| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
3,013 |
2,454 |
$417K |
| 99284 |
|
1,763 |
1,402 |
$307K |
| 99285 |
|
739 |
575 |
$142K |
| 96374 |
|
1,065 |
801 |
$85K |
| 87502 |
|
1,395 |
1,165 |
$77K |
| 99282 |
|
540 |
476 |
$50K |
| 87635 |
|
1,574 |
1,289 |
$45K |
| 74177 |
|
186 |
139 |
$28K |
| 96361 |
|
906 |
629 |
$25K |
| 71046 |
|
469 |
403 |
$22K |
| 93005 |
|
1,180 |
893 |
$21K |
| 71045 |
|
767 |
597 |
$21K |
| 96375 |
|
706 |
507 |
$19K |
| 94640 |
|
233 |
193 |
$18K |
| 96372 |
|
450 |
394 |
$17K |
| 70450 |
|
367 |
336 |
$17K |
| 87651 |
|
518 |
470 |
$13K |
| 96365 |
|
170 |
127 |
$11K |
| 36415 |
|
2,875 |
1,957 |
$8K |
| 80053 |
|
2,064 |
1,559 |
$8K |
| 85025 |
|
2,310 |
1,618 |
$6K |
| 96360 |
|
62 |
54 |
$6K |
| 86756 |
|
397 |
367 |
$5K |
| 80307 |
|
115 |
91 |
$3K |
| 84484 |
|
763 |
571 |
$3K |
| 83880 |
|
352 |
264 |
$2K |
| 84703 |
|
563 |
472 |
$2K |
| 87088 |
|
614 |
505 |
$2K |
| 81001 |
|
1,427 |
1,120 |
$2K |
| 83690 |
|
569 |
434 |
$2K |
| 73130 |
|
22 |
12 |
$1K |
| 87426 |
|
40 |
30 |
$953.38 |
| 80048 |
|
287 |
203 |
$935.95 |
| 82550 |
|
464 |
376 |
$868.21 |
| 73630 |
|
14 |
14 |
$831.90 |
| 83735 |
|
257 |
209 |
$561.17 |
| 84443 |
|
66 |
57 |
$512.70 |
| 85730 |
|
275 |
216 |
$481.74 |
| 82553 |
|
160 |
134 |
$449.69 |
| 83605 |
|
91 |
71 |
$404.98 |
| 85610 |
|
304 |
242 |
$394.98 |
| 87040 |
|
46 |
40 |
$263.01 |
| 82948 |
|
182 |
102 |
$258.29 |
| 90471 |
|
15 |
12 |
$256.42 |
| C9803 |
Hopd covid-19 spec collect |
20 |
18 |
$219.51 |
| 80061 |
|
25 |
24 |
$124.38 |
| 85027 |
|
42 |
25 |
$101.29 |
| 87186 |
|
16 |
13 |
$71.24 |
| 83036 |
|
15 |
14 |
$53.13 |
| 90715 |
|
15 |
12 |
$32.74 |
| J1885 |
Ketorolac tromethamine inj |
401 |
328 |
$9.08 |
| J2405 |
Ondansetron hcl injection |
674 |
495 |
$1.74 |
| J1100 |
Dexamethasone sodium phos |
129 |
114 |
$0.37 |
| J3490 |
Drugs unclassified injection |
2,873 |
1,397 |
$0.00 |
| 36416 |
|
174 |
102 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
56 |
40 |
$0.00 |
| J7050 |
Normal saline solution infus |
19 |
12 |
$0.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
14 |
13 |
$0.00 |
| G1004 |
Cdsm ndsc |
158 |
138 |
$0.00 |
| J2270 |
Morphine sulfate injection |
75 |
55 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
505 |
316 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
38 |
12 |
$0.00 |
| J2930 |
Methylprednisolone injection |
14 |
13 |
$0.00 |