| Code | Description | Claims | Beneficiaries | Total Paid |
| J9271 |
Inj pembrolizumab |
763 |
647 |
$2.37M |
| 96413 |
|
6,790 |
4,135 |
$402K |
| 78815 |
|
1,286 |
1,269 |
$365K |
| 77386 |
|
480 |
51 |
$136K |
| 80053 |
|
17,354 |
12,397 |
$122K |
| G0463 |
Hospital outpt clinic visit |
31,110 |
18,209 |
$122K |
| 74177 |
|
2,554 |
2,505 |
$92K |
| 93306 |
|
462 |
457 |
$77K |
| 77334 |
|
312 |
240 |
$73K |
| 70553 |
|
1,047 |
1,027 |
$70K |
| 71260 |
|
3,418 |
3,375 |
$55K |
| 77300 |
|
279 |
249 |
$50K |
| J0897 |
Denosumab injection |
142 |
139 |
$47K |
| 80050 |
|
160 |
139 |
$42K |
| 96417 |
|
1,863 |
1,281 |
$40K |
| 88305 |
|
1,990 |
1,496 |
$35K |
| G0498 |
Chemo extend iv infus w/pump |
349 |
204 |
$35K |
| 99213 |
|
509 |
311 |
$29K |
| 93005 |
|
1,658 |
1,560 |
$26K |
| 96365 |
|
1,104 |
619 |
$25K |
| 70491 |
|
762 |
755 |
$25K |
| 85025 |
|
19,115 |
13,220 |
$21K |
| 88341 |
|
996 |
554 |
$21K |
| 76641 |
|
424 |
421 |
$18K |
| J9299 |
Injection, nivolumab |
20 |
12 |
$17K |
| 77066 |
Tomosynthesis, mammo |
272 |
271 |
$17K |
| 96375 |
|
4,807 |
2,685 |
$16K |
| 83735 |
|
16,125 |
10,178 |
$15K |
| 88342 |
|
1,102 |
940 |
$12K |
| 77470 |
|
36 |
36 |
$11K |
| 76536 |
|
473 |
465 |
$11K |
| 97110 |
|
964 |
330 |
$11K |
| 71250 |
|
572 |
566 |
$11K |
| 74178 |
|
356 |
355 |
$11K |
| 72197 |
|
146 |
142 |
$11K |
| 87635 |
|
910 |
834 |
$10K |
| U0004 |
Cov-19 test non-cdc hgh thru |
1,066 |
1,006 |
$10K |
| 78306 |
|
240 |
240 |
$10K |
| 80069 |
|
1,819 |
803 |
$7K |
| 83615 |
|
10,069 |
6,683 |
$7K |
| 71046 |
|
1,049 |
1,008 |
$7K |
| 96367 |
|
2,202 |
1,367 |
$7K |
| 96402 |
|
433 |
389 |
$6K |
| 77336 |
|
1,003 |
510 |
$6K |
| 85027 |
|
4,393 |
2,455 |
$6K |
| J1100 |
Dexamethasone sodium phos |
3,717 |
2,159 |
$6K |
| 76604 |
|
338 |
336 |
$6K |
| J1453 |
Fosaprepitant injection |
138 |
91 |
$6K |
| 86885 |
|
4,549 |
2,540 |
$6K |
| Q3014 |
Telehealth facility fee |
1,839 |
1,664 |
$6K |
| 86900 |
|
7,307 |
3,381 |
$6K |
| 80048 |
|
1,652 |
1,294 |
$6K |
| G0279 |
Tomosynthesis, mammo |
522 |
519 |
$5K |
| 72156 |
|
13 |
13 |
$5K |
| 82248 |
|
13,914 |
9,422 |
$5K |
| 86901 |
|
6,536 |
3,368 |
$4K |
| 0001A |
|
354 |
354 |
$4K |
| 84550 |
|
6,477 |
3,825 |
$4K |
| 36430 |
|
418 |
224 |
$4K |
| J9045 |
Carboplatin injection |
317 |
223 |
$4K |
| 82306 |
|
1,716 |
1,669 |
$4K |
| 85007 |
|
3,951 |
2,176 |
$4K |
| 86850 |
|
1,393 |
851 |
$3K |
| 81455 |
|
72 |
66 |
$3K |
| 99214 |
|
50 |
38 |
$3K |
| 84443 |
|
4,061 |
3,746 |
$3K |
| 0002A |
|
297 |
296 |
$3K |
| 84439 |
|
3,904 |
3,596 |
$3K |
| 84100 |
|
11,719 |
8,392 |
$3K |
| J9217 |
Leuprolide acetate suspnsion |
12 |
12 |
$3K |
| J9190 |
Fluorouracil injection |
272 |
143 |
$3K |
| 82784 |
|
2,546 |
1,322 |
$3K |
| A9552 |
F18 fdg |
1,461 |
1,445 |
$2K |
| 82378 |
|
1,540 |
1,192 |
$2K |
| 94760 |
|
857 |
738 |
$2K |
| 96361 |
|
1,170 |
782 |
$2K |
| G0384 |
Lev 5 hosp type b ed visit |
310 |
281 |
$2K |
| 86920 |
|
288 |
162 |
$2K |
| 88321 |
|
587 |
534 |
$2K |
| 85610 |
|
2,671 |
2,298 |
$2K |
| 85730 |
|
1,363 |
1,185 |
$2K |
| J9267 |
Paclitaxel injection |
103 |
50 |
$2K |
| 83036 |
|
1,730 |
1,681 |
$2K |
| 72157 |
|
13 |
13 |
$1K |
| 83880 |
|
287 |
259 |
$1K |
| 72158 |
|
13 |
13 |
$1K |
| 96372 |
|
1,739 |
1,254 |
$1K |
| 87631 |
|
34 |
32 |
$1K |
| 71045 |
|
280 |
262 |
$1K |
| 88173 |
|
116 |
97 |
$1K |
| 81001 |
|
1,844 |
1,600 |
$1K |
| J7030 |
Normal saline solution infus |
1,452 |
835 |
$1K |
| 92060 |
|
14 |
14 |
$1K |
| 86304 |
|
754 |
653 |
$1K |
| 82565 |
|
4,686 |
4,041 |
$1K |
| 36591 |
|
670 |
485 |
$1K |
| 84460 |
|
3,226 |
1,900 |
$1K |
| 86300 |
|
599 |
499 |
$1K |
| 82247 |
|
2,953 |
1,627 |
$996.15 |
| 87086 |
|
888 |
819 |
$945.49 |
| 77067 |
|
79 |
79 |
$942.48 |
| 87389 |
|
193 |
184 |
$937.80 |
| 88307 |
|
52 |
37 |
$936.70 |
| 74183 |
|
14 |
13 |
$929.30 |
| 82728 |
|
695 |
582 |
$928.88 |
| 86803 |
|
643 |
620 |
$919.69 |
| 80051 |
|
1,246 |
1,058 |
$883.30 |
| 84075 |
|
2,426 |
1,285 |
$867.24 |
| 96374 |
|
1,199 |
870 |
$860.65 |
| 85097 |
|
40 |
40 |
$830.97 |
| 92133 |
|
13 |
13 |
$813.94 |
| 77080 |
|
193 |
191 |
$811.98 |
| 83690 |
|
794 |
691 |
$810.31 |
| 88172 |
|
37 |
29 |
$809.91 |
| J3475 |
Inj magnesium sulfate |
438 |
169 |
$788.21 |
| 77065 |
Tomosynthesis, mammo |
25 |
25 |
$784.73 |
| 36415 |
|
22,168 |
14,621 |
$744.64 |
| 82150 |
|
805 |
693 |
$729.05 |
| 84155 |
|
2,142 |
1,037 |
$719.42 |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$673.99 |
| 84484 |
|
274 |
195 |
$667.78 |
| 94010 |
|
39 |
39 |
$627.58 |
| 84403 |
|
776 |
734 |
$624.40 |
| 94729 |
|
62 |
62 |
$598.56 |
| J1170 |
Hydromorphone injection |
233 |
158 |
$584.31 |
| 80076 |
|
85 |
75 |
$512.82 |
| 96366 |
|
474 |
239 |
$494.61 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
5,277 |
5,045 |
$488.79 |
| 87040 |
|
166 |
112 |
$485.43 |
| 80061 |
|
804 |
779 |
$457.57 |
| 82533 |
|
112 |
93 |
$444.38 |
| 82550 |
|
592 |
462 |
$438.42 |
| J3010 |
Fentanyl citrate injection |
964 |
862 |
$437.03 |
| 82232 |
|
1,089 |
999 |
$435.37 |
| J7050 |
Normal saline solution infus |
1,222 |
871 |
$411.30 |
| 84450 |
|
1,434 |
1,193 |
$405.10 |
| 84480 |
|
280 |
258 |
$365.10 |
| 84520 |
|
1,780 |
1,524 |
$361.79 |
| J1200 |
Diphenhydramine hcl injectio |
2,247 |
1,324 |
$361.58 |
| 88237 |
|
25 |
25 |
$350.17 |
| 84153 |
|
863 |
801 |
$324.16 |
| 97162 |
|
12 |
12 |
$320.56 |
| 83521 |
|
817 |
664 |
$310.73 |
| A9585 |
Gadobutrol injection |
1,569 |
1,444 |
$282.28 |
| 87340 |
|
300 |
287 |
$280.59 |
| 82570 |
|
158 |
143 |
$268.75 |
| 82607 |
|
223 |
219 |
$254.10 |
| 81025 |
|
91 |
78 |
$245.13 |
| 86704 |
|
164 |
156 |
$243.24 |
| 84165 |
|
1,013 |
944 |
$233.62 |
| 86334 |
|
868 |
811 |
$225.24 |
| 84156 |
|
984 |
903 |
$210.24 |
| 86140 |
|
350 |
259 |
$208.39 |
| J2704 |
Inj, propofol, 10 mg |
1,519 |
1,061 |
$197.30 |
| 82310 |
|
822 |
718 |
$186.71 |
| 94726 |
|
38 |
38 |
$185.00 |
| 86301 |
|
149 |
109 |
$181.89 |
| 88108 |
|
17 |
14 |
$173.61 |
| 84466 |
|
162 |
154 |
$151.87 |
| J2250 |
Inj midazolam hydrochloride |
590 |
564 |
$144.20 |
| J3490 |
Drugs unclassified injection |
170 |
143 |
$141.94 |
| 87077 |
|
172 |
124 |
$133.31 |
| 88185 |
|
28 |
26 |
$122.15 |
| 83883 |
|
531 |
247 |
$114.20 |
| J7040 |
Normal saline solution infus |
1,127 |
800 |
$112.30 |
| 82947 |
|
813 |
701 |
$105.49 |
| 82040 |
|
648 |
574 |
$104.94 |
| 83970 |
|
28 |
26 |
$102.31 |
| 83540 |
|
193 |
183 |
$98.69 |
| 81050 |
|
590 |
549 |
$90.98 |
| 86335 |
|
278 |
267 |
$83.92 |
| J2405 |
Ondansetron hcl injection |
3,751 |
2,289 |
$82.25 |
| 81003 |
|
273 |
248 |
$74.67 |
| 36592 |
|
1,262 |
626 |
$68.37 |
| A9503 |
Tc99m medronate |
240 |
240 |
$66.32 |
| 86923 |
|
20 |
12 |
$62.22 |
| J7060 |
5% dextrose/water |
240 |
156 |
$59.73 |
| J0690 |
Cefazolin sodium injection |
16 |
13 |
$50.22 |
| 82553 |
|
34 |
31 |
$48.50 |
| 96415 |
|
1,365 |
819 |
$46.40 |
| 97750 |
|
14 |
12 |
$45.37 |
| 84166 |
|
396 |
374 |
$44.94 |
| 82105 |
|
83 |
73 |
$41.57 |
| 87186 |
|
51 |
39 |
$36.35 |
| 82746 |
|
42 |
41 |
$35.81 |
| 0202U |
|
69 |
66 |
$35.50 |
| 84432 |
|
65 |
62 |
$30.73 |
| 87070 |
|
46 |
39 |
$28.96 |
| 84481 |
|
13 |
12 |
$28.46 |
| 83605 |
|
28 |
25 |
$28.18 |
| J2001 |
Lidocaine injection |
941 |
874 |
$22.39 |
| 84436 |
|
12 |
12 |
$11.54 |
| 85379 |
|
12 |
12 |
$8.55 |
| 86800 |
|
39 |
36 |
$3.71 |
| 82962 |
|
2,339 |
1,318 |
$3.57 |
| J1940 |
Furosemide injection |
12 |
12 |
$0.98 |
| G1003 |
Cdsm medicalis |
4,552 |
3,742 |
$0.01 |
| 0003A |
|
19 |
19 |
$0.00 |
| 82523 |
|
13 |
13 |
$0.00 |
| 87497 |
|
65 |
39 |
$0.00 |
| U0005 |
Infec agen detec ampli probe |
914 |
867 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
41 |
38 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
19 |
19 |
$0.00 |
| 77063 |
|
53 |
53 |
$0.00 |
| 96376 |
|
27 |
19 |
$0.00 |
| 87205 |
|
14 |
12 |
$0.00 |
| 88363 |
|
12 |
12 |
$0.00 |
| G0008 |
Admin influenza virus vac |
16 |
16 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
27 |
27 |
$0.00 |
| 96368 |
|
17 |
12 |
$0.00 |
| 88184 |
|
29 |
27 |
$0.00 |
| C9399 |
Unclassified drugs or biolog |
12 |
12 |
$0.00 |
| 86706 |
|
16 |
15 |
$0.00 |