| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
5,725 |
5,596 |
$957K |
| 99284 |
|
1,789 |
1,738 |
$446K |
| 69436 |
|
629 |
628 |
$424K |
| 42820 |
|
65 |
65 |
$237K |
| 96374 |
|
1,027 |
996 |
$143K |
| 99282 |
|
994 |
990 |
$94K |
| 99281 |
|
1,377 |
1,358 |
$74K |
| 96372 |
|
575 |
552 |
$39K |
| 42830 |
|
18 |
18 |
$29K |
| 96375 |
|
570 |
548 |
$28K |
| U0003 |
Cov-19 amp prb hgh thruput |
251 |
248 |
$23K |
| 96361 |
|
453 |
444 |
$19K |
| 74177 |
|
105 |
105 |
$19K |
| 87400 |
|
1,080 |
1,075 |
$14K |
| 85025 |
|
1,986 |
1,918 |
$13K |
| 80053 |
|
1,516 |
1,462 |
$13K |
| 87430 |
|
848 |
846 |
$12K |
| 81025 |
|
1,397 |
1,363 |
$10K |
| 71045 |
|
537 |
527 |
$7K |
| 87635 |
|
143 |
142 |
$7K |
| 81001 |
|
2,058 |
1,999 |
$6K |
| 99285 |
|
13 |
13 |
$5K |
| 87086 |
|
673 |
660 |
$5K |
| 36415 |
|
526 |
515 |
$4K |
| 71046 |
|
255 |
253 |
$3K |
| 83690 |
|
319 |
312 |
$2K |
| 86756 |
|
112 |
112 |
$2K |
| 93005 |
|
223 |
215 |
$1K |
| 80048 |
|
181 |
181 |
$1K |
| 84484 |
|
48 |
43 |
$528.32 |
| 81003 |
|
282 |
280 |
$508.00 |
| 74022 |
|
13 |
13 |
$373.75 |
| 80305 |
|
27 |
27 |
$279.46 |
| A7002 |
Tubing used w suction pump |
63 |
63 |
$243.82 |
| 94640 |
|
14 |
13 |
$187.80 |
| 86850 |
|
14 |
14 |
$112.97 |
| J3010 |
Fentanyl citrate injection |
108 |
108 |
$93.89 |
| 82150 |
|
12 |
12 |
$63.36 |
| 86900 |
|
16 |
16 |
$44.24 |
| 86901 |
|
14 |
14 |
$34.58 |
| J0136 |
Inj, acetaminophen (b braun) |
14 |
14 |
$22.68 |
| 99152 |
|
111 |
100 |
$0.00 |
| J7030 |
Normal saline solution infus |
95 |
70 |
$0.00 |
| J2930 |
Methylprednisolone injection |
26 |
25 |
$0.00 |
| J7040 |
Normal saline solution infus |
14 |
14 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
444 |
434 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
49 |
49 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
27 |
27 |
$0.00 |