| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
5,850 |
4,264 |
$585K |
| 99285 |
|
5,570 |
3,400 |
$538K |
| 99283 |
|
7,133 |
6,008 |
$456K |
| 97110 |
|
8,701 |
2,433 |
$375K |
| 74177 |
|
1,623 |
1,178 |
$359K |
| 99282 |
|
3,544 |
3,017 |
$129K |
| 70450 |
|
1,414 |
1,079 |
$102K |
| 84443 |
|
5,538 |
4,836 |
$89K |
| 97140 |
|
6,992 |
2,028 |
$86K |
| 77067 |
|
736 |
695 |
$62K |
| G0463 |
Hospital outpt clinic visit |
2,296 |
1,413 |
$53K |
| 0450 |
|
914 |
812 |
$51K |
| 80053 |
|
15,481 |
11,665 |
$42K |
| U0003 |
Cov-19 amp prb hgh thruput |
904 |
830 |
$28K |
| 96365 |
|
3,946 |
1,784 |
$27K |
| 87426 |
|
1,533 |
1,017 |
$26K |
| 99213 |
|
847 |
313 |
$20K |
| 82306 |
|
1,805 |
1,657 |
$17K |
| 93005 |
|
5,321 |
3,897 |
$14K |
| 71046 |
|
2,040 |
1,633 |
$14K |
| G0378 |
Hospital observation per hr |
67 |
41 |
$12K |
| 99212 |
|
867 |
670 |
$12K |
| 96374 |
|
4,628 |
3,187 |
$10K |
| 80050 |
|
209 |
206 |
$10K |
| 97162 |
|
172 |
154 |
$9K |
| 99199 |
|
189 |
162 |
$9K |
| 80061 |
|
4,557 |
4,067 |
$8K |
| 96361 |
|
3,387 |
2,065 |
$7K |
| 85025 |
|
16,698 |
12,126 |
$6K |
| 82607 |
|
495 |
457 |
$6K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
2,155 |
1,599 |
$6K |
| 99291 |
|
24 |
13 |
$6K |
| 87186 |
|
973 |
730 |
$5K |
| 96375 |
|
4,113 |
2,637 |
$5K |
| 80048 |
|
3,199 |
2,385 |
$4K |
| 99281 |
|
241 |
229 |
$4K |
| 97161 |
|
93 |
73 |
$3K |
| 96360 |
|
280 |
154 |
$3K |
| 71275 |
|
20 |
13 |
$2K |
| 87633 |
|
1,051 |
939 |
$2K |
| 87086 |
|
2,219 |
1,805 |
$2K |
| 93306 |
|
15 |
14 |
$2K |
| 87635 |
|
61 |
52 |
$2K |
| 96372 |
|
1,832 |
1,246 |
$2K |
| 80307 |
|
533 |
398 |
$1K |
| 76830 |
|
14 |
12 |
$1K |
| 0241U |
|
747 |
654 |
$1K |
| 81025 |
|
1,127 |
867 |
$1K |
| 84484 |
|
3,525 |
2,167 |
$1K |
| 83690 |
|
3,433 |
2,446 |
$1K |
| J7030 |
Normal saline solution infus |
5,374 |
3,039 |
$961.21 |
| 87491 |
|
63 |
48 |
$945.55 |
| 71045 |
|
2,381 |
1,805 |
$785.44 |
| 0250 |
|
285 |
147 |
$781.83 |
| 80306 |
|
146 |
122 |
$766.12 |
| 85610 |
|
2,173 |
1,417 |
$682.59 |
| 83036 |
|
1,708 |
1,536 |
$682.06 |
| 87591 |
|
63 |
48 |
$607.20 |
| 82728 |
|
94 |
85 |
$580.83 |
| 81003 |
|
5,430 |
4,056 |
$514.79 |
| 83880 |
|
238 |
170 |
$504.30 |
| 85027 |
|
1,783 |
1,485 |
$489.84 |
| 84481 |
|
39 |
38 |
$460.13 |
| J1885 |
Ketorolac tromethamine inj |
2,889 |
1,803 |
$437.47 |
| 73630 |
|
44 |
36 |
$374.56 |
| 87077 |
|
1,129 |
835 |
$360.64 |
| 83605 |
|
1,147 |
738 |
$341.48 |
| 85730 |
|
526 |
368 |
$341.32 |
| 87400 |
|
992 |
529 |
$338.22 |
| 84439 |
|
2,834 |
2,470 |
$268.17 |
| 87070 |
|
198 |
152 |
$260.40 |
| J2405 |
Ondansetron hcl injection |
4,763 |
2,901 |
$244.48 |
| 96366 |
|
73 |
36 |
$230.44 |
| 84153 |
|
81 |
79 |
$225.98 |
| 72100 |
|
13 |
12 |
$215.85 |
| 83735 |
|
2,511 |
1,477 |
$212.48 |
| A6257 |
Transparent film <= 16 sq in |
5,066 |
3,791 |
$207.79 |
| J8597 |
Antiemetic drug oral nos |
501 |
402 |
$193.10 |
| 76856 |
|
14 |
13 |
$192.02 |
| 36415 |
|
15,484 |
12,476 |
$191.17 |
| 87040 |
|
234 |
93 |
$166.53 |
| 72125 |
|
13 |
12 |
$151.19 |
| J3010 |
Fentanyl citrate injection |
1,789 |
1,171 |
$140.39 |
| 94640 |
|
214 |
152 |
$137.54 |
| J1100 |
Dexamethasone sodium phos |
2,395 |
1,545 |
$135.85 |
| 77063 |
|
706 |
665 |
$135.35 |
| 86140 |
|
812 |
725 |
$130.30 |
| 86803 |
|
91 |
88 |
$125.25 |
| J7120 |
Ringers lactate infusion |
956 |
522 |
$110.27 |
| 87430 |
|
273 |
238 |
$96.02 |
| 80305 |
|
45 |
40 |
$93.56 |
| 73130 |
|
17 |
14 |
$78.30 |
| 93010 |
|
384 |
221 |
$65.98 |
| J1170 |
Hydromorphone injection |
1,351 |
805 |
$60.81 |
| J2270 |
Morphine sulfate injection |
218 |
145 |
$58.98 |
| J0690 |
Cefazolin sodium injection |
611 |
418 |
$56.52 |
| 82570 |
|
205 |
187 |
$53.29 |
| 96376 |
|
287 |
161 |
$51.04 |
| 86703 |
|
31 |
31 |
$33.78 |
| 85651 |
|
615 |
526 |
$26.80 |
| 80076 |
|
36 |
34 |
$25.86 |
| 86038 |
|
39 |
36 |
$24.55 |
| 84702 |
|
31 |
24 |
$21.83 |
| 97014 |
|
271 |
91 |
$14.18 |
| 82746 |
|
14 |
12 |
$10.03 |
| 85379 |
|
50 |
42 |
$6.95 |
| J2704 |
Inj, propofol, 10 mg |
1,116 |
781 |
$6.86 |
| J2060 |
Lorazepam injection |
15 |
12 |
$5.96 |
| 85652 |
|
268 |
241 |
$4.72 |
| A9270 |
Non-covered item or service |
3,130 |
622 |
$1.43 |
| J1200 |
Diphenhydramine hcl injectio |
61 |
37 |
$0.88 |
| 94760 |
|
105 |
52 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
347 |
255 |
$0.00 |
| 83550 |
|
206 |
190 |
$0.00 |
| J2001 |
Lidocaine injection |
14 |
12 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
101 |
36 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
54 |
36 |
$0.00 |
| 87205 |
|
15 |
12 |
$0.00 |
| 90471 |
|
13 |
13 |
$0.00 |
| 83540 |
|
276 |
252 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
67 |
42 |
$0.00 |
| J7040 |
Normal saline solution infus |
48 |
27 |
$0.00 |
| 96367 |
|
13 |
12 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
37 |
12 |
$0.00 |
| 90662 |
|
12 |
12 |
$0.00 |
| J0134 |
Inj acetaminophen -fresenius |
24 |
16 |
$0.00 |
| J0137 |
Inj, acetaminophen (hikma) |
13 |
12 |
$0.00 |
| G1004 |
Cdsm ndsc |
23 |
20 |
$0.00 |