| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
11,245 |
10,127 |
$4.87M |
| 99284 |
|
17,090 |
15,739 |
$4.71M |
| 99283 |
|
17,000 |
15,902 |
$4.06M |
| 74177 |
|
2,855 |
2,692 |
$2.08M |
| 74176 |
|
2,082 |
1,934 |
$982K |
| 99282 |
|
6,209 |
5,851 |
$902K |
| 70450 |
|
3,040 |
2,854 |
$436K |
| 99291 |
|
202 |
185 |
$220K |
| 71275 |
|
624 |
585 |
$153K |
| 72125 |
|
250 |
242 |
$84K |
| 96366 |
|
856 |
649 |
$35K |
| 70496 |
|
26 |
26 |
$19K |
| 96361 |
|
2,959 |
2,618 |
$13K |
| 93971 |
|
197 |
186 |
$10K |
| 80320 |
|
2,856 |
2,615 |
$9K |
| 93005 |
|
10,704 |
8,859 |
$6K |
| 80307 |
|
3,074 |
2,792 |
$5K |
| J3490 |
Drugs unclassified injection |
9,427 |
6,152 |
$5K |
| 80053 |
|
19,761 |
17,231 |
$4K |
| 96374 |
|
11,095 |
10,050 |
$4K |
| 71046 |
|
2,682 |
2,545 |
$3K |
| 96375 |
|
9,686 |
8,269 |
$3K |
| 96365 |
|
4,150 |
3,716 |
$2K |
| 71045 |
|
8,002 |
7,306 |
$2K |
| 87636 |
|
3,183 |
3,041 |
$2K |
| G0378 |
Hospital observation per hr |
197 |
108 |
$1K |
| 87631 |
|
593 |
575 |
$1K |
| 85025 |
|
21,620 |
18,917 |
$1K |
| 83690 |
|
8,326 |
7,507 |
$777.86 |
| 84484 |
|
7,531 |
5,025 |
$583.25 |
| 96372 |
|
4,634 |
4,140 |
$574.74 |
| 76705 |
|
627 |
592 |
$561.94 |
| J1885 |
Ketorolac tromethamine inj |
7,436 |
6,814 |
$440.11 |
| 94640 |
|
2,142 |
1,684 |
$395.36 |
| 96376 |
|
2,470 |
1,941 |
$383.69 |
| 84443 |
|
1,152 |
1,079 |
$381.37 |
| 73130 |
|
758 |
725 |
$370.84 |
| 87880 |
|
1,259 |
1,214 |
$333.13 |
| 81025 |
|
3,836 |
3,633 |
$330.73 |
| 12001 |
|
58 |
55 |
$292.70 |
| 96360 |
|
596 |
557 |
$285.07 |
| 87086 |
|
5,194 |
4,844 |
$275.13 |
| U0003 |
Cov-19 amp prb hgh thruput |
401 |
387 |
$275.00 |
| 81001 |
|
7,771 |
7,160 |
$272.38 |
| 84703 |
|
711 |
684 |
$267.99 |
| 73562 |
|
629 |
573 |
$266.86 |
| 73630 |
|
830 |
784 |
$248.32 |
| 87077 |
|
1,961 |
1,616 |
$241.84 |
| 80048 |
|
3,481 |
3,051 |
$229.38 |
| 72100 |
|
25 |
24 |
$221.31 |
| 87040 |
|
3,287 |
1,585 |
$212.99 |
| A9270 |
Non-covered item or service |
8,093 |
2,742 |
$162.84 |
| 73030 |
|
366 |
337 |
$159.89 |
| 83880 |
|
1,098 |
1,004 |
$147.48 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
4,740 |
4,418 |
$133.92 |
| 83735 |
|
4,099 |
3,529 |
$125.37 |
| 87651 |
|
312 |
306 |
$110.81 |
| 83605 |
|
3,833 |
2,991 |
$106.70 |
| 90715 |
|
459 |
452 |
$95.28 |
| 73610 |
|
531 |
500 |
$81.73 |
| J7030 |
Normal saline solution infus |
5,218 |
4,566 |
$76.58 |
| 82947 |
|
3,052 |
2,075 |
$65.56 |
| J8499 |
Oral prescrip drug non chemo |
11,269 |
6,809 |
$63.12 |
| 87088 |
|
3,876 |
3,470 |
$62.57 |
| J2405 |
Ondansetron hcl injection |
7,066 |
6,274 |
$53.32 |
| 87635 |
|
812 |
787 |
$51.31 |
| 84702 |
|
1,216 |
1,142 |
$49.95 |
| 87804 |
|
1,280 |
616 |
$47.88 |
| 73110 |
|
189 |
169 |
$45.69 |
| J8597 |
Antiemetic drug oral nos |
1,897 |
1,720 |
$44.97 |
| 81003 |
|
3,254 |
3,071 |
$44.22 |
| J2270 |
Morphine sulfate injection |
3,822 |
3,227 |
$43.02 |
| 85610 |
|
2,715 |
2,437 |
$34.73 |
| 82803 |
|
96 |
83 |
$33.98 |
| 82550 |
|
974 |
858 |
$32.97 |
| 87186 |
|
1,501 |
1,313 |
$31.15 |
| 87081 |
|
295 |
283 |
$29.23 |
| J3010 |
Fentanyl citrate injection |
920 |
778 |
$27.24 |
| J1100 |
Dexamethasone sodium phos |
1,278 |
1,199 |
$25.96 |
| J1790 |
Droperidol injection |
577 |
522 |
$25.32 |
| J1200 |
Diphenhydramine hcl injectio |
2,341 |
2,086 |
$15.95 |
| J3475 |
Inj magnesium sulfate |
486 |
433 |
$12.61 |
| J0696 |
Ceftriaxone sodium injection |
2,246 |
1,983 |
$12.49 |
| 86850 |
|
71 |
68 |
$11.85 |
| J2930 |
Methylprednisolone injection |
610 |
529 |
$10.55 |
| 90471 |
|
531 |
511 |
$8.92 |
| J2765 |
Metoclopramide hcl injection |
761 |
691 |
$7.58 |
| J2919 |
Inj, methylpred sod succ 5mg |
61 |
51 |
$7.50 |
| 85379 |
|
383 |
358 |
$7.33 |
| J7120 |
Ringers lactate infusion |
890 |
835 |
$6.93 |
| 85730 |
|
698 |
639 |
$6.67 |
| J8540 |
Oral dexamethasone |
460 |
377 |
$5.84 |
| J2060 |
Lorazepam injection |
1,103 |
953 |
$5.82 |
| 86901 |
|
333 |
308 |
$5.29 |
| 86900 |
|
173 |
159 |
$5.22 |
| J2250 |
Inj midazolam hydrochloride |
32 |
25 |
$4.90 |
| 86140 |
|
478 |
424 |
$4.60 |
| J7512 |
Prednisone ir or dr oral 1mg |
591 |
549 |
$1.80 |
| 93976 |
|
309 |
293 |
$0.00 |
| 96367 |
|
377 |
334 |
$0.00 |
| 84100 |
|
149 |
127 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
52 |
41 |
$0.00 |
| S0028 |
Injection, famotidine, 20 mg |
69 |
63 |
$0.00 |
| 87491 |
|
93 |
90 |
$0.00 |
| 76856 |
|
27 |
26 |
$0.00 |
| 74018 |
|
64 |
63 |
$0.00 |
| J2550 |
Promethazine hcl injection |
156 |
138 |
$0.00 |
| J0780 |
Prochlorperazine injection |
41 |
41 |
$0.00 |
| 85055 |
|
32 |
26 |
$0.00 |
| 73080 |
|
13 |
12 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
12 |
12 |
$0.00 |
| 87210 |
|
26 |
25 |
$0.00 |
| J3370 |
Vancomycin hcl injection |
13 |
12 |
$0.00 |
| 82010 |
|
16 |
14 |
$0.00 |
| J7040 |
Normal saline solution infus |
140 |
136 |
$0.00 |
| 51702 |
|
15 |
13 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
37 |
28 |
$0.00 |
| J1630 |
Haloperidol injection |
108 |
92 |
$0.00 |
| 87807 |
|
28 |
28 |
$0.00 |
| 85027 |
|
470 |
395 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
64 |
59 |
$0.00 |
| 80329 |
|
356 |
326 |
$0.00 |
| J7999 |
Compounded drug, noc |
496 |
337 |
$0.00 |
| J3480 |
Inj potassium chloride |
158 |
117 |
$0.00 |
| 73502 |
|
16 |
12 |
$0.00 |
| J1815 |
Insulin injection |
59 |
40 |
$0.00 |
| 70498 |
|
26 |
26 |
$0.00 |
| 87591 |
|
93 |
90 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
16 |
12 |
$0.00 |
| J1170 |
Hydromorphone injection |
45 |
37 |
$0.00 |
| U0005 |
Infec agen detec ampli probe |
90 |
88 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
17 |
17 |
$0.00 |