| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A9552 |
F18 fdg |
137 |
137 |
$239K |
| 36415 |
|
2,879 |
2,386 |
$215K |
| 99213 |
|
2,467 |
2,262 |
$145K |
| 81025 |
|
406 |
392 |
$50K |
| 64493 |
|
398 |
386 |
$48K |
| C9803 |
Hopd covid-19 spec collect |
359 |
349 |
$43K |
| 93303 |
|
166 |
162 |
$35K |
| 99214 |
|
539 |
480 |
$24K |
| 96372 |
|
418 |
354 |
$24K |
| 80053 |
|
1,083 |
1,007 |
$18K |
| 87070 |
|
996 |
944 |
$17K |
| 96374 |
|
542 |
511 |
$15K |
| 96376 |
|
248 |
191 |
$12K |
| 87077 |
|
496 |
470 |
$11K |
| J3490 |
Drugs unclassified injection |
3,548 |
2,254 |
$11K |
| 87086 |
|
1,024 |
972 |
$9K |
| 59025 |
|
617 |
540 |
$8K |
| 87635 |
|
410 |
400 |
$4K |
| 86850 |
|
193 |
181 |
$4K |
| 81001 |
|
498 |
474 |
$3K |
| 99215 |
Prolong outpt/office vis |
46 |
39 |
$3K |
| 82570 |
|
471 |
417 |
$3K |
| 93306 |
|
13 |
13 |
$3K |
| 78815 |
|
98 |
98 |
$3K |
| 80048 |
|
544 |
466 |
$2K |
| U0003 |
Cov-19 amp prb hgh thruput |
34 |
34 |
$2K |
| 85610 |
|
72 |
64 |
$2K |
| 88305 |
|
54 |
51 |
$2K |
| 82247 |
|
91 |
67 |
$2K |
| 83993 |
|
43 |
42 |
$2K |
| 85027 |
|
1,431 |
1,350 |
$1K |
| U0005 |
Infec agen detec ampli probe |
13 |
13 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
882 |
577 |
$1K |
| G0378 |
Hospital observation per hr |
810 |
686 |
$914.86 |
| 93005 |
|
284 |
265 |
$833.79 |
| 85025 |
|
256 |
240 |
$785.77 |
| 87081 |
|
306 |
302 |
$665.16 |
| 96361 |
|
154 |
104 |
$611.95 |
| J1100 |
Dexamethasone sodium phos |
2,580 |
2,286 |
$445.36 |
| J0702 |
Betamethasone acet&sod phosp |
476 |
446 |
$210.04 |
| J0690 |
Cefazolin sodium injection |
2,834 |
1,792 |
$82.48 |
| J2795 |
Ropivacaine hcl injection |
1,019 |
978 |
$53.72 |
| J1030 |
Methylprednisolone 40 mg inj |
29 |
27 |
$48.70 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
441 |
289 |
$24.52 |
| J2405 |
Ondansetron hcl injection |
2,509 |
2,155 |
$21.53 |
| J3301 |
Triamcinolone acet inj nos |
54 |
50 |
$15.93 |
| 84156 |
|
131 |
109 |
$4.87 |
| J7120 |
Ringers lactate infusion |
2,869 |
2,646 |
$0.93 |
| J2250 |
Inj midazolam hydrochloride |
2,084 |
1,942 |
$0.42 |
| J1170 |
Hydromorphone injection |
1,953 |
1,526 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
436 |
419 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
626 |
596 |
$0.00 |
| 87205 |
|
400 |
386 |
$0.00 |
| 85018 |
|
88 |
84 |
$0.00 |
| 97162 |
|
159 |
153 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
324 |
276 |
$0.00 |
| 86901 |
|
189 |
178 |
$0.00 |
| 88307 |
|
67 |
64 |
$0.00 |
| 64494 |
|
116 |
112 |
$0.00 |
| 51798 |
|
26 |
24 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
71 |
68 |
$0.00 |
| 96375 |
|
134 |
102 |
$0.00 |
| 93320 |
|
140 |
136 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
27 |
27 |
$0.00 |
| 64483 |
|
13 |
12 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
21 |
16 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
145 |
141 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
1,707 |
1,555 |
$0.00 |
| 97530 |
|
170 |
132 |
$0.00 |
| J0735 |
Clonidine hydrochloride |
119 |
115 |
$0.00 |
| J3370 |
Vancomycin hcl injection |
105 |
102 |
$0.00 |
| 86900 |
|
189 |
178 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
86 |
34 |
$0.00 |
| 87186 |
|
364 |
343 |
$0.00 |
| C1776 |
Joint device (implantable) |
154 |
150 |
$0.00 |
| 85014 |
|
83 |
81 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
87 |
85 |
$0.00 |
| 87502 |
|
19 |
19 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
63 |
55 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
59 |
58 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
42 |
39 |
$0.00 |
| J2270 |
Morphine sulfate injection |
15 |
14 |
$0.00 |
| 82248 |
|
48 |
37 |
$0.00 |
| 93325 |
|
141 |
137 |
$0.00 |
| J7030 |
Normal saline solution infus |
117 |
108 |
$0.00 |