| Code | Description | Claims | Beneficiaries | Total Paid |
| G0463 |
Hospital outpt clinic visit |
239,840 |
213,795 |
$11.95M |
| 99283 |
|
38,265 |
35,989 |
$6.24M |
| 99284 |
|
22,785 |
20,927 |
$6.23M |
| J1745 |
Infliximab not biosimil 10mg |
1,770 |
1,645 |
$4.75M |
| A0431 |
Rotary wing air transport |
306 |
235 |
$2.06M |
| U0003 |
Cov-19 amp prb hgh thruput |
18,311 |
16,242 |
$1.40M |
| J3490 |
Drugs unclassified injection |
143,889 |
42,063 |
$1.20M |
| 99285 |
|
3,507 |
3,099 |
$1.09M |
| 96365 |
|
12,392 |
10,166 |
$1.04M |
| 41899 |
|
556 |
478 |
$968K |
| Q5121 |
Inj. avsola, 10 mg |
264 |
252 |
$761K |
| 85025 |
|
94,024 |
78,276 |
$717K |
| 70551 |
|
814 |
773 |
$697K |
| 0241U |
|
3,804 |
3,608 |
$670K |
| 76770 |
|
3,442 |
3,221 |
$609K |
| 94010 |
|
3,632 |
3,430 |
$573K |
| 87637 |
|
2,660 |
2,400 |
$459K |
| 72082 |
|
2,312 |
2,213 |
$421K |
| 80053 |
|
38,709 |
33,571 |
$418K |
| 93005 |
|
9,755 |
8,317 |
$387K |
| 96413 |
|
3,155 |
1,748 |
$382K |
| U0005 |
Infec agen detec ampli probe |
13,995 |
12,389 |
$326K |
| 80307 |
|
4,543 |
3,259 |
$282K |
| 96374 |
|
3,648 |
3,257 |
$256K |
| Q0138 |
Ferumoxytol, non-esrd |
448 |
291 |
$247K |
| 92567 |
|
10,206 |
9,507 |
$234K |
| 42820 |
|
318 |
294 |
$214K |
| 97803 |
|
5,188 |
4,957 |
$210K |
| 87635 |
|
4,227 |
4,113 |
$206K |
| 96366 |
|
2,821 |
2,222 |
$204K |
| 96375 |
|
3,838 |
3,265 |
$168K |
| J7120 |
Ringers lactate infusion |
8,345 |
7,562 |
$160K |
| 93296 |
|
5,941 |
5,713 |
$156K |
| J7050 |
Normal saline solution infus |
17,807 |
9,869 |
$155K |
| 99282 |
|
1,773 |
1,716 |
$153K |
| 43239 |
|
265 |
257 |
$130K |
| P9016 |
Rbc leukocytes reduced |
318 |
297 |
$122K |
| Q3014 |
Telehealth facility fee |
2,818 |
2,418 |
$120K |
| G0480 |
Drug test def 1-7 classes |
2,039 |
1,388 |
$118K |
| 36512 |
|
270 |
251 |
$116K |
| 36415 |
|
41,292 |
36,300 |
$115K |
| 84443 |
|
4,909 |
4,503 |
$110K |
| J2704 |
Inj, propofol, 10 mg |
9,937 |
7,517 |
$105K |
| 82306 |
|
2,660 |
2,495 |
$104K |
| 96361 |
|
1,859 |
1,218 |
$98K |
| 76816 |
|
1,743 |
1,282 |
$97K |
| 77386 |
|
124 |
12 |
$93K |
| 88305 |
|
399 |
380 |
$91K |
| 72170 |
|
1,104 |
1,060 |
$85K |
| 83036 |
|
6,122 |
5,675 |
$79K |
| 82677 |
|
3,140 |
2,520 |
$77K |
| 83021 |
|
2,781 |
2,446 |
$76K |
| 70260 |
|
366 |
347 |
$65K |
| 86003 |
|
476 |
416 |
$63K |
| 71046 |
|
1,009 |
938 |
$63K |
| 82105 |
|
3,857 |
3,104 |
$61K |
| 69436 |
|
107 |
96 |
$61K |
| 93306 |
|
173 |
167 |
$61K |
| 86140 |
|
9,366 |
8,551 |
$59K |
| 77073 |
|
395 |
378 |
$59K |
| 82728 |
|
2,919 |
2,666 |
$55K |
| 97163 |
|
483 |
461 |
$55K |
| 76811 |
|
521 |
406 |
$54K |
| 86336 |
|
3,140 |
2,520 |
$53K |
| A0436 |
Rotary wing air mileage |
306 |
235 |
$51K |
| 81001 |
|
14,463 |
12,877 |
$50K |
| 92526 |
|
554 |
522 |
$48K |
| 92579 |
|
585 |
526 |
$46K |
| 43762 |
|
154 |
148 |
$44K |
| Q5104 |
Injection, renflexis |
13 |
12 |
$43K |
| 92582 |
|
519 |
447 |
$42K |
| 84439 |
|
3,153 |
2,965 |
$40K |
| G0378 |
Hospital observation per hr |
471 |
231 |
$40K |
| 0202U |
|
544 |
389 |
$40K |
| J3010 |
Fentanyl citrate injection |
5,772 |
4,498 |
$40K |
| 76805 |
|
502 |
383 |
$39K |
| 54161 |
|
39 |
38 |
$38K |
| 70553 |
|
38 |
36 |
$32K |
| 94375 |
|
545 |
483 |
$32K |
| U0002 |
Covid-19 lab test non-cdc |
933 |
733 |
$32K |
| 80047 |
|
5,947 |
4,469 |
$31K |
| 84702 |
|
3,302 |
2,671 |
$30K |
| 59025 |
|
356 |
309 |
$28K |
| 11042 |
|
373 |
249 |
$26K |
| 85027 |
|
3,017 |
2,677 |
$26K |
| 83880 |
|
883 |
692 |
$25K |
| 87086 |
|
3,384 |
2,918 |
$25K |
| 87502 |
|
392 |
384 |
$24K |
| 95004 |
|
470 |
445 |
$23K |
| A4217 |
Sterile water/saline, 500 ml |
1,461 |
1,090 |
$23K |
| M0243 |
Casirivi and imdevi inj |
77 |
62 |
$22K |
| J0490 |
Belimumab injection |
29 |
25 |
$21K |
| 92557 |
|
277 |
270 |
$21K |
| 84450 |
|
4,884 |
4,460 |
$20K |
| 76817 |
|
237 |
180 |
$20K |
| 85046 |
|
2,446 |
2,197 |
$20K |
| 85652 |
|
5,156 |
4,657 |
$20K |
| 96372 |
|
614 |
492 |
$19K |
| 51600 |
|
108 |
105 |
$19K |
| 31526 |
|
51 |
49 |
$19K |
| J1100 |
Dexamethasone sodium phos |
3,358 |
2,979 |
$19K |
| 72081 |
|
156 |
154 |
$19K |
| J0690 |
Cefazolin sodium injection |
1,094 |
875 |
$18K |
| 82977 |
|
1,990 |
1,762 |
$18K |
| 83540 |
|
2,074 |
1,958 |
$18K |
| 87522 |
Neg quan hep c or qual rna |
739 |
623 |
$18K |
| J2405 |
Ondansetron hcl injection |
3,505 |
3,098 |
$17K |
| 97535 |
|
768 |
680 |
$17K |
| 76801 |
|
225 |
177 |
$16K |
| 73521 |
|
94 |
88 |
$16K |
| 83735 |
|
3,631 |
2,697 |
$16K |
| J7040 |
Normal saline solution infus |
1,814 |
1,508 |
$16K |
| 84460 |
|
5,643 |
5,130 |
$16K |
| 93926 |
|
177 |
166 |
$15K |
| 82607 |
|
756 |
718 |
$15K |
| 82962 |
|
5,403 |
4,784 |
$15K |
| 87081 |
|
942 |
895 |
$15K |
| 81003 |
|
5,808 |
4,955 |
$15K |
| 90471 |
|
817 |
751 |
$15K |
| 87536 |
|
226 |
209 |
$14K |
| 74174 |
|
14 |
12 |
$14K |
| 74177 |
|
19 |
13 |
$14K |
| 82565 |
|
4,151 |
3,749 |
$14K |
| 93297 |
|
2,273 |
2,185 |
$14K |
| 80048 |
|
2,204 |
1,819 |
$13K |
| 74455 |
|
65 |
65 |
$13K |
| 30930 |
|
41 |
40 |
$13K |
| 93922 |
|
255 |
238 |
$13K |
| 80061 |
|
619 |
582 |
$13K |
| 83550 |
|
946 |
882 |
$12K |
| 84466 |
|
814 |
783 |
$12K |
| 31575 |
|
74 |
70 |
$12K |
| 84484 |
|
1,213 |
959 |
$12K |
| 86902 |
|
306 |
281 |
$12K |
| 80069 |
|
1,041 |
821 |
$12K |
| 83690 |
|
1,537 |
1,407 |
$11K |
| 87631 |
|
146 |
107 |
$11K |
| 87070 |
|
926 |
875 |
$11K |
| 36416 |
|
3,691 |
3,441 |
$11K |
| 73630 |
|
156 |
133 |
$11K |
| 73110 |
|
149 |
126 |
$11K |
| 76700 |
|
101 |
88 |
$11K |
| 31622 |
|
29 |
28 |
$11K |
| J2997 |
Alteplase recombinant |
91 |
76 |
$10K |
| 77066 |
Tomosynthesis, mammo |
231 |
205 |
$9K |
| 99199 |
|
1,525 |
1,075 |
$9K |
| 80076 |
|
1,504 |
1,297 |
$9K |
| 94618 |
|
102 |
94 |
$9K |
| 86160 |
|
287 |
246 |
$9K |
| 76642 |
|
179 |
147 |
$8K |
| 96415 |
|
47 |
41 |
$8K |
| 82784 |
|
716 |
646 |
$8K |
| 92587 |
|
68 |
58 |
$8K |
| 77072 |
|
94 |
93 |
$8K |
| 76819 |
|
147 |
108 |
$8K |
| 84425 |
|
263 |
245 |
$8K |
| 81025 |
|
931 |
853 |
$8K |
| 77065 |
Tomosynthesis, mammo |
240 |
212 |
$7K |
| 80197 |
|
1,191 |
806 |
$7K |
| 87389 |
|
231 |
212 |
$7K |
| J1885 |
Ketorolac tromethamine inj |
1,242 |
1,131 |
$7K |
| 85044 |
|
1,387 |
1,228 |
$7K |
| 73140 |
|
103 |
93 |
$7K |
| 97166 |
|
62 |
60 |
$7K |
| 82040 |
|
1,062 |
945 |
$7K |
| 86833 |
|
110 |
97 |
$6K |
| J8540 |
Oral dexamethasone |
2,326 |
1,279 |
$6K |
| 87491 |
|
171 |
161 |
$6K |
| 86300 |
|
314 |
266 |
$6K |
| 73564 |
|
129 |
126 |
$6K |
| 84075 |
|
910 |
812 |
$6K |
| 82570 |
|
1,967 |
1,473 |
$6K |
| 87591 |
|
171 |
161 |
$6K |
| 36591 |
|
198 |
155 |
$5K |
| 74183 |
|
18 |
13 |
$5K |
| 70450 |
|
12 |
12 |
$5K |
| 84520 |
|
1,976 |
1,819 |
$5K |
| 86832 |
|
99 |
86 |
$5K |
| 85610 |
|
1,517 |
1,293 |
$5K |
| 87497 |
|
476 |
360 |
$5K |
| 83516 |
|
340 |
333 |
$5K |
| 82610 |
|
206 |
201 |
$5K |
| 95886 |
|
62 |
62 |
$4K |
| 87799 |
|
92 |
76 |
$4K |
| 95885 |
|
43 |
43 |
$4K |
| 71045 |
|
96 |
90 |
$4K |
| 82746 |
|
209 |
198 |
$4K |
| 92610 |
|
40 |
40 |
$4K |
| 97802 |
|
89 |
82 |
$4K |
| 73503 |
|
40 |
40 |
$4K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
246 |
209 |
$4K |
| 85651 |
|
1,420 |
1,357 |
$4K |
| 77067 |
|
74 |
73 |
$4K |
| J2920 |
Methylprednisolone injection |
1,292 |
1,166 |
$4K |
| 96110 |
|
37 |
37 |
$4K |
| J2930 |
Methylprednisolone injection |
479 |
364 |
$4K |
| 93303 |
|
24 |
24 |
$3K |
| 90686 |
|
600 |
558 |
$3K |
| 84156 |
|
1,711 |
1,299 |
$3K |
| 72100 |
|
26 |
25 |
$3K |
| 86225 |
|
172 |
140 |
$3K |
| 0071A |
|
65 |
44 |
$3K |
| 73502 |
|
39 |
36 |
$3K |
| 96367 |
|
58 |
39 |
$3K |
| 83615 |
|
582 |
501 |
$3K |
| 90870 |
|
50 |
37 |
$3K |
| 71250 |
|
12 |
12 |
$3K |
| 94729 |
|
30 |
28 |
$3K |
| 92555 |
|
110 |
89 |
$2K |
| 84100 |
|
1,029 |
805 |
$2K |
| 90656 |
|
147 |
147 |
$2K |
| 73562 |
|
69 |
66 |
$2K |
| J1200 |
Diphenhydramine hcl injectio |
1,068 |
868 |
$2K |
| 85660 |
|
372 |
266 |
$2K |
| 93325 |
|
24 |
24 |
$2K |
| 93320 |
|
24 |
24 |
$2K |
| 97597 |
|
57 |
52 |
$2K |
| 80143 |
|
733 |
203 |
$2K |
| 86592 |
|
343 |
317 |
$2K |
| 86850 |
|
147 |
140 |
$2K |
| 73090 |
|
16 |
13 |
$2K |
| 72110 |
|
12 |
12 |
$2K |
| 83655 |
|
88 |
74 |
$2K |
| 86480 |
|
25 |
24 |
$2K |
| 73030 |
|
29 |
28 |
$2K |
| 86360 |
|
25 |
24 |
$1K |
| 97167 |
|
14 |
14 |
$1K |
| 86364 |
|
104 |
102 |
$1K |
| 97804 |
|
13 |
12 |
$1K |
| 76000 |
|
12 |
12 |
$1K |
| 86677 |
|
84 |
80 |
$1K |
| J8597 |
Antiemetic drug oral nos |
199 |
190 |
$1K |
| 97760 |
|
31 |
30 |
$1K |
| C1769 |
Guide wire |
29 |
25 |
$1K |
| 84305 |
|
55 |
53 |
$1K |
| 86334 |
|
66 |
55 |
$1K |
| 73552 |
|
14 |
12 |
$1K |
| 11721 |
|
75 |
66 |
$1K |
| 82248 |
|
254 |
222 |
$1K |
| 84436 |
|
137 |
135 |
$1K |
| 86359 |
|
25 |
24 |
$1K |
| 95816 |
|
13 |
13 |
$1K |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
199 |
188 |
$1K |
| 96409 |
|
14 |
13 |
$1K |
| J9370 |
Vincristine sulfate 1 mg inj |
19 |
16 |
$1K |
| 51798 |
|
59 |
53 |
$1K |
| 87077 |
|
73 |
71 |
$1K |
| J2001 |
Lidocaine injection |
106 |
93 |
$1K |
| 85240 |
|
39 |
36 |
$1K |
| 80179 |
|
723 |
201 |
$984.06 |
| 87880 |
|
56 |
53 |
$963.74 |
| 86900 |
|
341 |
298 |
$893.20 |
| 86901 |
|
341 |
298 |
$885.77 |
| C1889 |
Implant/insert device, noc |
36 |
36 |
$842.37 |
| 96417 |
|
20 |
12 |
$820.62 |
| 86923 |
|
26 |
25 |
$811.20 |
| 83521 |
|
50 |
40 |
$779.11 |
| 91200 |
|
12 |
12 |
$757.46 |
| 83970 |
|
13 |
12 |
$741.96 |
| 84590 |
|
53 |
52 |
$731.72 |
| 72040 |
|
16 |
12 |
$728.84 |
| 43760 |
|
13 |
13 |
$723.25 |
| 91307 |
|
105 |
67 |
$634.59 |
| 92556 |
|
16 |
13 |
$633.46 |
| J2919 |
Inj, methylpred sod succ 5mg |
112 |
103 |
$596.19 |
| 84165 |
|
66 |
55 |
$579.25 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
40 |
37 |
$531.06 |
| 84403 |
|
13 |
13 |
$529.84 |
| J2250 |
Inj midazolam hydrochloride |
146 |
129 |
$527.62 |
| 88112 |
|
189 |
124 |
$527.61 |
| 17111 |
|
14 |
14 |
$500.57 |
| 84402 |
|
12 |
12 |
$476.79 |
| 87340 |
|
39 |
36 |
$474.28 |
| J3301 |
Triamcinolone acet inj nos |
46 |
46 |
$444.17 |
| 82948 |
|
70 |
68 |
$361.66 |
| 82465 |
|
38 |
37 |
$341.90 |
| 93299 |
|
78 |
75 |
$338.92 |
| 87661 |
|
13 |
13 |
$335.60 |
| 86787 |
|
15 |
15 |
$330.03 |
| 36592 |
|
13 |
12 |
$303.46 |
| 84446 |
|
12 |
12 |
$302.37 |
| 87205 |
|
54 |
51 |
$292.37 |
| J3420 |
Vitamin b12 injection |
70 |
66 |
$273.64 |
| 86705 |
|
12 |
12 |
$257.52 |
| C1887 |
Catheter, guiding |
15 |
13 |
$256.88 |
| A4216 |
Sterile water/saline, 10 ml |
14 |
13 |
$256.64 |
| C1894 |
Intro/sheath, non-laser |
15 |
13 |
$255.10 |
| 86704 |
|
12 |
12 |
$254.76 |
| 87181 |
|
27 |
27 |
$242.72 |
| 84630 |
|
26 |
25 |
$238.87 |
| 86706 |
|
12 |
12 |
$226.20 |
| J7030 |
Normal saline solution infus |
13 |
12 |
$221.13 |
| 96523 |
|
13 |
13 |
$219.78 |
| A9270 |
Non-covered item or service |
6,310 |
2,580 |
$207.87 |
| 85007 |
|
41 |
31 |
$193.31 |
| 99152 |
|
14 |
12 |
$190.08 |
| 82247 |
|
27 |
26 |
$184.27 |
| 82950 |
|
27 |
25 |
$178.54 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
22 |
12 |
$177.48 |
| J1644 |
Inj heparin sodium per 1000u |
27 |
13 |
$126.61 |
| 82310 |
|
12 |
12 |
$112.85 |
| 81511 |
|
30 |
18 |
$108.62 |
| 87184 |
|
12 |
12 |
$94.38 |
| J0610 |
Calcium glucon (fresenius) |
14 |
12 |
$74.83 |
| J2795 |
Ropivacaine hcl injection |
13 |
13 |
$73.30 |
| J3260 |
Tobramycin sulfate injection |
14 |
13 |
$62.77 |
| J0330 |
Succinycholine chloride inj |
37 |
25 |
$61.80 |
| 82043 |
|
17 |
12 |
$57.68 |
| 82550 |
|
12 |
12 |
$47.48 |
| 84153 |
|
12 |
12 |
$22.92 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
13 |
12 |
$18.45 |
| 84550 |
|
19 |
12 |
$13.86 |
| Q0244 |
Casirivi and imdevi 1200 mg |
56 |
41 |
$1.68 |
| J1642 |
Inj heparin sodium per 10 u |
151 |
72 |
$0.00 |
| 84478 |
|
26 |
25 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
35 |
33 |
$0.00 |
| J2357 |
Omalizumab injection |
15 |
12 |
$0.00 |
| Q9958 |
Hocm <=149 mg/ml iodine, 1ml |
79 |
77 |
$0.00 |
| 83006 |
|
13 |
13 |
$0.00 |
| A9577 |
Inj multihance |
18 |
13 |
$0.00 |