| Code | Description | Claims | Beneficiaries | Total Paid |
| 0450 |
|
91,811 |
81,388 |
$4.65M |
| 99199 |
|
30,652 |
26,980 |
$1.47M |
| 0360 |
|
8,496 |
6,936 |
$1.10M |
| 70450 |
|
8,111 |
7,891 |
$1.01M |
| 74177 |
|
4,438 |
4,330 |
$824K |
| 80307 |
|
14,559 |
13,578 |
$769K |
| 80053 |
|
54,287 |
48,008 |
$562K |
| 0270 |
|
26,977 |
17,602 |
$544K |
| U0002 |
Covid-19 lab test non-cdc |
11,144 |
10,767 |
$529K |
| 74176 |
|
4,713 |
4,606 |
$441K |
| 96372 |
|
18,742 |
16,775 |
$421K |
| 85025 |
|
60,375 |
52,803 |
$416K |
| 71046 |
|
20,783 |
20,013 |
$406K |
| 87502 |
|
5,150 |
5,033 |
$388K |
| 0760 |
|
12,153 |
10,087 |
$383K |
| 93005 |
|
18,503 |
17,236 |
$369K |
| 0761 |
|
13,418 |
11,369 |
$352K |
| 96374 |
|
7,304 |
6,707 |
$326K |
| G0480 |
Drug test def 1-7 classes |
6,207 |
5,596 |
$324K |
| C9803 |
Hopd covid-19 spec collect |
13,657 |
13,219 |
$298K |
| 72125 |
|
1,749 |
1,729 |
$296K |
| J3490 |
Drugs unclassified injection |
25,143 |
14,327 |
$287K |
| 76705 |
|
5,643 |
5,416 |
$286K |
| 77067 |
|
5,467 |
5,387 |
$255K |
| 97110 |
|
20,130 |
6,340 |
$253K |
| 87811 |
|
6,183 |
6,075 |
$235K |
| T1999 |
Noc retail items andsupplies |
17,335 |
9,150 |
$222K |
| 96365 |
|
4,387 |
3,387 |
$217K |
| 99283 |
|
2,397 |
2,243 |
$193K |
| A4649 |
Surgical supplies |
1,810 |
1,511 |
$185K |
| Q0162 |
Ondansetron oral |
6,246 |
5,920 |
$183K |
| 83880 |
|
7,301 |
6,879 |
$172K |
| 99284 |
|
2,489 |
2,354 |
$171K |
| 96375 |
|
5,295 |
4,543 |
$163K |
| 76856 |
|
3,122 |
3,041 |
$158K |
| 76641 |
|
4,247 |
4,161 |
$155K |
| 0710 |
|
3,790 |
3,575 |
$153K |
| 84484 |
|
16,967 |
14,668 |
$149K |
| 87651 |
|
3,284 |
3,256 |
$142K |
| 73721 |
|
1,160 |
1,131 |
$138K |
| G0463 |
Hospital outpt clinic visit |
7,222 |
6,116 |
$136K |
| 81001 |
|
40,453 |
37,430 |
$133K |
| 83690 |
|
19,756 |
18,443 |
$130K |
| 96360 |
|
2,584 |
2,464 |
$124K |
| 72148 |
|
1,036 |
1,019 |
$119K |
| 87634 |
|
2,353 |
2,315 |
$118K |
| 76805 |
|
1,684 |
1,563 |
$116K |
| 94640 |
|
5,965 |
5,201 |
$111K |
| 59025 |
|
6,940 |
4,249 |
$110K |
| 96361 |
|
4,837 |
4,449 |
$108K |
| 71045 |
|
8,322 |
7,924 |
$107K |
| 87804 |
|
15,348 |
7,353 |
$105K |
| 71250 |
|
946 |
944 |
$102K |
| 76801 |
|
1,901 |
1,770 |
$95K |
| J2405 |
Ondansetron hcl injection |
7,101 |
5,518 |
$93K |
| 99070 |
|
5,684 |
3,974 |
$90K |
| 76700 |
|
2,123 |
2,101 |
$89K |
| 93971 |
|
1,150 |
1,129 |
$85K |
| 71260 |
|
649 |
621 |
$81K |
| 77065 |
Tomosynthesis, mammo |
1,977 |
1,954 |
$79K |
| 99000 |
|
44,301 |
38,548 |
$79K |
| 76819 |
|
2,300 |
1,264 |
$77K |
| 99285 |
|
907 |
769 |
$74K |
| 94760 |
|
11,385 |
10,352 |
$74K |
| 87086 |
|
12,606 |
12,108 |
$71K |
| 78815 |
|
68 |
67 |
$70K |
| J7030 |
Normal saline solution infus |
10,044 |
8,141 |
$70K |
| 87040 |
|
6,776 |
3,939 |
$70K |
| 77063 |
|
5,464 |
5,384 |
$65K |
| A4216 |
Sterile water/saline, 10 ml |
2,918 |
1,346 |
$65K |
| 81025 |
|
15,090 |
14,301 |
$63K |
| 87070 |
|
5,967 |
5,610 |
$62K |
| 96413 |
|
1,163 |
618 |
$61K |
| 87880 |
|
6,420 |
6,031 |
$61K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
5,940 |
5,763 |
$58K |
| 73630 |
|
2,880 |
2,811 |
$57K |
| J7050 |
Normal saline solution infus |
4,349 |
2,271 |
$56K |
| 99221 |
|
1,837 |
1,613 |
$56K |
| J1885 |
Ketorolac tromethamine inj |
9,455 |
8,867 |
$56K |
| 83605 |
|
5,272 |
4,547 |
$54K |
| 84145 |
|
3,120 |
3,024 |
$53K |
| 97161 |
|
2,276 |
2,099 |
$51K |
| 93306 |
|
506 |
501 |
$51K |
| J1100 |
Dexamethasone sodium phos |
8,180 |
7,074 |
$50K |
| 87400 |
|
4,936 |
4,857 |
$50K |
| 73562 |
|
2,893 |
2,830 |
$49K |
| 97139 |
|
1,887 |
675 |
$48K |
| 73130 |
|
2,491 |
2,408 |
$48K |
| 76770 |
|
1,030 |
1,013 |
$47K |
| 85730 |
|
9,204 |
8,726 |
$47K |
| 73610 |
|
2,276 |
2,226 |
$47K |
| J0696 |
Ceftriaxone sodium injection |
6,590 |
6,194 |
$46K |
| 84443 |
|
3,199 |
3,012 |
$42K |
| 83735 |
|
6,822 |
6,243 |
$41K |
| 70486 |
|
338 |
334 |
$41K |
| 73030 |
|
2,118 |
2,061 |
$41K |
| 72131 |
|
261 |
258 |
$40K |
| 87591 |
|
1,153 |
1,126 |
$39K |
| 87491 |
|
1,153 |
1,126 |
$39K |
| 77066 |
Tomosynthesis, mammo |
718 |
710 |
$38K |
| J1642 |
Inj heparin sodium per 10 u |
3,911 |
1,510 |
$38K |
| 74018 |
|
2,670 |
2,603 |
$38K |
| 73110 |
|
1,978 |
1,892 |
$37K |
| 85610 |
|
11,189 |
10,542 |
$36K |
| J2270 |
Morphine sulfate injection |
4,622 |
3,840 |
$36K |
| 97750 |
|
1,781 |
1,762 |
$33K |
| J7120 |
Ringers lactate infusion |
4,615 |
3,861 |
$30K |
| 84702 |
|
3,677 |
3,304 |
$29K |
| 70551 |
|
224 |
224 |
$28K |
| 96367 |
|
1,073 |
667 |
$27K |
| 90715 |
|
671 |
669 |
$25K |
| 0720 |
|
762 |
595 |
$23K |
| 76830 |
|
514 |
504 |
$23K |
| 73221 |
|
206 |
201 |
$22K |
| J3010 |
Fentanyl citrate injection |
4,307 |
3,410 |
$22K |
| A4648 |
Implantable tissue marker |
25 |
25 |
$21K |
| 80048 |
|
2,588 |
2,416 |
$21K |
| 76870 |
|
512 |
502 |
$21K |
| J1200 |
Diphenhydramine hcl injectio |
4,409 |
3,680 |
$21K |
| 72100 |
|
861 |
851 |
$20K |
| J7040 |
Normal saline solution infus |
4,475 |
3,355 |
$20K |
| 11042 |
|
474 |
333 |
$19K |
| 77061 |
|
1,193 |
1,187 |
$18K |
| J2250 |
Inj midazolam hydrochloride |
4,164 |
3,533 |
$18K |
| 99291 |
|
117 |
115 |
$18K |
| 87420 |
|
2,752 |
2,630 |
$18K |
| 73080 |
|
775 |
753 |
$18K |
| 97597 |
|
876 |
622 |
$17K |
| 72110 |
|
861 |
850 |
$17K |
| 87186 |
|
3,194 |
3,082 |
$17K |
| 76817 |
|
307 |
291 |
$16K |
| 70553 |
|
68 |
67 |
$15K |
| A9579 |
Gad-base mr contrast nos,1ml |
997 |
977 |
$15K |
| 86901 |
|
3,941 |
3,639 |
$15K |
| 84703 |
|
4,706 |
4,536 |
$14K |
| 76536 |
|
489 |
485 |
$14K |
| Q0144 |
Azithromycin dihydrate, oral |
283 |
253 |
$14K |
| 36415 |
|
5,790 |
4,942 |
$14K |
| 73502 |
|
531 |
523 |
$14K |
| 86140 |
|
2,690 |
2,608 |
$13K |
| 99214 |
|
563 |
502 |
$13K |
| 99213 |
|
962 |
819 |
$12K |
| 43239 |
|
611 |
602 |
$12K |
| 87077 |
|
3,208 |
3,102 |
$12K |
| A9552 |
F18 fdg |
77 |
76 |
$12K |
| 99281 |
|
274 |
255 |
$11K |
| 86850 |
|
1,827 |
1,681 |
$11K |
| 83615 |
|
1,251 |
1,143 |
$11K |
| 36591 |
|
524 |
294 |
$11K |
| 85379 |
|
1,028 |
1,011 |
$10K |
| 99215 |
Prolong outpt/office vis |
326 |
285 |
$10K |
| 73700 |
|
135 |
133 |
$10K |
| 84439 |
|
1,143 |
1,075 |
$10K |
| 83036 |
|
1,510 |
1,484 |
$10K |
| J2704 |
Inj, propofol, 10 mg |
890 |
814 |
$10K |
| 86900 |
|
3,613 |
3,372 |
$9K |
| 87661 |
|
312 |
311 |
$9K |
| 99212 |
|
894 |
769 |
$9K |
| 77062 |
|
475 |
470 |
$9K |
| 81003 |
|
4,207 |
3,932 |
$8K |
| 51701 |
|
92 |
88 |
$8K |
| 97010 |
|
420 |
187 |
$8K |
| A4217 |
Sterile water/saline, 500 ml |
494 |
452 |
$8K |
| 85652 |
|
1,249 |
1,207 |
$8K |
| 93970 |
|
86 |
86 |
$8K |
| 73590 |
|
439 |
426 |
$7K |
| A9270 |
Non-covered item or service |
29,378 |
18,777 |
$7K |
| 73564 |
|
480 |
477 |
$7K |
| J2060 |
Lorazepam injection |
1,231 |
1,005 |
$7K |
| 0762 |
|
195 |
110 |
$6K |
| J2930 |
Methylprednisolone injection |
558 |
498 |
$6K |
| 71275 |
|
40 |
40 |
$6K |
| S8037 |
Mrcp |
15 |
14 |
$6K |
| 73090 |
|
349 |
338 |
$6K |
| 90471 |
|
1,346 |
1,318 |
$6K |
| 82378 |
|
443 |
345 |
$6K |
| 52281 |
|
193 |
190 |
$5K |
| 82010 |
|
683 |
628 |
$5K |
| 29126 |
|
94 |
91 |
$5K |
| 72141 |
|
48 |
43 |
$5K |
| 90714 |
|
182 |
176 |
$5K |
| 72040 |
|
221 |
220 |
$5K |
| 71020 |
|
200 |
102 |
$5K |
| 82803 |
|
328 |
313 |
$5K |
| 72072 |
|
210 |
209 |
$5K |
| 74022 |
|
125 |
117 |
$4K |
| P9016 |
Rbc leukocytes reduced |
30 |
12 |
$4K |
| J1815 |
Insulin injection |
574 |
339 |
$4K |
| J1170 |
Hydromorphone injection |
700 |
484 |
$4K |
| G0378 |
Hospital observation per hr |
367 |
330 |
$4K |
| 71101 |
|
126 |
123 |
$4K |
| 82150 |
|
666 |
640 |
$4K |
| 82550 |
|
699 |
610 |
$4K |
| J0561 |
Penicillin g benzathine inj |
93 |
92 |
$4K |
| 73140 |
|
310 |
296 |
$4K |
| S0077 |
Injection, clindamycin phosp |
281 |
259 |
$4K |
| J2550 |
Promethazine hcl injection |
559 |
484 |
$4K |
| J2175 |
Meperidine hydrochl /100 mg |
410 |
337 |
$3K |
| 80061 |
|
721 |
710 |
$3K |
| 87807 |
|
584 |
483 |
$3K |
| 29515 |
|
88 |
86 |
$3K |
| J2765 |
Metoclopramide hcl injection |
582 |
558 |
$3K |
| 45380 |
|
86 |
85 |
$3K |
| A4364 |
Adhesive, liquid or equal |
54 |
51 |
$3K |
| 70491 |
|
24 |
24 |
$3K |
| 96366 |
|
135 |
119 |
$3K |
| 0301 |
|
46 |
26 |
$3K |
| 95816 |
|
116 |
116 |
$3K |
| 82553 |
|
263 |
251 |
$3K |
| 97039 |
|
341 |
159 |
$3K |
| 77080 |
|
265 |
265 |
$3K |
| J0500 |
Dicyclomine injection |
28 |
28 |
$3K |
| 20610 |
|
135 |
134 |
$2K |
| 49083 |
|
59 |
24 |
$2K |
| 96376 |
|
288 |
264 |
$2K |
| 96417 |
|
76 |
54 |
$2K |
| 45378 |
|
71 |
70 |
$2K |
| J7512 |
Prednisone ir or dr oral 1mg |
352 |
344 |
$2K |
| 72050 |
|
95 |
94 |
$2K |
| Q3014 |
Telehealth facility fee |
172 |
156 |
$2K |
| 71010 |
|
111 |
48 |
$2K |
| 72082 |
|
80 |
80 |
$2K |
| 66984 |
|
34 |
29 |
$2K |
| V2632 |
Post chmbr intraocular lens |
28 |
22 |
$1K |
| 99152 |
|
32 |
31 |
$1K |
| J3475 |
Inj magnesium sulfate |
226 |
160 |
$1K |
| 84550 |
|
479 |
418 |
$1K |
| J1453 |
Fosaprepitant injection |
51 |
41 |
$1K |
| J0702 |
Betamethasone acet&sod phosp |
57 |
39 |
$1K |
| 77336 |
|
71 |
27 |
$1K |
| 82140 |
|
88 |
77 |
$984.52 |
| 90839 |
|
16 |
15 |
$928.57 |
| J7510 |
Prednisolone oral per 5 mg |
151 |
140 |
$910.49 |
| J0694 |
Cefoxitin sodium injection |
64 |
36 |
$906.84 |
| 29125 |
|
13 |
12 |
$783.19 |
| 77300 |
|
13 |
12 |
$773.30 |
| 84100 |
|
258 |
220 |
$743.20 |
| 19083 |
|
12 |
12 |
$713.27 |
| S0164 |
Injection pantroprazole |
70 |
53 |
$697.08 |
| J1580 |
Garamycin gentamicin inj |
128 |
109 |
$677.07 |
| 82306 |
|
58 |
58 |
$656.33 |
| 82731 |
|
15 |
13 |
$645.42 |
| 85027 |
|
108 |
97 |
$589.01 |
| J2919 |
Inj, methylpred sod succ 5mg |
34 |
33 |
$537.39 |
| 73600 |
|
31 |
31 |
$531.90 |
| 96379 |
|
13 |
13 |
$528.55 |
| 96127 |
|
93 |
82 |
$497.05 |
| 70360 |
|
38 |
38 |
$438.77 |
| J0736 |
Inj, clindamycin phosp 300mg |
45 |
43 |
$423.58 |
| 94644 |
|
24 |
13 |
$401.82 |
| 0272 |
|
172 |
156 |
$387.12 |
| 85384 |
|
67 |
52 |
$365.52 |
| 80069 |
|
118 |
97 |
$350.77 |
| J2920 |
Methylprednisolone injection |
35 |
31 |
$336.26 |
| 82728 |
|
31 |
30 |
$313.40 |
| 90686 |
|
65 |
65 |
$281.85 |
| 84112 |
|
120 |
104 |
$281.08 |
| J0171 |
Adrenalin epinephrine inject |
80 |
49 |
$271.04 |
| J3301 |
Triamcinolone acet inj nos |
27 |
27 |
$270.29 |
| 85007 |
|
108 |
97 |
$270.20 |
| 36430 |
|
29 |
24 |
$267.81 |
| 73560 |
|
25 |
25 |
$265.56 |
| G0279 |
Tomosynthesis, mammo |
26 |
26 |
$250.94 |
| 29131 |
|
12 |
12 |
$246.28 |
| 73000 |
|
12 |
12 |
$233.82 |
| 73100 |
|
13 |
13 |
$212.94 |
| 86780 |
|
19 |
15 |
$210.96 |
| 94664 |
|
19 |
14 |
$185.78 |
| 73120 |
|
12 |
12 |
$183.94 |
| 87205 |
|
48 |
41 |
$165.40 |
| J0690 |
Cefazolin sodium injection |
50 |
50 |
$162.96 |
| 83540 |
|
59 |
52 |
$158.70 |
| 70220 |
|
14 |
13 |
$152.34 |
| J2001 |
Lidocaine injection |
40 |
27 |
$139.94 |
| 86635 |
|
14 |
13 |
$130.99 |
| 86308 |
|
27 |
27 |
$126.12 |
| 83550 |
|
44 |
37 |
$96.77 |
| 84450 |
|
31 |
30 |
$94.31 |
| 99173 |
|
72 |
71 |
$92.69 |
| 76882 |
|
13 |
12 |
$85.07 |
| 87430 |
|
29 |
28 |
$73.07 |
| 84153 |
|
24 |
24 |
$44.01 |
| 0516 |
|
49 |
45 |
$34.10 |
| 51741 |
|
12 |
12 |
$32.52 |
| 82043 |
|
24 |
24 |
$19.75 |
| 82570 |
|
37 |
37 |
$14.74 |
| 82565 |
|
27 |
25 |
$12.02 |
| 85018 |
|
13 |
13 |
$10.35 |
| 0637 |
|
70 |
30 |
$5.04 |
| 82607 |
|
12 |
12 |
$3.02 |
| 0258 |
|
220 |
93 |
$0.07 |
| G1004 |
Cdsm ndsc |
531 |
471 |
$0.05 |
| 0250 |
|
17 |
16 |
$0.02 |
| 0710R |
|
203 |
202 |
$0.00 |
| 0272R |
|
252 |
247 |
$0.00 |
| 0270R |
|
243 |
219 |
$0.00 |
| S0215 |
Nonemerg transp mileage |
24 |
12 |
$0.00 |
| 99231 |
|
47 |
33 |
$0.00 |
| 0370R |
|
21 |
17 |
$0.00 |
| 97035 |
|
174 |
80 |
$0.00 |
| 0250R |
|
72 |
68 |
$0.00 |
| 0271R |
|
21 |
17 |
$0.00 |
| J3471 |
Ovine, up to 999 usp units |
16 |
14 |
$0.00 |