| Code | Description | Claims | Beneficiaries | Total Paid |
| G0378 |
Hospital observation per hr |
3,043 |
2,784 |
$2.51M |
| 99285 |
|
13,340 |
12,614 |
$2.04M |
| 99284 |
|
6,091 |
5,940 |
$883K |
| 99283 |
|
6,665 |
6,519 |
$847K |
| 74177 |
|
1,929 |
1,862 |
$198K |
| 96374 |
|
6,994 |
6,590 |
$109K |
| 80307 |
|
2,521 |
2,307 |
$96K |
| 80053 |
|
13,281 |
11,879 |
$87K |
| 0241U |
|
1,297 |
1,271 |
$85K |
| 85025 |
|
22,096 |
19,031 |
$72K |
| U0003 |
Cov-19 amp prb hgh thruput |
1,126 |
1,078 |
$67K |
| T1015 |
Clinic service |
978 |
629 |
$66K |
| 70450 |
|
1,747 |
1,666 |
$66K |
| 87637 |
|
1,096 |
1,086 |
$64K |
| 87491 |
|
2,387 |
2,333 |
$63K |
| 87661 |
|
1,442 |
1,409 |
$58K |
| 87591 |
|
2,329 |
2,274 |
$55K |
| 93005 |
|
7,041 |
6,521 |
$36K |
| 96375 |
|
4,062 |
3,503 |
$35K |
| 80048 |
|
6,786 |
5,690 |
$31K |
| 70498 |
|
313 |
305 |
$29K |
| 99282 |
|
280 |
276 |
$27K |
| 71275 |
|
229 |
215 |
$25K |
| 84443 |
|
1,042 |
1,004 |
$23K |
| 77067 |
|
225 |
223 |
$21K |
| 84484 |
|
4,089 |
3,578 |
$21K |
| 87636 |
|
173 |
172 |
$20K |
| 71260 |
|
300 |
295 |
$19K |
| 74176 |
|
280 |
269 |
$17K |
| 80299 |
|
761 |
696 |
$17K |
| 84703 |
|
2,734 |
2,618 |
$17K |
| 0002A |
|
359 |
358 |
$16K |
| 88175 |
|
419 |
419 |
$16K |
| 87481 |
|
431 |
423 |
$16K |
| 96361 |
|
1,729 |
1,444 |
$15K |
| 87389 |
|
506 |
500 |
$15K |
| 72125 |
|
328 |
313 |
$15K |
| 80061 |
|
1,149 |
1,110 |
$14K |
| 84702 |
|
1,086 |
910 |
$13K |
| 83880 |
|
925 |
864 |
$13K |
| 80050 |
|
357 |
347 |
$13K |
| 87798 |
|
431 |
423 |
$12K |
| 93306 |
|
414 |
409 |
$12K |
| G0476 |
Hpv combo assay ca screen |
228 |
228 |
$11K |
| 71045 |
|
2,428 |
2,294 |
$10K |
| 70553 |
|
55 |
53 |
$10K |
| 87502 |
|
147 |
145 |
$10K |
| 0001A |
|
357 |
354 |
$10K |
| 71046 |
|
1,020 |
991 |
$9K |
| 86803 |
|
471 |
464 |
$9K |
| 83735 |
|
2,705 |
2,175 |
$9K |
| 70496 |
|
116 |
112 |
$9K |
| 96376 |
|
1,705 |
914 |
$8K |
| U0005 |
Infec agen detec ampli probe |
456 |
450 |
$8K |
| 88305 |
|
668 |
593 |
$8K |
| 78452 |
|
100 |
100 |
$7K |
| 87086 |
|
1,039 |
979 |
$7K |
| 76642 |
|
140 |
123 |
$7K |
| 96372 |
|
1,579 |
868 |
$7K |
| 83690 |
|
2,644 |
2,493 |
$7K |
| 70486 |
|
105 |
104 |
$6K |
| 84999 |
|
2,347 |
2,093 |
$6K |
| 96365 |
|
503 |
455 |
$6K |
| 93971 |
|
150 |
141 |
$6K |
| 81001 |
|
3,440 |
3,271 |
$6K |
| 94640 |
|
563 |
259 |
$6K |
| 83605 |
|
1,592 |
1,287 |
$6K |
| 83036 |
|
992 |
975 |
$6K |
| 96360 |
|
294 |
288 |
$5K |
| 82306 |
|
169 |
164 |
$5K |
| 76830 |
|
128 |
124 |
$5K |
| 86850 |
|
783 |
751 |
$4K |
| 86780 |
|
252 |
245 |
$4K |
| 77063 |
|
165 |
164 |
$4K |
| 84439 |
|
520 |
485 |
$4K |
| 87635 |
|
289 |
262 |
$4K |
| 43239 |
|
32 |
31 |
$4K |
| 87340 |
|
233 |
229 |
$3K |
| 87070 |
|
526 |
505 |
$3K |
| 80076 |
|
521 |
495 |
$3K |
| 85730 |
|
1,073 |
984 |
$3K |
| 85379 |
|
533 |
503 |
$3K |
| 86762 |
|
132 |
130 |
$3K |
| 85027 |
|
736 |
624 |
$3K |
| 82570 |
|
397 |
351 |
$3K |
| 93975 |
|
45 |
41 |
$3K |
| 36415 |
|
6,632 |
4,931 |
$3K |
| 73610 |
|
209 |
192 |
$3K |
| 96366 |
|
365 |
200 |
$3K |
| 84466 |
|
199 |
188 |
$3K |
| 77066 |
Tomosynthesis, mammo |
28 |
28 |
$3K |
| 87563 |
|
169 |
167 |
$3K |
| 85610 |
|
1,439 |
1,231 |
$3K |
| 81003 |
|
1,212 |
1,172 |
$2K |
| 76705 |
|
76 |
75 |
$2K |
| 87081 |
|
442 |
436 |
$2K |
| 82550 |
|
622 |
580 |
$2K |
| 82728 |
|
235 |
218 |
$2K |
| 87205 |
|
529 |
505 |
$2K |
| 86900 |
|
792 |
757 |
$2K |
| 87186 |
|
322 |
313 |
$2K |
| J2785 |
Regadenoson injection |
82 |
66 |
$2K |
| 86901 |
|
785 |
750 |
$2K |
| 73630 |
|
222 |
200 |
$2K |
| 84145 |
|
236 |
227 |
$2K |
| 87040 |
|
297 |
278 |
$2K |
| J7030 |
Normal saline solution infus |
9,830 |
7,164 |
$2K |
| 73560 |
|
206 |
194 |
$2K |
| 93017 |
|
105 |
105 |
$2K |
| 82553 |
|
411 |
385 |
$2K |
| 82043 |
|
190 |
187 |
$2K |
| 76801 |
|
47 |
44 |
$2K |
| 84100 |
|
572 |
398 |
$2K |
| 82607 |
|
223 |
214 |
$2K |
| 73130 |
|
197 |
171 |
$2K |
| 80320 |
|
260 |
234 |
$2K |
| 84550 |
|
249 |
201 |
$2K |
| 73030 |
|
135 |
128 |
$2K |
| 83615 |
|
220 |
177 |
$1K |
| 71250 |
|
35 |
33 |
$1K |
| 83540 |
|
204 |
195 |
$1K |
| 82805 |
|
94 |
87 |
$1K |
| 80349 |
|
141 |
135 |
$1K |
| 90715 |
|
284 |
271 |
$1K |
| 87480 |
|
41 |
40 |
$1K |
| 70551 |
|
30 |
29 |
$1K |
| 87077 |
|
169 |
166 |
$1K |
| 87660 |
|
41 |
40 |
$1K |
| 93970 |
|
30 |
27 |
$1K |
| 72131 |
|
38 |
36 |
$1K |
| 82565 |
|
232 |
215 |
$971.70 |
| J2704 |
Inj, propofol, 10 mg |
3,807 |
2,641 |
$960.25 |
| 82962 |
|
1,466 |
751 |
$958.89 |
| 86140 |
|
400 |
384 |
$937.60 |
| 81025 |
|
494 |
478 |
$917.18 |
| 86618 |
|
46 |
45 |
$909.45 |
| 85652 |
|
417 |
397 |
$853.82 |
| J3490 |
Drugs unclassified injection |
3,172 |
2,263 |
$816.34 |
| J2270 |
Morphine sulfate injection |
2,819 |
1,672 |
$767.05 |
| 87075 |
|
113 |
106 |
$750.78 |
| 76536 |
|
12 |
12 |
$657.71 |
| 73502 |
|
52 |
50 |
$636.22 |
| 87147 |
|
202 |
193 |
$585.17 |
| 76775 |
|
14 |
14 |
$576.60 |
| 80329 |
|
118 |
106 |
$558.36 |
| 87510 |
|
28 |
28 |
$556.92 |
| 72100 |
|
39 |
39 |
$555.33 |
| 84156 |
|
135 |
104 |
$549.30 |
| 83001 |
|
25 |
25 |
$547.01 |
| 86592 |
|
119 |
117 |
$522.71 |
| 73110 |
|
74 |
64 |
$519.00 |
| 88342 |
|
15 |
15 |
$399.18 |
| 77062 |
|
13 |
13 |
$359.52 |
| 74018 |
|
30 |
25 |
$351.90 |
| 84146 |
|
12 |
12 |
$347.04 |
| 59025 |
|
74 |
51 |
$333.00 |
| 0003A |
|
12 |
12 |
$324.00 |
| 82746 |
|
57 |
51 |
$317.83 |
| 90471 |
|
53 |
51 |
$306.15 |
| 82950 |
|
38 |
37 |
$304.36 |
| J7120 |
Ringers lactate infusion |
3,802 |
3,016 |
$303.82 |
| 73590 |
|
31 |
28 |
$289.32 |
| J2710 |
Neostigmine methylslfte inj |
312 |
246 |
$248.78 |
| J1815 |
Insulin injection |
1,852 |
440 |
$231.59 |
| J3010 |
Fentanyl citrate injection |
4,224 |
2,909 |
$211.50 |
| J0696 |
Ceftriaxone sodium injection |
1,467 |
894 |
$210.80 |
| J1885 |
Ketorolac tromethamine inj |
5,579 |
4,199 |
$200.07 |
| 73562 |
|
15 |
14 |
$189.16 |
| C9113 |
Inj pantoprazole sodium, via |
1,242 |
636 |
$180.07 |
| J1644 |
Inj heparin sodium per 1000u |
4,162 |
1,391 |
$175.11 |
| 72040 |
|
13 |
13 |
$156.85 |
| J1170 |
Hydromorphone injection |
834 |
546 |
$152.82 |
| 97162 |
|
144 |
137 |
$152.00 |
| J2405 |
Ondansetron hcl injection |
7,568 |
5,534 |
$147.03 |
| 86038 |
|
12 |
12 |
$128.20 |
| 87210 |
|
40 |
38 |
$116.49 |
| J0690 |
Cefazolin sodium injection |
1,797 |
1,204 |
$112.29 |
| 94760 |
|
464 |
312 |
$107.47 |
| 88304 |
|
36 |
36 |
$98.38 |
| 97166 |
|
166 |
158 |
$95.98 |
| 97165 |
|
29 |
27 |
$92.60 |
| J0330 |
Succinycholine chloride inj |
389 |
334 |
$75.96 |
| 99152 |
|
39 |
37 |
$73.06 |
| A9500 |
Tc99m sestamibi |
61 |
61 |
$70.56 |
| 87088 |
|
12 |
12 |
$70.39 |
| J1100 |
Dexamethasone sodium phos |
2,751 |
2,178 |
$68.04 |
| J0780 |
Prochlorperazine injection |
266 |
223 |
$63.86 |
| 73080 |
|
13 |
13 |
$63.25 |
| G0463 |
Hospital outpt clinic visit |
12 |
12 |
$61.10 |
| J1200 |
Diphenhydramine hcl injectio |
1,421 |
1,162 |
$55.45 |
| 82140 |
|
31 |
27 |
$49.22 |
| 87880 |
|
12 |
12 |
$47.88 |
| 82330 |
|
26 |
26 |
$42.89 |
| J3370 |
Vancomycin hcl injection |
187 |
89 |
$38.92 |
| J2060 |
Lorazepam injection |
542 |
377 |
$36.87 |
| 95816 |
|
15 |
14 |
$29.70 |
| J7040 |
Normal saline solution infus |
366 |
300 |
$27.18 |
| C1894 |
Intro/sheath, non-laser |
28 |
25 |
$24.74 |
| J2250 |
Inj midazolam hydrochloride |
2,834 |
2,452 |
$18.90 |
| J2930 |
Methylprednisolone injection |
19 |
12 |
$17.17 |
| J2370 |
Phenylephrine hcl injection |
143 |
109 |
$17.16 |
| 85018 |
|
17 |
14 |
$16.62 |
| J2765 |
Metoclopramide hcl injection |
298 |
238 |
$16.42 |
| J3475 |
Inj magnesium sulfate |
416 |
331 |
$15.14 |
| 97161 |
|
68 |
65 |
$12.37 |
| J1650 |
Inj enoxaparin sodium |
270 |
107 |
$10.83 |
| A9270 |
Non-covered item or service |
33,739 |
7,081 |
$10.53 |
| J2001 |
Lidocaine injection |
1,425 |
1,315 |
$10.10 |
| S0030 |
Injection, metronidazole |
62 |
40 |
$6.66 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
114 |
90 |
$6.44 |
| J7999 |
Compounded drug, noc |
133 |
125 |
$3.47 |
| G1004 |
Cdsm ndsc |
2,192 |
1,748 |
$0.09 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
17 |
13 |
$0.00 |
| 97116 |
|
23 |
13 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
109 |
96 |
$0.00 |
| 0004A |
|
17 |
17 |
$0.00 |
| G0480 |
Drug test def 1-7 classes |
36 |
32 |
$0.00 |
| C1769 |
Guide wire |
12 |
12 |
$0.00 |
| J7050 |
Normal saline solution infus |
186 |
124 |
$0.00 |
| J7060 |
5% dextrose/water |
33 |
25 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
105 |
59 |
$0.00 |
| J3480 |
Inj potassium chloride |
61 |
26 |
$0.00 |
| 82077 |
|
16 |
14 |
$0.00 |
| 97535 |
|
17 |
12 |
$0.00 |
| 94762 |
|
17 |
14 |
$0.00 |