| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
|
2,312 |
2,300 |
$333K |
| 93306 |
|
2,938 |
2,929 |
$303K |
| 76805 |
|
1,389 |
1,384 |
$203K |
| 99214 |
|
2,030 |
1,926 |
$145K |
| 76641 |
|
1,845 |
1,311 |
$144K |
| 36902 |
|
284 |
280 |
$127K |
| 77063 |
|
1,602 |
1,596 |
$90K |
| 99211 |
|
3,457 |
3,144 |
$86K |
| 76816 |
|
590 |
579 |
$68K |
| 99213 |
|
1,177 |
1,082 |
$60K |
| 93925 |
|
288 |
288 |
$50K |
| 71046 |
|
1,745 |
1,721 |
$44K |
| 77080 |
|
958 |
954 |
$40K |
| 93990 |
|
802 |
782 |
$40K |
| 77065 |
Tomosynthesis, mammo |
332 |
292 |
$36K |
| 74178 |
|
143 |
143 |
$35K |
| 71271 |
|
221 |
220 |
$34K |
| 93226 |
|
736 |
734 |
$18K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
2,821 |
2,713 |
$17K |
| G0279 |
Tomosynthesis, mammo |
379 |
373 |
$17K |
| 76815 |
|
184 |
184 |
$17K |
| 76937 |
|
990 |
941 |
$17K |
| 93005 |
|
3,073 |
3,028 |
$15K |
| G2023 |
Specimen collect covid-19 |
632 |
581 |
$15K |
| 01844 |
|
126 |
124 |
$10K |
| 72148 |
|
56 |
56 |
$9K |
| 93225 |
|
736 |
734 |
$8K |
| 93970 |
|
61 |
61 |
$7K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
365 |
359 |
$6K |
| 76377 |
|
136 |
136 |
$5K |
| 62323 |
|
29 |
24 |
$5K |
| 70553 |
|
24 |
24 |
$4K |
| G0296 |
Visit to determ ldct elig |
151 |
150 |
$4K |
| 99152 |
|
109 |
106 |
$3K |
| 99204 |
|
25 |
25 |
$3K |
| 0002A |
|
71 |
70 |
$3K |
| 93017 |
|
90 |
89 |
$3K |
| 0001A |
|
62 |
62 |
$2K |
| 36901 |
|
17 |
14 |
$2K |
| 71270 |
|
16 |
16 |
$2K |
| 72141 |
|
18 |
18 |
$2K |
| J3301 |
Triamcinolone acet inj nos |
401 |
343 |
$2K |
| 75635 |
|
12 |
12 |
$2K |
| 77066 |
Tomosynthesis, mammo |
12 |
12 |
$2K |
| 20611 |
|
22 |
12 |
$2K |
| 0011A |
|
39 |
39 |
$2K |
| 64493 |
|
13 |
12 |
$2K |
| 93016 |
|
90 |
89 |
$2K |
| 0012A |
|
36 |
35 |
$1K |
| J7040 |
Normal saline solution infus |
1,260 |
1,209 |
$1K |
| 71250 |
|
13 |
13 |
$1K |
| 01992 |
|
12 |
12 |
$1K |
| 99153 |
Mod sedat endo service >5yrs |
105 |
102 |
$1K |
| A9576 |
Inj prohance multipack |
45 |
42 |
$859.05 |
| 76942 |
|
14 |
13 |
$742.56 |
| 64494 |
|
13 |
12 |
$725.05 |
| 01924 |
|
12 |
12 |
$718.47 |
| 99203 |
|
12 |
12 |
$685.16 |
| 76775 |
|
12 |
12 |
$455.63 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
332 |
271 |
$289.36 |
| J3010 |
Fentanyl citrate injection |
96 |
94 |
$36.48 |
| J1100 |
Dexamethasone sodium phos |
14 |
12 |
$13.50 |
| J2250 |
Inj midazolam hydrochloride |
74 |
68 |
$7.93 |
| J1644 |
Inj heparin sodium per 1000u |
72 |
68 |
$1.71 |
| 91300 |
|
212 |
185 |
$0.00 |
| 91301 |
|
100 |
97 |
$0.00 |
| 99406 |
|
524 |
487 |
$0.00 |