| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
10,878 |
10,220 |
$3.06M |
| 99283 |
|
15,015 |
14,400 |
$1.72M |
| 99285 |
|
3,242 |
2,990 |
$945K |
| 85025 |
|
11,017 |
9,901 |
$351K |
| 86703 |
|
998 |
940 |
$172K |
| 80053 |
|
8,794 |
7,989 |
$108K |
| 87428 |
|
2,960 |
2,831 |
$57K |
| 87086 |
|
1,442 |
1,319 |
$51K |
| 86592 |
|
1,054 |
978 |
$45K |
| 59025 |
|
308 |
265 |
$33K |
| 93005 |
|
1,896 |
1,642 |
$32K |
| 80307 |
|
170 |
145 |
$31K |
| 87591 |
|
150 |
138 |
$29K |
| 87491 |
|
150 |
138 |
$27K |
| 71045 |
|
1,699 |
1,578 |
$25K |
| 87651 |
|
1,157 |
1,117 |
$24K |
| G0383 |
Lev 4 hosp type b ed visit |
141 |
117 |
$22K |
| 99282 |
|
169 |
162 |
$20K |
| 87637 |
|
733 |
703 |
$17K |
| 76805 |
|
60 |
54 |
$16K |
| 36415 |
|
9,691 |
8,379 |
$13K |
| 99281 |
|
107 |
101 |
$12K |
| 81025 |
|
1,574 |
1,491 |
$10K |
| 81001 |
|
2,668 |
2,478 |
$9K |
| 93976 |
|
91 |
81 |
$8K |
| 86762 |
|
141 |
74 |
$7K |
| 86803 |
|
52 |
38 |
$7K |
| 84484 |
|
1,086 |
802 |
$7K |
| 87340 |
|
98 |
84 |
$7K |
| 82950 |
|
125 |
122 |
$6K |
| 87081 |
|
89 |
86 |
$6K |
| 84443 |
|
82 |
80 |
$6K |
| 96374 |
|
706 |
624 |
$6K |
| 87426 |
|
280 |
264 |
$6K |
| 86900 |
|
194 |
187 |
$5K |
| 86787 |
|
77 |
26 |
$5K |
| 86850 |
|
52 |
52 |
$5K |
| 86901 |
|
195 |
187 |
$4K |
| U0003 |
Cov-19 amp prb hgh thruput |
82 |
80 |
$4K |
| 76801 |
|
43 |
38 |
$4K |
| 0002A |
|
153 |
152 |
$3K |
| 83690 |
|
691 |
638 |
$3K |
| J1100 |
Dexamethasone sodium phos |
1,718 |
1,592 |
$3K |
| 96375 |
|
264 |
226 |
$3K |
| 83021 |
|
25 |
25 |
$3K |
| 0001A |
|
168 |
152 |
$2K |
| 84702 |
|
244 |
200 |
$2K |
| 80061 |
|
126 |
123 |
$2K |
| 83036 |
|
84 |
83 |
$2K |
| 96372 |
|
115 |
106 |
$1K |
| 81003 |
|
994 |
926 |
$1K |
| 82105 |
|
13 |
13 |
$1K |
| 83735 |
|
430 |
395 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
676 |
636 |
$856.18 |
| 74177 |
|
12 |
12 |
$824.06 |
| J7030 |
Normal saline solution infus |
365 |
329 |
$807.29 |
| 87210 |
|
32 |
28 |
$534.10 |
| 82553 |
|
43 |
41 |
$277.09 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
69 |
65 |
$260.19 |
| 83880 |
|
49 |
40 |
$224.41 |
| 70450 |
|
17 |
13 |
$219.20 |
| G0463 |
Hospital outpt clinic visit |
44 |
40 |
$218.80 |
| 87804 |
|
58 |
29 |
$208.22 |
| 96361 |
|
31 |
29 |
$194.01 |
| 82550 |
|
72 |
68 |
$183.33 |
| 80048 |
|
31 |
29 |
$179.16 |
| J2405 |
Ondansetron hcl injection |
498 |
444 |
$127.39 |
| 84703 |
|
13 |
13 |
$89.31 |
| 83605 |
|
44 |
38 |
$67.58 |
| J2270 |
Morphine sulfate injection |
15 |
14 |
$45.02 |
| J3010 |
Fentanyl citrate injection |
203 |
183 |
$28.76 |
| J0696 |
Ceftriaxone sodium injection |
14 |
13 |
$24.70 |
| 82962 |
|
182 |
96 |
$8.69 |
| J2704 |
Inj, propofol, 10 mg |
116 |
113 |
$1.56 |
| G1004 |
Cdsm ndsc |
80 |
66 |
$0.00 |
| J2272 |
Inj, morphine (fresenius) |
13 |
13 |
$0.00 |
| J0137 |
Inj, acetaminophen (hikma) |
13 |
12 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
13 |
13 |
$0.00 |