| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
8,013 |
6,010 |
$406K |
| 99283 |
|
6,326 |
6,054 |
$392K |
| 99284 |
|
4,229 |
3,985 |
$390K |
| 99285 |
|
1,094 |
1,049 |
$124K |
| 87502 |
|
1,209 |
1,190 |
$96K |
| G0378 |
Hospital observation per hr |
139 |
126 |
$75K |
| 80053 |
|
7,001 |
6,540 |
$64K |
| U0002 |
Covid-19 lab test non-cdc |
2,055 |
2,005 |
$53K |
| U0004 |
Cov-19 test non-cdc hgh thru |
606 |
595 |
$50K |
| 74177 |
|
278 |
272 |
$42K |
| 80050 |
|
885 |
870 |
$40K |
| 85025 |
|
7,523 |
6,806 |
$35K |
| 96374 |
|
1,263 |
1,151 |
$28K |
| 80307 |
|
512 |
464 |
$24K |
| 80061 |
|
1,841 |
1,822 |
$23K |
| 87636 |
|
255 |
251 |
$23K |
| 70450 |
|
407 |
385 |
$19K |
| 84443 |
|
1,034 |
1,001 |
$19K |
| 74176 |
|
251 |
239 |
$18K |
| 93005 |
|
2,186 |
2,033 |
$17K |
| 71275 |
|
111 |
107 |
$16K |
| 77067 |
|
207 |
207 |
$16K |
| 82306 |
|
543 |
532 |
$15K |
| 99282 |
|
573 |
542 |
$15K |
| 93306 |
|
264 |
257 |
$15K |
| 71046 |
|
1,079 |
1,054 |
$14K |
| 84484 |
|
1,470 |
1,331 |
$11K |
| 87070 |
|
1,537 |
1,492 |
$10K |
| 96375 |
|
618 |
530 |
$9K |
| 84703 |
|
725 |
686 |
$7K |
| 80048 |
|
1,109 |
952 |
$7K |
| 96372 |
|
768 |
595 |
$7K |
| 83036 |
|
1,080 |
1,064 |
$7K |
| 83880 |
|
310 |
289 |
$6K |
| 71045 |
|
1,113 |
1,058 |
$6K |
| 87804 |
|
596 |
336 |
$6K |
| 83735 |
|
1,104 |
982 |
$6K |
| 87086 |
|
745 |
714 |
$5K |
| 81001 |
|
2,084 |
1,995 |
$5K |
| 76705 |
|
168 |
165 |
$5K |
| 0002A |
|
155 |
154 |
$4K |
| 77063 |
|
207 |
207 |
$4K |
| 83690 |
|
1,081 |
1,007 |
$4K |
| 96365 |
|
267 |
157 |
$4K |
| 0001A |
|
199 |
198 |
$4K |
| 82607 |
|
340 |
329 |
$4K |
| 84439 |
|
517 |
495 |
$4K |
| 73610 |
|
209 |
190 |
$3K |
| 86618 |
|
148 |
145 |
$3K |
| 85027 |
|
589 |
556 |
$3K |
| 87811 |
|
329 |
323 |
$3K |
| 93017 |
|
109 |
108 |
$3K |
| 88305 |
|
135 |
126 |
$3K |
| 82728 |
|
267 |
260 |
$3K |
| 73630 |
|
295 |
263 |
$3K |
| 36415 |
|
4,848 |
4,254 |
$3K |
| 73030 |
|
196 |
180 |
$2K |
| 85610 |
|
836 |
642 |
$2K |
| 87186 |
|
388 |
365 |
$2K |
| 87631 |
|
17 |
16 |
$2K |
| 83540 |
|
324 |
316 |
$2K |
| 71250 |
|
55 |
53 |
$2K |
| 85380 |
|
299 |
279 |
$2K |
| 84702 |
|
118 |
101 |
$2K |
| 87088 |
|
296 |
285 |
$2K |
| 85730 |
|
407 |
387 |
$2K |
| 74019 |
|
138 |
131 |
$2K |
| 72100 |
|
116 |
112 |
$2K |
| 82550 |
|
352 |
318 |
$2K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
504 |
491 |
$2K |
| 82043 |
|
226 |
222 |
$2K |
| 83605 |
|
272 |
242 |
$2K |
| 81003 |
|
631 |
591 |
$2K |
| 96376 |
|
102 |
61 |
$1K |
| 73110 |
|
141 |
121 |
$1K |
| 87880 |
|
210 |
205 |
$1K |
| 72125 |
|
30 |
27 |
$1K |
| 87077 |
|
211 |
196 |
$1K |
| 85652 |
|
497 |
442 |
$1K |
| 87081 |
|
185 |
178 |
$1K |
| 73130 |
|
100 |
86 |
$1K |
| 76830 |
|
27 |
27 |
$1K |
| 87040 |
|
95 |
86 |
$980.64 |
| 74018 |
|
79 |
76 |
$918.98 |
| 96361 |
|
77 |
72 |
$841.05 |
| 87493 |
|
25 |
13 |
$788.28 |
| 83550 |
|
190 |
186 |
$787.67 |
| 80320 |
|
69 |
61 |
$773.30 |
| 88342 |
|
14 |
13 |
$769.20 |
| 73562 |
|
49 |
48 |
$711.80 |
| 86140 |
|
332 |
304 |
$704.69 |
| 82150 |
|
155 |
147 |
$633.00 |
| 94729 |
|
27 |
27 |
$607.81 |
| 80076 |
|
71 |
69 |
$577.14 |
| 76856 |
|
13 |
13 |
$559.00 |
| 86617 |
|
12 |
12 |
$509.32 |
| 76816 |
|
14 |
13 |
$469.42 |
| 84436 |
|
54 |
54 |
$459.98 |
| 94060 |
|
52 |
52 |
$448.02 |
| 76536 |
|
12 |
12 |
$442.54 |
| 76642 |
|
13 |
12 |
$441.12 |
| 73564 |
|
27 |
25 |
$415.54 |
| 94727 |
|
26 |
26 |
$402.12 |
| 93226 |
|
15 |
15 |
$393.66 |
| 82248 |
|
55 |
53 |
$378.39 |
| 82553 |
|
56 |
51 |
$365.17 |
| 99213 |
|
428 |
422 |
$334.20 |
| 84153 |
|
12 |
12 |
$319.16 |
| 92567 |
|
30 |
30 |
$290.40 |
| 87591 |
|
12 |
12 |
$268.39 |
| 92557 |
|
13 |
12 |
$255.20 |
| 87491 |
|
12 |
12 |
$250.46 |
| 86803 |
|
12 |
12 |
$243.20 |
| 86038 |
|
18 |
17 |
$243.00 |
| 87428 |
|
27 |
27 |
$238.30 |
| 87015 |
|
28 |
28 |
$188.25 |
| 73080 |
|
17 |
14 |
$187.45 |
| 93225 |
|
15 |
15 |
$180.72 |
| J2704 |
Inj, propofol, 10 mg |
242 |
223 |
$177.65 |
| 84100 |
|
30 |
26 |
$128.46 |
| 86431 |
|
17 |
17 |
$125.19 |
| 87329 |
|
12 |
12 |
$105.86 |
| 73090 |
|
12 |
12 |
$98.90 |
| 87899 |
|
17 |
15 |
$97.60 |
| 81025 |
|
30 |
29 |
$93.14 |
| 87045 |
|
16 |
16 |
$89.70 |
| A6231 |
Hydrogel dsg<=16 sq in |
252 |
128 |
$81.60 |
| J1885 |
Ketorolac tromethamine inj |
900 |
822 |
$71.84 |
| 84550 |
|
12 |
12 |
$60.50 |
| 86901 |
|
15 |
14 |
$48.81 |
| 86900 |
|
15 |
14 |
$48.19 |
| 86592 |
|
13 |
12 |
$48.00 |
| 89055 |
|
12 |
12 |
$41.52 |
| 87046 |
|
16 |
16 |
$33.92 |
| 83615 |
|
19 |
18 |
$30.92 |
| 99212 |
|
77 |
75 |
$28.60 |
| J2765 |
Metoclopramide hcl injection |
73 |
69 |
$23.77 |
| J2405 |
Ondansetron hcl injection |
424 |
381 |
$22.95 |
| J0696 |
Ceftriaxone sodium injection |
33 |
27 |
$17.92 |
| 82140 |
|
13 |
12 |
$11.93 |
| J1100 |
Dexamethasone sodium phos |
39 |
36 |
$11.70 |
| J3010 |
Fentanyl citrate injection |
45 |
42 |
$9.98 |
| J2270 |
Morphine sulfate injection |
15 |
14 |
$4.36 |
| J7512 |
Prednisone ir or dr oral 1mg |
13 |
13 |
$1.00 |
| J2250 |
Inj midazolam hydrochloride |
13 |
13 |
$0.24 |
| 3075F |
|
113 |
112 |
$0.00 |
| 3079F |
|
358 |
345 |
$0.00 |
| A9270 |
Non-covered item or service |
58 |
53 |
$0.00 |
| 3074F |
|
558 |
539 |
$0.00 |
| G8510 |
Scr dep neg, no plan reqd |
112 |
110 |
$0.00 |
| 3080F |
|
87 |
87 |
$0.00 |
| J7030 |
Normal saline solution infus |
351 |
300 |
$0.00 |
| 3077F |
|
87 |
84 |
$0.00 |
| 3078F |
|
362 |
350 |
$0.00 |