| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpt clinic visit |
41,454 |
38,317 |
$3.81M |
| 99284 |
|
2,761 |
2,600 |
$743K |
| 99283 |
|
4,142 |
3,930 |
$728K |
| 99285 |
|
2,153 |
1,939 |
$643K |
| C9803 |
Hopd covid-19 spec collect |
6,858 |
6,502 |
$136K |
| 96374 |
|
596 |
538 |
$74K |
| 90460 |
|
2,293 |
2,221 |
$65K |
| 90837 |
|
575 |
326 |
$56K |
| 0241U |
|
412 |
392 |
$26K |
| 0002A |
|
632 |
627 |
$18K |
| 96361 |
|
393 |
349 |
$18K |
| 85025 |
|
6,970 |
6,186 |
$17K |
| 11721 |
|
647 |
627 |
$17K |
| 96372 |
|
405 |
372 |
$17K |
| 96375 |
|
395 |
355 |
$15K |
| 87631 |
|
505 |
491 |
$15K |
| 36415 |
|
10,397 |
9,352 |
$13K |
| 94640 |
|
132 |
108 |
$13K |
| 92014 |
|
125 |
125 |
$12K |
| 0001A |
|
504 |
481 |
$11K |
| 71046 |
|
254 |
235 |
$11K |
| 90834 |
|
90 |
64 |
$10K |
| 90471 |
|
833 |
826 |
$10K |
| 80053 |
|
2,972 |
2,648 |
$9K |
| 93005 |
|
850 |
736 |
$9K |
| 80048 |
|
1,834 |
1,603 |
$7K |
| 97110 |
|
258 |
101 |
$6K |
| 90686 |
|
1,507 |
1,493 |
$4K |
| 88305 |
|
83 |
69 |
$4K |
| 84443 |
|
454 |
415 |
$4K |
| 99282 |
|
26 |
26 |
$3K |
| 99214 |
|
176 |
157 |
$3K |
| 87635 |
|
101 |
94 |
$3K |
| 87651 |
|
130 |
129 |
$3K |
| 0072A |
|
66 |
66 |
$2K |
| 74177 |
|
12 |
12 |
$2K |
| 90461 |
|
250 |
237 |
$2K |
| 83036 |
|
420 |
396 |
$2K |
| 0071A |
|
52 |
52 |
$2K |
| U0003 |
Cov-19 amp prb hgh thruput |
25 |
25 |
$2K |
| 0004A |
|
53 |
52 |
$2K |
| 92557 |
|
12 |
12 |
$1K |
| 80061 |
|
195 |
186 |
$1K |
| U0005 |
Infec agen detec ampli probe |
68 |
68 |
$1K |
| 81001 |
|
924 |
834 |
$1K |
| 97161 |
|
18 |
18 |
$1K |
| 0064A |
|
28 |
28 |
$907.22 |
| 91322 |
|
14 |
13 |
$864.02 |
| 71045 |
|
47 |
44 |
$652.97 |
| 86140 |
|
333 |
293 |
$637.73 |
| 90480 |
|
26 |
25 |
$636.24 |
| 97140 |
|
21 |
12 |
$600.23 |
| 83605 |
|
237 |
208 |
$600.00 |
| 85027 |
|
239 |
215 |
$591.29 |
| 0031A |
|
19 |
19 |
$511.09 |
| 85610 |
|
248 |
164 |
$388.57 |
| 87086 |
|
150 |
141 |
$336.43 |
| 87634 |
|
13 |
13 |
$334.77 |
| 80307 |
|
14 |
12 |
$326.93 |
| 0124A |
|
12 |
12 |
$326.24 |
| 84484 |
|
104 |
92 |
$243.49 |
| 87880 |
|
30 |
30 |
$165.37 |
| 83690 |
|
142 |
128 |
$150.27 |
| 96376 |
|
14 |
13 |
$147.89 |
| Q3014 |
Telehealth facility fee |
12 |
12 |
$113.44 |
| 81025 |
|
71 |
69 |
$104.84 |
| 87660 |
|
13 |
12 |
$104.79 |
| 87510 |
|
13 |
12 |
$103.41 |
| 87480 |
|
13 |
12 |
$99.75 |
| 87491 |
|
12 |
12 |
$88.91 |
| 87591 |
|
12 |
12 |
$88.91 |
| J7030 |
Normal saline solution infus |
422 |
358 |
$88.68 |
| J1885 |
Ketorolac tromethamine inj |
724 |
632 |
$87.13 |
| 83880 |
|
13 |
13 |
$83.80 |
| 90472 |
|
101 |
101 |
$64.85 |
| 90656 |
|
105 |
105 |
$44.22 |
| G0008 |
Admin influenza virus vac |
15 |
15 |
$42.22 |
| 82805 |
|
14 |
13 |
$39.91 |
| 81003 |
|
71 |
65 |
$37.51 |
| 82248 |
|
64 |
62 |
$20.42 |
| 87804 |
|
12 |
12 |
$7.03 |
| J1170 |
Hydromorphone injection |
31 |
25 |
$1.81 |
| 90677 |
|
116 |
114 |
$1.68 |
| J2405 |
Ondansetron hcl injection |
367 |
308 |
$0.00 |
| J7120 |
Ringers lactate infusion |
183 |
136 |
$0.00 |
| 91300 |
|
1,023 |
970 |
$0.00 |
| 90670 |
|
139 |
125 |
$0.00 |
| 0753T |
|
46 |
42 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
175 |
99 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
360 |
144 |
$0.00 |
| 91307 |
|
128 |
126 |
$0.00 |
| J3490 |
Drugs unclassified injection |
194 |
137 |
$0.00 |
| 90698 |
|
90 |
78 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
148 |
118 |
$0.00 |
| 91306 |
|
26 |
26 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
286 |
262 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
184 |
157 |
$0.00 |
| 90680 |
|
13 |
13 |
$0.00 |
| 90697 |
|
52 |
52 |
$0.00 |
| A9270 |
Non-covered item or service |
39 |
32 |
$0.00 |
| 36416 |
|
21 |
13 |
$0.00 |
| 90651 |
|
40 |
39 |
$0.00 |
| J7050 |
Normal saline solution infus |
67 |
54 |
$0.00 |
| 91303 |
|
15 |
15 |
$0.00 |