| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
16,795 |
13,599 |
$928K |
| 99283 |
|
18,947 |
15,774 |
$579K |
| 99282 |
|
12,947 |
10,985 |
$420K |
| 80053 |
|
21,774 |
17,441 |
$178K |
| 85025 |
|
22,432 |
17,873 |
$148K |
| 80307 |
|
1,582 |
1,134 |
$59K |
| 93005 |
|
5,280 |
4,190 |
$40K |
| 87880 |
|
2,764 |
2,452 |
$38K |
| U0003 |
Cov-19 amp prb hgh thruput |
726 |
682 |
$36K |
| 87804 |
|
4,810 |
2,457 |
$35K |
| 81003 |
|
16,863 |
13,457 |
$35K |
| 70450 |
|
521 |
430 |
$32K |
| 87070 |
|
2,902 |
2,547 |
$29K |
| 71046 |
|
1,813 |
1,555 |
$15K |
| 87635 |
|
372 |
345 |
$15K |
| 84703 |
|
2,690 |
2,174 |
$14K |
| 71045 |
|
3,387 |
2,807 |
$13K |
| 99281 |
|
365 |
305 |
$12K |
| 87086 |
|
1,252 |
981 |
$10K |
| 84484 |
|
1,796 |
1,403 |
$9K |
| 93306 |
|
170 |
126 |
$9K |
| 83690 |
|
1,391 |
1,165 |
$7K |
| 80306 |
|
645 |
496 |
$6K |
| 30140 |
|
57 |
38 |
$6K |
| 85610 |
|
2,087 |
1,712 |
$5K |
| U0005 |
Infec agen detec ampli probe |
356 |
329 |
$5K |
| 80061 |
|
390 |
347 |
$5K |
| 83036 |
|
475 |
374 |
$4K |
| 87637 |
|
34 |
32 |
$4K |
| 84443 |
|
275 |
239 |
$4K |
| G0378 |
Hospital observation per hr |
116 |
76 |
$3K |
| 11042 |
|
67 |
37 |
$3K |
| 83880 |
|
196 |
167 |
$3K |
| 85730 |
|
2,085 |
1,710 |
$3K |
| 87420 |
|
186 |
163 |
$3K |
| 87633 |
|
18 |
13 |
$2K |
| 94640 |
|
254 |
210 |
$2K |
| 74177 |
|
23 |
13 |
$2K |
| 82947 |
|
696 |
515 |
$2K |
| 85027 |
|
415 |
355 |
$2K |
| 80048 |
|
211 |
156 |
$1K |
| 69436 |
|
17 |
13 |
$1K |
| J7030 |
Normal saline solution infus |
1,699 |
1,309 |
$1K |
| 87801 |
|
48 |
38 |
$1K |
| 72125 |
|
12 |
12 |
$897.92 |
| 82607 |
|
52 |
49 |
$734.76 |
| G0463 |
Hospital outpt clinic visit |
53 |
26 |
$673.53 |
| 74176 |
|
14 |
12 |
$672.63 |
| 84439 |
|
98 |
90 |
$635.67 |
| 96374 |
|
2,167 |
1,820 |
$622.22 |
| 0241U |
|
2,457 |
2,014 |
$603.33 |
| 86803 |
|
72 |
48 |
$545.61 |
| 82746 |
|
40 |
37 |
$433.80 |
| 87798 |
|
32 |
13 |
$432.12 |
| 74022 |
|
26 |
25 |
$405.92 |
| 87389 |
|
27 |
24 |
$404.96 |
| 83735 |
|
98 |
79 |
$378.91 |
| 87581 |
|
18 |
13 |
$332.40 |
| 87486 |
|
18 |
13 |
$332.40 |
| 87653 |
|
24 |
14 |
$296.52 |
| 87210 |
|
68 |
53 |
$260.15 |
| J1885 |
Ketorolac tromethamine inj |
895 |
764 |
$252.26 |
| 82306 |
|
42 |
38 |
$251.44 |
| 96372 |
|
3,231 |
2,719 |
$180.00 |
| J7120 |
Ringers lactate infusion |
547 |
384 |
$174.15 |
| 93017 |
|
15 |
12 |
$168.36 |
| J0696 |
Ceftriaxone sodium injection |
270 |
219 |
$153.64 |
| 82553 |
|
35 |
27 |
$153.09 |
| 83605 |
|
19 |
14 |
$148.00 |
| 96375 |
|
677 |
560 |
$136.00 |
| 87040 |
|
17 |
12 |
$111.21 |
| 82550 |
|
37 |
29 |
$105.60 |
| J2930 |
Methylprednisolone injection |
32 |
26 |
$103.53 |
| 86592 |
|
31 |
26 |
$103.02 |
| J2405 |
Ondansetron hcl injection |
1,279 |
1,037 |
$70.49 |
| 87015 |
|
24 |
14 |
$60.60 |
| 86140 |
|
28 |
24 |
$58.87 |
| 82043 |
|
17 |
14 |
$40.40 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
183 |
125 |
$29.15 |
| 36415 |
|
4,076 |
2,809 |
$18.77 |
| J1100 |
Dexamethasone sodium phos |
184 |
161 |
$15.88 |
| J0702 |
Betamethasone acet&sod phosp |
51 |
46 |
$14.64 |
| J2704 |
Inj, propofol, 10 mg |
696 |
485 |
$3.50 |
| S0020 |
Injection, bupivicaine hydro |
26 |
24 |
$2.86 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
33 |
25 |
$2.49 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
15 |
14 |
$0.02 |
| 0202U |
|
1,395 |
1,256 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
14 |
13 |
$0.00 |
| Q9960 |
Hocm 200-249mg/ml iodine,1ml |
187 |
165 |
$0.00 |
| J7040 |
Normal saline solution infus |
17 |
12 |
$0.00 |
| A9270 |
Non-covered item or service |
605 |
365 |
$0.00 |
| 94760 |
|
157 |
129 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
36 |
25 |
$0.00 |
| 96365 |
|
31 |
27 |
$0.00 |