| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
11,632 |
11,259 |
$6.88M |
| 99285 |
|
6,721 |
6,240 |
$3.71M |
| 99283 |
|
5,610 |
5,473 |
$1.11M |
| 74176 |
|
2,388 |
2,267 |
$592K |
| 71045 |
|
5,280 |
5,057 |
$591K |
| 87426 |
|
8,455 |
8,244 |
$389K |
| 76805 |
|
2,442 |
2,297 |
$380K |
| 87804 |
|
17,472 |
8,697 |
$370K |
| 71046 |
|
2,987 |
2,917 |
$365K |
| 87430 |
|
8,827 |
8,636 |
$204K |
| C9803 |
Hopd covid-19 spec collect |
8,719 |
8,454 |
$189K |
| 70450 |
|
1,444 |
1,378 |
$129K |
| 80307 |
|
1,331 |
1,247 |
$91K |
| U0003 |
Cov-19 amp prb hgh thruput |
911 |
883 |
$87K |
| 80053 |
|
11,242 |
10,129 |
$83K |
| 85025 |
|
12,581 |
11,347 |
$71K |
| J0696 |
Ceftriaxone sodium injection |
1,245 |
1,167 |
$69K |
| 76801 |
|
435 |
393 |
$67K |
| 93005 |
|
3,218 |
2,841 |
$63K |
| 87420 |
|
2,500 |
2,441 |
$56K |
| 71250 |
|
948 |
911 |
$34K |
| 59025 |
|
64 |
55 |
$22K |
| 81001 |
|
7,621 |
7,126 |
$17K |
| 97110 |
|
225 |
50 |
$16K |
| 74177 |
|
65 |
63 |
$16K |
| 83690 |
|
2,918 |
2,723 |
$16K |
| 84484 |
|
3,468 |
2,689 |
$15K |
| U0005 |
Infec agen detec ampli probe |
555 |
537 |
$15K |
| G0463 |
Hospital outpt clinic visit |
836 |
356 |
$14K |
| 87086 |
|
2,493 |
2,330 |
$10K |
| 96372 |
|
267 |
256 |
$9K |
| J2405 |
Ondansetron hcl injection |
2,271 |
2,089 |
$9K |
| 83874 |
|
2,607 |
2,247 |
$8K |
| 82550 |
|
2,747 |
2,375 |
$7K |
| 77067 |
|
140 |
140 |
$6K |
| 83605 |
|
1,300 |
1,111 |
$5K |
| 96361 |
|
588 |
542 |
$5K |
| 84703 |
|
467 |
440 |
$5K |
| 72125 |
|
87 |
81 |
$5K |
| 96365 |
|
759 |
721 |
$4K |
| 94640 |
|
60 |
57 |
$3K |
| 87070 |
|
337 |
324 |
$3K |
| 36415 |
|
15,646 |
13,472 |
$3K |
| 85610 |
|
1,797 |
1,661 |
$3K |
| 87040 |
|
1,290 |
695 |
$3K |
| 99281 |
|
44 |
43 |
$3K |
| J0561 |
Penicillin g benzathine inj |
13 |
12 |
$3K |
| 82553 |
|
890 |
770 |
$3K |
| 83880 |
|
588 |
523 |
$3K |
| 84443 |
|
996 |
975 |
$2K |
| 87186 |
|
1,149 |
1,011 |
$2K |
| 74018 |
|
14 |
14 |
$2K |
| 80048 |
|
685 |
648 |
$2K |
| 82306 |
|
732 |
726 |
$2K |
| 87651 |
|
55 |
55 |
$2K |
| 81003 |
|
1,139 |
1,088 |
$2K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
290 |
279 |
$2K |
| 99282 |
|
12 |
12 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
188 |
170 |
$1K |
| 80061 |
|
1,131 |
1,122 |
$1K |
| 85730 |
|
859 |
810 |
$1K |
| 83735 |
|
1,067 |
969 |
$1K |
| 83036 |
|
958 |
947 |
$1K |
| 76700 |
|
16 |
15 |
$1K |
| J3010 |
Fentanyl citrate injection |
286 |
266 |
$686.70 |
| 84702 |
|
36 |
25 |
$663.18 |
| 82803 |
|
150 |
103 |
$630.42 |
| 96360 |
|
50 |
50 |
$613.04 |
| 94664 |
|
17 |
16 |
$546.05 |
| 87077 |
|
355 |
326 |
$519.23 |
| 85027 |
|
212 |
195 |
$504.79 |
| 96375 |
|
791 |
724 |
$495.85 |
| 0241U |
|
83 |
82 |
$438.34 |
| J7510 |
Prednisolone oral per 5 mg |
454 |
444 |
$436.06 |
| J2270 |
Morphine sulfate injection |
454 |
389 |
$378.36 |
| J1100 |
Dexamethasone sodium phos |
132 |
129 |
$366.67 |
| 96374 |
|
910 |
844 |
$248.26 |
| 84030 |
|
26 |
25 |
$188.62 |
| 72100 |
|
13 |
13 |
$167.19 |
| 36600 |
|
14 |
14 |
$156.78 |
| 80069 |
|
319 |
303 |
$143.47 |
| 73564 |
|
14 |
13 |
$135.06 |
| 87205 |
|
135 |
115 |
$108.02 |
| 82570 |
|
322 |
297 |
$99.74 |
| 86901 |
|
27 |
26 |
$70.04 |
| 86900 |
|
27 |
26 |
$70.04 |
| 84156 |
|
237 |
225 |
$48.03 |
| 82150 |
|
29 |
26 |
$36.15 |
| 84550 |
|
108 |
104 |
$34.44 |
| 82962 |
|
1,214 |
526 |
$32.01 |
| 83540 |
|
37 |
37 |
$25.38 |
| 84439 |
|
12 |
12 |
$24.72 |
| 83550 |
|
36 |
36 |
$22.33 |
| J0360 |
Hydralazine hcl injection |
14 |
12 |
$15.47 |
| A9270 |
Non-covered item or service |
2,067 |
1,297 |
$0.00 |
| 82607 |
|
44 |
44 |
$0.00 |
| J2001 |
Lidocaine injection |
19 |
17 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
148 |
142 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
17 |
14 |
$0.00 |
| 36416 |
|
27 |
26 |
$0.00 |