| Code | Description | Claims | Beneficiaries | Total Paid |
| 0450 |
|
127,318 |
113,259 |
$5.93M |
| 74177 |
|
7,607 |
7,479 |
$1.74M |
| U0003 |
Cov-19 amp prb hgh thruput |
17,516 |
16,989 |
$1.29M |
| 87502 |
|
16,747 |
16,300 |
$1.21M |
| 87637 |
|
6,874 |
6,691 |
$1.04M |
| 96374 |
|
14,571 |
13,574 |
$979K |
| 70450 |
|
8,170 |
7,978 |
$787K |
| 93005 |
|
32,114 |
29,317 |
$644K |
| 87635 |
|
10,739 |
10,478 |
$634K |
| 80307 |
|
9,474 |
8,413 |
$611K |
| 96375 |
|
12,432 |
11,304 |
$606K |
| 0250 |
|
45,857 |
26,219 |
$590K |
| 93010 |
|
47,905 |
41,104 |
$574K |
| J0131 |
Inj, acetaminophen (nos) |
1,975 |
1,928 |
$564K |
| 80053 |
|
65,190 |
59,621 |
$563K |
| 97597 |
|
17,062 |
6,922 |
$532K |
| 96372 |
|
17,342 |
16,099 |
$506K |
| 0516 |
|
16,756 |
15,785 |
$498K |
| 74176 |
|
4,007 |
3,944 |
$473K |
| 71046 |
|
21,610 |
20,991 |
$463K |
| 85025 |
|
68,091 |
61,815 |
$432K |
| 96365 |
|
5,165 |
4,554 |
$417K |
| 0241U |
|
2,494 |
2,468 |
$412K |
| G0480 |
Drug test def 1-7 classes |
5,941 |
5,034 |
$412K |
| 97598 |
|
1,567 |
654 |
$397K |
| 97110 |
|
21,250 |
6,128 |
$395K |
| 0360 |
|
2,595 |
2,319 |
$379K |
| 96361 |
|
12,725 |
11,744 |
$368K |
| 99211 |
|
12,309 |
11,584 |
$356K |
| 87798 |
|
11,856 |
11,524 |
$355K |
| 0510 |
|
11,402 |
10,561 |
$337K |
| 99199 |
|
5,096 |
4,434 |
$336K |
| Z7502 |
|
8,464 |
8,263 |
$314K |
| 97140 |
|
11,208 |
4,082 |
$301K |
| 99213 |
|
7,099 |
6,473 |
$294K |
| J3490 |
Drugs unclassified injection |
18,981 |
11,662 |
$289K |
| 97112 |
|
15,998 |
4,844 |
$280K |
| 0761 |
|
8,258 |
7,665 |
$238K |
| 97530 |
|
14,377 |
4,751 |
$235K |
| 99284 |
|
4,880 |
4,519 |
$226K |
| C9803 |
Hopd covid-19 spec collect |
8,464 |
7,943 |
$224K |
| 96360 |
|
3,254 |
3,179 |
$224K |
| 71260 |
|
1,320 |
1,302 |
$223K |
| 76856 |
|
3,810 |
3,763 |
$220K |
| T1999 |
Noc retail items andsupplies |
13,518 |
9,378 |
$220K |
| 72125 |
|
1,647 |
1,629 |
$213K |
| 87651 |
|
6,700 |
6,543 |
$205K |
| Z7500 |
|
6,040 |
5,415 |
$203K |
| 76830 |
|
3,307 |
3,271 |
$195K |
| J2405 |
Ondansetron hcl injection |
10,242 |
9,517 |
$195K |
| 76705 |
|
3,791 |
3,732 |
$187K |
| 93306 |
|
1,042 |
1,033 |
$181K |
| 76801 |
|
2,989 |
2,548 |
$178K |
| 99283 |
|
4,058 |
3,751 |
$178K |
| J1885 |
Ketorolac tromethamine inj |
15,092 |
14,220 |
$165K |
| 93971 |
|
1,925 |
1,864 |
$162K |
| 71045 |
|
13,718 |
13,181 |
$162K |
| J1100 |
Dexamethasone sodium phos |
3,834 |
3,733 |
$156K |
| 99232 |
|
5,236 |
2,350 |
$156K |
| 11042 |
|
3,129 |
1,358 |
$153K |
| 84484 |
|
18,594 |
16,239 |
$147K |
| 99233 |
Prolong inpt eval add15 m |
3,771 |
1,804 |
$140K |
| J7030 |
Normal saline solution infus |
14,765 |
13,507 |
$138K |
| 83690 |
|
23,076 |
21,679 |
$137K |
| 83880 |
|
5,705 |
5,430 |
$133K |
| J0696 |
Ceftriaxone sodium injection |
6,609 |
6,270 |
$132K |
| 76817 |
|
2,125 |
1,807 |
$132K |
| 81001 |
|
46,323 |
43,109 |
$129K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
10,397 |
10,152 |
$128K |
| 87491 |
|
4,196 |
4,103 |
$128K |
| 87591 |
|
4,194 |
4,102 |
$127K |
| 99285 |
|
2,808 |
2,631 |
$125K |
| 94640 |
|
6,923 |
6,212 |
$119K |
| 87086 |
|
17,769 |
16,770 |
$115K |
| 97750 |
|
2,631 |
1,482 |
$110K |
| 99239 |
|
2,294 |
2,252 |
$106K |
| 83605 |
|
11,697 |
9,939 |
$105K |
| 87631 |
|
1,355 |
1,326 |
$99K |
| 87040 |
|
10,042 |
6,081 |
$93K |
| 84702 |
|
6,641 |
5,879 |
$82K |
| 99070 |
|
4,691 |
2,820 |
$80K |
| 73562 |
|
3,838 |
3,697 |
$77K |
| 0760 |
|
3,091 |
2,833 |
$75K |
| 73610 |
|
3,275 |
3,153 |
$74K |
| 0160 |
|
189 |
94 |
$73K |
| 73630 |
|
3,427 |
3,314 |
$71K |
| Z1034 |
|
993 |
705 |
$69K |
| 99214 |
|
1,511 |
1,483 |
$67K |
| 73030 |
|
3,046 |
2,959 |
$64K |
| 84145 |
|
5,249 |
5,107 |
$63K |
| 0270 |
|
8,204 |
4,652 |
$61K |
| 99281 |
|
738 |
665 |
$61K |
| 90715 |
|
1,441 |
1,432 |
$61K |
| 81025 |
|
15,405 |
14,828 |
$60K |
| 73130 |
|
2,538 |
2,433 |
$58K |
| 76700 |
|
899 |
895 |
$56K |
| 72131 |
|
491 |
490 |
$54K |
| 99223 |
Prolong inpt eval add15 m |
826 |
814 |
$53K |
| 99152 |
|
1,534 |
1,493 |
$51K |
| 73110 |
|
2,150 |
2,060 |
$49K |
| 0729 |
|
1,615 |
1,294 |
$48K |
| 84703 |
|
7,950 |
7,697 |
$48K |
| 83735 |
|
8,169 |
7,670 |
$45K |
| 84443 |
|
3,263 |
3,210 |
$45K |
| J2270 |
Morphine sulfate injection |
4,493 |
4,059 |
$45K |
| 87880 |
|
5,412 |
5,334 |
$44K |
| 82805 |
|
1,922 |
1,838 |
$44K |
| 70486 |
|
355 |
353 |
$43K |
| 0762 |
|
66 |
39 |
$41K |
| 73502 |
|
1,293 |
1,255 |
$40K |
| 86140 |
|
8,845 |
8,575 |
$39K |
| 76857 |
|
1,372 |
1,343 |
$38K |
| J8499 |
Oral prescrip drug non chemo |
3,378 |
3,224 |
$38K |
| 80048 |
|
5,354 |
5,083 |
$37K |
| 87634 |
|
499 |
494 |
$35K |
| J7120 |
Ringers lactate infusion |
3,825 |
3,564 |
$35K |
| 72100 |
|
1,285 |
1,280 |
$34K |
| J1756 |
Iron sucrose injection |
29 |
12 |
$33K |
| 70551 |
|
184 |
180 |
$33K |
| 76815 |
|
665 |
632 |
$32K |
| 85610 |
|
10,102 |
9,716 |
$32K |
| 87186 |
|
4,433 |
4,314 |
$32K |
| 99282 |
|
650 |
622 |
$32K |
| 70496 |
|
153 |
151 |
$31K |
| 43239 |
|
1,311 |
1,299 |
$30K |
| Z9725 |
|
693 |
675 |
$30K |
| 0636 |
|
2,758 |
2,629 |
$29K |
| J7040 |
Normal saline solution infus |
4,489 |
4,407 |
$28K |
| 70498 |
|
154 |
152 |
$28K |
| J1170 |
Hydromorphone injection |
3,087 |
2,604 |
$28K |
| 97116 |
|
2,164 |
864 |
$28K |
| 74018 |
|
1,353 |
1,322 |
$28K |
| 87081 |
|
4,877 |
4,807 |
$27K |
| 73080 |
|
1,080 |
1,026 |
$27K |
| G0463 |
Hospital outpt clinic visit |
6,937 |
6,217 |
$27K |
| 76770 |
|
409 |
403 |
$26K |
| 99499 |
|
465 |
375 |
$26K |
| 81514 |
|
104 |
100 |
$26K |
| 0710 |
|
563 |
517 |
$26K |
| 80179 |
|
1,489 |
1,387 |
$25K |
| 80143 |
|
1,510 |
1,392 |
$25K |
| 73590 |
|
1,108 |
1,051 |
$25K |
| 71250 |
|
218 |
217 |
$21K |
| J3010 |
Fentanyl citrate injection |
4,822 |
4,664 |
$21K |
| 85379 |
|
2,157 |
2,113 |
$20K |
| 85027 |
|
3,813 |
3,547 |
$20K |
| 85730 |
|
4,300 |
4,206 |
$20K |
| 99222 |
|
288 |
288 |
$19K |
| J2765 |
Metoclopramide hcl injection |
2,896 |
2,691 |
$19K |
| 95816 |
|
402 |
402 |
$19K |
| 76870 |
|
395 |
386 |
$18K |
| 81003 |
|
8,041 |
7,888 |
$17K |
| 96366 |
|
307 |
251 |
$17K |
| 82550 |
|
3,078 |
2,979 |
$17K |
| J1815 |
Insulin injection |
1,156 |
767 |
$17K |
| J1200 |
Diphenhydramine hcl injectio |
2,772 |
2,557 |
$17K |
| 87077 |
|
2,563 |
2,477 |
$17K |
| U0005 |
Infec agen detec ampli probe |
1,733 |
1,663 |
$15K |
| 99460 |
|
297 |
296 |
$14K |
| 71275 |
|
82 |
80 |
$14K |
| J2060 |
Lorazepam injection |
1,898 |
1,730 |
$14K |
| J2250 |
Inj midazolam hydrochloride |
3,567 |
3,491 |
$14K |
| 96367 |
|
281 |
272 |
$14K |
| 73090 |
|
774 |
721 |
$13K |
| 94726 |
|
287 |
283 |
$13K |
| 73564 |
|
814 |
803 |
$13K |
| 93970 |
|
99 |
98 |
$12K |
| J2930 |
Methylprednisolone injection |
808 |
760 |
$12K |
| 82962 |
|
4,416 |
3,503 |
$12K |
| 94060 |
|
394 |
390 |
$12K |
| 94729 |
|
262 |
258 |
$12K |
| 87088 |
|
2,071 |
2,022 |
$12K |
| 45385 |
|
404 |
403 |
$11K |
| 74019 |
|
462 |
458 |
$11K |
| 0456 |
|
296 |
280 |
$11K |
| 82948 |
|
4,326 |
3,480 |
$10K |
| 86901 |
|
3,978 |
3,727 |
$10K |
| 87070 |
|
1,381 |
1,370 |
$9K |
| 99153 |
Mod sedat endo service >5yrs |
831 |
828 |
$9K |
| 86900 |
|
3,983 |
3,728 |
$9K |
| 86780 |
|
880 |
848 |
$9K |
| 99291 |
|
88 |
41 |
$9K |
| 45380 |
|
364 |
356 |
$9K |
| 86769 |
|
230 |
225 |
$9K |
| 99203 |
|
116 |
116 |
$8K |
| 87389 |
|
453 |
451 |
$8K |
| J2704 |
Inj, propofol, 10 mg |
743 |
709 |
$8K |
| 85007 |
|
3,281 |
3,046 |
$8K |
| 87210 |
|
2,166 |
2,117 |
$8K |
| 83036 |
|
1,100 |
1,073 |
$7K |
| 94644 |
|
317 |
302 |
$7K |
| S0119 |
Ondansetron 4 mg |
2,073 |
2,010 |
$7K |
| Z6410 |
|
521 |
388 |
$6K |
| S0164 |
Injection pantroprazole |
462 |
426 |
$6K |
| 86850 |
|
1,919 |
1,790 |
$6K |
| Z7610 |
|
1,719 |
767 |
$6K |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
37 |
37 |
$6K |
| J0561 |
Penicillin g benzathine inj |
26 |
26 |
$6K |
| J2919 |
Inj, methylpred sod succ 5mg |
64 |
61 |
$6K |
| 0259 |
|
6,914 |
2,887 |
$5K |
| J7050 |
Normal saline solution infus |
727 |
666 |
$5K |
| 76805 |
|
45 |
45 |
$5K |
| 80061 |
|
569 |
545 |
$5K |
| 82010 |
|
750 |
702 |
$5K |
| 73140 |
|
343 |
331 |
$5K |
| 36415 |
|
945 |
870 |
$5K |
| 90471 |
|
880 |
855 |
$4K |
| 70491 |
|
28 |
28 |
$4K |
| 84439 |
|
570 |
560 |
$4K |
| J3475 |
Inj magnesium sulfate |
219 |
210 |
$4K |
| 0001A |
|
103 |
103 |
$4K |
| 95819 |
|
126 |
124 |
$4K |
| 76536 |
|
78 |
78 |
$4K |
| 72110 |
|
106 |
106 |
$4K |
| 97124 |
|
331 |
179 |
$4K |
| 99238 |
|
104 |
102 |
$4K |
| 0324 |
|
39 |
38 |
$4K |
| 59025 |
|
202 |
163 |
$4K |
| 87807 |
|
444 |
426 |
$4K |
| 85652 |
|
1,499 |
1,480 |
$3K |
| 72040 |
|
162 |
162 |
$3K |
| 90670 |
|
427 |
427 |
$3K |
| 90723 |
|
358 |
358 |
$3K |
| 90647 |
|
347 |
347 |
$3K |
| Z1032 |
|
13 |
13 |
$2K |
| 72128 |
|
24 |
24 |
$2K |
| 0002A |
|
55 |
55 |
$2K |
| 45378 |
|
71 |
71 |
$2K |
| 86413 |
|
32 |
31 |
$2K |
| 99215 |
Prolong outpt/office vis |
29 |
29 |
$2K |
| J0690 |
Cefazolin sodium injection |
184 |
153 |
$2K |
| 87205 |
|
567 |
561 |
$2K |
| 90681 |
|
197 |
197 |
$2K |
| 71101 |
|
62 |
62 |
$2K |
| J2550 |
Promethazine hcl injection |
219 |
210 |
$2K |
| 94664 |
|
147 |
133 |
$2K |
| 71100 |
|
70 |
70 |
$1K |
| 86480 |
|
27 |
27 |
$1K |
| 73560 |
|
92 |
87 |
$1K |
| 0011A |
|
35 |
35 |
$1K |
| Z6400 |
|
27 |
26 |
$1K |
| 87147 |
|
328 |
323 |
$1K |
| 36600 |
|
355 |
344 |
$1K |
| 71020 |
|
48 |
27 |
$1K |
| 97035 |
|
159 |
77 |
$1K |
| 99212 |
|
50 |
50 |
$1K |
| 94760 |
|
196 |
138 |
$1K |
| 85018 |
|
468 |
467 |
$1K |
| 73060 |
|
55 |
52 |
$943.08 |
| U0002 |
Covid-19 lab test non-cdc |
15 |
15 |
$687.57 |
| 84132 |
|
223 |
206 |
$682.87 |
| 73552 |
|
39 |
39 |
$631.33 |
| 92507 |
|
26 |
12 |
$623.82 |
| 86923 |
|
13 |
12 |
$609.24 |
| 0012A |
|
14 |
14 |
$560.00 |
| 92552 |
|
56 |
56 |
$555.35 |
| J1040 |
Methylprednisolone 80 mg inj |
29 |
29 |
$536.42 |
| 90688 |
|
22 |
22 |
$490.60 |
| S0020 |
Injection, bupivicaine hydro |
54 |
54 |
$490.25 |
| 99202 |
|
12 |
12 |
$481.70 |
| V5008 |
Hearing screening |
12 |
12 |
$450.00 |
| 80076 |
|
71 |
70 |
$440.04 |
| 73620 |
|
25 |
25 |
$425.15 |
| 90662 |
|
36 |
35 |
$424.42 |
| 73100 |
|
26 |
26 |
$400.42 |
| 84295 |
|
127 |
124 |
$395.92 |
| 99462 |
|
15 |
15 |
$377.99 |
| 82435 |
|
126 |
123 |
$348.81 |
| 87640 |
|
12 |
12 |
$276.91 |
| 86308 |
|
62 |
61 |
$264.37 |
| 84100 |
|
76 |
74 |
$260.47 |
| 97150 |
|
1,076 |
366 |
$257.22 |
| J2920 |
Methylprednisolone injection |
14 |
13 |
$197.47 |
| 86762 |
|
12 |
12 |
$195.72 |
| 69209 |
|
28 |
27 |
$150.00 |
| J0780 |
Prochlorperazine injection |
16 |
16 |
$139.68 |
| J1940 |
Furosemide injection |
14 |
12 |
$133.70 |
| 82150 |
|
27 |
27 |
$129.55 |
| J3370 |
Vancomycin hcl injection |
14 |
12 |
$126.80 |
| J0360 |
Hydralazine hcl injection |
15 |
14 |
$123.96 |
| 84550 |
|
24 |
24 |
$92.97 |
| 84156 |
|
28 |
25 |
$88.02 |
| 82570 |
|
14 |
14 |
$59.80 |
| 83615 |
|
12 |
12 |
$57.81 |
| J7611 |
Albuterol non-comp con |
121 |
120 |
$43.46 |
| 90658 |
|
12 |
12 |
$27.00 |
| 87340 |
|
12 |
12 |
$14.76 |
| J7613 |
Albuterol non-comp unit |
113 |
112 |
$6.83 |
| 88305 |
|
12 |
12 |
$0.00 |
| G0008 |
Admin influenza virus vac |
14 |
14 |
$0.00 |