| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpt clinic visit |
32,336 |
11,992 |
$489K |
| A9270 |
Non-covered item or service |
8,073 |
1,098 |
$162K |
| 90999 |
|
10,925 |
241 |
$117K |
| 88300 |
|
109 |
93 |
$85K |
| 99283 |
|
2,020 |
1,226 |
$80K |
| 93005 |
|
5,674 |
642 |
$76K |
| J3490 |
Drugs unclassified injection |
777 |
371 |
$73K |
| 99282 |
|
1,677 |
1,223 |
$50K |
| 99284 |
|
1,224 |
360 |
$49K |
| 99213 |
|
1,396 |
948 |
$27K |
| A0427 |
Als1-emergency |
276 |
237 |
$25K |
| 80053 |
|
274 |
212 |
$22K |
| A0429 |
Bls-emergency |
275 |
236 |
$22K |
| 99214 |
|
1,023 |
589 |
$21K |
| 96372 |
|
121 |
40 |
$19K |
| 88305 |
|
1,079 |
812 |
$19K |
| C9803 |
Hopd covid-19 spec collect |
165 |
150 |
$13K |
| A0425 |
Ground mileage |
573 |
487 |
$13K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
538 |
118 |
$12K |
| U0003 |
Cov-19 amp prb hgh thruput |
288 |
262 |
$9K |
| G0008 |
Admin influenza virus vac |
1,482 |
189 |
$8K |
| 00170 |
|
85 |
81 |
$7K |
| 99285 |
|
327 |
44 |
$7K |
| J3301 |
Triamcinolone acet inj nos |
154 |
52 |
$6K |
| 97110 |
|
374 |
130 |
$6K |
| 99212 |
|
164 |
140 |
$5K |
| E1390 |
Oxygen concentrator |
253 |
243 |
$5K |
| 97530 |
|
183 |
42 |
$4K |
| 99232 |
|
158 |
67 |
$3K |
| 92014 |
|
97 |
94 |
$3K |
| 93010 |
|
195 |
58 |
$3K |
| 36415 |
|
126 |
105 |
$3K |
| 99308 |
|
125 |
112 |
$3K |
| 92507 |
|
95 |
37 |
$2K |
| 90837 |
|
119 |
82 |
$2K |
| J2405 |
Ondansetron hcl injection |
340 |
176 |
$2K |
| 97112 |
|
133 |
48 |
$2K |
| 99281 |
|
28 |
18 |
$2K |
| J3010 |
Fentanyl citrate injection |
157 |
73 |
$2K |
| 93971 |
|
71 |
12 |
$2K |
| 98941 |
|
156 |
128 |
$1K |
| 00731 |
|
17 |
14 |
$1K |
| J1100 |
Dexamethasone sodium phos |
207 |
146 |
$1K |
| J2704 |
Inj, propofol, 10 mg |
251 |
169 |
$881.19 |
| 99203 |
|
31 |
29 |
$841.80 |
| Q3014 |
Telehealth facility fee |
195 |
118 |
$832.01 |
| 90834 |
|
54 |
50 |
$823.65 |
| 88307 |
|
28 |
26 |
$823.00 |
| 92134 |
|
38 |
26 |
$791.29 |
| 87502 |
|
13 |
12 |
$768.90 |
| 90832 |
|
52 |
45 |
$739.12 |
| 71046 |
|
64 |
31 |
$645.38 |
| G2025 |
Dis site tele svcs rhc/fqhc |
38 |
31 |
$639.22 |
| 87804 |
|
29 |
15 |
$627.36 |
| 99309 |
|
17 |
16 |
$552.26 |
| 85025 |
|
403 |
307 |
$459.75 |
| E1392 |
Portable oxygen concentrator |
55 |
54 |
$382.16 |
| 90853 |
|
75 |
53 |
$362.75 |
| 87635 |
|
33 |
32 |
$338.74 |
| 99334 |
|
25 |
25 |
$328.83 |
| E0601 |
Cont airway pressure device |
35 |
35 |
$326.99 |
| 11721 |
|
30 |
19 |
$316.96 |
| 99211 |
|
180 |
173 |
$307.16 |
| 97140 |
|
55 |
27 |
$292.66 |
| 99442 |
|
19 |
16 |
$246.50 |
| 99443 |
|
13 |
12 |
$240.24 |
| G0511 |
Ccm/bhi by rhc/fqhc 20min mo |
16 |
16 |
$213.60 |
| 98940 |
|
29 |
27 |
$187.47 |
| A4253 |
Blood glucose/reagent strips |
59 |
59 |
$186.36 |
| E0431 |
Portable gaseous 02 |
46 |
43 |
$169.80 |
| 87651 |
|
13 |
12 |
$154.60 |
| A4604 |
Tubing with heating element |
14 |
14 |
$151.06 |
| 93296 |
|
20 |
20 |
$149.10 |
| 87880 |
|
27 |
27 |
$114.71 |
| A7038 |
Pos airway pressure filter |
28 |
28 |
$103.18 |
| 87081 |
|
13 |
13 |
$79.17 |
| Q0513 |
Disp fee inhal drugs/30 days |
13 |
13 |
$72.60 |
| A4357 |
Bedside drainage bag |
12 |
12 |
$37.48 |
| 71045 |
|
21 |
14 |
$31.01 |
| J1885 |
Ketorolac tromethamine inj |
31 |
27 |
$0.78 |
| 90656 |
|
12 |
12 |
$0.00 |
| 80061 |
|
12 |
12 |
$0.00 |
| J2270 |
Morphine sulfate injection |
15 |
14 |
$0.00 |
| G8730 |
Pain doc pos and plan |
14 |
12 |
$0.00 |
| 92015 |
|
25 |
24 |
$0.00 |