| Code | Description | Claims | Beneficiaries | Total Paid |
| G0463 |
Hospital outpt clinic visit |
311,508 |
280,696 |
$27.60M |
| 99285 |
|
12,044 |
11,133 |
$4.57M |
| 99283 |
|
25,194 |
23,528 |
$4.39M |
| 99284 |
|
5,449 |
5,134 |
$1.55M |
| 92014 |
|
14,435 |
14,184 |
$1.28M |
| 96374 |
|
5,328 |
4,956 |
$720K |
| 92004 |
|
7,405 |
7,113 |
$655K |
| 99282 |
|
4,738 |
4,483 |
$421K |
| 67028 |
|
1,768 |
1,651 |
$392K |
| U0003 |
Cov-19 amp prb hgh thruput |
4,552 |
4,337 |
$342K |
| 20611 |
|
1,482 |
1,353 |
$312K |
| 0241U |
|
4,132 |
4,034 |
$281K |
| 99392 |
|
4,204 |
4,107 |
$259K |
| 71045 |
|
4,330 |
4,020 |
$229K |
| 99391 |
|
3,771 |
3,516 |
$214K |
| 90837 |
|
1,624 |
1,150 |
$188K |
| 97110 |
|
4,634 |
1,785 |
$181K |
| 96413 |
|
954 |
718 |
$180K |
| 11042 |
|
781 |
527 |
$173K |
| 59025 |
|
1,043 |
675 |
$153K |
| 93005 |
|
8,547 |
7,705 |
$152K |
| D7140 |
|
122 |
115 |
$143K |
| D0240 |
|
174 |
163 |
$138K |
| 96375 |
|
2,626 |
2,374 |
$133K |
| 90847 |
|
781 |
613 |
$107K |
| 96361 |
|
1,459 |
1,343 |
$106K |
| 96365 |
|
721 |
288 |
$104K |
| 92587 |
|
521 |
490 |
$102K |
| 90471 |
|
9,493 |
9,114 |
$100K |
| D0120 |
|
174 |
163 |
$100K |
| 74177 |
|
315 |
307 |
$97K |
| 76816 |
|
1,511 |
1,355 |
$94K |
| 36415 |
|
67,054 |
60,430 |
$83K |
| 99393 |
|
1,107 |
1,081 |
$75K |
| 87426 |
|
3,322 |
3,214 |
$72K |
| 70450 |
|
689 |
637 |
$65K |
| 92557 |
|
980 |
937 |
$63K |
| D2930 |
|
182 |
171 |
$62K |
| 66984 |
|
36 |
25 |
$57K |
| 90792 |
|
430 |
419 |
$57K |
| 96372 |
|
1,943 |
1,714 |
$55K |
| 90834 |
|
779 |
486 |
$55K |
| U0005 |
Infec agen detec ampli probe |
2,557 |
2,435 |
$52K |
| 87651 |
|
14,417 |
14,122 |
$51K |
| 90833 |
|
2,868 |
2,758 |
$51K |
| 42820 |
|
13 |
12 |
$50K |
| 80053 |
|
30,820 |
27,900 |
$45K |
| J0178 |
Aflibercept injection |
39 |
36 |
$39K |
| 0240U |
|
751 |
740 |
$38K |
| 99281 |
|
1,003 |
938 |
$38K |
| 90686 |
|
5,695 |
5,520 |
$37K |
| 73721 |
|
147 |
134 |
$35K |
| 97530 |
|
421 |
157 |
$33K |
| 92060 |
|
836 |
788 |
$30K |
| 85025 |
|
37,311 |
33,459 |
$29K |
| 86780 |
|
2,076 |
1,981 |
$27K |
| 0202U |
|
88 |
85 |
$26K |
| 71046 |
|
447 |
420 |
$26K |
| 80061 |
|
2,994 |
2,861 |
$25K |
| 76819 |
|
286 |
186 |
$23K |
| 93296 |
|
920 |
901 |
$22K |
| 92507 |
|
424 |
134 |
$21K |
| M0243 |
Casirivi and imdevi inj |
93 |
85 |
$21K |
| 0002A |
|
751 |
734 |
$20K |
| 0001A |
|
820 |
791 |
$20K |
| 98941 |
|
719 |
491 |
$19K |
| C9803 |
Hopd covid-19 spec collect |
606 |
594 |
$18K |
| 92567 |
|
2,017 |
1,934 |
$17K |
| J3490 |
Drugs unclassified injection |
20,062 |
10,402 |
$16K |
| 97140 |
|
718 |
276 |
$16K |
| Q3014 |
Telehealth facility fee |
1,302 |
1,217 |
$15K |
| 96110 |
|
599 |
586 |
$15K |
| 73630 |
|
890 |
701 |
$15K |
| 51798 |
|
802 |
770 |
$14K |
| 74176 |
|
67 |
67 |
$14K |
| 95810 |
|
27 |
26 |
$13K |
| 97802 |
|
201 |
196 |
$13K |
| 99394 |
|
177 |
176 |
$13K |
| 88175 |
|
944 |
903 |
$12K |
| 93306 |
|
26 |
26 |
$10K |
| 88305 |
|
381 |
330 |
$10K |
| 11102 |
|
54 |
53 |
$10K |
| 92134 |
|
2,696 |
2,521 |
$9K |
| G0378 |
Hospital observation per hr |
66 |
41 |
$9K |
| 0012A |
|
320 |
316 |
$9K |
| 76805 |
|
81 |
79 |
$9K |
| 87635 |
|
299 |
299 |
$9K |
| D1120 |
|
173 |
162 |
$8K |
| D1206 |
|
172 |
161 |
$7K |
| G0260 |
Inj for sacroiliac jt anesth |
15 |
12 |
$7K |
| 87389 |
|
622 |
586 |
$7K |
| 87491 |
|
377 |
368 |
$7K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
2,199 |
2,063 |
$7K |
| 86850 |
|
600 |
566 |
$6K |
| 97112 |
|
169 |
81 |
$6K |
| 96360 |
|
45 |
40 |
$6K |
| 90472 |
|
1,446 |
1,364 |
$6K |
| 87591 |
|
361 |
352 |
$6K |
| 76801 |
|
65 |
63 |
$6K |
| 20610 |
|
109 |
107 |
$6K |
| 98940 |
|
269 |
184 |
$5K |
| 90671 |
|
24 |
24 |
$5K |
| 94640 |
|
40 |
39 |
$5K |
| 84484 |
|
3,189 |
2,751 |
$5K |
| 80306 |
|
1,482 |
1,301 |
$5K |
| 85018 |
|
2,211 |
2,030 |
$5K |
| 83036 |
|
3,322 |
3,209 |
$5K |
| 43239 |
|
12 |
12 |
$5K |
| 11900 |
|
31 |
27 |
$5K |
| 0071A |
|
138 |
125 |
$5K |
| 29075 |
|
19 |
12 |
$5K |
| 81025 |
|
282 |
261 |
$5K |
| 86900 |
|
521 |
487 |
$4K |
| 91320 |
|
127 |
126 |
$4K |
| 85027 |
|
1,787 |
1,694 |
$4K |
| 0011A |
|
327 |
323 |
$4K |
| 17110 |
|
39 |
38 |
$4K |
| 0124A |
|
228 |
222 |
$4K |
| 97597 |
|
44 |
28 |
$4K |
| 29065 |
|
18 |
12 |
$4K |
| G2066 |
Inter devc remote 30d |
157 |
154 |
$4K |
| 87086 |
|
1,483 |
1,415 |
$4K |
| 0072A |
|
101 |
94 |
$4K |
| 99381 |
|
53 |
49 |
$4K |
| 80048 |
|
2,536 |
2,334 |
$4K |
| 99406 |
|
175 |
170 |
$4K |
| 80050 |
|
134 |
119 |
$3K |
| 90670 |
|
387 |
373 |
$3K |
| 90480 |
|
213 |
210 |
$3K |
| 73565 |
|
201 |
197 |
$3K |
| 80307 |
|
521 |
448 |
$3K |
| 81001 |
|
6,379 |
6,026 |
$3K |
| 99495 |
|
44 |
41 |
$3K |
| 84443 |
|
824 |
801 |
$3K |
| J2704 |
Inj, propofol, 10 mg |
3,763 |
3,464 |
$3K |
| 82077 |
|
1,238 |
1,117 |
$3K |
| 90739 |
|
25 |
25 |
$3K |
| 76817 |
|
116 |
107 |
$3K |
| 83605 |
|
2,058 |
1,863 |
$3K |
| 96130 |
|
16 |
12 |
$3K |
| 90651 |
|
144 |
140 |
$2K |
| 86803 |
|
333 |
324 |
$2K |
| 93298 |
|
87 |
84 |
$2K |
| 86901 |
|
521 |
487 |
$2K |
| 0004A |
|
83 |
83 |
$2K |
| 90732 |
|
27 |
26 |
$2K |
| 84145 |
|
1,265 |
1,210 |
$2K |
| 86762 |
|
230 |
224 |
$2K |
| 0054A |
|
78 |
74 |
$2K |
| 99173 |
|
599 |
576 |
$2K |
| 97803 |
|
43 |
40 |
$2K |
| 96161 |
|
72 |
68 |
$2K |
| 82306 |
|
175 |
160 |
$2K |
| 90791 |
|
15 |
12 |
$2K |
| 87631 |
|
386 |
355 |
$2K |
| 87340 |
|
267 |
252 |
$2K |
| 86140 |
|
3,547 |
3,322 |
$2K |
| 99395 |
|
18 |
17 |
$1K |
| G0008 |
Admin influenza virus vac |
305 |
301 |
$1K |
| 73610 |
|
51 |
39 |
$1K |
| 90656 |
|
135 |
131 |
$1K |
| 73560 |
|
238 |
181 |
$1K |
| 83690 |
|
2,650 |
2,427 |
$1K |
| 90785 |
|
254 |
159 |
$1K |
| D2940 |
|
25 |
25 |
$1K |
| 96415 |
|
14 |
12 |
$1K |
| 87624 |
|
55 |
51 |
$1K |
| 99383 |
|
14 |
14 |
$1K |
| 87081 |
|
201 |
196 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
2,241 |
1,990 |
$983.73 |
| D0220 |
|
174 |
163 |
$845.36 |
| 85610 |
|
2,296 |
2,092 |
$838.77 |
| 84439 |
|
238 |
219 |
$835.86 |
| 0064A |
|
42 |
37 |
$770.83 |
| J3301 |
Triamcinolone acet inj nos |
1,839 |
1,672 |
$759.71 |
| 82950 |
|
153 |
148 |
$736.50 |
| G0108 |
Diab manage trn per indiv |
15 |
13 |
$700.90 |
| 81003 |
|
292 |
270 |
$670.61 |
| 73030 |
|
45 |
39 |
$651.41 |
| 87150 |
|
29 |
27 |
$636.78 |
| 87502 |
|
149 |
143 |
$567.24 |
| 90474 |
|
111 |
106 |
$524.61 |
| 95819 |
|
12 |
12 |
$511.91 |
| 77067 |
|
12 |
12 |
$491.05 |
| 82607 |
|
138 |
124 |
$462.08 |
| 93325 |
|
26 |
26 |
$454.43 |
| 84702 |
|
42 |
37 |
$403.20 |
| 82728 |
|
100 |
92 |
$377.39 |
| 73110 |
|
35 |
24 |
$376.53 |
| 87210 |
|
270 |
258 |
$369.87 |
| 83735 |
|
1,003 |
924 |
$354.32 |
| 73140 |
|
39 |
26 |
$352.32 |
| 99459 |
|
62 |
60 |
$336.60 |
| J1642 |
Inj heparin sodium per 10 u |
180 |
86 |
$317.39 |
| J1010 |
Inj, methylpred acetate 1 mg |
52 |
47 |
$316.40 |
| J0690 |
Cefazolin sodium injection |
169 |
130 |
$310.49 |
| J3010 |
Fentanyl citrate injection |
763 |
621 |
$305.25 |
| 87880 |
|
413 |
398 |
$292.56 |
| 83550 |
|
131 |
119 |
$282.90 |
| J1100 |
Dexamethasone sodium phos |
947 |
847 |
$230.47 |
| 83540 |
|
131 |
119 |
$215.86 |
| J2405 |
Ondansetron hcl injection |
1,193 |
1,039 |
$209.75 |
| 80076 |
|
206 |
203 |
$175.78 |
| J1040 |
Methylprednisolone 80 mg inj |
120 |
114 |
$166.39 |
| 86592 |
|
141 |
124 |
$163.52 |
| 82803 |
|
12 |
12 |
$153.46 |
| J2250 |
Inj midazolam hydrochloride |
33 |
25 |
$130.41 |
| 85652 |
|
144 |
138 |
$121.90 |
| 96381 |
|
12 |
12 |
$116.84 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
29 |
27 |
$112.65 |
| 90715 |
|
82 |
77 |
$93.97 |
| C9257 |
Bevacizumab injection |
15 |
12 |
$93.17 |
| J1644 |
Inj heparin sodium per 1000u |
53 |
40 |
$91.46 |
| 82947 |
|
68 |
51 |
$88.08 |
| 77063 |
|
12 |
12 |
$74.12 |
| 84703 |
|
267 |
256 |
$68.20 |
| 88300 |
|
38 |
37 |
$68.10 |
| 92555 |
|
15 |
14 |
$67.50 |
| 90662 |
|
26 |
26 |
$65.91 |
| J1790 |
Droperidol injection |
12 |
12 |
$62.55 |
| 85730 |
|
273 |
249 |
$59.63 |
| 73130 |
|
21 |
12 |
$58.54 |
| 83970 |
|
15 |
14 |
$50.92 |
| 99188 |
|
175 |
173 |
$41.99 |
| 91300 |
|
1,327 |
1,195 |
$40.18 |
| 91307 |
|
356 |
324 |
$40.18 |
| 88720 |
|
35 |
26 |
$35.03 |
| 82570 |
|
115 |
68 |
$31.90 |
| J1170 |
Hydromorphone injection |
88 |
75 |
$31.25 |
| 82040 |
|
67 |
58 |
$28.54 |
| 85651 |
|
64 |
61 |
$22.10 |
| 82785 |
|
18 |
15 |
$20.31 |
| 84153 |
|
14 |
14 |
$18.37 |
| J0171 |
Adrenalin epinephrine inject |
37 |
25 |
$17.30 |
| 87186 |
|
69 |
64 |
$17.22 |
| 87077 |
|
26 |
25 |
$16.10 |
| 84478 |
|
12 |
12 |
$14.62 |
| 82043 |
|
41 |
37 |
$14.26 |
| J2360 |
Orphenadrine injection |
55 |
38 |
$12.22 |
| 91305 |
|
60 |
56 |
$10.79 |
| 84156 |
|
56 |
52 |
$9.06 |
| J0696 |
Ceftriaxone sodium injection |
13 |
13 |
$2.28 |
| G1004 |
Cdsm ndsc |
2,956 |
2,446 |
$0.00 |
| 90734 |
|
67 |
64 |
$0.00 |
| 91312 |
|
85 |
81 |
$0.00 |
| 90685 |
|
54 |
53 |
$0.00 |
| 90710 |
|
57 |
54 |
$0.00 |
| 90633 |
|
71 |
69 |
$0.00 |
| Q0244 |
Casirivi and imdevi 1200 mg |
18 |
17 |
$0.00 |
| 84100 |
|
60 |
54 |
$0.00 |
| 85379 |
|
38 |
38 |
$0.00 |
| 90723 |
|
223 |
213 |
$0.00 |
| 83880 |
|
46 |
43 |
$0.00 |
| 90647 |
|
249 |
239 |
$0.00 |
| 80069 |
|
14 |
12 |
$0.00 |
| 91301 |
|
439 |
435 |
$0.00 |
| 87040 |
|
18 |
12 |
$0.00 |
| 90680 |
|
109 |
105 |
$0.00 |
| V2632 |
Post chmbr intraocular lens |
35 |
24 |
$0.00 |
| 91319 |
|
12 |
12 |
$0.00 |
| 92136 |
|
13 |
12 |
$0.00 |
| A9270 |
Non-covered item or service |
21 |
12 |
$0.00 |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
14 |
14 |
$0.00 |
| 90381 |
|
12 |
12 |
$0.00 |