| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
12,905 |
12,675 |
$4.12M |
| 99283 |
|
11,971 |
11,847 |
$1.91M |
| 99284 |
|
7,700 |
7,625 |
$1.83M |
| 96374 |
|
7,922 |
7,723 |
$1.02M |
| 96375 |
|
4,278 |
3,999 |
$194K |
| 87636 |
|
1,217 |
1,205 |
$162K |
| 74177 |
|
1,004 |
1,000 |
$158K |
| 69436 |
|
324 |
166 |
$156K |
| 96413 |
|
1,099 |
641 |
$132K |
| 42820 |
|
43 |
43 |
$131K |
| 50590 |
|
117 |
117 |
$108K |
| 85025 |
|
14,849 |
13,872 |
$97K |
| 80053 |
|
9,745 |
9,421 |
$85K |
| 36415 |
|
11,198 |
10,288 |
$56K |
| 71045 |
|
4,159 |
4,101 |
$51K |
| 70450 |
|
611 |
610 |
$28K |
| 84484 |
|
1,103 |
1,026 |
$18K |
| 81001 |
|
5,604 |
5,452 |
$16K |
| 81025 |
|
2,237 |
2,208 |
$16K |
| 83880 |
|
470 |
465 |
$15K |
| 83690 |
|
2,660 |
2,614 |
$15K |
| 87880 |
|
1,020 |
1,008 |
$14K |
| 80306 |
|
854 |
843 |
$12K |
| 93005 |
|
2,292 |
2,241 |
$12K |
| 96367 |
|
372 |
232 |
$10K |
| 93306 |
|
128 |
128 |
$10K |
| A0427 |
Als1-emergency |
227 |
199 |
$9K |
| 87502 |
|
92 |
92 |
$7K |
| 66984 |
|
16 |
13 |
$7K |
| G0463 |
Hospital outpt clinic visit |
770 |
637 |
$7K |
| 84443 |
|
380 |
377 |
$6K |
| 71046 |
|
388 |
384 |
$6K |
| 80048 |
|
756 |
732 |
$5K |
| A0425 |
Ground mileage |
354 |
282 |
$5K |
| 87804 |
|
207 |
194 |
$5K |
| 87086 |
|
727 |
707 |
$5K |
| 87081 |
|
851 |
839 |
$5K |
| 80061 |
|
379 |
376 |
$5K |
| 83735 |
|
882 |
865 |
$5K |
| 43239 |
|
12 |
12 |
$4K |
| 87591 |
|
105 |
105 |
$4K |
| 87491 |
|
105 |
105 |
$4K |
| 97597 |
|
348 |
210 |
$3K |
| U0003 |
Cov-19 amp prb hgh thruput |
26 |
26 |
$3K |
| 83605 |
|
257 |
251 |
$3K |
| 80081 |
|
36 |
36 |
$2K |
| 99282 |
|
24 |
24 |
$2K |
| J7342 |
Ciprofloxacin otic susp 6 mg |
70 |
70 |
$2K |
| 74176 |
|
20 |
20 |
$2K |
| 81003 |
|
792 |
786 |
$1K |
| 83655 |
|
112 |
112 |
$1K |
| 85730 |
|
253 |
245 |
$1K |
| 87070 |
|
150 |
147 |
$1K |
| A0429 |
Bls-emergency |
36 |
34 |
$1K |
| 85610 |
|
303 |
294 |
$1K |
| 87653 |
|
26 |
25 |
$859.68 |
| 99212 |
|
13 |
13 |
$721.71 |
| 88300 |
|
82 |
82 |
$679.33 |
| 96361 |
|
13 |
12 |
$574.29 |
| 96417 |
|
19 |
12 |
$548.03 |
| 88142 |
|
24 |
24 |
$495.87 |
| 80143 |
|
30 |
30 |
$480.82 |
| 80179 |
|
30 |
30 |
$480.82 |
| 86140 |
|
88 |
85 |
$386.98 |
| 85379 |
|
46 |
46 |
$380.10 |
| 83036 |
|
36 |
36 |
$311.04 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,162 |
1,152 |
$257.48 |
| 82950 |
|
41 |
41 |
$172.02 |
| 82728 |
|
12 |
12 |
$129.32 |
| 86803 |
|
13 |
13 |
$126.90 |
| 86850 |
|
13 |
13 |
$112.97 |
| 86900 |
|
28 |
28 |
$79.95 |
| J7030 |
Normal saline solution infus |
1,975 |
1,922 |
$77.04 |
| 85027 |
|
12 |
12 |
$65.60 |
| 87205 |
|
14 |
12 |
$58.36 |
| 86901 |
|
14 |
14 |
$37.24 |
| J2405 |
Ondansetron hcl injection |
59 |
43 |
$13.44 |
| J1100 |
Dexamethasone sodium phos |
146 |
129 |
$0.00 |
| 94761 |
|
90 |
89 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
37 |
37 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
104 |
103 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
14 |
14 |
$0.00 |
| 30930 |
|
12 |
12 |
$0.00 |
| J7120 |
Ringers lactate infusion |
922 |
887 |
$0.00 |
| J2270 |
Morphine sulfate injection |
118 |
114 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
106 |
105 |
$0.00 |
| J7040 |
Normal saline solution infus |
22 |
13 |
$0.00 |
| C1758 |
Catheter, ureteral |
13 |
13 |
$0.00 |