| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
63,781 |
60,919 |
$15.03M |
| 99283 |
|
56,467 |
54,531 |
$8.35M |
| 99285 |
|
21,691 |
20,508 |
$7.23M |
| 96374 |
|
32,811 |
31,284 |
$4.25M |
| G0463 |
Hospital outpt clinic visit |
18,485 |
14,735 |
$1.34M |
| 71046 |
|
17,516 |
16,662 |
$900K |
| 96361 |
|
15,592 |
14,109 |
$804K |
| 96375 |
|
18,635 |
17,304 |
$681K |
| 97110 |
|
15,571 |
3,845 |
$617K |
| 92507 |
|
15,129 |
4,320 |
$611K |
| 71045 |
|
7,215 |
6,762 |
$385K |
| 93010 |
|
52,735 |
44,804 |
$383K |
| 87635 |
|
8,837 |
8,454 |
$369K |
| 74177 |
|
1,373 |
1,324 |
$355K |
| 97530 |
|
10,797 |
3,390 |
$340K |
| 97597 |
|
7,229 |
2,414 |
$339K |
| 99282 |
|
3,671 |
3,584 |
$304K |
| 77067 |
|
3,500 |
3,448 |
$303K |
| J0585 |
Injection,onabotulinumtoxina |
551 |
380 |
$284K |
| 59025 |
|
1,976 |
1,598 |
$267K |
| 70450 |
|
2,883 |
2,735 |
$264K |
| 77063 |
|
3,487 |
3,436 |
$134K |
| 96413 |
|
717 |
353 |
$126K |
| 64615 |
|
459 |
416 |
$78K |
| 99214 |
|
1,605 |
1,387 |
$54K |
| 62323 |
|
103 |
99 |
$40K |
| M0243 |
Casirivi and imdevi inj |
99 |
93 |
$39K |
| 93306 |
|
84 |
83 |
$35K |
| 95912 |
|
118 |
105 |
$34K |
| 96367 |
|
258 |
116 |
$32K |
| 96365 |
|
223 |
205 |
$28K |
| 96360 |
|
183 |
172 |
$26K |
| 97140 |
|
1,074 |
338 |
$23K |
| 93005 |
|
28,884 |
26,548 |
$18K |
| 80053 |
|
66,326 |
62,395 |
$18K |
| 36415 |
|
11,389 |
9,462 |
$17K |
| 87811 |
|
543 |
524 |
$17K |
| M0245 |
Bamlan and etesev infusion |
41 |
40 |
$17K |
| 85025 |
|
70,034 |
65,455 |
$14K |
| 20611 |
|
61 |
52 |
$12K |
| 87536 |
|
182 |
162 |
$10K |
| 99213 |
|
773 |
605 |
$10K |
| G0379 |
Direct refer hospital observ |
462 |
366 |
$10K |
| 64493 |
|
16 |
15 |
$10K |
| 97803 |
|
512 |
493 |
$9K |
| 97112 |
|
818 |
191 |
$8K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
2,662 |
2,529 |
$6K |
| 87491 |
|
277 |
266 |
$6K |
| 87591 |
|
277 |
266 |
$5K |
| J1885 |
Ketorolac tromethamine inj |
16,001 |
15,314 |
$5K |
| 83605 |
|
21,600 |
19,338 |
$4K |
| J2405 |
Ondansetron hcl injection |
8,671 |
8,245 |
$4K |
| 86360 |
|
119 |
106 |
$4K |
| 83690 |
|
24,649 |
23,559 |
$3K |
| 87400 |
|
12,571 |
6,028 |
$3K |
| M0247 |
Sotrovimab infusion |
13 |
12 |
$3K |
| G0378 |
Hospital observation per hr |
833 |
563 |
$3K |
| 71275 |
|
25 |
24 |
$3K |
| 81003 |
|
12,890 |
12,372 |
$2K |
| 86738 |
|
2,150 |
2,016 |
$2K |
| 11042 |
|
20 |
12 |
$2K |
| 97161 |
|
32 |
32 |
$2K |
| 99281 |
|
41 |
40 |
$2K |
| 96372 |
|
12,327 |
11,526 |
$2K |
| 80307 |
|
7,888 |
7,179 |
$2K |
| 96366 |
|
56 |
24 |
$2K |
| 97802 |
|
137 |
128 |
$2K |
| J2270 |
Morphine sulfate injection |
2,824 |
2,299 |
$2K |
| 97162 |
|
23 |
23 |
$2K |
| 87804 |
|
9,507 |
4,649 |
$1K |
| 83735 |
|
19,981 |
18,888 |
$1K |
| 76705 |
|
18 |
16 |
$1K |
| 83655 |
|
96 |
83 |
$1K |
| 87522 |
Neg quan hep c or qual rna |
25 |
25 |
$1K |
| 81025 |
|
10,864 |
10,528 |
$999.82 |
| 80061 |
|
104 |
96 |
$934.99 |
| 76642 |
|
12 |
12 |
$890.78 |
| 97165 |
|
14 |
13 |
$802.77 |
| 87880 |
|
5,643 |
5,403 |
$671.30 |
| 99204 |
|
12 |
12 |
$670.53 |
| 87502 |
|
276 |
270 |
$669.06 |
| 95886 |
|
995 |
850 |
$618.16 |
| 81001 |
|
25,572 |
24,478 |
$571.70 |
| 84484 |
|
18,614 |
14,604 |
$505.59 |
| 86592 |
|
161 |
146 |
$482.17 |
| 97598 |
|
46 |
25 |
$480.54 |
| J1040 |
Methylprednisolone 80 mg inj |
280 |
267 |
$447.30 |
| J2360 |
Orphenadrine injection |
447 |
422 |
$416.33 |
| C9803 |
Hopd covid-19 spec collect |
9,105 |
8,675 |
$374.12 |
| 87081 |
|
4,300 |
4,175 |
$307.97 |
| J2469 |
Palonosetron hcl |
26 |
12 |
$291.14 |
| 87086 |
|
3,666 |
3,493 |
$236.41 |
| 86361 |
|
13 |
12 |
$221.85 |
| 94640 |
|
505 |
464 |
$217.08 |
| 80048 |
|
1,843 |
1,700 |
$214.46 |
| J0696 |
Ceftriaxone sodium injection |
136 |
126 |
$213.59 |
| J2795 |
Ropivacaine hcl injection |
14 |
12 |
$208.02 |
| 72100 |
|
16 |
13 |
$199.24 |
| 84443 |
|
136 |
124 |
$176.81 |
| 85610 |
|
2,423 |
2,283 |
$172.91 |
| 90471 |
|
42 |
36 |
$170.69 |
| J1030 |
Methylprednisolone 40 mg inj |
45 |
43 |
$161.08 |
| 87420 |
|
871 |
852 |
$159.23 |
| 86803 |
|
15 |
13 |
$156.96 |
| J1100 |
Dexamethasone sodium phos |
262 |
233 |
$152.09 |
| J2765 |
Metoclopramide hcl injection |
438 |
421 |
$137.13 |
| 85018 |
|
59 |
51 |
$133.68 |
| 82803 |
|
2,077 |
1,909 |
$112.80 |
| 86900 |
|
51 |
49 |
$108.23 |
| 72125 |
|
14 |
14 |
$99.62 |
| J1200 |
Diphenhydramine hcl injectio |
301 |
286 |
$92.17 |
| 83036 |
|
17 |
17 |
$78.84 |
| J1790 |
Droperidol injection |
79 |
76 |
$77.42 |
| 83880 |
|
418 |
394 |
$74.88 |
| 82550 |
|
882 |
819 |
$66.87 |
| 84100 |
|
257 |
203 |
$50.91 |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
632 |
595 |
$50.20 |
| J2930 |
Methylprednisolone injection |
162 |
147 |
$44.44 |
| 85379 |
|
627 |
597 |
$40.06 |
| 83615 |
|
73 |
66 |
$37.58 |
| J3010 |
Fentanyl citrate injection |
285 |
261 |
$28.47 |
| 86141 |
|
327 |
317 |
$25.34 |
| J0690 |
Cefazolin sodium injection |
42 |
36 |
$24.76 |
| 85027 |
|
282 |
261 |
$24.17 |
| 85730 |
|
489 |
466 |
$23.52 |
| 82009 |
|
846 |
803 |
$21.89 |
| J3301 |
Triamcinolone acet inj nos |
29 |
27 |
$16.76 |
| 84702 |
|
121 |
111 |
$14.73 |
| J1170 |
Hydromorphone injection |
45 |
38 |
$11.71 |
| 82948 |
|
206 |
100 |
$10.95 |
| 87186 |
|
56 |
55 |
$8.47 |
| 87077 |
|
13 |
13 |
$7.91 |
| 84703 |
|
297 |
293 |
$7.35 |
| 87040 |
|
994 |
549 |
$6.64 |
| A9270 |
Non-covered item or service |
1,421 |
1,248 |
$0.24 |
| 64494 |
|
15 |
14 |
$0.00 |
| 87651 |
|
18 |
18 |
$0.00 |
| 87070 |
|
45 |
37 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
13 |
12 |
$0.00 |
| 74022 |
|
36 |
36 |
$0.00 |
| 86901 |
|
55 |
52 |
$0.00 |
| 86850 |
|
28 |
28 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
13 |
12 |
$0.00 |
| 87581 |
|
14 |
14 |
$0.00 |
| A9585 |
Gadobutrol injection |
13 |
12 |
$0.00 |
| 85651 |
|
15 |
15 |
$0.00 |
| 88304 |
|
12 |
12 |
$0.00 |
| J2060 |
Lorazepam injection |
14 |
13 |
$0.00 |
| 96376 |
|
23 |
22 |
$0.00 |
| 87210 |
|
115 |
113 |
$0.00 |
| 80076 |
|
140 |
137 |
$0.00 |
| 73630 |
|
15 |
14 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
58 |
53 |
$0.00 |
| 73130 |
|
16 |
15 |
$0.00 |
| 73610 |
|
14 |
14 |
$0.00 |
| J2550 |
Promethazine hcl injection |
13 |
12 |
$0.00 |