| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
|
88,862 |
80,146 |
$3.49M |
| 99285 |
|
3,805 |
3,386 |
$1.09M |
| 74177 |
|
5,432 |
5,293 |
$1.00M |
| 96374 |
|
20,095 |
18,745 |
$904K |
| 70450 |
|
7,816 |
7,589 |
$862K |
| 99281 |
|
6,107 |
5,035 |
$521K |
| 93005 |
|
24,387 |
21,007 |
$506K |
| 80053 |
|
42,440 |
38,253 |
$488K |
| 96375 |
|
17,683 |
15,593 |
$487K |
| 74176 |
|
4,761 |
4,656 |
$457K |
| 99199 |
|
9,186 |
8,225 |
$408K |
| 85025 |
|
43,690 |
39,199 |
$335K |
| 96365 |
|
5,701 |
5,417 |
$334K |
| 0241U |
|
3,984 |
3,905 |
$317K |
| 72125 |
|
2,202 |
2,155 |
$304K |
| 71045 |
|
22,694 |
21,431 |
$304K |
| 99284 |
|
2,790 |
2,635 |
$300K |
| 0121 |
|
224 |
203 |
$296K |
| Z7502 |
|
7,060 |
6,975 |
$255K |
| 71275 |
|
1,152 |
1,125 |
$179K |
| 84484 |
|
17,223 |
10,711 |
$170K |
| 99283 |
|
2,427 |
2,278 |
$167K |
| 76705 |
|
3,224 |
3,129 |
$159K |
| 96372 |
|
7,895 |
7,230 |
$142K |
| J7030 |
Normal saline solution infus |
22,881 |
18,233 |
$125K |
| 85610 |
|
27,890 |
25,849 |
$120K |
| 87635 |
|
3,172 |
3,043 |
$118K |
| 83690 |
|
16,982 |
15,841 |
$108K |
| 0270 |
|
19,630 |
10,787 |
$108K |
| J2405 |
Ondansetron hcl injection |
13,757 |
11,790 |
$105K |
| 0250 |
|
35,814 |
18,282 |
$101K |
| 93971 |
|
1,129 |
1,112 |
$101K |
| 97140 |
|
6,758 |
1,827 |
$101K |
| 76856 |
|
1,866 |
1,820 |
$99K |
| J3490 |
Drugs unclassified injection |
24,014 |
14,162 |
$92K |
| 77067 |
|
1,571 |
1,563 |
$91K |
| 76830 |
|
1,529 |
1,487 |
$84K |
| 83880 |
|
3,680 |
3,521 |
$83K |
| 87426 |
|
3,280 |
3,152 |
$80K |
| 83735 |
|
12,212 |
11,086 |
$79K |
| 84703 |
|
12,978 |
12,039 |
$78K |
| 84443 |
|
5,341 |
5,197 |
$72K |
| J0131 |
Inj, acetaminophen (nos) |
2,062 |
1,974 |
$68K |
| 81001 |
|
13,617 |
12,970 |
$64K |
| 87631 |
|
1,345 |
1,333 |
$63K |
| U0002 |
Covid-19 lab test non-cdc |
1,666 |
1,606 |
$60K |
| 76801 |
|
1,416 |
1,254 |
$59K |
| 76817 |
|
1,361 |
1,205 |
$59K |
| J1885 |
Ketorolac tromethamine inj |
11,177 |
10,209 |
$58K |
| 0202U |
|
586 |
575 |
$56K |
| 81003 |
|
14,185 |
13,414 |
$55K |
| 80307 |
|
1,232 |
1,174 |
$55K |
| 94640 |
|
3,028 |
2,850 |
$54K |
| 87086 |
|
6,789 |
6,571 |
$52K |
| 0762 |
|
1,187 |
1,115 |
$51K |
| 71046 |
|
2,543 |
2,497 |
$50K |
| 70486 |
|
401 |
394 |
$50K |
| 80305 |
|
2,930 |
2,767 |
$50K |
| 87040 |
|
4,460 |
2,789 |
$47K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
6,693 |
6,454 |
$47K |
| J2270 |
Morphine sulfate injection |
7,679 |
6,051 |
$44K |
| 72100 |
|
1,645 |
1,632 |
$44K |
| 87491 |
|
1,674 |
1,629 |
$43K |
| 87591 |
|
1,669 |
1,628 |
$43K |
| 73562 |
|
2,219 |
2,020 |
$42K |
| 73610 |
|
1,888 |
1,817 |
$42K |
| 71260 |
|
188 |
182 |
$41K |
| 96361 |
|
2,841 |
2,671 |
$41K |
| 97110 |
|
6,883 |
1,940 |
$40K |
| 87400 |
|
5,039 |
2,715 |
$37K |
| 73630 |
|
2,000 |
1,899 |
$36K |
| 96376 |
|
2,748 |
2,162 |
$36K |
| 85379 |
|
3,532 |
3,432 |
$35K |
| J1100 |
Dexamethasone sodium phos |
4,392 |
4,163 |
$34K |
| 73030 |
|
1,641 |
1,574 |
$32K |
| 80061 |
|
3,019 |
2,889 |
$32K |
| 85730 |
|
6,158 |
5,947 |
$32K |
| 80329 |
|
3,093 |
1,524 |
$32K |
| 96360 |
|
749 |
725 |
$32K |
| 83605 |
|
3,081 |
2,735 |
$28K |
| 73130 |
|
1,409 |
1,336 |
$28K |
| 80320 |
|
1,914 |
1,751 |
$27K |
| 0160 |
|
671 |
568 |
$26K |
| 87088 |
|
4,456 |
4,322 |
$26K |
| J0696 |
Ceftriaxone sodium injection |
3,186 |
2,857 |
$25K |
| 73110 |
|
1,063 |
1,012 |
$22K |
| 90715 |
|
786 |
779 |
$22K |
| 77063 |
|
1,282 |
1,275 |
$21K |
| 36415 |
|
26,080 |
22,321 |
$21K |
| 84702 |
|
1,804 |
1,576 |
$20K |
| 87651 |
|
674 |
672 |
$19K |
| 80048 |
|
2,141 |
1,771 |
$18K |
| 96366 |
|
674 |
553 |
$18K |
| 87880 |
|
1,470 |
1,435 |
$17K |
| 82947 |
|
6,101 |
3,422 |
$17K |
| 87081 |
|
1,745 |
1,708 |
$17K |
| 82150 |
|
3,066 |
2,939 |
$16K |
| 87186 |
|
2,084 |
2,033 |
$15K |
| 82077 |
|
1,036 |
940 |
$13K |
| J7040 |
Normal saline solution infus |
3,379 |
3,152 |
$13K |
| J2765 |
Metoclopramide hcl injection |
2,863 |
2,651 |
$13K |
| 72040 |
|
548 |
545 |
$13K |
| J1200 |
Diphenhydramine hcl injectio |
3,259 |
2,909 |
$13K |
| 80299 |
|
1,146 |
976 |
$13K |
| 70496 |
|
57 |
55 |
$13K |
| 76642 |
|
334 |
333 |
$13K |
| 59025 |
|
966 |
754 |
$12K |
| 87807 |
|
1,001 |
961 |
$12K |
| 70498 |
|
58 |
56 |
$12K |
| 74018 |
|
619 |
602 |
$12K |
| 0761 |
|
295 |
276 |
$11K |
| J2001 |
Lidocaine injection |
2,331 |
1,987 |
$10K |
| 86901 |
|
3,371 |
2,606 |
$10K |
| J2060 |
Lorazepam injection |
2,305 |
1,864 |
$10K |
| Q0162 |
Ondansetron oral |
3,145 |
2,966 |
$9K |
| J2930 |
Methylprednisolone injection |
858 |
802 |
$9K |
| S3620 |
Newborn metabolic screening |
51 |
40 |
$9K |
| 99213 |
|
237 |
210 |
$9K |
| 86900 |
|
3,353 |
2,599 |
$9K |
| 83036 |
|
1,050 |
1,018 |
$8K |
| 87077 |
|
1,317 |
1,294 |
$8K |
| 73080 |
|
337 |
325 |
$8K |
| Z7610 |
|
641 |
444 |
$7K |
| 85027 |
|
1,356 |
1,117 |
$7K |
| 73590 |
|
322 |
297 |
$7K |
| J3475 |
Inj magnesium sulfate |
828 |
756 |
$7K |
| 93306 |
|
52 |
50 |
$7K |
| 99070 |
|
1,779 |
661 |
$7K |
| 80143 |
|
551 |
510 |
$7K |
| 29125 |
|
271 |
268 |
$7K |
| A4649 |
Surgical supplies |
911 |
415 |
$7K |
| 93970 |
|
40 |
39 |
$6K |
| 96367 |
|
215 |
198 |
$6K |
| 73502 |
|
217 |
216 |
$5K |
| 84145 |
|
158 |
155 |
$5K |
| J0780 |
Prochlorperazine injection |
694 |
649 |
$5K |
| J1815 |
Insulin injection |
337 |
172 |
$5K |
| 84100 |
|
1,224 |
1,023 |
$5K |
| 78452 |
|
15 |
14 |
$5K |
| 76641 |
|
98 |
98 |
$4K |
| 86850 |
|
898 |
859 |
$4K |
| 80047 |
|
267 |
260 |
$4K |
| 0710 |
|
907 |
870 |
$4K |
| J1650 |
Inj enoxaparin sodium |
346 |
251 |
$4K |
| 90471 |
|
898 |
876 |
$4K |
| 73090 |
|
156 |
154 |
$3K |
| 90714 |
|
143 |
143 |
$3K |
| 82550 |
|
564 |
522 |
$3K |
| S0164 |
Injection pantroprazole |
372 |
337 |
$3K |
| 12001 |
|
38 |
38 |
$3K |
| J7120 |
Ringers lactate infusion |
1,064 |
911 |
$3K |
| 81025 |
|
677 |
672 |
$3K |
| 73140 |
|
210 |
209 |
$2K |
| J1170 |
Hydromorphone injection |
549 |
421 |
$2K |
| 76805 |
|
40 |
39 |
$2K |
| 0301 |
|
454 |
409 |
$2K |
| 84439 |
|
213 |
206 |
$2K |
| 0324 |
|
350 |
341 |
$2K |
| 84436 |
|
351 |
328 |
$2K |
| 93017 |
|
30 |
29 |
$2K |
| 0370 |
|
54 |
54 |
$2K |
| 29515 |
|
47 |
46 |
$1K |
| 86140 |
|
327 |
318 |
$1K |
| 99000 |
|
363 |
362 |
$1K |
| J2919 |
Inj, methylpred sod succ 5mg |
72 |
56 |
$1K |
| J2704 |
Inj, propofol, 10 mg |
389 |
346 |
$1K |
| 76870 |
|
27 |
25 |
$1K |
| 87147 |
|
224 |
220 |
$1K |
| J0690 |
Cefazolin sodium injection |
369 |
298 |
$1K |
| 0637 |
|
667 |
511 |
$990.34 |
| G0480 |
Drug test def 1-7 classes |
15 |
12 |
$958.61 |
| J3360 |
Diazepam injection |
102 |
82 |
$950.17 |
| 86308 |
|
62 |
61 |
$935.99 |
| 0403 |
|
60 |
60 |
$859.05 |
| 97161 |
|
40 |
40 |
$846.52 |
| J3010 |
Fentanyl citrate injection |
578 |
459 |
$834.77 |
| J7613 |
Albuterol non-comp unit |
2,588 |
2,087 |
$808.17 |
| J2250 |
Inj midazolam hydrochloride |
496 |
451 |
$799.00 |
| A9500 |
Tc99m sestamibi |
16 |
15 |
$748.17 |
| 10060 |
|
59 |
56 |
$739.20 |
| J7512 |
Prednisone ir or dr oral 1mg |
1,015 |
976 |
$729.82 |
| 12002 |
|
58 |
54 |
$686.02 |
| 82805 |
|
30 |
29 |
$676.94 |
| 99282 |
|
29 |
28 |
$614.49 |
| J2785 |
Regadenoson injection |
13 |
12 |
$609.56 |
| 87070 |
|
90 |
87 |
$594.19 |
| 0420 |
|
75 |
39 |
$590.01 |
| J7060 |
5% dextrose/water |
98 |
97 |
$553.13 |
| Q0163 |
Diphenhydramine hcl 50mg |
503 |
485 |
$511.06 |
| G0378 |
Hospital observation per hr |
17 |
14 |
$472.89 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
52 |
39 |
$468.26 |
| J1953 |
Levetiracetam injection |
32 |
24 |
$428.69 |
| 99232 |
|
22 |
12 |
$415.04 |
| 0258 |
|
407 |
334 |
$408.04 |
| 0360 |
|
74 |
73 |
$394.24 |
| J7644 |
Ipratropium bromide non-comp |
660 |
543 |
$350.78 |
| J1630 |
Haloperidol injection |
84 |
72 |
$326.11 |
| J2550 |
Promethazine hcl injection |
68 |
62 |
$296.10 |
| 12011 |
|
12 |
12 |
$288.81 |
| J7510 |
Prednisolone oral per 5 mg |
154 |
150 |
$246.78 |
| 94644 |
|
14 |
14 |
$217.66 |
| 85652 |
|
126 |
121 |
$201.62 |
| 80076 |
|
47 |
44 |
$187.59 |
| 73060 |
|
14 |
13 |
$184.62 |
| 82010 |
|
30 |
26 |
$166.98 |
| 73552 |
|
14 |
13 |
$155.32 |
| G0283 |
Elec stim other than wound |
81 |
26 |
$139.73 |
| 87210 |
|
54 |
51 |
$138.42 |
| 87205 |
|
26 |
25 |
$78.16 |
| J7612 |
Levalbuterol non-comp con |
46 |
38 |
$76.46 |
| 97530 |
|
33 |
15 |
$71.41 |
| 0636 |
|
320 |
254 |
$62.56 |
| Q0144 |
Azithromycin dihydrate, oral |
12 |
12 |
$62.26 |
| J7620 |
Albuterol ipratrop non-comp |
119 |
99 |
$62.06 |
| 88305 |
|
12 |
12 |
$61.84 |
| 97016 |
|
53 |
14 |
$55.16 |
| 0260 |
|
18 |
18 |
$49.60 |
| 99072 |
|
27 |
19 |
$39.54 |
| 29130 |
|
12 |
12 |
$36.00 |
| J2543 |
Piperacillin/tazobactam |
16 |
13 |
$24.68 |
| J8597 |
Antiemetic drug oral nos |
73 |
69 |
$18.40 |
| C9113 |
Inj pantoprazole sodium, via |
14 |
14 |
$10.08 |
| 0305 |
|
381 |
347 |
$4.97 |
| 0302 |
|
57 |
51 |
$4.09 |
| 0307 |
|
129 |
121 |
$0.00 |
| S9445 |
Pt education noc individ |
1,469 |
707 |
$0.00 |
| Q4051 |
Splint supplies misc |
42 |
22 |
$0.00 |
| 0352 |
|
13 |
13 |
$0.00 |
| 0306 |
|
62 |
58 |
$0.00 |
| 93042 |
|
33 |
32 |
$0.00 |
| 0300 |
|
489 |
419 |
$0.00 |
| 0730 |
|
105 |
98 |
$0.00 |
| 0940 |
|
55 |
53 |
$0.00 |
| G8978 |
Mobility current status |
13 |
12 |
$0.00 |
| 99499 |
|
18 |
12 |
$0.00 |
| 0760 |
|
12 |
12 |
$0.00 |