| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0280 |
Medical home, initial plan |
57,762 |
47,408 |
$8.82M |
| 99214 |
|
82,412 |
52,850 |
$3.78M |
| 99284 |
|
14,631 |
13,489 |
$3.49M |
| 90834 |
|
32,170 |
16,972 |
$1.93M |
| 90832 |
|
42,116 |
23,895 |
$1.67M |
| 99283 |
|
10,114 |
9,451 |
$1.48M |
| 99213 |
|
41,848 |
34,163 |
$1.33M |
| 99231 |
|
43,426 |
14,046 |
$1.25M |
| 90791 |
|
13,349 |
9,823 |
$1.14M |
| 99285 |
|
3,235 |
2,916 |
$1.06M |
| H2017 |
Psysoc rehab svc, per 15 min |
11,384 |
698 |
$754K |
| 99212 |
|
24,292 |
20,245 |
$628K |
| 90853 |
|
14,061 |
4,308 |
$308K |
| 43239 |
|
518 |
482 |
$275K |
| 99238 |
|
5,586 |
4,684 |
$265K |
| 90792 |
|
2,727 |
2,116 |
$207K |
| 45385 |
|
291 |
251 |
$189K |
| 99282 |
|
1,956 |
1,837 |
$163K |
| 99232 |
|
3,864 |
1,974 |
$150K |
| 85025 |
|
24,803 |
22,736 |
$98K |
| 96374 |
|
3,493 |
3,226 |
$82K |
| G0378 |
Hospital observation per hr |
396 |
237 |
$80K |
| 93010 |
|
28,177 |
24,636 |
$76K |
| 93306 |
|
1,921 |
1,442 |
$61K |
| 80048 |
|
9,787 |
8,729 |
$56K |
| 99215 |
Prolong outpt/office vis |
957 |
809 |
$42K |
| 45380 |
|
70 |
64 |
$42K |
| 90837 |
|
261 |
172 |
$33K |
| G0463 |
Hospital outpt clinic visit |
4,504 |
4,351 |
$33K |
| 80053 |
|
9,012 |
8,215 |
$33K |
| 71045 |
|
2,629 |
2,405 |
$33K |
| H0038 |
Self-help/peer svc per 15min |
1,448 |
474 |
$29K |
| 87426 |
|
1,133 |
1,027 |
$24K |
| 96372 |
|
4,992 |
3,483 |
$21K |
| 93016 |
|
2,073 |
1,934 |
$17K |
| 99442 |
|
3,668 |
3,501 |
$16K |
| 43248 |
|
27 |
24 |
$13K |
| 84484 |
|
954 |
727 |
$12K |
| 99233 |
Prolong inpt eval add15 m |
350 |
103 |
$11K |
| H0034 |
Med trng & support per 15min |
614 |
313 |
$10K |
| 90847 |
|
98 |
83 |
$8K |
| 45378 |
|
12 |
12 |
$8K |
| 83690 |
|
2,164 |
2,003 |
$8K |
| 93018 |
|
1,012 |
927 |
$7K |
| G0426 |
Inpt/ed teleconsult50 |
320 |
264 |
$7K |
| 3008F |
|
11,749 |
8,502 |
$7K |
| 95886 |
|
707 |
506 |
$6K |
| 90899 |
|
407 |
237 |
$6K |
| 83970 |
|
445 |
427 |
$6K |
| 96361 |
|
911 |
855 |
$5K |
| 3074F |
|
5,499 |
4,690 |
$5K |
| 3078F |
|
4,728 |
4,046 |
$5K |
| 83735 |
|
856 |
824 |
$4K |
| G0427 |
Inpt/ed teleconsult70 |
277 |
222 |
$4K |
| 82306 |
|
433 |
414 |
$4K |
| 36415 |
|
1,911 |
1,755 |
$4K |
| 96375 |
|
498 |
464 |
$4K |
| U0003 |
Cov-19 amp prb hgh thruput |
60 |
49 |
$4K |
| 87086 |
|
596 |
561 |
$3K |
| 76700 |
|
58 |
55 |
$3K |
| 84703 |
|
700 |
656 |
$3K |
| 99222 |
|
85 |
75 |
$3K |
| J2405 |
Ondansetron hcl injection |
612 |
559 |
$3K |
| U0004 |
Cov-19 test non-cdc hgh thru |
38 |
37 |
$2K |
| 80307 |
|
71 |
66 |
$2K |
| 93005 |
|
3,238 |
2,926 |
$2K |
| 84466 |
|
544 |
525 |
$2K |
| 82728 |
|
438 |
425 |
$2K |
| 87276 |
|
424 |
392 |
$2K |
| 77336 |
|
62 |
25 |
$2K |
| 99441 |
|
762 |
740 |
$2K |
| 85027 |
|
736 |
684 |
$2K |
| 80076 |
|
734 |
695 |
$2K |
| 82607 |
|
326 |
314 |
$2K |
| 81001 |
|
2,175 |
2,029 |
$1K |
| 84590 |
|
306 |
293 |
$1K |
| G0425 |
Inpt/ed teleconsult30 |
78 |
74 |
$1K |
| 87275 |
|
424 |
392 |
$1K |
| 3079F |
|
786 |
717 |
$1K |
| H2000 |
Comp multidisipln evaluation |
16 |
15 |
$1K |
| 99239 |
|
19 |
16 |
$1K |
| 83540 |
|
563 |
543 |
$1K |
| 82746 |
|
182 |
173 |
$810.12 |
| 86140 |
|
153 |
148 |
$720.21 |
| 84597 |
|
98 |
93 |
$567.80 |
| 81596 |
|
16 |
12 |
$552.18 |
| 84134 |
|
86 |
81 |
$548.43 |
| 84425 |
|
47 |
43 |
$507.50 |
| 87522 |
Neg quan hep c or qual rna |
45 |
41 |
$426.91 |
| 84446 |
|
74 |
70 |
$426.16 |
| 85610 |
|
210 |
190 |
$415.22 |
| 74176 |
|
18 |
14 |
$404.17 |
| 81003 |
|
604 |
550 |
$317.83 |
| 3080F |
|
167 |
149 |
$290.00 |
| 3075F |
|
261 |
232 |
$290.00 |
| 70450 |
|
43 |
39 |
$279.56 |
| 99443 |
|
53 |
52 |
$276.10 |
| 3077F |
|
141 |
122 |
$240.00 |
| 82077 |
|
56 |
51 |
$201.23 |
| 85652 |
|
77 |
74 |
$159.84 |
| 82248 |
|
40 |
40 |
$158.42 |
| 82105 |
|
16 |
12 |
$78.79 |
| 82525 |
|
12 |
12 |
$73.66 |
| 84630 |
|
12 |
12 |
$67.61 |
| 87389 |
|
13 |
13 |
$66.08 |
| 86803 |
|
15 |
15 |
$48.95 |
| 82150 |
|
27 |
27 |
$32.55 |
| 87081 |
|
335 |
310 |
$30.50 |
| J1650 |
Inj enoxaparin sodium |
37 |
12 |
$28.11 |
| 86677 |
|
14 |
13 |
$23.13 |
| G9011 |
Mccd, risk adj, level 5 |
5,837 |
3,228 |
$0.06 |
| G9010 |
Mccd, risk adj, level 4 |
82,233 |
34,555 |
$0.03 |
| G9006 |
Mccd, home monitoring |
17,505 |
9,379 |
$0.02 |
| G9004 |
Mccd, risk adj lo, initial |
11,041 |
8,695 |
$0.01 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
39 |
38 |
$0.00 |
| C7901 |
Hopd mntl hlt, 30-60 min |
42 |
24 |
$0.00 |
| 88305 |
|
134 |
116 |
$0.00 |
| G9005 |
Mccd, risk adj, maintenance |
20,223 |
9,282 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
411 |
390 |
$0.00 |
| A9270 |
Non-covered item or service |
129 |
76 |
$0.00 |
| Q3014 |
Telehealth facility fee |
14 |
14 |
$0.00 |