| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
7,997 |
7,557 |
$1.74M |
| 99283 |
|
10,725 |
10,287 |
$1.69M |
| 99285 |
|
5,269 |
4,934 |
$1.41M |
| 74177 |
|
1,174 |
1,143 |
$529K |
| 70450 |
|
1,798 |
1,727 |
$382K |
| 74176 |
|
1,002 |
974 |
$305K |
| 93005 |
|
4,076 |
3,737 |
$276K |
| 80307 |
|
2,464 |
2,227 |
$219K |
| 96374 |
|
5,427 |
5,063 |
$213K |
| 71045 |
|
4,104 |
3,799 |
$197K |
| 87426 |
|
6,605 |
6,354 |
$196K |
| 96375 |
|
4,121 |
3,625 |
$184K |
| 80053 |
|
11,467 |
10,289 |
$181K |
| 96365 |
|
1,406 |
1,280 |
$148K |
| 85025 |
|
12,444 |
10,980 |
$119K |
| 77067 |
|
734 |
730 |
$101K |
| 94640 |
|
1,135 |
951 |
$97K |
| 96372 |
|
2,642 |
2,364 |
$93K |
| 87880 |
|
2,624 |
2,582 |
$92K |
| 72125 |
|
310 |
307 |
$87K |
| G0378 |
Hospital observation per hr |
278 |
189 |
$85K |
| 84484 |
|
3,221 |
2,448 |
$85K |
| 87804 |
|
7,468 |
4,305 |
$82K |
| 99281 |
|
1,332 |
1,305 |
$82K |
| 96361 |
|
2,049 |
1,927 |
$63K |
| 84443 |
|
1,927 |
1,865 |
$59K |
| 87807 |
|
917 |
897 |
$54K |
| 99282 |
|
511 |
502 |
$51K |
| 83690 |
|
2,650 |
2,488 |
$48K |
| 96366 |
|
570 |
519 |
$45K |
| 71046 |
|
698 |
688 |
$43K |
| J2405 |
Ondansetron hcl injection |
3,271 |
2,904 |
$41K |
| 73610 |
|
385 |
366 |
$39K |
| C9803 |
Hopd covid-19 spec collect |
2,180 |
2,068 |
$35K |
| 83880 |
|
1,328 |
1,206 |
$33K |
| J1885 |
Ketorolac tromethamine inj |
2,933 |
2,668 |
$32K |
| 73562 |
|
356 |
351 |
$30K |
| 84702 |
|
913 |
729 |
$30K |
| J2270 |
Morphine sulfate injection |
2,154 |
1,806 |
$29K |
| 96360 |
|
536 |
528 |
$29K |
| 84703 |
|
1,311 |
1,266 |
$28K |
| G0463 |
Hospital outpt clinic visit |
287 |
244 |
$27K |
| J3490 |
Drugs unclassified injection |
164 |
140 |
$27K |
| 73630 |
|
344 |
334 |
$25K |
| 81001 |
|
4,053 |
3,804 |
$24K |
| 96376 |
|
1,200 |
921 |
$24K |
| 76705 |
|
235 |
226 |
$23K |
| 83605 |
|
1,337 |
1,097 |
$23K |
| J1100 |
Dexamethasone sodium phos |
1,580 |
1,498 |
$23K |
| 87086 |
|
1,082 |
1,036 |
$23K |
| 77063 |
|
720 |
716 |
$22K |
| 73030 |
|
275 |
265 |
$22K |
| 74018 |
|
375 |
365 |
$22K |
| 83735 |
|
1,240 |
1,063 |
$20K |
| J2704 |
Inj, propofol, 10 mg |
683 |
655 |
$20K |
| 87040 |
|
732 |
478 |
$18K |
| 80048 |
|
1,382 |
1,172 |
$18K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,847 |
1,785 |
$17K |
| 76801 |
|
126 |
119 |
$16K |
| J3010 |
Fentanyl citrate injection |
880 |
816 |
$15K |
| 85379 |
|
714 |
680 |
$15K |
| 76830 |
|
109 |
109 |
$15K |
| 80061 |
|
813 |
799 |
$15K |
| 73130 |
|
202 |
193 |
$14K |
| 71275 |
|
85 |
82 |
$13K |
| 86850 |
|
681 |
655 |
$13K |
| 36415 |
|
2,984 |
2,584 |
$13K |
| 73110 |
|
173 |
166 |
$13K |
| 83036 |
|
798 |
780 |
$12K |
| 76700 |
|
102 |
101 |
$12K |
| 81003 |
|
2,337 |
2,237 |
$11K |
| J0696 |
Ceftriaxone sodium injection |
1,133 |
988 |
$10K |
| 86900 |
|
910 |
860 |
$10K |
| 86901 |
|
909 |
859 |
$10K |
| 87591 |
|
408 |
400 |
$8K |
| 87186 |
|
447 |
429 |
$8K |
| 87491 |
|
410 |
402 |
$8K |
| 86140 |
|
482 |
462 |
$8K |
| 82077 |
|
281 |
255 |
$7K |
| 81025 |
|
1,333 |
1,288 |
$7K |
| 84439 |
|
390 |
384 |
$7K |
| 87389 |
|
480 |
471 |
$7K |
| J1200 |
Diphenhydramine hcl injectio |
697 |
640 |
$7K |
| 85027 |
|
1,219 |
1,135 |
$6K |
| 82306 |
|
475 |
465 |
$6K |
| 76811 |
|
30 |
30 |
$6K |
| 82150 |
|
244 |
240 |
$6K |
| J2250 |
Inj midazolam hydrochloride |
450 |
439 |
$6K |
| 85610 |
|
1,078 |
996 |
$5K |
| 90471 |
|
345 |
331 |
$5K |
| J2060 |
Lorazepam injection |
579 |
464 |
$5K |
| 76642 |
|
41 |
41 |
$5K |
| J1170 |
Hydromorphone injection |
511 |
423 |
$5K |
| J0561 |
Penicillin g benzathine inj |
38 |
38 |
$5K |
| 82962 |
|
1,745 |
1,041 |
$5K |
| 85730 |
|
384 |
362 |
$5K |
| 72100 |
|
57 |
57 |
$4K |
| 90715 |
|
113 |
112 |
$4K |
| 93971 |
|
36 |
36 |
$4K |
| 82550 |
|
318 |
298 |
$4K |
| 80143 |
|
133 |
122 |
$4K |
| 80179 |
|
129 |
119 |
$4K |
| 82803 |
|
68 |
62 |
$4K |
| 82553 |
|
223 |
208 |
$4K |
| 70486 |
|
14 |
14 |
$3K |
| J0690 |
Cefazolin sodium injection |
256 |
234 |
$3K |
| J2930 |
Methylprednisolone injection |
236 |
187 |
$3K |
| 86803 |
|
280 |
276 |
$3K |
| 73590 |
|
33 |
26 |
$3K |
| 73090 |
|
32 |
29 |
$2K |
| 73502 |
|
57 |
54 |
$2K |
| J2360 |
Orphenadrine injection |
122 |
117 |
$2K |
| J2001 |
Lidocaine injection |
248 |
231 |
$2K |
| 87088 |
|
103 |
100 |
$2K |
| 76856 |
|
15 |
15 |
$2K |
| 87340 |
|
268 |
262 |
$2K |
| 90714 |
|
58 |
57 |
$2K |
| 86780 |
|
187 |
181 |
$2K |
| 87420 |
|
161 |
158 |
$1K |
| C9113 |
Inj pantoprazole sodium, via |
147 |
110 |
$1K |
| 73140 |
|
18 |
18 |
$1K |
| 86762 |
|
164 |
160 |
$1K |
| 12001 |
|
12 |
12 |
$1K |
| J2765 |
Metoclopramide hcl injection |
105 |
90 |
$1K |
| U0003 |
Cov-19 amp prb hgh thruput |
24 |
24 |
$1K |
| J3475 |
Inj magnesium sulfate |
123 |
114 |
$1K |
| 82950 |
|
133 |
133 |
$1K |
| 87081 |
|
134 |
128 |
$1K |
| J2550 |
Promethazine hcl injection |
173 |
131 |
$1K |
| 76641 |
|
12 |
12 |
$1K |
| 84100 |
|
93 |
89 |
$1K |
| 73564 |
|
13 |
13 |
$1K |
| J7512 |
Prednisone ir or dr oral 1mg |
374 |
358 |
$998.35 |
| 88305 |
|
28 |
27 |
$951.98 |
| J0137 |
Inj, acetaminophen (hikma) |
57 |
57 |
$756.52 |
| 87070 |
|
36 |
34 |
$708.34 |
| 86592 |
|
205 |
202 |
$651.66 |
| 88175 |
|
31 |
31 |
$625.52 |
| J2919 |
Inj, methylpred sod succ 5mg |
47 |
41 |
$560.94 |
| 81005 |
|
65 |
58 |
$530.71 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
36 |
34 |
$530.18 |
| A9270 |
Non-covered item or service |
565 |
248 |
$458.92 |
| J1836 |
Inj, metronidazole, 10 mg |
15 |
12 |
$366.67 |
| J0780 |
Prochlorperazine injection |
27 |
27 |
$341.38 |
| J7999 |
Compounded drug, noc |
21 |
21 |
$294.55 |
| J7510 |
Prednisolone oral per 5 mg |
151 |
149 |
$261.68 |
| 96367 |
|
18 |
13 |
$258.91 |
| J0330 |
Succinycholine chloride inj |
16 |
16 |
$249.41 |
| J1650 |
Inj enoxaparin sodium |
42 |
25 |
$225.38 |
| J1630 |
Haloperidol injection |
37 |
37 |
$214.60 |
| J1940 |
Furosemide injection |
51 |
37 |
$178.62 |
| J1815 |
Insulin injection |
121 |
45 |
$176.47 |
| J0131 |
Inj, acetaminophen (nos) |
13 |
13 |
$167.00 |
| Q0162 |
Ondansetron oral |
21 |
20 |
$142.77 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
12 |
12 |
$137.74 |
| J2543 |
Piperacillin/tazobactam |
20 |
14 |
$107.59 |
| 82607 |
|
12 |
12 |
$78.20 |
| G1004 |
Cdsm ndsc |
1,545 |
1,197 |
$0.00 |