| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
6,636 |
6,177 |
$320K |
| G0463 |
Hospital outpt clinic visit |
4,098 |
3,365 |
$122K |
| 99284 |
|
1,126 |
1,029 |
$54K |
| 85027 |
|
8,824 |
6,775 |
$48K |
| 80053 |
|
4,057 |
3,528 |
$31K |
| 87426 |
|
703 |
653 |
$22K |
| 97530 |
|
397 |
101 |
$19K |
| 11042 |
|
295 |
81 |
$17K |
| 59025 |
|
379 |
195 |
$11K |
| 87624 |
|
262 |
247 |
$9K |
| 87804 |
|
693 |
348 |
$9K |
| 96374 |
|
273 |
244 |
$7K |
| 88175 |
|
288 |
261 |
$6K |
| 87086 |
|
577 |
485 |
$6K |
| 97110 |
|
202 |
50 |
$5K |
| 87491 |
|
132 |
123 |
$5K |
| 87591 |
|
131 |
121 |
$5K |
| 87635 |
|
106 |
97 |
$4K |
| 96375 |
|
149 |
117 |
$4K |
| 93005 |
|
486 |
425 |
$4K |
| 80048 |
|
1,040 |
901 |
$3K |
| 92507 |
|
82 |
26 |
$3K |
| 96372 |
|
185 |
161 |
$3K |
| 99285 |
|
59 |
54 |
$3K |
| 71045 |
|
388 |
346 |
$3K |
| 85007 |
|
2,426 |
1,474 |
$3K |
| 87661 |
|
121 |
116 |
$3K |
| 83655 |
|
173 |
165 |
$3K |
| 81001 |
|
749 |
625 |
$2K |
| 84443 |
|
217 |
208 |
$2K |
| 76805 |
|
31 |
30 |
$2K |
| 86592 |
|
361 |
342 |
$2K |
| 74177 |
|
15 |
14 |
$2K |
| 88305 |
|
13 |
12 |
$1K |
| G0378 |
Hospital observation per hr |
14 |
13 |
$1K |
| 86885 |
|
162 |
150 |
$1K |
| 80061 |
|
142 |
140 |
$1K |
| 83036 |
|
229 |
224 |
$1K |
| 83690 |
|
164 |
153 |
$968.08 |
| 70450 |
|
15 |
15 |
$965.42 |
| 82306 |
|
73 |
72 |
$951.68 |
| 99282 |
|
25 |
25 |
$937.29 |
| 84484 |
|
113 |
91 |
$923.17 |
| 87186 |
|
109 |
99 |
$919.74 |
| 71046 |
|
102 |
100 |
$871.92 |
| 87077 |
|
113 |
102 |
$759.55 |
| 96365 |
|
13 |
12 |
$736.19 |
| 82728 |
|
50 |
50 |
$721.07 |
| 86901 |
|
162 |
150 |
$695.53 |
| 88142 |
|
38 |
38 |
$674.98 |
| 36415 |
|
3,402 |
2,300 |
$608.10 |
| 86900 |
|
161 |
150 |
$571.88 |
| 81025 |
|
54 |
53 |
$467.63 |
| 82552 |
|
45 |
32 |
$452.80 |
| 83874 |
|
44 |
32 |
$431.00 |
| J1642 |
Inj heparin sodium per 10 u |
79 |
49 |
$430.95 |
| 87389 |
|
12 |
12 |
$400.85 |
| 87070 |
|
53 |
50 |
$291.20 |
| 84702 |
|
32 |
25 |
$288.40 |
| 96361 |
|
15 |
13 |
$284.90 |
| 85610 |
|
90 |
82 |
$273.45 |
| 84439 |
|
19 |
19 |
$273.06 |
| Q3014 |
Telehealth facility fee |
24 |
18 |
$237.11 |
| 83735 |
|
48 |
41 |
$235.99 |
| 87420 |
|
17 |
17 |
$222.36 |
| 94640 |
|
25 |
12 |
$198.24 |
| 85730 |
|
49 |
48 |
$194.24 |
| 87340 |
|
12 |
12 |
$176.33 |
| J7120 |
Ringers lactate infusion |
131 |
81 |
$172.22 |
| 82247 |
|
18 |
15 |
$131.24 |
| J1885 |
Ketorolac tromethamine inj |
53 |
52 |
$119.46 |
| 83880 |
|
15 |
15 |
$116.24 |
| 86762 |
|
12 |
12 |
$108.93 |
| J0696 |
Ceftriaxone sodium injection |
48 |
42 |
$98.83 |
| 80076 |
|
28 |
27 |
$97.90 |
| A0425 |
Ground mileage |
76 |
64 |
$91.17 |
| 83605 |
|
14 |
12 |
$89.10 |
| 85379 |
|
53 |
50 |
$83.78 |
| J2405 |
Ondansetron hcl injection |
102 |
82 |
$80.43 |
| J1100 |
Dexamethasone sodium phos |
57 |
50 |
$67.22 |
| 86140 |
|
59 |
50 |
$59.95 |
| J2270 |
Morphine sulfate injection |
31 |
24 |
$57.92 |
| 85018 |
|
29 |
29 |
$49.99 |
| 82550 |
|
36 |
36 |
$37.08 |
| G0476 |
Hpv combo assay ca screen |
13 |
12 |
$35.85 |
| 85384 |
|
36 |
36 |
$30.38 |
| J7030 |
Normal saline solution infus |
198 |
140 |
$28.57 |
| 85014 |
|
16 |
16 |
$27.36 |
| 83615 |
|
36 |
36 |
$23.48 |
| J3010 |
Fentanyl citrate injection |
29 |
14 |
$12.53 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
46 |
43 |
$11.90 |
| J2001 |
Lidocaine injection |
81 |
75 |
$9.91 |
| A9270 |
Non-covered item or service |
41 |
31 |
$6.63 |
| A6402 |
Sterile gauze <= 16 sq in |
101 |
37 |
$0.52 |
| 99213 |
|
14 |
13 |
$0.00 |
| A0427 |
Als1-emergency |
17 |
12 |
$0.00 |
| C1752 |
Cath,hemodialysis,short-term |
20 |
17 |
$0.00 |
| A0429 |
Bls-emergency |
16 |
15 |
$0.00 |