| Code | Description | Claims | Beneficiaries | Total Paid |
| 0450 |
|
78,944 |
70,685 |
$13.34M |
| 99199 |
|
51,361 |
43,398 |
$10.67M |
| 74177 |
|
8,530 |
8,201 |
$5.34M |
| 70450 |
|
9,727 |
9,330 |
$4.26M |
| 72125 |
|
4,135 |
3,996 |
$3.20M |
| 99281 |
|
14,157 |
12,707 |
$2.26M |
| 71260 |
|
1,750 |
1,691 |
$1.77M |
| 80053 |
|
62,661 |
56,200 |
$1.69M |
| 87637 |
|
6,786 |
6,637 |
$1.59M |
| 96374 |
|
16,161 |
14,929 |
$1.55M |
| 80307 |
|
10,863 |
9,991 |
$1.32M |
| 93005 |
|
26,422 |
24,527 |
$1.25M |
| 74176 |
|
4,924 |
4,745 |
$1.20M |
| 96375 |
|
15,261 |
12,801 |
$1.14M |
| 0250 |
|
18,116 |
7,550 |
$1.05M |
| 85025 |
|
73,211 |
64,214 |
$1.03M |
| 87635 |
|
12,612 |
12,032 |
$981K |
| 82077 |
|
8,060 |
7,310 |
$948K |
| 87636 |
|
3,738 |
3,674 |
$872K |
| 96365 |
|
7,314 |
5,951 |
$872K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
17,761 |
12,012 |
$800K |
| 96361 |
|
10,208 |
9,066 |
$750K |
| J3490 |
Drugs unclassified injection |
46,458 |
23,237 |
$700K |
| 71045 |
|
16,504 |
15,632 |
$691K |
| 72131 |
|
1,457 |
1,427 |
$658K |
| 0762 |
|
1,536 |
590 |
$635K |
| 71046 |
|
14,472 |
13,960 |
$620K |
| 0202U |
|
1,150 |
1,123 |
$583K |
| 71275 |
|
1,638 |
1,604 |
$578K |
| 96376 |
|
1,635 |
1,216 |
$533K |
| 80143 |
|
4,778 |
4,390 |
$485K |
| 96372 |
|
11,734 |
9,717 |
$473K |
| 80179 |
|
4,660 |
4,310 |
$462K |
| 70486 |
|
729 |
720 |
$461K |
| 84484 |
|
23,883 |
17,074 |
$450K |
| 76705 |
|
4,145 |
4,009 |
$444K |
| 0160 |
|
567 |
374 |
$428K |
| 99285 |
|
1,650 |
1,506 |
$426K |
| 93971 |
|
2,200 |
2,126 |
$417K |
| 99283 |
|
4,302 |
3,748 |
$411K |
| T1999 |
Noc retail items andsupplies |
16,198 |
7,868 |
$406K |
| 96360 |
|
3,790 |
3,559 |
$402K |
| 76856 |
|
3,375 |
3,279 |
$401K |
| 87502 |
|
3,114 |
3,008 |
$383K |
| 99284 |
|
2,514 |
2,286 |
$367K |
| 0270 |
|
12,265 |
6,586 |
$353K |
| 83690 |
|
23,171 |
21,378 |
$338K |
| Z7502 |
|
9,027 |
8,950 |
$329K |
| 70551 |
|
444 |
438 |
$315K |
| 76830 |
|
2,625 |
2,551 |
$314K |
| 87633 |
|
467 |
462 |
$307K |
| 70498 |
|
640 |
630 |
$301K |
| 70496 |
|
596 |
587 |
$256K |
| 99202 |
|
1,420 |
1,000 |
$250K |
| 80048 |
|
7,105 |
6,569 |
$249K |
| 83880 |
|
5,511 |
5,165 |
$242K |
| J7030 |
Normal saline solution infus |
17,652 |
15,550 |
$236K |
| 87040 |
|
9,186 |
5,839 |
$225K |
| 76801 |
|
2,118 |
1,880 |
$225K |
| 87086 |
|
16,759 |
15,809 |
$220K |
| 87651 |
|
3,416 |
3,364 |
$188K |
| J0131 |
Inj, acetaminophen (nos) |
5,248 |
3,065 |
$185K |
| 81001 |
|
27,707 |
25,852 |
$182K |
| 97110 |
|
3,092 |
998 |
$180K |
| 99499 |
|
2,850 |
2,345 |
$177K |
| 78452 |
|
357 |
351 |
$171K |
| 87491 |
|
2,328 |
2,256 |
$171K |
| 87591 |
|
2,317 |
2,245 |
$168K |
| 82803 |
|
5,110 |
4,542 |
$168K |
| 72128 |
|
331 |
325 |
$160K |
| 73630 |
|
2,975 |
2,895 |
$156K |
| 73610 |
|
2,633 |
2,583 |
$154K |
| 73030 |
|
2,184 |
2,099 |
$153K |
| 71250 |
|
344 |
333 |
$151K |
| 83605 |
|
7,858 |
6,231 |
$145K |
| 0510 |
|
2,212 |
1,755 |
$142K |
| 73130 |
|
1,967 |
1,906 |
$139K |
| 76817 |
|
1,325 |
1,192 |
$137K |
| 84443 |
|
4,726 |
4,557 |
$137K |
| 83735 |
|
10,795 |
9,854 |
$131K |
| 87798 |
|
950 |
930 |
$130K |
| A9502 |
Tc99m tetrofosmin |
396 |
393 |
$116K |
| 96366 |
|
1,631 |
1,363 |
$111K |
| 81025 |
|
9,211 |
8,904 |
$108K |
| 86850 |
|
2,425 |
2,312 |
$108K |
| 85730 |
|
5,570 |
5,244 |
$107K |
| J2405 |
Ondansetron hcl injection |
10,959 |
9,202 |
$107K |
| 0360 |
|
489 |
285 |
$103K |
| 73110 |
|
1,499 |
1,430 |
$103K |
| 93970 |
|
348 |
343 |
$102K |
| U0003 |
Cov-19 amp prb hgh thruput |
1,072 |
1,053 |
$100K |
| 73562 |
|
1,836 |
1,774 |
$99K |
| 70491 |
|
216 |
213 |
$99K |
| 85610 |
|
9,968 |
9,246 |
$98K |
| J1885 |
Ketorolac tromethamine inj |
9,015 |
8,516 |
$94K |
| 85379 |
|
4,521 |
4,363 |
$85K |
| 87486 |
|
1,075 |
1,063 |
$83K |
| 87581 |
|
1,074 |
1,063 |
$83K |
| 84702 |
|
5,877 |
5,356 |
$82K |
| 90715 |
|
967 |
955 |
$79K |
| 86901 |
|
4,445 |
3,816 |
$79K |
| J7120 |
Ringers lactate infusion |
6,580 |
5,979 |
$78K |
| 86900 |
|
4,586 |
3,723 |
$77K |
| J1170 |
Hydromorphone injection |
4,655 |
3,565 |
$73K |
| J2785 |
Regadenoson injection |
183 |
181 |
$70K |
| J1100 |
Dexamethasone sodium phos |
6,205 |
5,780 |
$69K |
| 41899 |
|
734 |
723 |
$68K |
| 93306 |
|
215 |
212 |
$66K |
| 81003 |
|
14,345 |
13,646 |
$64K |
| J0696 |
Ceftriaxone sodium injection |
4,453 |
3,826 |
$63K |
| 93017 |
|
483 |
480 |
$56K |
| 94640 |
|
1,468 |
1,228 |
$55K |
| J2270 |
Morphine sulfate injection |
3,917 |
3,337 |
$54K |
| 76770 |
|
333 |
326 |
$53K |
| 73080 |
|
717 |
698 |
$51K |
| 73502 |
|
583 |
565 |
$49K |
| 73560 |
|
787 |
747 |
$49K |
| 76497 |
|
18 |
17 |
$48K |
| 76815 |
|
698 |
509 |
$46K |
| Z9725 |
|
1,454 |
1,440 |
$45K |
| J1200 |
Diphenhydramine hcl injectio |
4,723 |
3,960 |
$45K |
| 76700 |
|
316 |
312 |
$44K |
| 84703 |
|
8,889 |
8,516 |
$44K |
| 73590 |
|
615 |
599 |
$42K |
| 97750 |
|
366 |
298 |
$42K |
| 72100 |
|
773 |
751 |
$40K |
| 87077 |
|
3,954 |
3,607 |
$37K |
| 96413 |
|
292 |
188 |
$36K |
| 87186 |
|
3,712 |
3,458 |
$35K |
| 76870 |
|
335 |
324 |
$34K |
| 82550 |
|
2,881 |
2,385 |
$33K |
| J2060 |
Lorazepam injection |
2,860 |
2,402 |
$32K |
| 82552 |
|
1,300 |
1,045 |
$31K |
| J3010 |
Fentanyl citrate injection |
2,828 |
2,443 |
$31K |
| 80076 |
|
939 |
923 |
$30K |
| J2765 |
Metoclopramide hcl injection |
3,014 |
2,707 |
$30K |
| 87634 |
|
300 |
294 |
$30K |
| 84145 |
|
851 |
829 |
$28K |
| J3475 |
Inj magnesium sulfate |
2,212 |
2,035 |
$28K |
| 73090 |
|
363 |
358 |
$26K |
| 74018 |
|
686 |
649 |
$25K |
| 84132 |
|
880 |
757 |
$24K |
| 82330 |
|
945 |
837 |
$23K |
| 86140 |
|
2,417 |
2,305 |
$23K |
| 87081 |
|
1,541 |
1,495 |
$21K |
| 72141 |
|
25 |
25 |
$21K |
| G0378 |
Hospital observation per hr |
425 |
319 |
$20K |
| 82947 |
|
2,489 |
2,221 |
$19K |
| 96367 |
|
292 |
235 |
$19K |
| 36415 |
|
16,822 |
14,474 |
$18K |
| 94644 |
|
497 |
471 |
$17K |
| 0760 |
|
258 |
222 |
$16K |
| 87400 |
|
1,570 |
1,469 |
$15K |
| 59025 |
|
793 |
312 |
$15K |
| J0780 |
Prochlorperazine injection |
683 |
613 |
$15K |
| J2930 |
Methylprednisolone injection |
612 |
487 |
$15K |
| 0710 |
|
291 |
286 |
$14K |
| 99201 |
|
131 |
82 |
$13K |
| J1815 |
Insulin injection |
796 |
463 |
$13K |
| 82150 |
|
175 |
174 |
$12K |
| 87430 |
|
693 |
661 |
$12K |
| S0028 |
Injection, famotidine, 20 mg |
534 |
467 |
$12K |
| 97530 |
|
328 |
158 |
$11K |
| 90471 |
|
709 |
692 |
$10K |
| J2001 |
Lidocaine injection |
761 |
682 |
$9K |
| 72148 |
|
13 |
13 |
$9K |
| J0137 |
Inj, acetaminophen (hikma) |
340 |
196 |
$9K |
| 72170 |
|
29 |
29 |
$9K |
| 73700 |
|
25 |
25 |
$8K |
| 73140 |
|
238 |
236 |
$8K |
| 85652 |
|
1,996 |
1,922 |
$8K |
| 99282 |
|
64 |
63 |
$8K |
| J3480 |
Inj potassium chloride |
130 |
85 |
$8K |
| Q0162 |
Ondansetron oral |
717 |
681 |
$7K |
| 83036 |
|
390 |
380 |
$7K |
| 71020 |
|
166 |
52 |
$7K |
| S0164 |
Injection pantroprazole |
328 |
246 |
$6K |
| J7040 |
Normal saline solution infus |
668 |
603 |
$6K |
| A9585 |
Gadobutrol injection |
56 |
51 |
$6K |
| J2704 |
Inj, propofol, 10 mg |
482 |
405 |
$5K |
| 73060 |
|
73 |
73 |
$5K |
| 87210 |
|
535 |
526 |
$5K |
| 84295 |
|
633 |
575 |
$4K |
| 10060 |
|
57 |
56 |
$4K |
| 93976 |
|
14 |
14 |
$4K |
| 73552 |
|
40 |
40 |
$4K |
| 87420 |
|
214 |
205 |
$3K |
| 80061 |
|
269 |
260 |
$3K |
| Z7610 |
|
363 |
172 |
$3K |
| 0324 |
|
15 |
15 |
$3K |
| J7512 |
Prednisone ir or dr oral 1mg |
1,753 |
1,674 |
$3K |
| J3360 |
Diazepam injection |
121 |
109 |
$3K |
| 84439 |
|
185 |
181 |
$3K |
| 72040 |
|
56 |
55 |
$3K |
| 87147 |
|
285 |
152 |
$3K |
| 29125 |
|
120 |
116 |
$3K |
| J7050 |
Normal saline solution infus |
207 |
147 |
$3K |
| J2250 |
Inj midazolam hydrochloride |
327 |
307 |
$3K |
| J7620 |
Albuterol ipratrop non-comp |
745 |
678 |
$2K |
| 87088 |
|
352 |
342 |
$2K |
| U0002 |
Covid-19 lab test non-cdc |
34 |
34 |
$2K |
| J8540 |
Oral dexamethasone |
928 |
574 |
$2K |
| U0005 |
Infec agen detec ampli probe |
88 |
88 |
$2K |
| 86308 |
|
218 |
217 |
$2K |
| J7611 |
Albuterol non-comp con |
936 |
879 |
$2K |
| J0690 |
Cefazolin sodium injection |
166 |
144 |
$2K |
| J2919 |
Inj, methylpred sod succ 5mg |
72 |
67 |
$2K |
| 85027 |
|
252 |
200 |
$1K |
| J1650 |
Inj enoxaparin sodium |
96 |
52 |
$1K |
| 84100 |
|
252 |
174 |
$1K |
| 12011 |
|
13 |
13 |
$1K |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
344 |
157 |
$1K |
| 88300 |
|
121 |
119 |
$1K |
| 74022 |
|
13 |
13 |
$980.66 |
| J7644 |
Ipratropium bromide non-comp |
239 |
218 |
$974.69 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
51 |
42 |
$840.93 |
| 12001 |
|
25 |
25 |
$833.05 |
| 82010 |
|
57 |
51 |
$790.67 |
| G0463 |
Hospital outpt clinic visit |
28 |
25 |
$699.93 |
| 72070 |
|
13 |
13 |
$612.18 |
| 99070 |
|
19 |
12 |
$576.10 |
| J1630 |
Haloperidol injection |
42 |
39 |
$467.09 |
| S0077 |
Injection, clindamycin phosp |
14 |
14 |
$424.05 |
| J2470 |
Inj pantoprazole sodium 40mg |
74 |
62 |
$412.25 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
45 |
32 |
$388.52 |
| J3370 |
Vancomycin hcl injection |
16 |
12 |
$373.08 |
| 87205 |
|
44 |
38 |
$346.98 |
| 81015 |
|
60 |
60 |
$334.67 |
| 29515 |
|
13 |
13 |
$319.08 |
| 87070 |
|
14 |
12 |
$246.24 |
| 84550 |
|
40 |
37 |
$227.73 |
| 82270 |
|
27 |
27 |
$175.68 |
| G8978 |
Mobility current status |
19 |
17 |
$170.38 |
| J7613 |
Albuterol non-comp unit |
60 |
52 |
$74.60 |
| 86592 |
|
13 |
13 |
$47.48 |
| 83550 |
|
12 |
12 |
$27.28 |
| 83540 |
|
12 |
12 |
$23.20 |
| G8979 |
Mobility goal status |
19 |
17 |
$0.00 |