| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 41899 |
|
4,216 |
3,878 |
$7.23M |
| 69436 |
|
1,892 |
1,839 |
$3.15M |
| 43239 |
|
2,117 |
1,958 |
$1.75M |
| 45380 |
|
753 |
700 |
$555K |
| 88305 |
|
2,237 |
2,066 |
$422K |
| 87651 |
|
6,347 |
6,244 |
$320K |
| 42830 |
|
147 |
144 |
$317K |
| 95812 |
|
443 |
437 |
$297K |
| 70553 |
|
326 |
308 |
$206K |
| G0378 |
Hospital observation per hr |
946 |
846 |
$116K |
| 82306 |
|
2,720 |
2,640 |
$114K |
| 80050 |
|
3,909 |
3,838 |
$110K |
| 74018 |
|
1,287 |
1,211 |
$89K |
| 80053 |
|
5,928 |
5,635 |
$76K |
| J3490 |
Drugs unclassified injection |
24,665 |
9,498 |
$76K |
| J3010 |
Fentanyl citrate injection |
8,879 |
8,253 |
$74K |
| 84439 |
|
4,041 |
3,908 |
$68K |
| 83655 |
|
3,699 |
3,683 |
$64K |
| 84443 |
|
4,106 |
3,950 |
$63K |
| 70310 |
|
2,358 |
2,106 |
$62K |
| J7120 |
Ringers lactate infusion |
9,863 |
9,087 |
$58K |
| 71046 |
|
843 |
825 |
$55K |
| 92586 |
|
371 |
365 |
$51K |
| J2405 |
Ondansetron hcl injection |
10,218 |
7,927 |
$47K |
| 80061 |
|
3,592 |
3,511 |
$46K |
| 88342 |
|
1,777 |
1,683 |
$45K |
| 85025 |
|
4,922 |
4,662 |
$42K |
| 95716 |
|
59 |
55 |
$40K |
| 70551 |
|
109 |
99 |
$36K |
| 86140 |
|
3,410 |
3,208 |
$35K |
| 83036 |
|
2,190 |
2,147 |
$31K |
| 87632 |
|
145 |
143 |
$31K |
| 45331 |
|
71 |
65 |
$29K |
| 87507 |
|
61 |
59 |
$26K |
| 92585 |
|
76 |
76 |
$26K |
| 85027 |
|
3,425 |
3,238 |
$26K |
| 42820 |
|
28 |
28 |
$24K |
| 82728 |
|
1,484 |
1,439 |
$22K |
| J1100 |
Dexamethasone sodium phos |
7,574 |
6,930 |
$22K |
| 82784 |
|
2,127 |
2,026 |
$21K |
| 95700 |
|
47 |
46 |
$19K |
| 87426 |
|
954 |
751 |
$17K |
| 85652 |
|
3,080 |
2,910 |
$16K |
| J8499 |
Oral prescrip drug non chemo |
5,555 |
4,790 |
$16K |
| 73562 |
|
174 |
156 |
$15K |
| J1885 |
Ketorolac tromethamine inj |
5,121 |
3,596 |
$14K |
| J2250 |
Inj midazolam hydrochloride |
1,792 |
1,636 |
$13K |
| 96365 |
|
127 |
97 |
$12K |
| 82247 |
|
1,703 |
949 |
$11K |
| A4649 |
Surgical supplies |
835 |
470 |
$10K |
| 73630 |
|
106 |
100 |
$10K |
| 87491 |
|
184 |
177 |
$10K |
| 95813 |
|
12 |
12 |
$10K |
| 96374 |
|
975 |
772 |
$10K |
| 82248 |
|
1,695 |
966 |
$9K |
| J2270 |
Morphine sulfate injection |
1,310 |
1,188 |
$8K |
| 72148 |
|
29 |
28 |
$7K |
| 83540 |
|
929 |
898 |
$6K |
| 73610 |
|
70 |
67 |
$6K |
| G0379 |
Direct refer hospital observ |
69 |
68 |
$5K |
| 87591 |
|
184 |
177 |
$5K |
| J0690 |
Cefazolin sodium injection |
784 |
672 |
$5K |
| 80306 |
|
280 |
253 |
$5K |
| 83690 |
|
695 |
661 |
$4K |
| 0202U |
|
13 |
12 |
$4K |
| 36415 |
|
2,250 |
2,017 |
$4K |
| 81025 |
|
1,129 |
1,065 |
$4K |
| 84703 |
|
501 |
486 |
$3K |
| 85651 |
|
777 |
740 |
$3K |
| 81003 |
|
839 |
795 |
$3K |
| 82657 |
|
236 |
211 |
$2K |
| S1015 |
Iv tubing extension set |
512 |
437 |
$2K |
| 83550 |
|
187 |
177 |
$2K |
| 82607 |
|
93 |
84 |
$2K |
| U0003 |
Cov-19 amp prb hgh thruput |
80 |
78 |
$2K |
| J7613 |
Albuterol non-comp unit |
91 |
89 |
$2K |
| A7002 |
Tubing used w suction pump |
350 |
313 |
$2K |
| 76700 |
|
12 |
12 |
$2K |
| 87798 |
|
41 |
41 |
$1K |
| 80048 |
|
151 |
134 |
$1K |
| 94640 |
|
115 |
107 |
$1K |
| A4624 |
Tracheal suction tube |
221 |
200 |
$1K |
| A4930 |
Sterile, gloves per pair |
441 |
404 |
$1K |
| 83516 |
|
97 |
95 |
$737.27 |
| 96366 |
|
31 |
27 |
$694.89 |
| 70320 |
|
215 |
192 |
$659.94 |
| J2704 |
Inj, propofol, 10 mg |
7,757 |
3,977 |
$545.82 |
| A4231 |
Infusion insulin pump needle |
502 |
428 |
$378.82 |
| 83525 |
|
12 |
12 |
$248.92 |
| 87086 |
|
79 |
78 |
$238.69 |
| 85610 |
|
38 |
38 |
$231.76 |
| J0330 |
Succinycholine chloride inj |
32 |
26 |
$185.55 |
| 86364 |
|
171 |
159 |
$179.31 |
| 82550 |
|
28 |
26 |
$170.00 |
| 83735 |
|
29 |
28 |
$162.86 |
| 85018 |
|
13 |
13 |
$153.36 |
| A4217 |
Sterile water/saline, 500 ml |
252 |
196 |
$143.26 |
| A4218 |
Sterile saline or water |
85 |
77 |
$106.88 |
| A6402 |
Sterile gauze <= 16 sq in |
15 |
14 |
$105.17 |
| 87070 |
|
15 |
14 |
$61.25 |
| 85007 |
|
13 |
12 |
$56.50 |
| 87205 |
|
13 |
12 |
$30.62 |
| 3044F |
|
50 |
50 |
$0.01 |
| A4248 |
Chlorhexidine antisept |
19 |
12 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
17 |
12 |
$0.00 |
| C9285 |
Patch, lidocaine/tetracaine |
310 |
274 |
$0.00 |
| J7050 |
Normal saline solution infus |
106 |
65 |
$0.00 |
| A9579 |
Gad-base mr contrast nos,1ml |
287 |
176 |
$0.00 |
| S0020 |
Injection, bupivicaine hydro |
129 |
111 |
$0.00 |
| A9150 |
Misc/exper non-prescript dru |
17 |
13 |
$0.00 |