| Code | Description | Claims | Beneficiaries | Total Paid |
| 0450 |
|
64,028 |
54,789 |
$554K |
| 96374 |
|
13,825 |
10,898 |
$481K |
| A0429 |
Bls-emergency |
12,451 |
8,572 |
$464K |
| 74177 |
|
2,823 |
2,277 |
$395K |
| Z7502 |
|
9,376 |
9,198 |
$352K |
| 80307 |
|
7,125 |
5,863 |
$274K |
| G0480 |
Drug test def 1-7 classes |
5,210 |
4,099 |
$233K |
| 70450 |
|
5,451 |
4,784 |
$226K |
| 96375 |
|
9,411 |
7,230 |
$198K |
| 74176 |
|
2,622 |
2,185 |
$189K |
| 93005 |
|
16,615 |
13,508 |
$180K |
| J3490 |
Drugs unclassified injection |
34,281 |
15,709 |
$163K |
| 80053 |
|
29,737 |
24,468 |
$159K |
| 96365 |
|
4,023 |
3,167 |
$154K |
| 87428 |
|
3,472 |
3,087 |
$153K |
| 96361 |
|
10,215 |
7,939 |
$149K |
| 85025 |
|
34,851 |
28,788 |
$140K |
| 96372 |
|
9,747 |
6,988 |
$138K |
| Z7500 |
|
2,969 |
2,231 |
$101K |
| 96360 |
|
3,141 |
2,552 |
$99K |
| J7030 |
Normal saline solution infus |
16,682 |
12,820 |
$94K |
| 71045 |
|
12,237 |
10,454 |
$87K |
| 99199 |
|
1,675 |
1,615 |
$85K |
| 99285 |
|
1,995 |
1,875 |
$68K |
| 83690 |
|
18,480 |
15,211 |
$63K |
| 72125 |
|
1,133 |
1,021 |
$62K |
| 87426 |
|
2,749 |
2,325 |
$61K |
| 76856 |
|
1,527 |
1,267 |
$59K |
| Z7610 |
|
5,275 |
3,397 |
$57K |
| 99284 |
|
1,841 |
1,731 |
$56K |
| 81025 |
|
21,125 |
18,041 |
$53K |
| 99283 |
|
4,557 |
4,144 |
$52K |
| 76705 |
|
1,513 |
1,247 |
$48K |
| 84484 |
|
10,592 |
8,368 |
$46K |
| J1885 |
Ketorolac tromethamine inj |
10,701 |
7,524 |
$43K |
| 90715 |
|
1,800 |
1,529 |
$39K |
| 83880 |
|
2,708 |
2,293 |
$37K |
| 0270 |
|
41,715 |
21,178 |
$35K |
| 81001 |
|
21,864 |
18,317 |
$32K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
4,730 |
3,237 |
$31K |
| 59025 |
|
1,694 |
591 |
$31K |
| C9803 |
Hopd covid-19 spec collect |
2,253 |
1,830 |
$31K |
| J2405 |
Ondansetron hcl injection |
8,425 |
6,519 |
$31K |
| 71046 |
|
2,356 |
2,123 |
$29K |
| 94640 |
|
2,640 |
1,908 |
$28K |
| 87086 |
|
7,441 |
6,254 |
$28K |
| 76700 |
|
661 |
552 |
$28K |
| 76801 |
|
666 |
546 |
$25K |
| 87040 |
|
5,844 |
2,480 |
$24K |
| 76830 |
|
478 |
386 |
$20K |
| 94762 |
|
808 |
736 |
$19K |
| 83605 |
|
4,038 |
2,921 |
$18K |
| J2270 |
Morphine sulfate injection |
3,326 |
2,613 |
$18K |
| 76805 |
|
288 |
252 |
$17K |
| J0696 |
Ceftriaxone sodium injection |
3,612 |
2,785 |
$17K |
| 96366 |
|
569 |
423 |
$17K |
| 73610 |
|
1,143 |
1,058 |
$16K |
| 73630 |
|
1,156 |
1,063 |
$15K |
| 80048 |
|
3,300 |
2,834 |
$14K |
| 84443 |
|
1,607 |
1,348 |
$13K |
| 73562 |
|
980 |
859 |
$12K |
| 73130 |
|
883 |
804 |
$12K |
| 93971 |
|
149 |
136 |
$11K |
| 87186 |
|
2,768 |
2,253 |
$11K |
| 87491 |
|
701 |
587 |
$11K |
| 85730 |
|
3,861 |
3,135 |
$11K |
| 87591 |
|
689 |
575 |
$11K |
| J1200 |
Diphenhydramine hcl injectio |
2,432 |
1,878 |
$10K |
| 87804 |
|
3,288 |
1,367 |
$10K |
| 84145 |
|
991 |
790 |
$10K |
| 85610 |
|
5,444 |
4,495 |
$10K |
| J1100 |
Dexamethasone sodium phos |
2,312 |
1,575 |
$9K |
| 73030 |
|
727 |
659 |
$9K |
| 87635 |
|
561 |
428 |
$9K |
| 71275 |
|
49 |
40 |
$9K |
| 82962 |
|
6,672 |
4,455 |
$8K |
| 70486 |
|
172 |
147 |
$8K |
| 84702 |
|
1,496 |
1,265 |
$8K |
| 85379 |
|
1,513 |
1,223 |
$8K |
| U0003 |
Cov-19 amp prb hgh thruput |
290 |
223 |
$8K |
| J2704 |
Inj, propofol, 10 mg |
1,813 |
798 |
$7K |
| J7060 |
5% dextrose/water |
1,789 |
1,314 |
$7K |
| J2765 |
Metoclopramide hcl injection |
1,415 |
1,101 |
$7K |
| J7040 |
Normal saline solution infus |
1,726 |
1,466 |
$6K |
| 72131 |
|
103 |
87 |
$6K |
| 76817 |
|
194 |
151 |
$6K |
| 83735 |
|
1,608 |
1,253 |
$5K |
| J2060 |
Lorazepam injection |
1,363 |
1,010 |
$5K |
| 73110 |
|
352 |
336 |
$5K |
| 90471 |
|
1,398 |
1,257 |
$4K |
| 43239 |
|
213 |
168 |
$4K |
| 88305 |
|
542 |
393 |
$4K |
| 87070 |
|
1,735 |
1,456 |
$4K |
| 87088 |
|
1,012 |
853 |
$4K |
| 86901 |
|
2,211 |
1,854 |
$3K |
| 93970 |
|
31 |
26 |
$3K |
| 86900 |
|
2,210 |
1,855 |
$3K |
| 82550 |
|
1,152 |
920 |
$3K |
| 87880 |
|
711 |
641 |
$3K |
| 73080 |
|
174 |
167 |
$3K |
| J2930 |
Methylprednisolone injection |
284 |
246 |
$3K |
| 0250 |
|
6,066 |
3,976 |
$2K |
| 12001 |
|
211 |
203 |
$2K |
| 0012A |
|
41 |
41 |
$2K |
| 29125 |
|
488 |
459 |
$2K |
| 0001A |
|
35 |
35 |
$1K |
| 86141 |
|
216 |
179 |
$1K |
| 82947 |
|
360 |
327 |
$1K |
| 86850 |
|
640 |
522 |
$988.37 |
| 0002A |
|
24 |
24 |
$960.00 |
| 99291 |
|
12 |
12 |
$855.67 |
| J1170 |
Hydromorphone injection |
177 |
137 |
$836.94 |
| 0011A |
|
20 |
20 |
$800.00 |
| 74018 |
|
108 |
102 |
$687.23 |
| 45378 |
|
15 |
15 |
$603.69 |
| 96376 |
|
669 |
527 |
$600.40 |
| 36415 |
|
10,835 |
9,041 |
$577.59 |
| 0272 |
|
3,455 |
3,221 |
$577.52 |
| 88312 |
|
91 |
77 |
$557.90 |
| 81005 |
|
870 |
737 |
$541.18 |
| J2250 |
Inj midazolam hydrochloride |
125 |
95 |
$540.82 |
| 73090 |
|
53 |
50 |
$536.88 |
| 71010 |
|
54 |
52 |
$536.04 |
| 73140 |
|
59 |
57 |
$532.96 |
| 29515 |
|
104 |
101 |
$523.65 |
| 76770 |
|
12 |
12 |
$518.70 |
| 12002 |
|
43 |
38 |
$514.31 |
| S0164 |
Injection pantroprazole |
70 |
53 |
$505.19 |
| 87184 |
|
196 |
164 |
$487.50 |
| J3010 |
Fentanyl citrate injection |
107 |
83 |
$456.23 |
| 72100 |
|
29 |
24 |
$452.50 |
| J1815 |
Insulin injection |
91 |
50 |
$422.30 |
| 73590 |
|
42 |
37 |
$414.03 |
| 99281 |
|
273 |
158 |
$346.20 |
| 73502 |
|
16 |
12 |
$336.63 |
| 10060 |
|
39 |
38 |
$315.00 |
| J7050 |
Normal saline solution infus |
95 |
84 |
$290.31 |
| 82009 |
|
130 |
106 |
$279.59 |
| 85027 |
|
1,119 |
924 |
$270.76 |
| 87077 |
|
85 |
73 |
$265.08 |
| 80076 |
|
82 |
62 |
$240.06 |
| 96368 |
|
17 |
13 |
$226.35 |
| 84439 |
|
60 |
48 |
$215.43 |
| 87420 |
|
149 |
138 |
$212.32 |
| 29505 |
|
52 |
51 |
$189.04 |
| J7120 |
Ringers lactate infusion |
40 |
26 |
$177.49 |
| 71020 |
|
15 |
15 |
$174.79 |
| 12011 |
|
26 |
25 |
$165.60 |
| J0690 |
Cefazolin sodium injection |
37 |
36 |
$150.00 |
| Q4051 |
Splint supplies misc |
37 |
13 |
$148.82 |
| 87081 |
|
25 |
25 |
$145.06 |
| A4217 |
Sterile water/saline, 500 ml |
35 |
29 |
$142.80 |
| 0636 |
|
782 |
606 |
$135.35 |
| 0762 |
|
234 |
185 |
$116.94 |
| 82150 |
|
39 |
32 |
$113.55 |
| 85651 |
|
53 |
42 |
$98.08 |
| S0020 |
Injection, bupivicaine hydro |
12 |
12 |
$87.97 |
| 29130 |
|
27 |
25 |
$79.20 |
| 87205 |
|
21 |
16 |
$51.60 |
| 84100 |
|
18 |
14 |
$26.90 |
| 0710 |
|
709 |
623 |
$26.13 |
| 36600 |
|
14 |
12 |
$25.20 |
| Q0144 |
Azithromycin dihydrate, oral |
12 |
12 |
$20.18 |
| A4606 |
Oxygen probe used w oximeter |
28 |
24 |
$20.05 |
| 85652 |
|
12 |
12 |
$16.14 |
| 82270 |
|
12 |
12 |
$14.99 |
| 81003 |
|
337 |
327 |
$11.46 |
| J1630 |
Haloperidol injection |
17 |
12 |
$5.89 |
| 0271 |
|
366 |
282 |
$2.39 |
| 85007 |
|
13 |
13 |
$1.26 |
| 85008 |
|
66 |
60 |
$0.98 |
| A6402 |
Sterile gauze <= 16 sq in |
13 |
12 |
$0.91 |
| U0005 |
Infec agen detec ampli probe |
262 |
197 |
$0.01 |
| 0760 |
|
611 |
407 |
$0.00 |
| 0402 |
|
108 |
74 |
$0.00 |
| 0360 |
|
118 |
81 |
$0.00 |
| 0320 |
|
91 |
67 |
$0.00 |
| 0302 |
|
78 |
43 |
$0.00 |
| 0351 |
|
71 |
63 |
$0.00 |
| 0160 |
|
18 |
16 |
$0.00 |
| 0305 |
|
395 |
261 |
$0.00 |
| 0370 |
|
152 |
151 |
$0.00 |
| A4615 |
Cannula nasal |
47 |
39 |
$0.00 |
| G0379 |
Direct refer hospital observ |
30 |
24 |
$0.00 |
| 0761 |
|
2,390 |
1,717 |
$0.00 |
| 0301 |
|
809 |
274 |
$0.00 |
| 0324 |
|
109 |
105 |
$0.00 |
| 0352 |
|
74 |
65 |
$0.00 |
| 0307 |
|
145 |
138 |
$0.00 |
| 0306 |
|
232 |
99 |
$0.00 |