| Code | Description | Claims | Beneficiaries | Total Paid |
| 41899 |
|
752 |
663 |
$1.48M |
| 99284 |
|
24,879 |
19,923 |
$1.09M |
| 99283 |
|
26,338 |
23,285 |
$995K |
| 99285 |
|
7,029 |
5,906 |
$335K |
| 87637 |
|
3,530 |
3,376 |
$326K |
| 80053 |
|
20,301 |
18,589 |
$189K |
| 87631 |
|
1,117 |
1,089 |
$115K |
| 85025 |
|
24,480 |
22,136 |
$106K |
| 96374 |
|
4,190 |
3,907 |
$79K |
| G0463 |
Hospital outpt clinic visit |
2,797 |
1,978 |
$70K |
| 96375 |
|
1,607 |
1,471 |
$51K |
| 96361 |
|
2,760 |
2,522 |
$50K |
| 81001 |
|
9,490 |
8,926 |
$36K |
| U0003 |
Cov-19 amp prb hgh thruput |
607 |
594 |
$35K |
| 93005 |
|
2,611 |
2,389 |
$27K |
| 87491 |
|
561 |
542 |
$25K |
| 87591 |
|
561 |
542 |
$25K |
| 80307 |
|
449 |
393 |
$24K |
| 43239 |
|
179 |
166 |
$22K |
| 88305 |
|
528 |
485 |
$18K |
| 70450 |
|
185 |
178 |
$14K |
| 87635 |
|
384 |
366 |
$13K |
| 87081 |
|
1,523 |
1,496 |
$13K |
| 71046 |
|
877 |
838 |
$12K |
| 74177 |
|
94 |
91 |
$10K |
| 99282 |
|
348 |
324 |
$9K |
| 84703 |
|
828 |
790 |
$7K |
| 84443 |
|
549 |
529 |
$7K |
| 96365 |
|
108 |
86 |
$7K |
| 97110 |
|
219 |
83 |
$6K |
| 87661 |
|
291 |
282 |
$6K |
| 87086 |
|
512 |
491 |
$5K |
| U0005 |
Infec agen detec ampli probe |
338 |
330 |
$5K |
| 83690 |
|
692 |
640 |
$5K |
| 84484 |
|
501 |
442 |
$4K |
| 36415 |
|
25,329 |
22,277 |
$4K |
| 87426 |
|
190 |
154 |
$4K |
| 71045 |
|
405 |
386 |
$4K |
| 86780 |
|
197 |
195 |
$4K |
| G0378 |
Hospital observation per hr |
58 |
40 |
$3K |
| 87070 |
|
387 |
378 |
$3K |
| J3490 |
Drugs unclassified injection |
4,230 |
2,817 |
$3K |
| 96360 |
|
74 |
70 |
$3K |
| 80061 |
|
237 |
237 |
$3K |
| 87389 |
|
95 |
95 |
$2K |
| 96372 |
|
127 |
118 |
$2K |
| 83874 |
|
231 |
210 |
$2K |
| 97530 |
|
90 |
43 |
$2K |
| 80048 |
|
241 |
226 |
$2K |
| 99070 |
|
564 |
515 |
$2K |
| 87205 |
|
330 |
323 |
$2K |
| 88142 |
|
80 |
78 |
$2K |
| 86803 |
|
96 |
96 |
$2K |
| 83605 |
|
196 |
182 |
$2K |
| 97597 |
|
22 |
13 |
$2K |
| 96376 |
|
106 |
89 |
$2K |
| 83036 |
|
172 |
170 |
$2K |
| 87624 |
|
44 |
42 |
$2K |
| 87186 |
|
123 |
119 |
$1K |
| 85610 |
|
508 |
380 |
$1K |
| 94640 |
|
126 |
119 |
$1K |
| 87430 |
|
113 |
112 |
$1K |
| 71275 |
|
12 |
12 |
$1K |
| 77067 |
|
43 |
43 |
$1K |
| 83735 |
|
237 |
218 |
$1K |
| 93971 |
|
13 |
12 |
$1K |
| 84439 |
|
93 |
92 |
$965.02 |
| 87340 |
|
64 |
64 |
$954.34 |
| 97140 |
|
66 |
30 |
$783.10 |
| 73630 |
|
40 |
40 |
$744.60 |
| 86850 |
|
78 |
78 |
$716.51 |
| 82962 |
|
148 |
95 |
$715.96 |
| 83655 |
|
48 |
47 |
$707.59 |
| 87088 |
|
61 |
61 |
$703.11 |
| 76856 |
|
14 |
13 |
$702.49 |
| 84702 |
|
64 |
53 |
$694.08 |
| 97161 |
|
18 |
18 |
$660.70 |
| 87077 |
|
63 |
62 |
$659.37 |
| 82728 |
|
34 |
33 |
$587.40 |
| 99212 |
|
28 |
25 |
$583.11 |
| J7030 |
Normal saline solution infus |
3,588 |
3,371 |
$565.82 |
| 81025 |
|
70 |
66 |
$555.69 |
| 73130 |
|
30 |
29 |
$529.19 |
| 86901 |
|
82 |
80 |
$521.59 |
| J2405 |
Ondansetron hcl injection |
1,254 |
1,126 |
$469.22 |
| 82306 |
|
48 |
48 |
$441.04 |
| 73562 |
|
29 |
28 |
$431.83 |
| 86900 |
|
82 |
80 |
$413.47 |
| 82607 |
|
28 |
28 |
$400.08 |
| 86140 |
|
59 |
52 |
$390.10 |
| 86762 |
|
41 |
41 |
$377.99 |
| J2704 |
Inj, propofol, 10 mg |
1,288 |
1,087 |
$369.69 |
| 85379 |
|
48 |
46 |
$347.38 |
| 87040 |
|
32 |
31 |
$341.47 |
| 82570 |
|
58 |
51 |
$322.09 |
| 0001A |
|
52 |
51 |
$318.30 |
| J3010 |
Fentanyl citrate injection |
647 |
568 |
$297.23 |
| 0002A |
|
49 |
49 |
$289.72 |
| 85652 |
|
58 |
50 |
$282.84 |
| 84145 |
|
13 |
13 |
$274.63 |
| 73110 |
|
15 |
15 |
$274.61 |
| 72100 |
|
16 |
16 |
$265.76 |
| 99211 |
|
32 |
31 |
$258.15 |
| 82951 |
|
13 |
12 |
$255.59 |
| 85027 |
|
29 |
29 |
$242.45 |
| 73610 |
|
15 |
15 |
$231.70 |
| 81003 |
|
161 |
152 |
$190.24 |
| J2270 |
Morphine sulfate injection |
83 |
70 |
$186.41 |
| J0780 |
Prochlorperazine injection |
21 |
17 |
$181.23 |
| 0011A |
|
20 |
19 |
$173.16 |
| 83550 |
|
16 |
16 |
$171.41 |
| 0012A |
|
16 |
16 |
$144.58 |
| 82950 |
|
19 |
19 |
$143.92 |
| J1885 |
Ketorolac tromethamine inj |
180 |
166 |
$142.45 |
| 83540 |
|
29 |
29 |
$133.11 |
| C9803 |
Hopd covid-19 spec collect |
1,042 |
1,013 |
$116.20 |
| J1100 |
Dexamethasone sodium phos |
614 |
553 |
$102.79 |
| 84550 |
|
14 |
14 |
$80.20 |
| J0696 |
Ceftriaxone sodium injection |
28 |
27 |
$68.29 |
| 80164 |
|
15 |
12 |
$62.96 |
| J2060 |
Lorazepam injection |
54 |
40 |
$59.37 |
| J1200 |
Diphenhydramine hcl injectio |
44 |
39 |
$43.63 |
| 82077 |
|
94 |
84 |
$31.08 |
| J2765 |
Metoclopramide hcl injection |
16 |
16 |
$22.34 |
| J2175 |
Meperidine hydrochl /100 mg |
12 |
12 |
$16.69 |
| P9604 |
One-way allow prorated trip |
56 |
55 |
$0.72 |
| J2250 |
Inj midazolam hydrochloride |
39 |
37 |
$0.12 |
| C1773 |
Ret dev, insertable |
82 |
79 |
$0.00 |
| A9579 |
Gad-base mr contrast nos,1ml |
27 |
27 |
$0.00 |
| 36416 |
|
26 |
24 |
$0.00 |
| J1940 |
Furosemide injection |
13 |
12 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
206 |
202 |
$0.00 |
| G8978 |
Mobility current status |
14 |
14 |
$0.00 |
| G9744 |
Pt not eli d/t act dig htn |
43 |
39 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
44 |
40 |
$0.00 |
| G8979 |
Mobility goal status |
17 |
17 |
$0.00 |