| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
6,496 |
5,543 |
$1.47M |
| 99283 |
|
7,061 |
6,416 |
$1.24M |
| 41899 |
|
1,797 |
1,465 |
$232K |
| 99282 |
|
1,087 |
1,032 |
$132K |
| G0330 |
Facility svs dental rehab |
121 |
95 |
$91K |
| 96361 |
|
698 |
517 |
$62K |
| 97530 |
|
2,060 |
549 |
$44K |
| 99285 |
|
205 |
183 |
$39K |
| 92507 |
|
538 |
126 |
$32K |
| 96374 |
|
1,412 |
1,183 |
$26K |
| G0378 |
Hospital observation per hr |
110 |
91 |
$21K |
| 70450 |
|
92 |
87 |
$13K |
| 36415 |
|
12,302 |
9,694 |
$11K |
| 97110 |
|
765 |
260 |
$11K |
| 87637 |
|
93 |
92 |
$11K |
| 69436 |
|
14 |
13 |
$11K |
| 96375 |
|
779 |
629 |
$10K |
| 80053 |
|
7,279 |
6,004 |
$9K |
| 96372 |
|
457 |
351 |
$7K |
| 96365 |
|
211 |
165 |
$7K |
| 97161 |
|
100 |
88 |
$7K |
| 71046 |
|
281 |
256 |
$5K |
| 71045 |
|
407 |
360 |
$5K |
| 97112 |
|
98 |
30 |
$2K |
| 93306 |
|
16 |
14 |
$2K |
| 87632 |
|
29 |
25 |
$2K |
| 97116 |
|
243 |
75 |
$2K |
| 85025 |
|
9,748 |
8,011 |
$2K |
| 80307 |
|
199 |
170 |
$1K |
| 93005 |
|
1,519 |
1,247 |
$1K |
| 80061 |
|
169 |
164 |
$733.44 |
| 88305 |
|
56 |
52 |
$661.74 |
| U0002 |
Covid-19 lab test non-cdc |
66 |
50 |
$636.24 |
| J7030 |
Normal saline solution infus |
1,117 |
869 |
$627.11 |
| J3490 |
Drugs unclassified injection |
1,426 |
424 |
$420.00 |
| 80048 |
|
765 |
621 |
$409.86 |
| 80069 |
|
41 |
39 |
$349.08 |
| J8499 |
Oral prescrip drug non chemo |
1,521 |
831 |
$314.81 |
| 0011A |
|
12 |
12 |
$291.47 |
| J1885 |
Ketorolac tromethamine inj |
1,359 |
1,172 |
$285.32 |
| 84443 |
|
181 |
170 |
$202.85 |
| 86140 |
|
835 |
701 |
$180.77 |
| J7120 |
Ringers lactate infusion |
2,512 |
2,041 |
$175.18 |
| 82962 |
|
344 |
150 |
$112.19 |
| 81001 |
|
554 |
485 |
$61.86 |
| 80076 |
|
82 |
65 |
$36.26 |
| 84484 |
|
377 |
265 |
$25.64 |
| 83690 |
|
503 |
421 |
$23.79 |
| J2405 |
Ondansetron hcl injection |
2,424 |
1,932 |
$21.93 |
| 85610 |
|
271 |
210 |
$18.49 |
| 84703 |
|
53 |
48 |
$17.10 |
| J3010 |
Fentanyl citrate injection |
2,443 |
1,863 |
$13.62 |
| J2704 |
Inj, propofol, 10 mg |
1,777 |
1,497 |
$8.80 |
| J1100 |
Dexamethasone sodium phos |
1,975 |
1,667 |
$3.84 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
414 |
337 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
82 |
72 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
16 |
16 |
$0.00 |
| 81003 |
|
180 |
165 |
$0.00 |
| J2270 |
Morphine sulfate injection |
36 |
29 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
49 |
29 |
$0.00 |
| 81025 |
|
137 |
127 |
$0.00 |
| 87804 |
|
92 |
40 |
$0.00 |
| 82947 |
|
14 |
12 |
$0.00 |
| 87798 |
|
29 |
25 |
$0.00 |
| 87880 |
|
12 |
12 |
$0.00 |
| A4649 |
Surgical supplies |
40 |
26 |
$0.00 |
| 83605 |
|
150 |
125 |
$0.00 |
| J1170 |
Hydromorphone injection |
281 |
184 |
$0.00 |
| G0463 |
Hospital outpt clinic visit |
1,146 |
1,005 |
$0.00 |
| 85652 |
|
31 |
25 |
$0.00 |
| 96376 |
|
173 |
111 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
142 |
114 |
$0.00 |
| J2001 |
Lidocaine injection |
191 |
160 |
$0.00 |
| A9270 |
Non-covered item or service |
1,207 |
199 |
$0.00 |
| A6257 |
Transparent film <= 16 sq in |
543 |
503 |
$0.00 |
| 85027 |
|
493 |
419 |
$0.00 |
| 87086 |
|
147 |
125 |
$0.00 |
| 83735 |
|
35 |
29 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
338 |
261 |
$0.00 |
| 87486 |
|
29 |
25 |
$0.00 |
| 87070 |
|
38 |
34 |
$0.00 |
| 99214 |
|
26 |
26 |
$0.00 |
| 94640 |
|
87 |
38 |
$0.00 |
| 82306 |
|
12 |
12 |
$0.00 |
| A9585 |
Gadobutrol injection |
43 |
42 |
$0.00 |
| 85730 |
|
15 |
14 |
$0.00 |
| 87581 |
|
29 |
25 |
$0.00 |
| 83036 |
|
13 |
13 |
$0.00 |
| 85379 |
|
12 |
12 |
$0.00 |
| C1769 |
Guide wire |
18 |
15 |
$0.00 |
| C1889 |
Implant/insert device, noc |
13 |
13 |
$0.00 |
| 80320 |
|
14 |
13 |
$0.00 |