| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
41,202 |
37,183 |
$13.21M |
| 99283 |
|
11,849 |
11,465 |
$5.10M |
| 99285 |
|
4,341 |
4,033 |
$3.81M |
| 99282 |
|
10,967 |
10,717 |
$2.88M |
| G0378 |
Hospital observation per hr |
4,485 |
3,137 |
$2.41M |
| 74177 |
|
5,925 |
5,808 |
$2.06M |
| 99281 |
|
14,112 |
13,700 |
$1.70M |
| 70450 |
|
6,173 |
5,974 |
$790K |
| 71045 |
|
11,344 |
10,698 |
$721K |
| 71046 |
|
8,466 |
8,308 |
$604K |
| 77067 |
|
4,227 |
4,219 |
$492K |
| 87637 |
|
8,187 |
7,970 |
$459K |
| 76705 |
|
4,092 |
4,048 |
$449K |
| 76830 |
|
3,659 |
3,623 |
$448K |
| 71260 |
|
2,088 |
2,070 |
$429K |
| 74176 |
|
1,883 |
1,864 |
$401K |
| 76856 |
|
3,263 |
3,231 |
$376K |
| 73630 |
|
3,118 |
2,726 |
$261K |
| 43239 |
|
334 |
333 |
$257K |
| 36415 |
|
40,751 |
31,812 |
$245K |
| 45380 |
|
241 |
240 |
$242K |
| 72148 |
|
775 |
774 |
$219K |
| 73610 |
|
2,480 |
2,328 |
$216K |
| 96374 |
|
10,356 |
9,416 |
$207K |
| 87635 |
|
8,109 |
7,795 |
$203K |
| 80051 |
|
32,311 |
27,580 |
$192K |
| 70551 |
|
738 |
736 |
$185K |
| 85025 |
|
47,439 |
38,833 |
$181K |
| 99218 |
|
247 |
167 |
$180K |
| 73030 |
|
2,140 |
1,944 |
$171K |
| 0450 |
|
3,995 |
3,550 |
$170K |
| 73560 |
|
2,449 |
2,203 |
$168K |
| 59025 |
|
1,457 |
1,238 |
$166K |
| 73564 |
|
1,206 |
884 |
$160K |
| 73130 |
|
2,000 |
1,719 |
$159K |
| 93005 |
|
15,280 |
14,036 |
$154K |
| 72100 |
|
1,379 |
1,369 |
$150K |
| 0270 |
|
4,994 |
3,829 |
$138K |
| 99070 |
|
8,858 |
3,183 |
$136K |
| 71275 |
|
499 |
494 |
$132K |
| J0131 |
Inj, acetaminophen (nos) |
4,896 |
4,585 |
$130K |
| 96375 |
|
8,799 |
8,051 |
$126K |
| 73110 |
|
1,440 |
1,325 |
$125K |
| 70553 |
|
293 |
292 |
$123K |
| 78815 |
|
121 |
121 |
$120K |
| 88305 |
|
1,373 |
1,360 |
$119K |
| 93976 |
|
401 |
398 |
$118K |
| 99199 |
|
2,158 |
1,815 |
$106K |
| 96361 |
|
7,194 |
6,767 |
$98K |
| 96365 |
|
4,119 |
3,907 |
$88K |
| 93971 |
|
710 |
693 |
$88K |
| 86900 |
|
3,025 |
2,843 |
$88K |
| 82565 |
|
39,194 |
32,444 |
$87K |
| 83880 |
|
4,939 |
4,627 |
$70K |
| 76817 |
|
599 |
569 |
$69K |
| 73140 |
|
813 |
788 |
$69K |
| 80307 |
|
2,208 |
1,981 |
$68K |
| 73721 |
|
200 |
194 |
$66K |
| 84702 |
|
5,711 |
4,734 |
$66K |
| 72125 |
|
460 |
454 |
$65K |
| 73502 |
|
809 |
802 |
$65K |
| 82247 |
|
23,719 |
19,679 |
$65K |
| 81001 |
|
26,050 |
24,239 |
$63K |
| 84460 |
|
23,266 |
19,689 |
$61K |
| 73080 |
|
664 |
625 |
$60K |
| 45378 |
|
87 |
82 |
$59K |
| 87636 |
|
1,008 |
997 |
$59K |
| 74018 |
|
632 |
602 |
$58K |
| J7030 |
Normal saline solution infus |
18,026 |
15,314 |
$56K |
| 76770 |
|
427 |
426 |
$54K |
| 76857 |
|
367 |
365 |
$51K |
| 70491 |
|
221 |
219 |
$51K |
| 96372 |
|
3,927 |
3,661 |
$50K |
| 86850 |
|
2,673 |
2,522 |
$49K |
| 84450 |
|
20,505 |
17,825 |
$46K |
| 87491 |
|
2,202 |
2,088 |
$46K |
| 80048 |
|
5,784 |
5,247 |
$45K |
| 83690 |
|
16,278 |
14,997 |
$45K |
| 82947 |
|
33,017 |
28,094 |
$45K |
| 72141 |
|
143 |
143 |
$43K |
| 84520 |
|
32,789 |
27,921 |
$42K |
| 87591 |
|
2,203 |
2,088 |
$42K |
| U0003 |
Cov-19 amp prb hgh thruput |
1,173 |
1,160 |
$38K |
| 84075 |
|
18,459 |
16,338 |
$37K |
| 84484 |
|
9,493 |
8,306 |
$37K |
| 76815 |
|
300 |
285 |
$37K |
| 70496 |
|
161 |
160 |
$36K |
| 83735 |
|
10,400 |
8,334 |
$35K |
| 73590 |
|
413 |
380 |
$34K |
| 96360 |
|
1,581 |
1,559 |
$33K |
| 72040 |
|
327 |
324 |
$32K |
| 71250 |
|
284 |
284 |
$31K |
| 70486 |
|
190 |
190 |
$30K |
| 77063 |
|
1,000 |
1,000 |
$29K |
| 76536 |
|
215 |
215 |
$28K |
| 70498 |
|
116 |
115 |
$27K |
| 87651 |
|
2,090 |
2,077 |
$27K |
| 86901 |
|
3,026 |
2,844 |
$26K |
| 87631 |
|
763 |
727 |
$24K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
4,533 |
4,450 |
$23K |
| 85652 |
|
8,440 |
8,176 |
$22K |
| J2405 |
Ondansetron hcl injection |
8,602 |
7,585 |
$22K |
| 83605 |
|
4,836 |
4,292 |
$21K |
| J1885 |
Ketorolac tromethamine inj |
8,313 |
7,600 |
$21K |
| 81003 |
|
12,969 |
12,529 |
$20K |
| 73221 |
|
66 |
63 |
$19K |
| J1100 |
Dexamethasone sodium phos |
2,618 |
2,442 |
$19K |
| 87040 |
|
3,992 |
3,747 |
$19K |
| 85610 |
|
8,734 |
6,923 |
$18K |
| 80306 |
|
2,234 |
2,077 |
$18K |
| J3490 |
Drugs unclassified injection |
5,318 |
3,813 |
$18K |
| 0637 |
|
59,664 |
17,496 |
$16K |
| 84132 |
|
3,379 |
2,526 |
$16K |
| 82248 |
|
3,302 |
2,243 |
$16K |
| 87088 |
|
5,021 |
4,847 |
$15K |
| J7120 |
Ringers lactate infusion |
6,230 |
5,389 |
$14K |
| 0250 |
|
9,387 |
5,068 |
$13K |
| J0696 |
Ceftriaxone sodium injection |
3,403 |
2,902 |
$13K |
| J2270 |
Morphine sulfate injection |
4,020 |
3,309 |
$12K |
| 86923 |
|
151 |
118 |
$12K |
| 84100 |
|
4,612 |
3,890 |
$12K |
| 96366 |
|
874 |
850 |
$11K |
| 87389 |
|
620 |
615 |
$11K |
| 45385 |
|
12 |
12 |
$11K |
| 82962 |
|
6,206 |
4,406 |
$11K |
| 82077 |
|
1,532 |
1,392 |
$11K |
| 84703 |
|
5,251 |
4,988 |
$11K |
| 73562 |
|
196 |
148 |
$11K |
| 82310 |
|
2,247 |
1,677 |
$11K |
| 85027 |
|
2,535 |
2,360 |
$11K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
544 |
537 |
$10K |
| 84295 |
|
1,898 |
1,415 |
$9K |
| 99221 |
|
222 |
214 |
$9K |
| 74183 |
|
12 |
12 |
$9K |
| A9552 |
F18 fdg |
109 |
109 |
$9K |
| J1170 |
Hydromorphone injection |
2,518 |
1,896 |
$8K |
| 96376 |
|
1,957 |
1,724 |
$8K |
| 73090 |
|
93 |
86 |
$8K |
| 87449 |
|
703 |
690 |
$7K |
| 0710 |
|
1,100 |
1,097 |
$7K |
| J2765 |
Metoclopramide hcl injection |
3,230 |
2,925 |
$7K |
| 87324 |
|
690 |
678 |
$7K |
| 76870 |
|
58 |
57 |
$7K |
| 82040 |
|
1,534 |
1,309 |
$7K |
| J1200 |
Diphenhydramine hcl injectio |
3,625 |
3,312 |
$6K |
| 85730 |
|
1,021 |
946 |
$6K |
| 94640 |
|
326 |
202 |
$6K |
| 72070 |
|
45 |
45 |
$5K |
| 88307 |
|
12 |
12 |
$5K |
| A9585 |
Gadobutrol injection |
393 |
386 |
$5K |
| J0690 |
Cefazolin sodium injection |
1,321 |
1,042 |
$5K |
| J1815 |
Insulin injection |
2,737 |
1,171 |
$5K |
| J2274 |
Inj morphine pf epid ithc |
412 |
343 |
$5K |
| 85379 |
|
1,362 |
1,351 |
$4K |
| J3475 |
Inj magnesium sulfate |
962 |
861 |
$4K |
| 82803 |
|
720 |
678 |
$4K |
| 87502 |
|
136 |
135 |
$4K |
| 86140 |
|
1,695 |
1,616 |
$4K |
| 73660 |
|
27 |
26 |
$4K |
| 80179 |
|
555 |
525 |
$4K |
| J2060 |
Lorazepam injection |
1,446 |
1,196 |
$3K |
| 73522 |
|
22 |
22 |
$3K |
| J3010 |
Fentanyl citrate injection |
2,799 |
2,684 |
$3K |
| Z7502 |
|
487 |
450 |
$3K |
| 86780 |
|
420 |
417 |
$3K |
| 84443 |
|
707 |
700 |
$3K |
| 82570 |
|
481 |
406 |
$3K |
| 72170 |
|
29 |
29 |
$2K |
| A9502 |
Tc99m tetrofosmin |
50 |
50 |
$2K |
| J1644 |
Inj heparin sodium per 1000u |
764 |
373 |
$2K |
| 78452 |
|
13 |
13 |
$2K |
| 85378 |
|
624 |
602 |
$2K |
| J0780 |
Prochlorperazine injection |
646 |
621 |
$2K |
| 83036 |
|
1,211 |
1,172 |
$1K |
| 0300 |
|
96 |
94 |
$1K |
| 84156 |
|
458 |
383 |
$1K |
| 82550 |
|
586 |
542 |
$1K |
| 73552 |
|
15 |
14 |
$1K |
| 43235 |
|
13 |
12 |
$1K |
| 96367 |
|
139 |
138 |
$1K |
| J2919 |
Inj, methylpred sod succ 5mg |
157 |
124 |
$1K |
| J1630 |
Haloperidol injection |
406 |
331 |
$1K |
| J1940 |
Furosemide injection |
509 |
291 |
$952.97 |
| 90686 |
|
138 |
136 |
$938.89 |
| 0370 |
|
990 |
987 |
$890.22 |
| 73600 |
|
57 |
55 |
$799.58 |
| J2250 |
Inj midazolam hydrochloride |
2,006 |
1,943 |
$785.69 |
| 83615 |
|
130 |
116 |
$752.69 |
| J0137 |
Inj, acetaminophen (hikma) |
52 |
50 |
$733.81 |
| 71101 |
|
15 |
15 |
$730.33 |
| 93306 |
|
39 |
39 |
$709.68 |
| 87070 |
|
165 |
155 |
$556.20 |
| 90471 |
|
189 |
188 |
$535.60 |
| 10060 |
|
12 |
12 |
$485.69 |
| 87081 |
|
190 |
184 |
$471.07 |
| 80069 |
|
62 |
49 |
$460.54 |
| J2930 |
Methylprednisolone injection |
190 |
168 |
$444.38 |
| 73060 |
|
12 |
12 |
$434.38 |
| 85007 |
|
667 |
550 |
$367.69 |
| J1650 |
Inj enoxaparin sodium |
105 |
54 |
$336.12 |
| 12001 |
|
41 |
41 |
$306.00 |
| 97161 |
|
112 |
106 |
$302.21 |
| 0301 |
|
1,141 |
682 |
$280.33 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
53 |
46 |
$247.20 |
| J2785 |
Regadenoson injection |
13 |
13 |
$204.00 |
| 85014 |
|
166 |
137 |
$164.33 |
| 82140 |
|
14 |
13 |
$155.90 |
| 85384 |
|
12 |
12 |
$147.63 |
| 12011 |
|
14 |
14 |
$121.60 |
| J0360 |
Hydralazine hcl injection |
66 |
54 |
$121.11 |
| G0008 |
Admin influenza virus vac |
149 |
149 |
$115.53 |
| 90656 |
|
16 |
16 |
$90.58 |
| 73620 |
|
26 |
25 |
$80.65 |
| 96368 |
|
44 |
44 |
$68.34 |
| 86706 |
|
12 |
12 |
$66.94 |
| 80349 |
|
53 |
52 |
$66.00 |
| 87340 |
|
13 |
13 |
$64.25 |
| 85018 |
|
84 |
65 |
$53.10 |
| 80061 |
|
27 |
26 |
$50.84 |
| 80047 |
|
12 |
12 |
$49.02 |
| S0119 |
Ondansetron 4 mg |
16 |
14 |
$34.69 |
| 85008 |
|
215 |
175 |
$31.14 |
| 29515 |
|
12 |
12 |
$30.00 |
| 84550 |
|
12 |
12 |
$27.03 |
| 87205 |
|
12 |
12 |
$21.92 |
| Z7610 |
|
71 |
16 |
$21.90 |
| J2470 |
Inj pantoprazole sodium 40mg |
60 |
51 |
$19.35 |
| Q0144 |
Azithromycin dihydrate, oral |
13 |
12 |
$15.27 |
| J7512 |
Prednisone ir or dr oral 1mg |
474 |
387 |
$15.13 |
| 82728 |
|
12 |
12 |
$15.00 |
| 76376 |
|
145 |
145 |
$0.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
44 |
28 |
$0.00 |
| 80320 |
|
41 |
33 |
$0.00 |
| 97162 |
|
110 |
107 |
$0.00 |
| 0258 |
|
508 |
430 |
$0.00 |
| 0636 |
|
12 |
12 |
$0.00 |
| 80329 |
|
15 |
15 |
$0.00 |