| Code | Description | Claims | Beneficiaries | Total Paid |
| 0450 |
|
294,228 |
254,117 |
$14.80M |
| 96374 |
|
94,333 |
84,782 |
$4.68M |
| 99281 |
|
28,217 |
23,278 |
$4.18M |
| 0241U |
|
36,825 |
34,628 |
$3.34M |
| 85025 |
|
208,298 |
176,925 |
$3.05M |
| 70450 |
|
26,560 |
24,855 |
$2.74M |
| 93005 |
|
103,774 |
92,984 |
$2.64M |
| 96375 |
|
72,596 |
64,078 |
$2.54M |
| Z7502 |
|
63,986 |
63,601 |
$2.46M |
| 74160 |
|
10,607 |
9,818 |
$1.92M |
| 74177 |
|
8,300 |
7,997 |
$1.82M |
| 0762 |
|
14,260 |
7,355 |
$1.76M |
| 85610 |
|
135,333 |
123,242 |
$1.67M |
| 80048 |
|
207,976 |
174,591 |
$1.63M |
| 96361 |
|
74,181 |
66,692 |
$1.51M |
| 80307 |
|
29,683 |
26,826 |
$1.47M |
| 99285 |
|
5,981 |
5,394 |
$1.28M |
| 96372 |
|
41,301 |
37,120 |
$1.10M |
| 96360 |
|
19,437 |
18,688 |
$1.02M |
| 71275 |
|
4,944 |
4,655 |
$936K |
| 74176 |
|
7,713 |
7,401 |
$925K |
| 80076 |
|
137,445 |
122,778 |
$912K |
| G0480 |
Drug test def 1-7 classes |
18,514 |
16,151 |
$903K |
| 71045 |
|
78,796 |
72,801 |
$897K |
| 83880 |
|
34,543 |
32,222 |
$893K |
| 83690 |
|
118,730 |
107,041 |
$836K |
| 0301 |
|
10,774 |
9,055 |
$802K |
| 0250 |
|
168,874 |
72,324 |
$796K |
| 84484 |
|
65,840 |
57,254 |
$757K |
| J7030 |
Normal saline solution infus |
94,998 |
81,603 |
$667K |
| U0002 |
Covid-19 lab test non-cdc |
14,079 |
13,192 |
$657K |
| 99199 |
|
15,898 |
13,800 |
$650K |
| Z7610 |
|
53,743 |
30,218 |
$589K |
| 0160 |
|
5,713 |
3,303 |
$577K |
| 72125 |
|
3,413 |
3,327 |
$543K |
| 99284 |
|
6,400 |
5,923 |
$513K |
| J2405 |
Ondansetron hcl injection |
75,167 |
66,271 |
$491K |
| 71046 |
|
22,480 |
21,282 |
$477K |
| 76700 |
|
5,965 |
5,702 |
$459K |
| 74150 |
|
3,512 |
3,339 |
$434K |
| 93971 |
|
4,129 |
3,919 |
$421K |
| 96365 |
|
7,289 |
6,898 |
$416K |
| 76705 |
|
6,956 |
6,650 |
$393K |
| 76801 |
|
7,322 |
6,332 |
$391K |
| 76830 |
|
6,117 |
5,826 |
$386K |
| J1885 |
Ketorolac tromethamine inj |
51,008 |
47,007 |
$379K |
| 0119 |
|
287 |
256 |
$363K |
| J2270 |
Morphine sulfate injection |
46,687 |
40,146 |
$341K |
| 70486 |
|
2,577 |
2,484 |
$334K |
| 93970 |
|
2,036 |
1,959 |
$329K |
| 87591 |
|
11,605 |
11,220 |
$323K |
| 87491 |
|
11,668 |
11,277 |
$322K |
| J3490 |
Drugs unclassified injection |
78,573 |
41,250 |
$310K |
| 76817 |
|
6,770 |
5,973 |
$307K |
| 87086 |
|
49,992 |
46,714 |
$302K |
| 84702 |
|
29,926 |
27,498 |
$296K |
| 99283 |
|
4,706 |
4,219 |
$288K |
| 94640 |
|
13,131 |
11,112 |
$272K |
| 81001 |
|
78,764 |
72,989 |
$262K |
| 93306 |
|
1,525 |
1,461 |
$237K |
| 82947 |
|
33,986 |
25,583 |
$236K |
| 0270 |
|
63,554 |
32,268 |
$212K |
| 70551 |
|
1,006 |
961 |
$202K |
| 87040 |
|
11,893 |
11,293 |
$175K |
| 72100 |
|
5,360 |
5,174 |
$162K |
| 96366 |
|
2,751 |
2,265 |
$162K |
| 73630 |
|
6,083 |
5,693 |
$153K |
| 76815 |
|
3,335 |
3,082 |
$148K |
| J0696 |
Ceftriaxone sodium injection |
26,371 |
24,177 |
$147K |
| 96376 |
|
5,933 |
5,217 |
$135K |
| 73610 |
|
5,212 |
4,965 |
$126K |
| 73130 |
|
4,819 |
4,521 |
$125K |
| 0761 |
|
4,505 |
3,791 |
$125K |
| 83605 |
|
12,486 |
11,603 |
$121K |
| 73562 |
|
4,728 |
4,378 |
$120K |
| 73030 |
|
5,093 |
4,798 |
$117K |
| 36415 |
|
79,063 |
66,045 |
$113K |
| 85730 |
|
17,358 |
16,678 |
$104K |
| 83036 |
|
6,760 |
6,349 |
$95K |
| 70496 |
|
543 |
522 |
$94K |
| J1815 |
Insulin injection |
11,661 |
6,139 |
$93K |
| J1650 |
Inj enoxaparin sodium |
3,044 |
1,636 |
$92K |
| 87631 |
|
2,191 |
2,161 |
$91K |
| 90715 |
|
2,977 |
2,937 |
$90K |
| 87186 |
|
12,414 |
11,878 |
$89K |
| 72131 |
|
691 |
675 |
$85K |
| 73564 |
|
2,446 |
2,348 |
$83K |
| 73110 |
|
2,842 |
2,696 |
$83K |
| 85379 |
|
8,372 |
8,082 |
$77K |
| 10060 |
|
1,888 |
1,771 |
$77K |
| 71260 |
|
487 |
476 |
$73K |
| J1170 |
Hydromorphone injection |
10,083 |
7,839 |
$71K |
| 0420 |
|
1,690 |
1,052 |
$70K |
| 81003 |
|
28,861 |
27,211 |
$69K |
| 70491 |
|
451 |
438 |
$69K |
| 82803 |
|
4,625 |
4,387 |
$66K |
| 73502 |
|
2,391 |
2,254 |
$65K |
| 80305 |
|
5,678 |
4,828 |
$63K |
| 80053 |
|
6,486 |
6,243 |
$63K |
| 73590 |
|
2,642 |
2,503 |
$63K |
| J1100 |
Dexamethasone sodium phos |
4,646 |
4,439 |
$63K |
| 74022 |
|
1,776 |
1,699 |
$63K |
| 73080 |
|
2,094 |
1,999 |
$60K |
| 74018 |
|
3,214 |
2,992 |
$60K |
| J1200 |
Diphenhydramine hcl injectio |
11,064 |
9,332 |
$59K |
| 83735 |
|
8,985 |
7,501 |
$59K |
| 76870 |
|
1,320 |
1,259 |
$58K |
| J2060 |
Lorazepam injection |
10,099 |
8,247 |
$57K |
| J2274 |
Inj morphine pf epid ithc |
3,560 |
3,235 |
$52K |
| 70498 |
|
348 |
337 |
$51K |
| J7042 |
5% dextrose/normal saline |
678 |
532 |
$50K |
| 94644 |
|
2,624 |
2,506 |
$45K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
23,554 |
22,665 |
$44K |
| 87077 |
|
6,488 |
6,190 |
$41K |
| 73140 |
|
2,078 |
1,984 |
$40K |
| J1644 |
Inj heparin sodium per 1000u |
3,102 |
1,323 |
$40K |
| 84443 |
|
3,084 |
2,951 |
$38K |
| 80061 |
|
4,487 |
4,225 |
$37K |
| 87426 |
|
1,143 |
1,031 |
$36K |
| 72040 |
|
1,364 |
1,328 |
$35K |
| 86900 |
|
3,075 |
2,990 |
$34K |
| 82550 |
|
6,098 |
5,636 |
$33K |
| J7040 |
Normal saline solution infus |
1,364 |
1,214 |
$32K |
| J2930 |
Methylprednisolone injection |
3,383 |
3,172 |
$32K |
| 73090 |
|
1,683 |
1,596 |
$32K |
| J1630 |
Haloperidol injection |
5,371 |
4,384 |
$31K |
| 12002 |
|
446 |
444 |
$30K |
| 86850 |
|
6,827 |
6,612 |
$30K |
| J3370 |
Vancomycin hcl injection |
2,064 |
1,398 |
$28K |
| J2765 |
Metoclopramide hcl injection |
5,495 |
4,974 |
$26K |
| 99221 |
|
421 |
342 |
$26K |
| 86140 |
|
5,283 |
5,141 |
$25K |
| J2543 |
Piperacillin/tazobactam |
1,934 |
1,555 |
$24K |
| 97802 |
|
397 |
380 |
$23K |
| 71250 |
|
176 |
171 |
$22K |
| J0561 |
Penicillin g benzathine inj |
213 |
208 |
$22K |
| 12001 |
|
168 |
166 |
$22K |
| 84100 |
|
4,028 |
3,201 |
$21K |
| 87210 |
|
6,208 |
5,992 |
$21K |
| 87880 |
|
2,640 |
2,563 |
$21K |
| 86901 |
|
7,059 |
6,824 |
$20K |
| G0378 |
Hospital observation per hr |
102 |
78 |
$20K |
| 87070 |
|
3,056 |
2,945 |
$20K |
| 29125 |
|
623 |
607 |
$19K |
| J0360 |
Hydralazine hcl injection |
2,176 |
1,887 |
$19K |
| 76770 |
|
270 |
260 |
$18K |
| 87635 |
|
451 |
436 |
$18K |
| 59025 |
|
1,643 |
1,323 |
$17K |
| J2001 |
Lidocaine injection |
4,783 |
4,667 |
$17K |
| Z9725 |
|
384 |
383 |
$17K |
| 85652 |
|
7,359 |
3,985 |
$16K |
| J7060 |
5% dextrose/water |
2,992 |
2,500 |
$16K |
| J1953 |
Levetiracetam injection |
1,699 |
1,485 |
$16K |
| 90471 |
|
4,024 |
3,949 |
$16K |
| J1940 |
Furosemide injection |
3,610 |
2,501 |
$15K |
| 70480 |
|
109 |
106 |
$15K |
| 80074 |
|
360 |
340 |
$15K |
| 29515 |
|
465 |
453 |
$15K |
| J3010 |
Fentanyl citrate injection |
3,027 |
2,872 |
$14K |
| 96367 |
|
477 |
443 |
$14K |
| 70547 |
|
114 |
108 |
$14K |
| J0780 |
Prochlorperazine injection |
1,369 |
1,319 |
$13K |
| J1171 |
Inj, hydromorphone, 0.1 mg |
287 |
238 |
$13K |
| 59050 |
|
2,051 |
1,693 |
$13K |
| 70544 |
|
123 |
116 |
$12K |
| 72070 |
|
472 |
460 |
$12K |
| 0760 |
|
626 |
572 |
$12K |
| Q0162 |
Ondansetron oral |
6,244 |
6,091 |
$12K |
| A4649 |
Surgical supplies |
12,140 |
6,813 |
$12K |
| 73552 |
|
548 |
513 |
$11K |
| 99499 |
|
38 |
24 |
$11K |
| 76856 |
|
205 |
200 |
$11K |
| 93880 |
|
84 |
81 |
$11K |
| 73060 |
|
435 |
423 |
$10K |
| 97750 |
|
268 |
254 |
$9K |
| 97161 |
|
219 |
215 |
$9K |
| 81025 |
|
1,850 |
1,814 |
$8K |
| 90686 |
|
561 |
548 |
$8K |
| 87184 |
|
1,600 |
1,516 |
$8K |
| J7120 |
Ringers lactate infusion |
1,543 |
1,177 |
$8K |
| 0324 |
|
698 |
655 |
$7K |
| 99070 |
|
3,518 |
1,352 |
$7K |
| J3475 |
Inj magnesium sulfate |
1,563 |
1,399 |
$7K |
| 73660 |
|
448 |
429 |
$7K |
| 11042 |
|
303 |
156 |
$7K |
| J1741 |
Ibuprofen injection |
631 |
608 |
$7K |
| 84145 |
|
409 |
397 |
$7K |
| J0461 |
Atropine sulfate injection |
863 |
835 |
$7K |
| 84439 |
|
882 |
850 |
$6K |
| 70360 |
|
218 |
216 |
$6K |
| 80185 |
|
542 |
483 |
$6K |
| 70487 |
|
47 |
47 |
$6K |
| 82805 |
|
176 |
166 |
$6K |
| 73700 |
|
49 |
48 |
$6K |
| C9113 |
Inj pantoprazole sodium, via |
1,018 |
768 |
$5K |
| J2250 |
Inj midazolam hydrochloride |
611 |
530 |
$5K |
| J3480 |
Inj potassium chloride |
300 |
226 |
$4K |
| 71101 |
|
154 |
150 |
$4K |
| 87804 |
|
696 |
648 |
$4K |
| 76641 |
|
67 |
64 |
$4K |
| 71020 |
|
191 |
131 |
$4K |
| 76819 |
|
110 |
92 |
$3K |
| 82140 |
|
318 |
293 |
$3K |
| 84481 |
|
276 |
251 |
$3K |
| A9270 |
Non-covered item or service |
1,679 |
601 |
$3K |
| J2358 |
Olanzapine long-acting inj |
72 |
62 |
$3K |
| 0636 |
|
1,584 |
1,379 |
$3K |
| 71010 |
|
325 |
307 |
$3K |
| 82728 |
|
303 |
296 |
$3K |
| J7512 |
Prednisone ir or dr oral 1mg |
1,108 |
1,020 |
$3K |
| J2920 |
Methylprednisolone injection |
265 |
232 |
$3K |
| J1956 |
Levofloxacin injection |
98 |
81 |
$3K |
| 72128 |
|
13 |
12 |
$2K |
| 86701 |
|
288 |
282 |
$2K |
| G0463 |
Hospital outpt clinic visit |
193 |
155 |
$2K |
| 72192 |
|
13 |
13 |
$2K |
| J2919 |
Inj, methylpred sod succ 5mg |
368 |
337 |
$2K |
| J2550 |
Promethazine hcl injection |
278 |
268 |
$2K |
| Z7500 |
|
51 |
43 |
$2K |
| 93000 |
|
56 |
53 |
$2K |
| 12011 |
|
49 |
48 |
$2K |
| 83615 |
|
333 |
325 |
$2K |
| 70490 |
|
14 |
14 |
$2K |
| J7050 |
Normal saline solution infus |
447 |
371 |
$2K |
| J3360 |
Diazepam injection |
107 |
95 |
$1K |
| 72148 |
|
12 |
12 |
$1K |
| J0456 |
Azithromycin |
294 |
257 |
$1K |
| J8540 |
Oral dexamethasone |
554 |
537 |
$1K |
| 86592 |
|
421 |
407 |
$1K |
| 87389 |
|
103 |
91 |
$1K |
| A0429 |
Bls-emergency |
34 |
28 |
$1K |
| J1165 |
Phenytoin sodium injection |
109 |
98 |
$1K |
| 87081 |
|
374 |
351 |
$1K |
| 87205 |
|
410 |
388 |
$1K |
| J0171 |
Adrenalin epinephrine inject |
40 |
38 |
$1K |
| 90656 |
|
30 |
30 |
$970.18 |
| 90935 |
|
38 |
24 |
$839.56 |
| J7510 |
Prednisolone oral per 5 mg |
160 |
160 |
$797.59 |
| 27502 |
|
12 |
12 |
$787.19 |
| J2470 |
Inj pantoprazole sodium 40mg |
176 |
142 |
$745.45 |
| 85007 |
|
854 |
788 |
$685.94 |
| 86922 |
|
25 |
25 |
$662.76 |
| 84550 |
|
146 |
141 |
$652.57 |
| 90714 |
|
60 |
59 |
$652.56 |
| 94664 |
|
94 |
61 |
$639.29 |
| 73000 |
|
25 |
24 |
$619.43 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
88 |
88 |
$494.69 |
| 86308 |
|
129 |
128 |
$410.44 |
| 97162 |
|
15 |
15 |
$388.27 |
| 72170 |
|
32 |
26 |
$380.33 |
| 87181 |
|
301 |
278 |
$358.90 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
56 |
42 |
$333.15 |
| 92558 |
|
115 |
115 |
$330.05 |
| 0430 |
|
15 |
12 |
$321.44 |
| Q2039 |
Influenza virus vaccine, nos |
18 |
13 |
$316.04 |
| J3410 |
Hydroxyzine hcl injection |
28 |
26 |
$303.84 |
| 73560 |
|
14 |
12 |
$284.43 |
| 36600 |
|
35 |
30 |
$271.86 |
| 85044 |
|
78 |
64 |
$263.10 |
| 87169 |
|
97 |
93 |
$238.20 |
| 0320 |
|
49 |
44 |
$229.52 |
| 0300 |
|
422 |
377 |
$226.99 |
| 85027 |
|
59 |
54 |
$223.62 |
| 84478 |
|
43 |
42 |
$198.25 |
| 83540 |
|
42 |
39 |
$190.26 |
| 82746 |
|
25 |
24 |
$173.81 |
| S0119 |
Ondansetron 4 mg |
57 |
56 |
$167.48 |
| J0690 |
Cefazolin sodium injection |
49 |
40 |
$133.66 |
| 10061 |
|
14 |
14 |
$120.00 |
| 0259 |
|
71 |
70 |
$114.40 |
| 86593 |
|
21 |
21 |
$90.24 |
| 99072 |
|
253 |
145 |
$73.47 |
| 0310 |
|
316 |
294 |
$49.60 |
| 0410 |
|
13 |
13 |
$49.10 |
| 85651 |
|
22 |
22 |
$46.11 |
| 0730 |
|
204 |
188 |
$29.84 |
| Q0163 |
Diphenhydramine hcl 50mg |
59 |
53 |
$8.35 |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
14 |
14 |
$3.80 |
| 0307 |
|
141 |
129 |
$0.00 |
| 99214 |
|
92 |
90 |
$0.00 |
| 0306 |
|
191 |
175 |
$0.00 |
| 0305 |
|
29 |
27 |
$0.00 |
| J7613 |
Albuterol non-comp unit |
91 |
77 |
$0.00 |
| S9445 |
Pt education noc individ |
429 |
192 |
$0.00 |
| 20553 |
|
159 |
149 |
$0.00 |
| 0949 |
|
27 |
24 |
$0.00 |
| Q4051 |
Splint supplies misc |
44 |
20 |
$0.00 |
| 99213 |
|
129 |
120 |
$0.00 |
| 0258 |
|
26 |
26 |
$0.00 |
| 0302 |
|
68 |
57 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
24 |
24 |
$0.00 |
| Q0144 |
Azithromycin dihydrate, oral |
84 |
80 |
$0.00 |
| 96413 |
|
62 |
48 |
$0.00 |
| 0402 |
|
15 |
15 |
$0.00 |
| 99211 |
|
27 |
15 |
$0.00 |
| 72275 |
|
12 |
12 |
$0.00 |