| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96374 |
|
1,395 |
1,034 |
$140K |
| 96361 |
|
1,099 |
827 |
$134K |
| 80048 |
|
3,165 |
2,121 |
$120K |
| 99283 |
|
2,663 |
2,320 |
$104K |
| 36415 |
|
6,241 |
4,090 |
$95K |
| 96360 |
|
509 |
439 |
$81K |
| 99284 |
|
2,812 |
2,457 |
$75K |
| 85025 |
|
6,683 |
4,441 |
$57K |
| 99285 |
|
2,398 |
1,977 |
$51K |
| 96365 |
|
545 |
270 |
$50K |
| 82962 |
|
3,470 |
1,930 |
$48K |
| 80307 |
|
594 |
501 |
$47K |
| 97110 |
|
3,313 |
1,013 |
$45K |
| 71046 |
|
2,334 |
2,023 |
$37K |
| 96375 |
|
858 |
625 |
$36K |
| 93306 |
|
631 |
562 |
$35K |
| G0463 |
Hospital outpt clinic visit |
2,511 |
1,707 |
$29K |
| 81001 |
|
1,912 |
1,641 |
$24K |
| 80053 |
|
3,283 |
2,510 |
$23K |
| 96413 |
|
112 |
63 |
$22K |
| 82550 |
|
1,170 |
966 |
$20K |
| 70450 |
|
861 |
752 |
$19K |
| 78452 |
|
142 |
120 |
$18K |
| U0003 |
Cov-19 amp prb hgh thruput |
214 |
144 |
$16K |
| 84443 |
|
574 |
495 |
$15K |
| 84484 |
|
2,305 |
1,270 |
$13K |
| 88305 |
|
120 |
115 |
$12K |
| 83735 |
|
1,433 |
1,070 |
$11K |
| G0659 |
Drug test def simple all cl |
127 |
112 |
$10K |
| 11042 |
|
219 |
106 |
$9K |
| 83690 |
|
747 |
625 |
$9K |
| 80061 |
|
179 |
153 |
$7K |
| 74177 |
|
467 |
442 |
$7K |
| 94640 |
|
1,094 |
553 |
$6K |
| C1769 |
Guide wire |
46 |
39 |
$6K |
| 76700 |
|
204 |
198 |
$6K |
| 84703 |
|
334 |
292 |
$6K |
| 87086 |
|
1,006 |
869 |
$6K |
| 72100 |
|
169 |
163 |
$5K |
| 85610 |
|
789 |
513 |
$5K |
| G0378 |
Hospital observation per hr |
1,108 |
787 |
$4K |
| 87502 |
|
179 |
163 |
$4K |
| 86850 |
|
328 |
259 |
$4K |
| 96376 |
|
175 |
93 |
$4K |
| 97140 |
|
1,681 |
560 |
$3K |
| 87077 |
|
364 |
312 |
$3K |
| 99152 |
|
222 |
179 |
$3K |
| 83605 |
|
435 |
332 |
$3K |
| 97162 |
|
609 |
546 |
$3K |
| 85027 |
|
473 |
363 |
$3K |
| 73630 |
|
107 |
95 |
$3K |
| 82248 |
|
205 |
184 |
$3K |
| 73564 |
|
88 |
75 |
$3K |
| 95810 |
|
12 |
12 |
$3K |
| 84450 |
|
726 |
614 |
$2K |
| 72125 |
|
138 |
124 |
$2K |
| 82565 |
|
396 |
312 |
$2K |
| 83880 |
|
128 |
112 |
$2K |
| 73502 |
|
78 |
73 |
$2K |
| 74176 |
|
276 |
257 |
$2K |
| 96372 |
|
1,777 |
1,187 |
$2K |
| 97530 |
|
1,138 |
345 |
$2K |
| 71260 |
|
26 |
26 |
$2K |
| 72148 |
|
44 |
42 |
$2K |
| 82310 |
|
111 |
90 |
$2K |
| 73030 |
|
68 |
57 |
$1K |
| 70553 |
|
26 |
24 |
$1K |
| 83036 |
|
106 |
90 |
$1K |
| G0383 |
Lev 4 hosp type b ed visit |
265 |
260 |
$1K |
| 85007 |
|
201 |
155 |
$1K |
| 99282 |
|
26 |
26 |
$1K |
| 82947 |
|
190 |
146 |
$1K |
| 76770 |
|
43 |
41 |
$1K |
| 71045 |
|
105 |
87 |
$1K |
| 93017 |
|
223 |
192 |
$1K |
| 84132 |
|
232 |
177 |
$1K |
| 82374 |
|
104 |
84 |
$998.35 |
| 84295 |
|
195 |
148 |
$921.11 |
| U0005 |
Infec agen detec ampli probe |
82 |
51 |
$828.25 |
| 82435 |
|
104 |
84 |
$793.56 |
| 71250 |
|
25 |
25 |
$752.70 |
| 82728 |
|
28 |
26 |
$669.88 |
| 73610 |
|
15 |
12 |
$656.62 |
| 93971 |
|
71 |
67 |
$650.14 |
| 93005 |
|
2,542 |
1,892 |
$638.08 |
| 87070 |
|
33 |
27 |
$556.09 |
| 87186 |
|
300 |
266 |
$553.53 |
| 97116 |
|
233 |
113 |
$529.13 |
| 86900 |
|
333 |
261 |
$499.63 |
| 70551 |
|
15 |
13 |
$497.59 |
| 86901 |
|
333 |
261 |
$414.40 |
| 99153 |
Mod sedat endo service >5yrs |
71 |
66 |
$406.76 |
| G0381 |
Lev 2 hosp type b ed visit |
13 |
13 |
$343.46 |
| 86618 |
|
28 |
27 |
$297.85 |
| 81003 |
|
12 |
12 |
$280.30 |
| J3490 |
Drugs unclassified injection |
140 |
70 |
$263.71 |
| 83540 |
|
31 |
29 |
$210.22 |
| 85379 |
|
42 |
39 |
$201.94 |
| 84520 |
|
109 |
89 |
$190.47 |
| 83550 |
|
30 |
28 |
$180.00 |
| 97166 |
|
69 |
56 |
$159.42 |
| 92567 |
|
53 |
53 |
$159.37 |
| 86140 |
|
62 |
44 |
$144.17 |
| 87040 |
|
269 |
122 |
$129.69 |
| G0384 |
Lev 5 hosp type b ed visit |
40 |
30 |
$77.17 |
| 94664 |
|
32 |
29 |
$60.61 |
| 71275 |
|
16 |
12 |
$48.45 |
| 87205 |
|
12 |
12 |
$44.00 |
| J2001 |
Lidocaine injection |
493 |
420 |
$36.94 |
| J1642 |
Inj heparin sodium per 10 u |
585 |
377 |
$35.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,858 |
1,152 |
$14.02 |
| J1885 |
Ketorolac tromethamine inj |
816 |
621 |
$12.16 |
| J2405 |
Ondansetron hcl injection |
511 |
428 |
$8.30 |
| G8979 |
Mobility goal status |
621 |
546 |
$3.84 |
| G8978 |
Mobility current status |
543 |
478 |
$3.13 |
| J7120 |
Ringers lactate infusion |
528 |
449 |
$3.08 |
| J2270 |
Morphine sulfate injection |
608 |
446 |
$1.64 |
| J7512 |
Prednisone ir or dr oral 1mg |
273 |
171 |
$1.42 |
| J3010 |
Fentanyl citrate injection |
363 |
308 |
$1.00 |
| G8988 |
Self care goal status |
214 |
172 |
$0.64 |
| G8987 |
Self care current status |
195 |
156 |
$0.57 |
| G8985 |
Carry goal status |
52 |
45 |
$0.41 |
| G8980 |
Mobility d/c status |
27 |
26 |
$0.23 |
| G8984 |
Carry current status |
16 |
14 |
$0.13 |
| G8982 |
Body pos goal status |
15 |
14 |
$0.11 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
292 |
276 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
191 |
143 |
$0.00 |
| J1650 |
Inj enoxaparin sodium |
149 |
51 |
$0.00 |
| A9502 |
Tc99m tetrofosmin |
35 |
27 |
$0.00 |
| Q9954 |
Oral mr contrast, 100 ml |
55 |
43 |
$0.00 |
| 76937 |
|
13 |
12 |
$0.00 |
| G0382 |
Lev 3 hosp type b ed visit |
16 |
13 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
54 |
41 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
123 |
89 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
455 |
349 |
$0.00 |
| A9500 |
Tc99m sestamibi |
153 |
107 |
$0.00 |
| J1040 |
Methylprednisolone 80 mg inj |
95 |
73 |
$0.00 |
| J2785 |
Regadenoson injection |
109 |
91 |
$0.00 |
| J0280 |
Aminophyllin 250 mg inj |
20 |
15 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
20 |
13 |
$0.00 |
| J1170 |
Hydromorphone injection |
27 |
17 |
$0.00 |