| Code | Description | Claims | Beneficiaries | Total Paid |
| 0450 |
|
54,351 |
51,145 |
$1.89M |
| 99284 |
|
5,614 |
5,253 |
$282K |
| 99283 |
|
7,575 |
7,081 |
$230K |
| J3490 |
Drugs unclassified injection |
7,478 |
6,609 |
$201K |
| 99213 |
|
610 |
562 |
$193K |
| 96374 |
|
7,069 |
6,557 |
$183K |
| 99285 |
|
868 |
809 |
$168K |
| 70450 |
|
3,303 |
3,207 |
$156K |
| 74176 |
|
2,172 |
2,123 |
$146K |
| 99199 |
|
2,962 |
2,868 |
$143K |
| 93005 |
|
11,024 |
10,143 |
$133K |
| 80053 |
|
18,775 |
17,116 |
$126K |
| A4649 |
Surgical supplies |
873 |
440 |
$112K |
| 0250 |
|
11,430 |
7,594 |
$110K |
| 71045 |
|
12,551 |
11,989 |
$99K |
| 96361 |
|
4,002 |
3,561 |
$98K |
| 80307 |
|
1,911 |
1,657 |
$92K |
| 74177 |
|
962 |
947 |
$84K |
| 99281 |
|
2,226 |
2,047 |
$71K |
| 0270 |
|
9,143 |
6,217 |
$70K |
| 96372 |
|
4,148 |
3,634 |
$69K |
| 85027 |
|
20,864 |
18,657 |
$61K |
| 96375 |
|
4,032 |
3,494 |
$54K |
| 0272 |
|
4,169 |
3,005 |
$34K |
| 84484 |
|
6,427 |
5,678 |
$30K |
| 85730 |
|
6,905 |
6,420 |
$25K |
| 76705 |
|
1,045 |
1,022 |
$24K |
| 99282 |
|
985 |
936 |
$20K |
| 96365 |
|
636 |
612 |
$18K |
| 83690 |
|
5,451 |
5,069 |
$16K |
| 85610 |
|
6,995 |
6,500 |
$16K |
| 76856 |
|
586 |
565 |
$15K |
| 72125 |
|
199 |
193 |
$14K |
| 94640 |
|
1,223 |
1,112 |
$14K |
| 81001 |
|
8,688 |
8,253 |
$13K |
| 96360 |
|
462 |
451 |
$13K |
| 83880 |
|
1,193 |
1,131 |
$13K |
| U0003 |
Cov-19 amp prb hgh thruput |
544 |
527 |
$12K |
| 93306 |
|
76 |
76 |
$10K |
| 80048 |
|
1,527 |
1,441 |
$9K |
| 87086 |
|
2,612 |
2,496 |
$9K |
| 87040 |
|
712 |
627 |
$7K |
| J2405 |
Ondansetron hcl injection |
1,704 |
1,541 |
$6K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,321 |
744 |
$6K |
| J7030 |
Normal saline solution infus |
2,088 |
1,884 |
$6K |
| 0259 |
|
525 |
393 |
$6K |
| 87426 |
|
440 |
433 |
$5K |
| 73564 |
|
463 |
425 |
$5K |
| 76801 |
|
163 |
137 |
$5K |
| A9270 |
Non-covered item or service |
483 |
226 |
$5K |
| 73610 |
|
373 |
365 |
$4K |
| 73630 |
|
375 |
364 |
$4K |
| 83735 |
|
1,373 |
1,217 |
$4K |
| 87077 |
|
783 |
750 |
$4K |
| 87804 |
|
640 |
630 |
$3K |
| 0762 |
|
81 |
78 |
$3K |
| 96376 |
|
530 |
419 |
$3K |
| 84443 |
|
508 |
492 |
$3K |
| 84703 |
|
1,578 |
1,507 |
$3K |
| J1885 |
Ketorolac tromethamine inj |
1,498 |
1,176 |
$3K |
| 83605 |
|
660 |
606 |
$3K |
| 90471 |
|
306 |
300 |
$3K |
| 84702 |
|
579 |
511 |
$3K |
| 71275 |
|
14 |
13 |
$2K |
| 73030 |
|
208 |
198 |
$2K |
| 73130 |
|
230 |
218 |
$2K |
| 93971 |
|
55 |
54 |
$2K |
| 87186 |
|
711 |
674 |
$2K |
| J2270 |
Morphine sulfate injection |
936 |
828 |
$2K |
| 87880 |
|
600 |
595 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
318 |
274 |
$2K |
| 81003 |
|
457 |
440 |
$2K |
| 80061 |
|
319 |
308 |
$2K |
| 93970 |
|
24 |
24 |
$2K |
| 0301 |
|
113 |
110 |
$2K |
| 0637 |
|
91 |
88 |
$2K |
| 81025 |
|
1,009 |
986 |
$2K |
| 0160 |
|
13 |
13 |
$2K |
| 87631 |
|
77 |
77 |
$1K |
| 73110 |
|
108 |
100 |
$1K |
| 72100 |
|
87 |
86 |
$1K |
| 86901 |
|
1,032 |
977 |
$1K |
| 90715 |
|
64 |
64 |
$1K |
| 0324 |
|
24 |
24 |
$1K |
| 82077 |
|
184 |
165 |
$1K |
| 87491 |
|
148 |
145 |
$1K |
| 86900 |
|
1,034 |
979 |
$1K |
| 82306 |
|
55 |
55 |
$1K |
| 87591 |
|
136 |
134 |
$946.32 |
| 83036 |
|
214 |
209 |
$793.28 |
| 74018 |
|
60 |
59 |
$731.28 |
| 87088 |
|
165 |
161 |
$632.46 |
| 80076 |
|
180 |
172 |
$594.33 |
| U0002 |
Covid-19 lab test non-cdc |
25 |
23 |
$582.03 |
| 86850 |
|
228 |
222 |
$555.25 |
| 85379 |
|
109 |
104 |
$542.64 |
| 0258 |
|
273 |
212 |
$526.19 |
| 0636 |
|
142 |
122 |
$480.48 |
| 83550 |
|
107 |
103 |
$360.10 |
| 36415 |
|
542 |
513 |
$350.40 |
| 87070 |
|
93 |
89 |
$343.22 |
| 72040 |
|
27 |
26 |
$339.89 |
| 83540 |
|
121 |
117 |
$321.91 |
| 86140 |
|
131 |
124 |
$294.83 |
| 96366 |
|
13 |
12 |
$266.57 |
| 82728 |
|
45 |
43 |
$254.02 |
| 76830 |
|
12 |
12 |
$232.88 |
| 85652 |
|
158 |
153 |
$191.74 |
| 82550 |
|
60 |
55 |
$182.36 |
| J2060 |
Lorazepam injection |
96 |
89 |
$161.74 |
| J1100 |
Dexamethasone sodium phos |
55 |
55 |
$127.79 |
| J1170 |
Hydromorphone injection |
47 |
36 |
$126.88 |
| J1200 |
Diphenhydramine hcl injectio |
73 |
67 |
$125.81 |
| 73140 |
|
29 |
27 |
$88.56 |
| J2765 |
Metoclopramide hcl injection |
57 |
55 |
$77.48 |
| 36000 |
|
18 |
16 |
$67.15 |
| 84439 |
|
25 |
25 |
$58.54 |
| 86756 |
|
28 |
28 |
$55.03 |
| 87210 |
|
12 |
12 |
$41.89 |
| G1003 |
Cdsm medicalis |
13 |
13 |
$23.52 |
| 97110 |
|
88 |
24 |
$15.72 |
| 82248 |
|
13 |
13 |
$11.88 |
| J7620 |
Albuterol ipratrop non-comp |
27 |
27 |
$1.95 |
| S9445 |
Pt education noc individ |
2,661 |
1,557 |
$0.00 |
| 77063 |
|
12 |
12 |
$0.00 |
| 0305 |
|
54 |
52 |
$0.00 |
| G0378 |
Hospital observation per hr |
13 |
12 |
$0.00 |
| 77067 |
|
13 |
13 |
$0.00 |
| 0121 |
|
29 |
26 |
$0.00 |