| Code | Description | Claims | Beneficiaries | Total Paid |
| G0463 |
Hospital outpt clinic visit |
385,656 |
347,770 |
$36.55M |
| 99284 |
|
23,697 |
21,569 |
$5.27M |
| 99283 |
|
19,757 |
18,503 |
$2.74M |
| 99285 |
|
5,071 |
4,537 |
$2.13M |
| 90471 |
|
29,780 |
28,929 |
$1.20M |
| 96374 |
|
9,987 |
9,011 |
$1.20M |
| 92507 |
|
19,239 |
6,551 |
$1.20M |
| 99391 |
|
12,428 |
11,524 |
$976K |
| 41874 |
|
456 |
362 |
$937K |
| 99392 |
|
10,343 |
10,148 |
$824K |
| 20610 |
|
4,533 |
3,650 |
$764K |
| 93303 |
|
2,002 |
1,681 |
$693K |
| 90853 |
|
10,110 |
1,490 |
$660K |
| D7311 |
|
653 |
468 |
$583K |
| 45380 |
|
1,022 |
862 |
$560K |
| 96110 |
|
8,959 |
8,739 |
$559K |
| 99393 |
|
6,783 |
6,661 |
$531K |
| 43239 |
|
1,739 |
1,487 |
$491K |
| 87811 |
|
12,020 |
11,804 |
$481K |
| 96361 |
|
6,796 |
6,074 |
$323K |
| U0003 |
Cov-19 amp prb hgh thruput |
5,072 |
4,439 |
$306K |
| 99394 |
|
3,039 |
2,992 |
$278K |
| G0378 |
Hospital observation per hr |
4,194 |
1,778 |
$273K |
| 97530 |
|
4,910 |
1,759 |
$218K |
| 71045 |
|
3,885 |
3,547 |
$202K |
| 90834 |
|
2,713 |
1,816 |
$201K |
| G0330 |
Facility svs dental rehab |
146 |
138 |
$175K |
| 96375 |
|
4,968 |
4,445 |
$171K |
| 11042 |
|
1,051 |
615 |
$170K |
| 96413 |
|
600 |
336 |
$150K |
| 97110 |
|
3,987 |
943 |
$130K |
| 95911 |
|
328 |
309 |
$111K |
| 69436 |
|
112 |
108 |
$101K |
| 95250 |
|
1,243 |
1,100 |
$83K |
| 95117 |
|
2,741 |
1,347 |
$80K |
| 90686 |
|
6,925 |
6,608 |
$77K |
| 71046 |
|
1,269 |
1,166 |
$71K |
| D2930 |
|
179 |
83 |
$68K |
| C9803 |
Hopd covid-19 spec collect |
6,163 |
5,711 |
$68K |
| U0005 |
Infec agen detec ampli probe |
3,739 |
3,358 |
$63K |
| 80061 |
|
5,330 |
4,981 |
$62K |
| D7230 |
|
245 |
54 |
$62K |
| 92587 |
|
273 |
249 |
$60K |
| 36415 |
|
65,715 |
57,117 |
$48K |
| 87491 |
|
2,692 |
2,361 |
$39K |
| 95909 |
|
207 |
197 |
$37K |
| 70553 |
|
105 |
96 |
$37K |
| 99282 |
|
478 |
458 |
$37K |
| H0035 |
Mh partial hosp tx under 24h |
429 |
62 |
$37K |
| 11056 |
|
690 |
651 |
$35K |
| 95004 |
|
509 |
496 |
$34K |
| D7140 |
|
173 |
29 |
$34K |
| D1351 |
|
75 |
27 |
$34K |
| J0585 |
Injection,onabotulinumtoxina |
100 |
55 |
$33K |
| U0002 |
Covid-19 lab test non-cdc |
850 |
741 |
$33K |
| 0241U |
|
319 |
296 |
$31K |
| 93306 |
|
114 |
112 |
$31K |
| 80053 |
|
47,769 |
41,721 |
$30K |
| 87591 |
|
2,690 |
2,359 |
$29K |
| 62323 |
|
88 |
81 |
$29K |
| G2023 |
Specimen collect covid-19 |
1,570 |
1,388 |
$28K |
| 78452 |
|
38 |
37 |
$26K |
| 84443 |
|
9,197 |
8,453 |
$26K |
| 96365 |
|
168 |
130 |
$26K |
| 92557 |
|
523 |
491 |
$25K |
| 87635 |
|
517 |
497 |
$25K |
| 43249 |
|
27 |
25 |
$24K |
| 11721 |
|
3,337 |
3,150 |
$24K |
| 82306 |
|
5,294 |
4,884 |
$23K |
| 99395 |
|
270 |
267 |
$23K |
| 45385 |
|
58 |
52 |
$19K |
| 87637 |
|
173 |
166 |
$18K |
| 92588 |
|
116 |
75 |
$17K |
| 70450 |
|
84 |
77 |
$16K |
| 90792 |
|
395 |
388 |
$16K |
| 85025 |
|
43,877 |
38,405 |
$15K |
| 0202U |
|
44 |
40 |
$15K |
| G0379 |
Direct refer hospital observ |
13 |
12 |
$15K |
| 90670 |
|
2,380 |
2,314 |
$14K |
| 87081 |
|
19,009 |
17,999 |
$12K |
| 90651 |
|
195 |
189 |
$12K |
| 83036 |
|
6,412 |
5,952 |
$10K |
| 90837 |
|
366 |
270 |
$9K |
| 74177 |
|
39 |
37 |
$9K |
| D7310 |
|
16 |
12 |
$8K |
| 93005 |
|
14,619 |
13,077 |
$8K |
| 86900 |
|
391 |
332 |
$8K |
| 74176 |
|
61 |
59 |
$8K |
| 87661 |
|
1,698 |
1,467 |
$8K |
| 83655 |
|
2,865 |
2,698 |
$8K |
| J7324 |
Orthovisc inj per dose |
52 |
26 |
$7K |
| 76805 |
|
71 |
65 |
$7K |
| 86780 |
|
529 |
461 |
$7K |
| 99396 |
|
66 |
65 |
$6K |
| 87880 |
|
35,582 |
34,697 |
$6K |
| 90791 |
|
106 |
100 |
$5K |
| 73562 |
|
746 |
690 |
$5K |
| A0425 |
Ground mileage |
2,738 |
2,109 |
$5K |
| 11057 |
|
79 |
79 |
$5K |
| 76816 |
|
121 |
99 |
$5K |
| 96372 |
|
7,270 |
6,778 |
$5K |
| 73630 |
|
331 |
245 |
$5K |
| 85027 |
|
5,991 |
5,477 |
$5K |
| 82728 |
|
1,538 |
1,400 |
$4K |
| 90847 |
|
258 |
201 |
$4K |
| 70320 |
|
33 |
26 |
$4K |
| 90723 |
|
1,191 |
1,165 |
$3K |
| 0071A |
|
71 |
71 |
$3K |
| A0428 |
Bls |
947 |
728 |
$3K |
| 88305 |
|
3,696 |
2,719 |
$3K |
| 83550 |
|
1,000 |
924 |
$2K |
| 97161 |
|
55 |
53 |
$2K |
| 0072A |
|
62 |
61 |
$2K |
| 92567 |
|
2,502 |
2,322 |
$2K |
| 84481 |
|
372 |
339 |
$2K |
| 59025 |
|
23 |
12 |
$2K |
| 73564 |
|
263 |
241 |
$2K |
| 77336 |
|
30 |
13 |
$2K |
| 87086 |
|
1,988 |
1,755 |
$2K |
| 83540 |
|
1,004 |
928 |
$2K |
| 64615 |
|
17 |
15 |
$2K |
| 51798 |
|
1,351 |
1,167 |
$2K |
| 92579 |
|
167 |
140 |
$2K |
| 87070 |
|
1,811 |
1,701 |
$2K |
| 84484 |
|
3,699 |
2,701 |
$2K |
| 84439 |
|
593 |
546 |
$1K |
| 87389 |
|
522 |
458 |
$1K |
| 76801 |
|
15 |
12 |
$1K |
| 87804 |
|
8,748 |
7,193 |
$1K |
| 84703 |
|
655 |
582 |
$1K |
| 90472 |
|
15,369 |
15,058 |
$1K |
| 20552 |
|
23 |
14 |
$956.77 |
| A0427 |
Als1-emergency |
135 |
119 |
$935.09 |
| 76830 |
|
14 |
12 |
$879.17 |
| 76815 |
|
19 |
16 |
$768.88 |
| 84144 |
|
43 |
26 |
$720.50 |
| 73030 |
|
48 |
44 |
$714.39 |
| 73130 |
|
14 |
12 |
$683.50 |
| 80305 |
|
1,053 |
905 |
$666.86 |
| 82950 |
|
112 |
102 |
$636.53 |
| 97140 |
|
33 |
14 |
$633.02 |
| 93320 |
|
2,007 |
1,683 |
$629.00 |
| 76536 |
|
204 |
188 |
$610.14 |
| 73100 |
|
14 |
12 |
$587.64 |
| 80048 |
|
1,251 |
1,143 |
$488.03 |
| A0429 |
Bls-emergency |
90 |
64 |
$411.63 |
| 87633 |
|
470 |
431 |
$404.28 |
| 87210 |
|
730 |
656 |
$377.20 |
| 99211 |
|
36 |
34 |
$372.97 |
| 80055 |
|
13 |
12 |
$327.64 |
| 83735 |
|
2,193 |
2,024 |
$325.72 |
| 81003 |
|
5,768 |
5,124 |
$295.71 |
| 94762 |
|
160 |
65 |
$294.30 |
| 94010 |
|
469 |
443 |
$291.67 |
| 99173 |
|
13 |
12 |
$266.00 |
| 90677 |
|
42 |
42 |
$262.23 |
| 93017 |
|
41 |
40 |
$252.82 |
| 82607 |
|
106 |
103 |
$225.71 |
| Q3014 |
Telehealth facility fee |
79 |
68 |
$206.56 |
| 84403 |
|
29 |
26 |
$200.05 |
| 85007 |
|
353 |
311 |
$181.09 |
| 85046 |
|
52 |
48 |
$180.60 |
| 82043 |
|
79 |
75 |
$161.47 |
| 81025 |
|
160 |
151 |
$152.40 |
| J2250 |
Inj midazolam hydrochloride |
946 |
792 |
$135.40 |
| 97542 |
|
12 |
12 |
$133.16 |
| 88720 |
|
15 |
13 |
$131.22 |
| 85018 |
|
260 |
250 |
$96.33 |
| 90656 |
|
13 |
13 |
$79.56 |
| 83690 |
|
2,995 |
2,683 |
$77.92 |
| 96127 |
|
208 |
204 |
$70.94 |
| 83605 |
|
4,242 |
3,697 |
$66.06 |
| 87400 |
|
122 |
108 |
$62.36 |
| 86140 |
|
8,080 |
7,288 |
$47.59 |
| 81001 |
|
5,232 |
4,741 |
$42.64 |
| 94761 |
|
3,729 |
3,059 |
$36.30 |
| 87798 |
|
501 |
449 |
$34.04 |
| 87581 |
|
499 |
447 |
$34.04 |
| 87486 |
|
499 |
447 |
$34.04 |
| 87186 |
|
25 |
25 |
$33.88 |
| 86762 |
|
116 |
105 |
$27.61 |
| 87807 |
|
725 |
705 |
$25.15 |
| 90647 |
|
1,125 |
1,090 |
$20.91 |
| 87340 |
|
118 |
107 |
$19.82 |
| J7030 |
Normal saline solution infus |
8,951 |
7,606 |
$18.66 |
| 82785 |
|
12 |
12 |
$13.17 |
| J1100 |
Dexamethasone sodium phos |
3,748 |
3,198 |
$12.00 |
| 85610 |
|
5,265 |
4,709 |
$10.38 |
| J2405 |
Ondansetron hcl injection |
4,743 |
4,054 |
$9.17 |
| 84145 |
|
975 |
883 |
$8.48 |
| J3301 |
Triamcinolone acet inj nos |
2,069 |
1,913 |
$8.00 |
| 87077 |
|
13 |
13 |
$7.91 |
| 83615 |
|
61 |
51 |
$7.08 |
| G0008 |
Admin influenza virus vac |
62 |
62 |
$6.54 |
| J1885 |
Ketorolac tromethamine inj |
7,381 |
6,781 |
$0.42 |
| J7120 |
Ringers lactate infusion |
635 |
520 |
$0.12 |
| J3010 |
Fentanyl citrate injection |
4,614 |
3,708 |
$0.10 |
| J2704 |
Inj, propofol, 10 mg |
693 |
588 |
$0.09 |
| 90785 |
|
971 |
724 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
1,444 |
1,218 |
$0.00 |
| 93325 |
|
2,007 |
1,683 |
$0.00 |
| 99152 |
|
1,209 |
1,021 |
$0.00 |
| 90633 |
|
316 |
300 |
$0.00 |
| 90648 |
|
242 |
242 |
$0.00 |
| 90833 |
|
50 |
44 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
53 |
40 |
$0.00 |
| 90460 |
|
66 |
66 |
$0.00 |
| 80307 |
|
25 |
13 |
$0.00 |
| 81002 |
|
38 |
37 |
$0.00 |
| 90681 |
|
37 |
37 |
$0.00 |
| 80179 |
|
37 |
35 |
$0.00 |
| A4649 |
Surgical supplies |
41 |
38 |
$0.00 |
| 90710 |
|
39 |
38 |
$0.00 |
| 90715 |
|
28 |
28 |
$0.00 |
| J2270 |
Morphine sulfate injection |
138 |
119 |
$0.00 |
| J7040 |
Normal saline solution infus |
31 |
28 |
$0.00 |
| 94664 |
|
30 |
25 |
$0.00 |
| 88312 |
|
30 |
29 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
13 |
12 |
$0.00 |
| J1050 |
Medroxyprogesterone acetate |
14 |
14 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
12 |
12 |
$0.00 |
| 87280 |
|
121 |
116 |
$0.00 |
| 90474 |
|
4,312 |
4,217 |
$0.00 |
| 95885 |
|
284 |
224 |
$0.00 |
| 36416 |
|
4,125 |
3,722 |
$0.00 |
| 90680 |
|
804 |
781 |
$0.00 |
| 85730 |
|
1,365 |
1,214 |
$0.00 |
| 86901 |
|
391 |
332 |
$0.00 |
| 86850 |
|
362 |
308 |
$0.00 |
| J2175 |
Meperidine hydrochl /100 mg |
64 |
55 |
$0.00 |
| 80320 |
|
20 |
17 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
790 |
662 |
$0.00 |
| 95886 |
|
666 |
568 |
$0.00 |
| G0480 |
Drug test def 1-7 classes |
1,659 |
1,415 |
$0.00 |
| 94640 |
|
184 |
172 |
$0.00 |
| J1040 |
Methylprednisolone 80 mg inj |
323 |
278 |
$0.00 |
| 88342 |
|
568 |
474 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
151 |
132 |
$0.00 |
| J1030 |
Methylprednisolone 40 mg inj |
193 |
166 |
$0.00 |
| 87040 |
|
334 |
176 |
$0.00 |
| J1170 |
Hydromorphone injection |
91 |
79 |
$0.00 |
| 82150 |
|
96 |
92 |
$0.00 |
| 86803 |
|
48 |
42 |
$0.00 |
| 83880 |
|
32 |
30 |
$0.00 |
| 85379 |
|
109 |
97 |
$0.00 |
| C1726 |
Cath, bal dil, non-vascular |
41 |
38 |
$0.00 |
| A9500 |
Tc99m sestamibi |
38 |
37 |
$0.00 |
| C1769 |
Guide wire |
12 |
12 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
34 |
26 |
$0.00 |
| J2785 |
Regadenoson injection |
13 |
12 |
$0.00 |
| 80329 |
|
19 |
17 |
$0.00 |
| 90696 |
|
39 |
38 |
$0.00 |
| 82550 |
|
15 |
14 |
$0.00 |
| 85652 |
|
17 |
15 |
$0.00 |