| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96361 |
|
2,715 |
1,569 |
$399K |
| 96365 |
|
2,566 |
1,534 |
$313K |
| 80053 |
|
11,834 |
9,374 |
$249K |
| 96374 |
|
3,747 |
2,673 |
$244K |
| 87631 |
|
1,444 |
1,386 |
$166K |
| 70450 |
|
1,861 |
1,566 |
$159K |
| 97110 |
|
3,364 |
916 |
$133K |
| 87502 |
|
1,414 |
1,231 |
$125K |
| 74177 |
|
721 |
655 |
$104K |
| 87651 |
|
2,176 |
2,001 |
$99K |
| 96375 |
|
3,145 |
2,199 |
$96K |
| 74176 |
|
1,248 |
1,087 |
$90K |
| 85025 |
|
12,844 |
9,037 |
$71K |
| 36415 |
|
16,761 |
11,626 |
$57K |
| 99283 |
|
3,626 |
2,536 |
$57K |
| 80048 |
|
4,141 |
2,930 |
$53K |
| 71046 |
|
3,256 |
2,793 |
$51K |
| U0002 |
Covid-19 lab test non-cdc |
1,319 |
1,197 |
$50K |
| 96372 |
|
2,819 |
2,112 |
$48K |
| 83880 |
|
2,536 |
2,053 |
$38K |
| 93005 |
|
4,592 |
3,595 |
$38K |
| 96360 |
|
373 |
257 |
$30K |
| 87426 |
|
1,061 |
946 |
$30K |
| 84443 |
|
2,371 |
2,166 |
$29K |
| 84484 |
|
4,371 |
2,663 |
$26K |
| U0004 |
Cov-19 test non-cdc hgh thru |
387 |
369 |
$24K |
| 99284 |
|
2,632 |
1,865 |
$23K |
| 81001 |
|
6,708 |
5,577 |
$22K |
| 87040 |
|
1,815 |
1,174 |
$22K |
| 85027 |
|
3,332 |
2,832 |
$19K |
| 87086 |
|
2,291 |
1,958 |
$18K |
| 99282 |
|
736 |
605 |
$18K |
| 82553 |
|
2,246 |
1,495 |
$17K |
| 71045 |
|
2,383 |
1,998 |
$17K |
| 82550 |
|
2,673 |
1,673 |
$17K |
| J0696 |
Ceftriaxone sodium injection |
1,365 |
839 |
$16K |
| 64493 |
|
71 |
58 |
$16K |
| 87077 |
|
1,428 |
1,209 |
$16K |
| 64635 |
|
51 |
43 |
$14K |
| 93306 |
|
94 |
76 |
$14K |
| 62323 |
|
103 |
75 |
$13K |
| 81025 |
|
1,448 |
1,268 |
$13K |
| 96376 |
|
596 |
327 |
$12K |
| 87637 |
|
402 |
358 |
$11K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,426 |
1,294 |
$11K |
| 82150 |
|
1,396 |
1,211 |
$11K |
| 83690 |
|
1,302 |
1,102 |
$10K |
| 83735 |
|
2,008 |
1,640 |
$10K |
| J2405 |
Ondansetron hcl injection |
2,426 |
1,733 |
$10K |
| J1885 |
Ketorolac tromethamine inj |
2,051 |
1,505 |
$9K |
| 80061 |
|
908 |
834 |
$9K |
| 82962 |
|
2,430 |
797 |
$9K |
| 87801 |
|
187 |
167 |
$8K |
| U0001 |
2019-ncov diagnostic p |
283 |
265 |
$8K |
| T1015 |
Clinic service |
720 |
566 |
$7K |
| 84145 |
|
812 |
588 |
$7K |
| 87186 |
|
1,332 |
1,145 |
$7K |
| 72148 |
|
30 |
26 |
$6K |
| 99285 |
|
745 |
466 |
$6K |
| 87632 |
|
35 |
35 |
$5K |
| 80305 |
|
537 |
458 |
$5K |
| J2250 |
Inj midazolam hydrochloride |
3,155 |
2,150 |
$5K |
| 96366 |
|
90 |
54 |
$4K |
| 85610 |
|
1,517 |
1,111 |
$4K |
| J1100 |
Dexamethasone sodium phos |
589 |
507 |
$4K |
| 83605 |
|
724 |
487 |
$4K |
| 85378 |
|
656 |
543 |
$4K |
| 82607 |
|
359 |
342 |
$4K |
| G0378 |
Hospital observation per hr |
1,426 |
742 |
$4K |
| 73630 |
|
128 |
109 |
$4K |
| U0003 |
Cov-19 amp prb hgh thruput |
97 |
72 |
$4K |
| 71020 |
|
263 |
227 |
$3K |
| 97162 |
|
41 |
37 |
$3K |
| 72125 |
|
14 |
12 |
$3K |
| M0243 |
Casirivi and imdevi inj |
17 |
14 |
$3K |
| 87070 |
|
235 |
202 |
$3K |
| 73562 |
|
68 |
52 |
$2K |
| 87807 |
|
213 |
186 |
$2K |
| 83036 |
|
330 |
305 |
$2K |
| 71260 |
|
12 |
12 |
$2K |
| 87428 |
|
31 |
31 |
$2K |
| 87581 |
|
35 |
35 |
$2K |
| 87486 |
|
35 |
35 |
$2K |
| 87400 |
|
377 |
302 |
$2K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
12 |
12 |
$1K |
| 64494 |
|
57 |
46 |
$1K |
| J1650 |
Inj enoxaparin sodium |
45 |
28 |
$1K |
| 87503 |
|
35 |
35 |
$935.04 |
| 82306 |
|
111 |
108 |
$929.94 |
| 86757 |
|
51 |
30 |
$927.04 |
| 73030 |
|
51 |
36 |
$854.41 |
| J1040 |
Methylprednisolone 80 mg inj |
982 |
768 |
$774.99 |
| 86666 |
|
43 |
30 |
$713.14 |
| 73130 |
|
13 |
12 |
$560.93 |
| J3010 |
Fentanyl citrate injection |
843 |
608 |
$515.87 |
| 86617 |
|
37 |
30 |
$498.36 |
| 72110 |
|
12 |
12 |
$495.80 |
| 80050 |
|
14 |
13 |
$438.03 |
| 94760 |
|
33 |
26 |
$343.56 |
| 86668 |
|
37 |
30 |
$334.94 |
| J2704 |
Inj, propofol, 10 mg |
791 |
538 |
$322.81 |
| G0463 |
Hospital outpt clinic visit |
23 |
12 |
$317.80 |
| J2270 |
Morphine sulfate injection |
1,328 |
772 |
$312.03 |
| 74022 |
|
15 |
13 |
$296.64 |
| 94640 |
|
188 |
52 |
$245.20 |
| 87635 |
|
169 |
160 |
$230.48 |
| 73610 |
|
14 |
12 |
$218.00 |
| 85652 |
|
29 |
26 |
$212.90 |
| 51702 |
|
24 |
12 |
$196.00 |
| 80307 |
|
23 |
12 |
$181.17 |
| 82803 |
|
16 |
13 |
$179.55 |
| 64636 |
|
63 |
42 |
$138.77 |
| J3490 |
Drugs unclassified injection |
30 |
13 |
$110.85 |
| 86308 |
|
14 |
14 |
$103.46 |
| 85730 |
|
12 |
12 |
$62.38 |
| J2550 |
Promethazine hcl injection |
101 |
64 |
$61.31 |
| J0690 |
Cefazolin sodium injection |
109 |
50 |
$41.32 |
| J1010 |
Inj, methylpred acetate 1 mg |
97 |
76 |
$30.25 |
| J1030 |
Methylprednisolone 40 mg inj |
39 |
27 |
$24.34 |
| T1502 |
Medication admin visit |
118 |
106 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
69 |
39 |
$0.00 |
| 36600 |
|
15 |
12 |
$0.00 |