| Code | Description | Claims | Beneficiaries | Total Paid |
| 0450 |
|
16,417 |
14,944 |
$986K |
| 77067 |
|
3,724 |
3,719 |
$220K |
| 96374 |
|
3,342 |
3,015 |
$180K |
| 93005 |
|
8,749 |
6,679 |
$169K |
| 99285 |
|
1,468 |
1,279 |
$162K |
| 74177 |
|
1,083 |
1,039 |
$161K |
| 80053 |
|
16,666 |
15,619 |
$155K |
| 70450 |
|
1,316 |
1,245 |
$137K |
| 85025 |
|
19,622 |
17,763 |
$123K |
| 99284 |
|
2,203 |
1,934 |
$123K |
| 76700 |
|
1,563 |
1,536 |
$99K |
| 82306 |
|
5,756 |
5,700 |
$90K |
| 84443 |
|
7,313 |
7,197 |
$87K |
| 0214 |
|
64 |
63 |
$86K |
| 0360 |
|
471 |
462 |
$84K |
| 99281 |
|
1,767 |
1,497 |
$75K |
| 80061 |
|
11,293 |
11,187 |
$73K |
| 99283 |
|
1,893 |
1,714 |
$70K |
| 96375 |
|
1,912 |
1,731 |
$69K |
| 93306 |
|
574 |
551 |
$62K |
| 71046 |
|
3,281 |
3,186 |
$59K |
| 87502 |
|
993 |
965 |
$58K |
| 96361 |
|
2,391 |
2,148 |
$56K |
| 76856 |
|
894 |
885 |
$54K |
| 0121 |
|
27 |
27 |
$46K |
| 76830 |
|
736 |
731 |
$43K |
| 96360 |
|
834 |
770 |
$40K |
| 81001 |
|
12,242 |
11,665 |
$38K |
| 96372 |
|
1,501 |
1,384 |
$38K |
| 83036 |
|
8,144 |
8,041 |
$37K |
| 74178 |
|
185 |
185 |
$37K |
| 80307 |
|
550 |
522 |
$35K |
| 96365 |
|
630 |
530 |
$35K |
| 84484 |
|
3,471 |
2,950 |
$32K |
| 76770 |
|
698 |
691 |
$31K |
| 77065 |
Tomosynthesis, mammo |
414 |
412 |
$31K |
| 87635 |
|
795 |
750 |
$31K |
| 71045 |
|
3,940 |
3,616 |
$30K |
| 88305 |
|
772 |
736 |
$29K |
| 74176 |
|
381 |
367 |
$28K |
| 86480 |
|
711 |
705 |
$28K |
| 76642 |
|
492 |
487 |
$27K |
| J3490 |
Drugs unclassified injection |
9,131 |
4,655 |
$25K |
| 80048 |
|
6,473 |
6,100 |
$25K |
| 76536 |
|
479 |
472 |
$24K |
| C8929 |
Tte w or wo fol wcon,doppler |
183 |
182 |
$24K |
| 83690 |
|
2,673 |
2,456 |
$23K |
| Z7502 |
|
612 |
601 |
$22K |
| 71250 |
|
250 |
247 |
$22K |
| 77080 |
|
1,533 |
1,531 |
$19K |
| J7030 |
Normal saline solution infus |
2,663 |
2,377 |
$19K |
| U0004 |
Cov-19 test non-cdc hgh thru |
207 |
183 |
$18K |
| 81025 |
|
2,253 |
2,106 |
$18K |
| 84153 |
|
1,205 |
1,192 |
$17K |
| 87491 |
|
310 |
297 |
$17K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,916 |
1,834 |
$17K |
| 83880 |
|
1,537 |
1,405 |
$17K |
| 0111 |
|
19 |
18 |
$16K |
| 72110 |
|
392 |
390 |
$16K |
| 93017 |
|
331 |
301 |
$16K |
| 73564 |
|
567 |
543 |
$16K |
| 87086 |
|
2,994 |
2,856 |
$15K |
| G0480 |
Drug test def 1-7 classes |
245 |
224 |
$15K |
| 82043 |
|
5,418 |
5,347 |
$15K |
| 87591 |
|
271 |
258 |
$15K |
| 77066 |
Tomosynthesis, mammo |
134 |
134 |
$14K |
| 94640 |
|
739 |
628 |
$14K |
| C9803 |
Hopd covid-19 spec collect |
666 |
621 |
$13K |
| 99070 |
|
5,006 |
2,705 |
$12K |
| U0003 |
Cov-19 amp prb hgh thruput |
164 |
160 |
$12K |
| 73030 |
|
473 |
459 |
$12K |
| 82550 |
|
3,775 |
3,599 |
$11K |
| 84439 |
|
2,088 |
2,057 |
$11K |
| J1885 |
Ketorolac tromethamine inj |
1,825 |
1,615 |
$11K |
| 73630 |
|
455 |
446 |
$11K |
| 87880 |
|
669 |
659 |
$11K |
| 73610 |
|
416 |
403 |
$11K |
| 77412 |
|
158 |
12 |
$10K |
| 0710 |
|
236 |
231 |
$9K |
| 78815 |
|
14 |
14 |
$9K |
| 87040 |
|
655 |
439 |
$9K |
| 87186 |
|
1,242 |
1,199 |
$9K |
| 43239 |
|
276 |
268 |
$8K |
| 82274 |
|
1,627 |
1,612 |
$8K |
| 72148 |
|
24 |
24 |
$8K |
| 83605 |
|
729 |
646 |
$8K |
| 96413 |
|
366 |
160 |
$8K |
| J2405 |
Ondansetron hcl injection |
1,604 |
1,356 |
$7K |
| G0463 |
Hospital outpt clinic visit |
313 |
283 |
$7K |
| 93350 |
|
108 |
102 |
$7K |
| 84466 |
|
1,382 |
1,358 |
$7K |
| 72125 |
|
42 |
39 |
$7K |
| 85610 |
|
2,312 |
2,021 |
$7K |
| 86803 |
|
419 |
410 |
$6K |
| 45380 |
|
148 |
137 |
$6K |
| J2270 |
Morphine sulfate injection |
763 |
631 |
$6K |
| 87077 |
|
1,415 |
1,366 |
$6K |
| U0001 |
2019-ncov diagnostic p |
159 |
148 |
$6K |
| 83970 |
|
353 |
345 |
$5K |
| T1999 |
Noc retail items andsupplies |
1,044 |
617 |
$5K |
| 93971 |
|
57 |
56 |
$5K |
| 70551 |
|
12 |
12 |
$5K |
| 80069 |
|
1,212 |
1,142 |
$5K |
| 71260 |
|
39 |
39 |
$4K |
| 82962 |
|
1,153 |
625 |
$4K |
| 87389 |
|
234 |
231 |
$4K |
| 85730 |
|
765 |
732 |
$4K |
| J2175 |
Meperidine hydrochl /100 mg |
417 |
399 |
$4K |
| 84550 |
|
1,960 |
1,942 |
$4K |
| 82728 |
|
813 |
798 |
$4K |
| 83735 |
|
881 |
817 |
$4K |
| 83540 |
|
1,411 |
1,386 |
$4K |
| 80076 |
|
764 |
749 |
$3K |
| 73110 |
|
143 |
134 |
$3K |
| 71275 |
|
17 |
16 |
$3K |
| 73130 |
|
120 |
117 |
$3K |
| J0696 |
Ceftriaxone sodium injection |
511 |
426 |
$3K |
| 73721 |
|
12 |
12 |
$3K |
| J1100 |
Dexamethasone sodium phos |
531 |
447 |
$3K |
| 99282 |
|
141 |
135 |
$3K |
| 84481 |
|
372 |
364 |
$3K |
| 87340 |
|
289 |
284 |
$3K |
| 85379 |
|
238 |
231 |
$3K |
| 82607 |
|
1,543 |
1,530 |
$3K |
| 82746 |
|
453 |
442 |
$2K |
| J2250 |
Inj midazolam hydrochloride |
503 |
480 |
$2K |
| 72100 |
|
88 |
85 |
$2K |
| J7050 |
Normal saline solution infus |
816 |
444 |
$2K |
| 85027 |
|
679 |
672 |
$2K |
| 82553 |
|
197 |
174 |
$2K |
| 84460 |
|
1,508 |
1,494 |
$2K |
| 94060 |
|
68 |
66 |
$2K |
| 94010 |
|
328 |
287 |
$2K |
| 94644 |
|
75 |
70 |
$2K |
| 86706 |
|
166 |
164 |
$2K |
| 72050 |
|
39 |
39 |
$2K |
| 86780 |
|
202 |
190 |
$2K |
| 82040 |
|
679 |
609 |
$2K |
| 0250 |
|
285 |
187 |
$1K |
| 87798 |
|
29 |
29 |
$1K |
| 93010 |
|
366 |
295 |
$1K |
| 84450 |
|
680 |
672 |
$1K |
| 85652 |
|
1,010 |
967 |
$1K |
| 84100 |
|
538 |
503 |
$1K |
| 0510 |
|
31 |
28 |
$1K |
| J2060 |
Lorazepam injection |
231 |
205 |
$1K |
| 11042 |
|
50 |
25 |
$1K |
| 82378 |
|
85 |
78 |
$1K |
| 36415 |
|
15,186 |
13,665 |
$993.44 |
| 81005 |
|
291 |
283 |
$816.44 |
| 99199 |
|
16 |
15 |
$778.23 |
| 82150 |
|
114 |
111 |
$744.54 |
| 74018 |
|
44 |
38 |
$722.59 |
| J2765 |
Metoclopramide hcl injection |
135 |
118 |
$691.77 |
| 86038 |
|
230 |
226 |
$680.14 |
| 96366 |
|
32 |
27 |
$635.71 |
| 87070 |
|
68 |
66 |
$627.42 |
| J1200 |
Diphenhydramine hcl injectio |
109 |
105 |
$543.86 |
| 86901 |
|
99 |
95 |
$479.64 |
| J7120 |
Ringers lactate infusion |
63 |
53 |
$463.56 |
| 85611 |
|
61 |
58 |
$393.03 |
| 72114 |
|
12 |
12 |
$387.82 |
| 45378 |
|
16 |
14 |
$381.30 |
| J7040 |
Normal saline solution infus |
85 |
76 |
$332.81 |
| Z7610 |
|
41 |
24 |
$326.64 |
| 86900 |
|
100 |
96 |
$317.96 |
| 83520 |
|
55 |
54 |
$312.08 |
| 94729 |
|
14 |
14 |
$305.88 |
| 94726 |
|
14 |
14 |
$280.38 |
| A9585 |
Gadobutrol injection |
29 |
29 |
$267.33 |
| 73565 |
|
12 |
12 |
$264.07 |
| 72070 |
|
12 |
12 |
$262.14 |
| 82565 |
|
114 |
113 |
$262.08 |
| 82248 |
|
108 |
104 |
$244.90 |
| 84156 |
|
285 |
255 |
$204.97 |
| 73080 |
|
12 |
12 |
$202.18 |
| J1170 |
Hydromorphone injection |
43 |
29 |
$195.69 |
| 80074 |
|
12 |
12 |
$177.66 |
| J3010 |
Fentanyl citrate injection |
46 |
37 |
$162.01 |
| 85007 |
|
76 |
76 |
$150.08 |
| J2704 |
Inj, propofol, 10 mg |
17 |
14 |
$123.19 |
| 83883 |
|
14 |
14 |
$122.80 |
| 82947 |
|
30 |
30 |
$117.39 |
| J2930 |
Methylprednisolone injection |
12 |
12 |
$106.44 |
| 84075 |
|
75 |
75 |
$87.02 |
| 82105 |
|
27 |
25 |
$67.88 |
| 86140 |
|
33 |
31 |
$60.40 |
| 84132 |
|
32 |
26 |
$60.16 |
| 82272 |
|
84 |
84 |
$51.02 |
| 82533 |
|
14 |
14 |
$30.91 |
| 86334 |
|
12 |
12 |
$29.25 |
| 86800 |
|
27 |
27 |
$28.54 |
| 0272 |
|
108 |
107 |
$22.14 |
| 86431 |
|
13 |
13 |
$17.85 |
| 83516 |
|
16 |
15 |
$17.20 |
| 82985 |
|
80 |
79 |
$16.41 |
| 86376 |
|
13 |
13 |
$13.16 |
| 85045 |
|
13 |
13 |
$0.00 |
| 0300 |
|
168 |
163 |
$0.00 |
| 0320 |
|
149 |
145 |
$0.00 |
| 0424 |
|
44 |
43 |
$0.00 |
| 82088 |
|
13 |
13 |
$0.00 |
| 0730 |
|
93 |
92 |
$0.00 |
| 0412 |
|
26 |
25 |
$0.00 |
| 0302 |
|
15 |
15 |
$0.00 |
| 0483 |
|
24 |
24 |
$0.00 |
| A9270 |
Non-covered item or service |
1,350 |
941 |
$0.00 |
| G0103 |
Psa screening |
459 |
458 |
$0.00 |
| 0301 |
|
169 |
164 |
$0.00 |
| 0258 |
|
155 |
150 |
$0.00 |
| U0002 |
Covid-19 lab test non-cdc |
126 |
121 |
$0.00 |
| 0271 |
|
44 |
42 |
$0.00 |
| 0305 |
|
139 |
136 |
$0.00 |
| 0352 |
|
14 |
14 |
$0.00 |
| 0420 |
|
42 |
41 |
$0.00 |
| 0306 |
|
129 |
125 |
$0.00 |
| 84244 |
|
13 |
13 |
$0.00 |
| G0378 |
Hospital observation per hr |
30 |
29 |
$0.00 |
| 0255 |
|
14 |
13 |
$0.00 |
| 0307 |
|
39 |
38 |
$0.00 |