| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59409 |
|
466 |
462 |
$207K |
| Z1034 |
|
3,886 |
2,551 |
$170K |
| Z1032 |
|
862 |
862 |
$98K |
| H1001 |
Antepartum management |
2,212 |
1,346 |
$87K |
| 59425 |
|
863 |
584 |
$30K |
| 77067 |
|
1,382 |
1,376 |
$21K |
| 99213 |
|
812 |
571 |
$20K |
| 93306 |
|
327 |
324 |
$18K |
| 90715 |
|
574 |
467 |
$15K |
| 76830 |
|
837 |
833 |
$12K |
| 0949 |
|
999 |
866 |
$12K |
| 76856 |
|
923 |
917 |
$11K |
| 96372 |
|
1,746 |
1,640 |
$9K |
| 76642 |
|
629 |
624 |
$8K |
| 76700 |
|
545 |
541 |
$7K |
| Z6406 |
|
326 |
245 |
$5K |
| Z6204 |
|
217 |
185 |
$5K |
| 71046 |
|
1,980 |
1,944 |
$5K |
| H1000 |
Prenatal care atrisk assessm |
52 |
52 |
$4K |
| 74177 |
|
209 |
205 |
$4K |
| 90658 |
|
241 |
202 |
$4K |
| Z6500 |
|
26 |
26 |
$3K |
| 97140 |
|
67 |
26 |
$3K |
| 77066 |
Tomosynthesis, mammo |
263 |
263 |
$3K |
| 77063 |
|
275 |
274 |
$3K |
| 77065 |
Tomosynthesis, mammo |
153 |
152 |
$2K |
| 36415 |
|
3,774 |
3,215 |
$2K |
| 93005 |
|
2,066 |
1,938 |
$2K |
| G0279 |
Tomosynthesis, mammo |
307 |
307 |
$2K |
| 59430 |
|
56 |
55 |
$2K |
| A9585 |
Gadobutrol injection |
150 |
148 |
$2K |
| 97110 |
|
253 |
88 |
$2K |
| 76536 |
|
107 |
107 |
$2K |
| 80053 |
|
4,448 |
4,031 |
$2K |
| 99212 |
|
42 |
40 |
$1K |
| Z6410 |
|
87 |
56 |
$1K |
| 85025 |
|
4,712 |
4,258 |
$1K |
| 85027 |
|
678 |
641 |
$1K |
| Z1038 |
|
27 |
27 |
$1K |
| 85730 |
|
918 |
894 |
$1K |
| 80048 |
|
424 |
412 |
$945.89 |
| Z6400 |
|
117 |
117 |
$892.53 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
454 |
442 |
$869.87 |
| 95810 |
|
13 |
13 |
$765.76 |
| 85610 |
|
996 |
970 |
$664.86 |
| 76801 |
|
227 |
203 |
$653.67 |
| 73030 |
|
156 |
156 |
$629.74 |
| Z6300 |
|
41 |
41 |
$624.17 |
| 73630 |
|
138 |
138 |
$520.64 |
| 70450 |
|
185 |
184 |
$507.29 |
| 81025 |
|
537 |
519 |
$501.22 |
| 73562 |
|
157 |
157 |
$487.62 |
| 84703 |
|
1,481 |
1,391 |
$417.47 |
| Z6200 |
|
27 |
27 |
$410.56 |
| J7050 |
Normal saline solution infus |
1,228 |
755 |
$394.15 |
| 86850 |
|
340 |
324 |
$337.49 |
| 86901 |
|
521 |
485 |
$317.15 |
| 86900 |
|
521 |
485 |
$308.42 |
| J3490 |
Drugs unclassified injection |
9,652 |
5,089 |
$282.67 |
| J1642 |
Inj heparin sodium per 10 u |
244 |
176 |
$271.48 |
| 76817 |
|
43 |
42 |
$240.76 |
| Z6402 |
|
15 |
15 |
$227.25 |
| 0761 |
|
329 |
285 |
$215.23 |
| 72110 |
|
12 |
12 |
$214.90 |
| 84702 |
|
359 |
321 |
$201.39 |
| 93976 |
|
13 |
13 |
$195.56 |
| 73610 |
|
58 |
56 |
$185.24 |
| 81001 |
|
2,734 |
2,587 |
$176.18 |
| 76705 |
|
59 |
59 |
$170.14 |
| 0760 |
|
3,724 |
3,447 |
$118.85 |
| 73130 |
|
53 |
52 |
$116.64 |
| 0450 |
|
15,910 |
14,237 |
$104.21 |
| 87086 |
|
949 |
901 |
$92.28 |
| 81003 |
|
224 |
220 |
$89.39 |
| 71045 |
|
566 |
531 |
$87.48 |
| 72100 |
|
18 |
18 |
$77.56 |
| 0515 |
|
119 |
113 |
$71.31 |
| 0121 |
|
349 |
338 |
$65.00 |
| 94060 |
|
13 |
13 |
$64.83 |
| 36416 |
|
550 |
487 |
$61.80 |
| 87077 |
|
63 |
60 |
$60.23 |
| 73502 |
|
16 |
15 |
$55.18 |
| 96360 |
|
103 |
82 |
$51.30 |
| 99000 |
|
26 |
25 |
$44.23 |
| 85007 |
|
146 |
131 |
$28.84 |
| J2704 |
Inj, propofol, 10 mg |
125 |
101 |
$28.00 |
| 82947 |
|
585 |
484 |
$24.42 |
| 87186 |
|
173 |
168 |
$24.24 |
| 0710 |
|
476 |
465 |
$18.22 |
| 73110 |
|
12 |
12 |
$16.59 |
| 96361 |
|
545 |
400 |
$14.60 |
| 87088 |
|
99 |
96 |
$14.58 |
| J2001 |
Lidocaine injection |
402 |
279 |
$13.48 |
| 83690 |
|
1,316 |
1,233 |
$9.72 |
| 84484 |
|
635 |
563 |
$6.78 |
| J2405 |
Ondansetron hcl injection |
486 |
409 |
$5.75 |
| 86140 |
|
28 |
26 |
$3.70 |
| J2250 |
Inj midazolam hydrochloride |
122 |
116 |
$3.25 |
| 0270 |
|
6,211 |
3,650 |
$0.02 |
| 0305 |
|
1,016 |
934 |
$0.00 |
| 0306 |
|
740 |
690 |
$0.00 |
| 0301 |
|
1,065 |
970 |
$0.00 |
| 0636 |
|
907 |
799 |
$0.00 |
| 94640 |
|
757 |
521 |
$0.00 |
| 96365 |
|
250 |
214 |
$0.00 |
| 0250 |
|
2,281 |
1,945 |
$0.00 |
| 0310 |
|
182 |
181 |
$0.00 |
| 0241U |
|
545 |
480 |
$0.00 |
| 0420 |
|
93 |
90 |
$0.00 |
| S9445 |
Pt education noc individ |
485 |
294 |
$0.00 |
| 0307 |
|
252 |
243 |
$0.00 |
| 96375 |
|
458 |
351 |
$0.00 |
| 96374 |
|
711 |
623 |
$0.00 |
| 87486 |
|
155 |
153 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
623 |
517 |
$0.00 |
| 0370 |
|
276 |
272 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
15 |
14 |
$0.00 |
| 0324 |
|
338 |
321 |
$0.00 |
| 0410 |
|
42 |
40 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
629 |
585 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
108 |
99 |
$0.00 |
| 87635 |
|
413 |
391 |
$0.00 |
| 87581 |
|
156 |
154 |
$0.00 |
| 0206 |
|
150 |
144 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
145 |
128 |
$0.00 |
| 0352 |
|
39 |
37 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
14 |
13 |
$0.00 |
| Q3014 |
Telehealth facility fee |
26 |
26 |
$0.00 |
| S0020 |
Injection, bupivicaine hydro |
26 |
26 |
$0.00 |
| 71020 |
|
46 |
26 |
$0.00 |
| 0402 |
|
191 |
183 |
$0.00 |
| 0272 |
|
1,064 |
987 |
$0.00 |
| J2270 |
Morphine sulfate injection |
343 |
262 |
$0.00 |
| 0300 |
|
1,289 |
1,129 |
$0.00 |
| 0360 |
|
544 |
461 |
$0.00 |
| 0302 |
|
448 |
390 |
$0.00 |
| 0123 |
|
128 |
125 |
$0.00 |
| 94664 |
|
232 |
226 |
$0.00 |
| C9803 |
Hopd covid-19 spec collect |
924 |
820 |
$0.00 |
| U0003 |
Cov-19 amp prb hgh thruput |
42 |
42 |
$0.00 |
| 0730 |
|
211 |
202 |
$0.00 |
| 87633 |
|
156 |
154 |
$0.00 |
| 0320 |
|
88 |
84 |
$0.00 |
| J7070 |
D5w infusion |
110 |
100 |
$0.00 |
| J7030 |
Normal saline solution infus |
257 |
206 |
$0.00 |
| 0403 |
|
62 |
62 |
$0.00 |
| 87798 |
|
156 |
154 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
118 |
90 |
$0.00 |
| 0278 |
|
62 |
59 |
$0.00 |
| 74176 |
|
12 |
12 |
$0.00 |
| A0429 |
Bls-emergency |
35 |
35 |
$0.00 |
| 0412 |
|
38 |
36 |
$0.00 |
| 51701 |
|
30 |
28 |
$0.00 |
| 0489 |
|
12 |
12 |
$0.00 |
| G1010 |
Cdsm stanson |
25 |
24 |
$0.00 |
| 76775 |
|
12 |
12 |
$0.00 |
| 0200 |
|
13 |
12 |
$0.00 |