| Code | Description | Claims | Beneficiaries | Total Paid |
| G0463 |
Hospital outpt clinic visit |
63,768 |
51,116 |
$10.21M |
| 96413 |
|
1,951 |
1,408 |
$989K |
| 96365 |
|
1,240 |
708 |
$399K |
| 90677 |
|
401 |
401 |
$228K |
| 96372 |
|
1,867 |
1,587 |
$191K |
| 91320 |
|
594 |
594 |
$151K |
| 96415 |
|
422 |
321 |
$87K |
| 80061 |
|
5,221 |
5,195 |
$67K |
| 90471 |
|
828 |
824 |
$56K |
| 96366 |
|
361 |
197 |
$49K |
| J0881 |
Darbepoetin alfa, non-esrd |
76 |
60 |
$41K |
| 83036 |
|
6,376 |
6,347 |
$37K |
| 80053 |
|
5,099 |
4,857 |
$34K |
| 92250 |
|
451 |
448 |
$34K |
| 90670 |
|
565 |
554 |
$34K |
| 87536 |
|
622 |
609 |
$33K |
| 90732 |
|
115 |
115 |
$33K |
| 71046 |
|
991 |
959 |
$30K |
| 80048 |
|
5,790 |
5,130 |
$29K |
| 91322 |
|
111 |
111 |
$28K |
| 0760 |
|
298 |
227 |
$21K |
| 93306 |
|
295 |
293 |
$20K |
| 90750 |
|
454 |
454 |
$19K |
| 85025 |
|
5,064 |
4,392 |
$16K |
| 87811 |
|
213 |
213 |
$15K |
| J9217 |
Leuprolide acetate suspnsion |
14 |
14 |
$15K |
| 90832 |
|
42 |
37 |
$13K |
| 86780 |
|
472 |
465 |
$12K |
| 0450 |
|
365 |
323 |
$12K |
| J3490 |
Drugs unclassified injection |
511 |
305 |
$10K |
| 93005 |
|
1,119 |
1,055 |
$10K |
| 96375 |
|
175 |
149 |
$10K |
| 84443 |
|
2,158 |
2,104 |
$9K |
| 82306 |
|
1,142 |
1,127 |
$9K |
| 76705 |
|
85 |
85 |
$8K |
| 82043 |
|
2,341 |
2,311 |
$8K |
| 82570 |
|
2,545 |
2,508 |
$8K |
| 77067 |
|
822 |
820 |
$7K |
| 80307 |
|
864 |
826 |
$7K |
| 85027 |
|
2,758 |
2,644 |
$7K |
| 92004 |
|
26 |
26 |
$6K |
| 0270 |
|
13 |
12 |
$5K |
| G0008 |
Admin influenza virus vac |
143 |
143 |
$5K |
| 99285 |
|
696 |
655 |
$5K |
| 96374 |
|
517 |
456 |
$5K |
| 70450 |
|
259 |
245 |
$5K |
| 85610 |
|
2,015 |
1,764 |
$5K |
| 71260 |
|
160 |
159 |
$4K |
| 99283 |
|
438 |
396 |
$4K |
| 99284 |
|
532 |
486 |
$3K |
| U0002 |
Covid-19 lab test non-cdc |
41 |
40 |
$3K |
| 96417 |
|
20 |
14 |
$3K |
| 84460 |
|
933 |
886 |
$3K |
| 99231 |
|
84 |
70 |
$3K |
| 92002 |
|
13 |
13 |
$3K |
| 99173 |
|
319 |
319 |
$3K |
| 74177 |
|
277 |
275 |
$3K |
| 83970 |
|
500 |
490 |
$3K |
| U0003 |
Cov-19 amp prb hgh thruput |
27 |
27 |
$3K |
| 87517 |
|
344 |
339 |
$2K |
| 82728 |
|
668 |
655 |
$2K |
| 86592 |
|
888 |
874 |
$2K |
| 82607 |
|
425 |
421 |
$2K |
| 82105 |
|
406 |
404 |
$2K |
| 92134 |
|
198 |
196 |
$2K |
| 80069 |
|
798 |
756 |
$2K |
| 84466 |
|
574 |
563 |
$1K |
| 87389 |
|
471 |
468 |
$1K |
| 82248 |
|
362 |
354 |
$1K |
| G0480 |
Drug test def 1-7 classes |
287 |
274 |
$1K |
| 84153 |
|
382 |
373 |
$1K |
| 82803 |
|
695 |
636 |
$1K |
| 82948 |
|
1,843 |
1,442 |
$1K |
| 86141 |
|
543 |
525 |
$1K |
| 71250 |
|
39 |
39 |
$892.71 |
| 90651 |
|
201 |
201 |
$790.20 |
| 81001 |
|
1,211 |
1,128 |
$699.89 |
| 83735 |
|
1,020 |
699 |
$689.69 |
| 80076 |
|
1,292 |
1,207 |
$659.80 |
| 36000 |
|
525 |
284 |
$652.74 |
| 83540 |
|
687 |
675 |
$620.74 |
| 87086 |
|
670 |
637 |
$610.33 |
| 87088 |
|
667 |
634 |
$559.43 |
| 71045 |
|
461 |
419 |
$404.05 |
| 97802 |
|
201 |
173 |
$364.20 |
| 83690 |
|
546 |
496 |
$362.63 |
| 84484 |
|
584 |
516 |
$321.53 |
| 99211 |
|
3,081 |
2,976 |
$314.10 |
| 82565 |
|
669 |
596 |
$288.55 |
| 87340 |
|
222 |
218 |
$286.40 |
| 85730 |
|
602 |
547 |
$263.97 |
| 83880 |
|
347 |
324 |
$241.20 |
| 76700 |
|
137 |
137 |
$231.87 |
| 84100 |
|
657 |
447 |
$197.83 |
| 99281 |
|
346 |
316 |
$178.77 |
| 85651 |
|
20 |
20 |
$169.00 |
| 87502 |
|
27 |
27 |
$154.00 |
| 86580 |
|
59 |
57 |
$124.50 |
| 86900 |
|
143 |
109 |
$123.84 |
| 85652 |
|
490 |
475 |
$116.76 |
| 97110 |
|
1,272 |
840 |
$98.44 |
| 87522 |
Neg quan hep c or qual rna |
178 |
174 |
$97.25 |
| 86901 |
|
141 |
108 |
$94.55 |
| T1999 |
Noc retail items andsupplies |
26 |
20 |
$89.80 |
| 82610 |
|
26 |
26 |
$88.14 |
| 87430 |
|
28 |
28 |
$75.71 |
| 83605 |
|
214 |
192 |
$58.57 |
| 86803 |
|
253 |
250 |
$56.52 |
| 81002 |
|
365 |
358 |
$56.01 |
| 97530 |
|
405 |
338 |
$54.70 |
| 90686 |
|
1,771 |
1,770 |
$54.22 |
| J2405 |
Ondansetron hcl injection |
98 |
75 |
$47.55 |
| 90723 |
|
397 |
389 |
$45.00 |
| 90680 |
|
344 |
339 |
$45.00 |
| 73630 |
|
30 |
28 |
$43.59 |
| J1170 |
Hydromorphone injection |
41 |
12 |
$43.16 |
| 84439 |
|
369 |
361 |
$43.13 |
| 87186 |
|
73 |
69 |
$40.88 |
| 29581 |
|
41 |
12 |
$38.67 |
| 87077 |
|
82 |
77 |
$38.23 |
| 36415 |
|
554 |
478 |
$38.00 |
| 87081 |
|
18 |
18 |
$37.20 |
| 90715 |
|
142 |
140 |
$36.51 |
| 83655 |
|
158 |
158 |
$36.40 |
| 90647 |
|
351 |
349 |
$36.00 |
| 92015 |
|
81 |
81 |
$35.24 |
| 85018 |
|
230 |
174 |
$33.68 |
| 0250 |
|
102 |
61 |
$32.45 |
| 81003 |
|
213 |
206 |
$28.09 |
| 85008 |
|
103 |
101 |
$27.44 |
| 86706 |
|
173 |
172 |
$23.72 |
| 97140 |
|
139 |
104 |
$23.50 |
| 84450 |
|
199 |
166 |
$21.87 |
| J2001 |
Lidocaine injection |
13 |
13 |
$17.92 |
| 82550 |
|
81 |
70 |
$17.69 |
| 85014 |
|
83 |
81 |
$17.01 |
| 84132 |
|
167 |
158 |
$15.13 |
| 81025 |
|
12 |
12 |
$14.00 |
| 86704 |
|
72 |
72 |
$10.83 |
| 82247 |
|
41 |
29 |
$9.94 |
| 84165 |
|
60 |
60 |
$9.58 |
| 70355 |
|
26 |
26 |
$8.58 |
| 94150 |
|
40 |
40 |
$4.79 |
| 90662 |
|
995 |
995 |
$0.29 |
| 90656 |
|
321 |
320 |
$0.08 |
| 82274 |
|
863 |
860 |
$0.00 |
| 92133 |
|
129 |
129 |
$0.00 |
| 90633 |
|
290 |
284 |
$0.00 |
| 94729 |
|
27 |
27 |
$0.00 |
| 84550 |
|
228 |
222 |
$0.00 |
| 90707 |
|
154 |
152 |
$0.00 |
| 90710 |
|
57 |
56 |
$0.00 |
| 99152 |
|
25 |
25 |
$0.00 |
| 90700 |
|
126 |
124 |
$0.00 |
| 99188 |
|
16 |
16 |
$0.00 |
| 94726 |
|
14 |
14 |
$0.00 |
| 86708 |
|
12 |
12 |
$0.00 |
| 90734 |
|
142 |
142 |
$0.00 |
| 92083 |
|
13 |
13 |
$0.00 |
| 85045 |
|
29 |
28 |
$0.00 |
| 84156 |
|
44 |
41 |
$0.00 |
| 97803 |
|
91 |
89 |
$0.00 |
| 93010 |
|
14 |
14 |
$0.00 |
| 97164 |
|
12 |
12 |
$0.00 |
| 73030 |
|
13 |
13 |
$0.00 |
| 86480 |
|
32 |
32 |
$0.00 |
| 97116 |
|
33 |
24 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
80 |
62 |
$0.00 |
| 82040 |
|
26 |
25 |
$0.00 |
| 94760 |
|
132 |
124 |
$0.00 |
| 90716 |
|
159 |
157 |
$0.00 |
| 77063 |
|
155 |
154 |
$0.00 |
| 88142 |
|
27 |
27 |
$0.00 |
| 86361 |
|
120 |
117 |
$0.00 |
| 99282 |
|
42 |
41 |
$0.00 |
| 90696 |
|
52 |
51 |
$0.00 |
| 90480 |
|
22 |
22 |
$0.00 |
| 94010 |
|
28 |
28 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
13 |
13 |
$0.00 |
| 73564 |
|
28 |
27 |
$0.00 |
| 87205 |
|
30 |
27 |
$0.00 |
| 94200 |
|
13 |
13 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
13 |
13 |
$0.00 |