| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
31,932 |
27,628 |
$3.97M |
| 99283 |
|
52,729 |
45,527 |
$3.40M |
| 99285 |
|
2,309 |
2,060 |
$422K |
| 74177 |
|
1,053 |
937 |
$413K |
| 87635 |
|
10,298 |
9,323 |
$388K |
| 99282 |
|
6,885 |
6,521 |
$326K |
| 87804 |
|
51,597 |
12,993 |
$283K |
| 69436 |
|
808 |
700 |
$259K |
| J2405 |
Ondansetron hcl injection |
7,093 |
6,020 |
$220K |
| 85025 |
|
29,434 |
25,344 |
$167K |
| 71045 |
|
5,958 |
5,071 |
$166K |
| J1885 |
Ketorolac tromethamine inj |
6,417 |
5,696 |
$163K |
| 80053 |
|
19,832 |
17,188 |
$157K |
| 93005 |
|
4,732 |
4,156 |
$155K |
| 87880 |
|
13,252 |
8,709 |
$123K |
| J0696 |
Ceftriaxone sodium injection |
2,391 |
1,983 |
$123K |
| 99213 |
|
3,330 |
2,226 |
$97K |
| 81025 |
|
14,396 |
12,945 |
$92K |
| 74176 |
|
296 |
266 |
$83K |
| 36415 |
|
32,596 |
27,690 |
$65K |
| 59025 |
|
2,023 |
1,152 |
$65K |
| 0202U |
|
1,174 |
1,011 |
$58K |
| 80307 |
|
1,187 |
1,059 |
$57K |
| 81001 |
|
21,993 |
19,148 |
$51K |
| 70450 |
|
370 |
333 |
$49K |
| 42820 |
|
99 |
95 |
$45K |
| 87081 |
|
10,170 |
6,470 |
$40K |
| 87651 |
|
1,101 |
1,009 |
$33K |
| 80048 |
|
5,014 |
4,358 |
$31K |
| J1100 |
Dexamethasone sodium phos |
1,505 |
1,293 |
$30K |
| 87086 |
|
3,929 |
3,519 |
$25K |
| 92507 |
|
703 |
349 |
$21K |
| 97110 |
|
937 |
476 |
$21K |
| J2270 |
Morphine sulfate injection |
1,248 |
942 |
$20K |
| 87420 |
|
2,060 |
1,531 |
$19K |
| 83690 |
|
3,569 |
3,163 |
$19K |
| 71046 |
|
808 |
702 |
$19K |
| 95819 |
|
180 |
173 |
$15K |
| 99214 |
|
293 |
262 |
$13K |
| 84484 |
|
1,424 |
1,132 |
$12K |
| 84145 |
|
647 |
578 |
$12K |
| 97530 |
|
740 |
389 |
$11K |
| 64721 |
|
41 |
39 |
$10K |
| 94640 |
|
613 |
488 |
$10K |
| 81003 |
|
4,417 |
3,835 |
$8K |
| 99281 |
|
330 |
317 |
$8K |
| 83605 |
|
795 |
668 |
$7K |
| 76856 |
|
83 |
77 |
$6K |
| G0378 |
Hospital observation per hr |
22 |
14 |
$6K |
| 86140 |
|
1,251 |
1,157 |
$5K |
| 96413 |
|
192 |
72 |
$4K |
| 82550 |
|
868 |
789 |
$4K |
| 43239 |
|
12 |
12 |
$4K |
| 85730 |
|
1,018 |
911 |
$4K |
| 86160 |
|
608 |
297 |
$4K |
| J2175 |
Meperidine hydrochl /100 mg |
413 |
383 |
$4K |
| 87426 |
|
99 |
89 |
$4K |
| 86038 |
|
314 |
297 |
$3K |
| 85610 |
|
1,073 |
975 |
$3K |
| 87040 |
|
465 |
235 |
$3K |
| J2550 |
Promethazine hcl injection |
240 |
212 |
$3K |
| 83735 |
|
598 |
532 |
$3K |
| 86328 |
|
727 |
617 |
$3K |
| C9803 |
Hopd covid-19 spec collect |
15,409 |
7,619 |
$2K |
| J2930 |
Methylprednisolone injection |
158 |
146 |
$2K |
| 45378 |
|
16 |
12 |
$2K |
| 80050 |
|
63 |
51 |
$2K |
| 84702 |
|
176 |
157 |
$2K |
| 74022 |
|
40 |
39 |
$2K |
| 82306 |
|
84 |
70 |
$2K |
| 82150 |
|
389 |
334 |
$2K |
| 86480 |
|
29 |
29 |
$2K |
| 83880 |
|
54 |
50 |
$2K |
| 85651 |
|
471 |
443 |
$2K |
| 85379 |
|
206 |
192 |
$2K |
| J0780 |
Prochlorperazine injection |
55 |
52 |
$1K |
| 94760 |
|
1,501 |
1,315 |
$1K |
| J1200 |
Diphenhydramine hcl injectio |
30 |
29 |
$1K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
20 |
13 |
$1K |
| U0003 |
Cov-19 amp prb hgh thruput |
14 |
13 |
$1K |
| 76815 |
|
22 |
15 |
$1K |
| 87807 |
|
71 |
63 |
$885.63 |
| 99211 |
|
33 |
25 |
$824.05 |
| 86850 |
|
520 |
407 |
$778.68 |
| 80061 |
|
72 |
59 |
$737.77 |
| J2250 |
Inj midazolam hydrochloride |
719 |
600 |
$732.22 |
| 87186 |
|
95 |
86 |
$663.15 |
| 87077 |
|
94 |
88 |
$652.11 |
| 73620 |
|
23 |
12 |
$638.44 |
| 73560 |
|
23 |
12 |
$638.44 |
| 73130 |
|
23 |
12 |
$638.44 |
| 59430 |
|
16 |
15 |
$597.30 |
| J1170 |
Hydromorphone injection |
240 |
177 |
$589.17 |
| J3010 |
Fentanyl citrate injection |
717 |
602 |
$588.50 |
| 83036 |
|
74 |
59 |
$534.65 |
| 84439 |
|
78 |
64 |
$524.06 |
| 84165 |
|
53 |
53 |
$516.84 |
| 86200 |
|
41 |
41 |
$506.48 |
| 73521 |
|
14 |
12 |
$460.35 |
| Q0162 |
Ondansetron oral |
126 |
123 |
$440.59 |
| 87591 |
|
12 |
12 |
$428.89 |
| 87491 |
|
12 |
12 |
$428.89 |
| 82553 |
|
54 |
45 |
$349.97 |
| 84703 |
|
71 |
60 |
$320.00 |
| 72040 |
|
14 |
12 |
$319.22 |
| 86901 |
|
453 |
355 |
$318.41 |
| 86900 |
|
453 |
355 |
$318.41 |
| 99395 |
|
63 |
62 |
$316.13 |
| C1751 |
Cath, inf, per/cent/midline |
341 |
319 |
$239.04 |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
12 |
12 |
$157.70 |
| 84550 |
|
29 |
29 |
$122.34 |
| C2617 |
Stent, non-cor, tem w/o del |
25 |
12 |
$103.68 |
| 84155 |
|
55 |
53 |
$99.53 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
18 |
15 |
$98.34 |
| 87340 |
|
15 |
15 |
$93.47 |
| J2274 |
Inj morphine pf epid ithc |
18 |
12 |
$81.35 |
| 86431 |
|
14 |
14 |
$79.62 |
| 83615 |
|
14 |
14 |
$78.64 |
| J0690 |
Cefazolin sodium injection |
975 |
622 |
$63.28 |
| J2704 |
Inj, propofol, 10 mg |
85 |
79 |
$45.47 |
| C1769 |
Guide wire |
25 |
12 |
$44.34 |
| G0463 |
Hospital outpt clinic visit |
13 |
13 |
$25.19 |
| 97010 |
|
132 |
39 |
$19.18 |
| A4351 |
Straight tip urine catheter |
352 |
332 |
$8.82 |
| A4314 |
Cath w/drainage 2-way latex |
18 |
12 |
$8.76 |
| G0499 |
Hepb screen high risk indiv |
15 |
15 |
$0.00 |
| C1889 |
Implant/insert device, noc |
505 |
479 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
97 |
42 |
$0.00 |
| A9270 |
Non-covered item or service |
16 |
13 |
$0.00 |
| L8699 |
Prosthetic implant nos |
27 |
27 |
$0.00 |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
45 |
40 |
$0.00 |
| 99152 |
|
168 |
100 |
$0.00 |
| 69990 |
|
119 |
47 |
$0.00 |
| A6402 |
Sterile gauze <= 16 sq in |
15 |
13 |
$0.00 |
| 87339 |
|
12 |
12 |
$0.00 |