| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
13,836 |
13,672 |
$3.81M |
| 99283 |
|
17,610 |
17,278 |
$3.28M |
| G0378 |
Hospital observation per hr |
705 |
659 |
$1.73M |
| T1015 |
Clinic service |
5,452 |
1,666 |
$294K |
| D2930 |
|
160 |
159 |
$225K |
| 42820 |
|
159 |
158 |
$145K |
| 54161 |
|
341 |
341 |
$125K |
| 14040 |
|
64 |
64 |
$88K |
| 69436 |
|
110 |
110 |
$51K |
| 87637 |
|
527 |
526 |
$37K |
| 99285 |
|
125 |
123 |
$31K |
| D1120 |
|
108 |
108 |
$27K |
| 96413 |
|
175 |
145 |
$24K |
| J1745 |
Infliximab not biosimil 10mg |
80 |
76 |
$24K |
| 85025 |
|
3,511 |
2,944 |
$19K |
| 54360 |
|
12 |
12 |
$14K |
| 54300 |
|
43 |
43 |
$11K |
| U0003 |
Cov-19 amp prb hgh thruput |
105 |
105 |
$11K |
| 80053 |
|
1,109 |
992 |
$10K |
| 92523 |
|
67 |
67 |
$6K |
| 99211 |
|
169 |
146 |
$5K |
| 43239 |
|
14 |
14 |
$5K |
| 99291 |
|
16 |
16 |
$4K |
| 82728 |
|
339 |
316 |
$4K |
| 87631 |
|
13 |
13 |
$3K |
| 85045 |
|
471 |
418 |
$2K |
| 96375 |
|
72 |
56 |
$2K |
| 82306 |
|
63 |
61 |
$2K |
| 96409 |
|
20 |
12 |
$940.44 |
| 82947 |
|
281 |
272 |
$885.30 |
| 81003 |
|
294 |
278 |
$662.08 |
| 96374 |
|
32 |
28 |
$604.84 |
| 96365 |
|
15 |
14 |
$600.97 |
| 85027 |
|
71 |
70 |
$560.92 |
| 85652 |
|
165 |
156 |
$372.55 |
| 86140 |
|
168 |
158 |
$359.76 |
| 84466 |
|
13 |
13 |
$211.34 |
| 71046 |
|
15 |
15 |
$167.72 |
| J7050 |
Normal saline solution infus |
1,292 |
955 |
$163.60 |
| G0008 |
Admin influenza virus vac |
17 |
16 |
$131.61 |
| 83540 |
|
13 |
13 |
$105.10 |
| J7030 |
Normal saline solution infus |
1,767 |
1,550 |
$98.85 |
| 81001 |
|
29 |
27 |
$75.86 |
| 36415 |
|
97 |
86 |
$71.23 |
| J2405 |
Ondansetron hcl injection |
2,993 |
2,606 |
$52.44 |
| J1100 |
Dexamethasone sodium phos |
2,560 |
2,343 |
$38.52 |
| J7120 |
Ringers lactate infusion |
2,333 |
2,230 |
$32.31 |
| 90688 |
|
32 |
32 |
$27.09 |
| J2704 |
Inj, propofol, 10 mg |
2,044 |
1,798 |
$15.40 |
| J3010 |
Fentanyl citrate injection |
2,277 |
2,242 |
$1.41 |
| J1885 |
Ketorolac tromethamine inj |
1,282 |
1,214 |
$1.23 |
| A9270 |
Non-covered item or service |
2,033 |
1,105 |
$0.00 |
| J7042 |
5% dextrose/normal saline |
64 |
55 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
515 |
473 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
40 |
36 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
60 |
49 |
$0.00 |
| J7613 |
Albuterol non-comp unit |
62 |
58 |
$0.00 |
| D1206 |
|
65 |
65 |
$0.00 |
| D3220 |
|
13 |
13 |
$0.00 |
| J1642 |
Inj heparin sodium per 10 u |
64 |
41 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
778 |
766 |
$0.00 |
| J2270 |
Morphine sulfate injection |
868 |
851 |
$0.00 |
| J7510 |
Prednisolone oral per 5 mg |
447 |
425 |
$0.00 |
| J7040 |
Normal saline solution infus |
274 |
256 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
32 |
28 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
45 |
41 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
311 |
308 |
$0.00 |
| J1756 |
Iron sucrose injection |
22 |
14 |
$0.00 |