| Code | Description | Claims | Beneficiaries | Total Paid |
| 97110 |
|
38,591 |
11,129 |
$3.22M |
| 97162 |
|
5,124 |
3,482 |
$567K |
| 92507 |
|
12,402 |
4,072 |
$395K |
| U0004 |
Cov-19 test non-cdc hgh thru |
4,499 |
2,563 |
$322K |
| 87502 |
|
4,772 |
4,171 |
$208K |
| J1050 |
Medroxyprogesterone acetate |
4,120 |
1,825 |
$208K |
| 90732 |
|
1,468 |
600 |
$140K |
| L4360 |
Pneumat walking boot pre cst |
920 |
682 |
$129K |
| 90670 |
|
9,770 |
5,155 |
$127K |
| 0502F |
|
3,019 |
1,075 |
$125K |
| 87591 |
|
8,094 |
7,294 |
$117K |
| 77067 |
|
2,225 |
2,144 |
$114K |
| 90651 |
|
3,431 |
1,781 |
$112K |
| 87491 |
|
8,099 |
7,295 |
$110K |
| 84443 |
|
14,915 |
13,212 |
$107K |
| J7298 |
Mirena, 52 mg |
247 |
119 |
$104K |
| 97163 |
|
898 |
619 |
$103K |
| 87880 |
|
9,314 |
8,542 |
$84K |
| 97161 |
|
794 |
484 |
$83K |
| 92551 |
|
5,153 |
3,471 |
$71K |
| 80053 |
|
21,592 |
18,538 |
$66K |
| 90715 |
|
4,065 |
1,965 |
$64K |
| 90688 |
|
6,940 |
3,503 |
$54K |
| 71046 |
|
4,443 |
4,181 |
$46K |
| 87507 |
|
214 |
191 |
$44K |
| 87081 |
|
11,380 |
10,774 |
$42K |
| 87086 |
|
9,637 |
8,502 |
$38K |
| 96372 |
|
3,951 |
2,162 |
$37K |
| 90686 |
|
4,608 |
2,623 |
$33K |
| 93005 |
|
3,048 |
2,849 |
$32K |
| 73610 |
|
2,089 |
1,856 |
$31K |
| 90734 |
|
2,569 |
1,479 |
$29K |
| 73630 |
|
2,768 |
2,335 |
$29K |
| 87624 |
|
2,241 |
2,099 |
$28K |
| 92014 |
|
790 |
644 |
$26K |
| 80307 |
|
1,112 |
878 |
$25K |
| 58300 |
|
323 |
190 |
$25K |
| 87536 |
|
525 |
415 |
$25K |
| L3908 |
Who cock-up nonmolde pre ots |
756 |
564 |
$23K |
| 99392 |
|
764 |
387 |
$22K |
| 92523 |
|
423 |
296 |
$22K |
| 87808 |
|
4,150 |
3,413 |
$21K |
| 80048 |
|
5,588 |
4,951 |
$21K |
| 85025 |
|
24,092 |
20,316 |
$21K |
| 90723 |
|
7,451 |
3,872 |
$19K |
| 92567 |
|
1,455 |
1,362 |
$18K |
| G0463 |
Hospital outpt clinic visit |
293 |
244 |
$18K |
| 86480 |
|
563 |
512 |
$18K |
| 90633 |
|
5,471 |
2,898 |
$18K |
| 88305 |
|
848 |
744 |
$18K |
| 92557 |
|
648 |
602 |
$18K |
| 73560 |
|
1,890 |
1,480 |
$17K |
| 94060 |
|
492 |
275 |
$17K |
| 17110 |
|
268 |
227 |
$16K |
| 97166 |
|
590 |
382 |
$16K |
| 90647 |
|
7,172 |
3,766 |
$16K |
| 73110 |
|
1,388 |
1,230 |
$16K |
| 87631 |
|
199 |
186 |
$15K |
| 99391 |
|
591 |
330 |
$15K |
| L3807 |
Whfo w/o joints pre cst |
102 |
96 |
$14K |
| 87522 |
Neg quan hep c or qual rna |
524 |
466 |
$14K |
| 86481 |
|
552 |
477 |
$14K |
| 83655 |
|
2,112 |
2,038 |
$14K |
| 72110 |
|
786 |
757 |
$14K |
| 85610 |
|
6,605 |
3,721 |
$14K |
| 83036 |
|
9,271 |
8,623 |
$13K |
| 90710 |
|
3,182 |
1,650 |
$13K |
| 96110 |
|
677 |
544 |
$13K |
| 0503F |
|
300 |
129 |
$13K |
| 73030 |
|
1,150 |
1,032 |
$13K |
| 90716 |
|
1,918 |
1,032 |
$13K |
| 0500F |
|
307 |
138 |
$12K |
| 82306 |
|
6,545 |
5,980 |
$12K |
| 86803 |
|
2,236 |
1,865 |
$12K |
| 87186 |
|
2,405 |
2,050 |
$11K |
| 92015 |
|
1,314 |
1,128 |
$11K |
| 74018 |
|
1,138 |
1,081 |
$11K |
| 72050 |
|
677 |
638 |
$11K |
| 90681 |
|
4,468 |
2,341 |
$11K |
| 90707 |
|
1,878 |
1,019 |
$11K |
| 73502 |
|
648 |
606 |
$10K |
| 87529 |
|
453 |
365 |
$10K |
| 94640 |
|
791 |
380 |
$10K |
| 99211 |
|
903 |
730 |
$10K |
| 73130 |
|
1,113 |
972 |
$10K |
| 99395 |
|
253 |
119 |
$10K |
| 92579 |
|
499 |
472 |
$10K |
| 84702 |
|
2,447 |
1,850 |
$9K |
| L1820 |
Ko elas w/ condyle pads & jo |
156 |
142 |
$9K |
| 86235 |
|
590 |
186 |
$9K |
| J3301 |
Triamcinolone acet inj nos |
1,267 |
494 |
$9K |
| 87801 |
|
662 |
535 |
$9K |
| J1885 |
Ketorolac tromethamine inj |
2,637 |
1,077 |
$9K |
| 73140 |
|
1,088 |
983 |
$8K |
| 81220 |
|
404 |
364 |
$8K |
| J7620 |
Albuterol ipratrop non-comp |
1,863 |
758 |
$8K |
| 81002 |
|
5,856 |
5,073 |
$8K |
| 72100 |
|
611 |
581 |
$8K |
| 95165 |
|
90 |
37 |
$8K |
| 73562 |
|
703 |
654 |
$7K |
| 90696 |
|
2,210 |
1,133 |
$7K |
| 87635 |
|
204 |
158 |
$7K |
| J7613 |
Albuterol non-comp unit |
1,717 |
720 |
$7K |
| 80061 |
|
7,731 |
7,172 |
$7K |
| 82728 |
|
5,519 |
5,031 |
$7K |
| 99396 |
|
168 |
78 |
$7K |
| 84466 |
|
3,688 |
3,229 |
$6K |
| G0432 |
Eia hiv-1/hiv-2 screen |
1,801 |
1,598 |
$6K |
| 90700 |
|
2,284 |
1,213 |
$6K |
| 73080 |
|
546 |
464 |
$6K |
| 87340 |
|
3,035 |
2,587 |
$6K |
| J0696 |
Ceftriaxone sodium injection |
1,305 |
454 |
$6K |
| 81511 |
|
231 |
191 |
$6K |
| G0145 |
Scr c/v cyto,thinlayer,rescr |
4,324 |
3,958 |
$6K |
| 83516 |
|
1,493 |
1,079 |
$6K |
| 88720 |
|
2,003 |
1,410 |
$5K |
| 86038 |
|
1,533 |
1,123 |
$5K |
| 81025 |
|
4,977 |
3,763 |
$5K |
| L1902 |
Afo ankle gauntlet pre ots |
152 |
120 |
$5K |
| 96413 |
|
458 |
240 |
$5K |
| J2001 |
Lidocaine injection |
1,208 |
494 |
$5K |
| 90662 |
|
98 |
29 |
$5K |
| 98926 |
|
270 |
82 |
$5K |
| 82784 |
|
1,227 |
847 |
$5K |
| 77063 |
|
1,079 |
1,041 |
$4K |
| 92134 |
|
250 |
227 |
$4K |
| 20552 |
|
196 |
105 |
$4K |
| 84439 |
|
4,784 |
4,132 |
$4K |
| 85027 |
|
3,576 |
3,264 |
$4K |
| 82607 |
|
1,591 |
1,489 |
$4K |
| 87088 |
|
954 |
872 |
$4K |
| 83001 |
|
651 |
547 |
$4K |
| 92012 |
|
241 |
208 |
$4K |
| 99393 |
|
169 |
109 |
$4K |
| 82105 |
|
547 |
487 |
$4K |
| 83970 |
|
277 |
242 |
$4K |
| 84403 |
|
649 |
498 |
$4K |
| 80305 |
|
552 |
508 |
$4K |
| 90847 |
|
69 |
25 |
$4K |
| 83520 |
|
353 |
219 |
$4K |
| G0103 |
Psa screening |
412 |
366 |
$4K |
| 86200 |
|
1,011 |
749 |
$4K |
| 86003 |
|
541 |
298 |
$4K |
| 95004 |
|
65 |
27 |
$3K |
| 97165 |
|
196 |
132 |
$3K |
| J3420 |
Vitamin b12 injection |
769 |
247 |
$3K |
| 86160 |
|
1,024 |
480 |
$3K |
| 80074 |
|
277 |
252 |
$3K |
| 97167 |
|
77 |
53 |
$3K |
| 95117 |
|
878 |
172 |
$3K |
| E0114 |
Crutch underarm pair no wood |
105 |
85 |
$3K |
| G0008 |
Admin influenza virus vac |
1,627 |
858 |
$3K |
| 87070 |
|
1,458 |
1,259 |
$3K |
| 87633 |
|
19 |
17 |
$3K |
| 84410 |
|
202 |
140 |
$3K |
| 99173 |
|
664 |
525 |
$3K |
| 99394 |
|
96 |
57 |
$3K |
| 84112 |
|
87 |
74 |
$3K |
| 92083 |
|
92 |
89 |
$2K |
| J1100 |
Dexamethasone sodium phos |
848 |
554 |
$2K |
| 73590 |
|
232 |
204 |
$2K |
| 81001 |
|
4,892 |
4,173 |
$2K |
| 82570 |
|
3,439 |
3,062 |
$2K |
| 94010 |
|
74 |
67 |
$2K |
| 87338 |
|
212 |
206 |
$2K |
| 86140 |
|
3,755 |
3,101 |
$2K |
| 87905 |
|
3,516 |
3,043 |
$2K |
| A4565 |
Slings |
328 |
267 |
$2K |
| 86592 |
|
4,486 |
3,942 |
$2K |
| 83880 |
|
361 |
335 |
$2K |
| 90636 |
|
26 |
14 |
$2K |
| 80069 |
|
708 |
616 |
$2K |
| 96118 |
|
28 |
27 |
$2K |
| 80164 |
|
543 |
493 |
$2K |
| 80076 |
|
847 |
721 |
$2K |
| 69210 |
|
98 |
78 |
$2K |
| 83020 |
|
565 |
521 |
$2K |
| 83540 |
|
3,916 |
3,424 |
$2K |
| 86696 |
|
610 |
540 |
$2K |
| 96040 |
|
41 |
33 |
$2K |
| 86901 |
|
1,791 |
1,551 |
$2K |
| 86850 |
|
1,650 |
1,457 |
$2K |
| 90746 |
|
32 |
12 |
$1K |
| 86762 |
|
1,285 |
1,141 |
$1K |
| 82950 |
|
2,353 |
2,105 |
$1K |
| 83735 |
|
1,922 |
1,474 |
$1K |
| 87077 |
|
705 |
608 |
$1K |
| 73090 |
|
163 |
139 |
$1K |
| 80055 |
|
132 |
106 |
$1K |
| L1836 |
Ko rigid w/o joints pre ots |
12 |
12 |
$1K |
| 86787 |
|
319 |
277 |
$1K |
| 86706 |
|
654 |
530 |
$1K |
| 84146 |
|
620 |
519 |
$1K |
| 86141 |
|
226 |
203 |
$1K |
| 83993 |
|
228 |
210 |
$1K |
| 96133 |
|
16 |
14 |
$1K |
| 77065 |
Tomosynthesis, mammo |
21 |
15 |
$1K |
| 86147 |
|
186 |
81 |
$1K |
| 87798 |
|
30 |
28 |
$1K |
| 72082 |
|
48 |
48 |
$1K |
| 86225 |
|
517 |
288 |
$1K |
| 86580 |
|
329 |
241 |
$1K |
| 90460 |
|
364 |
192 |
$1K |
| Q0111 |
Wet mounts/ w preparations |
687 |
631 |
$1K |
| 73660 |
|
121 |
111 |
$1K |
| 85730 |
|
761 |
552 |
$991.06 |
| 92610 |
|
34 |
12 |
$990.39 |
| 85379 |
|
364 |
335 |
$963.70 |
| 92550 |
|
78 |
56 |
$944.74 |
| G0009 |
Admin pneumococcal vaccine |
475 |
251 |
$925.44 |
| 96111 |
|
57 |
54 |
$862.83 |
| 86704 |
|
346 |
250 |
$832.76 |
| 73564 |
|
57 |
55 |
$820.84 |
| 82043 |
|
2,513 |
2,326 |
$776.94 |
| 86900 |
|
1,797 |
1,558 |
$753.53 |
| 92555 |
|
53 |
53 |
$750.29 |
| 85652 |
|
3,316 |
2,692 |
$738.25 |
| 86431 |
|
1,006 |
737 |
$722.63 |
| 82951 |
|
142 |
134 |
$704.95 |
| L3260 |
Ambulatory surgical boot eac |
49 |
41 |
$672.12 |
| G2066 |
Inter devc remote 30d |
13 |
13 |
$660.25 |
| 87493 |
|
29 |
27 |
$647.04 |
| 92582 |
|
30 |
29 |
$646.74 |
| 96132 |
|
44 |
40 |
$636.92 |
| 92060 |
|
50 |
50 |
$613.75 |
| 83615 |
|
1,112 |
883 |
$606.09 |
| 86376 |
|
562 |
467 |
$592.95 |
| 86360 |
|
586 |
418 |
$585.54 |
| 87210 |
|
2,229 |
1,998 |
$580.08 |
| 87205 |
|
1,249 |
1,085 |
$562.21 |
| 86695 |
|
634 |
555 |
$552.01 |
| 86769 |
|
17 |
17 |
$532.89 |
| 83883 |
|
171 |
67 |
$528.32 |
| 82533 |
|
76 |
55 |
$522.40 |
| Q0112 |
Potassium hydroxide preps |
464 |
430 |
$520.08 |
| 84550 |
|
1,224 |
1,032 |
$504.12 |
| 83690 |
|
649 |
597 |
$487.95 |
| 82962 |
|
540 |
442 |
$483.39 |
| 90461 |
|
148 |
85 |
$480.85 |
| J2550 |
Promethazine hcl injection |
110 |
39 |
$430.35 |
| 73120 |
|
52 |
39 |
$430.29 |
| A6449 |
Lt compres band >=3" <5"/yd |
291 |
220 |
$414.57 |
| 84481 |
|
414 |
343 |
$379.60 |
| 82550 |
|
497 |
390 |
$353.28 |
| 81003 |
|
615 |
508 |
$352.55 |
| 83021 |
|
70 |
67 |
$350.79 |
| 86708 |
|
356 |
281 |
$334.30 |
| J3490 |
Drugs unclassified injection |
85 |
29 |
$325.07 |
| J2930 |
Methylprednisolone injection |
37 |
12 |
$321.05 |
| 90713 |
|
89 |
40 |
$312.18 |
| 91200 |
|
29 |
26 |
$309.15 |
| 83986 |
|
450 |
408 |
$307.54 |
| 82746 |
|
288 |
261 |
$306.89 |
| 84480 |
|
286 |
244 |
$299.00 |
| 84446 |
|
75 |
65 |
$297.46 |
| J7510 |
Prednisolone oral per 5 mg |
73 |
29 |
$297.02 |
| 88304 |
|
13 |
12 |
$254.37 |
| 82670 |
|
230 |
188 |
$246.67 |
| 86618 |
|
13 |
12 |
$245.64 |
| 82274 |
|
31 |
26 |
$245.20 |
| 86359 |
|
553 |
406 |
$238.28 |
| 84402 |
|
263 |
222 |
$237.13 |
| 84156 |
|
1,078 |
868 |
$235.71 |
| 84153 |
|
44 |
41 |
$224.75 |
| 84144 |
|
60 |
56 |
$219.90 |
| 86765 |
|
74 |
66 |
$215.46 |
| 72072 |
|
29 |
28 |
$214.16 |
| 85018 |
|
695 |
651 |
$203.61 |
| 92133 |
|
16 |
15 |
$203.10 |
| 83721 |
|
173 |
164 |
$200.53 |
| 82565 |
|
117 |
111 |
$190.58 |
| 85014 |
|
602 |
563 |
$184.34 |
| 11721 |
|
15 |
15 |
$176.11 |
| 84100 |
|
530 |
325 |
$174.83 |
| 84165 |
|
73 |
52 |
$168.63 |
| 83002 |
|
150 |
123 |
$150.89 |
| 86308 |
|
170 |
158 |
$145.40 |
| 81050 |
|
196 |
187 |
$141.17 |
| 82247 |
|
78 |
55 |
$140.86 |
| 86304 |
|
18 |
13 |
$126.72 |
| 84305 |
|
20 |
16 |
$124.73 |
| 82626 |
|
64 |
38 |
$120.71 |
| 80178 |
|
56 |
49 |
$113.20 |
| 84460 |
|
211 |
184 |
$106.59 |
| 84432 |
|
24 |
24 |
$106.55 |
| 87075 |
|
16 |
12 |
$102.17 |
| 99406 |
|
20 |
12 |
$99.33 |
| 88342 |
|
51 |
48 |
$98.67 |
| 84134 |
|
231 |
171 |
$97.74 |
| J2795 |
Ropivacaine hcl injection |
134 |
33 |
$90.92 |
| 86800 |
|
90 |
77 |
$89.86 |
| 81015 |
|
140 |
125 |
$89.46 |
| 84590 |
|
81 |
68 |
$88.40 |
| 90744 |
|
26 |
14 |
$81.33 |
| 85613 |
|
49 |
38 |
$78.72 |
| A6448 |
Lt compres band <3"/yd |
78 |
57 |
$67.28 |
| 90471 |
|
756 |
350 |
$64.72 |
| 82150 |
|
13 |
12 |
$51.89 |
| 86705 |
|
23 |
15 |
$44.94 |
| 82952 |
|
128 |
121 |
$42.83 |
| 84450 |
|
151 |
131 |
$42.37 |
| 86780 |
|
15 |
14 |
$42.28 |
| 84478 |
|
88 |
68 |
$38.08 |
| 86735 |
|
15 |
15 |
$37.08 |
| 83498 |
|
16 |
13 |
$34.52 |
| 84597 |
|
47 |
38 |
$31.78 |
| 82465 |
|
127 |
103 |
$25.48 |
| 82977 |
|
39 |
37 |
$21.04 |
| 36415 |
|
899 |
664 |
$16.29 |
| 82248 |
|
26 |
24 |
$14.28 |
| 83605 |
|
29 |
28 |
$12.93 |
| 88312 |
|
15 |
13 |
$11.49 |
| 83789 |
|
14 |
13 |
$6.98 |
| 85004 |
|
36 |
25 |
$6.60 |
| 86709 |
|
16 |
14 |
$5.40 |
| 85660 |
|
18 |
14 |
$4.54 |
| 82103 |
|
25 |
15 |
$4.31 |
| 82390 |
|
25 |
15 |
$4.31 |
| 36416 |
|
12 |
12 |
$4.10 |
| 84155 |
|
21 |
14 |
$0.00 |
| Q0162 |
Ondansetron oral |
14 |
12 |
$0.00 |