| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
|
9,880 |
8,273 |
$133K |
| A0429 |
Bls-emergency |
2,868 |
1,602 |
$106K |
| U0002 |
Covid-19 lab test non-cdc |
4,696 |
3,464 |
$99K |
| 80307 |
|
2,325 |
1,745 |
$81K |
| 96374 |
|
2,460 |
1,963 |
$79K |
| 74176 |
|
833 |
680 |
$64K |
| C9803 |
Hopd covid-19 spec collect |
3,375 |
2,700 |
$43K |
| 93005 |
|
4,429 |
3,529 |
$36K |
| 70450 |
|
681 |
589 |
$32K |
| 0360 |
|
3,331 |
2,234 |
$29K |
| 96375 |
|
1,265 |
986 |
$28K |
| 96372 |
|
1,928 |
1,560 |
$27K |
| 99199 |
|
438 |
397 |
$27K |
| 85025 |
|
7,577 |
5,844 |
$25K |
| 80053 |
|
5,225 |
4,197 |
$25K |
| 96361 |
|
1,568 |
1,246 |
$23K |
| 96360 |
|
796 |
655 |
$22K |
| 96365 |
|
536 |
419 |
$20K |
| 87811 |
|
742 |
705 |
$19K |
| 71045 |
|
2,714 |
2,239 |
$17K |
| J3490 |
Drugs unclassified injection |
5,560 |
3,349 |
$17K |
| J7030 |
Normal saline solution infus |
3,784 |
2,925 |
$16K |
| 45378 |
|
1,229 |
960 |
$14K |
| J2704 |
Inj, propofol, 10 mg |
5,021 |
3,818 |
$12K |
| 43239 |
|
1,714 |
1,246 |
$12K |
| 99283 |
|
1,190 |
1,045 |
$11K |
| 84484 |
|
2,166 |
1,761 |
$10K |
| J1885 |
Ketorolac tromethamine inj |
2,458 |
1,906 |
$9K |
| J2405 |
Ondansetron hcl injection |
3,005 |
2,125 |
$9K |
| 87635 |
|
703 |
518 |
$8K |
| 83690 |
|
2,531 |
2,033 |
$8K |
| J0131 |
Inj, acetaminophen (nos) |
287 |
199 |
$8K |
| 80048 |
|
2,208 |
1,732 |
$7K |
| 85730 |
|
2,526 |
2,112 |
$6K |
| 83880 |
|
352 |
311 |
$6K |
| 81025 |
|
3,088 |
2,520 |
$6K |
| 0710 |
|
2,958 |
2,489 |
$5K |
| 0241U |
|
149 |
135 |
$5K |
| J3010 |
Fentanyl citrate injection |
1,629 |
1,114 |
$5K |
| 85610 |
|
2,631 |
2,186 |
$4K |
| 81001 |
|
3,288 |
2,766 |
$4K |
| 0270 |
|
3,758 |
2,249 |
$4K |
| J1100 |
Dexamethasone sodium phos |
764 |
539 |
$3K |
| J1170 |
Hydromorphone injection |
473 |
288 |
$2K |
| 87088 |
|
680 |
574 |
$2K |
| J2001 |
Lidocaine injection |
1,360 |
973 |
$2K |
| J0690 |
Cefazolin sodium injection |
469 |
324 |
$2K |
| J2270 |
Morphine sulfate injection |
428 |
287 |
$2K |
| J2765 |
Metoclopramide hcl injection |
449 |
296 |
$2K |
| 81003 |
|
2,730 |
2,336 |
$2K |
| J2250 |
Inj midazolam hydrochloride |
511 |
338 |
$2K |
| 82150 |
|
663 |
529 |
$2K |
| 45380 |
|
626 |
430 |
$1K |
| 36415 |
|
7,200 |
5,513 |
$1K |
| 86328 |
|
77 |
54 |
$1K |
| 82550 |
|
298 |
243 |
$962.11 |
| Z7502 |
|
25 |
24 |
$899.00 |
| 83605 |
|
137 |
130 |
$886.65 |
| 87040 |
|
154 |
107 |
$694.33 |
| J0696 |
Ceftriaxone sodium injection |
157 |
117 |
$674.85 |
| 90715 |
|
20 |
13 |
$664.02 |
| 83735 |
|
264 |
208 |
$593.64 |
| 88305 |
|
125 |
109 |
$484.03 |
| 82948 |
|
290 |
216 |
$370.10 |
| 71046 |
|
28 |
27 |
$322.14 |
| 94644 |
|
16 |
13 |
$227.62 |
| 87804 |
|
46 |
42 |
$191.92 |
| 87338 |
|
25 |
25 |
$166.26 |
| 83036 |
|
31 |
30 |
$146.26 |
| 45385 |
|
43 |
36 |
$103.68 |
| 0250 |
|
276 |
154 |
$56.93 |
| 85378 |
|
13 |
12 |
$28.34 |
| 88312 |
|
16 |
14 |
$25.06 |
| 0307 |
|
45 |
36 |
$0.00 |
| 0258 |
|
52 |
33 |
$0.00 |
| 0324 |
|
18 |
17 |
$0.00 |
| 0306 |
|
126 |
90 |
$0.00 |
| 0636 |
|
77 |
39 |
$0.00 |
| 99241 |
|
30 |
30 |
$0.00 |
| 0305 |
|
91 |
50 |
$0.00 |
| 0301 |
|
120 |
51 |
$0.00 |
| G9656 |
Pt trans from anest to pacu |
1,561 |
1,518 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
1,583 |
1,539 |
$0.00 |
| 0320 |
|
15 |
13 |
$0.00 |
| 99281 |
|
24 |
12 |
$0.00 |
| 0300 |
|
13 |
13 |
$0.00 |