| Code | Description | Claims | Beneficiaries | Total Paid |
| G0463 |
Hospital outpt clinic visit |
41,092 |
31,130 |
$602K |
| 99285 |
|
1,112 |
1,072 |
$109K |
| 92014 |
|
3,274 |
3,235 |
$55K |
| 78452 |
|
190 |
190 |
$49K |
| 45380 |
|
116 |
116 |
$29K |
| 71046 |
|
2,080 |
2,028 |
$27K |
| 77080 |
|
516 |
515 |
$23K |
| 67028 |
|
565 |
559 |
$21K |
| 93306 |
|
275 |
275 |
$19K |
| 99284 |
|
334 |
318 |
$17K |
| 45385 |
|
118 |
117 |
$16K |
| 99283 |
|
256 |
239 |
$13K |
| 97110 |
|
2,866 |
1,021 |
$13K |
| 92012 |
|
540 |
512 |
$11K |
| 71250 |
|
520 |
519 |
$11K |
| 43239 |
|
75 |
75 |
$10K |
| U0003 |
Cov-19 amp prb hgh thruput |
567 |
545 |
$6K |
| 77067 |
|
450 |
450 |
$5K |
| 74177 |
|
114 |
113 |
$5K |
| 96374 |
|
127 |
115 |
$5K |
| 80061 |
|
2,895 |
2,872 |
$5K |
| 96372 |
|
529 |
442 |
$4K |
| J0178 |
Aflibercept injection |
14 |
13 |
$4K |
| 96365 |
|
120 |
108 |
$3K |
| 20610 |
|
138 |
130 |
$3K |
| 76705 |
|
179 |
179 |
$3K |
| 97140 |
|
1,130 |
396 |
$3K |
| Q3014 |
Telehealth facility fee |
1,088 |
994 |
$3K |
| 70450 |
|
134 |
132 |
$3K |
| 80053 |
|
3,073 |
2,607 |
$3K |
| 85025 |
|
4,909 |
4,316 |
$2K |
| G0008 |
Admin influenza virus vac |
668 |
663 |
$2K |
| 93005 |
|
1,116 |
1,087 |
$2K |
| 82306 |
|
859 |
853 |
$2K |
| 84443 |
|
1,185 |
1,159 |
$2K |
| 93017 |
|
121 |
121 |
$1K |
| 83735 |
|
2,676 |
2,233 |
$1K |
| 83036 |
|
2,716 |
2,658 |
$1K |
| C9803 |
Hopd covid-19 spec collect |
264 |
253 |
$1K |
| 92553 |
|
74 |
73 |
$1K |
| 36415 |
|
7,927 |
7,226 |
$1K |
| 72100 |
|
66 |
66 |
$1K |
| 92083 |
|
959 |
957 |
$955.65 |
| 84100 |
|
1,747 |
1,384 |
$824.76 |
| 80048 |
|
1,836 |
1,744 |
$801.13 |
| U0005 |
Infec agen detec ampli probe |
251 |
242 |
$800.00 |
| 90694 |
|
73 |
73 |
$795.62 |
| 90677 |
|
26 |
26 |
$700.44 |
| 0002A |
|
12 |
12 |
$675.80 |
| 90653 |
|
64 |
63 |
$657.76 |
| 97162 |
|
117 |
117 |
$625.35 |
| 82947 |
|
1,474 |
1,394 |
$623.69 |
| 0001A |
|
18 |
18 |
$609.84 |
| 77063 |
|
208 |
208 |
$490.10 |
| 83970 |
|
343 |
341 |
$417.38 |
| 87635 |
|
57 |
55 |
$410.48 |
| 82565 |
|
1,292 |
1,228 |
$400.40 |
| 90662 |
|
93 |
93 |
$398.04 |
| 85027 |
|
806 |
757 |
$393.04 |
| 83615 |
|
939 |
826 |
$385.87 |
| 84460 |
|
1,230 |
1,210 |
$385.13 |
| 84450 |
|
1,225 |
1,205 |
$376.27 |
| 96360 |
|
19 |
13 |
$370.72 |
| 92557 |
|
147 |
147 |
$370.56 |
| 84550 |
|
1,022 |
905 |
$360.26 |
| 82570 |
|
1,635 |
1,584 |
$340.26 |
| 80051 |
|
699 |
655 |
$318.20 |
| 90686 |
|
201 |
201 |
$317.79 |
| 91322 |
|
41 |
41 |
$298.34 |
| 76700 |
|
38 |
38 |
$294.61 |
| 82043 |
|
1,376 |
1,343 |
$293.00 |
| 0004A |
|
83 |
83 |
$286.38 |
| 92134 |
|
1,212 |
1,199 |
$270.18 |
| 96361 |
|
38 |
26 |
$269.62 |
| 0064A |
|
35 |
35 |
$236.79 |
| 84520 |
|
973 |
919 |
$232.89 |
| 92133 |
|
1,088 |
1,087 |
$215.96 |
| 73030 |
|
27 |
26 |
$204.76 |
| 0134A |
|
29 |
29 |
$190.92 |
| 84075 |
|
662 |
648 |
$185.50 |
| 82607 |
|
152 |
151 |
$180.96 |
| 84466 |
|
273 |
268 |
$180.06 |
| 82247 |
|
629 |
614 |
$174.72 |
| 87517 |
|
36 |
36 |
$171.36 |
| 0124A |
|
91 |
91 |
$143.19 |
| 81002 |
|
1,399 |
1,363 |
$142.68 |
| 82728 |
|
262 |
252 |
$136.30 |
| 83880 |
|
25 |
24 |
$117.78 |
| 80069 |
|
516 |
495 |
$115.85 |
| 73562 |
|
29 |
26 |
$99.18 |
| 84153 |
|
78 |
77 |
$98.32 |
| 82248 |
|
174 |
172 |
$91.65 |
| 83540 |
|
272 |
267 |
$91.30 |
| 93296 |
|
13 |
13 |
$82.32 |
| 84156 |
|
658 |
627 |
$80.74 |
| 96375 |
|
33 |
26 |
$50.70 |
| 82105 |
|
25 |
25 |
$50.31 |
| G0009 |
Admin pneumococcal vaccine |
26 |
26 |
$49.93 |
| 81001 |
|
248 |
228 |
$41.56 |
| 86140 |
|
174 |
165 |
$31.08 |
| 84439 |
|
69 |
66 |
$27.06 |
| 90480 |
|
39 |
39 |
$19.02 |
| 85652 |
|
172 |
162 |
$13.50 |
| 85610 |
|
234 |
195 |
$13.11 |
| 85007 |
|
19 |
14 |
$11.40 |
| 82948 |
|
397 |
317 |
$10.08 |
| 82040 |
|
28 |
27 |
$9.90 |
| 81003 |
|
559 |
537 |
$9.76 |
| 91300 |
|
80 |
70 |
$0.03 |
| J2704 |
Inj, propofol, 10 mg |
653 |
649 |
$0.00 |
| A9500 |
Tc99m sestamibi |
111 |
111 |
$0.00 |
| 88305 |
|
559 |
556 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
377 |
349 |
$0.00 |
| 92567 |
|
53 |
53 |
$0.00 |
| 87086 |
|
69 |
65 |
$0.00 |
| A9579 |
Gad-base mr contrast nos,1ml |
26 |
26 |
$0.00 |
| 92136 |
|
50 |
50 |
$0.00 |
| A9585 |
Gadobutrol injection |
26 |
26 |
$0.00 |
| 73564 |
|
12 |
12 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
13 |
13 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
14 |
13 |
$0.00 |
| 0241U |
|
13 |
12 |
$0.00 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
286 |
283 |
$0.00 |
| J7120 |
Ringers lactate infusion |
204 |
197 |
$0.00 |
| J7030 |
Normal saline solution infus |
324 |
321 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
556 |
421 |
$0.00 |
| 91312 |
|
55 |
55 |
$0.00 |
| 92015 |
|
38 |
38 |
$0.00 |
| 92555 |
|
42 |
41 |
$0.00 |
| J2405 |
Ondansetron hcl injection |
39 |
37 |
$0.00 |
| 0690T |
|
35 |
35 |
$0.00 |
| 91313 |
|
14 |
14 |
$0.00 |