| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
172,180 |
145,714 |
$53.75M |
| 99283 |
|
181,711 |
162,844 |
$40.47M |
| 99285 |
|
64,361 |
45,968 |
$19.07M |
| 74177 |
|
31,946 |
28,254 |
$11.98M |
| 99282 |
|
57,392 |
52,311 |
$11.55M |
| 93306 |
|
19,342 |
16,684 |
$9.35M |
| G0378 |
Hospital observation per hr |
52,668 |
23,231 |
$8.21M |
| C1776 |
Joint device (implantable) |
782 |
683 |
$7.51M |
| J9271 |
Inj pembrolizumab |
1,347 |
808 |
$7.31M |
| C1713 |
Anchor/screw bn/bn,tis/bn |
5,303 |
4,322 |
$7.18M |
| 70450 |
|
35,783 |
30,019 |
$7.11M |
| 70551 |
|
11,598 |
10,516 |
$5.87M |
| 72148 |
|
10,752 |
9,778 |
$5.84M |
| 70553 |
|
10,518 |
8,487 |
$5.46M |
| 96375 |
|
74,558 |
46,152 |
$4.62M |
| J1745 |
Infliximab not biosimil 10mg |
1,592 |
1,311 |
$4.56M |
| 78815 |
|
2,061 |
1,675 |
$3.86M |
| 96374 |
|
135,986 |
62,486 |
$3.58M |
| 96365 |
|
75,838 |
25,602 |
$3.54M |
| 74176 |
|
11,581 |
10,152 |
$3.45M |
| 71275 |
|
10,934 |
9,633 |
$3.31M |
| 77386 |
|
7,611 |
595 |
$3.29M |
| 72141 |
|
5,800 |
5,083 |
$3.19M |
| 96361 |
|
93,860 |
49,004 |
$3.18M |
| 87637 |
|
25,135 |
23,307 |
$3.03M |
| 78452 |
|
9,681 |
5,145 |
$2.98M |
| 43239 |
|
7,735 |
6,068 |
$2.82M |
| J0585 |
Injection,onabotulinumtoxina |
6,172 |
5,324 |
$2.65M |
| 71260 |
|
8,810 |
6,365 |
$2.58M |
| 96413 |
|
19,271 |
10,046 |
$2.51M |
| 58661 |
|
1,182 |
911 |
$2.40M |
| J3490 |
Drugs unclassified injection |
234,043 |
62,614 |
$2.39M |
| 80053 |
|
244,382 |
168,889 |
$2.37M |
| 99281 |
|
14,392 |
13,210 |
$2.36M |
| 93005 |
|
99,987 |
72,435 |
$2.33M |
| 62323 |
|
6,270 |
4,779 |
$2.29M |
| 47562 |
|
1,361 |
941 |
$2.20M |
| 73721 |
|
4,518 |
3,995 |
$2.20M |
| 58571 |
|
873 |
497 |
$2.15M |
| 93458 |
|
1,473 |
775 |
$2.02M |
| 72125 |
|
8,748 |
7,484 |
$2.02M |
| 76770 |
|
11,851 |
11,269 |
$1.93M |
| 71045 |
|
58,733 |
46,506 |
$1.79M |
| 42820 |
|
1,235 |
1,188 |
$1.75M |
| 93017 |
|
7,795 |
6,723 |
$1.74M |
| 69436 |
|
2,168 |
2,075 |
$1.71M |
| 71250 |
|
7,816 |
6,246 |
$1.71M |
| 44970 |
|
744 |
642 |
$1.71M |
| 93320 |
|
7,092 |
6,405 |
$1.70M |
| 71046 |
|
39,451 |
35,381 |
$1.65M |
| 96372 |
|
67,824 |
25,800 |
$1.58M |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
71,114 |
57,130 |
$1.57M |
| 76705 |
|
12,656 |
11,764 |
$1.48M |
| 45380 |
|
3,131 |
2,636 |
$1.46M |
| J2323 |
Natalizumab injection |
338 |
280 |
$1.42M |
| 96360 |
|
30,682 |
19,196 |
$1.38M |
| J2350 |
Injection, ocrelizumab, 1 mg |
78 |
66 |
$1.35M |
| 95810 |
|
3,062 |
2,834 |
$1.34M |
| 85025 |
|
248,520 |
183,140 |
$1.30M |
| 93303 |
|
6,243 |
5,522 |
$1.27M |
| 77067 |
|
15,893 |
15,194 |
$1.27M |
| 76830 |
|
9,940 |
9,022 |
$1.25M |
| 36512 |
|
1,578 |
1,386 |
$1.20M |
| 72131 |
|
4,351 |
3,654 |
$1.19M |
| 72146 |
|
2,295 |
2,060 |
$1.16M |
| 45378 |
|
2,346 |
2,013 |
$1.14M |
| 41899 |
|
2,200 |
1,987 |
$1.13M |
| 74019 |
|
17,156 |
16,096 |
$1.11M |
| 36415 |
|
286,765 |
123,111 |
$1.08M |
| 87633 |
|
4,837 |
4,607 |
$1.07M |
| 45385 |
|
2,229 |
1,855 |
$1.06M |
| 96376 |
|
18,657 |
11,278 |
$1.06M |
| 97110 |
|
25,127 |
7,299 |
$1.06M |
| 73221 |
|
2,237 |
1,965 |
$1.04M |
| G0480 |
Drug test def 1-7 classes |
21,395 |
18,218 |
$1.02M |
| G0463 |
Hospital outpt clinic visit |
23,047 |
16,556 |
$988K |
| 70496 |
|
2,906 |
2,390 |
$953K |
| 76856 |
|
7,996 |
7,572 |
$925K |
| J3380 |
Inj vedolizumab iv 1 mg |
185 |
166 |
$914K |
| J2505 |
Injection, pegfilgrastim 6mg |
282 |
174 |
$908K |
| 77334 |
|
1,979 |
1,079 |
$895K |
| 99291 |
|
1,763 |
1,354 |
$858K |
| 70491 |
|
3,166 |
2,627 |
$849K |
| 88305 |
|
12,466 |
9,800 |
$843K |
| 70486 |
|
3,713 |
3,313 |
$825K |
| J0185 |
Inj., aprepitant, 1 mg |
3,892 |
2,125 |
$815K |
| 93975 |
|
6,370 |
5,919 |
$808K |
| 62321 |
|
2,023 |
1,650 |
$803K |
| 70498 |
|
2,833 |
2,467 |
$800K |
| 74018 |
|
13,334 |
11,930 |
$800K |
| 76536 |
|
6,391 |
5,966 |
$797K |
| 93971 |
|
7,314 |
6,593 |
$790K |
| 83880 |
|
39,430 |
33,980 |
$785K |
| 72158 |
|
1,640 |
1,395 |
$781K |
| 64615 |
|
6,479 |
4,890 |
$775K |
| 76642 |
|
8,720 |
8,093 |
$770K |
| 36561 |
|
874 |
552 |
$753K |
| P9016 |
Rbc leukocytes reduced |
4,628 |
3,108 |
$744K |
| 11042 |
|
5,709 |
2,324 |
$728K |
| 80307 |
|
25,240 |
22,010 |
$722K |
| 97530 |
|
17,590 |
6,828 |
$707K |
| J9312 |
Inj., rituximab, 10 mg |
193 |
90 |
$705K |
| 74178 |
|
1,445 |
1,138 |
$704K |
| 77412 |
|
3,548 |
369 |
$704K |
| C1769 |
Guide wire |
8,049 |
6,611 |
$684K |
| 64721 |
|
970 |
800 |
$663K |
| 54161 |
|
1,219 |
1,182 |
$655K |
| 20680 |
|
695 |
603 |
$629K |
| 96367 |
|
11,764 |
4,763 |
$624K |
| 95713 |
|
2,282 |
1,385 |
$609K |
| 74183 |
|
1,233 |
992 |
$606K |
| 70544 |
|
1,704 |
1,363 |
$590K |
| Q5118 |
Inj., zirabev, 10 mg |
329 |
117 |
$586K |
| 93325 |
|
8,727 |
8,055 |
$583K |
| 96415 |
|
4,387 |
3,250 |
$580K |
| 93970 |
|
4,050 |
3,617 |
$575K |
| 96366 |
|
12,189 |
6,599 |
$574K |
| 72156 |
|
1,123 |
946 |
$571K |
| 77063 |
|
14,784 |
12,959 |
$570K |
| 76700 |
|
3,258 |
3,021 |
$562K |
| C1725 |
Cath, translumin non-laser |
2,375 |
1,856 |
$555K |
| 99211 |
|
29,525 |
25,564 |
$547K |
| 95811 |
|
1,281 |
1,151 |
$545K |
| 84484 |
|
70,752 |
45,414 |
$541K |
| 72197 |
|
1,017 |
816 |
$534K |
| 54300 |
|
512 |
494 |
$532K |
| J0897 |
Denosumab injection |
544 |
395 |
$512K |
| 73630 |
|
11,289 |
9,647 |
$512K |
| 76817 |
|
6,555 |
5,775 |
$505K |
| 96417 |
|
4,617 |
2,623 |
$505K |
| 59025 |
|
13,190 |
10,426 |
$497K |
| 76801 |
|
6,915 |
6,032 |
$493K |
| 77066 |
Tomosynthesis, mammo |
4,420 |
4,028 |
$484K |
| C1781 |
Mesh (implantable) |
914 |
839 |
$480K |
| Q5111 |
Injection, udenyca 0.5 mg |
215 |
124 |
$436K |
| 87635 |
|
13,739 |
12,408 |
$434K |
| 78227 |
|
1,213 |
960 |
$432K |
| 67311 |
|
391 |
352 |
$429K |
| A9552 |
F18 fdg |
3,818 |
2,414 |
$424K |
| 19083 |
|
831 |
664 |
$422K |
| 58558 |
|
486 |
393 |
$413K |
| 95782 |
|
697 |
651 |
$412K |
| 77300 |
|
1,595 |
959 |
$411K |
| 92507 |
|
9,330 |
3,724 |
$406K |
| J2469 |
Palonosetron hcl |
4,861 |
2,690 |
$402K |
| 77336 |
|
4,481 |
1,582 |
$400K |
| 36430 |
|
3,310 |
1,818 |
$397K |
| J9306 |
Injection, pertuzumab, 1 mg |
82 |
65 |
$391K |
| 78264 |
|
1,688 |
1,272 |
$370K |
| 76870 |
|
3,241 |
2,959 |
$367K |
| 43235 |
|
1,151 |
796 |
$362K |
| 51600 |
|
2,737 |
2,623 |
$362K |
| 99213 |
|
17,044 |
12,214 |
$361K |
| 73610 |
|
9,684 |
8,406 |
$358K |
| 93225 |
|
3,899 |
3,316 |
$355K |
| 73562 |
|
9,067 |
6,853 |
$352K |
| 36593 |
|
2,188 |
1,779 |
$347K |
| 52332 |
|
667 |
425 |
$341K |
| 74455 |
|
3,050 |
2,879 |
$340K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
15,065 |
13,373 |
$338K |
| J1756 |
Iron sucrose injection |
6,000 |
2,689 |
$334K |
| C1874 |
Stent, coated/cov w/del sys |
151 |
134 |
$333K |
| 73030 |
|
8,036 |
6,094 |
$332K |
| 72157 |
|
611 |
532 |
$328K |
| 64642 |
|
1,046 |
752 |
$327K |
| 77290 |
|
2,387 |
796 |
$324K |
| J9299 |
Injection, nivolumab |
88 |
38 |
$321K |
| 64643 |
|
902 |
713 |
$321K |
| 77065 |
Tomosynthesis, mammo |
4,397 |
3,743 |
$318K |
| J2785 |
Regadenoson injection |
4,685 |
4,047 |
$318K |
| 64493 |
|
649 |
507 |
$315K |
| 73130 |
|
8,889 |
7,373 |
$310K |
| 97112 |
|
7,378 |
2,776 |
$309K |
| 80048 |
|
44,052 |
31,856 |
$307K |
| 94640 |
|
23,467 |
19,499 |
$307K |
| J9310 |
Rituximab injection |
94 |
41 |
$303K |
| Q0138 |
Ferumoxytol, non-esrd |
741 |
445 |
$301K |
| 93798 |
|
9,740 |
1,504 |
$301K |
| C1762 |
Conn tiss, human(inc fascia) |
85 |
79 |
$297K |
| 78492 |
|
288 |
130 |
$296K |
| 95951 |
|
1,611 |
1,046 |
$295K |
| 95812 |
|
1,127 |
1,091 |
$294K |
| A9500 |
Tc99m sestamibi |
5,189 |
4,513 |
$291K |
| 93351 |
|
733 |
645 |
$290K |
| 77295 |
|
293 |
223 |
$290K |
| C1894 |
Intro/sheath, non-laser |
4,541 |
3,827 |
$286K |
| 87591 |
|
17,230 |
16,102 |
$284K |
| 87491 |
|
17,442 |
16,112 |
$284K |
| 95816 |
|
1,832 |
1,729 |
$284K |
| 72128 |
|
1,309 |
1,116 |
$281K |
| G0382 |
Lev 3 hosp type b ed visit |
1,704 |
1,617 |
$281K |
| 72132 |
|
1,350 |
846 |
$277K |
| 84443 |
|
19,097 |
16,952 |
$273K |
| 86920 |
|
4,936 |
2,936 |
$268K |
| G0260 |
Inj for sacroiliac jt anesth |
938 |
724 |
$267K |
| 51728 |
|
1,419 |
1,374 |
$265K |
| 95700 |
|
2,237 |
2,043 |
$259K |
| J1459 |
Inj ivig privigen 500 mg |
224 |
108 |
$258K |
| 88341 |
|
2,451 |
1,852 |
$256K |
| 72110 |
|
5,108 |
4,320 |
$255K |
| C1887 |
Catheter, guiding |
2,614 |
2,181 |
$254K |
| 95716 |
|
850 |
687 |
$251K |
| 95886 |
|
1,770 |
1,622 |
$247K |
| 93922 |
|
2,389 |
1,865 |
$246K |
| 95813 |
|
1,189 |
1,079 |
$245K |
| 78431 |
|
212 |
176 |
$243K |
| C1788 |
Port, indwelling, imp |
679 |
598 |
$242K |
| 83735 |
|
46,813 |
34,861 |
$239K |
| 88342 |
|
6,005 |
5,104 |
$239K |
| G0121 |
Colon ca scrn not hi rsk ind |
549 |
429 |
$235K |
| 74230 |
|
2,164 |
1,855 |
$232K |
| J1439 |
Inj ferric carboxymaltos 1mg |
418 |
244 |
$232K |
| 96411 |
|
2,715 |
1,663 |
$231K |
| 77080 |
|
4,000 |
3,257 |
$229K |
| 95819 |
|
1,397 |
1,289 |
$227K |
| 73090 |
|
6,436 |
5,677 |
$226K |
| 50590 |
|
116 |
83 |
$226K |
| 86850 |
|
30,007 |
23,129 |
$224K |
| 78306 |
|
1,159 |
659 |
$224K |
| 73590 |
|
6,133 |
5,093 |
$219K |
| 73110 |
|
6,283 |
5,339 |
$216K |
| 72100 |
|
4,588 |
3,907 |
$216K |
| J9022 |
Inj, atezolizumab,10 mg |
53 |
25 |
$216K |
| 97161 |
|
7,614 |
4,019 |
$215K |
| 93880 |
|
2,030 |
1,619 |
$213K |
| M0243 |
Casirivi and imdevi inj |
1,348 |
1,275 |
$208K |
| 76885 |
|
1,710 |
1,621 |
$205K |
| G0297 |
Ldct for lung ca screen |
1,493 |
1,327 |
$205K |
| 88185 |
|
839 |
581 |
$202K |
| 87389 |
|
15,723 |
14,533 |
$200K |
| 87798 |
|
7,919 |
6,863 |
$200K |
| 82728 |
|
15,539 |
12,822 |
$198K |
| C2617 |
Stent, non-cor, tem w/o del |
1,413 |
1,205 |
$196K |
| 84703 |
|
47,640 |
42,118 |
$194K |
| 81025 |
|
44,551 |
40,269 |
$193K |
| 54163 |
|
239 |
216 |
$193K |
| 87502 |
|
12,341 |
11,554 |
$191K |
| 83690 |
|
51,759 |
44,945 |
$189K |
| J2704 |
Inj, propofol, 10 mg |
65,379 |
50,086 |
$188K |
| 88307 |
|
2,312 |
1,862 |
$188K |
| 22551 |
|
51 |
39 |
$187K |
| 12011 |
|
3,738 |
3,441 |
$186K |
| 72040 |
|
3,871 |
3,333 |
$183K |
| 76882 |
|
1,942 |
1,787 |
$182K |
| J2997 |
Alteplase recombinant |
4,075 |
1,981 |
$180K |
| 77062 |
|
4,024 |
3,349 |
$178K |
| 81229 |
|
241 |
217 |
$178K |
| 86900 |
|
33,444 |
25,428 |
$177K |
| 29881 |
|
131 |
125 |
$175K |
| 10060 |
|
2,731 |
2,418 |
$169K |
| C1760 |
Closure dev, vasc |
962 |
788 |
$168K |
| 94060 |
|
1,674 |
1,304 |
$165K |
| 74240 |
|
1,484 |
1,374 |
$164K |
| 27447 |
|
201 |
42 |
$161K |
| 97162 |
|
4,737 |
2,644 |
$160K |
| Q5103 |
Injection, inflectra |
85 |
63 |
$158K |
| 80061 |
|
12,380 |
8,167 |
$158K |
| A4648 |
Implantable tissue marker |
1,678 |
1,282 |
$156K |
| 76819 |
|
2,197 |
1,845 |
$156K |
| 75574 |
|
402 |
341 |
$155K |
| 12001 |
|
3,252 |
2,994 |
$154K |
| 76825 |
|
873 |
767 |
$153K |
| 77072 |
|
2,476 |
2,384 |
$152K |
| 94726 |
|
1,932 |
1,769 |
$151K |
| 86902 |
|
3,155 |
1,801 |
$148K |
| 87086 |
|
38,012 |
34,757 |
$147K |
| 93226 |
|
3,517 |
3,218 |
$147K |
| 73560 |
|
3,794 |
3,247 |
$146K |
| 97535 |
|
8,530 |
5,266 |
$144K |
| 73700 |
|
681 |
579 |
$144K |
| J9202 |
Goserelin acetate implant |
320 |
283 |
$143K |
| 73070 |
|
4,619 |
3,958 |
$142K |
| 74174 |
|
319 |
224 |
$142K |
| 85730 |
|
37,971 |
32,340 |
$142K |
| 92611 |
|
1,857 |
1,710 |
$140K |
| 29580 |
|
3,797 |
1,214 |
$138K |
| 81001 |
|
82,416 |
72,005 |
$136K |
| 87661 |
|
8,134 |
7,625 |
$136K |
| 49083 |
|
555 |
173 |
$135K |
| A9555 |
Rb82 rubidium |
821 |
417 |
$135K |
| 76800 |
|
926 |
901 |
$134K |
| 77061 |
|
3,550 |
2,873 |
$134K |
| 82565 |
|
11,257 |
6,777 |
$134K |
| 51784 |
|
1,464 |
1,383 |
$133K |
| Q9969 |
Non-heu tc-99m add-on/dose |
8,698 |
7,948 |
$132K |
| 77002 |
|
1,700 |
1,223 |
$131K |
| 99157 |
|
2,467 |
2,321 |
$130K |
| 73502 |
|
3,601 |
2,814 |
$130K |
| 82306 |
|
5,248 |
4,801 |
$130K |
| 73521 |
|
2,181 |
2,039 |
$128K |
| 94010 |
|
3,033 |
2,390 |
$125K |
| 54640 |
|
96 |
86 |
$125K |
| Q5107 |
Inj mvasi 10 mg |
97 |
38 |
$124K |
| 85027 |
|
31,670 |
26,658 |
$124K |
| 97140 |
|
4,914 |
1,934 |
$123K |
| 85610 |
|
46,352 |
37,678 |
$123K |
| 97116 |
|
6,219 |
2,939 |
$123K |
| U0004 |
Cov-19 test non-cdc hgh thru |
3,071 |
2,634 |
$122K |
| 95910 |
|
847 |
697 |
$121K |
| C1726 |
Cath, bal dil, non-vascular |
783 |
647 |
$121K |
| 20936 |
|
317 |
221 |
$121K |
| 20930 |
|
234 |
178 |
$121K |
| 62304 |
|
230 |
195 |
$119K |
| J1453 |
Fosaprepitant injection |
518 |
302 |
$113K |
| 86003 |
|
1,464 |
1,207 |
$112K |
| 87486 |
|
5,201 |
4,869 |
$110K |
| 96409 |
|
1,218 |
760 |
$110K |
| 72082 |
|
1,119 |
1,049 |
$110K |
| 73552 |
|
2,804 |
2,353 |
$106K |
| 86922 |
|
1,505 |
796 |
$106K |
| 84439 |
|
10,967 |
9,858 |
$106K |
| 96416 |
|
730 |
401 |
$105K |
| 87581 |
|
5,188 |
4,878 |
$105K |
| 72072 |
|
2,670 |
2,208 |
$103K |
| 55175 |
|
407 |
390 |
$103K |
| 84702 |
|
11,588 |
9,707 |
$100K |
| 76937 |
|
1,530 |
1,261 |
$99K |
| 88304 |
|
4,560 |
4,053 |
$99K |
| 96402 |
|
1,552 |
1,238 |
$98K |
| 73060 |
|
2,925 |
2,530 |
$97K |
| 29581 |
|
2,443 |
685 |
$97K |
| J7040 |
Normal saline solution infus |
49,710 |
23,445 |
$96K |
| 95806 |
|
1,075 |
994 |
$95K |
| 87651 |
|
5,439 |
5,145 |
$94K |
| Q9950 |
Inj sulf hexa lipid microsph |
2,856 |
1,863 |
$91K |
| 77075 |
|
632 |
602 |
$91K |
| C8908 |
Mri w/o fol w/cont, breast, |
188 |
138 |
$90K |
| 64644 |
|
306 |
194 |
$89K |
| J9035 |
Bevacizumab injection |
25 |
12 |
$88K |
| 86901 |
|
31,001 |
25,226 |
$88K |
| 70480 |
|
308 |
287 |
$88K |
| 83036 |
|
10,466 |
9,057 |
$88K |
| J9355 |
Inj trastuzumab excl biosimi |
32 |
12 |
$87K |
| 93308 |
|
576 |
401 |
$86K |
| 87040 |
|
15,977 |
10,447 |
$86K |
| 92526 |
|
1,550 |
814 |
$86K |
| 88360 |
|
581 |
455 |
$86K |
| 77001 |
|
1,119 |
916 |
$85K |
| 43762 |
|
634 |
549 |
$82K |
| 12002 |
|
1,421 |
1,300 |
$82K |
| 83540 |
|
11,143 |
10,107 |
$81K |
| 49585 |
|
90 |
88 |
$79K |
| 82784 |
|
5,513 |
3,776 |
$78K |
| 73222 |
|
185 |
166 |
$78K |
| 84112 |
|
1,940 |
1,726 |
$78K |
| 73140 |
|
2,842 |
2,533 |
$77K |
| 87522 |
Neg quan hep c or qual rna |
2,219 |
2,046 |
$77K |
| 99212 |
|
3,890 |
3,137 |
$77K |
| 70487 |
|
296 |
266 |
$77K |
| 96368 |
|
4,028 |
745 |
$77K |
| 82607 |
|
5,745 |
4,477 |
$76K |
| 76942 |
|
857 |
733 |
$76K |
| 73200 |
|
239 |
205 |
$74K |
| 10005 |
|
207 |
171 |
$74K |
| 71271 |
|
1,941 |
1,629 |
$74K |
| C1751 |
Cath, inf, per/cent/midline |
1,067 |
799 |
$74K |
| 51797 |
|
961 |
932 |
$73K |
| 83605 |
|
10,123 |
8,030 |
$73K |
| 94729 |
|
1,692 |
1,554 |
$73K |
| 87070 |
|
19,251 |
17,085 |
$72K |
| 86945 |
|
2,466 |
1,023 |
$70K |
| 58563 |
|
27 |
27 |
$69K |
| 87880 |
|
21,944 |
20,755 |
$67K |
| 42830 |
|
79 |
73 |
$67K |
| 76000 |
|
757 |
707 |
$67K |
| 76815 |
|
719 |
661 |
$67K |
| 80074 |
|
2,070 |
1,902 |
$66K |
| 97750 |
|
2,715 |
1,992 |
$65K |
| 72050 |
|
1,448 |
1,158 |
$65K |
| J9070 |
Cyclophosphamide 100 mg inj |
300 |
101 |
$62K |
| 71101 |
|
1,974 |
1,452 |
$62K |
| 70470 |
|
165 |
122 |
$62K |
| Q5115 |
Inj truxima 10 mg |
27 |
14 |
$61K |
| 86140 |
|
17,813 |
15,065 |
$61K |
| 29105 |
|
1,019 |
954 |
$61K |
| G1004 |
Cdsm ndsc |
4,678 |
1,416 |
$61K |
| 29125 |
|
1,622 |
1,503 |
$61K |
| 85007 |
|
26,304 |
22,687 |
$60K |
| 81003 |
|
45,356 |
41,056 |
$60K |
| Q5117 |
Inj., kanjinti, 10 mg |
22 |
13 |
$60K |
| 58300 |
|
148 |
130 |
$60K |
| 59820 |
|
57 |
51 |
$59K |
| J0696 |
Ceftriaxone sodium injection |
18,400 |
12,856 |
$59K |
| C9463 |
Injection, aprepitant |
253 |
143 |
$59K |
| J9173 |
Inj., durvalumab, 10 mg |
57 |
13 |
$59K |
| J7060 |
5% dextrose/water |
34,217 |
13,982 |
$59K |
| 83021 |
|
4,340 |
2,678 |
$59K |
| 94762 |
|
1,833 |
1,285 |
$59K |
| G0105 |
Colorectal scrn; hi risk ind |
128 |
106 |
$58K |
| C1889 |
Implant/insert device, noc |
31 |
26 |
$58K |
| 29826 |
|
107 |
97 |
$58K |
| 90715 |
|
4,455 |
4,113 |
$58K |
| 29827 |
|
50 |
43 |
$57K |
| J3489 |
Zoledronic acid 1mg |
740 |
611 |
$57K |
| 83516 |
|
2,118 |
1,764 |
$56K |
| 82803 |
|
3,944 |
3,195 |
$56K |
| 70250 |
|
941 |
804 |
$55K |
| J0690 |
Cefazolin sodium injection |
28,232 |
20,542 |
$55K |
| 99214 |
|
2,530 |
2,085 |
$54K |
| 62270 |
|
322 |
267 |
$53K |
| 64635 |
|
65 |
50 |
$53K |
| 80069 |
|
8,431 |
6,843 |
$52K |
| 76827 |
|
783 |
729 |
$52K |
| 91200 |
|
770 |
734 |
$52K |
| J9045 |
Carboplatin injection |
2,206 |
1,212 |
$51K |
| 92610 |
|
756 |
631 |
$51K |
| J2795 |
Ropivacaine hcl injection |
9,526 |
7,551 |
$50K |
| 72170 |
|
1,594 |
1,312 |
$50K |
| 25605 |
|
161 |
143 |
$50K |
| 97168 |
|
1,350 |
1,262 |
$50K |
| 88313 |
|
982 |
761 |
$49K |
| 82150 |
|
14,109 |
12,735 |
$48K |
| 70360 |
|
1,571 |
1,468 |
$47K |
| J7120 |
Ringers lactate infusion |
31,446 |
24,979 |
$47K |
| 87077 |
|
11,134 |
9,676 |
$47K |
| 94660 |
|
791 |
554 |
$47K |
| 36600 |
|
3,526 |
3,081 |
$47K |
| 85379 |
|
10,258 |
9,368 |
$47K |
| J2930 |
Methylprednisolone injection |
9,569 |
7,120 |
$46K |
| Q0222 |
Bebtelovimab 175 mg |
187 |
132 |
$46K |
| 99155 |
|
1,976 |
1,840 |
$46K |
| Q9958 |
Hocm <=149 mg/ml iodine, 1ml |
3,255 |
3,164 |
$46K |
| 36902 |
|
63 |
27 |
$45K |
| 72081 |
|
595 |
571 |
$45K |
| 87902 |
|
284 |
273 |
$45K |
| 51741 |
|
764 |
722 |
$45K |
| 97164 |
|
1,244 |
1,160 |
$45K |
| 84100 |
|
11,565 |
8,152 |
$44K |
| J0330 |
Succinycholine chloride inj |
12,158 |
10,158 |
$43K |
| 94760 |
|
3,843 |
2,540 |
$43K |
| 72020 |
|
819 |
699 |
$43K |
| 96450 |
|
248 |
197 |
$43K |
| 77076 |
|
603 |
530 |
$42K |
| 64494 |
|
526 |
443 |
$42K |
| J1100 |
Dexamethasone sodium phos |
65,999 |
48,657 |
$42K |
| C1729 |
Cath, drainage |
1,504 |
764 |
$42K |
| 97166 |
|
1,289 |
844 |
$42K |
| 99153 |
Mod sedat endo service >5yrs |
959 |
818 |
$41K |
| J3010 |
Fentanyl citrate injection |
55,552 |
46,132 |
$41K |
| 54304 |
|
44 |
44 |
$41K |
| 82330 |
|
3,749 |
2,926 |
$40K |
| J0561 |
Penicillin g benzathine inj |
843 |
791 |
$40K |
| 94664 |
|
8,625 |
6,319 |
$39K |
| 78708 |
|
189 |
159 |
$39K |
| 96523 |
|
1,823 |
1,304 |
$39K |
| 77280 |
|
713 |
228 |
$39K |
| J2405 |
Ondansetron hcl injection |
82,422 |
64,132 |
$38K |
| 27130 |
|
15 |
12 |
$38K |
| 94644 |
|
2,901 |
2,735 |
$38K |
| 73000 |
|
1,180 |
1,066 |
$38K |
| 86923 |
|
2,002 |
999 |
$38K |
| 73080 |
|
1,264 |
1,004 |
$37K |
| 87186 |
|
9,096 |
8,120 |
$36K |
| J1885 |
Ketorolac tromethamine inj |
57,161 |
40,052 |
$36K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
4,105 |
2,770 |
$36K |
| J3370 |
Vancomycin hcl injection |
6,122 |
3,330 |
$36K |
| 72070 |
|
889 |
730 |
$36K |
| 82550 |
|
6,528 |
5,274 |
$36K |
| G0279 |
Tomosynthesis, mammo |
1,988 |
1,171 |
$36K |
| 88348 |
|
107 |
103 |
$35K |
| 84145 |
|
2,396 |
2,112 |
$35K |
| 72195 |
|
70 |
64 |
$35K |
| 74270 |
|
241 |
223 |
$35K |
| J0780 |
Prochlorperazine injection |
9,448 |
7,803 |
$34K |
| 64483 |
|
72 |
64 |
$34K |
| J0640 |
Leucovorin calcium injection |
1,314 |
436 |
$33K |
| 93976 |
|
398 |
371 |
$33K |
| J1170 |
Hydromorphone injection |
24,080 |
15,993 |
$33K |
| 36591 |
|
1,578 |
1,199 |
$33K |
| J9267 |
Paclitaxel injection |
1,427 |
615 |
$33K |
| 93926 |
|
359 |
291 |
$32K |
| 86665 |
|
3,162 |
2,087 |
$31K |
| 87205 |
|
14,420 |
12,970 |
$31K |
| 73620 |
|
1,034 |
879 |
$31K |
| 82378 |
|
1,686 |
1,375 |
$31K |
| 82746 |
|
2,444 |
2,193 |
$31K |
| 75565 |
|
97 |
90 |
$31K |
| 83970 |
|
927 |
750 |
$30K |
| 85652 |
|
13,223 |
11,210 |
$30K |
| J3301 |
Triamcinolone acet inj nos |
7,736 |
6,658 |
$30K |
| 83615 |
|
4,697 |
3,978 |
$29K |
| J2250 |
Inj midazolam hydrochloride |
57,348 |
45,797 |
$29K |
| 99152 |
|
1,137 |
936 |
$29K |
| 23350 |
|
252 |
234 |
$29K |
| 93321 |
|
311 |
288 |
$29K |
| 80197 |
|
1,967 |
1,086 |
$29K |
| G0381 |
Lev 2 hosp type b ed visit |
297 |
289 |
$28K |
| A9537 |
Tc99m mebrofenin |
985 |
921 |
$28K |
| 97167 |
|
727 |
516 |
$28K |
| 95874 |
|
383 |
347 |
$28K |
| 14040 |
|
98 |
97 |
$28K |
| 85576 |
|
766 |
560 |
$27K |
| 85045 |
|
9,130 |
6,143 |
$27K |
| J0878 |
Daptomycin injection |
98 |
14 |
$27K |
| 87400 |
|
8,325 |
4,027 |
$27K |
| 77301 |
|
19 |
13 |
$27K |
| J1650 |
Inj enoxaparin sodium |
9,456 |
4,442 |
$27K |
| 97165 |
|
656 |
493 |
$27K |
| J0171 |
Adrenalin epinephrine inject |
4,919 |
4,044 |
$26K |
| 76376 |
|
303 |
288 |
$26K |
| P9041 |
Albumin (human),5%, 50ml |
1,149 |
965 |
$25K |
| 22853 |
|
78 |
66 |
$25K |
| 90471 |
|
7,295 |
6,671 |
$25K |
| 87634 |
|
804 |
779 |
$25K |
| 86780 |
|
3,008 |
2,673 |
$25K |
| 87210 |
|
14,038 |
10,010 |
$25K |
| 88184 |
|
731 |
597 |
$25K |
| 86664 |
|
2,332 |
2,080 |
$25K |
| 76805 |
|
287 |
254 |
$25K |
| A9585 |
Gadobutrol injection |
1,029 |
794 |
$25K |
| G0257 |
Unsched dialysis esrd pt hos |
128 |
74 |
$25K |
| 24640 |
|
304 |
292 |
$24K |
| 95911 |
|
126 |
99 |
$24K |
| 82785 |
|
1,339 |
1,268 |
$24K |
| 83883 |
|
2,018 |
1,021 |
$24K |
| 70543 |
|
44 |
42 |
$24K |
| 90375 |
|
17 |
12 |
$24K |
| 73660 |
|
966 |
833 |
$24K |
| 96401 |
|
355 |
157 |
$24K |
| 77470 |
|
47 |
40 |
$23K |
| A9541 |
Tc99m sulfur colloid |
1,433 |
1,306 |
$23K |
| 87804 |
|
7,478 |
3,819 |
$23K |
| Q9957 |
Inj perflutren lip micros,ml |
350 |
236 |
$22K |
| J9190 |
Fluorouracil injection |
3,009 |
665 |
$22K |
| C1758 |
Catheter, ureteral |
1,726 |
1,195 |
$22K |
| 74160 |
|
74 |
49 |
$22K |
| 62328 |
|
69 |
54 |
$22K |
| J1642 |
Inj heparin sodium per 10 u |
12,929 |
6,608 |
$22K |
| 82947 |
|
3,808 |
2,905 |
$22K |
| 84132 |
|
6,151 |
4,967 |
$21K |
| 72126 |
|
126 |
68 |
$21K |
| J2001 |
Lidocaine injection |
26,347 |
22,154 |
$21K |
| 58662 |
|
14 |
13 |
$21K |
| 86334 |
|
1,280 |
1,096 |
$21K |
| 86038 |
|
1,867 |
1,700 |
$20K |
| 29515 |
|
522 |
479 |
$20K |
| 43245 |
|
26 |
26 |
$20K |
| 86870 |
|
404 |
313 |
$20K |
| 70260 |
|
178 |
162 |
$20K |
| J2370 |
Phenylephrine hcl injection |
9,707 |
7,316 |
$19K |
| J2270 |
Morphine sulfate injection |
21,286 |
17,077 |
$19K |
| 86304 |
|
1,142 |
849 |
$19K |
| 11043 |
|
65 |
38 |
$19K |
| 77012 |
|
105 |
97 |
$19K |
| 88302 |
|
1,106 |
940 |
$18K |
| 87075 |
|
2,274 |
1,928 |
$18K |
| 90686 |
|
2,504 |
2,399 |
$18K |
| 86328 |
|
434 |
333 |
$18K |
| 92585 |
|
167 |
149 |
$17K |
| 31624 |
|
26 |
26 |
$17K |
| 88108 |
|
699 |
587 |
$17K |
| 84403 |
|
752 |
683 |
$17K |
| 88312 |
|
571 |
425 |
$17K |
| 95885 |
|
244 |
233 |
$17K |
| J1626 |
Granisetron hcl injection |
3,084 |
1,276 |
$17K |
| A9562 |
Tc99m mertiatide |
304 |
290 |
$17K |
| 94621 |
|
58 |
44 |
$17K |
| 74022 |
|
436 |
400 |
$17K |
| 73718 |
|
47 |
38 |
$16K |
| 86803 |
|
1,724 |
1,562 |
$16K |
| 85660 |
|
2,582 |
1,697 |
$16K |
| 87340 |
|
2,521 |
2,248 |
$16K |
| J2805 |
Sincalide injection |
286 |
265 |
$16K |
| J0295 |
Ampicillin sulbactam 1.5 gm |
4,465 |
1,029 |
$16K |
| 82533 |
|
1,081 |
837 |
$16K |
| J1200 |
Diphenhydramine hcl injectio |
18,435 |
13,443 |
$16K |
| 64636 |
|
48 |
37 |
$16K |
| 86301 |
|
622 |
500 |
$16K |
| J0360 |
Hydralazine hcl injection |
3,378 |
2,488 |
$16K |
| 43760 |
|
178 |
154 |
$16K |
| A9503 |
Tc99m medronate |
850 |
754 |
$16K |
| J2710 |
Neostigmine methylslfte inj |
3,904 |
3,453 |
$16K |
| 99156 |
|
974 |
896 |
$15K |
| J2543 |
Piperacillin/tazobactam |
4,350 |
1,546 |
$15K |
| 86663 |
|
2,203 |
2,079 |
$15K |
| 86706 |
|
1,997 |
1,845 |
$15K |
| 36590 |
|
53 |
43 |
$15K |
| 43249 |
|
46 |
25 |
$15K |
| 84238 |
|
540 |
494 |
$15K |
| G0008 |
Admin influenza virus vac |
308 |
227 |
$14K |
| C9113 |
Inj pantoprazole sodium, via |
7,442 |
4,949 |
$14K |
| 85240 |
|
966 |
876 |
$14K |
| 87046 |
|
2,405 |
1,496 |
$14K |
| 81002 |
|
2,645 |
2,287 |
$14K |
| 94645 |
|
687 |
640 |
$14K |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
1,155 |
809 |
$13K |
| J0500 |
Dicyclomine injection |
701 |
631 |
$13K |
| 90688 |
|
2,537 |
2,358 |
$13K |
| 82105 |
|
864 |
700 |
$13K |
| 53020 |
|
12 |
12 |
$13K |
| 80164 |
|
1,263 |
1,091 |
$13K |
| 38222 |
|
45 |
42 |
$13K |
| J1040 |
Methylprednisolone 80 mg inj |
3,257 |
2,815 |
$13K |
| 72083 |
|
117 |
110 |
$13K |
| 87529 |
|
628 |
418 |
$13K |
| 73564 |
|
411 |
348 |
$13K |
| 36416 |
|
3,769 |
2,864 |
$12K |
| 86704 |
|
1,036 |
948 |
$12K |
| 84165 |
|
1,438 |
1,241 |
$12K |
| 83520 |
|
933 |
832 |
$12K |
| 86147 |
|
355 |
243 |
$12K |
| 85384 |
|
1,635 |
1,318 |
$12K |
| 84481 |
|
873 |
811 |
$12K |
| 87799 |
|
387 |
268 |
$12K |
| 83921 |
|
662 |
612 |
$11K |
| 64718 |
|
13 |
12 |
$11K |
| J7298 |
Mirena, 52 mg |
15 |
13 |
$11K |
| 20610 |
|
88 |
75 |
$11K |
| 83655 |
|
943 |
871 |
$11K |
| 85014 |
|
5,766 |
4,528 |
$11K |
| 78582 |
|
71 |
60 |
$11K |
| 84156 |
|
2,554 |
2,110 |
$11K |
| J0248 |
Inj, remdesivir, 1 mg |
76 |
32 |
$11K |
| 90460 |
|
3,239 |
3,049 |
$11K |
| 82570 |
|
2,548 |
2,187 |
$11K |
| J9263 |
Oxaliplatin |
363 |
87 |
$10K |
| 84460 |
|
2,150 |
1,922 |
$10K |
| 83001 |
|
694 |
639 |
$10K |
| 80076 |
|
1,360 |
1,109 |
$10K |
| 86800 |
|
711 |
655 |
$10K |
| C2628 |
Catheter, occlusion |
98 |
91 |
$10K |
| 87088 |
|
2,920 |
2,714 |
$10K |
| 84146 |
|
623 |
586 |
$10K |
| 82248 |
|
2,327 |
1,680 |
$10K |
| 76506 |
|
72 |
69 |
$10K |
| J9370 |
Vincristine sulfate 1 mg inj |
1,689 |
1,078 |
$10K |
| 95909 |
|
112 |
82 |
$10K |
| 84550 |
|
2,557 |
2,151 |
$10K |
| 86008 |
|
127 |
118 |
$10K |
| J1610 |
Glucagon hydrochloride/1 mg |
122 |
106 |
$10K |
| 84153 |
|
406 |
324 |
$10K |
| 82247 |
|
2,174 |
1,492 |
$10K |
| 82140 |
|
762 |
638 |
$9K |
| J2274 |
Inj morphine pf epid ithc |
10,454 |
7,776 |
$9K |
| 92523 |
|
100 |
92 |
$9K |
| 77399 |
|
114 |
97 |
$9K |
| 76857 |
|
99 |
88 |
$9K |
| 88182 |
|
204 |
175 |
$9K |
| P9035 |
Platelet pheres leukoreduced |
22 |
12 |
$9K |
| 73720 |
|
16 |
13 |
$9K |
| 88173 |
|
339 |
281 |
$9K |
| 93312 |
|
28 |
24 |
$9K |
| 87045 |
|
1,643 |
1,542 |
$9K |
| 22845 |
|
44 |
38 |
$9K |
| 87427 |
|
1,468 |
1,388 |
$9K |
| 84295 |
|
2,831 |
2,414 |
$9K |
| M0222 |
Bebtelovimab injection |
93 |
88 |
$9K |
| J7042 |
5% dextrose/normal saline |
5,802 |
4,366 |
$9K |
| J3475 |
Inj magnesium sulfate |
7,110 |
4,653 |
$9K |
| 85597 |
|
599 |
483 |
$8K |
| 12013 |
|
149 |
133 |
$8K |
| 29505 |
|
140 |
131 |
$8K |
| 85018 |
|
4,580 |
3,489 |
$8K |
| 74328 |
|
71 |
68 |
$8K |
| 75561 |
|
18 |
15 |
$8K |
| 89051 |
|
1,793 |
1,553 |
$8K |
| 93923 |
|
68 |
59 |
$8K |
| 72220 |
|
225 |
205 |
$7K |
| J3480 |
Inj potassium chloride |
4,516 |
2,345 |
$7K |
| G0383 |
Lev 4 hosp type b ed visit |
36 |
35 |
$7K |
| 82668 |
|
298 |
247 |
$7K |
| 87081 |
|
1,174 |
1,027 |
$7K |
| 77338 |
|
33 |
25 |
$7K |
| J1644 |
Inj heparin sodium per 1000u |
5,770 |
3,530 |
$7K |
| 88377 |
|
53 |
43 |
$7K |
| 83525 |
|
518 |
487 |
$7K |
| 86146 |
|
299 |
190 |
$7K |
| 76816 |
|
131 |
125 |
$7K |
| 82270 |
|
2,467 |
1,908 |
$6K |
| 81243 |
|
141 |
130 |
$6K |
| G0283 |
Elec stim other than wound |
325 |
130 |
$6K |
| 70490 |
|
30 |
21 |
$6K |
| J2310 |
Inj naloxone hydrochloride |
967 |
723 |
$6K |
| 82977 |
|
1,030 |
819 |
$6K |
| 84305 |
|
328 |
311 |
$6K |
| 96377 |
|
134 |
83 |
$6K |
| 86769 |
|
332 |
310 |
$6K |
| 10022 |
|
45 |
40 |
$6K |
| 86480 |
|
124 |
114 |
$6K |
| 82945 |
|
1,201 |
1,024 |
$6K |
| J1953 |
Levetiracetam injection |
2,223 |
1,531 |
$6K |
| 84157 |
|
1,267 |
1,106 |
$6K |
| 36569 |
|
14 |
12 |
$6K |
| 84436 |
|
971 |
879 |
$6K |
| 54360 |
|
34 |
33 |
$6K |
| 86308 |
|
2,432 |
2,303 |
$6K |
| 97014 |
|
386 |
140 |
$5K |
| 90675 |
|
20 |
12 |
$5K |
| 85397 |
|
209 |
202 |
$5K |
| 73723 |
|
18 |
12 |
$5K |
| 95711 |
|
82 |
81 |
$5K |
| 27096 |
|
18 |
16 |
$5K |
| 83010 |
|
537 |
472 |
$5K |
| 90732 |
|
253 |
219 |
$5K |
| 87483 |
|
39 |
36 |
$5K |
| J9201 |
In gemcitabine hcl nos 200mg |
203 |
51 |
$5K |
| 86481 |
|
58 |
53 |
$5K |
| 85347 |
|
950 |
804 |
$5K |
| 83002 |
|
320 |
285 |
$5K |
| 82435 |
|
1,889 |
1,520 |
$5K |
| 84480 |
|
472 |
424 |
$5K |
| J9206 |
Irinotecan injection |
275 |
67 |
$5K |
| 72192 |
|
15 |
15 |
$5K |
| 82010 |
|
1,197 |
1,032 |
$5K |
| 77049 |
|
15 |
13 |
$5K |
| 52000 |
|
14 |
14 |
$5K |
| J2920 |
Methylprednisolone injection |
1,871 |
846 |
$4K |
| Q3014 |
Telehealth facility fee |
336 |
274 |
$4K |
| 99215 |
Prolong outpt/office vis |
205 |
162 |
$4K |
| J3420 |
Vitamin b12 injection |
1,797 |
1,288 |
$4K |
| 70481 |
|
31 |
25 |
$4K |
| 86703 |
|
711 |
665 |
$4K |
| 95912 |
|
13 |
13 |
$4K |
| J1956 |
Levofloxacin injection |
1,685 |
1,249 |
$4K |
| J3411 |
Thiamine hcl 100 mg |
2,453 |
1,815 |
$4K |
| 73100 |
|
174 |
149 |
$4K |
| 85246 |
|
201 |
193 |
$4K |
| J2765 |
Metoclopramide hcl injection |
6,082 |
4,810 |
$4K |
| 92587 |
|
77 |
71 |
$4K |
| 85613 |
|
492 |
469 |
$4K |
| 85612 |
|
291 |
282 |
$4K |
| 95908 |
|
52 |
43 |
$4K |
| 86708 |
|
367 |
346 |
$4K |
| 85245 |
|
201 |
191 |
$3K |
| 86431 |
|
684 |
643 |
$3K |
| 94618 |
|
147 |
133 |
$3K |
| 49452 |
|
13 |
13 |
$3K |
| 80177 |
|
298 |
272 |
$3K |
| J2060 |
Lorazepam injection |
5,891 |
4,494 |
$3K |
| C1730 |
Cath, ep, 19 or few elect |
15 |
12 |
$3K |
| 87102 |
|
417 |
360 |
$3K |
| J0456 |
Azithromycin |
1,420 |
904 |
$3K |
| 86160 |
|
223 |
152 |
$3K |
| J0461 |
Atropine sulfate injection |
1,030 |
704 |
$3K |
| J0694 |
Cefoxitin sodium injection |
769 |
528 |
$3K |
| 82310 |
|
517 |
400 |
$3K |
| 83003 |
|
50 |
37 |
$3K |
| 84450 |
|
406 |
339 |
$3K |
| 85244 |
|
182 |
170 |
$3K |
| 82670 |
|
132 |
107 |
$3K |
| 77003 |
|
45 |
41 |
$3K |
| 69209 |
|
51 |
50 |
$3K |
| 75625 |
|
15 |
14 |
$3K |
| 88112 |
|
137 |
115 |
$3K |
| 87420 |
|
863 |
828 |
$3K |
| 90632 |
|
156 |
149 |
$2K |
| J9000 |
Doxorubicin hcl injection |
133 |
74 |
$2K |
| 86376 |
|
235 |
227 |
$2K |
| 75710 |
|
14 |
13 |
$2K |
| M0239 |
Bamlanivimab-xxxx infusion |
24 |
16 |
$2K |
| J1940 |
Furosemide injection |
2,791 |
1,287 |
$2K |
| J2790 |
Rho d immune globulin inj |
40 |
39 |
$2K |
| J2916 |
Na ferric gluconate complex |
75 |
56 |
$2K |
| 69200 |
|
42 |
41 |
$2K |
| 88300 |
|
228 |
199 |
$2K |
| 87149 |
|
71 |
38 |
$2K |
| 86617 |
|
128 |
88 |
$2K |
| J0881 |
Darbepoetin alfa, non-esrd |
23 |
12 |
$2K |
| A9540 |
Tc99m maa |
71 |
64 |
$2K |
| 87177 |
|
337 |
316 |
$2K |
| 86757 |
|
137 |
78 |
$2K |
| 81479 |
|
82 |
70 |
$2K |
| 92567 |
|
122 |
114 |
$2K |
| 82747 |
|
119 |
113 |
$2K |
| J9171 |
Docetaxel injection |
16 |
13 |
$2K |
| 73600 |
|
69 |
62 |
$2K |
| 88311 |
|
263 |
222 |
$2K |
| 87015 |
|
470 |
386 |
$2K |
| 82397 |
|
129 |
121 |
$2K |
| A9270 |
Non-covered item or service |
30,293 |
8,788 |
$2K |
| 74420 |
|
31 |
28 |
$2K |
| 77417 |
|
34 |
12 |
$2K |
| 84520 |
|
1,195 |
1,038 |
$2K |
| 83930 |
|
432 |
376 |
$2K |
| 83521 |
|
60 |
42 |
$2K |
| 84134 |
|
166 |
146 |
$2K |
| 95873 |
|
70 |
51 |
$2K |
| 82043 |
|
305 |
280 |
$2K |
| 82731 |
|
101 |
91 |
$2K |
| J9060 |
Cisplatin 10 mg injection |
104 |
50 |
$2K |
| 86356 |
|
17 |
12 |
$2K |
| 97035 |
|
133 |
66 |
$1K |
| 86360 |
|
36 |
31 |
$1K |
| 87324 |
|
301 |
269 |
$1K |
| 82805 |
|
37 |
33 |
$1K |
| 76604 |
|
13 |
12 |
$1K |
| J8540 |
Oral dexamethasone |
2,429 |
2,204 |
$1K |
| 76811 |
|
33 |
30 |
$1K |
| 82379 |
|
89 |
81 |
$1K |
| 86880 |
|
253 |
151 |
$1K |
| 82525 |
|
81 |
74 |
$1K |
| 86618 |
|
138 |
122 |
$1K |
| J2550 |
Promethazine hcl injection |
2,438 |
1,825 |
$1K |
| 87535 |
|
29 |
28 |
$1K |
| J9260 |
Inj methotrexate sodium 50mg |
345 |
203 |
$1K |
| J0290 |
Ampicillin 500 mg inj |
390 |
214 |
$1K |
| 84432 |
|
107 |
96 |
$1K |
| 90461 |
|
145 |
133 |
$1K |
| 87116 |
|
190 |
152 |
$1K |
| 94200 |
|
325 |
307 |
$1K |
| 84270 |
|
70 |
58 |
$1K |
| 16020 |
|
29 |
24 |
$985.72 |
| 30300 |
|
39 |
38 |
$968.26 |
| 82810 |
|
77 |
67 |
$954.92 |
| 83986 |
|
632 |
568 |
$946.65 |
| 80202 |
|
96 |
48 |
$926.36 |
| 74241 |
|
16 |
12 |
$916.46 |
| 94667 |
|
61 |
50 |
$884.86 |
| 69210 |
|
12 |
12 |
$807.89 |
| 87206 |
|
203 |
164 |
$740.10 |
| J1020 |
Methylprednisolone 20 mg inj |
311 |
274 |
$729.84 |
| 86592 |
|
217 |
178 |
$727.44 |
| 80175 |
|
66 |
50 |
$701.07 |
| 81241 |
|
13 |
13 |
$692.80 |
| 72202 |
|
12 |
12 |
$638.60 |
| 83498 |
|
34 |
26 |
$633.08 |
| 84681 |
|
18 |
16 |
$619.53 |
| 82657 |
|
28 |
27 |
$618.62 |
| 82542 |
|
29 |
24 |
$618.39 |
| J1720 |
Hydrocortisone sodium succ i |
75 |
62 |
$593.93 |
| J2175 |
Meperidine hydrochl /100 mg |
948 |
760 |
$592.44 |
| 84479 |
|
89 |
82 |
$555.66 |
| 85303 |
|
52 |
50 |
$544.18 |
| 85306 |
|
44 |
41 |
$542.12 |
| 0031A |
|
16 |
14 |
$501.60 |
| 64495 |
|
12 |
12 |
$496.47 |
| 99151 |
|
30 |
30 |
$489.64 |
| 99195 |
|
21 |
13 |
$488.00 |
| 82365 |
|
57 |
52 |
$474.89 |
| J1580 |
Garamycin gentamicin inj |
341 |
269 |
$454.31 |
| 86644 |
|
18 |
16 |
$453.06 |
| 73020 |
|
14 |
12 |
$419.52 |
| J0692 |
Cefepime hcl for injection |
174 |
54 |
$410.87 |
| J1790 |
Droperidol injection |
321 |
283 |
$391.03 |
| 86762 |
|
86 |
80 |
$390.86 |
| 82652 |
|
13 |
13 |
$380.24 |
| 83020 |
|
29 |
26 |
$370.64 |
| 85300 |
|
45 |
43 |
$356.68 |
| 70160 |
|
12 |
12 |
$338.10 |
| 86359 |
|
16 |
12 |
$336.40 |
| 86355 |
|
16 |
12 |
$336.40 |
| J1630 |
Haloperidol injection |
514 |
420 |
$294.45 |
| 84402 |
|
17 |
13 |
$286.52 |
| 84207 |
|
12 |
12 |
$285.78 |
| 82232 |
|
30 |
26 |
$275.06 |
| 82627 |
|
20 |
13 |
$273.42 |
| 82139 |
|
17 |
15 |
$265.86 |
| 88175 |
|
19 |
16 |
$263.41 |
| 82950 |
|
30 |
28 |
$246.95 |
| J3360 |
Diazepam injection |
17 |
16 |
$225.08 |
| 84075 |
|
34 |
31 |
$216.05 |
| J1250 |
Inj dobutamine hcl/250 mg |
75 |
71 |
$215.00 |
| 86021 |
|
17 |
16 |
$208.45 |
| 0279U |
|
29 |
28 |
$207.54 |
| 85250 |
|
14 |
14 |
$206.58 |
| 71010 |
|
16 |
12 |
$195.64 |
| 84155 |
|
16 |
13 |
$188.86 |
| J2210 |
Methylergonovin maleate inj |
12 |
12 |
$174.09 |
| 86225 |
|
21 |
12 |
$167.49 |
| 80183 |
|
14 |
13 |
$153.22 |
| 86300 |
|
12 |
12 |
$142.55 |
| 85670 |
|
33 |
29 |
$133.00 |
| 80178 |
|
33 |
25 |
$121.03 |
| 87425 |
|
16 |
16 |
$119.80 |
| J0744 |
Ciprofloxacin iv |
146 |
68 |
$116.81 |
| 86705 |
|
26 |
26 |
$112.34 |
| 84300 |
|
39 |
35 |
$111.32 |
| J2800 |
Methocarbamol injection |
29 |
26 |
$92.54 |
| 84630 |
|
13 |
12 |
$91.12 |
| J9250 |
Methotrexate sodium inj |
32 |
25 |
$90.93 |
| J7644 |
Ipratropium bromide non-comp |
110 |
108 |
$80.57 |
| J7611 |
Albuterol non-comp con |
331 |
288 |
$71.64 |
| J0702 |
Betamethasone acet&sod phosp |
20 |
13 |
$69.51 |
| G8978 |
Mobility current status |
1,113 |
701 |
$58.67 |
| 90685 |
|
17 |
16 |
$54.64 |
| 84133 |
|
13 |
12 |
$28.38 |
| J0280 |
Aminophyllin 250 mg inj |
13 |
12 |
$20.58 |
| G8984 |
Carry current status |
269 |
215 |
$15.81 |
| G8996 |
Swallow current status |
109 |
76 |
$12.00 |
| J3105 |
Terbutaline sulfate inj |
28 |
26 |
$9.32 |
| C8937 |
Cad breast mri |
16 |
15 |
$1.17 |
| G8985 |
Carry goal status |
308 |
234 |
$1.00 |
| Q0244 |
Casirivi and imdevi 1200 mg |
16 |
16 |
$0.13 |
| Q0243 |
Casirivimab and imdevimab |
16 |
12 |
$0.01 |
| G8979 |
Mobility goal status |
1,017 |
737 |
$0.00 |
| G8997 |
Swallow goal status |
114 |
79 |
$0.00 |
| G8981 |
Body pos current status |
188 |
165 |
$0.00 |
| G8980 |
Mobility d/c status |
354 |
266 |
$0.00 |
| G8987 |
Self care current status |
68 |
41 |
$0.00 |
| G8982 |
Body pos goal status |
205 |
189 |
$0.00 |
| G8998 |
Swallow d/c status |
53 |
43 |
$0.00 |
| G8988 |
Self care goal status |
55 |
29 |
$0.00 |