| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
1,919 |
1,779 |
$177K |
| 99285 |
|
1,000 |
931 |
$117K |
| 99283 |
|
1,634 |
1,514 |
$94K |
| 96374 |
|
756 |
694 |
$26K |
| 99282 |
|
390 |
341 |
$13K |
| 96375 |
|
452 |
413 |
$11K |
| 80053 |
|
1,198 |
1,095 |
$8K |
| 96372 |
|
406 |
384 |
$8K |
| 87636 |
|
103 |
95 |
$7K |
| 96361 |
|
528 |
480 |
$6K |
| 85025 |
|
1,188 |
1,089 |
$5K |
| 36415 |
|
1,482 |
1,353 |
$3K |
| 84484 |
|
541 |
368 |
$3K |
| 71045 |
|
312 |
281 |
$2K |
| 93005 |
|
411 |
370 |
$2K |
| 81025 |
|
531 |
507 |
$2K |
| 71046 |
|
101 |
98 |
$2K |
| U0003 |
Cov-19 amp prb hgh thruput |
23 |
22 |
$2K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
128 |
120 |
$1K |
| 81001 |
|
592 |
561 |
$1K |
| 84702 |
|
202 |
188 |
$1K |
| 87798 |
|
82 |
32 |
$861.84 |
| 83690 |
|
243 |
228 |
$795.01 |
| 85027 |
|
184 |
173 |
$610.74 |
| 80048 |
|
139 |
132 |
$590.04 |
| 87581 |
|
41 |
32 |
$502.74 |
| 87486 |
|
41 |
32 |
$502.74 |
| 87086 |
|
112 |
111 |
$466.69 |
| 80307 |
|
17 |
14 |
$359.19 |
| 81003 |
|
285 |
243 |
$271.20 |
| 87661 |
|
13 |
13 |
$264.67 |
| J1885 |
Ketorolac tromethamine inj |
214 |
203 |
$248.37 |
| 87491 |
|
12 |
12 |
$243.00 |
| C9803 |
Hopd covid-19 spec collect |
123 |
115 |
$223.50 |
| J1100 |
Dexamethasone sodium phos |
72 |
61 |
$110.53 |
| 85379 |
|
13 |
13 |
$70.13 |
| J2405 |
Ondansetron hcl injection |
166 |
157 |
$59.51 |
| J7512 |
Prednisone ir or dr oral 1mg |
39 |
37 |
$41.97 |
| J0696 |
Ceftriaxone sodium injection |
25 |
25 |
$28.85 |
| J2765 |
Metoclopramide hcl injection |
13 |
13 |
$9.12 |
| J2001 |
Lidocaine injection |
26 |
26 |
$4.32 |
| 0353U |
|
25 |
25 |
$0.00 |
| 87633 |
|
41 |
32 |
$0.00 |