| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
13,369 |
9,613 |
$1.93M |
| 99284 |
|
10,629 |
6,734 |
$1.50M |
| 74177 |
|
958 |
751 |
$724K |
| 99285 |
|
3,871 |
2,182 |
$669K |
| 99282 |
|
5,352 |
4,145 |
$655K |
| 97110 |
|
4,321 |
1,170 |
$395K |
| G0378 |
Hospital observation per hr |
1,458 |
500 |
$363K |
| 70450 |
|
1,233 |
902 |
$348K |
| 96365 |
|
2,658 |
1,633 |
$264K |
| 96375 |
|
2,527 |
1,762 |
$192K |
| 96361 |
|
2,459 |
1,643 |
$188K |
| 97140 |
|
2,145 |
618 |
$148K |
| 96374 |
|
2,765 |
1,973 |
$143K |
| 71046 |
|
1,928 |
1,420 |
$140K |
| U0002 |
Covid-19 lab test non-cdc |
2,922 |
2,355 |
$129K |
| J3490 |
Drugs unclassified injection |
14,971 |
4,779 |
$114K |
| 71045 |
|
2,152 |
1,554 |
$112K |
| 96360 |
|
758 |
491 |
$71K |
| 93005 |
|
3,867 |
2,804 |
$69K |
| G2023 |
Specimen collect covid-19 |
2,743 |
2,149 |
$63K |
| 80053 |
|
11,104 |
7,961 |
$60K |
| J7030 |
Normal saline solution infus |
3,340 |
2,235 |
$56K |
| 80307 |
|
1,623 |
1,223 |
$54K |
| 85025 |
|
13,044 |
8,722 |
$51K |
| 87635 |
|
1,050 |
828 |
$38K |
| J7050 |
Normal saline solution infus |
2,773 |
1,329 |
$34K |
| 74176 |
|
62 |
53 |
$33K |
| 77067 |
|
159 |
135 |
$30K |
| G0480 |
Drug test def 1-7 classes |
984 |
744 |
$29K |
| 94640 |
|
672 |
314 |
$29K |
| 59025 |
|
198 |
67 |
$28K |
| 96372 |
|
537 |
391 |
$27K |
| 0241U |
|
289 |
281 |
$26K |
| 87491 |
|
1,123 |
1,003 |
$23K |
| 87591 |
|
1,120 |
1,000 |
$23K |
| 84443 |
|
2,302 |
1,904 |
$22K |
| J0131 |
Inj, acetaminophen (nos) |
427 |
309 |
$20K |
| J2704 |
Inj, propofol, 10 mg |
987 |
698 |
$19K |
| 93010 |
|
2,568 |
1,811 |
$17K |
| J7120 |
Ringers lactate infusion |
826 |
608 |
$16K |
| 76830 |
|
71 |
63 |
$16K |
| 84484 |
|
3,433 |
2,062 |
$14K |
| 99281 |
|
153 |
113 |
$14K |
| G0481 |
Drug test def 8-14 classes |
203 |
159 |
$11K |
| 87086 |
|
2,420 |
1,961 |
$10K |
| 99213 |
|
832 |
464 |
$9K |
| 83735 |
|
2,681 |
1,650 |
$9K |
| 99212 |
|
246 |
110 |
$9K |
| 80048 |
|
1,892 |
1,185 |
$9K |
| J1885 |
Ketorolac tromethamine inj |
1,953 |
1,364 |
$8K |
| 36415 |
|
17,759 |
11,764 |
$8K |
| 96366 |
|
133 |
80 |
$8K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,566 |
1,253 |
$8K |
| J2405 |
Ondansetron hcl injection |
2,066 |
1,382 |
$8K |
| 83880 |
|
626 |
418 |
$8K |
| 83690 |
|
2,084 |
1,518 |
$7K |
| 87804 |
|
917 |
535 |
$7K |
| 76816 |
|
49 |
43 |
$7K |
| 80061 |
|
743 |
645 |
$7K |
| 87660 |
|
452 |
371 |
$7K |
| 88175 |
|
295 |
264 |
$6K |
| 87510 |
|
456 |
371 |
$6K |
| 87480 |
|
456 |
371 |
$6K |
| 72125 |
|
16 |
12 |
$6K |
| 86850 |
|
741 |
615 |
$6K |
| C9803 |
Hopd covid-19 spec collect |
1,077 |
905 |
$6K |
| 81025 |
|
1,278 |
1,015 |
$6K |
| 88305 |
|
113 |
94 |
$5K |
| G0463 |
Hospital outpt clinic visit |
350 |
107 |
$5K |
| 87081 |
|
1,049 |
947 |
$5K |
| J1170 |
Hydromorphone injection |
776 |
430 |
$5K |
| 97161 |
|
54 |
46 |
$5K |
| 83605 |
|
1,011 |
678 |
$4K |
| 77063 |
|
159 |
135 |
$4K |
| 87186 |
|
882 |
647 |
$4K |
| 97530 |
|
44 |
25 |
$4K |
| 87040 |
|
745 |
450 |
$4K |
| 85027 |
|
799 |
682 |
$4K |
| 81003 |
|
3,372 |
2,694 |
$3K |
| 85610 |
|
1,762 |
1,204 |
$3K |
| 81001 |
|
2,017 |
1,522 |
$3K |
| 76705 |
|
14 |
14 |
$3K |
| 99393 |
|
117 |
83 |
$3K |
| 76805 |
|
14 |
13 |
$3K |
| 86140 |
|
876 |
670 |
$3K |
| J1100 |
Dexamethasone sodium phos |
631 |
473 |
$3K |
| 87088 |
|
985 |
747 |
$2K |
| 82306 |
|
126 |
111 |
$2K |
| 87389 |
|
99 |
96 |
$2K |
| 99214 |
|
560 |
309 |
$2K |
| 83036 |
|
292 |
240 |
$2K |
| 99406 |
|
75 |
45 |
$2K |
| J3475 |
Inj magnesium sulfate |
216 |
127 |
$2K |
| 82947 |
|
1,310 |
646 |
$2K |
| 85730 |
|
651 |
471 |
$2K |
| 85379 |
|
279 |
192 |
$2K |
| 73564 |
|
14 |
12 |
$2K |
| 87880 |
|
245 |
190 |
$2K |
| 73030 |
|
18 |
13 |
$2K |
| 72100 |
|
16 |
13 |
$1K |
| 82728 |
|
142 |
124 |
$1K |
| 85652 |
|
736 |
583 |
$1K |
| 73630 |
|
14 |
13 |
$1K |
| 73610 |
|
18 |
14 |
$1K |
| 96376 |
|
184 |
133 |
$1K |
| 86901 |
|
532 |
435 |
$1K |
| 86900 |
|
513 |
422 |
$1K |
| 87449 |
|
141 |
116 |
$1K |
| 99211 |
|
59 |
36 |
$1K |
| J0696 |
Ceftriaxone sodium injection |
97 |
50 |
$1K |
| 84703 |
|
200 |
152 |
$1K |
| 87624 |
|
42 |
39 |
$889.44 |
| 87077 |
|
122 |
98 |
$882.28 |
| 92551 |
|
165 |
119 |
$797.00 |
| 82550 |
|
142 |
110 |
$663.24 |
| 86803 |
|
57 |
56 |
$592.86 |
| 82607 |
|
73 |
63 |
$577.29 |
| 86317 |
|
47 |
38 |
$509.92 |
| 84439 |
|
76 |
68 |
$450.61 |
| 99217 |
|
15 |
12 |
$431.55 |
| J0690 |
Cefazolin sodium injection |
30 |
25 |
$410.13 |
| 86762 |
|
38 |
37 |
$404.84 |
| 87205 |
|
153 |
124 |
$389.65 |
| 90471 |
|
347 |
233 |
$386.70 |
| 82805 |
|
17 |
12 |
$351.20 |
| J2250 |
Inj midazolam hydrochloride |
99 |
68 |
$344.71 |
| 87340 |
|
42 |
41 |
$326.62 |
| J1790 |
Droperidol injection |
42 |
30 |
$282.82 |
| 87070 |
|
46 |
42 |
$260.76 |
| 86592 |
|
71 |
68 |
$220.18 |
| 83540 |
|
40 |
38 |
$199.83 |
| 90472 |
|
169 |
115 |
$195.25 |
| 99391 |
|
129 |
78 |
$174.00 |
| 80050 |
|
26 |
25 |
$173.25 |
| 86618 |
|
15 |
13 |
$138.67 |
| Q0162 |
Ondansetron oral |
20 |
16 |
$133.25 |
| J3010 |
Fentanyl citrate injection |
13 |
12 |
$103.76 |
| 84100 |
|
44 |
36 |
$101.87 |
| 83550 |
|
12 |
12 |
$96.47 |
| 82375 |
|
17 |
12 |
$94.95 |
| 80354 |
|
202 |
154 |
$79.00 |
| 82950 |
|
18 |
15 |
$74.23 |
| A9270 |
Non-covered item or service |
73 |
38 |
$73.28 |
| 99173 |
|
124 |
93 |
$66.00 |
| J1200 |
Diphenhydramine hcl injectio |
15 |
15 |
$62.72 |
| 85018 |
|
33 |
24 |
$44.43 |
| 85014 |
|
33 |
24 |
$44.43 |
| 81015 |
|
93 |
64 |
$39.32 |
| 90474 |
|
46 |
30 |
$21.00 |
| 90723 |
|
50 |
32 |
$0.00 |
| 90680 |
|
48 |
30 |
$0.00 |
| 90686 |
|
47 |
28 |
$0.00 |
| 90648 |
|
82 |
53 |
$0.00 |
| 99392 |
|
121 |
86 |
$0.00 |
| 99394 |
|
19 |
12 |
$0.00 |
| 90670 |
|
99 |
67 |
$0.00 |
| 90685 |
|
34 |
19 |
$0.00 |
| 90710 |
|
19 |
12 |
$0.00 |
| 90633 |
|
13 |
12 |
$0.00 |