| Code | Description | Claims | Beneficiaries | Total Paid |
| 0450 |
|
166,433 |
146,378 |
$42.69M |
| 96372 |
|
35,736 |
33,504 |
$8.24M |
| 80053 |
|
81,940 |
75,325 |
$7.04M |
| 99285 |
|
16,066 |
15,229 |
$4.69M |
| 99284 |
|
41,009 |
38,734 |
$4.34M |
| 71045 |
|
50,138 |
47,115 |
$3.83M |
| 96374 |
|
21,793 |
19,762 |
$3.70M |
| 74176 |
|
16,288 |
15,688 |
$2.10M |
| 70450 |
|
14,910 |
14,370 |
$1.90M |
| 99283 |
|
18,852 |
17,988 |
$1.90M |
| 96361 |
|
7,114 |
6,659 |
$1.65M |
| 96365 |
|
8,342 |
7,837 |
$1.54M |
| 0241U |
|
9,025 |
8,805 |
$1.22M |
| 81025 |
|
17,238 |
16,518 |
$1.10M |
| Z7502 |
|
29,014 |
28,465 |
$1.09M |
| 81003 |
|
41,820 |
37,468 |
$915K |
| 85025 |
|
87,408 |
80,092 |
$910K |
| 80307 |
|
12,664 |
10,956 |
$900K |
| 71046 |
|
7,339 |
7,166 |
$869K |
| 36415 |
|
56,419 |
49,847 |
$745K |
| 99281 |
|
7,563 |
6,766 |
$700K |
| 93005 |
|
45,244 |
40,868 |
$627K |
| 99282 |
|
4,085 |
4,007 |
$561K |
| 84484 |
|
31,100 |
25,743 |
$540K |
| C9803 |
Hopd covid-19 spec collect |
8,754 |
8,491 |
$539K |
| 73610 |
|
3,785 |
3,713 |
$517K |
| 73564 |
|
3,543 |
3,486 |
$517K |
| 74177 |
|
3,860 |
3,769 |
$492K |
| 94640 |
|
10,982 |
10,279 |
$474K |
| 83690 |
|
27,490 |
25,673 |
$469K |
| 87275 |
|
4,984 |
4,700 |
$465K |
| 73630 |
|
4,822 |
4,728 |
$424K |
| 73130 |
|
3,851 |
3,781 |
$421K |
| 96360 |
|
1,542 |
1,512 |
$407K |
| 83880 |
|
11,980 |
11,228 |
$406K |
| 76801 |
|
4,291 |
3,757 |
$355K |
| 82962 |
|
11,020 |
6,828 |
$351K |
| 73030 |
|
3,465 |
3,388 |
$349K |
| 72040 |
|
2,499 |
2,456 |
$327K |
| 96375 |
|
18,687 |
16,973 |
$314K |
| 72100 |
|
4,028 |
3,965 |
$309K |
| 72125 |
|
3,174 |
3,111 |
$307K |
| 87070 |
|
3,631 |
3,479 |
$299K |
| 74018 |
|
2,729 |
2,653 |
$289K |
| 80048 |
|
5,578 |
5,307 |
$270K |
| 73110 |
|
2,312 |
2,261 |
$261K |
| 87086 |
|
9,213 |
8,856 |
$259K |
| J3490 |
Drugs unclassified injection |
43,969 |
26,904 |
$257K |
| 76705 |
|
4,386 |
4,243 |
$250K |
| 85610 |
|
35,257 |
33,013 |
$222K |
| S0077 |
Injection, clindamycin phosp |
645 |
607 |
$201K |
| 81001 |
|
15,655 |
14,997 |
$197K |
| 84703 |
|
18,570 |
17,364 |
$185K |
| 71275 |
|
1,526 |
1,470 |
$180K |
| 70486 |
|
1,504 |
1,472 |
$172K |
| 99199 |
|
7,417 |
6,604 |
$171K |
| 11042 |
|
2,273 |
873 |
$161K |
| 83735 |
|
13,903 |
13,057 |
$146K |
| 90471 |
|
2,628 |
2,562 |
$145K |
| 73080 |
|
1,298 |
1,274 |
$140K |
| 76830 |
|
2,944 |
2,868 |
$139K |
| 76856 |
|
3,878 |
3,775 |
$128K |
| 84702 |
|
5,935 |
5,234 |
$113K |
| 87077 |
|
3,718 |
3,349 |
$106K |
| Z7610 |
|
12,235 |
7,663 |
$105K |
| 81002 |
|
2,654 |
2,590 |
$102K |
| 85730 |
|
14,610 |
13,922 |
$101K |
| 86900 |
|
5,117 |
4,837 |
$95K |
| 0202U |
|
374 |
368 |
$92K |
| 93971 |
|
2,146 |
2,085 |
$92K |
| J1100 |
Dexamethasone sodium phos |
21,347 |
20,507 |
$88K |
| 73590 |
|
1,106 |
1,091 |
$88K |
| 73562 |
|
713 |
706 |
$87K |
| 73090 |
|
963 |
951 |
$84K |
| 0250 |
|
56,953 |
35,164 |
$79K |
| 72131 |
|
758 |
753 |
$77K |
| 0353U |
|
718 |
708 |
$74K |
| 87491 |
|
1,907 |
1,797 |
$70K |
| 76817 |
|
2,496 |
2,259 |
$69K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
6,192 |
6,012 |
$63K |
| 87040 |
|
4,890 |
3,058 |
$59K |
| 96366 |
|
1,499 |
1,385 |
$57K |
| 83605 |
|
4,404 |
3,801 |
$54K |
| 97110 |
|
2,744 |
766 |
$53K |
| 74019 |
|
447 |
441 |
$53K |
| 76805 |
|
701 |
677 |
$49K |
| J1885 |
Ketorolac tromethamine inj |
19,927 |
18,990 |
$47K |
| 84443 |
|
3,863 |
3,713 |
$47K |
| 59025 |
|
1,240 |
951 |
$45K |
| 73502 |
|
652 |
644 |
$43K |
| J0696 |
Ceftriaxone sodium injection |
10,631 |
10,205 |
$41K |
| 76870 |
|
422 |
410 |
$41K |
| 0270 |
|
27,916 |
17,416 |
$39K |
| 86850 |
|
2,582 |
2,482 |
$37K |
| 96376 |
|
3,693 |
3,243 |
$36K |
| J2405 |
Ondansetron hcl injection |
15,070 |
13,601 |
$35K |
| 0260 |
|
310 |
228 |
$35K |
| 76700 |
|
489 |
477 |
$34K |
| 87430 |
|
2,813 |
2,725 |
$34K |
| 87651 |
|
2,059 |
2,035 |
$33K |
| 90715 |
|
2,394 |
2,362 |
$32K |
| 73140 |
|
206 |
205 |
$32K |
| 93970 |
|
480 |
469 |
$32K |
| J2270 |
Morphine sulfate injection |
10,300 |
8,999 |
$31K |
| J0561 |
Penicillin g benzathine inj |
548 |
535 |
$29K |
| 85379 |
|
2,539 |
2,456 |
$28K |
| 87186 |
|
3,377 |
3,096 |
$28K |
| J2001 |
Lidocaine injection |
5,071 |
4,930 |
$27K |
| 71101 |
|
167 |
164 |
$24K |
| U0003 |
Cov-19 amp prb hgh thruput |
297 |
275 |
$21K |
| 71250 |
|
291 |
287 |
$21K |
| 87088 |
|
4,244 |
4,112 |
$20K |
| 74022 |
|
164 |
162 |
$20K |
| 0710 |
|
321 |
281 |
$20K |
| 76815 |
|
226 |
214 |
$19K |
| 87276 |
|
4,982 |
4,700 |
$18K |
| 86901 |
|
5,153 |
4,874 |
$17K |
| 0320 |
|
594 |
567 |
$17K |
| 71010 |
|
287 |
150 |
$17K |
| 85027 |
|
1,267 |
1,212 |
$15K |
| J1953 |
Levetiracetam injection |
476 |
423 |
$14K |
| 82803 |
|
524 |
428 |
$14K |
| 94760 |
|
4,201 |
3,980 |
$14K |
| 87591 |
|
1,898 |
1,787 |
$13K |
| 72170 |
|
166 |
164 |
$13K |
| 97140 |
|
627 |
174 |
$12K |
| 12001 |
|
183 |
182 |
$12K |
| J1170 |
Hydromorphone injection |
5,166 |
3,871 |
$12K |
| 87420 |
|
1,465 |
1,385 |
$11K |
| 82550 |
|
801 |
753 |
$11K |
| 71111 |
|
69 |
66 |
$11K |
| P9016 |
Rbc leukocytes reduced |
75 |
70 |
$11K |
| H1001 |
Antepartum management |
251 |
216 |
$10K |
| 96367 |
|
560 |
538 |
$9K |
| 86140 |
|
1,056 |
1,030 |
$8K |
| 71260 |
|
100 |
99 |
$8K |
| J2930 |
Methylprednisolone injection |
2,304 |
2,219 |
$8K |
| 0300 |
|
270 |
252 |
$7K |
| J1200 |
Diphenhydramine hcl injectio |
3,855 |
3,429 |
$7K |
| 82010 |
|
236 |
223 |
$6K |
| 70490 |
|
29 |
29 |
$6K |
| J2060 |
Lorazepam injection |
3,931 |
3,311 |
$6K |
| 70496 |
|
54 |
54 |
$6K |
| 36430 |
|
49 |
45 |
$6K |
| 84439 |
|
718 |
698 |
$5K |
| 0636 |
|
802 |
567 |
$5K |
| 73060 |
|
77 |
77 |
$5K |
| 80076 |
|
451 |
447 |
$5K |
| 70498 |
|
54 |
54 |
$5K |
| 82140 |
|
354 |
335 |
$5K |
| 87635 |
|
291 |
274 |
$5K |
| 73620 |
|
38 |
38 |
$5K |
| 0510 |
|
88 |
73 |
$5K |
| 84100 |
|
723 |
686 |
$5K |
| 72072 |
|
131 |
130 |
$4K |
| 97530 |
|
251 |
90 |
$4K |
| 86308 |
|
132 |
126 |
$4K |
| 76775 |
|
24 |
24 |
$4K |
| J2919 |
Inj, methylpred sod succ 5mg |
307 |
296 |
$4K |
| 71020 |
|
41 |
18 |
$4K |
| S0164 |
Injection pantroprazole |
646 |
603 |
$3K |
| 73600 |
|
13 |
13 |
$3K |
| 87210 |
|
74 |
72 |
$3K |
| 94664 |
|
798 |
760 |
$3K |
| J2765 |
Metoclopramide hcl injection |
2,893 |
2,728 |
$3K |
| J0360 |
Hydralazine hcl injection |
923 |
811 |
$3K |
| 87147 |
|
620 |
448 |
$2K |
| 29126 |
|
101 |
100 |
$2K |
| 73552 |
|
26 |
26 |
$2K |
| G0463 |
Hospital outpt clinic visit |
607 |
473 |
$2K |
| 29125 |
|
40 |
39 |
$2K |
| 85652 |
|
540 |
534 |
$2K |
| 27502 |
|
19 |
19 |
$2K |
| J3475 |
Inj magnesium sulfate |
671 |
638 |
$2K |
| J3010 |
Fentanyl citrate injection |
379 |
346 |
$2K |
| J2704 |
Inj, propofol, 10 mg |
287 |
275 |
$2K |
| 36600 |
|
338 |
325 |
$2K |
| A9270 |
Non-covered item or service |
932 |
497 |
$2K |
| C9113 |
Inj pantoprazole sodium, via |
558 |
524 |
$2K |
| 99070 |
|
1,822 |
1,124 |
$2K |
| J7050 |
Normal saline solution infus |
88 |
85 |
$2K |
| 82247 |
|
465 |
450 |
$2K |
| 0258 |
|
560 |
505 |
$1K |
| 87205 |
|
161 |
156 |
$1K |
| J0780 |
Prochlorperazine injection |
247 |
245 |
$1K |
| 72128 |
|
13 |
13 |
$1K |
| J8540 |
Oral dexamethasone |
1,471 |
1,453 |
$1K |
| J1630 |
Haloperidol injection |
510 |
439 |
$1K |
| 12011 |
|
27 |
27 |
$1K |
| 73120 |
|
33 |
32 |
$1K |
| J1940 |
Furosemide injection |
338 |
290 |
$945.81 |
| 87561 |
|
72 |
71 |
$915.53 |
| 99072 |
|
1,305 |
881 |
$885.05 |
| J7510 |
Prednisolone oral per 5 mg |
720 |
711 |
$855.46 |
| 70360 |
|
15 |
15 |
$854.84 |
| J2543 |
Piperacillin/tazobactam |
248 |
230 |
$839.68 |
| J2250 |
Inj midazolam hydrochloride |
284 |
278 |
$810.33 |
| 97112 |
|
80 |
25 |
$804.55 |
| 84075 |
|
32 |
32 |
$802.94 |
| J0131 |
Inj, acetaminophen (nos) |
31 |
31 |
$801.05 |
| J7512 |
Prednisone ir or dr oral 1mg |
1,793 |
1,745 |
$737.56 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
94 |
93 |
$736.29 |
| 70491 |
|
12 |
12 |
$664.41 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
15 |
14 |
$655.50 |
| 83036 |
|
46 |
45 |
$494.78 |
| 94644 |
|
51 |
51 |
$491.84 |
| J0690 |
Cefazolin sodium injection |
212 |
188 |
$490.64 |
| 88305 |
|
41 |
38 |
$474.50 |
| 0272 |
|
217 |
213 |
$474.15 |
| 82728 |
|
74 |
70 |
$458.62 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
83 |
68 |
$383.76 |
| 72070 |
|
38 |
38 |
$300.70 |
| 86920 |
|
42 |
26 |
$286.59 |
| 84704 |
|
41 |
40 |
$223.80 |
| 27610 |
|
12 |
12 |
$220.43 |
| 82248 |
|
99 |
92 |
$209.78 |
| 29515 |
|
42 |
42 |
$203.63 |
| J0500 |
Dicyclomine injection |
28 |
28 |
$175.44 |
| J3486 |
Ziprasidone mesylate |
16 |
13 |
$173.02 |
| 90714 |
|
62 |
62 |
$170.50 |
| J2470 |
Inj pantoprazole sodium 40mg |
22 |
20 |
$91.78 |
| J1790 |
Droperidol injection |
15 |
15 |
$91.02 |
| 97116 |
|
34 |
13 |
$75.05 |
| J3411 |
Thiamine hcl 100 mg |
80 |
67 |
$70.58 |
| 82565 |
|
16 |
16 |
$51.21 |
| Q4051 |
Splint supplies misc |
239 |
127 |
$49.60 |
| J0171 |
Adrenalin epinephrine inject |
13 |
12 |
$43.52 |
| J7030 |
Normal saline solution infus |
61 |
53 |
$34.65 |
| 82310 |
|
21 |
20 |
$30.23 |
| 84450 |
|
12 |
12 |
$11.85 |
| J3480 |
Inj potassium chloride |
12 |
12 |
$10.09 |
| 0370 |
|
39 |
38 |
$8.70 |
| 0301 |
|
120 |
113 |
$0.00 |
| 0307 |
|
26 |
25 |
$0.00 |
| 0306 |
|
14 |
14 |
$0.00 |
| 0350 |
|
13 |
12 |
$0.00 |
| 0305 |
|
154 |
145 |
$0.00 |
| 0206 |
|
43 |
38 |
$0.00 |
| S9445 |
Pt education noc individ |
16 |
14 |
$0.00 |
| 0730 |
|
68 |
66 |
$0.00 |
| A4649 |
Surgical supplies |
98 |
58 |
$0.00 |
| 0760 |
|
18 |
17 |
$0.00 |