| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
2,230 |
2,089 |
$367K |
| 99283 |
|
2,919 |
2,786 |
$167K |
| 99285 |
|
632 |
583 |
$151K |
| 87502 |
|
1,044 |
1,010 |
$86K |
| 87635 |
|
855 |
822 |
$29K |
| 80053 |
|
2,325 |
2,019 |
$24K |
| 93005 |
|
977 |
876 |
$24K |
| 71045 |
|
1,008 |
926 |
$21K |
| 85025 |
|
2,960 |
2,436 |
$19K |
| 74177 |
|
77 |
73 |
$18K |
| C9803 |
Hopd covid-19 spec collect |
1,358 |
1,313 |
$16K |
| 87651 |
|
355 |
339 |
$10K |
| 84484 |
|
868 |
679 |
$5K |
| U0002 |
Covid-19 lab test non-cdc |
77 |
75 |
$4K |
| U0003 |
Cov-19 amp prb hgh thruput |
60 |
58 |
$3K |
| 96374 |
|
561 |
503 |
$3K |
| 70450 |
|
52 |
52 |
$3K |
| 96375 |
|
400 |
348 |
$2K |
| 97110 |
|
42 |
12 |
$2K |
| J7030 |
Normal saline solution infus |
609 |
490 |
$2K |
| 87634 |
|
44 |
42 |
$2K |
| 81025 |
|
316 |
301 |
$2K |
| 81001 |
|
951 |
872 |
$2K |
| 83880 |
|
106 |
102 |
$2K |
| 83690 |
|
492 |
458 |
$2K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
242 |
154 |
$1K |
| 99281 |
|
28 |
26 |
$1K |
| U0005 |
Infec agen detec ampli probe |
59 |
57 |
$967.68 |
| 99282 |
|
13 |
13 |
$827.09 |
| 96365 |
|
14 |
14 |
$696.85 |
| J2405 |
Ondansetron hcl injection |
562 |
481 |
$463.63 |
| 84703 |
|
64 |
57 |
$449.16 |
| 80048 |
|
86 |
65 |
$415.30 |
| J2270 |
Morphine sulfate injection |
249 |
172 |
$348.92 |
| 96372 |
|
50 |
41 |
$318.11 |
| 83605 |
|
58 |
38 |
$270.83 |
| 81003 |
|
155 |
145 |
$248.72 |
| J1885 |
Ketorolac tromethamine inj |
145 |
134 |
$189.75 |
| 96361 |
|
51 |
48 |
$182.84 |
| 84702 |
|
15 |
13 |
$113.76 |
| 83735 |
|
26 |
25 |
$85.90 |
| 36415 |
|
1,338 |
1,164 |
$82.48 |
| 85379 |
|
13 |
13 |
$54.20 |
| 87086 |
|
24 |
24 |
$46.70 |
| 85610 |
|
16 |
14 |
$18.67 |
| 86901 |
|
14 |
13 |
$15.06 |
| A9270 |
Non-covered item or service |
341 |
291 |
$0.00 |