| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
11,434 |
10,765 |
$4.49M |
| 99283 |
|
17,110 |
16,494 |
$2.46M |
| 99285 |
|
4,803 |
4,402 |
$1.71M |
| 87633 |
|
1,429 |
1,399 |
$503K |
| 80053 |
|
16,809 |
14,255 |
$445K |
| 99212 |
|
4,493 |
4,020 |
$351K |
| 85025 |
|
19,577 |
16,018 |
$331K |
| 93005 |
|
4,712 |
4,309 |
$277K |
| G0378 |
Hospital observation per hr |
576 |
287 |
$252K |
| 76816 |
|
1,725 |
1,445 |
$245K |
| G0463 |
Hospital outpt clinic visit |
2,216 |
1,747 |
$221K |
| 99282 |
|
1,680 |
1,623 |
$212K |
| J1200 |
Diphenhydramine hcl injectio |
311 |
240 |
$184K |
| 87637 |
|
2,925 |
2,833 |
$180K |
| 76700 |
|
903 |
888 |
$164K |
| 80050 |
|
1,067 |
1,039 |
$155K |
| 74177 |
|
395 |
375 |
$131K |
| J7050 |
Normal saline solution infus |
5,342 |
2,987 |
$128K |
| 70450 |
|
893 |
822 |
$126K |
| 96365 |
|
2,464 |
1,367 |
$125K |
| 93306 |
|
119 |
119 |
$117K |
| 43239 |
|
326 |
316 |
$105K |
| 80061 |
|
2,875 |
2,845 |
$105K |
| 96361 |
|
2,941 |
2,501 |
$103K |
| 71046 |
|
1,808 |
1,746 |
$101K |
| J7030 |
Normal saline solution infus |
4,192 |
3,459 |
$98K |
| J3490 |
Drugs unclassified injection |
4,559 |
2,079 |
$97K |
| 81001 |
|
12,665 |
11,872 |
$95K |
| 87086 |
|
7,489 |
7,038 |
$94K |
| 76819 |
|
706 |
468 |
$90K |
| 76856 |
|
456 |
445 |
$80K |
| 71045 |
|
2,267 |
2,028 |
$74K |
| 88305 |
|
1,090 |
851 |
$73K |
| U0002 |
Covid-19 lab test non-cdc |
2,150 |
2,080 |
$73K |
| 76770 |
|
391 |
385 |
$73K |
| 96374 |
|
3,184 |
2,814 |
$64K |
| J1100 |
Dexamethasone sodium phos |
1,968 |
1,728 |
$61K |
| 99211 |
|
1,945 |
1,451 |
$58K |
| 99218 |
|
194 |
85 |
$57K |
| 80307 |
|
793 |
707 |
$53K |
| 96375 |
|
3,359 |
2,685 |
$52K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,686 |
1,531 |
$49K |
| J0696 |
Ceftriaxone sodium injection |
707 |
485 |
$43K |
| 87798 |
|
1,412 |
1,371 |
$43K |
| 84439 |
|
1,795 |
1,770 |
$42K |
| 87581 |
|
1,399 |
1,368 |
$42K |
| 87486 |
|
1,388 |
1,357 |
$41K |
| J7120 |
Ringers lactate infusion |
2,460 |
2,164 |
$40K |
| 97165 |
|
689 |
676 |
$35K |
| 74176 |
|
155 |
148 |
$34K |
| 99213 |
|
238 |
211 |
$33K |
| J2405 |
Ondansetron hcl injection |
4,082 |
3,482 |
$33K |
| 84443 |
|
1,604 |
1,556 |
$31K |
| 74018 |
|
403 |
382 |
$30K |
| 96372 |
|
2,150 |
1,607 |
$29K |
| Q3014 |
Telehealth facility fee |
1,005 |
988 |
$29K |
| 84484 |
|
1,904 |
1,588 |
$28K |
| 94664 |
|
633 |
612 |
$25K |
| 81025 |
|
1,914 |
1,803 |
$25K |
| 97110 |
|
602 |
180 |
$24K |
| 83036 |
|
1,934 |
1,912 |
$23K |
| 74019 |
|
721 |
698 |
$23K |
| J1642 |
Inj heparin sodium per 10 u |
331 |
149 |
$22K |
| 76820 |
|
226 |
153 |
$20K |
| 83690 |
|
2,112 |
1,857 |
$19K |
| 86140 |
|
1,168 |
1,099 |
$19K |
| 99203 |
|
89 |
85 |
$18K |
| 87636 |
|
520 |
495 |
$18K |
| J2270 |
Morphine sulfate injection |
2,096 |
1,624 |
$17K |
| 96360 |
|
336 |
294 |
$17K |
| 82728 |
|
778 |
739 |
$15K |
| U0003 |
Cov-19 amp prb hgh thruput |
172 |
168 |
$14K |
| 87804 |
|
643 |
333 |
$14K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
26 |
25 |
$14K |
| 85730 |
|
1,967 |
1,803 |
$13K |
| 87077 |
|
1,442 |
1,319 |
$13K |
| 80048 |
|
768 |
622 |
$12K |
| 87186 |
|
1,147 |
1,055 |
$12K |
| 36415 |
|
2,538 |
2,204 |
$11K |
| 85652 |
|
881 |
830 |
$11K |
| 85610 |
|
2,637 |
2,374 |
$11K |
| 87070 |
|
1,259 |
1,198 |
$10K |
| 87880 |
|
790 |
770 |
$9K |
| J3010 |
Fentanyl citrate injection |
1,714 |
1,617 |
$9K |
| 76811 |
|
51 |
51 |
$9K |
| 0002A |
|
628 |
589 |
$9K |
| 85027 |
|
1,435 |
1,218 |
$8K |
| J1885 |
Ketorolac tromethamine inj |
1,521 |
1,349 |
$8K |
| C9803 |
Hopd covid-19 spec collect |
458 |
435 |
$8K |
| 74022 |
|
164 |
163 |
$8K |
| 83880 |
|
326 |
290 |
$8K |
| 76705 |
|
66 |
65 |
$8K |
| J0690 |
Cefazolin sodium injection |
529 |
465 |
$7K |
| 83735 |
|
1,439 |
1,076 |
$7K |
| 84702 |
|
427 |
373 |
$6K |
| 88312 |
|
175 |
157 |
$6K |
| 94640 |
|
214 |
164 |
$6K |
| 83605 |
|
628 |
515 |
$6K |
| 99001 |
|
820 |
777 |
$6K |
| J2704 |
Inj, propofol, 10 mg |
2,161 |
2,093 |
$5K |
| J1170 |
Hydromorphone injection |
665 |
582 |
$5K |
| J7040 |
Normal saline solution infus |
295 |
241 |
$5K |
| 83525 |
|
134 |
129 |
$5K |
| 87491 |
|
164 |
159 |
$5K |
| 97530 |
|
110 |
37 |
$5K |
| 87591 |
|
164 |
159 |
$5K |
| 86900 |
|
842 |
768 |
$5K |
| 97161 |
|
83 |
80 |
$4K |
| 80076 |
|
95 |
94 |
$4K |
| 76815 |
|
68 |
56 |
$4K |
| 96366 |
|
122 |
91 |
$4K |
| 97803 |
|
51 |
50 |
$4K |
| 97162 |
|
86 |
82 |
$4K |
| 97802 |
|
14 |
14 |
$3K |
| 96413 |
|
61 |
39 |
$3K |
| 93976 |
|
25 |
25 |
$3K |
| 76801 |
|
25 |
25 |
$3K |
| 0001A |
|
664 |
624 |
$3K |
| 82947 |
|
434 |
430 |
$3K |
| A4216 |
Sterile water/saline, 10 ml |
2,534 |
1,708 |
$3K |
| 86850 |
|
259 |
228 |
$2K |
| 76827 |
|
25 |
24 |
$2K |
| 82962 |
|
2,085 |
977 |
$2K |
| 87040 |
|
170 |
142 |
$2K |
| 86901 |
|
843 |
769 |
$2K |
| A9270 |
Non-covered item or service |
1,477 |
967 |
$2K |
| 87635 |
|
100 |
96 |
$2K |
| M0243 |
Casirivi and imdevi inj |
59 |
58 |
$2K |
| 97535 |
|
59 |
36 |
$2K |
| M0245 |
Bamlan and etesev infusion |
46 |
45 |
$2K |
| 84100 |
|
393 |
293 |
$1K |
| 82306 |
|
66 |
66 |
$1K |
| J7060 |
5% dextrose/water |
107 |
38 |
$1K |
| 0004A |
|
58 |
58 |
$1K |
| J0702 |
Betamethasone acet&sod phosp |
12 |
12 |
$871.92 |
| S0028 |
Injection, famotidine, 20 mg |
303 |
255 |
$797.86 |
| 0072A |
|
50 |
46 |
$745.20 |
| 86038 |
|
25 |
25 |
$740.13 |
| J2250 |
Inj midazolam hydrochloride |
1,550 |
1,473 |
$585.01 |
| J0173 |
Inj, epinephrine (belcher) |
51 |
50 |
$557.51 |
| 87426 |
|
36 |
34 |
$531.38 |
| 87806 |
|
12 |
12 |
$531.18 |
| 83655 |
|
24 |
24 |
$497.63 |
| 36416 |
|
218 |
188 |
$434.45 |
| 88342 |
|
14 |
14 |
$390.04 |
| 83540 |
|
52 |
50 |
$371.10 |
| 99202 |
|
13 |
13 |
$360.15 |
| 84379 |
|
94 |
91 |
$345.84 |
| 96367 |
|
21 |
12 |
$319.66 |
| 87081 |
|
15 |
15 |
$259.69 |
| 83550 |
|
25 |
24 |
$230.79 |
| 0071A |
|
54 |
49 |
$216.00 |
| 82784 |
|
16 |
12 |
$199.19 |
| 90686 |
|
16 |
16 |
$138.59 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
131 |
129 |
$131.27 |
| 87205 |
|
16 |
14 |
$78.29 |
| S0020 |
Injection, bupivicaine hydro |
21 |
20 |
$69.43 |
| J0687 |
Inj cefazolin (wg crit care) |
15 |
14 |
$63.77 |
| G0008 |
Admin influenza virus vac |
16 |
16 |
$44.37 |
| J2710 |
Neostigmine methylslfte inj |
13 |
13 |
$20.44 |
| 90833 |
|
35 |
35 |
$19.50 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
12 |
12 |
$8.14 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
15 |
12 |
$5.25 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
50 |
44 |
$4.98 |
| 93010 |
|
27 |
26 |
$2.88 |
| J8499 |
Oral prescrip drug non chemo |
880 |
595 |
$0.00 |