| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
7,056 |
6,727 |
$308K |
| 87635 |
|
2,265 |
2,160 |
$82K |
| 87502 |
|
620 |
598 |
$58K |
| 99284 |
|
1,127 |
1,066 |
$46K |
| 99282 |
|
1,257 |
1,189 |
$41K |
| 80053 |
|
3,746 |
3,487 |
$39K |
| 87633 |
|
95 |
88 |
$33K |
| 99285 |
|
656 |
616 |
$28K |
| 85025 |
|
3,586 |
3,346 |
$16K |
| 87631 |
|
109 |
109 |
$11K |
| 81001 |
|
2,323 |
2,186 |
$8K |
| 87591 |
|
149 |
148 |
$8K |
| 87491 |
|
149 |
148 |
$8K |
| 87798 |
|
166 |
88 |
$8K |
| 96375 |
|
194 |
178 |
$7K |
| 96374 |
|
312 |
287 |
$6K |
| G0463 |
Hospital outpt clinic visit |
960 |
823 |
$6K |
| 85027 |
|
751 |
676 |
$6K |
| 93005 |
|
475 |
408 |
$5K |
| 87634 |
|
71 |
68 |
$5K |
| 84443 |
|
318 |
303 |
$4K |
| 96361 |
|
134 |
121 |
$4K |
| 96372 |
|
157 |
149 |
$3K |
| 80055 |
|
42 |
40 |
$2K |
| G0378 |
Hospital observation per hr |
45 |
40 |
$2K |
| 71046 |
|
150 |
147 |
$2K |
| 71045 |
|
366 |
331 |
$2K |
| 83690 |
|
282 |
264 |
$2K |
| 70450 |
|
29 |
27 |
$2K |
| 84484 |
|
201 |
147 |
$2K |
| 87636 |
|
17 |
17 |
$2K |
| 87081 |
|
158 |
156 |
$1K |
| 87804 |
|
46 |
45 |
$1K |
| 87086 |
|
112 |
103 |
$1K |
| 80061 |
|
93 |
91 |
$1K |
| 83036 |
|
128 |
119 |
$1K |
| 87486 |
|
95 |
88 |
$979.65 |
| 87581 |
|
95 |
88 |
$979.65 |
| 83735 |
|
170 |
153 |
$908.17 |
| 80048 |
|
116 |
109 |
$833.12 |
| 81025 |
|
96 |
91 |
$806.68 |
| 80306 |
|
45 |
43 |
$768.93 |
| 87430 |
|
62 |
61 |
$741.98 |
| 86140 |
|
118 |
115 |
$710.65 |
| 94640 |
|
65 |
57 |
$668.11 |
| 80329 |
|
12 |
12 |
$616.00 |
| 87806 |
|
31 |
27 |
$507.87 |
| 0012A |
|
23 |
23 |
$492.30 |
| 84702 |
|
49 |
39 |
$471.07 |
| 80320 |
|
26 |
24 |
$457.55 |
| 85610 |
|
132 |
109 |
$444.29 |
| 36415 |
|
10,891 |
9,356 |
$418.75 |
| 99281 |
|
16 |
14 |
$414.93 |
| 0001A |
|
13 |
13 |
$408.00 |
| 0002A |
|
12 |
12 |
$406.00 |
| 82306 |
|
33 |
31 |
$356.04 |
| 87186 |
|
36 |
33 |
$324.12 |
| 84703 |
|
32 |
31 |
$290.19 |
| 86803 |
|
18 |
16 |
$284.86 |
| J1885 |
Ketorolac tromethamine inj |
144 |
128 |
$239.76 |
| 84439 |
|
17 |
15 |
$200.86 |
| 87210 |
|
29 |
27 |
$154.27 |
| 86703 |
|
25 |
25 |
$149.75 |
| 99211 |
|
18 |
17 |
$144.15 |
| 0003A |
|
12 |
12 |
$139.60 |
| 87651 |
|
12 |
12 |
$116.36 |
| 0011A |
|
16 |
16 |
$115.16 |
| 87070 |
|
12 |
12 |
$107.53 |
| 86901 |
|
14 |
13 |
$67.17 |
| J2405 |
Ondansetron hcl injection |
70 |
67 |
$38.61 |
| 85007 |
|
18 |
13 |
$26.84 |
| J3010 |
Fentanyl citrate injection |
15 |
15 |
$17.28 |
| 87340 |
|
17 |
15 |
$16.19 |
| 86762 |
|
18 |
16 |
$10.01 |
| J7030 |
Normal saline solution infus |
388 |
351 |
$7.71 |
| 91301 |
|
101 |
99 |
$0.00 |
| G0480 |
Drug test def 1-7 classes |
25 |
24 |
$0.00 |
| A9270 |
Non-covered item or service |
22 |
15 |
$0.00 |
| 91300 |
|
63 |
58 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
26 |
25 |
$0.00 |
| 90461 |
|
15 |
15 |
$0.00 |
| 90460 |
|
30 |
30 |
$0.00 |