| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 41899 |
|
169 |
165 |
$394K |
| 85025 |
|
3,796 |
3,399 |
$24K |
| 80053 |
|
2,874 |
2,640 |
$24K |
| 84443 |
|
955 |
930 |
$13K |
| 87804 |
|
508 |
496 |
$10K |
| U0003 |
Cov-19 amp prb hgh thruput |
117 |
112 |
$10K |
| 87491 |
|
233 |
225 |
$8K |
| 87591 |
|
233 |
225 |
$8K |
| 71046 |
|
660 |
636 |
$8K |
| 36415 |
|
3,944 |
3,455 |
$7K |
| 87086 |
|
751 |
723 |
$5K |
| 87430 |
|
358 |
353 |
$5K |
| 83690 |
|
735 |
680 |
$5K |
| 81001 |
|
1,428 |
1,355 |
$5K |
| 87081 |
|
627 |
617 |
$4K |
| 80048 |
|
567 |
510 |
$4K |
| 99283 |
|
28 |
26 |
$4K |
| 83036 |
|
658 |
649 |
$4K |
| G0463 |
Hospital outpt clinic visit |
433 |
361 |
$4K |
| 80061 |
|
361 |
355 |
$3K |
| 86140 |
|
557 |
518 |
$3K |
| 87077 |
|
320 |
313 |
$3K |
| J7030 |
Normal saline solution infus |
711 |
632 |
$2K |
| G0480 |
Drug test def 1-7 classes |
25 |
25 |
$2K |
| 99284 |
|
17 |
12 |
$2K |
| J7120 |
Ringers lactate infusion |
494 |
429 |
$2K |
| 74177 |
|
12 |
12 |
$2K |
| 83605 |
|
159 |
139 |
$1K |
| J7050 |
Normal saline solution infus |
405 |
340 |
$1K |
| 99282 |
|
14 |
12 |
$1K |
| 84484 |
|
108 |
92 |
$1K |
| U0002 |
Covid-19 lab test non-cdc |
25 |
25 |
$999.14 |
| J1885 |
Ketorolac tromethamine inj |
544 |
481 |
$863.41 |
| 87420 |
|
39 |
39 |
$533.39 |
| 81025 |
|
68 |
67 |
$481.05 |
| 71045 |
|
64 |
58 |
$395.29 |
| J2405 |
Ondansetron hcl injection |
516 |
448 |
$377.09 |
| 80306 |
|
27 |
27 |
$367.25 |
| 87186 |
|
39 |
37 |
$301.11 |
| 73110 |
|
13 |
13 |
$259.95 |
| 73610 |
|
13 |
12 |
$221.76 |
| 86703 |
|
13 |
12 |
$143.79 |
| J1100 |
Dexamethasone sodium phos |
135 |
131 |
$127.92 |
| 82962 |
|
38 |
26 |
$118.46 |
| J1170 |
Hydromorphone injection |
47 |
40 |
$95.72 |
| J2704 |
Inj, propofol, 10 mg |
66 |
66 |
$72.73 |
| 86901 |
|
12 |
12 |
$40.59 |
| J3010 |
Fentanyl citrate injection |
85 |
82 |
$36.68 |
| 82570 |
|
14 |
13 |
$27.68 |
| S0119 |
Ondansetron 4 mg |
290 |
255 |
$20.43 |
| 80050 |
|
32 |
32 |
$0.00 |