| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| X4003 |
|
6,860 |
4,050 |
$2.86M |
| X4011 |
|
7,288 |
6,660 |
$1.45M |
| 99285 |
|
3,220 |
2,902 |
$987K |
| 99284 |
|
2,097 |
1,995 |
$445K |
| 99283 |
|
2,983 |
2,869 |
$444K |
| 90870 |
|
3,502 |
1,429 |
$420K |
| G0463 |
Hospital outpt clinic visit |
9,669 |
8,642 |
$332K |
| Y7506 |
|
7,788 |
4,060 |
$307K |
| U0004 |
Cov-19 test non-cdc hgh thru |
6,366 |
1,683 |
$292K |
| 80307 |
|
2,649 |
2,435 |
$206K |
| 81001 |
|
3,138 |
3,010 |
$188K |
| 85025 |
|
5,146 |
4,698 |
$169K |
| 80053 |
|
4,855 |
4,505 |
$162K |
| U0005 |
Infec agen detec ampli probe |
6,375 |
1,686 |
$97K |
| C9803 |
Hopd covid-19 spec collect |
6,345 |
1,676 |
$96K |
| 81025 |
|
1,417 |
991 |
$76K |
| 36415 |
|
4,016 |
3,586 |
$66K |
| G0378 |
Hospital observation per hr |
233 |
190 |
$65K |
| 11042 |
|
922 |
470 |
$43K |
| 83735 |
|
1,078 |
980 |
$21K |
| 99291 |
|
63 |
57 |
$19K |
| 71045 |
|
309 |
288 |
$14K |
| 99282 |
|
147 |
138 |
$11K |
| 87426 |
|
417 |
388 |
$9K |
| 84443 |
|
231 |
222 |
$7K |
| 93005 |
|
209 |
196 |
$7K |
| 87276 |
|
113 |
111 |
$5K |
| 87275 |
|
115 |
112 |
$4K |
| 20610 |
|
27 |
27 |
$4K |
| 66984 |
|
12 |
12 |
$2K |
| 85610 |
|
74 |
68 |
$2K |
| 82962 |
|
1,689 |
524 |
$2K |
| 85730 |
|
72 |
67 |
$2K |
| 93970 |
|
25 |
24 |
$2K |
| 84484 |
|
170 |
151 |
$1K |
| 93306 |
|
14 |
13 |
$1K |
| 93925 |
|
15 |
14 |
$871.64 |
| J3490 |
Drugs unclassified injection |
12,036 |
6,563 |
$859.53 |
| 83605 |
|
114 |
94 |
$807.45 |
| 82550 |
|
151 |
131 |
$632.83 |
| 83036 |
|
99 |
95 |
$493.21 |
| 73562 |
|
16 |
14 |
$441.58 |
| 87591 |
|
15 |
14 |
$420.80 |
| 87491 |
|
14 |
13 |
$420.80 |
| 73565 |
|
14 |
14 |
$319.30 |
| 80061 |
|
78 |
77 |
$297.16 |
| 82306 |
|
19 |
19 |
$213.12 |
| 87880 |
|
15 |
15 |
$167.68 |
| 80048 |
|
48 |
44 |
$154.02 |
| 83690 |
|
26 |
25 |
$88.64 |
| 82607 |
|
12 |
12 |
$81.42 |
| 87070 |
|
12 |
12 |
$59.57 |
| J1040 |
Methylprednisolone 80 mg inj |
55 |
53 |
$12.08 |
| J0330 |
Succinycholine chloride inj |
2,399 |
1,016 |
$0.00 |
| A6197 |
Alginate drsg >16 <=48 sq in |
17 |
13 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
29 |
27 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
29 |
27 |
$0.00 |
| 11721 |
|
41 |
39 |
$0.00 |
| C1780 |
Lens, intraocular (new tech) |
41 |
39 |
$0.00 |