| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
|
36,650 |
32,747 |
$499K |
| A0429 |
Bls-emergency |
6,272 |
5,117 |
$358K |
| 96374 |
|
6,854 |
6,112 |
$314K |
| Z7502 |
|
7,004 |
6,867 |
$265K |
| G0480 |
Drug test def 1-7 classes |
4,973 |
4,079 |
$217K |
| 74176 |
|
2,292 |
2,103 |
$209K |
| 70450 |
|
2,962 |
2,762 |
$174K |
| 74177 |
|
767 |
713 |
$150K |
| 80053 |
|
15,688 |
14,180 |
$121K |
| 96375 |
|
4,587 |
3,953 |
$119K |
| 85025 |
|
17,942 |
16,048 |
$117K |
| 93005 |
|
7,844 |
7,082 |
$114K |
| 96372 |
|
5,724 |
5,046 |
$110K |
| J3490 |
Drugs unclassified injection |
13,171 |
9,011 |
$77K |
| 99199 |
|
1,351 |
1,270 |
$74K |
| 96365 |
|
1,574 |
1,401 |
$71K |
| 96361 |
|
4,273 |
3,697 |
$68K |
| 71045 |
|
6,464 |
5,916 |
$55K |
| 87426 |
|
1,792 |
1,650 |
$49K |
| J7030 |
Normal saline solution infus |
7,714 |
6,549 |
$46K |
| 0360 |
|
2,273 |
1,322 |
$37K |
| 84484 |
|
5,053 |
4,452 |
$36K |
| J1885 |
Ketorolac tromethamine inj |
6,856 |
5,972 |
$35K |
| 73630 |
|
1,519 |
1,344 |
$35K |
| 83690 |
|
6,834 |
6,207 |
$34K |
| 96360 |
|
904 |
816 |
$33K |
| 81025 |
|
12,181 |
11,122 |
$33K |
| 83880 |
|
1,386 |
1,252 |
$30K |
| 87631 |
|
800 |
732 |
$25K |
| J2405 |
Ondansetron hcl injection |
5,510 |
4,815 |
$24K |
| 76705 |
|
653 |
594 |
$23K |
| 83605 |
|
2,631 |
2,330 |
$21K |
| Z7500 |
|
616 |
505 |
$21K |
| 99283 |
|
2,203 |
2,042 |
$20K |
| 81001 |
|
9,171 |
8,424 |
$19K |
| 80048 |
|
2,681 |
2,443 |
$14K |
| 0270 |
|
13,668 |
8,512 |
$14K |
| 87086 |
|
2,216 |
2,049 |
$13K |
| 87804 |
|
1,558 |
1,263 |
$13K |
| 90715 |
|
427 |
405 |
$11K |
| 71046 |
|
800 |
765 |
$11K |
| J2270 |
Morphine sulfate injection |
1,667 |
1,462 |
$10K |
| 0710 |
|
1,517 |
1,423 |
$10K |
| J0696 |
Ceftriaxone sodium injection |
1,784 |
1,612 |
$10K |
| U0003 |
Cov-19 amp prb hgh thruput |
186 |
163 |
$10K |
| Z9725 |
|
217 |
213 |
$9K |
| Z7610 |
|
878 |
720 |
$9K |
| 73610 |
|
578 |
564 |
$9K |
| 87635 |
|
332 |
291 |
$8K |
| J7120 |
Ringers lactate infusion |
1,084 |
951 |
$7K |
| 83735 |
|
1,426 |
1,291 |
$7K |
| J0690 |
Cefazolin sodium injection |
1,153 |
1,059 |
$7K |
| 82948 |
|
2,433 |
2,015 |
$7K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
767 |
691 |
$7K |
| 72125 |
|
76 |
69 |
$6K |
| 87040 |
|
747 |
612 |
$6K |
| 76700 |
|
128 |
125 |
$6K |
| J2704 |
Inj, propofol, 10 mg |
1,424 |
1,302 |
$6K |
| 85610 |
|
2,287 |
2,098 |
$6K |
| 76856 |
|
154 |
139 |
$6K |
| 85027 |
|
1,015 |
947 |
$6K |
| 73564 |
|
274 |
263 |
$5K |
| 94640 |
|
370 |
279 |
$5K |
| 85730 |
|
1,344 |
1,247 |
$5K |
| 82150 |
|
1,146 |
1,078 |
$4K |
| J7050 |
Normal saline solution infus |
1,034 |
769 |
$4K |
| 59025 |
|
223 |
53 |
$4K |
| 88305 |
|
382 |
373 |
$4K |
| J2175 |
Meperidine hydrochl /100 mg |
375 |
368 |
$4K |
| J3010 |
Fentanyl citrate injection |
872 |
816 |
$4K |
| J0131 |
Inj, acetaminophen (nos) |
376 |
356 |
$4K |
| J1100 |
Dexamethasone sodium phos |
903 |
770 |
$3K |
| 87186 |
|
458 |
417 |
$3K |
| 76801 |
|
84 |
77 |
$3K |
| J1200 |
Diphenhydramine hcl injectio |
716 |
638 |
$3K |
| 99284 |
|
233 |
225 |
$3K |
| J2930 |
Methylprednisolone injection |
289 |
251 |
$3K |
| 84702 |
|
494 |
434 |
$3K |
| 86900 |
|
1,176 |
1,078 |
$3K |
| 87650 |
|
230 |
221 |
$3K |
| 73130 |
|
165 |
160 |
$2K |
| 86901 |
|
1,178 |
1,079 |
$2K |
| 80307 |
|
66 |
59 |
$2K |
| J2250 |
Inj midazolam hydrochloride |
621 |
585 |
$2K |
| S0020 |
Injection, bupivicaine hydro |
237 |
230 |
$2K |
| 85380 |
|
512 |
467 |
$2K |
| 80305 |
|
182 |
169 |
$2K |
| 76811 |
|
24 |
12 |
$2K |
| 84703 |
|
738 |
687 |
$2K |
| 88304 |
|
211 |
200 |
$2K |
| 82550 |
|
445 |
406 |
$2K |
| 94664 |
|
319 |
266 |
$2K |
| J2765 |
Metoclopramide hcl injection |
302 |
266 |
$2K |
| J2060 |
Lorazepam injection |
326 |
270 |
$1K |
| 0160 |
|
43 |
36 |
$1K |
| 73030 |
|
39 |
39 |
$1K |
| 84443 |
|
94 |
88 |
$1K |
| 76817 |
|
26 |
25 |
$1K |
| 76815 |
|
18 |
13 |
$1K |
| 86850 |
|
361 |
336 |
$949.32 |
| 0250 |
|
703 |
522 |
$929.08 |
| 73110 |
|
69 |
69 |
$843.95 |
| 96366 |
|
17 |
12 |
$711.93 |
| 43239 |
|
16 |
16 |
$671.95 |
| J7040 |
Normal saline solution infus |
133 |
104 |
$619.69 |
| J0330 |
Succinycholine chloride inj |
28 |
26 |
$613.86 |
| 93971 |
|
13 |
13 |
$611.28 |
| 45378 |
|
12 |
12 |
$576.00 |
| S0164 |
Injection pantroprazole |
57 |
39 |
$541.22 |
| 87077 |
|
60 |
54 |
$534.81 |
| 81003 |
|
269 |
261 |
$503.53 |
| 0300 |
|
1,016 |
296 |
$447.65 |
| A4217 |
Sterile water/saline, 500 ml |
66 |
62 |
$375.76 |
| 74018 |
|
38 |
38 |
$358.16 |
| J1170 |
Hydromorphone injection |
75 |
57 |
$312.78 |
| 90471 |
|
88 |
84 |
$298.77 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
34 |
34 |
$258.77 |
| 72100 |
|
13 |
13 |
$250.29 |
| 12001 |
|
32 |
32 |
$216.00 |
| 96376 |
|
15 |
13 |
$182.15 |
| 0762 |
|
246 |
224 |
$175.41 |
| 12011 |
|
14 |
14 |
$144.00 |
| 0100U |
|
97 |
74 |
$137.39 |
| 87070 |
|
17 |
13 |
$134.54 |
| 36415 |
|
2,534 |
2,307 |
$77.38 |
| J7060 |
5% dextrose/water |
12 |
12 |
$69.52 |
| 29125 |
|
37 |
37 |
$65.00 |
| 71010 |
|
12 |
12 |
$59.56 |
| C9113 |
Inj pantoprazole sodium, via |
15 |
13 |
$52.05 |
| 87420 |
|
15 |
13 |
$36.81 |
| 99285 |
|
14 |
13 |
$11.14 |
| 99001 |
|
761 |
701 |
$11.02 |
| J7620 |
Albuterol ipratrop non-comp |
112 |
102 |
$6.94 |
| Q0162 |
Ondansetron oral |
33 |
33 |
$3.28 |
| 0260 |
|
125 |
92 |
$0.00 |
| 0760 |
|
352 |
249 |
$0.00 |
| 99281 |
|
82 |
46 |
$0.00 |
| 0351 |
|
15 |
14 |
$0.00 |
| 0402 |
|
31 |
27 |
$0.00 |
| 0320 |
|
57 |
43 |
$0.00 |
| 0272 |
|
16 |
14 |
$0.00 |
| 80329 |
|
78 |
72 |
$0.00 |
| 0324 |
|
77 |
72 |
$0.00 |
| J2001 |
Lidocaine injection |
12 |
12 |
$0.00 |
| 0636 |
|
133 |
80 |
$0.00 |
| 0352 |
|
13 |
13 |
$0.00 |