| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 97110 |
|
4,130 |
832 |
$179K |
| 70450 |
|
1,305 |
1,099 |
$146K |
| 80053 |
|
13,542 |
10,536 |
$145K |
| 99283 |
|
3,926 |
2,061 |
$121K |
| 85025 |
|
11,697 |
8,888 |
$91K |
| 87428 |
|
1,432 |
1,270 |
$86K |
| 87631 |
|
541 |
498 |
$62K |
| 74176 |
|
663 |
554 |
$53K |
| 96361 |
|
1,111 |
610 |
$48K |
| 71045 |
|
4,325 |
3,470 |
$44K |
| 99284 |
|
3,037 |
1,442 |
$41K |
| 87426 |
|
1,388 |
1,138 |
$41K |
| U0003 |
Cov-19 amp prb hgh thruput |
2,562 |
802 |
$40K |
| 96374 |
|
810 |
684 |
$36K |
| 93005 |
|
3,445 |
2,795 |
$35K |
| 83880 |
|
1,811 |
1,452 |
$34K |
| 80061 |
|
2,768 |
2,479 |
$30K |
| 84443 |
|
2,775 |
2,426 |
$30K |
| 84484 |
|
3,009 |
2,366 |
$28K |
| 96365 |
|
319 |
253 |
$25K |
| 87804 |
|
2,574 |
1,124 |
$24K |
| U0002 |
Covid-19 lab test non-cdc |
1,190 |
709 |
$23K |
| 71046 |
|
1,222 |
1,054 |
$23K |
| 81001 |
|
6,093 |
5,068 |
$22K |
| 83605 |
|
1,771 |
1,385 |
$21K |
| 96372 |
|
596 |
423 |
$20K |
| 83036 |
|
2,715 |
2,441 |
$18K |
| 80048 |
|
3,115 |
2,471 |
$17K |
| 36415 |
|
9,134 |
6,608 |
$17K |
| 80305 |
|
1,218 |
1,033 |
$17K |
| 87086 |
|
3,120 |
2,645 |
$16K |
| 87880 |
|
1,349 |
1,185 |
$16K |
| 85027 |
|
3,870 |
3,237 |
$15K |
| 82306 |
|
488 |
427 |
$12K |
| 74177 |
|
89 |
79 |
$12K |
| 83690 |
|
1,491 |
1,175 |
$11K |
| 87081 |
|
1,173 |
1,028 |
$10K |
| 87040 |
|
1,057 |
735 |
$9K |
| 87077 |
|
1,800 |
1,525 |
$9K |
| 82607 |
|
673 |
603 |
$8K |
| 87186 |
|
1,788 |
1,510 |
$6K |
| 86756 |
|
400 |
327 |
$6K |
| 84439 |
|
476 |
421 |
$5K |
| 80050 |
|
114 |
112 |
$5K |
| 83735 |
|
1,142 |
910 |
$5K |
| 97161 |
|
57 |
52 |
$5K |
| 93306 |
|
17 |
12 |
$5K |
| 85610 |
|
1,481 |
1,067 |
$4K |
| 72148 |
|
13 |
12 |
$4K |
| 81025 |
|
493 |
411 |
$4K |
| 77067 |
|
65 |
61 |
$4K |
| 73030 |
|
136 |
97 |
$4K |
| 71020 |
|
282 |
226 |
$3K |
| 73630 |
|
138 |
112 |
$3K |
| 87400 |
|
376 |
296 |
$3K |
| 85730 |
|
542 |
454 |
$3K |
| 96375 |
|
339 |
254 |
$3K |
| 99282 |
|
81 |
53 |
$3K |
| 82728 |
|
266 |
234 |
$3K |
| 72125 |
|
28 |
26 |
$3K |
| 82150 |
|
380 |
307 |
$2K |
| J2405 |
Ondansetron hcl injection |
298 |
210 |
$2K |
| 76700 |
|
26 |
24 |
$2K |
| 87651 |
|
50 |
48 |
$2K |
| 94760 |
|
483 |
316 |
$2K |
| 83540 |
|
330 |
292 |
$2K |
| 82962 |
|
366 |
210 |
$1K |
| 82805 |
|
74 |
54 |
$1K |
| 87070 |
|
170 |
152 |
$1K |
| 83550 |
|
187 |
163 |
$1K |
| 80320 |
|
74 |
66 |
$1K |
| 71010 |
|
207 |
187 |
$1K |
| 96360 |
|
18 |
16 |
$999.91 |
| J1885 |
Ketorolac tromethamine inj |
133 |
123 |
$897.50 |
| 72100 |
|
27 |
24 |
$728.64 |
| 73610 |
|
44 |
38 |
$707.79 |
| 84703 |
|
54 |
52 |
$637.85 |
| 97150 |
|
89 |
39 |
$551.77 |
| P9612 |
Catheterize for urine spec |
13 |
12 |
$428.98 |
| 82550 |
|
52 |
43 |
$410.42 |
| A9576 |
Inj prohance multipack |
25 |
14 |
$385.76 |
| J1100 |
Dexamethasone sodium phos |
34 |
30 |
$346.86 |
| J0696 |
Ceftriaxone sodium injection |
108 |
68 |
$325.92 |
| 84145 |
|
16 |
12 |
$317.02 |
| U0005 |
Infec agen detec ampli probe |
2,143 |
634 |
$296.55 |
| 82746 |
|
13 |
13 |
$276.99 |
| 74018 |
|
13 |
12 |
$241.62 |
| 73110 |
|
18 |
15 |
$232.00 |
| 80076 |
|
63 |
58 |
$188.38 |
| 77063 |
|
12 |
12 |
$179.08 |
| 82947 |
|
87 |
79 |
$160.60 |
| 82570 |
|
27 |
24 |
$151.95 |
| 82043 |
|
14 |
12 |
$97.00 |
| 82565 |
|
15 |
13 |
$81.93 |
| T1502 |
Medication admin visit |
564 |
505 |
$62.26 |
| 99285 |
|
31 |
13 |
$53.55 |
| 96376 |
|
33 |
14 |
$49.49 |
| 81003 |
|
64 |
56 |
$41.60 |
| A9270 |
Non-covered item or service |
262 |
193 |
$21.00 |
| 94640 |
|
162 |
90 |
$12.00 |
| 93010 |
|
849 |
718 |
$6.42 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
26 |
24 |
$0.00 |
| G0008 |
Admin influenza virus vac |
30 |
28 |
$0.00 |
| 90686 |
|
12 |
12 |
$0.00 |
| G0378 |
Hospital observation per hr |
20 |
12 |
$0.00 |