| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
11,772 |
10,310 |
$1.75M |
| 74177 |
|
406 |
371 |
$550K |
| 99284 |
|
3,560 |
2,810 |
$511K |
| 80053 |
|
12,037 |
10,251 |
$461K |
| 85025 |
|
14,779 |
12,121 |
$417K |
| 70450 |
|
697 |
643 |
$351K |
| 93005 |
|
3,042 |
2,655 |
$296K |
| 97110 |
|
5,586 |
1,724 |
$244K |
| 71046 |
|
2,352 |
2,143 |
$227K |
| 99282 |
|
2,047 |
1,874 |
$216K |
| 87651 |
|
3,973 |
3,809 |
$212K |
| J3490 |
Drugs unclassified injection |
6,795 |
3,354 |
$189K |
| 96365 |
|
1,863 |
1,226 |
$188K |
| 84443 |
|
3,848 |
3,697 |
$183K |
| 36415 |
|
18,356 |
14,547 |
$180K |
| 99285 |
|
718 |
595 |
$157K |
| 87631 |
|
2,008 |
1,882 |
$152K |
| G0463 |
Hospital outpt clinic visit |
5,466 |
4,351 |
$137K |
| 96372 |
|
2,638 |
1,999 |
$137K |
| 96375 |
|
2,003 |
1,639 |
$136K |
| 96374 |
|
2,502 |
2,139 |
$133K |
| 71045 |
|
1,594 |
1,423 |
$126K |
| 99212 |
|
2,221 |
1,870 |
$105K |
| 84484 |
|
2,040 |
1,574 |
$103K |
| 93306 |
|
159 |
148 |
$102K |
| 97530 |
|
1,591 |
630 |
$97K |
| 80048 |
|
3,484 |
2,922 |
$95K |
| 87660 |
|
2,095 |
1,982 |
$92K |
| 87510 |
|
2,267 |
2,144 |
$92K |
| 87480 |
|
2,267 |
2,144 |
$92K |
| J2405 |
Ondansetron hcl injection |
1,976 |
1,672 |
$92K |
| 96361 |
|
2,952 |
2,208 |
$90K |
| 74176 |
|
68 |
62 |
$90K |
| 87086 |
|
3,602 |
3,291 |
$86K |
| G0378 |
Hospital observation per hr |
125 |
106 |
$82K |
| J1885 |
Ketorolac tromethamine inj |
1,773 |
1,532 |
$82K |
| 92507 |
|
746 |
260 |
$77K |
| 80061 |
|
2,996 |
2,916 |
$77K |
| 76817 |
|
428 |
400 |
$73K |
| J7030 |
Normal saline solution infus |
3,038 |
2,295 |
$67K |
| 81003 |
|
5,722 |
5,090 |
$65K |
| 83036 |
|
3,023 |
2,935 |
$64K |
| 84145 |
|
1,882 |
1,458 |
$63K |
| 96360 |
|
719 |
583 |
$63K |
| 59025 |
|
473 |
242 |
$62K |
| 87804 |
|
1,681 |
1,077 |
$59K |
| J8499 |
Oral prescrip drug non chemo |
6,129 |
3,023 |
$56K |
| 87880 |
|
1,923 |
1,893 |
$52K |
| 97112 |
|
755 |
276 |
$51K |
| 73630 |
|
431 |
401 |
$51K |
| 83690 |
|
1,359 |
1,223 |
$50K |
| 87635 |
|
1,300 |
1,232 |
$50K |
| J7120 |
Ringers lactate infusion |
1,595 |
1,065 |
$48K |
| 94640 |
|
706 |
568 |
$46K |
| 77067 |
|
445 |
441 |
$42K |
| 81001 |
|
2,744 |
2,487 |
$39K |
| 97161 |
|
896 |
862 |
$38K |
| J3010 |
Fentanyl citrate injection |
677 |
598 |
$37K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
671 |
588 |
$35K |
| 99281 |
|
470 |
434 |
$33K |
| 83605 |
|
1,533 |
1,247 |
$33K |
| 87428 |
|
778 |
751 |
$32K |
| 87591 |
|
1,005 |
985 |
$32K |
| 87491 |
|
999 |
980 |
$32K |
| 81025 |
|
1,769 |
1,695 |
$31K |
| J2704 |
Inj, propofol, 10 mg |
712 |
620 |
$31K |
| 76816 |
|
205 |
190 |
$29K |
| 0099U |
|
118 |
115 |
$29K |
| 83880 |
|
677 |
563 |
$28K |
| J1100 |
Dexamethasone sodium phos |
637 |
554 |
$28K |
| 85027 |
|
1,523 |
1,391 |
$28K |
| 76856 |
|
99 |
99 |
$25K |
| 97140 |
|
625 |
190 |
$23K |
| 83735 |
|
887 |
641 |
$20K |
| 76830 |
|
78 |
78 |
$20K |
| 74018 |
|
151 |
137 |
$20K |
| 73610 |
|
157 |
142 |
$18K |
| 84702 |
|
333 |
195 |
$18K |
| 82306 |
|
651 |
635 |
$17K |
| 99213 |
|
204 |
177 |
$16K |
| 84439 |
|
959 |
904 |
$15K |
| 11042 |
|
112 |
42 |
$14K |
| 85610 |
|
1,074 |
838 |
$14K |
| 87798 |
|
142 |
136 |
$14K |
| 80306 |
|
389 |
349 |
$14K |
| 86703 |
|
330 |
322 |
$13K |
| 87040 |
|
1,076 |
504 |
$13K |
| 76700 |
|
37 |
37 |
$13K |
| 73030 |
|
126 |
106 |
$12K |
| 86140 |
|
760 |
682 |
$11K |
| 80055 |
|
62 |
61 |
$11K |
| J0131 |
Inj, acetaminophen (nos) |
111 |
90 |
$10K |
| 73562 |
|
95 |
89 |
$10K |
| 83550 |
|
371 |
358 |
$10K |
| 96376 |
|
157 |
115 |
$10K |
| 83655 |
|
289 |
285 |
$10K |
| 83540 |
|
394 |
377 |
$9K |
| 72125 |
|
12 |
12 |
$8K |
| J2270 |
Morphine sulfate injection |
164 |
147 |
$8K |
| 85018 |
|
590 |
559 |
$8K |
| 77063 |
|
247 |
245 |
$8K |
| 82728 |
|
358 |
348 |
$8K |
| 85379 |
|
244 |
219 |
$7K |
| 85652 |
|
399 |
367 |
$6K |
| J2250 |
Inj midazolam hydrochloride |
154 |
137 |
$6K |
| J1170 |
Hydromorphone injection |
145 |
88 |
$6K |
| 84703 |
|
530 |
484 |
$5K |
| 73110 |
|
59 |
53 |
$5K |
| 82570 |
|
241 |
227 |
$5K |
| 87502 |
|
110 |
109 |
$5K |
| 82607 |
|
259 |
246 |
$4K |
| J7050 |
Normal saline solution infus |
569 |
284 |
$4K |
| 82043 |
|
130 |
126 |
$4K |
| 87420 |
|
136 |
125 |
$3K |
| 80320 |
|
74 |
64 |
$3K |
| Q0162 |
Ondansetron oral |
204 |
176 |
$3K |
| 73502 |
|
30 |
27 |
$3K |
| 80050 |
|
25 |
25 |
$3K |
| 86850 |
|
57 |
51 |
$2K |
| 87808 |
|
159 |
153 |
$2K |
| 73130 |
|
32 |
25 |
$2K |
| 87070 |
|
75 |
66 |
$2K |
| J0690 |
Cefazolin sodium injection |
16 |
12 |
$2K |
| 82962 |
|
559 |
265 |
$2K |
| 87486 |
|
114 |
110 |
$2K |
| 87581 |
|
113 |
109 |
$2K |
| U0003 |
Cov-19 amp prb hgh thruput |
24 |
24 |
$2K |
| 86901 |
|
59 |
52 |
$2K |
| 85730 |
|
46 |
43 |
$2K |
| J2550 |
Promethazine hcl injection |
26 |
24 |
$2K |
| 87653 |
|
24 |
24 |
$2K |
| 87633 |
|
95 |
92 |
$2K |
| M0239 |
Bamlanivimab-xxxx infusion |
17 |
17 |
$1K |
| 87661 |
|
38 |
37 |
$1K |
| 86900 |
|
58 |
52 |
$1K |
| 87205 |
|
92 |
81 |
$1K |
| 73564 |
|
12 |
12 |
$1K |
| 87075 |
|
70 |
62 |
$1K |
| 96366 |
|
26 |
15 |
$1K |
| 74019 |
|
13 |
13 |
$1K |
| U0002 |
Covid-19 lab test non-cdc |
15 |
14 |
$1K |
| 82803 |
|
14 |
13 |
$956.36 |
| 82950 |
|
43 |
43 |
$925.11 |
| J0696 |
Ceftriaxone sodium injection |
18 |
15 |
$861.92 |
| A9270 |
Non-covered item or service |
163 |
103 |
$777.71 |
| 36416 |
|
254 |
238 |
$769.26 |
| 97165 |
|
14 |
12 |
$690.63 |
| 84481 |
|
17 |
14 |
$545.60 |
| 84153 |
|
13 |
13 |
$502.40 |
| 93010 |
|
240 |
202 |
$500.45 |
| 84156 |
|
16 |
13 |
$492.42 |
| 87340 |
|
13 |
12 |
$308.76 |
| 86803 |
|
17 |
16 |
$287.25 |
| U0005 |
Infec agen detec ampli probe |
24 |
24 |
$275.00 |
| 86141 |
|
31 |
28 |
$238.49 |
| 86592 |
|
15 |
14 |
$232.26 |
| J7620 |
Albuterol ipratrop non-comp |
33 |
29 |
$217.18 |
| 87430 |
|
12 |
12 |
$141.00 |
| 84100 |
|
15 |
13 |
$116.06 |
| 82565 |
|
13 |
12 |
$104.06 |
| 82044 |
|
24 |
24 |
$99.81 |
| 99214 |
|
13 |
13 |
$55.92 |
| J7060 |
5% dextrose/water |
19 |
12 |
$5.22 |
| A4216 |
Sterile water/saline, 10 ml |
18 |
12 |
$0.22 |
| 3044F |
|
786 |
766 |
$0.03 |
| 3051F |
|
14 |
12 |
$0.00 |