| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
10,729 |
9,217 |
$1.20M |
| 99283 |
|
8,546 |
7,717 |
$811K |
| 99285 |
|
4,083 |
3,456 |
$603K |
| 87636 |
|
2,680 |
2,471 |
$257K |
| 59025 |
|
504 |
359 |
$190K |
| 71045 |
|
2,934 |
2,492 |
$133K |
| 80307 |
|
2,435 |
2,033 |
$124K |
| 96374 |
|
4,450 |
3,683 |
$121K |
| 93005 |
|
3,715 |
3,011 |
$117K |
| 87637 |
|
1,065 |
978 |
$57K |
| C9803 |
Hopd covid-19 spec collect |
3,216 |
2,926 |
$42K |
| 96372 |
|
1,870 |
1,515 |
$40K |
| 99282 |
|
753 |
689 |
$39K |
| 96375 |
|
2,591 |
2,105 |
$38K |
| 99281 |
|
727 |
645 |
$33K |
| 74177 |
|
300 |
265 |
$32K |
| 87631 |
|
327 |
300 |
$28K |
| 70450 |
|
510 |
425 |
$23K |
| 96365 |
|
303 |
249 |
$22K |
| 87635 |
|
488 |
432 |
$17K |
| 71046 |
|
230 |
215 |
$17K |
| 85025 |
|
12,708 |
10,632 |
$15K |
| 96361 |
|
1,581 |
1,246 |
$14K |
| 87426 |
|
588 |
518 |
$14K |
| 74176 |
|
234 |
193 |
$12K |
| 80053 |
|
5,574 |
4,707 |
$8K |
| G0378 |
Hospital observation per hr |
48 |
37 |
$7K |
| 80048 |
|
5,817 |
4,796 |
$7K |
| 86900 |
|
204 |
196 |
$5K |
| 97530 |
|
72 |
29 |
$4K |
| 87880 |
|
1,426 |
1,325 |
$4K |
| U0003 |
Cov-19 amp prb hgh thruput |
55 |
52 |
$3K |
| 80076 |
|
3,039 |
2,580 |
$3K |
| 83880 |
|
765 |
632 |
$3K |
| 87400 |
|
805 |
690 |
$3K |
| 84484 |
|
2,470 |
1,938 |
$3K |
| 81001 |
|
5,391 |
4,575 |
$3K |
| 83690 |
|
2,947 |
2,482 |
$3K |
| 87389 |
|
155 |
153 |
$3K |
| 87086 |
|
1,238 |
1,046 |
$2K |
| 87430 |
|
790 |
676 |
$2K |
| 76856 |
|
30 |
25 |
$2K |
| 76830 |
|
29 |
24 |
$2K |
| 87651 |
|
248 |
232 |
$2K |
| 86850 |
|
200 |
193 |
$2K |
| 36415 |
|
2,310 |
1,910 |
$2K |
| 84443 |
|
243 |
236 |
$1K |
| 83735 |
|
1,697 |
1,438 |
$1K |
| 84702 |
|
113 |
111 |
$1K |
| 82306 |
|
37 |
36 |
$1K |
| 81025 |
|
959 |
832 |
$910.10 |
| 87491 |
|
121 |
119 |
$843.52 |
| 87591 |
|
121 |
119 |
$842.82 |
| 87807 |
|
249 |
239 |
$802.99 |
| 87081 |
|
582 |
547 |
$758.91 |
| 84703 |
|
424 |
373 |
$752.64 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
136 |
122 |
$724.50 |
| J2405 |
Ondansetron hcl injection |
2,150 |
1,692 |
$723.57 |
| J0696 |
Ceftriaxone sodium injection |
587 |
496 |
$674.50 |
| 82077 |
|
50 |
41 |
$672.80 |
| 86901 |
|
205 |
196 |
$658.74 |
| 94640 |
|
15 |
13 |
$583.87 |
| 87420 |
|
136 |
123 |
$504.77 |
| 86780 |
|
159 |
156 |
$478.45 |
| 86803 |
|
157 |
154 |
$467.09 |
| 85610 |
|
886 |
764 |
$463.00 |
| 84439 |
|
83 |
81 |
$448.00 |
| 84144 |
|
94 |
94 |
$434.48 |
| 85027 |
|
349 |
324 |
$433.33 |
| 86762 |
|
152 |
149 |
$429.88 |
| 87529 |
|
60 |
60 |
$428.56 |
| 85730 |
|
541 |
459 |
$404.70 |
| J3490 |
Drugs unclassified injection |
74 |
65 |
$368.01 |
| 83655 |
|
38 |
25 |
$347.58 |
| 87340 |
|
157 |
154 |
$324.01 |
| 97110 |
|
32 |
12 |
$291.74 |
| 85379 |
|
154 |
133 |
$288.18 |
| J1885 |
Ketorolac tromethamine inj |
1,416 |
1,157 |
$251.77 |
| 86696 |
|
65 |
63 |
$240.43 |
| 82550 |
|
240 |
212 |
$239.89 |
| 80061 |
|
15 |
12 |
$208.73 |
| 83036 |
|
27 |
26 |
$176.24 |
| 86695 |
|
65 |
63 |
$162.74 |
| 87040 |
|
107 |
58 |
$148.16 |
| J2270 |
Morphine sulfate injection |
229 |
157 |
$110.72 |
| 85007 |
|
153 |
136 |
$83.89 |
| 82150 |
|
87 |
77 |
$79.98 |
| 85018 |
|
38 |
25 |
$70.14 |
| 83605 |
|
48 |
38 |
$65.78 |
| 87186 |
|
65 |
56 |
$39.28 |
| J1100 |
Dexamethasone sodium phos |
299 |
243 |
$38.81 |
| J2550 |
Promethazine hcl injection |
181 |
145 |
$37.44 |
| J0780 |
Prochlorperazine injection |
47 |
38 |
$20.50 |
| J2930 |
Methylprednisolone injection |
25 |
19 |
$6.20 |
| J2001 |
Lidocaine injection |
46 |
42 |
$0.34 |
| J2704 |
Inj, propofol, 10 mg |
35 |
27 |
$0.00 |
| A9270 |
Non-covered item or service |
131 |
119 |
$0.00 |