| Code | Description | Claims | Beneficiaries | Total Paid |
| 87502 |
|
1,237 |
1,117 |
$97K |
| 99283 |
|
1,741 |
1,668 |
$96K |
| 99284 |
|
699 |
648 |
$70K |
| 99285 |
|
330 |
315 |
$36K |
| 99282 |
|
713 |
695 |
$30K |
| 74176 |
|
82 |
76 |
$26K |
| U0003 |
Cov-19 amp prb hgh thruput |
421 |
342 |
$26K |
| 87631 |
|
116 |
96 |
$13K |
| 71045 |
|
435 |
389 |
$13K |
| 85025 |
|
1,358 |
1,175 |
$8K |
| 87581 |
|
215 |
182 |
$5K |
| 87486 |
|
211 |
182 |
$5K |
| 80048 |
|
728 |
624 |
$5K |
| 71046 |
|
150 |
135 |
$5K |
| 36415 |
|
2,159 |
1,857 |
$4K |
| 70450 |
|
39 |
37 |
$4K |
| 93005 |
|
246 |
222 |
$4K |
| 41899 |
|
14 |
14 |
$4K |
| 87880 |
|
305 |
276 |
$4K |
| J8499 |
Oral prescrip drug non chemo |
1,914 |
1,300 |
$3K |
| 84703 |
|
542 |
471 |
$3K |
| 80053 |
|
295 |
256 |
$2K |
| 87081 |
|
294 |
268 |
$2K |
| 81001 |
|
727 |
621 |
$2K |
| 83690 |
|
342 |
298 |
$2K |
| J1885 |
Ketorolac tromethamine inj |
380 |
362 |
$1K |
| J3490 |
Drugs unclassified injection |
363 |
214 |
$971.29 |
| J1100 |
Dexamethasone sodium phos |
234 |
226 |
$890.20 |
| J0696 |
Ceftriaxone sodium injection |
78 |
76 |
$869.88 |
| J2405 |
Ondansetron hcl injection |
209 |
187 |
$864.48 |
| 80076 |
|
133 |
116 |
$851.87 |
| 83735 |
|
185 |
153 |
$735.26 |
| 70210 |
|
14 |
14 |
$728.39 |
| 87798 |
|
38 |
26 |
$666.71 |
| 74018 |
|
20 |
18 |
$626.09 |
| 80061 |
|
59 |
55 |
$615.65 |
| 83036 |
|
75 |
67 |
$535.45 |
| 80050 |
|
12 |
12 |
$474.72 |
| 86738 |
|
28 |
26 |
$354.06 |
| 94640 |
|
19 |
17 |
$301.20 |
| 87086 |
|
36 |
34 |
$231.40 |
| J2550 |
Promethazine hcl injection |
49 |
47 |
$198.75 |
| J1170 |
Hydromorphone injection |
51 |
48 |
$191.12 |
| 86780 |
|
13 |
13 |
$182.04 |
| 84484 |
|
14 |
12 |
$131.07 |
| 86701 |
|
12 |
12 |
$109.12 |
| 81003 |
|
30 |
26 |
$65.49 |
| J3010 |
Fentanyl citrate injection |
13 |
13 |
$57.57 |
| 87635 |
|
12 |
12 |
$51.31 |
| 96372 |
|
14 |
14 |
$18.92 |
| J2704 |
Inj, propofol, 10 mg |
29 |
28 |
$4.43 |
| G0463 |
Hospital outpt clinic visit |
73 |
44 |
$0.00 |
| 87633 |
|
215 |
182 |
$0.00 |