| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
8,897 |
7,315 |
$456K |
| 99284 |
|
4,384 |
3,476 |
$325K |
| G0463 |
Hospital outpt clinic visit |
15,442 |
5,013 |
$209K |
| J3490 |
Drugs unclassified injection |
2,200 |
1,318 |
$195K |
| 99285 |
|
1,677 |
1,326 |
$193K |
| A9270 |
Non-covered item or service |
2,431 |
442 |
$83K |
| 99282 |
|
1,301 |
1,149 |
$36K |
| 80053 |
|
239 |
217 |
$27K |
| 87651 |
|
589 |
579 |
$20K |
| 87502 |
|
144 |
144 |
$18K |
| 01967 |
|
158 |
149 |
$15K |
| 93005 |
|
1,463 |
142 |
$15K |
| 0241U |
|
46 |
42 |
$13K |
| 87880 |
|
612 |
592 |
$9K |
| 87804 |
|
258 |
121 |
$5K |
| 93010 |
|
778 |
685 |
$4K |
| 36415 |
|
81 |
48 |
$4K |
| 87426 |
|
108 |
108 |
$3K |
| Q3014 |
Telehealth facility fee |
105 |
48 |
$3K |
| 36416 |
|
45 |
42 |
$2K |
| 41899 |
|
14 |
14 |
$2K |
| J3010 |
Fentanyl citrate injection |
66 |
25 |
$1K |
| 01480 |
|
21 |
13 |
$1K |
| 81001 |
|
27 |
26 |
$1K |
| 69436 |
|
12 |
12 |
$1K |
| C9803 |
Hopd covid-19 spec collect |
73 |
71 |
$1K |
| U0002 |
Covid-19 lab test non-cdc |
32 |
32 |
$984.58 |
| U0003 |
Cov-19 amp prb hgh thruput |
12 |
12 |
$750.00 |
| 96361 |
|
12 |
12 |
$721.10 |
| G0008 |
Admin influenza virus vac |
120 |
24 |
$685.42 |
| J3301 |
Triamcinolone acet inj nos |
45 |
13 |
$668.31 |
| 11721 |
|
26 |
12 |
$342.04 |
| 85025 |
|
507 |
452 |
$335.81 |
| 87081 |
|
218 |
210 |
$36.18 |
| 87811 |
|
58 |
15 |
$0.00 |
| J2405 |
Ondansetron hcl injection |
16 |
12 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
53 |
24 |
$0.00 |
| 00170 |
|
14 |
14 |
$0.00 |
| 90656 |
|
12 |
12 |
$0.00 |
| 86140 |
|
31 |
28 |
$0.00 |