| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
|
9,265 |
8,454 |
$3.37M |
| 74177 |
|
587 |
566 |
$841K |
| 70450 |
|
840 |
820 |
$520K |
| 96374 |
|
2,285 |
2,148 |
$427K |
| 80053 |
|
4,657 |
4,191 |
$386K |
| 93005 |
|
2,930 |
2,633 |
$365K |
| 96375 |
|
1,835 |
1,695 |
$246K |
| 96361 |
|
1,505 |
1,428 |
$169K |
| 71045 |
|
2,457 |
2,333 |
$135K |
| 99284 |
|
807 |
768 |
$131K |
| 96365 |
|
876 |
812 |
$128K |
| 84512 |
|
1,439 |
1,252 |
$116K |
| 81025 |
|
2,101 |
1,862 |
$93K |
| 83690 |
|
1,659 |
1,553 |
$90K |
| 99283 |
|
673 |
651 |
$90K |
| 96372 |
|
833 |
789 |
$87K |
| 85025 |
|
5,571 |
4,967 |
$81K |
| 99281 |
|
1,697 |
1,577 |
$75K |
| J3490 |
Drugs unclassified injection |
4,665 |
2,705 |
$75K |
| 93017 |
|
160 |
143 |
$72K |
| 96360 |
|
498 |
485 |
$69K |
| 99285 |
|
127 |
124 |
$65K |
| 74176 |
|
56 |
55 |
$61K |
| 71046 |
|
788 |
765 |
$59K |
| 80048 |
|
960 |
910 |
$57K |
| 83880 |
|
834 |
802 |
$53K |
| 87086 |
|
1,261 |
1,204 |
$53K |
| 83605 |
|
950 |
832 |
$49K |
| 76377 |
|
246 |
226 |
$48K |
| 85610 |
|
1,537 |
1,422 |
$38K |
| 87633 |
|
171 |
170 |
$37K |
| 36415 |
|
2,329 |
1,962 |
$35K |
| 81003 |
|
2,739 |
2,472 |
$29K |
| 76700 |
|
73 |
72 |
$27K |
| 99199 |
|
571 |
538 |
$27K |
| J7030 |
Normal saline solution infus |
2,305 |
2,049 |
$26K |
| 87040 |
|
259 |
143 |
$24K |
| 81001 |
|
1,859 |
1,753 |
$23K |
| 87798 |
|
360 |
352 |
$20K |
| 97110 |
|
2,039 |
506 |
$17K |
| 76705 |
|
72 |
69 |
$16K |
| J2270 |
Morphine sulfate injection |
1,017 |
858 |
$16K |
| J2405 |
Ondansetron hcl injection |
1,548 |
1,403 |
$15K |
| U0003 |
Cov-19 amp prb hgh thruput |
172 |
166 |
$15K |
| 84484 |
|
624 |
499 |
$14K |
| 87077 |
|
521 |
505 |
$14K |
| G0480 |
Drug test def 1-7 classes |
125 |
108 |
$12K |
| 0250 |
|
1,074 |
718 |
$12K |
| 97140 |
|
1,063 |
259 |
$11K |
| 80306 |
|
169 |
163 |
$11K |
| 84443 |
|
551 |
533 |
$11K |
| J1885 |
Ketorolac tromethamine inj |
1,051 |
999 |
$10K |
| 76856 |
|
25 |
25 |
$9K |
| 87641 |
|
158 |
150 |
$8K |
| 85379 |
|
151 |
145 |
$8K |
| 87651 |
|
192 |
190 |
$8K |
| 99282 |
|
72 |
68 |
$8K |
| 94664 |
|
104 |
99 |
$7K |
| 94760 |
|
414 |
398 |
$6K |
| 96376 |
|
162 |
150 |
$6K |
| Z7502 |
|
154 |
147 |
$6K |
| U0001 |
2019-ncov diagnostic p |
219 |
214 |
$6K |
| G0463 |
Hospital outpt clinic visit |
279 |
212 |
$6K |
| 87276 |
|
612 |
600 |
$5K |
| 82948 |
|
584 |
395 |
$5K |
| 0636 |
|
96 |
86 |
$5K |
| 0637 |
|
1,483 |
914 |
$5K |
| 87186 |
|
166 |
163 |
$5K |
| 87275 |
|
607 |
596 |
$4K |
| 87581 |
|
172 |
170 |
$4K |
| 0270 |
|
861 |
508 |
$4K |
| 87486 |
|
171 |
170 |
$4K |
| 94640 |
|
85 |
75 |
$3K |
| 87430 |
|
115 |
114 |
$3K |
| 87081 |
|
76 |
76 |
$3K |
| J1100 |
Dexamethasone sodium phos |
229 |
219 |
$2K |
| 97112 |
|
92 |
26 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
157 |
149 |
$2K |
| J7040 |
Normal saline solution infus |
158 |
150 |
$2K |
| J7120 |
Ringers lactate infusion |
147 |
141 |
$2K |
| 96366 |
|
34 |
33 |
$1K |
| J1170 |
Hydromorphone injection |
137 |
113 |
$1K |
| 85730 |
|
118 |
110 |
$1K |
| 0251 |
|
364 |
340 |
$1K |
| U0004 |
Cov-19 test non-cdc hgh thru |
12 |
12 |
$1K |
| 80061 |
|
183 |
182 |
$1K |
| 97161 |
|
12 |
12 |
$1K |
| J2060 |
Lorazepam injection |
111 |
96 |
$1K |
| 0202U |
|
44 |
44 |
$1K |
| 87661 |
|
27 |
26 |
$822.14 |
| 0324 |
|
12 |
12 |
$702.03 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
39 |
38 |
$626.30 |
| 83735 |
|
56 |
47 |
$435.29 |
| 83036 |
|
64 |
63 |
$337.97 |
| J1200 |
Diphenhydramine hcl injectio |
33 |
29 |
$326.75 |
| 87491 |
|
12 |
12 |
$251.26 |
| 87591 |
|
12 |
12 |
$251.08 |
| 86900 |
|
19 |
12 |
$232.56 |
| 86850 |
|
19 |
12 |
$203.91 |
| J2930 |
Methylprednisolone injection |
13 |
12 |
$137.83 |
| 86901 |
|
19 |
12 |
$112.30 |
| 84100 |
|
19 |
15 |
$103.27 |
| A9270 |
Non-covered item or service |
13 |
13 |
$0.00 |