| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
5,986 |
5,553 |
$390K |
| 99285 |
|
1,339 |
1,267 |
$317K |
| 11042 |
|
3,157 |
1,398 |
$256K |
| 99283 |
|
7,456 |
6,896 |
$253K |
| 87635 |
|
1,964 |
1,865 |
$79K |
| 80053 |
|
6,900 |
6,241 |
$64K |
| 85025 |
|
7,629 |
6,799 |
$57K |
| 87430 |
|
2,076 |
2,003 |
$34K |
| 87400 |
|
2,275 |
2,167 |
$25K |
| 80306 |
|
1,699 |
1,583 |
$18K |
| 81001 |
|
4,554 |
4,205 |
$16K |
| G0463 |
Hospital outpt clinic visit |
694 |
511 |
$13K |
| 87081 |
|
1,000 |
968 |
$10K |
| 87426 |
|
337 |
320 |
$10K |
| 97597 |
|
533 |
208 |
$9K |
| 93005 |
|
1,003 |
922 |
$8K |
| 85610 |
|
1,587 |
1,499 |
$6K |
| 71045 |
|
1,033 |
966 |
$4K |
| G0378 |
Hospital observation per hr |
111 |
105 |
$3K |
| 87086 |
|
371 |
346 |
$3K |
| 85730 |
|
1,537 |
1,456 |
$3K |
| U0003 |
Cov-19 amp prb hgh thruput |
44 |
44 |
$3K |
| 84484 |
|
385 |
341 |
$2K |
| 80061 |
|
121 |
119 |
$2K |
| 70450 |
|
37 |
36 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
1,169 |
1,106 |
$2K |
| 74176 |
|
31 |
28 |
$1K |
| 87420 |
|
49 |
47 |
$973.82 |
| 99282 |
|
44 |
24 |
$953.41 |
| 84443 |
|
53 |
50 |
$899.78 |
| 82553 |
|
106 |
95 |
$850.42 |
| 66984 |
|
21 |
12 |
$762.36 |
| 87070 |
|
140 |
114 |
$738.62 |
| J1100 |
Dexamethasone sodium phos |
668 |
624 |
$399.40 |
| 82550 |
|
73 |
67 |
$330.98 |
| 83690 |
|
55 |
50 |
$284.46 |
| J2270 |
Morphine sulfate injection |
161 |
149 |
$264.05 |
| 87186 |
|
51 |
37 |
$255.60 |
| J1885 |
Ketorolac tromethamine inj |
196 |
171 |
$216.94 |
| 85027 |
|
30 |
24 |
$198.52 |
| 87077 |
|
51 |
37 |
$182.10 |
| J2405 |
Ondansetron hcl injection |
655 |
596 |
$178.44 |
| 82805 |
|
13 |
12 |
$174.64 |
| 81025 |
|
40 |
40 |
$169.72 |
| J2550 |
Promethazine hcl injection |
128 |
121 |
$142.52 |
| 80048 |
|
16 |
14 |
$123.30 |
| 87040 |
|
13 |
12 |
$80.88 |
| 82150 |
|
13 |
12 |
$72.63 |
| 83735 |
|
15 |
12 |
$69.24 |
| 96372 |
|
1,048 |
969 |
$66.33 |
| J2704 |
Inj, propofol, 10 mg |
12 |
12 |
$0.00 |
| 96374 |
|
46 |
42 |
$0.00 |
| 96361 |
|
48 |
37 |
$0.00 |
| 36415 |
|
55 |
50 |
$0.00 |
| 96375 |
|
64 |
58 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
13 |
12 |
$0.00 |
| A9270 |
Non-covered item or service |
334 |
76 |
$0.00 |
| C1780 |
Lens, intraocular (new tech) |
21 |
12 |
$0.00 |
| G1004 |
Cdsm ndsc |
13 |
13 |
$0.00 |