| Code | Description | Claims | Beneficiaries | Total Paid |
| 80053 |
|
20,731 |
15,788 |
$350K |
| 87636 |
|
3,971 |
3,238 |
$338K |
| 80307 |
|
4,250 |
3,258 |
$250K |
| 70450 |
|
2,979 |
2,427 |
$234K |
| 74177 |
|
1,569 |
1,215 |
$162K |
| U0003 |
Cov-19 amp prb hgh thruput |
2,246 |
1,823 |
$148K |
| 85025 |
|
23,734 |
17,440 |
$135K |
| 99283 |
|
2,933 |
2,378 |
$83K |
| 99284 |
|
4,182 |
3,372 |
$69K |
| 93005 |
|
8,405 |
6,146 |
$62K |
| 99285 |
|
3,383 |
2,673 |
$58K |
| 96372 |
|
2,586 |
1,922 |
$52K |
| 87804 |
|
2,664 |
2,052 |
$46K |
| 71046 |
|
3,104 |
2,571 |
$45K |
| 80048 |
|
3,891 |
2,947 |
$44K |
| 36415 |
|
7,988 |
6,141 |
$42K |
| 74176 |
|
840 |
674 |
$41K |
| U0002 |
Covid-19 lab test non-cdc |
1,068 |
893 |
$40K |
| 80061 |
|
3,841 |
3,295 |
$39K |
| 84484 |
|
6,552 |
4,097 |
$38K |
| 83880 |
|
2,267 |
1,704 |
$38K |
| 71045 |
|
6,109 |
4,772 |
$38K |
| 84443 |
|
3,261 |
2,683 |
$34K |
| 77067 |
|
664 |
616 |
$31K |
| 84703 |
|
3,625 |
2,836 |
$30K |
| 87430 |
|
2,885 |
2,497 |
$29K |
| 86901 |
|
1,156 |
934 |
$26K |
| 73630 |
|
1,284 |
1,094 |
$26K |
| 87086 |
|
3,712 |
3,004 |
$25K |
| 73560 |
|
1,134 |
1,008 |
$24K |
| 81001 |
|
8,508 |
6,632 |
$24K |
| 72100 |
|
1,021 |
874 |
$22K |
| 82306 |
|
804 |
656 |
$21K |
| 87040 |
|
2,738 |
1,440 |
$21K |
| 74018 |
|
1,187 |
987 |
$20K |
| 83036 |
|
2,810 |
2,435 |
$20K |
| 96365 |
|
897 |
594 |
$20K |
| 87807 |
|
1,784 |
1,590 |
$20K |
| 76805 |
|
564 |
502 |
$18K |
| 92507 |
|
438 |
128 |
$18K |
| 96374 |
|
1,966 |
1,488 |
$16K |
| 85027 |
|
3,083 |
2,580 |
$16K |
| 83690 |
|
3,093 |
2,397 |
$16K |
| 96375 |
|
1,308 |
1,000 |
$13K |
| 97110 |
|
356 |
99 |
$12K |
| 80320 |
|
782 |
615 |
$10K |
| 84702 |
|
1,088 |
849 |
$10K |
| 83605 |
|
1,470 |
982 |
$10K |
| 82962 |
|
2,923 |
1,286 |
$9K |
| 73030 |
|
562 |
481 |
$9K |
| 73130 |
|
450 |
378 |
$9K |
| 72125 |
|
59 |
51 |
$7K |
| 87077 |
|
1,024 |
880 |
$7K |
| 96361 |
|
569 |
417 |
$7K |
| 86850 |
|
918 |
755 |
$7K |
| 94640 |
|
2,367 |
1,513 |
$6K |
| 87081 |
|
757 |
697 |
$6K |
| 72148 |
|
38 |
27 |
$6K |
| 82553 |
|
921 |
653 |
$5K |
| 73610 |
|
332 |
308 |
$5K |
| J0696 |
Ceftriaxone sodium injection |
483 |
410 |
$5K |
| 72040 |
|
206 |
189 |
$5K |
| 83735 |
|
1,327 |
1,031 |
$5K |
| 86762 |
|
297 |
271 |
$5K |
| 81005 |
|
2,601 |
2,042 |
$5K |
| 87186 |
|
1,024 |
879 |
$5K |
| J1885 |
Ketorolac tromethamine inj |
1,715 |
1,405 |
$5K |
| 71020 |
|
335 |
313 |
$5K |
| 80076 |
|
476 |
409 |
$5K |
| 86900 |
|
1,159 |
935 |
$5K |
| J2405 |
Ondansetron hcl injection |
1,218 |
995 |
$4K |
| 82550 |
|
1,029 |
726 |
$4K |
| 85730 |
|
999 |
799 |
$4K |
| 85610 |
|
1,660 |
1,306 |
$3K |
| 76856 |
|
134 |
109 |
$3K |
| 86592 |
|
704 |
633 |
$3K |
| 87205 |
|
932 |
687 |
$3K |
| 71010 |
|
433 |
368 |
$3K |
| 86703 |
|
152 |
136 |
$3K |
| 85378 |
|
485 |
432 |
$2K |
| 82947 |
|
499 |
441 |
$2K |
| G0480 |
Drug test def 1-7 classes |
634 |
431 |
$2K |
| 71260 |
|
15 |
12 |
$2K |
| 80050 |
|
45 |
43 |
$2K |
| 82150 |
|
431 |
375 |
$2K |
| 80143 |
|
104 |
78 |
$1K |
| 80179 |
|
91 |
66 |
$1K |
| 73502 |
|
74 |
67 |
$1K |
| 87591 |
|
39 |
33 |
$1K |
| 87491 |
|
39 |
33 |
$1K |
| 73110 |
|
88 |
67 |
$1K |
| 71250 |
|
15 |
12 |
$1K |
| 87340 |
|
113 |
101 |
$1K |
| 93971 |
|
30 |
24 |
$1K |
| 72070 |
|
61 |
58 |
$1K |
| 87070 |
|
154 |
135 |
$1K |
| 82728 |
|
64 |
57 |
$997.71 |
| 84439 |
|
92 |
82 |
$964.60 |
| 85660 |
|
140 |
130 |
$939.85 |
| 84436 |
|
125 |
90 |
$889.30 |
| 87210 |
|
141 |
130 |
$732.70 |
| 86803 |
|
44 |
39 |
$709.79 |
| T1015 |
Clinic service |
61 |
38 |
$700.29 |
| 74000 |
|
39 |
29 |
$631.28 |
| 82565 |
|
66 |
54 |
$591.70 |
| 84480 |
|
40 |
27 |
$560.95 |
| 85379 |
|
98 |
64 |
$558.82 |
| 97001 |
|
14 |
12 |
$543.84 |
| 81025 |
|
91 |
85 |
$532.77 |
| 82677 |
|
14 |
14 |
$527.43 |
| 74010 |
|
33 |
26 |
$525.00 |
| 80164 |
|
17 |
12 |
$502.24 |
| 87389 |
|
14 |
13 |
$452.77 |
| 74021 |
|
14 |
14 |
$375.79 |
| 82105 |
|
14 |
14 |
$365.72 |
| 82803 |
|
44 |
24 |
$359.19 |
| 84520 |
|
64 |
53 |
$334.29 |
| 86336 |
|
14 |
14 |
$332.43 |
| 99282 |
|
94 |
90 |
$312.48 |
| 82607 |
|
28 |
20 |
$281.48 |
| 36600 |
|
27 |
12 |
$278.11 |
| 70360 |
|
28 |
24 |
$272.28 |
| J7030 |
Normal saline solution infus |
1,591 |
1,023 |
$259.87 |
| 83540 |
|
36 |
30 |
$249.75 |
| 81003 |
|
167 |
156 |
$243.88 |
| 82746 |
|
14 |
12 |
$232.68 |
| G0463 |
Hospital outpt clinic visit |
139 |
75 |
$219.21 |
| 84550 |
|
61 |
47 |
$207.65 |
| 97150 |
|
45 |
14 |
$174.03 |
| J1100 |
Dexamethasone sodium phos |
90 |
69 |
$147.14 |
| 85651 |
|
41 |
38 |
$121.68 |
| 81002 |
|
52 |
50 |
$117.12 |
| 71271 |
|
16 |
14 |
$116.60 |
| 82270 |
|
30 |
29 |
$55.68 |
| J2550 |
Promethazine hcl injection |
77 |
70 |
$43.52 |
| J2270 |
Morphine sulfate injection |
175 |
150 |
$34.84 |
| 90471 |
|
14 |
12 |
$29.83 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
623 |
441 |
$6.65 |
| 87635 |
|
87 |
64 |
$5.92 |
| G1004 |
Cdsm ndsc |
1,523 |
1,101 |
$0.02 |
| J7050 |
Normal saline solution infus |
71 |
60 |
$0.00 |
| Q0162 |
Ondansetron oral |
204 |
185 |
$0.00 |
| G0378 |
Hospital observation per hr |
296 |
216 |
$0.00 |
| J1170 |
Hydromorphone injection |
30 |
25 |
$0.00 |
| J0360 |
Hydralazine hcl injection |
14 |
13 |
$0.00 |
| J2930 |
Methylprednisolone injection |
18 |
14 |
$0.00 |