| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
3,531 |
2,876 |
$368K |
| 99284 |
|
4,102 |
3,282 |
$346K |
| 74177 |
|
696 |
591 |
$156K |
| 99283 |
|
2,484 |
1,972 |
$126K |
| 96374 |
|
2,722 |
2,110 |
$74K |
| 74176 |
|
434 |
358 |
$60K |
| 70450 |
|
597 |
498 |
$46K |
| 87636 |
|
846 |
738 |
$43K |
| 96375 |
|
1,855 |
1,455 |
$33K |
| 80307 |
|
795 |
652 |
$19K |
| 96360 |
|
498 |
420 |
$15K |
| 96372 |
|
999 |
821 |
$15K |
| 99282 |
|
436 |
367 |
$14K |
| 96361 |
|
1,591 |
1,274 |
$14K |
| 85025 |
|
4,178 |
3,310 |
$13K |
| 80053 |
|
2,897 |
2,375 |
$13K |
| 72125 |
|
110 |
79 |
$10K |
| 71045 |
|
1,586 |
1,322 |
$10K |
| 84484 |
|
2,471 |
1,325 |
$10K |
| 93005 |
|
2,019 |
1,631 |
$9K |
| 71046 |
|
622 |
517 |
$8K |
| 87651 |
|
457 |
404 |
$8K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,009 |
836 |
$8K |
| 96365 |
|
208 |
177 |
$7K |
| 36415 |
|
4,545 |
3,515 |
$7K |
| 76856 |
|
126 |
107 |
$7K |
| 84702 |
|
1,341 |
1,100 |
$7K |
| 99281 |
|
280 |
238 |
$6K |
| 71275 |
|
26 |
26 |
$6K |
| 80048 |
|
1,453 |
1,157 |
$5K |
| 83690 |
|
1,615 |
1,320 |
$5K |
| 76830 |
|
59 |
49 |
$4K |
| 87086 |
|
1,104 |
943 |
$4K |
| 83880 |
|
296 |
258 |
$4K |
| 81001 |
|
2,809 |
2,306 |
$4K |
| 90715 |
|
190 |
161 |
$4K |
| 83605 |
|
762 |
584 |
$3K |
| 73564 |
|
169 |
141 |
$3K |
| 87491 |
|
152 |
147 |
$3K |
| 87591 |
|
152 |
147 |
$3K |
| 90471 |
|
201 |
165 |
$3K |
| J2270 |
Morphine sulfate injection |
979 |
818 |
$3K |
| 87661 |
|
151 |
146 |
$3K |
| 93971 |
|
54 |
49 |
$3K |
| 81025 |
|
879 |
737 |
$3K |
| 76801 |
|
51 |
38 |
$2K |
| 96376 |
|
325 |
231 |
$2K |
| 73630 |
|
141 |
123 |
$2K |
| 0241U |
|
118 |
95 |
$2K |
| 85379 |
|
399 |
331 |
$2K |
| 72131 |
|
12 |
12 |
$2K |
| 73130 |
|
104 |
79 |
$1K |
| 94640 |
|
114 |
102 |
$1K |
| 87077 |
|
355 |
276 |
$1K |
| 85730 |
|
462 |
395 |
$1K |
| 87040 |
|
198 |
101 |
$915.14 |
| J1885 |
Ketorolac tromethamine inj |
981 |
804 |
$887.77 |
| 85610 |
|
525 |
451 |
$824.08 |
| 82550 |
|
286 |
220 |
$734.58 |
| C9803 |
Hopd covid-19 spec collect |
501 |
378 |
$714.00 |
| 10060 |
|
13 |
12 |
$644.94 |
| 73030 |
|
50 |
37 |
$528.65 |
| J2405 |
Ondansetron hcl injection |
1,658 |
1,334 |
$513.32 |
| J0696 |
Ceftriaxone sodium injection |
557 |
461 |
$509.01 |
| 80076 |
|
139 |
115 |
$458.21 |
| 83735 |
|
169 |
140 |
$449.55 |
| 73610 |
|
37 |
29 |
$406.80 |
| 87186 |
|
104 |
90 |
$403.51 |
| J1100 |
Dexamethasone sodium phos |
561 |
476 |
$367.74 |
| 73110 |
|
23 |
12 |
$318.99 |
| 76376 |
|
16 |
16 |
$262.85 |
| J2930 |
Methylprednisolone injection |
64 |
52 |
$187.88 |
| 72100 |
|
20 |
12 |
$158.94 |
| 82962 |
|
229 |
151 |
$150.84 |
| 85027 |
|
28 |
28 |
$89.96 |
| J1200 |
Diphenhydramine hcl injectio |
232 |
140 |
$89.15 |
| J2765 |
Metoclopramide hcl injection |
125 |
95 |
$75.76 |
| J8540 |
Oral dexamethasone |
16 |
14 |
$47.37 |
| J7512 |
Prednisone ir or dr oral 1mg |
134 |
110 |
$45.46 |
| J0780 |
Prochlorperazine injection |
13 |
13 |
$43.81 |
| J2060 |
Lorazepam injection |
31 |
26 |
$22.35 |
| J1170 |
Hydromorphone injection |
49 |
32 |
$18.48 |
| J2001 |
Lidocaine injection |
259 |
184 |
$17.53 |
| 0353U |
|
261 |
195 |
$0.00 |
| A9270 |
Non-covered item or service |
298 |
153 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
14 |
14 |
$0.00 |