| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H0020 |
Alcohol and/or drug services |
76,892 |
8,490 |
$2.13M |
| 90853 |
|
17,991 |
2,777 |
$1.05M |
| 90832 |
|
10,931 |
7,486 |
$996K |
| 99283 |
|
5,785 |
5,478 |
$729K |
| 99284 |
|
5,856 |
5,476 |
$692K |
| 96361 |
|
2,081 |
1,932 |
$444K |
| 99285 |
|
2,868 |
2,689 |
$342K |
| 80307 |
|
10,008 |
6,484 |
$314K |
| 70450 |
|
982 |
954 |
$277K |
| 96365 |
|
1,586 |
1,455 |
$219K |
| 74177 |
|
847 |
830 |
$215K |
| U0003 |
Cov-19 amp prb hgh thruput |
2,293 |
1,994 |
$194K |
| 80053 |
|
7,681 |
6,679 |
$180K |
| 76856 |
|
369 |
360 |
$164K |
| 99213 |
|
1,460 |
982 |
$158K |
| 90791 |
|
852 |
849 |
$138K |
| 90834 |
|
1,131 |
822 |
$130K |
| 99282 |
|
1,086 |
1,049 |
$123K |
| H0004 |
Alcohol and/or drug services |
2,333 |
1,780 |
$102K |
| 99281 |
|
797 |
741 |
$99K |
| 74176 |
|
314 |
311 |
$87K |
| 97110 |
|
1,395 |
424 |
$83K |
| 96360 |
|
638 |
609 |
$79K |
| 99214 |
|
677 |
510 |
$73K |
| 99212 |
|
612 |
489 |
$65K |
| 93306 |
|
192 |
192 |
$37K |
| 87635 |
|
1,439 |
1,376 |
$35K |
| 76705 |
|
369 |
364 |
$35K |
| 71275 |
|
95 |
95 |
$29K |
| S5161 |
Emer rspns sys serv permonth |
985 |
985 |
$29K |
| 96366 |
|
172 |
166 |
$28K |
| 76801 |
|
277 |
246 |
$25K |
| 29125 |
|
127 |
124 |
$24K |
| 96372 |
|
1,878 |
1,506 |
$23K |
| 93971 |
|
188 |
184 |
$22K |
| J0131 |
Inj, acetaminophen (nos) |
857 |
798 |
$22K |
| G0378 |
Hospital observation per hr |
270 |
255 |
$21K |
| 87491 |
|
513 |
494 |
$19K |
| 99215 |
Prolong outpt/office vis |
140 |
133 |
$18K |
| 86850 |
|
505 |
488 |
$17K |
| 86901 |
|
505 |
488 |
$16K |
| 99291 |
|
116 |
113 |
$12K |
| 81003 |
|
4,791 |
3,949 |
$11K |
| 87591 |
|
513 |
494 |
$10K |
| U0004 |
Cov-19 test non-cdc hgh thru |
235 |
231 |
$10K |
| 90715 |
|
290 |
289 |
$9K |
| H0005 |
Alcohol and/or drug services |
198 |
34 |
$9K |
| 86900 |
|
510 |
489 |
$9K |
| 81025 |
|
2,682 |
2,430 |
$8K |
| 76775 |
|
91 |
89 |
$7K |
| 83880 |
|
226 |
224 |
$7K |
| 97161 |
|
73 |
73 |
$6K |
| H0002 |
Alcohol and/or drug screenin |
31 |
31 |
$5K |
| 76830 |
|
165 |
162 |
$5K |
| G0463 |
Hospital outpt clinic visit |
3,755 |
263 |
$5K |
| 88305 |
|
74 |
73 |
$5K |
| 12001 |
|
12 |
12 |
$4K |
| 76815 |
|
84 |
80 |
$4K |
| 36415 |
|
4,367 |
4,043 |
$4K |
| 0012A |
|
121 |
121 |
$4K |
| 72125 |
|
79 |
75 |
$4K |
| 0011A |
|
180 |
180 |
$3K |
| 96367 |
|
94 |
86 |
$2K |
| 97140 |
|
58 |
27 |
$2K |
| 93017 |
|
41 |
41 |
$2K |
| J1885 |
Ketorolac tromethamine inj |
1,306 |
1,219 |
$2K |
| 96374 |
|
1,665 |
1,591 |
$2K |
| 71046 |
|
1,237 |
1,204 |
$2K |
| 90837 |
|
13 |
12 |
$2K |
| 97010 |
|
92 |
43 |
$2K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
819 |
795 |
$2K |
| J7030 |
Normal saline solution infus |
1,133 |
1,026 |
$1K |
| J2704 |
Inj, propofol, 10 mg |
349 |
340 |
$1K |
| J2405 |
Ondansetron hcl injection |
1,189 |
1,069 |
$1K |
| J0690 |
Cefazolin sodium injection |
211 |
195 |
$1K |
| 86769 |
|
37 |
37 |
$1K |
| 59025 |
|
19 |
13 |
$1K |
| 71260 |
|
12 |
12 |
$1K |
| 76882 |
|
13 |
13 |
$980.04 |
| 82805 |
|
40 |
40 |
$966.87 |
| 76536 |
|
12 |
12 |
$931.38 |
| 87086 |
|
1,672 |
1,583 |
$845.27 |
| 85025 |
|
5,288 |
4,595 |
$831.40 |
| 88304 |
|
12 |
12 |
$830.40 |
| 93005 |
|
2,428 |
2,236 |
$825.10 |
| 96375 |
|
1,597 |
1,473 |
$714.71 |
| J0696 |
Ceftriaxone sodium injection |
186 |
165 |
$675.71 |
| 87798 |
|
17 |
17 |
$650.93 |
| J2250 |
Inj midazolam hydrochloride |
337 |
328 |
$640.27 |
| J1100 |
Dexamethasone sodium phos |
364 |
351 |
$639.94 |
| 81001 |
|
2,647 |
2,480 |
$548.78 |
| 80048 |
|
40 |
37 |
$542.22 |
| 71045 |
|
1,004 |
963 |
$509.67 |
| 85730 |
|
1,084 |
1,026 |
$446.90 |
| 99406 |
|
29 |
28 |
$431.07 |
| J1200 |
Diphenhydramine hcl injectio |
501 |
275 |
$373.80 |
| 85610 |
|
955 |
899 |
$367.20 |
| J2765 |
Metoclopramide hcl injection |
397 |
369 |
$355.06 |
| J3010 |
Fentanyl citrate injection |
245 |
240 |
$312.67 |
| 73630 |
|
193 |
193 |
$297.97 |
| 80361 |
|
15 |
15 |
$251.70 |
| 80299 |
|
250 |
239 |
$226.04 |
| 82948 |
|
942 |
715 |
$222.64 |
| 85027 |
|
201 |
175 |
$197.81 |
| 94761 |
|
929 |
901 |
$192.67 |
| 94640 |
|
619 |
529 |
$188.64 |
| 87070 |
|
945 |
904 |
$174.72 |
| 84484 |
|
1,540 |
1,389 |
$170.60 |
| 94729 |
|
12 |
12 |
$168.80 |
| 73562 |
|
126 |
125 |
$150.00 |
| J2060 |
Lorazepam injection |
123 |
107 |
$136.17 |
| 85379 |
|
385 |
378 |
$89.24 |
| 94760 |
|
1,256 |
1,203 |
$84.07 |
| Q0162 |
Ondansetron oral |
221 |
212 |
$83.11 |
| 83605 |
|
570 |
541 |
$81.73 |
| 83735 |
|
698 |
641 |
$77.56 |
| 73130 |
|
103 |
99 |
$70.00 |
| 90471 |
|
192 |
175 |
$65.95 |
| 80320 |
|
1,183 |
1,088 |
$56.61 |
| 84703 |
|
311 |
305 |
$50.57 |
| 80349 |
|
477 |
453 |
$45.93 |
| 87186 |
|
215 |
208 |
$45.68 |
| 72100 |
|
12 |
12 |
$45.00 |
| 73030 |
|
42 |
42 |
$42.00 |
| J1170 |
Hydromorphone injection |
27 |
25 |
$39.50 |
| 73610 |
|
98 |
96 |
$37.50 |
| 87804 |
|
698 |
691 |
$37.49 |
| 83690 |
|
1,142 |
1,075 |
$33.98 |
| 86171 |
|
696 |
689 |
$22.66 |
| J7050 |
Normal saline solution infus |
15 |
14 |
$21.26 |
| J7120 |
Ringers lactate infusion |
13 |
13 |
$20.88 |
| 87880 |
|
434 |
431 |
$15.75 |
| 96376 |
|
97 |
96 |
$14.24 |
| J7512 |
Prednisone ir or dr oral 1mg |
60 |
54 |
$13.94 |
| 84702 |
|
94 |
77 |
$12.37 |
| 83036 |
|
12 |
12 |
$10.64 |
| 85008 |
|
698 |
603 |
$6.99 |
| 85007 |
|
261 |
253 |
$2.86 |
| 87210 |
|
38 |
38 |
$0.00 |
| 73110 |
|
12 |
12 |
$0.00 |
| 73080 |
|
13 |
13 |
$0.00 |
| 86618 |
|
12 |
12 |
$0.00 |
| 85651 |
|
13 |
13 |
$0.00 |
| 87807 |
|
101 |
100 |
$0.00 |
| 87637 |
|
19 |
18 |
$0.00 |