| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 36415 |
|
6,737 |
4,235 |
$462K |
| 80053 |
|
10,465 |
7,206 |
$298K |
| 96361 |
|
4,048 |
3,448 |
$258K |
| 99284 |
|
10,208 |
8,857 |
$248K |
| 80048 |
|
6,870 |
5,662 |
$236K |
| 99283 |
|
8,377 |
7,379 |
$204K |
| 76815 |
|
2,535 |
2,208 |
$136K |
| S0028 |
Injection, famotidine, 20 mg |
1,564 |
1,328 |
$132K |
| A4216 |
Sterile water/saline, 10 ml |
2,474 |
1,154 |
$107K |
| 99285 |
|
6,001 |
4,992 |
$105K |
| 74176 |
|
2,878 |
2,495 |
$97K |
| 11042 |
|
1,704 |
677 |
$94K |
| 96360 |
|
2,383 |
2,144 |
$93K |
| J3490 |
Drugs unclassified injection |
595 |
260 |
$90K |
| 70450 |
|
2,599 |
2,125 |
$69K |
| 81001 |
|
9,193 |
8,074 |
$69K |
| U0002 |
Covid-19 lab test non-cdc |
1,262 |
1,109 |
$68K |
| 99282 |
|
1,942 |
1,565 |
$61K |
| 84703 |
|
7,141 |
6,458 |
$56K |
| J8499 |
Oral prescrip drug non chemo |
1,118 |
409 |
$54K |
| U0003 |
Cov-19 amp prb hgh thruput |
631 |
522 |
$49K |
| 96365 |
|
1,596 |
1,414 |
$40K |
| G0378 |
Hospital observation per hr |
7,470 |
2,850 |
$40K |
| 76856 |
|
1,157 |
1,068 |
$32K |
| 93306 |
|
1,027 |
871 |
$31K |
| 59025 |
|
642 |
464 |
$28K |
| 82962 |
|
6,157 |
2,061 |
$24K |
| 71045 |
|
8,718 |
7,214 |
$23K |
| 85025 |
|
17,424 |
12,054 |
$22K |
| 81003 |
|
2,447 |
2,151 |
$21K |
| 96372 |
|
3,628 |
3,216 |
$18K |
| 87070 |
|
1,944 |
1,754 |
$18K |
| 76705 |
|
991 |
898 |
$17K |
| A9270 |
Non-covered item or service |
3,836 |
1,682 |
$17K |
| 96374 |
|
6,732 |
5,763 |
$17K |
| 80307 |
|
2,694 |
2,272 |
$15K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
437 |
368 |
$13K |
| 76819 |
|
876 |
735 |
$13K |
| J0696 |
Ceftriaxone sodium injection |
2,447 |
1,932 |
$12K |
| 93005 |
|
7,732 |
5,914 |
$12K |
| J1815 |
Insulin injection |
537 |
232 |
$12K |
| 87804 |
|
5,746 |
3,019 |
$11K |
| 84484 |
|
6,317 |
3,851 |
$10K |
| 74177 |
|
209 |
185 |
$10K |
| 84702 |
|
2,537 |
2,141 |
$8K |
| 85610 |
|
6,472 |
5,338 |
$8K |
| 97110 |
|
52 |
13 |
$8K |
| J7030 |
Normal saline solution infus |
6,963 |
5,524 |
$7K |
| 85730 |
|
5,563 |
4,617 |
$7K |
| 94640 |
|
739 |
351 |
$7K |
| 72131 |
|
359 |
302 |
$6K |
| 87040 |
|
3,448 |
1,736 |
$6K |
| S0030 |
Injection, metronidazole |
409 |
232 |
$6K |
| C9113 |
Inj pantoprazole sodium, via |
1,656 |
1,018 |
$5K |
| 82550 |
|
4,311 |
2,557 |
$4K |
| J0690 |
Cefazolin sodium injection |
914 |
741 |
$4K |
| J3010 |
Fentanyl citrate injection |
989 |
821 |
$4K |
| 80076 |
|
1,687 |
1,447 |
$4K |
| J2250 |
Inj midazolam hydrochloride |
1,099 |
922 |
$4K |
| 84112 |
|
26 |
24 |
$4K |
| 76830 |
|
157 |
142 |
$4K |
| J0456 |
Azithromycin |
121 |
67 |
$3K |
| 83690 |
|
2,880 |
2,477 |
$3K |
| 73562 |
|
173 |
138 |
$3K |
| 83605 |
|
2,321 |
1,757 |
$3K |
| J1885 |
Ketorolac tromethamine inj |
4,494 |
3,865 |
$3K |
| 96375 |
|
4,093 |
3,521 |
$3K |
| J7120 |
Ringers lactate infusion |
1,554 |
1,239 |
$3K |
| 83880 |
|
1,775 |
1,443 |
$3K |
| 73030 |
|
303 |
242 |
$3K |
| J2175 |
Meperidine hydrochl /100 mg |
508 |
362 |
$3K |
| 72125 |
|
424 |
363 |
$3K |
| J1200 |
Diphenhydramine hcl injectio |
1,038 |
879 |
$2K |
| J2704 |
Inj, propofol, 10 mg |
1,247 |
1,064 |
$2K |
| 71046 |
|
228 |
159 |
$2K |
| 84443 |
|
1,323 |
1,091 |
$2K |
| 76818 |
|
94 |
79 |
$2K |
| U0001 |
2019-ncov diagnostic p |
130 |
90 |
$2K |
| 86900 |
|
1,991 |
1,802 |
$2K |
| 86850 |
|
1,622 |
1,470 |
$2K |
| 87086 |
|
3,861 |
3,424 |
$2K |
| J7040 |
Normal saline solution infus |
571 |
469 |
$2K |
| J7050 |
Normal saline solution infus |
1,453 |
910 |
$2K |
| 88305 |
|
827 |
674 |
$2K |
| 87077 |
|
1,301 |
1,093 |
$2K |
| J2405 |
Ondansetron hcl injection |
3,559 |
2,781 |
$2K |
| 90715 |
|
328 |
277 |
$2K |
| 71250 |
|
201 |
165 |
$2K |
| 73610 |
|
169 |
141 |
$1K |
| 73130 |
|
70 |
52 |
$1K |
| 94664 |
|
880 |
712 |
$1K |
| 87186 |
|
1,298 |
1,094 |
$1K |
| J2060 |
Lorazepam injection |
959 |
694 |
$1K |
| 96366 |
|
26 |
25 |
$1K |
| 90471 |
|
268 |
206 |
$1K |
| 82803 |
|
850 |
683 |
$1K |
| J2765 |
Metoclopramide hcl injection |
814 |
721 |
$1K |
| 86901 |
|
1,992 |
1,802 |
$1K |
| 73630 |
|
185 |
147 |
$1K |
| J7060 |
5% dextrose/water |
537 |
338 |
$982.09 |
| 87205 |
|
270 |
212 |
$960.72 |
| 87880 |
|
1,985 |
1,868 |
$872.16 |
| J2930 |
Methylprednisolone injection |
1,112 |
981 |
$844.72 |
| 93971 |
|
79 |
70 |
$754.49 |
| C1751 |
Cath, inf, per/cent/midline |
83 |
57 |
$595.18 |
| J2270 |
Morphine sulfate injection |
859 |
575 |
$569.39 |
| 43239 |
|
116 |
100 |
$558.20 |
| 76801 |
|
147 |
136 |
$532.05 |
| G0463 |
Hospital outpt clinic visit |
129 |
73 |
$394.86 |
| J1170 |
Hydromorphone injection |
664 |
436 |
$393.07 |
| J1956 |
Levofloxacin injection |
323 |
203 |
$389.12 |
| 73110 |
|
49 |
42 |
$385.76 |
| 76775 |
|
25 |
25 |
$384.67 |
| 93970 |
|
67 |
51 |
$314.57 |
| 97597 |
|
23 |
12 |
$278.58 |
| J2360 |
Orphenadrine injection |
851 |
758 |
$213.59 |
| 83735 |
|
1,624 |
915 |
$209.10 |
| J1650 |
Inj enoxaparin sodium |
1,156 |
588 |
$200.54 |
| 85379 |
|
539 |
422 |
$196.20 |
| 84100 |
|
1,430 |
805 |
$191.26 |
| 97163 |
|
65 |
49 |
$191.09 |
| 36410 |
|
59 |
40 |
$131.48 |
| 74018 |
|
42 |
35 |
$128.74 |
| 82150 |
|
368 |
317 |
$108.58 |
| 93880 |
|
33 |
25 |
$98.64 |
| 76817 |
|
27 |
24 |
$96.84 |
| J7512 |
Prednisone ir or dr oral 1mg |
14 |
13 |
$90.91 |
| J2543 |
Piperacillin/tazobactam |
298 |
156 |
$81.46 |
| J2920 |
Methylprednisolone injection |
116 |
69 |
$59.78 |
| 83036 |
|
29 |
24 |
$41.91 |
| 87426 |
|
711 |
645 |
$30.91 |
| 80061 |
|
196 |
166 |
$25.36 |
| J1100 |
Dexamethasone sodium phos |
744 |
615 |
$17.36 |
| 86592 |
|
16 |
16 |
$7.51 |
| 87807 |
|
152 |
151 |
$4.91 |
| 86140 |
|
117 |
87 |
$2.88 |
| 70486 |
|
15 |
13 |
$2.40 |
| 88304 |
|
123 |
118 |
$2.32 |
| 87210 |
|
15 |
13 |
$1.92 |
| 87320 |
|
14 |
13 |
$1.44 |
| 87081 |
|
15 |
14 |
$1.44 |
| 83615 |
|
76 |
59 |
$0.96 |
| J1940 |
Furosemide injection |
30 |
18 |
$0.96 |
| J3475 |
Inj magnesium sulfate |
15 |
13 |
$0.92 |
| 82728 |
|
134 |
103 |
$0.48 |
| 73564 |
|
21 |
17 |
$0.46 |
| 97166 |
|
13 |
12 |
$0.00 |
| S0020 |
Injection, bupivicaine hydro |
28 |
28 |
$0.00 |
| 87591 |
|
13 |
13 |
$0.00 |
| J7042 |
5% dextrose/normal saline |
17 |
13 |
$0.00 |
| J0360 |
Hydralazine hcl injection |
24 |
16 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
17 |
15 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
49 |
40 |
$0.00 |
| J2274 |
Inj morphine pf epid ithc |
95 |
75 |
$0.00 |
| 88312 |
|
45 |
39 |
$0.00 |
| 99218 |
|
62 |
26 |
$0.00 |
| 84145 |
|
18 |
12 |
$0.00 |
| 87491 |
|
13 |
13 |
$0.00 |