| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
12,673 |
10,818 |
$5.34M |
| 99283 |
|
16,142 |
14,317 |
$5.25M |
| 99285 |
|
4,262 |
3,744 |
$2.77M |
| 74177 |
|
1,441 |
1,286 |
$1.34M |
| 74176 |
|
1,305 |
1,190 |
$700K |
| 99282 |
|
2,656 |
2,431 |
$632K |
| 99281 |
|
1,684 |
1,543 |
$274K |
| 99291 |
|
189 |
173 |
$224K |
| 77067 |
|
1,141 |
1,133 |
$120K |
| 70450 |
|
2,328 |
2,058 |
$53K |
| 93306 |
|
76 |
74 |
$32K |
| 96366 |
|
828 |
697 |
$30K |
| 71046 |
|
2,651 |
2,528 |
$28K |
| 73130 |
|
235 |
209 |
$6K |
| 76856 |
|
95 |
92 |
$6K |
| 93005 |
|
8,651 |
6,922 |
$6K |
| 76705 |
|
232 |
213 |
$6K |
| 73562 |
|
478 |
413 |
$5K |
| 73630 |
|
430 |
389 |
$4K |
| A9270 |
Non-covered item or service |
8,146 |
6,389 |
$4K |
| 73610 |
|
318 |
282 |
$3K |
| 76830 |
|
85 |
81 |
$3K |
| 73030 |
|
242 |
216 |
$3K |
| 96361 |
|
4,746 |
4,050 |
$3K |
| 96365 |
|
3,463 |
2,930 |
$3K |
| 71045 |
|
5,387 |
4,611 |
$2K |
| 87635 |
|
3,922 |
3,446 |
$2K |
| 94640 |
|
2,358 |
1,627 |
$1K |
| 85025 |
|
14,529 |
11,447 |
$1K |
| 96374 |
|
5,689 |
4,853 |
$1K |
| 96375 |
|
4,878 |
3,991 |
$861.74 |
| 80053 |
|
289 |
195 |
$689.80 |
| 80048 |
|
14,184 |
11,236 |
$664.12 |
| 80307 |
|
2,042 |
1,757 |
$530.35 |
| 76641 |
|
15 |
12 |
$513.74 |
| 96360 |
|
1,416 |
1,287 |
$387.13 |
| 73110 |
|
47 |
43 |
$371.53 |
| 80076 |
|
7,954 |
6,749 |
$363.37 |
| 84443 |
|
640 |
570 |
$293.75 |
| 87086 |
|
1,545 |
1,402 |
$272.77 |
| 76642 |
|
13 |
12 |
$258.63 |
| 84484 |
|
6,144 |
4,212 |
$250.04 |
| G0480 |
Drug test def 1-7 classes |
2,326 |
1,151 |
$233.42 |
| 87804 |
|
3,934 |
1,879 |
$219.32 |
| 83690 |
|
4,658 |
4,000 |
$212.11 |
| 90715 |
|
749 |
716 |
$181.28 |
| 82550 |
|
1,393 |
1,014 |
$178.28 |
| 87186 |
|
729 |
565 |
$156.89 |
| 72100 |
|
15 |
14 |
$137.21 |
| 96372 |
|
2,940 |
2,247 |
$133.07 |
| 81001 |
|
4,295 |
3,862 |
$99.89 |
| 73080 |
|
15 |
12 |
$84.33 |
| 83880 |
|
1,642 |
1,414 |
$69.85 |
| J0696 |
Ceftriaxone sodium injection |
983 |
830 |
$57.32 |
| 87040 |
|
2,527 |
1,172 |
$55.53 |
| 83735 |
|
2,569 |
1,748 |
$54.36 |
| J2405 |
Ondansetron hcl injection |
3,289 |
2,679 |
$54.24 |
| 81025 |
|
2,442 |
2,245 |
$53.88 |
| J1100 |
Dexamethasone sodium phos |
1,120 |
983 |
$49.36 |
| J2270 |
Morphine sulfate injection |
2,896 |
1,950 |
$47.06 |
| 87880 |
|
639 |
606 |
$45.56 |
| 83605 |
|
2,681 |
1,879 |
$43.18 |
| 81000 |
|
2,704 |
2,354 |
$42.97 |
| J1885 |
Ketorolac tromethamine inj |
3,725 |
3,229 |
$42.01 |
| 85610 |
|
1,006 |
873 |
$31.50 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,984 |
1,721 |
$18.79 |
| 96376 |
|
1,349 |
1,048 |
$17.59 |
| 36415 |
|
5,651 |
4,327 |
$13.75 |
| 90471 |
|
707 |
678 |
$8.92 |
| 87081 |
|
108 |
103 |
$8.15 |
| 87088 |
|
491 |
431 |
$6.98 |
| 96160 |
|
70 |
40 |
$6.10 |
| 84439 |
|
491 |
426 |
$5.77 |
| J2060 |
Lorazepam injection |
296 |
196 |
$1.42 |
| J8499 |
Oral prescrip drug non chemo |
808 |
686 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
411 |
302 |
$0.00 |
| 84295 |
|
26 |
22 |
$0.00 |
| 80061 |
|
47 |
41 |
$0.00 |
| 84100 |
|
511 |
259 |
$0.00 |
| 29125 |
|
55 |
53 |
$0.00 |
| A4649 |
Surgical supplies |
13 |
13 |
$0.00 |
| J7030 |
Normal saline solution infus |
1,970 |
1,692 |
$0.00 |
| J7040 |
Normal saline solution infus |
529 |
411 |
$0.00 |
| J0137 |
Inj, acetaminophen (hikma) |
19 |
14 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
151 |
124 |
$0.00 |
| 96367 |
|
136 |
107 |
$0.00 |
| 82565 |
|
19 |
18 |
$0.00 |
| 87491 |
|
53 |
51 |
$0.00 |
| 87502 |
|
70 |
65 |
$0.00 |
| 87798 |
|
61 |
59 |
$0.00 |
| J0134 |
Inj acetaminophen -fresenius |
39 |
38 |
$0.00 |
| 84702 |
|
17 |
14 |
$0.00 |
| 94664 |
|
50 |
36 |
$0.00 |
| U0003 |
Cov-19 amp prb hgh thruput |
47 |
45 |
$0.00 |
| 83721 |
|
15 |
13 |
$0.00 |
| J2930 |
Methylprednisolone injection |
34 |
32 |
$0.00 |
| 82947 |
|
19 |
18 |
$0.00 |
| 93976 |
|
14 |
13 |
$0.00 |
| 10060 |
|
13 |
13 |
$0.00 |
| 86900 |
|
12 |
12 |
$0.00 |
| 77063 |
|
592 |
586 |
$0.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
549 |
461 |
$0.00 |
| 87591 |
|
53 |
51 |
$0.00 |
| 85730 |
|
361 |
331 |
$0.00 |
| 84703 |
|
842 |
745 |
$0.00 |
| J7050 |
Normal saline solution infus |
537 |
393 |
$0.00 |
| J2765 |
Metoclopramide hcl injection |
207 |
175 |
$0.00 |
| Q0162 |
Ondansetron oral |
146 |
136 |
$0.00 |
| 87651 |
|
61 |
59 |
$0.00 |
| J3490 |
Drugs unclassified injection |
115 |
92 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
400 |
286 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
211 |
199 |
$0.00 |
| 85379 |
|
180 |
174 |
$0.00 |
| J1170 |
Hydromorphone injection |
78 |
38 |
$0.00 |
| J7620 |
Albuterol ipratrop non-comp |
194 |
160 |
$0.00 |
| 82435 |
|
26 |
22 |
$0.00 |
| 12001 |
|
39 |
38 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
22 |
12 |
$0.00 |
| 83036 |
|
15 |
12 |
$0.00 |
| J1940 |
Furosemide injection |
22 |
13 |
$0.00 |
| 84132 |
|
26 |
22 |
$0.00 |
| 86901 |
|
12 |
12 |
$0.00 |
| 84480 |
|
31 |
27 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
14 |
13 |
$0.00 |
| 82330 |
|
20 |
18 |
$0.00 |
| 82803 |
|
17 |
12 |
$0.00 |