| Code | Description | Claims | Beneficiaries | Total Paid |
| 36415 |
|
65,348 |
50,568 |
$9.17M |
| G0463 |
Hospital outpt clinic visit |
38,637 |
32,228 |
$3.14M |
| 99283 |
|
40,403 |
36,729 |
$1.79M |
| 59025 |
|
18,216 |
7,309 |
$1.42M |
| 11042 |
|
3,291 |
1,478 |
$1.22M |
| 99282 |
|
8,421 |
7,859 |
$952K |
| 99391 |
|
9,589 |
8,660 |
$872K |
| 87070 |
|
6,429 |
5,937 |
$811K |
| 97110 |
|
11,425 |
3,818 |
$670K |
| C9803 |
Hopd covid-19 spec collect |
6,247 |
5,551 |
$629K |
| 96372 |
|
12,364 |
10,028 |
$484K |
| 99392 |
|
6,479 |
6,243 |
$449K |
| 88305 |
|
3,594 |
3,005 |
$433K |
| 0202U |
|
2,764 |
2,613 |
$420K |
| 0241U |
|
3,654 |
3,387 |
$402K |
| 80053 |
|
42,245 |
35,808 |
$319K |
| 99281 |
|
2,068 |
1,907 |
$304K |
| 81001 |
|
30,983 |
27,165 |
$301K |
| 71045 |
|
19,754 |
17,583 |
$278K |
| 99393 |
|
3,208 |
3,104 |
$257K |
| 99284 |
|
29,319 |
26,536 |
$250K |
| 87086 |
|
15,313 |
13,637 |
$232K |
| 70450 |
|
6,824 |
6,203 |
$215K |
| 87502 |
|
3,639 |
3,383 |
$212K |
| 92507 |
|
7,580 |
2,425 |
$207K |
| 97530 |
|
6,753 |
2,443 |
$206K |
| 76705 |
|
2,162 |
2,051 |
$198K |
| 81003 |
|
12,927 |
11,727 |
$195K |
| 81025 |
|
20,925 |
18,673 |
$192K |
| 82962 |
|
7,338 |
3,906 |
$186K |
| 73610 |
|
2,270 |
2,111 |
$184K |
| 73130 |
|
1,962 |
1,849 |
$180K |
| 73630 |
|
3,122 |
2,952 |
$177K |
| 74177 |
|
5,750 |
5,397 |
$175K |
| 71046 |
|
6,703 |
6,248 |
$168K |
| 73564 |
|
2,867 |
2,688 |
$155K |
| 77063 |
|
1,696 |
1,659 |
$145K |
| 82565 |
|
765 |
716 |
$143K |
| 87635 |
|
3,302 |
3,092 |
$139K |
| 96374 |
|
15,039 |
13,313 |
$135K |
| 80048 |
|
15,514 |
13,187 |
$132K |
| 70551 |
|
305 |
270 |
$119K |
| 76819 |
|
796 |
566 |
$109K |
| 93971 |
|
1,300 |
1,203 |
$104K |
| 99285 |
|
21,635 |
19,238 |
$103K |
| 99394 |
|
1,845 |
1,801 |
$100K |
| 97597 |
|
1,734 |
885 |
$100K |
| 93306 |
|
1,013 |
926 |
$97K |
| 80061 |
|
2,799 |
2,641 |
$95K |
| 87077 |
|
5,718 |
4,847 |
$94K |
| 84112 |
|
678 |
582 |
$93K |
| 96360 |
|
1,576 |
1,399 |
$92K |
| 73110 |
|
1,250 |
1,183 |
$90K |
| 74176 |
|
3,076 |
2,878 |
$90K |
| 73030 |
|
1,917 |
1,763 |
$90K |
| 87491 |
|
2,703 |
2,505 |
$87K |
| 72100 |
|
2,479 |
2,331 |
$86K |
| 83655 |
|
1,822 |
1,759 |
$82K |
| 10060 |
|
248 |
229 |
$75K |
| 87420 |
|
737 |
702 |
$70K |
| 76775 |
|
1,160 |
1,110 |
$61K |
| J2704 |
Inj, propofol, 10 mg |
7,898 |
6,686 |
$51K |
| U0003 |
Cov-19 amp prb hgh thruput |
2,804 |
2,436 |
$47K |
| 93005 |
|
24,991 |
20,921 |
$47K |
| 93970 |
|
317 |
304 |
$46K |
| 74018 |
|
1,416 |
1,224 |
$46K |
| 80306 |
|
2,348 |
2,001 |
$43K |
| 96365 |
|
3,556 |
3,126 |
$43K |
| 82948 |
|
3,652 |
1,924 |
$42K |
| 76642 |
|
983 |
929 |
$41K |
| 94010 |
|
131 |
128 |
$41K |
| 87804 |
|
5,093 |
2,779 |
$41K |
| 87210 |
|
1,194 |
1,122 |
$40K |
| 72040 |
|
601 |
556 |
$38K |
| 76830 |
|
455 |
438 |
$36K |
| 77067 |
|
2,499 |
2,449 |
$35K |
| 80307 |
|
5,406 |
4,633 |
$35K |
| 99213 |
|
860 |
737 |
$34K |
| 73502 |
|
1,088 |
1,020 |
$34K |
| 0353U |
|
740 |
695 |
$33K |
| 12001 |
|
165 |
156 |
$30K |
| 87430 |
|
4,572 |
4,350 |
$29K |
| 73080 |
|
455 |
430 |
$27K |
| 82247 |
|
1,154 |
769 |
$27K |
| 87651 |
|
732 |
711 |
$27K |
| J2405 |
Ondansetron hcl injection |
15,477 |
13,019 |
$27K |
| 96361 |
|
2,585 |
2,254 |
$26K |
| 85025 |
|
52,404 |
43,162 |
$25K |
| 77066 |
Tomosynthesis, mammo |
276 |
270 |
$25K |
| 71275 |
|
1,803 |
1,686 |
$24K |
| 85027 |
|
9,364 |
8,245 |
$24K |
| 88312 |
|
1,152 |
755 |
$22K |
| 71260 |
|
86 |
84 |
$21K |
| 94640 |
|
2,072 |
1,859 |
$18K |
| 76801 |
|
1,928 |
1,694 |
$18K |
| 93976 |
|
770 |
737 |
$17K |
| 73590 |
|
383 |
356 |
$16K |
| 99381 |
|
241 |
220 |
$15K |
| 76536 |
|
171 |
167 |
$13K |
| G0378 |
Hospital observation per hr |
3,696 |
2,303 |
$12K |
| 87880 |
|
433 |
424 |
$12K |
| 73090 |
|
218 |
199 |
$12K |
| 96375 |
|
8,062 |
6,897 |
$12K |
| 82731 |
|
154 |
141 |
$12K |
| 70553 |
|
15 |
14 |
$12K |
| 84439 |
|
1,702 |
1,572 |
$10K |
| 72148 |
|
27 |
27 |
$9K |
| 78452 |
|
27 |
27 |
$8K |
| 76856 |
|
701 |
673 |
$8K |
| 99214 |
|
403 |
345 |
$8K |
| J2250 |
Inj midazolam hydrochloride |
5,474 |
4,703 |
$8K |
| U0005 |
Infec agen detec ampli probe |
990 |
876 |
$8K |
| 81002 |
|
177 |
171 |
$8K |
| 76700 |
|
51 |
48 |
$7K |
| 71250 |
|
72 |
67 |
$7K |
| 72125 |
|
1,183 |
1,100 |
$7K |
| J0702 |
Betamethasone acet&sod phosp |
908 |
529 |
$7K |
| 96376 |
|
1,743 |
1,339 |
$7K |
| 97162 |
|
154 |
132 |
$7K |
| G0438 |
Ppps, initial visit |
63 |
62 |
$6K |
| 97161 |
|
102 |
92 |
$6K |
| 88304 |
|
631 |
578 |
$5K |
| 86850 |
|
4,288 |
3,762 |
$5K |
| 95816 |
|
26 |
25 |
$4K |
| 82810 |
|
174 |
146 |
$4K |
| 97116 |
|
1,588 |
834 |
$4K |
| 86140 |
|
347 |
307 |
$4K |
| 93975 |
|
111 |
108 |
$3K |
| 74178 |
|
13 |
12 |
$3K |
| 87040 |
|
4,555 |
2,416 |
$3K |
| 83036 |
|
2,043 |
1,848 |
$3K |
| 45380 |
|
104 |
95 |
$3K |
| 12011 |
|
12 |
12 |
$3K |
| 72072 |
|
85 |
81 |
$3K |
| 76815 |
|
411 |
369 |
$3K |
| 43239 |
|
726 |
660 |
$3K |
| 96366 |
|
227 |
153 |
$3K |
| 70486 |
|
98 |
91 |
$3K |
| G0008 |
Admin influenza virus vac |
394 |
361 |
$3K |
| 84484 |
|
18,444 |
13,678 |
$3K |
| 83880 |
|
7,108 |
6,278 |
$2K |
| A9270 |
Non-covered item or service |
28,828 |
6,883 |
$2K |
| 85018 |
|
275 |
223 |
$2K |
| 76817 |
|
2,167 |
1,910 |
$2K |
| J0330 |
Succinycholine chloride inj |
1,156 |
914 |
$2K |
| 82803 |
|
1,698 |
1,365 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
4,785 |
4,199 |
$2K |
| 90791 |
|
3,285 |
2,561 |
$2K |
| 74240 |
|
13 |
13 |
$2K |
| 84702 |
|
4,974 |
4,013 |
$2K |
| J2270 |
Morphine sulfate injection |
6,122 |
4,746 |
$2K |
| J1885 |
Ketorolac tromethamine inj |
10,805 |
9,408 |
$1K |
| 90471 |
|
1,232 |
1,116 |
$1K |
| J1100 |
Dexamethasone sodium phos |
6,319 |
5,657 |
$1K |
| 82375 |
|
133 |
115 |
$1K |
| 83690 |
|
19,781 |
17,630 |
$1K |
| 93017 |
|
29 |
29 |
$1K |
| 73140 |
|
16 |
14 |
$1K |
| J7512 |
Prednisone ir or dr oral 1mg |
959 |
855 |
$1K |
| 83735 |
|
9,680 |
8,122 |
$1K |
| 83540 |
|
38 |
37 |
$1K |
| J1200 |
Diphenhydramine hcl injectio |
2,486 |
2,143 |
$1K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
9,352 |
8,679 |
$1K |
| 86592 |
|
410 |
384 |
$1K |
| J0131 |
Inj, acetaminophen (nos) |
1,825 |
1,598 |
$1K |
| 82570 |
|
452 |
369 |
$975.98 |
| J3010 |
Fentanyl citrate injection |
5,498 |
4,688 |
$924.97 |
| 84443 |
|
3,994 |
3,686 |
$909.41 |
| 87426 |
|
232 |
217 |
$907.64 |
| J1170 |
Hydromorphone injection |
1,616 |
1,335 |
$901.97 |
| 80076 |
|
2,603 |
2,378 |
$893.59 |
| J3475 |
Inj magnesium sulfate |
855 |
719 |
$836.54 |
| 74022 |
|
45 |
39 |
$791.76 |
| 85379 |
|
3,011 |
2,813 |
$709.99 |
| 72170 |
|
51 |
44 |
$689.05 |
| 97165 |
|
24 |
24 |
$686.81 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
108 |
90 |
$650.91 |
| C9113 |
Inj pantoprazole sodium, via |
308 |
224 |
$629.39 |
| 87186 |
|
5,734 |
4,845 |
$599.65 |
| 90460 |
|
1,847 |
1,643 |
$599.61 |
| 86900 |
|
6,255 |
5,486 |
$582.38 |
| 81005 |
|
480 |
439 |
$579.61 |
| A9500 |
Tc99m sestamibi |
25 |
25 |
$547.76 |
| 83615 |
|
450 |
368 |
$523.94 |
| 70491 |
|
13 |
12 |
$502.74 |
| 77065 |
Tomosynthesis, mammo |
15 |
13 |
$473.16 |
| 82272 |
|
57 |
51 |
$467.55 |
| 82330 |
|
37 |
32 |
$434.63 |
| 73060 |
|
14 |
14 |
$414.07 |
| 85610 |
|
6,611 |
5,698 |
$402.56 |
| J0690 |
Cefazolin sodium injection |
3,154 |
2,329 |
$401.96 |
| C1769 |
Guide wire |
334 |
275 |
$389.99 |
| 87591 |
|
2,684 |
2,491 |
$376.61 |
| J0360 |
Hydralazine hcl injection |
320 |
276 |
$372.49 |
| 85730 |
|
5,994 |
5,205 |
$371.34 |
| J2550 |
Promethazine hcl injection |
373 |
328 |
$350.62 |
| J8540 |
Oral dexamethasone |
28 |
28 |
$332.22 |
| 87798 |
|
33 |
25 |
$329.11 |
| 97112 |
|
200 |
116 |
$279.17 |
| 90670 |
|
15 |
14 |
$266.55 |
| 87806 |
|
1,084 |
1,001 |
$264.26 |
| Q3014 |
Telehealth facility fee |
14 |
14 |
$258.88 |
| 83986 |
|
13 |
12 |
$224.69 |
| 83605 |
|
4,087 |
3,381 |
$204.60 |
| 84100 |
|
508 |
406 |
$202.43 |
| J2765 |
Metoclopramide hcl injection |
1,913 |
1,629 |
$190.24 |
| 84156 |
|
633 |
447 |
$183.76 |
| 86901 |
|
6,256 |
5,488 |
$149.08 |
| 90686 |
|
30 |
27 |
$131.39 |
| 87899 |
|
1,790 |
1,644 |
$117.58 |
| 82550 |
|
1,456 |
1,301 |
$117.39 |
| 90461 |
|
1,228 |
1,124 |
$106.99 |
| 90715 |
|
1,199 |
1,134 |
$101.60 |
| 82010 |
|
442 |
385 |
$71.40 |
| J0694 |
Cefoxitin sodium injection |
1,584 |
1,261 |
$69.36 |
| 88342 |
|
14 |
12 |
$49.30 |
| J1644 |
Inj heparin sodium per 1000u |
1,038 |
634 |
$33.24 |
| G0009 |
Admin pneumococcal vaccine |
317 |
304 |
$31.02 |
| 90633 |
|
62 |
48 |
$29.55 |
| 88302 |
|
12 |
12 |
$14.17 |
| J2930 |
Methylprednisolone injection |
1,213 |
1,095 |
$10.68 |
| 83050 |
|
130 |
114 |
$6.00 |
| J2001 |
Lidocaine injection |
4,477 |
3,708 |
$4.60 |
| J2060 |
Lorazepam injection |
1,163 |
971 |
$3.09 |
| A9585 |
Gadobutrol injection |
112 |
106 |
$1.09 |
| J1940 |
Furosemide injection |
181 |
140 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
164 |
143 |
$0.00 |
| C9290 |
Inj, bupivacaine liposome |
90 |
77 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
630 |
516 |
$0.00 |
| 87661 |
|
77 |
69 |
$0.00 |
| 36430 |
|
31 |
24 |
$0.00 |
| 70498 |
|
12 |
12 |
$0.00 |
| 86920 |
|
19 |
12 |
$0.00 |
| J3480 |
Inj potassium chloride |
86 |
40 |
$0.00 |
| 99291 |
|
27 |
24 |
$0.00 |
| 85651 |
|
140 |
114 |
$0.00 |
| 87205 |
|
152 |
117 |
$0.00 |
| 90651 |
|
20 |
19 |
$0.00 |
| 87640 |
|
67 |
53 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
147 |
121 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
15 |
13 |
$0.00 |
| 80069 |
|
13 |
12 |
$0.00 |
| 87340 |
|
24 |
24 |
$0.00 |
| 88307 |
|
12 |
12 |
$0.00 |
| J0500 |
Dicyclomine injection |
24 |
24 |
$0.00 |
| J2785 |
Regadenoson injection |
28 |
28 |
$0.00 |
| J1920 |
Inj, labetalol hcl, 5mg |
17 |
13 |
$0.00 |
| 84132 |
|
34 |
32 |
$0.00 |
| 85652 |
|
17 |
16 |
$0.00 |
| 82248 |
|
1,038 |
704 |
$0.00 |
| 80164 |
|
13 |
12 |
$0.00 |
| J0780 |
Prochlorperazine injection |
424 |
386 |
$0.00 |
| 87075 |
|
53 |
42 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
1,061 |
912 |
$0.00 |
| J7510 |
Prednisolone oral per 5 mg |
241 |
233 |
$0.00 |
| 84550 |
|
640 |
550 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
49 |
45 |
$0.00 |
| J2800 |
Methocarbamol injection |
29 |
24 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
600 |
480 |
$0.00 |
| 85384 |
|
100 |
91 |
$0.00 |
| J1650 |
Inj enoxaparin sodium |
145 |
88 |
$0.00 |
| 85014 |
|
58 |
48 |
$0.00 |
| 87641 |
|
166 |
139 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
173 |
150 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
56 |
48 |
$0.00 |
| 84295 |
|
19 |
18 |
$0.00 |
| P9016 |
Rbc leukocytes reduced |
15 |
12 |
$0.00 |
| 96367 |
|
16 |
12 |
$0.00 |
| 94727 |
|
28 |
28 |
$0.00 |
| 93925 |
|
14 |
14 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
30 |
25 |
$0.00 |
| 82947 |
|
23 |
20 |
$0.00 |
| 84520 |
|
19 |
18 |
$0.00 |
| 99152 |
|
27 |
26 |
$0.00 |
| 45385 |
|
14 |
13 |
$0.00 |