| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
|
18,972 |
18,204 |
$2.17M |
| 99285 |
|
5,744 |
5,522 |
$938K |
| 99283 |
|
8,892 |
8,611 |
$731K |
| G0378 |
Hospital observation per hr |
1,027 |
414 |
$295K |
| 74177 |
|
1,260 |
1,234 |
$196K |
| 96374 |
|
7,471 |
7,095 |
$187K |
| T1015 |
Clinic service |
5,882 |
5,416 |
$172K |
| 80053 |
|
14,655 |
13,674 |
$150K |
| 0241U |
|
2,205 |
2,179 |
$119K |
| 70450 |
|
1,989 |
1,890 |
$106K |
| 85025 |
|
19,268 |
17,600 |
$96K |
| 80307 |
|
1,942 |
1,719 |
$91K |
| 74176 |
|
835 |
784 |
$63K |
| U0003 |
Cov-19 amp prb hgh thruput |
757 |
725 |
$57K |
| 80050 |
|
1,232 |
1,220 |
$55K |
| 96375 |
|
3,418 |
3,142 |
$54K |
| 71275 |
|
297 |
294 |
$51K |
| 71046 |
|
3,676 |
3,531 |
$48K |
| 93005 |
|
5,086 |
4,817 |
$45K |
| 73721 |
|
178 |
173 |
$43K |
| 84484 |
|
5,154 |
4,728 |
$41K |
| 43239 |
|
234 |
233 |
$37K |
| 77067 |
|
423 |
421 |
$35K |
| 80061 |
|
2,941 |
2,890 |
$35K |
| 72148 |
|
218 |
212 |
$33K |
| 70553 |
|
170 |
166 |
$33K |
| 80048 |
|
4,167 |
3,643 |
$33K |
| 82306 |
|
957 |
947 |
$27K |
| 93306 |
|
414 |
404 |
$26K |
| 84443 |
|
1,197 |
1,178 |
$25K |
| M0243 |
Casirivi and imdevi inj |
54 |
54 |
$20K |
| 72125 |
|
372 |
354 |
$20K |
| 71045 |
|
3,035 |
2,907 |
$20K |
| 70551 |
|
104 |
102 |
$19K |
| 76830 |
|
426 |
416 |
$19K |
| 76811 |
|
196 |
196 |
$18K |
| 83735 |
|
3,468 |
2,942 |
$18K |
| 87502 |
|
166 |
159 |
$18K |
| 83605 |
|
2,707 |
2,547 |
$18K |
| 96372 |
|
1,314 |
1,125 |
$16K |
| 71250 |
|
307 |
294 |
$16K |
| 93971 |
|
304 |
294 |
$16K |
| 71260 |
|
246 |
244 |
$15K |
| 83690 |
|
3,179 |
2,980 |
$14K |
| 96365 |
|
600 |
513 |
$14K |
| 76705 |
|
424 |
412 |
$13K |
| 76816 |
|
293 |
283 |
$13K |
| 76801 |
|
303 |
286 |
$13K |
| 83880 |
|
541 |
507 |
$12K |
| 76856 |
|
263 |
260 |
$12K |
| 76536 |
|
262 |
255 |
$12K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
5,010 |
4,787 |
$11K |
| 99281 |
|
400 |
387 |
$11K |
| 87635 |
|
272 |
263 |
$11K |
| 99282 |
|
255 |
251 |
$11K |
| 81003 |
|
3,595 |
3,348 |
$10K |
| 62323 |
|
125 |
108 |
$10K |
| 85610 |
|
3,729 |
3,279 |
$10K |
| 83036 |
|
1,669 |
1,632 |
$10K |
| 72100 |
|
467 |
457 |
$10K |
| 76770 |
|
283 |
275 |
$10K |
| 76817 |
|
166 |
154 |
$9K |
| 93970 |
|
142 |
136 |
$9K |
| 77063 |
|
417 |
415 |
$9K |
| 87088 |
|
1,272 |
1,199 |
$8K |
| 85730 |
|
1,718 |
1,618 |
$8K |
| 80329 |
|
700 |
632 |
$8K |
| 72141 |
|
40 |
40 |
$8K |
| 86803 |
|
374 |
370 |
$7K |
| 82607 |
|
618 |
604 |
$7K |
| 76642 |
|
182 |
175 |
$7K |
| 72020 |
|
701 |
655 |
$7K |
| 84702 |
|
437 |
370 |
$7K |
| 73564 |
|
320 |
307 |
$6K |
| 81025 |
|
1,747 |
1,690 |
$6K |
| 81015 |
|
2,534 |
2,389 |
$6K |
| 95886 |
|
138 |
129 |
$6K |
| 88305 |
|
553 |
534 |
$6K |
| 73610 |
|
377 |
359 |
$6K |
| 84439 |
|
767 |
753 |
$6K |
| 73030 |
|
396 |
369 |
$6K |
| 87040 |
|
593 |
385 |
$6K |
| 74018 |
|
435 |
416 |
$5K |
| 80076 |
|
644 |
586 |
$5K |
| 90715 |
|
389 |
381 |
$5K |
| 85027 |
|
934 |
830 |
$5K |
| 93017 |
|
151 |
149 |
$5K |
| 82728 |
|
460 |
437 |
$5K |
| 73630 |
|
467 |
444 |
$5K |
| 85379 |
|
489 |
475 |
$4K |
| A9577 |
Inj multihance |
763 |
741 |
$4K |
| 84100 |
|
906 |
727 |
$4K |
| 73502 |
|
279 |
271 |
$4K |
| J7030 |
Normal saline solution infus |
7,677 |
4,943 |
$4K |
| 72110 |
|
193 |
190 |
$4K |
| 78452 |
|
30 |
30 |
$4K |
| 83540 |
|
558 |
535 |
$4K |
| 94729 |
|
151 |
146 |
$4K |
| 84703 |
|
370 |
364 |
$4K |
| 96361 |
|
446 |
366 |
$4K |
| J1815 |
Insulin injection |
326 |
207 |
$4K |
| 87077 |
|
631 |
585 |
$4K |
| 77066 |
Tomosynthesis, mammo |
47 |
45 |
$4K |
| 73221 |
|
14 |
14 |
$4K |
| 70486 |
|
50 |
50 |
$4K |
| 87186 |
|
525 |
489 |
$4K |
| 82043 |
|
487 |
472 |
$3K |
| 94726 |
|
148 |
143 |
$3K |
| Q3014 |
Telehealth facility fee |
217 |
211 |
$3K |
| 73130 |
|
309 |
301 |
$3K |
| 45385 |
|
13 |
13 |
$3K |
| 87591 |
|
129 |
126 |
$3K |
| 86038 |
|
212 |
208 |
$3K |
| 87491 |
|
124 |
121 |
$3K |
| 83970 |
|
78 |
77 |
$3K |
| J3490 |
Drugs unclassified injection |
2,375 |
1,454 |
$3K |
| 76700 |
|
62 |
61 |
$3K |
| 73110 |
|
286 |
267 |
$3K |
| 86140 |
|
1,015 |
927 |
$3K |
| G0279 |
Tomosynthesis, mammo |
175 |
165 |
$3K |
| 82746 |
|
243 |
237 |
$3K |
| 72050 |
|
109 |
107 |
$2K |
| 45378 |
|
12 |
12 |
$2K |
| 85652 |
|
913 |
832 |
$2K |
| 86480 |
|
39 |
39 |
$2K |
| 84153 |
|
103 |
99 |
$2K |
| 80081 |
|
26 |
25 |
$2K |
| 82550 |
|
354 |
293 |
$2K |
| 84436 |
|
211 |
211 |
$2K |
| 83550 |
|
462 |
451 |
$2K |
| 82962 |
|
1,216 |
758 |
$2K |
| G0463 |
Hospital outpt clinic visit |
282 |
199 |
$2K |
| 82565 |
|
339 |
311 |
$2K |
| 93226 |
|
57 |
57 |
$2K |
| 82784 |
|
121 |
118 |
$2K |
| 45380 |
|
12 |
12 |
$2K |
| 86850 |
|
271 |
244 |
$2K |
| 72040 |
|
113 |
109 |
$2K |
| 77065 |
Tomosynthesis, mammo |
32 |
30 |
$2K |
| J1170 |
Hydromorphone injection |
3,018 |
1,779 |
$2K |
| 82150 |
|
347 |
317 |
$2K |
| 95911 |
|
27 |
25 |
$2K |
| 73560 |
|
112 |
109 |
$1K |
| 94060 |
|
154 |
147 |
$1K |
| 87389 |
|
51 |
51 |
$1K |
| 84480 |
|
174 |
174 |
$1K |
| 84460 |
|
208 |
203 |
$1K |
| 73562 |
|
92 |
89 |
$1K |
| 76815 |
|
35 |
31 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
4,878 |
4,351 |
$1K |
| 93041 |
|
299 |
281 |
$1K |
| 76805 |
|
24 |
24 |
$1K |
| 84450 |
|
182 |
177 |
$1K |
| 96366 |
|
144 |
96 |
$1K |
| 82977 |
|
143 |
89 |
$1K |
| 11043 |
|
23 |
12 |
$1K |
| 73590 |
|
91 |
87 |
$1K |
| 86901 |
|
304 |
275 |
$997.67 |
| 86900 |
|
304 |
275 |
$982.41 |
| J2930 |
Methylprednisolone injection |
357 |
336 |
$977.92 |
| 84520 |
|
221 |
196 |
$970.72 |
| J2785 |
Regadenoson injection |
84 |
84 |
$943.84 |
| 84403 |
|
27 |
27 |
$915.24 |
| 73090 |
|
95 |
91 |
$888.22 |
| 86618 |
|
42 |
40 |
$884.15 |
| 84550 |
|
158 |
141 |
$855.55 |
| 93225 |
|
57 |
57 |
$800.28 |
| 97597 |
|
36 |
26 |
$789.00 |
| 93296 |
|
76 |
75 |
$786.60 |
| 87070 |
|
176 |
164 |
$753.84 |
| 87340 |
|
56 |
55 |
$752.47 |
| 96360 |
|
41 |
41 |
$647.74 |
| J1040 |
Methylprednisolone 80 mg inj |
162 |
141 |
$605.60 |
| 73080 |
|
56 |
55 |
$591.80 |
| 83615 |
|
96 |
88 |
$590.49 |
| 87205 |
|
184 |
172 |
$588.39 |
| 80348 |
|
12 |
12 |
$579.34 |
| 82805 |
|
16 |
14 |
$575.55 |
| 72070 |
|
33 |
33 |
$574.55 |
| 82248 |
|
109 |
73 |
$545.41 |
| 86592 |
|
126 |
125 |
$506.73 |
| 82570 |
|
74 |
64 |
$498.25 |
| J0696 |
Ceftriaxone sodium injection |
1,277 |
1,092 |
$497.95 |
| J3535 |
Metered dose inhaler drug |
43 |
38 |
$495.20 |
| 86706 |
|
39 |
38 |
$474.05 |
| A9500 |
Tc99m sestamibi |
12 |
12 |
$457.10 |
| J2405 |
Ondansetron hcl injection |
5,239 |
4,406 |
$455.81 |
| 70496 |
|
12 |
12 |
$440.44 |
| J7120 |
Ringers lactate infusion |
1,778 |
1,243 |
$424.30 |
| J1100 |
Dexamethasone sodium phos |
1,991 |
1,887 |
$417.85 |
| 36415 |
|
2,308 |
1,745 |
$389.44 |
| 80197 |
|
18 |
12 |
$380.52 |
| J0131 |
Inj, acetaminophen (nos) |
676 |
624 |
$365.43 |
| 80345 |
|
27 |
27 |
$360.61 |
| 82947 |
|
120 |
113 |
$354.85 |
| J0780 |
Prochlorperazine injection |
325 |
303 |
$311.51 |
| J7050 |
Normal saline solution infus |
3,632 |
2,412 |
$306.91 |
| 84146 |
|
13 |
13 |
$280.32 |
| 20552 |
|
12 |
12 |
$280.15 |
| J2270 |
Morphine sulfate injection |
289 |
231 |
$270.44 |
| 80361 |
|
12 |
12 |
$268.80 |
| J1644 |
Inj heparin sodium per 1000u |
1,013 |
433 |
$264.67 |
| 84481 |
|
12 |
12 |
$246.12 |
| 76942 |
|
43 |
43 |
$244.94 |
| J2360 |
Orphenadrine injection |
63 |
63 |
$238.84 |
| 95816 |
|
29 |
28 |
$227.69 |
| 84156 |
|
53 |
42 |
$225.64 |
| 72072 |
|
12 |
12 |
$225.49 |
| 80358 |
|
12 |
12 |
$224.99 |
| J3010 |
Fentanyl citrate injection |
1,814 |
1,454 |
$220.28 |
| 80347 |
|
12 |
12 |
$217.25 |
| 73552 |
|
12 |
12 |
$210.26 |
| J7040 |
Normal saline solution infus |
926 |
798 |
$209.64 |
| 82140 |
|
50 |
47 |
$201.03 |
| 86431 |
|
24 |
24 |
$199.12 |
| 80353 |
|
12 |
12 |
$192.77 |
| 72114 |
|
12 |
12 |
$189.74 |
| J1200 |
Diphenhydramine hcl injectio |
1,127 |
1,031 |
$178.41 |
| J7999 |
Compounded drug, noc |
518 |
387 |
$163.75 |
| 87430 |
|
13 |
13 |
$149.76 |
| 82950 |
|
29 |
28 |
$148.94 |
| 36600 |
|
13 |
12 |
$141.10 |
| 80051 |
|
28 |
24 |
$137.97 |
| 82009 |
|
30 |
27 |
$119.55 |
| J2704 |
Inj, propofol, 10 mg |
1,499 |
758 |
$98.86 |
| 87210 |
|
15 |
13 |
$98.33 |
| J1030 |
Methylprednisolone 40 mg inj |
44 |
42 |
$97.67 |
| 80069 |
|
12 |
12 |
$95.96 |
| J2250 |
Inj midazolam hydrochloride |
1,801 |
1,563 |
$84.38 |
| 87081 |
|
35 |
33 |
$77.92 |
| J2765 |
Metoclopramide hcl injection |
332 |
311 |
$73.64 |
| J2060 |
Lorazepam injection |
387 |
290 |
$73.43 |
| 84425 |
|
12 |
12 |
$61.95 |
| S0028 |
Injection, famotidine, 20 mg |
215 |
173 |
$59.93 |
| J2001 |
Lidocaine injection |
1,839 |
1,626 |
$53.46 |
| S0119 |
Ondansetron 4 mg |
170 |
144 |
$46.94 |
| S0020 |
Injection, bupivicaine hydro |
174 |
155 |
$37.35 |
| 88304 |
|
37 |
37 |
$28.15 |
| J0690 |
Cefazolin sodium injection |
52 |
26 |
$25.48 |
| J3480 |
Inj potassium chloride |
71 |
38 |
$25.05 |
| J7512 |
Prednisone ir or dr oral 1mg |
454 |
379 |
$17.67 |
| J7620 |
Albuterol ipratrop non-comp |
602 |
454 |
$13.40 |
| J1940 |
Furosemide injection |
19 |
12 |
$3.30 |
| J7613 |
Albuterol non-comp unit |
69 |
58 |
$2.26 |
| Q0243 |
Casirivimab and imdevimab |
41 |
41 |
$0.22 |
| 97165 |
|
14 |
14 |
$0.00 |
| A9579 |
Gad-base mr contrast nos,1ml |
67 |
66 |
$0.00 |
| 96376 |
|
64 |
33 |
$0.00 |
| 94640 |
|
20 |
12 |
$0.00 |
| J8501 |
Oral aprepitant |
14 |
14 |
$0.00 |
| Q9957 |
Inj perflutren lip micros,ml |
28 |
27 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
51 |
43 |
$0.00 |
| J0136 |
Inj, acetaminophen (b braun) |
36 |
36 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
111 |
89 |
$0.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
14 |
12 |
$0.00 |
| 97161 |
|
14 |
14 |
$0.00 |
| 96136 |
|
24 |
23 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
15 |
13 |
$0.00 |
| J1650 |
Inj enoxaparin sodium |
14 |
12 |
$0.00 |
| J2916 |
Na ferric gluconate complex |
32 |
13 |
$0.00 |