| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87426 |
|
5,807 |
5,021 |
$188K |
| 70450 |
|
1,345 |
1,170 |
$109K |
| 99499 |
|
5,309 |
4,537 |
$102K |
| 80307 |
|
1,661 |
1,436 |
$90K |
| 80053 |
|
6,599 |
4,980 |
$60K |
| 74177 |
|
322 |
285 |
$38K |
| 99283 |
|
1,058 |
809 |
$37K |
| U0002 |
Covid-19 lab test non-cdc |
740 |
637 |
$35K |
| 83880 |
|
1,578 |
1,306 |
$34K |
| 85025 |
|
5,856 |
4,720 |
$33K |
| 93005 |
|
2,682 |
2,114 |
$25K |
| 82805 |
|
1,046 |
894 |
$23K |
| 74176 |
|
351 |
313 |
$20K |
| 87086 |
|
2,745 |
2,268 |
$20K |
| 99284 |
|
1,089 |
856 |
$19K |
| 84484 |
|
2,343 |
1,786 |
$17K |
| 84703 |
|
2,096 |
1,757 |
$17K |
| 85027 |
|
3,332 |
2,523 |
$16K |
| 96372 |
|
1,340 |
898 |
$15K |
| 80048 |
|
1,852 |
1,516 |
$15K |
| 82553 |
|
1,638 |
1,346 |
$14K |
| 82550 |
|
2,307 |
1,789 |
$14K |
| 71045 |
|
2,297 |
1,913 |
$13K |
| 81001 |
|
4,476 |
3,568 |
$12K |
| 87040 |
|
963 |
834 |
$11K |
| 87430 |
|
1,483 |
1,338 |
$11K |
| 83690 |
|
1,886 |
1,632 |
$10K |
| 36415 |
|
3,579 |
2,162 |
$10K |
| 72125 |
|
95 |
84 |
$10K |
| 71046 |
|
556 |
496 |
$9K |
| 87276 |
|
945 |
841 |
$8K |
| 96374 |
|
531 |
373 |
$7K |
| 83605 |
|
869 |
753 |
$7K |
| 84443 |
|
841 |
699 |
$7K |
| 85730 |
|
1,570 |
1,303 |
$6K |
| 99282 |
|
119 |
76 |
$6K |
| J0696 |
Ceftriaxone sodium injection |
662 |
503 |
$6K |
| 86901 |
|
289 |
239 |
$5K |
| 72131 |
|
44 |
36 |
$5K |
| J1885 |
Ketorolac tromethamine inj |
1,321 |
1,091 |
$5K |
| J2405 |
Ondansetron hcl injection |
1,005 |
829 |
$5K |
| 85610 |
|
2,194 |
1,569 |
$5K |
| 87400 |
|
2,498 |
1,155 |
$5K |
| 85378 |
|
776 |
678 |
$4K |
| 71275 |
|
31 |
25 |
$4K |
| 80061 |
|
438 |
376 |
$4K |
| J1100 |
Dexamethasone sodium phos |
277 |
235 |
$4K |
| 96365 |
|
88 |
79 |
$3K |
| 87420 |
|
473 |
429 |
$3K |
| 96361 |
|
383 |
236 |
$2K |
| 99285 |
|
312 |
284 |
$2K |
| 87088 |
|
363 |
312 |
$2K |
| J1650 |
Inj enoxaparin sodium |
60 |
45 |
$2K |
| 71020 |
|
169 |
141 |
$2K |
| 87186 |
|
483 |
406 |
$2K |
| 82150 |
|
382 |
334 |
$2K |
| 76856 |
|
80 |
66 |
$2K |
| 36600 |
|
295 |
238 |
$2K |
| 80320 |
|
136 |
117 |
$1K |
| 71250 |
|
15 |
14 |
$1K |
| 84145 |
|
115 |
96 |
$1K |
| 71010 |
|
190 |
167 |
$1K |
| 86885 |
|
289 |
239 |
$1K |
| 82950 |
|
212 |
169 |
$1K |
| 83735 |
|
317 |
235 |
$1K |
| 82948 |
|
347 |
217 |
$1K |
| 77067 |
|
24 |
24 |
$1K |
| 93306 |
|
13 |
13 |
$1K |
| 76815 |
|
67 |
54 |
$1K |
| 82947 |
|
298 |
76 |
$924.00 |
| 99188 |
|
66 |
58 |
$914.76 |
| J3010 |
Fentanyl citrate injection |
248 |
209 |
$848.62 |
| 96375 |
|
129 |
104 |
$761.98 |
| 86900 |
|
292 |
239 |
$749.50 |
| 73630 |
|
52 |
41 |
$625.41 |
| M0239 |
Bamlanivimab-xxxx infusion |
14 |
13 |
$619.20 |
| 73610 |
|
27 |
24 |
$444.74 |
| 83874 |
|
34 |
20 |
$393.50 |
| 83036 |
|
84 |
79 |
$374.49 |
| 96360 |
|
28 |
13 |
$336.40 |
| C9803 |
Hopd covid-19 spec collect |
643 |
519 |
$318.48 |
| D2930 |
|
65 |
54 |
$297.00 |
| 80329 |
|
49 |
25 |
$294.50 |
| J2250 |
Inj midazolam hydrochloride |
206 |
168 |
$114.12 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
114 |
100 |
$95.34 |
| J2550 |
Promethazine hcl injection |
48 |
39 |
$91.59 |
| J2704 |
Inj, propofol, 10 mg |
376 |
319 |
$77.54 |
| 94760 |
|
65 |
30 |
$56.00 |
| 81003 |
|
14 |
12 |
$22.40 |
| J2930 |
Methylprednisolone injection |
13 |
12 |
$10.85 |
| J2270 |
Morphine sulfate injection |
26 |
24 |
$9.05 |
| J1815 |
Insulin injection |
68 |
42 |
$7.00 |
| 94664 |
|
14 |
12 |
$6.00 |
| 99001 |
|
238 |
191 |
$1.12 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
105 |
89 |
$0.00 |
| G0378 |
Hospital observation per hr |
106 |
89 |
$0.00 |
| J7050 |
Normal saline solution infus |
153 |
131 |
$0.00 |
| 96366 |
|
32 |
14 |
$0.00 |