| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
|
13,776 |
10,980 |
$2.81M |
| 99283 |
|
14,659 |
12,623 |
$2.22M |
| 99285 |
|
3,785 |
2,506 |
$972K |
| 74176 |
|
2,731 |
2,130 |
$742K |
| 87502 |
|
8,099 |
7,373 |
$633K |
| 74177 |
|
1,806 |
1,496 |
$578K |
| 70450 |
|
2,523 |
1,935 |
$564K |
| 87635 |
|
17,449 |
11,676 |
$557K |
| 99282 |
|
4,540 |
4,055 |
$542K |
| 96374 |
|
5,624 |
4,395 |
$475K |
| 96365 |
|
7,456 |
2,227 |
$375K |
| 96361 |
|
7,856 |
4,168 |
$335K |
| 96372 |
|
6,259 |
4,715 |
$247K |
| 80050 |
|
8,755 |
4,318 |
$204K |
| 97110 |
|
4,712 |
1,316 |
$183K |
| 80053 |
|
24,397 |
13,837 |
$177K |
| G0378 |
Hospital observation per hr |
1,681 |
599 |
$174K |
| 11042 |
|
1,518 |
527 |
$172K |
| 80307 |
|
3,848 |
3,174 |
$168K |
| 71045 |
|
6,757 |
4,648 |
$160K |
| 93005 |
|
6,529 |
5,436 |
$159K |
| 99211 |
|
8,477 |
7,390 |
$155K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
2,914 |
2,540 |
$145K |
| G0463 |
Hospital outpt clinic visit |
7,758 |
5,672 |
$141K |
| 87651 |
|
4,656 |
4,345 |
$138K |
| 36415 |
|
34,986 |
20,203 |
$133K |
| 96360 |
|
2,084 |
1,229 |
$131K |
| 87634 |
|
1,951 |
1,810 |
$121K |
| 85025 |
|
20,345 |
15,722 |
$121K |
| 71046 |
|
3,692 |
3,185 |
$113K |
| 96375 |
|
4,212 |
3,257 |
$106K |
| 72125 |
|
417 |
336 |
$105K |
| 72148 |
|
395 |
293 |
$101K |
| G0481 |
Drug test def 8-14 classes |
1,363 |
711 |
$88K |
| 76805 |
|
839 |
811 |
$83K |
| 73630 |
|
2,556 |
1,957 |
$79K |
| 71275 |
|
295 |
237 |
$78K |
| 76705 |
|
836 |
754 |
$76K |
| 99281 |
|
765 |
703 |
$74K |
| 77067 |
|
1,275 |
1,171 |
$73K |
| 70553 |
|
170 |
142 |
$69K |
| 93306 |
|
463 |
406 |
$68K |
| 83880 |
|
2,784 |
1,896 |
$66K |
| 76856 |
|
693 |
646 |
$65K |
| 94640 |
|
1,746 |
1,484 |
$62K |
| 80081 |
|
916 |
839 |
$61K |
| 82306 |
|
2,680 |
2,498 |
$61K |
| 73610 |
|
1,871 |
1,380 |
$59K |
| 71250 |
|
291 |
210 |
$55K |
| C9803 |
Hopd covid-19 spec collect |
11,288 |
7,795 |
$53K |
| 76816 |
|
758 |
716 |
$52K |
| 94760 |
|
4,132 |
3,453 |
$52K |
| 80061 |
|
6,042 |
4,431 |
$49K |
| 97140 |
|
1,816 |
681 |
$49K |
| 87507 |
|
206 |
148 |
$46K |
| 84484 |
|
5,051 |
3,312 |
$46K |
| 73030 |
|
1,483 |
1,134 |
$43K |
| 96366 |
|
714 |
357 |
$42K |
| 96376 |
|
1,079 |
647 |
$40K |
| 71260 |
|
158 |
119 |
$37K |
| 73110 |
|
1,427 |
1,030 |
$36K |
| 72100 |
|
951 |
745 |
$33K |
| 80048 |
|
4,998 |
3,260 |
$32K |
| 84443 |
|
2,972 |
2,061 |
$32K |
| 83735 |
|
6,349 |
4,946 |
$32K |
| 73721 |
|
87 |
79 |
$32K |
| 74018 |
|
936 |
845 |
$31K |
| 87086 |
|
4,766 |
3,875 |
$29K |
| 83036 |
|
4,395 |
4,098 |
$29K |
| 73130 |
|
1,132 |
920 |
$29K |
| 82607 |
|
2,413 |
2,207 |
$28K |
| J0131 |
Inj, acetaminophen (nos) |
500 |
433 |
$27K |
| J7030 |
Normal saline solution infus |
6,118 |
4,641 |
$27K |
| 73562 |
|
977 |
786 |
$26K |
| 87804 |
|
2,050 |
1,013 |
$26K |
| 83690 |
|
4,864 |
4,158 |
$26K |
| 42820 |
|
32 |
31 |
$26K |
| 83605 |
|
2,967 |
2,015 |
$25K |
| 87040 |
|
3,120 |
1,405 |
$24K |
| 81001 |
|
9,968 |
7,912 |
$23K |
| J3490 |
Drugs unclassified injection |
1,969 |
993 |
$23K |
| J2704 |
Inj, propofol, 10 mg |
2,048 |
1,814 |
$21K |
| 81025 |
|
3,246 |
2,875 |
$21K |
| 86803 |
|
1,487 |
1,336 |
$19K |
| 97162 |
|
290 |
262 |
$19K |
| J1885 |
Ketorolac tromethamine inj |
5,942 |
5,062 |
$19K |
| J7050 |
Normal saline solution infus |
4,037 |
1,914 |
$19K |
| 73502 |
|
667 |
509 |
$18K |
| 86140 |
|
4,257 |
3,694 |
$17K |
| 78452 |
|
85 |
36 |
$17K |
| 84702 |
|
1,267 |
861 |
$16K |
| 77063 |
|
1,293 |
1,185 |
$16K |
| A9585 |
Gadobutrol injection |
322 |
285 |
$15K |
| 76536 |
|
211 |
200 |
$14K |
| 85379 |
|
1,855 |
1,636 |
$14K |
| U0003 |
Cov-19 amp prb hgh thruput |
269 |
224 |
$14K |
| 84439 |
|
1,895 |
1,487 |
$13K |
| 82728 |
|
1,218 |
1,127 |
$13K |
| 90715 |
|
266 |
245 |
$13K |
| 99218 |
|
346 |
121 |
$13K |
| 87186 |
|
1,917 |
1,555 |
$13K |
| 82746 |
|
1,118 |
1,049 |
$13K |
| J7120 |
Ringers lactate infusion |
2,122 |
1,552 |
$13K |
| J2930 |
Methylprednisolone injection |
742 |
614 |
$13K |
| 87077 |
|
1,962 |
1,581 |
$12K |
| 82550 |
|
2,422 |
2,012 |
$12K |
| 90471 |
|
828 |
752 |
$12K |
| 82948 |
|
2,218 |
1,140 |
$12K |
| 59025 |
|
154 |
113 |
$12K |
| 85610 |
|
3,827 |
2,723 |
$11K |
| 90686 |
|
284 |
236 |
$10K |
| 73221 |
|
31 |
27 |
$10K |
| 87880 |
|
789 |
703 |
$10K |
| 73080 |
|
348 |
250 |
$10K |
| 82803 |
|
654 |
414 |
$10K |
| 99291 |
|
17 |
14 |
$9K |
| 87491 |
|
360 |
331 |
$9K |
| 72131 |
|
27 |
27 |
$9K |
| 87591 |
|
360 |
331 |
$9K |
| 81003 |
|
4,444 |
3,928 |
$9K |
| G2023 |
Specimen collect covid-19 |
425 |
410 |
$9K |
| 85730 |
|
1,198 |
992 |
$9K |
| J0696 |
Ceftriaxone sodium injection |
1,941 |
1,355 |
$9K |
| 12001 |
|
97 |
94 |
$9K |
| 71271 |
|
82 |
76 |
$8K |
| 73560 |
|
342 |
246 |
$8K |
| 83550 |
|
1,148 |
1,081 |
$8K |
| 87070 |
|
1,262 |
969 |
$7K |
| 70486 |
|
27 |
24 |
$7K |
| 96367 |
|
549 |
131 |
$7K |
| J2405 |
Ondansetron hcl injection |
4,731 |
3,831 |
$7K |
| 43239 |
|
12 |
12 |
$7K |
| 83540 |
|
1,276 |
1,205 |
$6K |
| Q0162 |
Ondansetron oral |
1,984 |
1,830 |
$6K |
| 97161 |
|
531 |
135 |
$6K |
| J2360 |
Orphenadrine injection |
258 |
229 |
$6K |
| J3010 |
Fentanyl citrate injection |
1,719 |
1,512 |
$6K |
| 84703 |
|
846 |
751 |
$5K |
| 85027 |
|
909 |
833 |
$5K |
| 73140 |
|
209 |
167 |
$5K |
| 82570 |
|
1,026 |
796 |
$5K |
| J1170 |
Hydromorphone injection |
653 |
465 |
$5K |
| J1100 |
Dexamethasone sodium phos |
1,858 |
1,629 |
$5K |
| J1200 |
Diphenhydramine hcl injectio |
519 |
452 |
$4K |
| J0690 |
Cefazolin sodium injection |
316 |
237 |
$4K |
| U0005 |
Infec agen detec ampli probe |
211 |
188 |
$4K |
| 86769 |
|
201 |
67 |
$4K |
| 87807 |
|
363 |
315 |
$4K |
| 86376 |
|
345 |
282 |
$3K |
| 82565 |
|
331 |
126 |
$3K |
| C9113 |
Inj pantoprazole sodium, via |
441 |
272 |
$3K |
| 71101 |
|
105 |
77 |
$3K |
| 45380 |
|
20 |
13 |
$3K |
| 73564 |
|
94 |
75 |
$3K |
| 93017 |
|
27 |
24 |
$3K |
| G0103 |
Psa screening |
537 |
216 |
$3K |
| 82248 |
|
881 |
582 |
$3K |
| J0780 |
Prochlorperazine injection |
348 |
308 |
$3K |
| 82553 |
|
321 |
250 |
$3K |
| 82950 |
|
629 |
598 |
$3K |
| 86703 |
|
287 |
274 |
$3K |
| 62323 |
|
21 |
13 |
$3K |
| M0243 |
Casirivi and imdevi inj |
27 |
27 |
$3K |
| 82043 |
|
621 |
579 |
$3K |
| G1004 |
Cdsm ndsc |
765 |
150 |
$3K |
| J3301 |
Triamcinolone acet inj nos |
118 |
100 |
$3K |
| 87081 |
|
491 |
423 |
$3K |
| 84481 |
|
190 |
175 |
$3K |
| J2270 |
Morphine sulfate injection |
594 |
463 |
$2K |
| 72110 |
|
77 |
66 |
$2K |
| 84550 |
|
586 |
507 |
$2K |
| J7040 |
Normal saline solution infus |
456 |
421 |
$2K |
| 82150 |
|
462 |
412 |
$2K |
| 87205 |
|
627 |
507 |
$2K |
| J3475 |
Inj magnesium sulfate |
130 |
100 |
$2K |
| 85652 |
|
952 |
869 |
$2K |
| 80055 |
|
52 |
52 |
$2K |
| 84145 |
|
146 |
67 |
$2K |
| 36600 |
|
270 |
157 |
$2K |
| 73590 |
|
67 |
52 |
$2K |
| 84146 |
|
133 |
118 |
$2K |
| 86003 |
|
77 |
43 |
$2K |
| 84681 |
|
67 |
28 |
$2K |
| 00811 |
|
14 |
13 |
$2K |
| J2919 |
Inj, methylpred sod succ 5mg |
165 |
129 |
$2K |
| 80320 |
|
73 |
61 |
$2K |
| 86850 |
|
235 |
183 |
$2K |
| 81002 |
|
645 |
503 |
$2K |
| 86039 |
|
159 |
157 |
$1K |
| 86900 |
|
480 |
374 |
$1K |
| 84156 |
|
456 |
374 |
$1K |
| 84112 |
|
14 |
13 |
$1K |
| 77080 |
|
39 |
26 |
$1K |
| 84403 |
|
64 |
53 |
$1K |
| 99406 |
|
110 |
99 |
$1K |
| J1010 |
Inj, methylpred acetate 1 mg |
114 |
112 |
$1K |
| J2272 |
Inj, morphine (fresenius) |
328 |
266 |
$1K |
| 90656 |
|
89 |
87 |
$1K |
| J2250 |
Inj midazolam hydrochloride |
1,254 |
1,079 |
$1K |
| 76830 |
|
29 |
28 |
$1K |
| 84520 |
|
197 |
182 |
$1K |
| J1030 |
Methylprednisolone 40 mg inj |
115 |
95 |
$1K |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
347 |
310 |
$1K |
| 99213 |
|
50 |
48 |
$1K |
| 76770 |
|
30 |
27 |
$1K |
| 83615 |
|
154 |
121 |
$992.20 |
| 93971 |
|
13 |
12 |
$967.95 |
| 86901 |
|
408 |
333 |
$946.18 |
| 93226 |
|
28 |
26 |
$927.99 |
| 72050 |
|
16 |
14 |
$786.75 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
44 |
42 |
$755.58 |
| 82247 |
|
210 |
102 |
$749.08 |
| 87522 |
Neg quan hep c or qual rna |
17 |
16 |
$747.59 |
| 72040 |
|
14 |
14 |
$742.58 |
| J1650 |
Inj enoxaparin sodium |
80 |
39 |
$702.88 |
| 93225 |
|
25 |
25 |
$654.94 |
| 83516 |
|
63 |
36 |
$652.85 |
| 76801 |
|
14 |
12 |
$615.86 |
| 86592 |
|
159 |
146 |
$578.24 |
| 84436 |
|
94 |
83 |
$570.81 |
| 87661 |
|
32 |
30 |
$545.03 |
| 99214 |
|
14 |
13 |
$537.38 |
| 73090 |
|
34 |
29 |
$532.00 |
| 80299 |
|
27 |
25 |
$529.17 |
| A6021 |
Collagen dressing <=16 sq in |
89 |
28 |
$519.50 |
| 82270 |
|
175 |
68 |
$516.64 |
| 87088 |
|
97 |
89 |
$503.91 |
| 97032 |
|
52 |
12 |
$489.00 |
| 80076 |
|
84 |
72 |
$467.16 |
| 80074 |
|
12 |
12 |
$466.46 |
| J2800 |
Methocarbamol injection |
36 |
33 |
$427.70 |
| 83525 |
|
42 |
39 |
$352.61 |
| Q3014 |
Telehealth facility fee |
24 |
19 |
$334.69 |
| J1040 |
Methylprednisolone 80 mg inj |
13 |
13 |
$296.10 |
| 84153 |
|
31 |
28 |
$284.11 |
| 86709 |
|
28 |
28 |
$278.12 |
| J7042 |
5% dextrose/normal saline |
73 |
64 |
$274.07 |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
27 |
26 |
$256.55 |
| 82784 |
|
33 |
25 |
$239.00 |
| 86008 |
|
13 |
13 |
$233.09 |
| 85018 |
|
125 |
111 |
$204.21 |
| J8540 |
Oral dexamethasone |
39 |
39 |
$189.43 |
| 84100 |
|
48 |
25 |
$184.15 |
| J7510 |
Prednisolone oral per 5 mg |
61 |
58 |
$181.34 |
| 84270 |
|
15 |
12 |
$173.84 |
| 85045 |
|
64 |
57 |
$170.93 |
| 83001 |
|
14 |
13 |
$164.43 |
| 85014 |
|
94 |
85 |
$159.83 |
| 83874 |
|
18 |
13 |
$135.03 |
| J3420 |
Vitamin b12 injection |
21 |
12 |
$95.18 |
| 86706 |
|
12 |
12 |
$95.05 |
| J2550 |
Promethazine hcl injection |
13 |
12 |
$84.79 |
| J2765 |
Metoclopramide hcl injection |
29 |
26 |
$66.22 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
16 |
15 |
$50.98 |
| J7512 |
Prednisone ir or dr oral 1mg |
83 |
73 |
$49.59 |
| 86308 |
|
13 |
12 |
$40.66 |
| 85651 |
|
14 |
13 |
$26.49 |
| J2060 |
Lorazepam injection |
14 |
12 |
$19.80 |
| 3044F |
|
1,110 |
1,060 |
$0.00 |
| A9270 |
Non-covered item or service |
24 |
14 |
$0.00 |
| 3046F |
|
14 |
12 |
$0.00 |