| Code | Description | Claims | Beneficiaries | Total Paid |
| 0450 |
|
82,576 |
73,426 |
$12.74M |
| T1999 |
Noc retail items andsupplies |
10,694 |
9,178 |
$848K |
| 74177 |
|
3,166 |
3,060 |
$845K |
| C1820 |
Generator neuro rechg bat sy |
34 |
30 |
$671K |
| 96374 |
|
6,462 |
5,830 |
$497K |
| U0002 |
Covid-19 lab test non-cdc |
7,321 |
7,135 |
$400K |
| 77067 |
|
3,795 |
3,788 |
$374K |
| 70450 |
|
2,747 |
2,626 |
$320K |
| Z7502 |
|
8,143 |
7,914 |
$305K |
| 0272 |
|
5,213 |
4,575 |
$266K |
| 96375 |
|
5,653 |
5,073 |
$262K |
| 71045 |
|
5,735 |
5,381 |
$260K |
| J3490 |
Drugs unclassified injection |
4,454 |
3,480 |
$257K |
| 71046 |
|
7,922 |
7,642 |
$233K |
| 96372 |
|
6,399 |
5,922 |
$218K |
| 80053 |
|
18,424 |
16,680 |
$212K |
| 93005 |
|
7,449 |
6,714 |
$185K |
| 96365 |
|
1,910 |
1,548 |
$182K |
| 74176 |
|
1,221 |
1,190 |
$180K |
| 87636 |
|
1,285 |
1,266 |
$169K |
| 0360 |
|
1,334 |
1,223 |
$162K |
| 80307 |
|
2,123 |
1,920 |
$159K |
| 85025 |
|
19,997 |
17,820 |
$142K |
| 96361 |
|
4,679 |
4,250 |
$140K |
| 76856 |
|
2,571 |
2,553 |
$135K |
| J2405 |
Ondansetron hcl injection |
4,829 |
4,253 |
$113K |
| 76830 |
|
2,021 |
2,003 |
$113K |
| 99284 |
|
2,035 |
1,879 |
$110K |
| 87635 |
|
2,088 |
2,059 |
$109K |
| 76700 |
|
1,577 |
1,571 |
$95K |
| U0003 |
Cov-19 amp prb hgh thruput |
1,930 |
1,891 |
$94K |
| 96360 |
|
1,040 |
988 |
$91K |
| L8699 |
Prosthetic implant nos |
19 |
12 |
$86K |
| 87400 |
|
5,896 |
5,353 |
$76K |
| 73721 |
|
347 |
342 |
$73K |
| 66984 |
|
376 |
320 |
$71K |
| 99283 |
|
1,360 |
1,271 |
$69K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
4,185 |
4,048 |
$68K |
| 99213 |
|
991 |
497 |
$68K |
| J7030 |
Normal saline solution infus |
6,290 |
5,406 |
$65K |
| 76705 |
|
1,068 |
1,051 |
$62K |
| 73562 |
|
2,355 |
2,186 |
$60K |
| 72148 |
|
442 |
442 |
$59K |
| 84703 |
|
7,500 |
6,863 |
$58K |
| 73030 |
|
2,011 |
1,941 |
$57K |
| 73630 |
|
2,247 |
2,155 |
$56K |
| 0270 |
|
1,949 |
1,749 |
$52K |
| J0696 |
Ceftriaxone sodium injection |
1,910 |
1,559 |
$51K |
| 84484 |
|
5,231 |
4,607 |
$50K |
| 83880 |
|
1,890 |
1,722 |
$49K |
| 73610 |
|
1,509 |
1,466 |
$48K |
| J1885 |
Ketorolac tromethamine inj |
4,815 |
4,531 |
$47K |
| 87086 |
|
5,893 |
5,490 |
$45K |
| 83690 |
|
6,176 |
5,656 |
$43K |
| J2704 |
Inj, propofol, 10 mg |
311 |
222 |
$41K |
| 72110 |
|
1,178 |
1,169 |
$41K |
| 72100 |
|
1,252 |
1,236 |
$41K |
| 0762 |
|
43 |
26 |
$40K |
| 99285 |
|
668 |
629 |
$40K |
| 74018 |
|
1,418 |
1,391 |
$40K |
| 81001 |
|
10,507 |
9,643 |
$36K |
| 0710 |
|
1,737 |
1,683 |
$35K |
| 63650 |
|
465 |
190 |
$31K |
| 87040 |
|
2,156 |
1,672 |
$31K |
| V2632 |
Post chmbr intraocular lens |
118 |
102 |
$28K |
| 71275 |
|
113 |
110 |
$28K |
| 73560 |
|
924 |
872 |
$26K |
| 94640 |
|
1,131 |
951 |
$26K |
| 87430 |
|
2,325 |
2,230 |
$25K |
| 73130 |
|
909 |
869 |
$25K |
| 75571 |
|
423 |
421 |
$24K |
| 83605 |
|
2,194 |
1,952 |
$23K |
| 80305 |
|
1,326 |
1,250 |
$23K |
| J2270 |
Morphine sulfate injection |
2,302 |
1,996 |
$23K |
| 87426 |
|
474 |
461 |
$22K |
| 76642 |
|
355 |
340 |
$21K |
| J1100 |
Dexamethasone sodium phos |
836 |
785 |
$20K |
| 76536 |
|
411 |
411 |
$20K |
| Z9725 |
|
449 |
445 |
$19K |
| J1170 |
Hydromorphone injection |
1,523 |
1,232 |
$19K |
| 72125 |
|
123 |
112 |
$19K |
| 29125 |
|
70 |
68 |
$18K |
| 99211 |
|
541 |
382 |
$18K |
| J2250 |
Inj midazolam hydrochloride |
1,596 |
1,549 |
$17K |
| J7120 |
Ringers lactate infusion |
2,213 |
1,956 |
$16K |
| 76801 |
|
150 |
137 |
$16K |
| 87502 |
|
373 |
368 |
$15K |
| 84443 |
|
988 |
940 |
$15K |
| 94664 |
|
900 |
808 |
$15K |
| 0750 |
|
87 |
79 |
$15K |
| 76770 |
|
283 |
282 |
$15K |
| 93971 |
|
128 |
123 |
$14K |
| 73502 |
|
480 |
463 |
$14K |
| 81003 |
|
5,663 |
5,321 |
$14K |
| 73110 |
|
589 |
571 |
$14K |
| J8499 |
Oral prescrip drug non chemo |
1,778 |
1,237 |
$14K |
| 76641 |
|
141 |
141 |
$13K |
| 87186 |
|
1,298 |
1,227 |
$12K |
| 70551 |
|
83 |
83 |
$12K |
| 99281 |
|
205 |
195 |
$11K |
| 94060 |
|
362 |
362 |
$11K |
| 71250 |
|
96 |
96 |
$11K |
| 85379 |
|
991 |
939 |
$11K |
| 87077 |
|
1,271 |
1,205 |
$11K |
| 72070 |
|
444 |
440 |
$10K |
| 43239 |
|
294 |
289 |
$10K |
| 83735 |
|
1,642 |
1,421 |
$10K |
| 86140 |
|
1,737 |
1,641 |
$9K |
| 85610 |
|
2,388 |
2,246 |
$9K |
| 84702 |
|
611 |
532 |
$9K |
| 72050 |
|
291 |
291 |
$8K |
| 85730 |
|
1,473 |
1,408 |
$8K |
| 71260 |
|
57 |
55 |
$8K |
| 76815 |
|
91 |
66 |
$8K |
| 72040 |
|
212 |
209 |
$7K |
| 90715 |
|
162 |
159 |
$7K |
| 99199 |
|
142 |
131 |
$7K |
| J3010 |
Fentanyl citrate injection |
2,035 |
1,939 |
$7K |
| J7040 |
Normal saline solution infus |
705 |
654 |
$6K |
| 73221 |
|
42 |
41 |
$6K |
| 82550 |
|
790 |
694 |
$6K |
| A9577 |
Inj multihance |
56 |
56 |
$6K |
| 77065 |
Tomosynthesis, mammo |
69 |
68 |
$6K |
| 80048 |
|
793 |
685 |
$6K |
| 82962 |
|
1,827 |
1,354 |
$5K |
| J0330 |
Succinycholine chloride inj |
72 |
64 |
$5K |
| 77066 |
Tomosynthesis, mammo |
39 |
39 |
$4K |
| 87591 |
|
370 |
348 |
$4K |
| J1200 |
Diphenhydramine hcl injectio |
586 |
536 |
$4K |
| J2550 |
Promethazine hcl injection |
396 |
346 |
$4K |
| J0690 |
Cefazolin sodium injection |
262 |
217 |
$4K |
| 73620 |
|
132 |
131 |
$4K |
| 87798 |
|
76 |
76 |
$4K |
| J7050 |
Normal saline solution infus |
465 |
380 |
$4K |
| Z7610 |
|
281 |
267 |
$3K |
| 63685 |
|
52 |
42 |
$3K |
| 87420 |
|
835 |
779 |
$3K |
| S0020 |
Injection, bupivicaine hydro |
275 |
231 |
$3K |
| 74178 |
|
12 |
12 |
$3K |
| J2060 |
Lorazepam injection |
339 |
282 |
$3K |
| J2930 |
Methylprednisolone injection |
174 |
157 |
$3K |
| 87631 |
|
71 |
70 |
$3K |
| 87491 |
|
281 |
271 |
$2K |
| 82140 |
|
141 |
138 |
$2K |
| 77080 |
|
74 |
74 |
$2K |
| J3301 |
Triamcinolone acet inj nos |
68 |
67 |
$2K |
| 82150 |
|
264 |
261 |
$2K |
| 72081 |
|
62 |
62 |
$2K |
| 45378 |
|
30 |
30 |
$2K |
| 71020 |
|
54 |
24 |
$2K |
| 73140 |
|
65 |
64 |
$1K |
| 87088 |
|
225 |
198 |
$1K |
| 72141 |
|
12 |
12 |
$1K |
| 87070 |
|
150 |
142 |
$1K |
| S0164 |
Injection pantroprazole |
103 |
84 |
$1K |
| J2175 |
Meperidine hydrochl /100 mg |
93 |
81 |
$1K |
| 59025 |
|
67 |
28 |
$1K |
| 86901 |
|
302 |
293 |
$948.03 |
| 86900 |
|
302 |
293 |
$893.60 |
| 90471 |
|
123 |
120 |
$821.07 |
| 82009 |
|
186 |
176 |
$811.77 |
| A4217 |
Sterile water/saline, 500 ml |
119 |
109 |
$769.80 |
| 84100 |
|
142 |
128 |
$708.43 |
| 81025 |
|
116 |
109 |
$556.27 |
| 73070 |
|
26 |
26 |
$544.66 |
| 80299 |
|
15 |
14 |
$535.75 |
| 71101 |
|
13 |
12 |
$456.25 |
| 94729 |
|
12 |
12 |
$439.37 |
| 45385 |
|
13 |
13 |
$396.00 |
| 76870 |
|
12 |
12 |
$394.58 |
| 82805 |
|
13 |
12 |
$348.68 |
| J3475 |
Inj magnesium sulfate |
18 |
16 |
$340.77 |
| J3105 |
Terbutaline sulfate inj |
37 |
37 |
$327.77 |
| 87210 |
|
69 |
64 |
$317.64 |
| 73590 |
|
15 |
14 |
$301.74 |
| 73090 |
|
12 |
12 |
$269.99 |
| 84439 |
|
27 |
25 |
$166.84 |
| 82248 |
|
26 |
26 |
$125.54 |
| J2765 |
Metoclopramide hcl injection |
14 |
12 |
$121.03 |
| 87147 |
|
15 |
15 |
$94.65 |
| 85027 |
|
14 |
14 |
$87.52 |
| J7611 |
Albuterol non-comp con |
233 |
206 |
$84.92 |
| 0250 |
|
272 |
232 |
$65.12 |
| U0001 |
2019-ncov diagnostic p |
193 |
192 |
$59.30 |
| 36600 |
|
12 |
12 |
$48.85 |
| 0270R |
|
17 |
17 |
$0.00 |