| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 80053 |
|
10,950 |
8,187 |
$670K |
| 11042 |
|
4,911 |
1,613 |
$441K |
| 80048 |
|
8,251 |
5,785 |
$392K |
| G0463 |
Hospital outpt clinic visit |
2,319 |
1,364 |
$280K |
| 99283 |
|
16,478 |
12,614 |
$246K |
| 99282 |
|
3,776 |
3,100 |
$157K |
| 99281 |
|
954 |
714 |
$121K |
| 81001 |
|
12,014 |
9,322 |
$110K |
| 36415 |
|
1,084 |
796 |
$105K |
| 87081 |
|
2,035 |
1,753 |
$104K |
| 87275 |
|
3,197 |
2,667 |
$104K |
| 84702 |
|
1,659 |
1,256 |
$96K |
| 97110 |
|
2,603 |
510 |
$82K |
| 99284 |
|
14,143 |
11,099 |
$74K |
| 87210 |
|
796 |
704 |
$58K |
| 76816 |
|
347 |
272 |
$55K |
| 71046 |
|
4,288 |
3,446 |
$55K |
| 82565 |
|
378 |
241 |
$53K |
| A9552 |
F18 fdg |
35 |
12 |
$52K |
| 76811 |
|
236 |
193 |
$51K |
| 81002 |
|
350 |
263 |
$50K |
| 87086 |
|
3,092 |
2,519 |
$48K |
| 96372 |
|
3,570 |
2,763 |
$45K |
| 87070 |
|
290 |
193 |
$43K |
| Q0162 |
Ondansetron oral |
1,223 |
1,013 |
$41K |
| 80047 |
|
631 |
467 |
$41K |
| 93971 |
|
669 |
520 |
$37K |
| 81025 |
|
5,704 |
4,651 |
$36K |
| 70450 |
|
2,757 |
2,243 |
$25K |
| 80307 |
|
2,770 |
2,229 |
$22K |
| 73562 |
|
1,034 |
756 |
$22K |
| 73630 |
|
717 |
547 |
$20K |
| 76801 |
|
1,122 |
919 |
$19K |
| 72100 |
|
974 |
725 |
$15K |
| 85027 |
|
19,624 |
13,570 |
$14K |
| 74176 |
|
909 |
779 |
$13K |
| 73610 |
|
490 |
381 |
$13K |
| 87491 |
|
1,098 |
967 |
$13K |
| 73030 |
|
690 |
520 |
$13K |
| A9270 |
Non-covered item or service |
13,933 |
3,750 |
$12K |
| 73130 |
|
451 |
366 |
$12K |
| 72125 |
|
738 |
623 |
$11K |
| 74019 |
|
277 |
226 |
$10K |
| 76817 |
|
952 |
727 |
$10K |
| 88305 |
|
930 |
650 |
$10K |
| 87077 |
|
923 |
689 |
$10K |
| 96374 |
|
7,632 |
6,076 |
$9K |
| 80076 |
|
615 |
497 |
$9K |
| 71045 |
|
5,579 |
4,155 |
$9K |
| 93306 |
|
484 |
411 |
$9K |
| 72050 |
|
261 |
178 |
$9K |
| 82306 |
|
136 |
108 |
$9K |
| 10060 |
|
71 |
57 |
$9K |
| 99285 |
|
3,145 |
2,427 |
$8K |
| 76705 |
|
624 |
504 |
$8K |
| 74018 |
|
238 |
188 |
$8K |
| 76815 |
|
88 |
73 |
$7K |
| 73110 |
|
245 |
192 |
$7K |
| 83036 |
|
1,411 |
1,120 |
$6K |
| 77336 |
|
253 |
68 |
$6K |
| 71275 |
|
790 |
663 |
$6K |
| 87880 |
|
1,946 |
1,699 |
$6K |
| 85610 |
|
3,267 |
2,427 |
$6K |
| 84484 |
|
7,912 |
5,018 |
$6K |
| 86850 |
|
808 |
603 |
$5K |
| 81003 |
|
748 |
620 |
$5K |
| 76805 |
|
50 |
42 |
$4K |
| 78452 |
|
271 |
244 |
$4K |
| 11045 |
|
730 |
185 |
$4K |
| 73502 |
|
254 |
186 |
$3K |
| 71250 |
|
22 |
12 |
$3K |
| 93005 |
|
9,834 |
6,679 |
$3K |
| 72072 |
|
194 |
156 |
$3K |
| 84703 |
|
470 |
416 |
$2K |
| 83605 |
|
2,244 |
1,553 |
$2K |
| 84443 |
|
1,370 |
1,081 |
$2K |
| 77067 |
|
74 |
65 |
$2K |
| 76642 |
|
143 |
107 |
$2K |
| 12011 |
|
15 |
13 |
$2K |
| 97530 |
|
139 |
50 |
$1K |
| 84439 |
|
382 |
292 |
$1K |
| 93922 |
|
12 |
12 |
$1K |
| 96361 |
|
12 |
12 |
$1K |
| 86900 |
|
1,431 |
1,125 |
$1K |
| 76830 |
|
59 |
51 |
$1K |
| U0003 |
Cov-19 amp prb hgh thruput |
19 |
18 |
$1K |
| 36600 |
|
15 |
12 |
$1K |
| J7512 |
Prednisone ir or dr oral 1mg |
373 |
251 |
$1K |
| 76770 |
|
31 |
24 |
$999.18 |
| 74177 |
|
1,724 |
1,432 |
$989.47 |
| 73080 |
|
56 |
54 |
$953.92 |
| 87420 |
|
120 |
104 |
$895.87 |
| 73590 |
|
48 |
40 |
$891.64 |
| 77066 |
Tomosynthesis, mammo |
17 |
15 |
$814.97 |
| 86592 |
|
110 |
94 |
$746.20 |
| 80061 |
|
921 |
780 |
$729.81 |
| 77065 |
Tomosynthesis, mammo |
35 |
24 |
$724.92 |
| 85651 |
|
271 |
197 |
$716.37 |
| 82607 |
|
48 |
39 |
$672.04 |
| 82247 |
|
49 |
40 |
$631.53 |
| 85379 |
|
880 |
750 |
$548.09 |
| J7120 |
Ringers lactate infusion |
1,266 |
893 |
$499.10 |
| 76856 |
|
107 |
87 |
$467.28 |
| 73140 |
|
17 |
12 |
$387.86 |
| 83880 |
|
2,492 |
1,864 |
$331.49 |
| J2704 |
Inj, propofol, 10 mg |
1,446 |
1,050 |
$227.19 |
| 87147 |
|
779 |
569 |
$220.07 |
| G0279 |
Tomosynthesis, mammo |
35 |
25 |
$213.23 |
| 87040 |
|
1,399 |
775 |
$213.09 |
| 86701 |
|
40 |
34 |
$193.48 |
| 94640 |
|
1,582 |
1,190 |
$185.77 |
| 86780 |
|
29 |
24 |
$175.64 |
| 36000 |
|
251 |
201 |
$132.87 |
| 82550 |
|
892 |
717 |
$122.95 |
| 87205 |
|
491 |
329 |
$118.42 |
| 87389 |
|
44 |
38 |
$113.22 |
| 82728 |
|
14 |
12 |
$107.16 |
| 29125 |
|
13 |
12 |
$90.92 |
| 86141 |
|
137 |
99 |
$79.54 |
| 97597 |
|
60 |
25 |
$39.27 |
| 80164 |
|
165 |
108 |
$29.44 |
| 83735 |
|
2,635 |
1,672 |
$5.24 |
| 84132 |
|
108 |
85 |
$4.16 |
| J7040 |
Normal saline solution infus |
1,286 |
907 |
$0.00 |
| J7030 |
Normal saline solution infus |
6,019 |
4,296 |
$0.00 |
| 87186 |
|
925 |
692 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
3,474 |
2,692 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
382 |
271 |
$0.00 |
| 90714 |
|
368 |
274 |
$0.00 |
| J2405 |
Ondansetron hcl injection |
4,230 |
3,228 |
$0.00 |
| 84100 |
|
886 |
501 |
$0.00 |
| J2270 |
Morphine sulfate injection |
1,805 |
1,355 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
1,066 |
747 |
$0.00 |
| J2930 |
Methylprednisolone injection |
468 |
375 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
889 |
389 |
$0.00 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
86 |
37 |
$0.00 |
| J2550 |
Promethazine hcl injection |
750 |
564 |
$0.00 |
| S0119 |
Ondansetron 4 mg |
196 |
181 |
$0.00 |
| J1650 |
Inj enoxaparin sodium |
310 |
167 |
$0.00 |
| 96413 |
|
28 |
13 |
$0.00 |
| 85046 |
|
29 |
25 |
$0.00 |
| 93017 |
|
271 |
244 |
$0.00 |
| A9577 |
Inj multihance |
108 |
63 |
$0.00 |
| J0153 |
Adenosine inj 1mg |
28 |
24 |
$0.00 |
| J3370 |
Vancomycin hcl injection |
136 |
84 |
$0.00 |
| 93970 |
|
14 |
12 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
57 |
52 |
$0.00 |
| 82310 |
|
17 |
15 |
$0.00 |
| A6212 |
Foam drg <=16 sq in w/border |
75 |
61 |
$0.00 |
| C1887 |
Catheter, guiding |
17 |
15 |
$0.00 |
| 86703 |
|
124 |
103 |
$0.00 |
| 82248 |
|
29 |
26 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
18 |
16 |
$0.00 |
| 78815 |
|
35 |
12 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
65 |
43 |
$0.00 |
| 85007 |
|
17 |
13 |
$0.00 |
| 87591 |
|
1,097 |
966 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
775 |
510 |
$0.00 |
| 85730 |
|
2,672 |
1,989 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
1,992 |
1,414 |
$0.00 |
| 96375 |
|
3,294 |
2,516 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
5,085 |
2,758 |
$0.00 |
| 96376 |
|
392 |
296 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
1,888 |
1,173 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
232 |
172 |
$0.00 |
| J2765 |
Metoclopramide hcl injection |
571 |
460 |
$0.00 |
| G0378 |
Hospital observation per hr |
1,631 |
1,185 |
$0.00 |
| 83690 |
|
4,245 |
3,367 |
$0.00 |
| A9500 |
Tc99m sestamibi |
289 |
262 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
1,655 |
1,340 |
$0.00 |
| 82553 |
|
403 |
312 |
$0.00 |
| J1170 |
Hydromorphone injection |
1,037 |
678 |
$0.00 |
| 87276 |
|
3,195 |
2,668 |
$0.00 |
| 82330 |
|
319 |
256 |
$0.00 |
| J2060 |
Lorazepam injection |
696 |
553 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
3,041 |
2,167 |
$0.00 |
| 88342 |
|
17 |
13 |
$0.00 |
| J1642 |
Inj heparin sodium per 10 u |
521 |
328 |
$0.00 |
| J0360 |
Hydralazine hcl injection |
96 |
67 |
$0.00 |
| J1815 |
Insulin injection |
1,157 |
509 |
$0.00 |
| 86901 |
|
1,431 |
1,125 |
$0.00 |
| J7644 |
Ipratropium bromide non-comp |
168 |
151 |
$0.00 |
| 71260 |
|
63 |
53 |
$0.00 |
| 82150 |
|
14 |
14 |
$0.00 |
| 90471 |
|
488 |
368 |
$0.00 |
| J0500 |
Dicyclomine injection |
44 |
39 |
$0.00 |
| 97162 |
|
72 |
65 |
$0.00 |
| J1940 |
Furosemide injection |
105 |
78 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
80 |
71 |
$0.00 |
| 86762 |
|
38 |
34 |
$0.00 |
| J7050 |
Normal saline solution infus |
472 |
305 |
$0.00 |
| C1769 |
Guide wire |
324 |
229 |
$0.00 |
| 87340 |
|
40 |
36 |
$0.00 |
| 70496 |
|
27 |
24 |
$0.00 |
| 86140 |
|
15 |
14 |
$0.00 |
| J3490 |
Drugs unclassified injection |
73 |
54 |
$0.00 |
| 70486 |
|
26 |
24 |
$0.00 |
| 70498 |
|
16 |
13 |
$0.00 |
| 82803 |
|
16 |
12 |
$0.00 |
| 74022 |
|
15 |
15 |
$0.00 |
| G0008 |
Admin influenza virus vac |
13 |
12 |
$0.00 |
| 86920 |
|
19 |
12 |
$0.00 |
| 85018 |
|
35 |
26 |
$0.00 |
| J1630 |
Haloperidol injection |
23 |
13 |
$0.00 |
| 73090 |
|
22 |
14 |
$0.00 |
| J7999 |
Compounded drug, noc |
16 |
14 |
$0.00 |