solution infus |
1,544 |
1,402 |
$29.67 |
| J1885 |
Ketorolac tromethamine inj |
966 |
887 |
$26.01 |
| 81003 |
|
1,756 |
1,639 |
$21.58 |
| 84484 |
|
781 |
680 |
$16.52 |
| J8499 |
Oral prescrip drug non chemo |
2,708 |
1,893 |
$15.53 |
| 85610 |
|
397 |
370 |
$9.59 |
| 83690 |
|
558 |
520 |
$6.08 |
| J2405 |
Ondansetron hcl injection |
828 |
759 |
$3.14 |
| 81025 |
|
916 |
869 |
$2.00 |
| J3490 |
Drugs unclassified injection |
81 |
75 |
$1.12 |
| 87086 |
|
173 |
169 |
$0.00 |
| 83735 |
|
615 |
572 |
$0.00 |
| 96372 |
|
420 |
402 |
$0.00 |
| 83605 |
|
87 |
71 |
$0.00 |
| 84443 |
|
98 |
94 |
$0.00 |
| 85379 |
|
163 |
150 |
$0.00 |
| 87428 |
|
123 |
111 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
76 |
70 |
$0.00 |
| 82550 |
|
16 |
15 |
$0.00 |
| J8540 |
Oral dexamethasone |
56 |
50 |
$0.00 |
| 96376 |
|
49 |
41 |
$0.00 |
| 84703 |
|
12 |
12 |
$0.00 |
| 80320 |
|
59 |
58 |
$0.00 |
| 94640 |
|
15 |
13 |
$0.00 |
| J7620 |
Albuterol ipratrop non-comp |
13 |
12 |
$0.00 |
| J2060 |
Lorazepam injection |
16 |
12 |
$0.00 |
| A6250 |
Skin seal protect moisturizr |
42 |
40 |
$0.00 |
| 93041 |
|
44 |
41 |
$0.00 |
| 80305 |
|
412 |
393 |
$0.00 |
| 84439 |
|
86 |
82 |
$0.00 |
| J2270 |
Morphine sulfate injection |
280 |
219 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
93 |
68 |
$0.00 |
| 96360 |
|
58 |
58 |
$0.00 |
| 84100 |
|
29 |
26 |
$0.00 |