| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
1,929 |
1,572 |
$772K |
| 99283 |
|
1,374 |
1,164 |
$470K |
| 99285 |
|
903 |
743 |
$402K |
| 85025 |
|
5,833 |
4,405 |
$251K |
| 99218 |
|
252 |
186 |
$198K |
| 80048 |
|
2,818 |
2,069 |
$191K |
| 99282 |
|
1,041 |
838 |
$171K |
| 36415 |
|
6,799 |
5,463 |
$139K |
| 80053 |
|
3,238 |
2,507 |
$115K |
| 59025 |
|
479 |
212 |
$97K |
| 93005 |
|
1,143 |
848 |
$89K |
| 84443 |
|
2,315 |
1,827 |
$88K |
| 76830 |
|
494 |
354 |
$84K |
| 96375 |
|
499 |
327 |
$80K |
| 85027 |
|
2,294 |
1,590 |
$78K |
| J2405 |
Ondansetron hcl injection |
419 |
283 |
$77K |
| 96365 |
|
494 |
293 |
$71K |
| 71046 |
|
1,446 |
1,086 |
$61K |
| 86317 |
|
1,400 |
542 |
$61K |
| 80061 |
|
2,315 |
1,864 |
$57K |
| 82306 |
|
986 |
773 |
$54K |
| 93306 |
|
179 |
116 |
$53K |
| 77067 |
|
594 |
449 |
$51K |
| 83735 |
|
790 |
563 |
$50K |
| 88305 |
|
360 |
273 |
$50K |
| 87798 |
|
634 |
290 |
$50K |
| 81001 |
|
1,431 |
1,040 |
$49K |
| 76856 |
|
262 |
214 |
$46K |
| 96374 |
|
360 |
264 |
$45K |
| 80076 |
|
984 |
757 |
$44K |
| 84484 |
|
374 |
237 |
$43K |
| G0480 |
Drug test def 1-7 classes |
351 |
191 |
$43K |
| 87086 |
|
2,041 |
1,421 |
$41K |
| 87081 |
|
1,787 |
1,300 |
$40K |
| 85610 |
|
1,218 |
676 |
$38K |
| J2250 |
Inj midazolam hydrochloride |
416 |
228 |
$35K |
| J1100 |
Dexamethasone sodium phos |
294 |
208 |
$35K |
| 76817 |
|
200 |
111 |
$33K |
| 88142 |
|
989 |
732 |
$31K |
| J1885 |
Ketorolac tromethamine inj |
395 |
241 |
$31K |
| 80306 |
|
440 |
292 |
$31K |
| 87491 |
|
767 |
577 |
$28K |
| 87591 |
|
764 |
575 |
$28K |
| 43239 |
|
59 |
43 |
$28K |
| 76700 |
|
180 |
126 |
$27K |
| 87077 |
|
877 |
657 |
$25K |
| 82728 |
|
947 |
720 |
$24K |
| J3010 |
Fentanyl citrate injection |
298 |
170 |
$24K |
| 82607 |
|
860 |
710 |
$24K |
| 74177 |
|
83 |
71 |
$23K |
| 86803 |
|
741 |
536 |
$22K |
| 81003 |
|
793 |
596 |
$21K |
| 83036 |
|
1,018 |
805 |
$21K |
| 87624 |
|
516 |
383 |
$21K |
| 99211 |
|
265 |
95 |
$20K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
226 |
179 |
$20K |
| 87186 |
|
636 |
491 |
$19K |
| 77063 |
|
452 |
417 |
$18K |
| 84450 |
|
941 |
699 |
$17K |
| 85652 |
|
923 |
712 |
$17K |
| 83550 |
|
847 |
662 |
$17K |
| 83690 |
|
299 |
211 |
$17K |
| 76805 |
|
83 |
57 |
$15K |
| 83540 |
|
877 |
690 |
$14K |
| 73630 |
|
205 |
153 |
$14K |
| 73562 |
|
118 |
90 |
$14K |
| 87088 |
|
539 |
420 |
$13K |
| 76816 |
|
99 |
48 |
$13K |
| 82565 |
|
977 |
710 |
$13K |
| 86140 |
|
680 |
540 |
$13K |
| 86703 |
|
674 |
478 |
$12K |
| 70450 |
|
93 |
81 |
$12K |
| 86901 |
|
281 |
220 |
$11K |
| 86850 |
|
286 |
226 |
$11K |
| 73610 |
|
128 |
80 |
$11K |
| 82550 |
|
237 |
184 |
$11K |
| 86900 |
|
276 |
217 |
$11K |
| 84460 |
|
772 |
557 |
$10K |
| 11042 |
|
30 |
12 |
$9K |
| 87070 |
|
193 |
127 |
$9K |
| 84439 |
|
437 |
337 |
$8K |
| 82746 |
|
374 |
293 |
$8K |
| 93017 |
|
60 |
43 |
$8K |
| 84100 |
|
65 |
50 |
$7K |
| 84520 |
|
525 |
351 |
$6K |
| 83615 |
|
184 |
154 |
$6K |
| 87653 |
|
161 |
90 |
$6K |
| 85007 |
|
124 |
103 |
$6K |
| J0690 |
Cefazolin sodium injection |
115 |
99 |
$6K |
| 80055 |
|
30 |
15 |
$5K |
| 80051 |
|
309 |
211 |
$5K |
| 87340 |
|
314 |
275 |
$5K |
| 87801 |
|
50 |
49 |
$5K |
| 76813 |
|
34 |
25 |
$4K |
| 87804 |
|
148 |
63 |
$4K |
| 72100 |
|
40 |
30 |
$4K |
| 76642 |
|
59 |
41 |
$4K |
| 82947 |
|
132 |
110 |
$4K |
| 87205 |
|
57 |
27 |
$3K |
| 85730 |
|
40 |
33 |
$3K |
| 86592 |
|
358 |
297 |
$3K |
| 84550 |
|
211 |
114 |
$3K |
| 86038 |
|
121 |
106 |
$3K |
| 71045 |
|
14 |
12 |
$3K |
| 87075 |
|
15 |
12 |
$3K |
| 82310 |
|
209 |
129 |
$3K |
| 85379 |
|
15 |
14 |
$2K |
| 97803 |
|
16 |
12 |
$2K |
| 84153 |
|
78 |
48 |
$2K |
| 84481 |
|
96 |
37 |
$2K |
| 82950 |
|
179 |
119 |
$2K |
| 87480 |
|
65 |
52 |
$2K |
| 82043 |
|
152 |
127 |
$2K |
| 84436 |
|
49 |
45 |
$2K |
| 87660 |
|
52 |
40 |
$2K |
| 87510 |
|
52 |
40 |
$2K |
| 84702 |
|
54 |
40 |
$2K |
| 96372 |
|
37 |
24 |
$1K |
| 86762 |
|
57 |
49 |
$1K |
| 82150 |
|
36 |
31 |
$1K |
| 73030 |
|
19 |
13 |
$1K |
| 82247 |
|
78 |
45 |
$1K |
| G0123 |
Screen cerv/vag thin layer |
14 |
14 |
$968.94 |
| 87661 |
|
32 |
31 |
$800.61 |
| 82570 |
|
79 |
77 |
$648.88 |
| 73502 |
|
15 |
12 |
$471.01 |
| 84075 |
|
27 |
25 |
$456.35 |
| 86706 |
|
13 |
13 |
$264.24 |
| J1200 |
Diphenhydramine hcl injectio |
14 |
14 |
$23.47 |
| P9604 |
One-way allow prorated trip |
16 |
14 |
$0.00 |