| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
7,440 |
6,979 |
$2.34M |
| 99285 |
|
3,804 |
3,432 |
$829K |
| 87633 |
|
690 |
658 |
$576K |
| 99283 |
|
6,555 |
6,245 |
$438K |
| 87631 |
|
1,034 |
984 |
$134K |
| 80053 |
|
13,780 |
11,254 |
$87K |
| 85025 |
|
17,840 |
14,384 |
$80K |
| 74177 |
|
655 |
630 |
$58K |
| 87651 |
|
891 |
847 |
$50K |
| 87635 |
|
500 |
478 |
$37K |
| 0241U |
|
908 |
873 |
$36K |
| 71045 |
|
1,984 |
1,837 |
$31K |
| 93005 |
|
2,406 |
1,814 |
$27K |
| 84702 |
|
1,534 |
1,257 |
$24K |
| 96374 |
|
1,545 |
1,397 |
$19K |
| 81001 |
|
6,837 |
6,131 |
$17K |
| 80048 |
|
3,475 |
2,830 |
$13K |
| 70450 |
|
491 |
469 |
$12K |
| 36415 |
|
21,375 |
16,167 |
$12K |
| J7030 |
Normal saline solution infus |
1,361 |
1,172 |
$9K |
| 87426 |
|
295 |
281 |
$8K |
| 96375 |
|
1,277 |
1,036 |
$7K |
| 80076 |
|
1,040 |
955 |
$7K |
| 83690 |
|
1,730 |
1,582 |
$6K |
| U0003 |
Cov-19 amp prb hgh thruput |
115 |
113 |
$6K |
| 87086 |
|
1,995 |
1,839 |
$6K |
| 83880 |
|
1,365 |
1,261 |
$5K |
| 11042 |
|
1,208 |
530 |
$5K |
| 84703 |
|
769 |
710 |
$4K |
| 84484 |
|
1,582 |
1,130 |
$4K |
| J7050 |
Normal saline solution infus |
1,670 |
472 |
$4K |
| 76801 |
|
49 |
42 |
$4K |
| 74176 |
|
49 |
47 |
$4K |
| 84443 |
|
2,027 |
1,898 |
$4K |
| 96413 |
|
64 |
26 |
$4K |
| 83735 |
|
1,719 |
1,377 |
$3K |
| 71046 |
|
266 |
258 |
$2K |
| 96361 |
|
354 |
312 |
$2K |
| 77067 |
|
534 |
534 |
$2K |
| 76817 |
|
34 |
29 |
$2K |
| 86850 |
|
404 |
368 |
$2K |
| 80306 |
|
346 |
324 |
$2K |
| 94761 |
|
302 |
215 |
$2K |
| 82306 |
|
361 |
356 |
$1K |
| 83605 |
|
395 |
353 |
$1K |
| 85610 |
|
1,603 |
1,363 |
$1K |
| 85730 |
|
1,011 |
944 |
$1K |
| 87804 |
|
48 |
38 |
$1K |
| J1100 |
Dexamethasone sodium phos |
805 |
585 |
$939.43 |
| 87077 |
|
1,180 |
1,046 |
$933.12 |
| 87186 |
|
1,099 |
985 |
$916.31 |
| 86901 |
|
424 |
382 |
$897.65 |
| 86900 |
|
424 |
382 |
$897.49 |
| 84100 |
|
293 |
217 |
$866.06 |
| 83036 |
|
1,508 |
1,437 |
$801.79 |
| J1885 |
Ketorolac tromethamine inj |
528 |
485 |
$767.99 |
| 97597 |
|
452 |
232 |
$732.91 |
| 96365 |
|
110 |
99 |
$695.38 |
| 86140 |
|
761 |
635 |
$691.99 |
| 87798 |
|
12 |
12 |
$679.97 |
| 88305 |
|
39 |
37 |
$637.65 |
| 99282 |
|
12 |
12 |
$636.46 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
979 |
934 |
$632.10 |
| CP008 |
|
14 |
12 |
$576.93 |
| 87641 |
|
131 |
127 |
$555.75 |
| 87640 |
|
131 |
127 |
$555.75 |
| 80061 |
|
1,283 |
1,238 |
$542.66 |
| 84145 |
|
223 |
209 |
$514.66 |
| 82962 |
|
1,789 |
1,061 |
$430.17 |
| 72125 |
|
24 |
24 |
$421.30 |
| J2405 |
Ondansetron hcl injection |
1,473 |
1,245 |
$414.56 |
| J2270 |
Morphine sulfate injection |
263 |
229 |
$385.95 |
| 82607 |
|
199 |
195 |
$379.84 |
| 84439 |
|
448 |
439 |
$372.50 |
| 86645 |
|
12 |
12 |
$365.42 |
| 86663 |
|
12 |
12 |
$362.48 |
| 93971 |
|
13 |
13 |
$360.45 |
| 86376 |
|
13 |
12 |
$358.75 |
| 77063 |
|
339 |
339 |
$317.16 |
| 86644 |
|
12 |
12 |
$312.08 |
| 87040 |
|
169 |
100 |
$310.49 |
| 76937 |
|
33 |
28 |
$308.24 |
| 87071 |
|
169 |
158 |
$302.86 |
| 82728 |
|
12 |
12 |
$295.59 |
| 84480 |
|
12 |
12 |
$286.97 |
| J1644 |
Inj heparin sodium per 1000u |
86 |
51 |
$269.59 |
| 96372 |
|
154 |
139 |
$268.85 |
| J0696 |
Ceftriaxone sodium injection |
83 |
77 |
$268.10 |
| 86038 |
|
12 |
12 |
$262.39 |
| 85379 |
|
128 |
120 |
$228.40 |
| J3010 |
Fentanyl citrate injection |
666 |
569 |
$221.61 |
| 94664 |
|
12 |
12 |
$152.61 |
| 83540 |
|
73 |
73 |
$151.03 |
| 80164 |
|
394 |
374 |
$144.11 |
| 84436 |
|
29 |
26 |
$138.99 |
| 99152 |
|
59 |
57 |
$96.40 |
| J0131 |
Inj, acetaminophen (nos) |
15 |
15 |
$86.68 |
| 80177 |
|
56 |
51 |
$77.38 |
| 87205 |
|
149 |
136 |
$76.04 |
| 85652 |
|
195 |
150 |
$64.75 |
| 82565 |
|
117 |
114 |
$61.18 |
| J2704 |
Inj, propofol, 10 mg |
343 |
324 |
$60.28 |
| J1200 |
Diphenhydramine hcl injectio |
89 |
67 |
$50.36 |
| C1769 |
Guide wire |
125 |
115 |
$49.13 |
| 82550 |
|
58 |
39 |
$43.81 |
| 84481 |
|
48 |
47 |
$42.69 |
| J1642 |
Inj heparin sodium per 10 u |
306 |
157 |
$40.02 |
| 85027 |
|
179 |
163 |
$38.29 |
| J7120 |
Ringers lactate infusion |
14 |
13 |
$34.42 |
| G0463 |
Hospital outpt clinic visit |
42 |
26 |
$33.50 |
| J2250 |
Inj midazolam hydrochloride |
241 |
231 |
$28.61 |
| J0690 |
Cefazolin sodium injection |
69 |
66 |
$21.71 |
| 82140 |
|
16 |
12 |
$7.43 |
| 83550 |
|
46 |
46 |
$7.34 |
| A9270 |
Non-covered item or service |
1,137 |
667 |
$0.43 |
| G1004 |
Cdsm ndsc |
891 |
730 |
$0.00 |
| J7040 |
Normal saline solution infus |
83 |
54 |
$0.00 |
| 82746 |
|
25 |
25 |
$0.00 |
| 87147 |
|
17 |
12 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
32 |
30 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
24 |
16 |
$0.00 |
| 36410 |
|
15 |
12 |
$0.00 |
| 96376 |
|
13 |
12 |
$0.00 |
| 83615 |
|
12 |
12 |
$0.00 |