| Code | Description | Claims | Beneficiaries | Total Paid |
| 0241U |
|
4,151 |
3,898 |
$492K |
| 74177 |
|
2,937 |
2,694 |
$414K |
| 70450 |
|
3,263 |
2,945 |
$294K |
| U0003 |
Cov-19 amp prb hgh thruput |
3,122 |
2,739 |
$270K |
| 80048 |
|
13,406 |
11,124 |
$249K |
| 72148 |
|
704 |
595 |
$156K |
| 93306 |
|
1,022 |
935 |
$129K |
| 87633 |
|
487 |
470 |
$114K |
| 93005 |
|
10,152 |
8,564 |
$103K |
| 36415 |
|
19,811 |
16,782 |
$91K |
| 80053 |
|
4,552 |
4,005 |
$86K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,140 |
1,045 |
$77K |
| 74176 |
|
1,156 |
1,054 |
$70K |
| 71046 |
|
3,821 |
3,479 |
$68K |
| 85025 |
|
9,328 |
8,073 |
$65K |
| 96365 |
|
1,570 |
1,378 |
$62K |
| 87637 |
|
609 |
547 |
$61K |
| 72125 |
|
498 |
464 |
$57K |
| 85027 |
|
9,235 |
7,837 |
$57K |
| 80076 |
|
3,918 |
3,397 |
$48K |
| 81025 |
|
5,598 |
5,019 |
$48K |
| 87631 |
|
585 |
549 |
$47K |
| 87651 |
|
961 |
916 |
$47K |
| U0002 |
Covid-19 lab test non-cdc |
1,025 |
894 |
$44K |
| 71045 |
|
4,882 |
4,343 |
$37K |
| 96372 |
|
3,960 |
3,376 |
$36K |
| T1015 |
Clinic service |
3,160 |
2,700 |
$34K |
| 84484 |
|
4,972 |
3,797 |
$33K |
| 96361 |
|
2,652 |
2,088 |
$30K |
| 96374 |
|
5,574 |
4,940 |
$30K |
| 71275 |
|
158 |
146 |
$29K |
| 81001 |
|
7,396 |
6,582 |
$25K |
| 83690 |
|
3,591 |
3,196 |
$24K |
| 87486 |
|
487 |
470 |
$24K |
| 87581 |
|
487 |
470 |
$24K |
| 86901 |
|
1,110 |
927 |
$24K |
| 82962 |
|
2,896 |
1,850 |
$23K |
| 80305 |
|
1,479 |
1,315 |
$21K |
| 86900 |
|
1,094 |
915 |
$19K |
| 73630 |
|
640 |
590 |
$18K |
| 80307 |
|
441 |
390 |
$17K |
| 96375 |
|
3,340 |
2,837 |
$17K |
| G0463 |
Hospital outpt clinic visit |
1,068 |
959 |
$17K |
| 87088 |
|
1,959 |
1,769 |
$16K |
| J2405 |
Ondansetron hcl injection |
9,205 |
7,130 |
$15K |
| 80061 |
|
1,130 |
947 |
$15K |
| 72100 |
|
646 |
579 |
$15K |
| 87502 |
|
167 |
152 |
$14K |
| 83880 |
|
720 |
640 |
$14K |
| 82077 |
|
782 |
695 |
$14K |
| 83605 |
|
1,470 |
1,171 |
$13K |
| 80143 |
|
652 |
583 |
$13K |
| 80179 |
|
644 |
582 |
$12K |
| 93975 |
|
155 |
143 |
$12K |
| 80320 |
|
846 |
696 |
$12K |
| C9803 |
Hopd covid-19 spec collect |
7,663 |
6,884 |
$11K |
| 87040 |
|
1,010 |
653 |
$10K |
| 99283 |
|
1,524 |
1,387 |
$10K |
| 81003 |
|
4,113 |
3,737 |
$10K |
| 80329 |
|
853 |
662 |
$10K |
| 96376 |
|
1,089 |
800 |
$10K |
| 82947 |
|
1,108 |
689 |
$10K |
| J1100 |
Dexamethasone sodium phos |
3,410 |
3,009 |
$10K |
| 72141 |
|
44 |
39 |
$10K |
| 76000 |
|
194 |
183 |
$10K |
| 99284 |
|
1,974 |
1,794 |
$9K |
| 70553 |
|
31 |
24 |
$9K |
| 73130 |
|
318 |
278 |
$9K |
| 73560 |
|
337 |
307 |
$8K |
| 85610 |
|
2,975 |
2,473 |
$8K |
| 85730 |
|
2,019 |
1,667 |
$8K |
| 73610 |
|
416 |
375 |
$8K |
| 87077 |
|
695 |
619 |
$7K |
| J1885 |
Ketorolac tromethamine inj |
5,893 |
5,024 |
$7K |
| 94640 |
|
1,569 |
1,349 |
$7K |
| 84703 |
|
644 |
567 |
$7K |
| 85055 |
|
412 |
362 |
$7K |
| 71260 |
|
47 |
42 |
$7K |
| 80051 |
|
279 |
215 |
$7K |
| 70551 |
|
39 |
24 |
$6K |
| 73030 |
|
246 |
216 |
$6K |
| 87086 |
|
639 |
582 |
$5K |
| 71020 |
|
388 |
361 |
$5K |
| J0696 |
Ceftriaxone sodium injection |
1,408 |
1,218 |
$5K |
| 80306 |
|
300 |
241 |
$5K |
| 76700 |
|
128 |
121 |
$4K |
| 87426 |
|
100 |
93 |
$4K |
| 83735 |
|
669 |
547 |
$4K |
| 82550 |
|
685 |
588 |
$4K |
| 85379 |
|
419 |
387 |
$4K |
| 82248 |
|
711 |
645 |
$4K |
| 87880 |
|
307 |
285 |
$4K |
| 87798 |
|
204 |
189 |
$3K |
| 87804 |
|
168 |
148 |
$3K |
| 73721 |
|
12 |
12 |
$3K |
| 86850 |
|
890 |
736 |
$3K |
| 82565 |
|
663 |
562 |
$3K |
| 90715 |
|
199 |
174 |
$3K |
| J3010 |
Fentanyl citrate injection |
5,216 |
4,276 |
$3K |
| 12001 |
|
13 |
12 |
$2K |
| 71010 |
|
353 |
331 |
$2K |
| J2250 |
Inj midazolam hydrochloride |
4,045 |
3,348 |
$2K |
| J0171 |
Adrenalin epinephrine inject |
115 |
98 |
$2K |
| 80050 |
|
69 |
58 |
$2K |
| J0690 |
Cefazolin sodium injection |
3,082 |
2,388 |
$2K |
| 87186 |
|
256 |
225 |
$2K |
| 96360 |
|
395 |
356 |
$1K |
| 93458 |
|
24 |
15 |
$1K |
| 90471 |
|
321 |
253 |
$1K |
| 84443 |
|
91 |
79 |
$1K |
| 94760 |
|
90 |
87 |
$1K |
| 99282 |
|
56 |
53 |
$1K |
| J2001 |
Lidocaine injection |
2,440 |
1,929 |
$902.20 |
| 74018 |
|
53 |
49 |
$895.85 |
| 74019 |
|
44 |
39 |
$879.81 |
| 76705 |
|
49 |
43 |
$822.91 |
| 72040 |
|
48 |
39 |
$744.95 |
| J2704 |
Inj, propofol, 10 mg |
3,324 |
2,948 |
$719.95 |
| 77067 |
|
17 |
16 |
$708.70 |
| 0225U |
|
295 |
283 |
$682.89 |
| 76805 |
|
16 |
16 |
$672.00 |
| 73110 |
|
46 |
36 |
$653.14 |
| 87389 |
|
17 |
17 |
$636.46 |
| J1644 |
Inj heparin sodium per 1000u |
1,108 |
493 |
$628.56 |
| J2270 |
Morphine sulfate injection |
3,246 |
2,529 |
$614.21 |
| J1170 |
Hydromorphone injection |
3,152 |
2,419 |
$601.67 |
| 87070 |
|
27 |
24 |
$572.77 |
| 73502 |
|
32 |
28 |
$540.46 |
| 84520 |
|
183 |
144 |
$522.78 |
| 93017 |
|
24 |
24 |
$408.09 |
| 85007 |
|
125 |
110 |
$374.66 |
| 76856 |
|
14 |
13 |
$360.00 |
| 86780 |
|
16 |
16 |
$325.58 |
| 73070 |
|
13 |
12 |
$314.10 |
| 84100 |
|
71 |
63 |
$298.96 |
| 84702 |
|
24 |
24 |
$290.31 |
| 87807 |
|
24 |
23 |
$273.21 |
| J1815 |
Insulin injection |
282 |
143 |
$248.61 |
| J2765 |
Metoclopramide hcl injection |
831 |
698 |
$217.26 |
| J2060 |
Lorazepam injection |
282 |
221 |
$211.29 |
| 76815 |
|
17 |
15 |
$182.00 |
| J1200 |
Diphenhydramine hcl injectio |
584 |
507 |
$161.61 |
| 94729 |
|
12 |
12 |
$144.60 |
| 82247 |
|
23 |
14 |
$136.23 |
| 81015 |
|
117 |
99 |
$126.94 |
| 83615 |
|
14 |
12 |
$112.19 |
| 87205 |
|
27 |
24 |
$103.70 |
| 99285 |
|
27 |
24 |
$95.91 |
| J3370 |
Vancomycin hcl injection |
30 |
27 |
$95.41 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
59 |
55 |
$87.57 |
| J2550 |
Promethazine hcl injection |
292 |
240 |
$82.94 |
| 82570 |
|
14 |
12 |
$73.90 |
| 84156 |
|
17 |
13 |
$73.50 |
| 99152 |
|
225 |
165 |
$59.98 |
| J2370 |
Phenylephrine hcl injection |
238 |
213 |
$55.78 |
| J0780 |
Prochlorperazine injection |
109 |
98 |
$54.99 |
| J2272 |
Inj, morphine (fresenius) |
228 |
194 |
$37.05 |
| J7120 |
Ringers lactate infusion |
2,350 |
1,813 |
$18.63 |
| J2919 |
Inj, methylpred sod succ 5mg |
17 |
15 |
$12.15 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
38 |
36 |
$5.28 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
82 |
78 |
$4.98 |
| G1004 |
Cdsm ndsc |
753 |
570 |
$2.21 |
| J7050 |
Normal saline solution infus |
4,628 |
3,012 |
$1.82 |
| Q0162 |
Ondansetron oral |
642 |
548 |
$1.60 |
| J2930 |
Methylprednisolone injection |
15 |
13 |
$1.10 |
| J7030 |
Normal saline solution infus |
2,548 |
2,047 |
$0.16 |
| A9270 |
Non-covered item or service |
4,587 |
1,210 |
$0.03 |
| J0360 |
Hydralazine hcl injection |
76 |
53 |
$0.00 |
| U0005 |
Infec agen detec ampli probe |
2,339 |
2,084 |
$0.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
18 |
14 |
$0.00 |
| 87635 |
|
29 |
26 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
46 |
44 |
$0.00 |
| J0561 |
Penicillin g benzathine inj |
16 |
13 |
$0.00 |
| J3490 |
Drugs unclassified injection |
22 |
14 |
$0.00 |
| 0202U |
|
1,268 |
1,225 |
$0.00 |
| 93356 |
|
109 |
107 |
$0.00 |
| J7040 |
Normal saline solution infus |
362 |
306 |
$0.00 |