| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
|
5,590 |
5,206 |
$2.39M |
| 99283 |
|
4,719 |
4,522 |
$1.37M |
| 99282 |
|
6,394 |
6,167 |
$974K |
| 0450 |
|
14,799 |
13,282 |
$646K |
| 74177 |
|
2,091 |
2,060 |
$516K |
| 99281 |
|
5,457 |
4,903 |
$438K |
| 99285 |
|
593 |
568 |
$436K |
| 70450 |
|
2,024 |
1,982 |
$192K |
| 87637 |
|
2,896 |
2,826 |
$187K |
| 71046 |
|
3,620 |
3,556 |
$160K |
| 71045 |
|
3,796 |
3,677 |
$152K |
| 88305 |
|
2,447 |
2,420 |
$123K |
| 76705 |
|
1,180 |
1,166 |
$94K |
| 96374 |
|
3,999 |
3,742 |
$92K |
| J0131 |
Inj, acetaminophen (nos) |
4,204 |
3,972 |
$90K |
| 74176 |
|
551 |
549 |
$80K |
| 93005 |
|
6,203 |
5,854 |
$80K |
| 85025 |
|
13,755 |
11,717 |
$66K |
| 71260 |
|
292 |
292 |
$57K |
| 96375 |
|
3,315 |
3,121 |
$57K |
| 87635 |
|
2,632 |
2,552 |
$56K |
| 73630 |
|
899 |
763 |
$51K |
| 80051 |
|
8,852 |
8,109 |
$46K |
| 76830 |
|
426 |
425 |
$39K |
| 72100 |
|
410 |
409 |
$34K |
| 83880 |
|
2,201 |
2,048 |
$34K |
| 73030 |
|
500 |
454 |
$33K |
| 96365 |
|
1,541 |
1,471 |
$32K |
| 82565 |
|
10,518 |
9,413 |
$32K |
| 73610 |
|
606 |
566 |
$32K |
| 36415 |
|
10,987 |
9,039 |
$30K |
| U0003 |
Cov-19 amp prb hgh thruput |
586 |
580 |
$27K |
| 87651 |
|
1,209 |
1,197 |
$27K |
| 73564 |
|
278 |
204 |
$26K |
| J7030 |
Normal saline solution infus |
5,927 |
5,241 |
$23K |
| 84520 |
|
8,944 |
8,191 |
$23K |
| 82247 |
|
6,748 |
5,935 |
$23K |
| 96361 |
|
2,274 |
2,181 |
$22K |
| 73560 |
|
398 |
362 |
$22K |
| 84460 |
|
6,477 |
5,729 |
$22K |
| 73130 |
|
318 |
263 |
$22K |
| 82947 |
|
8,930 |
8,169 |
$22K |
| 83690 |
|
5,068 |
4,781 |
$22K |
| 76856 |
|
237 |
237 |
$22K |
| 80307 |
|
473 |
439 |
$21K |
| 84450 |
|
6,012 |
5,418 |
$20K |
| 93976 |
|
161 |
161 |
$20K |
| 84075 |
|
5,525 |
5,001 |
$19K |
| 81001 |
|
8,646 |
8,184 |
$18K |
| 84484 |
|
3,014 |
2,806 |
$17K |
| 93971 |
|
82 |
82 |
$12K |
| 80048 |
|
2,119 |
1,969 |
$11K |
| 83735 |
|
2,803 |
2,408 |
$11K |
| 86900 |
|
296 |
279 |
$11K |
| 73562 |
|
130 |
91 |
$11K |
| 96372 |
|
1,191 |
1,159 |
$10K |
| J1885 |
Ketorolac tromethamine inj |
3,248 |
3,065 |
$10K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,723 |
1,692 |
$10K |
| 73110 |
|
161 |
149 |
$9K |
| 73502 |
|
141 |
137 |
$9K |
| J2405 |
Ondansetron hcl injection |
3,058 |
2,838 |
$9K |
| 99070 |
|
3,988 |
2,104 |
$8K |
| 0270 |
|
1,030 |
798 |
$8K |
| 82077 |
|
657 |
604 |
$7K |
| 81003 |
|
4,821 |
4,698 |
$7K |
| 87491 |
|
217 |
204 |
$6K |
| 87591 |
|
217 |
204 |
$6K |
| 84702 |
|
527 |
384 |
$6K |
| J1100 |
Dexamethasone sodium phos |
1,269 |
1,216 |
$6K |
| J7120 |
Ringers lactate infusion |
1,445 |
1,361 |
$6K |
| 87631 |
|
219 |
217 |
$5K |
| J3490 |
Drugs unclassified injection |
1,702 |
1,414 |
$5K |
| 85610 |
|
1,720 |
1,305 |
$5K |
| 73140 |
|
56 |
51 |
$4K |
| 87088 |
|
1,309 |
1,277 |
$4K |
| 76815 |
|
25 |
25 |
$4K |
| 85652 |
|
2,310 |
2,234 |
$4K |
| 86850 |
|
154 |
148 |
$4K |
| 86901 |
|
297 |
280 |
$4K |
| 82962 |
|
1,412 |
1,196 |
$3K |
| J0696 |
Ceftriaxone sodium injection |
662 |
610 |
$3K |
| 87636 |
|
189 |
189 |
$3K |
| 96360 |
|
170 |
164 |
$3K |
| 87502 |
|
59 |
59 |
$2K |
| 82248 |
|
491 |
384 |
$2K |
| 87040 |
|
239 |
228 |
$2K |
| 72040 |
|
13 |
13 |
$2K |
| 0637 |
|
13,755 |
6,704 |
$2K |
| 85027 |
|
669 |
588 |
$2K |
| 84100 |
|
644 |
569 |
$2K |
| 99199 |
|
35 |
34 |
$2K |
| J0690 |
Cefazolin sodium injection |
161 |
150 |
$2K |
| 73080 |
|
27 |
26 |
$2K |
| 76770 |
|
12 |
12 |
$2K |
| 84703 |
|
321 |
314 |
$1K |
| 71101 |
|
12 |
12 |
$1K |
| 83605 |
|
251 |
232 |
$1K |
| J2765 |
Metoclopramide hcl injection |
584 |
553 |
$1K |
| 82310 |
|
317 |
209 |
$1K |
| 84132 |
|
297 |
216 |
$1K |
| 76536 |
|
26 |
26 |
$1K |
| T1999 |
Noc retail items andsupplies |
45 |
28 |
$1K |
| 80306 |
|
151 |
148 |
$1K |
| 0710 |
|
412 |
410 |
$1K |
| 85379 |
|
252 |
249 |
$971.96 |
| 87449 |
|
86 |
86 |
$971.00 |
| 74018 |
|
26 |
24 |
$875.75 |
| 87324 |
|
72 |
72 |
$861.52 |
| Z7502 |
|
43 |
42 |
$629.30 |
| J1200 |
Diphenhydramine hcl injectio |
165 |
159 |
$538.79 |
| 84443 |
|
47 |
45 |
$492.06 |
| 0250 |
|
1,833 |
1,272 |
$455.68 |
| 71250 |
|
12 |
12 |
$429.02 |
| J3475 |
Inj magnesium sulfate |
77 |
72 |
$393.60 |
| J2060 |
Lorazepam injection |
103 |
92 |
$280.04 |
| J1170 |
Hydromorphone injection |
48 |
38 |
$242.15 |
| J0780 |
Prochlorperazine injection |
74 |
72 |
$222.14 |
| 85730 |
|
33 |
27 |
$216.00 |
| J3010 |
Fentanyl citrate injection |
139 |
132 |
$179.03 |
| 85007 |
|
107 |
93 |
$119.84 |
| 86140 |
|
22 |
21 |
$104.58 |
| 0258 |
|
128 |
117 |
$25.20 |
| 88304 |
|
27 |
27 |
$10.90 |
| 76376 |
|
75 |
75 |
$0.00 |
| 0370 |
|
299 |
298 |
$0.00 |
| 96376 |
|
16 |
12 |
$0.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
15 |
14 |
$0.00 |