| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99281 |
|
30,640 |
26,947 |
$4.22M |
| 99283 |
|
34,702 |
30,194 |
$3.20M |
| 74177 |
|
2,830 |
2,739 |
$1.41M |
| 70450 |
|
3,256 |
3,160 |
$948K |
| 96374 |
|
7,692 |
6,978 |
$891K |
| 99202 |
|
3,404 |
2,314 |
$773K |
| 0450 |
|
7,575 |
6,766 |
$600K |
| 96375 |
|
6,898 |
6,016 |
$596K |
| 93005 |
|
9,115 |
8,448 |
$523K |
| 96365 |
|
3,160 |
2,736 |
$470K |
| 99201 |
|
2,543 |
1,690 |
$433K |
| 87637 |
|
2,918 |
2,687 |
$431K |
| 71046 |
|
7,757 |
7,437 |
$340K |
| 87635 |
|
5,410 |
5,121 |
$288K |
| 80307 |
|
3,756 |
3,482 |
$265K |
| 74176 |
|
1,056 |
1,022 |
$263K |
| 96361 |
|
4,131 |
3,589 |
$249K |
| 99199 |
|
2,470 |
2,149 |
$243K |
| 96372 |
|
4,327 |
3,856 |
$231K |
| J3490 |
Drugs unclassified injection |
38,706 |
21,839 |
$226K |
| 80053 |
|
19,741 |
17,963 |
$207K |
| 87502 |
|
2,698 |
2,591 |
$173K |
| 85025 |
|
23,000 |
20,447 |
$165K |
| 76705 |
|
1,223 |
1,186 |
$161K |
| 96360 |
|
1,128 |
1,041 |
$149K |
| 72125 |
|
271 |
265 |
$145K |
| 87636 |
|
793 |
772 |
$120K |
| Z7502 |
|
2,923 |
2,882 |
$109K |
| 76856 |
|
730 |
704 |
$101K |
| J0131 |
Inj, acetaminophen (nos) |
4,697 |
2,351 |
$93K |
| 87086 |
|
8,235 |
7,785 |
$74K |
| 71275 |
|
139 |
135 |
$70K |
| 84484 |
|
6,878 |
5,376 |
$66K |
| J7030 |
Normal saline solution infus |
7,082 |
6,089 |
$64K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
7,194 |
4,006 |
$64K |
| 83690 |
|
8,896 |
8,237 |
$59K |
| 73610 |
|
932 |
906 |
$58K |
| 71045 |
|
2,162 |
2,064 |
$57K |
| 94640 |
|
1,213 |
1,114 |
$51K |
| 93971 |
|
183 |
180 |
$49K |
| U0003 |
Cov-19 amp prb hgh thruput |
558 |
548 |
$49K |
| 82077 |
|
1,440 |
1,319 |
$47K |
| 83880 |
|
1,446 |
1,353 |
$44K |
| 73630 |
|
732 |
714 |
$43K |
| J2405 |
Ondansetron hcl injection |
6,252 |
5,323 |
$40K |
| 87491 |
|
1,044 |
1,014 |
$39K |
| 81025 |
|
8,854 |
8,372 |
$39K |
| J7120 |
Ringers lactate infusion |
4,684 |
4,105 |
$39K |
| 87591 |
|
1,034 |
1,005 |
$39K |
| 87651 |
|
1,330 |
1,286 |
$38K |
| 76801 |
|
291 |
266 |
$36K |
| 99284 |
|
80 |
70 |
$35K |
| J1885 |
Ketorolac tromethamine inj |
5,197 |
4,921 |
$34K |
| 87040 |
|
2,646 |
1,654 |
$33K |
| 81001 |
|
6,744 |
6,313 |
$33K |
| 87633 |
|
72 |
70 |
$32K |
| 76830 |
|
191 |
187 |
$28K |
| 82803 |
|
1,892 |
1,749 |
$27K |
| 76815 |
|
174 |
149 |
$27K |
| 80143 |
|
597 |
563 |
$25K |
| 0270 |
|
954 |
579 |
$23K |
| 84443 |
|
1,433 |
1,394 |
$23K |
| 73130 |
|
375 |
364 |
$23K |
| 80179 |
|
590 |
558 |
$23K |
| J1170 |
Hydromorphone injection |
1,910 |
1,634 |
$22K |
| J3010 |
Fentanyl citrate injection |
3,038 |
2,426 |
$21K |
| 83605 |
|
2,250 |
1,849 |
$21K |
| 73030 |
|
325 |
318 |
$21K |
| 85379 |
|
2,028 |
1,990 |
$21K |
| J1100 |
Dexamethasone sodium phos |
3,136 |
2,841 |
$20K |
| T1999 |
Noc retail items andsupplies |
1,003 |
579 |
$19K |
| 83735 |
|
3,090 |
2,804 |
$19K |
| 73110 |
|
293 |
280 |
$18K |
| 80048 |
|
2,273 |
2,128 |
$17K |
| 81015 |
|
4,301 |
4,067 |
$17K |
| 70486 |
|
39 |
39 |
$17K |
| 81003 |
|
6,471 |
6,149 |
$16K |
| J0696 |
Ceftriaxone sodium injection |
1,816 |
1,702 |
$15K |
| 59025 |
|
262 |
168 |
$15K |
| 87077 |
|
1,679 |
1,518 |
$14K |
| J2250 |
Inj midazolam hydrochloride |
2,272 |
1,922 |
$14K |
| 87186 |
|
1,584 |
1,466 |
$14K |
| 96366 |
|
176 |
148 |
$12K |
| J2765 |
Metoclopramide hcl injection |
1,738 |
1,647 |
$12K |
| 99499 |
|
151 |
140 |
$11K |
| 87430 |
|
1,047 |
1,029 |
$11K |
| J2270 |
Morphine sulfate injection |
1,217 |
1,066 |
$11K |
| J1200 |
Diphenhydramine hcl injectio |
1,712 |
1,589 |
$11K |
| 82330 |
|
597 |
572 |
$10K |
| 87400 |
|
1,088 |
1,063 |
$10K |
| 70551 |
|
16 |
16 |
$10K |
| 74018 |
|
210 |
203 |
$10K |
| 85730 |
|
1,912 |
1,827 |
$10K |
| 73560 |
|
235 |
229 |
$10K |
| 87081 |
|
1,121 |
1,103 |
$10K |
| J7050 |
Normal saline solution infus |
1,595 |
873 |
$10K |
| 72100 |
|
129 |
127 |
$9K |
| J2704 |
Inj, propofol, 10 mg |
1,138 |
1,008 |
$9K |
| 85610 |
|
2,502 |
2,371 |
$9K |
| 0250 |
|
361 |
217 |
$8K |
| J2060 |
Lorazepam injection |
1,213 |
1,062 |
$8K |
| 82947 |
|
1,793 |
1,643 |
$7K |
| 82550 |
|
767 |
719 |
$5K |
| 86140 |
|
1,061 |
991 |
$5K |
| 73562 |
|
48 |
48 |
$4K |
| Z9725 |
|
77 |
76 |
$3K |
| 76817 |
|
31 |
26 |
$3K |
| 82552 |
|
200 |
190 |
$3K |
| J0690 |
Cefazolin sodium injection |
349 |
325 |
$3K |
| 74019 |
|
37 |
37 |
$3K |
| 99070 |
|
259 |
188 |
$3K |
| 86901 |
|
856 |
793 |
$3K |
| 87581 |
|
72 |
70 |
$3K |
| 87486 |
|
72 |
70 |
$3K |
| 87798 |
|
72 |
70 |
$2K |
| 84702 |
|
178 |
147 |
$2K |
| 88305 |
|
270 |
229 |
$2K |
| 87420 |
|
472 |
446 |
$2K |
| 86900 |
|
638 |
552 |
$2K |
| 73140 |
|
51 |
50 |
$2K |
| Z7610 |
|
180 |
101 |
$2K |
| S0028 |
Injection, famotidine, 20 mg |
278 |
256 |
$2K |
| 12001 |
|
36 |
36 |
$2K |
| 90715 |
|
39 |
39 |
$1K |
| 73590 |
|
24 |
24 |
$1K |
| 73080 |
|
13 |
12 |
$1K |
| J2919 |
Inj, methylpred sod succ 5mg |
82 |
78 |
$1K |
| J2930 |
Methylprednisolone injection |
82 |
77 |
$947.31 |
| 96367 |
|
13 |
13 |
$943.01 |
| 84132 |
|
211 |
203 |
$867.08 |
| 10060 |
|
14 |
14 |
$822.21 |
| J0780 |
Prochlorperazine injection |
63 |
60 |
$805.62 |
| 36415 |
|
707 |
656 |
$755.04 |
| 84295 |
|
196 |
189 |
$732.34 |
| J7040 |
Normal saline solution infus |
87 |
85 |
$625.00 |
| 84703 |
|
58 |
58 |
$541.15 |
| 87210 |
|
135 |
130 |
$539.91 |
| 87147 |
|
47 |
26 |
$489.60 |
| S0020 |
Injection, bupivicaine hydro |
46 |
43 |
$394.27 |
| J8540 |
Oral dexamethasone |
471 |
423 |
$352.03 |
| 86850 |
|
122 |
116 |
$350.81 |
| J1815 |
Insulin injection |
54 |
26 |
$339.82 |
| 85652 |
|
159 |
148 |
$338.01 |
| Q0162 |
Ondansetron oral |
50 |
49 |
$285.35 |
| J1642 |
Inj heparin sodium per 10 u |
44 |
24 |
$270.80 |
| J7512 |
Prednisone ir or dr oral 1mg |
473 |
455 |
$219.76 |
| S0164 |
Injection pantroprazole |
18 |
15 |
$211.86 |
| J7620 |
Albuterol ipratrop non-comp |
448 |
410 |
$194.21 |
| 87205 |
|
42 |
26 |
$180.48 |
| J7611 |
Albuterol non-comp con |
155 |
149 |
$177.31 |
| 29125 |
|
15 |
14 |
$172.51 |
| 87088 |
|
25 |
25 |
$147.85 |
| J3475 |
Inj magnesium sulfate |
19 |
16 |
$139.81 |
| J2470 |
Inj pantoprazole sodium 40mg |
22 |
19 |
$104.64 |
| J2710 |
Neostigmine methylslfte inj |
12 |
12 |
$103.09 |
| 87070 |
|
12 |
12 |
$95.48 |
| 90471 |
|
12 |
12 |
$50.84 |
| 86308 |
|
13 |
13 |
$50.25 |