| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7140 |
|
3,984 |
1,289 |
$1.94M |
| D2930 |
|
15,218 |
2,828 |
$1.08M |
| D3220 |
|
3,119 |
1,293 |
$195K |
| 94640 |
|
1,240 |
738 |
$104K |
| D2391 |
|
1,338 |
467 |
$65K |
| D2392 |
|
765 |
275 |
$62K |
| D2330 |
|
1,765 |
657 |
$62K |
| 87426 |
|
1,648 |
1,345 |
$48K |
| D2933 |
|
331 |
178 |
$47K |
| 76642 |
|
1,016 |
796 |
$34K |
| C9803 |
Hopd covid-19 spec collect |
1,427 |
1,163 |
$22K |
| 77065 |
Tomosynthesis, mammo |
506 |
390 |
$20K |
| 77066 |
Tomosynthesis, mammo |
368 |
264 |
$15K |
| 99211 |
|
2,108 |
1,459 |
$12K |
| 77067 |
|
177 |
149 |
$12K |
| D2934 |
|
128 |
25 |
$9K |
| 88720 |
|
1,929 |
1,348 |
$9K |
| 41899 |
|
71 |
58 |
$7K |
| 86900 |
|
145 |
120 |
$6K |
| 87641 |
|
381 |
282 |
$5K |
| 85025 |
|
1,568 |
1,072 |
$5K |
| 36415 |
|
2,899 |
1,900 |
$5K |
| 86850 |
|
145 |
120 |
$3K |
| 86901 |
|
147 |
120 |
$2K |
| 84703 |
|
499 |
335 |
$2K |
| 87635 |
|
49 |
42 |
$2K |
| D1351 |
|
131 |
52 |
$1K |
| 80053 |
|
175 |
130 |
$815.62 |
| G0279 |
Tomosynthesis, mammo |
220 |
173 |
$762.53 |
| J1100 |
Dexamethasone sodium phos |
4,813 |
3,695 |
$462.13 |
| 94664 |
|
607 |
406 |
$395.77 |
| D2929 |
|
315 |
73 |
$98.25 |
| J2250 |
Inj midazolam hydrochloride |
6,089 |
4,581 |
$79.60 |
| J3010 |
Fentanyl citrate injection |
5,994 |
4,558 |
$51.28 |
| 77061 |
|
98 |
76 |
$32.67 |
| 81001 |
|
18 |
12 |
$20.00 |
| 77062 |
|
42 |
37 |
$4.13 |
| J1170 |
Hydromorphone injection |
722 |
483 |
$2.74 |
| J2405 |
Ondansetron hcl injection |
3,303 |
2,470 |
$2.53 |
| J7120 |
Ringers lactate infusion |
3,418 |
2,341 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
685 |
516 |
$0.00 |
| 77063 |
|
148 |
122 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
2,011 |
1,422 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
4,237 |
3,361 |
$0.00 |
| J7121 |
5% dextrose in lac ringers |
1,549 |
1,279 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
763 |
479 |
$0.00 |
| 94760 |
|
71 |
51 |
$0.00 |
| J3410 |
Hydroxyzine hcl injection |
69 |
51 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
94 |
67 |
$0.00 |
| G0463 |
Hospital outpt clinic visit |
17 |
12 |
$0.00 |