| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87635 |
|
65,238 |
43,067 |
$10.36M |
| 99284 |
|
6,145 |
4,591 |
$5.83M |
| 99283 |
|
10,346 |
7,887 |
$5.61M |
| 80053 |
|
15,245 |
12,778 |
$2.98M |
| 96372 |
|
13,895 |
10,726 |
$2.19M |
| 87880 |
|
11,316 |
10,455 |
$1.84M |
| 85025 |
|
16,049 |
13,496 |
$1.75M |
| 99282 |
|
5,667 |
4,403 |
$1.75M |
| 99285 |
|
1,251 |
982 |
$1.61M |
| 87591 |
|
7,607 |
6,990 |
$1.51M |
| 87491 |
|
7,520 |
6,921 |
$1.48M |
| 74177 |
|
400 |
347 |
$1.17M |
| 70450 |
|
821 |
720 |
$1.16M |
| 96360 |
|
2,803 |
2,223 |
$925K |
| 84443 |
|
5,461 |
5,031 |
$904K |
| 87804 |
|
3,681 |
3,457 |
$892K |
| 87633 |
|
565 |
525 |
$878K |
| 71046 |
|
2,304 |
2,083 |
$827K |
| 96374 |
|
3,524 |
2,762 |
$798K |
| 81025 |
|
8,496 |
7,314 |
$749K |
| 96365 |
|
2,370 |
1,687 |
$699K |
| 83036 |
|
5,049 |
4,790 |
$617K |
| 97110 |
|
3,733 |
2,144 |
$611K |
| 94640 |
|
3,311 |
2,435 |
$610K |
| 87086 |
|
5,156 |
4,602 |
$585K |
| J3490 |
Drugs unclassified injection |
3,147 |
2,049 |
$576K |
| 87651 |
|
3,673 |
3,362 |
$538K |
| 81001 |
|
6,796 |
5,832 |
$525K |
| 96375 |
|
2,418 |
1,790 |
$499K |
| 96361 |
|
2,758 |
2,145 |
$493K |
| 85018 |
|
8,652 |
7,853 |
$491K |
| 80061 |
|
3,731 |
3,469 |
$464K |
| 81002 |
|
11,178 |
9,340 |
$460K |
| 82948 |
|
6,132 |
4,832 |
$420K |
| 86141 |
|
3,008 |
2,601 |
$393K |
| J0561 |
Penicillin g benzathine inj |
1,412 |
1,289 |
$362K |
| 86803 |
|
1,868 |
1,772 |
$360K |
| 93005 |
|
2,508 |
2,202 |
$354K |
| 87210 |
|
3,783 |
3,452 |
$347K |
| 82728 |
|
1,923 |
1,779 |
$338K |
| 97161 |
|
1,306 |
1,262 |
$295K |
| 82306 |
|
1,515 |
1,390 |
$273K |
| 87186 |
|
1,987 |
1,807 |
$266K |
| 76805 |
|
320 |
302 |
$259K |
| 83880 |
|
1,149 |
972 |
$254K |
| 83735 |
|
3,406 |
2,790 |
$250K |
| 80048 |
|
1,346 |
1,250 |
$240K |
| 86780 |
|
2,212 |
2,074 |
$237K |
| 80305 |
|
1,615 |
1,410 |
$237K |
| 83690 |
|
2,620 |
2,121 |
$208K |
| 87389 |
|
2,501 |
2,365 |
$192K |
| 85027 |
|
1,796 |
1,644 |
$180K |
| 80306 |
|
1,400 |
1,080 |
$179K |
| 84484 |
|
1,417 |
1,156 |
$178K |
| 84466 |
|
1,544 |
1,435 |
$176K |
| 86481 |
|
672 |
633 |
$174K |
| 74176 |
|
61 |
53 |
$156K |
| 87502 |
|
497 |
467 |
$151K |
| J1050 |
Medroxyprogesterone acetate |
754 |
718 |
$151K |
| 99211 |
|
8,011 |
5,937 |
$150K |
| 87807 |
|
1,055 |
973 |
$139K |
| 77067 |
|
575 |
555 |
$133K |
| 83540 |
|
1,730 |
1,604 |
$128K |
| J1885 |
Ketorolac tromethamine inj |
5,542 |
3,935 |
$127K |
| 71045 |
|
541 |
449 |
$126K |
| 73610 |
|
283 |
250 |
$124K |
| 87340 |
|
988 |
945 |
$124K |
| 85610 |
|
1,642 |
1,327 |
$106K |
| 86850 |
|
980 |
855 |
$106K |
| 99213 |
|
5,071 |
4,105 |
$94K |
| J7030 |
Normal saline solution infus |
4,147 |
3,221 |
$91K |
| 84702 |
|
549 |
386 |
$88K |
| 99281 |
|
272 |
248 |
$84K |
| 85652 |
|
1,569 |
1,416 |
$83K |
| 87624 |
|
645 |
631 |
$79K |
| 87798 |
|
605 |
561 |
$79K |
| 87486 |
|
597 |
556 |
$79K |
| 87581 |
|
597 |
556 |
$78K |
| 77063 |
|
549 |
530 |
$77K |
| 82977 |
|
1,091 |
974 |
$76K |
| 88305 |
|
338 |
313 |
$73K |
| 72125 |
|
47 |
38 |
$69K |
| 73130 |
|
164 |
147 |
$67K |
| 86480 |
|
248 |
244 |
$66K |
| 84439 |
|
498 |
462 |
$65K |
| 76705 |
|
141 |
125 |
$64K |
| 73562 |
|
168 |
144 |
$61K |
| J7120 |
Ringers lactate infusion |
1,617 |
1,242 |
$61K |
| 86900 |
|
1,017 |
889 |
$59K |
| J2510 |
Penicillin g procaine inj |
119 |
114 |
$53K |
| 73030 |
|
124 |
109 |
$53K |
| 80076 |
|
352 |
329 |
$50K |
| 36415 |
|
5,667 |
5,041 |
$49K |
| G0378 |
Hospital observation per hr |
17 |
12 |
$48K |
| 86901 |
|
1,017 |
889 |
$48K |
| 76801 |
|
100 |
91 |
$48K |
| 85730 |
|
464 |
391 |
$47K |
| 83605 |
|
457 |
322 |
$46K |
| 97140 |
|
170 |
95 |
$45K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
668 |
560 |
$45K |
| 96366 |
|
210 |
155 |
$44K |
| 86702 |
|
2,328 |
2,202 |
$43K |
| 87070 |
|
312 |
298 |
$42K |
| 86762 |
|
328 |
315 |
$41K |
| J3010 |
Fentanyl citrate injection |
1,076 |
925 |
$41K |
| 82550 |
|
391 |
318 |
$40K |
| J2405 |
Ondansetron hcl injection |
2,278 |
1,726 |
$38K |
| 82607 |
|
367 |
329 |
$38K |
| J2315 |
Naltrexone, depot form |
14 |
12 |
$35K |
| J0696 |
Ceftriaxone sodium injection |
2,085 |
1,587 |
$32K |
| J7050 |
Normal saline solution infus |
1,255 |
737 |
$30K |
| 84703 |
|
339 |
297 |
$29K |
| Q0162 |
Ondansetron oral |
799 |
692 |
$27K |
| 84100 |
|
426 |
356 |
$27K |
| 73100 |
|
65 |
50 |
$26K |
| 86701 |
|
2,328 |
2,202 |
$24K |
| 70486 |
|
12 |
12 |
$24K |
| 84145 |
|
311 |
255 |
$22K |
| 87081 |
|
203 |
198 |
$22K |
| 99212 |
|
2,018 |
1,711 |
$21K |
| 83721 |
|
1,192 |
1,138 |
$19K |
| J2060 |
Lorazepam injection |
493 |
367 |
$18K |
| 99214 |
|
588 |
561 |
$16K |
| J2270 |
Morphine sulfate injection |
899 |
606 |
$13K |
| 82746 |
|
97 |
93 |
$13K |
| 85014 |
|
333 |
315 |
$11K |
| 97530 |
|
74 |
38 |
$11K |
| J2001 |
Lidocaine injection |
175 |
141 |
$10K |
| J1100 |
Dexamethasone sodium phos |
640 |
541 |
$9K |
| 73630 |
|
28 |
24 |
$9K |
| 83719 |
|
176 |
170 |
$9K |
| 87040 |
|
43 |
42 |
$9K |
| 87150 |
|
59 |
56 |
$8K |
| 86706 |
|
53 |
52 |
$8K |
| 73090 |
|
14 |
12 |
$8K |
| 82570 |
|
94 |
86 |
$7K |
| J7040 |
Normal saline solution infus |
301 |
232 |
$7K |
| 80074 |
|
17 |
14 |
$7K |
| J1200 |
Diphenhydramine hcl injectio |
121 |
112 |
$6K |
| 84512 |
|
88 |
80 |
$6K |
| 96376 |
|
30 |
26 |
$6K |
| 87390 |
|
502 |
486 |
$6K |
| 82565 |
|
45 |
40 |
$5K |
| 83550 |
|
77 |
70 |
$5K |
| 84153 |
|
28 |
27 |
$4K |
| 85007 |
|
79 |
66 |
$4K |
| 86704 |
|
41 |
40 |
$4K |
| J2250 |
Inj midazolam hydrochloride |
878 |
750 |
$4K |
| 85379 |
|
28 |
27 |
$4K |
| 83655 |
|
27 |
27 |
$4K |
| J2765 |
Metoclopramide hcl injection |
64 |
57 |
$4K |
| 82951 |
|
26 |
26 |
$4K |
| 82435 |
|
28 |
25 |
$4K |
| 86703 |
|
37 |
35 |
$3K |
| 86431 |
|
25 |
25 |
$3K |
| 84132 |
|
44 |
41 |
$3K |
| 84295 |
|
44 |
41 |
$3K |
| J2930 |
Methylprednisolone injection |
42 |
38 |
$3K |
| 92014 |
|
72 |
66 |
$3K |
| 82310 |
|
28 |
25 |
$3K |
| 84075 |
|
25 |
22 |
$2K |
| 99152 |
|
45 |
44 |
$2K |
| Q0144 |
Azithromycin dihydrate, oral |
31 |
24 |
$2K |
| 82040 |
|
24 |
21 |
$2K |
| J2550 |
Promethazine hcl injection |
108 |
91 |
$2K |
| 82947 |
|
36 |
32 |
$2K |
| J3411 |
Thiamine hcl 100 mg |
59 |
53 |
$2K |
| 92504 |
|
21 |
20 |
$2K |
| 82247 |
|
42 |
38 |
$2K |
| J7060 |
5% dextrose/water |
128 |
65 |
$2K |
| 82105 |
|
13 |
12 |
$2K |
| 86708 |
|
12 |
12 |
$2K |
| 84520 |
|
28 |
25 |
$2K |
| 84460 |
|
26 |
23 |
$1K |
| 84155 |
|
24 |
21 |
$1K |
| 84450 |
|
24 |
21 |
$1K |
| 92567 |
|
85 |
78 |
$1K |
| V2750 |
Anti-reflective coating |
69 |
69 |
$1K |
| V2020 |
Vision svcs frames purchases |
43 |
43 |
$776.54 |
| 82043 |
|
15 |
13 |
$541.76 |
| J7613 |
Albuterol non-comp unit |
79 |
66 |
$449.81 |
| 90715 |
|
16 |
16 |
$401.68 |
| C9803 |
Hopd covid-19 spec collect |
196 |
171 |
$239.43 |
| 90471 |
|
156 |
154 |
$181.57 |
| V2745 |
Tint, any color/solid/grad |
26 |
26 |
$130.87 |
| J1630 |
Haloperidol injection |
156 |
106 |
$32.80 |
| J7620 |
Albuterol ipratrop non-comp |
1,627 |
1,378 |
$24.56 |
| 90647 |
|
12 |
12 |
$0.12 |
| 0202U |
|
680 |
620 |
$0.00 |
| 87634 |
|
2,178 |
2,046 |
$0.00 |
| Q0177 |
Hydroxyzine pamoate 25mg |
14 |
12 |
$0.00 |
| 90472 |
|
39 |
38 |
$0.00 |
| 90670 |
|
16 |
16 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
47 |
41 |
$0.00 |
| 0352U |
|
1,086 |
1,000 |
$0.00 |
| 80320 |
|
1,446 |
1,145 |
$0.00 |