| Code | Description | Claims | Beneficiaries | Total Paid |
| 0450 |
|
25,797 |
22,956 |
$1.56M |
| 90999 |
|
5,455 |
451 |
$871K |
| 0682 |
|
128 |
128 |
$512K |
| 0241U |
|
2,461 |
2,406 |
$452K |
| J0882 |
Darbepoetin alfa, esrd use |
999 |
272 |
$414K |
| 0510 |
|
12,267 |
10,788 |
$403K |
| J0606 |
Inj, etelcalcetide, 0.1 mg |
971 |
79 |
$367K |
| 74177 |
|
1,691 |
1,385 |
$343K |
| 70450 |
|
2,844 |
2,436 |
$324K |
| 96374 |
|
3,766 |
3,499 |
$250K |
| 80053 |
|
19,045 |
17,565 |
$226K |
| 93005 |
|
7,821 |
7,250 |
$205K |
| 0762 |
|
372 |
254 |
$205K |
| 96365 |
|
2,565 |
2,246 |
$203K |
| 72125 |
|
1,194 |
1,021 |
$198K |
| 80307 |
|
3,404 |
3,250 |
$194K |
| 85025 |
|
21,084 |
19,200 |
$186K |
| G0480 |
Drug test def 1-7 classes |
2,098 |
1,987 |
$160K |
| 0760 |
|
12,561 |
11,287 |
$137K |
| U0003 |
Cov-19 amp prb hgh thruput |
1,751 |
1,681 |
$131K |
| 96361 |
|
2,569 |
2,327 |
$115K |
| 96375 |
|
2,815 |
2,526 |
$115K |
| 71045 |
|
11,045 |
9,222 |
$100K |
| 0270 |
|
15,923 |
6,763 |
$99K |
| 96372 |
|
3,397 |
3,110 |
$96K |
| 87811 |
|
2,038 |
1,979 |
$94K |
| 99284 |
|
1,115 |
1,001 |
$88K |
| 0250 |
|
13,884 |
4,807 |
$86K |
| 77067 |
|
803 |
802 |
$86K |
| 96360 |
|
1,087 |
1,063 |
$77K |
| J3490 |
Drugs unclassified injection |
6,787 |
3,477 |
$75K |
| 87591 |
|
2,423 |
2,370 |
$75K |
| 71046 |
|
3,435 |
3,106 |
$72K |
| 83880 |
|
1,997 |
1,883 |
$69K |
| 93306 |
|
335 |
335 |
$69K |
| 84443 |
|
4,482 |
4,422 |
$69K |
| 0360 |
|
1,027 |
970 |
$66K |
| 76705 |
|
1,094 |
975 |
$66K |
| 87491 |
|
2,286 |
2,231 |
$65K |
| 84484 |
|
5,069 |
4,666 |
$64K |
| G0378 |
Hospital observation per hr |
353 |
324 |
$64K |
| 74176 |
|
406 |
382 |
$61K |
| J1644 |
Inj heparin sodium per 1000u |
1,931 |
255 |
$46K |
| 99199 |
|
824 |
715 |
$42K |
| 71260 |
|
272 |
226 |
$41K |
| 0750 |
|
309 |
306 |
$41K |
| 82306 |
|
2,038 |
2,031 |
$39K |
| 81001 |
|
9,131 |
8,641 |
$37K |
| 97110 |
|
1,434 |
517 |
$36K |
| 71250 |
|
240 |
235 |
$34K |
| 76856 |
|
552 |
532 |
$33K |
| 86141 |
|
2,496 |
2,430 |
$31K |
| 83690 |
|
3,429 |
3,240 |
$30K |
| 97530 |
|
1,126 |
446 |
$30K |
| 99214 |
|
1,803 |
1,778 |
$29K |
| 73130 |
|
1,132 |
1,025 |
$29K |
| 88305 |
|
487 |
445 |
$29K |
| J1885 |
Ketorolac tromethamine inj |
3,194 |
3,038 |
$28K |
| 87088 |
|
3,545 |
3,380 |
$28K |
| 70486 |
|
206 |
191 |
$28K |
| 70498 |
|
169 |
138 |
$28K |
| 80061 |
|
3,333 |
3,315 |
$27K |
| 72170 |
|
1,266 |
1,051 |
$27K |
| 87502 |
|
325 |
313 |
$27K |
| 83735 |
|
3,126 |
2,787 |
$27K |
| 96366 |
|
567 |
503 |
$26K |
| J1756 |
Iron sucrose injection |
245 |
65 |
$26K |
| 83605 |
|
1,551 |
1,453 |
$24K |
| 99281 |
|
460 |
395 |
$24K |
| 73610 |
|
963 |
867 |
$24K |
| 85610 |
|
5,284 |
4,986 |
$24K |
| 86780 |
|
1,365 |
1,322 |
$23K |
| 83036 |
|
3,655 |
3,626 |
$23K |
| 93970 |
|
131 |
127 |
$23K |
| 86803 |
|
1,831 |
1,822 |
$21K |
| 77063 |
|
788 |
787 |
$21K |
| 92557 |
|
231 |
231 |
$21K |
| 0761 |
|
1,773 |
1,577 |
$20K |
| 93971 |
|
184 |
173 |
$19K |
| 76801 |
|
296 |
244 |
$19K |
| 73630 |
|
783 |
720 |
$18K |
| 95810 |
|
68 |
68 |
$18K |
| 72148 |
|
106 |
105 |
$18K |
| J2405 |
Ondansetron hcl injection |
1,694 |
1,577 |
$18K |
| 87880 |
|
1,526 |
1,502 |
$18K |
| 90715 |
|
351 |
351 |
$18K |
| 84702 |
|
1,221 |
1,113 |
$18K |
| 92588 |
|
357 |
357 |
$17K |
| 73110 |
|
713 |
641 |
$17K |
| 76830 |
|
270 |
264 |
$17K |
| 0710 |
|
603 |
588 |
$17K |
| 85730 |
|
2,375 |
2,286 |
$17K |
| 86703 |
|
1,647 |
1,641 |
$16K |
| 82948 |
|
2,092 |
1,709 |
$16K |
| 87040 |
|
670 |
647 |
$16K |
| 81025 |
|
2,957 |
2,836 |
$16K |
| U0002 |
Covid-19 lab test non-cdc |
323 |
312 |
$15K |
| 86481 |
|
256 |
253 |
$15K |
| 76817 |
|
190 |
161 |
$13K |
| 80143 |
|
569 |
542 |
$13K |
| 76700 |
|
167 |
167 |
$13K |
| 73560 |
|
723 |
681 |
$12K |
| J1100 |
Dexamethasone sodium phos |
441 |
398 |
$12K |
| 87070 |
|
1,127 |
1,106 |
$12K |
| 73721 |
|
61 |
56 |
$12K |
| 94729 |
|
266 |
264 |
$11K |
| 80048 |
|
1,226 |
1,179 |
$11K |
| 90675 |
|
27 |
15 |
$11K |
| 73030 |
|
433 |
411 |
$11K |
| 71271 |
|
99 |
99 |
$11K |
| 94726 |
|
262 |
260 |
$10K |
| 87340 |
|
1,211 |
1,194 |
$10K |
| 74018 |
|
476 |
453 |
$10K |
| 82728 |
|
865 |
850 |
$10K |
| 84439 |
|
1,195 |
1,178 |
$10K |
| 76770 |
|
127 |
125 |
$10K |
| J0696 |
Ceftriaxone sodium injection |
739 |
711 |
$9K |
| J3301 |
Triamcinolone acet inj nos |
194 |
191 |
$9K |
| 92550 |
|
388 |
388 |
$9K |
| 59025 |
|
360 |
313 |
$9K |
| 86850 |
|
1,627 |
1,565 |
$9K |
| J2270 |
Morphine sulfate injection |
935 |
793 |
$9K |
| U0004 |
Cov-19 test non-cdc hgh thru |
105 |
103 |
$9K |
| 76641 |
|
110 |
109 |
$9K |
| 82077 |
|
433 |
419 |
$8K |
| 94640 |
|
343 |
314 |
$8K |
| 84145 |
|
286 |
283 |
$8K |
| 97750 |
|
202 |
110 |
$8K |
| 96413 |
|
197 |
125 |
$7K |
| 99213 |
|
534 |
518 |
$7K |
| 82607 |
|
714 |
712 |
$7K |
| 86706 |
|
761 |
752 |
$7K |
| 86901 |
|
1,664 |
1,600 |
$7K |
| 94060 |
|
236 |
234 |
$7K |
| 80069 |
|
943 |
874 |
$7K |
| 86160 |
|
317 |
314 |
$7K |
| 72131 |
|
46 |
44 |
$6K |
| 83970 |
|
165 |
158 |
$6K |
| 85651 |
|
2,088 |
2,062 |
$6K |
| 87634 |
|
80 |
75 |
$6K |
| 0160 |
|
79 |
66 |
$6K |
| 73070 |
|
275 |
259 |
$6K |
| 85027 |
|
1,017 |
628 |
$6K |
| 86900 |
|
1,674 |
1,610 |
$6K |
| 86704 |
|
481 |
479 |
$6K |
| 96367 |
|
123 |
93 |
$5K |
| 73090 |
|
254 |
228 |
$5K |
| 73562 |
|
266 |
256 |
$5K |
| 73590 |
|
242 |
222 |
$5K |
| J3010 |
Fentanyl citrate injection |
729 |
659 |
$5K |
| 83550 |
|
760 |
750 |
$5K |
| 76536 |
|
80 |
80 |
$5K |
| 87632 |
|
30 |
25 |
$5K |
| 72100 |
|
165 |
164 |
$5K |
| 80076 |
|
589 |
587 |
$5K |
| 77066 |
Tomosynthesis, mammo |
31 |
31 |
$5K |
| 86225 |
|
375 |
371 |
$4K |
| 87186 |
|
410 |
396 |
$4K |
| 82550 |
|
502 |
468 |
$4K |
| 73552 |
|
113 |
106 |
$4K |
| J1453 |
Fosaprepitant injection |
52 |
37 |
$4K |
| 87077 |
|
485 |
470 |
$4K |
| 86705 |
|
333 |
332 |
$4K |
| 45385 |
|
87 |
85 |
$4K |
| 80179 |
|
195 |
188 |
$4K |
| 73502 |
|
111 |
106 |
$4K |
| 76805 |
|
36 |
34 |
$4K |
| 99070 |
|
592 |
281 |
$3K |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
190 |
105 |
$3K |
| 0324 |
|
60 |
51 |
$3K |
| 93000 |
|
80 |
78 |
$3K |
| 93308 |
|
33 |
33 |
$3K |
| 73140 |
|
210 |
193 |
$3K |
| 95811 |
|
12 |
12 |
$3K |
| 99000 |
|
935 |
870 |
$3K |
| 82565 |
|
605 |
553 |
$3K |
| 76870 |
|
70 |
67 |
$3K |
| 97140 |
|
76 |
43 |
$3K |
| J2469 |
Palonosetron hcl |
61 |
42 |
$3K |
| 84100 |
|
522 |
451 |
$3K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
2,360 |
2,303 |
$3K |
| 99211 |
|
91 |
91 |
$3K |
| 85379 |
|
191 |
189 |
$3K |
| 94664 |
|
231 |
231 |
$2K |
| 93793 |
|
886 |
658 |
$2K |
| 74022 |
|
67 |
64 |
$2K |
| 82803 |
|
85 |
79 |
$2K |
| 69210 |
|
72 |
71 |
$2K |
| 72040 |
|
75 |
75 |
$2K |
| J3475 |
Inj magnesium sulfate |
115 |
101 |
$2K |
| 90471 |
|
389 |
333 |
$2K |
| 20610 |
|
88 |
82 |
$2K |
| 45378 |
|
27 |
27 |
$2K |
| 82746 |
|
146 |
144 |
$2K |
| T1999 |
Noc retail items andsupplies |
148 |
78 |
$2K |
| 84520 |
|
472 |
370 |
$2K |
| 77080 |
|
54 |
54 |
$2K |
| J1200 |
Diphenhydramine hcl injectio |
250 |
210 |
$2K |
| 87661 |
|
65 |
64 |
$2K |
| 90686 |
|
54 |
51 |
$2K |
| G0279 |
Tomosynthesis, mammo |
50 |
50 |
$1K |
| 71020 |
|
46 |
21 |
$1K |
| J2704 |
Inj, propofol, 10 mg |
279 |
278 |
$1K |
| 87635 |
|
40 |
40 |
$1K |
| 94618 |
|
109 |
108 |
$1K |
| 43239 |
|
30 |
30 |
$1K |
| 82043 |
|
359 |
359 |
$1K |
| 73060 |
|
65 |
60 |
$1K |
| 86038 |
|
125 |
125 |
$1K |
| J1953 |
Levetiracetam injection |
34 |
31 |
$1K |
| 0636 |
|
150 |
144 |
$1K |
| J2919 |
Inj, methylpred sod succ 5mg |
74 |
62 |
$1K |
| 81002 |
|
491 |
440 |
$1K |
| J2765 |
Metoclopramide hcl injection |
141 |
139 |
$1K |
| 83721 |
|
173 |
171 |
$975.46 |
| 99499 |
|
30 |
13 |
$942.40 |
| J1815 |
Insulin injection |
124 |
82 |
$940.41 |
| 36000 |
|
58 |
56 |
$923.58 |
| 93017 |
|
15 |
14 |
$908.78 |
| 86235 |
|
65 |
46 |
$836.96 |
| J2250 |
Inj midazolam hydrochloride |
99 |
94 |
$834.52 |
| 73020 |
|
29 |
29 |
$799.59 |
| 87210 |
|
143 |
139 |
$729.36 |
| 72110 |
|
16 |
16 |
$701.70 |
| 99203 |
|
13 |
13 |
$695.13 |
| 82805 |
|
13 |
12 |
$689.80 |
| A4649 |
Surgical supplies |
91 |
53 |
$678.70 |
| 93242 |
|
42 |
42 |
$653.04 |
| 82553 |
|
52 |
29 |
$625.92 |
| 76881 |
|
15 |
14 |
$611.16 |
| Q3014 |
Telehealth facility fee |
42 |
41 |
$607.36 |
| 97112 |
|
29 |
18 |
$590.97 |
| 86430 |
|
91 |
90 |
$575.51 |
| 73521 |
|
18 |
18 |
$556.53 |
| 84550 |
|
116 |
112 |
$541.17 |
| 99244 |
|
26 |
26 |
$519.44 |
| 86255 |
|
40 |
39 |
$509.27 |
| 82009 |
|
92 |
85 |
$488.34 |
| G2023 |
Specimen collect covid-19 |
118 |
111 |
$449.06 |
| 81015 |
|
127 |
118 |
$418.19 |
| 93246 |
|
25 |
25 |
$370.50 |
| J8540 |
Oral dexamethasone |
16 |
15 |
$353.26 |
| 90656 |
|
14 |
14 |
$331.65 |
| 92587 |
|
13 |
13 |
$328.00 |
| 87147 |
|
68 |
68 |
$321.29 |
| 29700 |
|
16 |
16 |
$281.51 |
| 82150 |
|
45 |
32 |
$280.91 |
| 0700 |
|
16 |
12 |
$280.24 |
| J2060 |
Lorazepam injection |
27 |
24 |
$271.18 |
| 82140 |
|
15 |
14 |
$268.90 |
| 45380 |
|
14 |
14 |
$267.58 |
| 72200 |
|
12 |
12 |
$264.84 |
| J1790 |
Droperidol injection |
14 |
13 |
$258.71 |
| U0001 |
2019-ncov diagnostic p |
13 |
13 |
$236.40 |
| 86708 |
|
14 |
13 |
$187.30 |
| 87205 |
|
42 |
40 |
$176.68 |
| 83615 |
|
26 |
25 |
$166.80 |
| 99024 |
|
79 |
74 |
$135.54 |
| 87400 |
|
21 |
21 |
$130.58 |
| 84466 |
|
20 |
20 |
$123.34 |
| G0463 |
Hospital outpt clinic visit |
47 |
42 |
$114.09 |
| 84481 |
|
17 |
17 |
$109.25 |
| 87389 |
|
12 |
12 |
$89.15 |
| 82570 |
|
27 |
25 |
$88.93 |
| 86200 |
|
12 |
12 |
$87.18 |
| 36415 |
|
371 |
349 |
$82.25 |
| 94760 |
|
12 |
12 |
$68.90 |
| 83540 |
|
20 |
20 |
$64.12 |
| 84156 |
|
27 |
25 |
$62.28 |
| 86592 |
|
27 |
26 |
$61.42 |
| 0272 |
|
159 |
157 |
$29.77 |
| 87081 |
|
14 |
14 |
$27.33 |
| 80320 |
|
65 |
58 |
$11.29 |
| 80050 |
|
19 |
19 |
$0.00 |
| 80377 |
|
18 |
17 |
$0.00 |