| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74176 |
|
1,777 |
1,356 |
$263K |
| 99284 |
|
4,757 |
3,737 |
$222K |
| 99285 |
|
5,829 |
4,221 |
$173K |
| 70450 |
|
2,289 |
1,650 |
$135K |
| 96366 |
|
3,843 |
2,628 |
$130K |
| 81003 |
|
2,703 |
1,986 |
$98K |
| 96365 |
|
4,730 |
3,502 |
$94K |
| G0378 |
Hospital observation per hr |
4,578 |
2,704 |
$71K |
| 87635 |
|
2,099 |
1,344 |
$68K |
| 80048 |
|
7,982 |
4,174 |
$67K |
| 99283 |
|
1,381 |
1,143 |
$62K |
| 82962 |
|
4,213 |
1,430 |
$45K |
| 96368 |
|
2,664 |
1,800 |
$43K |
| 80053 |
|
5,360 |
3,130 |
$30K |
| 85025 |
|
13,183 |
6,527 |
$27K |
| 84484 |
|
6,231 |
3,996 |
$23K |
| J7050 |
Normal saline solution infus |
3,024 |
1,058 |
$22K |
| U0003 |
Cov-19 amp prb hgh thruput |
2,241 |
1,471 |
$21K |
| 71045 |
|
6,557 |
4,709 |
$18K |
| 80076 |
|
2,486 |
1,747 |
$18K |
| 94640 |
|
1,607 |
646 |
$17K |
| 36415 |
|
6,672 |
3,282 |
$16K |
| 96374 |
|
1,104 |
874 |
$15K |
| 93041 |
|
6,499 |
4,516 |
$15K |
| 83690 |
|
2,442 |
1,766 |
$15K |
| 85610 |
|
3,977 |
2,775 |
$13K |
| 85730 |
|
3,964 |
2,766 |
$13K |
| 81000 |
|
1,902 |
1,384 |
$10K |
| 93306 |
|
630 |
443 |
$10K |
| 82150 |
|
1,434 |
1,009 |
$9K |
| 96372 |
|
1,578 |
1,142 |
$9K |
| 87040 |
|
2,171 |
1,561 |
$7K |
| 82550 |
|
2,061 |
1,476 |
$7K |
| 99282 |
|
151 |
116 |
$7K |
| J7030 |
Normal saline solution infus |
1,391 |
741 |
$7K |
| 83880 |
|
1,251 |
879 |
$6K |
| 87804 |
|
1,135 |
883 |
$5K |
| J1650 |
Inj enoxaparin sodium |
1,736 |
665 |
$5K |
| J2250 |
Inj midazolam hydrochloride |
513 |
362 |
$5K |
| 74177 |
|
186 |
143 |
$5K |
| 87086 |
|
1,370 |
975 |
$4K |
| 43239 |
|
282 |
196 |
$4K |
| A4216 |
Sterile water/saline, 10 ml |
1,289 |
446 |
$4K |
| 84703 |
|
1,133 |
981 |
$4K |
| 87070 |
|
354 |
259 |
$3K |
| 82803 |
|
503 |
304 |
$3K |
| 84443 |
|
1,756 |
1,197 |
$3K |
| 96375 |
|
1,046 |
797 |
$3K |
| 96361 |
|
171 |
87 |
$3K |
| 94664 |
|
370 |
214 |
$2K |
| Q0162 |
Ondansetron oral |
313 |
225 |
$2K |
| 83605 |
|
1,448 |
988 |
$2K |
| 87186 |
|
423 |
292 |
$2K |
| 93005 |
|
1,546 |
1,026 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
493 |
237 |
$1K |
| 86141 |
|
41 |
35 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
632 |
467 |
$1K |
| J2175 |
Meperidine hydrochl /100 mg |
210 |
141 |
$1K |
| 81001 |
|
1,958 |
1,485 |
$1K |
| 93970 |
|
106 |
72 |
$1K |
| 99281 |
|
31 |
25 |
$1K |
| 96367 |
|
103 |
73 |
$1K |
| J0360 |
Hydralazine hcl injection |
46 |
40 |
$993.77 |
| J2543 |
Piperacillin/tazobactam |
27 |
13 |
$739.33 |
| C9803 |
Hopd covid-19 spec collect |
96 |
62 |
$718.64 |
| 80061 |
|
616 |
418 |
$658.09 |
| 72131 |
|
65 |
45 |
$617.88 |
| U0004 |
Cov-19 test non-cdc hgh thru |
49 |
36 |
$601.82 |
| 76705 |
|
36 |
27 |
$589.81 |
| 80307 |
|
121 |
107 |
$580.40 |
| G0480 |
Drug test def 1-7 classes |
15 |
15 |
$558.15 |
| 45378 |
|
72 |
58 |
$448.36 |
| 85379 |
|
445 |
340 |
$432.86 |
| 87880 |
|
16 |
15 |
$430.33 |
| 86900 |
|
18 |
12 |
$375.97 |
| 72170 |
|
154 |
100 |
$348.90 |
| J2930 |
Methylprednisolone injection |
240 |
122 |
$313.10 |
| J2270 |
Morphine sulfate injection |
57 |
41 |
$271.94 |
| 88305 |
|
299 |
202 |
$254.07 |
| 87205 |
|
634 |
472 |
$225.03 |
| 93880 |
|
24 |
14 |
$202.98 |
| J7040 |
Normal saline solution infus |
186 |
112 |
$185.28 |
| 71250 |
|
44 |
28 |
$173.88 |
| 82607 |
|
57 |
36 |
$164.36 |
| J0735 |
Clonidine hydrochloride |
224 |
138 |
$162.53 |
| 83735 |
|
580 |
383 |
$154.70 |
| 86769 |
|
1,311 |
914 |
$133.67 |
| J1200 |
Diphenhydramine hcl injectio |
127 |
79 |
$119.83 |
| 71046 |
|
32 |
28 |
$111.70 |
| 85652 |
|
81 |
66 |
$100.51 |
| J2060 |
Lorazepam injection |
105 |
63 |
$88.43 |
| 76770 |
|
18 |
14 |
$52.38 |
| 83036 |
|
171 |
117 |
$29.27 |
| 82553 |
|
169 |
132 |
$12.36 |
| U0005 |
Infec agen detec ampli probe |
817 |
559 |
$11.88 |
| 82746 |
|
18 |
12 |
$11.86 |
| 84436 |
|
141 |
92 |
$11.86 |
| 86850 |
|
37 |
24 |
$8.86 |
| U0002 |
Covid-19 lab test non-cdc |
41 |
27 |
$7.02 |
| 82947 |
|
164 |
59 |
$3.13 |
| 87081 |
|
433 |
316 |
$2.69 |
| 82570 |
|
38 |
34 |
$1.56 |
| 83615 |
|
39 |
26 |
$0.00 |
| 88342 |
|
157 |
108 |
$0.00 |
| 80320 |
|
26 |
15 |
$0.00 |
| J0456 |
Azithromycin |
54 |
15 |
$0.00 |
| 86738 |
|
19 |
14 |
$0.00 |
| 86403 |
|
42 |
42 |
$0.00 |
| J7060 |
5% dextrose/water |
133 |
48 |
$0.00 |
| 82728 |
|
39 |
24 |
$0.00 |
| J2405 |
Ondansetron hcl injection |
232 |
184 |
$0.00 |
| 84100 |
|
51 |
25 |
$0.00 |
| 82805 |
|
19 |
12 |
$0.00 |
| 72125 |
|
51 |
36 |
$0.00 |
| 81025 |
|
146 |
143 |
$0.00 |
| J1956 |
Levofloxacin injection |
84 |
40 |
$0.00 |
| 83540 |
|
23 |
12 |
$0.00 |