| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic service |
26,921 |
21,097 |
$291K |
| U0003 |
Cov-19 amp prb hgh thruput |
1,938 |
1,557 |
$140K |
| G0463 |
Hospital outpt clinic visit |
12,425 |
6,799 |
$92K |
| 85025 |
|
12,917 |
9,822 |
$77K |
| 99213 |
|
2,993 |
2,393 |
$69K |
| 80053 |
|
8,767 |
6,936 |
$65K |
| 80050 |
|
817 |
810 |
$39K |
| 36415 |
|
13,817 |
10,112 |
$37K |
| 87804 |
|
2,318 |
1,944 |
$35K |
| 87426 |
|
1,096 |
859 |
$34K |
| 80061 |
|
3,620 |
2,818 |
$26K |
| 92507 |
|
359 |
143 |
$24K |
| 87631 |
|
189 |
174 |
$23K |
| 87880 |
|
2,235 |
1,881 |
$23K |
| 81001 |
|
5,136 |
4,087 |
$23K |
| 93005 |
|
2,389 |
1,917 |
$22K |
| J0696 |
Ceftriaxone sodium injection |
2,431 |
1,880 |
$21K |
| 83036 |
|
3,519 |
2,788 |
$19K |
| 82306 |
|
1,033 |
863 |
$17K |
| 96372 |
|
6,960 |
5,039 |
$16K |
| U0002 |
Covid-19 lab test non-cdc |
424 |
335 |
$16K |
| 84443 |
|
3,558 |
2,868 |
$14K |
| 70450 |
|
139 |
116 |
$14K |
| 71045 |
|
1,388 |
1,164 |
$12K |
| 71046 |
|
1,096 |
856 |
$12K |
| 99283 |
|
393 |
333 |
$12K |
| 80048 |
|
2,417 |
1,819 |
$12K |
| 97110 |
|
472 |
102 |
$12K |
| 87088 |
|
1,466 |
1,186 |
$9K |
| 80305 |
|
738 |
631 |
$9K |
| J1100 |
Dexamethasone sodium phos |
2,617 |
2,006 |
$8K |
| 83880 |
|
683 |
547 |
$7K |
| J1885 |
Ketorolac tromethamine inj |
3,139 |
2,439 |
$7K |
| 81025 |
|
864 |
724 |
$6K |
| 82607 |
|
661 |
557 |
$6K |
| 84484 |
|
623 |
501 |
$5K |
| 84436 |
|
957 |
822 |
$4K |
| 86756 |
|
272 |
200 |
$4K |
| 80047 |
|
411 |
276 |
$4K |
| 74177 |
|
26 |
25 |
$3K |
| 99214 |
|
114 |
110 |
$2K |
| 80306 |
|
126 |
113 |
$2K |
| 81000 |
|
579 |
401 |
$2K |
| 83690 |
|
295 |
254 |
$2K |
| 90688 |
|
375 |
284 |
$2K |
| 92523 |
|
16 |
14 |
$2K |
| J3301 |
Triamcinolone acet inj nos |
1,638 |
1,308 |
$1K |
| 87077 |
|
288 |
227 |
$1K |
| C9803 |
Hopd covid-19 spec collect |
782 |
604 |
$1K |
| J1580 |
Garamycin gentamicin inj |
1,225 |
831 |
$1K |
| 84439 |
|
210 |
149 |
$1K |
| 82150 |
|
160 |
144 |
$1K |
| 85610 |
|
539 |
273 |
$1K |
| J2405 |
Ondansetron hcl injection |
358 |
306 |
$1K |
| 87186 |
|
268 |
212 |
$995.84 |
| 96365 |
|
13 |
13 |
$935.16 |
| 71020 |
|
69 |
59 |
$901.00 |
| 83735 |
|
154 |
134 |
$867.21 |
| 99284 |
|
14 |
13 |
$831.99 |
| 86677 |
|
30 |
25 |
$393.68 |
| G0008 |
Admin influenza virus vac |
219 |
171 |
$355.35 |
| 74018 |
|
14 |
12 |
$203.16 |
| 85379 |
|
40 |
29 |
$197.16 |
| 82043 |
|
67 |
52 |
$179.75 |
| 87635 |
|
219 |
130 |
$94.02 |
| 36416 |
|
45 |
25 |
$52.78 |
| 85651 |
|
23 |
15 |
$30.42 |
| J2550 |
Promethazine hcl injection |
60 |
56 |
$16.32 |
| P9604 |
One-way allow prorated trip |
119 |
75 |
$1.47 |
| J2704 |
Inj, propofol, 10 mg |
26 |
26 |
$1.08 |
| 97530 |
|
67 |
15 |
$0.00 |
| 82947 |
|
13 |
13 |
$0.00 |
| J2001 |
Lidocaine injection |
42 |
38 |
$0.00 |
| 90471 |
|
124 |
92 |
$0.00 |
| T1502 |
Medication admin visit |
500 |
465 |
$0.00 |
| 92508 |
|
23 |
13 |
$0.00 |