| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
71,861 |
63,676 |
$14.34M |
| 0450 |
|
11,288 |
10,129 |
$2.86M |
| 74177 |
|
6,204 |
6,021 |
$2.74M |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
15,882 |
8,742 |
$2.71M |
| 99199 |
|
8,575 |
7,167 |
$2.36M |
| 99070 |
|
29,955 |
12,605 |
$2.18M |
| 70450 |
|
6,673 |
6,300 |
$2.17M |
| 96374 |
|
18,158 |
16,627 |
$1.82M |
| 72125 |
|
2,619 |
2,541 |
$1.36M |
| 96375 |
|
13,849 |
12,152 |
$970K |
| 71260 |
|
1,561 |
1,522 |
$914K |
| 93005 |
|
22,302 |
20,502 |
$883K |
| 80053 |
|
45,034 |
40,702 |
$819K |
| J3490 |
Drugs unclassified injection |
29,915 |
13,279 |
$792K |
| 87637 |
|
3,168 |
3,116 |
$736K |
| 87636 |
|
3,180 |
3,109 |
$731K |
| 80048 |
|
5,328 |
4,777 |
$678K |
| 80307 |
|
5,628 |
5,142 |
$636K |
| 96361 |
|
8,429 |
7,506 |
$573K |
| 96365 |
|
4,598 |
4,113 |
$559K |
| 96372 |
|
11,253 |
9,271 |
$500K |
| 85025 |
|
54,014 |
46,939 |
$487K |
| 87635 |
|
6,261 |
6,030 |
$446K |
| 99218 |
|
3,083 |
1,431 |
$434K |
| 71045 |
|
15,033 |
14,169 |
$404K |
| 71275 |
|
1,245 |
1,221 |
$341K |
| 0250 |
|
4,434 |
2,819 |
$336K |
| 82077 |
|
2,946 |
2,787 |
$330K |
| 74176 |
|
1,898 |
1,845 |
$312K |
| 71046 |
|
7,763 |
7,516 |
$253K |
| J2405 |
Ondansetron hcl injection |
9,171 |
8,151 |
$247K |
| 99285 |
|
1,888 |
1,755 |
$234K |
| J7030 |
Normal saline solution infus |
13,016 |
11,523 |
$223K |
| 96360 |
|
1,945 |
1,877 |
$219K |
| 97139 |
|
5,326 |
1,253 |
$208K |
| 84484 |
|
17,658 |
12,855 |
$197K |
| Z7502 |
|
5,086 |
4,979 |
$189K |
| 87502 |
|
1,716 |
1,638 |
$189K |
| 70496 |
|
696 |
686 |
$182K |
| 70498 |
|
687 |
676 |
$179K |
| 86850 |
|
2,754 |
2,594 |
$166K |
| 76856 |
|
1,657 |
1,621 |
$165K |
| 87491 |
|
2,928 |
2,853 |
$164K |
| 81001 |
|
18,700 |
17,571 |
$163K |
| 87591 |
|
2,927 |
2,852 |
$162K |
| 93971 |
|
941 |
908 |
$155K |
| 76801 |
|
1,719 |
1,520 |
$152K |
| 76705 |
|
1,580 |
1,542 |
$141K |
| 99221 |
|
998 |
373 |
$137K |
| 83690 |
|
16,074 |
14,789 |
$136K |
| 80143 |
|
1,170 |
1,093 |
$134K |
| 76830 |
|
1,330 |
1,303 |
$134K |
| 93306 |
|
533 |
520 |
$130K |
| 80179 |
|
1,118 |
1,059 |
$127K |
| 76817 |
|
1,336 |
1,195 |
$120K |
| J1885 |
Ketorolac tromethamine inj |
9,910 |
9,309 |
$118K |
| 77067 |
|
789 |
788 |
$117K |
| 86901 |
|
4,357 |
3,536 |
$114K |
| 76700 |
|
881 |
878 |
$110K |
| 99283 |
|
1,674 |
1,546 |
$109K |
| J0131 |
Inj, acetaminophen (nos) |
1,040 |
554 |
$109K |
| T1999 |
Noc retail items andsupplies |
4,438 |
2,236 |
$109K |
| 86900 |
|
4,615 |
3,295 |
$98K |
| 97750 |
|
1,448 |
906 |
$97K |
| J1100 |
Dexamethasone sodium phos |
1,847 |
1,783 |
$97K |
| 85730 |
|
4,796 |
4,614 |
$93K |
| J0696 |
Ceftriaxone sodium injection |
3,472 |
2,938 |
$92K |
| 85610 |
|
6,232 |
5,878 |
$91K |
| 83880 |
|
2,686 |
2,488 |
$89K |
| 87651 |
|
1,592 |
1,572 |
$75K |
| J2270 |
Morphine sulfate injection |
5,406 |
4,638 |
$74K |
| 73630 |
|
1,294 |
1,247 |
$74K |
| 70486 |
|
206 |
205 |
$71K |
| 84703 |
|
3,677 |
3,563 |
$64K |
| 73030 |
|
1,324 |
1,275 |
$62K |
| 73610 |
|
1,314 |
1,267 |
$58K |
| 94640 |
|
1,628 |
1,423 |
$57K |
| 73562 |
|
1,427 |
1,379 |
$57K |
| 81025 |
|
8,783 |
8,422 |
$49K |
| 71250 |
|
250 |
250 |
$49K |
| 70551 |
|
95 |
95 |
$49K |
| 87086 |
|
4,647 |
4,476 |
$48K |
| 72170 |
|
449 |
446 |
$48K |
| 84702 |
|
2,688 |
2,368 |
$47K |
| 82947 |
|
7,393 |
4,898 |
$47K |
| 90715 |
|
720 |
712 |
$46K |
| J1170 |
Hydromorphone injection |
2,721 |
2,124 |
$45K |
| 97110 |
|
1,395 |
570 |
$45K |
| 83605 |
|
3,619 |
2,662 |
$42K |
| 70553 |
|
30 |
30 |
$41K |
| 87040 |
|
3,667 |
2,073 |
$41K |
| 96366 |
|
619 |
536 |
$41K |
| U0003 |
Cov-19 amp prb hgh thruput |
459 |
448 |
$40K |
| 0762 |
|
45 |
25 |
$40K |
| 99281 |
|
792 |
721 |
$39K |
| 76816 |
|
442 |
440 |
$37K |
| 73130 |
|
763 |
719 |
$37K |
| 96376 |
|
319 |
251 |
$36K |
| J7120 |
Ringers lactate infusion |
2,626 |
2,472 |
$34K |
| 97113 |
|
802 |
234 |
$33K |
| 76981 |
|
276 |
274 |
$31K |
| 97140 |
|
698 |
311 |
$31K |
| 84443 |
|
1,661 |
1,624 |
$31K |
| 83735 |
|
3,996 |
3,434 |
$30K |
| 77063 |
|
788 |
787 |
$30K |
| J1815 |
Insulin injection |
849 |
438 |
$30K |
| J1650 |
Inj enoxaparin sodium |
982 |
590 |
$30K |
| J2765 |
Metoclopramide hcl injection |
2,831 |
2,580 |
$27K |
| 81003 |
|
8,016 |
7,627 |
$25K |
| 74174 |
|
45 |
44 |
$24K |
| J1200 |
Diphenhydramine hcl injectio |
2,540 |
2,293 |
$23K |
| 87186 |
|
2,126 |
1,939 |
$20K |
| J2060 |
Lorazepam injection |
1,973 |
1,672 |
$20K |
| 87077 |
|
2,096 |
1,863 |
$20K |
| 85379 |
|
1,595 |
1,560 |
$19K |
| 82805 |
|
656 |
566 |
$19K |
| 87430 |
|
1,438 |
1,398 |
$18K |
| A9585 |
Gadobutrol injection |
469 |
380 |
$17K |
| 86920 |
|
63 |
37 |
$14K |
| 0270 |
|
586 |
237 |
$14K |
| 94060 |
|
169 |
166 |
$13K |
| 94644 |
|
425 |
387 |
$12K |
| 72100 |
|
270 |
265 |
$12K |
| J1171 |
Inj, hydromorphone, 0.1 mg |
102 |
68 |
$11K |
| 90471 |
|
920 |
888 |
$10K |
| 87634 |
|
111 |
111 |
$10K |
| 83036 |
|
812 |
781 |
$10K |
| 87210 |
|
1,594 |
1,552 |
$9K |
| A9552 |
F18 fdg |
27 |
25 |
$8K |
| 73110 |
|
204 |
196 |
$8K |
| 94726 |
|
170 |
167 |
$8K |
| 73560 |
|
214 |
205 |
$8K |
| 94729 |
|
154 |
152 |
$8K |
| 59025 |
|
174 |
139 |
$8K |
| 73502 |
|
193 |
186 |
$8K |
| 76770 |
|
79 |
78 |
$8K |
| 87400 |
|
990 |
955 |
$8K |
| 93970 |
|
28 |
27 |
$8K |
| Z7610 |
|
662 |
359 |
$6K |
| J1644 |
Inj heparin sodium per 1000u |
189 |
105 |
$5K |
| 96367 |
|
99 |
93 |
$5K |
| P9016 |
Rbc leukocytes reduced |
13 |
12 |
$5K |
| 99231 |
|
91 |
91 |
$5K |
| J3475 |
Inj magnesium sulfate |
127 |
119 |
$4K |
| 93975 |
|
14 |
13 |
$4K |
| 95816 |
|
43 |
43 |
$4K |
| J7050 |
Normal saline solution infus |
159 |
129 |
$4K |
| J1940 |
Furosemide injection |
280 |
227 |
$3K |
| J2560 |
Phenobarbital sodium inj |
12 |
12 |
$3K |
| 72131 |
|
13 |
13 |
$3K |
| 73590 |
|
79 |
75 |
$3K |
| 73080 |
|
50 |
50 |
$3K |
| 36415 |
|
2,596 |
2,316 |
$3K |
| J0780 |
Prochlorperazine injection |
116 |
111 |
$3K |
| 82550 |
|
302 |
270 |
$2K |
| 71020 |
|
63 |
58 |
$2K |
| 76870 |
|
27 |
26 |
$2K |
| 86140 |
|
282 |
280 |
$2K |
| G0378 |
Hospital observation per hr |
61 |
49 |
$2K |
| J2930 |
Methylprednisolone injection |
84 |
66 |
$2K |
| 73090 |
|
26 |
24 |
$2K |
| U0002 |
Covid-19 lab test non-cdc |
32 |
31 |
$2K |
| 76805 |
|
12 |
12 |
$2K |
| J2919 |
Inj, methylpred sod succ 5mg |
27 |
27 |
$2K |
| 73140 |
|
40 |
39 |
$2K |
| 99282 |
|
14 |
14 |
$1K |
| 84100 |
|
259 |
227 |
$1K |
| J7611 |
Albuterol non-comp con |
393 |
371 |
$1K |
| J7620 |
Albuterol ipratrop non-comp |
669 |
579 |
$1K |
| 76536 |
|
14 |
14 |
$1K |
| J3010 |
Fentanyl citrate injection |
104 |
97 |
$1K |
| 71010 |
|
53 |
50 |
$1K |
| 88305 |
|
71 |
44 |
$1K |
| 97799 |
|
39 |
12 |
$1K |
| 87081 |
|
96 |
86 |
$1K |
| 72040 |
|
24 |
24 |
$972.10 |
| S0164 |
Injection pantroprazole |
43 |
36 |
$842.24 |
| 85651 |
|
269 |
266 |
$823.63 |
| 80061 |
|
69 |
68 |
$787.54 |
| 80076 |
|
72 |
72 |
$773.76 |
| J7040 |
Normal saline solution infus |
101 |
98 |
$763.32 |
| 93017 |
|
12 |
12 |
$748.34 |
| J2274 |
Inj morphine pf epid ithc |
26 |
25 |
$737.06 |
| 99232 |
|
20 |
12 |
$662.34 |
| J2250 |
Inj midazolam hydrochloride |
26 |
25 |
$635.31 |
| J2001 |
Lidocaine injection |
33 |
25 |
$625.12 |
| J3370 |
Vancomycin hcl injection |
22 |
12 |
$607.14 |
| S0028 |
Injection, famotidine, 20 mg |
20 |
13 |
$566.35 |
| 73552 |
|
12 |
12 |
$547.97 |
| J1630 |
Haloperidol injection |
64 |
59 |
$524.39 |
| 87420 |
|
61 |
59 |
$400.31 |
| 87899 |
|
41 |
41 |
$376.26 |
| 74018 |
|
12 |
12 |
$302.46 |
| 80047 |
|
27 |
25 |
$267.51 |
| 85027 |
|
29 |
29 |
$206.93 |
| G8978 |
Mobility current status |
43 |
42 |
$189.04 |
| 84145 |
|
12 |
12 |
$175.00 |
| 82010 |
|
15 |
13 |
$163.28 |
| 86592 |
|
24 |
24 |
$144.43 |
| J2470 |
Inj pantoprazole sodium 40mg |
20 |
14 |
$137.21 |
| 87088 |
|
13 |
13 |
$105.59 |
| J2550 |
Promethazine hcl injection |
13 |
12 |
$100.10 |
| 84439 |
|
12 |
12 |
$99.76 |
| Q0162 |
Ondansetron oral |
71 |
66 |
$74.83 |
| J7512 |
Prednisone ir or dr oral 1mg |
91 |
58 |
$56.44 |
| G8979 |
Mobility goal status |
84 |
81 |
$43.19 |
| 0250R |
|
228 |
220 |
$0.00 |