| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
|
34,525 |
30,370 |
$1.32M |
| 74177 |
|
2,382 |
2,073 |
$358K |
| 70450 |
|
4,243 |
3,862 |
$310K |
| 96374 |
|
7,527 |
6,199 |
$286K |
| 93005 |
|
14,742 |
12,660 |
$239K |
| U0002 |
Covid-19 lab test non-cdc |
6,003 |
5,275 |
$202K |
| 99285 |
|
1,190 |
1,006 |
$193K |
| 96375 |
|
5,955 |
4,790 |
$161K |
| 80053 |
|
14,957 |
12,904 |
$157K |
| 74176 |
|
1,573 |
1,447 |
$155K |
| 85025 |
|
23,617 |
19,441 |
$139K |
| 76700 |
|
1,994 |
1,832 |
$116K |
| A0429 |
Bls-emergency |
2,967 |
1,827 |
$114K |
| 96365 |
|
2,187 |
1,872 |
$109K |
| 99199 |
|
1,979 |
1,824 |
$103K |
| 99284 |
|
1,563 |
1,375 |
$100K |
| 80307 |
|
2,252 |
1,934 |
$97K |
| 96361 |
|
5,155 |
4,151 |
$95K |
| 96372 |
|
5,106 |
4,122 |
$91K |
| 87502 |
|
1,863 |
1,760 |
$91K |
| 84484 |
|
10,788 |
8,885 |
$90K |
| 80048 |
|
9,651 |
8,083 |
$80K |
| J3490 |
Drugs unclassified injection |
10,238 |
7,059 |
$73K |
| 71045 |
|
8,147 |
7,257 |
$70K |
| 99283 |
|
2,020 |
1,808 |
$66K |
| 71046 |
|
4,170 |
3,840 |
$65K |
| J7030 |
Normal saline solution infus |
8,754 |
6,820 |
$56K |
| 96360 |
|
1,409 |
1,248 |
$54K |
| 0250 |
|
1,792 |
1,263 |
$50K |
| 99281 |
|
875 |
734 |
$45K |
| 83880 |
|
2,479 |
2,175 |
$43K |
| 83690 |
|
7,732 |
6,613 |
$42K |
| 72125 |
|
422 |
384 |
$41K |
| 93971 |
|
542 |
509 |
$39K |
| 0270 |
|
11,445 |
6,809 |
$38K |
| 76856 |
|
816 |
753 |
$37K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
3,608 |
3,065 |
$35K |
| 81001 |
|
11,497 |
10,057 |
$33K |
| J2405 |
Ondansetron hcl injection |
5,909 |
4,671 |
$31K |
| J1885 |
Ketorolac tromethamine inj |
4,935 |
4,171 |
$27K |
| 93970 |
|
292 |
269 |
$27K |
| 87040 |
|
2,229 |
1,669 |
$26K |
| J2270 |
Morphine sulfate injection |
3,926 |
2,850 |
$25K |
| 87086 |
|
3,468 |
3,050 |
$21K |
| 0272 |
|
4,319 |
2,942 |
$21K |
| 81025 |
|
4,424 |
3,997 |
$20K |
| 83605 |
|
2,440 |
1,975 |
$17K |
| 76830 |
|
351 |
331 |
$16K |
| 87631 |
|
360 |
352 |
$16K |
| J7050 |
Normal saline solution infus |
4,241 |
3,242 |
$16K |
| 84703 |
|
3,618 |
3,257 |
$15K |
| J1100 |
Dexamethasone sodium phos |
1,799 |
1,476 |
$15K |
| 80076 |
|
2,313 |
2,056 |
$14K |
| J0696 |
Ceftriaxone sodium injection |
1,402 |
1,130 |
$14K |
| 0360 |
|
739 |
316 |
$13K |
| 94664 |
|
1,159 |
970 |
$12K |
| 84443 |
|
1,005 |
902 |
$11K |
| 87400 |
|
1,077 |
873 |
$11K |
| 96376 |
|
866 |
629 |
$10K |
| 83735 |
|
2,513 |
2,021 |
$10K |
| 87077 |
|
1,744 |
1,518 |
$10K |
| A9270 |
Non-covered item or service |
1,758 |
1,080 |
$10K |
| 76770 |
|
118 |
111 |
$8K |
| 76705 |
|
123 |
117 |
$8K |
| 87186 |
|
1,021 |
892 |
$8K |
| 90715 |
|
273 |
256 |
$8K |
| 85610 |
|
3,036 |
2,575 |
$8K |
| Z9725 |
|
253 |
253 |
$8K |
| 73564 |
|
389 |
363 |
$7K |
| 73630 |
|
399 |
373 |
$7K |
| J8499 |
Oral prescrip drug non chemo |
1,959 |
1,057 |
$7K |
| 87430 |
|
991 |
949 |
$7K |
| 82962 |
|
3,366 |
1,673 |
$7K |
| 85730 |
|
2,000 |
1,708 |
$7K |
| U0003 |
Cov-19 amp prb hgh thruput |
137 |
110 |
$6K |
| 71275 |
|
46 |
38 |
$6K |
| 73610 |
|
269 |
255 |
$6K |
| 85379 |
|
692 |
608 |
$6K |
| 72100 |
|
287 |
267 |
$6K |
| A4216 |
Sterile water/saline, 10 ml |
1,776 |
1,347 |
$5K |
| 87801 |
|
231 |
216 |
$5K |
| J1200 |
Diphenhydramine hcl injectio |
1,206 |
979 |
$5K |
| 73030 |
|
321 |
302 |
$5K |
| J0690 |
Cefazolin sodium injection |
444 |
326 |
$5K |
| J2704 |
Inj, propofol, 10 mg |
742 |
558 |
$4K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
230 |
190 |
$4K |
| 73130 |
|
248 |
234 |
$4K |
| J7040 |
Normal saline solution infus |
1,017 |
849 |
$3K |
| J2765 |
Metoclopramide hcl injection |
721 |
576 |
$3K |
| 94760 |
|
528 |
415 |
$3K |
| 94640 |
|
233 |
163 |
$3K |
| G0463 |
Hospital outpt clinic visit |
94 |
80 |
$3K |
| 0001A |
|
69 |
69 |
$3K |
| 87081 |
|
643 |
614 |
$3K |
| J2060 |
Lorazepam injection |
603 |
438 |
$3K |
| Z7502 |
|
68 |
67 |
$3K |
| J1170 |
Hydromorphone injection |
450 |
275 |
$2K |
| 84100 |
|
627 |
508 |
$2K |
| J3010 |
Fentanyl citrate injection |
838 |
632 |
$2K |
| 85027 |
|
486 |
436 |
$2K |
| 84702 |
|
294 |
251 |
$2K |
| 0710 |
|
674 |
531 |
$2K |
| 86901 |
|
855 |
749 |
$2K |
| 86900 |
|
803 |
701 |
$2K |
| 71020 |
|
55 |
49 |
$2K |
| 76801 |
|
44 |
39 |
$1K |
| 0011A |
|
32 |
32 |
$1K |
| A4217 |
Sterile water/saline, 500 ml |
245 |
228 |
$1K |
| J7120 |
Ringers lactate infusion |
188 |
162 |
$1K |
| 0160 |
|
226 |
82 |
$1K |
| 90471 |
|
274 |
255 |
$1K |
| 87070 |
|
34 |
26 |
$968.84 |
| 88305 |
|
86 |
76 |
$911.59 |
| 11042 |
|
32 |
13 |
$823.98 |
| J2250 |
Inj midazolam hydrochloride |
409 |
305 |
$799.32 |
| 71010 |
|
40 |
29 |
$758.46 |
| 80306 |
|
61 |
57 |
$701.13 |
| 36415 |
|
1,146 |
980 |
$663.05 |
| 0012A |
|
15 |
15 |
$600.00 |
| 0320 |
|
124 |
107 |
$498.75 |
| 87591 |
|
44 |
43 |
$348.82 |
| 86850 |
|
115 |
102 |
$320.76 |
| 82550 |
|
49 |
38 |
$263.80 |
| S0164 |
Injection pantroprazole |
35 |
26 |
$234.36 |
| 73110 |
|
15 |
14 |
$209.69 |
| 0761 |
|
33 |
26 |
$192.84 |
| S0020 |
Injection, bupivicaine hydro |
56 |
29 |
$163.02 |
| 84439 |
|
19 |
16 |
$117.39 |
| 87491 |
|
12 |
12 |
$110.10 |
| 87420 |
|
51 |
49 |
$105.06 |
| 29125 |
|
13 |
13 |
$98.92 |
| 99070 |
|
40 |
25 |
$81.80 |
| J2930 |
Methylprednisolone injection |
14 |
12 |
$76.24 |
| J2175 |
Meperidine hydrochl /100 mg |
13 |
12 |
$74.90 |
| A9150 |
Misc/exper non-prescript dru |
432 |
260 |
$2.32 |
| J7611 |
Albuterol non-comp con |
13 |
13 |
$2.31 |
| 0255 |
|
13 |
13 |
$0.00 |
| 0350 |
|
59 |
50 |
$0.00 |
| 0370 |
|
15 |
15 |
$0.00 |
| 0258 |
|
14 |
14 |
$0.00 |
| 0636 |
|
80 |
50 |
$0.00 |
| 0300 |
|
779 |
133 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
26 |
15 |
$0.00 |