| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 80307 |
|
3,961 |
3,005 |
$277K |
| 87633 |
|
1,027 |
917 |
$228K |
| 70450 |
|
2,265 |
2,023 |
$217K |
| 87426 |
|
5,889 |
5,003 |
$180K |
| 80053 |
|
10,619 |
8,803 |
$171K |
| A0425 |
Ground mileage |
3,134 |
1,918 |
$164K |
| 74177 |
|
1,168 |
1,044 |
$156K |
| 97110 |
|
2,985 |
767 |
$118K |
| 85025 |
|
15,044 |
11,949 |
$110K |
| 99283 |
|
1,915 |
1,575 |
$65K |
| 74176 |
|
916 |
816 |
$65K |
| 80048 |
|
4,511 |
3,693 |
$59K |
| A0427 |
Als1-emergency |
2,259 |
1,681 |
$54K |
| 93005 |
|
4,755 |
3,859 |
$52K |
| 87486 |
|
1,103 |
989 |
$48K |
| 87581 |
|
1,083 |
972 |
$47K |
| 71045 |
|
4,313 |
3,759 |
$40K |
| 87252 |
|
1,287 |
1,144 |
$37K |
| 71046 |
|
1,969 |
1,742 |
$36K |
| 99284 |
|
1,231 |
1,061 |
$32K |
| 77067 |
|
616 |
564 |
$31K |
| 87400 |
|
2,177 |
1,938 |
$22K |
| 84484 |
|
2,506 |
1,902 |
$22K |
| 81025 |
|
2,279 |
2,022 |
$19K |
| 99282 |
|
342 |
270 |
$19K |
| 87086 |
|
2,404 |
2,072 |
$18K |
| 87276 |
|
1,686 |
1,526 |
$17K |
| 86901 |
|
751 |
653 |
$17K |
| 83880 |
|
728 |
638 |
$17K |
| 80061 |
|
1,573 |
1,303 |
$17K |
| 87275 |
|
1,548 |
1,410 |
$17K |
| 81003 |
|
5,925 |
4,920 |
$15K |
| 96372 |
|
495 |
357 |
$14K |
| 83690 |
|
2,004 |
1,737 |
$14K |
| 83735 |
|
2,412 |
2,012 |
$13K |
| 0011A |
|
530 |
494 |
$13K |
| 82552 |
|
1,061 |
907 |
$13K |
| 36415 |
|
4,183 |
3,414 |
$12K |
| 97001 |
|
248 |
232 |
$12K |
| 81001 |
|
2,700 |
2,217 |
$10K |
| 83036 |
|
1,112 |
932 |
$10K |
| 80050 |
|
241 |
200 |
$10K |
| 83986 |
|
2,229 |
1,787 |
$9K |
| 76805 |
|
188 |
174 |
$9K |
| 87880 |
|
794 |
706 |
$9K |
| 83605 |
|
506 |
409 |
$9K |
| 87186 |
|
1,400 |
1,225 |
$9K |
| 87430 |
|
714 |
658 |
$8K |
| 99285 |
|
401 |
341 |
$8K |
| 87420 |
|
741 |
686 |
$8K |
| 87040 |
|
429 |
310 |
$8K |
| 82565 |
|
646 |
525 |
$7K |
| J2405 |
Ondansetron hcl injection |
1,907 |
1,652 |
$6K |
| 82077 |
|
381 |
319 |
$6K |
| 72125 |
|
41 |
39 |
$6K |
| M0243 |
Casirivi and imdevi inj |
30 |
27 |
$6K |
| 84443 |
|
430 |
374 |
$6K |
| J0696 |
Ceftriaxone sodium injection |
421 |
326 |
$5K |
| 86756 |
|
295 |
281 |
$5K |
| 76856 |
|
184 |
146 |
$5K |
| 87088 |
|
720 |
630 |
$5K |
| T1015 |
Clinic service |
331 |
140 |
$5K |
| 82553 |
|
531 |
458 |
$5K |
| 96365 |
|
160 |
93 |
$5K |
| 85610 |
|
1,404 |
1,097 |
$4K |
| 97530 |
|
78 |
24 |
$4K |
| 82550 |
|
682 |
569 |
$4K |
| 82948 |
|
915 |
545 |
$4K |
| J1885 |
Ketorolac tromethamine inj |
1,842 |
1,710 |
$4K |
| 71020 |
|
272 |
239 |
$4K |
| 96374 |
|
253 |
190 |
$4K |
| J1100 |
Dexamethasone sodium phos |
638 |
598 |
$3K |
| 85730 |
|
690 |
581 |
$3K |
| M0245 |
Bamlan and etesev infusion |
14 |
14 |
$3K |
| 80179 |
|
142 |
121 |
$3K |
| 71260 |
|
15 |
15 |
$3K |
| 73610 |
|
162 |
144 |
$2K |
| 86900 |
|
769 |
668 |
$2K |
| 76801 |
|
55 |
51 |
$2K |
| 73630 |
|
86 |
77 |
$2K |
| 77063 |
|
118 |
112 |
$2K |
| 84703 |
|
164 |
141 |
$2K |
| 86850 |
|
489 |
428 |
$1K |
| 76700 |
|
42 |
37 |
$1K |
| U0001 |
2019-ncov diagnostic p |
47 |
42 |
$1K |
| 71010 |
|
194 |
161 |
$1K |
| M0239 |
Bamlanivimab-xxxx infusion |
26 |
26 |
$1K |
| 0071A |
|
15 |
12 |
$1K |
| 76830 |
|
32 |
24 |
$1K |
| 73130 |
|
47 |
42 |
$1K |
| U0002 |
Covid-19 lab test non-cdc |
33 |
28 |
$923.94 |
| 0225U |
|
40 |
38 |
$835.31 |
| 97602 |
|
22 |
12 |
$812.10 |
| 84520 |
|
200 |
158 |
$681.48 |
| 82306 |
|
32 |
27 |
$675.88 |
| 0064A |
|
48 |
48 |
$501.60 |
| 82570 |
|
82 |
69 |
$487.08 |
| 82950 |
|
68 |
63 |
$470.81 |
| 84702 |
|
36 |
27 |
$369.28 |
| 73560 |
|
15 |
12 |
$350.20 |
| 96375 |
|
84 |
62 |
$347.31 |
| 82945 |
|
45 |
38 |
$294.22 |
| 73030 |
|
19 |
14 |
$284.81 |
| 87635 |
|
216 |
204 |
$274.64 |
| 82043 |
|
50 |
44 |
$273.56 |
| 74018 |
|
14 |
12 |
$255.28 |
| 0002A |
|
28 |
24 |
$221.60 |
| 94640 |
|
119 |
93 |
$211.54 |
| 0012A |
|
107 |
104 |
$181.60 |
| 84439 |
|
16 |
13 |
$165.00 |
| A0426 |
Als 1 |
15 |
13 |
$161.18 |
| S0119 |
Ondansetron 4 mg |
636 |
599 |
$149.13 |
| J2270 |
Morphine sulfate injection |
444 |
383 |
$124.81 |
| 86140 |
|
19 |
14 |
$105.46 |
| 85651 |
|
18 |
14 |
$72.35 |
| 82150 |
|
12 |
12 |
$67.32 |
| J1170 |
Hydromorphone injection |
110 |
89 |
$60.39 |
| J2250 |
Inj midazolam hydrochloride |
29 |
27 |
$48.78 |
| J2919 |
Inj, methylpred sod succ 5mg |
48 |
44 |
$45.96 |
| J2272 |
Inj, morphine (fresenius) |
45 |
42 |
$33.82 |
| J2060 |
Lorazepam injection |
26 |
24 |
$23.20 |
| J3010 |
Fentanyl citrate injection |
32 |
30 |
$19.29 |
| J7510 |
Prednisolone oral per 5 mg |
16 |
15 |
$1.12 |
| 91307 |
|
39 |
30 |
$0.28 |
| 91306 |
|
33 |
33 |
$0.04 |
| G0378 |
Hospital observation per hr |
57 |
37 |
$0.00 |
| 0001A |
|
13 |
13 |
$0.00 |
| Q0245 |
Bamlanivimab and etesevima |
21 |
12 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
12 |
12 |
$0.00 |