| Code | Description | Claims | Beneficiaries | Total Paid |
| 0450 |
|
34,899 |
30,442 |
$7.80M |
| A0427 |
Als1-emergency |
10,323 |
8,985 |
$1.97M |
| 99281 |
|
6,726 |
5,822 |
$1.30M |
| A9150 |
Misc/exper non-prescript dru |
13,082 |
5,826 |
$1.25M |
| 99199 |
|
13,127 |
10,825 |
$982K |
| 36415 |
|
9,808 |
8,203 |
$977K |
| J3490 |
Drugs unclassified injection |
10,646 |
5,351 |
$625K |
| T1999 |
Noc retail items andsupplies |
4,916 |
2,796 |
$591K |
| A0425 |
Ground mileage |
13,132 |
10,883 |
$476K |
| 0949 |
|
1,937 |
1,529 |
$412K |
| 74177 |
|
2,417 |
2,359 |
$407K |
| A0429 |
Bls-emergency |
2,462 |
2,187 |
$405K |
| 99283 |
|
2,655 |
2,343 |
$393K |
| 96365 |
|
3,246 |
2,129 |
$267K |
| 0250 |
|
18,399 |
8,940 |
$267K |
| 0241U |
|
3,626 |
3,556 |
$254K |
| 77067 |
|
1,334 |
1,332 |
$251K |
| 96374 |
|
6,619 |
6,137 |
$250K |
| 70450 |
|
2,728 |
2,644 |
$242K |
| 99284 |
|
1,114 |
1,034 |
$230K |
| 80053 |
|
19,039 |
16,351 |
$200K |
| 96375 |
|
5,649 |
4,723 |
$157K |
| 0762 |
|
130 |
100 |
$151K |
| 99202 |
|
764 |
629 |
$150K |
| 71046 |
|
2,955 |
2,873 |
$115K |
| 96372 |
|
5,756 |
4,957 |
$113K |
| 73610 |
|
1,642 |
1,519 |
$109K |
| 93306 |
|
292 |
291 |
$98K |
| 99282 |
|
679 |
639 |
$95K |
| 93005 |
|
7,303 |
6,724 |
$95K |
| 73630 |
|
1,718 |
1,671 |
$92K |
| 76856 |
|
1,085 |
1,075 |
$92K |
| 73030 |
|
1,429 |
1,388 |
$89K |
| 80307 |
|
5,094 |
4,714 |
$83K |
| G0480 |
Drug test def 1-7 classes |
5,200 |
4,580 |
$83K |
| G0378 |
Hospital observation per hr |
1,626 |
1,134 |
$83K |
| 73110 |
|
1,288 |
1,157 |
$80K |
| 73130 |
|
1,236 |
1,166 |
$78K |
| 71045 |
|
6,333 |
6,022 |
$77K |
| 76700 |
|
643 |
636 |
$75K |
| Z7502 |
|
1,931 |
1,889 |
$74K |
| 87635 |
|
1,942 |
1,886 |
$62K |
| 85025 |
|
20,534 |
17,050 |
$59K |
| 73562 |
|
999 |
977 |
$57K |
| 77063 |
|
1,309 |
1,305 |
$57K |
| 87081 |
|
1,250 |
1,229 |
$54K |
| 76830 |
|
580 |
578 |
$53K |
| 81001 |
|
7,733 |
7,265 |
$49K |
| 81003 |
|
5,372 |
5,146 |
$46K |
| 93971 |
|
448 |
431 |
$43K |
| 96360 |
|
606 |
562 |
$42K |
| 87086 |
|
3,719 |
3,533 |
$41K |
| 74176 |
|
881 |
877 |
$40K |
| 96361 |
|
1,925 |
1,634 |
$38K |
| 0510 |
|
893 |
750 |
$36K |
| 76705 |
|
513 |
509 |
$36K |
| 72100 |
|
465 |
463 |
$30K |
| 73502 |
|
489 |
480 |
$27K |
| 87077 |
|
1,158 |
1,137 |
$25K |
| 72148 |
|
44 |
44 |
$23K |
| 99285 |
|
292 |
273 |
$22K |
| 71275 |
|
119 |
118 |
$22K |
| U0003 |
Cov-19 amp prb hgh thruput |
978 |
940 |
$21K |
| 87880 |
|
1,461 |
1,443 |
$19K |
| 87631 |
|
578 |
565 |
$18K |
| T5999 |
Supply, nos |
122 |
115 |
$18K |
| 73564 |
|
214 |
214 |
$17K |
| 96413 |
|
499 |
302 |
$17K |
| 29125 |
|
157 |
150 |
$16K |
| U0002 |
Covid-19 lab test non-cdc |
189 |
186 |
$16K |
| 12001 |
|
94 |
94 |
$15K |
| 73080 |
|
187 |
170 |
$15K |
| A0428 |
Bls |
350 |
322 |
$14K |
| 71260 |
|
122 |
121 |
$14K |
| 73140 |
|
246 |
229 |
$14K |
| 82962 |
|
1,480 |
1,070 |
$13K |
| 73221 |
|
15 |
14 |
$13K |
| J7030 |
Normal saline solution infus |
8,453 |
7,062 |
$13K |
| J1100 |
Dexamethasone sodium phos |
1,436 |
1,106 |
$13K |
| 80048 |
|
4,452 |
3,990 |
$11K |
| 72125 |
|
173 |
172 |
$11K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
3,669 |
3,521 |
$11K |
| 83605 |
|
2,540 |
2,391 |
$10K |
| 73721 |
|
13 |
13 |
$10K |
| 81025 |
|
5,267 |
5,007 |
$9K |
| 0720 |
|
184 |
148 |
$9K |
| 83880 |
|
1,885 |
1,773 |
$9K |
| J7040 |
Normal saline solution infus |
1,248 |
799 |
$8K |
| 87491 |
|
370 |
358 |
$8K |
| 83735 |
|
2,496 |
1,819 |
$8K |
| 84484 |
|
4,755 |
4,191 |
$7K |
| 87502 |
|
262 |
256 |
$7K |
| 94640 |
|
542 |
460 |
$7K |
| 99070 |
|
416 |
356 |
$7K |
| 84443 |
|
1,450 |
1,402 |
$7K |
| 12002 |
|
39 |
39 |
$7K |
| 71250 |
|
16 |
16 |
$7K |
| J2405 |
Ondansetron hcl injection |
3,996 |
3,405 |
$7K |
| 83690 |
|
5,479 |
5,142 |
$6K |
| 72072 |
|
106 |
106 |
$6K |
| 96366 |
|
226 |
149 |
$6K |
| J7050 |
Normal saline solution infus |
531 |
351 |
$6K |
| 96367 |
|
114 |
62 |
$5K |
| 76815 |
|
106 |
50 |
$5K |
| 96376 |
|
1,006 |
795 |
$5K |
| J1885 |
Ketorolac tromethamine inj |
4,903 |
4,563 |
$5K |
| 85027 |
|
3,517 |
3,359 |
$5K |
| 72040 |
|
80 |
79 |
$5K |
| 76536 |
|
37 |
37 |
$4K |
| 87040 |
|
2,277 |
2,005 |
$4K |
| 72110 |
|
32 |
32 |
$4K |
| 0760 |
|
86 |
71 |
$4K |
| J1170 |
Hydromorphone injection |
2,361 |
1,872 |
$4K |
| 76642 |
|
26 |
25 |
$3K |
| 90715 |
|
538 |
533 |
$3K |
| 87591 |
|
360 |
348 |
$3K |
| 12011 |
|
12 |
12 |
$3K |
| 87804 |
|
162 |
160 |
$3K |
| A9579 |
Gad-base mr contrast nos,1ml |
99 |
92 |
$3K |
| J0696 |
Ceftriaxone sodium injection |
799 |
661 |
$3K |
| 87661 |
|
249 |
241 |
$3K |
| J7120 |
Ringers lactate infusion |
463 |
293 |
$3K |
| 0011A |
|
64 |
64 |
$3K |
| 87147 |
|
303 |
295 |
$2K |
| 73100 |
|
54 |
50 |
$2K |
| A9270 |
Non-covered item or service |
1,094 |
392 |
$2K |
| 0012A |
|
55 |
55 |
$2K |
| 85610 |
|
1,843 |
1,702 |
$2K |
| 76805 |
|
14 |
14 |
$2K |
| 87070 |
|
26 |
26 |
$2K |
| 73590 |
|
55 |
50 |
$2K |
| 72050 |
|
27 |
27 |
$2K |
| J2060 |
Lorazepam injection |
1,477 |
1,299 |
$2K |
| J1200 |
Diphenhydramine hcl injectio |
638 |
547 |
$2K |
| 76770 |
|
27 |
27 |
$1K |
| 84145 |
|
391 |
364 |
$1K |
| 86901 |
|
597 |
505 |
$1K |
| 87186 |
|
890 |
874 |
$1K |
| 73090 |
|
15 |
15 |
$1K |
| 87637 |
|
44 |
44 |
$1K |
| J2270 |
Morphine sulfate injection |
767 |
663 |
$1K |
| 97165 |
|
15 |
12 |
$940.26 |
| J0780 |
Prochlorperazine injection |
305 |
291 |
$935.86 |
| 86141 |
|
199 |
191 |
$933.61 |
| 85379 |
|
714 |
697 |
$822.38 |
| 59025 |
|
93 |
40 |
$798.21 |
| 86885 |
|
202 |
160 |
$797.07 |
| 74019 |
|
15 |
15 |
$774.57 |
| J2704 |
Inj, propofol, 10 mg |
84 |
73 |
$718.81 |
| J2765 |
Metoclopramide hcl injection |
523 |
487 |
$701.88 |
| 85730 |
|
310 |
302 |
$655.76 |
| 86900 |
|
308 |
251 |
$630.52 |
| 0761 |
|
14 |
14 |
$576.29 |
| J1642 |
Inj heparin sodium per 10 u |
114 |
48 |
$552.93 |
| S0028 |
Injection, famotidine, 20 mg |
94 |
89 |
$514.50 |
| 88305 |
|
46 |
46 |
$500.20 |
| G0463 |
Hospital outpt clinic visit |
87 |
79 |
$446.96 |
| J3010 |
Fentanyl citrate injection |
82 |
78 |
$446.25 |
| Z7500 |
|
13 |
13 |
$443.30 |
| 76801 |
|
30 |
25 |
$400.72 |
| 0272 |
|
145 |
144 |
$272.96 |
| 84702 |
|
469 |
419 |
$271.82 |
| 85007 |
|
358 |
338 |
$221.37 |
| J2250 |
Inj midazolam hydrochloride |
44 |
44 |
$198.17 |
| J0690 |
Cefazolin sodium injection |
15 |
14 |
$101.86 |
| 83036 |
|
13 |
12 |
$83.23 |
| J3475 |
Inj magnesium sulfate |
47 |
25 |
$81.61 |
| 82550 |
|
15 |
14 |
$67.74 |
| 99406 |
|
401 |
395 |
$54.44 |
| 90471 |
|
83 |
76 |
$53.50 |
| J1650 |
Inj enoxaparin sodium |
17 |
12 |
$31.89 |
| 86880 |
|
17 |
15 |
$25.70 |
| 84439 |
|
14 |
14 |
$23.69 |
| 84100 |
|
20 |
17 |
$14.48 |
| 85651 |
|
15 |
12 |
$14.32 |
| 87205 |
|
12 |
12 |
$0.00 |
| 0636 |
|
16 |
14 |
$0.00 |
| 0271 |
|
14 |
14 |
$0.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
29 |
26 |
$0.00 |