| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpt clinic visit |
28,548 |
20,297 |
$6.72M |
| 99213 |
|
20,806 |
15,810 |
$4.65M |
| C9803 |
Hopd covid-19 spec collect |
3,049 |
2,781 |
$2.38M |
| 80053 |
|
6,348 |
5,200 |
$2.27M |
| 96372 |
|
2,925 |
2,167 |
$1.51M |
| 99282 |
|
7,080 |
3,562 |
$1.21M |
| 99212 |
|
4,577 |
3,931 |
$1.10M |
| 99442 |
|
1,615 |
1,335 |
$1.06M |
| 92004 |
|
1,269 |
1,192 |
$896K |
| 99283 |
|
9,708 |
5,666 |
$878K |
| 92014 |
|
1,123 |
1,083 |
$824K |
| 99214 |
|
5,410 |
4,760 |
$795K |
| U0002 |
Covid-19 lab test non-cdc |
4,557 |
4,104 |
$714K |
| 97110 |
|
1,492 |
988 |
$696K |
| 99394 |
|
1,645 |
901 |
$652K |
| 87086 |
|
1,972 |
1,717 |
$637K |
| 80305 |
|
2,782 |
1,796 |
$631K |
| 36415 |
|
5,151 |
3,772 |
$555K |
| 87880 |
|
1,486 |
1,320 |
$544K |
| 87491 |
|
3,145 |
2,673 |
$479K |
| 96374 |
|
1,360 |
1,077 |
$479K |
| 87070 |
|
864 |
791 |
$451K |
| 0241U |
|
1,059 |
1,003 |
$428K |
| 99393 |
|
1,122 |
561 |
$376K |
| 99443 |
|
558 |
467 |
$367K |
| 81025 |
|
2,012 |
1,737 |
$357K |
| 99392 |
|
1,104 |
604 |
$342K |
| 86592 |
|
1,580 |
1,400 |
$318K |
| 99441 |
|
511 |
457 |
$316K |
| 87081 |
|
720 |
576 |
$294K |
| 81001 |
|
3,430 |
2,925 |
$287K |
| 71046 |
|
2,124 |
930 |
$242K |
| 99284 |
|
3,175 |
2,367 |
$199K |
| 99391 |
|
562 |
294 |
$169K |
| 90471 |
|
3,804 |
3,353 |
$154K |
| 96365 |
|
391 |
326 |
$152K |
| 96361 |
|
249 |
208 |
$150K |
| 85025 |
|
6,534 |
5,278 |
$147K |
| 80307 |
|
209 |
128 |
$143K |
| 83036 |
|
2,181 |
1,940 |
$139K |
| 92015 |
|
2,583 |
2,428 |
$133K |
| 85018 |
|
743 |
497 |
$128K |
| 99281 |
|
461 |
309 |
$121K |
| U0003 |
Cov-19 amp prb hgh thruput |
190 |
186 |
$120K |
| 99285 |
|
1,345 |
1,186 |
$109K |
| 87400 |
|
406 |
238 |
$102K |
| 92504 |
|
380 |
268 |
$99K |
| 87210 |
|
481 |
441 |
$97K |
| 80061 |
|
922 |
851 |
$94K |
| 92567 |
|
595 |
397 |
$80K |
| 83655 |
|
212 |
120 |
$75K |
| J8499 |
Oral prescrip drug non chemo |
3,210 |
1,585 |
$67K |
| G0481 |
Drug test def 8-14 classes |
227 |
161 |
$64K |
| 99211 |
|
1,880 |
1,480 |
$61K |
| 81003 |
|
130 |
122 |
$57K |
| 99202 |
|
312 |
221 |
$51K |
| 80048 |
|
115 |
100 |
$48K |
| 92553 |
|
52 |
49 |
$41K |
| 87502 |
|
45 |
45 |
$41K |
| 86703 |
|
1,368 |
1,134 |
$39K |
| 97140 |
|
117 |
85 |
$38K |
| 90686 |
|
567 |
549 |
$37K |
| 92557 |
|
199 |
74 |
$36K |
| J1885 |
Ketorolac tromethamine inj |
644 |
487 |
$35K |
| J3490 |
Drugs unclassified injection |
578 |
406 |
$32K |
| 97530 |
|
146 |
94 |
$27K |
| 84443 |
|
1,269 |
1,121 |
$26K |
| 86850 |
|
41 |
39 |
$26K |
| 93005 |
|
1,352 |
1,144 |
$22K |
| 90647 |
|
253 |
169 |
$22K |
| 77067 |
|
114 |
58 |
$20K |
| 96360 |
|
27 |
24 |
$20K |
| 85027 |
|
451 |
438 |
$20K |
| S9484 |
Crisis intervention per hour |
76 |
32 |
$19K |
| 85014 |
|
305 |
170 |
$19K |
| 86580 |
|
129 |
66 |
$17K |
| 86803 |
|
1,298 |
1,161 |
$15K |
| T1016 |
Case management |
63 |
13 |
$15K |
| 97161 |
|
489 |
421 |
$15K |
| 90633 |
|
160 |
75 |
$15K |
| 82962 |
|
48 |
39 |
$12K |
| 86140 |
|
278 |
253 |
$10K |
| 92507 |
|
14 |
13 |
$10K |
| 81002 |
|
29 |
27 |
$9K |
| 76805 |
|
47 |
26 |
$9K |
| J2405 |
Ondansetron hcl injection |
480 |
406 |
$9K |
| 90715 |
|
325 |
268 |
$9K |
| 71045 |
|
192 |
95 |
$8K |
| J7120 |
Ringers lactate infusion |
29 |
27 |
$8K |
| 92552 |
|
12 |
12 |
$8K |
| 87635 |
|
28 |
16 |
$7K |
| 85610 |
|
63 |
54 |
$7K |
| 70450 |
|
72 |
36 |
$7K |
| 82570 |
|
136 |
128 |
$6K |
| 94640 |
|
65 |
48 |
$5K |
| 73130 |
|
28 |
14 |
$5K |
| 99000 |
|
6,463 |
5,400 |
$5K |
| 92100 |
|
55 |
54 |
$4K |
| 88175 |
|
83 |
66 |
$4K |
| 96375 |
|
794 |
574 |
$4K |
| 83690 |
|
668 |
586 |
$3K |
| 76705 |
|
23 |
12 |
$3K |
| 87661 |
|
225 |
217 |
$3K |
| 99152 |
|
19 |
17 |
$3K |
| 83540 |
|
29 |
26 |
$2K |
| 90696 |
|
87 |
49 |
$2K |
| 82306 |
|
55 |
51 |
$2K |
| 83735 |
|
638 |
536 |
$2K |
| 87806 |
|
359 |
343 |
$2K |
| A0180 |
Noner transport lodgng recip |
15 |
12 |
$2K |
| 92250 |
|
28 |
28 |
$2K |
| 87591 |
|
3,120 |
2,673 |
$2K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
25 |
25 |
$2K |
| 87077 |
|
207 |
132 |
$1K |
| J0696 |
Ceftriaxone sodium injection |
91 |
69 |
$1K |
| 87624 |
|
35 |
19 |
$1K |
| 90723 |
|
154 |
122 |
$808.00 |
| 90670 |
|
369 |
267 |
$710.00 |
| 87420 |
|
15 |
14 |
$682.00 |
| J7030 |
Normal saline solution infus |
97 |
41 |
$682.00 |
| 90685 |
|
14 |
14 |
$653.00 |
| 82043 |
|
28 |
27 |
$653.00 |
| 86704 |
|
91 |
47 |
$653.00 |
| 90472 |
|
2,097 |
1,486 |
$0.00 |
| 87186 |
|
720 |
600 |
$0.00 |
| 90707 |
|
253 |
157 |
$0.00 |
| 90734 |
|
158 |
110 |
$0.00 |
| 87798 |
|
81 |
77 |
$0.00 |
| 84100 |
|
85 |
71 |
$0.00 |
| 86900 |
|
41 |
39 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
31 |
12 |
$0.00 |
| 82248 |
|
13 |
13 |
$0.00 |
| 74177 |
|
24 |
12 |
$0.00 |
| 90651 |
|
201 |
143 |
$0.00 |
| 84484 |
|
244 |
200 |
$0.00 |
| 80320 |
|
827 |
637 |
$0.00 |
| 85730 |
|
26 |
25 |
$0.00 |
| 87340 |
|
226 |
216 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
35 |
32 |
$0.00 |
| 83605 |
|
49 |
42 |
$0.00 |
| 0352U |
|
172 |
170 |
$0.00 |
| 90716 |
|
176 |
96 |
$0.00 |
| G0378 |
Hospital observation per hr |
57 |
38 |
$0.00 |
| 90680 |
|
39 |
39 |
$0.00 |
| J0561 |
Penicillin g benzathine inj |
49 |
47 |
$0.00 |
| 90474 |
|
25 |
25 |
$0.00 |
| 86901 |
|
41 |
39 |
$0.00 |
| Q3014 |
Telehealth facility fee |
13 |
12 |
$0.00 |
| 90688 |
|
13 |
13 |
$0.00 |
| 97802 |
|
28 |
28 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
24 |
19 |
$0.00 |
| 87522 |
Neg quan hep c or qual rna |
12 |
12 |
$0.00 |
| J2060 |
Lorazepam injection |
14 |
13 |
$0.00 |
| 83550 |
|
16 |
14 |
$0.00 |