| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
|
645 |
600 |
$662K |
| 99283 |
|
3,798 |
3,355 |
$593K |
| 99282 |
|
879 |
842 |
$360K |
| 99281 |
|
4,538 |
4,032 |
$347K |
| 87637 |
|
869 |
839 |
$100K |
| 74177 |
|
194 |
189 |
$93K |
| 71046 |
|
319 |
303 |
$37K |
| 85025 |
|
5,341 |
4,429 |
$32K |
| 87635 |
|
920 |
874 |
$32K |
| 70450 |
|
209 |
203 |
$31K |
| 71045 |
|
274 |
266 |
$28K |
| 36415 |
|
3,420 |
2,786 |
$28K |
| 76705 |
|
181 |
181 |
$26K |
| 76830 |
|
132 |
131 |
$23K |
| 93005 |
|
1,357 |
1,258 |
$21K |
| 80051 |
|
3,364 |
2,976 |
$18K |
| 82565 |
|
4,422 |
3,748 |
$17K |
| 77067 |
|
85 |
85 |
$13K |
| 96374 |
|
475 |
454 |
$10K |
| 82947 |
|
3,485 |
3,034 |
$10K |
| 84460 |
|
2,734 |
2,303 |
$10K |
| 82247 |
|
2,459 |
2,005 |
$9K |
| 84520 |
|
3,373 |
2,981 |
$9K |
| 76856 |
|
54 |
54 |
$7K |
| 83880 |
|
279 |
259 |
$7K |
| J3490 |
Drugs unclassified injection |
1,051 |
580 |
$7K |
| 84450 |
|
2,172 |
1,886 |
$7K |
| 83690 |
|
1,448 |
1,356 |
$6K |
| 81001 |
|
2,060 |
1,895 |
$6K |
| 84075 |
|
1,845 |
1,669 |
$5K |
| 84443 |
|
281 |
278 |
$5K |
| 71260 |
|
24 |
24 |
$5K |
| J7030 |
Normal saline solution infus |
980 |
875 |
$5K |
| 84702 |
|
255 |
176 |
$4K |
| 80307 |
|
152 |
143 |
$4K |
| 77063 |
|
85 |
85 |
$3K |
| 83036 |
|
348 |
346 |
$3K |
| 87636 |
|
14 |
14 |
$3K |
| U0003 |
Cov-19 amp prb hgh thruput |
31 |
30 |
$3K |
| 83735 |
|
652 |
537 |
$3K |
| 80061 |
|
192 |
191 |
$3K |
| 87491 |
|
80 |
71 |
$3K |
| 87591 |
|
80 |
71 |
$3K |
| 85652 |
|
689 |
670 |
$2K |
| 81003 |
|
1,241 |
1,193 |
$2K |
| 0450 |
|
33 |
30 |
$2K |
| 96361 |
|
269 |
257 |
$2K |
| 76770 |
|
13 |
13 |
$2K |
| 73110 |
|
13 |
12 |
$2K |
| 84132 |
|
327 |
277 |
$2K |
| 85027 |
|
247 |
239 |
$1K |
| 87088 |
|
287 |
274 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
398 |
380 |
$1K |
| 82728 |
|
89 |
89 |
$1K |
| 85610 |
|
415 |
333 |
$1K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
242 |
238 |
$1K |
| 0637 |
|
1,964 |
797 |
$1K |
| 80048 |
|
353 |
341 |
$1K |
| 84484 |
|
359 |
332 |
$1K |
| 84100 |
|
384 |
330 |
$1K |
| 84295 |
|
206 |
127 |
$1K |
| 82310 |
|
187 |
159 |
$1K |
| 87389 |
|
27 |
27 |
$910.49 |
| 85379 |
|
128 |
126 |
$666.42 |
| 83605 |
|
234 |
221 |
$644.42 |
| 82077 |
|
183 |
161 |
$639.90 |
| 96375 |
|
303 |
285 |
$637.79 |
| 87651 |
|
66 |
66 |
$637.31 |
| 87040 |
|
167 |
161 |
$605.24 |
| 86140 |
|
121 |
121 |
$593.98 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
32 |
32 |
$559.21 |
| 84703 |
|
265 |
250 |
$557.37 |
| J2405 |
Ondansetron hcl injection |
344 |
314 |
$479.28 |
| 82306 |
|
17 |
16 |
$463.00 |
| J0136 |
Inj, acetaminophen (b braun) |
171 |
167 |
$388.16 |
| 82607 |
|
26 |
26 |
$383.33 |
| 82040 |
|
71 |
64 |
$339.80 |
| J7120 |
Ringers lactate infusion |
252 |
234 |
$334.10 |
| 80306 |
|
25 |
24 |
$242.64 |
| 82248 |
|
76 |
72 |
$233.94 |
| 96372 |
|
107 |
105 |
$191.59 |
| 80178 |
|
28 |
24 |
$150.00 |
| 96365 |
|
111 |
106 |
$125.20 |
| 85730 |
|
12 |
12 |
$85.34 |
| 0250 |
|
169 |
129 |
$9.49 |
| J2270 |
Morphine sulfate injection |
13 |
12 |
$9.13 |
| 96360 |
|
24 |
24 |
$0.00 |