| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 8888888 |
|
2,290 |
1,352 |
$2.26M |
| J7120 |
Ringers lactate infusion |
2,947 |
2,665 |
$572K |
| 99284 |
|
9,865 |
8,489 |
$457K |
| 80053 |
|
14,329 |
11,748 |
$324K |
| C9803 |
Hopd covid-19 spec collect |
4,045 |
3,673 |
$263K |
| 36415 |
|
3,155 |
2,811 |
$236K |
| 99283 |
|
8,054 |
7,282 |
$236K |
| J7030 |
Normal saline solution infus |
3,001 |
2,624 |
$212K |
| J7050 |
Normal saline solution infus |
3,968 |
3,451 |
$169K |
| 99282 |
|
1,659 |
1,571 |
$160K |
| 70450 |
|
1,686 |
1,553 |
$103K |
| 71046 |
|
2,466 |
2,294 |
$92K |
| 96372 |
|
3,695 |
3,187 |
$86K |
| 81001 |
|
7,041 |
5,951 |
$84K |
| J1885 |
Ketorolac tromethamine inj |
3,532 |
3,158 |
$65K |
| 96374 |
|
4,417 |
3,766 |
$43K |
| 99285 |
|
3,676 |
3,206 |
$40K |
| 71045 |
|
1,963 |
1,758 |
$31K |
| 87088 |
|
2,429 |
2,233 |
$30K |
| 80048 |
|
2,092 |
1,841 |
$30K |
| 87275 |
|
819 |
785 |
$30K |
| 87631 |
|
314 |
295 |
$23K |
| J2175 |
Meperidine hydrochl /100 mg |
317 |
293 |
$22K |
| 73610 |
|
205 |
188 |
$20K |
| 86140 |
|
6,257 |
5,313 |
$19K |
| 80307 |
|
1,539 |
1,272 |
$18K |
| 76830 |
|
119 |
117 |
$17K |
| 87077 |
|
1,159 |
1,040 |
$16K |
| 87880 |
|
499 |
486 |
$14K |
| 77063 |
|
185 |
184 |
$13K |
| 88305 |
|
1,052 |
661 |
$13K |
| 73630 |
|
271 |
249 |
$13K |
| J1100 |
Dexamethasone sodium phos |
1,558 |
1,435 |
$12K |
| 85610 |
|
1,813 |
1,534 |
$12K |
| 76811 |
|
67 |
62 |
$12K |
| 97110 |
|
585 |
353 |
$12K |
| 96361 |
|
2,784 |
2,375 |
$11K |
| 74176 |
|
328 |
311 |
$10K |
| 96365 |
|
1,979 |
1,557 |
$10K |
| 73562 |
|
156 |
137 |
$10K |
| 72148 |
|
38 |
37 |
$9K |
| 84443 |
|
3,434 |
3,216 |
$8K |
| 76805 |
|
71 |
70 |
$8K |
| 84439 |
|
1,208 |
1,151 |
$8K |
| 73110 |
|
79 |
67 |
$8K |
| J7040 |
Normal saline solution infus |
121 |
104 |
$8K |
| 87070 |
|
200 |
169 |
$7K |
| 80061 |
|
978 |
938 |
$7K |
| 73030 |
|
90 |
83 |
$7K |
| 85025 |
|
15,882 |
12,873 |
$7K |
| 87491 |
|
239 |
228 |
$7K |
| 93005 |
|
4,364 |
3,737 |
$6K |
| 73130 |
|
122 |
102 |
$6K |
| 99281 |
|
106 |
97 |
$6K |
| 77067 |
|
248 |
247 |
$5K |
| J2001 |
Lidocaine injection |
1,600 |
1,454 |
$5K |
| 86850 |
|
277 |
246 |
$5K |
| 82962 |
|
1,017 |
624 |
$5K |
| 84484 |
|
2,679 |
1,825 |
$5K |
| 74018 |
|
125 |
119 |
$5K |
| 76705 |
|
51 |
50 |
$5K |
| 96375 |
|
2,932 |
2,422 |
$4K |
| 87420 |
|
234 |
227 |
$4K |
| J2270 |
Morphine sulfate injection |
810 |
730 |
$3K |
| 74177 |
|
2,220 |
2,034 |
$3K |
| A9577 |
Inj multihance |
67 |
64 |
$3K |
| 96360 |
|
565 |
500 |
$3K |
| 87591 |
|
225 |
217 |
$3K |
| J0696 |
Ceftriaxone sodium injection |
297 |
277 |
$3K |
| 85379 |
|
1,095 |
1,017 |
$2K |
| 72125 |
|
118 |
111 |
$2K |
| J1170 |
Hydromorphone injection |
820 |
732 |
$2K |
| 84702 |
|
208 |
145 |
$2K |
| 80055 |
|
26 |
26 |
$2K |
| G0378 |
Hospital observation per hr |
1,014 |
900 |
$2K |
| J1200 |
Diphenhydramine hcl injectio |
107 |
97 |
$2K |
| 93971 |
|
41 |
38 |
$2K |
| 76856 |
|
72 |
69 |
$2K |
| 81025 |
|
1,369 |
1,230 |
$2K |
| 83690 |
|
2,670 |
2,328 |
$1K |
| 85027 |
|
1,154 |
1,060 |
$1K |
| 82306 |
|
280 |
256 |
$1K |
| 84703 |
|
960 |
884 |
$1K |
| 83880 |
|
866 |
771 |
$1K |
| J2550 |
Promethazine hcl injection |
618 |
550 |
$1K |
| J2405 |
Ondansetron hcl injection |
3,813 |
3,352 |
$1K |
| 41899 |
|
275 |
258 |
$1K |
| J0690 |
Cefazolin sodium injection |
128 |
124 |
$961.80 |
| U0003 |
Cov-19 amp prb hgh thruput |
670 |
640 |
$920.55 |
| 87081 |
|
45 |
45 |
$915.38 |
| 82247 |
|
132 |
74 |
$910.93 |
| 80074 |
|
60 |
58 |
$853.29 |
| 87635 |
|
2,150 |
1,975 |
$828.47 |
| 70486 |
|
12 |
12 |
$804.96 |
| 86592 |
|
27 |
27 |
$757.03 |
| 83036 |
|
515 |
486 |
$656.62 |
| 85007 |
|
289 |
265 |
$615.39 |
| 87040 |
|
1,133 |
736 |
$605.69 |
| 86803 |
|
29 |
28 |
$533.69 |
| 86703 |
|
265 |
259 |
$401.24 |
| 83540 |
|
262 |
251 |
$346.87 |
| 82728 |
|
55 |
51 |
$335.36 |
| 83605 |
|
1,402 |
1,195 |
$327.67 |
| 71275 |
|
394 |
360 |
$310.26 |
| 86900 |
|
481 |
423 |
$260.61 |
| 0202U |
|
157 |
145 |
$237.75 |
| J3010 |
Fentanyl citrate injection |
1,288 |
1,161 |
$221.82 |
| 84403 |
|
14 |
13 |
$181.01 |
| 82950 |
|
12 |
12 |
$154.52 |
| 73502 |
|
14 |
13 |
$142.97 |
| 82607 |
|
34 |
29 |
$129.39 |
| 87276 |
|
819 |
785 |
$114.41 |
| 85652 |
|
886 |
779 |
$95.20 |
| U0005 |
Infec agen detec ampli probe |
614 |
592 |
$91.75 |
| 82550 |
|
148 |
127 |
$83.87 |
| 82150 |
|
119 |
111 |
$68.33 |
| 83735 |
|
912 |
755 |
$62.35 |
| 82565 |
|
52 |
44 |
$60.92 |
| 88304 |
|
75 |
51 |
$51.05 |
| 97140 |
|
33 |
16 |
$47.77 |
| 85730 |
|
698 |
628 |
$23.80 |
| 87186 |
|
1,122 |
1,010 |
$23.79 |
| 86677 |
|
57 |
57 |
$12.95 |
| J2710 |
Neostigmine methylslfte inj |
42 |
40 |
$0.00 |
| 82977 |
|
44 |
41 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
47 |
40 |
$0.00 |
| 87653 |
|
43 |
43 |
$0.00 |
| Q0244 |
Casirivi and imdevi 1200 mg |
25 |
22 |
$0.00 |
| 43239 |
|
15 |
12 |
$0.00 |
| 94761 |
|
92 |
84 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
1,954 |
1,774 |
$0.00 |
| 96366 |
|
183 |
143 |
$0.00 |
| 86901 |
|
467 |
411 |
$0.00 |
| A9270 |
Non-covered item or service |
246 |
235 |
$0.00 |
| J2765 |
Metoclopramide hcl injection |
85 |
81 |
$0.00 |
| 83550 |
|
145 |
137 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
587 |
524 |
$0.00 |
| J2060 |
Lorazepam injection |
12 |
12 |
$0.00 |
| 96376 |
|
419 |
362 |
$0.00 |
| 82746 |
|
16 |
14 |
$0.00 |
| 82553 |
|
45 |
40 |
$0.00 |
| 94640 |
|
33 |
31 |
$0.00 |
| 71260 |
|
13 |
12 |
$0.00 |
| M0243 |
Casirivi and imdevi inj |
45 |
41 |
$0.00 |
| J7060 |
5% dextrose/water |
15 |
14 |
$0.00 |
| J8540 |
Oral dexamethasone |
12 |
12 |
$0.00 |
| 97162 |
|
12 |
12 |
$0.00 |
| J1630 |
Haloperidol injection |
13 |
12 |
$0.00 |