| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
|
21,334 |
19,132 |
$960K |
| 0250 |
|
4,956 |
3,506 |
$342K |
| 99281 |
|
4,270 |
3,643 |
$305K |
| 99284 |
|
1,584 |
1,459 |
$179K |
| 96374 |
|
3,804 |
3,508 |
$163K |
| 70450 |
|
1,502 |
1,435 |
$126K |
| 74177 |
|
637 |
608 |
$125K |
| J3490 |
Drugs unclassified injection |
6,784 |
5,031 |
$98K |
| 96375 |
|
2,379 |
2,203 |
$85K |
| 80053 |
|
7,376 |
6,707 |
$80K |
| 80307 |
|
1,676 |
1,559 |
$76K |
| 99283 |
|
1,021 |
899 |
$74K |
| 93005 |
|
4,077 |
3,782 |
$73K |
| 96372 |
|
2,853 |
2,645 |
$70K |
| 96361 |
|
3,040 |
2,783 |
$65K |
| 96365 |
|
957 |
918 |
$60K |
| 74176 |
|
623 |
603 |
$54K |
| 0300 |
|
165 |
153 |
$54K |
| 71045 |
|
4,280 |
4,010 |
$47K |
| 0258 |
|
455 |
432 |
$47K |
| 0270 |
|
1,795 |
1,356 |
$47K |
| 85025 |
|
7,872 |
7,043 |
$47K |
| 36415 |
|
5,594 |
4,991 |
$45K |
| G0480 |
Drug test def 1-7 classes |
717 |
568 |
$36K |
| 84484 |
|
2,875 |
2,649 |
$36K |
| 99282 |
|
592 |
545 |
$33K |
| 96360 |
|
629 |
604 |
$30K |
| 81003 |
|
6,739 |
6,244 |
$26K |
| G0463 |
Hospital outpt clinic visit |
761 |
668 |
$25K |
| 83880 |
|
1,169 |
1,082 |
$23K |
| 81025 |
|
3,949 |
3,664 |
$23K |
| Z7502 |
|
614 |
605 |
$23K |
| 94640 |
|
1,283 |
1,162 |
$22K |
| J2405 |
Ondansetron hcl injection |
2,212 |
2,021 |
$22K |
| 0370 |
|
45 |
43 |
$22K |
| 83690 |
|
3,409 |
3,128 |
$20K |
| 99199 |
|
488 |
440 |
$19K |
| 0259 |
|
1,545 |
1,470 |
$18K |
| J7030 |
Normal saline solution infus |
2,270 |
2,095 |
$17K |
| J0696 |
Ceftriaxone sodium injection |
1,255 |
1,173 |
$14K |
| U0002 |
Covid-19 lab test non-cdc |
364 |
355 |
$14K |
| 87086 |
|
2,014 |
1,914 |
$12K |
| 73562 |
|
383 |
354 |
$12K |
| 0637 |
|
1,437 |
1,359 |
$11K |
| J2270 |
Morphine sulfate injection |
1,554 |
1,340 |
$11K |
| 0324 |
|
104 |
97 |
$11K |
| 99221 |
|
405 |
403 |
$11K |
| J1885 |
Ketorolac tromethamine inj |
2,270 |
2,105 |
$10K |
| 0301 |
|
20 |
16 |
$8K |
| 82550 |
|
1,590 |
1,521 |
$8K |
| 90715 |
|
292 |
272 |
$8K |
| 85730 |
|
1,777 |
1,690 |
$8K |
| 0305 |
|
16 |
13 |
$8K |
| 85610 |
|
1,833 |
1,734 |
$7K |
| 72125 |
|
69 |
69 |
$7K |
| 73630 |
|
303 |
295 |
$7K |
| 82553 |
|
807 |
763 |
$7K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
800 |
765 |
$6K |
| 86710 |
|
446 |
424 |
$5K |
| 73130 |
|
241 |
230 |
$5K |
| 94664 |
|
334 |
319 |
$5K |
| 0710 |
|
53 |
48 |
$5K |
| 99203 |
|
95 |
95 |
$5K |
| 84702 |
|
366 |
331 |
$4K |
| 87040 |
|
329 |
291 |
$4K |
| 73030 |
|
187 |
179 |
$4K |
| 99212 |
|
248 |
239 |
$4K |
| 80048 |
|
607 |
566 |
$4K |
| J1100 |
Dexamethasone sodium phos |
235 |
217 |
$4K |
| J1200 |
Diphenhydramine hcl injectio |
713 |
655 |
$4K |
| 76856 |
|
78 |
72 |
$3K |
| G0481 |
Drug test def 8-14 classes |
42 |
38 |
$3K |
| 73610 |
|
171 |
162 |
$3K |
| 83605 |
|
395 |
372 |
$3K |
| 76700 |
|
63 |
59 |
$3K |
| 99202 |
|
77 |
77 |
$3K |
| J7040 |
Normal saline solution infus |
676 |
606 |
$3K |
| 76830 |
|
58 |
56 |
$2K |
| 87181 |
|
788 |
750 |
$2K |
| 0730 |
|
13 |
13 |
$2K |
| 81001 |
|
564 |
544 |
$2K |
| J7512 |
Prednisone ir or dr oral 1mg |
519 |
476 |
$2K |
| J2765 |
Metoclopramide hcl injection |
336 |
320 |
$2K |
| J2060 |
Lorazepam injection |
97 |
92 |
$2K |
| J0500 |
Dicyclomine injection |
24 |
24 |
$2K |
| 0272 |
|
20 |
19 |
$2K |
| 86850 |
|
512 |
494 |
$2K |
| 74018 |
|
105 |
99 |
$2K |
| 97110 |
|
169 |
56 |
$1K |
| A9270 |
Non-covered item or service |
281 |
256 |
$1K |
| 86901 |
|
615 |
590 |
$1K |
| 90471 |
|
307 |
290 |
$1K |
| 70486 |
|
12 |
12 |
$1K |
| 86900 |
|
613 |
589 |
$1K |
| 82248 |
|
345 |
327 |
$1K |
| 82962 |
|
466 |
374 |
$1K |
| 73110 |
|
75 |
69 |
$1K |
| 84443 |
|
108 |
102 |
$1K |
| 80329 |
|
261 |
218 |
$1K |
| 71046 |
|
30 |
29 |
$1K |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
80 |
79 |
$1K |
| J1170 |
Hydromorphone injection |
171 |
146 |
$1K |
| 83735 |
|
203 |
196 |
$1K |
| 85379 |
|
121 |
120 |
$958.49 |
| 85007 |
|
360 |
338 |
$870.32 |
| 96376 |
|
114 |
109 |
$835.39 |
| 76817 |
|
14 |
13 |
$698.90 |
| S0028 |
Injection, famotidine, 20 mg |
308 |
288 |
$640.99 |
| 0636 |
|
71 |
68 |
$632.91 |
| A4649 |
Surgical supplies |
862 |
591 |
$548.89 |
| U0004 |
Cov-19 test non-cdc hgh thru |
12 |
12 |
$475.00 |
| 72020 |
|
24 |
24 |
$374.26 |
| 0510 |
|
12 |
12 |
$349.67 |
| 86140 |
|
81 |
77 |
$320.79 |
| 71010 |
|
26 |
13 |
$300.36 |
| 87491 |
|
12 |
12 |
$299.14 |
| 0260 |
|
21 |
20 |
$299.00 |
| J2930 |
Methylprednisolone injection |
28 |
24 |
$218.93 |
| Z7610 |
|
14 |
14 |
$197.96 |
| J2704 |
Inj, propofol, 10 mg |
26 |
25 |
$143.54 |
| J7120 |
Ringers lactate infusion |
28 |
27 |
$130.07 |
| J1815 |
Insulin injection |
13 |
13 |
$97.64 |
| J8499 |
Oral prescrip drug non chemo |
13 |
12 |
$83.90 |
| J7620 |
Albuterol ipratrop non-comp |
15 |
15 |
$63.69 |
| 85651 |
|
28 |
28 |
$58.50 |
| J3010 |
Fentanyl citrate injection |
16 |
15 |
$47.22 |
| J2250 |
Inj midazolam hydrochloride |
15 |
14 |
$39.35 |
| J7611 |
Albuterol non-comp con |
80 |
76 |
$37.66 |
| S9445 |
Pt education noc individ |
91 |
73 |
$0.00 |
| 90834 |
|
324 |
239 |
$0.00 |
| 90853 |
|
3,338 |
468 |
$0.00 |