| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0378 |
Hospital observation per hr |
3,444 |
1,826 |
$334K |
| 99285 |
|
5,089 |
2,873 |
$203K |
| 99284 |
|
2,649 |
2,102 |
$155K |
| 58558 |
|
149 |
142 |
$125K |
| J3490 |
Drugs unclassified injection |
624 |
345 |
$75K |
| J7030 |
Normal saline solution infus |
2,229 |
1,565 |
$63K |
| 80048 |
|
9,230 |
3,871 |
$27K |
| 87635 |
|
3,384 |
2,424 |
$22K |
| 96361 |
|
595 |
489 |
$19K |
| 74176 |
|
693 |
541 |
$15K |
| 70450 |
|
1,149 |
877 |
$11K |
| 85025 |
|
11,510 |
4,666 |
$4K |
| 99283 |
|
157 |
133 |
$3K |
| J3010 |
Fentanyl citrate injection |
307 |
257 |
$3K |
| 84702 |
|
425 |
353 |
$2K |
| 36415 |
|
4,955 |
3,207 |
$2K |
| 93005 |
|
3,196 |
2,345 |
$2K |
| 80053 |
|
2,093 |
1,272 |
$2K |
| 94762 |
|
1,529 |
1,330 |
$2K |
| 71045 |
|
4,226 |
2,870 |
$2K |
| 82550 |
|
3,084 |
1,723 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
1,324 |
1,008 |
$1K |
| 81025 |
|
529 |
460 |
$1K |
| 81001 |
|
3,148 |
2,440 |
$1K |
| 87086 |
|
778 |
616 |
$1K |
| 82553 |
|
2,347 |
1,412 |
$1K |
| 82962 |
|
1,668 |
598 |
$954.25 |
| Q0222 |
Bebtelovimab 175 mg |
62 |
42 |
$614.88 |
| 85610 |
|
1,508 |
1,188 |
$542.92 |
| 80076 |
|
1,176 |
936 |
$498.31 |
| 84484 |
|
1,406 |
740 |
$479.69 |
| J0690 |
Cefazolin sodium injection |
286 |
198 |
$421.40 |
| 96374 |
|
1,328 |
1,060 |
$417.60 |
| M0222 |
Bebtelovimab injection |
63 |
42 |
$397.40 |
| 85730 |
|
996 |
795 |
$337.33 |
| 93041 |
|
969 |
866 |
$328.12 |
| J2060 |
Lorazepam injection |
980 |
525 |
$320.98 |
| 87400 |
|
98 |
80 |
$314.66 |
| M0247 |
Sotrovimab infusion |
17 |
13 |
$305.68 |
| 93306 |
|
12 |
12 |
$302.45 |
| 96375 |
|
557 |
434 |
$289.16 |
| 88305 |
|
528 |
455 |
$280.31 |
| 83690 |
|
946 |
774 |
$245.37 |
| 71250 |
|
18 |
13 |
$217.00 |
| 82140 |
|
119 |
67 |
$208.28 |
| 80307 |
|
114 |
102 |
$159.23 |
| J0696 |
Ceftriaxone sodium injection |
818 |
343 |
$115.68 |
| J2405 |
Ondansetron hcl injection |
1,262 |
948 |
$109.80 |
| 86901 |
|
225 |
174 |
$88.61 |
| J2250 |
Inj midazolam hydrochloride |
817 |
670 |
$79.33 |
| 88307 |
|
42 |
38 |
$67.15 |
| J2704 |
Inj, propofol, 10 mg |
805 |
669 |
$51.82 |
| 96360 |
|
32 |
29 |
$50.22 |
| J0131 |
Inj, acetaminophen (nos) |
184 |
163 |
$46.49 |
| 86850 |
|
183 |
146 |
$41.22 |
| J7120 |
Ringers lactate infusion |
229 |
175 |
$33.55 |
| J1630 |
Haloperidol injection |
37 |
25 |
$33.29 |
| G0480 |
Drug test def 1-7 classes |
19 |
16 |
$19.43 |
| J8499 |
Oral prescrip drug non chemo |
156 |
76 |
$14.19 |
| 86900 |
|
207 |
162 |
$13.66 |
| 85027 |
|
139 |
103 |
$5.44 |
| 85007 |
|
92 |
65 |
$3.31 |
| J2001 |
Lidocaine injection |
116 |
93 |
$0.98 |
| 96372 |
|
97 |
77 |
$0.75 |
| J1645 |
Dalteparin sodium |
43 |
32 |
$0.66 |
| J7050 |
Normal saline solution infus |
27 |
24 |
$0.44 |
| 36000 |
|
66 |
54 |
$0.33 |
| 82150 |
|
311 |
237 |
$0.15 |
| 83615 |
|
41 |
33 |
$0.00 |
| 85379 |
|
51 |
40 |
$0.00 |
| J2175 |
Meperidine hydrochl /100 mg |
74 |
60 |
$0.00 |
| 83605 |
|
112 |
82 |
$0.00 |
| 87040 |
|
65 |
52 |
$0.00 |
| Q0247 |
Sotrovimab |
18 |
15 |
$0.00 |
| 84443 |
|
37 |
25 |
$0.00 |
| 82607 |
|
17 |
12 |
$0.00 |
| 82746 |
|
17 |
12 |
$0.00 |
| J1170 |
Hydromorphone injection |
18 |
13 |
$0.00 |
| 83520 |
|
15 |
13 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
34 |
26 |
$0.00 |
| 82948 |
|
40 |
13 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
16 |
13 |
$0.00 |