| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
|
28,429 |
24,987 |
$606K |
| 96374 |
|
6,140 |
5,125 |
$232K |
| 70450 |
|
2,526 |
2,344 |
$166K |
| 74177 |
|
921 |
785 |
$137K |
| A0429 |
Bls-emergency |
3,080 |
2,015 |
$114K |
| 87426 |
|
4,418 |
3,955 |
$108K |
| 96375 |
|
3,886 |
3,203 |
$93K |
| 74176 |
|
1,170 |
1,043 |
$88K |
| 93005 |
|
6,433 |
5,414 |
$88K |
| G0480 |
Drug test def 1-7 classes |
1,566 |
1,343 |
$74K |
| 99285 |
|
717 |
681 |
$73K |
| 96372 |
|
4,683 |
3,540 |
$73K |
| J3490 |
Drugs unclassified injection |
13,934 |
6,547 |
$67K |
| 80307 |
|
1,721 |
1,539 |
$66K |
| 96361 |
|
4,158 |
3,432 |
$65K |
| 80053 |
|
10,167 |
8,710 |
$62K |
| 85025 |
|
12,968 |
11,173 |
$58K |
| 0270 |
|
24,669 |
10,599 |
$49K |
| Z7502 |
|
1,261 |
1,238 |
$47K |
| 99284 |
|
999 |
946 |
$46K |
| 96365 |
|
1,001 |
846 |
$45K |
| 71045 |
|
5,277 |
4,717 |
$44K |
| 99281 |
|
1,206 |
1,025 |
$44K |
| 96360 |
|
1,089 |
930 |
$42K |
| C9803 |
Hopd covid-19 spec collect |
2,473 |
2,148 |
$41K |
| 87804 |
|
7,120 |
3,302 |
$38K |
| J1885 |
Ketorolac tromethamine inj |
8,436 |
4,727 |
$36K |
| 99283 |
|
1,586 |
1,404 |
$36K |
| J7030 |
Normal saline solution infus |
6,027 |
4,938 |
$34K |
| 99199 |
|
746 |
713 |
$33K |
| 83690 |
|
7,840 |
6,680 |
$31K |
| A4606 |
Oxygen probe used w oximeter |
4,647 |
4,265 |
$27K |
| 84484 |
|
4,078 |
3,100 |
$22K |
| 94640 |
|
1,473 |
1,085 |
$18K |
| 81025 |
|
6,017 |
5,252 |
$18K |
| 81001 |
|
8,602 |
7,517 |
$16K |
| 87086 |
|
3,436 |
2,927 |
$15K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,793 |
1,357 |
$14K |
| 0250 |
|
5,284 |
3,427 |
$14K |
| J2270 |
Morphine sulfate injection |
1,940 |
1,566 |
$12K |
| J2405 |
Ondansetron hcl injection |
2,718 |
2,249 |
$11K |
| Z7610 |
|
907 |
567 |
$11K |
| 80048 |
|
2,211 |
1,989 |
$11K |
| 0271 |
|
4,662 |
3,704 |
$7K |
| 87880 |
|
1,346 |
1,245 |
$7K |
| 71046 |
|
520 |
471 |
$7K |
| 0272 |
|
4,397 |
3,927 |
$6K |
| 87040 |
|
892 |
410 |
$5K |
| 72125 |
|
40 |
39 |
$4K |
| 83605 |
|
698 |
555 |
$4K |
| 73562 |
|
227 |
205 |
$4K |
| 73610 |
|
200 |
182 |
$3K |
| J0696 |
Ceftriaxone sodium injection |
545 |
403 |
$3K |
| 83880 |
|
202 |
183 |
$3K |
| J2765 |
Metoclopramide hcl injection |
668 |
574 |
$3K |
| 90715 |
|
112 |
96 |
$3K |
| 87186 |
|
632 |
545 |
$3K |
| J1200 |
Diphenhydramine hcl injectio |
461 |
377 |
$2K |
| 85610 |
|
912 |
824 |
$2K |
| 73030 |
|
119 |
102 |
$2K |
| 76700 |
|
46 |
39 |
$2K |
| 73630 |
|
110 |
106 |
$2K |
| 82962 |
|
1,376 |
931 |
$2K |
| 87070 |
|
636 |
563 |
$2K |
| 99406 |
|
262 |
234 |
$2K |
| 94760 |
|
316 |
274 |
$2K |
| 36415 |
|
4,063 |
3,513 |
$1K |
| J1100 |
Dexamethasone sodium phos |
216 |
123 |
$1K |
| J7060 |
5% dextrose/water |
302 |
238 |
$1K |
| 87420 |
|
369 |
340 |
$1K |
| G0463 |
Hospital outpt clinic visit |
51 |
40 |
$1K |
| 85379 |
|
177 |
156 |
$1K |
| 76856 |
|
32 |
27 |
$1K |
| 85730 |
|
311 |
291 |
$1K |
| 85027 |
|
719 |
617 |
$621.42 |
| 0636 |
|
245 |
191 |
$558.77 |
| 0011A |
|
12 |
12 |
$480.00 |
| Z9725 |
|
13 |
13 |
$390.00 |
| 87088 |
|
92 |
84 |
$375.57 |
| 99070 |
|
120 |
68 |
$333.98 |
| 84702 |
|
41 |
37 |
$292.10 |
| 73130 |
|
16 |
15 |
$278.53 |
| 0301 |
|
174 |
67 |
$255.80 |
| 90471 |
|
60 |
57 |
$214.89 |
| 73110 |
|
13 |
12 |
$209.95 |
| 87591 |
|
16 |
13 |
$173.60 |
| 87491 |
|
16 |
13 |
$173.50 |
| 74018 |
|
14 |
13 |
$150.71 |
| J2060 |
Lorazepam injection |
27 |
24 |
$135.89 |
| 80076 |
|
27 |
27 |
$122.88 |
| 29125 |
|
48 |
48 |
$118.25 |
| 87184 |
|
44 |
41 |
$117.12 |
| 86901 |
|
41 |
37 |
$116.57 |
| J7040 |
Normal saline solution infus |
32 |
27 |
$116.04 |
| A4649 |
Surgical supplies |
279 |
132 |
$108.21 |
| 96376 |
|
70 |
57 |
$105.12 |
| 86900 |
|
41 |
37 |
$93.11 |
| 87205 |
|
47 |
44 |
$79.86 |
| 82947 |
|
30 |
29 |
$57.28 |
| 82550 |
|
14 |
12 |
$44.43 |
| A4657 |
Syringe w/wo needle |
13 |
13 |
$26.56 |
| A4215 |
Sterile needle |
24 |
19 |
$3.15 |
| 0305 |
|
77 |
59 |
$0.00 |
| 0324 |
|
18 |
17 |
$0.00 |
| 0306 |
|
28 |
12 |
$0.00 |
| 0320 |
|
25 |
20 |
$0.00 |