| Code | Description | Claims | Beneficiaries | Total Paid |
| 0360 |
|
1,086 |
661 |
$2.15M |
| 93306 |
|
1,570 |
1,499 |
$1.28M |
| 78815 |
|
1,008 |
978 |
$1.16M |
| 70553 |
|
1,010 |
960 |
$1.00M |
| G0463 |
Hospital outpt clinic visit |
34,690 |
28,833 |
$828K |
| 74177 |
|
826 |
790 |
$705K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
3,256 |
2,368 |
$511K |
| 71260 |
|
1,172 |
1,125 |
$493K |
| 96365 |
|
2,698 |
1,791 |
$441K |
| 80053 |
|
8,483 |
6,936 |
$403K |
| 0710 |
|
1,312 |
1,239 |
$369K |
| 96375 |
|
1,742 |
1,132 |
$329K |
| 74178 |
|
281 |
262 |
$322K |
| 93017 |
|
810 |
759 |
$309K |
| 71250 |
|
852 |
818 |
$303K |
| 0510 |
|
9,119 |
8,065 |
$271K |
| J1200 |
Diphenhydramine hcl injectio |
868 |
618 |
$262K |
| 0272 |
|
3,086 |
2,606 |
$236K |
| 78452 |
|
466 |
437 |
$224K |
| 0761 |
|
2,642 |
2,313 |
$219K |
| 74176 |
|
232 |
213 |
$211K |
| A9577 |
Inj multihance |
1,759 |
1,676 |
$198K |
| 96413 |
|
1,917 |
1,348 |
$197K |
| 0270 |
|
3,849 |
3,298 |
$192K |
| 0250 |
|
6,023 |
5,026 |
$190K |
| J0178 |
Aflibercept injection |
115 |
111 |
$174K |
| 86850 |
|
2,885 |
2,657 |
$174K |
| J3490 |
Drugs unclassified injection |
1,285 |
963 |
$171K |
| 74183 |
|
189 |
182 |
$152K |
| 93975 |
|
595 |
563 |
$148K |
| 71046 |
|
1,883 |
1,726 |
$141K |
| 93005 |
|
2,859 |
2,642 |
$124K |
| 74174 |
|
198 |
193 |
$124K |
| 88305 |
|
1,487 |
1,404 |
$124K |
| 83735 |
|
5,028 |
3,320 |
$123K |
| 99281 |
|
344 |
300 |
$119K |
| J0585 |
Injection,onabotulinumtoxina |
353 |
218 |
$117K |
| 80197 |
|
3,566 |
2,283 |
$117K |
| 99199 |
|
417 |
353 |
$116K |
| J0897 |
Denosumab injection |
202 |
189 |
$116K |
| Q3014 |
Telehealth facility fee |
7,267 |
6,457 |
$115K |
| C8929 |
Tte w or wo fol wcon,doppler |
178 |
175 |
$115K |
| 86920 |
|
521 |
478 |
$113K |
| 0450 |
|
985 |
903 |
$109K |
| 76700 |
|
277 |
259 |
$101K |
| 36415 |
|
9,289 |
7,464 |
$92K |
| 92134 |
|
2,161 |
2,050 |
$91K |
| 67028 |
|
574 |
526 |
$88K |
| 99070 |
|
326 |
202 |
$87K |
| 80048 |
|
1,955 |
1,636 |
$87K |
| J1569 |
Gammagard liquid injection |
83 |
50 |
$85K |
| J2785 |
Regadenoson injection |
288 |
277 |
$85K |
| 93325 |
|
355 |
336 |
$78K |
| 86900 |
|
2,868 |
2,670 |
$77K |
| A0429 |
Bls-emergency |
475 |
294 |
$77K |
| 82962 |
|
2,393 |
1,941 |
$76K |
| 87635 |
|
1,830 |
1,602 |
$75K |
| 0370 |
|
1,091 |
1,021 |
$72K |
| 94010 |
|
811 |
738 |
$69K |
| 85610 |
|
3,899 |
3,341 |
$67K |
| 72148 |
|
123 |
119 |
$67K |
| J2704 |
Inj, propofol, 10 mg |
2,506 |
1,873 |
$66K |
| 86901 |
|
3,365 |
3,089 |
$64K |
| 96415 |
|
806 |
630 |
$64K |
| Q9957 |
Inj perflutren lip micros,ml |
368 |
357 |
$64K |
| 85025 |
|
9,760 |
7,261 |
$63K |
| A4217 |
Sterile water/saline, 500 ml |
734 |
704 |
$62K |
| A9552 |
F18 fdg |
750 |
733 |
$59K |
| 96366 |
|
813 |
434 |
$57K |
| 96374 |
|
310 |
277 |
$56K |
| J7050 |
Normal saline solution infus |
3,284 |
2,451 |
$55K |
| C9399 |
Unclassified drugs or biolog |
112 |
106 |
$55K |
| 92083 |
|
912 |
883 |
$55K |
| 80069 |
|
1,344 |
782 |
$55K |
| 81376 |
|
392 |
344 |
$51K |
| A9502 |
Tc99m tetrofosmin |
173 |
163 |
$51K |
| 81001 |
|
3,454 |
2,659 |
$51K |
| 96372 |
|
1,593 |
1,291 |
$50K |
| 87497 |
|
975 |
720 |
$50K |
| 94618 |
|
253 |
243 |
$47K |
| J2405 |
Ondansetron hcl injection |
1,754 |
1,468 |
$43K |
| 70450 |
|
98 |
94 |
$43K |
| 83036 |
|
3,096 |
2,863 |
$42K |
| 72197 |
|
57 |
55 |
$41K |
| 93320 |
|
125 |
123 |
$39K |
| U0003 |
Cov-19 amp prb hgh thruput |
567 |
525 |
$37K |
| 81373 |
|
432 |
365 |
$37K |
| 73030 |
|
392 |
368 |
$36K |
| 71045 |
|
902 |
805 |
$36K |
| 86833 |
|
745 |
683 |
$36K |
| 99212 |
|
1,625 |
1,522 |
$35K |
| 86832 |
|
745 |
683 |
$34K |
| 84100 |
|
2,899 |
2,036 |
$33K |
| A9270 |
Non-covered item or service |
3,092 |
2,163 |
$32K |
| 86807 |
|
623 |
575 |
$31K |
| J7060 |
5% dextrose/water |
799 |
536 |
$29K |
| 43239 |
|
83 |
82 |
$28K |
| P9011 |
Blood split unit |
343 |
306 |
$27K |
| 73562 |
|
351 |
345 |
$26K |
| 96367 |
|
267 |
203 |
$26K |
| 0760 |
|
727 |
617 |
$25K |
| 81375 |
|
423 |
372 |
$24K |
| 85730 |
|
2,313 |
2,109 |
$23K |
| 73502 |
|
310 |
305 |
$23K |
| 94729 |
|
176 |
165 |
$23K |
| 93880 |
|
82 |
79 |
$23K |
| 92133 |
|
460 |
448 |
$22K |
| 87798 |
|
808 |
698 |
$21K |
| 73630 |
|
242 |
215 |
$21K |
| 92557 |
|
316 |
306 |
$20K |
| 87070 |
|
492 |
462 |
$19K |
| 86481 |
|
156 |
143 |
$19K |
| J7030 |
Normal saline solution infus |
881 |
710 |
$19K |
| 80061 |
|
1,037 |
985 |
$19K |
| 87081 |
|
1,817 |
1,702 |
$19K |
| 97110 |
|
190 |
76 |
$18K |
| 72100 |
|
262 |
251 |
$18K |
| 70551 |
|
44 |
44 |
$18K |
| 94726 |
|
154 |
144 |
$18K |
| 85027 |
|
3,078 |
2,549 |
$16K |
| 83880 |
|
568 |
529 |
$16K |
| 82306 |
|
908 |
885 |
$16K |
| 84443 |
|
1,247 |
1,192 |
$16K |
| 73564 |
|
187 |
182 |
$16K |
| 71275 |
|
27 |
26 |
$16K |
| J3010 |
Fentanyl citrate injection |
2,539 |
2,371 |
$15K |
| 87633 |
|
41 |
39 |
$14K |
| 73560 |
|
140 |
134 |
$13K |
| 86140 |
|
995 |
925 |
$13K |
| 88342 |
|
88 |
83 |
$13K |
| Z7500 |
|
394 |
351 |
$13K |
| 31231 |
|
150 |
142 |
$13K |
| 82565 |
|
1,763 |
1,609 |
$13K |
| 87186 |
|
306 |
289 |
$13K |
| 86480 |
|
130 |
118 |
$13K |
| 99214 |
|
452 |
436 |
$12K |
| 96361 |
|
231 |
191 |
$12K |
| 45380 |
|
14 |
13 |
$12K |
| 84156 |
|
679 |
481 |
$11K |
| 81025 |
|
684 |
629 |
$11K |
| 97597 |
|
354 |
82 |
$11K |
| 74230 |
|
106 |
103 |
$11K |
| 87086 |
|
762 |
715 |
$11K |
| J1100 |
Dexamethasone sodium phos |
1,469 |
1,206 |
$11K |
| 87205 |
|
451 |
422 |
$11K |
| 0271 |
|
648 |
615 |
$11K |
| 93970 |
|
43 |
39 |
$11K |
| J0690 |
Cefazolin sodium injection |
1,003 |
841 |
$10K |
| 86592 |
|
293 |
268 |
$10K |
| 94060 |
|
44 |
42 |
$9K |
| J1170 |
Hydromorphone injection |
460 |
369 |
$9K |
| 92504 |
|
282 |
273 |
$9K |
| 87077 |
|
613 |
582 |
$9K |
| J7120 |
Ringers lactate infusion |
186 |
154 |
$7K |
| 82570 |
|
962 |
722 |
$7K |
| J7040 |
Normal saline solution infus |
257 |
194 |
$7K |
| 93922 |
|
81 |
79 |
$7K |
| G0378 |
Hospital observation per hr |
201 |
190 |
$7K |
| 97140 |
|
183 |
64 |
$7K |
| 31575 |
|
94 |
89 |
$6K |
| J1644 |
Inj heparin sodium per 1000u |
550 |
427 |
$6K |
| 86317 |
|
271 |
242 |
$6K |
| 72110 |
|
60 |
58 |
$5K |
| J3590 |
Unclassified biologics |
59 |
58 |
$5K |
| 99213 |
|
233 |
208 |
$5K |
| 31579 |
|
25 |
24 |
$5K |
| 87040 |
|
44 |
37 |
$5K |
| 83970 |
|
142 |
136 |
$5K |
| J2270 |
Morphine sulfate injection |
330 |
233 |
$5K |
| 87340 |
|
244 |
226 |
$4K |
| 87389 |
|
100 |
88 |
$4K |
| 72050 |
|
14 |
12 |
$4K |
| 72141 |
|
13 |
13 |
$4K |
| 84439 |
|
328 |
323 |
$4K |
| C1760 |
Closure dev, vasc |
24 |
24 |
$4K |
| 83540 |
|
386 |
372 |
$4K |
| 83550 |
|
371 |
357 |
$4K |
| 83605 |
|
165 |
140 |
$4K |
| 83690 |
|
191 |
167 |
$3K |
| 86704 |
|
198 |
173 |
$3K |
| J2250 |
Inj midazolam hydrochloride |
1,964 |
1,723 |
$3K |
| 82728 |
|
236 |
221 |
$3K |
| 73522 |
|
24 |
24 |
$3K |
| 86803 |
|
122 |
108 |
$3K |
| 83615 |
|
203 |
168 |
$3K |
| 72170 |
|
40 |
40 |
$3K |
| 73610 |
|
33 |
30 |
$3K |
| J0131 |
Inj, acetaminophen (nos) |
75 |
53 |
$2K |
| 74241 |
|
25 |
24 |
$2K |
| 82550 |
|
66 |
53 |
$2K |
| 87150 |
|
71 |
59 |
$2K |
| J3420 |
Vitamin b12 injection |
242 |
213 |
$2K |
| 82607 |
|
228 |
222 |
$2K |
| 20610 |
|
120 |
101 |
$2K |
| J1885 |
Ketorolac tromethamine inj |
349 |
270 |
$2K |
| 87210 |
|
109 |
103 |
$2K |
| 85651 |
|
242 |
232 |
$2K |
| 96360 |
|
29 |
25 |
$2K |
| 87102 |
|
108 |
102 |
$2K |
| 82105 |
|
161 |
153 |
$2K |
| J1642 |
Inj heparin sodium per 10 u |
471 |
304 |
$2K |
| 80307 |
|
43 |
40 |
$2K |
| 92526 |
|
71 |
25 |
$2K |
| 83037 |
|
79 |
78 |
$2K |
| 93971 |
|
14 |
13 |
$1K |
| J1626 |
Granisetron hcl injection |
47 |
30 |
$1K |
| 96417 |
|
72 |
54 |
$1K |
| 84484 |
|
65 |
51 |
$1K |
| 88304 |
|
27 |
25 |
$1K |
| 86635 |
|
106 |
91 |
$1K |
| 92136 |
|
27 |
27 |
$1K |
| 87502 |
|
14 |
14 |
$1K |
| 72040 |
|
19 |
18 |
$1K |
| 90662 |
|
138 |
137 |
$1K |
| 93926 |
|
14 |
12 |
$1K |
| 86665 |
|
145 |
126 |
$1K |
| G0008 |
Admin influenza virus vac |
261 |
253 |
$1K |
| 0255 |
|
85 |
84 |
$1K |
| 81003 |
|
212 |
189 |
$1K |
| 80047 |
|
347 |
229 |
$1K |
| 77080 |
|
15 |
12 |
$1K |
| 76512 |
|
12 |
12 |
$964.56 |
| 86828 |
|
17 |
17 |
$963.47 |
| 82803 |
|
13 |
13 |
$920.34 |
| 84153 |
|
39 |
34 |
$879.18 |
| 92250 |
|
40 |
39 |
$857.52 |
| 90686 |
|
107 |
102 |
$740.09 |
| 92550 |
|
41 |
31 |
$718.66 |
| 92285 |
|
28 |
27 |
$712.44 |
| 86644 |
|
161 |
142 |
$634.52 |
| 94640 |
|
22 |
13 |
$604.64 |
| 87116 |
|
101 |
90 |
$478.74 |
| 92567 |
|
32 |
29 |
$474.86 |
| 86645 |
|
113 |
101 |
$461.41 |
| 87799 |
|
34 |
26 |
$438.63 |
| J2765 |
Metoclopramide hcl injection |
23 |
12 |
$414.64 |
| 80180 |
|
37 |
26 |
$388.79 |
| J0330 |
Succinycholine chloride inj |
60 |
54 |
$381.27 |
| 86235 |
|
13 |
13 |
$348.22 |
| J2370 |
Phenylephrine hcl injection |
92 |
85 |
$347.37 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
17 |
13 |
$335.78 |
| 82330 |
|
47 |
28 |
$272.64 |
| 0637 |
|
192 |
158 |
$270.88 |
| 86431 |
|
30 |
30 |
$240.15 |
| 85652 |
|
159 |
157 |
$239.70 |
| 82947 |
|
73 |
41 |
$226.06 |
| 84152 |
|
14 |
14 |
$208.54 |
| 87015 |
|
52 |
49 |
$207.43 |
| 87206 |
|
83 |
77 |
$174.61 |
| 86160 |
|
12 |
12 |
$165.96 |
| 82043 |
|
61 |
55 |
$162.71 |
| U0005 |
Infec agen detec ampli probe |
16 |
16 |
$161.62 |
| 69210 |
|
17 |
16 |
$151.55 |
| G0009 |
Admin pneumococcal vaccine |
13 |
12 |
$145.29 |
| 86039 |
|
74 |
64 |
$135.51 |
| 94760 |
|
14 |
13 |
$127.81 |
| C1769 |
Guide wire |
15 |
14 |
$116.45 |
| 76514 |
|
13 |
12 |
$113.54 |
| 84132 |
|
64 |
40 |
$107.73 |
| 84550 |
|
15 |
14 |
$88.12 |
| 84295 |
|
47 |
28 |
$76.08 |
| 82435 |
|
47 |
28 |
$74.59 |
| 0300 |
|
292 |
52 |
$60.00 |
| 86849 |
|
19 |
19 |
$55.50 |
| 82746 |
|
12 |
12 |
$24.06 |
| 87275 |
|
14 |
14 |
$9.35 |
| 87276 |
|
14 |
14 |
$7.70 |
| 0260 |
|
25 |
13 |
$0.00 |
| G8990 |
Other pt/ot current status |
32 |
27 |
$0.00 |
| 0320 |
|
16 |
15 |
$0.00 |
| 0636 |
|
70 |
21 |
$0.00 |
| G8991 |
Other pt/ot goal status |
34 |
29 |
$0.00 |