| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
58,517 |
50,300 |
$10.30M |
| 99283 |
|
58,239 |
51,427 |
$10.24M |
| 99285 |
|
47,933 |
40,851 |
$8.45M |
| 96361 |
|
24,706 |
20,267 |
$7.22M |
| 41899 |
|
3,373 |
2,866 |
$4.22M |
| 43239 |
|
5,709 |
5,310 |
$3.17M |
| 74177 |
|
13,158 |
12,025 |
$2.79M |
| 97110 |
|
49,702 |
17,080 |
$2.66M |
| 99282 |
|
15,289 |
13,826 |
$2.50M |
| 93306 |
|
7,245 |
6,724 |
$2.31M |
| 59899 |
|
2,669 |
2,141 |
$2.27M |
| 70450 |
|
13,576 |
12,116 |
$2.24M |
| 92507 |
|
18,536 |
7,343 |
$2.24M |
| 64493 |
|
1,969 |
1,779 |
$1.84M |
| 70553 |
|
5,390 |
5,063 |
$1.81M |
| 77386 |
|
3,309 |
286 |
$1.68M |
| 96366 |
|
5,872 |
4,247 |
$1.59M |
| 99213 |
|
10,641 |
8,968 |
$1.58M |
| 99220 |
|
28,940 |
10,092 |
$1.38M |
| 64483 |
|
1,826 |
1,716 |
$1.37M |
| 97530 |
|
20,566 |
10,218 |
$1.31M |
| 45385 |
|
2,016 |
1,872 |
$1.28M |
| 95810 |
|
2,040 |
1,913 |
$1.27M |
| 62323 |
|
2,528 |
2,407 |
$1.27M |
| 78815 |
|
1,612 |
1,491 |
$1.26M |
| 0241U |
|
16,090 |
14,703 |
$1.25M |
| 45380 |
|
2,236 |
2,097 |
$1.22M |
| 96360 |
|
8,853 |
8,028 |
$1.21M |
| 71275 |
|
5,911 |
5,451 |
$1.06M |
| 76705 |
|
9,660 |
8,957 |
$944K |
| G0463 |
Hospital outpt clinic visit |
64,564 |
46,011 |
$918K |
| 80307 |
|
19,394 |
16,490 |
$908K |
| 69436 |
|
633 |
597 |
$884K |
| 96365 |
|
9,586 |
7,936 |
$872K |
| 78452 |
|
1,395 |
1,277 |
$871K |
| 72148 |
|
3,855 |
3,647 |
$797K |
| 97161 |
|
6,204 |
5,861 |
$796K |
| 97162 |
|
6,997 |
6,374 |
$709K |
| 11042 |
|
3,364 |
2,579 |
$695K |
| 96415 |
|
2,278 |
1,752 |
$695K |
| 74176 |
|
3,701 |
3,371 |
$686K |
| 99214 |
|
4,627 |
4,240 |
$671K |
| 64635 |
|
895 |
670 |
$641K |
| 59025 |
|
3,138 |
2,536 |
$627K |
| 62321 |
|
1,156 |
1,096 |
$613K |
| 76830 |
|
5,409 |
5,029 |
$590K |
| 43235 |
|
1,067 |
979 |
$577K |
| 95806 |
|
1,078 |
1,056 |
$577K |
| 99281 |
|
4,080 |
3,492 |
$572K |
| 70551 |
|
2,419 |
2,247 |
$555K |
| 94640 |
|
7,243 |
5,519 |
$534K |
| 97802 |
|
5,594 |
5,100 |
$504K |
| 96413 |
|
4,631 |
3,197 |
$496K |
| 72141 |
|
2,522 |
2,391 |
$468K |
| 73721 |
|
2,001 |
1,867 |
$448K |
| 77067 |
|
7,972 |
7,767 |
$447K |
| 74183 |
|
1,496 |
1,401 |
$433K |
| 76642 |
|
4,020 |
3,518 |
$431K |
| 70496 |
|
1,794 |
1,653 |
$424K |
| 95811 |
|
792 |
707 |
$407K |
| 71046 |
|
17,402 |
15,953 |
$404K |
| 47563 |
|
115 |
106 |
$400K |
| 93971 |
|
3,764 |
3,423 |
$389K |
| 97803 |
|
4,210 |
3,729 |
$387K |
| 92523 |
|
2,653 |
2,582 |
$366K |
| 99212 |
|
2,498 |
2,234 |
$342K |
| 76816 |
|
3,632 |
3,441 |
$340K |
| 80053 |
|
71,432 |
57,702 |
$333K |
| 76770 |
|
2,255 |
2,153 |
$317K |
| 93017 |
|
2,741 |
2,531 |
$305K |
| 64494 |
|
2,016 |
1,539 |
$294K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
6,198 |
3,381 |
$294K |
| 76805 |
|
2,744 |
2,619 |
$290K |
| 93308 |
|
1,041 |
956 |
$289K |
| 36430 |
|
1,636 |
1,206 |
$286K |
| 99215 |
Prolong outpt/office vis |
1,215 |
1,130 |
$276K |
| 77412 |
|
485 |
50 |
$272K |
| 74174 |
|
1,250 |
1,172 |
$272K |
| 74018 |
|
9,651 |
8,632 |
$269K |
| G0108 |
Diab manage trn per indiv |
5,466 |
4,844 |
$254K |
| Q5103 |
Injection, inflectra |
257 |
232 |
$248K |
| 76536 |
|
2,035 |
1,923 |
$242K |
| 99234 |
|
11,720 |
2,685 |
$241K |
| 45378 |
|
366 |
350 |
$237K |
| 93005 |
|
63,165 |
50,141 |
$237K |
| 97166 |
|
3,230 |
2,879 |
$233K |
| 72158 |
|
1,241 |
1,160 |
$233K |
| 80048 |
|
45,805 |
34,258 |
$229K |
| G0330 |
Facility svs dental rehab |
202 |
166 |
$225K |
| J1745 |
Infliximab not biosimil 10mg |
156 |
130 |
$222K |
| C8929 |
Tte w or wo fol wcon,doppler |
704 |
640 |
$218K |
| 10060 |
|
1,771 |
1,596 |
$214K |
| 12001 |
|
1,065 |
998 |
$212K |
| 71250 |
|
3,115 |
2,897 |
$212K |
| 78431 |
|
253 |
238 |
$211K |
| 97140 |
|
5,260 |
2,360 |
$211K |
| 77336 |
|
2,601 |
1,051 |
$210K |
| 20680 |
|
164 |
140 |
$209K |
| 97112 |
|
4,285 |
1,979 |
$207K |
| 64636 |
|
852 |
587 |
$206K |
| 99211 |
|
1,711 |
1,133 |
$201K |
| 97165 |
|
1,880 |
1,747 |
$201K |
| 71260 |
|
3,643 |
3,375 |
$189K |
| 99203 |
|
1,321 |
1,290 |
$188K |
| 94060 |
|
2,961 |
2,726 |
$187K |
| 49083 |
|
378 |
203 |
$186K |
| P9045 |
Albumin (human), 5%, 250 ml |
695 |
545 |
$184K |
| 19083 |
|
220 |
179 |
$183K |
| 76817 |
|
3,080 |
2,561 |
$180K |
| 20610 |
|
2,174 |
1,752 |
$171K |
| 76801 |
|
1,831 |
1,711 |
$168K |
| P9016 |
Rbc leukocytes reduced |
577 |
496 |
$162K |
| 99235 |
|
7,928 |
1,827 |
$160K |
| 70491 |
|
958 |
910 |
$158K |
| 93970 |
|
1,203 |
1,108 |
$155K |
| 78492 |
|
204 |
179 |
$152K |
| 73221 |
|
735 |
687 |
$152K |
| 99291 |
|
1,069 |
989 |
$146K |
| G0480 |
Drug test def 1-7 classes |
10,472 |
8,842 |
$145K |
| 97116 |
|
4,233 |
2,386 |
$144K |
| 58661 |
|
57 |
39 |
$144K |
| 92526 |
|
2,845 |
1,718 |
$144K |
| G0378 |
Hospital observation per hr |
4,266 |
3,507 |
$142K |
| 12011 |
|
670 |
631 |
$141K |
| 76819 |
|
1,412 |
967 |
$137K |
| 42820 |
|
78 |
77 |
$136K |
| U0003 |
Cov-19 amp prb hgh thruput |
5,709 |
5,176 |
$132K |
| 97113 |
|
2,326 |
1,006 |
$127K |
| 96374 |
|
44,733 |
37,673 |
$124K |
| 93880 |
|
1,287 |
1,192 |
$118K |
| 93458 |
|
111 |
101 |
$118K |
| 70498 |
|
2,015 |
1,857 |
$116K |
| 76870 |
|
1,073 |
1,010 |
$115K |
| 73130 |
|
5,884 |
4,129 |
$114K |
| 97163 |
|
952 |
885 |
$110K |
| 85025 |
|
107,699 |
80,519 |
$110K |
| 92610 |
|
1,048 |
982 |
$109K |
| 76700 |
|
835 |
795 |
$107K |
| 73630 |
|
5,946 |
4,629 |
$106K |
| 77066 |
Tomosynthesis, mammo |
2,556 |
2,394 |
$106K |
| 72100 |
|
4,576 |
4,231 |
$103K |
| 77065 |
Tomosynthesis, mammo |
2,662 |
2,293 |
$101K |
| 71045 |
|
28,622 |
24,800 |
$99K |
| 90935 |
|
201 |
80 |
$98K |
| 72197 |
|
295 |
278 |
$95K |
| 76641 |
|
784 |
699 |
$91K |
| 97167 |
|
920 |
886 |
$90K |
| 72125 |
|
5,535 |
5,022 |
$86K |
| 44970 |
|
15 |
13 |
$84K |
| 71271 |
|
815 |
784 |
$81K |
| 94726 |
|
2,144 |
1,985 |
$77K |
| 73562 |
|
4,440 |
3,372 |
$76K |
| 12002 |
|
369 |
344 |
$71K |
| 72131 |
|
1,283 |
1,183 |
$70K |
| 70486 |
|
1,570 |
1,472 |
$69K |
| 94729 |
|
2,797 |
2,592 |
$69K |
| 73030 |
|
5,046 |
4,293 |
$67K |
| J8597 |
Antiemetic drug oral nos |
10,190 |
8,643 |
$65K |
| 80047 |
|
16,033 |
14,209 |
$65K |
| 83880 |
|
6,974 |
6,083 |
$65K |
| 99204 |
|
447 |
429 |
$62K |
| 70360 |
|
1,157 |
1,129 |
$62K |
| 58571 |
|
18 |
14 |
$61K |
| 87641 |
|
4,287 |
3,926 |
$60K |
| J3490 |
Drugs unclassified injection |
216,135 |
79,001 |
$58K |
| 77334 |
|
376 |
270 |
$57K |
| P9047 |
Albumin (human), 25%, 50ml |
118 |
67 |
$55K |
| 97804 |
|
581 |
526 |
$54K |
| 84484 |
|
32,356 |
22,402 |
$54K |
| 90715 |
|
2,885 |
2,681 |
$52K |
| 73610 |
|
4,151 |
3,617 |
$50K |
| 76775 |
|
500 |
472 |
$49K |
| 77300 |
|
740 |
649 |
$49K |
| 76882 |
|
475 |
436 |
$47K |
| 73502 |
|
3,607 |
3,255 |
$47K |
| 93325 |
|
1,419 |
1,298 |
$46K |
| 72040 |
|
2,000 |
1,812 |
$45K |
| 76815 |
|
731 |
655 |
$45K |
| 83036 |
|
10,844 |
9,857 |
$44K |
| 77063 |
|
3,034 |
2,952 |
$41K |
| 47562 |
|
14 |
13 |
$41K |
| 72170 |
|
1,988 |
1,876 |
$41K |
| J0585 |
Injection,onabotulinumtoxina |
472 |
240 |
$40K |
| 85610 |
|
24,060 |
17,783 |
$40K |
| 77470 |
|
58 |
54 |
$39K |
| 87502 |
|
2,508 |
2,365 |
$39K |
| 77072 |
|
622 |
609 |
$38K |
| 97535 |
|
1,390 |
808 |
$38K |
| 88305 |
|
13,826 |
9,917 |
$38K |
| 96375 |
|
34,042 |
25,655 |
$37K |
| 87591 |
|
4,790 |
4,375 |
$37K |
| 75561 |
|
102 |
95 |
$36K |
| 72156 |
|
184 |
168 |
$36K |
| 73700 |
|
368 |
339 |
$35K |
| 82962 |
|
40,226 |
20,263 |
$35K |
| 90471 |
|
5,024 |
4,399 |
$34K |
| 36415 |
|
38,705 |
27,492 |
$33K |
| 77002 |
|
262 |
246 |
$33K |
| 86850 |
|
13,068 |
11,706 |
$33K |
| 87040 |
|
4,037 |
3,157 |
$33K |
| 88307 |
|
2,035 |
1,624 |
$32K |
| 73564 |
|
2,358 |
1,957 |
$32K |
| C1769 |
Guide wire |
5,205 |
4,272 |
$32K |
| 86923 |
|
1,434 |
1,020 |
$31K |
| 73110 |
|
2,463 |
2,144 |
$30K |
| 76604 |
|
960 |
898 |
$28K |
| 93922 |
|
364 |
353 |
$28K |
| 95819 |
|
145 |
132 |
$28K |
| 77338 |
|
70 |
62 |
$27K |
| 87510 |
|
3,150 |
2,895 |
$27K |
| 76937 |
|
548 |
483 |
$27K |
| M0243 |
Casirivi and imdevi inj |
89 |
86 |
$27K |
| 72110 |
|
1,123 |
995 |
$26K |
| 96372 |
|
17,031 |
11,105 |
$26K |
| 58558 |
|
14 |
12 |
$24K |
| 86900 |
|
13,632 |
12,210 |
$24K |
| 76885 |
|
176 |
167 |
$24K |
| M0245 |
Bamlan and etesev infusion |
79 |
75 |
$23K |
| 73560 |
|
1,814 |
1,498 |
$23K |
| 77062 |
|
1,161 |
1,127 |
$23K |
| J7307 |
Etonogestrel implant system |
28 |
26 |
$22K |
| 72146 |
|
290 |
269 |
$22K |
| 73590 |
|
2,333 |
1,980 |
$21K |
| 86803 |
|
1,961 |
1,818 |
$20K |
| 76856 |
|
125 |
121 |
$20K |
| 85027 |
|
12,197 |
9,907 |
$20K |
| 83605 |
|
12,706 |
10,573 |
$19K |
| 72050 |
|
888 |
819 |
$19K |
| 94660 |
|
94 |
48 |
$19K |
| 76813 |
|
303 |
286 |
$19K |
| 97022 |
|
589 |
248 |
$19K |
| 88342 |
|
4,122 |
3,441 |
$19K |
| 77061 |
|
751 |
682 |
$18K |
| 95816 |
|
95 |
86 |
$18K |
| 87636 |
|
1,091 |
978 |
$17K |
| 27096 |
|
44 |
36 |
$17K |
| J0131 |
Inj, acetaminophen (nos) |
11,805 |
10,071 |
$17K |
| 73140 |
|
943 |
863 |
$17K |
| 80076 |
|
3,991 |
3,394 |
$16K |
| 82565 |
|
6,065 |
5,379 |
$16K |
| 77295 |
|
12 |
12 |
$16K |
| 96376 |
|
17,033 |
10,759 |
$16K |
| J2405 |
Ondansetron hcl injection |
49,784 |
40,220 |
$15K |
| 73090 |
|
1,649 |
1,481 |
$15K |
| 50435 |
|
12 |
12 |
$15K |
| 64450 |
|
89 |
81 |
$15K |
| 93351 |
|
40 |
39 |
$15K |
| 94010 |
|
335 |
324 |
$15K |
| 75574 |
|
58 |
56 |
$15K |
| 96367 |
|
541 |
429 |
$14K |
| 87660 |
|
3,150 |
2,895 |
$14K |
| 90686 |
|
2,144 |
1,936 |
$14K |
| 64415 |
|
40 |
39 |
$14K |
| J1650 |
Inj enoxaparin sodium |
12,957 |
5,328 |
$14K |
| A4216 |
Sterile water/saline, 10 ml |
1,586 |
1,481 |
$14K |
| 64495 |
|
81 |
72 |
$13K |
| Q9957 |
Inj perflutren lip micros,ml |
1,982 |
1,813 |
$13K |
| 81002 |
|
5,650 |
4,592 |
$13K |
| 94667 |
|
99 |
84 |
$13K |
| 86901 |
|
13,833 |
12,393 |
$13K |
| 85379 |
|
2,496 |
2,302 |
$13K |
| 73080 |
|
1,356 |
1,230 |
$13K |
| 88341 |
|
2,439 |
1,728 |
$12K |
| J3010 |
Fentanyl citrate injection |
53,824 |
37,185 |
$12K |
| 92611 |
|
222 |
205 |
$12K |
| 74230 |
|
106 |
99 |
$12K |
| 11721 |
|
1,320 |
1,040 |
$12K |
| 73552 |
|
1,126 |
965 |
$11K |
| 97760 |
|
219 |
205 |
$11K |
| C1894 |
Intro/sheath, non-laser |
2,803 |
2,354 |
$11K |
| J2704 |
Inj, propofol, 10 mg |
42,099 |
34,147 |
$11K |
| 81001 |
|
28,582 |
25,002 |
$11K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
5,051 |
4,775 |
$11K |
| 77080 |
|
182 |
176 |
$11K |
| 87491 |
|
4,783 |
4,366 |
$10K |
| 80061 |
|
2,665 |
2,350 |
$10K |
| 84443 |
|
5,175 |
4,679 |
$9K |
| J7120 |
Ringers lactate infusion |
32,964 |
26,207 |
$9K |
| 64490 |
|
13 |
12 |
$9K |
| 90732 |
|
479 |
443 |
$8K |
| 84145 |
|
800 |
730 |
$8K |
| J7298 |
Mirena, 52 mg |
14 |
14 |
$8K |
| 85014 |
|
16,961 |
14,841 |
$8K |
| 83735 |
|
16,257 |
12,298 |
$8K |
| 31575 |
|
62 |
55 |
$8K |
| 99153 |
Mod sedat endo service >5yrs |
2,550 |
2,244 |
$8K |
| 72157 |
|
71 |
66 |
$8K |
| 64447 |
|
43 |
38 |
$8K |
| 82803 |
|
5,226 |
4,501 |
$8K |
| 78499 |
|
57 |
57 |
$7K |
| J7050 |
Normal saline solution infus |
24,095 |
13,389 |
$7K |
| 87632 |
|
405 |
385 |
$7K |
| 82306 |
|
866 |
778 |
$7K |
| J8499 |
Oral prescrip drug non chemo |
152,696 |
22,937 |
$7K |
| 80179 |
|
1,214 |
1,134 |
$7K |
| 94618 |
|
54 |
52 |
$7K |
| 36600 |
|
570 |
498 |
$7K |
| 99202 |
|
65 |
61 |
$7K |
| 86140 |
|
9,741 |
8,580 |
$7K |
| 93798 |
|
48 |
14 |
$7K |
| M0247 |
Sotrovimab infusion |
27 |
22 |
$7K |
| 72070 |
|
428 |
400 |
$7K |
| 74220 |
|
162 |
150 |
$7K |
| 84703 |
|
11,261 |
10,137 |
$6K |
| 87086 |
|
10,771 |
9,653 |
$6K |
| 94727 |
|
202 |
191 |
$6K |
| 78320 |
|
26 |
25 |
$6K |
| 85730 |
|
7,230 |
6,454 |
$6K |
| 99152 |
|
3,391 |
2,963 |
$6K |
| C9399 |
Unclassified drugs or biolog |
725 |
661 |
$6K |
| 94644 |
|
2,662 |
2,381 |
$6K |
| 81025 |
|
4,975 |
4,539 |
$6K |
| 87522 |
Neg quan hep c or qual rna |
267 |
241 |
$6K |
| 82657 |
|
748 |
499 |
$6K |
| 83690 |
|
19,986 |
16,995 |
$6K |
| 77001 |
|
44 |
41 |
$6K |
| 84702 |
|
4,254 |
3,669 |
$5K |
| 77085 |
|
87 |
85 |
$5K |
| 77290 |
|
14 |
12 |
$5K |
| 87635 |
|
182 |
167 |
$5K |
| 73100 |
|
297 |
237 |
$5K |
| J0690 |
Cefazolin sodium injection |
20,298 |
13,920 |
$5K |
| J1050 |
Medroxyprogesterone acetate |
247 |
225 |
$5K |
| 72082 |
|
93 |
92 |
$5K |
| 72128 |
|
138 |
132 |
$4K |
| 76942 |
|
106 |
98 |
$4K |
| J2250 |
Inj midazolam hydrochloride |
18,269 |
15,180 |
$4K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
30,109 |
26,836 |
$4K |
| 43762 |
|
31 |
25 |
$4K |
| G0297 |
Ldct for lung ca screen |
37 |
36 |
$4K |
| G0008 |
Admin influenza virus vac |
1,586 |
1,378 |
$4K |
| 97035 |
|
137 |
50 |
$4K |
| G0379 |
Direct refer hospital observ |
12 |
12 |
$4K |
| 93975 |
|
27 |
26 |
$4K |
| 77301 |
|
13 |
12 |
$4K |
| C1725 |
Cath, translumin non-laser |
219 |
172 |
$4K |
| 87480 |
|
3,140 |
2,886 |
$4K |
| 82728 |
|
1,429 |
1,240 |
$4K |
| J1100 |
Dexamethasone sodium phos |
29,895 |
24,864 |
$4K |
| 74300 |
|
15 |
13 |
$4K |
| J2001 |
Lidocaine injection |
7,826 |
6,311 |
$4K |
| 36416 |
|
8,939 |
5,107 |
$4K |
| 81003 |
|
10,959 |
9,757 |
$3K |
| 80143 |
|
1,388 |
1,281 |
$3K |
| 86920 |
|
302 |
242 |
$3K |
| 29125 |
|
96 |
93 |
$3K |
| 74022 |
|
507 |
468 |
$3K |
| A9500 |
Tc99m sestamibi |
1,497 |
1,372 |
$3K |
| 0482T |
|
205 |
180 |
$3K |
| 74240 |
|
25 |
24 |
$3K |
| C1776 |
Joint device (implantable) |
328 |
299 |
$3K |
| 43760 |
|
13 |
12 |
$3K |
| 76811 |
|
46 |
41 |
$3K |
| 72072 |
|
112 |
103 |
$3K |
| 12013 |
|
13 |
13 |
$3K |
| J1885 |
Ketorolac tromethamine inj |
26,741 |
20,016 |
$3K |
| 80074 |
|
403 |
377 |
$3K |
| 87081 |
|
3,821 |
3,628 |
$3K |
| 87880 |
|
3,553 |
3,397 |
$3K |
| 74019 |
|
221 |
214 |
$3K |
| 74178 |
|
14 |
12 |
$3K |
| 87116 |
|
214 |
172 |
$3K |
| J7030 |
Normal saline solution infus |
16,170 |
12,335 |
$3K |
| 73060 |
|
387 |
343 |
$2K |
| 73070 |
|
219 |
198 |
$2K |
| 17250 |
|
14 |
12 |
$2K |
| 85652 |
|
6,879 |
6,094 |
$2K |
| 72202 |
|
39 |
39 |
$2K |
| 87186 |
|
4,817 |
4,150 |
$2K |
| 88304 |
|
1,621 |
1,449 |
$2K |
| C1887 |
Catheter, guiding |
1,607 |
1,281 |
$2K |
| 87070 |
|
3,525 |
2,923 |
$2K |
| C1729 |
Cath, drainage |
485 |
427 |
$2K |
| 87075 |
|
2,894 |
2,355 |
$2K |
| A4648 |
Implantable tissue marker |
686 |
549 |
$2K |
| 74241 |
|
12 |
12 |
$2K |
| 87077 |
|
4,080 |
3,487 |
$2K |
| A9579 |
Gad-base mr contrast nos,1ml |
7,396 |
6,937 |
$2K |
| J0171 |
Adrenalin epinephrine inject |
1,630 |
1,378 |
$2K |
| G0109 |
Diab manage trn ind/group |
27 |
13 |
$2K |
| J7999 |
Compounded drug, noc |
3,261 |
2,432 |
$2K |
| 84100 |
|
4,265 |
2,939 |
$2K |
| 29515 |
|
12 |
12 |
$2K |
| J0330 |
Succinycholine chloride inj |
7,054 |
5,853 |
$2K |
| 87205 |
|
3,651 |
2,999 |
$2K |
| 80164 |
|
265 |
222 |
$2K |
| J2785 |
Regadenoson injection |
2,157 |
1,987 |
$2K |
| 96368 |
|
129 |
115 |
$2K |
| 73120 |
|
144 |
120 |
$2K |
| J1610 |
Glucagon hydrochloride/1 mg |
26 |
24 |
$2K |
| 00170 |
|
960 |
875 |
$1K |
| 83550 |
|
918 |
811 |
$1K |
| J8540 |
Oral dexamethasone |
324 |
195 |
$1K |
| J0134 |
Inj acetaminophen -fresenius |
1,764 |
1,191 |
$1K |
| J2270 |
Morphine sulfate injection |
11,969 |
8,900 |
$1K |
| 84550 |
|
785 |
649 |
$1K |
| Q0247 |
Sotrovimab |
21 |
19 |
$1K |
| J7512 |
Prednisone ir or dr oral 1mg |
6,388 |
2,980 |
$1K |
| A9555 |
Rb82 rubidium |
440 |
391 |
$1K |
| 93926 |
|
12 |
12 |
$1K |
| 97542 |
|
14 |
13 |
$1K |
| 51798 |
|
1,124 |
913 |
$1K |
| J1815 |
Insulin injection |
4,860 |
2,309 |
$1K |
| 85045 |
|
841 |
748 |
$1K |
| A9585 |
Gadobutrol injection |
2,456 |
2,263 |
$1K |
| J1170 |
Hydromorphone injection |
8,223 |
6,464 |
$1K |
| C1874 |
Stent, coated/cov w/del sys |
32 |
28 |
$1K |
| J1756 |
Iron sucrose injection |
187 |
102 |
$1K |
| 94645 |
|
777 |
426 |
$1K |
| A9552 |
F18 fdg |
1,761 |
1,633 |
$1K |
| 82550 |
|
2,713 |
2,265 |
$1K |
| 87015 |
|
2,802 |
2,033 |
$955.66 |
| 73200 |
|
13 |
13 |
$952.97 |
| J0702 |
Betamethasone acet&sod phosp |
248 |
157 |
$935.52 |
| 93296 |
|
161 |
141 |
$905.08 |
| 99236 |
Prolong inpt eval add15 m |
54 |
12 |
$894.62 |
| 83540 |
|
997 |
900 |
$885.11 |
| 97014 |
|
27 |
13 |
$881.72 |
| 82140 |
|
1,347 |
1,145 |
$835.89 |
| J2930 |
Methylprednisolone injection |
2,556 |
2,011 |
$831.39 |
| 93976 |
|
30 |
25 |
$796.14 |
| 85018 |
|
664 |
463 |
$755.71 |
| 87426 |
|
1,653 |
1,428 |
$739.52 |
| 82607 |
|
891 |
807 |
$739.45 |
| 83615 |
|
2,047 |
1,675 |
$738.89 |
| J0696 |
Ceftriaxone sodium injection |
7,402 |
5,535 |
$736.87 |
| 82570 |
|
1,728 |
1,465 |
$721.57 |
| J1642 |
Inj heparin sodium per 10 u |
5,590 |
2,985 |
$718.04 |
| J1644 |
Inj heparin sodium per 1000u |
9,193 |
3,633 |
$701.28 |
| 87389 |
|
510 |
482 |
$678.68 |
| J1200 |
Diphenhydramine hcl injectio |
8,583 |
6,615 |
$667.57 |
| 89051 |
|
837 |
632 |
$647.91 |
| 90694 |
|
140 |
132 |
$641.37 |
| J3370 |
Vancomycin hcl injection |
3,576 |
2,088 |
$636.79 |
| A9577 |
Inj multihance |
1,368 |
1,253 |
$632.13 |
| 85046 |
|
361 |
329 |
$616.69 |
| 87088 |
|
1,430 |
1,298 |
$594.33 |
| J3535 |
Metered dose inhaler drug |
3,144 |
2,321 |
$534.83 |
| 73522 |
|
14 |
14 |
$524.27 |
| J3475 |
Inj magnesium sulfate |
3,515 |
2,740 |
$509.83 |
| J1030 |
Methylprednisolone 40 mg inj |
2,429 |
2,250 |
$501.87 |
| C1893 |
Intro/sheath, fixed,non-peel |
32 |
24 |
$495.60 |
| A9270 |
Non-covered item or service |
4,178 |
2,663 |
$494.59 |
| 82330 |
|
357 |
265 |
$492.44 |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
1,871 |
1,728 |
$472.19 |
| 78434 |
|
252 |
237 |
$466.42 |
| J0780 |
Prochlorperazine injection |
3,862 |
3,124 |
$458.46 |
| 90656 |
|
52 |
52 |
$443.41 |
| J1790 |
Droperidol injection |
4,459 |
3,801 |
$441.23 |
| J2370 |
Phenylephrine hcl injection |
4,307 |
3,427 |
$439.80 |
| J2060 |
Lorazepam injection |
3,566 |
2,638 |
$397.37 |
| J3480 |
Inj potassium chloride |
2,941 |
1,950 |
$384.66 |
| A6198 |
Alginate dressing > 48 sq in |
252 |
205 |
$368.50 |
| J2795 |
Ropivacaine hcl injection |
831 |
746 |
$366.84 |
| J7040 |
Normal saline solution infus |
4,237 |
3,365 |
$361.12 |
| J2765 |
Metoclopramide hcl injection |
3,942 |
3,210 |
$359.28 |
| 82746 |
|
546 |
495 |
$356.84 |
| 93226 |
|
13 |
12 |
$355.85 |
| 88313 |
|
211 |
181 |
$338.40 |
| 84156 |
|
1,053 |
890 |
$327.68 |
| 87804 |
|
1,397 |
1,144 |
$321.84 |
| J2710 |
Neostigmine methylslfte inj |
1,535 |
1,329 |
$320.91 |
| 88360 |
|
60 |
50 |
$278.88 |
| 90653 |
|
86 |
75 |
$266.69 |
| 0004A |
|
13 |
12 |
$254.10 |
| 90833 |
|
174 |
135 |
$249.72 |
| G0257 |
Unsched dialysis esrd pt hos |
28 |
14 |
$243.69 |
| 87340 |
|
664 |
580 |
$241.07 |
| J1626 |
Granisetron hcl injection |
1,296 |
611 |
$237.70 |
| J2550 |
Promethazine hcl injection |
2,232 |
1,692 |
$225.02 |
| 86706 |
|
530 |
470 |
$224.37 |
| G1004 |
Cdsm ndsc |
10,332 |
8,071 |
$221.77 |
| S0028 |
Injection, famotidine, 20 mg |
3,063 |
2,096 |
$220.32 |
| 84439 |
|
288 |
268 |
$216.31 |
| J1940 |
Furosemide injection |
2,275 |
1,297 |
$211.89 |
| S0164 |
Injection pantroprazole |
2,206 |
1,240 |
$210.01 |
| 88112 |
|
27 |
24 |
$206.64 |
| J2310 |
Inj naloxone hydrochloride |
413 |
291 |
$186.05 |
| 88312 |
|
58 |
37 |
$176.16 |
| J1040 |
Methylprednisolone 80 mg inj |
906 |
819 |
$164.12 |
| 89050 |
|
101 |
84 |
$162.61 |
| 43450 |
|
45 |
40 |
$151.29 |
| L0120 |
Cerv flex n/adj foam pre ots |
1,080 |
907 |
$145.29 |
| J1580 |
Garamycin gentamicin inj |
1,347 |
1,096 |
$137.09 |
| 51701 |
|
108 |
95 |
$120.47 |
| 90662 |
|
33 |
27 |
$118.30 |
| 87206 |
|
344 |
254 |
$117.62 |
| 86592 |
|
205 |
192 |
$114.26 |
| Q0169 |
Promethazine hcl 12.5mg oral |
952 |
682 |
$111.49 |
| J3301 |
Triamcinolone acet inj nos |
1,647 |
1,417 |
$100.57 |
| 93225 |
|
14 |
12 |
$99.74 |
| U0005 |
Infec agen detec ampli probe |
458 |
408 |
$99.16 |
| J3360 |
Diazepam injection |
486 |
396 |
$98.45 |
| 80069 |
|
44 |
28 |
$97.48 |
| G0009 |
Admin pneumococcal vaccine |
299 |
246 |
$96.25 |
| 64615 |
|
29 |
25 |
$96.24 |
| J7042 |
5% dextrose/normal saline |
763 |
546 |
$94.09 |
| G0475 |
Hiv combination assay |
24 |
15 |
$93.71 |
| 82272 |
|
871 |
789 |
$91.47 |
| J0360 |
Hydralazine hcl injection |
1,204 |
898 |
$90.18 |
| J3372 |
Inj, vancomycin hcl (xellia) |
203 |
114 |
$85.53 |
| J2919 |
Inj, methylpred sod succ 5mg |
368 |
293 |
$83.41 |
| J3486 |
Ziprasidone mesylate |
16 |
13 |
$82.68 |
| 87807 |
|
188 |
180 |
$79.87 |
| 87071 |
|
124 |
113 |
$75.25 |
| 87102 |
|
230 |
180 |
$73.53 |
| J3411 |
Thiamine hcl 100 mg |
1,059 |
349 |
$73.22 |
| 87899 |
|
125 |
90 |
$71.21 |
| 82150 |
|
141 |
127 |
$70.41 |
| 80178 |
|
12 |
12 |
$68.72 |
| 80050 |
|
89 |
85 |
$67.05 |
| 93356 |
|
42 |
40 |
$64.49 |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
2,341 |
2,074 |
$64.44 |
| 82784 |
|
53 |
48 |
$63.99 |
| 85384 |
|
162 |
145 |
$63.92 |
| J2470 |
Inj pantoprazole sodium 40mg |
233 |
162 |
$63.70 |
| 87046 |
|
105 |
89 |
$62.59 |
| J0136 |
Inj, acetaminophen (b braun) |
29 |
13 |
$60.51 |
| A6197 |
Alginate drsg >16 <=48 sq in |
637 |
463 |
$51.48 |
| J0692 |
Cefepime hcl for injection |
474 |
137 |
$47.51 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,990 |
1,346 |
$46.04 |
| J1630 |
Haloperidol injection |
385 |
289 |
$45.63 |
| 87045 |
|
96 |
89 |
$44.61 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
1,612 |
470 |
$41.34 |
| 87449 |
|
88 |
70 |
$40.06 |
| P9612 |
Catheterize for urine spec |
788 |
697 |
$40.02 |
| S0077 |
Injection, clindamycin phosp |
1,324 |
782 |
$38.26 |
| 84132 |
|
145 |
127 |
$35.14 |
| 87147 |
|
106 |
95 |
$33.96 |
| 88302 |
|
32 |
24 |
$32.12 |
| 82010 |
|
163 |
147 |
$31.50 |
| J1010 |
Inj, methylpred acetate 1 mg |
225 |
220 |
$27.55 |
| A6210 |
Foam drg >16<=48 sq in w/o b |
815 |
556 |
$24.47 |
| J0737 |
Inj, clindamycin (baxter) |
123 |
90 |
$19.58 |
| J7060 |
5% dextrose/water |
324 |
170 |
$18.81 |
| 88311 |
|
13 |
13 |
$17.41 |
| G0279 |
Tomosynthesis, mammo |
17 |
17 |
$14.97 |
| 93321 |
|
320 |
305 |
$11.81 |
| J1836 |
Inj, metronidazole, 10 mg |
562 |
324 |
$8.48 |
| 94761 |
|
310 |
194 |
$7.69 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
1,000 |
869 |
$6.82 |
| 85347 |
|
25 |
24 |
$5.67 |
| 82945 |
|
29 |
26 |
$5.51 |
| C9113 |
Inj pantoprazole sodium, via |
62 |
30 |
$5.24 |
| 86308 |
|
77 |
74 |
$4.66 |
| J1920 |
Inj, labetalol hcl, 5mg |
151 |
118 |
$4.07 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
182 |
164 |
$2.97 |
| 84157 |
|
72 |
65 |
$2.85 |
| S0030 |
Injection, metronidazole |
1,019 |
618 |
$2.27 |
| G8979 |
Mobility goal status |
623 |
425 |
$0.01 |
| A4649 |
Surgical supplies |
2,123 |
1,508 |
$0.00 |
| A6196 |
Alginate dressing <=16 sq in |
41 |
27 |
$0.00 |
| 87324 |
|
32 |
28 |
$0.00 |
| G8985 |
Carry goal status |
57 |
39 |
$0.00 |
| 51702 |
|
45 |
40 |
$0.00 |
| 99157 |
|
34 |
27 |
$0.00 |
| J1953 |
Levetiracetam injection |
377 |
269 |
$0.00 |
| 22853 |
|
28 |
26 |
$0.00 |
| C1760 |
Closure dev, vasc |
118 |
99 |
$0.00 |
| G8978 |
Mobility current status |
540 |
380 |
$0.00 |
| A6021 |
Collagen dressing <=16 sq in |
671 |
465 |
$0.00 |
| 20930 |
|
67 |
53 |
$0.00 |
| Q9961 |
Hocm 250-299mg/ml iodine,1ml |
68 |
62 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
132 |
122 |
$0.00 |
| A9526 |
Nitrogen n-13 ammonia |
91 |
40 |
$0.00 |
| J0736 |
Inj, clindamycin phosp 300mg |
60 |
44 |
$0.00 |
| J3260 |
Tobramycin sulfate injection |
23 |
13 |
$0.00 |
| C1758 |
Catheter, ureteral |
31 |
26 |
$0.00 |
| M0222 |
Bebtelovimab injection |
34 |
30 |
$0.00 |
| J9370 |
Vincristine sulfate 1 mg inj |
57 |
24 |
$0.00 |
| 70250 |
|
13 |
12 |
$0.00 |
| J2359 |
Inj. olanzapine, 0.5mg |
34 |
27 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
158 |
125 |
$0.00 |
| J2920 |
Methylprednisolone injection |
209 |
137 |
$0.00 |
| G8980 |
Mobility d/c status |
160 |
113 |
$0.00 |
| G8988 |
Self care goal status |
175 |
120 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
158 |
74 |
$0.00 |
| J2358 |
Olanzapine long-acting inj |
227 |
135 |
$0.00 |
| A9503 |
Tc99m medronate |
107 |
103 |
$0.00 |
| 99156 |
|
206 |
182 |
$0.00 |
| C1781 |
Mesh (implantable) |
127 |
118 |
$0.00 |
| G8987 |
Self care current status |
171 |
118 |
$0.00 |
| G8982 |
Body pos goal status |
14 |
12 |
$0.00 |
| 96409 |
|
85 |
51 |
$0.00 |
| J3590 |
Unclassified biologics |
68 |
57 |
$0.00 |
| J9045 |
Carboplatin injection |
25 |
12 |
$0.00 |
| J2305 |
Inj, nitroglycerin, 5 mg |
12 |
12 |
$0.00 |
| G0269 |
Occlusive device in vein art |
12 |
12 |
$0.00 |
| 88300 |
|
13 |
12 |
$0.00 |