| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99221 |
|
6,502 |
5,171 |
$216K |
| 80053 |
|
5,674 |
4,744 |
$103K |
| 92507 |
|
1,739 |
709 |
$101K |
| 99281 |
|
2,931 |
2,423 |
$65K |
| 87636 |
|
837 |
772 |
$57K |
| 97530 |
|
1,461 |
672 |
$50K |
| 85025 |
|
5,789 |
4,771 |
$48K |
| 84443 |
|
1,862 |
1,757 |
$32K |
| 87491 |
|
873 |
823 |
$32K |
| 87591 |
|
858 |
811 |
$31K |
| 93325 |
|
305 |
294 |
$30K |
| G0463 |
Hospital outpt clinic visit |
1,083 |
847 |
$28K |
| 82306 |
|
853 |
835 |
$25K |
| 80061 |
|
1,782 |
1,732 |
$24K |
| 93005 |
|
1,107 |
1,007 |
$20K |
| 0450 |
|
503 |
425 |
$19K |
| 83036 |
|
1,823 |
1,782 |
$17K |
| 99000 |
|
8,428 |
7,444 |
$17K |
| 83735 |
|
2,135 |
1,560 |
$15K |
| 85027 |
|
2,776 |
2,515 |
$14K |
| 93306 |
|
86 |
84 |
$13K |
| 93303 |
|
104 |
96 |
$13K |
| 96375 |
|
566 |
428 |
$13K |
| 96365 |
|
330 |
280 |
$13K |
| 80307 |
|
375 |
343 |
$12K |
| 80197 |
|
1,015 |
698 |
$11K |
| U0003 |
Cov-19 amp prb hgh thruput |
604 |
560 |
$10K |
| 87086 |
|
938 |
875 |
$10K |
| 80048 |
|
818 |
699 |
$9K |
| 81001 |
|
2,667 |
2,255 |
$9K |
| 93320 |
|
116 |
108 |
$9K |
| 0370 |
|
273 |
130 |
$8K |
| 84100 |
|
1,737 |
1,277 |
$8K |
| 85610 |
|
1,327 |
1,103 |
$8K |
| 97110 |
|
405 |
219 |
$8K |
| 0710 |
|
196 |
189 |
$8K |
| 83880 |
|
393 |
347 |
$8K |
| 70450 |
|
75 |
72 |
$7K |
| 87389 |
|
401 |
394 |
$7K |
| 86140 |
|
1,034 |
968 |
$7K |
| 71046 |
|
429 |
411 |
$7K |
| J3490 |
Drugs unclassified injection |
2,593 |
1,195 |
$7K |
| 86850 |
|
795 |
646 |
$7K |
| 86900 |
|
888 |
698 |
$6K |
| 96413 |
|
172 |
118 |
$6K |
| 80076 |
|
777 |
759 |
$6K |
| 87497 |
|
106 |
91 |
$5K |
| 97112 |
|
200 |
125 |
$4K |
| 82728 |
|
315 |
292 |
$4K |
| 80051 |
|
1,256 |
1,156 |
$4K |
| 85652 |
|
1,119 |
1,054 |
$4K |
| 87635 |
|
295 |
278 |
$4K |
| 86481 |
|
74 |
73 |
$4K |
| 82565 |
|
1,473 |
1,366 |
$4K |
| 96374 |
|
188 |
180 |
$4K |
| 86901 |
|
900 |
709 |
$4K |
| C9803 |
Hopd covid-19 spec collect |
179 |
164 |
$4K |
| 87631 |
|
128 |
123 |
$3K |
| 82570 |
|
588 |
483 |
$3K |
| 84439 |
|
287 |
271 |
$3K |
| 82947 |
|
1,311 |
1,202 |
$2K |
| 83550 |
|
263 |
249 |
$2K |
| A4649 |
Surgical supplies |
3,564 |
1,634 |
$2K |
| 83540 |
|
299 |
285 |
$2K |
| Q3014 |
Telehealth facility fee |
94 |
88 |
$2K |
| 86592 |
|
382 |
370 |
$2K |
| 83615 |
|
285 |
216 |
$2K |
| 74177 |
|
13 |
13 |
$2K |
| 96361 |
|
133 |
117 |
$2K |
| 96372 |
|
179 |
153 |
$2K |
| 83655 |
|
358 |
356 |
$2K |
| 84703 |
|
367 |
342 |
$1K |
| 71045 |
|
272 |
259 |
$1K |
| 86480 |
|
29 |
29 |
$1K |
| 0949 |
|
34 |
31 |
$1K |
| 84520 |
|
599 |
564 |
$1K |
| 84484 |
|
226 |
188 |
$905.42 |
| H1001 |
Antepartum management |
13 |
12 |
$902.20 |
| 84156 |
|
285 |
261 |
$840.01 |
| J2405 |
Ondansetron hcl injection |
348 |
278 |
$812.79 |
| J7030 |
Normal saline solution infus |
424 |
392 |
$799.94 |
| 87088 |
|
107 |
99 |
$781.46 |
| 90686 |
|
35 |
35 |
$699.23 |
| 90471 |
|
110 |
108 |
$625.20 |
| 92550 |
|
13 |
13 |
$574.79 |
| 87637 |
|
12 |
12 |
$570.52 |
| 0250 |
|
341 |
166 |
$559.99 |
| 83690 |
|
159 |
146 |
$454.76 |
| 83605 |
|
38 |
29 |
$358.67 |
| G2023 |
Specimen collect covid-19 |
18 |
18 |
$329.48 |
| 82550 |
|
47 |
42 |
$276.57 |
| 82607 |
|
12 |
12 |
$250.28 |
| 87205 |
|
44 |
43 |
$241.69 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
209 |
202 |
$241.30 |
| 86225 |
|
13 |
13 |
$220.61 |
| 87077 |
|
52 |
39 |
$218.97 |
| 86160 |
|
22 |
12 |
$207.34 |
| J2704 |
Inj, propofol, 10 mg |
130 |
116 |
$199.52 |
| 87070 |
|
26 |
26 |
$191.52 |
| 87186 |
|
19 |
14 |
$181.39 |
| 99401 |
|
13 |
13 |
$144.72 |
| J1885 |
Ketorolac tromethamine inj |
80 |
77 |
$135.54 |
| 87340 |
|
13 |
12 |
$127.50 |
| J3010 |
Fentanyl citrate injection |
90 |
83 |
$121.04 |
| 36415 |
|
126 |
101 |
$106.00 |
| 73610 |
|
15 |
13 |
$96.64 |
| 85730 |
|
12 |
12 |
$74.20 |
| J1200 |
Diphenhydramine hcl injectio |
38 |
25 |
$64.89 |
| J2270 |
Morphine sulfate injection |
15 |
13 |
$45.58 |
| J7040 |
Normal saline solution infus |
12 |
12 |
$23.39 |
| J1100 |
Dexamethasone sodium phos |
17 |
15 |
$14.12 |
| 82962 |
|
27 |
26 |
$4.71 |
| J2250 |
Inj midazolam hydrochloride |
26 |
26 |
$4.68 |
| 0258 |
|
59 |
40 |
$0.00 |
| 96376 |
|
16 |
12 |
$0.00 |