| Code | Description | Claims | Beneficiaries | Total Paid |
| 99285 |
|
14,448 |
13,736 |
$5.76M |
| U0003 |
Cov-19 amp prb hgh thruput |
47,564 |
40,713 |
$3.35M |
| 99284 |
|
8,132 |
7,734 |
$2.25M |
| 99283 |
|
7,339 |
7,093 |
$1.36M |
| U0005 |
Infec agen detec ampli probe |
36,921 |
33,138 |
$768K |
| 36415 |
|
54,736 |
33,637 |
$386K |
| 87491 |
|
4,029 |
3,917 |
$309K |
| 80048 |
|
33,416 |
29,636 |
$273K |
| 87635 |
|
4,939 |
4,853 |
$226K |
| 0241U |
|
1,580 |
1,551 |
$196K |
| 96374 |
|
1,335 |
1,241 |
$193K |
| 84443 |
|
12,093 |
11,682 |
$180K |
| 87591 |
|
3,978 |
3,870 |
$180K |
| 80053 |
|
7,188 |
6,159 |
$113K |
| 93005 |
|
8,945 |
8,270 |
$112K |
| 80061 |
|
6,801 |
6,651 |
$103K |
| 83036 |
|
11,196 |
10,901 |
$98K |
| 85025 |
|
46,380 |
41,566 |
$73K |
| 0002A |
|
3,292 |
3,242 |
$73K |
| 88305 |
|
3,158 |
2,666 |
$73K |
| 82306 |
|
3,046 |
2,952 |
$62K |
| 0001A |
|
3,508 |
3,442 |
$62K |
| 86481 |
|
373 |
363 |
$54K |
| 87086 |
|
5,449 |
5,197 |
$50K |
| 86780 |
|
2,850 |
2,767 |
$48K |
| G1004 |
Cdsm ndsc |
1,959 |
1,828 |
$46K |
| 87389 |
|
1,500 |
1,450 |
$45K |
| 87084 |
|
4,425 |
4,267 |
$38K |
| 82565 |
|
3,410 |
3,015 |
$35K |
| 80307 |
|
438 |
428 |
$34K |
| 87502 |
|
731 |
707 |
$32K |
| 87081 |
|
2,748 |
2,685 |
$31K |
| 83655 |
|
1,840 |
1,820 |
$27K |
| P9603 |
One-way allow prorated miles |
36,837 |
23,585 |
$22K |
| 86803 |
|
990 |
961 |
$19K |
| 87077 |
|
1,466 |
1,395 |
$18K |
| 82607 |
|
1,354 |
1,313 |
$18K |
| 87661 |
|
328 |
320 |
$17K |
| 84439 |
|
1,479 |
1,434 |
$17K |
| 87801 |
|
153 |
150 |
$16K |
| 87637 |
|
107 |
103 |
$15K |
| 95810 |
|
27 |
25 |
$14K |
| 84466 |
|
1,233 |
1,188 |
$14K |
| 71046 |
|
342 |
315 |
$13K |
| 87636 |
|
92 |
91 |
$13K |
| 87481 |
|
237 |
233 |
$13K |
| 93306 |
|
41 |
41 |
$12K |
| 81513 |
|
55 |
54 |
$12K |
| 82728 |
|
1,032 |
996 |
$11K |
| 85610 |
|
6,105 |
2,639 |
$11K |
| 87340 |
|
887 |
857 |
$11K |
| 86900 |
|
381 |
369 |
$11K |
| 87186 |
|
1,323 |
1,259 |
$10K |
| 71045 |
|
310 |
293 |
$10K |
| 74177 |
|
100 |
91 |
$10K |
| 87634 |
|
512 |
497 |
$10K |
| 86762 |
|
521 |
506 |
$10K |
| 82947 |
|
1,799 |
1,165 |
$9K |
| 86850 |
|
655 |
632 |
$8K |
| 97110 |
|
66 |
50 |
$8K |
| 83540 |
|
1,281 |
1,234 |
$7K |
| 70450 |
|
124 |
120 |
$7K |
| U0001 |
2019-ncov diagnostic p |
305 |
256 |
$7K |
| 87088 |
|
1,079 |
1,042 |
$6K |
| 83880 |
|
514 |
454 |
$6K |
| 80051 |
|
282 |
261 |
$5K |
| 96361 |
|
116 |
106 |
$5K |
| 83718 |
|
536 |
525 |
$5K |
| 81001 |
|
3,715 |
3,456 |
$4K |
| 85027 |
|
1,432 |
1,295 |
$4K |
| 87147 |
|
591 |
576 |
$4K |
| 84403 |
|
109 |
105 |
$4K |
| 83735 |
|
1,077 |
793 |
$4K |
| P9604 |
One-way allow prorated trip |
3,691 |
2,622 |
$3K |
| 0296T |
|
41 |
41 |
$3K |
| 82570 |
|
840 |
791 |
$3K |
| 84100 |
|
504 |
354 |
$3K |
| 96375 |
|
51 |
51 |
$3K |
| 82465 |
|
548 |
537 |
$3K |
| 84270 |
|
83 |
79 |
$3K |
| 01961 |
|
12 |
12 |
$2K |
| G0463 |
Hospital outpt clinic visit |
148 |
103 |
$2K |
| 82043 |
|
334 |
327 |
$2K |
| 80076 |
|
484 |
436 |
$2K |
| 86706 |
|
127 |
125 |
$2K |
| 99282 |
|
12 |
12 |
$2K |
| 84460 |
|
424 |
395 |
$2K |
| 85018 |
|
808 |
698 |
$2K |
| 82248 |
|
1,782 |
1,588 |
$2K |
| 00170 |
|
12 |
12 |
$2K |
| G0123 |
Screen cerv/vag thin layer |
68 |
64 |
$1K |
| J7030 |
Normal saline solution infus |
2,581 |
2,067 |
$1K |
| 93017 |
|
43 |
41 |
$1K |
| 84484 |
|
3,782 |
3,164 |
$1K |
| 84450 |
|
367 |
290 |
$1K |
| 87624 |
|
37 |
32 |
$1K |
| 84153 |
|
51 |
50 |
$1K |
| G0103 |
Psa screening |
40 |
39 |
$1K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,327 |
859 |
$1K |
| 82310 |
|
178 |
136 |
$937.37 |
| 45380 |
|
12 |
12 |
$874.96 |
| 82247 |
|
165 |
123 |
$850.92 |
| 86901 |
|
381 |
369 |
$819.60 |
| 84075 |
|
146 |
110 |
$751.66 |
| 84132 |
|
176 |
139 |
$612.45 |
| 83970 |
|
41 |
41 |
$576.25 |
| 97535 |
|
32 |
12 |
$566.07 |
| 80050 |
|
13 |
12 |
$554.34 |
| 84481 |
|
29 |
29 |
$532.69 |
| 87070 |
|
27 |
27 |
$532.13 |
| 86140 |
|
254 |
173 |
$467.44 |
| J3010 |
Fentanyl citrate injection |
1,971 |
1,795 |
$445.84 |
| 83721 |
|
25 |
25 |
$440.52 |
| J2250 |
Inj midazolam hydrochloride |
2,161 |
1,719 |
$351.37 |
| 86787 |
|
12 |
12 |
$267.37 |
| 80069 |
|
42 |
42 |
$229.62 |
| G0378 |
Hospital observation per hr |
54 |
37 |
$212.24 |
| 83690 |
|
642 |
609 |
$198.23 |
| 86704 |
|
13 |
13 |
$198.20 |
| 86480 |
|
14 |
12 |
$175.04 |
| 84295 |
|
13 |
13 |
$125.36 |
| J2001 |
Lidocaine injection |
544 |
300 |
$97.12 |
| 80164 |
|
13 |
12 |
$76.84 |
| J2704 |
Inj, propofol, 10 mg |
193 |
91 |
$61.41 |
| 84520 |
|
30 |
25 |
$61.14 |
| 82962 |
|
268 |
76 |
$60.10 |
| 87651 |
|
37 |
36 |
$36.39 |
| J2405 |
Ondansetron hcl injection |
238 |
191 |
$30.58 |
| 84703 |
|
178 |
172 |
$23.71 |
| 81003 |
|
12 |
12 |
$10.70 |
| G0500 |
Mod sedat endo service >5yrs |
42 |
42 |
$9.51 |
| J1885 |
Ketorolac tromethamine inj |
82 |
77 |
$4.06 |
| A9270 |
Non-covered item or service |
1,892 |
214 |
$0.00 |
| A9585 |
Gadobutrol injection |
46 |
25 |
$0.00 |
| 85379 |
|
26 |
25 |
$0.00 |
| 91300 |
|
276 |
247 |
$0.00 |
| Q9956 |
Inj octafluoropropane mic,ml |
14 |
12 |
$0.00 |
| 87880 |
|
24 |
22 |
$0.00 |