| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic service |
34,986 |
27,835 |
$1.13M |
| 97530 |
|
3,458 |
1,385 |
$243K |
| U0003 |
Cov-19 amp prb hgh thruput |
2,622 |
2,559 |
$225K |
| 97110 |
|
7,554 |
2,059 |
$222K |
| 87633 |
|
357 |
353 |
$175K |
| 78815 |
|
78 |
75 |
$74K |
| 96413 |
|
688 |
425 |
$70K |
| 84443 |
|
3,117 |
3,044 |
$69K |
| G0378 |
Hospital observation per hr |
94 |
62 |
$68K |
| 77067 |
|
810 |
806 |
$64K |
| 97140 |
|
2,916 |
811 |
$63K |
| 70553 |
|
266 |
260 |
$61K |
| 73721 |
|
243 |
243 |
$59K |
| 80048 |
|
7,292 |
5,686 |
$59K |
| 72148 |
|
317 |
307 |
$50K |
| 85025 |
|
8,667 |
7,029 |
$46K |
| 80053 |
|
3,704 |
3,503 |
$41K |
| 82306 |
|
1,041 |
1,030 |
$41K |
| 80061 |
|
2,949 |
2,911 |
$40K |
| 80076 |
|
4,916 |
3,557 |
$38K |
| 97597 |
|
1,886 |
1,152 |
$36K |
| 93306 |
|
416 |
408 |
$34K |
| 80307 |
|
528 |
496 |
$33K |
| 74177 |
|
197 |
197 |
$31K |
| 97112 |
|
1,690 |
504 |
$29K |
| 72141 |
|
125 |
121 |
$28K |
| 92507 |
|
1,466 |
429 |
$26K |
| 87491 |
|
1,112 |
1,093 |
$26K |
| 87591 |
|
1,109 |
1,091 |
$26K |
| 80050 |
|
518 |
515 |
$23K |
| 93005 |
|
2,225 |
2,148 |
$21K |
| 87389 |
|
790 |
783 |
$21K |
| 97161 |
|
327 |
272 |
$18K |
| 88175 |
|
573 |
571 |
$18K |
| 76641 |
|
308 |
281 |
$17K |
| 96365 |
|
448 |
217 |
$16K |
| 76642 |
|
413 |
400 |
$16K |
| 86803 |
|
872 |
861 |
$16K |
| 83036 |
|
2,395 |
2,362 |
$16K |
| 78452 |
|
99 |
95 |
$16K |
| 77066 |
Tomosynthesis, mammo |
172 |
168 |
$15K |
| 87624 |
|
362 |
361 |
$15K |
| 87653 |
|
356 |
353 |
$14K |
| 97162 |
|
282 |
229 |
$14K |
| 76536 |
|
288 |
286 |
$13K |
| 95810 |
|
55 |
53 |
$13K |
| 96367 |
|
451 |
207 |
$13K |
| 87086 |
|
1,607 |
1,534 |
$13K |
| 84702 |
|
736 |
645 |
$12K |
| 85027 |
|
1,761 |
1,649 |
$12K |
| 77063 |
|
574 |
570 |
$12K |
| 76705 |
|
329 |
325 |
$11K |
| 96372 |
|
491 |
389 |
$11K |
| 27096 |
|
203 |
171 |
$11K |
| 84439 |
|
1,353 |
1,322 |
$10K |
| 72110 |
|
541 |
531 |
$10K |
| 71046 |
|
810 |
789 |
$10K |
| 76830 |
|
209 |
201 |
$10K |
| 93971 |
|
143 |
137 |
$10K |
| 84466 |
|
575 |
563 |
$10K |
| 73630 |
|
900 |
840 |
$9K |
| 82607 |
|
707 |
700 |
$9K |
| 86780 |
|
573 |
568 |
$9K |
| 73610 |
|
513 |
484 |
$9K |
| Q9957 |
Inj perflutren lip micros,ml |
240 |
236 |
$8K |
| 94729 |
|
337 |
326 |
$8K |
| 87081 |
|
1,501 |
1,487 |
$8K |
| 73564 |
|
420 |
394 |
$8K |
| 77065 |
Tomosynthesis, mammo |
111 |
108 |
$8K |
| 72100 |
|
407 |
398 |
$7K |
| G0279 |
Tomosynthesis, mammo |
400 |
388 |
$7K |
| 99214 |
|
147 |
133 |
$7K |
| 59025 |
|
1,694 |
1,146 |
$7K |
| 71250 |
|
98 |
96 |
$7K |
| G0463 |
Hospital outpt clinic visit |
356 |
242 |
$7K |
| 62323 |
|
103 |
102 |
$7K |
| 82728 |
|
594 |
575 |
$7K |
| 87522 |
Neg quan hep c or qual rna |
186 |
184 |
$7K |
| 76815 |
|
175 |
146 |
$7K |
| 84153 |
|
299 |
293 |
$7K |
| 73562 |
|
393 |
368 |
$6K |
| 84403 |
|
237 |
232 |
$6K |
| 87077 |
|
726 |
707 |
$6K |
| 87186 |
|
631 |
614 |
$6K |
| 74183 |
|
14 |
14 |
$6K |
| 81001 |
|
2,057 |
1,956 |
$6K |
| 86762 |
|
311 |
310 |
$6K |
| 87340 |
|
420 |
418 |
$6K |
| 93296 |
|
477 |
457 |
$5K |
| 80069 |
|
672 |
595 |
$5K |
| 84146 |
|
227 |
218 |
$5K |
| 83540 |
|
651 |
638 |
$5K |
| 93017 |
|
186 |
178 |
$5K |
| 83880 |
|
164 |
159 |
$5K |
| 97035 |
|
631 |
179 |
$5K |
| 99212 |
|
137 |
99 |
$5K |
| 73030 |
|
347 |
334 |
$5K |
| 71260 |
|
68 |
68 |
$5K |
| 82043 |
|
595 |
588 |
$5K |
| 88305 |
|
383 |
374 |
$5K |
| 83655 |
|
439 |
427 |
$5K |
| 94726 |
|
181 |
174 |
$4K |
| 73502 |
|
269 |
259 |
$4K |
| 93922 |
|
184 |
168 |
$4K |
| 96415 |
|
139 |
92 |
$4K |
| 90682 |
|
142 |
137 |
$4K |
| 82746 |
|
324 |
323 |
$4K |
| 83615 |
|
679 |
551 |
$4K |
| 86850 |
|
542 |
499 |
$4K |
| 74018 |
|
320 |
309 |
$4K |
| 99213 |
|
107 |
87 |
$4K |
| 86038 |
|
244 |
240 |
$4K |
| 82105 |
|
194 |
185 |
$4K |
| 93226 |
|
109 |
106 |
$4K |
| 83735 |
|
600 |
511 |
$4K |
| 73110 |
|
359 |
315 |
$4K |
| 88342 |
|
70 |
69 |
$4K |
| 70551 |
|
14 |
14 |
$3K |
| 73560 |
|
233 |
218 |
$3K |
| 86360 |
|
55 |
54 |
$3K |
| 90715 |
|
129 |
123 |
$3K |
| 87070 |
|
443 |
434 |
$3K |
| G0008 |
Admin influenza virus vac |
303 |
300 |
$3K |
| 20553 |
|
113 |
112 |
$3K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,129 |
1,083 |
$3K |
| 84402 |
|
106 |
105 |
$3K |
| 86618 |
|
112 |
112 |
$3K |
| 85610 |
|
731 |
617 |
$3K |
| 76770 |
|
70 |
68 |
$3K |
| 87536 |
|
26 |
25 |
$3K |
| 74176 |
|
42 |
40 |
$3K |
| J2469 |
Palonosetron hcl |
180 |
101 |
$2K |
| 64635 |
|
12 |
12 |
$2K |
| 83001 |
|
139 |
136 |
$2K |
| 82950 |
|
344 |
344 |
$2K |
| 93970 |
|
27 |
26 |
$2K |
| 72050 |
|
117 |
116 |
$2K |
| 96417 |
|
41 |
24 |
$2K |
| 82565 |
|
336 |
296 |
$2K |
| 82247 |
|
295 |
180 |
$2K |
| 93225 |
|
122 |
119 |
$2K |
| 86900 |
|
531 |
489 |
$2K |
| 96375 |
|
167 |
113 |
$2K |
| 76805 |
|
37 |
37 |
$2K |
| 86901 |
|
526 |
484 |
$2K |
| 93350 |
|
39 |
39 |
$2K |
| 82378 |
|
130 |
107 |
$2K |
| 86003 |
|
56 |
56 |
$2K |
| 84480 |
|
196 |
186 |
$2K |
| 76942 |
|
62 |
62 |
$2K |
| 73130 |
|
155 |
142 |
$2K |
| 85652 |
|
526 |
512 |
$2K |
| 85730 |
|
224 |
220 |
$2K |
| J1030 |
Methylprednisolone 40 mg inj |
1,494 |
1,425 |
$1K |
| 87205 |
|
334 |
327 |
$1K |
| 86300 |
|
58 |
52 |
$1K |
| 72040 |
|
96 |
95 |
$1K |
| 82784 |
|
56 |
52 |
$1K |
| 84100 |
|
252 |
194 |
$1K |
| 83525 |
|
118 |
116 |
$1K |
| 86140 |
|
445 |
412 |
$1K |
| 93880 |
|
13 |
13 |
$1K |
| 77080 |
|
26 |
25 |
$1K |
| 64493 |
|
15 |
14 |
$1K |
| 82570 |
|
186 |
155 |
$1K |
| 87210 |
|
202 |
184 |
$1K |
| 83002 |
|
68 |
68 |
$1K |
| 76856 |
|
26 |
26 |
$1K |
| G0297 |
Ldct for lung ca screen |
14 |
14 |
$1K |
| 82947 |
|
238 |
234 |
$949.93 |
| 97010 |
|
351 |
89 |
$944.70 |
| 86787 |
|
46 |
46 |
$885.11 |
| 84460 |
|
128 |
127 |
$865.09 |
| 84156 |
|
221 |
174 |
$847.49 |
| 87075 |
|
83 |
79 |
$812.39 |
| 93926 |
|
13 |
12 |
$804.77 |
| 96366 |
|
75 |
52 |
$797.61 |
| 94060 |
|
89 |
87 |
$787.84 |
| 94727 |
|
45 |
44 |
$783.63 |
| 94375 |
|
51 |
50 |
$764.38 |
| 81025 |
|
207 |
199 |
$762.19 |
| 85018 |
|
212 |
203 |
$669.60 |
| 73590 |
|
43 |
38 |
$669.05 |
| 82550 |
|
96 |
86 |
$667.26 |
| 82785 |
|
29 |
29 |
$654.27 |
| 86706 |
|
45 |
45 |
$645.92 |
| 86430 |
|
86 |
86 |
$623.50 |
| 83690 |
|
114 |
113 |
$569.10 |
| 84550 |
|
110 |
99 |
$565.62 |
| 82533 |
|
45 |
41 |
$560.79 |
| 94010 |
|
105 |
98 |
$545.44 |
| 72070 |
|
29 |
29 |
$543.31 |
| 87430 |
|
77 |
75 |
$536.94 |
| 77077 |
|
25 |
25 |
$535.98 |
| J1100 |
Dexamethasone sodium phos |
1,081 |
539 |
$531.69 |
| 83970 |
|
14 |
14 |
$521.93 |
| Q3014 |
Telehealth facility fee |
40 |
36 |
$513.86 |
| 84520 |
|
89 |
88 |
$452.58 |
| 96361 |
|
37 |
25 |
$423.00 |
| 77002 |
|
13 |
13 |
$395.96 |
| 36415 |
|
719 |
563 |
$340.91 |
| 81003 |
|
106 |
95 |
$312.48 |
| 82962 |
|
203 |
176 |
$307.98 |
| 82626 |
|
13 |
12 |
$300.30 |
| 86713 |
|
13 |
13 |
$254.42 |
| 85045 |
|
59 |
57 |
$240.40 |
| 85014 |
|
69 |
66 |
$236.61 |
| 96374 |
|
15 |
14 |
$204.72 |
| 74021 |
|
17 |
14 |
$200.90 |
| J7050 |
Normal saline solution infus |
950 |
611 |
$189.14 |
| 84165 |
|
12 |
12 |
$151.95 |
| 84436 |
|
15 |
15 |
$148.98 |
| 81002 |
|
44 |
43 |
$146.46 |
| J1626 |
Granisetron hcl injection |
74 |
36 |
$125.20 |
| 73660 |
|
13 |
12 |
$104.08 |
| A9585 |
Gadobutrol injection |
73 |
72 |
$27.00 |
| J1200 |
Diphenhydramine hcl injectio |
87 |
50 |
$19.22 |
| 90674 |
|
79 |
76 |
$0.00 |
| J1010 |
Inj, methylpred acetate 1 mg |
257 |
253 |
$0.00 |
| J3490 |
Drugs unclassified injection |
17 |
13 |
$0.00 |
| G0379 |
Direct refer hospital observ |
14 |
14 |
$0.00 |
| J1040 |
Methylprednisolone 80 mg inj |
49 |
47 |
$0.00 |
| J1756 |
Iron sucrose injection |
82 |
55 |
$0.00 |
| 90661 |
|
29 |
29 |
$0.00 |
| J0585 |
Injection,onabotulinumtoxina |
14 |
13 |
$0.00 |