| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
|
984 |
943 |
$1.81M |
| 99285 |
|
4,420 |
3,265 |
$1.66M |
| 99284 |
|
5,437 |
4,199 |
$1.34M |
| 99283 |
|
7,141 |
6,061 |
$1.20M |
| 80053 |
|
8,788 |
7,390 |
$412K |
| 85025 |
|
9,203 |
7,655 |
$304K |
| 96361 |
|
3,075 |
2,548 |
$293K |
| 70450 |
|
636 |
608 |
$286K |
| 96375 |
|
2,645 |
2,214 |
$280K |
| 96365 |
|
2,027 |
1,353 |
$272K |
| 97140 |
|
4,643 |
1,843 |
$248K |
| 97110 |
|
6,419 |
2,495 |
$228K |
| 93005 |
|
2,311 |
2,084 |
$179K |
| 96374 |
|
2,931 |
2,455 |
$172K |
| 87636 |
|
1,706 |
1,615 |
$136K |
| 71046 |
|
1,228 |
1,184 |
$132K |
| 81001 |
|
4,561 |
4,204 |
$115K |
| 36415 |
|
7,344 |
6,183 |
$101K |
| 96376 |
|
762 |
584 |
$98K |
| 71045 |
|
1,420 |
1,302 |
$97K |
| 99282 |
|
721 |
676 |
$86K |
| 83605 |
|
2,462 |
1,927 |
$84K |
| 84484 |
|
2,243 |
1,522 |
$79K |
| 96372 |
|
1,221 |
987 |
$78K |
| 97112 |
|
1,180 |
588 |
$75K |
| 83690 |
|
1,905 |
1,743 |
$70K |
| 87631 |
|
811 |
773 |
$68K |
| 96360 |
|
515 |
410 |
$65K |
| 84443 |
|
1,568 |
1,524 |
$60K |
| J7030 |
Normal saline solution infus |
1,825 |
1,529 |
$53K |
| J2405 |
Ondansetron hcl injection |
2,037 |
1,745 |
$52K |
| U0003 |
Cov-19 amp prb hgh thruput |
619 |
595 |
$52K |
| 74176 |
|
42 |
37 |
$52K |
| 82077 |
|
499 |
464 |
$43K |
| J1170 |
Hydromorphone injection |
998 |
737 |
$40K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,840 |
1,764 |
$39K |
| 80050 |
|
252 |
248 |
$39K |
| 96366 |
|
160 |
122 |
$35K |
| 99281 |
|
370 |
350 |
$32K |
| 81025 |
|
993 |
948 |
$31K |
| J1885 |
Ketorolac tromethamine inj |
1,228 |
1,140 |
$30K |
| 83735 |
|
1,654 |
1,307 |
$27K |
| 80307 |
|
189 |
177 |
$27K |
| 87502 |
|
194 |
188 |
$25K |
| 72100 |
|
132 |
130 |
$24K |
| 83880 |
|
557 |
509 |
$23K |
| 80306 |
|
1,482 |
1,399 |
$23K |
| 94640 |
|
337 |
249 |
$21K |
| J7050 |
Normal saline solution infus |
1,179 |
486 |
$19K |
| 85610 |
|
1,125 |
1,020 |
$19K |
| 73630 |
|
123 |
117 |
$19K |
| 80061 |
|
456 |
447 |
$15K |
| 87040 |
|
462 |
240 |
$15K |
| 87651 |
|
194 |
189 |
$15K |
| 85379 |
|
295 |
283 |
$12K |
| G0463 |
Hospital outpt clinic visit |
104 |
96 |
$11K |
| 86140 |
|
353 |
317 |
$10K |
| 73030 |
|
70 |
63 |
$10K |
| 76700 |
|
27 |
27 |
$8K |
| 80048 |
|
203 |
175 |
$7K |
| 77067 |
|
60 |
60 |
$7K |
| 83036 |
|
188 |
183 |
$7K |
| 84439 |
|
207 |
202 |
$7K |
| 73562 |
|
40 |
40 |
$6K |
| J0696 |
Ceftriaxone sodium injection |
318 |
146 |
$6K |
| 85652 |
|
237 |
219 |
$6K |
| 87077 |
|
83 |
78 |
$5K |
| 97161 |
|
78 |
77 |
$5K |
| 73610 |
|
32 |
30 |
$5K |
| 82962 |
|
426 |
239 |
$5K |
| 82150 |
|
108 |
103 |
$5K |
| 80179 |
|
44 |
44 |
$4K |
| 80143 |
|
43 |
43 |
$4K |
| J7120 |
Ringers lactate infusion |
90 |
72 |
$3K |
| 97162 |
|
38 |
36 |
$3K |
| 73130 |
|
18 |
14 |
$2K |
| 90715 |
|
13 |
12 |
$2K |
| 85027 |
|
87 |
75 |
$2K |
| 81003 |
|
150 |
142 |
$2K |
| 87086 |
|
86 |
82 |
$2K |
| 87634 |
|
14 |
14 |
$2K |
| 73110 |
|
13 |
12 |
$2K |
| 97530 |
|
50 |
25 |
$2K |
| 87400 |
|
24 |
12 |
$1K |
| 82607 |
|
27 |
26 |
$1K |
| 82805 |
|
25 |
24 |
$1K |
| 73502 |
|
12 |
12 |
$1K |
| 85730 |
|
65 |
65 |
$1K |
| 77063 |
|
60 |
60 |
$1K |
| U0005 |
Infec agen detec ampli probe |
192 |
189 |
$959.29 |
| 82306 |
|
57 |
57 |
$884.58 |
| 82746 |
|
14 |
13 |
$742.05 |
| 86803 |
|
13 |
13 |
$643.15 |
| 87205 |
|
27 |
24 |
$610.28 |
| 85651 |
|
25 |
25 |
$531.48 |
| J0780 |
Prochlorperazine injection |
16 |
12 |
$530.06 |
| J2001 |
Lidocaine injection |
85 |
70 |
$480.72 |
| J1200 |
Diphenhydramine hcl injectio |
27 |
24 |
$480.25 |
| 90471 |
|
27 |
26 |
$394.26 |
| 94760 |
|
17 |
14 |
$341.05 |
| 87635 |
|
12 |
12 |
$275.48 |
| A9270 |
Non-covered item or service |
444 |
192 |
$0.00 |