| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
12,566 |
10,881 |
$3.04M |
| 99285 |
|
7,099 |
5,964 |
$2.16M |
| 99283 |
|
10,841 |
9,649 |
$1.67M |
| 0202U |
|
1,813 |
1,638 |
$618K |
| 96365 |
|
6,509 |
4,815 |
$417K |
| 96361 |
|
7,478 |
4,634 |
$352K |
| 96375 |
|
7,674 |
5,501 |
$330K |
| 96372 |
|
7,257 |
5,562 |
$280K |
| 80050 |
|
7,353 |
6,480 |
$270K |
| 96374 |
|
3,968 |
3,074 |
$245K |
| 71045 |
|
6,882 |
5,696 |
$230K |
| 80053 |
|
27,805 |
23,142 |
$203K |
| 99213 |
|
5,331 |
4,200 |
$173K |
| 87635 |
|
4,768 |
4,016 |
$153K |
| 94762 |
|
3,434 |
2,576 |
$148K |
| 36415 |
|
69,011 |
54,803 |
$141K |
| 93005 |
|
8,244 |
6,745 |
$139K |
| 80061 |
|
10,301 |
9,333 |
$118K |
| 70450 |
|
969 |
796 |
$108K |
| 85027 |
|
18,172 |
15,382 |
$99K |
| 84443 |
|
5,789 |
5,337 |
$94K |
| 87502 |
|
1,326 |
1,098 |
$91K |
| 84439 |
|
11,830 |
10,589 |
$89K |
| 85025 |
|
16,832 |
13,656 |
$83K |
| U0003 |
Cov-19 amp prb hgh thruput |
1,037 |
887 |
$77K |
| 20610 |
|
1,158 |
837 |
$73K |
| 87591 |
|
2,077 |
1,912 |
$70K |
| 87491 |
|
2,074 |
1,911 |
$70K |
| 73523 |
|
505 |
450 |
$69K |
| 83036 |
|
7,756 |
6,853 |
$56K |
| G0378 |
Hospital observation per hr |
274 |
180 |
$55K |
| 82306 |
|
2,651 |
2,272 |
$52K |
| J7030 |
Normal saline solution infus |
5,689 |
4,545 |
$47K |
| 74177 |
|
119 |
108 |
$46K |
| 81001 |
|
19,723 |
16,614 |
$42K |
| 99214 |
|
867 |
788 |
$41K |
| 84484 |
|
6,821 |
4,881 |
$36K |
| 72100 |
|
754 |
701 |
$36K |
| 83735 |
|
8,581 |
6,996 |
$31K |
| 82728 |
|
2,945 |
2,337 |
$31K |
| 80305 |
|
3,219 |
2,701 |
$29K |
| 99212 |
|
940 |
739 |
$26K |
| J0131 |
Inj, acetaminophen (nos) |
1,052 |
858 |
$26K |
| 97110 |
|
907 |
226 |
$21K |
| 71046 |
|
504 |
439 |
$20K |
| 83550 |
|
2,953 |
2,333 |
$20K |
| 72040 |
|
401 |
363 |
$19K |
| 73562 |
|
413 |
319 |
$18K |
| 73522 |
|
302 |
262 |
$17K |
| 81025 |
|
2,271 |
1,923 |
$15K |
| 83880 |
|
1,021 |
857 |
$15K |
| 83540 |
|
3,038 |
2,388 |
$15K |
| 84481 |
|
1,446 |
1,240 |
$15K |
| 99291 |
|
34 |
29 |
$15K |
| 82607 |
|
1,146 |
1,020 |
$14K |
| 84480 |
|
1,942 |
1,745 |
$14K |
| 11042 |
|
150 |
41 |
$14K |
| 73564 |
|
259 |
175 |
$11K |
| 82746 |
|
934 |
833 |
$11K |
| 94640 |
|
236 |
164 |
$10K |
| M0243 |
Casirivi and imdevi inj |
106 |
28 |
$10K |
| J1885 |
Ketorolac tromethamine inj |
3,177 |
2,648 |
$8K |
| J7040 |
Normal saline solution infus |
1,970 |
1,260 |
$8K |
| 83605 |
|
1,279 |
1,011 |
$7K |
| J3301 |
Triamcinolone acet inj nos |
895 |
786 |
$6K |
| 96366 |
|
121 |
75 |
$6K |
| 85730 |
|
2,017 |
1,690 |
$5K |
| 87633 |
|
226 |
181 |
$5K |
| 87486 |
|
2,012 |
1,591 |
$5K |
| 87086 |
|
836 |
728 |
$5K |
| 87581 |
|
1,979 |
1,565 |
$5K |
| 73130 |
|
102 |
65 |
$5K |
| J0696 |
Ceftriaxone sodium injection |
524 |
449 |
$5K |
| 83690 |
|
1,111 |
939 |
$5K |
| J2405 |
Ondansetron hcl injection |
1,844 |
1,560 |
$4K |
| 87798 |
|
2,101 |
1,609 |
$4K |
| 85610 |
|
2,234 |
1,896 |
$4K |
| 99282 |
|
39 |
38 |
$4K |
| 82670 |
|
160 |
149 |
$4K |
| 82553 |
|
1,055 |
809 |
$4K |
| 82550 |
|
1,143 |
976 |
$4K |
| 80048 |
|
771 |
601 |
$4K |
| 82077 |
|
289 |
220 |
$3K |
| 84403 |
|
154 |
141 |
$3K |
| 77078 |
|
68 |
65 |
$3K |
| J7120 |
Ringers lactate infusion |
1,059 |
885 |
$3K |
| 87651 |
|
109 |
92 |
$3K |
| J2270 |
Morphine sulfate injection |
999 |
682 |
$3K |
| 73030 |
|
58 |
40 |
$3K |
| 83001 |
|
157 |
146 |
$3K |
| 72052 |
|
70 |
56 |
$3K |
| 73110 |
|
43 |
25 |
$2K |
| 74176 |
|
13 |
12 |
$2K |
| 99281 |
|
164 |
154 |
$2K |
| 99203 |
|
80 |
58 |
$2K |
| J1100 |
Dexamethasone sodium phos |
798 |
697 |
$2K |
| 72125 |
|
14 |
12 |
$2K |
| 77067 |
|
16 |
14 |
$2K |
| 72110 |
|
40 |
33 |
$2K |
| 74018 |
|
45 |
36 |
$1K |
| 96367 |
|
38 |
27 |
$1K |
| 84550 |
|
388 |
353 |
$1K |
| 85651 |
|
388 |
355 |
$1K |
| 82962 |
|
684 |
501 |
$1K |
| 86140 |
|
302 |
276 |
$1K |
| J3475 |
Inj magnesium sulfate |
97 |
80 |
$1K |
| 94761 |
|
108 |
15 |
$1K |
| 51798 |
|
324 |
269 |
$973.66 |
| 86225 |
|
78 |
75 |
$926.34 |
| 73610 |
|
18 |
12 |
$882.13 |
| 82150 |
|
197 |
177 |
$838.87 |
| M0239 |
Bamlanivimab-xxxx infusion |
43 |
13 |
$832.29 |
| 83970 |
|
27 |
26 |
$784.32 |
| 96360 |
|
13 |
12 |
$778.07 |
| 87040 |
|
151 |
66 |
$741.47 |
| 74022 |
|
14 |
13 |
$730.07 |
| 87880 |
|
51 |
48 |
$701.76 |
| 86038 |
|
66 |
63 |
$694.20 |
| 82948 |
|
265 |
194 |
$677.09 |
| 73565 |
|
19 |
18 |
$641.68 |
| 82043 |
|
122 |
112 |
$554.23 |
| J2001 |
Lidocaine injection |
1,285 |
831 |
$537.54 |
| 72050 |
|
13 |
12 |
$531.62 |
| 80143 |
|
35 |
25 |
$466.00 |
| 80179 |
|
34 |
25 |
$447.36 |
| J2550 |
Promethazine hcl injection |
175 |
129 |
$424.49 |
| 84153 |
|
26 |
26 |
$405.57 |
| J1200 |
Diphenhydramine hcl injectio |
176 |
139 |
$395.36 |
| 85379 |
|
52 |
49 |
$376.66 |
| Q0162 |
Ondansetron oral |
30 |
25 |
$371.66 |
| 82570 |
|
96 |
87 |
$368.11 |
| 86431 |
|
72 |
70 |
$359.59 |
| 86376 |
|
25 |
25 |
$334.65 |
| 96376 |
|
119 |
73 |
$334.53 |
| 84630 |
|
40 |
37 |
$330.31 |
| J0780 |
Prochlorperazine injection |
48 |
44 |
$329.98 |
| 87210 |
|
60 |
55 |
$325.36 |
| 87070 |
|
52 |
41 |
$285.48 |
| S0119 |
Ondansetron 4 mg |
12 |
12 |
$285.02 |
| 87389 |
|
15 |
12 |
$264.88 |
| 81003 |
|
290 |
240 |
$258.66 |
| 84466 |
|
29 |
28 |
$229.68 |
| 86141 |
|
16 |
16 |
$194.25 |
| 99211 |
|
19 |
13 |
$174.92 |
| 87807 |
|
14 |
12 |
$173.16 |
| J7050 |
Normal saline solution infus |
33 |
14 |
$162.40 |
| J2704 |
Inj, propofol, 10 mg |
837 |
702 |
$93.20 |
| J0690 |
Cefazolin sodium injection |
206 |
148 |
$65.57 |
| J2930 |
Methylprednisolone injection |
12 |
12 |
$32.90 |
| J3490 |
Drugs unclassified injection |
74 |
49 |
$26.95 |
| J3010 |
Fentanyl citrate injection |
174 |
146 |
$21.00 |
| J2250 |
Inj midazolam hydrochloride |
47 |
42 |
$8.02 |
| J2274 |
Inj morphine pf epid ithc |
13 |
12 |
$6.02 |
| 86901 |
|
35 |
34 |
$3.32 |
| 86900 |
|
35 |
34 |
$3.32 |
| G0463 |
Hospital outpt clinic visit |
648 |
523 |
$0.00 |
| 90853 |
|
8,706 |
830 |
$0.00 |
| J1956 |
Levofloxacin injection |
35 |
27 |
$0.00 |
| Q0243 |
Casirivimab and imdevimab |
15 |
13 |
$0.00 |
| T1015 |
Clinic service |
19 |
18 |
$0.00 |