| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
5,870 |
5,419 |
$2.23M |
| 99284 |
|
10,843 |
9,926 |
$1.84M |
| 99283 |
|
7,099 |
6,657 |
$1.37M |
| 74177 |
|
2,309 |
2,223 |
$1.27M |
| 74176 |
|
1,962 |
1,833 |
$620K |
| 70450 |
|
2,489 |
2,355 |
$353K |
| 71275 |
|
996 |
953 |
$158K |
| 99282 |
|
1,333 |
1,276 |
$140K |
| 72125 |
|
374 |
364 |
$96K |
| G0378 |
Hospital observation per hr |
2,609 |
1,270 |
$91K |
| 49083 |
|
69 |
25 |
$37K |
| 88305 |
|
567 |
382 |
$25K |
| 93971 |
|
316 |
299 |
$16K |
| 99203 |
|
113 |
111 |
$12K |
| 96365 |
|
2,600 |
2,390 |
$8K |
| 96374 |
|
8,604 |
7,746 |
$6K |
| 96366 |
|
183 |
149 |
$6K |
| 76705 |
|
534 |
503 |
$5K |
| 96376 |
|
2,230 |
1,480 |
$5K |
| 80053 |
|
15,320 |
13,285 |
$4K |
| U0003 |
Cov-19 amp prb hgh thruput |
747 |
715 |
$4K |
| 93306 |
|
13 |
12 |
$4K |
| 43235 |
|
12 |
12 |
$3K |
| 80320 |
|
1,715 |
1,606 |
$3K |
| 99213 |
|
32 |
25 |
$3K |
| 43239 |
|
31 |
27 |
$2K |
| 93005 |
|
6,782 |
5,797 |
$2K |
| 96361 |
|
1,953 |
1,802 |
$2K |
| 96375 |
|
7,614 |
6,349 |
$2K |
| 96372 |
|
2,078 |
1,643 |
$627.04 |
| 70486 |
|
12 |
12 |
$583.01 |
| 71045 |
|
5,730 |
5,327 |
$542.68 |
| 85025 |
|
16,197 |
13,802 |
$524.94 |
| J3490 |
Drugs unclassified injection |
11,587 |
5,750 |
$523.80 |
| 96360 |
|
483 |
466 |
$438.02 |
| 71250 |
|
34 |
30 |
$336.61 |
| 84484 |
|
5,415 |
3,607 |
$330.72 |
| 87636 |
|
1,994 |
1,927 |
$275.62 |
| 80048 |
|
2,548 |
1,985 |
$271.18 |
| 76856 |
|
155 |
147 |
$257.76 |
| 71046 |
|
1,239 |
1,201 |
$256.44 |
| 87631 |
|
862 |
829 |
$252.71 |
| 80307 |
|
1,658 |
1,490 |
$228.04 |
| 93976 |
|
400 |
361 |
$221.93 |
| 73562 |
|
246 |
226 |
$218.03 |
| 83690 |
|
7,289 |
6,587 |
$185.63 |
| J7030 |
Normal saline solution infus |
7,682 |
6,709 |
$148.86 |
| 85379 |
|
800 |
771 |
$147.07 |
| 87086 |
|
2,761 |
2,563 |
$131.47 |
| 81025 |
|
1,749 |
1,667 |
$127.16 |
| 84703 |
|
2,386 |
2,254 |
$120.86 |
| 84702 |
|
2,015 |
1,883 |
$117.93 |
| 83735 |
|
4,008 |
3,631 |
$107.16 |
| J8499 |
Oral prescrip drug non chemo |
14,995 |
6,690 |
$104.02 |
| 74018 |
|
182 |
178 |
$84.44 |
| J1885 |
Ketorolac tromethamine inj |
4,832 |
4,301 |
$69.87 |
| 82947 |
|
5,108 |
3,237 |
$67.44 |
| J2405 |
Ondansetron hcl injection |
6,833 |
5,681 |
$62.94 |
| 83880 |
|
1,289 |
1,210 |
$60.30 |
| 84443 |
|
1,161 |
1,108 |
$56.77 |
| 87186 |
|
674 |
607 |
$54.88 |
| J2270 |
Morphine sulfate injection |
3,762 |
3,007 |
$54.75 |
| 87651 |
|
272 |
267 |
$53.39 |
| 87635 |
|
840 |
812 |
$52.59 |
| U0005 |
Infec agen detec ampli probe |
636 |
610 |
$50.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
4,019 |
3,792 |
$48.87 |
| 87088 |
|
2,218 |
1,965 |
$46.34 |
| 81001 |
|
5,716 |
5,218 |
$44.40 |
| 85027 |
|
1,465 |
1,115 |
$41.81 |
| J3010 |
Fentanyl citrate injection |
2,085 |
1,810 |
$37.62 |
| 90715 |
|
17 |
17 |
$36.76 |
| 87077 |
|
975 |
832 |
$35.03 |
| 82550 |
|
1,419 |
1,328 |
$35.03 |
| 81003 |
|
2,762 |
2,603 |
$32.95 |
| 83605 |
|
2,811 |
2,227 |
$30.63 |
| 85610 |
|
3,083 |
2,788 |
$30.27 |
| 87880 |
|
355 |
351 |
$24.56 |
| J0696 |
Ceftriaxone sodium injection |
1,599 |
1,309 |
$24.06 |
| 87040 |
|
2,099 |
1,023 |
$21.40 |
| 86850 |
|
717 |
655 |
$20.88 |
| 85730 |
|
206 |
194 |
$19.62 |
| 94640 |
|
608 |
524 |
$14.53 |
| J1170 |
Hydromorphone injection |
767 |
584 |
$12.90 |
| J1100 |
Dexamethasone sodium phos |
1,513 |
1,418 |
$12.38 |
| 87081 |
|
117 |
116 |
$12.20 |
| J1200 |
Diphenhydramine hcl injectio |
1,266 |
1,126 |
$12.16 |
| J7040 |
Normal saline solution infus |
395 |
374 |
$11.66 |
| J2060 |
Lorazepam injection |
884 |
749 |
$11.16 |
| C9113 |
Inj pantoprazole sodium, via |
447 |
356 |
$10.41 |
| J2930 |
Methylprednisolone injection |
55 |
52 |
$9.95 |
| 86901 |
|
952 |
879 |
$9.84 |
| 86900 |
|
759 |
706 |
$9.52 |
| 86140 |
|
558 |
526 |
$9.35 |
| J2704 |
Inj, propofol, 10 mg |
1,573 |
1,441 |
$7.26 |
| J2765 |
Metoclopramide hcl injection |
792 |
746 |
$6.50 |
| J0690 |
Cefazolin sodium injection |
385 |
305 |
$5.92 |
| J2001 |
Lidocaine injection |
823 |
731 |
$4.76 |
| 90471 |
|
16 |
16 |
$4.46 |
| J1790 |
Droperidol injection |
365 |
348 |
$3.46 |
| J1815 |
Insulin injection |
542 |
293 |
$1.20 |
| S0028 |
Injection, famotidine, 20 mg |
351 |
307 |
$0.00 |
| 87075 |
|
85 |
40 |
$0.00 |
| J7120 |
Ringers lactate infusion |
1,052 |
936 |
$0.00 |
| 85055 |
|
84 |
63 |
$0.00 |
| 84145 |
|
225 |
212 |
$0.00 |
| 72100 |
|
13 |
12 |
$0.00 |
| 73630 |
|
208 |
190 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
368 |
358 |
$0.00 |
| 73610 |
|
119 |
111 |
$0.00 |
| 73030 |
|
55 |
50 |
$0.00 |
| 96367 |
|
45 |
42 |
$0.00 |
| J2550 |
Promethazine hcl injection |
212 |
182 |
$0.00 |
| 82805 |
|
14 |
12 |
$0.00 |
| 84100 |
|
68 |
61 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
54 |
32 |
$0.00 |
| 82010 |
|
30 |
29 |
$0.00 |
| 89051 |
|
31 |
13 |
$0.00 |
| J1650 |
Inj enoxaparin sodium |
22 |
14 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
28 |
17 |
$0.00 |
| J3370 |
Vancomycin hcl injection |
18 |
13 |
$0.00 |
| 87491 |
|
12 |
12 |
$0.00 |
| J0780 |
Prochlorperazine injection |
14 |
13 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
15 |
13 |
$0.00 |
| A9270 |
Non-covered item or service |
6,840 |
1,202 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
80 |
76 |
$0.00 |
| 87205 |
|
210 |
109 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
1,210 |
1,125 |
$0.00 |
| J3360 |
Diazepam injection |
38 |
38 |
$0.00 |
| J8597 |
Antiemetic drug oral nos |
186 |
169 |
$0.00 |
| 87070 |
|
205 |
107 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
51 |
41 |
$0.00 |
| C1769 |
Guide wire |
15 |
13 |
$0.00 |
| 82270 |
|
12 |
12 |
$0.00 |
| 94760 |
|
151 |
71 |
$0.00 |
| J2175 |
Meperidine hydrochl /100 mg |
73 |
65 |
$0.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
71 |
66 |
$0.00 |
| 83036 |
|
26 |
25 |
$0.00 |
| 76801 |
|
82 |
70 |
$0.00 |
| 87591 |
|
12 |
12 |
$0.00 |
| J2360 |
Orphenadrine injection |
27 |
25 |
$0.00 |
| 88342 |
|
20 |
12 |
$0.00 |
| 76815 |
|
12 |
12 |
$0.00 |
| 84132 |
|
15 |
13 |
$0.00 |
| 76817 |
|
14 |
13 |
$0.00 |
| J0360 |
Hydralazine hcl injection |
18 |
14 |
$0.00 |