| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0202U |
|
7,711 |
7,531 |
$1.08M |
| 0450 |
|
54,732 |
48,547 |
$976K |
| 74177 |
|
3,311 |
3,239 |
$341K |
| 99199 |
|
5,877 |
5,056 |
$294K |
| 87633 |
|
1,663 |
1,558 |
$238K |
| Z7502 |
|
6,362 |
5,917 |
$231K |
| 93005 |
|
19,282 |
17,681 |
$223K |
| 70450 |
|
4,429 |
4,288 |
$215K |
| 80053 |
|
35,683 |
31,406 |
$183K |
| 87635 |
|
5,153 |
4,677 |
$140K |
| 87636 |
|
2,133 |
2,108 |
$135K |
| 85025 |
|
37,254 |
32,384 |
$133K |
| 36415 |
|
2,657 |
2,006 |
$107K |
| 96375 |
|
4,097 |
3,359 |
$103K |
| 96374 |
|
4,258 |
4,032 |
$99K |
| 74176 |
|
1,507 |
1,483 |
$89K |
| 99284 |
|
3,004 |
2,780 |
$84K |
| 71045 |
|
10,849 |
10,235 |
$69K |
| 0510 |
|
2,841 |
2,016 |
$61K |
| 84484 |
|
14,433 |
11,147 |
$61K |
| 72125 |
|
980 |
968 |
$60K |
| 76705 |
|
2,240 |
2,196 |
$58K |
| 99281 |
|
1,402 |
1,257 |
$56K |
| 78815 |
|
55 |
55 |
$51K |
| 97110 |
|
3,849 |
1,503 |
$49K |
| 96413 |
|
1,938 |
1,175 |
$47K |
| 99283 |
|
1,305 |
1,223 |
$45K |
| 87798 |
|
1,670 |
1,481 |
$42K |
| 96372 |
|
3,353 |
2,777 |
$41K |
| 96361 |
|
2,988 |
2,798 |
$41K |
| 83690 |
|
12,064 |
11,259 |
$41K |
| 71046 |
|
3,567 |
3,420 |
$35K |
| 83880 |
|
3,592 |
3,376 |
$35K |
| 81001 |
|
20,971 |
19,647 |
$35K |
| 76856 |
|
1,032 |
1,000 |
$35K |
| 0241U |
|
1,221 |
1,191 |
$31K |
| 97140 |
|
1,630 |
707 |
$31K |
| 96360 |
|
1,139 |
1,015 |
$31K |
| 71275 |
|
397 |
394 |
$31K |
| 96365 |
|
900 |
848 |
$30K |
| 84443 |
|
4,228 |
3,851 |
$29K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
7,519 |
5,241 |
$27K |
| 87086 |
|
8,774 |
8,373 |
$27K |
| 87486 |
|
1,655 |
1,549 |
$25K |
| 87581 |
|
1,657 |
1,551 |
$25K |
| J7030 |
Normal saline solution infus |
7,837 |
6,375 |
$24K |
| 94640 |
|
2,968 |
2,357 |
$24K |
| J0897 |
Denosumab injection |
42 |
24 |
$24K |
| G0378 |
Hospital observation per hr |
341 |
172 |
$23K |
| 93971 |
|
393 |
384 |
$18K |
| 88305 |
|
1,005 |
986 |
$18K |
| 76830 |
|
467 |
455 |
$17K |
| 83735 |
|
6,141 |
5,461 |
$16K |
| 87040 |
|
3,185 |
2,357 |
$16K |
| 83605 |
|
3,605 |
3,120 |
$16K |
| 87804 |
|
2,445 |
2,226 |
$15K |
| 0250 |
|
1,006 |
752 |
$14K |
| 93306 |
|
181 |
181 |
$14K |
| 84439 |
|
3,495 |
3,201 |
$13K |
| 87631 |
|
530 |
527 |
$12K |
| 0270 |
|
2,145 |
1,695 |
$12K |
| J1885 |
Ketorolac tromethamine inj |
4,529 |
3,938 |
$12K |
| 85379 |
|
2,444 |
2,365 |
$12K |
| 76816 |
|
520 |
469 |
$10K |
| C9803 |
Hopd covid-19 spec collect |
914 |
779 |
$10K |
| 76801 |
|
317 |
288 |
$10K |
| 81025 |
|
2,915 |
2,848 |
$9K |
| 82077 |
|
1,649 |
1,476 |
$9K |
| 0762 |
|
184 |
105 |
$9K |
| 87880 |
|
2,767 |
2,722 |
$9K |
| 80143 |
|
1,311 |
1,212 |
$8K |
| 80179 |
|
1,304 |
1,208 |
$8K |
| J0696 |
Ceftriaxone sodium injection |
2,626 |
2,398 |
$7K |
| 80048 |
|
2,544 |
2,160 |
$7K |
| J7050 |
Normal saline solution infus |
4,257 |
1,995 |
$7K |
| 87081 |
|
2,813 |
2,748 |
$7K |
| J1170 |
Hydromorphone injection |
1,440 |
1,036 |
$6K |
| J7120 |
Ringers lactate infusion |
1,924 |
1,522 |
$6K |
| J2405 |
Ondansetron hcl injection |
4,854 |
3,860 |
$6K |
| 76817 |
|
187 |
163 |
$6K |
| 82553 |
|
1,188 |
957 |
$6K |
| 70551 |
|
58 |
58 |
$5K |
| 85730 |
|
2,683 |
2,592 |
$5K |
| 87591 |
|
635 |
627 |
$5K |
| J3490 |
Drugs unclassified injection |
572 |
438 |
$5K |
| 85610 |
|
4,051 |
3,836 |
$5K |
| A9552 |
F18 fdg |
38 |
38 |
$5K |
| J2270 |
Morphine sulfate injection |
1,217 |
1,045 |
$5K |
| 87186 |
|
2,118 |
2,026 |
$5K |
| J1100 |
Dexamethasone sodium phos |
1,629 |
1,017 |
$5K |
| 86140 |
|
2,215 |
2,144 |
$5K |
| 70496 |
|
72 |
72 |
$4K |
| 86850 |
|
1,642 |
1,567 |
$4K |
| 82550 |
|
1,781 |
1,525 |
$4K |
| 73630 |
|
474 |
469 |
$4K |
| 73610 |
|
428 |
424 |
$4K |
| 99285 |
|
93 |
88 |
$4K |
| 73030 |
|
373 |
369 |
$4K |
| 0360 |
|
113 |
55 |
$4K |
| 87077 |
|
1,894 |
1,811 |
$4K |
| 90832 |
|
117 |
93 |
$3K |
| 70498 |
|
84 |
84 |
$3K |
| 87491 |
|
634 |
626 |
$3K |
| 90839 |
|
121 |
115 |
$3K |
| J2765 |
Metoclopramide hcl injection |
1,043 |
937 |
$3K |
| J1200 |
Diphenhydramine hcl injectio |
1,097 |
899 |
$3K |
| 86901 |
|
1,779 |
1,691 |
$2K |
| 85027 |
|
974 |
881 |
$2K |
| 82803 |
|
311 |
310 |
$2K |
| 87807 |
|
661 |
608 |
$2K |
| 86900 |
|
1,778 |
1,690 |
$2K |
| 97530 |
|
214 |
122 |
$2K |
| J7040 |
Normal saline solution infus |
899 |
800 |
$2K |
| 76805 |
|
39 |
39 |
$2K |
| J1642 |
Inj heparin sodium per 10 u |
751 |
419 |
$2K |
| J0131 |
Inj, acetaminophen (nos) |
130 |
70 |
$1K |
| J2272 |
Inj, morphine (fresenius) |
376 |
356 |
$1K |
| J3475 |
Inj magnesium sulfate |
411 |
332 |
$1K |
| 99282 |
|
25 |
24 |
$1K |
| G0463 |
Hospital outpt clinic visit |
714 |
497 |
$1K |
| 82330 |
|
223 |
223 |
$1K |
| 84100 |
|
691 |
648 |
$1K |
| 96367 |
|
45 |
37 |
$1K |
| 80061 |
|
490 |
444 |
$1K |
| 71250 |
|
13 |
13 |
$1K |
| 97112 |
|
96 |
49 |
$1K |
| 0710 |
|
240 |
184 |
$979.25 |
| 84145 |
|
231 |
222 |
$945.32 |
| 87147 |
|
552 |
545 |
$928.82 |
| 82728 |
|
280 |
258 |
$892.27 |
| 82378 |
|
217 |
153 |
$887.07 |
| 81003 |
|
409 |
405 |
$820.30 |
| 73562 |
|
139 |
138 |
$767.39 |
| 90715 |
|
63 |
63 |
$682.23 |
| 71260 |
|
12 |
12 |
$499.63 |
| 71020 |
|
20 |
12 |
$485.96 |
| 83550 |
|
236 |
215 |
$483.53 |
| 72131 |
|
12 |
12 |
$473.76 |
| 85651 |
|
355 |
346 |
$426.02 |
| 83540 |
|
236 |
216 |
$407.87 |
| J1650 |
Inj enoxaparin sodium |
161 |
94 |
$391.19 |
| 93308 |
|
15 |
14 |
$387.54 |
| 73564 |
|
37 |
37 |
$380.91 |
| 86308 |
|
181 |
180 |
$373.24 |
| 87210 |
|
96 |
90 |
$370.88 |
| U0004 |
Cov-19 test non-cdc hgh thru |
419 |
363 |
$350.33 |
| A9577 |
Inj multihance |
28 |
28 |
$339.76 |
| J2001 |
Lidocaine injection |
234 |
220 |
$326.42 |
| 85652 |
|
309 |
304 |
$290.92 |
| T1999 |
Noc retail items andsupplies |
26 |
25 |
$270.20 |
| 71010 |
|
14 |
14 |
$208.46 |
| 83036 |
|
109 |
109 |
$207.25 |
| 97161 |
|
40 |
40 |
$207.23 |
| J2060 |
Lorazepam injection |
113 |
99 |
$176.28 |
| U0005 |
Infec agen detec ampli probe |
85 |
74 |
$175.00 |
| 72100 |
|
12 |
12 |
$171.20 |
| 88342 |
|
12 |
12 |
$158.22 |
| 73080 |
|
13 |
13 |
$154.27 |
| 90471 |
|
99 |
94 |
$133.80 |
| 94760 |
|
28 |
28 |
$131.05 |
| A9270 |
Non-covered item or service |
1,718 |
1,052 |
$64.84 |
| J2930 |
Methylprednisolone injection |
14 |
12 |
$48.14 |
| J1644 |
Inj heparin sodium per 1000u |
21 |
14 |
$45.42 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
20 |
16 |
$30.33 |
| 82270 |
|
26 |
24 |
$28.56 |
| J3010 |
Fentanyl citrate injection |
40 |
36 |
$25.63 |
| 82565 |
|
15 |
15 |
$19.48 |
| 82607 |
|
12 |
12 |
$15.30 |
| 84132 |
|
12 |
12 |
$13.53 |
| J8540 |
Oral dexamethasone |
262 |
258 |
$10.62 |
| 80307 |
|
16 |
12 |
$5.54 |
| U0003 |
Cov-19 amp prb hgh thruput |
129 |
118 |
$3.87 |
| 0272 |
|
24 |
24 |
$3.66 |
| G1004 |
Cdsm ndsc |
572 |
383 |
$0.02 |
| 0300 |
|
24 |
24 |
$0.00 |
| 96376 |
|
178 |
163 |
$0.00 |