| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
9,460 |
8,808 |
$2.93M |
| 99283 |
|
8,978 |
8,434 |
$1.91M |
| 99285 |
|
1,622 |
1,491 |
$614K |
| G0378 |
Hospital observation per hr |
266 |
223 |
$263K |
| S0201 |
Partial hospitalization serv |
507 |
51 |
$229K |
| 99282 |
|
1,473 |
1,384 |
$170K |
| 43239 |
|
256 |
239 |
$158K |
| 96374 |
|
4,439 |
4,089 |
$107K |
| 80053 |
|
18,144 |
16,007 |
$97K |
| 96413 |
|
695 |
424 |
$74K |
| 92507 |
|
1,252 |
282 |
$68K |
| G0463 |
Hospital outpt clinic visit |
8,167 |
6,867 |
$49K |
| 97530 |
|
779 |
277 |
$46K |
| 36415 |
|
26,007 |
22,426 |
$45K |
| 97110 |
|
1,325 |
453 |
$43K |
| 74177 |
|
134 |
132 |
$39K |
| 87491 |
|
622 |
600 |
$35K |
| 96375 |
|
2,829 |
2,264 |
$33K |
| 85025 |
|
18,968 |
16,664 |
$30K |
| 80307 |
|
1,987 |
1,700 |
$29K |
| 88305 |
|
1,200 |
1,132 |
$26K |
| 85027 |
|
3,410 |
3,136 |
$23K |
| 41899 |
|
321 |
310 |
$23K |
| 0241U |
|
150 |
146 |
$23K |
| 87591 |
|
606 |
583 |
$19K |
| 80048 |
|
1,161 |
1,045 |
$15K |
| 96365 |
|
327 |
208 |
$15K |
| 99281 |
|
204 |
182 |
$14K |
| 87426 |
|
909 |
869 |
$14K |
| 81001 |
|
6,139 |
5,045 |
$11K |
| 73630 |
|
305 |
259 |
$10K |
| 70450 |
|
127 |
116 |
$10K |
| 71045 |
|
863 |
776 |
$10K |
| G0330 |
Facility svs dental rehab |
12 |
12 |
$9K |
| 80061 |
|
679 |
643 |
$9K |
| 45378 |
|
14 |
13 |
$7K |
| 82306 |
|
174 |
168 |
$7K |
| 45380 |
|
12 |
12 |
$7K |
| 84443 |
|
890 |
837 |
$6K |
| 97161 |
|
91 |
88 |
$6K |
| 87480 |
|
274 |
262 |
$6K |
| 96361 |
|
16 |
12 |
$6K |
| 87086 |
|
773 |
684 |
$6K |
| 87510 |
|
274 |
262 |
$5K |
| 87502 |
|
142 |
135 |
$5K |
| 87660 |
|
274 |
262 |
$5K |
| 86850 |
|
388 |
359 |
$5K |
| U0003 |
Cov-19 amp prb hgh thruput |
55 |
52 |
$5K |
| 87150 |
|
112 |
111 |
$4K |
| G0123 |
Screen cerv/vag thin layer |
210 |
198 |
$4K |
| 93005 |
|
4,095 |
3,553 |
$4K |
| 86900 |
|
304 |
277 |
$4K |
| 86780 |
|
321 |
308 |
$4K |
| 0240U |
|
49 |
40 |
$4K |
| 83036 |
|
501 |
484 |
$4K |
| 71046 |
|
192 |
181 |
$4K |
| 86140 |
|
417 |
365 |
$3K |
| 96372 |
|
545 |
401 |
$3K |
| 76816 |
|
37 |
26 |
$3K |
| 87880 |
|
246 |
229 |
$3K |
| 87070 |
|
432 |
405 |
$3K |
| 87624 |
|
48 |
42 |
$3K |
| 82728 |
|
234 |
206 |
$3K |
| 87389 |
|
113 |
111 |
$3K |
| 77334 |
|
27 |
12 |
$3K |
| 71260 |
|
13 |
13 |
$2K |
| 80050 |
|
58 |
54 |
$2K |
| 81003 |
|
782 |
707 |
$2K |
| 87522 |
Neg quan hep c or qual rna |
55 |
52 |
$2K |
| J7030 |
Normal saline solution infus |
1,978 |
1,761 |
$2K |
| 84481 |
|
139 |
122 |
$2K |
| 87186 |
|
220 |
212 |
$1K |
| 93017 |
|
13 |
13 |
$1K |
| J2704 |
Inj, propofol, 10 mg |
2,680 |
2,485 |
$1K |
| 87077 |
|
216 |
208 |
$1K |
| 87081 |
|
137 |
135 |
$1K |
| 85652 |
|
411 |
357 |
$1K |
| 82607 |
|
141 |
132 |
$1K |
| 87340 |
|
113 |
111 |
$1K |
| 83516 |
|
14 |
12 |
$969.68 |
| 84439 |
|
168 |
154 |
$922.42 |
| A9270 |
Non-covered item or service |
5,629 |
3,856 |
$917.56 |
| 80306 |
|
211 |
158 |
$915.97 |
| 20610 |
|
35 |
28 |
$863.99 |
| 85610 |
|
535 |
439 |
$854.48 |
| 74018 |
|
85 |
72 |
$853.40 |
| 78815 |
|
17 |
14 |
$751.38 |
| 86762 |
|
45 |
44 |
$697.68 |
| 87807 |
|
76 |
73 |
$683.14 |
| J3490 |
Drugs unclassified injection |
1,193 |
783 |
$660.06 |
| 86901 |
|
304 |
277 |
$627.58 |
| 67028 |
|
351 |
331 |
$625.00 |
| 87804 |
|
42 |
37 |
$598.50 |
| 86803 |
|
45 |
45 |
$592.61 |
| 86592 |
|
137 |
132 |
$566.80 |
| 82950 |
|
93 |
92 |
$509.04 |
| J1790 |
Droperidol injection |
253 |
231 |
$464.25 |
| 83735 |
|
474 |
400 |
$461.09 |
| J7120 |
Ringers lactate infusion |
1,002 |
920 |
$396.16 |
| 87147 |
|
92 |
85 |
$356.43 |
| 83690 |
|
546 |
515 |
$333.92 |
| 84146 |
|
19 |
17 |
$321.36 |
| 92134 |
|
514 |
489 |
$311.77 |
| 73501 |
|
12 |
12 |
$292.46 |
| 84484 |
|
532 |
433 |
$274.26 |
| 82570 |
|
57 |
57 |
$224.18 |
| 83540 |
|
95 |
85 |
$221.45 |
| 90834 |
|
128 |
81 |
$198.37 |
| 83550 |
|
68 |
62 |
$187.43 |
| 97162 |
|
15 |
14 |
$184.37 |
| 87040 |
|
40 |
38 |
$164.91 |
| 85007 |
|
111 |
88 |
$142.56 |
| 80076 |
|
13 |
12 |
$134.85 |
| 82784 |
|
17 |
15 |
$130.48 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
398 |
368 |
$124.00 |
| 81025 |
|
162 |
154 |
$119.58 |
| J8499 |
Oral prescrip drug non chemo |
82 |
37 |
$118.81 |
| 85730 |
|
103 |
97 |
$107.38 |
| 84703 |
|
733 |
689 |
$97.30 |
| 87205 |
|
34 |
31 |
$87.20 |
| J3010 |
Fentanyl citrate injection |
1,457 |
1,232 |
$85.57 |
| 84156 |
|
27 |
25 |
$79.40 |
| 11721 |
|
531 |
523 |
$59.93 |
| J1642 |
Inj heparin sodium per 10 u |
1,078 |
565 |
$56.87 |
| 82746 |
|
13 |
12 |
$56.25 |
| J1170 |
Hydromorphone injection |
231 |
196 |
$48.81 |
| 82550 |
|
450 |
391 |
$41.55 |
| Q9969 |
Non-heu tc-99m add-on/dose |
32 |
26 |
$35.04 |
| J1885 |
Ketorolac tromethamine inj |
519 |
472 |
$16.23 |
| J1100 |
Dexamethasone sodium phos |
1,117 |
986 |
$13.22 |
| J2405 |
Ondansetron hcl injection |
1,361 |
1,189 |
$6.52 |
| 82962 |
|
310 |
190 |
$5.88 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
12 |
12 |
$4.00 |
| J2250 |
Inj midazolam hydrochloride |
503 |
446 |
$1.70 |
| 96376 |
|
137 |
93 |
$0.00 |
| J7050 |
Normal saline solution infus |
403 |
210 |
$0.00 |
| 94640 |
|
98 |
87 |
$0.00 |
| J2060 |
Lorazepam injection |
95 |
64 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
168 |
123 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
53 |
42 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
39 |
26 |
$0.00 |
| C1769 |
Guide wire |
17 |
13 |
$0.00 |
| 83605 |
|
18 |
15 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
29 |
25 |
$0.00 |
| Q3014 |
Telehealth facility fee |
12 |
12 |
$0.00 |
| 87500 |
|
14 |
12 |
$0.00 |
| 88304 |
|
12 |
12 |
$0.00 |
| 92014 |
|
174 |
168 |
$0.00 |
| J1650 |
Inj enoxaparin sodium |
51 |
25 |
$0.00 |
| J2550 |
Promethazine hcl injection |
15 |
12 |
$0.00 |
| J2270 |
Morphine sulfate injection |
155 |
106 |
$0.00 |
| J7040 |
Normal saline solution infus |
18 |
13 |
$0.00 |
| 93296 |
|
27 |
27 |
$0.00 |
| G8978 |
Mobility current status |
47 |
44 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
13 |
12 |
$0.00 |
| J0897 |
Denosumab injection |
13 |
12 |
$0.00 |
| G8979 |
Mobility goal status |
63 |
58 |
$0.00 |
| A9552 |
F18 fdg |
17 |
14 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
13 |
12 |
$0.00 |