| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 80053 |
|
11,855 |
9,835 |
$548K |
| 0241U |
|
2,940 |
2,709 |
$388K |
| 70450 |
|
2,275 |
1,944 |
$316K |
| 97110 |
|
7,237 |
1,786 |
$245K |
| 80048 |
|
5,028 |
4,220 |
$237K |
| U0003 |
Cov-19 amp prb hgh thruput |
2,351 |
2,130 |
$220K |
| 74177 |
|
1,316 |
1,155 |
$197K |
| 85025 |
|
15,320 |
12,357 |
$100K |
| 96365 |
|
1,642 |
1,343 |
$74K |
| 80050 |
|
1,593 |
1,518 |
$74K |
| 80076 |
|
2,016 |
1,773 |
$71K |
| 74176 |
|
788 |
705 |
$71K |
| 96372 |
|
2,877 |
2,355 |
$51K |
| 36415 |
|
7,781 |
6,477 |
$45K |
| 71046 |
|
2,436 |
2,076 |
$41K |
| 93005 |
|
4,136 |
3,443 |
$40K |
| 96374 |
|
2,955 |
2,487 |
$36K |
| 84484 |
|
3,507 |
2,664 |
$36K |
| 87804 |
|
1,750 |
1,531 |
$35K |
| 80061 |
|
3,140 |
2,933 |
$34K |
| 96361 |
|
1,364 |
1,053 |
$34K |
| 84443 |
|
3,383 |
3,110 |
$31K |
| 80307 |
|
570 |
476 |
$31K |
| 87637 |
|
369 |
330 |
$31K |
| 83880 |
|
1,674 |
1,412 |
$30K |
| 87880 |
|
2,372 |
2,226 |
$30K |
| 87651 |
|
586 |
566 |
$28K |
| 72148 |
|
75 |
66 |
$27K |
| 71045 |
|
3,727 |
3,178 |
$27K |
| 83605 |
|
2,528 |
1,933 |
$27K |
| 96375 |
|
2,059 |
1,630 |
$25K |
| 82550 |
|
2,929 |
2,404 |
$23K |
| 80305 |
|
1,726 |
1,512 |
$22K |
| 72100 |
|
524 |
459 |
$19K |
| 87088 |
|
2,472 |
2,172 |
$19K |
| 87040 |
|
2,427 |
1,365 |
$19K |
| C9803 |
Hopd covid-19 spec collect |
5,062 |
4,548 |
$19K |
| 83690 |
|
2,372 |
2,086 |
$18K |
| J2405 |
Ondansetron hcl injection |
3,534 |
2,812 |
$18K |
| 81025 |
|
1,851 |
1,644 |
$18K |
| 87631 |
|
261 |
233 |
$18K |
| 81001 |
|
4,873 |
4,155 |
$16K |
| 87426 |
|
387 |
354 |
$15K |
| 72125 |
|
135 |
119 |
$13K |
| 83036 |
|
1,538 |
1,479 |
$12K |
| 43239 |
|
107 |
81 |
$12K |
| U0002 |
Covid-19 lab test non-cdc |
319 |
221 |
$12K |
| 85027 |
|
1,907 |
1,602 |
$11K |
| 82150 |
|
1,354 |
1,221 |
$10K |
| 99283 |
|
903 |
724 |
$10K |
| 82077 |
|
555 |
463 |
$10K |
| 83735 |
|
1,567 |
1,313 |
$9K |
| 99284 |
|
1,413 |
1,171 |
$9K |
| 81003 |
|
4,245 |
3,802 |
$8K |
| J1885 |
Ketorolac tromethamine inj |
2,885 |
2,301 |
$7K |
| J1100 |
Dexamethasone sodium phos |
1,223 |
1,061 |
$7K |
| 87077 |
|
845 |
759 |
$7K |
| 97032 |
|
306 |
63 |
$6K |
| 77067 |
|
125 |
112 |
$6K |
| 96376 |
|
231 |
167 |
$6K |
| 87086 |
|
876 |
796 |
$6K |
| 80179 |
|
295 |
244 |
$6K |
| 73630 |
|
185 |
169 |
$6K |
| 85610 |
|
2,128 |
1,738 |
$5K |
| 80143 |
|
280 |
239 |
$5K |
| J0696 |
Ceftriaxone sodium injection |
1,399 |
1,177 |
$5K |
| 82962 |
|
595 |
315 |
$5K |
| 94640 |
|
1,058 |
844 |
$5K |
| 82803 |
|
277 |
214 |
$4K |
| 80306 |
|
221 |
167 |
$4K |
| 97161 |
|
80 |
72 |
$4K |
| 88305 |
|
12 |
12 |
$4K |
| 73560 |
|
137 |
107 |
$4K |
| 87186 |
|
798 |
716 |
$3K |
| 82306 |
|
147 |
134 |
$3K |
| 73721 |
|
18 |
14 |
$3K |
| 85379 |
|
345 |
311 |
$3K |
| 73610 |
|
114 |
107 |
$3K |
| 97001 |
|
112 |
88 |
$3K |
| 87420 |
|
172 |
169 |
$2K |
| 82607 |
|
185 |
170 |
$2K |
| 71020 |
|
206 |
180 |
$2K |
| 82375 |
|
277 |
218 |
$2K |
| 72040 |
|
67 |
56 |
$2K |
| 74018 |
|
123 |
110 |
$2K |
| 71275 |
|
12 |
12 |
$2K |
| 86803 |
|
135 |
127 |
$2K |
| 80320 |
|
106 |
75 |
$2K |
| 72131 |
|
14 |
14 |
$2K |
| 86900 |
|
31 |
23 |
$1K |
| J2704 |
Inj, propofol, 10 mg |
1,312 |
1,105 |
$1K |
| 80069 |
|
168 |
151 |
$1K |
| 82805 |
|
65 |
48 |
$1K |
| 96360 |
|
101 |
82 |
$1K |
| 73110 |
|
27 |
26 |
$1K |
| 73030 |
|
63 |
57 |
$1K |
| 87502 |
|
21 |
18 |
$997.65 |
| 85730 |
|
267 |
242 |
$928.85 |
| 73562 |
|
12 |
12 |
$861.21 |
| 80329 |
|
44 |
31 |
$792.66 |
| J7040 |
Normal saline solution infus |
603 |
539 |
$774.79 |
| 99285 |
|
52 |
40 |
$750.50 |
| 82248 |
|
152 |
137 |
$747.20 |
| 82947 |
|
158 |
105 |
$660.51 |
| 76830 |
|
13 |
12 |
$635.80 |
| 85007 |
|
233 |
190 |
$609.29 |
| 74019 |
|
35 |
29 |
$599.85 |
| 71010 |
|
102 |
95 |
$585.00 |
| J2001 |
Lidocaine injection |
973 |
783 |
$573.05 |
| 84450 |
|
127 |
107 |
$558.78 |
| 84460 |
|
122 |
103 |
$542.19 |
| 74022 |
|
26 |
24 |
$518.27 |
| J7030 |
Normal saline solution infus |
2,060 |
1,698 |
$511.19 |
| 36600 |
|
292 |
243 |
$488.56 |
| 73502 |
|
15 |
12 |
$460.70 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
174 |
128 |
$450.29 |
| J2270 |
Morphine sulfate injection |
1,456 |
1,169 |
$428.27 |
| 84703 |
|
27 |
27 |
$358.20 |
| 86901 |
|
31 |
23 |
$357.00 |
| 87661 |
|
21 |
20 |
$342.27 |
| 85055 |
|
26 |
25 |
$333.02 |
| 77063 |
|
13 |
13 |
$280.12 |
| 94760 |
|
25 |
24 |
$280.00 |
| 87389 |
|
31 |
29 |
$278.11 |
| J7050 |
Normal saline solution infus |
2,888 |
1,699 |
$238.17 |
| 82247 |
|
46 |
32 |
$216.50 |
| 82728 |
|
28 |
24 |
$211.68 |
| J1170 |
Hydromorphone injection |
459 |
359 |
$198.01 |
| 87807 |
|
14 |
13 |
$187.34 |
| J2060 |
Lorazepam injection |
75 |
56 |
$183.68 |
| 73130 |
|
16 |
13 |
$183.54 |
| 87400 |
|
14 |
13 |
$149.44 |
| 84075 |
|
32 |
26 |
$141.86 |
| U0005 |
Infec agen detec ampli probe |
1,653 |
1,512 |
$126.00 |
| 86140 |
|
13 |
12 |
$118.53 |
| 90471 |
|
13 |
13 |
$115.22 |
| J0690 |
Cefazolin sodium injection |
200 |
157 |
$109.05 |
| J3010 |
Fentanyl citrate injection |
340 |
294 |
$100.22 |
| 86780 |
|
17 |
17 |
$93.20 |
| 87070 |
|
23 |
22 |
$77.12 |
| 87340 |
|
14 |
14 |
$70.32 |
| J2272 |
Inj, morphine (fresenius) |
80 |
74 |
$64.04 |
| 87798 |
|
21 |
17 |
$60.00 |
| J2250 |
Inj midazolam hydrochloride |
163 |
133 |
$50.65 |
| 86762 |
|
14 |
14 |
$48.99 |
| 87205 |
|
18 |
17 |
$32.15 |
| A9270 |
Non-covered item or service |
2,585 |
701 |
$25.45 |
| 82746 |
|
17 |
13 |
$21.00 |
| 81015 |
|
36 |
34 |
$20.77 |
| J7120 |
Ringers lactate infusion |
1,179 |
864 |
$13.77 |
| 85652 |
|
20 |
13 |
$11.55 |
| J2550 |
Promethazine hcl injection |
72 |
52 |
$6.21 |
| G1004 |
Cdsm ndsc |
422 |
302 |
$1.17 |
| J1200 |
Diphenhydramine hcl injectio |
16 |
13 |
$0.60 |
| G8979 |
Mobility goal status |
18 |
13 |
$0.08 |
| 0353U |
|
34 |
30 |
$0.00 |
| 86850 |
|
27 |
21 |
$0.00 |
| G0103 |
Psa screening |
13 |
12 |
$0.00 |