| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
8,887 |
8,026 |
$2.98M |
| 99283 |
|
12,005 |
10,637 |
$2.54M |
| 76816 |
|
15,994 |
13,437 |
$2.15M |
| 99282 |
|
15,867 |
14,380 |
$1.96M |
| 76819 |
|
11,099 |
9,184 |
$1.95M |
| 99213 |
|
57,203 |
50,465 |
$1.88M |
| 76811 |
|
6,680 |
5,799 |
$1.78M |
| 87491 |
|
39,336 |
35,596 |
$1.26M |
| 87591 |
|
39,361 |
35,532 |
$1.26M |
| J1050 |
Medroxyprogesterone acetate |
8,137 |
6,605 |
$900K |
| 87661 |
|
28,469 |
25,141 |
$869K |
| 76817 |
|
5,131 |
4,347 |
$708K |
| 99212 |
|
21,918 |
19,417 |
$629K |
| 76805 |
|
3,374 |
3,049 |
$592K |
| J7307 |
Etonogestrel implant system |
934 |
674 |
$564K |
| 59025 |
|
4,009 |
3,204 |
$529K |
| 88175 |
|
24,571 |
22,282 |
$515K |
| 80081 |
|
5,569 |
5,096 |
$374K |
| 19318 |
|
704 |
578 |
$346K |
| 87389 |
|
14,531 |
13,083 |
$299K |
| 85025 |
|
48,244 |
39,777 |
$299K |
| 76830 |
|
1,299 |
1,229 |
$259K |
| 99211 |
|
8,879 |
7,840 |
$258K |
| J7298 |
Mirena, 52 mg |
438 |
313 |
$248K |
| 87624 |
|
7,310 |
6,524 |
$221K |
| 99214 |
|
4,432 |
4,064 |
$215K |
| 81025 |
|
30,064 |
26,471 |
$189K |
| 77067 |
|
1,454 |
1,365 |
$146K |
| 80306 |
|
9,468 |
8,476 |
$141K |
| 76857 |
|
1,263 |
1,157 |
$138K |
| 86703 |
|
11,731 |
10,932 |
$123K |
| 87086 |
|
17,992 |
16,014 |
$118K |
| 87653 |
|
3,417 |
3,213 |
$116K |
| 99285 |
|
236 |
204 |
$115K |
| 96413 |
|
826 |
445 |
$103K |
| 80053 |
|
12,131 |
9,400 |
$98K |
| 84702 |
|
7,558 |
6,320 |
$97K |
| 82306 |
|
3,473 |
3,036 |
$86K |
| 77066 |
Tomosynthesis, mammo |
825 |
711 |
$77K |
| 87660 |
|
4,834 |
3,793 |
$77K |
| 87480 |
|
4,580 |
3,586 |
$74K |
| 87510 |
|
4,582 |
3,586 |
$73K |
| 76642 |
|
522 |
492 |
$69K |
| 86592 |
|
16,202 |
15,088 |
$66K |
| 96374 |
|
1,035 |
881 |
$64K |
| 81000 |
|
20,702 |
18,155 |
$62K |
| 99203 |
|
2,069 |
1,805 |
$58K |
| 80055 |
|
2,612 |
2,365 |
$51K |
| 90715 |
|
1,911 |
1,744 |
$50K |
| 76801 |
|
311 |
302 |
$46K |
| T2101 |
Breast milk proc/store/dist |
2,287 |
31 |
$39K |
| 88305 |
|
2,209 |
1,651 |
$38K |
| 96375 |
|
401 |
206 |
$35K |
| 96372 |
|
4,048 |
3,357 |
$33K |
| 77063 |
|
1,421 |
1,332 |
$33K |
| 86803 |
|
2,233 |
1,937 |
$26K |
| 82950 |
|
5,834 |
5,514 |
$26K |
| 87210 |
|
6,666 |
5,899 |
$25K |
| 99281 |
|
507 |
457 |
$25K |
| 85660 |
|
4,800 |
4,270 |
$23K |
| 83036 |
|
2,848 |
2,496 |
$23K |
| 99204 |
|
451 |
406 |
$21K |
| 81002 |
|
7,504 |
5,687 |
$18K |
| 86300 |
|
923 |
824 |
$16K |
| J2405 |
Ondansetron hcl injection |
2,245 |
1,402 |
$14K |
| 82378 |
|
880 |
784 |
$14K |
| 76820 |
|
118 |
90 |
$14K |
| 82951 |
|
1,065 |
1,005 |
$13K |
| 84443 |
|
856 |
758 |
$13K |
| 71046 |
|
219 |
178 |
$12K |
| 87340 |
|
1,104 |
1,014 |
$11K |
| 87070 |
|
1,500 |
1,289 |
$11K |
| 90686 |
|
706 |
670 |
$10K |
| 77062 |
|
563 |
468 |
$10K |
| 36415 |
|
2,959 |
2,379 |
$9K |
| 82947 |
|
1,928 |
1,748 |
$8K |
| 90651 |
|
36 |
36 |
$7K |
| 83615 |
|
1,336 |
1,160 |
$7K |
| J3490 |
Drugs unclassified injection |
3,398 |
677 |
$6K |
| 87205 |
|
1,613 |
1,437 |
$6K |
| 82677 |
|
265 |
252 |
$6K |
| 0202U |
|
14 |
14 |
$6K |
| 76815 |
|
42 |
40 |
$6K |
| J1885 |
Ketorolac tromethamine inj |
1,158 |
1,041 |
$6K |
| 81001 |
|
2,293 |
2,089 |
$6K |
| J2469 |
Palonosetron hcl |
56 |
27 |
$5K |
| 81003 |
|
4,628 |
3,853 |
$5K |
| G0378 |
Hospital observation per hr |
16 |
12 |
$5K |
| 99395 |
|
330 |
221 |
$5K |
| 0241U |
|
48 |
48 |
$4K |
| 82105 |
|
278 |
264 |
$4K |
| 86336 |
|
278 |
264 |
$4K |
| 99396 |
|
234 |
160 |
$4K |
| 85044 |
|
980 |
899 |
$4K |
| 96417 |
|
51 |
39 |
$3K |
| 87635 |
|
158 |
129 |
$3K |
| Q0162 |
Ondansetron oral |
162 |
137 |
$3K |
| J7120 |
Ringers lactate infusion |
261 |
194 |
$3K |
| 80061 |
|
249 |
214 |
$3K |
| 86850 |
|
1,512 |
1,021 |
$3K |
| 82962 |
|
675 |
541 |
$2K |
| 86780 |
|
234 |
202 |
$2K |
| V5266 |
Battery for hearing device |
328 |
188 |
$2K |
| 86704 |
|
193 |
167 |
$2K |
| 84460 |
|
484 |
403 |
$2K |
| 84450 |
|
484 |
403 |
$2K |
| 84439 |
|
230 |
215 |
$2K |
| 90471 |
|
1,134 |
883 |
$2K |
| 82565 |
|
431 |
360 |
$2K |
| 93005 |
|
26 |
24 |
$2K |
| 86706 |
|
167 |
154 |
$2K |
| J2704 |
Inj, propofol, 10 mg |
1,466 |
1,004 |
$2K |
| 84550 |
|
470 |
387 |
$2K |
| 84146 |
|
92 |
87 |
$2K |
| 86900 |
|
1,743 |
1,194 |
$2K |
| 86901 |
|
1,684 |
1,152 |
$1K |
| J1100 |
Dexamethasone sodium phos |
589 |
431 |
$1K |
| 99385 |
|
101 |
63 |
$1K |
| J7050 |
Normal saline solution infus |
456 |
38 |
$1K |
| 84520 |
|
446 |
360 |
$1K |
| 81005 |
|
797 |
608 |
$1K |
| 99215 |
Prolong outpt/office vis |
24 |
22 |
$1K |
| 82570 |
|
330 |
278 |
$1K |
| 71045 |
|
12 |
12 |
$1K |
| 90656 |
|
122 |
110 |
$1K |
| 94762 |
|
191 |
125 |
$991.65 |
| 99202 |
|
26 |
26 |
$857.90 |
| 84156 |
|
346 |
291 |
$803.65 |
| 00402 |
|
396 |
339 |
$780.84 |
| J3010 |
Fentanyl citrate injection |
2,297 |
1,049 |
$747.17 |
| V5264 |
Ear mold/insert |
23 |
13 |
$521.97 |
| 96361 |
|
13 |
12 |
$473.05 |
| 85027 |
|
375 |
329 |
$463.29 |
| 88142 |
|
58 |
34 |
$402.87 |
| 86304 |
|
34 |
25 |
$378.74 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
13 |
12 |
$335.09 |
| 0002A |
|
17 |
14 |
$293.37 |
| J0696 |
Ceftriaxone sodium injection |
17 |
14 |
$259.72 |
| 83690 |
|
44 |
39 |
$256.29 |
| 86705 |
|
16 |
16 |
$213.15 |
| 80048 |
|
48 |
39 |
$178.08 |
| 84134 |
|
27 |
25 |
$166.32 |
| J0131 |
Inj, acetaminophen (nos) |
152 |
131 |
$164.87 |
| 0001A |
|
18 |
18 |
$160.00 |
| 82607 |
|
19 |
12 |
$146.40 |
| 82746 |
|
19 |
12 |
$142.76 |
| A9585 |
Gadobutrol injection |
62 |
29 |
$141.45 |
| 82952 |
|
37 |
36 |
$137.20 |
| P9612 |
Catheterize for urine spec |
56 |
50 |
$114.92 |
| J2710 |
Neostigmine methylslfte inj |
150 |
110 |
$114.40 |
| J2001 |
Lidocaine injection |
779 |
403 |
$78.09 |
| 82248 |
|
13 |
13 |
$58.08 |
| 82247 |
|
13 |
13 |
$58.08 |
| J0690 |
Cefazolin sodium injection |
628 |
480 |
$53.85 |
| J2550 |
Promethazine hcl injection |
15 |
14 |
$49.38 |
| J2250 |
Inj midazolam hydrochloride |
184 |
121 |
$47.46 |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
557 |
471 |
$40.61 |
| A4600 |
Sleeve, inter limb comp dev |
79 |
52 |
$32.81 |
| 90472 |
|
39 |
28 |
$26.62 |
| A9150 |
Misc/exper non-prescript dru |
135 |
112 |
$24.71 |
| J0330 |
Succinycholine chloride inj |
136 |
86 |
$0.00 |
| S0020 |
Injection, bupivicaine hydro |
13 |
12 |
$0.00 |
| J1170 |
Hydromorphone injection |
16 |
12 |
$0.00 |
| 91300 |
|
37 |
32 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
136 |
98 |
$0.00 |
| A4216 |
Sterile water/saline, 10 ml |
49 |
42 |
$0.00 |
| 94770 |
|
26 |
13 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
28 |
26 |
$0.00 |
| 00400 |
|
15 |
12 |
$0.00 |