| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S9083 |
Urgent care center global |
28,597 |
22,987 |
$4.02M |
| S9088 |
Services provided in urgent |
11,524 |
10,244 |
$1.23M |
| 99213 |
|
16,541 |
14,572 |
$464K |
| 99214 |
|
16,619 |
14,053 |
$416K |
| 99203 |
|
3,207 |
2,988 |
$95K |
| 87428 |
|
12,172 |
9,269 |
$89K |
| 99204 |
|
2,605 |
2,300 |
$83K |
| 87426 |
|
6,703 |
6,085 |
$71K |
| 99212 |
|
1,911 |
1,727 |
$33K |
| 99215 |
Prolong outpt/office vis |
257 |
227 |
$9K |
| A6449 |
Lt compres band >=3" <5"/yd |
566 |
542 |
$7K |
| 99202 |
|
523 |
483 |
$5K |
| 90471 |
|
216 |
199 |
$3K |
| 87880 |
|
12,899 |
10,710 |
$2K |
| 71046 |
|
3,359 |
2,998 |
$2K |
| A4565 |
Slings |
90 |
88 |
$2K |
| 90686 |
|
90 |
84 |
$1K |
| 87804 |
|
4,133 |
1,951 |
$882.06 |
| 99058 |
|
88 |
62 |
$880.00 |
| 81000 |
|
3,133 |
2,784 |
$823.29 |
| A4570 |
Splint |
66 |
63 |
$618.36 |
| 93000 |
|
968 |
880 |
$478.84 |
| 80047 |
|
2,492 |
2,241 |
$439.55 |
| 81002 |
|
3,172 |
2,841 |
$353.51 |
| 85025 |
|
2,706 |
2,421 |
$318.22 |
| S0119 |
Ondansetron 4 mg |
298 |
268 |
$309.18 |
| 29125 |
|
26 |
25 |
$306.74 |
| 73630 |
|
507 |
470 |
$300.87 |
| 99201 |
|
105 |
92 |
$279.91 |
| 73610 |
|
541 |
516 |
$267.57 |
| 96372 |
|
440 |
387 |
$180.19 |
| L3260 |
Ambulatory surgical boot eac |
57 |
52 |
$177.39 |
| 73140 |
|
196 |
174 |
$176.56 |
| 36415 |
|
3,069 |
2,730 |
$159.45 |
| 73564 |
|
300 |
279 |
$157.91 |
| 81025 |
|
1,795 |
1,624 |
$116.49 |
| E0114 |
Crutch underarm pair no wood |
114 |
111 |
$112.70 |
| 73110 |
|
184 |
172 |
$84.75 |
| 87210 |
|
1,045 |
953 |
$76.58 |
| 87220 |
|
1,064 |
972 |
$61.76 |
| 94640 |
|
182 |
177 |
$38.67 |
| 73130 |
|
55 |
52 |
$24.55 |
| J7510 |
Prednisolone oral per 5 mg |
48 |
43 |
$0.53 |
| J7620 |
Albuterol ipratrop non-comp |
83 |
80 |
$0.42 |
| 99070 |
|
48 |
45 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
15 |
15 |
$0.00 |
| L3908 |
Who cock-up nonmolde pre ots |
38 |
36 |
$0.00 |
| 99051 |
|
587 |
556 |
$0.00 |
| 73030 |
|
30 |
29 |
$0.00 |
| J7030 |
Normal saline solution infus |
19 |
14 |
$0.00 |
| 96360 |
|
14 |
13 |
$0.00 |