| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Z7502 |
|
12,774 |
12,328 |
$470K |
| 80053 |
|
3,296 |
3,145 |
$37K |
| 85025 |
|
3,871 |
3,672 |
$32K |
| Z7610 |
|
2,723 |
1,816 |
$19K |
| 80307 |
|
378 |
301 |
$18K |
| 99000 |
|
4,864 |
4,586 |
$17K |
| 93005 |
|
495 |
483 |
$10K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
174 |
170 |
$9K |
| 96372 |
|
399 |
369 |
$8K |
| 0761 |
|
230 |
219 |
$8K |
| 70450 |
|
41 |
41 |
$7K |
| 81001 |
|
1,927 |
1,852 |
$7K |
| 84484 |
|
593 |
531 |
$6K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
260 |
252 |
$6K |
| 83690 |
|
737 |
711 |
$6K |
| 59025 |
|
282 |
163 |
$5K |
| 71046 |
|
211 |
206 |
$4K |
| Z7500 |
|
102 |
98 |
$3K |
| 81025 |
|
290 |
288 |
$3K |
| 87811 |
|
54 |
51 |
$2K |
| 87502 |
|
25 |
25 |
$2K |
| 94760 |
|
224 |
217 |
$2K |
| 87086 |
|
186 |
182 |
$2K |
| 76819 |
|
21 |
12 |
$936.60 |
| 87804 |
|
158 |
106 |
$902.70 |
| 85610 |
|
188 |
187 |
$739.82 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
132 |
128 |
$713.84 |
| 83880 |
|
27 |
26 |
$651.24 |
| 76705 |
|
12 |
12 |
$601.20 |
| 71045 |
|
59 |
57 |
$554.04 |
| 85730 |
|
85 |
84 |
$489.60 |
| 87400 |
|
39 |
37 |
$451.62 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
66 |
58 |
$338.20 |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
31 |
16 |
$265.11 |
| 87880 |
|
25 |
25 |
$129.28 |
| 87070 |
|
29 |
29 |
$110.48 |
| J3490 |
Unclassified drugs |
33 |
24 |
$76.66 |
| 84443 |
|
12 |
12 |
$76.16 |
| 80061 |
|
16 |
16 |
$60.72 |
| 87807 |
|
15 |
15 |
$42.85 |
| 83036 |
|
16 |
16 |
$33.00 |