| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 41899 |
|
1,143 |
1,069 |
$4.49M |
| 99284 |
|
8,755 |
8,221 |
$4.00M |
| 99283 |
|
13,074 |
12,617 |
$1.77M |
| G0330 |
Facility svs dental rehab |
541 |
492 |
$814K |
| 42820 |
|
169 |
167 |
$781K |
| 93005 |
|
2,495 |
2,274 |
$194K |
| 69436 |
|
61 |
57 |
$137K |
| 87426 |
|
4,024 |
3,943 |
$92K |
| 80048 |
|
5,773 |
5,306 |
$76K |
| 87400 |
|
3,023 |
2,954 |
$58K |
| 99285 |
|
686 |
600 |
$53K |
| J7030 |
Normal saline solution infus |
668 |
602 |
$45K |
| 85027 |
|
10,404 |
9,464 |
$44K |
| 99282 |
|
273 |
265 |
$39K |
| 71045 |
|
2,074 |
1,956 |
$35K |
| 96374 |
|
2,665 |
2,527 |
$24K |
| 80053 |
|
1,833 |
1,616 |
$23K |
| 81001 |
|
6,589 |
6,307 |
$19K |
| 36415 |
|
10,637 |
9,529 |
$14K |
| U0003 |
Cov-19 amp prb hgh thruput |
120 |
119 |
$9K |
| 88300 |
|
203 |
201 |
$9K |
| 99281 |
|
59 |
56 |
$8K |
| 70450 |
|
192 |
173 |
$8K |
| 71046 |
|
245 |
239 |
$7K |
| 80076 |
|
965 |
942 |
$6K |
| 84702 |
|
883 |
784 |
$6K |
| 87880 |
|
573 |
569 |
$6K |
| 84484 |
|
1,116 |
831 |
$3K |
| 83690 |
|
1,085 |
1,022 |
$3K |
| 74177 |
|
29 |
28 |
$2K |
| 87081 |
|
483 |
480 |
$2K |
| 87635 |
|
90 |
88 |
$2K |
| 81025 |
|
254 |
247 |
$975.52 |
| U0002 |
Covid-19 lab test non-cdc |
31 |
31 |
$739.98 |
| 86756 |
|
74 |
73 |
$717.91 |
| 82248 |
|
455 |
430 |
$322.57 |
| 86901 |
|
217 |
205 |
$321.48 |
| 86900 |
|
218 |
206 |
$321.32 |
| J2405 |
Ondansetron hcl injection |
439 |
402 |
$216.08 |
| 72125 |
|
12 |
12 |
$108.97 |
| 85610 |
|
155 |
140 |
$69.61 |
| J0696 |
Ceftriaxone sodium injection |
63 |
55 |
$69.49 |
| 85730 |
|
111 |
101 |
$67.68 |
| 87086 |
|
57 |
52 |
$60.59 |
| 94760 |
|
14 |
13 |
$52.40 |
| 83735 |
|
74 |
63 |
$39.77 |
| 85018 |
|
62 |
58 |
$39.54 |
| 85014 |
|
62 |
58 |
$39.54 |
| J2765 |
Metoclopramide hcl injection |
37 |
29 |
$34.22 |
| J1100 |
Dexamethasone sodium phos |
120 |
109 |
$26.35 |
| J2270 |
Morphine sulfate injection |
47 |
38 |
$19.70 |
| J2704 |
Inj, propofol, 10 mg |
85 |
84 |
$3.70 |
| J3010 |
Fentanyl citrate injection |
14 |
12 |
$3.12 |
| 96375 |
|
69 |
62 |
$0.00 |
| A9270 |
Non-covered item or service |
645 |
318 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
47 |
44 |
$0.00 |
| 96372 |
|
12 |
12 |
$0.00 |
| G1003 |
Cdsm medicalis |
58 |
49 |
$0.00 |
| J7120 |
Ringers lactate infusion |
20 |
13 |
$0.00 |
| C1758 |
Catheter, ureteral |
12 |
12 |
$0.00 |