| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
2,628 |
2,286 |
$236K |
| 99283 |
|
4,161 |
3,692 |
$215K |
| A4223 |
Infusion supplies w/o pump |
2,794 |
2,188 |
$171K |
| 99285 |
|
1,467 |
1,059 |
$127K |
| 99282 |
|
1,448 |
1,333 |
$49K |
| U0002 |
Covid-19 lab test non-cdc |
1,524 |
1,205 |
$48K |
| 80053 |
|
8,604 |
5,723 |
$42K |
| 0202U |
|
1,755 |
624 |
$38K |
| 96374 |
|
1,945 |
1,505 |
$23K |
| 96361 |
|
1,808 |
1,425 |
$18K |
| 85025 |
|
9,311 |
6,035 |
$17K |
| 80307 |
|
783 |
660 |
$17K |
| 96375 |
|
1,573 |
1,216 |
$16K |
| 74177 |
|
65 |
47 |
$10K |
| 84443 |
|
1,198 |
1,091 |
$8K |
| 93005 |
|
2,246 |
1,723 |
$7K |
| 96365 |
|
572 |
382 |
$6K |
| J7030 |
Normal saline solution infus |
1,674 |
1,237 |
$6K |
| 70450 |
|
167 |
129 |
$6K |
| G0378 |
Hospital observation per hr |
80 |
26 |
$6K |
| 80061 |
|
893 |
858 |
$6K |
| 84484 |
|
1,856 |
1,367 |
$5K |
| 71046 |
|
373 |
333 |
$5K |
| 36415 |
|
8,970 |
5,079 |
$5K |
| 83690 |
|
1,510 |
1,201 |
$4K |
| 71045 |
|
1,292 |
905 |
$4K |
| 83735 |
|
3,159 |
2,209 |
$4K |
| 83036 |
|
931 |
859 |
$3K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
247 |
211 |
$3K |
| 96372 |
|
538 |
437 |
$3K |
| 83880 |
|
393 |
269 |
$3K |
| 87086 |
|
1,017 |
833 |
$2K |
| 82607 |
|
304 |
296 |
$2K |
| 97110 |
|
193 |
38 |
$1K |
| 87804 |
|
111 |
105 |
$1K |
| 96360 |
|
69 |
64 |
$1K |
| 81001 |
|
1,535 |
1,319 |
$1K |
| 82306 |
|
93 |
88 |
$1K |
| 84436 |
|
319 |
312 |
$989.59 |
| 80050 |
|
43 |
43 |
$923.78 |
| 94640 |
|
154 |
86 |
$805.44 |
| 85610 |
|
891 |
581 |
$752.64 |
| 81025 |
|
227 |
204 |
$703.62 |
| 81003 |
|
1,156 |
938 |
$551.78 |
| J2405 |
Ondansetron hcl injection |
1,252 |
923 |
$472.72 |
| 82746 |
|
61 |
58 |
$451.35 |
| 82553 |
|
149 |
114 |
$417.64 |
| 87635 |
|
436 |
210 |
$354.74 |
| J1885 |
Ketorolac tromethamine inj |
171 |
153 |
$259.42 |
| 83605 |
|
87 |
66 |
$223.58 |
| 80048 |
|
132 |
87 |
$216.16 |
| 86038 |
|
41 |
38 |
$214.50 |
| 85652 |
|
158 |
127 |
$141.86 |
| J1170 |
Hydromorphone injection |
32 |
26 |
$95.50 |
| 86140 |
|
53 |
41 |
$84.72 |
| 81005 |
|
88 |
82 |
$63.64 |
| C9113 |
Inj pantoprazole sodium, via |
16 |
12 |
$53.98 |
| 82550 |
|
14 |
12 |
$48.84 |
| J0696 |
Ceftriaxone sodium injection |
82 |
44 |
$43.06 |
| A4216 |
Sterile water/saline, 10 ml |
12 |
12 |
$20.25 |
| 84100 |
|
13 |
13 |
$16.15 |
| 84439 |
|
18 |
12 |
$12.30 |
| 80320 |
|
466 |
377 |
$11.99 |
| S1015 |
Iv tubing extension set |
568 |
481 |
$11.97 |
| J8499 |
Oral prescrip drug non chemo |
1,493 |
232 |
$7.01 |
| 90853 |
|
9,414 |
649 |
$0.00 |
| J7050 |
Normal saline solution infus |
18 |
12 |
$0.00 |