| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
2,982 |
2,859 |
$902K |
| 99283 |
|
11,753 |
11,318 |
$807K |
| 99282 |
|
7,065 |
6,940 |
$565K |
| 87633 |
|
864 |
852 |
$233K |
| 87389 |
|
1,812 |
1,728 |
$138K |
| 86850 |
|
1,147 |
1,076 |
$136K |
| 85025 |
|
15,333 |
13,573 |
$123K |
| 87637 |
|
1,818 |
1,775 |
$102K |
| 86900 |
|
1,106 |
1,032 |
$100K |
| 41899 |
|
51 |
51 |
$92K |
| 81001 |
|
9,835 |
9,093 |
$85K |
| 87086 |
|
2,871 |
2,680 |
$62K |
| 84443 |
|
2,241 |
2,139 |
$57K |
| 82951 |
|
519 |
493 |
$48K |
| 69436 |
|
100 |
91 |
$44K |
| 86901 |
|
1,093 |
1,020 |
$37K |
| 86780 |
|
1,313 |
1,239 |
$37K |
| 99001 |
|
1,573 |
1,336 |
$36K |
| 86762 |
|
698 |
659 |
$36K |
| 87635 |
|
450 |
405 |
$34K |
| 87340 |
|
774 |
733 |
$34K |
| 83036 |
|
2,393 |
2,309 |
$32K |
| 80053 |
|
10,879 |
9,950 |
$30K |
| 71045 |
|
2,612 |
2,491 |
$16K |
| 86787 |
|
355 |
334 |
$16K |
| 82565 |
|
390 |
369 |
$13K |
| 93005 |
|
1,772 |
1,611 |
$13K |
| 96374 |
|
1,875 |
1,789 |
$10K |
| 87426 |
|
213 |
205 |
$9K |
| 90715 |
|
84 |
84 |
$9K |
| 86592 |
|
180 |
175 |
$8K |
| 96375 |
|
818 |
739 |
$7K |
| 99281 |
|
76 |
75 |
$6K |
| 81025 |
|
1,741 |
1,679 |
$6K |
| 70450 |
|
224 |
215 |
$6K |
| 82947 |
|
155 |
148 |
$6K |
| 80061 |
|
1,509 |
1,474 |
$5K |
| 90471 |
|
89 |
86 |
$5K |
| 83880 |
|
819 |
758 |
$4K |
| 99213 |
|
25 |
17 |
$4K |
| 76816 |
|
14 |
12 |
$4K |
| 80048 |
|
1,608 |
1,349 |
$4K |
| 90678 |
|
28 |
27 |
$4K |
| 99285 |
|
92 |
87 |
$3K |
| 87651 |
|
674 |
661 |
$3K |
| 82306 |
|
1,522 |
1,461 |
$3K |
| 83690 |
|
2,697 |
2,555 |
$3K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
405 |
335 |
$3K |
| 74177 |
|
37 |
37 |
$2K |
| 86803 |
|
30 |
29 |
$2K |
| 96372 |
|
710 |
679 |
$2K |
| Q0092 |
Set up port xray equipment |
1,836 |
1,738 |
$2K |
| 87088 |
|
790 |
758 |
$2K |
| 84484 |
|
1,053 |
853 |
$2K |
| 84439 |
|
55 |
51 |
$1K |
| 87186 |
|
924 |
883 |
$1K |
| 85014 |
|
54 |
53 |
$990.20 |
| 85018 |
|
54 |
53 |
$986.02 |
| 82553 |
|
608 |
549 |
$953.80 |
| 87624 |
|
12 |
12 |
$826.83 |
| 88175 |
|
13 |
13 |
$571.22 |
| 83735 |
|
622 |
535 |
$555.48 |
| 87070 |
|
176 |
130 |
$515.21 |
| 83021 |
|
13 |
13 |
$428.19 |
| 80069 |
|
141 |
131 |
$345.85 |
| 85610 |
|
414 |
338 |
$309.36 |
| C9803 |
Hopd covid-19 spec collect |
21 |
13 |
$300.15 |
| 36415 |
|
21,960 |
17,716 |
$252.52 |
| J7030 |
Normal saline solution infus |
71 |
65 |
$238.72 |
| 84702 |
|
21 |
13 |
$227.52 |
| 90472 |
|
13 |
12 |
$202.88 |
| 71046 |
|
12 |
12 |
$155.59 |
| 80307 |
|
40 |
37 |
$136.62 |
| 80164 |
|
119 |
110 |
$122.93 |
| 87804 |
|
30 |
14 |
$119.48 |
| 82607 |
|
83 |
79 |
$114.03 |
| G0463 |
Hospital outpt clinic visit |
160 |
109 |
$107.87 |
| 85041 |
|
13 |
13 |
$87.15 |
| J0696 |
Ceftriaxone sodium injection |
69 |
55 |
$75.86 |
| 83605 |
|
34 |
25 |
$59.79 |
| 85730 |
|
43 |
41 |
$43.01 |
| J2405 |
Ondansetron hcl injection |
402 |
341 |
$29.36 |
| 82728 |
|
12 |
12 |
$29.17 |
| 85007 |
|
31 |
26 |
$25.08 |
| J1885 |
Ketorolac tromethamine inj |
195 |
180 |
$22.59 |
| 82962 |
|
832 |
489 |
$19.70 |
| J3010 |
Fentanyl citrate injection |
197 |
147 |
$15.77 |
| 83550 |
|
27 |
26 |
$15.27 |
| 94640 |
|
14 |
14 |
$15.03 |
| J1100 |
Dexamethasone sodium phos |
55 |
49 |
$12.44 |
| J7510 |
Prednisolone oral per 5 mg |
28 |
25 |
$8.29 |
| J8499 |
Oral prescrip drug non chemo |
16 |
13 |
$4.32 |
| J2250 |
Inj midazolam hydrochloride |
112 |
78 |
$1.98 |
| 87880 |
|
14 |
14 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
74 |
67 |
$0.00 |
| M0243 |
Casirivi and imdevi inj |
14 |
14 |
$0.00 |