| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
|
13,506 |
12,484 |
$875K |
| 99281 |
|
4,740 |
4,302 |
$280K |
| 70450 |
|
1,261 |
1,207 |
$85K |
| 93005 |
|
3,975 |
3,570 |
$83K |
| 74174 |
|
600 |
585 |
$81K |
| 99199 |
|
3,688 |
3,371 |
$66K |
| 99282 |
|
1,242 |
1,140 |
$36K |
| 0241U |
|
441 |
436 |
$18K |
| U0003 |
Cov-19 amp prb hgh thruput |
440 |
418 |
$18K |
| 80048 |
|
5,679 |
5,151 |
$17K |
| 71045 |
|
2,091 |
1,978 |
$14K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
752 |
737 |
$14K |
| 85025 |
|
5,964 |
5,406 |
$14K |
| 99283 |
|
301 |
293 |
$12K |
| 72125 |
|
170 |
167 |
$12K |
| 71046 |
|
1,011 |
972 |
$11K |
| J7030 |
Normal saline solution infus |
1,720 |
1,545 |
$11K |
| 80076 |
|
3,733 |
3,487 |
$9K |
| 84484 |
|
1,817 |
1,606 |
$6K |
| J2405 |
Ondansetron hcl injection |
929 |
849 |
$6K |
| 83690 |
|
2,562 |
2,409 |
$5K |
| U0005 |
Infec agen detec ampli probe |
768 |
741 |
$5K |
| 0250 |
|
7,664 |
6,119 |
$4K |
| J2270 |
Morphine sulfate injection |
590 |
525 |
$4K |
| 83605 |
|
919 |
811 |
$3K |
| 85610 |
|
2,283 |
2,144 |
$3K |
| J1885 |
Ketorolac tromethamine inj |
650 |
607 |
$3K |
| 99205 |
Prolong outpt/office vis |
41 |
41 |
$2K |
| 80047 |
|
402 |
388 |
$2K |
| 87491 |
|
123 |
122 |
$2K |
| 87591 |
|
124 |
123 |
$2K |
| Q0162 |
Ondansetron oral |
449 |
428 |
$2K |
| J7120 |
Ringers lactate infusion |
327 |
293 |
$2K |
| 83880 |
|
236 |
216 |
$2K |
| 86901 |
|
937 |
860 |
$1K |
| 86850 |
|
883 |
854 |
$1K |
| 86900 |
|
936 |
860 |
$1K |
| 80053 |
|
365 |
334 |
$1K |
| 99231 |
|
193 |
176 |
$1K |
| 81000 |
|
860 |
835 |
$1K |
| 71260 |
|
14 |
14 |
$1K |
| 0510 |
|
89 |
80 |
$1K |
| 81001 |
|
1,457 |
1,402 |
$815.17 |
| 36415 |
|
7,305 |
6,198 |
$814.23 |
| 81015 |
|
423 |
409 |
$727.47 |
| 0202U |
|
12 |
12 |
$645.00 |
| 84702 |
|
168 |
163 |
$545.04 |
| 87088 |
|
224 |
212 |
$513.39 |
| 81025 |
|
243 |
231 |
$511.73 |
| 80305 |
|
67 |
66 |
$433.77 |
| 82550 |
|
222 |
196 |
$407.20 |
| 85730 |
|
291 |
283 |
$397.42 |
| 86780 |
|
191 |
183 |
$387.60 |
| J0696 |
Ceftriaxone sodium injection |
40 |
37 |
$372.53 |
| 99284 |
|
13 |
13 |
$341.75 |
| 87086 |
|
232 |
229 |
$335.81 |
| 0760 |
|
135 |
116 |
$323.45 |
| 86703 |
|
107 |
105 |
$307.14 |
| 86141 |
|
102 |
98 |
$224.16 |
| 90715 |
|
16 |
16 |
$213.70 |
| 81002 |
|
249 |
240 |
$205.19 |
| 73610 |
|
12 |
12 |
$194.72 |
| 73564 |
|
15 |
15 |
$180.84 |
| 0761 |
|
38 |
36 |
$142.62 |
| 73590 |
|
15 |
14 |
$135.63 |
| 87040 |
|
26 |
24 |
$129.60 |
| 90471 |
|
55 |
55 |
$120.42 |
| 73130 |
|
15 |
15 |
$113.55 |
| 73090 |
|
14 |
13 |
$95.70 |
| 82962 |
|
61 |
56 |
$83.21 |
| 73110 |
|
12 |
12 |
$77.47 |
| G0378 |
Hospital observation per hr |
42 |
27 |
$76.06 |
| 81003 |
|
236 |
234 |
$60.37 |
| 85027 |
|
59 |
54 |
$50.26 |
| 86593 |
|
149 |
142 |
$46.92 |
| J3010 |
Fentanyl citrate injection |
13 |
13 |
$42.97 |
| 86592 |
|
156 |
149 |
$39.40 |
| 87210 |
|
12 |
12 |
$39.18 |
| 80320 |
|
119 |
115 |
$37.50 |
| 0320 |
|
18 |
18 |
$0.00 |