| Code | Description | Claims | Beneficiaries | Total Paid |
| 0450 |
|
54,654 |
47,169 |
$13.37M |
| 99281 |
|
13,670 |
11,997 |
$2.64M |
| A0427 |
Als1-emergency |
13,032 |
11,304 |
$1.90M |
| A9150 |
Misc/exper non-prescript dru |
12,403 |
7,030 |
$1.85M |
| 99283 |
|
9,311 |
8,043 |
$1.44M |
| 0762 |
|
1,085 |
796 |
$1.30M |
| 36415 |
|
16,892 |
14,265 |
$1.25M |
| 99199 |
|
13,914 |
11,655 |
$851K |
| 74177 |
|
3,684 |
3,547 |
$812K |
| 80053 |
|
44,105 |
38,920 |
$801K |
| T1999 |
Noc retail items andsupplies |
4,823 |
3,172 |
$716K |
| 93976 |
|
2,621 |
2,571 |
$603K |
| 99284 |
|
2,488 |
2,100 |
$561K |
| 0241U |
|
7,771 |
7,481 |
$458K |
| 70450 |
|
3,730 |
3,580 |
$452K |
| 96374 |
|
8,503 |
7,679 |
$419K |
| 77067 |
|
2,485 |
2,485 |
$387K |
| 0250 |
|
31,153 |
17,734 |
$377K |
| Z7502 |
|
9,730 |
9,549 |
$365K |
| A0425 |
Ground mileage |
14,793 |
12,585 |
$363K |
| 80307 |
|
8,195 |
7,664 |
$330K |
| 93306 |
|
1,315 |
1,288 |
$330K |
| 76805 |
|
1,654 |
1,636 |
$277K |
| 71046 |
|
9,162 |
8,767 |
$275K |
| 93005 |
|
15,340 |
13,881 |
$275K |
| 76856 |
|
2,747 |
2,693 |
$275K |
| 99202 |
|
761 |
690 |
$275K |
| 11042 |
|
4,974 |
2,249 |
$260K |
| 96372 |
|
8,175 |
7,178 |
$236K |
| 0750 |
|
164 |
143 |
$235K |
| 99282 |
|
1,541 |
1,441 |
$224K |
| 72125 |
|
1,042 |
1,028 |
$220K |
| 96375 |
|
6,535 |
5,623 |
$218K |
| 85025 |
|
44,227 |
38,369 |
$192K |
| 76700 |
|
1,427 |
1,415 |
$186K |
| J3490 |
Drugs unclassified injection |
22,159 |
13,596 |
$175K |
| U0003 |
Cov-19 amp prb hgh thruput |
1,663 |
1,628 |
$158K |
| G0480 |
Drug test def 1-7 classes |
3,882 |
3,523 |
$156K |
| 96365 |
|
2,177 |
1,946 |
$149K |
| 96361 |
|
4,226 |
3,577 |
$143K |
| 84443 |
|
8,724 |
8,438 |
$138K |
| 74176 |
|
1,380 |
1,329 |
$134K |
| 76705 |
|
1,849 |
1,804 |
$134K |
| 99285 |
|
672 |
619 |
$121K |
| 73030 |
|
1,607 |
1,539 |
$100K |
| 73130 |
|
1,235 |
1,192 |
$99K |
| 73630 |
|
1,874 |
1,813 |
$94K |
| 76830 |
|
891 |
877 |
$94K |
| 87086 |
|
10,615 |
9,972 |
$90K |
| 71045 |
|
7,233 |
6,690 |
$89K |
| 96360 |
|
1,297 |
1,165 |
$86K |
| 80061 |
|
5,900 |
5,847 |
$85K |
| 71275 |
|
415 |
406 |
$85K |
| 87880 |
|
2,872 |
2,819 |
$85K |
| 73610 |
|
1,421 |
1,393 |
$82K |
| 87070 |
|
3,633 |
3,491 |
$77K |
| 81001 |
|
16,732 |
15,542 |
$77K |
| 93971 |
|
664 |
643 |
$76K |
| 87491 |
|
2,517 |
2,472 |
$74K |
| 77063 |
|
1,595 |
1,595 |
$73K |
| 82306 |
|
2,361 |
2,348 |
$72K |
| 72148 |
|
122 |
118 |
$72K |
| 87635 |
|
2,039 |
1,992 |
$71K |
| 83036 |
|
5,876 |
5,823 |
$70K |
| 99201 |
|
238 |
194 |
$69K |
| 0360 |
|
47 |
43 |
$67K |
| 87591 |
|
2,522 |
2,477 |
$64K |
| 73110 |
|
864 |
827 |
$64K |
| 84703 |
|
2,770 |
2,650 |
$62K |
| 94640 |
|
3,462 |
2,747 |
$58K |
| 85027 |
|
7,185 |
6,596 |
$56K |
| 87389 |
|
2,397 |
2,380 |
$56K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
5,936 |
5,667 |
$55K |
| 71260 |
|
253 |
249 |
$53K |
| 73562 |
|
777 |
748 |
$50K |
| 0949 |
|
699 |
577 |
$49K |
| 10060 |
|
235 |
227 |
$46K |
| 81003 |
|
9,110 |
8,671 |
$46K |
| 86803 |
|
2,007 |
1,993 |
$45K |
| 76536 |
|
375 |
372 |
$40K |
| 72110 |
|
423 |
421 |
$36K |
| 84484 |
|
9,891 |
8,596 |
$36K |
| 29125 |
|
219 |
213 |
$34K |
| 84439 |
|
3,287 |
3,228 |
$33K |
| 12001 |
|
164 |
162 |
$33K |
| 86850 |
|
3,415 |
3,297 |
$31K |
| 83880 |
|
3,196 |
2,916 |
$30K |
| 82962 |
|
3,620 |
2,741 |
$29K |
| A0429 |
Bls-emergency |
615 |
526 |
$28K |
| 74018 |
|
702 |
672 |
$28K |
| J7030 |
Normal saline solution infus |
8,776 |
7,567 |
$28K |
| 80048 |
|
3,758 |
3,325 |
$28K |
| 87340 |
|
1,675 |
1,661 |
$26K |
| J2704 |
Inj, propofol, 10 mg |
2,094 |
1,852 |
$26K |
| 73721 |
|
54 |
53 |
$25K |
| 87077 |
|
3,042 |
2,918 |
$24K |
| 78815 |
|
12 |
12 |
$24K |
| 87186 |
|
4,024 |
3,817 |
$23K |
| 83735 |
|
4,886 |
4,129 |
$23K |
| 86762 |
|
1,464 |
1,455 |
$21K |
| 76801 |
|
454 |
419 |
$20K |
| 83690 |
|
10,190 |
9,285 |
$20K |
| J2405 |
Ondansetron hcl injection |
5,396 |
4,798 |
$20K |
| 96366 |
|
382 |
317 |
$18K |
| 87040 |
|
3,989 |
3,447 |
$18K |
| 70551 |
|
54 |
53 |
$18K |
| 86141 |
|
2,446 |
2,199 |
$18K |
| 84702 |
|
1,343 |
1,006 |
$17K |
| 73564 |
|
354 |
344 |
$17K |
| 73140 |
|
249 |
244 |
$17K |
| 83605 |
|
4,998 |
4,449 |
$16K |
| Z9725 |
|
336 |
326 |
$14K |
| 87631 |
|
397 |
374 |
$14K |
| 86592 |
|
2,296 |
2,281 |
$14K |
| 82746 |
|
624 |
617 |
$14K |
| 87502 |
|
498 |
484 |
$14K |
| G0378 |
Hospital observation per hr |
338 |
277 |
$13K |
| 73502 |
|
296 |
292 |
$13K |
| J1885 |
Ketorolac tromethamine inj |
6,774 |
6,295 |
$13K |
| 86900 |
|
3,575 |
3,434 |
$13K |
| 0720 |
|
225 |
184 |
$12K |
| 88305 |
|
410 |
359 |
$12K |
| 76770 |
|
94 |
93 |
$12K |
| J2250 |
Inj midazolam hydrochloride |
804 |
722 |
$12K |
| 87426 |
|
172 |
167 |
$12K |
| J7120 |
Ringers lactate infusion |
2,671 |
2,254 |
$11K |
| 90715 |
|
1,083 |
1,064 |
$11K |
| 76641 |
|
75 |
74 |
$11K |
| 87661 |
|
359 |
348 |
$11K |
| 86901 |
|
3,574 |
3,433 |
$11K |
| 72100 |
|
189 |
187 |
$10K |
| J1100 |
Dexamethasone sodium phos |
2,439 |
2,254 |
$10K |
| 82607 |
|
651 |
644 |
$10K |
| 84145 |
|
1,459 |
1,358 |
$10K |
| 71250 |
|
29 |
28 |
$9K |
| 85610 |
|
4,298 |
3,739 |
$9K |
| G0481 |
Drug test def 8-14 classes |
198 |
191 |
$9K |
| 99070 |
|
446 |
382 |
$9K |
| 85730 |
|
2,417 |
2,246 |
$8K |
| J2270 |
Morphine sulfate injection |
2,462 |
2,085 |
$8K |
| J1170 |
Hydromorphone injection |
2,023 |
1,702 |
$8K |
| 82728 |
|
560 |
530 |
$8K |
| 97802 |
|
44 |
44 |
$7K |
| 66984 |
|
17 |
13 |
$7K |
| 87205 |
|
1,842 |
1,729 |
$7K |
| Z7610 |
|
1,402 |
903 |
$7K |
| 73080 |
|
171 |
167 |
$7K |
| A9270 |
Non-covered item or service |
2,263 |
1,065 |
$7K |
| 70498 |
|
130 |
129 |
$6K |
| 86787 |
|
646 |
638 |
$6K |
| 87075 |
|
689 |
656 |
$6K |
| 85379 |
|
1,698 |
1,649 |
$6K |
| J3010 |
Fentanyl citrate injection |
1,574 |
1,431 |
$6K |
| 82570 |
|
1,285 |
1,221 |
$6K |
| J0696 |
Ceftriaxone sodium injection |
2,340 |
2,105 |
$6K |
| 70486 |
|
38 |
38 |
$6K |
| 70496 |
|
100 |
99 |
$6K |
| 87804 |
|
291 |
267 |
$6K |
| 85652 |
|
2,376 |
2,187 |
$6K |
| 87637 |
|
232 |
227 |
$5K |
| 82805 |
|
409 |
347 |
$5K |
| 83540 |
|
652 |
636 |
$4K |
| 82950 |
|
624 |
622 |
$4K |
| 76775 |
|
57 |
57 |
$4K |
| J0780 |
Prochlorperazine injection |
1,132 |
1,010 |
$4K |
| J1200 |
Diphenhydramine hcl injectio |
1,788 |
1,580 |
$4K |
| 72050 |
|
57 |
57 |
$4K |
| 84100 |
|
1,710 |
1,496 |
$4K |
| 12011 |
|
13 |
13 |
$3K |
| 76870 |
|
70 |
68 |
$3K |
| 77065 |
Tomosynthesis, mammo |
25 |
25 |
$3K |
| 82951 |
|
185 |
180 |
$3K |
| 82043 |
|
697 |
697 |
$3K |
| 83550 |
|
459 |
449 |
$3K |
| 81025 |
|
663 |
644 |
$3K |
| G0463 |
Hospital outpt clinic visit |
609 |
543 |
$3K |
| 77080 |
|
73 |
73 |
$3K |
| 83615 |
|
474 |
354 |
$3K |
| 87210 |
|
253 |
249 |
$3K |
| 87506 |
|
12 |
12 |
$3K |
| G0279 |
Tomosynthesis, mammo |
42 |
42 |
$3K |
| 97597 |
|
55 |
39 |
$2K |
| 73590 |
|
57 |
56 |
$2K |
| 82550 |
|
577 |
536 |
$2K |
| J2060 |
Lorazepam injection |
1,228 |
1,052 |
$2K |
| J2765 |
Metoclopramide hcl injection |
977 |
897 |
$2K |
| 96376 |
|
1,302 |
1,079 |
$2K |
| 0272 |
|
49 |
49 |
$2K |
| 70491 |
|
19 |
18 |
$2K |
| 10061 |
|
13 |
12 |
$2K |
| V2632 |
Post chmbr intraocular lens |
15 |
12 |
$2K |
| 71101 |
|
13 |
13 |
$2K |
| 72131 |
|
27 |
27 |
$2K |
| 86003 |
|
13 |
13 |
$2K |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
70 |
70 |
$2K |
| 96367 |
|
74 |
63 |
$1K |
| 85007 |
|
915 |
797 |
$1K |
| 74019 |
|
28 |
28 |
$1K |
| 87634 |
|
21 |
21 |
$1K |
| J1815 |
Insulin injection |
117 |
85 |
$1K |
| J2360 |
Orphenadrine injection |
393 |
378 |
$1K |
| J7050 |
Normal saline solution infus |
276 |
214 |
$991.45 |
| 84153 |
|
54 |
51 |
$954.32 |
| 80074 |
|
13 |
13 |
$930.41 |
| 86756 |
|
39 |
38 |
$926.53 |
| J0690 |
Cefazolin sodium injection |
168 |
120 |
$895.95 |
| J8540 |
Oral dexamethasone |
241 |
233 |
$891.31 |
| 76817 |
|
13 |
13 |
$855.41 |
| 87522 |
Neg quan hep c or qual rna |
25 |
25 |
$831.02 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
70 |
65 |
$759.90 |
| U0005 |
Infec agen detec ampli probe |
471 |
461 |
$679.75 |
| 88720 |
|
94 |
83 |
$642.33 |
| 59025 |
|
32 |
26 |
$575.60 |
| J3475 |
Inj magnesium sulfate |
235 |
205 |
$535.76 |
| 82270 |
|
104 |
103 |
$494.14 |
| U0002 |
Covid-19 lab test non-cdc |
12 |
12 |
$494.00 |
| 87147 |
|
66 |
63 |
$487.48 |
| 73090 |
|
12 |
12 |
$466.56 |
| 0710 |
|
343 |
290 |
$459.94 |
| S0028 |
Injection, famotidine, 20 mg |
85 |
77 |
$459.20 |
| 72170 |
|
14 |
14 |
$435.95 |
| J7040 |
Normal saline solution infus |
231 |
227 |
$417.40 |
| J0171 |
Adrenalin epinephrine inject |
35 |
34 |
$409.64 |
| 83655 |
|
74 |
73 |
$370.00 |
| 86780 |
|
48 |
47 |
$349.08 |
| 86038 |
|
101 |
101 |
$343.69 |
| 84550 |
|
94 |
89 |
$342.78 |
| 90471 |
|
97 |
83 |
$324.86 |
| 84481 |
|
30 |
29 |
$320.46 |
| 87400 |
|
20 |
20 |
$231.60 |
| 83001 |
|
25 |
25 |
$226.94 |
| A9579 |
Gad-base mr contrast nos,1ml |
13 |
13 |
$218.52 |
| 84156 |
|
55 |
47 |
$184.01 |
| S0020 |
Injection, bupivicaine hydro |
41 |
40 |
$168.24 |
| J1642 |
Inj heparin sodium per 10 u |
70 |
55 |
$142.68 |
| 82248 |
|
17 |
13 |
$142.46 |
| 82247 |
|
15 |
12 |
$122.76 |
| 82670 |
|
12 |
12 |
$111.20 |
| J2710 |
Neostigmine methylslfte inj |
19 |
19 |
$106.94 |
| 76376 |
|
55 |
53 |
$99.88 |
| 82140 |
|
40 |
38 |
$96.70 |
| 84403 |
|
15 |
14 |
$87.00 |
| 85018 |
|
44 |
44 |
$73.45 |
| 86431 |
|
13 |
13 |
$70.87 |
| 80076 |
|
12 |
12 |
$61.20 |
| 82565 |
|
13 |
13 |
$57.85 |
| J2470 |
Inj pantoprazole sodium 40mg |
14 |
14 |
$55.30 |
| 87081 |
|
12 |
12 |
$39.33 |
| 82009 |
|
53 |
42 |
$33.11 |
| 84132 |
|
14 |
12 |
$20.93 |
| J2930 |
Methylprednisolone injection |
50 |
47 |
$9.93 |
| J1644 |
Inj heparin sodium per 1000u |
24 |
12 |
$2.12 |
| J7512 |
Prednisone ir or dr oral 1mg |
127 |
116 |
$0.00 |
| 0636 |
|
204 |
199 |
$0.00 |
| J1940 |
Furosemide injection |
15 |
12 |
$0.00 |
| 45380 |
|
38 |
25 |
$0.00 |
| 99001 |
|
12 |
12 |
$0.00 |