| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 41899 |
|
685 |
640 |
$1.92M |
| 99282 |
|
6,813 |
5,911 |
$901K |
| 36415 |
|
18,570 |
15,341 |
$381K |
| 99283 |
|
2,684 |
2,271 |
$366K |
| A0427 |
Als1-emergency |
805 |
674 |
$357K |
| A0425 |
Ground mileage |
1,373 |
1,066 |
$322K |
| 80053 |
|
4,555 |
4,169 |
$203K |
| 99284 |
|
813 |
711 |
$178K |
| 0241U |
|
2,509 |
2,412 |
$173K |
| A0080 |
Noninterest escort in non er |
4,035 |
665 |
$153K |
| 85025 |
|
4,544 |
4,161 |
$110K |
| U0002 |
Covid-19 lab test non-cdc |
2,183 |
1,804 |
$100K |
| U0003 |
Cov-19 amp prb hgh thruput |
1,819 |
1,618 |
$91K |
| A0100 |
Nonemergency transport taxi |
4,410 |
759 |
$80K |
| S0215 |
Nonemerg transp mileage |
2,014 |
552 |
$62K |
| 87651 |
|
1,687 |
1,651 |
$52K |
| 00170 |
|
232 |
212 |
$46K |
| 85027 |
|
1,767 |
1,590 |
$38K |
| 64483 |
|
42 |
25 |
$36K |
| S0209 |
Wc van mileage per mi |
835 |
231 |
$34K |
| J3490 |
Drugs unclassified injection |
1,732 |
920 |
$31K |
| C9803 |
Hopd covid-19 spec collect |
2,426 |
1,981 |
$29K |
| T2003 |
N-et; encounter/trip |
1,920 |
525 |
$26K |
| 86140 |
|
1,139 |
1,067 |
$24K |
| J2401 |
Chloroprocaine hcl injection |
734 |
478 |
$21K |
| M0243 |
Casirivi and imdevi inj |
66 |
65 |
$17K |
| A0130 |
Noner transport wheelch van |
875 |
243 |
$17K |
| J2400 |
Chloroprocaine hcl injection |
396 |
346 |
$14K |
| 80048 |
|
457 |
417 |
$14K |
| 97110 |
|
154 |
50 |
$14K |
| 97530 |
|
174 |
63 |
$13K |
| 87635 |
|
227 |
82 |
$13K |
| D1110 |
|
295 |
282 |
$12K |
| J1100 |
Dexamethasone sodium phos |
316 |
277 |
$11K |
| 84443 |
|
375 |
357 |
$10K |
| J2704 |
Inj, propofol, 10 mg |
274 |
169 |
$9K |
| J3010 |
Fentanyl citrate injection |
276 |
252 |
$9K |
| 97112 |
|
134 |
53 |
$9K |
| J7030 |
Normal saline solution infus |
377 |
319 |
$8K |
| D1206 |
|
336 |
322 |
$7K |
| 96374 |
|
149 |
139 |
$7K |
| J1885 |
Ketorolac tromethamine inj |
190 |
176 |
$7K |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
314 |
193 |
$7K |
| 87804 |
|
285 |
264 |
$6K |
| 99281 |
|
57 |
54 |
$6K |
| 82306 |
|
127 |
118 |
$6K |
| D9420 |
|
470 |
449 |
$5K |
| 87502 |
|
87 |
81 |
$5K |
| 87480 |
|
422 |
397 |
$5K |
| 87510 |
|
422 |
397 |
$5K |
| D0140 |
|
279 |
274 |
$5K |
| 87880 |
|
184 |
177 |
$5K |
| 81001 |
|
754 |
710 |
$5K |
| 87660 |
|
422 |
397 |
$5K |
| 84439 |
|
170 |
163 |
$4K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
102 |
78 |
$4K |
| M0245 |
Bamlan and etesev infusion |
13 |
13 |
$4K |
| 87086 |
|
194 |
188 |
$3K |
| D1330 |
|
307 |
292 |
$3K |
| 83036 |
|
134 |
132 |
$3K |
| J7120 |
Ringers lactate infusion |
126 |
123 |
$3K |
| 97140 |
|
45 |
19 |
$3K |
| 83655 |
|
99 |
97 |
$3K |
| 85652 |
|
158 |
148 |
$3K |
| 99285 |
|
12 |
12 |
$3K |
| 71046 |
|
27 |
27 |
$3K |
| 83930 |
|
65 |
62 |
$2K |
| 93005 |
|
43 |
41 |
$2K |
| 82728 |
|
39 |
38 |
$2K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
84 |
60 |
$2K |
| 86850 |
|
84 |
40 |
$2K |
| 96372 |
|
43 |
41 |
$2K |
| 73630 |
|
16 |
12 |
$2K |
| J2405 |
Ondansetron hcl injection |
56 |
50 |
$2K |
| 81003 |
|
145 |
130 |
$2K |
| J3301 |
Triamcinolone acet inj nos |
40 |
38 |
$2K |
| 85018 |
|
73 |
72 |
$1K |
| 87491 |
|
41 |
38 |
$1K |
| 87591 |
|
41 |
38 |
$1K |
| 87088 |
|
40 |
39 |
$1K |
| 80061 |
|
45 |
44 |
$1K |
| J7040 |
Normal saline solution infus |
56 |
40 |
$1K |
| D2391 |
|
31 |
13 |
$1K |
| 73620 |
|
15 |
12 |
$1K |
| J0136 |
Inj, acetaminophen (b braun) |
27 |
25 |
$948.79 |
| D0120 |
|
41 |
37 |
$793.28 |
| 87081 |
|
29 |
27 |
$774.58 |
| 80076 |
|
12 |
12 |
$583.56 |
| J0134 |
Inj acetaminophen -fresenius |
17 |
13 |
$552.15 |
| 85651 |
|
28 |
28 |
$534.36 |
| 87186 |
|
17 |
17 |
$476.61 |
| 81025 |
|
18 |
17 |
$450.00 |
| 90682 |
|
24 |
24 |
$438.33 |
| 83540 |
|
12 |
12 |
$290.30 |
| D9920 |
|
389 |
340 |
$108.34 |
| U0005 |
Infec agen detec ampli probe |
16 |
16 |
$31.68 |
| A9270 |
Non-covered item or service |
46 |
12 |
$12.50 |
| Q0244 |
Casirivi and imdevi 1200 mg |
16 |
16 |
$0.37 |
| 99188 |
|
12 |
12 |
$0.01 |
| 90460 |
|
27 |
27 |
$0.00 |
| 99391 |
|
12 |
12 |
$0.00 |
| 90461 |
|
12 |
12 |
$0.00 |
| 96127 |
|
27 |
27 |
$0.00 |
| S0302 |
Completed epsdt |
46 |
46 |
$0.00 |
| 90834 |
|
26 |
24 |
$0.00 |
| 90686 |
|
16 |
16 |
$0.00 |
| 90471 |
|
18 |
18 |
$0.00 |
| 99214 |
|
76 |
73 |
$0.00 |
| 99213 |
|
171 |
144 |
$0.00 |