| Code | Description | Claims | Beneficiaries | Total Paid |
| 0450 |
|
17,694 |
15,954 |
$4.42M |
| 97110 |
|
8,600 |
2,757 |
$486K |
| 99199 |
|
4,434 |
4,041 |
$292K |
| 77067 |
|
1,818 |
1,816 |
$274K |
| 80053 |
|
16,689 |
15,708 |
$253K |
| A9150 |
Misc/exper non-prescript dru |
2,273 |
1,185 |
$209K |
| 96374 |
|
3,780 |
3,509 |
$189K |
| 84443 |
|
8,302 |
8,156 |
$188K |
| 74177 |
|
1,514 |
1,464 |
$169K |
| 96372 |
|
3,264 |
2,961 |
$166K |
| 85025 |
|
20,799 |
19,088 |
$165K |
| A9270 |
Non-covered item or service |
3,099 |
1,766 |
$161K |
| J1885 |
Ketorolac tromethamine inj |
2,984 |
2,761 |
$140K |
| 80061 |
|
7,792 |
7,756 |
$139K |
| J3490 |
Drugs unclassified injection |
3,446 |
2,390 |
$137K |
| T1999 |
Noc retail items andsupplies |
2,127 |
1,101 |
$137K |
| 36415 |
|
9,374 |
8,507 |
$119K |
| 96361 |
|
1,536 |
1,427 |
$119K |
| 76856 |
|
1,220 |
1,214 |
$119K |
| 82306 |
|
2,895 |
2,878 |
$113K |
| J7030 |
Normal saline solution infus |
2,129 |
1,871 |
$108K |
| 76830 |
|
919 |
912 |
$90K |
| 97750 |
|
662 |
542 |
$83K |
| 70450 |
|
1,406 |
1,367 |
$82K |
| 71046 |
|
2,548 |
2,501 |
$77K |
| 87502 |
|
1,792 |
1,758 |
$75K |
| 83036 |
|
4,901 |
4,861 |
$72K |
| 76641 |
|
583 |
538 |
$70K |
| 96375 |
|
3,014 |
2,630 |
$69K |
| 96365 |
|
679 |
527 |
$68K |
| 97139 |
|
1,029 |
303 |
$68K |
| 99283 |
|
533 |
489 |
$63K |
| J2405 |
Ondansetron hcl injection |
2,281 |
1,984 |
$61K |
| 80307 |
|
2,406 |
2,279 |
$60K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,951 |
1,902 |
$57K |
| 80048 |
|
5,341 |
5,001 |
$56K |
| 84439 |
|
4,063 |
4,027 |
$56K |
| 76700 |
|
459 |
457 |
$55K |
| U0003 |
Cov-19 amp prb hgh thruput |
867 |
838 |
$55K |
| 87635 |
|
2,807 |
2,715 |
$55K |
| 0510 |
|
1,072 |
1,014 |
$54K |
| 77063 |
|
1,199 |
1,198 |
$54K |
| 93005 |
|
4,267 |
4,017 |
$48K |
| G0378 |
Hospital observation per hr |
989 |
901 |
$47K |
| 81001 |
|
9,635 |
9,124 |
$46K |
| 73030 |
|
1,094 |
1,076 |
$43K |
| Z7502 |
|
1,057 |
1,034 |
$39K |
| 87088 |
|
2,821 |
2,682 |
$33K |
| 99284 |
|
235 |
213 |
$30K |
| 72100 |
|
631 |
628 |
$29K |
| 97140 |
|
462 |
214 |
$28K |
| 83880 |
|
2,086 |
1,931 |
$26K |
| 73630 |
|
594 |
572 |
$24K |
| 87634 |
|
1,321 |
1,294 |
$24K |
| 71045 |
|
2,892 |
2,724 |
$23K |
| 87081 |
|
985 |
975 |
$22K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
310 |
302 |
$21K |
| 93010 |
|
1,595 |
1,452 |
$21K |
| 99214 |
|
482 |
439 |
$21K |
| 80076 |
|
3,838 |
3,690 |
$19K |
| 99213 |
|
672 |
641 |
$18K |
| G0480 |
Drug test def 1-7 classes |
1,614 |
1,486 |
$17K |
| 0250 |
|
8,067 |
4,399 |
$17K |
| 99282 |
|
123 |
120 |
$16K |
| J2704 |
Inj, propofol, 10 mg |
63 |
52 |
$16K |
| 87430 |
|
628 |
617 |
$15K |
| J0696 |
Ceftriaxone sodium injection |
306 |
275 |
$15K |
| 87491 |
|
453 |
445 |
$14K |
| 81025 |
|
2,313 |
2,237 |
$14K |
| 87591 |
|
454 |
446 |
$13K |
| 73562 |
|
322 |
315 |
$13K |
| 73130 |
|
316 |
308 |
$12K |
| 87186 |
|
1,586 |
1,502 |
$12K |
| 0760 |
|
227 |
214 |
$12K |
| J1100 |
Dexamethasone sodium phos |
228 |
202 |
$12K |
| 0710 |
|
250 |
243 |
$11K |
| 82607 |
|
904 |
903 |
$11K |
| 87077 |
|
1,250 |
1,189 |
$11K |
| 74176 |
|
219 |
214 |
$11K |
| 86140 |
|
1,699 |
1,657 |
$11K |
| 27096 |
|
21 |
12 |
$11K |
| 85610 |
|
3,408 |
3,142 |
$10K |
| 99203 |
|
153 |
152 |
$10K |
| 82728 |
|
509 |
499 |
$10K |
| 84484 |
|
2,813 |
2,484 |
$9K |
| 82746 |
|
369 |
369 |
$8K |
| 83540 |
|
891 |
878 |
$8K |
| 96360 |
|
106 |
94 |
$8K |
| 85018 |
|
2,096 |
2,085 |
$8K |
| 83690 |
|
3,364 |
3,188 |
$8K |
| 85730 |
|
2,432 |
2,340 |
$8K |
| 73721 |
|
15 |
15 |
$7K |
| 81002 |
|
1,869 |
1,825 |
$7K |
| 84153 |
|
253 |
251 |
$7K |
| 84466 |
|
356 |
353 |
$6K |
| 84481 |
|
281 |
281 |
$6K |
| U0002 |
Covid-19 lab test non-cdc |
193 |
192 |
$6K |
| 73564 |
|
124 |
123 |
$6K |
| 87389 |
|
221 |
217 |
$6K |
| 72040 |
|
141 |
140 |
$6K |
| G0463 |
Hospital outpt clinic visit |
621 |
585 |
$6K |
| 99215 |
Prolong outpt/office vis |
107 |
98 |
$6K |
| 87070 |
|
504 |
495 |
$5K |
| 72125 |
|
84 |
80 |
$5K |
| 85651 |
|
1,063 |
1,040 |
$5K |
| 0270 |
|
668 |
387 |
$5K |
| 73110 |
|
112 |
104 |
$5K |
| 85027 |
|
654 |
597 |
$5K |
| 83735 |
|
1,037 |
918 |
$4K |
| 86803 |
|
183 |
181 |
$4K |
| J1170 |
Hydromorphone injection |
411 |
301 |
$3K |
| J2001 |
Lidocaine injection |
51 |
48 |
$3K |
| 73502 |
|
54 |
54 |
$3K |
| 84403 |
|
65 |
64 |
$3K |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
52 |
50 |
$3K |
| J1200 |
Diphenhydramine hcl injectio |
174 |
149 |
$3K |
| 93306 |
|
12 |
12 |
$2K |
| 82043 |
|
252 |
252 |
$2K |
| 92551 |
|
82 |
82 |
$2K |
| 83605 |
|
855 |
795 |
$2K |
| J2270 |
Morphine sulfate injection |
185 |
148 |
$2K |
| 73610 |
|
41 |
38 |
$2K |
| 90715 |
|
41 |
38 |
$2K |
| 86710 |
|
72 |
70 |
$1K |
| 87040 |
|
406 |
371 |
$1K |
| 86780 |
|
124 |
121 |
$1K |
| 86038 |
|
92 |
91 |
$1K |
| 99244 |
|
12 |
12 |
$1K |
| 96127 |
|
168 |
156 |
$1K |
| 73600 |
|
27 |
26 |
$1K |
| 96376 |
|
119 |
106 |
$837.15 |
| 82150 |
|
255 |
247 |
$799.63 |
| 85652 |
|
239 |
232 |
$763.41 |
| 86430 |
|
75 |
75 |
$721.59 |
| 94640 |
|
241 |
189 |
$720.49 |
| 87340 |
|
38 |
38 |
$708.94 |
| 76705 |
|
12 |
12 |
$666.34 |
| 71275 |
|
24 |
24 |
$640.78 |
| 94729 |
|
13 |
13 |
$610.35 |
| 94060 |
|
13 |
13 |
$605.86 |
| 93971 |
|
13 |
13 |
$587.39 |
| 80074 |
|
12 |
12 |
$579.26 |
| 94726 |
|
13 |
13 |
$542.36 |
| 82962 |
|
29 |
26 |
$520.88 |
| A9579 |
Gad-base mr contrast nos,1ml |
12 |
12 |
$446.60 |
| G0279 |
Tomosynthesis, mammo |
13 |
12 |
$436.13 |
| 77080 |
|
13 |
13 |
$416.76 |
| G0103 |
Psa screening |
204 |
204 |
$402.72 |
| 87880 |
|
24 |
24 |
$360.38 |
| 99173 |
|
91 |
91 |
$332.86 |
| 84145 |
|
124 |
118 |
$329.20 |
| J2060 |
Lorazepam injection |
103 |
89 |
$286.01 |
| 86039 |
|
29 |
29 |
$250.00 |
| 83655 |
|
25 |
25 |
$195.09 |
| 82550 |
|
27 |
26 |
$178.19 |
| J3301 |
Triamcinolone acet inj nos |
12 |
12 |
$172.82 |
| 86160 |
|
12 |
12 |
$159.24 |
| 82248 |
|
13 |
13 |
$95.42 |
| 84550 |
|
14 |
14 |
$84.93 |
| 85007 |
|
64 |
51 |
$73.48 |
| 72020 |
|
54 |
52 |
$44.18 |
| 76000 |
|
25 |
24 |
$41.28 |
| 84703 |
|
28 |
28 |
$15.87 |
| J3010 |
Fentanyl citrate injection |
13 |
12 |
$9.19 |
| 0370 |
|
16 |
15 |
$0.00 |
| J2765 |
Metoclopramide hcl injection |
13 |
13 |
$0.00 |
| 0253 |
|
60 |
51 |
$0.00 |
| 0272 |
|
25 |
24 |
$0.00 |
| 0360 |
|
14 |
14 |
$0.00 |