| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 97110 |
|
1,648 |
428 |
$125K |
| 36415 |
|
775 |
663 |
$84K |
| 80053 |
|
1,418 |
1,313 |
$81K |
| 81001 |
|
1,261 |
1,141 |
$76K |
| 99283 |
|
1,890 |
1,807 |
$62K |
| 99284 |
|
1,076 |
1,027 |
$31K |
| 99282 |
|
438 |
419 |
$29K |
| 87804 |
|
492 |
472 |
$29K |
| 97530 |
|
536 |
189 |
$22K |
| 87880 |
|
284 |
274 |
$21K |
| 92507 |
|
407 |
135 |
$18K |
| 80048 |
|
322 |
290 |
$13K |
| 87086 |
|
782 |
731 |
$13K |
| 87070 |
|
158 |
151 |
$9K |
| 71046 |
|
380 |
369 |
$7K |
| G0463 |
Hospital outpt clinic visit |
204 |
155 |
$7K |
| 99285 |
|
331 |
311 |
$6K |
| 87491 |
|
169 |
167 |
$5K |
| 96372 |
|
221 |
210 |
$5K |
| 80307 |
|
378 |
338 |
$5K |
| 70450 |
|
94 |
94 |
$5K |
| 81025 |
|
620 |
585 |
$3K |
| 85027 |
|
189 |
181 |
$3K |
| 84484 |
|
285 |
170 |
$3K |
| 82950 |
|
144 |
144 |
$2K |
| 73630 |
|
42 |
37 |
$2K |
| 82306 |
|
153 |
153 |
$2K |
| 85025 |
|
1,502 |
1,362 |
$2K |
| 74177 |
|
129 |
129 |
$2K |
| 87077 |
|
223 |
214 |
$2K |
| 73610 |
|
26 |
26 |
$2K |
| 96374 |
|
494 |
463 |
$2K |
| 80061 |
|
355 |
354 |
$2K |
| 84443 |
|
639 |
623 |
$1K |
| 82105 |
|
26 |
26 |
$1K |
| 87147 |
|
46 |
43 |
$1K |
| 93005 |
|
345 |
293 |
$906.57 |
| 84439 |
|
150 |
147 |
$898.03 |
| 72100 |
|
15 |
15 |
$830.46 |
| 96361 |
|
238 |
218 |
$748.07 |
| 83036 |
|
192 |
191 |
$695.83 |
| 84702 |
|
135 |
117 |
$677.33 |
| 82607 |
|
63 |
63 |
$373.39 |
| 87081 |
|
311 |
301 |
$368.08 |
| 88305 |
|
15 |
15 |
$254.02 |
| 80055 |
|
16 |
16 |
$244.42 |
| 87210 |
|
78 |
78 |
$151.14 |
| 85018 |
|
139 |
133 |
$73.67 |
| 74022 |
|
13 |
13 |
$50.62 |
| 83690 |
|
341 |
314 |
$31.66 |
| 71045 |
|
109 |
106 |
$29.52 |
| 84146 |
|
14 |
12 |
$27.48 |
| 86850 |
|
13 |
13 |
$24.00 |
| 85610 |
|
77 |
73 |
$22.28 |
| 83735 |
|
166 |
145 |
$16.04 |
| 83605 |
|
29 |
24 |
$7.38 |
| J1100 |
Dexamethasone sodium phos |
198 |
194 |
$0.23 |
| J2270 |
Morphine sulfate injection |
116 |
100 |
$0.00 |
| 86703 |
|
129 |
125 |
$0.00 |
| 94664 |
|
120 |
99 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
26 |
25 |
$0.00 |
| J7120 |
Ringers lactate infusion |
189 |
182 |
$0.00 |
| 87186 |
|
202 |
194 |
$0.00 |
| J2405 |
Ondansetron hcl injection |
320 |
296 |
$0.00 |
| 96360 |
|
13 |
13 |
$0.00 |
| 93976 |
|
12 |
12 |
$0.00 |
| J2550 |
Promethazine hcl injection |
65 |
58 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
127 |
123 |
$0.00 |
| 96375 |
|
214 |
195 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
64 |
56 |
$0.00 |
| 87591 |
|
169 |
167 |
$0.00 |
| 82550 |
|
23 |
15 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
337 |
324 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
15 |
15 |
$0.00 |
| 94640 |
|
108 |
81 |
$0.00 |
| 87040 |
|
46 |
27 |
$0.00 |
| J2765 |
Metoclopramide hcl injection |
12 |
12 |
$0.00 |
| J1170 |
Hydromorphone injection |
34 |
32 |
$0.00 |
| 83880 |
|
27 |
25 |
$0.00 |
| 83874 |
|
21 |
13 |
$0.00 |
| 85651 |
|
26 |
26 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
14 |
14 |
$0.00 |
| 85730 |
|
13 |
12 |
$0.00 |
| 96376 |
|
12 |
12 |
$0.00 |