| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0427 |
Als1-emergency |
606 |
471 |
$454K |
| 99213 |
|
7,845 |
6,540 |
$390K |
| 99212 |
|
7,335 |
6,292 |
$256K |
| A0425 |
Ground mileage |
979 |
711 |
$255K |
| 99282 |
|
950 |
737 |
$114K |
| 99284 |
|
563 |
382 |
$102K |
| 99283 |
|
777 |
605 |
$89K |
| 99214 |
|
1,158 |
996 |
$87K |
| G0463 |
Hospital outpt clinic visit |
3,452 |
2,469 |
$64K |
| 85025 |
|
1,436 |
1,194 |
$62K |
| 36415 |
|
4,402 |
3,553 |
$59K |
| U0003 |
Cov-19 amp prb hgh thruput |
837 |
321 |
$56K |
| 80053 |
|
532 |
448 |
$26K |
| 97530 |
|
248 |
101 |
$22K |
| 90837 |
|
495 |
170 |
$18K |
| 96110 |
|
473 |
335 |
$12K |
| 87811 |
|
758 |
197 |
$11K |
| 0241U |
|
71 |
68 |
$10K |
| 87426 |
|
174 |
157 |
$9K |
| 96127 |
|
311 |
271 |
$8K |
| 87651 |
|
150 |
128 |
$7K |
| 99285 |
|
24 |
12 |
$7K |
| 90471 |
|
536 |
503 |
$7K |
| S0209 |
Wc van mileage per mi |
77 |
24 |
$5K |
| 87502 |
|
98 |
79 |
$4K |
| 87635 |
|
67 |
21 |
$4K |
| 11721 |
|
340 |
151 |
$3K |
| 99393 |
|
52 |
26 |
$3K |
| J3490 |
Drugs unclassified injection |
146 |
79 |
$2K |
| 84443 |
|
57 |
56 |
$2K |
| 96372 |
|
69 |
51 |
$2K |
| Q2038 |
Fluzone vacc, 3 yrs & >, im |
15 |
14 |
$2K |
| 80048 |
|
33 |
27 |
$2K |
| 80061 |
|
39 |
39 |
$2K |
| 90686 |
|
252 |
238 |
$1K |
| 93010 |
|
273 |
234 |
$1K |
| G0008 |
Admin influenza virus vac |
69 |
67 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
34 |
26 |
$1K |
| A0130 |
Noner transport wheelch van |
77 |
24 |
$1K |
| 96374 |
|
13 |
12 |
$1K |
| 99394 |
|
28 |
12 |
$995.90 |
| 90662 |
|
30 |
26 |
$910.44 |
| 81001 |
|
27 |
25 |
$742.78 |
| 99211 |
|
69 |
63 |
$672.31 |
| A9270 |
Non-covered item or service |
545 |
239 |
$665.81 |
| C9803 |
Hopd covid-19 spec collect |
14 |
14 |
$445.18 |
| 92551 |
|
66 |
65 |
$391.26 |
| 90472 |
|
66 |
60 |
$389.23 |
| 85018 |
|
13 |
12 |
$240.58 |
| 99173 |
|
69 |
68 |
$200.22 |
| P9604 |
One-way allow prorated trip |
148 |
82 |
$184.79 |
| 90656 |
|
16 |
16 |
$84.35 |
| G2211 |
Complex e/m visit add on |
12 |
12 |
$17.65 |
| 90651 |
|
17 |
15 |
$0.00 |
| 99188 |
|
14 |
14 |
$0.00 |