| Code | Description | Claims | Beneficiaries | Total Paid |
| 0450 |
|
61,762 |
54,222 |
$6.41M |
| G9002 |
Mccd,maintenance rate |
13,535 |
13,479 |
$4.21M |
| 74177 |
|
5,143 |
4,984 |
$993K |
| 99281 |
|
11,145 |
9,837 |
$847K |
| 70450 |
|
7,719 |
7,424 |
$827K |
| 96374 |
|
12,640 |
11,809 |
$522K |
| 80053 |
|
45,251 |
41,093 |
$521K |
| 0202U |
|
4,251 |
4,108 |
$511K |
| 99283 |
|
5,774 |
5,441 |
$504K |
| 93005 |
|
22,326 |
20,064 |
$500K |
| 71045 |
|
20,792 |
19,554 |
$383K |
| 96375 |
|
12,142 |
10,941 |
$346K |
| 99284 |
|
3,765 |
3,563 |
$337K |
| 85025 |
|
48,958 |
43,843 |
$335K |
| 72125 |
|
3,032 |
2,951 |
$335K |
| 76700 |
|
5,645 |
5,444 |
$322K |
| 96365 |
|
5,564 |
5,313 |
$285K |
| 71275 |
|
1,909 |
1,846 |
$276K |
| 99199 |
|
6,780 |
6,076 |
$220K |
| 96361 |
|
8,535 |
7,849 |
$218K |
| 0241U |
|
5,219 |
4,981 |
$206K |
| G0480 |
Drug test def 1-7 classes |
5,358 |
4,500 |
$190K |
| 84484 |
|
16,075 |
12,476 |
$184K |
| 99285 |
|
1,021 |
981 |
$183K |
| 87635 |
|
4,130 |
3,588 |
$174K |
| 93970 |
|
1,481 |
1,439 |
$168K |
| 74176 |
|
1,617 |
1,571 |
$154K |
| 80307 |
|
3,276 |
3,059 |
$131K |
| G0463 |
Hospital outpt clinic visit |
3,446 |
2,631 |
$123K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
8,569 |
8,073 |
$116K |
| 71260 |
|
893 |
887 |
$112K |
| 96360 |
|
2,331 |
2,277 |
$112K |
| 76856 |
|
2,297 |
2,202 |
$111K |
| 87633 |
|
590 |
571 |
$110K |
| 80306 |
|
6,518 |
5,047 |
$109K |
| 93971 |
|
1,132 |
1,099 |
$100K |
| 96372 |
|
4,662 |
4,289 |
$91K |
| 97110 |
|
4,550 |
1,617 |
$81K |
| U0003 |
Cov-19 amp prb hgh thruput |
1,632 |
1,541 |
$78K |
| 83605 |
|
9,220 |
8,048 |
$72K |
| 83880 |
|
3,971 |
3,672 |
$69K |
| 87040 |
|
6,012 |
3,949 |
$68K |
| J7030 |
Normal saline solution infus |
8,941 |
8,257 |
$68K |
| 0300 |
|
1,239 |
1,035 |
$68K |
| 87086 |
|
7,967 |
7,525 |
$66K |
| 85610 |
|
15,184 |
14,126 |
$65K |
| J3490 |
Drugs unclassified injection |
14,955 |
11,273 |
$65K |
| 83690 |
|
11,056 |
10,272 |
$64K |
| 76830 |
|
1,230 |
1,179 |
$61K |
| 0250 |
|
8,019 |
6,461 |
$54K |
| 76801 |
|
887 |
752 |
$48K |
| 0259 |
|
7,834 |
5,129 |
$48K |
| 0270 |
|
7,240 |
5,133 |
$47K |
| Z7502 |
|
1,277 |
1,253 |
$47K |
| 97140 |
|
2,929 |
1,084 |
$46K |
| 84703 |
|
7,662 |
7,155 |
$46K |
| 94640 |
|
2,674 |
2,226 |
$42K |
| 73630 |
|
1,548 |
1,432 |
$39K |
| 81001 |
|
14,051 |
13,261 |
$39K |
| 76705 |
|
914 |
890 |
$39K |
| J2405 |
Ondansetron hcl injection |
9,082 |
8,209 |
$36K |
| 84145 |
|
2,916 |
2,780 |
$33K |
| 76942 |
|
801 |
698 |
$33K |
| 99282 |
|
668 |
651 |
$33K |
| J2270 |
Morphine sulfate injection |
5,836 |
5,117 |
$31K |
| 0160 |
|
974 |
710 |
$31K |
| 72131 |
|
191 |
188 |
$31K |
| 81003 |
|
12,776 |
12,017 |
$31K |
| 84702 |
|
3,358 |
3,051 |
$30K |
| 76817 |
|
634 |
550 |
$30K |
| 90715 |
|
954 |
932 |
$29K |
| 80048 |
|
2,715 |
2,460 |
$29K |
| 73610 |
|
1,202 |
1,121 |
$29K |
| 85730 |
|
5,161 |
4,985 |
$27K |
| 73030 |
|
1,208 |
1,130 |
$27K |
| 73130 |
|
1,025 |
931 |
$26K |
| 96367 |
|
862 |
828 |
$26K |
| 0272 |
|
1,464 |
1,346 |
$26K |
| J1885 |
Ketorolac tromethamine inj |
5,899 |
5,366 |
$25K |
| J0696 |
Ceftriaxone sodium injection |
3,471 |
3,214 |
$25K |
| 70486 |
|
251 |
247 |
$24K |
| 84443 |
|
2,392 |
2,309 |
$23K |
| 86850 |
|
2,785 |
2,657 |
$22K |
| 71250 |
|
259 |
252 |
$22K |
| 94762 |
|
1,318 |
1,204 |
$22K |
| 0949 |
|
170 |
109 |
$21K |
| Z7500 |
|
584 |
504 |
$20K |
| 82948 |
|
3,227 |
1,940 |
$20K |
| J0131 |
Inj, acetaminophen (nos) |
1,323 |
1,214 |
$19K |
| 83735 |
|
3,225 |
2,852 |
$19K |
| 74174 |
|
132 |
132 |
$19K |
| 71046 |
|
802 |
788 |
$19K |
| 85379 |
|
2,172 |
2,110 |
$17K |
| U0005 |
Infec agen detec ampli probe |
1,354 |
1,301 |
$17K |
| 86140 |
|
3,284 |
3,117 |
$17K |
| 87651 |
|
872 |
854 |
$16K |
| 76770 |
|
237 |
227 |
$16K |
| J2001 |
Lidocaine injection |
1,269 |
1,229 |
$16K |
| 87186 |
|
2,006 |
1,872 |
$16K |
| G0378 |
Hospital observation per hr |
349 |
242 |
$16K |
| 86900 |
|
3,544 |
3,346 |
$15K |
| 80047 |
|
2,136 |
2,021 |
$15K |
| 93975 |
|
124 |
123 |
$15K |
| J7040 |
Normal saline solution infus |
1,784 |
1,711 |
$14K |
| 93306 |
|
228 |
227 |
$14K |
| 0762 |
|
99 |
53 |
$13K |
| 73564 |
|
382 |
352 |
$13K |
| 36415 |
|
12,497 |
11,054 |
$13K |
| 72100 |
|
428 |
421 |
$12K |
| 86141 |
|
1,812 |
1,728 |
$12K |
| 82550 |
|
2,670 |
2,480 |
$12K |
| 81002 |
|
5,026 |
4,628 |
$11K |
| 87581 |
|
617 |
590 |
$11K |
| 81025 |
|
2,733 |
2,527 |
$11K |
| J1170 |
Hydromorphone injection |
1,850 |
1,443 |
$11K |
| 87486 |
|
618 |
591 |
$11K |
| 86901 |
|
3,484 |
3,293 |
$11K |
| 87798 |
|
627 |
596 |
$10K |
| 0710 |
|
348 |
320 |
$10K |
| 94760 |
|
1,352 |
1,214 |
$10K |
| 96366 |
|
319 |
301 |
$10K |
| 87591 |
|
768 |
741 |
$10K |
| 87491 |
|
767 |
740 |
$10K |
| 70498 |
|
122 |
121 |
$10K |
| J7060 |
5% dextrose/water |
1,084 |
900 |
$9K |
| 74018 |
|
539 |
511 |
$9K |
| J1200 |
Diphenhydramine hcl injectio |
2,225 |
2,038 |
$9K |
| 76805 |
|
98 |
93 |
$9K |
| 99000 |
|
3,150 |
2,943 |
$9K |
| J1100 |
Dexamethasone sodium phos |
1,044 |
993 |
$9K |
| Q0162 |
Ondansetron oral |
1,175 |
1,141 |
$9K |
| 96376 |
|
2,458 |
2,177 |
$8K |
| 73562 |
|
353 |
307 |
$8K |
| 86769 |
|
183 |
145 |
$8K |
| J2060 |
Lorazepam injection |
2,012 |
1,767 |
$8K |
| A4216 |
Sterile water/saline, 10 ml |
1,144 |
1,053 |
$7K |
| 70496 |
|
69 |
69 |
$7K |
| 73560 |
|
417 |
363 |
$7K |
| 80050 |
|
594 |
585 |
$6K |
| J2930 |
Methylprednisolone injection |
1,075 |
1,033 |
$6K |
| M0243 |
Casirivi and imdevi inj |
13 |
13 |
$6K |
| 87804 |
|
755 |
703 |
$6K |
| 84439 |
|
964 |
941 |
$6K |
| J2765 |
Metoclopramide hcl injection |
1,796 |
1,669 |
$6K |
| 70551 |
|
41 |
41 |
$6K |
| 88305 |
|
183 |
170 |
$6K |
| P9016 |
Rbc leukocytes reduced |
75 |
55 |
$6K |
| 87077 |
|
1,191 |
1,100 |
$6K |
| 87880 |
|
524 |
514 |
$5K |
| 27502 |
|
20 |
18 |
$5K |
| 36430 |
|
76 |
58 |
$5K |
| J7120 |
Ringers lactate infusion |
379 |
366 |
$5K |
| J1815 |
Insulin injection |
190 |
136 |
$5K |
| 80061 |
|
567 |
558 |
$4K |
| U0002 |
Covid-19 lab test non-cdc |
1,202 |
1,163 |
$4K |
| 90471 |
|
749 |
721 |
$4K |
| 85652 |
|
1,368 |
1,303 |
$4K |
| 99070 |
|
256 |
169 |
$4K |
| 97010 |
|
183 |
76 |
$3K |
| 87081 |
|
737 |
709 |
$3K |
| 85014 |
|
2,035 |
1,925 |
$3K |
| A4649 |
Surgical supplies |
1,729 |
1,243 |
$3K |
| 87088 |
|
720 |
689 |
$3K |
| 82728 |
|
304 |
277 |
$3K |
| 0271 |
|
572 |
522 |
$3K |
| 73590 |
|
146 |
134 |
$3K |
| 83036 |
|
632 |
621 |
$3K |
| 76870 |
|
52 |
52 |
$2K |
| J2919 |
Inj, methylpred sod succ 5mg |
119 |
108 |
$2K |
| J0134 |
Inj acetaminophen -fresenius |
336 |
305 |
$2K |
| 73502 |
|
85 |
81 |
$2K |
| 0320 |
|
186 |
175 |
$2K |
| 97163 |
|
52 |
52 |
$2K |
| J7050 |
Normal saline solution infus |
392 |
357 |
$2K |
| Q0144 |
Azithromycin dihydrate, oral |
69 |
67 |
$2K |
| 73090 |
|
68 |
67 |
$1K |
| 84100 |
|
457 |
425 |
$1K |
| J7611 |
Albuterol non-comp con |
1,155 |
1,053 |
$1K |
| 78452 |
|
13 |
13 |
$1K |
| 73110 |
|
70 |
65 |
$1K |
| E0112 |
Crutch underarm pair wood |
123 |
120 |
$1K |
| S0164 |
Injection pantroprazole |
183 |
163 |
$1K |
| 86308 |
|
328 |
326 |
$1K |
| 83615 |
|
224 |
215 |
$1K |
| 80320 |
|
756 |
667 |
$989.95 |
| J3370 |
Vancomycin hcl injection |
118 |
113 |
$977.62 |
| 99001 |
|
95 |
90 |
$954.88 |
| J3475 |
Inj magnesium sulfate |
220 |
202 |
$953.54 |
| 0510 |
|
346 |
275 |
$865.83 |
| 71010 |
|
75 |
27 |
$863.62 |
| 87205 |
|
370 |
338 |
$849.62 |
| J2704 |
Inj, propofol, 10 mg |
108 |
84 |
$804.29 |
| J3486 |
Ziprasidone mesylate |
14 |
12 |
$776.80 |
| 76815 |
|
12 |
12 |
$761.80 |
| J3010 |
Fentanyl citrate injection |
299 |
278 |
$710.73 |
| 74021 |
|
17 |
17 |
$703.90 |
| 80076 |
|
124 |
120 |
$648.46 |
| J7512 |
Prednisone ir or dr oral 1mg |
378 |
357 |
$541.82 |
| 72040 |
|
41 |
39 |
$522.98 |
| J2800 |
Methocarbamol injection |
97 |
93 |
$494.09 |
| 0636 |
|
64 |
55 |
$445.90 |
| 86923 |
|
13 |
12 |
$439.42 |
| 82803 |
|
48 |
44 |
$429.30 |
| 85027 |
|
121 |
115 |
$426.87 |
| 85007 |
|
190 |
172 |
$408.74 |
| 73100 |
|
29 |
25 |
$381.04 |
| 87420 |
|
143 |
139 |
$370.18 |
| 82330 |
|
45 |
41 |
$359.21 |
| 0258 |
|
79 |
57 |
$327.96 |
| J2250 |
Inj midazolam hydrochloride |
176 |
152 |
$321.58 |
| 73140 |
|
25 |
25 |
$307.93 |
| L1830 |
Ko immob canvas long pre ots |
12 |
12 |
$258.91 |
| J1644 |
Inj heparin sodium per 1000u |
120 |
69 |
$244.22 |
| J7613 |
Albuterol non-comp unit |
298 |
285 |
$240.09 |
| J1630 |
Haloperidol injection |
77 |
68 |
$234.49 |
| 84436 |
|
114 |
114 |
$222.23 |
| Z7610 |
|
32 |
26 |
$214.27 |
| J3360 |
Diazepam injection |
48 |
46 |
$198.14 |
| 76937 |
|
14 |
12 |
$163.27 |
| 94644 |
|
20 |
18 |
$157.89 |
| 84295 |
|
44 |
41 |
$153.82 |
| J0456 |
Azithromycin |
31 |
24 |
$153.59 |
| 84132 |
|
44 |
41 |
$152.40 |
| S0119 |
Ondansetron 4 mg |
251 |
238 |
$140.94 |
| S0028 |
Injection, famotidine, 20 mg |
74 |
69 |
$127.22 |
| 82947 |
|
44 |
41 |
$125.63 |
| J7609 |
Albuterol comp unit |
81 |
77 |
$124.43 |
| 87210 |
|
28 |
26 |
$105.09 |
| 82010 |
|
39 |
37 |
$99.31 |
| Q0163 |
Diphenhydramine hcl 50mg |
174 |
165 |
$89.22 |
| J2272 |
Inj, morphine (fresenius) |
19 |
18 |
$72.41 |
| 82150 |
|
28 |
28 |
$67.71 |
| J7644 |
Ipratropium bromide non-comp |
95 |
89 |
$62.61 |
| J2470 |
Inj pantoprazole sodium 40mg |
13 |
12 |
$55.87 |
| J7510 |
Prednisolone oral per 5 mg |
42 |
42 |
$47.88 |
| 82570 |
|
31 |
27 |
$47.42 |
| 87147 |
|
13 |
12 |
$34.56 |
| J2543 |
Piperacillin/tazobactam |
39 |
37 |
$28.03 |
| 82306 |
|
26 |
26 |
$27.06 |
| 82607 |
|
12 |
12 |
$26.84 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
25 |
21 |
$14.10 |
| 96379 |
|
19 |
19 |
$0.00 |
| 0301 |
|
19 |
17 |
$0.00 |
| 80349 |
|
28 |
27 |
$0.00 |
| 90686 |
|
13 |
13 |
$0.00 |
| G0008 |
Admin influenza virus vac |
12 |
12 |
$0.00 |