| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
6,078 |
5,357 |
$849K |
| 99283 |
|
7,182 |
6,448 |
$600K |
| 99285 |
|
1,983 |
1,747 |
$389K |
| J1885 |
Ketorolac tromethamine inj |
1,203 |
1,054 |
$61K |
| 96372 |
|
2,633 |
2,141 |
$60K |
| 93005 |
|
2,146 |
1,814 |
$48K |
| 80053 |
|
8,075 |
6,814 |
$46K |
| 80050 |
|
1,089 |
985 |
$41K |
| 96375 |
|
511 |
409 |
$41K |
| 85025 |
|
9,943 |
8,191 |
$40K |
| 74176 |
|
79 |
69 |
$36K |
| 71045 |
|
925 |
816 |
$26K |
| 96374 |
|
745 |
608 |
$25K |
| 87426 |
|
840 |
746 |
$23K |
| 71046 |
|
797 |
717 |
$21K |
| 93306 |
|
69 |
62 |
$18K |
| 80061 |
|
1,720 |
1,574 |
$18K |
| 82306 |
|
639 |
579 |
$15K |
| 36415 |
|
6,580 |
5,284 |
$10K |
| 83036 |
|
1,270 |
1,164 |
$10K |
| 80307 |
|
220 |
186 |
$9K |
| 70450 |
|
65 |
56 |
$9K |
| 96361 |
|
480 |
353 |
$9K |
| 74177 |
|
19 |
16 |
$8K |
| 87804 |
|
693 |
597 |
$8K |
| 82607 |
|
600 |
555 |
$8K |
| 43239 |
|
77 |
39 |
$7K |
| J2405 |
Ondansetron hcl injection |
334 |
286 |
$5K |
| 83880 |
|
282 |
251 |
$5K |
| 81003 |
|
3,624 |
3,112 |
$5K |
| 84484 |
|
799 |
666 |
$5K |
| 83735 |
|
983 |
887 |
$5K |
| 84439 |
|
583 |
537 |
$4K |
| J0696 |
Ceftriaxone sodium injection |
162 |
135 |
$4K |
| 96365 |
|
83 |
72 |
$3K |
| 87880 |
|
269 |
234 |
$3K |
| J1100 |
Dexamethasone sodium phos |
119 |
105 |
$3K |
| 81025 |
|
358 |
312 |
$2K |
| 87801 |
|
43 |
40 |
$2K |
| U0003 |
Cov-19 amp prb hgh thruput |
29 |
29 |
$2K |
| J2704 |
Inj, propofol, 10 mg |
1,125 |
876 |
$2K |
| 93041 |
|
49 |
44 |
$2K |
| J3490 |
Drugs unclassified injection |
572 |
313 |
$2K |
| 82553 |
|
320 |
277 |
$2K |
| 94762 |
|
38 |
38 |
$2K |
| 99281 |
|
34 |
33 |
$1K |
| 82550 |
|
304 |
263 |
$871.38 |
| 83690 |
|
148 |
132 |
$674.03 |
| 87400 |
|
82 |
73 |
$663.47 |
| 84481 |
|
52 |
51 |
$652.02 |
| 80048 |
|
144 |
124 |
$650.20 |
| 82746 |
|
47 |
44 |
$646.80 |
| 82150 |
|
125 |
111 |
$517.35 |
| J2250 |
Inj midazolam hydrochloride |
295 |
248 |
$506.47 |
| J1335 |
Ertapenem injection |
35 |
25 |
$431.24 |
| 81001 |
|
230 |
193 |
$390.16 |
| J2930 |
Methylprednisolone injection |
16 |
13 |
$349.92 |
| 85730 |
|
118 |
105 |
$331.64 |
| Q0162 |
Ondansetron oral |
32 |
28 |
$329.43 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
26 |
22 |
$325.40 |
| 84436 |
|
54 |
51 |
$289.52 |
| 85610 |
|
123 |
109 |
$252.76 |
| 83540 |
|
53 |
49 |
$252.33 |
| 83550 |
|
27 |
27 |
$231.77 |
| J2270 |
Morphine sulfate injection |
16 |
16 |
$230.01 |
| 87449 |
|
19 |
16 |
$204.20 |
| 87086 |
|
44 |
39 |
$201.75 |
| 84443 |
|
18 |
15 |
$156.00 |
| J3010 |
Fentanyl citrate injection |
135 |
94 |
$155.10 |
| 80178 |
|
29 |
28 |
$138.81 |
| 87070 |
|
14 |
13 |
$129.09 |
| 87040 |
|
16 |
13 |
$103.20 |
| 83605 |
|
16 |
12 |
$80.99 |
| 83874 |
|
15 |
12 |
$52.52 |
| 94664 |
|
15 |
12 |
$0.00 |