| Code | Description | Claims | Beneficiaries | Total Paid |
| 99283 |
|
19,383 |
17,843 |
$2.36M |
| 96361 |
|
5,652 |
4,366 |
$1.81M |
| 99284 |
|
12,849 |
11,651 |
$1.80M |
| 99285 |
|
5,509 |
4,768 |
$778K |
| 70450 |
|
1,847 |
1,530 |
$457K |
| G0463 |
Hospital outpt clinic visit |
4,616 |
3,566 |
$390K |
| 74176 |
|
1,221 |
959 |
$333K |
| 74177 |
|
1,260 |
1,055 |
$325K |
| 29581 |
|
2,877 |
964 |
$291K |
| 97110 |
|
3,013 |
988 |
$228K |
| 99282 |
|
1,598 |
1,454 |
$218K |
| 96365 |
|
1,448 |
1,124 |
$171K |
| 96360 |
|
719 |
640 |
$166K |
| 95810 |
|
197 |
188 |
$160K |
| 11042 |
|
928 |
537 |
$134K |
| 92507 |
|
1,247 |
334 |
$118K |
| 99281 |
|
842 |
746 |
$116K |
| 94640 |
|
996 |
791 |
$114K |
| 71275 |
|
298 |
241 |
$85K |
| G0378 |
Hospital observation per hr |
1,306 |
709 |
$84K |
| 80048 |
|
14,573 |
12,373 |
$83K |
| C9803 |
Hopd covid-19 spec collect |
2,225 |
1,994 |
$75K |
| 87502 |
|
3,641 |
3,189 |
$70K |
| 80053 |
|
5,850 |
5,099 |
$64K |
| 99291 |
|
518 |
401 |
$58K |
| 96366 |
|
369 |
234 |
$50K |
| 71046 |
|
2,209 |
2,054 |
$41K |
| U0003 |
Cov-19 amp prb hgh thruput |
255 |
245 |
$41K |
| 97162 |
|
615 |
528 |
$37K |
| 87086 |
|
2,618 |
2,366 |
$33K |
| 76705 |
|
264 |
227 |
$30K |
| 77063 |
|
592 |
558 |
$30K |
| 71250 |
|
379 |
327 |
$29K |
| 80307 |
|
2,015 |
1,620 |
$27K |
| 87529 |
|
1,689 |
899 |
$25K |
| 85025 |
|
21,852 |
18,211 |
$23K |
| 71260 |
|
135 |
113 |
$21K |
| 84443 |
|
1,445 |
1,284 |
$20K |
| 87491 |
|
1,048 |
971 |
$19K |
| 73630 |
|
700 |
590 |
$19K |
| 80061 |
|
1,403 |
1,294 |
$17K |
| 36415 |
|
6,489 |
5,191 |
$16K |
| 71045 |
|
5,341 |
4,560 |
$14K |
| 72131 |
|
266 |
213 |
$14K |
| 82805 |
|
697 |
502 |
$14K |
| 72125 |
|
669 |
565 |
$13K |
| 84484 |
|
6,200 |
3,871 |
$13K |
| 73030 |
|
564 |
480 |
$13K |
| 87591 |
|
1,047 |
970 |
$13K |
| 87661 |
|
1,058 |
985 |
$12K |
| 73562 |
|
268 |
219 |
$12K |
| 87070 |
|
647 |
636 |
$11K |
| 73130 |
|
434 |
374 |
$9K |
| 82306 |
|
325 |
295 |
$9K |
| 84439 |
|
486 |
436 |
$9K |
| 96374 |
|
7,578 |
6,507 |
$9K |
| 93306 |
|
98 |
90 |
$9K |
| 77067 |
|
605 |
571 |
$8K |
| 93005 |
|
7,406 |
6,198 |
$8K |
| 83036 |
|
670 |
612 |
$8K |
| 73610 |
|
474 |
412 |
$7K |
| 97166 |
|
105 |
82 |
$7K |
| 72100 |
|
153 |
142 |
$6K |
| 80076 |
|
4,195 |
3,532 |
$6K |
| 84702 |
|
340 |
278 |
$5K |
| 87389 |
|
154 |
147 |
$5K |
| 86780 |
|
201 |
190 |
$5K |
| U0002 |
Covid-19 lab test non-cdc |
3,924 |
3,387 |
$4K |
| 97161 |
|
57 |
46 |
$4K |
| 80069 |
|
455 |
265 |
$4K |
| 87186 |
|
783 |
669 |
$4K |
| 73502 |
|
133 |
117 |
$4K |
| 96375 |
|
5,466 |
4,378 |
$3K |
| 73110 |
|
205 |
160 |
$3K |
| 83735 |
|
1,555 |
1,180 |
$3K |
| 76830 |
|
77 |
70 |
$3K |
| 81001 |
|
7,521 |
6,578 |
$3K |
| 43239 |
|
12 |
12 |
$3K |
| 96372 |
|
3,586 |
2,648 |
$3K |
| 82607 |
|
116 |
105 |
$3K |
| 86803 |
|
101 |
98 |
$3K |
| 70496 |
|
16 |
12 |
$2K |
| 74018 |
|
55 |
52 |
$2K |
| 85027 |
|
613 |
491 |
$2K |
| 90715 |
|
128 |
112 |
$2K |
| 96367 |
|
125 |
79 |
$2K |
| 87651 |
|
1,249 |
1,106 |
$2K |
| 82043 |
|
242 |
225 |
$2K |
| 86705 |
|
39 |
39 |
$2K |
| 82728 |
|
94 |
88 |
$2K |
| 85610 |
|
763 |
592 |
$2K |
| 87077 |
|
561 |
429 |
$2K |
| 83540 |
|
145 |
136 |
$2K |
| 80074 |
|
44 |
42 |
$1K |
| 83690 |
|
4,775 |
4,075 |
$1K |
| 93971 |
|
13 |
12 |
$1K |
| 96376 |
|
1,001 |
615 |
$1K |
| 70486 |
|
42 |
40 |
$1K |
| 73560 |
|
170 |
127 |
$1K |
| 86709 |
|
52 |
52 |
$1K |
| 92523 |
|
12 |
12 |
$1K |
| 86706 |
|
40 |
40 |
$1K |
| 86708 |
|
40 |
40 |
$1K |
| 90471 |
|
117 |
103 |
$945.43 |
| 81003 |
|
1,591 |
1,354 |
$887.45 |
| 83880 |
|
572 |
411 |
$880.38 |
| 83550 |
|
112 |
104 |
$853.66 |
| 87340 |
|
54 |
54 |
$820.55 |
| 83970 |
|
26 |
24 |
$801.01 |
| 81025 |
|
2,884 |
2,576 |
$708.97 |
| 85651 |
|
251 |
204 |
$673.50 |
| 82746 |
|
74 |
67 |
$618.17 |
| 87634 |
|
122 |
106 |
$467.09 |
| 82570 |
|
44 |
44 |
$438.79 |
| 85378 |
|
689 |
578 |
$384.22 |
| 85007 |
|
300 |
228 |
$377.66 |
| 87040 |
|
1,050 |
489 |
$377.23 |
| 84145 |
|
825 |
618 |
$365.84 |
| 83605 |
|
1,315 |
842 |
$363.09 |
| 84450 |
|
17 |
17 |
$309.12 |
| J3490 |
Drugs unclassified injection |
716 |
464 |
$305.35 |
| J1650 |
Inj enoxaparin sodium |
188 |
90 |
$250.98 |
| 73140 |
|
13 |
13 |
$242.07 |
| 84550 |
|
26 |
25 |
$211.87 |
| J1170 |
Hydromorphone injection |
346 |
212 |
$206.13 |
| J2543 |
Piperacillin/tazobactam |
74 |
50 |
$181.54 |
| 84460 |
|
17 |
17 |
$164.31 |
| U0005 |
Infec agen detec ampli probe |
150 |
144 |
$159.03 |
| 87210 |
|
153 |
137 |
$158.49 |
| 85014 |
|
14 |
13 |
$137.78 |
| 82550 |
|
137 |
113 |
$131.79 |
| 73080 |
|
15 |
12 |
$128.51 |
| J2270 |
Morphine sulfate injection |
774 |
576 |
$108.87 |
| J1885 |
Ketorolac tromethamine inj |
3,713 |
3,110 |
$103.85 |
| 29125 |
|
33 |
29 |
$83.35 |
| 84100 |
|
60 |
37 |
$71.68 |
| 85018 |
|
14 |
13 |
$62.63 |
| J2919 |
Inj, methylpred sod succ 5mg |
100 |
77 |
$45.84 |
| J2405 |
Ondansetron hcl injection |
2,939 |
2,395 |
$43.92 |
| J1100 |
Dexamethasone sodium phos |
560 |
407 |
$37.61 |
| J3010 |
Fentanyl citrate injection |
1,001 |
769 |
$37.15 |
| J2930 |
Methylprednisolone injection |
281 |
180 |
$34.75 |
| J0696 |
Ceftriaxone sodium injection |
589 |
433 |
$24.91 |
| 85730 |
|
64 |
52 |
$18.77 |
| 87880 |
|
27 |
26 |
$18.74 |
| J2360 |
Orphenadrine injection |
79 |
54 |
$18.12 |
| J1200 |
Diphenhydramine hcl injectio |
459 |
370 |
$14.69 |
| 81015 |
|
91 |
87 |
$10.32 |
| J1790 |
Droperidol injection |
195 |
150 |
$9.08 |
| J2800 |
Methocarbamol injection |
15 |
14 |
$8.51 |
| J2550 |
Promethazine hcl injection |
227 |
196 |
$6.76 |
| J2060 |
Lorazepam injection |
115 |
82 |
$5.64 |
| J3370 |
Vancomycin hcl injection |
47 |
29 |
$4.82 |
| J2765 |
Metoclopramide hcl injection |
225 |
177 |
$2.32 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
23 |
14 |
$1.89 |
| J3475 |
Inj magnesium sulfate |
62 |
42 |
$1.66 |
| J2250 |
Inj midazolam hydrochloride |
50 |
46 |
$0.38 |
| J2471 |
Inj pantoprazole(hikma) 40mg |
37 |
35 |
$0.26 |
| 94760 |
|
26 |
26 |
$0.00 |
| 84703 |
|
29 |
25 |
$0.00 |
| 97140 |
|
24 |
16 |
$0.00 |
| 72128 |
|
16 |
12 |
$0.00 |
| J0500 |
Dicyclomine injection |
13 |
12 |
$0.00 |
| 70498 |
|
16 |
12 |
$0.00 |
| 82010 |
|
13 |
12 |
$0.00 |