| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
|
13,287 |
11,000 |
$2.16M |
| 99283 |
|
8,748 |
7,528 |
$1.05M |
| 70450 |
|
1,068 |
845 |
$262K |
| 74177 |
|
332 |
273 |
$246K |
| 87502 |
|
2,782 |
2,292 |
$185K |
| 96365 |
|
2,464 |
1,821 |
$158K |
| 96372 |
|
5,562 |
3,689 |
$141K |
| 80050 |
|
3,653 |
3,131 |
$139K |
| 80053 |
|
20,951 |
14,911 |
$135K |
| 99285 |
|
750 |
587 |
$134K |
| 85025 |
|
25,980 |
19,334 |
$132K |
| 71046 |
|
2,964 |
2,675 |
$125K |
| 76856 |
|
1,297 |
1,152 |
$122K |
| 96374 |
|
1,437 |
1,006 |
$104K |
| 96361 |
|
1,804 |
1,064 |
$102K |
| 87651 |
|
2,970 |
2,478 |
$78K |
| 93005 |
|
3,412 |
2,644 |
$76K |
| 96375 |
|
2,254 |
1,583 |
$72K |
| 76830 |
|
662 |
604 |
$67K |
| 36415 |
|
32,587 |
24,007 |
$64K |
| 71045 |
|
4,794 |
3,851 |
$63K |
| 99212 |
|
1,996 |
1,660 |
$57K |
| 99215 |
Prolong outpt/office vis |
1,061 |
1,015 |
$56K |
| 80061 |
|
4,442 |
3,864 |
$47K |
| J0696 |
Ceftriaxone sodium injection |
953 |
734 |
$46K |
| 82306 |
|
2,075 |
1,735 |
$41K |
| 96366 |
|
386 |
204 |
$27K |
| 99282 |
|
324 |
281 |
$24K |
| 84443 |
|
1,757 |
1,599 |
$23K |
| 83036 |
|
3,007 |
2,563 |
$22K |
| U0003 |
Cov-19 amp prb hgh thruput |
254 |
236 |
$20K |
| 82607 |
|
1,631 |
1,386 |
$20K |
| 84484 |
|
3,260 |
2,153 |
$20K |
| 80305 |
|
2,461 |
1,993 |
$19K |
| J2405 |
Ondansetron hcl injection |
1,882 |
1,456 |
$19K |
| 87591 |
|
625 |
552 |
$19K |
| 87661 |
|
628 |
552 |
$19K |
| 87491 |
|
627 |
552 |
$19K |
| 83880 |
|
953 |
789 |
$18K |
| G0378 |
Hospital observation per hr |
26 |
18 |
$16K |
| 99205 |
Prolong outpt/office vis |
303 |
269 |
$14K |
| 84481 |
|
1,184 |
1,011 |
$13K |
| 74176 |
|
50 |
30 |
$12K |
| 81025 |
|
2,036 |
1,662 |
$11K |
| 90853 |
|
18,772 |
1,503 |
$11K |
| 82553 |
|
2,017 |
1,404 |
$10K |
| J1885 |
Ketorolac tromethamine inj |
1,744 |
1,393 |
$10K |
| 96360 |
|
139 |
76 |
$9K |
| 82550 |
|
2,679 |
1,888 |
$9K |
| 84439 |
|
1,198 |
1,012 |
$9K |
| 81001 |
|
4,655 |
3,745 |
$9K |
| 94640 |
|
251 |
108 |
$8K |
| 0001A |
|
239 |
221 |
$8K |
| 87086 |
|
1,167 |
1,034 |
$8K |
| 0002A |
|
210 |
184 |
$7K |
| 93000 |
|
235 |
193 |
$7K |
| 99213 |
|
489 |
418 |
$6K |
| M0243 |
Casirivi and imdevi inj |
46 |
17 |
$6K |
| 83690 |
|
1,447 |
1,130 |
$6K |
| 0240U |
|
39 |
38 |
$6K |
| 82746 |
|
476 |
394 |
$5K |
| 85730 |
|
1,703 |
1,350 |
$5K |
| 0241U |
|
39 |
35 |
$5K |
| 80048 |
|
580 |
455 |
$4K |
| 77067 |
|
27 |
27 |
$4K |
| 85610 |
|
1,683 |
1,367 |
$4K |
| 81003 |
|
2,867 |
2,253 |
$4K |
| 84403 |
|
131 |
111 |
$3K |
| 93010 |
|
410 |
357 |
$3K |
| 83735 |
|
761 |
518 |
$2K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
347 |
169 |
$2K |
| 83540 |
|
428 |
365 |
$2K |
| 74018 |
|
46 |
39 |
$2K |
| 84146 |
|
99 |
90 |
$2K |
| 83001 |
|
103 |
91 |
$1K |
| 97110 |
|
43 |
12 |
$1K |
| 82670 |
|
59 |
50 |
$1K |
| 84100 |
|
416 |
297 |
$964.51 |
| 84436 |
|
243 |
195 |
$837.28 |
| 86780 |
|
76 |
62 |
$797.65 |
| 99203 |
|
12 |
12 |
$795.92 |
| 87040 |
|
120 |
59 |
$621.56 |
| 86677 |
|
85 |
52 |
$620.80 |
| 87389 |
|
27 |
25 |
$602.00 |
| 80150 |
|
52 |
47 |
$545.52 |
| J2704 |
Inj, propofol, 10 mg |
2,082 |
1,666 |
$534.28 |
| 86850 |
|
140 |
117 |
$521.70 |
| 77063 |
|
27 |
27 |
$506.37 |
| 99281 |
|
12 |
12 |
$444.29 |
| J1100 |
Dexamethasone sodium phos |
490 |
438 |
$438.69 |
| G0463 |
Hospital outpt clinic visit |
705 |
554 |
$337.27 |
| 86901 |
|
141 |
117 |
$312.84 |
| 86900 |
|
141 |
117 |
$312.84 |
| J2001 |
Lidocaine injection |
1,416 |
1,043 |
$261.86 |
| 82672 |
|
15 |
12 |
$238.70 |
| J3010 |
Fentanyl citrate injection |
1,187 |
1,010 |
$230.28 |
| 86803 |
|
20 |
18 |
$228.32 |
| 82150 |
|
53 |
48 |
$222.84 |
| 86140 |
|
66 |
51 |
$218.82 |
| 86703 |
|
12 |
12 |
$158.07 |
| J2250 |
Inj midazolam hydrochloride |
570 |
492 |
$141.23 |
| 86039 |
|
23 |
12 |
$125.48 |
| 87077 |
|
15 |
12 |
$121.20 |
| J0690 |
Cefazolin sodium injection |
1,197 |
933 |
$111.33 |
| J3490 |
Drugs unclassified injection |
308 |
249 |
$109.72 |
| 87070 |
|
12 |
12 |
$103.44 |
| J2270 |
Morphine sulfate injection |
17 |
12 |
$66.88 |
| 86592 |
|
12 |
12 |
$49.58 |
| S0020 |
Injection, bupivicaine hydro |
80 |
62 |
$26.68 |
| 82962 |
|
15 |
13 |
$12.76 |
| J1644 |
Inj heparin sodium per 1000u |
22 |
13 |
$10.33 |
| 91300 |
|
666 |
573 |
$5.02 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
47 |
37 |
$0.00 |
| 99214 |
|
104 |
83 |
$0.00 |
| J2175 |
Meperidine hydrochl /100 mg |
80 |
66 |
$0.00 |
| T1015 |
Clinic service |
281 |
199 |
$0.00 |
| 81002 |
|
18 |
13 |
$0.00 |
| Q0244 |
Casirivi and imdevi 1200 mg |
14 |
12 |
$0.00 |