| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S9083 |
Urgent care center global |
30,580 |
25,095 |
$4.13M |
| S9088 |
Services provided in urgent |
9,399 |
8,509 |
$1.12M |
| 99213 |
|
15,743 |
14,062 |
$412K |
| 99214 |
|
13,752 |
11,772 |
$322K |
| 99203 |
|
3,836 |
3,637 |
$98K |
| 87428 |
|
10,414 |
7,984 |
$88K |
| 99204 |
|
2,514 |
2,266 |
$66K |
| 87426 |
|
5,512 |
5,145 |
$56K |
| 99215 |
Prolong outpt/office vis |
631 |
602 |
$21K |
| 99212 |
|
1,509 |
1,398 |
$20K |
| A6449 |
Lt compres band >=3" <5"/yd |
908 |
879 |
$17K |
| J1885 |
Ketorolac tromethamine inj |
555 |
516 |
$13K |
| 99202 |
|
616 |
577 |
$5K |
| A4565 |
Slings |
155 |
147 |
$4K |
| 90471 |
|
252 |
225 |
$3K |
| 99058 |
|
299 |
147 |
$3K |
| J0696 |
Ceftriaxone sodium injection |
87 |
83 |
$2K |
| 90686 |
|
108 |
89 |
$1K |
| 87880 |
|
11,253 |
9,464 |
$1K |
| 81002 |
|
3,203 |
2,943 |
$1K |
| 71046 |
|
3,530 |
3,157 |
$787.34 |
| E0114 |
Crutch underarm pair no wood |
111 |
108 |
$743.20 |
| 81000 |
|
3,562 |
3,253 |
$524.60 |
| L3260 |
Ambulatory surgical boot eac |
32 |
30 |
$445.92 |
| 81025 |
|
1,849 |
1,717 |
$369.80 |
| 85025 |
|
5,149 |
4,578 |
$323.16 |
| 73630 |
|
627 |
601 |
$297.56 |
| 73564 |
|
433 |
400 |
$297.53 |
| 87804 |
|
2,775 |
1,297 |
$203.36 |
| L3908 |
Who cock-up nonmolde pre ots |
68 |
65 |
$191.23 |
| 80047 |
|
3,494 |
3,155 |
$182.32 |
| 90715 |
|
53 |
51 |
$180.80 |
| 93000 |
|
1,045 |
980 |
$162.82 |
| 73140 |
|
249 |
235 |
$79.07 |
| 96372 |
|
1,309 |
1,194 |
$76.88 |
| 72050 |
|
26 |
25 |
$73.76 |
| 73110 |
|
196 |
191 |
$69.32 |
| 94640 |
|
102 |
95 |
$61.84 |
| 73610 |
|
705 |
669 |
$54.13 |
| 36415 |
|
5,428 |
4,823 |
$50.92 |
| 73030 |
|
82 |
82 |
$46.69 |
| 87210 |
|
931 |
879 |
$18.01 |
| 87220 |
|
966 |
913 |
$14.68 |
| 73130 |
|
73 |
68 |
$10.24 |
| 99201 |
|
28 |
28 |
$0.01 |
| 99070 |
|
220 |
208 |
$0.00 |
| A4570 |
Splint |
77 |
74 |
$0.00 |
| 86308 |
|
12 |
12 |
$0.00 |
| J7620 |
Albuterol ipratrop non-comp |
27 |
26 |
$0.00 |
| 99051 |
|
483 |
444 |
$0.00 |
| 73080 |
|
15 |
15 |
$0.00 |
| S0119 |
Ondansetron 4 mg |
74 |
50 |
$0.00 |