| Code | Description | Claims | Beneficiaries | Total Paid |
| 0450 |
|
40,414 |
34,695 |
$964K |
| 74176 |
|
6,004 |
5,529 |
$632K |
| 96374 |
|
13,659 |
11,753 |
$631K |
| 80307 |
|
7,816 |
6,675 |
$409K |
| 74177 |
|
1,990 |
1,865 |
$393K |
| 70450 |
|
6,073 |
5,675 |
$380K |
| 96375 |
|
11,555 |
8,868 |
$353K |
| 77067 |
|
3,007 |
2,982 |
$341K |
| 93005 |
|
17,284 |
15,189 |
$326K |
| 87635 |
|
5,031 |
4,575 |
$291K |
| 72125 |
|
2,326 |
2,208 |
$229K |
| A0429 |
Bls-emergency |
4,061 |
2,925 |
$225K |
| 85025 |
|
33,905 |
27,869 |
$204K |
| 71275 |
|
1,085 |
1,007 |
$201K |
| 80053 |
|
23,426 |
20,264 |
$199K |
| 76856 |
|
2,995 |
2,871 |
$154K |
| 96365 |
|
2,755 |
2,300 |
$152K |
| 76830 |
|
2,798 |
2,678 |
$151K |
| 96361 |
|
5,756 |
4,680 |
$148K |
| 83880 |
|
5,634 |
5,116 |
$141K |
| J3490 |
Drugs unclassified injection |
30,300 |
10,597 |
$139K |
| 71045 |
|
12,649 |
11,507 |
$134K |
| 96372 |
|
5,814 |
4,490 |
$128K |
| 76815 |
|
2,612 |
1,723 |
$113K |
| 99199 |
|
1,624 |
1,407 |
$110K |
| 76705 |
|
2,249 |
2,094 |
$109K |
| 87636 |
|
604 |
570 |
$106K |
| 97110 |
|
3,963 |
1,023 |
$106K |
| 84484 |
|
12,184 |
9,574 |
$98K |
| 77066 |
Tomosynthesis, mammo |
680 |
675 |
$97K |
| 76817 |
|
1,593 |
1,418 |
$93K |
| 93971 |
|
711 |
682 |
$85K |
| 77063 |
|
3,030 |
3,005 |
$85K |
| 83690 |
|
12,209 |
10,658 |
$64K |
| Z7502 |
|
1,670 |
1,644 |
$64K |
| 96360 |
|
1,072 |
1,003 |
$60K |
| Z9725 |
|
1,350 |
1,327 |
$58K |
| 0160 |
|
2,533 |
1,573 |
$57K |
| 80048 |
|
10,078 |
8,236 |
$57K |
| 76641 |
|
702 |
647 |
$54K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
4,862 |
4,413 |
$51K |
| 71046 |
|
2,436 |
2,328 |
$50K |
| 84145 |
|
2,516 |
2,131 |
$50K |
| 84443 |
|
3,881 |
3,530 |
$48K |
| U0003 |
Cov-19 amp prb hgh thruput |
586 |
545 |
$47K |
| 76811 |
|
558 |
552 |
$45K |
| 93976 |
|
902 |
867 |
$42K |
| 71260 |
|
437 |
400 |
$38K |
| 99283 |
|
1,472 |
1,280 |
$36K |
| J1170 |
Hydromorphone injection |
6,948 |
4,150 |
$36K |
| 73630 |
|
1,633 |
1,485 |
$36K |
| 93970 |
|
157 |
151 |
$36K |
| 76801 |
|
576 |
522 |
$35K |
| 76700 |
|
476 |
471 |
$35K |
| 72148 |
|
287 |
254 |
$34K |
| G0480 |
Drug test def 1-7 classes |
308 |
277 |
$33K |
| J2405 |
Ondansetron hcl injection |
11,103 |
7,942 |
$33K |
| 87086 |
|
4,778 |
4,350 |
$29K |
| 81001 |
|
12,328 |
11,147 |
$29K |
| 76642 |
|
446 |
443 |
$29K |
| 87040 |
|
2,940 |
1,929 |
$28K |
| G0279 |
Tomosynthesis, mammo |
913 |
909 |
$28K |
| 82553 |
|
3,852 |
3,290 |
$28K |
| 83605 |
|
3,263 |
2,714 |
$28K |
| 0760 |
|
1,700 |
1,362 |
$26K |
| 83735 |
|
5,319 |
4,247 |
$26K |
| 72131 |
|
373 |
334 |
$25K |
| 90715 |
|
746 |
711 |
$24K |
| 0241U |
|
825 |
761 |
$23K |
| 73562 |
|
1,005 |
894 |
$22K |
| 94640 |
|
1,266 |
945 |
$21K |
| 82550 |
|
4,907 |
4,138 |
$21K |
| J1885 |
Ketorolac tromethamine inj |
6,799 |
5,314 |
$21K |
| 72100 |
|
842 |
814 |
$21K |
| 73030 |
|
949 |
875 |
$20K |
| 70486 |
|
236 |
232 |
$20K |
| 71250 |
|
223 |
200 |
$20K |
| 84702 |
|
3,373 |
3,055 |
$20K |
| 97750 |
|
318 |
280 |
$19K |
| 73610 |
|
874 |
814 |
$19K |
| 87631 |
|
422 |
348 |
$19K |
| 70551 |
|
119 |
107 |
$17K |
| 96366 |
|
718 |
502 |
$17K |
| 85379 |
|
2,026 |
1,909 |
$15K |
| 85610 |
|
5,373 |
4,791 |
$14K |
| 84703 |
|
5,929 |
5,449 |
$14K |
| J2270 |
Morphine sulfate injection |
2,432 |
1,728 |
$13K |
| 80076 |
|
2,438 |
2,163 |
$13K |
| 76805 |
|
151 |
149 |
$13K |
| J0131 |
Inj, acetaminophen (nos) |
327 |
297 |
$12K |
| 59025 |
|
863 |
325 |
$12K |
| 73721 |
|
65 |
58 |
$12K |
| 77065 |
Tomosynthesis, mammo |
109 |
100 |
$11K |
| 77080 |
|
307 |
307 |
$11K |
| J3010 |
Fentanyl citrate injection |
2,634 |
1,719 |
$11K |
| 85730 |
|
2,883 |
2,640 |
$11K |
| J0696 |
Ceftriaxone sodium injection |
2,918 |
2,241 |
$10K |
| 73130 |
|
460 |
429 |
$10K |
| 85027 |
|
2,166 |
1,812 |
$10K |
| J2704 |
Inj, propofol, 10 mg |
1,635 |
1,243 |
$10K |
| J2060 |
Lorazepam injection |
3,102 |
2,091 |
$10K |
| 80047 |
|
2,069 |
1,871 |
$10K |
| J1100 |
Dexamethasone sodium phos |
2,659 |
2,009 |
$9K |
| 72141 |
|
87 |
75 |
$9K |
| A9585 |
Gadobutrol injection |
372 |
315 |
$8K |
| 87804 |
|
918 |
884 |
$8K |
| 81025 |
|
2,362 |
2,171 |
$8K |
| 72128 |
|
136 |
117 |
$8K |
| 87077 |
|
994 |
903 |
$7K |
| 86901 |
|
3,072 |
2,818 |
$7K |
| 81003 |
|
6,694 |
6,122 |
$7K |
| J7030 |
Normal saline solution infus |
967 |
782 |
$7K |
| 86900 |
|
3,070 |
2,816 |
$7K |
| 70496 |
|
25 |
24 |
$6K |
| 93306 |
|
75 |
73 |
$6K |
| 88305 |
|
657 |
608 |
$6K |
| 86140 |
|
1,540 |
1,280 |
$6K |
| 87186 |
|
903 |
833 |
$6K |
| J2250 |
Inj midazolam hydrochloride |
1,675 |
1,394 |
$6K |
| J0690 |
Cefazolin sodium injection |
969 |
746 |
$6K |
| 94760 |
|
1,359 |
778 |
$5K |
| 0270 |
|
32,968 |
12,846 |
$5K |
| 86850 |
|
2,101 |
1,933 |
$5K |
| 97139 |
|
356 |
41 |
$5K |
| 87081 |
|
1,269 |
1,158 |
$5K |
| 73110 |
|
231 |
210 |
$5K |
| 82150 |
|
1,630 |
1,498 |
$5K |
| J1200 |
Diphenhydramine hcl injectio |
1,862 |
1,433 |
$5K |
| 96376 |
|
5,128 |
3,308 |
$4K |
| 84100 |
|
1,311 |
996 |
$4K |
| 82947 |
|
2,415 |
1,553 |
$3K |
| 80143 |
|
136 |
127 |
$3K |
| 80179 |
|
133 |
126 |
$3K |
| 74018 |
|
230 |
208 |
$3K |
| 90471 |
|
774 |
725 |
$3K |
| A4217 |
Sterile water/saline, 500 ml |
503 |
460 |
$3K |
| J7050 |
Normal saline solution infus |
531 |
228 |
$3K |
| S0164 |
Injection pantroprazole |
374 |
241 |
$3K |
| 85652 |
|
1,178 |
1,057 |
$2K |
| J3411 |
Thiamine hcl 100 mg |
200 |
138 |
$2K |
| 87880 |
|
270 |
259 |
$2K |
| 93017 |
|
44 |
40 |
$2K |
| J2785 |
Regadenoson injection |
13 |
13 |
$2K |
| J3475 |
Inj magnesium sulfate |
225 |
194 |
$2K |
| 97802 |
|
14 |
14 |
$2K |
| J1815 |
Insulin injection |
73 |
51 |
$2K |
| G0202 |
Scr mammo bi incl cad |
42 |
42 |
$2K |
| 76536 |
|
33 |
32 |
$1K |
| J3370 |
Vancomycin hcl injection |
143 |
96 |
$1K |
| J2765 |
Metoclopramide hcl injection |
611 |
430 |
$1K |
| J7120 |
Ringers lactate infusion |
180 |
127 |
$1K |
| J1642 |
Inj heparin sodium per 10 u |
170 |
89 |
$1K |
| 96367 |
|
46 |
25 |
$1K |
| 85007 |
|
640 |
540 |
$1K |
| 84439 |
|
174 |
158 |
$937.57 |
| 86141 |
|
230 |
211 |
$931.83 |
| J1644 |
Inj heparin sodium per 1000u |
205 |
108 |
$922.53 |
| 71020 |
|
48 |
47 |
$898.92 |
| J3535 |
Metered dose inhaler drug |
40 |
38 |
$892.95 |
| 71010 |
|
118 |
112 |
$818.95 |
| J2001 |
Lidocaine injection |
831 |
758 |
$811.14 |
| 73590 |
|
40 |
38 |
$755.90 |
| 76770 |
|
12 |
12 |
$741.00 |
| 87205 |
|
351 |
308 |
$736.30 |
| 73080 |
|
30 |
26 |
$702.46 |
| J1650 |
Inj enoxaparin sodium |
135 |
65 |
$698.31 |
| 72170 |
|
47 |
40 |
$691.58 |
| Z7610 |
|
126 |
64 |
$659.75 |
| 85014 |
|
744 |
618 |
$608.79 |
| 76870 |
|
13 |
13 |
$598.39 |
| 73502 |
|
16 |
16 |
$568.41 |
| 87420 |
|
176 |
170 |
$540.64 |
| 83036 |
|
136 |
129 |
$529.62 |
| J2930 |
Methylprednisolone injection |
114 |
81 |
$529.20 |
| 87070 |
|
144 |
127 |
$509.35 |
| A9500 |
Tc99m sestamibi |
17 |
14 |
$486.80 |
| J3360 |
Diazepam injection |
44 |
36 |
$445.82 |
| 72040 |
|
12 |
12 |
$444.47 |
| 0250 |
|
1,199 |
574 |
$383.47 |
| J0171 |
Adrenalin epinephrine inject |
44 |
42 |
$382.80 |
| 87491 |
|
42 |
38 |
$326.50 |
| 87591 |
|
41 |
37 |
$319.50 |
| M0243 |
Casirivi and imdevi inj |
12 |
12 |
$309.60 |
| 0710 |
|
951 |
881 |
$287.42 |
| 99285 |
|
49 |
29 |
$270.41 |
| 99281 |
|
32 |
19 |
$248.00 |
| 82077 |
|
24 |
23 |
$228.55 |
| 0258 |
|
706 |
449 |
$191.06 |
| J2550 |
Promethazine hcl injection |
72 |
56 |
$189.05 |
| J7512 |
Prednisone ir or dr oral 1mg |
290 |
261 |
$185.54 |
| 82248 |
|
60 |
53 |
$182.23 |
| 0761 |
|
226 |
191 |
$170.50 |
| S0020 |
Injection, bupivicaine hydro |
71 |
60 |
$170.43 |
| 87430 |
|
46 |
46 |
$170.04 |
| 10060 |
|
17 |
16 |
$165.00 |
| 80061 |
|
53 |
53 |
$164.62 |
| 99070 |
|
284 |
140 |
$160.04 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
74 |
55 |
$156.69 |
| J2919 |
Inj, methylpred sod succ 5mg |
36 |
25 |
$154.79 |
| 82728 |
|
32 |
27 |
$148.80 |
| 0360 |
|
524 |
410 |
$146.17 |
| 83615 |
|
41 |
31 |
$125.15 |
| 0272 |
|
829 |
530 |
$120.80 |
| J3480 |
Inj potassium chloride |
18 |
15 |
$113.36 |
| 12001 |
|
13 |
12 |
$112.80 |
| 80050 |
|
94 |
56 |
$103.95 |
| 87147 |
|
38 |
37 |
$103.11 |
| J2272 |
Inj, morphine (fresenius) |
33 |
24 |
$67.70 |
| 99152 |
|
15 |
12 |
$65.31 |
| Q0144 |
Azithromycin dihydrate, oral |
12 |
12 |
$63.65 |
| 87075 |
|
13 |
13 |
$57.94 |
| U0005 |
Infec agen detec ampli probe |
381 |
362 |
$57.50 |
| 87210 |
|
23 |
16 |
$45.94 |
| 0637 |
|
50 |
23 |
$39.62 |
| 86308 |
|
13 |
13 |
$32.31 |
| A4216 |
Sterile water/saline, 10 ml |
551 |
237 |
$29.56 |
| 94664 |
|
75 |
69 |
$24.68 |
| G1004 |
Cdsm ndsc |
8,154 |
5,590 |
$16.81 |
| S0028 |
Injection, famotidine, 20 mg |
134 |
104 |
$8.84 |
| 0636 |
|
266 |
138 |
$0.00 |
| 0307 |
|
80 |
71 |
$0.00 |
| 0305 |
|
121 |
76 |
$0.00 |
| 0352 |
|
99 |
72 |
$0.00 |
| 0301 |
|
821 |
222 |
$0.00 |
| 0350 |
|
14 |
13 |
$0.00 |
| 0324 |
|
114 |
108 |
$0.00 |
| C9399 |
Unclassified drugs or biolog |
26 |
25 |
$0.00 |
| J1630 |
Haloperidol injection |
17 |
13 |
$0.00 |
| 0306 |
|
180 |
102 |
$0.00 |
| 0922 |
|
12 |
12 |
$0.00 |
| C1769 |
Guide wire |
16 |
12 |
$0.00 |
| 0949 |
|
67 |
22 |
$0.00 |
| 77062 |
|
125 |
125 |
$0.00 |
| 0300 |
|
513 |
212 |
$0.00 |
| G0500 |
Mod sedat endo service >5yrs |
30 |
29 |
$0.00 |
| 0351 |
|
58 |
48 |
$0.00 |
| 0762 |
|
317 |
305 |
$0.00 |
| 0403 |
|
40 |
20 |
$0.00 |
| 0302 |
|
28 |
26 |
$0.00 |
| 0402 |
|
154 |
98 |
$0.00 |
| 0320 |
|
116 |
86 |
$0.00 |
| 0489 |
|
16 |
12 |
$0.00 |