| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
13,009 |
11,487 |
$2.76M |
| 99283 |
|
11,632 |
10,469 |
$1.92M |
| 99285 |
|
2,603 |
2,244 |
$783K |
| G0378 |
Hospital observation per hr |
815 |
663 |
$308K |
| U0003 |
Cov-19 amp prb hgh thruput |
5,101 |
4,536 |
$254K |
| 93306 |
|
790 |
703 |
$185K |
| 58662 |
|
436 |
310 |
$174K |
| 71045 |
|
3,293 |
2,910 |
$135K |
| 93005 |
|
2,803 |
2,485 |
$103K |
| 80053 |
|
14,863 |
12,618 |
$82K |
| 80307 |
|
1,641 |
1,339 |
$73K |
| 71046 |
|
1,225 |
1,123 |
$67K |
| 69436 |
|
205 |
177 |
$58K |
| 85025 |
|
15,219 |
12,846 |
$58K |
| 78452 |
|
199 |
173 |
$55K |
| 87276 |
|
4,114 |
3,673 |
$52K |
| 96372 |
|
4,453 |
3,302 |
$48K |
| 87635 |
|
1,633 |
1,481 |
$48K |
| J1885 |
Ketorolac tromethamine inj |
7,120 |
6,117 |
$46K |
| 58558 |
|
95 |
84 |
$43K |
| 87275 |
|
3,955 |
3,521 |
$38K |
| 58563 |
|
65 |
56 |
$29K |
| 80050 |
|
665 |
601 |
$27K |
| 36415 |
|
16,475 |
12,978 |
$25K |
| 87880 |
|
1,784 |
1,601 |
$24K |
| 99282 |
|
237 |
215 |
$24K |
| 74176 |
|
106 |
90 |
$24K |
| 99214 |
|
598 |
277 |
$24K |
| J2785 |
Regadenoson injection |
196 |
173 |
$18K |
| 81025 |
|
2,288 |
2,073 |
$15K |
| 70450 |
|
87 |
77 |
$15K |
| 74177 |
|
32 |
31 |
$14K |
| 74019 |
|
266 |
249 |
$13K |
| 93017 |
|
198 |
173 |
$13K |
| G0379 |
Direct refer hospital observ |
304 |
240 |
$12K |
| 81001 |
|
6,227 |
5,379 |
$11K |
| 84702 |
|
3,147 |
2,389 |
$9K |
| 59025 |
|
102 |
77 |
$8K |
| J0690 |
Cefazolin sodium injection |
2,588 |
1,855 |
$8K |
| 80061 |
|
666 |
605 |
$7K |
| A9502 |
Tc99m tetrofosmin |
199 |
172 |
$7K |
| 85730 |
|
2,903 |
2,547 |
$7K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
139 |
121 |
$6K |
| 42820 |
|
12 |
12 |
$6K |
| 87081 |
|
1,082 |
957 |
$6K |
| 84439 |
|
780 |
686 |
$6K |
| 99281 |
|
81 |
77 |
$6K |
| 85610 |
|
2,967 |
2,594 |
$5K |
| 93970 |
|
69 |
63 |
$5K |
| 0598T |
|
140 |
76 |
$5K |
| 83735 |
|
1,055 |
936 |
$4K |
| 87086 |
|
624 |
574 |
$4K |
| 96374 |
|
353 |
264 |
$4K |
| 84484 |
|
432 |
363 |
$3K |
| 87280 |
|
259 |
235 |
$3K |
| 87389 |
|
138 |
136 |
$3K |
| 87040 |
|
270 |
235 |
$3K |
| 81003 |
|
2,475 |
2,127 |
$3K |
| 83655 |
|
248 |
231 |
$3K |
| 96375 |
|
182 |
136 |
$3K |
| 83690 |
|
585 |
518 |
$3K |
| 86850 |
|
3,001 |
2,417 |
$3K |
| Q0162 |
Ondansetron oral |
233 |
205 |
$2K |
| 74018 |
|
50 |
43 |
$2K |
| 86803 |
|
146 |
139 |
$2K |
| 73562 |
|
30 |
25 |
$2K |
| 80048 |
|
764 |
624 |
$2K |
| J2405 |
Ondansetron hcl injection |
2,951 |
2,429 |
$2K |
| 96365 |
|
44 |
32 |
$2K |
| J1100 |
Dexamethasone sodium phos |
1,460 |
1,268 |
$2K |
| 96361 |
|
98 |
85 |
$1K |
| 82550 |
|
332 |
284 |
$1K |
| 82553 |
|
181 |
149 |
$1K |
| 86901 |
|
3,059 |
2,457 |
$1K |
| 86592 |
|
1,093 |
959 |
$1K |
| 86900 |
|
3,053 |
2,451 |
$1K |
| J0696 |
Ceftriaxone sodium injection |
170 |
158 |
$1K |
| 82105 |
|
70 |
69 |
$1K |
| J1170 |
Hydromorphone injection |
144 |
127 |
$1K |
| 83880 |
|
41 |
37 |
$902.98 |
| 86706 |
|
76 |
75 |
$801.47 |
| 86762 |
|
60 |
59 |
$800.44 |
| 86787 |
|
63 |
62 |
$793.73 |
| J7030 |
Normal saline solution infus |
89 |
85 |
$763.82 |
| 84153 |
|
46 |
43 |
$753.99 |
| 84146 |
|
42 |
40 |
$736.44 |
| J3010 |
Fentanyl citrate injection |
3,124 |
2,545 |
$684.70 |
| 87340 |
|
61 |
60 |
$584.93 |
| 84144 |
|
33 |
31 |
$584.08 |
| 83036 |
|
65 |
61 |
$534.05 |
| 82670 |
|
21 |
21 |
$530.86 |
| 84100 |
|
1,034 |
920 |
$512.91 |
| 36416 |
|
273 |
215 |
$504.86 |
| 84403 |
|
21 |
21 |
$490.39 |
| 84402 |
|
21 |
21 |
$483.93 |
| 30140 |
|
105 |
82 |
$481.27 |
| J2175 |
Meperidine hydrochl /100 mg |
1,773 |
1,430 |
$448.76 |
| 82627 |
|
20 |
20 |
$400.14 |
| J2704 |
Inj, propofol, 10 mg |
4,353 |
3,432 |
$395.10 |
| 84443 |
|
27 |
26 |
$386.40 |
| 87430 |
|
26 |
25 |
$384.10 |
| 94640 |
|
23 |
19 |
$372.41 |
| 83001 |
|
22 |
22 |
$371.60 |
| 83002 |
|
22 |
22 |
$370.40 |
| J0702 |
Betamethasone acet&sod phosp |
13 |
12 |
$356.96 |
| 86703 |
|
28 |
28 |
$347.49 |
| 82157 |
|
12 |
12 |
$322.08 |
| 82306 |
|
12 |
12 |
$296.00 |
| 84481 |
|
28 |
21 |
$228.38 |
| J7120 |
Ringers lactate infusion |
152 |
121 |
$226.50 |
| 85027 |
|
43 |
38 |
$194.10 |
| J1644 |
Inj heparin sodium per 1000u |
17 |
13 |
$191.35 |
| 82785 |
|
41 |
38 |
$181.06 |
| 83020 |
|
13 |
13 |
$167.31 |
| C1769 |
Guide wire |
14 |
14 |
$143.68 |
| J2550 |
Promethazine hcl injection |
80 |
67 |
$142.93 |
| 82950 |
|
28 |
28 |
$133.00 |
| 84270 |
|
21 |
21 |
$118.56 |
| 83605 |
|
14 |
12 |
$115.70 |
| J2001 |
Lidocaine injection |
2,193 |
1,749 |
$111.94 |
| 82150 |
|
19 |
17 |
$103.68 |
| 85018 |
|
40 |
40 |
$90.06 |
| 85007 |
|
43 |
38 |
$85.40 |
| 85014 |
|
28 |
28 |
$61.62 |
| A6213 |
Foam drg >16<=48 sq in w/bdr |
35 |
24 |
$49.28 |
| A6199 |
Alginate drsg wound filler |
28 |
25 |
$45.88 |
| A6216 |
Non-sterile gauze<=16 sq in |
240 |
178 |
$45.17 |
| A6443 |
Conform band n/s w>=3"<5"/yd |
59 |
50 |
$29.94 |
| J2250 |
Inj midazolam hydrochloride |
270 |
213 |
$23.08 |
| J1580 |
Garamycin gentamicin inj |
237 |
176 |
$14.63 |
| 82962 |
|
18 |
12 |
$3.26 |
| A6253 |
Absorpt drg > 48 sq in w/o b |
15 |
12 |
$2.40 |
| 05983 |
|
498 |
213 |
$0.00 |
| L8699 |
Prosthetic implant nos |
162 |
148 |
$0.00 |
| G0463 |
Hospital outpt clinic visit |
1,454 |
615 |
$0.00 |
| A9270 |
Non-covered item or service |
23 |
22 |
$0.00 |
| A4649 |
Surgical supplies |
159 |
110 |
$0.00 |
| C1780 |
Lens, intraocular (new tech) |
37 |
25 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
69 |
52 |
$0.00 |