| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 97110 |
|
6,804 |
1,623 |
$416K |
| 64721 |
|
200 |
118 |
$106K |
| 62323 |
|
211 |
137 |
$89K |
| 76000 |
|
651 |
423 |
$58K |
| 64415 |
|
463 |
307 |
$47K |
| J3490 |
Drugs unclassified injection |
7,678 |
2,402 |
$30K |
| 64450 |
|
536 |
346 |
$17K |
| 87641 |
|
507 |
420 |
$14K |
| 29881 |
|
27 |
26 |
$13K |
| 93005 |
|
642 |
550 |
$13K |
| 97161 |
|
341 |
284 |
$12K |
| 80048 |
|
734 |
613 |
$11K |
| 64483 |
|
19 |
13 |
$9K |
| 64445 |
|
51 |
37 |
$8K |
| 97162 |
|
214 |
168 |
$7K |
| 20611 |
|
23 |
14 |
$4K |
| 64447 |
|
42 |
28 |
$4K |
| 85025 |
|
514 |
449 |
$4K |
| 36415 |
|
1,192 |
969 |
$2K |
| 27096 |
|
14 |
12 |
$2K |
| 20610 |
|
18 |
13 |
$2K |
| G0378 |
Hospital observation per hr |
50 |
39 |
$2K |
| 97140 |
|
75 |
24 |
$2K |
| 85027 |
|
89 |
71 |
$865.07 |
| 97035 |
|
32 |
12 |
$732.54 |
| 86140 |
|
13 |
12 |
$254.89 |
| J1040 |
Methylprednisolone 80 mg inj |
799 |
551 |
$151.05 |
| 85651 |
|
13 |
12 |
$127.36 |
| 81001 |
|
12 |
12 |
$88.87 |
| 82948 |
|
413 |
252 |
$81.15 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
654 |
446 |
$19.54 |
| J1030 |
Methylprednisolone 40 mg inj |
40 |
27 |
$16.16 |
| 85014 |
|
18 |
14 |
$14.44 |
| 81025 |
|
425 |
255 |
$10.83 |
| 85018 |
|
18 |
14 |
$7.22 |
| J0690 |
Cefazolin sodium injection |
1,435 |
933 |
$2.28 |
| J7040 |
Normal saline solution infus |
197 |
118 |
$1.28 |
| J0171 |
Adrenalin epinephrine inject |
210 |
126 |
$0.75 |
| J1885 |
Ketorolac tromethamine inj |
1,306 |
882 |
$0.49 |
| J2250 |
Inj midazolam hydrochloride |
1,653 |
1,131 |
$0.14 |
| J2704 |
Inj, propofol, 10 mg |
2,204 |
1,241 |
$0.13 |
| J1100 |
Dexamethasone sodium phos |
1,853 |
1,266 |
$0.12 |
| J2405 |
Ondansetron hcl injection |
1,830 |
1,284 |
$0.10 |
| J2795 |
Ropivacaine hcl injection |
367 |
252 |
$0.08 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
657 |
481 |
$0.05 |
| J7120 |
Ringers lactate infusion |
970 |
668 |
$0.00 |
| J0689 |
Inj cefazolin sodium, baxter |
133 |
119 |
$0.00 |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
911 |
657 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
317 |
243 |
$0.00 |
| J1010 |
Inj, methylpred acetate 1 mg |
314 |
260 |
$0.00 |
| J2001 |
Lidocaine injection |
234 |
189 |
$0.00 |
| A4217 |
Sterile water/saline, 500 ml |
16 |
15 |
$0.00 |
| J7999 |
Compounded drug, noc |
29 |
28 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
175 |
137 |
$0.00 |
| 73560 |
|
17 |
12 |
$0.00 |