| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
7,215 |
6,920 |
$1.19M |
| 99284 |
|
5,026 |
4,837 |
$1.17M |
| 99285 |
|
1,535 |
1,468 |
$501K |
| 74176 |
|
434 |
425 |
$196K |
| 74177 |
|
291 |
290 |
$168K |
| 99282 |
|
924 |
906 |
$85K |
| 70450 |
|
275 |
273 |
$54K |
| 72125 |
|
61 |
61 |
$14K |
| 10060 |
|
41 |
39 |
$9K |
| 99291 |
|
13 |
13 |
$6K |
| 72131 |
|
16 |
16 |
$5K |
| 99281 |
|
57 |
54 |
$2K |
| 70486 |
|
13 |
13 |
$1K |
| 71250 |
|
40 |
40 |
$809.01 |
| 96361 |
|
873 |
791 |
$553.96 |
| 96374 |
|
1,827 |
1,743 |
$99.64 |
| 96372 |
|
1,211 |
1,096 |
$82.46 |
| 96375 |
|
1,388 |
1,277 |
$63.87 |
| 80053 |
|
2,547 |
2,406 |
$35.27 |
| 85025 |
|
2,629 |
2,513 |
$13.74 |
| 81025 |
|
1,535 |
1,500 |
$13.32 |
| J3490 |
Drugs unclassified injection |
534 |
490 |
$10.39 |
| J2405 |
Ondansetron hcl injection |
1,170 |
1,096 |
$9.12 |
| 82550 |
|
599 |
584 |
$8.82 |
| 80076 |
|
401 |
388 |
$7.35 |
| J7030 |
Normal saline solution infus |
1,499 |
1,395 |
$7.15 |
| 80051 |
|
599 |
584 |
$6.31 |
| 81003 |
|
3,152 |
3,033 |
$5.93 |
| J1200 |
Diphenhydramine hcl injectio |
139 |
127 |
$5.26 |
| J0696 |
Ceftriaxone sodium injection |
215 |
208 |
$4.91 |
| J2270 |
Morphine sulfate injection |
206 |
192 |
$4.46 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
347 |
347 |
$0.17 |
| 87591 |
|
196 |
194 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
1,856 |
1,794 |
$0.00 |
| 87661 |
|
168 |
125 |
$0.00 |
| 94640 |
|
410 |
374 |
$0.00 |
| 82803 |
|
222 |
210 |
$0.00 |
| 76801 |
|
103 |
101 |
$0.00 |
| 83605 |
|
238 |
210 |
$0.00 |
| 87086 |
|
265 |
261 |
$0.00 |
| J2765 |
Metoclopramide hcl injection |
53 |
52 |
$0.00 |
| 87651 |
|
1,501 |
1,413 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
599 |
589 |
$0.00 |
| 84484 |
|
370 |
356 |
$0.00 |
| 76817 |
|
42 |
42 |
$0.00 |
| 87635 |
|
136 |
136 |
$0.00 |
| J2360 |
Orphenadrine injection |
46 |
45 |
$0.00 |
| 36415 |
|
2,146 |
2,060 |
$0.00 |
| 90471 |
|
109 |
109 |
$0.00 |
| 84703 |
|
612 |
574 |
$0.00 |
| 82150 |
|
45 |
41 |
$0.00 |
| 96365 |
|
155 |
151 |
$0.00 |
| 71045 |
|
528 |
517 |
$0.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
181 |
176 |
$0.00 |
| 85379 |
|
102 |
101 |
$0.00 |
| 93971 |
|
42 |
42 |
$0.00 |
| 87428 |
|
84 |
84 |
$0.00 |
| 82962 |
|
74 |
64 |
$0.00 |
| 12001 |
|
40 |
40 |
$0.00 |
| 96366 |
|
15 |
14 |
$0.00 |
| 83880 |
|
126 |
125 |
$0.00 |
| 96376 |
|
32 |
32 |
$0.00 |
| 87480 |
|
32 |
32 |
$0.00 |
| 87510 |
|
32 |
32 |
$0.00 |
| 87077 |
|
50 |
50 |
$0.00 |
| 76830 |
|
12 |
12 |
$0.00 |
| A9270 |
Non-covered item or service |
39 |
34 |
$0.00 |
| 82947 |
|
527 |
515 |
$0.00 |
| 87491 |
|
196 |
194 |
$0.00 |
| 87634 |
|
124 |
124 |
$0.00 |
| 87502 |
|
546 |
528 |
$0.00 |
| 71046 |
|
1,066 |
1,029 |
$0.00 |
| 87631 |
|
1,045 |
1,033 |
$0.00 |
| 93005 |
|
616 |
598 |
$0.00 |
| 87420 |
|
13 |
13 |
$0.00 |
| 80306 |
|
265 |
253 |
$0.00 |
| 82565 |
|
538 |
519 |
$0.00 |
| 73130 |
|
159 |
156 |
$0.00 |
| 74018 |
|
116 |
116 |
$0.00 |
| 73110 |
|
59 |
57 |
$0.00 |
| 90715 |
|
109 |
109 |
$0.00 |
| J7120 |
Ringers lactate infusion |
114 |
114 |
$0.00 |
| 81513 |
|
41 |
40 |
$0.00 |
| 93976 |
|
61 |
60 |
$0.00 |
| 73080 |
|
46 |
45 |
$0.00 |
| J7040 |
Normal saline solution infus |
85 |
83 |
$0.00 |
| 76856 |
|
55 |
54 |
$0.00 |
| 73562 |
|
127 |
121 |
$0.00 |
| 84520 |
|
537 |
519 |
$0.00 |
| 96360 |
|
43 |
43 |
$0.00 |
| 76705 |
|
74 |
74 |
$0.00 |
| U0003 |
Cov-19 amp prb hgh thruput |
105 |
102 |
$0.00 |
| 73630 |
|
168 |
165 |
$0.00 |
| 73610 |
|
123 |
122 |
$0.00 |
| 73030 |
|
56 |
56 |
$0.00 |
| 87186 |
|
35 |
35 |
$0.00 |
| 87660 |
|
32 |
32 |
$0.00 |
| 85610 |
|
13 |
12 |
$0.00 |
| 87481 |
|
41 |
40 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
14 |
14 |
$0.00 |
| J0780 |
Prochlorperazine injection |
12 |
12 |
$0.00 |
| 84702 |
|
65 |
64 |
$0.00 |
| 72100 |
|
15 |
15 |
$0.00 |