| Code | Description | Claims | Beneficiaries | Total Paid |
| 99283 |
|
3,312 |
3,164 |
$215K |
| 99281 |
|
1,425 |
1,341 |
$212K |
| 0450 |
|
3,622 |
3,339 |
$184K |
| 99199 |
|
2,837 |
2,645 |
$148K |
| 99284 |
|
1,703 |
1,645 |
$143K |
| 96374 |
|
1,092 |
1,050 |
$93K |
| 93000 |
|
1,673 |
1,607 |
$87K |
| 80053 |
|
8,931 |
8,540 |
$84K |
| 76700 |
|
661 |
656 |
$84K |
| 96372 |
|
2,500 |
2,352 |
$73K |
| 93306 |
|
355 |
347 |
$71K |
| 85025 |
|
9,245 |
8,809 |
$66K |
| 84443 |
|
3,858 |
3,798 |
$54K |
| 96360 |
|
578 |
550 |
$53K |
| 97140 |
|
1,818 |
613 |
$51K |
| 99070 |
|
2,280 |
1,960 |
$49K |
| 99282 |
|
1,625 |
1,562 |
$47K |
| 71046 |
|
1,462 |
1,420 |
$40K |
| 80061 |
|
4,338 |
4,312 |
$40K |
| U0002 |
Covid-19 lab test non-cdc |
801 |
788 |
$39K |
| 45385 |
|
44 |
43 |
$39K |
| 0270 |
|
7,195 |
6,830 |
$36K |
| 70450 |
|
119 |
117 |
$32K |
| 82306 |
|
1,548 |
1,532 |
$30K |
| 96375 |
|
502 |
482 |
$27K |
| 83036 |
|
3,420 |
3,390 |
$26K |
| 71045 |
|
1,054 |
1,026 |
$24K |
| T1999 |
Noc retail items andsupplies |
844 |
659 |
$16K |
| 74177 |
|
26 |
25 |
$15K |
| 99285 |
|
126 |
117 |
$14K |
| 76856 |
|
137 |
137 |
$13K |
| 84439 |
|
1,925 |
1,896 |
$12K |
| 99213 |
|
1,012 |
896 |
$12K |
| 0250 |
|
2,760 |
2,636 |
$12K |
| J1885 |
Ketorolac tromethamine inj |
2,158 |
2,053 |
$11K |
| 81001 |
|
3,126 |
3,034 |
$11K |
| J7030 |
Normal saline solution infus |
1,297 |
1,225 |
$10K |
| 36000 |
|
234 |
215 |
$9K |
| 94640 |
|
301 |
284 |
$7K |
| 83540 |
|
1,123 |
1,114 |
$7K |
| 84484 |
|
606 |
562 |
$7K |
| 87804 |
|
811 |
560 |
$6K |
| 80305 |
|
498 |
480 |
$6K |
| 83690 |
|
819 |
780 |
$6K |
| 82728 |
|
638 |
636 |
$6K |
| 83550 |
|
1,065 |
1,058 |
$5K |
| 76770 |
|
27 |
27 |
$5K |
| 72100 |
|
80 |
79 |
$5K |
| 81025 |
|
818 |
797 |
$4K |
| 99212 |
|
196 |
170 |
$4K |
| 73030 |
|
70 |
66 |
$4K |
| 97110 |
|
648 |
247 |
$4K |
| 73630 |
|
85 |
77 |
$3K |
| 83605 |
|
291 |
276 |
$3K |
| 82043 |
|
509 |
504 |
$3K |
| 80048 |
|
396 |
385 |
$3K |
| 00811 |
|
26 |
26 |
$3K |
| 45378 |
|
21 |
21 |
$3K |
| 43239 |
|
32 |
32 |
$3K |
| 73610 |
|
70 |
68 |
$3K |
| 86803 |
|
228 |
227 |
$3K |
| 73562 |
|
129 |
101 |
$2K |
| 87086 |
|
381 |
374 |
$2K |
| 83735 |
|
351 |
332 |
$2K |
| 82607 |
|
181 |
181 |
$2K |
| 87880 |
|
270 |
267 |
$2K |
| 94760 |
|
210 |
203 |
$2K |
| 74176 |
|
13 |
13 |
$2K |
| 0710 |
|
58 |
58 |
$2K |
| 87389 |
|
78 |
77 |
$2K |
| 85027 |
|
290 |
274 |
$2K |
| 81003 |
|
667 |
652 |
$1K |
| 73130 |
|
28 |
25 |
$1K |
| J0696 |
Ceftriaxone sodium injection |
258 |
250 |
$1K |
| 82570 |
|
333 |
329 |
$1K |
| 82746 |
|
105 |
105 |
$1K |
| 83655 |
|
115 |
114 |
$1K |
| J2405 |
Ondansetron hcl injection |
233 |
225 |
$1K |
| J1100 |
Dexamethasone sodium phos |
216 |
214 |
$979.85 |
| 45380 |
|
21 |
21 |
$946.66 |
| 83880 |
|
28 |
27 |
$826.66 |
| 83525 |
|
117 |
116 |
$790.66 |
| J2704 |
Inj, propofol, 10 mg |
169 |
169 |
$790.01 |
| J3490 |
Drugs unclassified injection |
73 |
67 |
$754.23 |
| 87491 |
|
25 |
24 |
$751.53 |
| 87591 |
|
24 |
24 |
$751.23 |
| 86480 |
|
16 |
16 |
$694.24 |
| J2250 |
Inj midazolam hydrochloride |
139 |
139 |
$644.42 |
| 87635 |
|
12 |
12 |
$615.72 |
| 85007 |
|
257 |
240 |
$615.70 |
| 36415 |
|
4,825 |
4,501 |
$527.67 |
| 99214 |
|
52 |
49 |
$424.93 |
| Z7610 |
|
39 |
36 |
$417.27 |
| 82652 |
|
12 |
12 |
$398.16 |
| 96361 |
|
12 |
12 |
$363.61 |
| 82077 |
|
25 |
24 |
$321.96 |
| 87340 |
|
26 |
25 |
$247.92 |
| 85610 |
|
72 |
70 |
$244.29 |
| 82150 |
|
42 |
40 |
$228.04 |
| 90715 |
|
15 |
15 |
$189.21 |
| 85652 |
|
72 |
72 |
$175.20 |
| J3010 |
Fentanyl citrate injection |
28 |
28 |
$152.04 |
| 86705 |
|
13 |
12 |
$150.38 |
| S0164 |
Injection pantroprazole |
14 |
13 |
$145.60 |
| 86709 |
|
13 |
12 |
$139.88 |
| J2765 |
Metoclopramide hcl injection |
24 |
24 |
$137.21 |
| 99393 |
|
12 |
12 |
$135.51 |
| 87070 |
|
13 |
13 |
$97.63 |
| 82947 |
|
14 |
14 |
$82.50 |
| 87420 |
|
13 |
13 |
$74.86 |
| 84481 |
|
12 |
12 |
$67.26 |
| 85730 |
|
12 |
12 |
$64.08 |
| J1200 |
Diphenhydramine hcl injectio |
12 |
12 |
$63.12 |
| J0131 |
Inj, acetaminophen (nos) |
13 |
13 |
$58.63 |
| 86140 |
|
12 |
12 |
$55.20 |
| 85018 |
|
126 |
124 |
$25.56 |
| 84550 |
|
12 |
12 |
$22.44 |
| 99173 |
|
133 |
133 |
$13.20 |
| 81000 |
|
69 |
68 |
$5.32 |
| 92551 |
|
79 |
79 |
$0.00 |
| 3074F |
|
161 |
158 |
$0.00 |
| 96127 |
|
14 |
14 |
$0.00 |
| 3079F |
|
25 |
25 |
$0.00 |
| T1015 |
Clinic service |
21 |
18 |
$0.00 |
| 3078F |
|
138 |
137 |
$0.00 |
| 0270R |
|
12 |
12 |
$0.00 |
| 92552 |
|
19 |
19 |
$0.00 |