| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
|
224 |
212 |
$148.80 |
| 85025 |
|
1,868 |
1,171 |
$8.09 |
| 81001 |
|
26 |
26 |
$0.00 |
| 80053 |
|
1,111 |
712 |
$0.00 |
| 87635 |
|
345 |
325 |
$0.00 |
| G0463 |
Hospital outpt clinic visit |
2,912 |
2,425 |
$0.00 |
| 0250 |
|
267 |
251 |
$0.00 |
| Q3014 |
Telehealth facility fee |
961 |
852 |
$0.00 |
| A9150 |
Misc/exper non-prescript dru |
73 |
69 |
$0.00 |
| 80048 |
|
401 |
291 |
$0.00 |
| 0301 |
|
204 |
195 |
$0.00 |
| 0636 |
|
100 |
93 |
$0.00 |
| 36415 |
|
591 |
375 |
$0.00 |
| 0305 |
|
246 |
232 |
$0.00 |
| J3490 |
Drugs unclassified injection |
164 |
76 |
$0.00 |
| 0324 |
|
39 |
39 |
$0.00 |
| U0005 |
Infec agen detec ampli probe |
381 |
352 |
$0.00 |
| 0306 |
|
76 |
74 |
$0.00 |
| 99213 |
|
130 |
39 |
$0.00 |
| 85018 |
|
14 |
13 |
$0.00 |
| 85027 |
|
41 |
38 |
$0.00 |
| 71045 |
|
72 |
55 |
$0.00 |
| 83735 |
|
91 |
53 |
$0.00 |
| 86140 |
|
12 |
12 |
$0.00 |
| 0307 |
|
12 |
12 |
$0.00 |
| 84075 |
|
14 |
14 |
$0.00 |
| Q0162 |
Ondansetron oral |
17 |
17 |
$0.00 |
| 99281 |
|
1,785 |
1,633 |
$0.00 |
| 93010 |
|
1,375 |
911 |
$0.00 |
| J7030 |
Normal saline solution infus |
470 |
247 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
42 |
41 |
$0.00 |
| 0272 |
|
261 |
226 |
$0.00 |
| J8499 |
Oral prescrip drug non chemo |
1,464 |
705 |
$0.00 |
| 99211 |
|
1,659 |
1,468 |
$0.00 |
| 93005 |
|
113 |
106 |
$0.00 |
| U0003 |
Cov-19 amp prb hgh thruput |
724 |
679 |
$0.00 |
| 0300 |
|
163 |
153 |
$0.00 |
| 71046 |
|
119 |
111 |
$0.00 |
| J2405 |
Ondansetron hcl injection |
78 |
74 |
$0.00 |
| 82947 |
|
39 |
38 |
$0.00 |
| 0730 |
|
37 |
37 |
$0.00 |
| 82565 |
|
34 |
31 |
$0.00 |
| 82247 |
|
29 |
25 |
$0.00 |
| 0121 |
|
12 |
12 |
$0.00 |
| 84100 |
|
17 |
15 |
$0.00 |
| 0302 |
|
38 |
37 |
$0.00 |
| 84460 |
|
14 |
14 |
$0.00 |
| 84450 |
|
14 |
14 |
$0.00 |