| Code | Description | Claims | Beneficiaries | Total Paid |
| H0020 |
Alcohol and/or drug services |
59,121 |
5,366 |
$1.60M |
| 99283 |
|
10,815 |
10,351 |
$1.49M |
| 99284 |
|
9,538 |
9,010 |
$1.21M |
| H0035 |
Mh partial hosp tx under 24h |
5,722 |
764 |
$995K |
| 90853 |
|
12,359 |
1,693 |
$766K |
| 99285 |
|
5,482 |
5,191 |
$717K |
| 96361 |
|
3,296 |
2,818 |
$631K |
| 70450 |
|
1,919 |
1,865 |
$510K |
| 74177 |
|
1,536 |
1,518 |
$412K |
| 99282 |
|
3,064 |
2,985 |
$398K |
| 90832 |
|
4,095 |
3,129 |
$385K |
| 96365 |
|
3,275 |
2,612 |
$376K |
| 80053 |
|
14,977 |
12,905 |
$338K |
| 80307 |
|
8,044 |
6,124 |
$300K |
| 76856 |
|
617 |
607 |
$298K |
| 71275 |
|
589 |
584 |
$176K |
| 96366 |
|
1,143 |
993 |
$158K |
| 74176 |
|
528 |
522 |
$150K |
| U0003 |
Cov-19 amp prb hgh thruput |
1,986 |
1,792 |
$147K |
| 93306 |
|
767 |
763 |
$145K |
| 99213 |
|
1,113 |
823 |
$140K |
| 99212 |
|
1,135 |
830 |
$140K |
| 96360 |
|
1,008 |
805 |
$100K |
| 90834 |
|
652 |
507 |
$91K |
| 77067 |
|
1,497 |
1,496 |
$85K |
| 87635 |
|
6,110 |
5,648 |
$85K |
| 97110 |
|
1,094 |
392 |
$83K |
| 0241U |
|
11,602 |
4,429 |
$72K |
| 36415 |
|
12,395 |
8,915 |
$68K |
| 90791 |
|
330 |
330 |
$53K |
| 96372 |
|
3,600 |
2,576 |
$46K |
| H0004 |
Alcohol and/or drug services |
787 |
668 |
$39K |
| S5161 |
Emer rspns sys serv permonth |
1,452 |
1,418 |
$38K |
| 83880 |
|
1,209 |
1,153 |
$38K |
| 99281 |
|
257 |
209 |
$35K |
| 88305 |
|
723 |
673 |
$33K |
| 86850 |
|
1,000 |
963 |
$32K |
| 99291 |
|
270 |
269 |
$32K |
| 29125 |
|
161 |
159 |
$32K |
| 12001 |
|
64 |
63 |
$25K |
| 72125 |
|
448 |
439 |
$24K |
| 76801 |
|
272 |
247 |
$24K |
| 99214 |
|
164 |
148 |
$23K |
| U0004 |
Cov-19 test non-cdc hgh thru |
322 |
311 |
$22K |
| 70496 |
|
75 |
75 |
$21K |
| G0378 |
Hospital observation per hr |
218 |
213 |
$18K |
| 86900 |
|
1,035 |
977 |
$17K |
| 86901 |
|
1,031 |
975 |
$16K |
| 90792 |
|
90 |
90 |
$16K |
| 87491 |
|
429 |
423 |
$15K |
| 90715 |
|
473 |
471 |
$13K |
| 76641 |
|
612 |
610 |
$12K |
| 76705 |
|
589 |
573 |
$11K |
| 96367 |
|
470 |
280 |
$10K |
| 93970 |
|
28 |
27 |
$9K |
| 96413 |
|
273 |
163 |
$9K |
| 87591 |
|
427 |
421 |
$8K |
| J0131 |
Inj, acetaminophen (nos) |
1,036 |
966 |
$6K |
| 81025 |
|
1,847 |
1,675 |
$5K |
| 93971 |
|
140 |
139 |
$5K |
| 85025 |
|
9,741 |
8,310 |
$5K |
| 76830 |
|
124 |
123 |
$4K |
| 90837 |
|
29 |
26 |
$4K |
| 80048 |
|
281 |
250 |
$3K |
| 0012A |
|
129 |
129 |
$3K |
| 96374 |
|
3,641 |
3,466 |
$3K |
| 97161 |
|
34 |
34 |
$3K |
| 76700 |
|
14 |
14 |
$3K |
| 93005 |
|
4,612 |
4,232 |
$3K |
| 71046 |
|
711 |
706 |
$3K |
| 93017 |
|
56 |
54 |
$3K |
| 97140 |
|
99 |
38 |
$3K |
| 29130 |
|
12 |
12 |
$2K |
| 29530 |
|
12 |
12 |
$2K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
668 |
651 |
$2K |
| J7030 |
Normal saline solution infus |
3,443 |
2,972 |
$2K |
| 76775 |
|
36 |
35 |
$2K |
| 92557 |
|
70 |
69 |
$2K |
| 0011A |
|
95 |
95 |
$2K |
| 84443 |
|
345 |
320 |
$2K |
| 87086 |
|
2,072 |
2,005 |
$2K |
| 96375 |
|
3,290 |
3,051 |
$2K |
| 80061 |
|
184 |
183 |
$1K |
| 76817 |
|
27 |
24 |
$1K |
| 92567 |
|
92 |
91 |
$1K |
| 71045 |
|
3,305 |
3,141 |
$1K |
| 85610 |
|
2,216 |
2,121 |
$1K |
| 85730 |
|
1,775 |
1,692 |
$1K |
| 82947 |
|
1,224 |
712 |
$789.85 |
| 70498 |
|
12 |
12 |
$787.38 |
| J1100 |
Dexamethasone sodium phos |
1,344 |
1,178 |
$787.36 |
| 81001 |
|
3,928 |
3,735 |
$761.40 |
| 94640 |
|
1,174 |
1,013 |
$751.59 |
| J7050 |
Normal saline solution infus |
245 |
185 |
$701.75 |
| 0064A |
|
17 |
17 |
$680.00 |
| 76376 |
|
13 |
13 |
$649.96 |
| 77080 |
|
12 |
12 |
$640.00 |
| 85027 |
|
195 |
173 |
$622.56 |
| 83735 |
|
2,128 |
1,930 |
$614.14 |
| 94729 |
|
36 |
36 |
$592.50 |
| 84484 |
|
2,974 |
2,503 |
$591.20 |
| 82805 |
|
26 |
25 |
$538.81 |
| 87804 |
|
1,138 |
1,091 |
$537.67 |
| 83690 |
|
2,073 |
1,943 |
$432.08 |
| 83036 |
|
81 |
79 |
$424.27 |
| J2704 |
Inj, propofol, 10 mg |
774 |
748 |
$380.82 |
| 83605 |
|
1,493 |
1,334 |
$360.93 |
| 84703 |
|
1,396 |
1,325 |
$341.06 |
| 80320 |
|
1,993 |
1,812 |
$320.22 |
| 87807 |
|
680 |
640 |
$281.52 |
| J2405 |
Ondansetron hcl injection |
2,242 |
2,049 |
$280.29 |
| 73630 |
|
250 |
246 |
$275.16 |
| J7120 |
Ringers lactate infusion |
123 |
103 |
$264.18 |
| 87070 |
|
692 |
674 |
$261.06 |
| 81003 |
|
4,596 |
4,339 |
$233.77 |
| J1885 |
Ketorolac tromethamine inj |
2,051 |
1,927 |
$220.80 |
| 86703 |
|
14 |
14 |
$212.62 |
| J1200 |
Diphenhydramine hcl injectio |
786 |
592 |
$204.32 |
| 82948 |
|
689 |
514 |
$203.12 |
| J0690 |
Cefazolin sodium injection |
287 |
270 |
$201.55 |
| J0136 |
Inj, acetaminophen (b braun) |
853 |
789 |
$184.48 |
| 94726 |
|
12 |
12 |
$171.60 |
| 94727 |
|
12 |
12 |
$159.96 |
| 73130 |
|
182 |
181 |
$153.11 |
| 73562 |
|
133 |
131 |
$141.45 |
| J0696 |
Ceftriaxone sodium injection |
250 |
219 |
$137.60 |
| J2250 |
Inj midazolam hydrochloride |
899 |
849 |
$131.79 |
| 85379 |
|
841 |
821 |
$129.40 |
| 84439 |
|
28 |
27 |
$126.00 |
| 59025 |
|
12 |
12 |
$120.00 |
| 87186 |
|
262 |
242 |
$118.41 |
| 80299 |
|
197 |
188 |
$104.83 |
| 90471 |
|
607 |
506 |
$97.36 |
| 88304 |
|
14 |
14 |
$91.34 |
| 73610 |
|
200 |
196 |
$82.66 |
| J3010 |
Fentanyl citrate injection |
629 |
606 |
$75.20 |
| J2765 |
Metoclopramide hcl injection |
442 |
404 |
$67.91 |
| 94761 |
|
1,262 |
1,230 |
$64.35 |
| 80349 |
|
338 |
316 |
$55.00 |
| 96376 |
|
293 |
279 |
$52.70 |
| 84702 |
|
70 |
65 |
$49.72 |
| 94760 |
|
884 |
875 |
$44.43 |
| J2270 |
Morphine sulfate injection |
125 |
116 |
$39.14 |
| 73110 |
|
24 |
24 |
$37.90 |
| 73030 |
|
42 |
42 |
$36.18 |
| 87040 |
|
192 |
108 |
$35.58 |
| 86618 |
|
25 |
25 |
$34.06 |
| 87430 |
|
458 |
450 |
$28.28 |
| J3475 |
Inj magnesium sulfate |
16 |
12 |
$27.95 |
| 86171 |
|
422 |
417 |
$27.61 |
| J1170 |
Hydromorphone injection |
179 |
162 |
$26.67 |
| J2060 |
Lorazepam injection |
255 |
225 |
$22.30 |
| 87880 |
|
309 |
307 |
$18.33 |
| Q0162 |
Ondansetron oral |
485 |
466 |
$12.46 |
| 87077 |
|
71 |
65 |
$8.08 |
| 85008 |
|
550 |
496 |
$7.92 |
| 85651 |
|
24 |
24 |
$5.65 |
| 87081 |
|
342 |
335 |
$5.30 |
| 80353 |
|
14 |
12 |
$5.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
26 |
24 |
$2.72 |
| 85007 |
|
185 |
179 |
$0.00 |
| 83721 |
|
140 |
140 |
$0.00 |
| 80321 |
|
322 |
222 |
$0.00 |
| 94799 |
|
15 |
12 |
$0.00 |
| J1790 |
Droperidol injection |
14 |
12 |
$0.00 |
| J2001 |
Lidocaine injection |
13 |
12 |
$0.00 |
| J1630 |
Haloperidol injection |
17 |
13 |
$0.00 |
| 93799 |
|
15 |
12 |
$0.00 |