| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
|
29,473 |
25,437 |
$2.42M |
| 99199 |
|
16,724 |
14,255 |
$1.29M |
| 74177 |
|
2,198 |
2,089 |
$652K |
| 96374 |
|
5,232 |
4,660 |
$392K |
| 70450 |
|
1,876 |
1,770 |
$356K |
| 0250 |
|
6,090 |
3,521 |
$343K |
| 87635 |
|
4,740 |
4,553 |
$333K |
| 96375 |
|
4,810 |
4,125 |
$280K |
| 80053 |
|
9,609 |
8,557 |
$263K |
| 87636 |
|
1,195 |
1,171 |
$252K |
| 80307 |
|
2,727 |
2,477 |
$243K |
| 87637 |
|
1,182 |
1,153 |
$228K |
| 93005 |
|
5,668 |
5,184 |
$206K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
5,467 |
3,104 |
$206K |
| 96365 |
|
2,106 |
1,798 |
$192K |
| J3490 |
Drugs unclassified injection |
8,260 |
5,134 |
$187K |
| 96372 |
|
4,821 |
4,326 |
$179K |
| 77067 |
|
1,382 |
1,377 |
$165K |
| 85025 |
|
14,249 |
12,246 |
$156K |
| 82077 |
|
1,018 |
906 |
$148K |
| 87502 |
|
1,375 |
1,340 |
$133K |
| T1999 |
Noc retail items andsupplies |
5,640 |
3,114 |
$128K |
| Z7502 |
|
3,083 |
2,961 |
$115K |
| 0270 |
|
2,075 |
1,195 |
$110K |
| 74176 |
|
542 |
522 |
$105K |
| 71046 |
|
3,050 |
2,916 |
$101K |
| 96361 |
|
2,215 |
1,969 |
$95K |
| 71260 |
|
318 |
305 |
$90K |
| 87651 |
|
1,706 |
1,681 |
$87K |
| 71045 |
|
3,964 |
3,605 |
$85K |
| 83880 |
|
2,417 |
2,198 |
$81K |
| 84484 |
|
5,237 |
3,491 |
$70K |
| 80048 |
|
3,905 |
3,593 |
$70K |
| 96376 |
|
434 |
371 |
$68K |
| U0003 |
Cov-19 amp prb hgh thruput |
663 |
651 |
$61K |
| J7030 |
Normal saline solution infus |
5,044 |
4,293 |
$53K |
| 99283 |
|
297 |
273 |
$44K |
| 80179 |
|
358 |
329 |
$43K |
| 80143 |
|
353 |
326 |
$43K |
| 99284 |
|
263 |
245 |
$42K |
| 73630 |
|
1,046 |
997 |
$42K |
| 76856 |
|
435 |
433 |
$42K |
| 83690 |
|
4,080 |
3,691 |
$42K |
| 77063 |
|
1,366 |
1,361 |
$41K |
| 73610 |
|
932 |
871 |
$40K |
| 73030 |
|
950 |
907 |
$39K |
| J1885 |
Ketorolac tromethamine inj |
4,116 |
3,813 |
$36K |
| 81001 |
|
5,666 |
5,234 |
$35K |
| 80076 |
|
2,966 |
2,786 |
$34K |
| J2405 |
Ondansetron hcl injection |
3,366 |
2,965 |
$32K |
| J1170 |
Hydromorphone injection |
2,666 |
2,038 |
$31K |
| 72125 |
|
115 |
108 |
$31K |
| 81025 |
|
2,338 |
2,235 |
$30K |
| 73110 |
|
593 |
539 |
$30K |
| 84443 |
|
1,195 |
1,155 |
$28K |
| 0510 |
|
539 |
245 |
$28K |
| 99285 |
|
93 |
88 |
$28K |
| 87040 |
|
1,317 |
773 |
$24K |
| 73130 |
|
506 |
473 |
$22K |
| 87086 |
|
2,366 |
2,240 |
$22K |
| J0696 |
Ceftriaxone sodium injection |
1,830 |
1,635 |
$21K |
| 94640 |
|
712 |
617 |
$21K |
| 73564 |
|
465 |
442 |
$20K |
| 96360 |
|
224 |
192 |
$19K |
| 83735 |
|
2,014 |
1,743 |
$19K |
| 76830 |
|
171 |
171 |
$19K |
| 82803 |
|
767 |
650 |
$18K |
| 85379 |
|
1,174 |
1,126 |
$18K |
| 81003 |
|
4,007 |
3,794 |
$18K |
| 83605 |
|
1,055 |
802 |
$15K |
| J1100 |
Dexamethasone sodium phos |
1,306 |
1,250 |
$13K |
| 0760 |
|
220 |
140 |
$12K |
| 76805 |
|
106 |
106 |
$12K |
| 85610 |
|
2,209 |
1,947 |
$11K |
| 86140 |
|
1,423 |
1,348 |
$10K |
| 87077 |
|
738 |
629 |
$10K |
| 73562 |
|
212 |
200 |
$10K |
| 87186 |
|
923 |
822 |
$10K |
| J2060 |
Lorazepam injection |
993 |
839 |
$8K |
| 76705 |
|
97 |
91 |
$7K |
| J2765 |
Metoclopramide hcl injection |
927 |
859 |
$7K |
| 87634 |
|
97 |
96 |
$7K |
| 87430 |
|
484 |
469 |
$7K |
| 87633 |
|
15 |
14 |
$7K |
| 93971 |
|
55 |
53 |
$7K |
| 70551 |
|
14 |
13 |
$6K |
| 87591 |
|
101 |
99 |
$6K |
| 87491 |
|
99 |
99 |
$6K |
| 87081 |
|
488 |
473 |
$5K |
| 71250 |
|
29 |
27 |
$5K |
| 73502 |
|
95 |
87 |
$5K |
| 72100 |
|
131 |
123 |
$5K |
| J7120 |
Ringers lactate infusion |
456 |
425 |
$5K |
| 85730 |
|
576 |
546 |
$4K |
| 76641 |
|
54 |
53 |
$4K |
| 99282 |
|
19 |
15 |
$4K |
| 87400 |
|
432 |
410 |
$4K |
| J2270 |
Morphine sulfate injection |
346 |
283 |
$4K |
| J0131 |
Inj, acetaminophen (nos) |
114 |
67 |
$3K |
| U0005 |
Infec agen detec ampli probe |
140 |
139 |
$3K |
| 90715 |
|
43 |
43 |
$3K |
| 99281 |
|
55 |
53 |
$2K |
| J2930 |
Methylprednisolone injection |
153 |
134 |
$2K |
| 84703 |
|
802 |
779 |
$2K |
| 72110 |
|
24 |
24 |
$1K |
| 87070 |
|
106 |
79 |
$1K |
| 82947 |
|
99 |
87 |
$1K |
| 36415 |
|
1,456 |
1,318 |
$1K |
| G0279 |
Tomosynthesis, mammo |
56 |
55 |
$1K |
| 71020 |
|
27 |
14 |
$1K |
| Z7610 |
|
124 |
54 |
$1K |
| 87075 |
|
74 |
59 |
$1K |
| Z9725 |
|
24 |
24 |
$1K |
| 59025 |
|
44 |
24 |
$981.03 |
| J7050 |
Normal saline solution infus |
113 |
102 |
$939.88 |
| 87581 |
|
15 |
14 |
$861.72 |
| 87486 |
|
15 |
14 |
$861.72 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
25 |
16 |
$820.56 |
| 87798 |
|
15 |
14 |
$816.59 |
| 96366 |
|
15 |
14 |
$795.85 |
| 87205 |
|
100 |
80 |
$735.90 |
| J2704 |
Inj, propofol, 10 mg |
40 |
39 |
$591.17 |
| J2550 |
Promethazine hcl injection |
56 |
54 |
$474.92 |
| 84702 |
|
42 |
38 |
$341.65 |
| 85652 |
|
100 |
97 |
$290.86 |
| 73140 |
|
13 |
12 |
$233.54 |
| J7512 |
Prednisone ir or dr oral 1mg |
193 |
171 |
$230.40 |
| J7620 |
Albuterol ipratrop non-comp |
178 |
158 |
$222.46 |
| J2250 |
Inj midazolam hydrochloride |
41 |
41 |
$207.83 |
| Q0162 |
Ondansetron oral |
151 |
139 |
$189.56 |
| J2001 |
Lidocaine injection |
28 |
28 |
$188.91 |
| J1200 |
Diphenhydramine hcl injectio |
29 |
26 |
$181.78 |
| 87420 |
|
14 |
14 |
$150.93 |
| J3475 |
Inj magnesium sulfate |
17 |
13 |
$117.86 |
| S0028 |
Injection, famotidine, 20 mg |
12 |
12 |
$90.00 |
| J3010 |
Fentanyl citrate injection |
14 |
14 |
$84.02 |
| J7611 |
Albuterol non-comp con |
47 |
43 |
$61.17 |
| 86901 |
|
12 |
12 |
$55.14 |
| 86900 |
|
16 |
13 |
$46.10 |
| 80061 |
|
12 |
12 |
$19.25 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
13 |
13 |
$8.60 |