| Code | Description | Claims | Beneficiaries | Total Paid |
| 97110 |
|
14,783 |
3,942 |
$773K |
| 93306 |
|
4,230 |
3,879 |
$586K |
| 62323 |
|
3,054 |
2,736 |
$510K |
| 72148 |
|
1,943 |
1,830 |
$468K |
| 74177 |
|
3,229 |
2,938 |
$467K |
| 11042 |
|
4,151 |
1,906 |
$457K |
| 64635 |
|
1,752 |
1,538 |
$398K |
| 70450 |
|
4,041 |
3,641 |
$390K |
| 59025 |
|
2,255 |
1,609 |
$380K |
| 80305 |
|
28,969 |
25,729 |
$356K |
| 80053 |
|
28,559 |
24,140 |
$354K |
| 80048 |
|
24,510 |
20,468 |
$329K |
| 78452 |
|
1,695 |
1,525 |
$325K |
| U0002 |
Covid-19 lab test non-cdc |
6,077 |
5,420 |
$319K |
| 87502 |
|
3,053 |
2,839 |
$305K |
| T1015 |
Clinic service |
23,225 |
19,963 |
$294K |
| 85025 |
|
45,351 |
37,106 |
$290K |
| A0425 |
Ground mileage |
5,451 |
4,017 |
$277K |
| G0463 |
Hospital outpt clinic visit |
20,813 |
17,663 |
$270K |
| 64493 |
|
939 |
773 |
$203K |
| 72141 |
|
806 |
763 |
$200K |
| 96375 |
|
3,216 |
2,481 |
$167K |
| 62321 |
|
993 |
902 |
$166K |
| 72125 |
|
1,422 |
1,300 |
$161K |
| 77067 |
|
3,023 |
2,819 |
$151K |
| G0480 |
Drug test def 1-7 classes |
8,742 |
8,026 |
$146K |
| 80307 |
|
3,427 |
2,743 |
$146K |
| 87426 |
|
4,132 |
3,760 |
$145K |
| 80361 |
|
3,970 |
3,764 |
$140K |
| 93005 |
|
16,387 |
13,666 |
$135K |
| 84443 |
|
10,315 |
9,404 |
$131K |
| 87591 |
|
2,800 |
2,537 |
$125K |
| 87491 |
|
2,800 |
2,539 |
$124K |
| 64636 |
|
852 |
739 |
$119K |
| 71250 |
|
1,435 |
1,340 |
$118K |
| 87634 |
|
1,459 |
1,385 |
$117K |
| 80050 |
|
2,476 |
2,412 |
$116K |
| 80348 |
|
4,130 |
3,556 |
$115K |
| 74176 |
|
1,645 |
1,497 |
$113K |
| 96365 |
|
1,646 |
1,174 |
$112K |
| 36415 |
|
15,643 |
12,553 |
$111K |
| 97162 |
|
1,159 |
1,081 |
$107K |
| 71046 |
|
6,703 |
6,090 |
$105K |
| 80061 |
|
9,113 |
8,408 |
$103K |
| J2405 |
Ondansetron hcl injection |
14,583 |
11,316 |
$103K |
| 88305 |
|
3,522 |
3,032 |
$99K |
| 86901 |
|
4,428 |
3,905 |
$99K |
| J1100 |
Dexamethasone sodium phos |
9,635 |
8,145 |
$92K |
| 84484 |
|
7,928 |
6,105 |
$91K |
| 96413 |
|
376 |
219 |
$90K |
| 96372 |
|
2,640 |
2,022 |
$81K |
| J2785 |
Regadenoson injection |
1,167 |
1,071 |
$80K |
| 74022 |
|
3,325 |
3,038 |
$78K |
| 87086 |
|
9,978 |
8,548 |
$78K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
7,350 |
6,664 |
$77K |
| 99283 |
|
3,588 |
3,072 |
$74K |
| 83880 |
|
2,761 |
2,481 |
$73K |
| 86140 |
|
9,262 |
7,823 |
$71K |
| 71045 |
|
9,245 |
8,176 |
$71K |
| 82306 |
|
2,970 |
2,733 |
$68K |
| 71275 |
|
401 |
359 |
$67K |
| 87389 |
|
2,429 |
2,208 |
$67K |
| 83605 |
|
5,606 |
4,926 |
$66K |
| 80346 |
|
2,367 |
2,113 |
$66K |
| A0427 |
Als1-emergency |
2,875 |
2,342 |
$64K |
| 73721 |
|
214 |
187 |
$63K |
| 82803 |
|
2,259 |
1,985 |
$56K |
| 84145 |
|
2,732 |
2,450 |
$54K |
| 97597 |
|
1,661 |
935 |
$49K |
| 70553 |
|
149 |
129 |
$47K |
| 87040 |
|
3,547 |
2,842 |
$46K |
| 99284 |
|
4,722 |
4,039 |
$46K |
| 87077 |
|
4,485 |
4,023 |
$46K |
| 87624 |
|
1,201 |
1,099 |
$46K |
| 72100 |
|
1,711 |
1,597 |
$44K |
| 74178 |
|
350 |
332 |
$41K |
| 81025 |
|
4,872 |
4,200 |
$41K |
| 42820 |
|
120 |
114 |
$41K |
| C1769 |
Guide wire |
702 |
620 |
$40K |
| 72131 |
|
351 |
328 |
$40K |
| 85027 |
|
5,782 |
5,015 |
$40K |
| 83036 |
|
5,210 |
4,887 |
$39K |
| 76642 |
|
1,408 |
1,136 |
$38K |
| 93017 |
|
1,909 |
1,743 |
$37K |
| 83690 |
|
4,909 |
4,380 |
$36K |
| 77063 |
|
3,020 |
2,817 |
$34K |
| A0429 |
Bls-emergency |
1,553 |
1,279 |
$33K |
| 82607 |
|
2,010 |
1,836 |
$32K |
| 45385 |
|
336 |
298 |
$31K |
| 80320 |
|
1,681 |
1,427 |
$30K |
| J1885 |
Ketorolac tromethamine inj |
5,914 |
4,872 |
$30K |
| A9500 |
Tc99m sestamibi |
1,164 |
1,086 |
$30K |
| 51701 |
|
162 |
138 |
$30K |
| 87070 |
|
2,268 |
2,032 |
$30K |
| 72040 |
|
1,168 |
1,060 |
$29K |
| 99285 |
|
2,839 |
2,425 |
$28K |
| 80365 |
|
1,097 |
1,041 |
$28K |
| J0696 |
Ceftriaxone sodium injection |
2,737 |
2,470 |
$28K |
| 95886 |
|
474 |
449 |
$28K |
| 96374 |
|
3,692 |
3,153 |
$28K |
| 86850 |
|
4,372 |
3,797 |
$28K |
| 86900 |
|
4,438 |
3,910 |
$27K |
| 84439 |
|
2,439 |
2,273 |
$27K |
| J1650 |
Inj enoxaparin sodium |
1,409 |
1,044 |
$27K |
| 43239 |
|
218 |
189 |
$27K |
| 69436 |
|
124 |
115 |
$26K |
| 80076 |
|
3,316 |
2,887 |
$25K |
| 81001 |
|
8,721 |
7,698 |
$24K |
| 73630 |
|
848 |
788 |
$24K |
| 88175 |
|
1,428 |
1,297 |
$23K |
| 87186 |
|
4,484 |
4,018 |
$23K |
| 86003 |
|
113 |
105 |
$22K |
| A9576 |
Inj prohance multipack |
358 |
323 |
$21K |
| 85730 |
|
4,494 |
3,999 |
$21K |
| 71260 |
|
125 |
109 |
$21K |
| 87075 |
|
1,572 |
1,418 |
$21K |
| 73562 |
|
546 |
514 |
$20K |
| 83735 |
|
3,691 |
2,884 |
$20K |
| 73030 |
|
821 |
759 |
$20K |
| 80324 |
|
991 |
838 |
$20K |
| 77066 |
Tomosynthesis, mammo |
250 |
241 |
$20K |
| 82948 |
|
3,850 |
2,769 |
$19K |
| 86803 |
|
1,099 |
988 |
$19K |
| 82728 |
|
1,564 |
1,411 |
$19K |
| 85610 |
|
6,107 |
5,329 |
$18K |
| 81003 |
|
8,066 |
7,177 |
$18K |
| 78815 |
|
51 |
43 |
$18K |
| 97001 |
|
374 |
358 |
$18K |
| M0243 |
Casirivi and imdevi inj |
109 |
107 |
$17K |
| 74018 |
|
854 |
788 |
$17K |
| 80355 |
|
940 |
868 |
$16K |
| J2250 |
Inj midazolam hydrochloride |
11,483 |
10,010 |
$16K |
| 76705 |
|
815 |
750 |
$15K |
| 73130 |
|
557 |
525 |
$15K |
| 73610 |
|
723 |
665 |
$14K |
| 86762 |
|
784 |
709 |
$14K |
| 0002A |
|
539 |
516 |
$14K |
| 80349 |
|
566 |
499 |
$13K |
| 88304 |
|
587 |
544 |
$12K |
| 93226 |
|
196 |
185 |
$12K |
| 84702 |
|
1,054 |
777 |
$12K |
| 86787 |
|
738 |
668 |
$12K |
| Q9969 |
Non-heu tc-99m add-on/dose |
432 |
391 |
$11K |
| 86592 |
|
2,168 |
1,965 |
$11K |
| 73110 |
|
397 |
369 |
$10K |
| 82565 |
|
776 |
681 |
$10K |
| 99282 |
|
208 |
169 |
$9K |
| 84481 |
|
390 |
364 |
$9K |
| 95911 |
|
93 |
91 |
$9K |
| 73502 |
|
387 |
355 |
$9K |
| 80074 |
|
210 |
186 |
$9K |
| 82150 |
|
1,174 |
1,051 |
$9K |
| A9552 |
F18 fdg |
68 |
53 |
$8K |
| C1887 |
Catheter, guiding |
168 |
147 |
$8K |
| 85379 |
|
883 |
796 |
$8K |
| J3010 |
Fentanyl citrate injection |
11,410 |
9,970 |
$8K |
| 12001 |
|
40 |
38 |
$7K |
| 87522 |
Neg quan hep c or qual rna |
301 |
268 |
$7K |
| J0690 |
Cefazolin sodium injection |
3,884 |
3,059 |
$7K |
| 93458 |
|
63 |
60 |
$7K |
| 93225 |
|
186 |
175 |
$7K |
| 83540 |
|
1,245 |
1,153 |
$7K |
| 0001A |
|
465 |
446 |
$7K |
| 82746 |
|
401 |
366 |
$7K |
| 87660 |
|
251 |
236 |
$6K |
| 87481 |
|
147 |
138 |
$6K |
| 87340 |
|
508 |
456 |
$6K |
| 70551 |
|
25 |
24 |
$6K |
| 94640 |
|
1,836 |
1,305 |
$6K |
| M0245 |
Bamlan and etesev infusion |
20 |
19 |
$5K |
| 64494 |
|
272 |
170 |
$5K |
| 84100 |
|
1,769 |
1,370 |
$5K |
| 71020 |
|
423 |
374 |
$5K |
| 87185 |
|
1,337 |
1,200 |
$5K |
| 84403 |
|
185 |
175 |
$5K |
| 76700 |
|
107 |
106 |
$5K |
| 76770 |
|
165 |
151 |
$5K |
| 96361 |
|
837 |
701 |
$5K |
| 77065 |
Tomosynthesis, mammo |
127 |
109 |
$5K |
| 85652 |
|
2,147 |
1,947 |
$5K |
| 82947 |
|
819 |
756 |
$5K |
| 87400 |
|
414 |
384 |
$5K |
| 64495 |
|
244 |
159 |
$5K |
| 82962 |
|
1,028 |
657 |
$4K |
| 95810 |
|
31 |
28 |
$4K |
| J1642 |
Inj heparin sodium per 10 u |
1,106 |
740 |
$4K |
| 71271 |
|
85 |
74 |
$4K |
| 42830 |
|
19 |
15 |
$4K |
| 96367 |
|
73 |
40 |
$4K |
| 82248 |
|
559 |
349 |
$4K |
| A0428 |
Bls |
72 |
56 |
$4K |
| 70486 |
|
24 |
24 |
$4K |
| 77080 |
|
79 |
67 |
$4K |
| 87081 |
|
416 |
395 |
$4K |
| 90715 |
|
220 |
206 |
$4K |
| C1894 |
Intro/sheath, non-laser |
205 |
186 |
$4K |
| 87510 |
|
147 |
138 |
$4K |
| J2704 |
Inj, propofol, 10 mg |
7,276 |
6,329 |
$4K |
| 85007 |
|
1,028 |
881 |
$3K |
| 86038 |
|
262 |
241 |
$3K |
| 84520 |
|
539 |
468 |
$3K |
| J3490 |
Drugs unclassified injection |
99 |
86 |
$3K |
| 93971 |
|
99 |
82 |
$3K |
| 82274 |
|
182 |
167 |
$3K |
| 84550 |
|
1,160 |
1,050 |
$3K |
| 82247 |
|
353 |
206 |
$3K |
| J1040 |
Methylprednisolone 80 mg inj |
3,723 |
3,372 |
$3K |
| 82043 |
|
780 |
734 |
$3K |
| J1170 |
Hydromorphone injection |
4,979 |
3,732 |
$3K |
| 87902 |
|
14 |
12 |
$3K |
| Q3014 |
Telehealth facility fee |
454 |
425 |
$3K |
| 80366 |
|
114 |
110 |
$2K |
| 87631 |
|
32 |
29 |
$2K |
| 71270 |
|
12 |
12 |
$2K |
| 71010 |
|
329 |
283 |
$2K |
| 84144 |
|
43 |
40 |
$2K |
| 93880 |
|
62 |
46 |
$2K |
| 82785 |
|
85 |
78 |
$2K |
| J2930 |
Methylprednisolone injection |
926 |
842 |
$2K |
| J1738 |
Inj. meloxicam 1 mg |
228 |
204 |
$2K |
| J2710 |
Neostigmine methylslfte inj |
816 |
667 |
$2K |
| 84152 |
|
175 |
164 |
$2K |
| 90471 |
|
326 |
295 |
$2K |
| 87641 |
|
105 |
97 |
$2K |
| A9270 |
Non-covered item or service |
7,257 |
4,888 |
$2K |
| 83615 |
|
360 |
292 |
$2K |
| J2272 |
Inj, morphine (fresenius) |
712 |
595 |
$2K |
| G0279 |
Tomosynthesis, mammo |
127 |
121 |
$2K |
| 83970 |
|
81 |
74 |
$2K |
| 83550 |
|
301 |
268 |
$2K |
| 87430 |
|
109 |
105 |
$1K |
| 83520 |
|
190 |
175 |
$1K |
| 82550 |
|
208 |
176 |
$1K |
| 85055 |
|
101 |
84 |
$1K |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
723 |
432 |
$1K |
| J2270 |
Morphine sulfate injection |
2,767 |
2,272 |
$1K |
| 86920 |
|
24 |
12 |
$1K |
| C8929 |
Tte w or wo fol wcon,doppler |
31 |
28 |
$1K |
| J1200 |
Diphenhydramine hcl injectio |
1,906 |
1,466 |
$1K |
| 80359 |
|
66 |
55 |
$1K |
| U0001 |
2019-ncov diagnostic p |
48 |
46 |
$1K |
| 84436 |
|
195 |
169 |
$1K |
| 87635 |
|
1,397 |
1,261 |
$1K |
| J2370 |
Phenylephrine hcl injection |
543 |
475 |
$1K |
| 80358 |
|
39 |
36 |
$939.74 |
| J2360 |
Orphenadrine injection |
487 |
462 |
$933.97 |
| 75571 |
|
28 |
27 |
$898.66 |
| C9803 |
Hopd covid-19 spec collect |
2,644 |
2,371 |
$897.93 |
| 87804 |
|
81 |
78 |
$881.16 |
| J1644 |
Inj heparin sodium per 1000u |
1,177 |
774 |
$879.56 |
| 86703 |
|
54 |
49 |
$861.96 |
| 0004A |
|
123 |
114 |
$858.06 |
| 82670 |
|
30 |
27 |
$816.28 |
| J2060 |
Lorazepam injection |
426 |
365 |
$758.83 |
| 74019 |
|
37 |
37 |
$737.37 |
| 86200 |
|
103 |
93 |
$724.48 |
| 94729 |
|
34 |
26 |
$718.36 |
| 80347 |
|
27 |
25 |
$691.38 |
| J7030 |
Normal saline solution infus |
23 |
21 |
$675.00 |
| 72110 |
|
14 |
13 |
$665.37 |
| J1030 |
Methylprednisolone 40 mg inj |
1,651 |
1,475 |
$654.54 |
| 93975 |
|
15 |
12 |
$593.18 |
| 87467 |
|
42 |
38 |
$589.43 |
| 84480 |
|
43 |
38 |
$568.50 |
| 87798 |
|
16 |
12 |
$551.32 |
| 86431 |
|
167 |
153 |
$545.92 |
| 96376 |
|
53 |
40 |
$545.24 |
| 77062 |
|
13 |
13 |
$536.87 |
| 94726 |
|
13 |
13 |
$526.38 |
| 87880 |
|
44 |
44 |
$524.49 |
| J7120 |
Ringers lactate infusion |
21 |
20 |
$514.56 |
| G0378 |
Hospital observation per hr |
442 |
417 |
$481.00 |
| 86780 |
|
31 |
30 |
$463.16 |
| 90714 |
|
48 |
44 |
$458.60 |
| 73560 |
|
32 |
25 |
$453.77 |
| 76856 |
|
13 |
13 |
$431.56 |
| 87205 |
|
87 |
77 |
$381.15 |
| 82105 |
|
31 |
26 |
$380.84 |
| 72070 |
|
25 |
24 |
$354.50 |
| 87420 |
|
27 |
27 |
$334.62 |
| 76870 |
|
24 |
12 |
$316.80 |
| 87045 |
|
27 |
24 |
$311.85 |
| J2001 |
Lidocaine injection |
945 |
862 |
$289.87 |
| 84156 |
|
111 |
99 |
$276.49 |
| 84146 |
|
16 |
14 |
$276.46 |
| 83002 |
|
13 |
13 |
$273.44 |
| 83001 |
|
13 |
13 |
$251.34 |
| A9585 |
Gadobutrol injection |
263 |
248 |
$250.55 |
| 73080 |
|
12 |
12 |
$234.42 |
| J2550 |
Promethazine hcl injection |
174 |
140 |
$226.35 |
| 87046 |
|
27 |
24 |
$223.28 |
| J2175 |
Meperidine hydrochl /100 mg |
439 |
375 |
$211.14 |
| 74000 |
|
13 |
13 |
$210.00 |
| J0330 |
Succinycholine chloride inj |
215 |
175 |
$167.65 |
| J0171 |
Adrenalin epinephrine inject |
30 |
29 |
$166.06 |
| J2765 |
Metoclopramide hcl injection |
152 |
135 |
$164.77 |
| J3475 |
Inj magnesium sulfate |
57 |
37 |
$158.59 |
| G0103 |
Psa screening |
99 |
96 |
$152.44 |
| 82140 |
|
15 |
14 |
$137.39 |
| 86334 |
|
13 |
13 |
$134.63 |
| J0780 |
Prochlorperazine injection |
115 |
100 |
$133.76 |
| 83721 |
|
41 |
39 |
$113.25 |
| J3370 |
Vancomycin hcl injection |
151 |
119 |
$106.52 |
| 82977 |
|
14 |
12 |
$96.00 |
| 82570 |
|
29 |
25 |
$90.68 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
95 |
81 |
$60.34 |
| J0744 |
Ciprofloxacin iv |
13 |
12 |
$56.73 |
| 84165 |
|
14 |
14 |
$51.42 |
| J1010 |
Inj, methylpred acetate 1 mg |
197 |
165 |
$48.74 |
| 81002 |
|
18 |
16 |
$47.22 |
| 36591 |
|
295 |
206 |
$22.44 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
53 |
39 |
$17.95 |
| J2372 |
Inj, biorphen, 20 micrograms |
34 |
34 |
$15.53 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
207 |
179 |
$3.98 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
15 |
14 |
$0.57 |
| 97598 |
|
17 |
12 |
$0.00 |
| J2305 |
Inj, nitroglycerin, 5 mg |
13 |
12 |
$0.00 |
| 99406 |
|
84 |
82 |
$0.00 |
| J0360 |
Hydralazine hcl injection |
52 |
42 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
12 |
12 |
$0.00 |