| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
|
15,678 |
14,380 |
$1.18M |
| 99285 |
|
2,058 |
1,981 |
$392K |
| 74177 |
|
1,322 |
1,306 |
$265K |
| 70450 |
|
1,780 |
1,740 |
$233K |
| T1999 |
Noc retail items andsupplies |
1,010 |
689 |
$180K |
| U0003 |
Cov-19 amp prb hgh thruput |
2,207 |
2,157 |
$170K |
| 99281 |
|
1,841 |
1,577 |
$154K |
| 77067 |
|
2,909 |
2,904 |
$147K |
| 93000 |
|
3,010 |
2,873 |
$143K |
| 96360 |
|
1,982 |
1,908 |
$140K |
| 80053 |
|
14,480 |
14,018 |
$139K |
| 96374 |
|
1,918 |
1,826 |
$134K |
| 85025 |
|
18,622 |
17,695 |
$131K |
| 99284 |
|
1,257 |
1,176 |
$111K |
| 84443 |
|
7,572 |
7,536 |
$99K |
| 82306 |
|
6,165 |
6,132 |
$97K |
| 93306 |
|
899 |
898 |
$89K |
| 99283 |
|
1,110 |
1,070 |
$64K |
| 80061 |
|
9,363 |
9,313 |
$63K |
| 71045 |
|
4,263 |
4,094 |
$60K |
| 0270 |
|
264 |
183 |
$56K |
| 99070 |
|
11,161 |
7,156 |
$54K |
| 96375 |
|
1,087 |
1,020 |
$50K |
| 76700 |
|
842 |
842 |
$45K |
| 87426 |
|
1,285 |
1,268 |
$44K |
| 96365 |
|
465 |
448 |
$40K |
| 99282 |
|
867 |
836 |
$40K |
| 84484 |
|
3,344 |
3,118 |
$40K |
| 87502 |
|
483 |
479 |
$34K |
| 74176 |
|
332 |
324 |
$33K |
| 83036 |
|
7,123 |
7,055 |
$32K |
| 71046 |
|
1,595 |
1,564 |
$32K |
| 77063 |
|
2,274 |
2,273 |
$32K |
| C9803 |
Hopd covid-19 spec collect |
1,828 |
1,785 |
$32K |
| 83690 |
|
3,093 |
2,981 |
$29K |
| 80307 |
|
485 |
477 |
$29K |
| 81005 |
|
11,885 |
11,609 |
$28K |
| 96372 |
|
908 |
889 |
$28K |
| 80048 |
|
4,829 |
4,690 |
$27K |
| 99199 |
|
373 |
338 |
$23K |
| J7030 |
Normal saline solution infus |
3,224 |
2,956 |
$22K |
| 93005 |
|
2,221 |
2,130 |
$21K |
| 83880 |
|
1,323 |
1,273 |
$21K |
| 87635 |
|
786 |
761 |
$20K |
| 84153 |
|
1,283 |
1,283 |
$18K |
| 97597 |
|
262 |
133 |
$16K |
| 76856 |
|
258 |
258 |
$15K |
| 81025 |
|
1,764 |
1,709 |
$15K |
| 77080 |
|
1,647 |
1,646 |
$14K |
| 72125 |
|
62 |
62 |
$14K |
| 83605 |
|
1,028 |
996 |
$13K |
| 87086 |
|
2,194 |
2,158 |
$12K |
| G0463 |
Hospital outpt clinic visit |
181 |
94 |
$11K |
| 76770 |
|
305 |
304 |
$11K |
| 82043 |
|
4,628 |
4,593 |
$11K |
| J1885 |
Ketorolac tromethamine inj |
2,236 |
2,117 |
$11K |
| 87491 |
|
193 |
190 |
$10K |
| 96361 |
|
346 |
331 |
$10K |
| 84439 |
|
2,460 |
2,454 |
$10K |
| 82550 |
|
3,656 |
3,623 |
$10K |
| 11042 |
|
436 |
162 |
$10K |
| 80076 |
|
1,252 |
1,235 |
$10K |
| 86480 |
|
265 |
264 |
$10K |
| 76830 |
|
178 |
177 |
$9K |
| J2405 |
Ondansetron hcl injection |
1,565 |
1,477 |
$7K |
| 83970 |
|
500 |
498 |
$7K |
| J2270 |
Morphine sulfate injection |
866 |
787 |
$7K |
| 94640 |
|
316 |
289 |
$6K |
| 73030 |
|
237 |
235 |
$6K |
| Z7502 |
|
165 |
164 |
$6K |
| 85379 |
|
436 |
432 |
$6K |
| 82077 |
|
304 |
289 |
$6K |
| 70553 |
|
12 |
12 |
$5K |
| 73610 |
|
197 |
195 |
$5K |
| 87077 |
|
1,221 |
1,204 |
$5K |
| 71250 |
|
41 |
41 |
$5K |
| 73630 |
|
211 |
207 |
$5K |
| 87880 |
|
290 |
286 |
$5K |
| 66984 |
|
13 |
13 |
$5K |
| 71275 |
|
27 |
26 |
$4K |
| 80069 |
|
1,294 |
1,258 |
$4K |
| 84550 |
|
2,154 |
2,136 |
$4K |
| 76536 |
|
92 |
91 |
$4K |
| 83735 |
|
666 |
633 |
$4K |
| 85610 |
|
1,083 |
1,000 |
$4K |
| 73564 |
|
123 |
120 |
$4K |
| 85730 |
|
620 |
606 |
$4K |
| 82607 |
|
1,514 |
1,513 |
$4K |
| 82962 |
|
813 |
645 |
$3K |
| 0271 |
|
26 |
24 |
$3K |
| 87040 |
|
132 |
128 |
$3K |
| 84466 |
|
884 |
874 |
$3K |
| 76642 |
|
39 |
39 |
$3K |
| 87798 |
|
44 |
44 |
$3K |
| J0696 |
Ceftriaxone sodium injection |
585 |
552 |
$2K |
| 0510 |
|
47 |
25 |
$2K |
| J7120 |
Ringers lactate infusion |
342 |
307 |
$2K |
| 72110 |
|
54 |
54 |
$2K |
| 71260 |
|
12 |
12 |
$2K |
| 87637 |
|
134 |
133 |
$2K |
| G0279 |
Tomosynthesis, mammo |
83 |
83 |
$2K |
| 83540 |
|
915 |
905 |
$2K |
| J1170 |
Hydromorphone injection |
165 |
147 |
$1K |
| 81001 |
|
324 |
323 |
$1K |
| 82728 |
|
503 |
499 |
$1K |
| 77065 |
Tomosynthesis, mammo |
12 |
12 |
$979.66 |
| 93971 |
|
12 |
12 |
$952.16 |
| J2060 |
Lorazepam injection |
124 |
109 |
$756.36 |
| J1200 |
Diphenhydramine hcl injectio |
140 |
133 |
$688.41 |
| 86140 |
|
124 |
124 |
$676.89 |
| 84460 |
|
857 |
856 |
$666.39 |
| 84450 |
|
640 |
639 |
$535.17 |
| 85027 |
|
87 |
87 |
$503.64 |
| 0002A |
|
21 |
21 |
$480.00 |
| 82272 |
|
855 |
853 |
$450.25 |
| 73562 |
|
15 |
15 |
$445.13 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
2,019 |
1,825 |
$400.70 |
| 85652 |
|
274 |
274 |
$379.86 |
| 73130 |
|
12 |
12 |
$363.36 |
| 84100 |
|
128 |
127 |
$357.31 |
| J1100 |
Dexamethasone sodium phos |
80 |
78 |
$333.97 |
| J2765 |
Metoclopramide hcl injection |
63 |
62 |
$330.89 |
| 73560 |
|
13 |
13 |
$283.53 |
| 84481 |
|
24 |
24 |
$275.11 |
| 82948 |
|
39 |
39 |
$215.12 |
| 84156 |
|
183 |
179 |
$149.03 |
| 82040 |
|
67 |
65 |
$141.01 |
| 85611 |
|
19 |
16 |
$128.82 |
| 87205 |
|
13 |
12 |
$124.48 |
| 82746 |
|
24 |
24 |
$111.16 |
| 86038 |
|
13 |
13 |
$110.39 |
| J0131 |
Inj, acetaminophen (nos) |
30 |
30 |
$107.66 |
| 86900 |
|
24 |
24 |
$83.57 |
| J3010 |
Fentanyl citrate injection |
24 |
24 |
$76.22 |
| 85007 |
|
13 |
13 |
$51.51 |
| J7060 |
5% dextrose/water |
18 |
12 |
$48.57 |
| 86592 |
|
14 |
12 |
$48.34 |
| 84075 |
|
76 |
76 |
$46.05 |
| J0171 |
Adrenalin epinephrine inject |
15 |
12 |
$32.66 |
| A9585 |
Gadobutrol injection |
15 |
13 |
$2.40 |
| 36415 |
|
11,086 |
10,466 |
$1.60 |
| 0305 |
|
16 |
15 |
$0.00 |
| 0250 |
|
29 |
27 |
$0.00 |
| G0103 |
Psa screening |
86 |
86 |
$0.00 |
| 88305 |
|
12 |
12 |
$0.00 |
| J2175 |
Meperidine hydrochl /100 mg |
12 |
12 |
$0.00 |
| G0378 |
Hospital observation per hr |
13 |
13 |
$0.00 |
| 0258 |
|
13 |
13 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
14 |
14 |
$0.00 |
| 0301 |
|
16 |
15 |
$0.00 |
| C1753 |
Cath, intravas ultrasound |
12 |
12 |
$0.00 |
| 0300 |
|
16 |
15 |
$0.00 |
| 0730 |
|
15 |
14 |
$0.00 |
| 0272 |
|
15 |
14 |
$0.00 |
| 0320 |
|
14 |
13 |
$0.00 |