| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S9083 |
Urgent care center global |
25,171 |
21,066 |
$3.48M |
| S9088 |
Services provided in urgent |
7,274 |
6,479 |
$818K |
| 99213 |
|
12,422 |
11,049 |
$318K |
| 99214 |
|
10,301 |
9,042 |
$214K |
| 99203 |
|
3,651 |
3,365 |
$97K |
| 99204 |
|
2,563 |
2,277 |
$72K |
| 87428 |
|
7,130 |
5,583 |
$57K |
| 87426 |
|
4,216 |
3,930 |
$44K |
| 99212 |
|
1,484 |
1,346 |
$25K |
| A6449 |
Lt compres band >=3" <5"/yd |
431 |
407 |
$8K |
| 99202 |
|
633 |
584 |
$5K |
| 99215 |
Prolong outpt/office vis |
172 |
153 |
$4K |
| 90471 |
|
191 |
166 |
$3K |
| 71046 |
|
2,193 |
1,923 |
$2K |
| 87880 |
|
6,820 |
5,879 |
$1K |
| 90686 |
|
96 |
80 |
$1K |
| 99058 |
|
79 |
61 |
$780.00 |
| 80047 |
|
2,887 |
2,620 |
$634.70 |
| 81002 |
|
2,782 |
2,549 |
$552.51 |
| 87804 |
|
2,718 |
1,339 |
$507.12 |
| 36415 |
|
3,184 |
2,844 |
$475.55 |
| J1885 |
Ketorolac tromethamine inj |
208 |
188 |
$465.97 |
| 81025 |
|
1,278 |
1,188 |
$465.95 |
| A4565 |
Slings |
15 |
15 |
$445.92 |
| 85025 |
|
3,175 |
2,847 |
$416.17 |
| 81000 |
|
3,306 |
3,010 |
$311.20 |
| J0696 |
Ceftriaxone sodium injection |
53 |
52 |
$309.18 |
| 93000 |
|
845 |
769 |
$224.57 |
| 73610 |
|
343 |
308 |
$131.60 |
| 73564 |
|
129 |
122 |
$94.74 |
| 96372 |
|
830 |
745 |
$76.75 |
| E0114 |
Crutch underarm pair no wood |
53 |
52 |
$75.55 |
| 73630 |
|
105 |
92 |
$71.52 |
| 87210 |
|
1,329 |
1,231 |
$64.86 |
| 87220 |
|
1,343 |
1,242 |
$53.51 |
| 86580 |
|
13 |
12 |
$49.00 |
| 99201 |
|
22 |
20 |
$46.65 |
| L4350 |
Ankle control ortho pre ots |
35 |
27 |
$41.22 |
| 73140 |
|
134 |
123 |
$25.19 |
| 84703 |
|
13 |
13 |
$7.39 |
| 96360 |
|
18 |
16 |
$0.00 |
| S0119 |
Ondansetron 4 mg |
76 |
69 |
$0.00 |
| 73130 |
|
27 |
24 |
$0.00 |
| 73110 |
|
15 |
12 |
$0.00 |
| J7030 |
Normal saline solution infus |
16 |
14 |
$0.00 |
| 94640 |
|
13 |
13 |
$0.00 |
| 99070 |
|
12 |
12 |
$0.00 |
| A4570 |
Splint |
30 |
27 |
$0.00 |
| J7620 |
Albuterol ipratrop non-comp |
13 |
13 |
$0.00 |
| A6257 |
Transparent film <= 16 sq in |
15 |
14 |
$0.00 |
| 96365 |
|
13 |
13 |
$0.00 |