| Code | Description | Claims | Beneficiaries | Total Paid |
| A4216 |
Sterile water/saline, 10 ml |
6,642 |
4,349 |
$702K |
| 36415 |
|
9,618 |
6,579 |
$460K |
| 99284 |
|
14,629 |
12,552 |
$418K |
| 99283 |
|
13,056 |
11,640 |
$389K |
| 96361 |
|
3,981 |
3,164 |
$236K |
| 81001 |
|
12,819 |
11,245 |
$197K |
| 99285 |
|
7,235 |
6,036 |
$196K |
| 80053 |
|
14,457 |
11,273 |
$183K |
| 99282 |
|
3,537 |
3,173 |
$173K |
| 96360 |
|
1,695 |
1,531 |
$163K |
| 70450 |
|
3,043 |
2,593 |
$85K |
| 81025 |
|
10,257 |
9,242 |
$72K |
| 96372 |
|
6,908 |
5,117 |
$69K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,259 |
1,060 |
$61K |
| J8499 |
Oral prescrip drug non chemo |
1,889 |
732 |
$60K |
| J3490 |
Drugs unclassified injection |
344 |
198 |
$50K |
| 71046 |
|
3,840 |
3,593 |
$49K |
| S0028 |
Injection, famotidine, 20 mg |
1,112 |
875 |
$48K |
| 80048 |
|
3,971 |
3,129 |
$37K |
| 76819 |
|
783 |
654 |
$36K |
| 96365 |
|
1,397 |
1,210 |
$35K |
| G0378 |
Hospital observation per hr |
6,911 |
2,915 |
$34K |
| 74176 |
|
1,282 |
1,137 |
$33K |
| 94640 |
|
2,447 |
1,499 |
$31K |
| 76805 |
|
1,229 |
1,169 |
$31K |
| 74177 |
|
1,077 |
975 |
$29K |
| 76801 |
|
2,006 |
1,878 |
$28K |
| 71045 |
|
7,316 |
5,793 |
$27K |
| 99281 |
|
498 |
355 |
$25K |
| 76856 |
|
885 |
824 |
$22K |
| U0002 |
Covid-19 lab test non-cdc |
1,035 |
916 |
$21K |
| 85025 |
|
18,946 |
13,765 |
$19K |
| 96374 |
|
7,269 |
6,009 |
$19K |
| 93306 |
|
552 |
490 |
$17K |
| 76816 |
|
923 |
770 |
$17K |
| 82962 |
|
4,508 |
2,133 |
$15K |
| 87804 |
|
4,707 |
2,568 |
$14K |
| 87070 |
|
1,546 |
1,476 |
$13K |
| 87449 |
|
694 |
658 |
$13K |
| 76830 |
|
397 |
349 |
$13K |
| J1815 |
Insulin injection |
1,202 |
460 |
$12K |
| 76705 |
|
566 |
538 |
$12K |
| 80307 |
|
2,519 |
2,091 |
$12K |
| 73562 |
|
762 |
630 |
$11K |
| 99213 |
|
575 |
459 |
$10K |
| 93005 |
|
7,264 |
5,743 |
$10K |
| J7030 |
Normal saline solution infus |
6,598 |
5,011 |
$9K |
| 77067 |
|
368 |
330 |
$9K |
| 73130 |
|
362 |
329 |
$8K |
| 73630 |
|
680 |
585 |
$7K |
| 85610 |
|
6,890 |
5,657 |
$7K |
| 85730 |
|
6,619 |
5,452 |
$7K |
| A9270 |
Non-covered item or service |
2,162 |
1,202 |
$7K |
| 73610 |
|
451 |
412 |
$7K |
| 96375 |
|
5,265 |
3,802 |
$6K |
| 76817 |
|
715 |
588 |
$6K |
| J1644 |
Inj heparin sodium per 1000u |
766 |
379 |
$5K |
| 84484 |
|
6,460 |
4,373 |
$5K |
| 73030 |
|
470 |
384 |
$5K |
| J2704 |
Inj, propofol, 10 mg |
1,200 |
1,004 |
$5K |
| 96376 |
|
2,288 |
1,225 |
$5K |
| J2405 |
Ondansetron hcl injection |
3,228 |
2,555 |
$4K |
| 72100 |
|
564 |
511 |
$4K |
| 96366 |
|
280 |
171 |
$4K |
| 93970 |
|
327 |
282 |
$4K |
| 97116 |
|
434 |
187 |
$4K |
| 99203 |
|
132 |
119 |
$4K |
| J1170 |
Hydromorphone injection |
2,139 |
886 |
$4K |
| J7512 |
Prednisone ir or dr oral 1mg |
269 |
242 |
$4K |
| 83690 |
|
4,684 |
4,092 |
$3K |
| 83880 |
|
2,311 |
1,906 |
$3K |
| 82550 |
|
3,239 |
2,598 |
$3K |
| J1885 |
Ketorolac tromethamine inj |
4,041 |
3,513 |
$3K |
| 84702 |
|
3,712 |
3,035 |
$3K |
| 97162 |
|
147 |
131 |
$3K |
| J2270 |
Morphine sulfate injection |
3,118 |
2,079 |
$2K |
| 87086 |
|
5,402 |
4,770 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
2,001 |
1,667 |
$2K |
| J7120 |
Ringers lactate infusion |
1,486 |
1,174 |
$2K |
| 87430 |
|
861 |
841 |
$2K |
| 93971 |
|
202 |
167 |
$2K |
| 72125 |
|
660 |
554 |
$2K |
| 72040 |
|
165 |
146 |
$2K |
| 87591 |
|
1,030 |
987 |
$2K |
| 76641 |
|
67 |
38 |
$2K |
| J1650 |
Inj enoxaparin sodium |
2,069 |
1,233 |
$2K |
| 86900 |
|
2,220 |
1,961 |
$2K |
| 87040 |
|
1,455 |
807 |
$2K |
| A4217 |
Sterile water/saline, 500 ml |
363 |
256 |
$2K |
| 71275 |
|
183 |
166 |
$2K |
| 12001 |
|
47 |
39 |
$1K |
| 59025 |
|
156 |
131 |
$1K |
| 87637 |
|
131 |
119 |
$1K |
| J1200 |
Diphenhydramine hcl injectio |
2,048 |
1,020 |
$1K |
| 96367 |
|
23 |
19 |
$1K |
| 87081 |
|
182 |
147 |
$1K |
| 70551 |
|
58 |
49 |
$1K |
| J0690 |
Cefazolin sodium injection |
742 |
578 |
$974.40 |
| J1100 |
Dexamethasone sodium phos |
725 |
619 |
$943.74 |
| 86850 |
|
1,308 |
1,134 |
$910.56 |
| 74018 |
|
163 |
147 |
$907.38 |
| 72131 |
|
97 |
84 |
$855.44 |
| 83735 |
|
2,025 |
1,585 |
$799.98 |
| 73110 |
|
124 |
111 |
$778.77 |
| J2765 |
Metoclopramide hcl injection |
1,090 |
920 |
$757.31 |
| 97166 |
|
56 |
51 |
$754.49 |
| 90714 |
|
554 |
475 |
$707.27 |
| 83605 |
|
1,118 |
843 |
$691.86 |
| 97530 |
|
14 |
12 |
$630.63 |
| C9113 |
Inj pantoprazole sodium, via |
544 |
361 |
$618.39 |
| 80061 |
|
351 |
313 |
$614.16 |
| 87491 |
|
1,017 |
971 |
$602.75 |
| 86901 |
|
2,220 |
1,961 |
$596.34 |
| J3010 |
Fentanyl citrate injection |
713 |
598 |
$591.72 |
| 87426 |
|
674 |
610 |
$587.81 |
| 97535 |
|
120 |
79 |
$560.48 |
| 87186 |
|
1,673 |
1,448 |
$542.88 |
| 84703 |
|
1,405 |
1,278 |
$536.50 |
| 83036 |
|
553 |
485 |
$534.51 |
| 86592 |
|
268 |
254 |
$514.79 |
| 73140 |
|
15 |
15 |
$495.08 |
| 85379 |
|
1,058 |
922 |
$469.23 |
| 87077 |
|
1,649 |
1,426 |
$444.60 |
| J0360 |
Hydralazine hcl injection |
571 |
422 |
$433.63 |
| J7050 |
Normal saline solution infus |
2,178 |
1,531 |
$430.61 |
| 10060 |
|
15 |
14 |
$417.36 |
| 82805 |
|
66 |
49 |
$391.19 |
| 73590 |
|
43 |
37 |
$378.49 |
| U0003 |
Cov-19 amp prb hgh thruput |
16 |
13 |
$375.51 |
| 73620 |
|
31 |
25 |
$373.16 |
| 90471 |
|
402 |
341 |
$368.49 |
| J2250 |
Inj midazolam hydrochloride |
698 |
570 |
$310.74 |
| 80076 |
|
523 |
464 |
$303.50 |
| 97110 |
|
57 |
12 |
$298.45 |
| 73080 |
|
14 |
14 |
$288.62 |
| J2060 |
Lorazepam injection |
567 |
446 |
$272.01 |
| 85045 |
|
49 |
30 |
$270.24 |
| 72170 |
|
117 |
94 |
$223.45 |
| 84145 |
|
569 |
476 |
$201.47 |
| J7040 |
Normal saline solution infus |
402 |
342 |
$196.22 |
| 71250 |
|
40 |
37 |
$188.09 |
| 87210 |
|
574 |
544 |
$186.67 |
| J7060 |
5% dextrose/water |
910 |
610 |
$182.75 |
| 86140 |
|
736 |
634 |
$170.89 |
| 87205 |
|
932 |
820 |
$150.88 |
| 84443 |
|
837 |
701 |
$149.51 |
| 84100 |
|
1,100 |
890 |
$125.01 |
| 73502 |
|
70 |
56 |
$117.65 |
| 85651 |
|
152 |
126 |
$112.57 |
| 74022 |
|
109 |
106 |
$101.65 |
| 88305 |
|
475 |
406 |
$97.98 |
| 87899 |
|
555 |
520 |
$86.40 |
| 84550 |
|
58 |
48 |
$81.11 |
| 12011 |
|
18 |
13 |
$80.93 |
| 82150 |
|
243 |
214 |
$77.54 |
| J0330 |
Succinycholine chloride inj |
157 |
123 |
$51.79 |
| 29125 |
|
38 |
31 |
$39.90 |
| J2930 |
Methylprednisolone injection |
584 |
440 |
$33.16 |
| 83615 |
|
117 |
96 |
$32.43 |
| 80164 |
|
14 |
12 |
$32.40 |
| J2543 |
Piperacillin/tazobactam |
169 |
94 |
$29.02 |
| 84439 |
|
338 |
291 |
$24.39 |
| 70486 |
|
33 |
28 |
$17.05 |
| 87340 |
|
42 |
37 |
$6.87 |
| 87076 |
|
100 |
93 |
$6.62 |
| 82010 |
|
78 |
65 |
$6.33 |
| 86703 |
|
43 |
41 |
$4.37 |
| J7121 |
5% dextrose in lac ringers |
34 |
25 |
$2.20 |
| J3370 |
Vancomycin hcl injection |
82 |
42 |
$2.20 |
| J1953 |
Levetiracetam injection |
50 |
29 |
$2.20 |
| 87185 |
|
14 |
12 |
$1.86 |
| 73090 |
|
12 |
12 |
$1.10 |
| 88304 |
|
17 |
13 |
$1.10 |
| J1940 |
Furosemide injection |
70 |
36 |
$1.10 |
| 85384 |
|
129 |
105 |
$1.10 |
| 36600 |
|
46 |
33 |
$0.58 |
| 82607 |
|
47 |
42 |
$0.55 |
| 87147 |
|
13 |
12 |
$0.55 |
| 82947 |
|
48 |
40 |
$0.55 |
| 82728 |
|
127 |
106 |
$0.00 |
| J0456 |
Azithromycin |
31 |
21 |
$0.00 |
| 82746 |
|
15 |
14 |
$0.00 |
| J2920 |
Methylprednisolone injection |
27 |
12 |
$0.00 |
| J3590 |
Unclassified biologics |
15 |
12 |
$0.00 |
| 99218 |
|
93 |
39 |
$0.00 |
| 85007 |
|
38 |
26 |
$0.00 |
| J1956 |
Levofloxacin injection |
15 |
13 |
$0.00 |