| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92507 |
|
22,262 |
6,639 |
$3.81M |
| 97530 |
|
13,233 |
4,309 |
$1.26M |
| 99284 |
|
8,709 |
7,596 |
$1.08M |
| 97110 |
|
8,584 |
2,950 |
$1.00M |
| 99283 |
|
7,591 |
7,044 |
$939K |
| 99285 |
|
6,991 |
5,817 |
$653K |
| 74177 |
|
1,470 |
1,305 |
$246K |
| 70450 |
|
1,452 |
1,243 |
$237K |
| 96361 |
|
2,116 |
1,756 |
$195K |
| U0003 |
Cov-19 amp prb hgh thruput |
2,015 |
1,879 |
$174K |
| 36415 |
|
7,557 |
6,233 |
$157K |
| 74176 |
|
579 |
500 |
$123K |
| 80053 |
|
13,377 |
10,661 |
$123K |
| 41899 |
|
1,115 |
1,061 |
$110K |
| 92523 |
|
619 |
595 |
$89K |
| 96374 |
|
6,949 |
5,323 |
$78K |
| 99282 |
|
522 |
499 |
$67K |
| 71275 |
|
230 |
208 |
$66K |
| 96360 |
|
872 |
749 |
$64K |
| 97168 |
|
400 |
396 |
$64K |
| A9270 |
Non-covered item or service |
2,277 |
800 |
$62K |
| 87502 |
|
4,459 |
4,169 |
$59K |
| 96365 |
|
781 |
554 |
$58K |
| 85025 |
|
16,624 |
13,194 |
$53K |
| 87651 |
|
2,133 |
2,024 |
$51K |
| 80048 |
|
2,905 |
2,338 |
$44K |
| 81001 |
|
7,754 |
6,543 |
$37K |
| 80307 |
|
1,802 |
1,607 |
$32K |
| 71045 |
|
4,044 |
3,511 |
$30K |
| 97161 |
|
151 |
143 |
$30K |
| 87653 |
|
1,233 |
1,164 |
$29K |
| 71046 |
|
2,635 |
2,396 |
$29K |
| 87635 |
|
2,145 |
2,005 |
$27K |
| 81003 |
|
3,145 |
2,703 |
$27K |
| J2405 |
Ondansetron hcl injection |
5,935 |
4,903 |
$27K |
| J3010 |
Fentanyl citrate injection |
2,206 |
1,959 |
$27K |
| 87634 |
|
1,264 |
1,211 |
$26K |
| 76705 |
|
617 |
558 |
$25K |
| 97165 |
|
155 |
150 |
$25K |
| G0463 |
Hospital outpt clinic visit |
359 |
266 |
$24K |
| 93005 |
|
3,495 |
2,847 |
$22K |
| 96372 |
|
1,849 |
1,537 |
$22K |
| 84484 |
|
2,862 |
2,122 |
$22K |
| 96375 |
|
4,611 |
3,507 |
$21K |
| J7120 |
Ringers lactate infusion |
2,792 |
2,050 |
$21K |
| J2001 |
Lidocaine injection |
1,624 |
1,424 |
$21K |
| J2250 |
Inj midazolam hydrochloride |
948 |
803 |
$20K |
| 94640 |
|
796 |
615 |
$20K |
| 83735 |
|
3,273 |
2,519 |
$18K |
| J2704 |
Inj, propofol, 10 mg |
2,157 |
1,924 |
$17K |
| J1170 |
Hydromorphone injection |
3,101 |
2,058 |
$17K |
| 76801 |
|
678 |
554 |
$16K |
| 87637 |
|
151 |
145 |
$14K |
| 87798 |
|
327 |
308 |
$14K |
| 99281 |
|
119 |
109 |
$14K |
| 82962 |
|
1,249 |
834 |
$13K |
| 86762 |
|
370 |
344 |
$12K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
2,113 |
1,846 |
$12K |
| 87070 |
|
239 |
223 |
$12K |
| 85027 |
|
1,494 |
1,230 |
$11K |
| 84443 |
|
2,416 |
2,169 |
$11K |
| 83690 |
|
4,199 |
3,540 |
$11K |
| 87086 |
|
3,788 |
3,331 |
$11K |
| 86850 |
|
1,266 |
1,102 |
$11K |
| J1100 |
Dexamethasone sodium phos |
2,642 |
2,398 |
$10K |
| 43239 |
|
49 |
43 |
$10K |
| 96376 |
|
1,602 |
1,136 |
$10K |
| 87491 |
|
1,824 |
1,663 |
$10K |
| 85610 |
|
1,393 |
1,132 |
$10K |
| 01999 |
|
1,926 |
1,675 |
$10K |
| 84703 |
|
3,097 |
2,753 |
$10K |
| 86900 |
|
2,353 |
2,017 |
$9K |
| J2270 |
Morphine sulfate injection |
1,257 |
998 |
$9K |
| J1885 |
Ketorolac tromethamine inj |
3,731 |
3,236 |
$9K |
| 83880 |
|
1,302 |
1,063 |
$8K |
| 97164 |
|
68 |
66 |
$8K |
| 86140 |
|
2,600 |
2,287 |
$8K |
| U0002 |
Covid-19 lab test non-cdc |
1,214 |
1,118 |
$8K |
| 87591 |
|
1,803 |
1,653 |
$8K |
| 84439 |
|
643 |
592 |
$8K |
| G0378 |
Hospital observation per hr |
331 |
171 |
$8K |
| J0690 |
Cefazolin sodium injection |
1,596 |
1,393 |
$8K |
| 87077 |
|
1,570 |
1,396 |
$6K |
| 97162 |
|
46 |
39 |
$6K |
| 93306 |
|
28 |
26 |
$6K |
| J7030 |
Normal saline solution infus |
450 |
368 |
$6K |
| 86901 |
|
2,351 |
2,018 |
$6K |
| 83036 |
|
711 |
629 |
$5K |
| 92526 |
|
139 |
72 |
$5K |
| J3490 |
Drugs unclassified injection |
219 |
142 |
$4K |
| 80061 |
|
1,238 |
1,095 |
$4K |
| 87040 |
|
802 |
692 |
$4K |
| 83605 |
|
586 |
474 |
$4K |
| 87186 |
|
920 |
820 |
$4K |
| J0696 |
Ceftriaxone sodium injection |
1,321 |
1,074 |
$4K |
| 84702 |
|
1,444 |
1,067 |
$4K |
| 82728 |
|
193 |
178 |
$3K |
| 80076 |
|
409 |
366 |
$3K |
| 85730 |
|
646 |
558 |
$3K |
| 73610 |
|
44 |
38 |
$2K |
| 93971 |
|
30 |
25 |
$2K |
| 86803 |
|
775 |
705 |
$2K |
| 76805 |
|
26 |
26 |
$2K |
| 82306 |
|
565 |
504 |
$2K |
| 99234 |
|
59 |
26 |
$2K |
| 72125 |
|
47 |
38 |
$2K |
| J2550 |
Promethazine hcl injection |
588 |
419 |
$2K |
| 76641 |
|
40 |
32 |
$1K |
| 87389 |
|
718 |
659 |
$1K |
| 76817 |
|
282 |
227 |
$1K |
| 77063 |
|
64 |
60 |
$1K |
| 82950 |
|
462 |
445 |
$1K |
| 77067 |
|
64 |
60 |
$1K |
| 87340 |
|
630 |
574 |
$1K |
| 97140 |
|
54 |
26 |
$1K |
| 76815 |
|
46 |
41 |
$1K |
| 87486 |
|
30 |
28 |
$1K |
| 76856 |
|
79 |
71 |
$1K |
| 74018 |
|
59 |
54 |
$905.37 |
| 83540 |
|
258 |
239 |
$897.70 |
| 85379 |
|
399 |
351 |
$848.13 |
| 82570 |
|
1,023 |
770 |
$842.34 |
| 85652 |
|
586 |
508 |
$827.68 |
| 82607 |
|
137 |
125 |
$706.19 |
| J0330 |
Succinycholine chloride inj |
179 |
161 |
$667.11 |
| 71260 |
|
42 |
38 |
$646.63 |
| 73630 |
|
70 |
65 |
$589.55 |
| 84156 |
|
859 |
613 |
$505.21 |
| 76830 |
|
15 |
12 |
$454.93 |
| P9604 |
One-way allow prorated trip |
381 |
217 |
$435.18 |
| 84112 |
|
29 |
24 |
$364.22 |
| 82565 |
|
58 |
43 |
$358.40 |
| 73030 |
|
14 |
12 |
$258.75 |
| J1200 |
Diphenhydramine hcl injectio |
203 |
139 |
$234.23 |
| 84550 |
|
660 |
503 |
$229.97 |
| 83615 |
|
670 |
513 |
$225.60 |
| 82550 |
|
50 |
37 |
$223.70 |
| 87210 |
|
732 |
676 |
$216.07 |
| 84466 |
|
136 |
130 |
$123.31 |
| 86592 |
|
734 |
668 |
$117.07 |
| 87581 |
|
30 |
28 |
$51.13 |
| 87633 |
|
30 |
28 |
$51.13 |
| U0005 |
Infec agen detec ampli probe |
941 |
910 |
$50.48 |
| 84450 |
|
52 |
39 |
$25.71 |
| 84460 |
|
50 |
37 |
$25.71 |
| 73564 |
|
32 |
25 |
$25.13 |
| 82746 |
|
32 |
27 |
$17.24 |
| 84520 |
|
43 |
29 |
$13.80 |
| 83550 |
|
124 |
118 |
$0.00 |
| J0561 |
Penicillin g benzathine inj |
13 |
13 |
$0.00 |
| Q0162 |
Ondansetron oral |
70 |
58 |
$0.00 |
| J7620 |
Albuterol ipratrop non-comp |
82 |
70 |
$0.00 |
| D9420 |
|
88 |
87 |
$0.00 |
| 3044F |
|
61 |
59 |
$0.00 |
| J2060 |
Lorazepam injection |
79 |
67 |
$0.00 |
| 99211 |
|
51 |
39 |
$0.00 |
| J7040 |
Normal saline solution infus |
125 |
111 |
$0.00 |
| 81025 |
|
19 |
18 |
$0.00 |