| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 43239 |
|
647 |
646 |
$283K |
| 93306 |
|
502 |
485 |
$95K |
| 80053 |
|
1,968 |
1,753 |
$37K |
| 93970 |
|
262 |
259 |
$35K |
| 71046 |
|
666 |
660 |
$21K |
| 85025 |
|
2,334 |
2,005 |
$21K |
| 88305 |
|
325 |
325 |
$19K |
| 93005 |
|
1,498 |
1,237 |
$19K |
| 85730 |
|
1,315 |
1,266 |
$14K |
| 82306 |
|
521 |
498 |
$10K |
| 85610 |
|
1,402 |
1,347 |
$10K |
| 80061 |
|
1,110 |
1,044 |
$10K |
| 84425 |
|
525 |
504 |
$9K |
| J7120 |
Ringers lactate infusion |
542 |
512 |
$8K |
| G0463 |
Hospital outpt clinic visit |
1,242 |
1,119 |
$8K |
| 82607 |
|
533 |
508 |
$6K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
278 |
214 |
$4K |
| 83735 |
|
479 |
428 |
$3K |
| 83036 |
|
324 |
324 |
$3K |
| 82728 |
|
206 |
206 |
$3K |
| 84703 |
|
129 |
129 |
$3K |
| 82390 |
|
227 |
225 |
$2K |
| 84630 |
|
237 |
235 |
$2K |
| J1644 |
Inj heparin sodium per 1000u |
433 |
302 |
$2K |
| 82746 |
|
183 |
183 |
$2K |
| 36415 |
|
923 |
820 |
$1K |
| J3010 |
Fentanyl citrate injection |
410 |
383 |
$1K |
| J7030 |
Normal saline solution infus |
335 |
306 |
$986.24 |
| J2250 |
Inj midazolam hydrochloride |
429 |
397 |
$914.36 |
| 88342 |
|
15 |
15 |
$719.03 |
| J7040 |
Normal saline solution infus |
200 |
163 |
$714.57 |
| J2704 |
Inj, propofol, 10 mg |
57 |
52 |
$494.89 |
| 80048 |
|
311 |
227 |
$392.34 |
| C1769 |
Guide wire |
85 |
77 |
$301.36 |
| J2405 |
Ondansetron hcl injection |
45 |
38 |
$194.56 |
| A9270 |
Non-covered item or service |
26 |
13 |
$194.05 |
| C1894 |
Intro/sheath, non-laser |
104 |
95 |
$121.63 |
| 82948 |
|
80 |
53 |
$32.20 |
| 80076 |
|
87 |
79 |
$18.97 |
| 84443 |
|
12 |
12 |
$0.00 |
| 84439 |
|
12 |
12 |
$0.00 |