| Code | Description | Claims | Beneficiaries | Total Paid |
| J7050 |
Normal saline solution infus |
18,833 |
8,850 |
$2.82M |
| 99211 |
|
48,438 |
30,072 |
$1.73M |
| J9271 |
Inj pembrolizumab |
834 |
597 |
$1.71M |
| 77386 |
|
8,283 |
804 |
$1.66M |
| J2505 |
Injection, pegfilgrastim 6mg |
1,632 |
1,049 |
$972K |
| 96413 |
|
20,891 |
10,598 |
$954K |
| J7030 |
Normal saline solution infus |
7,823 |
4,481 |
$707K |
| J7040 |
Normal saline solution infus |
5,336 |
2,712 |
$696K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
9,489 |
8,005 |
$529K |
| 80053 |
|
51,854 |
29,564 |
$509K |
| 36415 |
|
33,884 |
22,980 |
$502K |
| 77412 |
|
3,812 |
483 |
$500K |
| Q5116 |
Inj., trazimera, 10 mg |
577 |
406 |
$492K |
| Q5107 |
Inj mvasi 10 mg |
1,069 |
517 |
$438K |
| J9306 |
Injection, pertuzumab, 1 mg |
663 |
442 |
$415K |
| J9299 |
Injection, nivolumab |
559 |
353 |
$400K |
| 78815 |
|
2,539 |
2,176 |
$399K |
| 96415 |
|
5,285 |
2,941 |
$385K |
| J9355 |
Inj trastuzumab excl biosimi |
986 |
661 |
$361K |
| 77336 |
|
3,735 |
1,766 |
$361K |
| 71260 |
|
7,882 |
6,708 |
$294K |
| 96361 |
|
3,830 |
1,881 |
$280K |
| 96372 |
|
4,058 |
2,115 |
$244K |
| 36591 |
|
12,107 |
7,068 |
$238K |
| 96416 |
|
2,988 |
1,437 |
$236K |
| 70553 |
|
2,703 |
2,365 |
$227K |
| 96365 |
|
3,409 |
1,718 |
$213K |
| 96402 |
|
2,249 |
1,553 |
$203K |
| J2506 |
Inj pegfilgrast ex bio 0.5mg |
413 |
283 |
$201K |
| 96367 |
|
4,741 |
2,879 |
$182K |
| 82948 |
|
4,221 |
3,169 |
$180K |
| A9576 |
Inj prohance multipack |
3,439 |
2,916 |
$180K |
| 74177 |
|
6,294 |
5,339 |
$169K |
| 85025 |
|
52,537 |
28,450 |
$168K |
| 93306 |
|
1,423 |
1,195 |
$154K |
| 96375 |
|
12,434 |
6,337 |
$142K |
| 38222 |
|
1,103 |
924 |
$141K |
| G0463 |
Hospital outpt clinic visit |
24,470 |
14,192 |
$139K |
| Q5119 |
Inj ruxience, 10 mg |
80 |
36 |
$138K |
| J0897 |
Denosumab injection |
635 |
545 |
$136K |
| 36592 |
|
2,382 |
1,252 |
$122K |
| J1453 |
Fosaprepitant injection |
3,398 |
2,090 |
$120K |
| U0003 |
Cov-19 amp prb hgh thruput |
2,847 |
2,240 |
$119K |
| J2469 |
Palonosetron hcl |
5,934 |
3,283 |
$117K |
| 77300 |
|
1,731 |
925 |
$115K |
| J9035 |
Bevacizumab injection |
282 |
160 |
$111K |
| J1930 |
Lanreotide injection |
74 |
65 |
$110K |
| 36430 |
|
2,848 |
1,314 |
$108K |
| P9040 |
Rbc leukoreduced irradiated |
1,585 |
997 |
$106K |
| 96366 |
|
2,275 |
1,317 |
$103K |
| 88185 |
|
2,376 |
1,459 |
$83K |
| A9585 |
Gadobutrol injection |
1,466 |
1,222 |
$79K |
| 78306 |
|
840 |
747 |
$79K |
| 96360 |
|
1,007 |
649 |
$71K |
| 77334 |
|
1,770 |
1,106 |
$67K |
| 36561 |
|
172 |
134 |
$66K |
| 96374 |
|
2,843 |
1,606 |
$65K |
| 77387 |
|
835 |
124 |
$64K |
| 70491 |
|
1,839 |
1,553 |
$60K |
| J3490 |
Drugs unclassified injection |
10,410 |
5,192 |
$59K |
| 77290 |
|
486 |
393 |
$56K |
| 96523 |
|
3,209 |
2,033 |
$55K |
| 88305 |
|
4,672 |
3,808 |
$53K |
| 71250 |
|
1,566 |
1,305 |
$52K |
| 96401 |
|
2,009 |
1,086 |
$48K |
| J8540 |
Oral dexamethasone |
8,599 |
4,419 |
$45K |
| 77301 |
|
344 |
250 |
$43K |
| 82565 |
|
6,423 |
5,516 |
$42K |
| 88321 |
|
3,773 |
3,052 |
$38K |
| J9202 |
Goserelin acetate implant |
476 |
366 |
$38K |
| 76536 |
|
859 |
787 |
$37K |
| J2704 |
Inj, propofol, 10 mg |
3,855 |
3,072 |
$37K |
| J9395 |
Injection, fulvestrant |
154 |
126 |
$37K |
| 31575 |
|
1,012 |
845 |
$36K |
| 83735 |
|
13,690 |
6,727 |
$33K |
| 83615 |
|
15,034 |
8,850 |
$31K |
| 86900 |
|
3,883 |
2,820 |
$31K |
| J9070 |
Cyclophosphamide 100 mg inj |
394 |
214 |
$29K |
| 76642 |
|
693 |
572 |
$28K |
| 81025 |
|
1,430 |
1,120 |
$28K |
| 82728 |
|
2,825 |
1,954 |
$27K |
| 96368 |
|
691 |
423 |
$27K |
| 86885 |
|
3,501 |
2,543 |
$26K |
| 84439 |
|
6,379 |
5,157 |
$26K |
| J3010 |
Fentanyl citrate injection |
4,847 |
3,702 |
$26K |
| J2405 |
Ondansetron hcl injection |
4,932 |
3,146 |
$26K |
| 88184 |
|
2,243 |
1,570 |
$25K |
| 88341 |
|
2,530 |
1,889 |
$25K |
| J2353 |
Octreotide injection, depot |
100 |
67 |
$24K |
| 0202U |
|
362 |
302 |
$24K |
| 85027 |
|
4,360 |
3,429 |
$24K |
| 96417 |
|
5,830 |
3,368 |
$23K |
| 84100 |
|
8,345 |
4,605 |
$23K |
| 84443 |
|
7,343 |
5,934 |
$23K |
| J1170 |
Hydromorphone injection |
3,061 |
1,623 |
$22K |
| J0690 |
Cefazolin sodium injection |
2,556 |
1,781 |
$22K |
| 78816 |
|
78 |
69 |
$22K |
| 88271 |
|
594 |
422 |
$21K |
| 94760 |
|
3,114 |
2,230 |
$21K |
| J2997 |
Alteplase recombinant |
639 |
525 |
$20K |
| J7060 |
5% dextrose/water |
1,866 |
993 |
$20K |
| J9263 |
Oxaliplatin |
503 |
266 |
$20K |
| 86300 |
|
2,571 |
1,912 |
$19K |
| J9312 |
Inj., rituximab, 10 mg |
41 |
31 |
$19K |
| J1100 |
Dexamethasone sodium phos |
2,897 |
1,896 |
$19K |
| 85610 |
|
6,942 |
5,213 |
$18K |
| J2250 |
Inj midazolam hydrochloride |
4,001 |
2,916 |
$18K |
| 85730 |
|
6,838 |
5,149 |
$18K |
| 74183 |
|
228 |
188 |
$17K |
| J1200 |
Diphenhydramine hcl injectio |
4,188 |
2,040 |
$17K |
| 80048 |
|
2,464 |
1,968 |
$17K |
| 88342 |
|
3,169 |
2,523 |
$16K |
| 88307 |
|
497 |
414 |
$16K |
| 77049 |
|
81 |
78 |
$16K |
| 84481 |
|
3,539 |
2,730 |
$15K |
| 81455 |
|
16 |
13 |
$15K |
| J8501 |
Oral aprepitant |
522 |
454 |
$14K |
| 85097 |
|
1,064 |
878 |
$14K |
| 71046 |
|
1,418 |
1,158 |
$14K |
| 93005 |
|
2,958 |
2,412 |
$14K |
| C1769 |
Guide wire |
1,279 |
982 |
$13K |
| 82378 |
|
4,609 |
3,577 |
$13K |
| A9579 |
Gad-base mr contrast nos,1ml |
84 |
69 |
$13K |
| J9171 |
Docetaxel injection |
172 |
113 |
$12K |
| 77062 |
|
428 |
382 |
$12K |
| J9045 |
Carboplatin injection |
1,959 |
1,157 |
$11K |
| 77001 |
|
893 |
729 |
$11K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
83 |
66 |
$10K |
| 88264 |
|
678 |
564 |
$10K |
| 77065 |
Tomosynthesis, mammo |
1,046 |
845 |
$10K |
| 96409 |
|
778 |
475 |
$10K |
| 74160 |
|
504 |
406 |
$10K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
437 |
227 |
$10K |
| 96376 |
|
1,115 |
482 |
$10K |
| 80197 |
|
1,720 |
796 |
$10K |
| G1004 |
Cdsm ndsc |
1,421 |
1,042 |
$10K |
| 77066 |
Tomosynthesis, mammo |
988 |
820 |
$10K |
| 77338 |
|
392 |
282 |
$9K |
| 86920 |
|
2,283 |
1,503 |
$9K |
| 86901 |
|
3,837 |
2,786 |
$9K |
| J9190 |
Fluorouracil injection |
2,697 |
1,277 |
$9K |
| J9267 |
Paclitaxel injection |
1,821 |
885 |
$8K |
| P9037 |
Plate pheres leukoredu irrad |
52 |
25 |
$8K |
| J3475 |
Inj magnesium sulfate |
1,233 |
597 |
$8K |
| 81001 |
|
2,232 |
1,709 |
$8K |
| 96411 |
|
2,128 |
1,274 |
$8K |
| 87641 |
|
426 |
384 |
$7K |
| 77061 |
|
189 |
176 |
$7K |
| 82784 |
|
3,601 |
2,615 |
$7K |
| Q5101 |
Injection, zarxio |
84 |
12 |
$7K |
| 85046 |
|
1,757 |
1,328 |
$7K |
| A9552 |
F18 fdg |
2,844 |
2,439 |
$7K |
| 82306 |
|
1,334 |
1,179 |
$6K |
| J2370 |
Phenylephrine hcl injection |
1,268 |
1,028 |
$6K |
| 72197 |
|
46 |
37 |
$6K |
| 77295 |
|
29 |
26 |
$6K |
| G0378 |
Hospital observation per hr |
423 |
205 |
$6K |
| 86334 |
|
2,600 |
1,972 |
$6K |
| Q9969 |
Non-heu tc-99m add-on/dose |
1,002 |
887 |
$5K |
| 99152 |
|
1,121 |
872 |
$5K |
| 88311 |
|
1,072 |
871 |
$5K |
| 84165 |
|
2,596 |
1,967 |
$5K |
| 0399T |
|
44 |
40 |
$5K |
| 87086 |
|
859 |
685 |
$5K |
| 80061 |
|
1,035 |
851 |
$5K |
| 88237 |
|
753 |
624 |
$5K |
| 71275 |
|
29 |
25 |
$5K |
| 88313 |
|
1,193 |
970 |
$5K |
| 76937 |
|
602 |
465 |
$5K |
| 99153 |
Mod sedat endo service >5yrs |
1,014 |
789 |
$5K |
| 86304 |
|
1,016 |
805 |
$5K |
| 96377 |
|
1,764 |
1,146 |
$4K |
| 36593 |
|
396 |
328 |
$4K |
| 87633 |
|
210 |
159 |
$4K |
| 97110 |
|
85 |
27 |
$4K |
| 94761 |
|
1,067 |
826 |
$4K |
| G0482 |
Drug test def 15-21 classes |
144 |
131 |
$4K |
| 74178 |
|
85 |
71 |
$4K |
| 84156 |
|
722 |
596 |
$4K |
| 83521 |
|
798 |
463 |
$4K |
| A6258 |
Transparent film >16<=48 in |
395 |
248 |
$4K |
| J9201 |
In gemcitabine hcl nos 200mg |
612 |
268 |
$4K |
| 88275 |
|
613 |
400 |
$4K |
| 83883 |
|
1,556 |
1,105 |
$4K |
| J9206 |
Irinotecan injection |
664 |
374 |
$4K |
| J3480 |
Inj potassium chloride |
492 |
220 |
$3K |
| 88360 |
|
357 |
285 |
$3K |
| 77280 |
|
21 |
16 |
$3K |
| 97140 |
|
43 |
15 |
$3K |
| 80195 |
|
1,370 |
590 |
$3K |
| 43239 |
|
14 |
12 |
$3K |
| 81206 |
|
29 |
26 |
$3K |
| 84550 |
|
1,726 |
1,013 |
$3K |
| 72156 |
|
24 |
24 |
$3K |
| 85049 |
|
656 |
461 |
$3K |
| 82232 |
|
1,024 |
802 |
$3K |
| 94729 |
|
249 |
225 |
$3K |
| C9399 |
Unclassified drugs or biolog |
291 |
217 |
$3K |
| 72158 |
|
69 |
64 |
$3K |
| 94010 |
|
119 |
97 |
$2K |
| 71045 |
|
124 |
88 |
$2K |
| J0461 |
Atropine sulfate injection |
184 |
119 |
$2K |
| 88112 |
|
49 |
39 |
$2K |
| J9144 |
Daratumumab, hyaluronidase |
125 |
50 |
$2K |
| 87070 |
|
252 |
183 |
$2K |
| 81003 |
|
640 |
529 |
$2K |
| 86141 |
|
568 |
310 |
$2K |
| 84432 |
|
211 |
186 |
$2K |
| 87040 |
|
268 |
153 |
$2K |
| 87497 |
|
471 |
234 |
$2K |
| 97161 |
|
45 |
40 |
$2K |
| 93356 |
|
668 |
557 |
$2K |
| 36590 |
|
14 |
12 |
$2K |
| 0002A |
|
273 |
244 |
$2K |
| 86301 |
|
1,409 |
1,038 |
$2K |
| 82803 |
|
17 |
13 |
$2K |
| 88172 |
|
133 |
115 |
$2K |
| 94726 |
|
248 |
223 |
$2K |
| 93971 |
|
62 |
51 |
$2K |
| 87340 |
|
620 |
514 |
$2K |
| 81450 |
|
25 |
24 |
$2K |
| 86355 |
|
242 |
182 |
$1K |
| 77370 |
|
44 |
39 |
$1K |
| 84153 |
|
727 |
567 |
$1K |
| 0241U |
|
124 |
106 |
$1K |
| 82607 |
|
870 |
741 |
$1K |
| 0099U |
|
100 |
85 |
$1K |
| Q0162 |
Ondansetron oral |
780 |
436 |
$1K |
| 83540 |
|
1,214 |
1,001 |
$1K |
| 86803 |
|
567 |
477 |
$1K |
| Q0164 |
Prochlorperazine maleate 5mg |
42 |
25 |
$1K |
| J7999 |
Compounded drug, noc |
232 |
180 |
$1K |
| U0005 |
Infec agen detec ampli probe |
1,588 |
1,260 |
$1K |
| 84166 |
|
395 |
321 |
$1K |
| G0279 |
Tomosynthesis, mammo |
288 |
230 |
$1K |
| 82533 |
|
463 |
358 |
$1K |
| 83550 |
|
988 |
830 |
$1K |
| 86704 |
|
221 |
183 |
$1K |
| 0001A |
|
255 |
223 |
$1K |
| 83036 |
|
767 |
621 |
$1K |
| 87798 |
|
222 |
166 |
$986.91 |
| 74170 |
|
47 |
42 |
$982.79 |
| 86335 |
|
334 |
268 |
$956.21 |
| 77085 |
|
28 |
24 |
$929.12 |
| 84484 |
|
273 |
204 |
$922.77 |
| 83970 |
|
154 |
132 |
$912.05 |
| 94642 |
|
27 |
24 |
$894.02 |
| 87486 |
|
194 |
145 |
$869.15 |
| J3489 |
Zoledronic acid 1mg |
275 |
204 |
$842.97 |
| 87581 |
|
194 |
145 |
$838.52 |
| A6402 |
Sterile gauze <= 16 sq in |
61 |
48 |
$835.82 |
| 86357 |
|
242 |
182 |
$770.20 |
| 86356 |
|
240 |
181 |
$770.20 |
| 86800 |
|
212 |
190 |
$762.51 |
| 86359 |
|
206 |
154 |
$759.68 |
| 97802 |
|
50 |
44 |
$758.75 |
| A4216 |
Sterile water/saline, 10 ml |
122 |
95 |
$749.48 |
| 86360 |
|
206 |
154 |
$721.57 |
| 82746 |
|
475 |
406 |
$695.70 |
| 88173 |
|
258 |
208 |
$669.29 |
| 81378 |
|
16 |
12 |
$616.59 |
| J2001 |
Lidocaine injection |
158 |
130 |
$616.19 |
| 86140 |
|
354 |
191 |
$599.74 |
| 83690 |
|
542 |
448 |
$588.78 |
| J1885 |
Ketorolac tromethamine inj |
92 |
61 |
$568.91 |
| 90472 |
|
106 |
81 |
$511.52 |
| 88300 |
|
12 |
12 |
$494.00 |
| 85651 |
|
512 |
401 |
$468.95 |
| 84403 |
|
364 |
303 |
$460.11 |
| 88108 |
|
44 |
27 |
$451.90 |
| 87205 |
|
37 |
27 |
$434.56 |
| 87389 |
|
98 |
84 |
$415.51 |
| 82105 |
|
207 |
166 |
$396.65 |
| 86644 |
|
87 |
75 |
$391.58 |
| A9561 |
Tc99m oxidronate |
746 |
671 |
$378.76 |
| 0011A |
|
304 |
231 |
$364.83 |
| J2930 |
Methylprednisolone injection |
152 |
84 |
$363.41 |
| 77470 |
|
19 |
15 |
$300.42 |
| 82024 |
|
126 |
104 |
$299.16 |
| 81268 |
|
26 |
24 |
$263.67 |
| 88161 |
|
52 |
38 |
$254.99 |
| J0330 |
Succinycholine chloride inj |
118 |
93 |
$235.66 |
| 83520 |
|
558 |
288 |
$228.50 |
| 73552 |
|
17 |
13 |
$225.63 |
| 83880 |
|
50 |
42 |
$189.60 |
| 93702 |
|
13 |
12 |
$162.20 |
| J0131 |
Inj, acetaminophen (nos) |
103 |
78 |
$154.68 |
| 82248 |
|
20 |
16 |
$139.39 |
| 82977 |
|
40 |
14 |
$132.14 |
| C1788 |
Port, indwelling, imp |
103 |
68 |
$105.51 |
| J9060 |
Cisplatin 10 mg injection |
100 |
39 |
$102.47 |
| C1729 |
Cath, drainage |
16 |
12 |
$100.34 |
| 86592 |
|
27 |
25 |
$91.37 |
| 96040 |
|
12 |
12 |
$87.89 |
| 83010 |
|
88 |
70 |
$87.14 |
| 0012A |
|
219 |
197 |
$46.54 |
| 82570 |
|
18 |
12 |
$43.28 |
| 0013A |
|
38 |
28 |
$40.00 |
| J0780 |
Prochlorperazine injection |
46 |
36 |
$38.00 |
| 90471 |
|
174 |
128 |
$35.88 |
| 88177 |
|
37 |
27 |
$35.40 |
| J1720 |
Hydrocortisone sodium succ i |
108 |
69 |
$34.00 |
| 83605 |
|
110 |
87 |
$32.25 |
| J0640 |
Leucovorin calcium injection |
234 |
131 |
$29.58 |
| 84702 |
|
12 |
12 |
$18.14 |
| 87799 |
|
16 |
14 |
$16.49 |
| 90686 |
|
179 |
150 |
$14.32 |
| 84145 |
|
34 |
27 |
$11.63 |
| 85652 |
|
35 |
28 |
$10.56 |
| 89051 |
|
18 |
12 |
$10.08 |
| 87077 |
|
30 |
26 |
$9.28 |
| 36600 |
|
17 |
13 |
$4.34 |
| 83001 |
|
15 |
13 |
$4.05 |
| 82150 |
|
16 |
12 |
$3.13 |
| G0008 |
Admin influenza virus vac |
18 |
12 |
$0.00 |
| 0064A |
|
17 |
15 |
$0.00 |
| J2060 |
Lorazepam injection |
27 |
16 |
$0.00 |
| 72157 |
|
18 |
14 |
$0.00 |
| 87186 |
|
16 |
13 |
$0.00 |
| J9000 |
Doxorubicin hcl injection |
98 |
63 |
$0.00 |
| 90670 |
|
87 |
73 |
$0.00 |
| 0003A |
|
96 |
83 |
$0.00 |
| 90746 |
|
13 |
12 |
$0.00 |
| A6403 |
Sterile gauze>16 <= 48 sq in |
16 |
13 |
$0.00 |
| J9370 |
Vincristine sulfate 1 mg inj |
38 |
25 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
42 |
24 |
$0.00 |
| 90648 |
|
13 |
12 |
$0.00 |
| A6250 |
Skin seal protect moisturizr |
18 |
13 |
$0.00 |
| 76942 |
|
19 |
13 |
$0.00 |