| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
16,220 |
11,193 |
$539K |
| 99284 |
|
6,651 |
6,395 |
$412K |
| 87633 |
|
658 |
640 |
$258K |
| 99283 |
|
3,958 |
3,845 |
$173K |
| 99285 |
|
1,748 |
1,702 |
$122K |
| 74177 |
|
451 |
439 |
$77K |
| 96374 |
|
2,798 |
2,713 |
$69K |
| G0378 |
Hospital observation per hr |
63 |
53 |
$55K |
| 80053 |
|
4,563 |
4,361 |
$42K |
| 85025 |
|
7,720 |
7,076 |
$35K |
| U0003 |
Cov-19 amp prb hgh thruput |
522 |
470 |
$34K |
| 80307 |
|
605 |
530 |
$34K |
| 96375 |
|
1,434 |
1,355 |
$29K |
| 70450 |
|
404 |
382 |
$23K |
| 82803 |
|
1,107 |
1,036 |
$22K |
| 80048 |
|
3,267 |
2,855 |
$22K |
| 80050 |
|
514 |
506 |
$21K |
| 93005 |
|
2,365 |
2,229 |
$20K |
| 84443 |
|
838 |
822 |
$17K |
| 87481 |
|
109 |
106 |
$14K |
| 77067 |
|
180 |
180 |
$14K |
| 80076 |
|
1,883 |
1,648 |
$13K |
| 80061 |
|
988 |
984 |
$12K |
| 74176 |
|
149 |
144 |
$11K |
| 82306 |
|
307 |
304 |
$10K |
| 84484 |
|
1,174 |
1,071 |
$9K |
| 87491 |
|
430 |
419 |
$9K |
| 87624 |
|
251 |
249 |
$9K |
| 87591 |
|
399 |
389 |
$9K |
| 87086 |
|
1,224 |
1,143 |
$8K |
| 83605 |
|
1,170 |
1,089 |
$8K |
| 88175 |
|
253 |
251 |
$7K |
| 71046 |
|
576 |
549 |
$7K |
| 81001 |
|
2,853 |
2,713 |
$7K |
| 83735 |
|
1,092 |
1,045 |
$6K |
| 96365 |
|
208 |
164 |
$6K |
| 71275 |
|
38 |
38 |
$5K |
| 85027 |
|
771 |
756 |
$5K |
| 82375 |
|
1,109 |
1,038 |
$5K |
| 87798 |
|
167 |
165 |
$5K |
| 99214 |
|
284 |
183 |
$5K |
| 84702 |
|
302 |
235 |
$4K |
| 83690 |
|
1,068 |
1,020 |
$4K |
| 87186 |
|
589 |
540 |
$4K |
| 96372 |
|
296 |
282 |
$4K |
| 71045 |
|
645 |
603 |
$4K |
| 82607 |
|
339 |
335 |
$4K |
| 84466 |
|
268 |
260 |
$4K |
| 87077 |
|
599 |
549 |
$4K |
| 73564 |
|
191 |
180 |
$4K |
| 73610 |
|
215 |
196 |
$4K |
| 81025 |
|
950 |
921 |
$3K |
| 82728 |
|
315 |
308 |
$3K |
| 80329 |
|
236 |
223 |
$3K |
| 99282 |
|
114 |
113 |
$3K |
| 88305 |
|
273 |
258 |
$3K |
| 96361 |
|
176 |
160 |
$3K |
| 77063 |
|
155 |
155 |
$3K |
| 73630 |
|
292 |
275 |
$3K |
| 83050 |
|
1,107 |
1,036 |
$3K |
| 99281 |
|
155 |
152 |
$3K |
| 93306 |
|
38 |
37 |
$3K |
| 11721 |
|
429 |
361 |
$3K |
| 83036 |
|
411 |
408 |
$2K |
| 86803 |
|
130 |
130 |
$2K |
| 84132 |
|
586 |
558 |
$2K |
| 87081 |
|
439 |
427 |
$2K |
| 87040 |
|
164 |
136 |
$2K |
| 83540 |
|
282 |
274 |
$2K |
| 85379 |
|
199 |
191 |
$2K |
| 84439 |
|
228 |
222 |
$2K |
| 87430 |
|
270 |
262 |
$2K |
| 99213 |
|
130 |
100 |
$1K |
| 85018 |
|
643 |
607 |
$1K |
| 72125 |
|
15 |
14 |
$1K |
| 85610 |
|
529 |
469 |
$1K |
| 86618 |
|
59 |
59 |
$1K |
| 76705 |
|
31 |
31 |
$1K |
| 84153 |
|
57 |
57 |
$1K |
| 87070 |
|
212 |
199 |
$1K |
| 90715 |
|
52 |
52 |
$939.97 |
| 83880 |
|
55 |
49 |
$878.05 |
| 82550 |
|
148 |
128 |
$844.23 |
| 85730 |
|
169 |
166 |
$799.13 |
| 87389 |
|
28 |
27 |
$796.85 |
| 85652 |
|
297 |
281 |
$786.70 |
| 73030 |
|
54 |
54 |
$749.88 |
| J7030 |
Normal saline solution infus |
1,848 |
1,715 |
$737.34 |
| 86140 |
|
272 |
252 |
$688.71 |
| 93226 |
|
14 |
14 |
$584.83 |
| 82962 |
|
325 |
205 |
$576.20 |
| 82746 |
|
56 |
54 |
$571.20 |
| 82043 |
|
68 |
67 |
$492.28 |
| G0009 |
Admin pneumococcal vaccine |
41 |
41 |
$451.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
146 |
141 |
$417.67 |
| 86780 |
|
28 |
28 |
$414.42 |
| 86850 |
|
69 |
69 |
$398.23 |
| 96110 |
|
53 |
53 |
$387.94 |
| J1885 |
Ketorolac tromethamine inj |
2,011 |
1,872 |
$324.95 |
| 20610 |
|
42 |
27 |
$322.24 |
| 73110 |
|
29 |
28 |
$310.15 |
| 87880 |
|
31 |
28 |
$302.50 |
| 93225 |
|
14 |
14 |
$268.48 |
| 84550 |
|
55 |
53 |
$257.60 |
| 36415 |
|
634 |
420 |
$243.76 |
| J1100 |
Dexamethasone sodium phos |
1,138 |
986 |
$236.31 |
| 81002 |
|
60 |
57 |
$198.87 |
| 86592 |
|
44 |
44 |
$168.04 |
| 86038 |
|
13 |
12 |
$156.00 |
| 87205 |
|
44 |
40 |
$147.80 |
| G0008 |
Admin influenza virus vac |
13 |
13 |
$146.50 |
| 73130 |
|
14 |
14 |
$144.25 |
| 90670 |
|
12 |
12 |
$132.00 |
| J2405 |
Ondansetron hcl injection |
1,841 |
1,613 |
$120.34 |
| 86901 |
|
40 |
40 |
$120.08 |
| 86900 |
|
40 |
40 |
$118.64 |
| 92551 |
|
14 |
14 |
$118.37 |
| 86430 |
|
15 |
15 |
$98.70 |
| J7050 |
Normal saline solution infus |
572 |
398 |
$87.83 |
| J3010 |
Fentanyl citrate injection |
983 |
828 |
$68.49 |
| J2765 |
Metoclopramide hcl injection |
107 |
104 |
$39.15 |
| J1200 |
Diphenhydramine hcl injectio |
88 |
79 |
$16.51 |
| J7611 |
Albuterol non-comp con |
136 |
130 |
$0.78 |
| J2250 |
Inj midazolam hydrochloride |
284 |
261 |
$0.26 |
| J3490 |
Drugs unclassified injection |
481 |
265 |
$0.00 |
| J7613 |
Albuterol non-comp unit |
49 |
45 |
$0.00 |
| J2060 |
Lorazepam injection |
52 |
42 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
77 |
63 |
$0.00 |
| J1030 |
Methylprednisolone 40 mg inj |
34 |
26 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
202 |
190 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
37 |
30 |
$0.00 |
| J1170 |
Hydromorphone injection |
55 |
38 |
$0.00 |
| J0134 |
Inj acetaminophen -fresenius |
69 |
65 |
$0.00 |
| J7040 |
Normal saline solution infus |
40 |
38 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
17 |
15 |
$0.00 |
| J2270 |
Morphine sulfate injection |
12 |
12 |
$0.00 |