| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpt clinic visit |
9,867 |
5,451 |
$310K |
| 99283 |
|
2,731 |
2,308 |
$242K |
| J3490 |
Drugs unclassified injection |
7,834 |
2,721 |
$125K |
| A9270 |
Non-covered item or service |
8,174 |
1,127 |
$64K |
| 93005 |
|
3,422 |
326 |
$55K |
| U0003 |
Cov-19 amp prb hgh thruput |
302 |
278 |
$24K |
| 36415 |
|
1,152 |
925 |
$21K |
| 99285 |
|
160 |
134 |
$16K |
| 80053 |
|
1,087 |
892 |
$16K |
| 99284 |
|
222 |
200 |
$14K |
| 99282 |
|
202 |
171 |
$10K |
| J3010 |
Fentanyl citrate injection |
682 |
407 |
$5K |
| J2704 |
Inj, propofol, 10 mg |
340 |
251 |
$5K |
| C9803 |
Hopd covid-19 spec collect |
318 |
272 |
$5K |
| J2405 |
Ondansetron hcl injection |
410 |
264 |
$4K |
| J7030 |
Normal saline solution infus |
229 |
37 |
$4K |
| J1100 |
Dexamethasone sodium phos |
141 |
105 |
$4K |
| 87635 |
|
88 |
72 |
$3K |
| 85025 |
|
1,915 |
1,521 |
$3K |
| 11720 |
|
240 |
103 |
$3K |
| 11721 |
|
100 |
68 |
$2K |
| J1885 |
Ketorolac tromethamine inj |
209 |
88 |
$2K |
| U0002 |
Covid-19 lab test non-cdc |
35 |
35 |
$2K |
| 84443 |
|
86 |
82 |
$1K |
| 87426 |
|
34 |
30 |
$817.29 |
| 88305 |
|
16 |
13 |
$471.38 |
| 96372 |
|
19 |
13 |
$358.97 |
| 80048 |
|
59 |
39 |
$93.05 |
| 87811 |
|
96 |
44 |
$0.00 |
| 99214 |
|
136 |
130 |
$0.00 |
| 99213 |
|
366 |
345 |
$0.00 |
| 96374 |
|
14 |
14 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
14 |
12 |
$0.00 |
| 81001 |
|
17 |
16 |
$0.00 |