| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 80053 |
|
7,238 |
5,218 |
$614K |
| 99283 |
|
7,572 |
5,951 |
$147K |
| 36415 |
|
1,362 |
977 |
$99K |
| 80048 |
|
1,986 |
1,291 |
$68K |
| 99282 |
|
1,703 |
1,359 |
$66K |
| 82565 |
|
304 |
205 |
$48K |
| 87070 |
|
840 |
697 |
$38K |
| 84702 |
|
869 |
602 |
$32K |
| 81001 |
|
3,869 |
3,086 |
$31K |
| 71046 |
|
2,959 |
2,366 |
$30K |
| 87804 |
|
1,410 |
690 |
$25K |
| 99281 |
|
215 |
173 |
$24K |
| 70450 |
|
1,255 |
1,004 |
$23K |
| 81003 |
|
1,660 |
1,296 |
$19K |
| 96372 |
|
1,717 |
1,285 |
$16K |
| Q0162 |
Ondansetron oral |
514 |
424 |
$16K |
| 99284 |
|
5,420 |
4,430 |
$15K |
| 80307 |
|
756 |
570 |
$11K |
| 87086 |
|
983 |
806 |
$10K |
| G0463 |
Hospital outpt clinic visit |
433 |
246 |
$10K |
| 73562 |
|
393 |
256 |
$9K |
| 85027 |
|
9,368 |
6,259 |
$8K |
| 81025 |
|
1,775 |
1,460 |
$7K |
| 73630 |
|
270 |
203 |
$7K |
| 73030 |
|
210 |
145 |
$7K |
| 73610 |
|
200 |
139 |
$6K |
| 71250 |
|
46 |
42 |
$6K |
| 87880 |
|
678 |
595 |
$6K |
| 74177 |
|
1,049 |
913 |
$5K |
| 87491 |
|
398 |
314 |
$5K |
| 72125 |
|
357 |
318 |
$5K |
| 71045 |
|
1,832 |
1,430 |
$5K |
| 87210 |
|
150 |
116 |
$3K |
| 84484 |
|
3,041 |
1,940 |
$3K |
| 96374 |
|
2,993 |
2,445 |
$2K |
| 73590 |
|
74 |
31 |
$2K |
| 93005 |
|
4,376 |
2,911 |
$2K |
| 73502 |
|
98 |
64 |
$2K |
| 93971 |
|
22 |
15 |
$1K |
| 76705 |
|
70 |
51 |
$1K |
| 71260 |
|
22 |
12 |
$1K |
| 74176 |
|
206 |
169 |
$1K |
| 87077 |
|
198 |
137 |
$993.30 |
| 78452 |
|
74 |
69 |
$961.42 |
| 80047 |
|
16 |
14 |
$922.49 |
| 86850 |
|
248 |
184 |
$915.69 |
| 83036 |
|
302 |
234 |
$837.13 |
| 71275 |
|
50 |
41 |
$792.67 |
| 73130 |
|
38 |
26 |
$769.82 |
| 86900 |
|
901 |
697 |
$743.46 |
| 99285 |
|
1,520 |
788 |
$725.35 |
| 83605 |
|
649 |
472 |
$611.57 |
| 84703 |
|
91 |
77 |
$444.52 |
| 87635 |
|
13 |
13 |
$427.77 |
| 76801 |
|
227 |
191 |
$422.40 |
| 94640 |
|
627 |
494 |
$394.07 |
| 73110 |
|
14 |
13 |
$369.61 |
| 84443 |
|
796 |
600 |
$209.59 |
| 76817 |
|
200 |
164 |
$205.66 |
| 96375 |
|
1,082 |
916 |
$132.08 |
| J7512 |
Prednisone ir or dr oral 1mg |
107 |
63 |
$121.41 |
| 93017 |
|
76 |
71 |
$115.57 |
| 36000 |
|
94 |
73 |
$100.44 |
| 72100 |
|
16 |
12 |
$95.38 |
| J7030 |
Normal saline solution infus |
2,774 |
2,059 |
$48.27 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,309 |
1,040 |
$32.92 |
| 83880 |
|
640 |
534 |
$29.17 |
| 85610 |
|
1,529 |
1,148 |
$22.29 |
| 87040 |
|
407 |
229 |
$17.74 |
| J0696 |
Ceftriaxone sodium injection |
687 |
543 |
$16.00 |
| J2270 |
Morphine sulfate injection |
905 |
620 |
$15.08 |
| J2765 |
Metoclopramide hcl injection |
205 |
177 |
$12.02 |
| 80061 |
|
256 |
209 |
$8.57 |
| 83690 |
|
2,068 |
1,727 |
$5.92 |
| C1894 |
Intro/sheath, non-laser |
89 |
65 |
$0.00 |
| 85007 |
|
32 |
25 |
$0.00 |
| J2405 |
Ondansetron hcl injection |
1,338 |
1,080 |
$0.00 |
| J1650 |
Inj enoxaparin sodium |
64 |
37 |
$0.00 |
| S0119 |
Ondansetron 4 mg |
110 |
105 |
$0.00 |
| A9577 |
Inj multihance |
63 |
25 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
274 |
205 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
443 |
173 |
$0.00 |
| J2550 |
Promethazine hcl injection |
68 |
43 |
$0.00 |
| 87186 |
|
158 |
119 |
$0.00 |
| J2930 |
Methylprednisolone injection |
70 |
54 |
$0.00 |
| J7120 |
Ringers lactate infusion |
74 |
38 |
$0.00 |
| 80076 |
|
13 |
13 |
$0.00 |
| 84439 |
|
25 |
14 |
$0.00 |
| J7040 |
Normal saline solution infus |
14 |
13 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
907 |
697 |
$0.00 |
| A9270 |
Non-covered item or service |
4,421 |
1,697 |
$0.00 |
| 83735 |
|
2,731 |
1,888 |
$0.00 |
| G0378 |
Hospital observation per hr |
682 |
461 |
$0.00 |
| 85730 |
|
922 |
702 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
372 |
281 |
$0.00 |
| C1769 |
Guide wire |
137 |
109 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
468 |
392 |
$0.00 |
| 86901 |
|
901 |
697 |
$0.00 |
| 96376 |
|
118 |
99 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
378 |
264 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
1,936 |
1,413 |
$0.00 |
| 87591 |
|
398 |
314 |
$0.00 |
| A9500 |
Tc99m sestamibi |
73 |
68 |
$0.00 |
| 90471 |
|
33 |
25 |
$0.00 |
| 88305 |
|
19 |
13 |
$0.00 |
| J2060 |
Lorazepam injection |
25 |
24 |
$0.00 |
| 85651 |
|
16 |
15 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
75 |
52 |
$0.00 |
| J1815 |
Insulin injection |
30 |
12 |
$0.00 |
| 82330 |
|
15 |
12 |
$0.00 |
| 85379 |
|
45 |
40 |
$0.00 |