| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
5,321 |
5,025 |
$948K |
| 99283 |
|
8,723 |
8,380 |
$490K |
| 87502 |
|
2,422 |
2,357 |
$220K |
| 87635 |
|
2,096 |
2,041 |
$108K |
| 99285 |
|
894 |
835 |
$94K |
| 71045 |
|
2,854 |
2,654 |
$74K |
| C9803 |
Hopd covid-19 spec collect |
3,504 |
3,423 |
$63K |
| 80053 |
|
4,597 |
4,116 |
$61K |
| 85025 |
|
5,268 |
4,727 |
$40K |
| U0002 |
Covid-19 lab test non-cdc |
733 |
710 |
$35K |
| 99282 |
|
634 |
620 |
$34K |
| 87651 |
|
698 |
684 |
$23K |
| 93005 |
|
1,266 |
1,118 |
$23K |
| 87634 |
|
226 |
222 |
$20K |
| 81003 |
|
3,574 |
3,341 |
$11K |
| 70450 |
|
235 |
229 |
$10K |
| 74177 |
|
63 |
62 |
$10K |
| 96375 |
|
674 |
599 |
$6K |
| J7030 |
Normal saline solution infus |
1,899 |
1,622 |
$5K |
| CP007 |
|
91 |
77 |
$4K |
| 84484 |
|
955 |
776 |
$4K |
| 96374 |
|
766 |
712 |
$4K |
| 84703 |
|
540 |
513 |
$3K |
| 83880 |
|
221 |
201 |
$3K |
| 83690 |
|
872 |
804 |
$2K |
| 99211 |
|
14 |
13 |
$2K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
214 |
204 |
$2K |
| S3620 |
Newborn metabolic screening |
665 |
650 |
$2K |
| 99281 |
|
30 |
28 |
$1K |
| 87804 |
|
78 |
29 |
$1K |
| 74176 |
|
12 |
12 |
$1K |
| 96361 |
|
393 |
368 |
$736.50 |
| 71046 |
|
13 |
13 |
$721.78 |
| 59025 |
|
22 |
14 |
$681.87 |
| 81025 |
|
83 |
81 |
$568.95 |
| 80307 |
|
13 |
12 |
$491.96 |
| J2405 |
Ondansetron hcl injection |
954 |
859 |
$423.59 |
| 96372 |
|
100 |
94 |
$357.55 |
| 96365 |
|
24 |
24 |
$331.70 |
| 80048 |
|
42 |
38 |
$210.54 |
| J1885 |
Ketorolac tromethamine inj |
286 |
269 |
$166.08 |
| J2270 |
Morphine sulfate injection |
175 |
158 |
$153.18 |
| 87880 |
|
16 |
12 |
$140.01 |
| J1100 |
Dexamethasone sodium phos |
72 |
70 |
$119.77 |
| 85610 |
|
32 |
29 |
$100.26 |
| 83605 |
|
39 |
25 |
$69.08 |
| 88720 |
|
14 |
12 |
$66.51 |
| 83735 |
|
18 |
15 |
$46.84 |
| 81001 |
|
13 |
13 |
$33.37 |
| Q0162 |
Ondansetron oral |
25 |
25 |
$26.59 |
| 36415 |
|
1,187 |
1,007 |
$20.48 |
| 85379 |
|
13 |
12 |
$17.10 |
| A9270 |
Non-covered item or service |
1,411 |
1,326 |
$1.80 |
| J0131 |
Inj, acetaminophen (nos) |
12 |
12 |
$0.00 |