| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0410 |
Grp psych php/iop 45-50 |
12,503 |
799 |
$615K |
| 90853 |
|
4,303 |
168 |
$408K |
| G0378 |
Hospital observation per hr |
3,339 |
2,090 |
$251K |
| U0004 |
Cov-19 test non-cdc hgh thru |
9,786 |
5,108 |
$209K |
| 99285 |
|
2,985 |
2,074 |
$171K |
| 80053 |
|
9,508 |
3,723 |
$82K |
| 70450 |
|
1,681 |
1,086 |
$74K |
| 70553 |
|
686 |
486 |
$63K |
| 99283 |
|
1,659 |
1,154 |
$56K |
| 96365 |
|
1,167 |
768 |
$48K |
| C9803 |
Hopd covid-19 spec collect |
5,235 |
2,774 |
$39K |
| 90791 |
|
363 |
271 |
$28K |
| 80048 |
|
2,274 |
1,237 |
$26K |
| 96361 |
|
719 |
412 |
$24K |
| 97530 |
|
374 |
77 |
$21K |
| 85025 |
|
12,466 |
4,794 |
$17K |
| 82947 |
|
4,470 |
1,026 |
$16K |
| 96372 |
|
765 |
453 |
$14K |
| 96366 |
|
182 |
120 |
$9K |
| J1100 |
Dexamethasone sodium phos |
473 |
259 |
$9K |
| 93005 |
|
2,333 |
1,439 |
$7K |
| 86769 |
|
402 |
274 |
$7K |
| 80307 |
|
2,696 |
1,805 |
$7K |
| U0002 |
Covid-19 lab test non-cdc |
880 |
498 |
$5K |
| G0480 |
Drug test def 1-7 classes |
3,614 |
1,719 |
$5K |
| 97161 |
|
444 |
260 |
$5K |
| G8979 |
Mobility goal status |
252 |
154 |
$4K |
| 84443 |
|
2,679 |
1,824 |
$4K |
| 36415 |
|
3,797 |
2,613 |
$4K |
| 83735 |
|
379 |
204 |
$4K |
| 84100 |
|
384 |
203 |
$4K |
| 71045 |
|
2,284 |
1,451 |
$4K |
| G8978 |
Mobility current status |
216 |
147 |
$4K |
| 85730 |
|
1,251 |
851 |
$4K |
| 85610 |
|
1,319 |
881 |
$4K |
| J1200 |
Diphenhydramine hcl injectio |
780 |
401 |
$4K |
| 81001 |
|
2,172 |
1,517 |
$4K |
| 96375 |
|
570 |
355 |
$3K |
| G0481 |
Drug test def 8-14 classes |
508 |
238 |
$3K |
| J2405 |
Ondansetron hcl injection |
787 |
438 |
$3K |
| 81003 |
|
2,384 |
1,682 |
$3K |
| 97110 |
|
76 |
13 |
$2K |
| 82550 |
|
3,496 |
2,139 |
$2K |
| 96374 |
|
21 |
12 |
$2K |
| 99284 |
|
364 |
303 |
$2K |
| 84484 |
|
373 |
224 |
$1K |
| 97165 |
|
118 |
69 |
$1K |
| 77067 |
|
550 |
394 |
$1K |
| U0003 |
Cov-19 amp prb hgh thruput |
33 |
19 |
$1K |
| 83550 |
|
19 |
12 |
$1K |
| 87635 |
|
205 |
108 |
$932.28 |
| A9579 |
Gad-base mr contrast nos,1ml |
508 |
364 |
$924.21 |
| 85652 |
|
830 |
560 |
$771.71 |
| G0177 |
Opps/php/iop; train & educ |
37 |
24 |
$739.70 |
| 76770 |
|
287 |
187 |
$618.74 |
| 84703 |
|
612 |
466 |
$610.23 |
| 74018 |
|
386 |
218 |
$568.85 |
| 96367 |
|
92 |
44 |
$485.75 |
| J0696 |
Ceftriaxone sodium injection |
186 |
64 |
$485.64 |
| 87088 |
|
862 |
568 |
$464.34 |
| 94640 |
|
93 |
55 |
$388.43 |
| 76641 |
|
178 |
108 |
$387.49 |
| 71046 |
|
815 |
504 |
$376.91 |
| 80164 |
|
399 |
240 |
$332.02 |
| 71250 |
|
287 |
184 |
$323.59 |
| 76705 |
|
55 |
26 |
$319.63 |
| 83690 |
|
69 |
44 |
$286.75 |
| 82150 |
|
68 |
43 |
$286.75 |
| J1885 |
Ketorolac tromethamine inj |
324 |
224 |
$284.46 |
| 72148 |
|
144 |
89 |
$204.14 |
| 74176 |
|
155 |
105 |
$201.54 |
| 0011A |
|
40 |
31 |
$200.00 |
| 0012A |
|
19 |
16 |
$200.00 |
| 88305 |
|
224 |
184 |
$189.18 |
| 96413 |
|
54 |
27 |
$155.08 |
| 72100 |
|
208 |
129 |
$149.30 |
| G8988 |
Self care goal status |
59 |
41 |
$148.77 |
| 93306 |
|
112 |
74 |
$148.77 |
| G8987 |
Self care current status |
59 |
41 |
$148.77 |
| 83605 |
|
57 |
27 |
$148.36 |
| 87075 |
|
91 |
32 |
$126.87 |
| J3010 |
Fentanyl citrate injection |
154 |
106 |
$118.04 |
| 87040 |
|
82 |
45 |
$104.74 |
| U0005 |
Infec agen detec ampli probe |
46 |
32 |
$90.15 |
| 82607 |
|
131 |
94 |
$65.11 |
| J2060 |
Lorazepam injection |
543 |
249 |
$60.66 |
| 72040 |
|
55 |
30 |
$52.94 |
| 82140 |
|
85 |
44 |
$51.50 |
| 82746 |
|
76 |
55 |
$51.50 |
| 73030 |
|
80 |
55 |
$44.00 |
| J2001 |
Lidocaine injection |
89 |
57 |
$40.63 |
| 87186 |
|
131 |
79 |
$40.55 |
| 87426 |
|
66 |
49 |
$32.39 |
| 80320 |
|
365 |
312 |
$28.94 |
| G1007 |
Cdsm aim |
16 |
12 |
$24.81 |
| 73565 |
|
23 |
12 |
$22.00 |
| 76830 |
|
18 |
13 |
$22.00 |
| 76856 |
|
25 |
16 |
$17.91 |
| 83880 |
|
45 |
28 |
$15.40 |
| 76536 |
|
28 |
15 |
$14.91 |
| A9576 |
Inj prohance multipack |
57 |
45 |
$7.59 |
| J1956 |
Levofloxacin injection |
345 |
86 |
$5.04 |
| 87205 |
|
86 |
48 |
$1.26 |
| 80076 |
|
18 |
14 |
$0.00 |
| 93970 |
|
80 |
51 |
$0.00 |
| 96360 |
|
22 |
12 |
$0.00 |
| J1650 |
Inj enoxaparin sodium |
44 |
15 |
$0.00 |
| 93880 |
|
25 |
15 |
$0.00 |
| 77080 |
|
405 |
252 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
36 |
27 |
$0.00 |
| J7120 |
Ringers lactate infusion |
94 |
70 |
$0.00 |
| 87804 |
|
57 |
40 |
$0.00 |
| 83540 |
|
23 |
14 |
$0.00 |
| 93925 |
|
23 |
13 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
69 |
49 |
$0.00 |
| J3490 |
Drugs unclassified injection |
61 |
12 |
$0.00 |
| J1170 |
Hydromorphone injection |
122 |
56 |
$0.00 |
| 90686 |
|
17 |
12 |
$0.00 |
| 73521 |
|
23 |
13 |
$0.00 |
| 85379 |
|
27 |
13 |
$0.00 |
| 82728 |
|
23 |
14 |
$0.00 |
| 94760 |
|
23 |
15 |
$0.00 |
| 83036 |
|
25 |
12 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
28 |
12 |
$0.00 |
| 88342 |
|
19 |
14 |
$0.00 |
| 82553 |
|
31 |
18 |
$0.00 |
| J3411 |
Thiamine hcl 100 mg |
19 |
12 |
$0.00 |