| Code | Description | Claims | Beneficiaries | Total Paid |
| 0450 |
|
127,720 |
114,355 |
$19.72M |
| 99281 |
|
65,338 |
59,692 |
$3.67M |
| J2505 |
Injection, pegfilgrastim 6mg |
225 |
149 |
$1.85M |
| 74177 |
|
7,226 |
7,092 |
$1.51M |
| J1453 |
Fosaprepitant injection |
3,296 |
1,580 |
$1.50M |
| 78815 |
|
810 |
804 |
$1.31M |
| J0897 |
Denosumab injection |
724 |
528 |
$1.26M |
| 87637 |
|
7,348 |
7,183 |
$1.11M |
| 80053 |
|
100,192 |
84,825 |
$1.10M |
| 70450 |
|
8,259 |
8,049 |
$1.09M |
| 77067 |
|
9,363 |
9,345 |
$1.01M |
| J1642 |
Inj heparin sodium per 10 u |
6,959 |
4,272 |
$888K |
| 96374 |
|
12,599 |
11,508 |
$786K |
| 87635 |
|
13,551 |
13,168 |
$728K |
| 85025 |
|
105,987 |
89,657 |
$714K |
| 93005 |
|
27,559 |
25,506 |
$673K |
| 96375 |
|
16,867 |
13,269 |
$650K |
| Z7502 |
|
15,619 |
15,427 |
$582K |
| 96372 |
|
19,370 |
17,219 |
$577K |
| 97139 |
|
25,633 |
3,944 |
$567K |
| J3490 |
Drugs unclassified injection |
21,880 |
13,306 |
$555K |
| 74176 |
|
4,654 |
4,577 |
$523K |
| 71045 |
|
20,735 |
19,717 |
$513K |
| 99213 |
|
1,597 |
812 |
$506K |
| 87502 |
|
6,629 |
6,442 |
$503K |
| 80307 |
|
7,006 |
6,273 |
$477K |
| T1999 |
Noc retail items andsupplies |
48,441 |
27,453 |
$453K |
| J9271 |
Inj pembrolizumab |
31 |
26 |
$418K |
| 96365 |
|
5,956 |
4,968 |
$413K |
| 97799 |
|
16,818 |
2,595 |
$411K |
| 99283 |
|
3,185 |
2,978 |
$385K |
| 71046 |
|
13,901 |
13,587 |
$356K |
| 97530 |
|
7,503 |
2,518 |
$353K |
| J1100 |
Dexamethasone sodium phos |
11,210 |
8,153 |
$328K |
| 76705 |
|
4,826 |
4,724 |
$324K |
| 96360 |
|
4,911 |
4,481 |
$315K |
| 99284 |
|
3,494 |
3,315 |
$309K |
| 72125 |
|
1,761 |
1,741 |
$295K |
| 71275 |
|
1,506 |
1,484 |
$277K |
| 96361 |
|
11,050 |
9,557 |
$272K |
| 97110 |
|
9,671 |
2,852 |
$260K |
| U0003 |
Cov-19 amp prb hgh thruput |
4,619 |
4,535 |
$253K |
| 96413 |
|
8,520 |
4,682 |
$249K |
| 77065 |
Tomosynthesis, mammo |
2,268 |
2,222 |
$247K |
| 99211 |
|
7,505 |
5,926 |
$243K |
| A9552 |
F18 fdg |
773 |
769 |
$240K |
| 84484 |
|
23,606 |
21,061 |
$233K |
| 83735 |
|
33,020 |
23,610 |
$228K |
| J7050 |
Normal saline solution infus |
29,471 |
13,992 |
$225K |
| 96367 |
|
5,034 |
3,152 |
$223K |
| 76642 |
|
3,527 |
3,349 |
$216K |
| 77066 |
Tomosynthesis, mammo |
1,786 |
1,782 |
$215K |
| 76801 |
|
2,843 |
2,583 |
$214K |
| 93458 |
|
325 |
319 |
$198K |
| 71260 |
|
1,104 |
1,098 |
$195K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
14,716 |
10,711 |
$187K |
| J9267 |
Paclitaxel injection |
632 |
126 |
$184K |
| 76856 |
|
2,680 |
2,628 |
$181K |
| J7030 |
Normal saline solution infus |
14,626 |
12,144 |
$170K |
| 92507 |
|
4,026 |
1,482 |
$166K |
| J1626 |
Granisetron hcl injection |
5,603 |
2,723 |
$165K |
| 83880 |
|
7,994 |
7,541 |
$164K |
| 83690 |
|
23,333 |
22,016 |
$159K |
| 97750 |
|
2,810 |
1,738 |
$148K |
| 93971 |
|
1,494 |
1,464 |
$147K |
| 0160 |
|
163 |
103 |
$146K |
| 0510 |
|
5,527 |
4,765 |
$144K |
| 82306 |
|
5,603 |
5,481 |
$143K |
| U0002 |
Covid-19 lab test non-cdc |
2,865 |
2,763 |
$137K |
| 0762 |
|
135 |
83 |
$135K |
| 96417 |
|
3,467 |
2,128 |
$134K |
| 87491 |
|
3,448 |
3,374 |
$123K |
| 87591 |
|
3,426 |
3,352 |
$123K |
| J2405 |
Ondansetron hcl injection |
8,323 |
7,210 |
$118K |
| 59025 |
|
3,699 |
2,548 |
$117K |
| 81001 |
|
32,840 |
31,134 |
$116K |
| 0761 |
|
3,665 |
2,874 |
$115K |
| 99285 |
|
1,760 |
1,688 |
$111K |
| Q3014 |
Telehealth facility fee |
4,894 |
4,232 |
$107K |
| J1885 |
Ketorolac tromethamine inj |
10,941 |
10,472 |
$106K |
| 76830 |
|
1,362 |
1,342 |
$103K |
| J1950 |
Leuprolide acetate /3.75 mg |
53 |
50 |
$100K |
| 76817 |
|
1,568 |
1,430 |
$96K |
| 87086 |
|
11,238 |
10,676 |
$90K |
| 87040 |
|
5,950 |
5,365 |
$89K |
| 96415 |
|
2,897 |
1,829 |
$86K |
| J3489 |
Zoledronic acid 1mg |
555 |
450 |
$84K |
| 73610 |
|
2,308 |
2,260 |
$84K |
| 0259 |
|
2,198 |
1,602 |
$80K |
| 73630 |
|
2,357 |
2,294 |
$75K |
| 83605 |
|
6,794 |
6,215 |
$75K |
| 93306 |
|
541 |
532 |
$73K |
| 73562 |
|
2,295 |
2,230 |
$73K |
| 82378 |
|
4,550 |
4,377 |
$72K |
| 84443 |
|
4,515 |
4,390 |
$68K |
| 87636 |
|
461 |
458 |
$68K |
| 84703 |
|
9,116 |
8,743 |
$67K |
| 73030 |
|
1,991 |
1,943 |
$67K |
| 62323 |
|
60 |
59 |
$66K |
| G0480 |
Drug test def 1-7 classes |
560 |
477 |
$65K |
| 29125 |
|
389 |
382 |
$65K |
| 0760 |
|
2,093 |
1,777 |
$64K |
| 73130 |
|
1,916 |
1,880 |
$62K |
| 81025 |
|
8,407 |
8,165 |
$61K |
| 78452 |
|
344 |
343 |
$61K |
| 87088 |
|
8,844 |
8,567 |
$61K |
| 84702 |
|
4,343 |
3,722 |
$60K |
| 0270 |
|
4,834 |
3,979 |
$60K |
| 87651 |
|
1,570 |
1,558 |
$60K |
| J1200 |
Diphenhydramine hcl injectio |
5,447 |
4,161 |
$58K |
| 87631 |
|
1,043 |
1,035 |
$56K |
| 80048 |
|
7,608 |
7,010 |
$56K |
| 96366 |
|
1,593 |
1,103 |
$53K |
| 73110 |
|
1,572 |
1,512 |
$51K |
| 85730 |
|
10,317 |
9,847 |
$51K |
| 0272 |
|
1,620 |
885 |
$50K |
| 94640 |
|
2,381 |
2,155 |
$50K |
| 76815 |
|
620 |
569 |
$49K |
| J2270 |
Morphine sulfate injection |
5,659 |
4,886 |
$49K |
| G0463 |
Hospital outpt clinic visit |
4,013 |
3,380 |
$48K |
| 85610 |
|
13,591 |
12,946 |
$47K |
| 12001 |
|
265 |
265 |
$47K |
| J0640 |
Leucovorin calcium injection |
530 |
247 |
$46K |
| 87880 |
|
3,780 |
3,721 |
$46K |
| 90715 |
|
1,063 |
1,057 |
$45K |
| J9190 |
Fluorouracil injection |
1,269 |
292 |
$45K |
| 99282 |
|
200 |
196 |
$44K |
| J8499 |
Oral prescrip drug non chemo |
5,629 |
3,726 |
$44K |
| J0696 |
Ceftriaxone sodium injection |
4,025 |
3,710 |
$43K |
| 77063 |
|
1,258 |
1,255 |
$42K |
| J2785 |
Regadenoson injection |
298 |
297 |
$41K |
| 87186 |
|
4,576 |
4,447 |
$39K |
| Z9725 |
|
1,289 |
1,287 |
$39K |
| 36415 |
|
10,781 |
8,318 |
$38K |
| 29515 |
|
247 |
244 |
$36K |
| 74018 |
|
927 |
908 |
$36K |
| J1756 |
Iron sucrose injection |
34 |
15 |
$35K |
| 87634 |
|
548 |
530 |
$34K |
| 82607 |
|
2,756 |
2,695 |
$33K |
| J1442 |
Inj filgrastim excl biosimil |
134 |
12 |
$33K |
| 86300 |
|
3,278 |
2,912 |
$33K |
| 81003 |
|
13,247 |
11,919 |
$32K |
| J9263 |
Oxaliplatin |
82 |
12 |
$32K |
| 97010 |
|
683 |
176 |
$31K |
| 86301 |
|
1,942 |
1,825 |
$31K |
| 82728 |
|
2,732 |
2,677 |
$31K |
| 85379 |
|
3,239 |
3,152 |
$31K |
| J7040 |
Normal saline solution infus |
4,009 |
2,796 |
$30K |
| J2001 |
Lidocaine injection |
1,069 |
1,031 |
$28K |
| 96416 |
|
534 |
328 |
$27K |
| 85027 |
|
4,406 |
3,928 |
$27K |
| 87081 |
|
4,044 |
3,978 |
$27K |
| 86141 |
|
2,217 |
2,113 |
$26K |
| J7060 |
5% dextrose/water |
2,407 |
636 |
$26K |
| 93970 |
|
161 |
160 |
$25K |
| 87798 |
|
634 |
627 |
$25K |
| J1815 |
Insulin injection |
663 |
425 |
$24K |
| 87632 |
|
132 |
127 |
$24K |
| 82077 |
|
298 |
276 |
$23K |
| 77061 |
|
480 |
478 |
$23K |
| 77336 |
|
542 |
238 |
$23K |
| 97161 |
|
628 |
384 |
$22K |
| A9502 |
Tc99m tetrofosmin |
345 |
344 |
$21K |
| 0360 |
|
289 |
225 |
$21K |
| 73080 |
|
602 |
588 |
$21K |
| 96523 |
|
481 |
454 |
$21K |
| J9045 |
Carboplatin injection |
274 |
155 |
$21K |
| 87804 |
|
1,403 |
1,267 |
$20K |
| 72100 |
|
696 |
687 |
$20K |
| 87506 |
|
86 |
86 |
$19K |
| 84145 |
|
1,187 |
1,157 |
$19K |
| 72131 |
|
130 |
130 |
$19K |
| J2930 |
Methylprednisolone injection |
1,466 |
1,378 |
$18K |
| 37252 |
|
219 |
214 |
$18K |
| 87389 |
|
402 |
390 |
$18K |
| J3420 |
Vitamin b12 injection |
1,778 |
1,470 |
$18K |
| J1170 |
Hydromorphone injection |
1,970 |
1,570 |
$18K |
| 86850 |
|
2,822 |
2,666 |
$18K |
| Z7610 |
|
2,037 |
1,403 |
$17K |
| 76870 |
|
245 |
240 |
$16K |
| 86901 |
|
5,148 |
4,818 |
$16K |
| 80143 |
|
159 |
147 |
$16K |
| 77412 |
|
250 |
25 |
$16K |
| 97165 |
|
248 |
187 |
$16K |
| 76641 |
|
157 |
148 |
$16K |
| 77334 |
|
72 |
54 |
$15K |
| 80179 |
|
153 |
141 |
$15K |
| 73590 |
|
540 |
533 |
$15K |
| 86900 |
|
5,180 |
4,849 |
$15K |
| 71250 |
|
89 |
89 |
$15K |
| 82550 |
|
2,660 |
2,446 |
$15K |
| 96411 |
|
679 |
483 |
$14K |
| 84439 |
|
1,683 |
1,645 |
$14K |
| 77085 |
|
281 |
279 |
$14K |
| J2765 |
Metoclopramide hcl injection |
2,238 |
2,135 |
$14K |
| 73090 |
|
526 |
509 |
$14K |
| 96368 |
|
685 |
468 |
$13K |
| 82948 |
|
3,430 |
2,674 |
$12K |
| 83036 |
|
1,545 |
1,511 |
$12K |
| 94664 |
|
872 |
846 |
$12K |
| U0005 |
Infec agen detec ampli probe |
1,486 |
1,462 |
$12K |
| 93017 |
|
341 |
340 |
$11K |
| 82803 |
|
583 |
561 |
$11K |
| 77080 |
|
350 |
350 |
$10K |
| 87420 |
|
1,332 |
1,293 |
$10K |
| 80061 |
|
974 |
946 |
$10K |
| J3010 |
Fentanyl citrate injection |
2,181 |
2,046 |
$10K |
| 82962 |
|
2,511 |
2,050 |
$9K |
| J7120 |
Ringers lactate infusion |
1,206 |
1,046 |
$9K |
| 87210 |
|
1,820 |
1,794 |
$9K |
| 70486 |
|
61 |
58 |
$9K |
| 86304 |
|
573 |
545 |
$9K |
| 82805 |
|
245 |
240 |
$9K |
| 87641 |
|
459 |
439 |
$9K |
| J1644 |
Inj heparin sodium per 1000u |
949 |
557 |
$8K |
| 86140 |
|
1,696 |
1,634 |
$8K |
| 97140 |
|
1,510 |
534 |
$8K |
| 84466 |
|
624 |
608 |
$7K |
| 82746 |
|
631 |
625 |
$7K |
| J2250 |
Inj midazolam hydrochloride |
1,592 |
1,518 |
$7K |
| 96402 |
|
458 |
424 |
$7K |
| 77300 |
|
40 |
39 |
$7K |
| 86780 |
|
649 |
634 |
$7K |
| 70551 |
|
26 |
26 |
$7K |
| 83540 |
|
1,208 |
1,190 |
$7K |
| 29105 |
|
42 |
39 |
$7K |
| 85007 |
|
2,080 |
1,646 |
$7K |
| 37253 |
|
179 |
160 |
$6K |
| 74019 |
|
269 |
266 |
$6K |
| 87806 |
|
222 |
222 |
$6K |
| 85611 |
|
1,956 |
1,798 |
$6K |
| 70491 |
|
24 |
24 |
$6K |
| J2060 |
Lorazepam injection |
945 |
814 |
$6K |
| 37238 |
|
147 |
145 |
$6K |
| J0171 |
Adrenalin epinephrine inject |
146 |
102 |
$6K |
| 10060 |
|
30 |
29 |
$5K |
| 73140 |
|
296 |
290 |
$5K |
| 76700 |
|
60 |
55 |
$4K |
| J0690 |
Cefazolin sodium injection |
412 |
368 |
$4K |
| 72040 |
|
159 |
157 |
$4K |
| 85652 |
|
1,378 |
1,304 |
$4K |
| 87077 |
|
667 |
655 |
$4K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
12 |
12 |
$4K |
| 84100 |
|
1,065 |
997 |
$4K |
| 99199 |
|
74 |
70 |
$4K |
| 73502 |
|
141 |
139 |
$3K |
| 85651 |
|
1,048 |
1,022 |
$3K |
| 75822 |
|
55 |
55 |
$3K |
| P9016 |
Rbc leukocytes reduced |
26 |
25 |
$3K |
| 87147 |
|
567 |
554 |
$3K |
| 82010 |
|
364 |
348 |
$3K |
| 0301 |
|
39 |
30 |
$3K |
| J0780 |
Prochlorperazine injection |
193 |
191 |
$3K |
| 77062 |
|
52 |
52 |
$3K |
| 86592 |
|
502 |
486 |
$3K |
| 76775 |
|
51 |
51 |
$3K |
| 82248 |
|
450 |
388 |
$2K |
| 90471 |
|
447 |
434 |
$2K |
| J0561 |
Penicillin g benzathine inj |
14 |
13 |
$2K |
| 71020 |
|
73 |
39 |
$2K |
| J0131 |
Inj, acetaminophen (nos) |
13 |
12 |
$2K |
| J0500 |
Dicyclomine injection |
26 |
26 |
$2K |
| J2550 |
Promethazine hcl injection |
230 |
206 |
$2K |
| 82140 |
|
142 |
134 |
$2K |
| J2919 |
Inj, methylpred sod succ 5mg |
114 |
113 |
$2K |
| 82784 |
|
241 |
221 |
$2K |
| 0250 |
|
734 |
520 |
$2K |
| 82150 |
|
285 |
260 |
$2K |
| 85732 |
|
272 |
235 |
$2K |
| 87045 |
|
160 |
152 |
$2K |
| 92523 |
|
12 |
12 |
$1K |
| 71010 |
|
84 |
38 |
$1K |
| 92557 |
|
32 |
30 |
$1K |
| S0164 |
Injection pantroprazole |
114 |
102 |
$1K |
| 71101 |
|
41 |
41 |
$1K |
| 82247 |
|
259 |
201 |
$1K |
| 12011 |
|
86 |
85 |
$1K |
| 72020 |
|
296 |
261 |
$1K |
| 83615 |
|
174 |
163 |
$1K |
| 96376 |
|
12 |
12 |
$1K |
| 87801 |
|
29 |
28 |
$986.83 |
| 86920 |
|
13 |
12 |
$982.02 |
| 73564 |
|
41 |
40 |
$956.21 |
| 69210 |
|
180 |
164 |
$954.54 |
| 84165 |
|
223 |
221 |
$937.38 |
| J1720 |
Hydrocortisone sodium succ i |
28 |
13 |
$927.11 |
| 83521 |
|
40 |
36 |
$906.10 |
| 87046 |
|
157 |
151 |
$862.69 |
| J1650 |
Inj enoxaparin sodium |
65 |
37 |
$861.58 |
| 37239 |
|
27 |
24 |
$851.77 |
| 36010 |
|
92 |
82 |
$809.16 |
| J2305 |
Inj, nitroglycerin, 5 mg |
49 |
49 |
$791.98 |
| 0324 |
|
86 |
86 |
$733.64 |
| 86334 |
|
203 |
200 |
$725.68 |
| 84550 |
|
157 |
141 |
$703.88 |
| 87999 |
|
33 |
32 |
$692.71 |
| 83655 |
|
193 |
192 |
$629.18 |
| Z7500 |
|
21 |
12 |
$613.80 |
| 86703 |
|
50 |
48 |
$587.98 |
| 92588 |
|
12 |
12 |
$574.45 |
| S0077 |
Injection, clindamycin phosp |
29 |
29 |
$540.50 |
| 0710 |
|
25 |
25 |
$522.82 |
| 81002 |
|
406 |
390 |
$522.77 |
| 80074 |
|
12 |
12 |
$461.31 |
| 72072 |
|
14 |
14 |
$453.16 |
| 87070 |
|
46 |
45 |
$451.37 |
| 12002 |
|
39 |
38 |
$447.85 |
| 82565 |
|
95 |
95 |
$391.94 |
| 87467 |
|
12 |
12 |
$389.84 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
34 |
34 |
$384.11 |
| 73552 |
|
25 |
24 |
$380.27 |
| J3475 |
Inj magnesium sulfate |
43 |
25 |
$362.80 |
| J1940 |
Furosemide injection |
59 |
49 |
$328.37 |
| 86706 |
|
45 |
44 |
$324.86 |
| J2710 |
Neostigmine methylslfte inj |
13 |
13 |
$292.40 |
| 99001 |
|
290 |
257 |
$292.27 |
| 92570 |
|
12 |
12 |
$289.84 |
| 92504 |
|
15 |
15 |
$285.92 |
| 73560 |
|
12 |
12 |
$248.63 |
| 86705 |
|
28 |
28 |
$234.25 |
| 86308 |
|
45 |
39 |
$229.71 |
| J2704 |
Inj, propofol, 10 mg |
92 |
92 |
$212.57 |
| 19083 |
|
13 |
13 |
$188.80 |
| 84155 |
|
79 |
79 |
$177.85 |
| 89055 |
|
33 |
32 |
$151.97 |
| J2470 |
Inj pantoprazole sodium 40mg |
15 |
15 |
$97.12 |
| 29130 |
|
12 |
12 |
$88.27 |
| 86331 |
|
12 |
12 |
$88.25 |
| 96379 |
|
4,097 |
2,149 |
$87.75 |
| 97112 |
|
219 |
53 |
$74.11 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
16 |
13 |
$73.35 |
| G0283 |
Elec stim other than wound |
164 |
56 |
$61.37 |
| 87205 |
|
13 |
12 |
$44.63 |
| J7611 |
Albuterol non-comp con |
76 |
74 |
$38.98 |
| 84156 |
|
14 |
12 |
$28.95 |
| 86038 |
|
12 |
12 |
$25.67 |
| 0258 |
|
1,823 |
667 |
$3.09 |
| 99152 |
|
89 |
73 |
$0.00 |
| 97116 |
|
28 |
12 |
$0.00 |
| 0258R |
|
208 |
109 |
$0.00 |
| 0250R |
|
57 |
36 |
$0.00 |
| A9270 |
Non-covered item or service |
50 |
26 |
$0.00 |