| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
4,962 |
4,411 |
$874K |
| 99284 |
|
2,697 |
2,389 |
$726K |
| 99282 |
|
5,170 |
4,648 |
$598K |
| 96374 |
|
1,835 |
1,630 |
$275K |
| G0463 |
Hospital outpt clinic visit |
1,113 |
859 |
$100K |
| 74177 |
|
429 |
401 |
$84K |
| 71046 |
|
1,616 |
1,460 |
$83K |
| 70450 |
|
721 |
648 |
$73K |
| 99285 |
|
189 |
166 |
$69K |
| 74176 |
|
327 |
293 |
$52K |
| 96365 |
|
440 |
304 |
$52K |
| 45380 |
|
95 |
79 |
$49K |
| 96375 |
|
1,097 |
985 |
$46K |
| 96361 |
|
769 |
690 |
$40K |
| 43239 |
|
82 |
71 |
$29K |
| 96360 |
|
134 |
123 |
$19K |
| 71045 |
|
473 |
406 |
$19K |
| 99281 |
|
239 |
225 |
$16K |
| 88305 |
|
687 |
498 |
$10K |
| 80307 |
|
1,801 |
969 |
$9K |
| 87591 |
|
270 |
247 |
$8K |
| 87491 |
|
267 |
245 |
$8K |
| 82947 |
|
1,923 |
1,655 |
$7K |
| 93010 |
|
2,135 |
1,676 |
$6K |
| 85025 |
|
5,472 |
4,258 |
$6K |
| 84443 |
|
856 |
777 |
$5K |
| 87070 |
|
1,910 |
1,589 |
$5K |
| 99233 |
Prolong inpt eval add15 m |
176 |
77 |
$4K |
| 80061 |
|
549 |
503 |
$4K |
| 80053 |
|
2,108 |
1,799 |
$4K |
| 87076 |
|
978 |
643 |
$4K |
| 36415 |
|
6,900 |
4,912 |
$4K |
| 88142 |
|
266 |
260 |
$4K |
| 99232 |
|
235 |
110 |
$4K |
| 80048 |
|
1,152 |
703 |
$3K |
| 99291 |
|
42 |
13 |
$3K |
| 87184 |
|
1,212 |
727 |
$3K |
| 93005 |
|
1,793 |
1,502 |
$3K |
| 82306 |
|
170 |
151 |
$2K |
| 93971 |
|
38 |
37 |
$2K |
| 87205 |
|
1,024 |
708 |
$2K |
| 87624 |
|
71 |
67 |
$2K |
| 72125 |
|
95 |
79 |
$2K |
| 73564 |
|
135 |
129 |
$2K |
| G0381 |
Lev 2 hosp type b ed visit |
81 |
76 |
$2K |
| 83036 |
|
384 |
341 |
$2K |
| 87081 |
|
1,151 |
971 |
$1K |
| 96366 |
|
19 |
12 |
$1K |
| 83540 |
|
273 |
251 |
$1K |
| 82607 |
|
167 |
145 |
$1K |
| 84436 |
|
301 |
285 |
$978.64 |
| 87086 |
|
1,226 |
1,092 |
$901.49 |
| 73610 |
|
216 |
197 |
$806.52 |
| 99223 |
Prolong inpt eval add15 m |
13 |
12 |
$639.90 |
| 84479 |
|
175 |
168 |
$579.38 |
| 84134 |
|
73 |
67 |
$570.72 |
| 87102 |
|
83 |
55 |
$553.38 |
| 88312 |
|
135 |
107 |
$538.56 |
| 83615 |
|
137 |
131 |
$524.27 |
| 83880 |
|
324 |
291 |
$455.04 |
| 83735 |
|
1,132 |
845 |
$404.10 |
| 85610 |
|
980 |
725 |
$374.76 |
| 96372 |
|
1,085 |
946 |
$367.48 |
| 73110 |
|
77 |
72 |
$353.38 |
| 82746 |
|
42 |
41 |
$351.00 |
| 73030 |
|
157 |
141 |
$315.64 |
| 99239 |
|
12 |
12 |
$293.80 |
| 81000 |
|
1,397 |
1,246 |
$261.17 |
| 70486 |
|
12 |
12 |
$249.76 |
| 87088 |
|
421 |
358 |
$248.08 |
| 74019 |
|
55 |
51 |
$241.75 |
| 82565 |
|
1,845 |
1,652 |
$189.21 |
| 84100 |
|
434 |
319 |
$178.40 |
| 99212 |
|
97 |
72 |
$176.98 |
| 81002 |
|
1,027 |
929 |
$168.56 |
| 85651 |
|
142 |
116 |
$156.45 |
| 85730 |
|
502 |
421 |
$154.71 |
| 87400 |
|
1,519 |
665 |
$152.80 |
| 73630 |
|
161 |
146 |
$143.09 |
| 86885 |
|
43 |
28 |
$139.74 |
| 73130 |
|
113 |
105 |
$136.36 |
| 80164 |
|
12 |
12 |
$113.52 |
| 84703 |
|
530 |
466 |
$93.91 |
| 84550 |
|
231 |
215 |
$92.34 |
| 82040 |
|
1,807 |
1,612 |
$87.00 |
| 83690 |
|
1,323 |
1,168 |
$72.38 |
| 84439 |
|
14 |
14 |
$60.54 |
| P9604 |
One-way allow prorated trip |
50 |
38 |
$59.76 |
| 82310 |
|
2,098 |
1,792 |
$44.09 |
| 80076 |
|
13 |
12 |
$42.22 |
| 82550 |
|
345 |
304 |
$33.91 |
| 72050 |
|
14 |
14 |
$31.93 |
| 83605 |
|
148 |
129 |
$28.38 |
| 82247 |
|
1,766 |
1,578 |
$22.31 |
| 84450 |
|
1,777 |
1,588 |
$21.18 |
| 87040 |
|
303 |
155 |
$17.78 |
| J3490 |
Drugs unclassified injection |
12,416 |
4,406 |
$17.78 |
| 84520 |
|
2,185 |
1,863 |
$16.93 |
| 84484 |
|
990 |
760 |
$9.39 |
| 73502 |
|
14 |
13 |
$8.67 |
| 90471 |
|
307 |
210 |
$6.00 |
| 84075 |
|
1,767 |
1,578 |
$5.13 |
| 82945 |
|
197 |
162 |
$3.75 |
| 84155 |
|
1,774 |
1,585 |
$1.89 |
| J1885 |
Ketorolac tromethamine inj |
1,966 |
1,685 |
$1.19 |
| J0696 |
Ceftriaxone sodium injection |
395 |
281 |
$0.46 |
| J2765 |
Metoclopramide hcl injection |
98 |
75 |
$0.23 |
| 84460 |
|
1,776 |
1,587 |
$0.16 |
| J7512 |
Prednisone ir or dr oral 1mg |
333 |
303 |
$0.00 |
| 94760 |
|
535 |
355 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
475 |
394 |
$0.00 |
| J7620 |
Albuterol ipratrop non-comp |
513 |
385 |
$0.00 |
| 85379 |
|
100 |
89 |
$0.00 |
| Q0162 |
Ondansetron oral |
102 |
87 |
$0.00 |
| J2060 |
Lorazepam injection |
542 |
375 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
381 |
302 |
$0.00 |
| 82435 |
|
2,086 |
1,778 |
$0.00 |
| 96376 |
|
140 |
129 |
$0.00 |
| 84132 |
|
2,086 |
1,778 |
$0.00 |
| G0378 |
Hospital observation per hr |
29 |
27 |
$0.00 |
| 94640 |
|
45 |
26 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
93 |
88 |
$0.00 |
| J1630 |
Haloperidol injection |
19 |
12 |
$0.00 |
| 71101 |
|
13 |
12 |
$0.00 |
| 87430 |
|
52 |
51 |
$0.00 |
| 90714 |
|
186 |
131 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
112 |
89 |
$0.00 |
| Q0144 |
Azithromycin dihydrate, oral |
14 |
14 |
$0.00 |
| J2270 |
Morphine sulfate injection |
488 |
316 |
$0.00 |
| J7030 |
Normal saline solution infus |
2,157 |
1,376 |
$0.00 |
| 82374 |
|
2,085 |
1,778 |
$0.00 |
| J2405 |
Ondansetron hcl injection |
1,427 |
1,074 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
596 |
547 |
$0.00 |
| 84295 |
|
2,085 |
1,778 |
$0.00 |
| J7120 |
Ringers lactate infusion |
353 |
290 |
$0.00 |
| 86900 |
|
100 |
69 |
$0.00 |
| J2930 |
Methylprednisolone injection |
26 |
26 |
$0.00 |
| S0164 |
Injection pantroprazole |
49 |
38 |
$0.00 |