| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
|
51,175 |
46,790 |
$1.82M |
| Z7502 |
|
7,379 |
7,257 |
$279K |
| 70450 |
|
2,839 |
2,720 |
$264K |
| 96374 |
|
7,271 |
6,769 |
$252K |
| 93005 |
|
11,173 |
10,316 |
$206K |
| 99281 |
|
4,909 |
4,311 |
$181K |
| 80053 |
|
21,951 |
20,479 |
$164K |
| 96375 |
|
6,435 |
5,703 |
$156K |
| 99284 |
|
2,281 |
2,127 |
$147K |
| U0002 |
Covid-19 lab test non-cdc |
3,662 |
3,573 |
$136K |
| 85025 |
|
25,097 |
23,283 |
$135K |
| 99283 |
|
3,053 |
2,883 |
$130K |
| 74176 |
|
1,228 |
1,190 |
$112K |
| 74177 |
|
665 |
631 |
$106K |
| 87502 |
|
2,907 |
2,780 |
$104K |
| 87635 |
|
4,614 |
4,271 |
$97K |
| 99285 |
|
352 |
329 |
$96K |
| 71045 |
|
10,450 |
9,855 |
$95K |
| 96365 |
|
2,499 |
2,331 |
$93K |
| 96372 |
|
4,690 |
4,204 |
$74K |
| C9803 |
Hopd covid-19 spec collect |
5,250 |
4,912 |
$71K |
| G0480 |
Drug test def 1-7 classes |
1,998 |
1,784 |
$67K |
| 80307 |
|
2,190 |
2,017 |
$64K |
| 96361 |
|
3,065 |
2,776 |
$42K |
| 84484 |
|
5,312 |
4,731 |
$34K |
| 87801 |
|
1,800 |
1,719 |
$33K |
| 0250 |
|
5,642 |
4,435 |
$33K |
| 99199 |
|
1,415 |
1,302 |
$31K |
| 83690 |
|
6,952 |
6,476 |
$30K |
| 83880 |
|
2,488 |
2,306 |
$30K |
| J1885 |
Ketorolac tromethamine inj |
5,538 |
5,025 |
$24K |
| J2405 |
Ondansetron hcl injection |
4,614 |
4,145 |
$24K |
| J3490 |
Drugs unclassified injection |
4,605 |
3,552 |
$20K |
| 96376 |
|
1,361 |
1,115 |
$20K |
| 81025 |
|
5,608 |
5,263 |
$20K |
| 0760 |
|
834 |
700 |
$20K |
| 83605 |
|
2,628 |
2,385 |
$19K |
| 72125 |
|
176 |
173 |
$19K |
| 80048 |
|
3,486 |
3,140 |
$16K |
| J2270 |
Morphine sulfate injection |
2,564 |
2,172 |
$15K |
| 81001 |
|
5,975 |
5,663 |
$13K |
| 87040 |
|
1,450 |
1,214 |
$13K |
| J7030 |
Normal saline solution infus |
3,036 |
2,633 |
$12K |
| 0270 |
|
1,671 |
1,214 |
$12K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,738 |
1,638 |
$11K |
| 87088 |
|
2,796 |
2,641 |
$10K |
| 99282 |
|
574 |
559 |
$9K |
| 94640 |
|
702 |
605 |
$9K |
| 87591 |
|
599 |
577 |
$8K |
| 87491 |
|
582 |
561 |
$8K |
| 99221 |
|
446 |
381 |
$7K |
| 85610 |
|
3,061 |
2,870 |
$7K |
| 85027 |
|
1,972 |
1,782 |
$7K |
| 87651 |
|
437 |
421 |
$7K |
| 81002 |
|
3,689 |
3,486 |
$6K |
| 76705 |
|
193 |
186 |
$6K |
| J0696 |
Ceftriaxone sodium injection |
1,278 |
1,200 |
$6K |
| 96360 |
|
156 |
153 |
$5K |
| 71275 |
|
61 |
60 |
$5K |
| 85379 |
|
808 |
770 |
$4K |
| 73562 |
|
308 |
285 |
$4K |
| 85730 |
|
1,254 |
1,169 |
$4K |
| 87077 |
|
1,036 |
988 |
$4K |
| 73610 |
|
183 |
168 |
$4K |
| 73630 |
|
181 |
174 |
$3K |
| J2060 |
Lorazepam injection |
943 |
813 |
$3K |
| 76856 |
|
66 |
65 |
$3K |
| 90715 |
|
130 |
127 |
$3K |
| 73130 |
|
198 |
189 |
$2K |
| J1100 |
Dexamethasone sodium phos |
600 |
557 |
$2K |
| 93971 |
|
65 |
64 |
$2K |
| 81003 |
|
1,936 |
1,852 |
$2K |
| G0378 |
Hospital observation per hr |
19 |
12 |
$2K |
| 87186 |
|
369 |
357 |
$2K |
| J7040 |
Normal saline solution infus |
154 |
131 |
$1K |
| 82962 |
|
315 |
253 |
$1K |
| 71046 |
|
59 |
57 |
$1K |
| J1200 |
Diphenhydramine hcl injectio |
345 |
315 |
$1K |
| 0324 |
|
77 |
73 |
$1K |
| 0301 |
|
30 |
25 |
$1K |
| 83735 |
|
382 |
340 |
$980.06 |
| 96366 |
|
60 |
56 |
$977.68 |
| 90471 |
|
197 |
192 |
$973.85 |
| 84702 |
|
132 |
119 |
$895.97 |
| S0119 |
Ondansetron 4 mg |
217 |
211 |
$879.03 |
| 84703 |
|
150 |
134 |
$827.46 |
| J2001 |
Lidocaine injection |
153 |
139 |
$816.55 |
| 85007 |
|
414 |
390 |
$767.93 |
| U0003 |
Cov-19 amp prb hgh thruput |
27 |
26 |
$763.41 |
| 80329 |
|
84 |
75 |
$728.74 |
| 80320 |
|
262 |
221 |
$577.55 |
| Z7610 |
|
34 |
27 |
$573.75 |
| 86901 |
|
244 |
225 |
$569.55 |
| 86900 |
|
253 |
236 |
$535.90 |
| 87086 |
|
184 |
170 |
$462.13 |
| 73110 |
|
27 |
26 |
$422.45 |
| J2765 |
Metoclopramide hcl injection |
98 |
89 |
$401.68 |
| J2930 |
Methylprednisolone injection |
25 |
25 |
$339.09 |
| J7613 |
Albuterol non-comp unit |
66 |
58 |
$310.75 |
| 0637 |
|
377 |
288 |
$304.20 |
| 87400 |
|
137 |
130 |
$294.01 |
| J7620 |
Albuterol ipratrop non-comp |
238 |
205 |
$258.91 |
| 96368 |
|
14 |
12 |
$257.80 |
| 73030 |
|
27 |
26 |
$192.53 |
| 0272 |
|
854 |
817 |
$116.12 |
| A4649 |
Surgical supplies |
297 |
211 |
$109.26 |
| 0206 |
|
12 |
12 |
$77.54 |
| J1630 |
Haloperidol injection |
30 |
25 |
$77.27 |
| 96367 |
|
12 |
12 |
$70.03 |
| 87070 |
|
12 |
12 |
$69.36 |
| 0271 |
|
836 |
810 |
$57.62 |
| 87081 |
|
13 |
13 |
$52.17 |
| C9113 |
Inj pantoprazole sodium, via |
31 |
26 |
$19.42 |
| 86850 |
|
12 |
12 |
$18.09 |
| J2471 |
Inj pantoprazole(hikma) 40mg |
19 |
16 |
$16.55 |
| 0636 |
|
17 |
15 |
$2.26 |
| 0305 |
|
12 |
12 |
$0.00 |
| 0306 |
|
12 |
12 |
$0.00 |