| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
|
43,171 |
42,741 |
$10.48M |
| 99283 |
|
62,124 |
61,836 |
$10.21M |
| 99285 |
|
28,478 |
28,337 |
$9.21M |
| 96374 |
|
24,866 |
24,702 |
$3.45M |
| 36415 |
|
54,183 |
52,271 |
$497K |
| U0003 |
Cov-19 amp prb hgh thruput |
6,536 |
6,419 |
$472K |
| 96375 |
|
8,897 |
8,704 |
$387K |
| 99282 |
|
4,042 |
4,028 |
$369K |
| 80053 |
|
33,670 |
33,323 |
$320K |
| 85025 |
|
40,203 |
39,551 |
$253K |
| 96365 |
|
1,616 |
1,606 |
$221K |
| 88305 |
|
813 |
804 |
$170K |
| A0427 |
Als1-emergency |
4,006 |
3,494 |
$166K |
| 71045 |
|
12,886 |
12,815 |
$162K |
| 81001 |
|
36,331 |
35,841 |
$143K |
| 96361 |
|
3,121 |
3,033 |
$126K |
| 93005 |
|
18,030 |
17,836 |
$96K |
| 87400 |
|
2,842 |
2,838 |
$79K |
| 87631 |
|
539 |
535 |
$66K |
| 93306 |
|
868 |
868 |
$65K |
| 87428 |
|
2,301 |
2,298 |
$65K |
| 80050 |
|
2,011 |
2,009 |
$60K |
| A0429 |
Bls-emergency |
1,552 |
1,297 |
$56K |
| 84703 |
|
7,544 |
7,494 |
$49K |
| 96372 |
|
689 |
687 |
$40K |
| 87804 |
|
1,421 |
1,420 |
$40K |
| A0425 |
Ground mileage |
7,248 |
5,366 |
$37K |
| 80061 |
|
3,041 |
3,039 |
$35K |
| 87086 |
|
4,743 |
4,682 |
$33K |
| 88312 |
|
269 |
268 |
$28K |
| A0428 |
Bls |
1,173 |
994 |
$27K |
| 87591 |
|
787 |
786 |
$25K |
| 87491 |
|
787 |
786 |
$25K |
| 87502 |
|
296 |
296 |
$23K |
| 87426 |
|
700 |
700 |
$20K |
| 71046 |
|
1,207 |
1,205 |
$19K |
| 83690 |
|
3,327 |
3,309 |
$19K |
| 80074 |
|
411 |
411 |
$17K |
| 80307 |
|
319 |
311 |
$17K |
| 36902 |
|
15 |
15 |
$15K |
| 88313 |
|
189 |
189 |
$13K |
| 74177 |
|
76 |
76 |
$13K |
| 83036 |
|
1,153 |
1,152 |
$10K |
| 87389 |
|
465 |
465 |
$9K |
| 86160 |
|
459 |
459 |
$8K |
| 86885 |
|
1,650 |
1,591 |
$8K |
| 78452 |
|
37 |
37 |
$8K |
| 83735 |
|
1,374 |
1,350 |
$8K |
| 86592 |
|
1,913 |
1,910 |
$7K |
| 86762 |
|
495 |
494 |
$7K |
| J0131 |
Inj, acetaminophen (nos) |
899 |
896 |
$6K |
| 84484 |
|
469 |
452 |
$6K |
| 97597 |
|
572 |
328 |
$6K |
| 87798 |
|
150 |
149 |
$5K |
| 87581 |
|
150 |
149 |
$5K |
| 87486 |
|
151 |
150 |
$5K |
| 87635 |
|
102 |
102 |
$5K |
| 87661 |
|
154 |
154 |
$5K |
| 86140 |
|
1,184 |
1,176 |
$5K |
| 86803 |
|
402 |
402 |
$5K |
| 70450 |
|
99 |
99 |
$5K |
| 84439 |
|
497 |
497 |
$4K |
| 11042 |
|
64 |
37 |
$4K |
| 76805 |
|
38 |
38 |
$3K |
| 85652 |
|
1,512 |
1,497 |
$3K |
| 84112 |
|
41 |
40 |
$3K |
| 86900 |
|
913 |
867 |
$2K |
| 87081 |
|
394 |
391 |
$2K |
| 86901 |
|
899 |
855 |
$2K |
| 84443 |
|
213 |
213 |
$2K |
| 86703 |
|
279 |
279 |
$2K |
| 96413 |
|
15 |
14 |
$2K |
| 85730 |
|
463 |
456 |
$2K |
| 94640 |
|
147 |
145 |
$2K |
| 86235 |
|
47 |
44 |
$2K |
| 87880 |
|
152 |
150 |
$2K |
| 86812 |
|
91 |
90 |
$2K |
| 87340 |
|
192 |
192 |
$2K |
| 85027 |
|
319 |
316 |
$2K |
| 87070 |
|
243 |
242 |
$2K |
| J2405 |
Ondansetron hcl injection |
4,580 |
4,523 |
$2K |
| 85610 |
|
516 |
508 |
$2K |
| 93351 |
|
12 |
12 |
$2K |
| 82950 |
|
311 |
309 |
$1K |
| 87636 |
|
12 |
12 |
$1K |
| 99281 |
|
26 |
26 |
$1K |
| 87522 |
Neg quan hep c or qual rna |
34 |
34 |
$1K |
| 83655 |
|
110 |
110 |
$1K |
| 71250 |
|
26 |
26 |
$1K |
| 82728 |
|
79 |
79 |
$999.13 |
| 86200 |
|
83 |
83 |
$876.17 |
| 86704 |
|
76 |
76 |
$793.28 |
| 84702 |
|
64 |
64 |
$735.10 |
| 87210 |
|
165 |
164 |
$717.44 |
| 80048 |
|
95 |
94 |
$679.53 |
| 87660 |
|
43 |
42 |
$677.54 |
| 87510 |
|
43 |
42 |
$677.54 |
| 87480 |
|
43 |
42 |
$661.54 |
| 73562 |
|
26 |
24 |
$654.00 |
| 86787 |
|
55 |
55 |
$614.08 |
| 86038 |
|
60 |
59 |
$602.26 |
| 86706 |
|
56 |
56 |
$525.25 |
| 86376 |
|
41 |
41 |
$491.72 |
| 76815 |
|
14 |
13 |
$469.70 |
| 87280 |
|
31 |
31 |
$370.14 |
| 72100 |
|
17 |
17 |
$343.51 |
| 86225 |
|
29 |
29 |
$342.16 |
| 72202 |
|
15 |
15 |
$329.98 |
| 82731 |
|
12 |
12 |
$327.00 |
| 86431 |
|
74 |
74 |
$322.56 |
| 73130 |
|
14 |
13 |
$302.64 |
| 84550 |
|
83 |
81 |
$297.48 |
| 83540 |
|
53 |
53 |
$247.25 |
| 83550 |
|
41 |
41 |
$240.87 |
| 73620 |
|
14 |
13 |
$227.89 |
| 82550 |
|
41 |
41 |
$220.02 |
| 83021 |
|
13 |
13 |
$208.78 |
| J3010 |
Fentanyl citrate injection |
118 |
116 |
$204.24 |
| 80179 |
|
12 |
12 |
$198.96 |
| 80143 |
|
12 |
12 |
$198.96 |
| 84481 |
|
12 |
12 |
$180.84 |
| 83020 |
|
13 |
13 |
$148.85 |
| 82570 |
|
38 |
37 |
$133.69 |
| G0463 |
Hospital outpt clinic visit |
15 |
12 |
$125.96 |
| 85018 |
|
48 |
48 |
$98.96 |
| 85014 |
|
48 |
48 |
$97.64 |
| J7030 |
Normal saline solution infus |
10,986 |
10,889 |
$87.17 |
| 81002 |
|
27 |
25 |
$74.36 |
| 84156 |
|
28 |
25 |
$61.94 |
| 83615 |
|
13 |
12 |
$59.07 |
| 82043 |
|
12 |
12 |
$48.54 |
| J3490 |
Drugs unclassified injection |
220 |
210 |
$45.50 |
| J1885 |
Ketorolac tromethamine inj |
1,385 |
1,381 |
$3.10 |
| J7050 |
Normal saline solution infus |
15 |
12 |
$2.89 |
| J7120 |
Ringers lactate infusion |
1,357 |
1,285 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
175 |
173 |
$0.00 |
| J2270 |
Morphine sulfate injection |
37 |
37 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
330 |
329 |
$0.00 |
| J2360 |
Orphenadrine injection |
14 |
14 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
64 |
64 |
$0.00 |