| Code | Description | Claims | Beneficiaries | Total Paid |
| X4011 |
|
41,619 |
37,723 |
$39.38M |
| G0463 |
Hospital outpt clinic visit |
355,858 |
323,739 |
$31.84M |
| J3490 |
Drugs unclassified injection |
72,641 |
43,183 |
$17.16M |
| X4006 |
|
15,137 |
12,153 |
$15.28M |
| 99284 |
|
35,699 |
33,355 |
$11.18M |
| 99285 |
|
21,740 |
20,074 |
$9.27M |
| X4003 |
|
170,702 |
152,661 |
$9.17M |
| Y7507 |
|
27,217 |
20,532 |
$8.62M |
| 99283 |
|
34,068 |
31,620 |
$7.08M |
| 85025 |
|
143,645 |
116,909 |
$7.07M |
| 80048 |
|
95,594 |
79,616 |
$5.13M |
| Y7506 |
|
12,064 |
9,230 |
$4.71M |
| 99213 |
|
45,871 |
40,845 |
$3.96M |
| 93005 |
|
39,387 |
34,727 |
$3.93M |
| 95811 |
|
1,251 |
1,196 |
$3.26M |
| 96374 |
|
17,995 |
16,042 |
$2.92M |
| 81025 |
|
17,162 |
16,209 |
$2.69M |
| 81003 |
|
56,186 |
47,636 |
$2.40M |
| 81001 |
|
18,767 |
17,320 |
$2.34M |
| G0378 |
Hospital observation per hr |
4,126 |
3,535 |
$2.31M |
| 95810 |
|
1,538 |
1,471 |
$2.07M |
| 71046 |
|
19,743 |
18,019 |
$1.87M |
| 80076 |
|
31,849 |
28,664 |
$1.83M |
| 43239 |
|
3,142 |
2,886 |
$1.52M |
| 0241U |
|
10,095 |
9,459 |
$1.44M |
| 45385 |
|
1,622 |
1,520 |
$1.31M |
| 84484 |
|
21,511 |
18,288 |
$1.21M |
| 82948 |
|
26,357 |
22,197 |
$1.11M |
| 83690 |
|
14,616 |
13,411 |
$1.09M |
| 96413 |
|
4,961 |
2,853 |
$1.09M |
| 76819 |
|
10,412 |
6,387 |
$1.03M |
| 76816 |
|
10,701 |
9,876 |
$1.02M |
| 88305 |
|
8,846 |
8,259 |
$1.00M |
| U0003 |
Cov-19 amp prb hgh thruput |
17,596 |
15,990 |
$905K |
| 87088 |
|
9,252 |
8,648 |
$858K |
| 80307 |
|
9,294 |
8,301 |
$817K |
| 96372 |
|
19,209 |
17,087 |
$803K |
| 59025 |
|
4,635 |
4,265 |
$767K |
| 85610 |
|
15,578 |
12,240 |
$733K |
| 45380 |
|
1,210 |
1,133 |
$718K |
| 76817 |
|
7,114 |
6,552 |
$694K |
| 83880 |
|
10,920 |
9,895 |
$660K |
| G0480 |
Drug test def 1-7 classes |
6,649 |
6,182 |
$648K |
| 20610 |
|
5,325 |
4,526 |
$631K |
| 83735 |
|
23,905 |
18,251 |
$621K |
| 76805 |
|
5,895 |
5,619 |
$586K |
| 85730 |
|
4,593 |
4,101 |
$580K |
| 70355 |
|
12,070 |
11,513 |
$535K |
| 99282 |
|
3,810 |
3,584 |
$504K |
| 86850 |
|
4,882 |
4,532 |
$472K |
| 86780 |
|
7,739 |
7,396 |
$455K |
| J2426 |
Inj, invega sustenna, 1 mg |
583 |
543 |
$441K |
| 96375 |
|
9,267 |
7,835 |
$439K |
| 86900 |
|
4,587 |
4,255 |
$438K |
| 66984 |
|
589 |
475 |
$431K |
| 20553 |
|
3,496 |
3,204 |
$417K |
| 80053 |
|
24,357 |
17,389 |
$405K |
| 86901 |
|
4,570 |
4,240 |
$404K |
| 87389 |
|
6,323 |
6,059 |
$403K |
| 94060 |
|
1,639 |
1,523 |
$402K |
| 45378 |
|
505 |
484 |
$398K |
| 87801 |
|
5,641 |
5,439 |
$376K |
| 76811 |
|
2,029 |
1,937 |
$288K |
| 74177 |
|
1,118 |
1,009 |
$280K |
| 88342 |
|
2,740 |
2,509 |
$263K |
| 92014 |
|
4,133 |
3,959 |
$255K |
| D7240 |
|
415 |
413 |
$247K |
| 92012 |
|
3,674 |
3,425 |
$240K |
| 92004 |
|
2,612 |
2,516 |
$214K |
| 64555 |
|
50 |
37 |
$214K |
| 87631 |
|
582 |
540 |
$212K |
| 70450 |
|
1,991 |
1,788 |
$212K |
| 90834 |
|
1,944 |
1,105 |
$210K |
| 96365 |
|
1,370 |
926 |
$208K |
| 83036 |
|
22,763 |
21,256 |
$207K |
| 59050 |
|
857 |
718 |
$206K |
| D7140 |
|
538 |
506 |
$191K |
| C9803 |
Hopd covid-19 spec collect |
10,521 |
9,885 |
$182K |
| 92083 |
|
3,138 |
2,907 |
$175K |
| 97110 |
|
3,621 |
905 |
$169K |
| 67028 |
|
822 |
749 |
$166K |
| 94726 |
|
964 |
897 |
$161K |
| 11042 |
|
1,107 |
698 |
$160K |
| U0005 |
Infec agen detec ampli probe |
12,310 |
11,229 |
$159K |
| 87536 |
|
1,981 |
1,831 |
$150K |
| 87491 |
|
1,640 |
1,551 |
$143K |
| 87591 |
|
1,648 |
1,562 |
$142K |
| 94729 |
|
1,297 |
1,207 |
$132K |
| 84443 |
|
6,826 |
6,217 |
$128K |
| 80061 |
|
10,157 |
9,604 |
$127K |
| 64493 |
|
227 |
165 |
$109K |
| 62323 |
|
509 |
465 |
$107K |
| 96361 |
|
2,216 |
1,951 |
$106K |
| 0001A |
|
2,871 |
2,529 |
$105K |
| 86803 |
|
2,653 |
2,527 |
$104K |
| 64450 |
|
461 |
424 |
$97K |
| 96367 |
|
1,795 |
1,033 |
$94K |
| D7210 |
|
191 |
187 |
$93K |
| 87340 |
|
2,556 |
2,428 |
$91K |
| 93306 |
|
166 |
164 |
$91K |
| 0002A |
|
2,320 |
2,121 |
$88K |
| 76820 |
|
654 |
437 |
$86K |
| 82306 |
|
3,501 |
3,308 |
$84K |
| 92134 |
|
2,333 |
2,151 |
$81K |
| 84702 |
|
853 |
790 |
$81K |
| 86762 |
|
1,922 |
1,841 |
$81K |
| 71045 |
|
1,291 |
1,175 |
$79K |
| 88142 |
|
2,022 |
1,934 |
$77K |
| 11900 |
|
1,003 |
924 |
$74K |
| 83655 |
|
1,400 |
1,330 |
$73K |
| 70553 |
|
230 |
217 |
$72K |
| 87635 |
|
1,522 |
1,367 |
$71K |
| 82950 |
|
1,408 |
1,348 |
$67K |
| 96900 |
|
4,125 |
736 |
$66K |
| 83605 |
|
373 |
325 |
$64K |
| 73630 |
|
1,078 |
895 |
$62K |
| 92133 |
|
2,091 |
1,934 |
$61K |
| 27096 |
|
204 |
191 |
$57K |
| G0260 |
Inj for sacroiliac jt anesth |
128 |
113 |
$55K |
| 94640 |
|
648 |
555 |
$54K |
| 91200 |
|
812 |
776 |
$51K |
| 92557 |
|
455 |
423 |
$49K |
| 96415 |
|
801 |
590 |
$48K |
| 99212 |
|
13,154 |
11,349 |
$47K |
| 73030 |
|
1,128 |
905 |
$47K |
| 76801 |
|
606 |
573 |
$46K |
| 73565 |
|
1,052 |
991 |
$45K |
| 95004 |
|
101 |
97 |
$43K |
| 17110 |
|
447 |
411 |
$42K |
| 11102 |
|
497 |
444 |
$41K |
| 96417 |
|
640 |
384 |
$40K |
| 73564 |
|
532 |
334 |
$39K |
| 64635 |
|
42 |
25 |
$39K |
| 86360 |
|
1,308 |
1,219 |
$37K |
| D9230 |
|
826 |
813 |
$37K |
| 11721 |
|
7,554 |
6,580 |
$36K |
| 84439 |
|
3,736 |
3,469 |
$36K |
| 29581 |
|
622 |
224 |
$36K |
| X4014 |
|
51 |
38 |
$36K |
| 93458 |
|
12 |
12 |
$34K |
| 90792 |
|
333 |
296 |
$34K |
| 73502 |
|
867 |
764 |
$33K |
| 64405 |
|
311 |
283 |
$33K |
| 87210 |
|
891 |
845 |
$30K |
| 96416 |
|
109 |
65 |
$30K |
| 96366 |
|
632 |
432 |
$29K |
| 99214 |
|
388 |
355 |
$29K |
| 84481 |
|
1,784 |
1,687 |
$29K |
| 87624 |
|
765 |
721 |
$28K |
| 93296 |
|
1,290 |
1,241 |
$28K |
| 36415 |
|
14,234 |
11,659 |
$27K |
| 83020 |
|
459 |
425 |
$27K |
| 31575 |
|
253 |
245 |
$26K |
| 51798 |
|
1,347 |
1,252 |
$24K |
| 71260 |
|
253 |
211 |
$24K |
| 73110 |
|
394 |
333 |
$24K |
| 73130 |
|
412 |
337 |
$24K |
| 85651 |
|
2,068 |
1,888 |
$23K |
| 87081 |
|
448 |
438 |
$23K |
| 86003 |
|
256 |
180 |
$23K |
| 73610 |
|
466 |
393 |
$23K |
| 96158 |
|
291 |
242 |
$22K |
| 71275 |
|
13 |
12 |
$21K |
| 96360 |
|
128 |
121 |
$21K |
| 86235 |
|
206 |
191 |
$20K |
| 17000 |
|
320 |
280 |
$19K |
| 76700 |
|
248 |
245 |
$19K |
| 90832 |
|
715 |
370 |
$19K |
| 86706 |
|
419 |
398 |
$18K |
| 99152 |
|
96 |
92 |
$18K |
| 97530 |
|
482 |
192 |
$18K |
| D7999 |
|
12 |
12 |
$17K |
| 72148 |
|
131 |
117 |
$17K |
| 76815 |
|
417 |
363 |
$16K |
| 87637 |
|
184 |
131 |
$16K |
| 0011A |
|
464 |
444 |
$16K |
| 87661 |
|
429 |
412 |
$16K |
| 96523 |
|
361 |
285 |
$16K |
| 0004A |
|
463 |
344 |
$16K |
| 17311 |
|
31 |
26 |
$15K |
| 86481 |
|
164 |
153 |
$15K |
| 11720 |
|
2,455 |
2,127 |
$14K |
| 95886 |
|
515 |
476 |
$14K |
| 11100 |
|
201 |
184 |
$14K |
| 51702 |
|
182 |
167 |
$14K |
| 99281 |
|
160 |
151 |
$12K |
| 72125 |
|
131 |
125 |
$12K |
| 82570 |
|
1,687 |
1,567 |
$12K |
| 49083 |
|
65 |
37 |
$12K |
| 92567 |
|
457 |
423 |
$12K |
| 90837 |
|
460 |
296 |
$11K |
| 0124A |
|
289 |
274 |
$10K |
| 83970 |
|
342 |
311 |
$10K |
| 0054A |
|
255 |
249 |
$10K |
| 72110 |
|
99 |
94 |
$10K |
| 85652 |
|
118 |
111 |
$9K |
| 73562 |
|
201 |
176 |
$9K |
| 86336 |
|
118 |
107 |
$9K |
| 82728 |
|
667 |
612 |
$8K |
| 74176 |
|
52 |
51 |
$8K |
| 76830 |
|
37 |
37 |
$7K |
| 82607 |
|
543 |
510 |
$7K |
| 20552 |
|
34 |
29 |
$7K |
| 84466 |
|
580 |
528 |
$7K |
| 11056 |
|
61 |
55 |
$6K |
| 86140 |
|
1,334 |
1,219 |
$6K |
| 96156 |
|
84 |
82 |
$6K |
| 86361 |
|
239 |
214 |
$6K |
| 0012A |
|
187 |
182 |
$6K |
| 87522 |
Neg quan hep c or qual rna |
128 |
126 |
$6K |
| 80069 |
|
685 |
616 |
$6K |
| 64494 |
|
157 |
80 |
$6K |
| 0013A |
|
130 |
128 |
$6K |
| 87563 |
|
268 |
258 |
$5K |
| 83516 |
|
503 |
354 |
$5K |
| 71250 |
|
125 |
115 |
$5K |
| 0051A |
|
122 |
102 |
$5K |
| 84156 |
|
1,162 |
1,073 |
$5K |
| 95117 |
|
108 |
38 |
$5K |
| 90480 |
|
119 |
114 |
$5K |
| 76813 |
|
55 |
51 |
$5K |
| 91010 |
|
14 |
12 |
$4K |
| 73140 |
|
70 |
60 |
$4K |
| 85018 |
|
56 |
48 |
$4K |
| 51701 |
|
39 |
38 |
$4K |
| 76642 |
|
72 |
71 |
$4K |
| 82043 |
|
324 |
305 |
$4K |
| 36591 |
|
68 |
47 |
$4K |
| 83540 |
|
581 |
529 |
$4K |
| 64483 |
|
13 |
12 |
$4K |
| 95910 |
|
15 |
15 |
$4K |
| 96368 |
|
394 |
230 |
$4K |
| 72170 |
|
147 |
142 |
$4K |
| 97602 |
|
19 |
14 |
$3K |
| 76827 |
|
24 |
24 |
$3K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
611 |
585 |
$3K |
| J0401 |
Inj, abilify maintena, 1 mg |
12 |
12 |
$3K |
| M0243 |
Casirivi and imdevi inj |
20 |
18 |
$3K |
| 64615 |
|
13 |
13 |
$3K |
| 0003A |
|
66 |
66 |
$3K |
| 77067 |
|
24 |
24 |
$3K |
| 82565 |
|
885 |
751 |
$3K |
| 11101 |
|
36 |
33 |
$3K |
| 85045 |
|
824 |
667 |
$3K |
| V2630 |
Anter chamber intraocul lens |
125 |
110 |
$2K |
| 83986 |
|
29 |
28 |
$2K |
| 84163 |
|
42 |
39 |
$2K |
| 97161 |
|
47 |
28 |
$2K |
| 97116 |
|
119 |
54 |
$2K |
| 17003 |
|
128 |
84 |
$2K |
| 90471 |
|
27 |
26 |
$2K |
| 91065 |
|
15 |
12 |
$2K |
| 82746 |
|
167 |
154 |
$2K |
| 86704 |
|
215 |
198 |
$2K |
| 90791 |
|
12 |
12 |
$2K |
| 86225 |
|
179 |
166 |
$2K |
| 86160 |
|
155 |
116 |
$2K |
| 0134A |
|
59 |
57 |
$2K |
| 93017 |
|
13 |
12 |
$2K |
| 86038 |
|
179 |
166 |
$2K |
| 94760 |
|
70 |
36 |
$2K |
| 86708 |
|
75 |
73 |
$2K |
| 72050 |
|
14 |
13 |
$2K |
| U0002 |
Covid-19 lab test non-cdc |
32 |
29 |
$2K |
| 82550 |
|
361 |
315 |
$2K |
| 0064A |
|
46 |
44 |
$2K |
| 11055 |
|
14 |
13 |
$2K |
| 83615 |
|
422 |
354 |
$2K |
| 41874 |
|
15 |
12 |
$1K |
| 82784 |
|
159 |
153 |
$1K |
| 76519 |
|
15 |
14 |
$1K |
| 90853 |
|
23 |
12 |
$1K |
| 82985 |
|
53 |
51 |
$1K |
| 87880 |
|
54 |
53 |
$1K |
| 83921 |
|
45 |
42 |
$962.67 |
| 82800 |
|
51 |
51 |
$957.92 |
| 93010 |
|
119 |
113 |
$927.36 |
| 84153 |
|
62 |
54 |
$822.50 |
| 99232 |
|
14 |
14 |
$759.08 |
| 82378 |
|
51 |
37 |
$716.12 |
| 86880 |
|
14 |
14 |
$709.97 |
| XXXXX |
|
582 |
290 |
$673.07 |
| 86200 |
|
55 |
48 |
$637.28 |
| 69210 |
|
16 |
12 |
$605.02 |
| 76514 |
|
57 |
50 |
$599.44 |
| 73080 |
|
13 |
12 |
$572.55 |
| 92082 |
|
14 |
13 |
$555.39 |
| 0071A |
|
30 |
21 |
$550.00 |
| 0031A |
|
13 |
12 |
$494.00 |
| 77063 |
|
12 |
12 |
$350.00 |
| 88175 |
|
14 |
14 |
$323.32 |
| 86592 |
|
53 |
53 |
$310.56 |
| 84100 |
|
87 |
51 |
$248.41 |
| J3301 |
Triamcinolone acet inj nos |
1,075 |
1,030 |
$247.69 |
| 87040 |
|
13 |
12 |
$241.57 |
| Q3014 |
Telehealth facility fee |
15 |
15 |
$240.82 |
| 84403 |
|
15 |
15 |
$235.16 |
| 86376 |
|
12 |
12 |
$205.38 |
| 87338 |
|
12 |
12 |
$190.90 |
| 86709 |
|
15 |
15 |
$174.74 |
| J2704 |
Inj, propofol, 10 mg |
536 |
492 |
$143.11 |
| 82103 |
|
12 |
12 |
$142.20 |
| 82105 |
|
12 |
12 |
$134.10 |
| 86255 |
|
13 |
13 |
$127.48 |
| 76937 |
|
14 |
12 |
$119.28 |
| 86256 |
|
23 |
12 |
$114.00 |
| 84460 |
|
25 |
25 |
$103.38 |
| 84450 |
|
25 |
25 |
$101.04 |
| 97162 |
|
15 |
14 |
$93.92 |
| 90686 |
|
45 |
37 |
$82.11 |
| 84550 |
|
33 |
28 |
$80.20 |
| 76825 |
|
12 |
12 |
$68.11 |
| 86431 |
|
13 |
12 |
$64.32 |
| 81015 |
|
12 |
12 |
$62.57 |
| J3010 |
Fentanyl citrate injection |
69 |
53 |
$53.22 |
| J1642 |
Inj heparin sodium per 10 u |
284 |
193 |
$47.16 |
| 80329 |
|
660 |
627 |
$45.56 |
| J1885 |
Ketorolac tromethamine inj |
173 |
157 |
$35.53 |
| 96376 |
|
103 |
78 |
$31.20 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
261 |
228 |
$24.67 |
| 95806 |
|
29 |
29 |
$20.79 |
| 90688 |
|
13 |
12 |
$19.98 |
| G0008 |
Admin influenza virus vac |
621 |
567 |
$17.39 |
| 80320 |
|
693 |
661 |
$15.50 |
| G8978 |
Mobility current status |
49 |
36 |
$12.95 |
| J2405 |
Ondansetron hcl injection |
53 |
39 |
$3.23 |
| A4216 |
Sterile water/saline, 10 ml |
57 |
29 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
60 |
57 |
$0.00 |
| 93325 |
|
12 |
12 |
$0.00 |
| J2270 |
Morphine sulfate injection |
21 |
12 |
$0.00 |
| 64495 |
|
69 |
29 |
$0.00 |
| 11103 |
|
18 |
12 |
$0.00 |
| G8979 |
Mobility goal status |
51 |
36 |
$0.00 |
| 64636 |
|
48 |
13 |
$0.00 |
| 93356 |
|
28 |
26 |
$0.00 |
| 0370 |
|
41 |
34 |
$0.00 |
| A9270 |
Non-covered item or service |
172 |
104 |
$0.00 |
| J1030 |
Methylprednisolone 40 mg inj |
33 |
30 |
$0.00 |
| C9290 |
Inj, bupivacaine liposome |
187 |
180 |
$0.00 |
| 0270 |
|
76 |
61 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
17 |
14 |
$0.00 |
| 0250 |
|
359 |
289 |
$0.00 |
| A9585 |
Gadobutrol injection |
49 |
49 |
$0.00 |
| C1769 |
Guide wire |
26 |
15 |
$0.00 |
| J7050 |
Normal saline solution infus |
17 |
12 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
13 |
13 |
$0.00 |