| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0241U |
|
4,408 |
4,143 |
$490K |
| 74177 |
|
1,922 |
1,733 |
$303K |
| 70450 |
|
2,048 |
1,810 |
$220K |
| 97110 |
|
3,793 |
1,014 |
$149K |
| 87651 |
|
2,778 |
2,598 |
$131K |
| 74176 |
|
1,279 |
1,149 |
$94K |
| 80048 |
|
5,651 |
4,884 |
$89K |
| 80053 |
|
4,508 |
3,736 |
$75K |
| 85025 |
|
9,071 |
7,535 |
$69K |
| 71045 |
|
5,656 |
5,034 |
$60K |
| 36415 |
|
6,803 |
5,872 |
$49K |
| 96365 |
|
1,035 |
894 |
$46K |
| 93005 |
|
4,037 |
3,436 |
$44K |
| U0003 |
Cov-19 amp prb hgh thruput |
469 |
444 |
$41K |
| 87637 |
|
350 |
311 |
$34K |
| 96372 |
|
4,153 |
3,544 |
$30K |
| 81025 |
|
3,376 |
3,048 |
$29K |
| 87804 |
|
1,279 |
1,094 |
$28K |
| 71046 |
|
1,339 |
1,117 |
$25K |
| 86710 |
|
1,125 |
664 |
$24K |
| 73630 |
|
719 |
646 |
$23K |
| 81001 |
|
5,338 |
4,624 |
$22K |
| 12001 |
|
97 |
86 |
$21K |
| 84484 |
|
2,717 |
2,119 |
$21K |
| 83690 |
|
2,810 |
2,452 |
$21K |
| 73130 |
|
623 |
539 |
$15K |
| 73610 |
|
774 |
686 |
$14K |
| 80076 |
|
1,146 |
1,040 |
$14K |
| 99283 |
|
728 |
652 |
$14K |
| 87633 |
|
53 |
52 |
$12K |
| 80307 |
|
260 |
187 |
$11K |
| 80305 |
|
801 |
726 |
$11K |
| 87088 |
|
1,006 |
890 |
$10K |
| 87880 |
|
829 |
764 |
$10K |
| 73110 |
|
418 |
350 |
$9K |
| 96374 |
|
2,606 |
2,340 |
$9K |
| 43239 |
|
86 |
64 |
$9K |
| 94640 |
|
1,783 |
1,398 |
$8K |
| 81003 |
|
2,665 |
2,384 |
$8K |
| J0696 |
Ceftriaxone sodium injection |
1,728 |
1,505 |
$7K |
| 87430 |
|
751 |
597 |
$7K |
| 85027 |
|
1,162 |
992 |
$7K |
| 31720 |
|
28 |
28 |
$6K |
| C9803 |
Hopd covid-19 spec collect |
4,026 |
3,745 |
$6K |
| 82150 |
|
989 |
853 |
$6K |
| J2405 |
Ondansetron hcl injection |
2,855 |
2,444 |
$6K |
| 96361 |
|
1,011 |
868 |
$6K |
| 82550 |
|
982 |
842 |
$6K |
| 87086 |
|
650 |
532 |
$6K |
| 85610 |
|
869 |
706 |
$5K |
| U0002 |
Covid-19 lab test non-cdc |
127 |
116 |
$5K |
| 87081 |
|
601 |
472 |
$4K |
| 83880 |
|
188 |
159 |
$4K |
| 73030 |
|
240 |
192 |
$4K |
| 96375 |
|
1,560 |
1,347 |
$4K |
| 84703 |
|
545 |
389 |
$4K |
| 87040 |
|
357 |
228 |
$4K |
| 82962 |
|
484 |
286 |
$4K |
| 80050 |
|
89 |
84 |
$3K |
| 73562 |
|
134 |
96 |
$3K |
| J1100 |
Dexamethasone sodium phos |
496 |
421 |
$3K |
| 85730 |
|
632 |
500 |
$3K |
| 12011 |
|
13 |
12 |
$3K |
| M0243 |
Casirivi and imdevi inj |
15 |
15 |
$2K |
| 87807 |
|
193 |
185 |
$2K |
| 87486 |
|
53 |
52 |
$2K |
| 87581 |
|
53 |
52 |
$2K |
| 83605 |
|
318 |
246 |
$2K |
| 70486 |
|
12 |
12 |
$2K |
| J1885 |
Ketorolac tromethamine inj |
2,437 |
2,124 |
$2K |
| 72100 |
|
77 |
64 |
$2K |
| 88305 |
|
138 |
107 |
$2K |
| 80306 |
|
138 |
123 |
$2K |
| 72125 |
|
18 |
16 |
$2K |
| 84443 |
|
171 |
143 |
$2K |
| 82077 |
|
99 |
89 |
$2K |
| 0225U |
|
411 |
391 |
$2K |
| 97162 |
|
12 |
12 |
$2K |
| 99284 |
|
378 |
352 |
$1K |
| 80320 |
|
143 |
113 |
$1K |
| 87186 |
|
244 |
200 |
$1K |
| 87077 |
|
141 |
130 |
$1K |
| 96376 |
|
153 |
117 |
$1K |
| 96360 |
|
85 |
79 |
$1K |
| 97161 |
|
17 |
13 |
$1K |
| 82553 |
|
144 |
82 |
$955.84 |
| 99282 |
|
31 |
28 |
$926.49 |
| 94664 |
|
965 |
848 |
$898.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
12 |
12 |
$672.61 |
| 73560 |
|
15 |
13 |
$617.54 |
| J2930 |
Methylprednisolone injection |
849 |
748 |
$493.91 |
| 86677 |
|
35 |
28 |
$435.12 |
| 82803 |
|
18 |
17 |
$423.60 |
| 87420 |
|
34 |
33 |
$411.84 |
| J7030 |
Normal saline solution infus |
1,370 |
1,155 |
$383.88 |
| J2550 |
Promethazine hcl injection |
559 |
465 |
$347.78 |
| J7120 |
Ringers lactate infusion |
825 |
684 |
$340.07 |
| 0202U |
|
121 |
110 |
$335.00 |
| 90714 |
|
49 |
38 |
$327.37 |
| J2001 |
Lidocaine injection |
488 |
403 |
$285.94 |
| 90715 |
|
15 |
14 |
$272.21 |
| 74018 |
|
13 |
12 |
$263.38 |
| 90471 |
|
86 |
72 |
$249.66 |
| 85379 |
|
27 |
26 |
$238.06 |
| 73140 |
|
16 |
12 |
$224.00 |
| 88312 |
|
88 |
66 |
$175.06 |
| J2270 |
Morphine sulfate injection |
922 |
774 |
$145.68 |
| 80329 |
|
17 |
13 |
$136.26 |
| J1170 |
Hydromorphone injection |
823 |
678 |
$119.82 |
| 85007 |
|
41 |
35 |
$114.49 |
| 81015 |
|
105 |
104 |
$68.61 |
| U0005 |
Infec agen detec ampli probe |
349 |
337 |
$63.00 |
| J1200 |
Diphenhydramine hcl injectio |
122 |
102 |
$59.98 |
| J2704 |
Inj, propofol, 10 mg |
208 |
165 |
$59.33 |
| 82248 |
|
12 |
12 |
$57.36 |
| 82947 |
|
20 |
13 |
$39.20 |
| J0780 |
Prochlorperazine injection |
62 |
59 |
$26.02 |
| J1040 |
Methylprednisolone 80 mg inj |
13 |
12 |
$16.88 |
| J2060 |
Lorazepam injection |
15 |
12 |
$13.92 |
| J2919 |
Inj, methylpred sod succ 5mg |
197 |
173 |
$4.31 |
| J2765 |
Metoclopramide hcl injection |
12 |
12 |
$3.95 |
| J3010 |
Fentanyl citrate injection |
55 |
40 |
$3.66 |
| J2272 |
Inj, morphine (fresenius) |
13 |
12 |
$2.07 |
| G1004 |
Cdsm ndsc |
71 |
63 |
$0.12 |
| J7050 |
Normal saline solution infus |
873 |
588 |
$0.00 |
| A9270 |
Non-covered item or service |
538 |
218 |
$0.00 |
| Q0162 |
Ondansetron oral |
147 |
127 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
34 |
25 |
$0.00 |
| 36600 |
|
18 |
17 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
88 |
42 |
$0.00 |