| Code | Description | Claims | Beneficiaries | Total Paid |
| 11042 |
|
4,835 |
2,353 |
$470K |
| 43239 |
|
849 |
752 |
$151K |
| 64494 |
|
375 |
235 |
$139K |
| 64495 |
|
293 |
167 |
$138K |
| 11043 |
|
937 |
478 |
$135K |
| 88305 |
|
1,577 |
1,392 |
$130K |
| 69436 |
|
210 |
174 |
$121K |
| 64493 |
|
339 |
255 |
$121K |
| G0463 |
Hospital outpt clinic visit |
9,651 |
8,627 |
$110K |
| J2250 |
Inj midazolam hydrochloride |
940 |
835 |
$92K |
| 84703 |
|
244 |
213 |
$88K |
| 36415 |
|
3,293 |
2,842 |
$86K |
| 85027 |
|
327 |
261 |
$85K |
| 88304 |
|
199 |
171 |
$85K |
| J2704 |
Inj, propofol, 10 mg |
1,492 |
1,356 |
$76K |
| 82948 |
|
209 |
144 |
$76K |
| 80048 |
|
264 |
217 |
$70K |
| 85610 |
|
387 |
333 |
$68K |
| G0480 |
Drug test def 1-7 classes |
1,282 |
1,204 |
$66K |
| J3010 |
Fentanyl citrate injection |
1,046 |
896 |
$66K |
| 99213 |
|
2,560 |
2,398 |
$62K |
| G0382 |
Lev 3 hosp type b ed visit |
628 |
565 |
$52K |
| 42820 |
|
50 |
45 |
$51K |
| 99214 |
|
1,686 |
1,597 |
$50K |
| 80307 |
|
1,555 |
1,454 |
$46K |
| 45385 |
|
150 |
132 |
$45K |
| 52281 |
|
14 |
12 |
$43K |
| 93458 |
|
43 |
34 |
$38K |
| 71046 |
|
316 |
273 |
$36K |
| 66984 |
|
103 |
75 |
$33K |
| 88342 |
|
594 |
516 |
$32K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
112 |
99 |
$30K |
| 97110 |
|
837 |
213 |
$27K |
| 99204 |
|
1,032 |
993 |
$26K |
| G0383 |
Lev 4 hosp type b ed visit |
281 |
254 |
$23K |
| 11045 |
|
224 |
52 |
$22K |
| J1644 |
Inj heparin sodium per 1000u |
15 |
14 |
$22K |
| J2001 |
Lidocaine injection |
958 |
871 |
$22K |
| J2405 |
Ondansetron hcl injection |
1,596 |
1,404 |
$22K |
| 93005 |
|
710 |
624 |
$22K |
| J1212 |
Dimethyl sulfoxide 50% 50 ml |
38 |
29 |
$21K |
| J3301 |
Triamcinolone acet inj nos |
2,736 |
2,279 |
$20K |
| 80047 |
|
104 |
86 |
$20K |
| 99212 |
|
366 |
321 |
$18K |
| 85730 |
|
164 |
145 |
$18K |
| C1894 |
Intro/sheath, non-laser |
46 |
37 |
$17K |
| C1725 |
Cath, translumin non-laser |
45 |
36 |
$17K |
| C1769 |
Guide wire |
41 |
33 |
$17K |
| 87077 |
|
488 |
427 |
$17K |
| 97597 |
|
538 |
334 |
$17K |
| 20610 |
|
41 |
26 |
$16K |
| 11044 |
|
91 |
39 |
$15K |
| 87635 |
|
470 |
421 |
$14K |
| 99202 |
|
122 |
115 |
$13K |
| 00145 |
|
36 |
27 |
$11K |
| 80053 |
|
1,462 |
1,274 |
$11K |
| G0481 |
Drug test def 8-14 classes |
81 |
69 |
$11K |
| 85025 |
|
1,664 |
1,436 |
$11K |
| 00731 |
|
187 |
169 |
$10K |
| 82962 |
|
573 |
383 |
$10K |
| J1100 |
Dexamethasone sodium phos |
1,601 |
1,344 |
$9K |
| 87426 |
|
359 |
332 |
$9K |
| 00910 |
|
25 |
19 |
$8K |
| 00812 |
|
20 |
16 |
$7K |
| 00813 |
|
96 |
82 |
$5K |
| 80355 |
|
92 |
83 |
$5K |
| A6453 |
Self-adher band w <3"/yd |
123 |
46 |
$4K |
| G0260 |
Inj for sacroiliac jt anesth |
138 |
118 |
$4K |
| G0384 |
Lev 5 hosp type b ed visit |
58 |
54 |
$4K |
| 77067 |
|
39 |
39 |
$3K |
| 87205 |
|
332 |
271 |
$3K |
| 87804 |
|
168 |
130 |
$3K |
| 87075 |
|
255 |
208 |
$3K |
| 87186 |
|
233 |
180 |
$3K |
| 00170 |
|
31 |
27 |
$3K |
| Q3014 |
Telehealth facility fee |
70 |
58 |
$3K |
| 99203 |
|
120 |
119 |
$3K |
| 71045 |
|
438 |
391 |
$3K |
| 99205 |
Prolong outpt/office vis |
44 |
38 |
$2K |
| 45380 |
|
28 |
26 |
$2K |
| V2632 |
Post chmbr intraocular lens |
72 |
42 |
$2K |
| 96374 |
|
114 |
92 |
$2K |
| 96372 |
|
87 |
73 |
$2K |
| 00142 |
|
20 |
15 |
$1K |
| 80061 |
|
233 |
204 |
$1K |
| A4649 |
Surgical supplies |
46 |
27 |
$1K |
| 87102 |
|
117 |
94 |
$986.92 |
| J8501 |
Oral aprepitant |
55 |
40 |
$975.61 |
| Q4100 |
Skin substitute, nos |
56 |
40 |
$920.09 |
| 00811 |
|
53 |
51 |
$841.15 |
| 84484 |
|
231 |
148 |
$805.68 |
| 88313 |
|
13 |
13 |
$693.78 |
| 87210 |
|
117 |
94 |
$588.06 |
| 64635 |
|
32 |
28 |
$578.20 |
| 70450 |
|
25 |
24 |
$550.58 |
| J7030 |
Normal saline solution infus |
297 |
240 |
$484.23 |
| 92504 |
|
84 |
78 |
$450.54 |
| 84443 |
|
13 |
13 |
$443.62 |
| 83036 |
|
95 |
88 |
$350.50 |
| 81001 |
|
277 |
241 |
$325.77 |
| 83605 |
|
48 |
41 |
$206.81 |
| 90686 |
|
31 |
27 |
$196.00 |
| 83880 |
|
32 |
27 |
$155.67 |
| 96375 |
|
17 |
15 |
$144.48 |
| 81003 |
|
15 |
15 |
$118.20 |
| G0008 |
Admin influenza virus vac |
100 |
92 |
$85.92 |
| 73562 |
|
23 |
18 |
$62.72 |
| 73630 |
|
13 |
12 |
$46.65 |
| 64636 |
|
19 |
16 |
$42.35 |
| 87040 |
|
22 |
12 |
$37.28 |
| 83690 |
|
18 |
17 |
$21.82 |
| J0690 |
Cefazolin sodium injection |
40 |
30 |
$13.37 |
| 90674 |
|
30 |
30 |
$8.92 |
| J0330 |
Succinycholine chloride inj |
17 |
16 |
$0.00 |
| C1780 |
Lens, intraocular (new tech) |
17 |
12 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
15 |
13 |
$0.00 |