| Code | Description | Claims | Beneficiaries | Total Paid |
| 97110 |
|
11,481 |
2,656 |
$411K |
| 80307 |
|
4,699 |
3,689 |
$252K |
| 80053 |
|
25,697 |
18,199 |
$230K |
| 97530 |
|
4,746 |
1,005 |
$185K |
| 70450 |
|
2,147 |
1,668 |
$156K |
| 96375 |
|
4,369 |
2,735 |
$119K |
| 96374 |
|
5,238 |
3,683 |
$115K |
| 96361 |
|
5,735 |
2,108 |
$111K |
| 87491 |
|
2,683 |
2,356 |
$104K |
| 87591 |
|
2,682 |
2,355 |
$103K |
| 87661 |
|
2,606 |
2,288 |
$95K |
| 96365 |
|
1,906 |
754 |
$86K |
| 85025 |
|
14,825 |
9,691 |
$84K |
| 74177 |
|
819 |
648 |
$82K |
| 96372 |
|
5,180 |
3,104 |
$76K |
| 92507 |
|
2,078 |
408 |
$72K |
| U0002 |
Covid-19 lab test non-cdc |
1,464 |
1,194 |
$62K |
| 83880 |
|
3,759 |
2,706 |
$57K |
| 90853 |
|
6,928 |
274 |
$51K |
| 72148 |
|
261 |
202 |
$49K |
| 74178 |
|
416 |
330 |
$49K |
| 99283 |
|
1,743 |
1,288 |
$47K |
| 0241U |
|
397 |
353 |
$44K |
| 93005 |
|
6,994 |
4,451 |
$43K |
| 85027 |
|
9,536 |
6,680 |
$42K |
| 99284 |
|
2,962 |
2,107 |
$42K |
| 84443 |
|
3,473 |
2,960 |
$42K |
| 74176 |
|
747 |
618 |
$38K |
| 87088 |
|
5,632 |
4,395 |
$35K |
| 87426 |
|
1,228 |
993 |
$33K |
| 71046 |
|
3,027 |
2,079 |
$32K |
| 87804 |
|
3,340 |
1,409 |
$30K |
| 84484 |
|
5,765 |
3,261 |
$29K |
| 83735 |
|
5,820 |
3,929 |
$28K |
| 80048 |
|
4,293 |
3,177 |
$25K |
| 81001 |
|
10,092 |
7,270 |
$23K |
| 36415 |
|
12,158 |
6,820 |
$22K |
| 71045 |
|
3,596 |
2,750 |
$21K |
| 87040 |
|
2,765 |
1,612 |
$21K |
| 71110 |
|
1,483 |
1,146 |
$21K |
| 97001 |
|
802 |
669 |
$20K |
| 77067 |
|
490 |
414 |
$20K |
| 86901 |
|
2,923 |
1,500 |
$19K |
| 99285 |
|
1,945 |
1,429 |
$19K |
| 87430 |
|
1,846 |
1,549 |
$19K |
| 96360 |
|
502 |
399 |
$18K |
| J0696 |
Ceftriaxone sodium injection |
3,529 |
1,911 |
$16K |
| 80061 |
|
1,972 |
1,718 |
$16K |
| 82550 |
|
3,286 |
2,156 |
$15K |
| 96369 |
|
241 |
78 |
$15K |
| 83605 |
|
1,794 |
1,323 |
$14K |
| 70553 |
|
65 |
51 |
$14K |
| J2405 |
Ondansetron hcl injection |
4,611 |
2,680 |
$14K |
| 80074 |
|
279 |
231 |
$13K |
| 83690 |
|
2,367 |
1,795 |
$13K |
| 87086 |
|
2,362 |
1,808 |
$13K |
| 87186 |
|
3,095 |
2,294 |
$12K |
| 85730 |
|
3,383 |
2,336 |
$12K |
| 84439 |
|
1,554 |
1,381 |
$11K |
| 81025 |
|
1,689 |
1,267 |
$11K |
| 83874 |
|
1,442 |
1,050 |
$10K |
| 86885 |
|
2,182 |
1,438 |
$10K |
| U0003 |
Cov-19 amp prb hgh thruput |
237 |
198 |
$10K |
| 94640 |
|
4,479 |
1,369 |
$10K |
| J1885 |
Ketorolac tromethamine inj |
3,691 |
2,354 |
$9K |
| 95811 |
|
74 |
60 |
$9K |
| 80320 |
|
768 |
636 |
$9K |
| 85610 |
|
3,988 |
2,717 |
$9K |
| 82947 |
|
3,705 |
1,249 |
$8K |
| J1650 |
Inj enoxaparin sodium |
489 |
160 |
$7K |
| J1100 |
Dexamethasone sodium phos |
2,956 |
1,714 |
$7K |
| 86900 |
|
2,895 |
1,478 |
$7K |
| 93306 |
|
72 |
64 |
$7K |
| G0463 |
Hospital outpt clinic visit |
64 |
51 |
$7K |
| 82150 |
|
1,262 |
971 |
$7K |
| 82607 |
|
535 |
462 |
$7K |
| 82306 |
|
319 |
272 |
$6K |
| 84702 |
|
658 |
473 |
$6K |
| 86140 |
|
1,537 |
1,221 |
$6K |
| 85379 |
|
1,125 |
894 |
$6K |
| 86317 |
|
351 |
297 |
$6K |
| 88305 |
|
263 |
180 |
$6K |
| 95810 |
|
64 |
50 |
$6K |
| 82565 |
|
615 |
473 |
$5K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
2,461 |
1,884 |
$5K |
| 83036 |
|
682 |
564 |
$5K |
| 82553 |
|
607 |
446 |
$5K |
| 71275 |
|
53 |
44 |
$5K |
| 97162 |
|
56 |
49 |
$5K |
| 86701 |
|
487 |
413 |
$4K |
| M0243 |
Casirivi and imdevi inj |
31 |
29 |
$4K |
| 86762 |
|
203 |
174 |
$4K |
| 87635 |
|
959 |
762 |
$4K |
| A9577 |
Inj multihance |
222 |
167 |
$4K |
| 82728 |
|
283 |
240 |
$3K |
| 96376 |
|
3,165 |
1,258 |
$3K |
| G0378 |
Hospital observation per hr |
2,210 |
1,406 |
$3K |
| 73721 |
|
15 |
12 |
$3K |
| 97161 |
|
210 |
149 |
$3K |
| 59025 |
|
24 |
12 |
$3K |
| G0379 |
Direct refer hospital observ |
459 |
322 |
$3K |
| 97597 |
|
154 |
67 |
$3K |
| 83540 |
|
621 |
519 |
$3K |
| 94760 |
|
670 |
225 |
$3K |
| 77063 |
|
321 |
283 |
$3K |
| 36591 |
|
297 |
139 |
$2K |
| 82247 |
|
368 |
201 |
$2K |
| 80051 |
|
431 |
250 |
$2K |
| 72125 |
|
16 |
14 |
$2K |
| 83655 |
|
137 |
128 |
$2K |
| 76641 |
|
61 |
38 |
$2K |
| 76817 |
|
46 |
39 |
$2K |
| 73562 |
|
96 |
64 |
$2K |
| 86592 |
|
404 |
344 |
$2K |
| 90832 |
|
12 |
12 |
$2K |
| 87070 |
|
210 |
156 |
$2K |
| 87210 |
|
393 |
274 |
$2K |
| 73630 |
|
83 |
63 |
$2K |
| 74022 |
|
82 |
70 |
$2K |
| J2001 |
Lidocaine injection |
1,807 |
1,079 |
$2K |
| 73030 |
|
95 |
74 |
$1K |
| 0001A |
|
54 |
51 |
$1K |
| 83550 |
|
245 |
203 |
$1K |
| 84703 |
|
191 |
113 |
$1K |
| 87150 |
|
25 |
24 |
$1K |
| J1170 |
Hydromorphone injection |
2,299 |
1,248 |
$1K |
| J2550 |
Promethazine hcl injection |
2,796 |
1,441 |
$1K |
| 99282 |
|
33 |
26 |
$1K |
| T1015 |
Clinic service |
144 |
95 |
$1K |
| J7030 |
Normal saline solution infus |
6,148 |
3,641 |
$994.19 |
| 82803 |
|
44 |
30 |
$792.88 |
| J0780 |
Prochlorperazine injection |
743 |
509 |
$725.70 |
| 73610 |
|
51 |
41 |
$643.32 |
| J1200 |
Diphenhydramine hcl injectio |
501 |
265 |
$637.16 |
| 72100 |
|
29 |
26 |
$598.63 |
| J0690 |
Cefazolin sodium injection |
650 |
341 |
$531.60 |
| 36600 |
|
44 |
30 |
$528.13 |
| 94664 |
|
255 |
111 |
$522.96 |
| 86696 |
|
12 |
12 |
$521.92 |
| 74018 |
|
30 |
27 |
$509.33 |
| J2704 |
Inj, propofol, 10 mg |
2,283 |
1,466 |
$504.80 |
| J2250 |
Inj midazolam hydrochloride |
1,404 |
899 |
$454.23 |
| 76856 |
|
13 |
12 |
$410.80 |
| J7050 |
Normal saline solution infus |
1,155 |
439 |
$383.48 |
| J3010 |
Fentanyl citrate injection |
1,892 |
1,156 |
$379.12 |
| 85652 |
|
156 |
123 |
$342.57 |
| J2270 |
Morphine sulfate injection |
919 |
477 |
$308.73 |
| 76830 |
|
15 |
13 |
$285.66 |
| 82746 |
|
49 |
32 |
$262.49 |
| 86695 |
|
12 |
12 |
$257.45 |
| J2060 |
Lorazepam injection |
369 |
227 |
$244.14 |
| 84145 |
|
13 |
12 |
$229.52 |
| 0002A |
|
17 |
17 |
$210.80 |
| 87081 |
|
25 |
24 |
$208.34 |
| J2930 |
Methylprednisolone injection |
334 |
217 |
$204.09 |
| J2175 |
Meperidine hydrochl /100 mg |
1,153 |
603 |
$196.20 |
| 85651 |
|
71 |
49 |
$173.15 |
| 80076 |
|
21 |
17 |
$161.16 |
| 90686 |
|
31 |
20 |
$129.12 |
| 84550 |
|
35 |
28 |
$117.24 |
| 97116 |
|
31 |
12 |
$104.81 |
| 82950 |
|
12 |
12 |
$75.50 |
| 96366 |
|
20 |
12 |
$75.39 |
| 82248 |
|
17 |
14 |
$63.66 |
| J3490 |
Drugs unclassified injection |
261 |
111 |
$25.30 |
| 99406 |
|
400 |
271 |
$25.12 |
| 82043 |
|
15 |
13 |
$16.54 |
| J7040 |
Normal saline solution infus |
226 |
159 |
$8.13 |
| G0008 |
Admin influenza virus vac |
29 |
19 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
31 |
12 |
$0.00 |
| 97762 |
|
30 |
29 |
$0.00 |
| J1940 |
Furosemide injection |
43 |
12 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
176 |
91 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
20 |
13 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
18 |
15 |
$0.00 |