| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 81003 |
|
150 |
149 |
$0.00 |
| 84481 |
|
230 |
229 |
$0.00 |
| 82274 |
|
138 |
137 |
$0.00 |
| 99204 |
|
194 |
191 |
$0.00 |
| 88175 |
|
344 |
344 |
$0.00 |
| 84439 |
|
348 |
346 |
$0.00 |
| 86696 |
|
217 |
215 |
$0.00 |
| 80307 |
|
711 |
640 |
$0.00 |
| 99211 |
|
113 |
107 |
$0.00 |
| 99393 |
|
27 |
27 |
$0.00 |
| 84403 |
|
92 |
88 |
$0.00 |
| 80061 |
|
1,773 |
1,766 |
$0.00 |
| 86480 |
|
35 |
35 |
$0.00 |
| 87491 |
|
691 |
681 |
$0.00 |
| 86708 |
|
210 |
209 |
$0.00 |
| 84100 |
|
158 |
155 |
$0.00 |
| 80074 |
|
140 |
139 |
$0.00 |
| 83540 |
|
132 |
132 |
$0.00 |
| 99284 |
|
180 |
178 |
$0.00 |
| 86038 |
|
26 |
26 |
$0.00 |
| 90460 |
|
130 |
129 |
$0.00 |
| 87880 |
|
142 |
135 |
$0.00 |
| T4541 |
Large disposable underpad |
83 |
82 |
$0.00 |
| 86900 |
|
113 |
98 |
$0.00 |
| 71046 |
|
212 |
210 |
$0.00 |
| 82570 |
|
249 |
247 |
$0.00 |
| 83655 |
|
141 |
141 |
$0.00 |
| 99173 |
|
274 |
274 |
$0.00 |
| 99392 |
|
112 |
112 |
$0.00 |
| 84702 |
|
18 |
15 |
$0.00 |
| 82565 |
|
13 |
12 |
$0.00 |
| 90670 |
|
29 |
29 |
$0.00 |
| 92081 |
|
136 |
136 |
$0.00 |
| 85610 |
|
197 |
177 |
$0.00 |
| 99212 |
|
1,204 |
1,103 |
$0.00 |
| 77067 |
|
54 |
54 |
$0.00 |
| 87186 |
|
56 |
56 |
$0.00 |
| 90633 |
|
26 |
26 |
$0.00 |
| 86709 |
|
112 |
111 |
$0.00 |
| 81025 |
|
260 |
239 |
$0.00 |
| 81002 |
|
173 |
162 |
$0.00 |
| 92552 |
|
137 |
137 |
$0.00 |
| 99223 |
Prolong inpt eval add15 m |
12 |
12 |
$0.00 |
| 59425 |
|
17 |
12 |
$0.00 |
| 82172 |
|
29 |
29 |
$0.00 |
| 99395 |
|
12 |
12 |
$0.00 |
| 99203 |
|
77 |
77 |
$0.00 |
| 84550 |
|
20 |
20 |
$0.00 |
| 93010 |
|
131 |
127 |
$0.00 |
| 84460 |
|
89 |
88 |
$0.00 |
| 99051 |
|
428 |
401 |
$0.00 |
| 90461 |
|
14 |
14 |
$0.00 |
| G8417 |
Calc bmi abv up param f/u |
74 |
66 |
$0.00 |
| 83970 |
|
14 |
14 |
$0.00 |
| 87799 |
|
43 |
43 |
$0.00 |
| 82542 |
|
65 |
60 |
$0.00 |
| 72114 |
|
16 |
16 |
$0.00 |
| 85007 |
|
27 |
27 |
$0.00 |
| 97110 |
|
27 |
15 |
$0.00 |
| 82248 |
|
143 |
136 |
$0.00 |
| 82947 |
|
27 |
27 |
$0.00 |
| 80076 |
|
16 |
16 |
$0.00 |
| 99222 |
|
15 |
15 |
$0.00 |
| 82627 |
|
38 |
38 |
$0.00 |
| 3078F |
|
13 |
12 |
$0.00 |
| 87502 |
|
17 |
16 |
$0.00 |
| 83525 |
|
17 |
17 |
$0.00 |
| 87512 |
|
16 |
16 |
$0.00 |
| G0483 |
Drug test def 22+ classes |
13 |
13 |
$0.00 |
| 86850 |
|
120 |
100 |
$0.00 |
| 81001 |
|
1,029 |
981 |
$0.00 |
| 82607 |
|
179 |
179 |
$0.00 |
| 96372 |
|
197 |
183 |
$0.00 |
| G0480 |
Drug test def 1-7 classes |
121 |
116 |
$0.00 |
| 96127 |
|
290 |
285 |
$0.00 |
| 82306 |
|
511 |
508 |
$0.00 |
| 99285 |
|
131 |
128 |
$0.00 |
| 99283 |
|
451 |
442 |
$0.00 |
| 99214 |
|
1,576 |
1,466 |
$0.00 |
| 83690 |
|
172 |
158 |
$0.00 |
| 99213 |
|
7,725 |
6,565 |
$0.00 |
| 85018 |
|
388 |
386 |
$0.00 |
| 82550 |
|
89 |
84 |
$0.00 |
| 80053 |
|
2,691 |
2,543 |
$0.00 |
| 82962 |
|
169 |
154 |
$0.00 |
| 85025 |
|
2,949 |
2,742 |
$0.00 |
| G8419 |
Calc bmi out nrm param nof/u |
246 |
215 |
$0.00 |
| 87086 |
|
454 |
436 |
$0.00 |
| 36415 |
|
3,317 |
3,151 |
$0.00 |
| 86695 |
|
219 |
217 |
$0.00 |
| 86704 |
|
211 |
210 |
$0.00 |
| 86762 |
|
57 |
57 |
$0.00 |
| 86901 |
|
98 |
84 |
$0.00 |
| 97802 |
|
312 |
303 |
$0.00 |
| 80050 |
|
66 |
66 |
$0.00 |
| 82553 |
|
77 |
75 |
$0.00 |
| 99000 |
|
134 |
132 |
$0.00 |
| 86317 |
|
210 |
209 |
$0.00 |
| 80048 |
|
360 |
339 |
$0.00 |
| 83036 |
|
1,366 |
1,360 |
$0.00 |
| 85027 |
|
369 |
359 |
$0.00 |
| 86800 |
|
80 |
80 |
$0.00 |
| 87624 |
|
190 |
190 |
$0.00 |
| 84443 |
|
1,453 |
1,446 |
$0.00 |
| 87088 |
|
228 |
223 |
$0.00 |
| 87340 |
|
411 |
410 |
$0.00 |
| 83001 |
|
80 |
80 |
$0.00 |
| 81000 |
|
159 |
159 |
$0.00 |
| 90471 |
|
633 |
624 |
$0.00 |
| T4535 |
Disposable liner/shield/pad |
42 |
37 |
$0.00 |
| 97140 |
|
28 |
15 |
$0.00 |
| 84484 |
|
166 |
158 |
$0.00 |
| J3490 |
Drugs unclassified injection |
179 |
110 |
$0.00 |
| 87389 |
|
746 |
744 |
$0.00 |
| 87591 |
|
691 |
681 |
$0.00 |
| 86592 |
|
500 |
498 |
$0.00 |
| 80069 |
|
20 |
18 |
$0.00 |
| 99202 |
|
107 |
106 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
65 |
59 |
$0.00 |
| 87040 |
|
42 |
40 |
$0.00 |
| D1206 |
|
104 |
104 |
$0.00 |
| 92551 |
|
251 |
250 |
$0.00 |
| 87081 |
|
178 |
172 |
$0.00 |
| 87522 |
Neg quan hep c or qual rna |
30 |
29 |
$0.00 |
| 86140 |
|
107 |
100 |
$0.00 |
| 83605 |
|
30 |
29 |
$0.00 |
| 84480 |
|
86 |
86 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
57 |
53 |
$0.00 |
| 86803 |
|
372 |
370 |
$0.00 |
| 84479 |
|
120 |
120 |
$0.00 |
| 84153 |
|
119 |
118 |
$0.00 |
| 90674 |
|
13 |
13 |
$0.00 |
| 82672 |
|
46 |
46 |
$0.00 |
| 93000 |
|
12 |
12 |
$0.00 |
| 83735 |
|
44 |
43 |
$0.00 |
| 87070 |
|
16 |
16 |
$0.00 |
| 86376 |
|
89 |
89 |
$0.00 |
| 87801 |
|
15 |
15 |
$0.00 |
| 82664 |
|
13 |
13 |
$0.00 |
| 83880 |
|
29 |
27 |
$0.00 |
| 82670 |
|
67 |
67 |
$0.00 |
| 83704 |
|
68 |
68 |
$0.00 |
| 87661 |
|
51 |
51 |
$0.00 |
| 82043 |
|
198 |
198 |
$0.00 |
| 85652 |
|
82 |
79 |
$0.00 |
| G8420 |
Calc bmi norm parameters |
216 |
182 |
$0.00 |
| 85730 |
|
50 |
47 |
$0.00 |
| 97010 |
|
25 |
12 |
$0.00 |
| 87077 |
|
27 |
27 |
$0.00 |
| G0447 |
Behavior counsel obesity 15m |
54 |
54 |
$0.00 |
| 94760 |
|
187 |
85 |
$0.00 |
| 3008F |
|
340 |
305 |
$0.00 |
| 83789 |
|
64 |
60 |
$0.00 |
| 82746 |
|
59 |
59 |
$0.00 |
| 83002 |
|
31 |
31 |
$0.00 |
| 94640 |
|
15 |
14 |
$0.00 |
| 99232 |
|
28 |
12 |
$0.00 |
| J2001 |
Lidocaine injection |
60 |
56 |
$0.00 |
| 82728 |
|
33 |
33 |
$0.00 |
| 84436 |
|
23 |
23 |
$0.00 |
| 71045 |
|
40 |
40 |
$0.00 |
| 82950 |
|
12 |
12 |
$0.00 |
| 99385 |
|
15 |
15 |
$0.00 |
| 84144 |
|
16 |
16 |
$0.00 |
| 90686 |
|
28 |
28 |
$0.00 |
| 83550 |
|
27 |
27 |
$0.00 |
| 87147 |
|
12 |
12 |
$0.00 |
| 99444 |
|
12 |
12 |
$0.00 |