| Code | Description | Claims | Beneficiaries | Total Paid |
| 97110 |
|
22,444 |
5,021 |
$759K |
| 87502 |
|
5,838 |
5,046 |
$574K |
| A0425 |
Ground mileage |
6,494 |
4,289 |
$442K |
| 73721 |
|
1,240 |
1,045 |
$386K |
| 74177 |
|
2,737 |
2,376 |
$374K |
| 70450 |
|
3,696 |
3,252 |
$349K |
| 80053 |
|
22,843 |
18,305 |
$336K |
| 72148 |
|
820 |
722 |
$233K |
| 99283 |
|
4,743 |
3,708 |
$204K |
| 96365 |
|
3,420 |
2,086 |
$204K |
| 80050 |
|
4,981 |
2,274 |
$187K |
| 85025 |
|
26,177 |
20,355 |
$180K |
| 97530 |
|
5,017 |
1,185 |
$178K |
| 87503 |
|
5,835 |
5,045 |
$140K |
| 72125 |
|
1,131 |
995 |
$140K |
| 96374 |
|
8,042 |
6,557 |
$132K |
| 92507 |
|
2,360 |
543 |
$122K |
| 87651 |
|
2,574 |
2,262 |
$113K |
| 93005 |
|
10,037 |
8,262 |
$105K |
| 74176 |
|
1,493 |
1,309 |
$100K |
| J1100 |
Dexamethasone sodium phos |
7,305 |
5,199 |
$99K |
| 99284 |
|
3,806 |
3,036 |
$99K |
| 96361 |
|
6,252 |
4,625 |
$97K |
| U0003 |
Cov-19 amp prb hgh thruput |
1,585 |
1,395 |
$90K |
| 80306 |
|
5,116 |
4,136 |
$84K |
| 71046 |
|
5,067 |
4,172 |
$80K |
| 87591 |
|
1,658 |
1,488 |
$71K |
| 87491 |
|
1,638 |
1,472 |
$70K |
| 71045 |
|
8,686 |
7,055 |
$67K |
| A0427 |
Als1-emergency |
2,627 |
2,173 |
$62K |
| G0463 |
Hospital outpt clinic visit |
5,864 |
3,621 |
$59K |
| 84703 |
|
6,570 |
5,292 |
$59K |
| 96375 |
|
7,058 |
4,969 |
$58K |
| 96372 |
|
5,428 |
4,246 |
$56K |
| 84443 |
|
4,654 |
4,264 |
$56K |
| A0429 |
Bls-emergency |
1,917 |
1,447 |
$52K |
| 97161 |
|
782 |
685 |
$51K |
| 76805 |
|
1,203 |
1,089 |
$50K |
| 80048 |
|
6,895 |
5,610 |
$49K |
| 87086 |
|
6,238 |
5,294 |
$49K |
| 83880 |
|
2,311 |
1,967 |
$46K |
| 86901 |
|
2,501 |
2,017 |
$42K |
| 80061 |
|
4,486 |
4,166 |
$41K |
| 97162 |
|
421 |
367 |
$40K |
| 84484 |
|
4,966 |
4,123 |
$37K |
| 81000 |
|
11,698 |
9,160 |
$36K |
| 96360 |
|
1,752 |
1,486 |
$34K |
| 83690 |
|
4,912 |
4,078 |
$34K |
| J0696 |
Ceftriaxone sodium injection |
2,710 |
1,891 |
$31K |
| 88305 |
|
1,035 |
863 |
$31K |
| 77067 |
|
702 |
689 |
$30K |
| 71275 |
|
188 |
155 |
$27K |
| 80320 |
|
1,777 |
1,412 |
$27K |
| 99282 |
|
524 |
403 |
$26K |
| J2704 |
Inj, propofol, 10 mg |
1,692 |
1,174 |
$25K |
| 86850 |
|
4,317 |
1,904 |
$24K |
| 74018 |
|
1,304 |
1,034 |
$22K |
| 87040 |
|
1,622 |
1,377 |
$22K |
| 83735 |
|
4,210 |
3,472 |
$22K |
| 73630 |
|
940 |
810 |
$21K |
| 87420 |
|
1,927 |
1,703 |
$21K |
| 93306 |
|
146 |
124 |
$20K |
| 76705 |
|
1,289 |
1,099 |
$20K |
| 80329 |
|
1,500 |
1,122 |
$20K |
| 85027 |
|
4,028 |
3,257 |
$20K |
| 82565 |
|
1,793 |
1,469 |
$19K |
| 73610 |
|
1,187 |
1,002 |
$19K |
| 87635 |
|
6,078 |
5,343 |
$19K |
| 97001 |
|
394 |
365 |
$18K |
| 83036 |
|
2,485 |
2,258 |
$18K |
| 87077 |
|
2,293 |
1,983 |
$17K |
| J2405 |
Ondansetron hcl injection |
2,107 |
1,510 |
$16K |
| 99285 |
|
974 |
783 |
$16K |
| 87186 |
|
3,103 |
2,589 |
$16K |
| 80081 |
|
161 |
156 |
$15K |
| J1885 |
Ketorolac tromethamine inj |
4,183 |
3,203 |
$15K |
| 73130 |
|
667 |
568 |
$15K |
| 72141 |
|
41 |
40 |
$14K |
| 87389 |
|
922 |
827 |
$13K |
| A0428 |
Bls |
560 |
439 |
$13K |
| 94640 |
|
2,928 |
2,003 |
$13K |
| 73221 |
|
44 |
39 |
$12K |
| 87070 |
|
1,235 |
1,022 |
$12K |
| 70551 |
|
42 |
39 |
$12K |
| 81003 |
|
4,567 |
3,614 |
$11K |
| 76830 |
|
217 |
192 |
$11K |
| 73110 |
|
470 |
403 |
$10K |
| 73562 |
|
366 |
308 |
$10K |
| 82948 |
|
2,244 |
1,500 |
$10K |
| 83605 |
|
936 |
800 |
$9K |
| M0243 |
Casirivi and imdevi inj |
93 |
89 |
$9K |
| 86140 |
|
1,632 |
1,340 |
$9K |
| 84702 |
|
853 |
624 |
$9K |
| 86803 |
|
557 |
515 |
$9K |
| 87341 |
|
624 |
572 |
$8K |
| J2250 |
Inj midazolam hydrochloride |
4,027 |
2,820 |
$8K |
| 82607 |
|
543 |
497 |
$8K |
| 85610 |
|
2,740 |
2,068 |
$8K |
| 73030 |
|
388 |
336 |
$7K |
| J3010 |
Fentanyl citrate injection |
4,744 |
3,145 |
$7K |
| J0690 |
Cefazolin sodium injection |
3,066 |
1,478 |
$7K |
| 85730 |
|
1,635 |
1,386 |
$7K |
| 90715 |
|
405 |
362 |
$7K |
| 86900 |
|
2,664 |
2,159 |
$6K |
| 82728 |
|
498 |
447 |
$6K |
| 76856 |
|
206 |
174 |
$6K |
| 85379 |
|
560 |
491 |
$5K |
| 71260 |
|
43 |
39 |
$5K |
| 76813 |
|
89 |
67 |
$5K |
| 76815 |
|
512 |
405 |
$5K |
| 87081 |
|
610 |
564 |
$5K |
| 87340 |
|
1,040 |
939 |
$5K |
| 82306 |
|
260 |
234 |
$5K |
| 88304 |
|
301 |
242 |
$5K |
| 84439 |
|
406 |
374 |
$5K |
| 72131 |
|
44 |
38 |
$4K |
| 82947 |
|
1,072 |
859 |
$4K |
| J1642 |
Inj heparin sodium per 10 u |
884 |
477 |
$4K |
| 36415 |
|
10,850 |
8,026 |
$4K |
| 77063 |
|
284 |
269 |
$4K |
| 96413 |
|
93 |
24 |
$4K |
| 72100 |
|
211 |
189 |
$3K |
| 83540 |
|
564 |
504 |
$3K |
| 87088 |
|
424 |
373 |
$3K |
| 86762 |
|
524 |
473 |
$3K |
| A9270 |
Non-covered item or service |
4,574 |
3,207 |
$3K |
| 82570 |
|
701 |
539 |
$3K |
| 86592 |
|
992 |
884 |
$3K |
| 73502 |
|
161 |
130 |
$2K |
| 80076 |
|
524 |
465 |
$2K |
| 87075 |
|
305 |
262 |
$2K |
| 93971 |
|
67 |
64 |
$2K |
| 97140 |
|
911 |
343 |
$2K |
| 81001 |
|
557 |
466 |
$2K |
| 85652 |
|
880 |
772 |
$2K |
| A0426 |
Als 1 |
84 |
76 |
$2K |
| 87804 |
|
162 |
78 |
$1K |
| 83655 |
|
104 |
86 |
$1K |
| 84112 |
|
20 |
13 |
$1K |
| 73090 |
|
84 |
68 |
$1K |
| J0780 |
Prochlorperazine injection |
2,047 |
1,701 |
$1K |
| G0283 |
Elec stim other than wound |
1,902 |
550 |
$1K |
| 95886 |
|
22 |
17 |
$1K |
| 88300 |
|
122 |
109 |
$1K |
| J7030 |
Normal saline solution infus |
7,350 |
5,083 |
$1K |
| 82803 |
|
104 |
56 |
$997.87 |
| 73560 |
|
86 |
53 |
$940.35 |
| 76642 |
|
57 |
44 |
$915.21 |
| 96376 |
|
504 |
370 |
$899.77 |
| 73590 |
|
54 |
39 |
$895.98 |
| 73080 |
|
51 |
40 |
$876.15 |
| 97032 |
|
355 |
93 |
$861.30 |
| 92523 |
|
20 |
12 |
$833.88 |
| 86705 |
|
68 |
57 |
$820.31 |
| J1170 |
Hydromorphone injection |
1,749 |
1,072 |
$775.06 |
| 83550 |
|
113 |
105 |
$722.61 |
| J7120 |
Ringers lactate infusion |
6,590 |
4,709 |
$641.63 |
| 85007 |
|
573 |
495 |
$609.11 |
| 95911 |
|
12 |
12 |
$522.19 |
| J2060 |
Lorazepam injection |
611 |
437 |
$492.51 |
| 86317 |
|
29 |
24 |
$486.36 |
| 85014 |
|
169 |
141 |
$480.15 |
| 87209 |
|
27 |
24 |
$467.10 |
| 85018 |
|
167 |
139 |
$460.24 |
| J2270 |
Morphine sulfate injection |
759 |
489 |
$454.11 |
| 84156 |
|
98 |
67 |
$405.56 |
| 87045 |
|
48 |
40 |
$350.22 |
| 82550 |
|
49 |
38 |
$319.39 |
| 82553 |
|
27 |
26 |
$275.54 |
| J2550 |
Promethazine hcl injection |
286 |
215 |
$255.15 |
| J7121 |
5% dextrose in lac ringers |
414 |
345 |
$246.40 |
| G0480 |
Drug test def 1-7 classes |
783 |
597 |
$220.58 |
| 87324 |
|
32 |
29 |
$218.79 |
| 87177 |
|
27 |
24 |
$213.47 |
| 87427 |
|
30 |
24 |
$205.92 |
| 83874 |
|
15 |
14 |
$172.50 |
| 81015 |
|
1,349 |
1,037 |
$167.85 |
| 87210 |
|
41 |
36 |
$164.70 |
| 87449 |
|
13 |
12 |
$128.70 |
| J2175 |
Meperidine hydrochl /100 mg |
283 |
174 |
$127.02 |
| 88720 |
|
120 |
95 |
$109.95 |
| J1200 |
Diphenhydramine hcl injectio |
223 |
173 |
$90.52 |
| 84460 |
|
13 |
12 |
$86.56 |
| 87450 |
|
31 |
25 |
$85.15 |
| J2930 |
Methylprednisolone injection |
96 |
64 |
$65.10 |
| 84153 |
|
14 |
12 |
$52.54 |
| 83615 |
|
19 |
14 |
$51.78 |
| 82043 |
|
12 |
12 |
$49.62 |
| 93010 |
|
63 |
61 |
$45.92 |
| 84550 |
|
27 |
24 |
$45.22 |
| 82272 |
|
24 |
15 |
$37.52 |
| J2765 |
Metoclopramide hcl injection |
33 |
26 |
$23.70 |
| 96523 |
|
42 |
41 |
$11.00 |
| J0171 |
Adrenalin epinephrine inject |
51 |
35 |
$0.00 |
| A4649 |
Surgical supplies |
18 |
15 |
$0.00 |
| M0245 |
Bamlan and etesev infusion |
16 |
15 |
$0.00 |
| A4216 |
Sterile water/saline, 10 ml |
17 |
17 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
14 |
12 |
$0.00 |
| G0103 |
Psa screening |
60 |
53 |
$0.00 |
| G0008 |
Admin influenza virus vac |
14 |
14 |
$0.00 |