| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
4,040 |
3,728 |
$263K |
| 99284 |
|
1,172 |
1,081 |
$183K |
| 99214 |
|
1,412 |
1,316 |
$100K |
| G0463 |
Hospital outpt clinic visit |
11,214 |
8,379 |
$81K |
| U0002 |
Covid-19 lab test non-cdc |
370 |
356 |
$20K |
| 99283 |
|
873 |
773 |
$14K |
| 99282 |
|
591 |
506 |
$14K |
| 87632 |
|
47 |
44 |
$13K |
| C9803 |
Hopd covid-19 spec collect |
659 |
627 |
$12K |
| 80053 |
|
3,953 |
3,460 |
$11K |
| 93005 |
|
1,101 |
1,026 |
$10K |
| 85025 |
|
4,232 |
3,554 |
$7K |
| 87880 |
|
135 |
128 |
$5K |
| 71045 |
|
501 |
466 |
$4K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
493 |
443 |
$3K |
| 84443 |
|
1,523 |
1,494 |
$3K |
| 74177 |
|
42 |
42 |
$2K |
| 87636 |
|
55 |
52 |
$2K |
| 87804 |
|
92 |
44 |
$2K |
| 87081 |
|
80 |
78 |
$2K |
| 96375 |
|
114 |
78 |
$2K |
| 99285 |
|
38 |
38 |
$2K |
| 80048 |
|
1,106 |
971 |
$1K |
| 81001 |
|
1,355 |
1,224 |
$1K |
| 84702 |
|
223 |
179 |
$1K |
| 99212 |
|
13 |
12 |
$940.79 |
| 87086 |
|
556 |
516 |
$817.07 |
| 82306 |
|
298 |
296 |
$717.83 |
| 96374 |
|
197 |
176 |
$687.08 |
| 85027 |
|
601 |
556 |
$668.01 |
| 83036 |
|
1,371 |
1,361 |
$587.89 |
| 70450 |
|
26 |
24 |
$508.40 |
| 0001A |
|
21 |
21 |
$471.32 |
| 83690 |
|
267 |
215 |
$466.96 |
| 98941 |
|
22 |
12 |
$446.67 |
| 0072A |
|
15 |
15 |
$437.29 |
| 80061 |
|
1,412 |
1,404 |
$431.87 |
| 83735 |
|
579 |
444 |
$401.44 |
| 84703 |
|
80 |
78 |
$391.84 |
| 0071A |
|
12 |
12 |
$354.19 |
| 84484 |
|
413 |
366 |
$341.40 |
| 0031A |
|
28 |
27 |
$330.71 |
| 0002A |
|
20 |
20 |
$324.81 |
| 90686 |
|
98 |
98 |
$285.81 |
| 81003 |
|
326 |
307 |
$259.20 |
| 85610 |
|
427 |
339 |
$233.32 |
| 84439 |
|
397 |
389 |
$193.60 |
| Q3014 |
Telehealth facility fee |
70 |
58 |
$182.07 |
| 96372 |
|
145 |
135 |
$182.04 |
| 83880 |
|
55 |
52 |
$131.92 |
| 0011A |
|
28 |
28 |
$120.00 |
| 0012A |
|
44 |
44 |
$120.00 |
| 36415 |
|
5,940 |
4,977 |
$116.97 |
| 82043 |
|
414 |
412 |
$51.45 |
| J2405 |
Ondansetron hcl injection |
309 |
249 |
$51.08 |
| 82570 |
|
500 |
494 |
$41.54 |
| 90460 |
|
29 |
29 |
$40.92 |
| J3010 |
Fentanyl citrate injection |
143 |
110 |
$33.58 |
| J1885 |
Ketorolac tromethamine inj |
157 |
93 |
$18.04 |
| 86140 |
|
25 |
25 |
$13.05 |
| 82728 |
|
14 |
14 |
$11.45 |
| 80069 |
|
73 |
54 |
$10.00 |
| 83550 |
|
13 |
13 |
$7.34 |
| 83540 |
|
14 |
14 |
$5.43 |
| J1100 |
Dexamethasone sodium phos |
39 |
24 |
$1.77 |
| G1004 |
Cdsm ndsc |
1,194 |
909 |
$0.01 |
| 0202U |
|
26 |
25 |
$0.00 |
| 90833 |
|
52 |
51 |
$0.00 |
| 90662 |
|
67 |
66 |
$0.00 |
| 96127 |
|
18 |
16 |
$0.00 |
| 82962 |
|
51 |
39 |
$0.00 |
| G0008 |
Admin influenza virus vac |
200 |
199 |
$0.00 |
| 88305 |
|
18 |
12 |
$0.00 |
| 90471 |
|
21 |
21 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
54 |
26 |
$0.00 |
| 82607 |
|
12 |
12 |
$0.00 |
| 96361 |
|
19 |
15 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
18 |
16 |
$0.00 |