| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
|
29,886 |
22,522 |
$3.55M |
| 99285 |
|
18,926 |
14,147 |
$3.24M |
| Y7506 |
|
35,164 |
21,116 |
$3.10M |
| 99283 |
|
35,394 |
26,804 |
$2.71M |
| X4011 |
|
12,412 |
10,030 |
$2.67M |
| 99214 |
|
50,760 |
40,548 |
$1.86M |
| G0463 |
Hospital outpt clinic visit |
48,349 |
40,819 |
$1.78M |
| 85025 |
|
49,017 |
40,829 |
$1.40M |
| 80053 |
|
47,055 |
40,207 |
$1.36M |
| 92507 |
|
13,257 |
4,613 |
$1.26M |
| X4003 |
|
16,920 |
15,024 |
$1.26M |
| 99213 |
|
29,137 |
24,352 |
$924K |
| 71045 |
|
24,952 |
20,375 |
$669K |
| 96374 |
|
7,152 |
6,185 |
$644K |
| 93005 |
|
14,236 |
10,545 |
$595K |
| 11042 |
|
11,631 |
3,557 |
$575K |
| 99232 |
|
14,425 |
5,029 |
$415K |
| 99282 |
|
12,333 |
10,282 |
$388K |
| 97530 |
|
2,592 |
945 |
$334K |
| X4006 |
|
1,116 |
739 |
$310K |
| 81001 |
|
7,758 |
6,723 |
$297K |
| 87804 |
|
3,062 |
2,223 |
$256K |
| 99204 |
|
2,924 |
2,568 |
$241K |
| 90834 |
|
7,141 |
4,019 |
$240K |
| 93306 |
|
4,121 |
2,957 |
$234K |
| 74177 |
|
2,341 |
1,994 |
$230K |
| 83690 |
|
6,582 |
5,692 |
$225K |
| G0481 |
Drug test def 8-14 classes |
2,051 |
1,778 |
$222K |
| 80307 |
|
3,398 |
2,896 |
$212K |
| 97597 |
|
6,901 |
1,622 |
$197K |
| 99203 |
|
3,327 |
2,954 |
$185K |
| 99223 |
Prolong inpt eval add15 m |
2,124 |
1,818 |
$171K |
| 87633 |
|
426 |
410 |
$164K |
| T1040 |
Comm bh clinic svc per diem |
631 |
121 |
$154K |
| 70450 |
|
3,739 |
3,109 |
$146K |
| 64615 |
|
2,144 |
1,252 |
$138K |
| 43239 |
|
576 |
279 |
$132K |
| 84484 |
|
5,879 |
4,358 |
$126K |
| 96375 |
|
4,266 |
3,507 |
$126K |
| 73630 |
|
5,080 |
3,755 |
$112K |
| 93010 |
|
28,175 |
17,863 |
$105K |
| 96361 |
|
1,446 |
1,297 |
$95K |
| 99239 |
|
2,593 |
2,144 |
$92K |
| 87880 |
|
5,573 |
5,377 |
$86K |
| 96372 |
|
2,188 |
1,860 |
$79K |
| 99238 |
|
2,260 |
1,955 |
$78K |
| 99231 |
|
3,885 |
1,296 |
$76K |
| 99281 |
|
1,896 |
1,670 |
$72K |
| 71046 |
|
3,254 |
2,959 |
$71K |
| 87400 |
|
3,585 |
3,431 |
$69K |
| 95810 |
|
586 |
546 |
$68K |
| 74018 |
|
1,636 |
1,298 |
$68K |
| 97110 |
|
769 |
206 |
$66K |
| 83735 |
|
1,242 |
1,001 |
$60K |
| 78452 |
|
480 |
326 |
$60K |
| 99222 |
|
794 |
700 |
$59K |
| 84443 |
|
4,536 |
4,266 |
$54K |
| 85610 |
|
1,365 |
1,109 |
$49K |
| 81000 |
|
7,865 |
5,816 |
$48K |
| 20610 |
|
875 |
465 |
$44K |
| 85027 |
|
1,636 |
1,505 |
$43K |
| 81003 |
|
4,126 |
3,662 |
$41K |
| 47562 |
|
22 |
13 |
$38K |
| 80061 |
|
3,547 |
3,402 |
$34K |
| J3490 |
Drugs unclassified injection |
7,771 |
5,048 |
$34K |
| 99215 |
Prolong outpt/office vis |
615 |
478 |
$31K |
| 96365 |
|
427 |
310 |
$30K |
| 84512 |
|
512 |
458 |
$30K |
| G0378 |
Hospital observation per hr |
409 |
185 |
$30K |
| 72148 |
|
549 |
494 |
$29K |
| 77067 |
|
958 |
943 |
$28K |
| 17110 |
|
490 |
294 |
$27K |
| 74176 |
|
318 |
263 |
$26K |
| 81025 |
|
658 |
621 |
$25K |
| J0585 |
Injection,onabotulinumtoxina |
282 |
170 |
$24K |
| 59025 |
|
356 |
220 |
$24K |
| 87426 |
|
1,169 |
1,020 |
$24K |
| 45385 |
|
68 |
33 |
$24K |
| 94640 |
|
234 |
173 |
$23K |
| 87635 |
|
2,149 |
2,086 |
$23K |
| 72100 |
|
974 |
849 |
$23K |
| 64483 |
|
106 |
53 |
$22K |
| 77063 |
|
896 |
881 |
$22K |
| 69436 |
|
43 |
24 |
$21K |
| 96413 |
|
254 |
121 |
$21K |
| 99212 |
|
1,033 |
832 |
$21K |
| 87081 |
|
233 |
221 |
$20K |
| 95816 |
|
280 |
154 |
$20K |
| 45378 |
|
52 |
27 |
$20K |
| 87420 |
|
455 |
432 |
$19K |
| 99233 |
Prolong inpt eval add15 m |
482 |
159 |
$19K |
| 99291 |
|
154 |
46 |
$19K |
| 87086 |
|
1,361 |
1,136 |
$19K |
| 82306 |
|
926 |
898 |
$18K |
| 84703 |
|
829 |
776 |
$18K |
| 88305 |
|
543 |
468 |
$18K |
| 99205 |
Prolong outpt/office vis |
275 |
247 |
$18K |
| 87040 |
|
727 |
580 |
$18K |
| 83605 |
|
1,261 |
996 |
$18K |
| 95886 |
|
298 |
163 |
$17K |
| 64493 |
|
76 |
39 |
$17K |
| 73560 |
|
873 |
652 |
$17K |
| 72110 |
|
456 |
418 |
$16K |
| 76705 |
|
983 |
873 |
$16K |
| 17000 |
|
763 |
405 |
$15K |
| 36415 |
|
4,563 |
3,643 |
$15K |
| 87581 |
|
487 |
467 |
$15K |
| 87486 |
|
486 |
466 |
$15K |
| 97598 |
|
827 |
179 |
$14K |
| 99443 |
|
963 |
550 |
$13K |
| 76830 |
|
427 |
404 |
$13K |
| 73610 |
|
1,017 |
816 |
$13K |
| 83036 |
|
1,840 |
1,771 |
$12K |
| 92526 |
|
154 |
61 |
$12K |
| 99309 |
|
789 |
634 |
$11K |
| 76805 |
|
341 |
329 |
$11K |
| 94726 |
|
248 |
161 |
$11K |
| 11102 |
|
279 |
151 |
$11K |
| 90832 |
|
664 |
414 |
$10K |
| 0241U |
|
131 |
120 |
$10K |
| 80048 |
|
849 |
722 |
$9K |
| 87070 |
|
1,069 |
1,038 |
$9K |
| 83880 |
|
638 |
500 |
$9K |
| 90792 |
|
133 |
111 |
$9K |
| 95251 |
|
582 |
505 |
$8K |
| 11721 |
|
3,083 |
1,375 |
$8K |
| 73565 |
|
520 |
458 |
$7K |
| 94060 |
|
166 |
110 |
$7K |
| T1015 |
Clinic service |
675 |
583 |
$7K |
| 86850 |
|
222 |
200 |
$6K |
| 87071 |
|
847 |
827 |
$6K |
| 82962 |
|
226 |
144 |
$5K |
| 90791 |
|
62 |
57 |
$5K |
| 99406 |
|
2,648 |
1,617 |
$5K |
| 70553 |
|
37 |
36 |
$5K |
| 93458 |
|
16 |
12 |
$5K |
| 11045 |
|
255 |
77 |
$5K |
| 84439 |
|
905 |
847 |
$5K |
| 86140 |
|
1,897 |
1,679 |
$5K |
| 76642 |
|
236 |
173 |
$4K |
| 82550 |
|
168 |
152 |
$4K |
| 86900 |
|
88 |
81 |
$4K |
| 73110 |
|
454 |
405 |
$4K |
| 86141 |
|
15 |
13 |
$4K |
| 73721 |
|
86 |
78 |
$4K |
| 95909 |
|
47 |
28 |
$4K |
| 76816 |
|
87 |
79 |
$4K |
| 64484 |
|
101 |
52 |
$4K |
| 85730 |
|
121 |
92 |
$4K |
| 64635 |
|
29 |
16 |
$4K |
| 73130 |
|
518 |
405 |
$4K |
| 72050 |
|
81 |
74 |
$4K |
| 80076 |
|
902 |
830 |
$3K |
| 99490 |
Ccm add 20min |
422 |
369 |
$3K |
| 99308 |
|
373 |
175 |
$3K |
| 76856 |
|
137 |
133 |
$3K |
| 70551 |
|
72 |
65 |
$3K |
| 88342 |
|
43 |
39 |
$3K |
| 95811 |
|
40 |
38 |
$3K |
| 93016 |
|
287 |
253 |
$2K |
| 36600 |
|
63 |
60 |
$2K |
| 82805 |
|
59 |
56 |
$2K |
| 71250 |
|
96 |
74 |
$2K |
| 82565 |
|
875 |
806 |
$2K |
| 20553 |
|
26 |
15 |
$2K |
| 72141 |
|
28 |
25 |
$2K |
| 93018 |
|
269 |
238 |
$2K |
| 76770 |
|
103 |
95 |
$2K |
| 95910 |
|
21 |
14 |
$2K |
| 99221 |
|
66 |
52 |
$2K |
| 64494 |
|
53 |
27 |
$2K |
| 99442 |
|
93 |
78 |
$2K |
| 51798 |
|
296 |
211 |
$2K |
| 73030 |
|
216 |
186 |
$2K |
| 76801 |
|
49 |
44 |
$2K |
| 94729 |
|
297 |
198 |
$2K |
| 93017 |
|
29 |
24 |
$2K |
| 94799 |
|
13 |
12 |
$2K |
| 83540 |
|
218 |
175 |
$1K |
| 17003 |
|
317 |
226 |
$1K |
| 99202 |
|
27 |
27 |
$1K |
| Y7510 |
|
21 |
16 |
$1K |
| 99211 |
|
178 |
150 |
$1K |
| 85651 |
|
491 |
441 |
$1K |
| 36591 |
|
55 |
36 |
$1K |
| 82607 |
|
132 |
127 |
$1K |
| 72040 |
|
134 |
118 |
$1K |
| 92504 |
|
123 |
107 |
$1K |
| 71260 |
|
33 |
29 |
$1K |
| 88304 |
|
83 |
75 |
$1K |
| 76536 |
|
55 |
51 |
$1K |
| 97161 |
|
27 |
24 |
$1K |
| 11056 |
|
92 |
42 |
$985.31 |
| 94618 |
|
26 |
25 |
$921.30 |
| Y7507 |
|
16 |
15 |
$844.83 |
| 82728 |
|
141 |
117 |
$826.12 |
| 73562 |
|
136 |
104 |
$809.68 |
| 64495 |
|
26 |
12 |
$767.65 |
| 76817 |
|
28 |
24 |
$717.27 |
| 97760 |
|
106 |
98 |
$672.24 |
| 84145 |
|
56 |
45 |
$652.68 |
| Q3014 |
Telehealth facility fee |
36 |
31 |
$617.41 |
| 87801 |
|
13 |
13 |
$598.97 |
| 72114 |
|
20 |
20 |
$560.54 |
| J7050 |
Normal saline solution infus |
139 |
92 |
$508.34 |
| 86803 |
|
56 |
54 |
$471.60 |
| 87806 |
|
19 |
18 |
$461.23 |
| 86003 |
|
18 |
15 |
$445.28 |
| 99392 |
|
16 |
16 |
$408.98 |
| 82044 |
|
124 |
121 |
$389.43 |
| 71271 |
|
12 |
12 |
$375.08 |
| 99201 |
|
13 |
13 |
$362.05 |
| 82803 |
|
24 |
21 |
$354.45 |
| 93294 |
|
22 |
12 |
$347.77 |
| 64636 |
|
29 |
15 |
$339.63 |
| 99217 |
|
15 |
12 |
$331.38 |
| 83550 |
|
179 |
143 |
$329.31 |
| 82330 |
|
46 |
44 |
$323.71 |
| 71275 |
|
15 |
13 |
$298.79 |
| 93970 |
|
16 |
16 |
$293.81 |
| 82785 |
|
30 |
27 |
$274.06 |
| G2012 |
Brief check in by md/qhp |
266 |
218 |
$260.46 |
| 84481 |
|
19 |
18 |
$252.25 |
| 86762 |
|
31 |
29 |
$248.09 |
| 90833 |
|
44 |
40 |
$247.50 |
| 93296 |
|
23 |
13 |
$228.83 |
| 93880 |
|
15 |
13 |
$225.34 |
| 76882 |
|
14 |
12 |
$221.29 |
| 83921 |
|
12 |
12 |
$179.82 |
| 83615 |
|
80 |
63 |
$176.58 |
| 87624 |
|
13 |
12 |
$169.90 |
| 87340 |
|
31 |
29 |
$168.81 |
| 84702 |
|
13 |
13 |
$155.83 |
| 82950 |
|
53 |
48 |
$149.31 |
| 88175 |
|
25 |
25 |
$148.96 |
| 82746 |
|
14 |
14 |
$137.85 |
| 83655 |
|
13 |
13 |
$127.99 |
| 86592 |
|
43 |
41 |
$105.52 |
| 80051 |
|
31 |
30 |
$96.16 |
| 73590 |
|
14 |
12 |
$95.20 |
| 84480 |
|
16 |
13 |
$93.75 |
| 87077 |
|
14 |
12 |
$85.90 |
| 73502 |
|
15 |
12 |
$71.95 |
| 87661 |
|
12 |
12 |
$31.58 |
| 85378 |
|
16 |
12 |
$31.08 |
| 87491 |
|
12 |
12 |
$28.07 |
| 85018 |
|
12 |
12 |
$25.02 |
| J7613 |
Albuterol non-comp unit |
20 |
18 |
$20.82 |
| 1125F |
|
147 |
117 |
$18.69 |
| 1126F |
|
700 |
598 |
$15.85 |
| 99441 |
|
16 |
12 |
$6.74 |
| 81015 |
|
25 |
22 |
$5.50 |
| J2405 |
Ondansetron hcl injection |
28 |
16 |
$2.66 |
| 1008F |
|
802 |
760 |
$0.10 |
| 3078F |
|
151 |
142 |
$0.03 |
| 3725F |
|
1,310 |
792 |
$0.03 |
| 1160F |
|
602 |
574 |
$0.03 |
| 3074F |
|
118 |
116 |
$0.02 |
| 3077F |
|
48 |
43 |
$0.01 |
| A9270 |
Non-covered item or service |
12 |
12 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
28 |
27 |
$0.00 |
| J1642 |
Inj heparin sodium per 10 u |
19 |
12 |
$0.00 |
| 3079F |
|
14 |
13 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
13 |
12 |
$0.00 |
| J7030 |
Normal saline solution infus |
39 |
26 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
55 |
44 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
13 |
13 |
$0.00 |