| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
741 |
623 |
$13K |
| 64415 |
|
27 |
27 |
$5K |
| 99220 |
|
50 |
40 |
$2K |
| 71045 |
|
210 |
191 |
$1K |
| 76942 |
|
27 |
27 |
$1K |
| J7030 |
Normal saline solution infus |
388 |
212 |
$1K |
| 86769 |
|
119 |
107 |
$676.69 |
| C9803 |
Hopd covid-19 spec collect |
158 |
145 |
$637.37 |
| 80048 |
|
253 |
203 |
$624.03 |
| 76937 |
|
29 |
25 |
$418.31 |
| 85025 |
|
252 |
218 |
$374.86 |
| J0690 |
Cefazolin sodium injection |
54 |
53 |
$264.19 |
| 99217 |
|
12 |
12 |
$228.90 |
| 80053 |
|
58 |
53 |
$182.62 |
| 85730 |
|
211 |
190 |
$146.67 |
| J2795 |
Ropivacaine hcl injection |
24 |
24 |
$139.56 |
| J1644 |
Inj heparin sodium per 1000u |
245 |
198 |
$129.27 |
| 93005 |
|
29 |
27 |
$114.97 |
| 85610 |
|
211 |
190 |
$103.63 |
| J2250 |
Inj midazolam hydrochloride |
166 |
145 |
$96.44 |
| J3010 |
Fentanyl citrate injection |
73 |
64 |
$53.01 |
| 36415 |
|
474 |
294 |
$22.42 |
| J2001 |
Lidocaine injection |
161 |
145 |
$11.73 |
| G0378 |
Hospital observation per hr |
13 |
13 |
$0.00 |
| J3490 |
Drugs unclassified injection |
90 |
57 |
$0.00 |
| J8499 |
Oral prescrip drug non chemo |
48 |
26 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
17 |
13 |
$0.00 |