| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
3,778 |
3,035 |
$160K |
| 99284 |
|
2,144 |
1,832 |
$105K |
| 99283 |
|
1,338 |
1,174 |
$68K |
| 80053 |
|
1,994 |
1,461 |
$59K |
| 74177 |
|
317 |
268 |
$56K |
| 80048 |
|
2,584 |
1,978 |
$56K |
| 96361 |
|
1,420 |
1,176 |
$48K |
| A9270 |
Non-covered item or service |
2,888 |
1,752 |
$32K |
| J2704 |
Inj, propofol, 10 mg |
2,853 |
1,132 |
$27K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
2,400 |
1,336 |
$26K |
| 96365 |
|
659 |
412 |
$16K |
| J2001 |
Lidocaine injection |
1,889 |
926 |
$16K |
| U0003 |
Cov-19 amp prb hgh thruput |
349 |
277 |
$14K |
| 93306 |
|
210 |
177 |
$12K |
| J2405 |
Ondansetron hcl injection |
2,002 |
1,413 |
$11K |
| J2250 |
Inj midazolam hydrochloride |
606 |
417 |
$10K |
| J7030 |
Normal saline solution infus |
985 |
679 |
$10K |
| C9803 |
Hopd covid-19 spec collect |
1,128 |
959 |
$10K |
| 82948 |
|
1,598 |
606 |
$9K |
| 70450 |
|
350 |
290 |
$9K |
| J3010 |
Fentanyl citrate injection |
799 |
552 |
$8K |
| 96375 |
|
1,424 |
1,104 |
$7K |
| 82947 |
|
574 |
364 |
$7K |
| 85025 |
|
2,571 |
1,821 |
$7K |
| 88305 |
|
602 |
466 |
$7K |
| G0378 |
Hospital observation per hr |
552 |
286 |
$6K |
| J1644 |
Inj heparin sodium per 1000u |
216 |
105 |
$5K |
| 85027 |
|
3,209 |
2,326 |
$5K |
| 36415 |
|
868 |
481 |
$5K |
| 83735 |
|
846 |
580 |
$3K |
| J1100 |
Dexamethasone sodium phos |
580 |
332 |
$3K |
| 87086 |
|
1,163 |
970 |
$3K |
| 82248 |
|
1,869 |
1,395 |
$3K |
| 81001 |
|
2,012 |
1,677 |
$3K |
| 87631 |
|
35 |
30 |
$2K |
| 87635 |
|
413 |
346 |
$2K |
| G1004 |
Cdsm ndsc |
702 |
465 |
$2K |
| J1170 |
Hydromorphone injection |
523 |
336 |
$2K |
| 94762 |
|
800 |
613 |
$2K |
| 96374 |
|
2,065 |
1,618 |
$2K |
| 85610 |
|
949 |
697 |
$2K |
| J7120 |
Ringers lactate infusion |
312 |
251 |
$2K |
| 71045 |
|
995 |
774 |
$2K |
| 87636 |
|
457 |
384 |
$2K |
| 96372 |
|
214 |
141 |
$2K |
| 93005 |
|
1,937 |
1,476 |
$2K |
| J3490 |
Drugs unclassified injection |
433 |
270 |
$2K |
| 76942 |
|
106 |
90 |
$1K |
| 96360 |
|
46 |
37 |
$1K |
| 84132 |
|
356 |
297 |
$912.05 |
| 71046 |
|
650 |
532 |
$785.15 |
| J7050 |
Normal saline solution infus |
231 |
146 |
$635.98 |
| 87040 |
|
98 |
40 |
$616.08 |
| 83605 |
|
878 |
684 |
$604.99 |
| 81025 |
|
357 |
317 |
$539.32 |
| 82374 |
|
345 |
288 |
$386.32 |
| 84520 |
|
344 |
287 |
$381.79 |
| 84295 |
|
347 |
289 |
$381.79 |
| 82565 |
|
345 |
287 |
$381.79 |
| 82435 |
|
345 |
288 |
$381.79 |
| U0005 |
Infec agen detec ampli probe |
96 |
79 |
$376.38 |
| 85730 |
|
15 |
13 |
$328.60 |
| 83690 |
|
941 |
747 |
$324.86 |
| J7040 |
Normal saline solution infus |
15 |
12 |
$324.55 |
| 87103 |
|
53 |
40 |
$308.04 |
| 83880 |
|
161 |
131 |
$300.53 |
| 76937 |
|
56 |
44 |
$242.30 |
| J2370 |
Phenylephrine hcl injection |
14 |
12 |
$202.26 |
| 80076 |
|
94 |
80 |
$197.40 |
| 84484 |
|
764 |
574 |
$133.44 |
| 86901 |
|
35 |
24 |
$68.34 |
| 88342 |
|
14 |
13 |
$38.40 |
| J0690 |
Cefazolin sodium injection |
68 |
53 |
$38.10 |
| J1200 |
Diphenhydramine hcl injectio |
51 |
36 |
$37.97 |
| 0753T |
|
13 |
13 |
$19.77 |
| J2270 |
Morphine sulfate injection |
134 |
102 |
$0.00 |
| 86900 |
|
20 |
12 |
$0.00 |
| 88313 |
|
13 |
12 |
$0.00 |
| 84703 |
|
148 |
134 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
266 |
180 |
$0.00 |
| 87077 |
|
16 |
15 |
$0.00 |
| 87070 |
|
28 |
25 |
$0.00 |
| 0241U |
|
14 |
13 |
$0.00 |
| 86850 |
|
19 |
12 |
$0.00 |
| C1769 |
Guide wire |
13 |
13 |
$0.00 |