| Code | Description | Claims | Beneficiaries | Total Paid |
| 0450 |
|
130,898 |
117,616 |
$2.46M |
| J3490 |
Drugs unclassified injection |
83,378 |
35,660 |
$1.79M |
| 80048 |
|
92,545 |
86,561 |
$1.70M |
| 99199 |
|
21,065 |
20,196 |
$1.38M |
| T1999 |
Noc retail items andsupplies |
8,439 |
4,905 |
$937K |
| J9271 |
Inj pembrolizumab |
1,010 |
784 |
$510K |
| Z7502 |
|
12,468 |
12,279 |
$466K |
| Z9725 |
|
9,132 |
9,103 |
$393K |
| 77386 |
|
5,581 |
529 |
$310K |
| 96372 |
|
26,570 |
22,019 |
$309K |
| 96374 |
|
20,793 |
19,450 |
$289K |
| 80047 |
|
15,858 |
14,291 |
$286K |
| Q5107 |
Inj mvasi 10 mg |
1,657 |
546 |
$206K |
| U0002 |
Covid-19 lab test non-cdc |
17,523 |
17,041 |
$199K |
| 85025 |
|
154,951 |
131,511 |
$190K |
| J7030 |
Normal saline solution infus |
26,424 |
21,088 |
$154K |
| 78815 |
|
1,006 |
1,003 |
$133K |
| J2505 |
Injection, pegfilgrastim 6mg |
805 |
563 |
$115K |
| 80053 |
|
43,502 |
28,986 |
$112K |
| 74177 |
|
12,783 |
12,531 |
$106K |
| 71046 |
|
28,542 |
27,831 |
$99K |
| 93010 |
|
50,558 |
47,195 |
$96K |
| 96413 |
|
11,999 |
7,319 |
$86K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
16,027 |
15,595 |
$86K |
| 0360 |
|
3,959 |
3,060 |
$78K |
| 70553 |
|
1,211 |
1,202 |
$76K |
| 93005 |
|
39,317 |
37,342 |
$73K |
| 96367 |
|
8,842 |
5,018 |
$63K |
| 36415 |
|
5,469 |
4,963 |
$59K |
| 70450 |
|
8,370 |
8,217 |
$56K |
| 0761 |
|
4,161 |
3,142 |
$56K |
| 81001 |
|
54,314 |
51,123 |
$49K |
| Z7610 |
|
5,998 |
3,360 |
$44K |
| 99283 |
|
2,947 |
2,767 |
$43K |
| 81025 |
|
5,053 |
4,935 |
$42K |
| 77067 |
|
4,077 |
4,063 |
$38K |
| 80307 |
|
6,029 |
5,754 |
$32K |
| 96379 |
|
611 |
351 |
$31K |
| A9552 |
F18 fdg |
878 |
868 |
$31K |
| 0160 |
|
2,474 |
1,652 |
$31K |
| 77300 |
|
693 |
638 |
$31K |
| 71260 |
|
2,209 |
2,185 |
$30K |
| 87502 |
|
7,042 |
6,833 |
$29K |
| 74176 |
|
6,218 |
6,116 |
$29K |
| 86900 |
|
7,339 |
6,783 |
$29K |
| 80076 |
|
53,338 |
50,647 |
$26K |
| 77336 |
|
3,156 |
1,432 |
$25K |
| 59025 |
|
9,881 |
3,730 |
$24K |
| 77334 |
|
964 |
767 |
$23K |
| 84702 |
|
23,595 |
22,033 |
$22K |
| Q5111 |
Injection, udenyca 0.5 mg |
285 |
200 |
$21K |
| 84484 |
|
23,975 |
22,316 |
$21K |
| 88305 |
|
2,189 |
2,111 |
$20K |
| 83690 |
|
34,768 |
32,764 |
$20K |
| J0897 |
Denosumab injection |
594 |
564 |
$20K |
| J1453 |
Fosaprepitant injection |
2,419 |
1,579 |
$20K |
| 76815 |
|
6,135 |
3,681 |
$19K |
| 96415 |
|
4,023 |
2,576 |
$19K |
| 96375 |
|
11,638 |
10,148 |
$19K |
| 96417 |
|
3,343 |
2,230 |
$18K |
| 83615 |
|
12,227 |
8,038 |
$18K |
| 0270 |
|
97,240 |
49,817 |
$18K |
| 93975 |
|
1,597 |
1,572 |
$18K |
| 43239 |
|
871 |
862 |
$17K |
| 77412 |
|
3,116 |
391 |
$17K |
| J7620 |
Albuterol ipratrop non-comp |
91 |
89 |
$17K |
| 86850 |
|
4,888 |
4,448 |
$16K |
| 71045 |
|
8,152 |
7,965 |
$16K |
| 96365 |
|
1,805 |
1,247 |
$15K |
| 73564 |
|
2,956 |
2,848 |
$14K |
| 0710 |
|
1,985 |
1,948 |
$13K |
| 77066 |
Tomosynthesis, mammo |
2,195 |
2,180 |
$13K |
| J7050 |
Normal saline solution infus |
16,205 |
7,589 |
$13K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
1,277 |
1,250 |
$13K |
| 73610 |
|
2,635 |
2,536 |
$13K |
| 77065 |
Tomosynthesis, mammo |
1,905 |
1,866 |
$13K |
| 70551 |
|
977 |
970 |
$12K |
| 97110 |
|
8,406 |
2,527 |
$12K |
| 71275 |
|
3,117 |
3,060 |
$11K |
| U0003 |
Cov-19 amp prb hgh thruput |
555 |
553 |
$11K |
| 0324 |
|
337 |
331 |
$11K |
| 71250 |
|
409 |
409 |
$11K |
| 73130 |
|
2,238 |
2,174 |
$11K |
| 97139 |
|
3,454 |
541 |
$11K |
| J2506 |
Inj pegfilgrast ex bio 0.5mg |
311 |
239 |
$11K |
| 96416 |
|
1,933 |
1,216 |
$10K |
| 76700 |
|
1,796 |
1,778 |
$10K |
| 77080 |
|
663 |
659 |
$10K |
| 87088 |
|
9,988 |
9,593 |
$10K |
| 84443 |
|
9,267 |
8,305 |
$10K |
| 0250 |
|
1,666 |
1,262 |
$10K |
| 73630 |
|
3,150 |
3,045 |
$10K |
| 76642 |
|
3,297 |
3,150 |
$10K |
| J1642 |
Inj heparin sodium per 10 u |
10,174 |
5,883 |
$9K |
| 76830 |
|
4,804 |
4,726 |
$9K |
| 99284 |
|
1,169 |
1,111 |
$9K |
| 82728 |
|
5,979 |
5,587 |
$8K |
| 73110 |
|
1,661 |
1,588 |
$8K |
| 72125 |
|
1,900 |
1,884 |
$7K |
| 96411 |
|
2,253 |
1,548 |
$7K |
| 73030 |
|
2,537 |
2,454 |
$7K |
| 97750 |
|
1,173 |
906 |
$7K |
| 93971 |
|
2,261 |
2,214 |
$7K |
| 77063 |
|
3,374 |
3,368 |
$7K |
| 86923 |
|
1,145 |
945 |
$7K |
| 76705 |
|
4,599 |
4,489 |
$7K |
| J2405 |
Ondansetron hcl injection |
16,794 |
12,043 |
$6K |
| 76856 |
|
4,849 |
4,773 |
$6K |
| J1200 |
Diphenhydramine hcl injectio |
7,832 |
6,241 |
$6K |
| 96377 |
|
673 |
483 |
$6K |
| 87632 |
|
1,206 |
1,201 |
$6K |
| 96361 |
|
1,603 |
1,368 |
$6K |
| G0480 |
Drug test def 1-7 classes |
4,032 |
3,767 |
$6K |
| J2704 |
Inj, propofol, 10 mg |
2,603 |
2,293 |
$6K |
| 0750 |
|
27 |
27 |
$6K |
| 0760 |
|
8,735 |
7,081 |
$6K |
| 87503 |
|
6,937 |
6,730 |
$6K |
| 72100 |
|
1,654 |
1,627 |
$6K |
| 87081 |
|
2,544 |
2,503 |
$6K |
| 84466 |
|
5,771 |
5,507 |
$6K |
| 83880 |
|
8,067 |
7,738 |
$6K |
| 76770 |
|
938 |
922 |
$6K |
| 84550 |
|
6,331 |
4,514 |
$6K |
| G0279 |
Tomosynthesis, mammo |
3,525 |
3,510 |
$6K |
| 82746 |
|
4,422 |
4,229 |
$5K |
| 77290 |
|
191 |
165 |
$5K |
| 83735 |
|
5,236 |
3,607 |
$5K |
| 85045 |
|
5,746 |
4,881 |
$4K |
| 76801 |
|
3,577 |
3,285 |
$4K |
| J1100 |
Dexamethasone sodium phos |
8,969 |
5,974 |
$4K |
| P9040 |
Rbc leukoreduced irradiated |
47 |
38 |
$4K |
| 96360 |
|
858 |
750 |
$4K |
| P9016 |
Rbc leukocytes reduced |
421 |
376 |
$4K |
| 93306 |
|
371 |
369 |
$4K |
| 87077 |
|
3,677 |
3,604 |
$3K |
| 70491 |
|
292 |
290 |
$3K |
| 76811 |
|
379 |
375 |
$3K |
| J1885 |
Ketorolac tromethamine inj |
14,331 |
13,628 |
$3K |
| Q5106 |
Inj retacrit non-esrd use |
475 |
256 |
$3K |
| 82784 |
|
1,380 |
985 |
$3K |
| 84703 |
|
8,840 |
8,530 |
$3K |
| 85730 |
|
2,719 |
2,512 |
$3K |
| 71020 |
|
612 |
342 |
$3K |
| 73080 |
|
747 |
728 |
$3K |
| 83540 |
|
5,746 |
5,487 |
$3K |
| 82378 |
|
1,692 |
1,451 |
$3K |
| 85610 |
|
6,984 |
6,510 |
$3K |
| 85379 |
|
5,802 |
5,649 |
$3K |
| J3010 |
Fentanyl citrate injection |
5,016 |
4,560 |
$3K |
| 87491 |
|
3,025 |
2,979 |
$3K |
| J7040 |
Normal saline solution infus |
3,438 |
2,119 |
$3K |
| 87210 |
|
4,408 |
4,180 |
$3K |
| J0640 |
Leucovorin calcium injection |
2,537 |
1,158 |
$2K |
| 72050 |
|
365 |
363 |
$2K |
| 77295 |
|
75 |
71 |
$2K |
| A9579 |
Gad-base mr contrast nos,1ml |
962 |
937 |
$2K |
| 87389 |
|
578 |
576 |
$2K |
| 82607 |
|
4,172 |
3,998 |
$2K |
| 83883 |
|
1,181 |
836 |
$2K |
| 76817 |
|
1,977 |
1,823 |
$2K |
| 84439 |
|
3,072 |
2,425 |
$2K |
| 72148 |
|
423 |
419 |
$2K |
| 86901 |
|
7,277 |
6,725 |
$2K |
| J9190 |
Fluorouracil injection |
2,240 |
1,226 |
$2K |
| J2250 |
Inj midazolam hydrochloride |
1,232 |
1,169 |
$2K |
| J7120 |
Ringers lactate infusion |
2,609 |
2,522 |
$2K |
| 87040 |
|
2,656 |
2,499 |
$2K |
| 76870 |
|
295 |
290 |
$2K |
| 85027 |
|
2,451 |
2,167 |
$2K |
| 82731 |
|
852 |
774 |
$2K |
| 87591 |
|
3,025 |
2,979 |
$2K |
| 82306 |
|
758 |
744 |
$2K |
| 74018 |
|
521 |
506 |
$1K |
| 86780 |
|
1,327 |
1,288 |
$1K |
| 83605 |
|
4,476 |
4,248 |
$1K |
| 73502 |
|
708 |
696 |
$1K |
| 77338 |
|
40 |
37 |
$1K |
| 73590 |
|
801 |
775 |
$1K |
| 82565 |
|
2,457 |
2,331 |
$1K |
| J9045 |
Carboplatin injection |
536 |
348 |
$1K |
| J7060 |
5% dextrose/water |
3,715 |
1,571 |
$1K |
| 45380 |
|
53 |
52 |
$1K |
| 72131 |
|
371 |
369 |
$1K |
| 83036 |
|
1,569 |
1,541 |
$1K |
| 84100 |
|
2,430 |
1,778 |
$1K |
| 87186 |
|
3,304 |
3,228 |
$1K |
| 0301 |
|
109 |
80 |
$1K |
| J0131 |
Inj, acetaminophen (nos) |
134 |
131 |
$1K |
| 74178 |
|
12 |
12 |
$1K |
| J2001 |
Lidocaine injection |
2,806 |
2,543 |
$1K |
| 90471 |
|
3,214 |
3,029 |
$1K |
| 87430 |
|
2,784 |
2,736 |
$1K |
| 93970 |
|
319 |
318 |
$1K |
| 96549 |
|
1,077 |
703 |
$1K |
| 0403 |
|
17 |
17 |
$1K |
| Q5108 |
Injection, fulphila |
16 |
12 |
$1K |
| 90715 |
|
1,753 |
1,750 |
$1K |
| J1439 |
Inj ferric carboxymaltos 1mg |
41 |
28 |
$1K |
| J2765 |
Metoclopramide hcl injection |
4,150 |
3,787 |
$1K |
| 94640 |
|
1,991 |
1,851 |
$1K |
| J1170 |
Hydromorphone injection |
2,642 |
2,229 |
$1K |
| 45378 |
|
52 |
52 |
$925.00 |
| G0500 |
Mod sedat endo service >5yrs |
35 |
28 |
$907.16 |
| 87798 |
|
864 |
839 |
$901.84 |
| 72141 |
|
50 |
50 |
$878.71 |
| J9267 |
Paclitaxel injection |
248 |
142 |
$871.25 |
| 86334 |
|
965 |
704 |
$860.00 |
| 88342 |
|
193 |
190 |
$817.77 |
| 70486 |
|
127 |
127 |
$814.49 |
| 96401 |
|
356 |
156 |
$807.57 |
| 99285 |
|
256 |
249 |
$758.77 |
| 80061 |
|
576 |
559 |
$755.56 |
| 97140 |
|
569 |
216 |
$711.87 |
| 96366 |
|
61 |
52 |
$693.71 |
| 77280 |
|
102 |
89 |
$668.41 |
| 94644 |
|
212 |
172 |
$659.51 |
| J9070 |
Cyclophosphamide 100 mg inj |
36 |
13 |
$652.64 |
| 94664 |
|
1,153 |
1,046 |
$648.52 |
| 82105 |
|
40 |
27 |
$592.25 |
| J9263 |
Oxaliplatin |
1,240 |
361 |
$576.70 |
| J2270 |
Morphine sulfate injection |
4,198 |
3,813 |
$556.77 |
| A4217 |
Sterile water/saline, 500 ml |
97 |
97 |
$548.03 |
| J3105 |
Terbutaline sulfate inj |
397 |
323 |
$534.69 |
| 84165 |
|
1,072 |
798 |
$526.95 |
| 86308 |
|
393 |
390 |
$505.63 |
| 99152 |
|
85 |
82 |
$496.37 |
| 82247 |
|
522 |
458 |
$494.97 |
| 99281 |
|
15 |
12 |
$475.57 |
| J0696 |
Ceftriaxone sodium injection |
3,573 |
3,415 |
$457.82 |
| 0320 |
|
17 |
17 |
$442.85 |
| 11042 |
|
304 |
208 |
$438.44 |
| 86140 |
|
1,494 |
1,444 |
$418.52 |
| 82570 |
|
1,142 |
1,036 |
$398.16 |
| 80074 |
|
76 |
75 |
$396.70 |
| J9060 |
Cisplatin 10 mg injection |
115 |
50 |
$370.01 |
| J2175 |
Meperidine hydrochl /100 mg |
71 |
61 |
$364.33 |
| J0690 |
Cefazolin sodium injection |
78 |
74 |
$342.01 |
| J3475 |
Inj magnesium sulfate |
263 |
134 |
$336.62 |
| J2060 |
Lorazepam injection |
2,313 |
1,971 |
$331.01 |
| Q5101 |
Injection, zarxio |
44 |
14 |
$320.69 |
| 86304 |
|
167 |
134 |
$318.50 |
| 11043 |
|
21 |
12 |
$313.88 |
| 96402 |
|
700 |
638 |
$311.97 |
| 83010 |
|
155 |
143 |
$310.72 |
| 84460 |
|
496 |
443 |
$299.12 |
| 84450 |
|
481 |
428 |
$285.23 |
| 85651 |
|
1,399 |
1,350 |
$283.15 |
| 73562 |
|
36 |
27 |
$265.12 |
| 90686 |
|
138 |
137 |
$255.55 |
| 96376 |
|
957 |
720 |
$253.91 |
| 96368 |
|
208 |
128 |
$249.69 |
| 87506 |
|
194 |
191 |
$240.26 |
| Q0162 |
Ondansetron oral |
2,015 |
1,887 |
$235.70 |
| 96523 |
|
34 |
34 |
$223.17 |
| 76641 |
|
184 |
115 |
$207.52 |
| 84156 |
|
1,088 |
932 |
$203.42 |
| J2780 |
Ranitidine hydrochloride inj |
177 |
115 |
$198.27 |
| 70498 |
|
27 |
27 |
$190.93 |
| J9202 |
Goserelin acetate implant |
27 |
25 |
$174.38 |
| 92507 |
|
72 |
39 |
$171.96 |
| 73090 |
|
265 |
261 |
$170.47 |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
155 |
153 |
$161.26 |
| 90744 |
|
1,110 |
1,099 |
$128.08 |
| 82550 |
|
576 |
559 |
$126.91 |
| 99153 |
Mod sedat endo service >5yrs |
15 |
15 |
$122.72 |
| J1815 |
Insulin injection |
676 |
482 |
$111.66 |
| 82140 |
|
431 |
410 |
$100.37 |
| G0463 |
Hospital outpt clinic visit |
80 |
76 |
$88.75 |
| 73060 |
|
27 |
27 |
$85.79 |
| 87070 |
|
193 |
176 |
$80.08 |
| 87075 |
|
134 |
121 |
$74.86 |
| 95816 |
|
13 |
12 |
$72.56 |
| 87205 |
|
317 |
288 |
$70.59 |
| 71010 |
|
59 |
30 |
$70.58 |
| 85384 |
|
46 |
40 |
$68.29 |
| 73140 |
|
24 |
24 |
$67.32 |
| 84155 |
|
655 |
499 |
$65.86 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
84 |
81 |
$65.28 |
| 84520 |
|
186 |
179 |
$64.15 |
| J2919 |
Inj, methylpred sod succ 5mg |
78 |
61 |
$63.35 |
| 87340 |
|
26 |
25 |
$57.72 |
| J1630 |
Haloperidol injection |
1,463 |
1,239 |
$50.82 |
| 74000 |
|
24 |
12 |
$48.39 |
| 86300 |
|
137 |
100 |
$46.92 |
| 97163 |
|
12 |
12 |
$41.56 |
| 72040 |
|
41 |
41 |
$41.20 |
| S0020 |
Injection, bupivicaine hydro |
351 |
350 |
$31.55 |
| 96409 |
|
15 |
12 |
$29.63 |
| J0780 |
Prochlorperazine injection |
516 |
503 |
$26.17 |
| 76536 |
|
72 |
72 |
$24.63 |
| 86301 |
|
16 |
12 |
$24.42 |
| J1644 |
Inj heparin sodium per 1000u |
14 |
14 |
$21.34 |
| J1720 |
Hydrocortisone sodium succ i |
13 |
12 |
$11.70 |
| J7611 |
Albuterol non-comp con |
240 |
219 |
$11.55 |
| 84436 |
|
27 |
25 |
$10.59 |
| J0137 |
Inj, acetaminophen (hikma) |
96 |
96 |
$8.96 |
| Q0163 |
Diphenhydramine hcl 50mg |
135 |
116 |
$8.80 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
52 |
51 |
$5.75 |
| A4216 |
Sterile water/saline, 10 ml |
14 |
12 |
$5.19 |
| 72110 |
|
99 |
99 |
$4.77 |
| S0164 |
Injection pantroprazole |
103 |
102 |
$4.65 |
| J7512 |
Prednisone ir or dr oral 1mg |
321 |
317 |
$0.91 |
| J7613 |
Albuterol non-comp unit |
34 |
33 |
$0.50 |
| 0250R |
|
530 |
395 |
$0.00 |
| 89060 |
|
55 |
55 |
$0.00 |
| 87493 |
|
20 |
17 |
$0.00 |
| 71101 |
|
64 |
63 |
$0.00 |
| 70496 |
|
24 |
24 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
70 |
70 |
$0.00 |
| J0461 |
Atropine sulfate injection |
79 |
50 |
$0.00 |
| 73552 |
|
37 |
37 |
$0.00 |
| 72128 |
|
38 |
38 |
$0.00 |
| 72072 |
|
37 |
37 |
$0.00 |
| 82803 |
|
12 |
12 |
$0.00 |
| J1940 |
Furosemide injection |
15 |
13 |
$0.00 |
| J2560 |
Phenobarbital sodium inj |
16 |
13 |
$0.00 |
| 0370 |
|
13 |
13 |
$0.00 |
| Q5120 |
Inj pegfilgrastim-bmez 0.5mg |
85 |
64 |
$0.00 |
| 84153 |
|
14 |
12 |
$0.00 |
| 83921 |
|
12 |
12 |
$0.00 |
| 86880 |
|
14 |
13 |
$0.00 |
| 77470 |
|
12 |
12 |
$0.00 |
| 94729 |
|
58 |
53 |
$0.00 |
| 94060 |
|
39 |
39 |
$0.00 |
| J9206 |
Irinotecan injection |
34 |
14 |
$0.00 |
| G1004 |
Cdsm ndsc |
21 |
20 |
$0.00 |
| 76999 |
|
12 |
12 |
$0.00 |
| 99231 |
|
30 |
28 |
$0.00 |
| 76805 |
|
25 |
25 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
62 |
46 |
$0.00 |
| J0702 |
Betamethasone acet&sod phosp |
20 |
12 |
$0.00 |
| 94726 |
|
29 |
24 |
$0.00 |
| 92611 |
|
13 |
13 |
$0.00 |
| 87653 |
|
13 |
13 |
$0.00 |
| 0510 |
|
24 |
19 |
$0.00 |