| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
|
28,123 |
24,468 |
$1.62M |
| J3490 |
Drugs unclassified injection |
7,363 |
6,069 |
$694K |
| 99070 |
|
17,595 |
7,896 |
$483K |
| 70450 |
|
1,532 |
1,475 |
$375K |
| 96374 |
|
4,135 |
3,876 |
$348K |
| 0450 |
|
5,596 |
4,863 |
$325K |
| 74177 |
|
1,161 |
1,120 |
$324K |
| 93005 |
|
7,597 |
6,952 |
$307K |
| 99221 |
|
365 |
139 |
$298K |
| 99218 |
|
535 |
274 |
$233K |
| 96375 |
|
2,915 |
2,701 |
$177K |
| G0480 |
Drug test def 1-7 classes |
2,041 |
1,866 |
$146K |
| 96361 |
|
2,833 |
2,582 |
$145K |
| 96372 |
|
4,070 |
3,849 |
$139K |
| 80053 |
|
13,337 |
12,222 |
$126K |
| 93306 |
|
389 |
380 |
$103K |
| Z7502 |
|
2,632 |
2,563 |
$96K |
| T1999 |
Noc retail items andsupplies |
2,618 |
2,242 |
$93K |
| 96365 |
|
807 |
777 |
$86K |
| 77067 |
|
715 |
709 |
$85K |
| 85025 |
|
14,466 |
13,030 |
$83K |
| 71046 |
|
3,014 |
2,935 |
$81K |
| 96360 |
|
796 |
756 |
$73K |
| 74176 |
|
471 |
461 |
$66K |
| 87502 |
|
852 |
821 |
$56K |
| 71045 |
|
3,378 |
3,204 |
$48K |
| 83880 |
|
2,045 |
1,914 |
$44K |
| 87491 |
|
1,661 |
1,612 |
$44K |
| 87591 |
|
1,663 |
1,614 |
$44K |
| J7030 |
Normal saline solution infus |
3,069 |
2,829 |
$42K |
| 76700 |
|
471 |
466 |
$39K |
| 83690 |
|
7,437 |
6,907 |
$39K |
| 76856 |
|
497 |
487 |
$37K |
| 84484 |
|
4,666 |
4,184 |
$35K |
| 76830 |
|
422 |
412 |
$31K |
| 72125 |
|
88 |
87 |
$29K |
| 71260 |
|
75 |
74 |
$29K |
| J2405 |
Ondansetron hcl injection |
2,227 |
2,044 |
$29K |
| 99231 |
|
102 |
51 |
$27K |
| 70498 |
|
69 |
69 |
$26K |
| 87811 |
|
1,806 |
1,703 |
$26K |
| 86703 |
|
2,402 |
2,328 |
$24K |
| 80306 |
|
1,516 |
1,444 |
$23K |
| J1885 |
Ketorolac tromethamine inj |
4,040 |
3,801 |
$23K |
| 93308 |
|
82 |
75 |
$21K |
| 73030 |
|
559 |
528 |
$20K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,499 |
1,438 |
$19K |
| 80307 |
|
524 |
486 |
$19K |
| 70496 |
|
45 |
45 |
$17K |
| 73630 |
|
569 |
533 |
$17K |
| 76801 |
|
265 |
252 |
$17K |
| 73562 |
|
499 |
449 |
$15K |
| 76705 |
|
153 |
146 |
$14K |
| 73610 |
|
382 |
374 |
$14K |
| 36415 |
|
3,135 |
2,715 |
$13K |
| 71250 |
|
40 |
40 |
$13K |
| 99232 |
|
71 |
71 |
$13K |
| 81001 |
|
4,851 |
4,642 |
$12K |
| 81025 |
|
4,064 |
3,868 |
$12K |
| J0696 |
Ceftriaxone sodium injection |
1,385 |
1,304 |
$12K |
| 73130 |
|
335 |
310 |
$11K |
| 84702 |
|
1,060 |
1,009 |
$10K |
| 80048 |
|
1,446 |
1,306 |
$10K |
| J2270 |
Morphine sulfate injection |
1,046 |
920 |
$9K |
| 99281 |
|
353 |
312 |
$9K |
| 83605 |
|
1,011 |
932 |
$9K |
| 87086 |
|
1,516 |
1,477 |
$9K |
| 87040 |
|
585 |
564 |
$9K |
| 99199 |
|
144 |
136 |
$9K |
| 90715 |
|
219 |
216 |
$9K |
| 81003 |
|
4,693 |
4,434 |
$8K |
| 70486 |
|
28 |
28 |
$7K |
| 99283 |
|
186 |
164 |
$7K |
| 87088 |
|
1,319 |
1,247 |
$7K |
| 93971 |
|
36 |
36 |
$7K |
| 94664 |
|
401 |
374 |
$7K |
| 84703 |
|
1,647 |
1,581 |
$7K |
| 82553 |
|
676 |
636 |
$7K |
| 72100 |
|
185 |
184 |
$7K |
| J1100 |
Dexamethasone sodium phos |
675 |
654 |
$6K |
| 83735 |
|
1,271 |
1,154 |
$6K |
| 86803 |
|
510 |
483 |
$6K |
| 87081 |
|
882 |
854 |
$5K |
| 87634 |
|
84 |
83 |
$5K |
| J1815 |
Insulin injection |
55 |
48 |
$5K |
| 94640 |
|
152 |
128 |
$5K |
| Z7610 |
|
388 |
246 |
$5K |
| 84443 |
|
381 |
365 |
$5K |
| 87186 |
|
829 |
810 |
$4K |
| 73560 |
|
169 |
152 |
$4K |
| 71275 |
|
13 |
12 |
$4K |
| J2765 |
Metoclopramide hcl injection |
713 |
657 |
$4K |
| 85610 |
|
1,339 |
1,291 |
$4K |
| 82550 |
|
754 |
720 |
$4K |
| J1200 |
Diphenhydramine hcl injectio |
623 |
587 |
$3K |
| J1170 |
Hydromorphone injection |
151 |
135 |
$3K |
| 76811 |
|
26 |
26 |
$3K |
| 87880 |
|
477 |
466 |
$3K |
| 87210 |
|
794 |
773 |
$3K |
| J7050 |
Normal saline solution infus |
496 |
459 |
$3K |
| 94060 |
|
27 |
27 |
$3K |
| J2060 |
Lorazepam injection |
453 |
415 |
$3K |
| 82803 |
|
132 |
124 |
$3K |
| 87804 |
|
312 |
306 |
$2K |
| 87077 |
|
228 |
221 |
$2K |
| 71271 |
|
16 |
16 |
$2K |
| 77066 |
Tomosynthesis, mammo |
12 |
12 |
$2K |
| J2250 |
Inj midazolam hydrochloride |
208 |
204 |
$2K |
| 85379 |
|
293 |
288 |
$2K |
| 76604 |
|
25 |
24 |
$2K |
| 93226 |
|
20 |
20 |
$2K |
| 82962 |
|
851 |
734 |
$2K |
| J3486 |
Ziprasidone mesylate |
83 |
78 |
$2K |
| 83036 |
|
251 |
244 |
$2K |
| 85027 |
|
303 |
262 |
$2K |
| 93225 |
|
20 |
20 |
$1K |
| 76775 |
|
13 |
13 |
$1K |
| 80143 |
|
123 |
117 |
$1K |
| 76817 |
|
29 |
24 |
$1K |
| 80179 |
|
118 |
112 |
$1K |
| 76815 |
|
13 |
13 |
$1K |
| J2001 |
Lidocaine injection |
64 |
62 |
$1K |
| 87341 |
|
185 |
182 |
$1K |
| 90471 |
|
223 |
217 |
$1K |
| 71010 |
|
52 |
49 |
$1K |
| 76642 |
|
14 |
14 |
$1K |
| 94729 |
|
14 |
14 |
$977.52 |
| 85730 |
|
227 |
219 |
$913.14 |
| J3010 |
Fentanyl citrate injection |
186 |
183 |
$896.54 |
| 94726 |
|
13 |
13 |
$893.97 |
| J7512 |
Prednisone ir or dr oral 1mg |
469 |
432 |
$888.05 |
| 86780 |
|
78 |
77 |
$877.80 |
| 87340 |
|
100 |
98 |
$875.52 |
| 0250 |
|
75 |
58 |
$827.18 |
| 87490 |
|
33 |
32 |
$689.09 |
| 73590 |
|
17 |
17 |
$665.10 |
| J0131 |
Inj, acetaminophen (nos) |
119 |
117 |
$665.05 |
| 90656 |
|
16 |
16 |
$664.96 |
| 71020 |
|
18 |
18 |
$624.01 |
| 73502 |
|
28 |
25 |
$620.46 |
| 73110 |
|
14 |
14 |
$597.14 |
| 87590 |
|
33 |
32 |
$575.09 |
| G0279 |
Tomosynthesis, mammo |
16 |
16 |
$518.08 |
| 82140 |
|
44 |
42 |
$474.22 |
| 82009 |
|
130 |
121 |
$467.98 |
| 94760 |
|
37 |
26 |
$448.71 |
| J2930 |
Methylprednisolone injection |
45 |
45 |
$416.11 |
| 86140 |
|
74 |
73 |
$331.20 |
| J3475 |
Inj magnesium sulfate |
31 |
28 |
$292.56 |
| J0780 |
Prochlorperazine injection |
13 |
13 |
$179.03 |
| S0164 |
Injection pantroprazole |
12 |
12 |
$172.63 |
| J3370 |
Vancomycin hcl injection |
13 |
13 |
$160.23 |
| 87400 |
|
13 |
13 |
$159.82 |
| 80061 |
|
14 |
14 |
$150.02 |
| J1644 |
Inj heparin sodium per 1000u |
39 |
38 |
$147.21 |
| 81015 |
|
73 |
66 |
$144.12 |
| 85007 |
|
47 |
44 |
$142.32 |
| 86901 |
|
55 |
53 |
$137.76 |
| 86900 |
|
55 |
53 |
$133.28 |
| J7040 |
Normal saline solution infus |
13 |
13 |
$116.73 |
| 87147 |
|
14 |
14 |
$105.27 |
| 88304 |
|
13 |
13 |
$98.54 |
| 86850 |
|
42 |
41 |
$96.20 |
| J1940 |
Furosemide injection |
14 |
13 |
$82.18 |
| 86885 |
|
15 |
15 |
$66.88 |
| 82010 |
|
15 |
13 |
$21.45 |
| J8540 |
Oral dexamethasone |
69 |
67 |
$7.79 |
| J7613 |
Albuterol non-comp unit |
18 |
16 |
$6.07 |
| 0250R |
|
98 |
93 |
$0.00 |
| 99285 |
|
14 |
14 |
$0.00 |