| Code | Description | Claims | Beneficiaries | Total Paid |
| 0450 |
|
135,796 |
121,849 |
$4.74M |
| J3490 |
Drugs unclassified injection |
152,524 |
65,618 |
$2.25M |
| J9271 |
Inj pembrolizumab |
149 |
122 |
$1.57M |
| 0121 |
|
208 |
204 |
$1.52M |
| 0202U |
|
4,523 |
4,486 |
$1.25M |
| 0206 |
|
198 |
194 |
$1.17M |
| 96374 |
|
20,144 |
18,723 |
$1.15M |
| 74177 |
|
5,674 |
5,577 |
$1.15M |
| J9144 |
Daratumumab, hyaluronidase |
113 |
80 |
$780K |
| 0272 |
|
8,064 |
7,685 |
$699K |
| 93005 |
|
35,858 |
32,980 |
$684K |
| 0241U |
|
4,845 |
4,738 |
$621K |
| Q0162 |
Ondansetron oral |
10,774 |
10,432 |
$586K |
| 93976 |
|
2,778 |
2,727 |
$537K |
| 87635 |
|
11,247 |
10,897 |
$536K |
| 80053 |
|
54,295 |
49,481 |
$520K |
| 70450 |
|
6,383 |
6,261 |
$498K |
| 85025 |
|
65,717 |
58,142 |
$432K |
| 74176 |
|
3,855 |
3,811 |
$383K |
| 96375 |
|
13,960 |
12,074 |
$362K |
| 71275 |
|
1,716 |
1,694 |
$314K |
| 96372 |
|
14,082 |
10,686 |
$309K |
| 99291 |
|
2,603 |
1,022 |
$307K |
| 96360 |
|
5,283 |
5,130 |
$307K |
| G0480 |
Drug test def 1-7 classes |
4,881 |
4,504 |
$304K |
| 96361 |
|
16,112 |
14,229 |
$304K |
| 96376 |
|
4,805 |
3,240 |
$299K |
| 93306 |
|
1,183 |
1,179 |
$277K |
| 99199 |
|
5,306 |
4,725 |
$275K |
| C9803 |
Hopd covid-19 spec collect |
12,660 |
12,300 |
$274K |
| 97140 |
|
7,994 |
3,788 |
$224K |
| 71045 |
|
22,975 |
21,840 |
$224K |
| 87502 |
|
2,989 |
2,952 |
$219K |
| 0250 |
|
2,447 |
1,444 |
$209K |
| 76705 |
|
4,697 |
4,630 |
$201K |
| 87651 |
|
5,834 |
5,756 |
$196K |
| 84484 |
|
22,770 |
18,655 |
$195K |
| 97110 |
|
14,776 |
6,661 |
$191K |
| 72125 |
|
1,619 |
1,608 |
$184K |
| 96365 |
|
2,489 |
2,343 |
$182K |
| 70498 |
|
947 |
943 |
$181K |
| 80307 |
|
3,193 |
3,074 |
$179K |
| 70496 |
|
920 |
915 |
$173K |
| 93971 |
|
1,916 |
1,889 |
$166K |
| U0003 |
Cov-19 amp prb hgh thruput |
2,223 |
2,144 |
$164K |
| Z7502 |
|
5,283 |
5,026 |
$160K |
| 76856 |
|
3,220 |
3,175 |
$153K |
| 99283 |
|
2,304 |
2,075 |
$143K |
| J7030 |
Normal saline solution infus |
22,781 |
19,420 |
$141K |
| 83690 |
|
23,047 |
21,636 |
$141K |
| 99281 |
|
1,882 |
1,705 |
$139K |
| 76830 |
|
2,796 |
2,756 |
$137K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
11,168 |
10,153 |
$120K |
| 71046 |
|
6,802 |
6,713 |
$118K |
| 84703 |
|
16,630 |
15,884 |
$104K |
| 99284 |
|
2,395 |
2,113 |
$103K |
| 83880 |
|
3,979 |
3,768 |
$101K |
| 81001 |
|
34,235 |
32,548 |
$99K |
| 76801 |
|
1,481 |
1,341 |
$94K |
| 97162 |
|
2,053 |
2,044 |
$94K |
| 87086 |
|
13,642 |
13,155 |
$92K |
| 99233 |
Prolong inpt eval add15 m |
2,046 |
942 |
$91K |
| J2506 |
Inj pegfilgrast ex bio 0.5mg |
113 |
86 |
$87K |
| 80048 |
|
11,275 |
9,942 |
$85K |
| 76817 |
|
1,329 |
1,206 |
$77K |
| 94664 |
|
6,076 |
5,756 |
$72K |
| 76770 |
|
1,229 |
1,219 |
$72K |
| 84702 |
|
5,583 |
5,182 |
$70K |
| 84443 |
|
4,451 |
4,315 |
$67K |
| 0510 |
|
2,796 |
2,377 |
$61K |
| 87491 |
|
3,079 |
3,038 |
$61K |
| 87040 |
|
6,258 |
3,340 |
$54K |
| J2405 |
Ondansetron hcl injection |
11,614 |
10,388 |
$49K |
| 77067 |
|
525 |
525 |
$47K |
| T1999 |
Noc retail items andsupplies |
3,930 |
1,930 |
$47K |
| 93010 |
|
3,082 |
2,726 |
$43K |
| J2270 |
Morphine sulfate injection |
6,119 |
5,372 |
$42K |
| J1885 |
Ketorolac tromethamine inj |
8,872 |
8,397 |
$41K |
| J1815 |
Insulin injection |
2,458 |
1,482 |
$41K |
| 93458 |
|
40 |
40 |
$40K |
| 83735 |
|
6,756 |
6,073 |
$39K |
| 87591 |
|
3,078 |
3,038 |
$39K |
| 74018 |
|
2,233 |
2,192 |
$36K |
| 83605 |
|
4,165 |
3,574 |
$36K |
| 73630 |
|
2,083 |
2,068 |
$36K |
| 87077 |
|
5,404 |
4,543 |
$36K |
| 99070 |
|
1,693 |
812 |
$34K |
| 97530 |
|
2,630 |
1,773 |
$34K |
| 97139 |
|
2,099 |
499 |
$33K |
| 73030 |
|
1,678 |
1,668 |
$31K |
| 73564 |
|
1,492 |
1,483 |
$31K |
| 76700 |
|
510 |
509 |
$31K |
| 73610 |
|
1,634 |
1,627 |
$31K |
| 87186 |
|
4,415 |
3,884 |
$30K |
| J1170 |
Hydromorphone injection |
3,976 |
3,057 |
$30K |
| 99152 |
|
539 |
524 |
$29K |
| 71260 |
|
197 |
197 |
$27K |
| J7620 |
Albuterol ipratrop non-comp |
5,256 |
4,514 |
$27K |
| 87661 |
|
844 |
833 |
$27K |
| 99232 |
|
704 |
364 |
$26K |
| 96413 |
|
914 |
641 |
$25K |
| 97014 |
|
2,709 |
1,384 |
$23K |
| A9500 |
Tc99m sestamibi |
141 |
132 |
$23K |
| 85379 |
|
2,509 |
2,478 |
$23K |
| 93970 |
|
159 |
153 |
$22K |
| J0780 |
Prochlorperazine injection |
2,117 |
1,975 |
$22K |
| 78452 |
|
69 |
66 |
$21K |
| J0696 |
Ceftriaxone sodium injection |
3,785 |
3,453 |
$21K |
| 72100 |
|
932 |
928 |
$20K |
| J7050 |
Normal saline solution infus |
4,953 |
3,117 |
$20K |
| 85730 |
|
4,033 |
3,883 |
$20K |
| J1644 |
Inj heparin sodium per 1000u |
3,342 |
1,740 |
$19K |
| J0885 |
Epoetin alfa, non-esrd |
79 |
55 |
$18K |
| 0002A |
|
469 |
469 |
$18K |
| 73130 |
|
942 |
937 |
$18K |
| 96366 |
|
779 |
546 |
$17K |
| 85610 |
|
5,339 |
5,087 |
$17K |
| 0001A |
|
420 |
420 |
$17K |
| 97112 |
|
1,252 |
695 |
$17K |
| 82550 |
|
2,942 |
2,624 |
$16K |
| J1200 |
Diphenhydramine hcl injectio |
3,511 |
3,143 |
$16K |
| 97161 |
|
242 |
241 |
$16K |
| J7611 |
Albuterol non-comp con |
2,675 |
2,484 |
$15K |
| 71250 |
|
164 |
164 |
$14K |
| Z7610 |
|
1,868 |
1,622 |
$14K |
| 70486 |
|
152 |
148 |
$14K |
| 80306 |
|
863 |
838 |
$14K |
| 94640 |
|
941 |
796 |
$14K |
| 82553 |
|
1,342 |
1,252 |
$14K |
| 82803 |
|
1,119 |
1,027 |
$13K |
| 87070 |
|
1,671 |
1,640 |
$13K |
| 96367 |
|
361 |
252 |
$12K |
| 77063 |
|
523 |
523 |
$12K |
| 73502 |
|
424 |
421 |
$12K |
| 83036 |
|
1,537 |
1,521 |
$12K |
| 90715 |
|
273 |
272 |
$11K |
| J0561 |
Penicillin g benzathine inj |
215 |
213 |
$11K |
| 84145 |
|
575 |
536 |
$11K |
| 76536 |
|
211 |
209 |
$10K |
| J7512 |
Prednisone ir or dr oral 1mg |
3,748 |
3,357 |
$9K |
| J1100 |
Dexamethasone sodium phos |
1,774 |
1,556 |
$9K |
| 84439 |
|
1,096 |
1,073 |
$9K |
| 76642 |
|
197 |
165 |
$9K |
| J3010 |
Fentanyl citrate injection |
1,823 |
1,574 |
$8K |
| 73110 |
|
363 |
359 |
$8K |
| J2060 |
Lorazepam injection |
1,773 |
1,620 |
$7K |
| 96523 |
|
133 |
115 |
$7K |
| 96417 |
|
261 |
186 |
$7K |
| J2785 |
Regadenoson injection |
61 |
61 |
$7K |
| 71101 |
|
307 |
307 |
$7K |
| 86901 |
|
2,596 |
2,492 |
$7K |
| J0640 |
Leucovorin calcium injection |
143 |
62 |
$7K |
| 76870 |
|
180 |
178 |
$7K |
| 86140 |
|
1,423 |
1,353 |
$7K |
| 73560 |
|
458 |
455 |
$7K |
| 0271 |
|
166 |
157 |
$6K |
| 82010 |
|
941 |
867 |
$6K |
| J2765 |
Metoclopramide hcl injection |
1,328 |
1,225 |
$6K |
| J1453 |
Fosaprepitant injection |
306 |
206 |
$6K |
| 86900 |
|
2,421 |
2,331 |
$6K |
| J2469 |
Palonosetron hcl |
433 |
292 |
$6K |
| J3535 |
Metered dose inhaler drug |
55 |
53 |
$6K |
| 0636 |
|
573 |
412 |
$6K |
| J8540 |
Oral dexamethasone |
1,679 |
873 |
$6K |
| 96415 |
|
242 |
175 |
$6K |
| J2250 |
Inj midazolam hydrochloride |
1,415 |
1,244 |
$6K |
| 87210 |
|
1,368 |
1,347 |
$6K |
| J1650 |
Inj enoxaparin sodium |
871 |
414 |
$5K |
| 77336 |
|
162 |
67 |
$5K |
| 90714 |
|
169 |
169 |
$5K |
| 87507 |
|
12 |
12 |
$5K |
| 87633 |
|
17 |
17 |
$5K |
| 0420 |
|
315 |
312 |
$5K |
| 93017 |
|
84 |
81 |
$4K |
| 90471 |
|
665 |
636 |
$4K |
| 77334 |
|
30 |
25 |
$4K |
| 77412 |
|
132 |
13 |
$4K |
| 97166 |
|
57 |
57 |
$4K |
| J1642 |
Inj heparin sodium per 10 u |
1,021 |
650 |
$4K |
| J9190 |
Fluorouracil injection |
297 |
96 |
$4K |
| 0762 |
|
1,053 |
483 |
$4K |
| J3480 |
Inj potassium chloride |
272 |
195 |
$4K |
| Q0138 |
Ferumoxytol, non-esrd |
19 |
12 |
$4K |
| 85652 |
|
1,423 |
1,373 |
$3K |
| 73140 |
|
237 |
237 |
$3K |
| 73590 |
|
190 |
189 |
$3K |
| J2704 |
Inj, propofol, 10 mg |
285 |
254 |
$3K |
| 74174 |
|
13 |
13 |
$3K |
| J7040 |
Normal saline solution infus |
868 |
814 |
$3K |
| 96377 |
|
30 |
26 |
$3K |
| J2930 |
Methylprednisolone injection |
325 |
302 |
$3K |
| 82728 |
|
350 |
328 |
$3K |
| 85027 |
|
619 |
576 |
$3K |
| 97802 |
|
25 |
25 |
$3K |
| 73080 |
|
146 |
144 |
$3K |
| 99223 |
Prolong inpt eval add15 m |
40 |
40 |
$3K |
| 86850 |
|
965 |
915 |
$3K |
| 76815 |
|
32 |
30 |
$3K |
| 85018 |
|
1,309 |
955 |
$2K |
| 72040 |
|
128 |
128 |
$2K |
| J7060 |
5% dextrose/water |
470 |
237 |
$2K |
| 99153 |
Mod sedat endo service >5yrs |
225 |
215 |
$2K |
| 80061 |
|
220 |
219 |
$2K |
| J1171 |
Inj, hydromorphone, 0.1 mg |
133 |
99 |
$2K |
| J2560 |
Phenobarbital sodium inj |
15 |
12 |
$2K |
| J2001 |
Lidocaine injection |
303 |
281 |
$2K |
| 96401 |
|
184 |
120 |
$2K |
| 82565 |
|
503 |
474 |
$2K |
| 84132 |
|
590 |
529 |
$2K |
| J2919 |
Inj, methylpred sod succ 5mg |
134 |
109 |
$2K |
| 72131 |
|
14 |
14 |
$2K |
| 0270 |
|
402 |
194 |
$2K |
| 83550 |
|
319 |
305 |
$2K |
| 82247 |
|
349 |
332 |
$2K |
| 85014 |
|
751 |
641 |
$1K |
| 83540 |
|
326 |
309 |
$1K |
| 72070 |
|
60 |
59 |
$1K |
| 97116 |
|
114 |
69 |
$1K |
| 84450 |
|
257 |
248 |
$1K |
| 84075 |
|
257 |
248 |
$1K |
| 82040 |
|
255 |
247 |
$1K |
| J1756 |
Iron sucrose injection |
17 |
12 |
$1K |
| 77066 |
Tomosynthesis, mammo |
12 |
12 |
$1K |
| 36600 |
|
366 |
326 |
$1K |
| 72110 |
|
31 |
31 |
$1K |
| 96368 |
|
61 |
41 |
$1K |
| 83615 |
|
218 |
175 |
$998.45 |
| 77065 |
Tomosynthesis, mammo |
13 |
12 |
$962.09 |
| 84100 |
|
241 |
196 |
$926.01 |
| 84155 |
|
257 |
248 |
$885.10 |
| 99222 |
|
13 |
13 |
$885.06 |
| J7613 |
Albuterol non-comp unit |
845 |
766 |
$828.12 |
| J0131 |
Inj, acetaminophen (nos) |
41 |
41 |
$776.97 |
| 80047 |
|
108 |
107 |
$760.78 |
| 96402 |
|
83 |
79 |
$697.75 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
36 |
31 |
$684.83 |
| 82248 |
|
150 |
127 |
$655.07 |
| 85049 |
|
190 |
173 |
$650.15 |
| 86403 |
|
61 |
55 |
$574.90 |
| 90686 |
|
26 |
26 |
$556.99 |
| 87420 |
|
151 |
149 |
$506.88 |
| 73090 |
|
32 |
32 |
$501.79 |
| 84295 |
|
162 |
156 |
$499.27 |
| 84520 |
|
172 |
166 |
$482.36 |
| 77080 |
|
13 |
13 |
$468.37 |
| 87486 |
|
17 |
17 |
$452.68 |
| 87581 |
|
17 |
17 |
$452.68 |
| J2470 |
Inj pantoprazole sodium 40mg |
92 |
78 |
$435.98 |
| J7510 |
Prednisolone oral per 5 mg |
31 |
29 |
$434.71 |
| Q0163 |
Diphenhydramine hcl 50mg |
1,570 |
1,482 |
$420.89 |
| 84550 |
|
117 |
97 |
$417.34 |
| 87798 |
|
17 |
17 |
$412.09 |
| J1940 |
Furosemide injection |
191 |
152 |
$382.60 |
| 87081 |
|
69 |
67 |
$338.81 |
| 97035 |
|
60 |
43 |
$314.82 |
| 73660 |
|
25 |
25 |
$304.80 |
| J3475 |
Inj magnesium sulfate |
25 |
18 |
$281.25 |
| 85347 |
|
60 |
31 |
$263.34 |
| J7120 |
Ringers lactate infusion |
50 |
43 |
$241.04 |
| 36430 |
|
4,523 |
1,944 |
$183.04 |
| 73620 |
|
15 |
14 |
$157.50 |
| 87205 |
|
46 |
40 |
$150.97 |
| J0360 |
Hydralazine hcl injection |
15 |
14 |
$142.65 |
| 86780 |
|
13 |
12 |
$139.39 |
| 97032 |
|
20 |
14 |
$138.60 |
| J0690 |
Cefazolin sodium injection |
21 |
12 |
$122.16 |
| 82947 |
|
42 |
41 |
$117.04 |
| J1630 |
Haloperidol injection |
16 |
12 |
$116.68 |
| 77062 |
|
12 |
12 |
$110.39 |
| J3420 |
Vitamin b12 injection |
17 |
13 |
$99.73 |
| 97535 |
|
281 |
252 |
$88.75 |
| J3360 |
Diazepam injection |
13 |
13 |
$88.40 |
| 80076 |
|
12 |
12 |
$76.56 |
| 0300 |
|
307 |
302 |
$75.00 |
| 85048 |
|
26 |
26 |
$53.63 |
| G0498 |
Chemo extend iv infus w/pump |
155 |
98 |
$48.14 |
| 81015 |
|
15 |
15 |
$41.00 |
| 74021 |
|
13 |
13 |
$40.68 |
| 80320 |
|
657 |
626 |
$38.77 |
| 80329 |
|
617 |
300 |
$15.10 |
| G1004 |
Cdsm ndsc |
596 |
452 |
$1.00 |
| J7644 |
Ipratropium bromide non-comp |
13 |
12 |
$0.50 |
| 0306 |
|
272 |
265 |
$0.00 |
| 0250R |
|
119 |
69 |
$0.00 |
| 0352 |
|
136 |
136 |
$0.00 |
| 0324 |
|
214 |
209 |
$0.00 |
| 0307 |
|
246 |
241 |
$0.00 |
| 0305 |
|
370 |
361 |
$0.00 |
| 0410 |
|
100 |
98 |
$0.00 |
| 0301 |
|
370 |
361 |
$0.00 |
| 0320 |
|
66 |
65 |
$0.00 |
| 0730 |
|
296 |
289 |
$0.00 |
| 0402 |
|
102 |
101 |
$0.00 |
| 0483 |
|
49 |
49 |
$0.00 |
| 0351 |
|
14 |
14 |
$0.00 |
| 0430 |
|
15 |
15 |
$0.00 |