| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 36415 |
|
26,398 |
20,760 |
$1.97M |
| 97110 |
|
15,080 |
4,246 |
$1.41M |
| 99283 |
|
21,466 |
19,959 |
$778K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
4,075 |
3,814 |
$581K |
| 87430 |
|
2,742 |
2,617 |
$544K |
| 0241U |
|
4,788 |
4,509 |
$517K |
| 99282 |
|
4,674 |
4,440 |
$340K |
| 81001 |
|
13,166 |
11,901 |
$287K |
| 87651 |
|
4,075 |
3,908 |
$285K |
| 99281 |
|
2,672 |
2,498 |
$272K |
| 96372 |
|
7,044 |
5,877 |
$240K |
| 87635 |
|
2,353 |
2,181 |
$157K |
| 87804 |
|
7,762 |
5,024 |
$151K |
| J7030 |
Normal saline solution infus |
1,670 |
1,340 |
$145K |
| 99284 |
|
17,140 |
15,790 |
$143K |
| 87086 |
|
2,779 |
2,583 |
$131K |
| U0003 |
Cov-19 amp prb hgh thruput |
1,348 |
1,272 |
$127K |
| 81025 |
|
7,021 |
6,586 |
$124K |
| 81003 |
|
4,314 |
4,051 |
$122K |
| 96374 |
|
8,818 |
7,676 |
$120K |
| 70450 |
|
4,296 |
3,894 |
$109K |
| 71046 |
|
4,240 |
4,065 |
$85K |
| J7120 |
Ringers lactate infusion |
1,069 |
870 |
$82K |
| 73630 |
|
1,355 |
1,253 |
$80K |
| 93306 |
|
801 |
775 |
$74K |
| 71045 |
|
9,676 |
8,610 |
$68K |
| 77063 |
|
962 |
957 |
$67K |
| 73610 |
|
948 |
888 |
$67K |
| 96365 |
|
2,607 |
2,159 |
$67K |
| 88305 |
|
1,180 |
867 |
$55K |
| 92507 |
|
3,625 |
1,206 |
$52K |
| 97530 |
|
7,685 |
2,575 |
$50K |
| 73030 |
|
1,063 |
973 |
$50K |
| 73564 |
|
814 |
734 |
$48K |
| 96361 |
|
5,378 |
4,490 |
$43K |
| 73130 |
|
526 |
484 |
$40K |
| 36416 |
|
1,950 |
1,239 |
$38K |
| 80307 |
|
2,806 |
2,577 |
$38K |
| 74176 |
|
2,180 |
2,037 |
$35K |
| 99285 |
|
9,306 |
8,246 |
$34K |
| 74018 |
|
645 |
605 |
$28K |
| 59025 |
|
784 |
643 |
$23K |
| 96360 |
|
1,457 |
1,376 |
$19K |
| 74177 |
|
2,561 |
2,406 |
$17K |
| 94640 |
|
1,917 |
1,524 |
$16K |
| 80305 |
|
602 |
559 |
$15K |
| 93005 |
|
11,057 |
9,354 |
$15K |
| 72100 |
|
349 |
341 |
$14K |
| 73502 |
|
376 |
342 |
$13K |
| 85027 |
|
2,563 |
2,223 |
$13K |
| 87491 |
|
363 |
347 |
$13K |
| 80053 |
|
15,998 |
13,717 |
$13K |
| 77067 |
|
1,249 |
1,240 |
$12K |
| 80048 |
|
7,544 |
6,203 |
$12K |
| 93356 |
|
27 |
25 |
$11K |
| 87077 |
|
506 |
445 |
$9K |
| J7050 |
Normal saline solution infus |
963 |
636 |
$8K |
| 85025 |
|
21,684 |
17,914 |
$8K |
| Q0162 |
Ondansetron oral |
73 |
67 |
$8K |
| 73110 |
|
126 |
106 |
$8K |
| 99213 |
|
263 |
158 |
$7K |
| 97140 |
|
1,324 |
489 |
$7K |
| 96376 |
|
1,799 |
1,207 |
$7K |
| G0463 |
Hospital outpt clinic visit |
314 |
160 |
$6K |
| 76805 |
|
43 |
43 |
$6K |
| 76705 |
|
82 |
80 |
$6K |
| 97535 |
|
151 |
127 |
$6K |
| J7040 |
Normal saline solution infus |
98 |
86 |
$6K |
| 93971 |
|
45 |
44 |
$5K |
| 96375 |
|
6,190 |
5,107 |
$5K |
| 72148 |
|
12 |
12 |
$5K |
| 72110 |
|
92 |
91 |
$4K |
| 87490 |
|
59 |
59 |
$4K |
| 72125 |
|
886 |
823 |
$4K |
| 71260 |
|
105 |
99 |
$4K |
| G0378 |
Hospital observation per hr |
1,584 |
708 |
$4K |
| 77080 |
|
45 |
44 |
$3K |
| 43239 |
|
43 |
39 |
$3K |
| 87807 |
|
620 |
593 |
$3K |
| 85610 |
|
5,383 |
4,565 |
$3K |
| 71250 |
|
26 |
25 |
$2K |
| J2270 |
Morphine sulfate injection |
2,329 |
1,993 |
$2K |
| 72050 |
|
25 |
25 |
$2K |
| 72040 |
|
41 |
40 |
$2K |
| 97161 |
|
379 |
359 |
$2K |
| 96366 |
|
430 |
346 |
$2K |
| 77066 |
Tomosynthesis, mammo |
38 |
37 |
$2K |
| 73140 |
|
13 |
13 |
$2K |
| J2704 |
Inj, propofol, 10 mg |
2,191 |
2,060 |
$2K |
| 87591 |
|
405 |
386 |
$2K |
| 76700 |
|
24 |
24 |
$2K |
| 73590 |
|
24 |
20 |
$2K |
| M0243 |
Casirivi and imdevi inj |
15 |
15 |
$2K |
| 74021 |
|
46 |
45 |
$2K |
| 73562 |
|
30 |
29 |
$1K |
| 86850 |
|
297 |
269 |
$1K |
| 76801 |
|
20 |
20 |
$1K |
| 97164 |
|
272 |
257 |
$1K |
| 86900 |
|
732 |
660 |
$1K |
| J2405 |
Ondansetron hcl injection |
5,678 |
4,960 |
$1K |
| 82948 |
|
266 |
149 |
$944.25 |
| J1885 |
Ketorolac tromethamine inj |
5,983 |
5,453 |
$865.25 |
| J0696 |
Ceftriaxone sodium injection |
2,929 |
2,585 |
$768.35 |
| 83735 |
|
7,613 |
6,208 |
$712.86 |
| 82803 |
|
261 |
216 |
$636.08 |
| J3490 |
Drugs unclassified injection |
1,523 |
1,362 |
$433.64 |
| 36600 |
|
136 |
117 |
$426.58 |
| 82570 |
|
42 |
38 |
$373.23 |
| 73090 |
|
13 |
12 |
$368.77 |
| 84484 |
|
9,114 |
6,731 |
$320.66 |
| J1200 |
Diphenhydramine hcl injectio |
634 |
533 |
$317.69 |
| 82805 |
|
16 |
13 |
$268.48 |
| 73560 |
|
16 |
13 |
$244.94 |
| 83690 |
|
5,498 |
4,962 |
$207.89 |
| 84439 |
|
86 |
80 |
$195.86 |
| 83880 |
|
3,505 |
3,110 |
$187.13 |
| J2550 |
Promethazine hcl injection |
991 |
851 |
$174.91 |
| 87088 |
|
471 |
452 |
$171.56 |
| J1170 |
Hydromorphone injection |
1,366 |
1,046 |
$170.92 |
| C9803 |
Hopd covid-19 spec collect |
494 |
467 |
$138.76 |
| 85007 |
|
177 |
164 |
$114.08 |
| 80076 |
|
1,019 |
959 |
$111.73 |
| 84443 |
|
2,398 |
2,192 |
$84.60 |
| 97162 |
|
12 |
12 |
$69.91 |
| J2001 |
Lidocaine injection |
328 |
312 |
$68.45 |
| 84702 |
|
295 |
257 |
$66.26 |
| 97167 |
|
28 |
25 |
$65.77 |
| A9270 |
Non-covered item or service |
1,712 |
1,224 |
$50.79 |
| 80061 |
|
618 |
567 |
$49.69 |
| 87040 |
|
3,577 |
2,026 |
$37.62 |
| J1100 |
Dexamethasone sodium phos |
3,680 |
3,437 |
$37.59 |
| 90715 |
|
69 |
68 |
$23.93 |
| 83605 |
|
2,828 |
2,338 |
$19.50 |
| 82077 |
|
1,041 |
923 |
$18.38 |
| 86140 |
|
900 |
748 |
$16.74 |
| 85730 |
|
4,628 |
4,126 |
$15.56 |
| 82247 |
|
22 |
12 |
$15.02 |
| J1650 |
Inj enoxaparin sodium |
306 |
168 |
$8.52 |
| 85379 |
|
1,269 |
1,185 |
$8.21 |
| 80320 |
|
557 |
512 |
$5.00 |
| 86901 |
|
732 |
661 |
$3.99 |
| J7512 |
Prednisone ir or dr oral 1mg |
158 |
132 |
$1.71 |
| J3010 |
Fentanyl citrate injection |
436 |
414 |
$0.24 |
| J3475 |
Inj magnesium sulfate |
165 |
144 |
$0.00 |
| 80179 |
|
198 |
180 |
$0.00 |
| 87186 |
|
1,367 |
1,221 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
108 |
82 |
$0.00 |
| 80143 |
|
242 |
209 |
$0.00 |
| 87798 |
|
1,511 |
1,428 |
$0.00 |
| J2272 |
Inj, morphine (fresenius) |
132 |
107 |
$0.00 |
| 85378 |
|
89 |
84 |
$0.00 |
| J2930 |
Methylprednisolone injection |
371 |
328 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
25 |
25 |
$0.00 |
| Q0163 |
Diphenhydramine hcl 50mg |
43 |
40 |
$0.00 |
| 84145 |
|
60 |
47 |
$0.00 |
| 84156 |
|
41 |
37 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
13 |
12 |
$0.00 |
| 84100 |
|
60 |
51 |
$0.00 |
| 82248 |
|
37 |
24 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
14 |
13 |
$0.00 |
| 97168 |
|
16 |
16 |
$0.00 |
| 94760 |
|
70 |
25 |
$0.00 |
| 83036 |
|
237 |
220 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
583 |
560 |
$0.00 |
| 71275 |
|
451 |
421 |
$0.00 |
| U0005 |
Infec agen detec ampli probe |
56 |
53 |
$0.00 |
| 87590 |
|
59 |
59 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
468 |
413 |
$0.00 |
| J2060 |
Lorazepam injection |
258 |
223 |
$0.00 |
| 85651 |
|
120 |
105 |
$0.00 |
| 82550 |
|
369 |
334 |
$0.00 |
| 90471 |
|
58 |
58 |
$0.00 |
| 87205 |
|
63 |
44 |
$0.00 |
| J1940 |
Furosemide injection |
250 |
160 |
$0.00 |
| G0480 |
Drug test def 1-7 classes |
12 |
12 |
$0.00 |
| J8540 |
Oral dexamethasone |
69 |
67 |
$0.00 |
| 87140 |
|
13 |
13 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
48 |
47 |
$0.00 |
| 88342 |
|
28 |
27 |
$0.00 |
| 94644 |
|
92 |
85 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
40 |
36 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
19 |
17 |
$0.00 |
| J0360 |
Hydralazine hcl injection |
14 |
13 |
$0.00 |