| Code | Description | Claims | Beneficiaries | Total Paid |
| 99499 |
|
9,489 |
7,505 |
$2.31M |
| 0450 |
|
24,762 |
21,966 |
$1.79M |
| 99283 |
|
15,118 |
14,773 |
$1.13M |
| 96374 |
|
8,857 |
8,054 |
$629K |
| 74177 |
|
2,045 |
1,875 |
$565K |
| 80053 |
|
30,599 |
28,171 |
$487K |
| 93005 |
|
12,930 |
11,914 |
$391K |
| 87636 |
|
2,174 |
2,148 |
$357K |
| 0762 |
|
264 |
253 |
$354K |
| 70450 |
|
2,437 |
2,306 |
$330K |
| 85025 |
|
34,818 |
31,408 |
$312K |
| 96375 |
|
5,868 |
5,102 |
$295K |
| 99285 |
|
1,345 |
1,206 |
$197K |
| 74176 |
|
1,180 |
1,142 |
$196K |
| U0003 |
Cov-19 amp prb hgh thruput |
1,942 |
1,919 |
$164K |
| 80307 |
|
2,379 |
2,099 |
$164K |
| 99284 |
|
1,541 |
1,458 |
$160K |
| Z7502 |
|
4,241 |
4,123 |
$151K |
| 72125 |
|
665 |
650 |
$124K |
| A4217 |
Sterile water/saline, 500 ml |
9,053 |
7,571 |
$120K |
| 87502 |
|
1,584 |
1,463 |
$120K |
| 71046 |
|
4,856 |
4,562 |
$118K |
| U0002 |
Covid-19 lab test non-cdc |
2,294 |
2,202 |
$115K |
| 96372 |
|
3,141 |
2,633 |
$85K |
| 84484 |
|
7,484 |
6,598 |
$83K |
| 96361 |
|
2,300 |
2,032 |
$83K |
| 71045 |
|
4,478 |
4,193 |
$70K |
| 83690 |
|
7,255 |
6,556 |
$58K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
3,606 |
3,256 |
$56K |
| 96365 |
|
640 |
570 |
$55K |
| J3490 |
Drugs unclassified injection |
34,211 |
14,703 |
$48K |
| J1885 |
Ketorolac tromethamine inj |
4,324 |
3,950 |
$41K |
| J2405 |
Ondansetron hcl injection |
4,134 |
3,484 |
$31K |
| 96379 |
|
1,389 |
1,080 |
$26K |
| 81001 |
|
7,008 |
6,511 |
$26K |
| 96360 |
|
375 |
353 |
$25K |
| 83605 |
|
2,368 |
2,142 |
$25K |
| 80048 |
|
2,260 |
1,928 |
$24K |
| 94640 |
|
966 |
759 |
$24K |
| 0270 |
|
2,390 |
1,699 |
$23K |
| J1170 |
Hydromorphone injection |
2,023 |
1,490 |
$23K |
| J0696 |
Ceftriaxone sodium injection |
1,481 |
1,372 |
$22K |
| 43239 |
|
65 |
65 |
$22K |
| 71275 |
|
120 |
119 |
$20K |
| 87086 |
|
2,157 |
2,007 |
$19K |
| 83880 |
|
674 |
636 |
$17K |
| 70496 |
|
102 |
79 |
$17K |
| 0360 |
|
203 |
137 |
$17K |
| 73630 |
|
418 |
398 |
$15K |
| 87040 |
|
1,012 |
891 |
$15K |
| 80306 |
|
493 |
466 |
$14K |
| 85379 |
|
1,352 |
1,291 |
$14K |
| 93306 |
|
123 |
117 |
$13K |
| 88305 |
|
526 |
523 |
$13K |
| 81025 |
|
2,058 |
1,911 |
$12K |
| 70498 |
|
74 |
52 |
$12K |
| 45380 |
|
26 |
26 |
$11K |
| 87798 |
|
285 |
278 |
$11K |
| 73610 |
|
332 |
317 |
$11K |
| J2270 |
Morphine sulfate injection |
1,179 |
987 |
$11K |
| 73562 |
|
384 |
355 |
$10K |
| 72100 |
|
302 |
288 |
$10K |
| J2704 |
Inj, propofol, 10 mg |
1,191 |
994 |
$10K |
| 70486 |
|
55 |
55 |
$10K |
| Z7610 |
|
995 |
652 |
$9K |
| 36415 |
|
6,024 |
4,793 |
$9K |
| J7120 |
Ringers lactate infusion |
1,237 |
1,109 |
$9K |
| 76856 |
|
125 |
111 |
$8K |
| 84703 |
|
1,202 |
1,131 |
$8K |
| 76705 |
|
158 |
156 |
$8K |
| 99199 |
|
309 |
285 |
$8K |
| J1100 |
Dexamethasone sodium phos |
434 |
411 |
$8K |
| 81003 |
|
3,065 |
2,859 |
$7K |
| 97139 |
|
246 |
71 |
$7K |
| 0710 |
|
157 |
156 |
$7K |
| 76830 |
|
106 |
92 |
$7K |
| 97110 |
|
527 |
230 |
$7K |
| 93971 |
|
68 |
68 |
$6K |
| 93970 |
|
38 |
38 |
$6K |
| 99282 |
|
150 |
142 |
$6K |
| J2765 |
Metoclopramide hcl injection |
605 |
573 |
$5K |
| J2060 |
Lorazepam injection |
672 |
544 |
$5K |
| J3010 |
Fentanyl citrate injection |
810 |
707 |
$4K |
| 87077 |
|
633 |
597 |
$4K |
| 82550 |
|
776 |
684 |
$4K |
| 85610 |
|
1,422 |
1,303 |
$4K |
| 73130 |
|
143 |
134 |
$4K |
| 87880 |
|
500 |
469 |
$4K |
| 87186 |
|
512 |
488 |
$4K |
| 86140 |
|
833 |
779 |
$4K |
| 83735 |
|
840 |
726 |
$4K |
| 86900 |
|
432 |
411 |
$4K |
| 0259 |
|
1,183 |
663 |
$4K |
| 71020 |
|
124 |
64 |
$4K |
| 85730 |
|
770 |
712 |
$4K |
| J1200 |
Diphenhydramine hcl injectio |
576 |
515 |
$3K |
| 87081 |
|
505 |
473 |
$3K |
| 93976 |
|
18 |
13 |
$3K |
| 73030 |
|
107 |
102 |
$3K |
| J2250 |
Inj midazolam hydrochloride |
533 |
526 |
$3K |
| 86901 |
|
414 |
393 |
$2K |
| 93975 |
|
13 |
12 |
$2K |
| 84702 |
|
171 |
138 |
$2K |
| Q4051 |
Splint supplies misc |
46 |
12 |
$2K |
| 71250 |
|
15 |
15 |
$2K |
| 0258 |
|
152 |
143 |
$2K |
| 86850 |
|
125 |
119 |
$2K |
| 29515 |
|
37 |
36 |
$2K |
| 97140 |
|
79 |
26 |
$2K |
| 72040 |
|
56 |
51 |
$2K |
| 84443 |
|
110 |
109 |
$1K |
| 97112 |
|
83 |
26 |
$1K |
| 73110 |
|
48 |
44 |
$1K |
| 94664 |
|
78 |
60 |
$1K |
| 87591 |
|
38 |
36 |
$1K |
| 87491 |
|
38 |
36 |
$1K |
| 87651 |
|
38 |
38 |
$1K |
| 0272 |
|
1,023 |
955 |
$1K |
| 90715 |
|
28 |
27 |
$1K |
| 97530 |
|
122 |
58 |
$1K |
| 85652 |
|
393 |
358 |
$894.47 |
| 87070 |
|
120 |
115 |
$840.29 |
| 84145 |
|
60 |
57 |
$815.85 |
| 29125 |
|
12 |
12 |
$756.10 |
| 87205 |
|
165 |
155 |
$663.02 |
| 87631 |
|
12 |
12 |
$635.96 |
| J7030 |
Normal saline solution infus |
206 |
167 |
$465.70 |
| J2550 |
Promethazine hcl injection |
61 |
51 |
$391.44 |
| U0005 |
Infec agen detec ampli probe |
397 |
391 |
$357.27 |
| 74018 |
|
25 |
25 |
$330.07 |
| 90471 |
|
28 |
27 |
$294.88 |
| 82803 |
|
12 |
12 |
$148.47 |
| 83036 |
|
42 |
41 |
$131.51 |
| 0250 |
|
53 |
41 |
$36.85 |
| 0370 |
|
28 |
27 |
$0.00 |
| G1004 |
Cdsm ndsc |
43 |
42 |
$0.00 |