| Code | Description | Claims | Beneficiaries | Total Paid |
| J0791 |
Inj crizanlizumab-tmca 5mg |
1,027 |
864 |
$5.98M |
| G0463 |
Hospital outpt clinic visit |
98,345 |
91,680 |
$3.60M |
| 99284 |
|
17,398 |
16,691 |
$1.16M |
| 99283 |
|
24,450 |
23,536 |
$944K |
| U0003 |
Cov-19 amp prb hgh thruput |
12,668 |
11,868 |
$600K |
| 85025 |
|
66,718 |
60,640 |
$564K |
| 99282 |
|
12,918 |
12,411 |
$543K |
| 80048 |
|
50,566 |
47,388 |
$515K |
| 36430 |
|
2,528 |
2,291 |
$291K |
| 80053 |
|
24,834 |
20,681 |
$256K |
| 87086 |
|
24,316 |
20,098 |
$250K |
| 88175 |
|
9,346 |
8,006 |
$202K |
| 70553 |
|
651 |
639 |
$198K |
| 93005 |
|
15,329 |
14,595 |
$192K |
| 83020 |
|
12,585 |
10,147 |
$176K |
| 36512 |
|
1,164 |
1,065 |
$133K |
| 87636 |
|
1,486 |
1,427 |
$133K |
| 86850 |
|
22,670 |
19,881 |
$126K |
| 96365 |
|
3,830 |
2,264 |
$123K |
| 83036 |
|
9,453 |
8,850 |
$120K |
| G2023 |
Specimen collect covid-19 |
6,852 |
6,377 |
$104K |
| A9502 |
Tc99m tetrofosmin |
1,133 |
1,085 |
$101K |
| 80306 |
|
7,894 |
6,774 |
$94K |
| 64615 |
|
535 |
532 |
$90K |
| 82728 |
|
9,585 |
8,781 |
$88K |
| 85027 |
|
18,917 |
15,526 |
$82K |
| 0001A |
|
2,735 |
2,515 |
$79K |
| 97110 |
|
2,870 |
969 |
$78K |
| 0002A |
|
2,337 |
2,241 |
$76K |
| J2785 |
Regadenoson injection |
647 |
625 |
$76K |
| 86832 |
|
724 |
574 |
$70K |
| 96366 |
|
1,986 |
1,207 |
$68K |
| 86833 |
|
719 |
574 |
$64K |
| 87624 |
|
3,907 |
3,349 |
$60K |
| 99233 |
Prolong inpt eval add15 m |
3,459 |
3,015 |
$59K |
| 86922 |
|
3,524 |
3,136 |
$59K |
| 86901 |
|
22,568 |
19,769 |
$58K |
| 86900 |
|
22,299 |
19,539 |
$58K |
| 83735 |
|
7,772 |
7,291 |
$57K |
| 87536 |
|
1,757 |
1,729 |
$53K |
| 85045 |
|
10,313 |
7,868 |
$51K |
| 96413 |
|
684 |
452 |
$48K |
| 82607 |
|
2,884 |
2,781 |
$48K |
| 83615 |
|
8,449 |
6,414 |
$47K |
| J2997 |
Alteplase recombinant |
843 |
779 |
$47K |
| 87661 |
|
2,246 |
2,196 |
$46K |
| 74183 |
|
113 |
113 |
$45K |
| 82950 |
|
6,518 |
5,488 |
$43K |
| 87077 |
|
5,695 |
4,771 |
$42K |
| 87631 |
|
895 |
820 |
$38K |
| 82746 |
|
2,747 |
2,645 |
$34K |
| 84443 |
|
2,060 |
1,988 |
$33K |
| 88305 |
|
1,844 |
1,733 |
$33K |
| 93306 |
|
429 |
421 |
$33K |
| 84466 |
|
1,958 |
1,832 |
$32K |
| 80076 |
|
4,353 |
4,081 |
$29K |
| 73610 |
|
2,126 |
1,997 |
$29K |
| 78451 |
|
385 |
370 |
$27K |
| 82570 |
|
6,042 |
5,303 |
$27K |
| 83970 |
|
417 |
412 |
$26K |
| 81001 |
|
7,055 |
6,708 |
$26K |
| 83880 |
|
905 |
847 |
$25K |
| 81025 |
|
7,009 |
6,724 |
$24K |
| 73630 |
|
1,792 |
1,729 |
$24K |
| 99281 |
|
486 |
470 |
$23K |
| 93017 |
|
1,233 |
1,192 |
$22K |
| 59025 |
|
4,345 |
3,847 |
$21K |
| G0480 |
Drug test def 1-7 classes |
408 |
399 |
$21K |
| 83540 |
|
3,281 |
3,143 |
$21K |
| 82565 |
|
2,894 |
2,420 |
$18K |
| 80061 |
|
1,034 |
1,020 |
$18K |
| 76815 |
|
775 |
700 |
$18K |
| 84156 |
|
5,823 |
5,112 |
$18K |
| 87522 |
Neg quan hep c or qual rna |
528 |
522 |
$17K |
| 87186 |
|
2,182 |
1,821 |
$17K |
| 77067 |
|
346 |
340 |
$17K |
| U0002 |
Covid-19 lab test non-cdc |
540 |
489 |
$16K |
| 31231 |
|
81 |
78 |
$14K |
| 84450 |
|
2,003 |
1,604 |
$14K |
| 72148 |
|
98 |
97 |
$13K |
| 84484 |
|
1,392 |
1,227 |
$13K |
| G0378 |
Hospital observation per hr |
114 |
110 |
$13K |
| 85610 |
|
3,291 |
3,104 |
$13K |
| 82306 |
|
1,603 |
1,564 |
$13K |
| 82043 |
|
3,053 |
2,827 |
$13K |
| 95886 |
|
607 |
581 |
$12K |
| 80197 |
|
2,213 |
1,774 |
$12K |
| 80307 |
|
247 |
241 |
$12K |
| 83550 |
|
1,583 |
1,503 |
$11K |
| 87804 |
|
955 |
926 |
$11K |
| 91320 |
|
84 |
83 |
$10K |
| 82977 |
|
1,756 |
1,648 |
$10K |
| J7297 |
Liletta, 52 mg |
14 |
14 |
$10K |
| 85007 |
|
2,356 |
1,839 |
$10K |
| 84439 |
|
1,121 |
1,077 |
$9K |
| 82105 |
|
663 |
651 |
$9K |
| 86780 |
|
510 |
459 |
$9K |
| 73502 |
|
708 |
693 |
$9K |
| 80069 |
|
1,676 |
1,337 |
$9K |
| 11042 |
|
49 |
38 |
$8K |
| 78452 |
|
58 |
56 |
$8K |
| 70551 |
|
61 |
61 |
$8K |
| 36455 |
|
44 |
43 |
$7K |
| 73564 |
|
439 |
430 |
$7K |
| 86160 |
|
569 |
557 |
$7K |
| 97112 |
|
456 |
181 |
$6K |
| 71046 |
|
666 |
644 |
$6K |
| 62323 |
|
37 |
37 |
$6K |
| 86902 |
|
2,178 |
1,941 |
$6K |
| 82951 |
|
780 |
618 |
$6K |
| M0243 |
Casirivi and imdevi inj |
31 |
31 |
$6K |
| 73562 |
|
314 |
307 |
$5K |
| 36415 |
|
3,954 |
3,391 |
$5K |
| 76642 |
|
163 |
158 |
$5K |
| 90686 |
|
288 |
285 |
$4K |
| 83690 |
|
568 |
547 |
$4K |
| 73030 |
|
408 |
389 |
$4K |
| 84702 |
|
324 |
216 |
$4K |
| 94729 |
|
235 |
224 |
$4K |
| 87880 |
|
225 |
219 |
$4K |
| 0003A |
|
125 |
123 |
$4K |
| 73620 |
|
333 |
325 |
$4K |
| 0053A |
|
92 |
91 |
$3K |
| 0124A |
|
90 |
89 |
$3K |
| 87426 |
|
136 |
132 |
$3K |
| 72110 |
|
171 |
167 |
$3K |
| 93303 |
|
64 |
63 |
$3K |
| 82952 |
|
779 |
617 |
$3K |
| 91200 |
|
41 |
39 |
$3K |
| 84681 |
|
209 |
206 |
$3K |
| 86225 |
|
264 |
260 |
$3K |
| 94010 |
|
310 |
299 |
$3K |
| 90480 |
|
85 |
84 |
$3K |
| 92587 |
|
81 |
79 |
$3K |
| 76770 |
|
72 |
71 |
$2K |
| 86677 |
|
118 |
116 |
$2K |
| J1170 |
Hydromorphone injection |
2,584 |
1,436 |
$2K |
| 85652 |
|
621 |
610 |
$2K |
| 97140 |
|
171 |
92 |
$2K |
| 84134 |
|
253 |
250 |
$2K |
| 82652 |
|
47 |
47 |
$2K |
| 76700 |
|
63 |
62 |
$2K |
| 92567 |
|
232 |
221 |
$2K |
| 87801 |
|
80 |
75 |
$2K |
| 92557 |
|
81 |
77 |
$2K |
| 94727 |
|
143 |
138 |
$2K |
| 85379 |
|
220 |
209 |
$2K |
| 74177 |
|
14 |
14 |
$2K |
| 51600 |
|
14 |
13 |
$2K |
| 74018 |
|
148 |
145 |
$2K |
| 86140 |
|
715 |
702 |
$1K |
| 96374 |
|
768 |
732 |
$1K |
| 73130 |
|
149 |
137 |
$1K |
| 87635 |
|
31 |
29 |
$1K |
| 95911 |
|
16 |
12 |
$1K |
| 71045 |
|
250 |
232 |
$1K |
| 86870 |
|
96 |
81 |
$1K |
| 97161 |
|
39 |
38 |
$1K |
| 87340 |
|
116 |
113 |
$1K |
| 73221 |
|
14 |
13 |
$1K |
| 73110 |
|
113 |
96 |
$1K |
| 83883 |
|
101 |
73 |
$1K |
| 36593 |
|
17 |
12 |
$1K |
| 86706 |
|
115 |
111 |
$1K |
| 0051A |
|
30 |
30 |
$1K |
| 85730 |
|
479 |
459 |
$1K |
| 96375 |
|
59 |
48 |
$1K |
| 92588 |
|
29 |
26 |
$1K |
| J0585 |
Injection,onabotulinumtoxina |
672 |
514 |
$943.95 |
| 82248 |
|
203 |
201 |
$928.75 |
| J1644 |
Inj heparin sodium per 1000u |
1,799 |
1,655 |
$907.90 |
| 86803 |
|
72 |
69 |
$904.32 |
| 72100 |
|
53 |
51 |
$833.90 |
| 86905 |
|
348 |
330 |
$822.96 |
| 82172 |
|
49 |
49 |
$821.88 |
| 88142 |
|
42 |
32 |
$797.21 |
| 70450 |
|
12 |
12 |
$778.61 |
| 80305 |
|
103 |
102 |
$768.87 |
| 86923 |
|
108 |
102 |
$714.31 |
| 0072A |
|
20 |
19 |
$680.00 |
| 85018 |
|
247 |
233 |
$643.61 |
| 0071A |
|
18 |
17 |
$640.00 |
| 87070 |
|
50 |
48 |
$630.27 |
| 86300 |
|
43 |
38 |
$608.35 |
| 99195 |
|
13 |
13 |
$600.66 |
| 86256 |
|
64 |
60 |
$564.90 |
| Q3014 |
Telehealth facility fee |
108 |
106 |
$561.51 |
| 82784 |
|
62 |
58 |
$548.00 |
| 86039 |
|
44 |
43 |
$493.50 |
| 81003 |
|
201 |
193 |
$479.78 |
| 82390 |
|
63 |
59 |
$459.61 |
| 82103 |
|
65 |
61 |
$448.14 |
| 83010 |
|
49 |
49 |
$436.32 |
| 97162 |
|
14 |
14 |
$434.80 |
| 93320 |
|
13 |
13 |
$373.74 |
| 70355 |
|
21 |
18 |
$373.16 |
| 73590 |
|
41 |
36 |
$370.50 |
| 86704 |
|
36 |
36 |
$358.96 |
| 87147 |
|
125 |
104 |
$303.94 |
| 83525 |
|
30 |
30 |
$303.30 |
| 76705 |
|
37 |
36 |
$303.20 |
| 93325 |
|
13 |
13 |
$276.36 |
| 81002 |
|
158 |
150 |
$274.72 |
| 73560 |
|
16 |
15 |
$238.98 |
| 80180 |
|
93 |
83 |
$224.26 |
| J1885 |
Ketorolac tromethamine inj |
301 |
286 |
$206.44 |
| 72052 |
|
14 |
13 |
$197.68 |
| 51797 |
|
14 |
13 |
$177.90 |
| 84165 |
|
27 |
25 |
$172.26 |
| 72190 |
|
16 |
15 |
$171.80 |
| 86038 |
|
16 |
14 |
$168.20 |
| 86592 |
|
25 |
24 |
$166.78 |
| 86790 |
|
12 |
12 |
$166.77 |
| 84460 |
|
29 |
26 |
$162.58 |
| 91010 |
|
12 |
12 |
$161.76 |
| 51784 |
|
14 |
13 |
$148.20 |
| 86200 |
|
12 |
12 |
$146.00 |
| 84100 |
|
31 |
31 |
$141.00 |
| 95885 |
|
14 |
12 |
$131.00 |
| 88304 |
|
12 |
12 |
$101.34 |
| 82040 |
|
13 |
13 |
$88.00 |
| J1650 |
Inj enoxaparin sodium |
20 |
13 |
$79.20 |
| J0690 |
Cefazolin sodium injection |
100 |
83 |
$78.58 |
| J2405 |
Ondansetron hcl injection |
425 |
390 |
$76.53 |
| 85613 |
|
12 |
12 |
$60.66 |
| 86431 |
|
12 |
12 |
$56.10 |
| C9803 |
Hopd covid-19 spec collect |
1,304 |
1,233 |
$45.11 |
| J3010 |
Fentanyl citrate injection |
1,172 |
1,116 |
$43.60 |
| J2704 |
Inj, propofol, 10 mg |
99 |
96 |
$30.09 |
| J0612 |
Inj, calcium gluconate, nos |
240 |
223 |
$29.20 |
| J1030 |
Methylprednisolone 40 mg inj |
176 |
169 |
$25.84 |
| 85014 |
|
15 |
13 |
$24.29 |
| J2270 |
Morphine sulfate injection |
14 |
13 |
$22.95 |
| J1100 |
Dexamethasone sodium phos |
208 |
195 |
$19.04 |
| 96372 |
|
871 |
840 |
$13.45 |
| J2250 |
Inj midazolam hydrochloride |
1,430 |
1,337 |
$13.26 |
| 82962 |
|
652 |
617 |
$7.26 |
| J3301 |
Triamcinolone acet inj nos |
25 |
24 |
$6.96 |
| G0008 |
Admin influenza virus vac |
15 |
15 |
$4.64 |
| J1642 |
Inj heparin sodium per 10 u |
41 |
26 |
$0.52 |
| 0001U |
|
18 |
18 |
$0.00 |
| 86361 |
|
504 |
498 |
$0.00 |
| 90656 |
|
29 |
29 |
$0.00 |
| 0241U |
|
706 |
678 |
$0.00 |
| 77063 |
|
319 |
314 |
$0.00 |
| C1769 |
Guide wire |
67 |
49 |
$0.00 |
| G0475 |
Hiv combination assay |
73 |
70 |
$0.00 |
| 90471 |
|
251 |
249 |
$0.00 |
| G9172 |
Voice goal status |
12 |
12 |
$0.00 |
| G0472 |
Hep c screen high risk/other |
38 |
37 |
$0.00 |
| Q0162 |
Ondansetron oral |
38 |
20 |
$0.00 |
| 74430 |
|
14 |
13 |
$0.00 |
| 93797 |
|
41 |
12 |
$0.00 |
| G9171 |
Voice current status |
12 |
12 |
$0.00 |
| P9016 |
Rbc leukocytes reduced |
1,659 |
1,535 |
$0.00 |
| Q9957 |
Inj perflutren lip micros,ml |
53 |
52 |
$0.00 |
| P9045 |
Albumin (human), 5%, 250 ml |
222 |
204 |
$0.00 |
| G0500 |
Mod sedat endo service >5yrs |
56 |
56 |
$0.00 |
| G8996 |
Swallow current status |
13 |
12 |
$0.00 |
| 91300 |
|
150 |
149 |
$0.00 |
| 87799 |
|
33 |
28 |
$0.00 |
| G8997 |
Swallow goal status |
13 |
12 |
$0.00 |