| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpt clinic visit |
387,130 |
304,809 |
$38.84M |
| 99213 |
|
189,285 |
173,395 |
$17.78M |
| 99214 |
|
136,656 |
126,832 |
$14.95M |
| 99284 |
|
48,606 |
42,292 |
$6.03M |
| 99285 |
|
30,180 |
26,031 |
$4.03M |
| 99283 |
|
23,316 |
21,801 |
$2.58M |
| 70450 |
|
9,954 |
8,636 |
$2.47M |
| C9803 |
Hopd covid-19 spec collect |
66,921 |
59,390 |
$2.24M |
| 99212 |
|
25,734 |
24,102 |
$2.17M |
| 74177 |
|
6,305 |
5,438 |
$2.11M |
| 97110 |
|
36,231 |
7,917 |
$2.07M |
| 87635 |
|
64,485 |
57,294 |
$1.86M |
| 96361 |
|
8,877 |
5,739 |
$1.79M |
| 74176 |
|
4,503 |
3,943 |
$1.51M |
| 87502 |
|
56,291 |
48,295 |
$1.44M |
| 87633 |
|
11,348 |
10,774 |
$1.32M |
| 80053 |
|
74,429 |
64,417 |
$1.28M |
| 11042 |
|
11,235 |
4,671 |
$1.10M |
| 43239 |
|
3,089 |
2,743 |
$1.01M |
| 93306 |
|
3,941 |
3,480 |
$927K |
| 96366 |
|
4,433 |
2,014 |
$908K |
| 96365 |
|
11,150 |
5,167 |
$882K |
| 20610 |
|
7,571 |
6,297 |
$872K |
| G0378 |
Hospital observation per hr |
9,466 |
3,762 |
$870K |
| 80307 |
|
38,257 |
31,844 |
$844K |
| 0223U |
|
4,337 |
4,151 |
$843K |
| 93458 |
|
717 |
605 |
$839K |
| 99211 |
|
11,391 |
10,397 |
$797K |
| 84443 |
|
58,987 |
54,780 |
$774K |
| 76817 |
|
6,714 |
5,790 |
$670K |
| 76816 |
|
7,641 |
7,033 |
$624K |
| 95810 |
|
913 |
880 |
$588K |
| 80048 |
|
85,126 |
70,409 |
$587K |
| 82306 |
|
35,631 |
33,332 |
$584K |
| 93005 |
|
73,896 |
59,744 |
$578K |
| 85025 |
|
136,577 |
114,285 |
$578K |
| 78452 |
|
1,467 |
1,100 |
$558K |
| 36415 |
|
248,555 |
177,252 |
$549K |
| 97140 |
|
18,113 |
4,590 |
$519K |
| 94640 |
|
5,081 |
3,355 |
$468K |
| 87651 |
|
56,310 |
51,915 |
$448K |
| 71046 |
|
19,201 |
16,809 |
$437K |
| J0585 |
Injection,onabotulinumtoxina |
886 |
528 |
$421K |
| 80061 |
|
39,669 |
36,243 |
$402K |
| 71275 |
|
1,320 |
1,133 |
$399K |
| 76705 |
|
3,962 |
3,414 |
$388K |
| 45380 |
|
1,068 |
935 |
$376K |
| 59025 |
|
2,371 |
1,160 |
$373K |
| 99281 |
|
2,993 |
2,696 |
$367K |
| 82607 |
|
22,837 |
21,266 |
$359K |
| 83036 |
|
35,412 |
33,191 |
$350K |
| 95886 |
|
1,665 |
1,078 |
$343K |
| 92507 |
|
5,430 |
1,845 |
$343K |
| 76830 |
|
3,453 |
3,203 |
$333K |
| 90839 |
|
2,506 |
2,061 |
$316K |
| 99282 |
|
3,011 |
2,813 |
$291K |
| 71045 |
|
32,477 |
27,513 |
$272K |
| 99215 |
Prolong outpt/office vis |
2,877 |
2,501 |
$271K |
| 93975 |
|
1,650 |
1,400 |
$242K |
| 95811 |
|
381 |
347 |
$240K |
| 97530 |
|
5,070 |
2,587 |
$235K |
| 11045 |
|
691 |
260 |
$232K |
| G0483 |
Drug test def 22+ classes |
3,374 |
2,601 |
$230K |
| 96360 |
|
1,337 |
864 |
$228K |
| 96374 |
|
28,447 |
20,676 |
$211K |
| 96375 |
|
18,686 |
13,332 |
$207K |
| 87491 |
|
14,364 |
13,258 |
$202K |
| 78431 |
|
371 |
281 |
$202K |
| 76805 |
|
1,634 |
1,566 |
$201K |
| 84439 |
|
21,152 |
19,618 |
$201K |
| 71271 |
|
1,237 |
1,172 |
$201K |
| 87591 |
|
14,164 |
13,110 |
$189K |
| 87086 |
|
36,608 |
32,588 |
$182K |
| 71250 |
|
1,637 |
1,473 |
$181K |
| 75574 |
|
589 |
509 |
$179K |
| 73721 |
|
658 |
596 |
$174K |
| 97161 |
|
2,586 |
2,403 |
$173K |
| 93017 |
|
2,142 |
1,928 |
$170K |
| J7307 |
Etonogestrel implant system |
173 |
154 |
$167K |
| 87798 |
|
10,362 |
6,454 |
$167K |
| 72125 |
|
3,067 |
2,680 |
$161K |
| 78815 |
|
340 |
297 |
$161K |
| 72148 |
|
811 |
746 |
$159K |
| J3490 |
Drugs unclassified injection |
15,052 |
8,875 |
$159K |
| 45378 |
|
325 |
269 |
$157K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
15,210 |
12,641 |
$154K |
| 83605 |
|
31,390 |
25,021 |
$150K |
| 96413 |
|
1,580 |
809 |
$150K |
| J7030 |
Normal saline solution infus |
49,151 |
35,389 |
$147K |
| 70553 |
|
547 |
481 |
$145K |
| 96372 |
|
22,374 |
17,231 |
$142K |
| 71260 |
|
884 |
727 |
$138K |
| 80076 |
|
36,703 |
31,971 |
$136K |
| 97112 |
|
3,556 |
1,009 |
$133K |
| 84484 |
|
28,710 |
21,867 |
$127K |
| J0561 |
Penicillin g benzathine inj |
670 |
589 |
$124K |
| 76536 |
|
1,177 |
1,093 |
$122K |
| 64615 |
|
512 |
396 |
$122K |
| U0002 |
Covid-19 lab test non-cdc |
21,273 |
18,031 |
$122K |
| 76641 |
|
1,227 |
824 |
$116K |
| C1776 |
Joint device (implantable) |
147 |
120 |
$115K |
| 72131 |
|
1,344 |
1,152 |
$115K |
| 70551 |
|
542 |
488 |
$115K |
| 76815 |
|
1,425 |
1,174 |
$110K |
| 94060 |
|
1,190 |
1,103 |
$107K |
| 87481 |
|
8,796 |
5,525 |
$105K |
| 73221 |
|
408 |
372 |
$105K |
| 81003 |
|
51,994 |
41,788 |
$105K |
| 87661 |
|
10,244 |
9,513 |
$104K |
| 87522 |
Neg quan hep c or qual rna |
3,763 |
3,395 |
$104K |
| 73630 |
|
4,912 |
4,028 |
$103K |
| 84145 |
|
14,275 |
12,445 |
$100K |
| J3301 |
Triamcinolone acet inj nos |
5,280 |
4,472 |
$91K |
| 45385 |
|
205 |
154 |
$91K |
| 87625 |
|
5,029 |
4,759 |
$91K |
| 12001 |
|
591 |
541 |
$91K |
| 93970 |
|
673 |
587 |
$90K |
| 87653 |
|
5,232 |
4,818 |
$89K |
| 74178 |
|
257 |
229 |
$88K |
| 83540 |
|
11,857 |
10,885 |
$88K |
| 87902 |
|
637 |
589 |
$86K |
| 88175 |
|
9,451 |
8,997 |
$83K |
| 80074 |
|
5,098 |
4,585 |
$83K |
| 84702 |
|
5,692 |
3,985 |
$83K |
| 31575 |
|
508 |
482 |
$82K |
| 82728 |
|
6,749 |
5,965 |
$81K |
| 73030 |
|
3,482 |
2,816 |
$81K |
| 58558 |
|
91 |
72 |
$81K |
| 87040 |
|
18,536 |
10,145 |
$79K |
| 87081 |
|
7,116 |
6,503 |
$78K |
| 73562 |
|
3,320 |
2,571 |
$76K |
| 81596 |
|
668 |
628 |
$75K |
| 83735 |
|
25,047 |
19,605 |
$75K |
| 96376 |
|
4,605 |
2,210 |
$75K |
| 97162 |
|
1,422 |
1,223 |
$73K |
| 97016 |
|
2,280 |
583 |
$73K |
| 93971 |
|
1,037 |
911 |
$73K |
| 99203 |
|
1,090 |
1,043 |
$73K |
| 77063 |
|
1,664 |
1,517 |
$72K |
| 47562 |
|
30 |
26 |
$71K |
| 52000 |
|
120 |
108 |
$71K |
| 84703 |
|
15,688 |
13,907 |
$69K |
| 95816 |
|
483 |
436 |
$69K |
| 73610 |
|
3,115 |
2,595 |
$69K |
| 81025 |
|
8,347 |
7,649 |
$68K |
| 93356 |
|
341 |
299 |
$65K |
| 87529 |
|
4,824 |
3,353 |
$65K |
| 87511 |
|
5,976 |
5,500 |
$64K |
| 94726 |
|
1,098 |
1,035 |
$63K |
| 96367 |
|
1,512 |
965 |
$63K |
| 73130 |
|
3,037 |
2,404 |
$62K |
| 20550 |
|
470 |
385 |
$62K |
| 93880 |
|
689 |
625 |
$61K |
| 97165 |
|
882 |
767 |
$60K |
| 81220 |
|
209 |
205 |
$60K |
| 92928 |
|
16 |
13 |
$58K |
| 93226 |
|
532 |
506 |
$57K |
| 83525 |
|
3,547 |
3,262 |
$57K |
| 72100 |
|
1,661 |
1,504 |
$56K |
| 84481 |
|
5,122 |
4,734 |
$55K |
| 83550 |
|
7,861 |
7,248 |
$54K |
| 82746 |
|
5,184 |
4,866 |
$53K |
| 87389 |
|
3,010 |
2,698 |
$53K |
| 86140 |
|
12,322 |
10,701 |
$52K |
| 83880 |
|
7,753 |
6,407 |
$52K |
| J1885 |
Ketorolac tromethamine inj |
18,672 |
11,613 |
$51K |
| 86592 |
|
2,830 |
2,429 |
$51K |
| 85007 |
|
11,637 |
9,555 |
$51K |
| 95913 |
|
445 |
406 |
$51K |
| 72141 |
|
320 |
291 |
$50K |
| G0482 |
Drug test def 15-21 classes |
697 |
556 |
$49K |
| 81001 |
|
41,079 |
36,235 |
$48K |
| 73560 |
|
2,398 |
1,747 |
$48K |
| 70491 |
|
158 |
140 |
$48K |
| J2405 |
Ondansetron hcl injection |
20,219 |
15,045 |
$48K |
| 84144 |
|
1,987 |
1,699 |
$48K |
| C1769 |
Guide wire |
1,118 |
910 |
$47K |
| 86695 |
|
2,914 |
2,711 |
$47K |
| 93798 |
|
1,655 |
275 |
$47K |
| 94729 |
|
1,137 |
1,072 |
$46K |
| 93225 |
|
564 |
521 |
$45K |
| 80081 |
|
2,169 |
2,024 |
$45K |
| 94618 |
|
609 |
555 |
$45K |
| 83655 |
|
3,263 |
3,064 |
$44K |
| G0481 |
Drug test def 8-14 classes |
618 |
593 |
$43K |
| 84403 |
|
2,829 |
2,554 |
$43K |
| C8929 |
Tte w or wo fol wcon,doppler |
224 |
190 |
$43K |
| 85027 |
|
12,711 |
10,574 |
$43K |
| 85610 |
|
18,221 |
14,611 |
$42K |
| 86696 |
|
2,989 |
2,712 |
$42K |
| 73110 |
|
2,132 |
1,686 |
$41K |
| 76775 |
|
544 |
494 |
$41K |
| 86481 |
|
819 |
691 |
$40K |
| 73502 |
|
1,877 |
1,518 |
$40K |
| 97116 |
|
1,532 |
563 |
$39K |
| J3010 |
Fentanyl citrate injection |
13,488 |
10,618 |
$39K |
| 73700 |
|
308 |
265 |
$38K |
| 70486 |
|
533 |
457 |
$37K |
| 58661 |
|
22 |
13 |
$37K |
| J2704 |
Inj, propofol, 10 mg |
12,717 |
9,659 |
$37K |
| 87186 |
|
6,871 |
5,965 |
$36K |
| 82950 |
|
3,327 |
3,103 |
$36K |
| 97113 |
|
602 |
183 |
$36K |
| 77067 |
|
1,575 |
1,476 |
$36K |
| 91200 |
|
467 |
447 |
$35K |
| 72128 |
|
634 |
547 |
$34K |
| 92557 |
|
508 |
449 |
$34K |
| 74018 |
|
2,060 |
1,792 |
$33K |
| 82670 |
|
1,715 |
1,547 |
$33K |
| J1756 |
Iron sucrose injection |
1,009 |
379 |
$33K |
| 11981 |
|
159 |
142 |
$32K |
| 95912 |
|
261 |
244 |
$32K |
| J1100 |
Dexamethasone sodium phos |
8,963 |
6,862 |
$32K |
| 90715 |
|
1,805 |
1,618 |
$31K |
| 83690 |
|
21,331 |
18,610 |
$31K |
| 76981 |
|
508 |
474 |
$30K |
| J2250 |
Inj midazolam hydrochloride |
12,879 |
10,065 |
$30K |
| 95911 |
|
311 |
284 |
$29K |
| 90686 |
|
1,963 |
1,781 |
$29K |
| 20552 |
|
358 |
343 |
$29K |
| G0297 |
Ldct for lung ca screen |
199 |
192 |
$29K |
| 76857 |
|
223 |
194 |
$28K |
| 72040 |
|
730 |
655 |
$28K |
| P9016 |
Rbc leukocytes reduced |
161 |
110 |
$28K |
| 84146 |
|
2,180 |
1,961 |
$28K |
| 76819 |
|
278 |
151 |
$28K |
| A9555 |
Rb82 rubidium |
389 |
304 |
$28K |
| 72070 |
|
831 |
757 |
$27K |
| J1050 |
Medroxyprogesterone acetate |
581 |
508 |
$27K |
| 74019 |
|
1,172 |
1,067 |
$27K |
| 84402 |
|
1,960 |
1,787 |
$27K |
| C1753 |
Cath, intravas ultrasound |
336 |
282 |
$26K |
| 72110 |
|
677 |
598 |
$26K |
| 86850 |
|
1,365 |
1,092 |
$26K |
| 83001 |
|
1,832 |
1,652 |
$26K |
| C1887 |
Catheter, guiding |
724 |
619 |
$26K |
| 36430 |
|
244 |
158 |
$25K |
| 86038 |
|
1,430 |
1,230 |
$25K |
| 82962 |
|
13,448 |
7,615 |
$25K |
| 70496 |
|
115 |
97 |
$25K |
| 96127 |
|
676 |
624 |
$24K |
| 84153 |
|
1,839 |
1,697 |
$24K |
| 10060 |
|
148 |
134 |
$24K |
| 86900 |
|
2,053 |
1,485 |
$24K |
| 77062 |
|
763 |
659 |
$23K |
| 86376 |
|
1,597 |
1,477 |
$23K |
| 88305 |
|
2,307 |
1,406 |
$22K |
| 77080 |
|
336 |
294 |
$22K |
| 87109 |
|
1,939 |
1,857 |
$22K |
| 87641 |
|
1,398 |
1,222 |
$22K |
| 87631 |
|
189 |
175 |
$21K |
| C1894 |
Intro/sheath, non-laser |
1,361 |
1,161 |
$21K |
| 36416 |
|
8,941 |
6,677 |
$21K |
| 99202 |
|
315 |
307 |
$21K |
| 76856 |
|
110 |
104 |
$21K |
| C1751 |
Cath, inf, per/cent/midline |
1,520 |
1,249 |
$21K |
| 69436 |
|
14 |
12 |
$21K |
| 74022 |
|
1,006 |
902 |
$20K |
| 73564 |
|
838 |
701 |
$20K |
| 86803 |
|
1,427 |
1,328 |
$20K |
| 92978 |
|
263 |
223 |
$20K |
| C1725 |
Cath, translumin non-laser |
419 |
221 |
$20K |
| 85652 |
|
6,785 |
5,913 |
$19K |
| 90471 |
|
2,831 |
2,478 |
$19K |
| 83970 |
|
852 |
758 |
$19K |
| 84681 |
|
1,603 |
1,505 |
$19K |
| 64493 |
|
44 |
39 |
$19K |
| A9500 |
Tc99m sestamibi |
1,161 |
1,026 |
$19K |
| 82626 |
|
995 |
898 |
$18K |
| J7120 |
Ringers lactate infusion |
6,829 |
4,842 |
$18K |
| 70498 |
|
168 |
142 |
$18K |
| J0690 |
Cefazolin sodium injection |
5,027 |
2,974 |
$18K |
| 72050 |
|
320 |
289 |
$18K |
| 73080 |
|
922 |
775 |
$18K |
| 83002 |
|
1,398 |
1,258 |
$18K |
| 96368 |
|
472 |
328 |
$18K |
| 85730 |
|
10,428 |
8,922 |
$18K |
| 82043 |
|
3,263 |
3,037 |
$18K |
| 11102 |
|
40 |
40 |
$18K |
| 93922 |
|
258 |
244 |
$18K |
| 31231 |
|
107 |
104 |
$17K |
| 86800 |
|
1,467 |
1,337 |
$17K |
| 87340 |
|
1,177 |
1,106 |
$17K |
| 58563 |
|
17 |
12 |
$17K |
| 82248 |
|
1,887 |
1,605 |
$17K |
| 84207 |
|
1,346 |
1,242 |
$17K |
| 87506 |
|
152 |
140 |
$16K |
| J1170 |
Hydromorphone injection |
3,716 |
1,934 |
$16K |
| C1874 |
Stent, coated/cov w/del sys |
237 |
200 |
$16K |
| C9290 |
Inj, bupivacaine liposome |
110 |
94 |
$16K |
| J7298 |
Mirena, 52 mg |
16 |
13 |
$16K |
| 76010 |
|
935 |
831 |
$15K |
| 69210 |
|
1,066 |
986 |
$15K |
| 73523 |
|
429 |
377 |
$15K |
| 86787 |
|
823 |
746 |
$15K |
| 86694 |
|
588 |
531 |
$15K |
| 82077 |
|
6,133 |
5,116 |
$14K |
| 88142 |
|
1,144 |
1,113 |
$14K |
| 87070 |
|
3,523 |
3,237 |
$14K |
| 20605 |
|
104 |
88 |
$14K |
| J2270 |
Morphine sulfate injection |
4,269 |
2,659 |
$14K |
| 12002 |
|
100 |
95 |
$14K |
| 76882 |
|
130 |
121 |
$14K |
| 19081 |
|
18 |
16 |
$13K |
| 73590 |
|
981 |
792 |
$13K |
| 17110 |
|
91 |
89 |
$13K |
| 86706 |
|
1,086 |
1,017 |
$13K |
| 77061 |
|
418 |
363 |
$13K |
| 77066 |
Tomosynthesis, mammo |
733 |
653 |
$13K |
| 83498 |
|
923 |
838 |
$13K |
| 76870 |
|
342 |
288 |
$13K |
| 85018 |
|
6,965 |
6,145 |
$13K |
| 58300 |
|
88 |
79 |
$13K |
| 73090 |
|
786 |
672 |
$12K |
| J1644 |
Inj heparin sodium per 1000u |
4,685 |
2,402 |
$12K |
| 84100 |
|
5,224 |
3,915 |
$12K |
| 11982 |
|
57 |
56 |
$12K |
| 82533 |
|
581 |
477 |
$12K |
| J0696 |
Ceftriaxone sodium injection |
4,077 |
2,794 |
$12K |
| 87071 |
|
1,829 |
1,461 |
$12K |
| 82947 |
|
2,858 |
2,310 |
$12K |
| 82565 |
|
1,956 |
1,584 |
$11K |
| 64721 |
|
15 |
13 |
$11K |
| 72170 |
|
978 |
792 |
$11K |
| 82552 |
|
2,002 |
1,633 |
$11K |
| M0243 |
Casirivi and imdevi inj |
62 |
57 |
$11K |
| 92567 |
|
747 |
689 |
$10K |
| J2930 |
Methylprednisolone injection |
2,665 |
2,200 |
$10K |
| 70544 |
|
87 |
69 |
$10K |
| 86431 |
|
874 |
747 |
$10K |
| 72114 |
|
244 |
225 |
$10K |
| U0003 |
Cov-19 amp prb hgh thruput |
1,310 |
913 |
$10K |
| J0702 |
Betamethasone acet&sod phosp |
686 |
580 |
$10K |
| J2785 |
Regadenoson injection |
1,339 |
1,180 |
$10K |
| 97010 |
|
771 |
161 |
$9K |
| 86704 |
|
508 |
477 |
$9K |
| 62323 |
|
12 |
12 |
$9K |
| 70480 |
|
85 |
61 |
$9K |
| 84436 |
|
1,038 |
972 |
$9K |
| 93299 |
|
691 |
665 |
$9K |
| 83883 |
|
345 |
304 |
$9K |
| 85379 |
|
3,329 |
2,836 |
$9K |
| 76642 |
|
110 |
95 |
$9K |
| 36600 |
|
1,903 |
1,420 |
$9K |
| 76000 |
|
185 |
150 |
$8K |
| 82140 |
|
1,698 |
1,371 |
$8K |
| 82570 |
|
1,292 |
1,098 |
$8K |
| 84480 |
|
753 |
678 |
$8K |
| 77065 |
Tomosynthesis, mammo |
424 |
384 |
$8K |
| 66984 |
|
16 |
12 |
$8K |
| 73140 |
|
467 |
400 |
$8K |
| 86901 |
|
2,024 |
1,493 |
$8K |
| 84550 |
|
1,872 |
1,595 |
$8K |
| 52204 |
|
17 |
13 |
$7K |
| 73620 |
|
410 |
357 |
$7K |
| 76770 |
|
44 |
41 |
$7K |
| 82150 |
|
3,503 |
3,032 |
$7K |
| 80143 |
|
3,826 |
3,261 |
$7K |
| 43450 |
|
454 |
365 |
$7K |
| 82951 |
|
343 |
308 |
$7K |
| 77336 |
|
113 |
48 |
$7K |
| 95012 |
|
190 |
177 |
$7K |
| 90677 |
|
69 |
67 |
$6K |
| 84112 |
|
217 |
190 |
$6K |
| 86200 |
|
550 |
483 |
$6K |
| 87807 |
|
2,675 |
2,379 |
$6K |
| 84425 |
|
608 |
566 |
$6K |
| 80164 |
|
424 |
382 |
$6K |
| 71101 |
|
476 |
416 |
$6K |
| 82977 |
|
972 |
771 |
$6K |
| 74420 |
|
84 |
77 |
$6K |
| J0558 |
Peng benzathine/procaine inj |
58 |
49 |
$6K |
| 83516 |
|
388 |
145 |
$6K |
| 36591 |
|
1,072 |
396 |
$6K |
| 97164 |
|
183 |
159 |
$6K |
| 82784 |
|
664 |
585 |
$6K |
| 80179 |
|
3,813 |
3,265 |
$6K |
| 82105 |
|
557 |
507 |
$6K |
| 87205 |
|
2,410 |
2,110 |
$5K |
| 80051 |
|
436 |
369 |
$5K |
| 82803 |
|
1,893 |
1,443 |
$5K |
| J1200 |
Diphenhydramine hcl injectio |
2,329 |
1,686 |
$5K |
| 73060 |
|
361 |
296 |
$5K |
| 73552 |
|
342 |
288 |
$5K |
| 93571 |
|
195 |
159 |
$5K |
| 93321 |
|
31 |
25 |
$5K |
| G2066 |
Inter devc remote 30d |
800 |
697 |
$5K |
| 86364 |
|
328 |
306 |
$5K |
| 99204 |
|
154 |
136 |
$5K |
| J2001 |
Lidocaine injection |
11,647 |
7,043 |
$5K |
| J7050 |
Normal saline solution infus |
2,800 |
1,319 |
$5K |
| J3420 |
Vitamin b12 injection |
1,138 |
840 |
$5K |
| 90656 |
|
357 |
352 |
$5K |
| 83519 |
|
167 |
137 |
$5K |
| 87184 |
|
471 |
398 |
$5K |
| J3370 |
Vancomycin hcl injection |
1,106 |
541 |
$5K |
| 86255 |
|
408 |
364 |
$4K |
| 93288 |
|
379 |
366 |
$4K |
| A9552 |
F18 fdg |
311 |
271 |
$4K |
| J0131 |
Inj, acetaminophen (nos) |
732 |
405 |
$4K |
| 80361 |
|
507 |
484 |
$4K |
| 58301 |
|
51 |
41 |
$4K |
| 99406 |
|
137 |
122 |
$4K |
| 84479 |
|
586 |
558 |
$4K |
| 82952 |
|
340 |
305 |
$4K |
| J3475 |
Inj magnesium sulfate |
1,587 |
1,122 |
$4K |
| 87077 |
|
1,557 |
1,378 |
$4K |
| 70470 |
|
16 |
14 |
$4K |
| 97597 |
|
87 |
54 |
$4K |
| 72020 |
|
611 |
522 |
$4K |
| 82103 |
|
303 |
262 |
$4K |
| 85520 |
|
2,078 |
1,587 |
$4K |
| 82310 |
|
719 |
624 |
$4K |
| J2791 |
Rhophylac injection |
56 |
51 |
$4K |
| 90460 |
|
2,804 |
2,555 |
$4K |
| 83010 |
|
554 |
496 |
$4K |
| 84156 |
|
894 |
601 |
$4K |
| 83615 |
|
1,147 |
951 |
$4K |
| 73120 |
|
188 |
159 |
$4K |
| 29125 |
|
289 |
249 |
$4K |
| J2919 |
Inj, methylpred sod succ 5mg |
666 |
472 |
$4K |
| 82172 |
|
359 |
318 |
$3K |
| 57454 |
|
12 |
12 |
$3K |
| J8501 |
Oral aprepitant |
260 |
215 |
$3K |
| 82330 |
|
1,634 |
1,267 |
$3K |
| 87636 |
|
64 |
60 |
$3K |
| J2800 |
Methocarbamol injection |
433 |
331 |
$3K |
| P9047 |
Albumin (human), 25%, 50ml |
24 |
15 |
$3K |
| 83721 |
|
495 |
450 |
$3K |
| 82375 |
|
1,542 |
1,224 |
$3K |
| 84520 |
|
891 |
771 |
$3K |
| 77002 |
|
43 |
37 |
$3K |
| 84132 |
|
1,845 |
1,465 |
$3K |
| 86003 |
|
174 |
101 |
$3K |
| 86618 |
|
340 |
303 |
$3K |
| 86617 |
|
362 |
225 |
$3K |
| 93325 |
|
45 |
38 |
$3K |
| 84460 |
|
630 |
499 |
$3K |
| 80354 |
|
505 |
483 |
$3K |
| 80348 |
|
507 |
484 |
$3K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
1,333 |
1,029 |
$3K |
| J2060 |
Lorazepam injection |
1,344 |
899 |
$3K |
| 87493 |
|
201 |
179 |
$3K |
| 80346 |
|
440 |
423 |
$3K |
| 83921 |
|
461 |
432 |
$3K |
| 84450 |
|
515 |
395 |
$3K |
| J2765 |
Metoclopramide hcl injection |
1,122 |
791 |
$3K |
| J1650 |
Inj enoxaparin sodium |
873 |
388 |
$3K |
| 90837 |
|
13 |
12 |
$3K |
| 85014 |
|
521 |
394 |
$3K |
| 80353 |
|
508 |
485 |
$3K |
| 80365 |
|
491 |
469 |
$3K |
| 80358 |
|
508 |
484 |
$3K |
| 83992 |
|
197 |
183 |
$3K |
| 82024 |
|
74 |
64 |
$2K |
| 87210 |
|
837 |
745 |
$2K |
| 86308 |
|
643 |
575 |
$2K |
| 73600 |
|
167 |
138 |
$2K |
| 86923 |
|
119 |
83 |
$2K |
| 80326 |
|
211 |
197 |
$2K |
| 64483 |
|
18 |
17 |
$2K |
| 80321 |
|
310 |
301 |
$2K |
| J1030 |
Methylprednisolone 40 mg inj |
230 |
180 |
$2K |
| Q9950 |
Inj sulf hexa lipid microsph |
303 |
265 |
$2K |
| 82550 |
|
201 |
198 |
$2K |
| 86665 |
|
222 |
131 |
$2K |
| 82247 |
|
377 |
218 |
$2K |
| J1010 |
Inj, methylpred acetate 1 mg |
210 |
180 |
$2K |
| J7040 |
Normal saline solution infus |
1,372 |
1,083 |
$2K |
| 97163 |
|
32 |
32 |
$2K |
| 84295 |
|
1,303 |
1,021 |
$2K |
| G0480 |
Drug test def 1-7 classes |
153 |
144 |
$2K |
| 80355 |
|
219 |
204 |
$2K |
| 86235 |
|
132 |
112 |
$2K |
| 80178 |
|
159 |
136 |
$2K |
| 86141 |
|
87 |
75 |
$2K |
| C1781 |
Mesh (implantable) |
15 |
14 |
$2K |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,220 |
979 |
$2K |
| 90461 |
|
2,326 |
2,116 |
$2K |
| 88184 |
|
16 |
12 |
$2K |
| 84445 |
|
67 |
60 |
$2K |
| 97535 |
|
66 |
38 |
$2K |
| 83050 |
|
1,506 |
1,194 |
$2K |
| 86015 |
|
132 |
115 |
$2K |
| 93799 |
|
47 |
44 |
$2K |
| 80377 |
|
195 |
182 |
$2K |
| 80360 |
|
197 |
183 |
$2K |
| 80337 |
|
197 |
183 |
$2K |
| 80334 |
|
197 |
183 |
$2K |
| 80338 |
|
197 |
183 |
$2K |
| 80331 |
|
197 |
183 |
$2K |
| J2795 |
Ropivacaine hcl injection |
503 |
418 |
$2K |
| 80373 |
|
197 |
183 |
$2K |
| 84305 |
|
95 |
90 |
$2K |
| 80341 |
|
197 |
183 |
$2K |
| 80370 |
|
197 |
183 |
$2K |
| 80344 |
|
197 |
183 |
$2K |
| 73100 |
|
86 |
70 |
$2K |
| 80366 |
|
197 |
183 |
$2K |
| 80368 |
|
197 |
183 |
$2K |
| 80372 |
|
197 |
183 |
$2K |
| 80367 |
|
197 |
183 |
$2K |
| 80357 |
|
197 |
183 |
$2K |
| 80364 |
|
197 |
183 |
$2K |
| 80359 |
|
197 |
183 |
$2K |
| 80371 |
|
197 |
183 |
$2K |
| 90694 |
|
191 |
168 |
$2K |
| 86225 |
|
158 |
147 |
$2K |
| 12011 |
|
12 |
12 |
$1K |
| 87581 |
|
272 |
270 |
$1K |
| 82040 |
|
334 |
279 |
$1K |
| 86664 |
|
149 |
131 |
$1K |
| 82652 |
|
137 |
120 |
$1K |
| 97166 |
|
13 |
12 |
$1K |
| 82465 |
|
308 |
274 |
$1K |
| J2598 |
Inj, vasopressin, 1 unit |
107 |
63 |
$1K |
| 51798 |
|
575 |
527 |
$1K |
| J2370 |
Phenylephrine hcl injection |
534 |
415 |
$1K |
| 80362 |
|
295 |
286 |
$1K |
| 82785 |
|
138 |
127 |
$1K |
| 73070 |
|
66 |
55 |
$1K |
| 83521 |
|
334 |
224 |
$1K |
| J3480 |
Inj potassium chloride |
581 |
370 |
$1K |
| 80349 |
|
296 |
287 |
$1K |
| 92523 |
|
14 |
14 |
$1K |
| 80356 |
|
294 |
285 |
$1K |
| 87880 |
|
124 |
112 |
$1K |
| 80324 |
|
279 |
270 |
$1K |
| 82272 |
|
176 |
164 |
$1K |
| 76377 |
|
48 |
46 |
$1K |
| 87045 |
|
87 |
77 |
$1K |
| J2470 |
Inj pantoprazole sodium 40mg |
179 |
111 |
$1K |
| 87177 |
|
82 |
71 |
$1K |
| J1953 |
Levetiracetam injection |
175 |
124 |
$1K |
| 20553 |
|
33 |
26 |
$1K |
| J2920 |
Methylprednisolone injection |
261 |
139 |
$1K |
| 72220 |
|
26 |
26 |
$972.43 |
| 93925 |
|
13 |
13 |
$942.03 |
| 90674 |
|
38 |
35 |
$921.16 |
| 81420 |
|
15 |
14 |
$902.86 |
| 88185 |
|
15 |
12 |
$872.24 |
| 85045 |
|
413 |
372 |
$872.02 |
| A4217 |
Sterile water/saline, 500 ml |
979 |
904 |
$860.33 |
| J0171 |
Adrenalin epinephrine inject |
441 |
313 |
$849.59 |
| 99195 |
|
24 |
13 |
$819.44 |
| 86160 |
|
84 |
72 |
$818.61 |
| J1940 |
Furosemide injection |
556 |
298 |
$814.82 |
| 29581 |
|
26 |
15 |
$796.27 |
| 84482 |
|
96 |
95 |
$781.10 |
| J0360 |
Hydralazine hcl injection |
291 |
194 |
$773.14 |
| 80069 |
|
81 |
60 |
$745.67 |
| 84478 |
|
281 |
237 |
$745.42 |
| 73000 |
|
47 |
41 |
$727.16 |
| J7121 |
5% dextrose in lac ringers |
189 |
127 |
$725.14 |
| 72081 |
|
13 |
13 |
$721.37 |
| 72052 |
|
16 |
14 |
$703.19 |
| 90653 |
|
113 |
113 |
$701.23 |
| C1760 |
Closure dev, vasc |
85 |
67 |
$675.45 |
| G0103 |
Psa screening |
572 |
387 |
$661.53 |
| J2543 |
Piperacillin/tazobactam |
35 |
16 |
$648.00 |
| J1642 |
Inj heparin sodium per 10 u |
1,144 |
488 |
$641.05 |
| 11721 |
|
58 |
54 |
$623.53 |
| J1580 |
Garamycin gentamicin inj |
454 |
362 |
$611.75 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
125 |
56 |
$598.37 |
| 84165 |
|
175 |
157 |
$572.08 |
| 80177 |
|
46 |
41 |
$567.91 |
| 87185 |
|
211 |
179 |
$552.55 |
| 88304 |
|
34 |
28 |
$530.25 |
| J0574 |
Bupren/nal 6.1 to 10mg bupre |
60 |
24 |
$529.63 |
| 86705 |
|
42 |
33 |
$499.74 |
| 95249 |
|
156 |
141 |
$474.25 |
| 80347 |
|
67 |
60 |
$419.82 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
262 |
132 |
$413.99 |
| J1630 |
Haloperidol injection |
540 |
411 |
$411.71 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
304 |
213 |
$396.10 |
| J2372 |
Inj, biorphen, 20 micrograms |
1,568 |
693 |
$390.12 |
| 90678 |
|
21 |
14 |
$389.86 |
| U0005 |
Infec agen detec ampli probe |
888 |
721 |
$386.63 |
| J1836 |
Inj, metronidazole, 10 mg |
101 |
43 |
$377.11 |
| J1941 |
Inj, furoscix, 20 mg |
64 |
24 |
$354.77 |
| 80299 |
|
24 |
24 |
$354.72 |
| 86304 |
|
17 |
14 |
$350.39 |
| 84155 |
|
179 |
161 |
$349.44 |
| 90472 |
|
66 |
62 |
$333.68 |
| 83993 |
|
14 |
12 |
$329.78 |
| 86708 |
|
87 |
87 |
$293.99 |
| 86709 |
|
27 |
27 |
$293.83 |
| 86334 |
|
27 |
24 |
$292.37 |
| 82378 |
|
31 |
25 |
$277.96 |
| 86666 |
|
57 |
44 |
$251.11 |
| 90661 |
|
19 |
19 |
$243.36 |
| 87149 |
|
58 |
53 |
$233.50 |
| 84154 |
|
25 |
25 |
$233.19 |
| 87523 |
|
14 |
13 |
$219.69 |
| 86039 |
|
16 |
13 |
$217.53 |
| 87804 |
|
135 |
131 |
$216.17 |
| J3535 |
Metered dose inhaler drug |
216 |
199 |
$210.25 |
| 82010 |
|
141 |
125 |
$184.17 |
| 80156 |
|
13 |
12 |
$182.10 |
| 82274 |
|
16 |
15 |
$171.34 |
| 86753 |
|
39 |
37 |
$164.48 |
| 90662 |
|
47 |
42 |
$160.53 |
| 86008 |
|
25 |
25 |
$160.07 |
| J8499 |
Oral prescrip drug non chemo |
129 |
117 |
$160.06 |
| A9537 |
Tc99m mebrofenin |
14 |
13 |
$159.76 |
| 85347 |
|
195 |
157 |
$139.54 |
| 64494 |
|
44 |
39 |
$138.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
698 |
494 |
$124.19 |
| 87075 |
|
33 |
27 |
$112.52 |
| 90682 |
|
17 |
13 |
$109.86 |
| 87430 |
|
83 |
83 |
$109.33 |
| J0134 |
Inj acetaminophen -fresenius |
29 |
13 |
$108.88 |
| 87338 |
|
15 |
13 |
$92.52 |
| 84238 |
|
13 |
12 |
$78.90 |
| J0173 |
Inj, epinephrine (belcher) |
19 |
15 |
$74.58 |
| 88720 |
|
58 |
54 |
$60.32 |
| G0009 |
Admin pneumococcal vaccine |
33 |
30 |
$58.27 |
| G0008 |
Admin influenza virus vac |
97 |
93 |
$55.92 |
| J2010 |
Lincomycin injection |
14 |
13 |
$50.38 |
| J2310 |
Inj naloxone hydrochloride |
18 |
13 |
$50.11 |
| J1956 |
Levofloxacin injection |
224 |
192 |
$48.46 |
| J2360 |
Orphenadrine injection |
13 |
13 |
$47.60 |
| J0692 |
Cefepime hcl for injection |
42 |
28 |
$32.91 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
124 |
43 |
$32.60 |
| 89055 |
|
15 |
13 |
$27.41 |
| J7512 |
Prednisone ir or dr oral 1mg |
152 |
109 |
$23.66 |
| J7620 |
Albuterol ipratrop non-comp |
219 |
129 |
$23.03 |
| J1790 |
Droperidol injection |
37 |
33 |
$21.70 |
| G0476 |
Hpv combo assay ca screen |
47 |
36 |
$20.21 |
| Q3014 |
Telehealth facility fee |
15 |
15 |
$12.48 |
| J0136 |
Inj, acetaminophen (b braun) |
24 |
15 |
$5.00 |
| 87102 |
|
13 |
12 |
$0.00 |
| 00840 |
|
165 |
158 |
$0.00 |
| 00170 |
|
17 |
15 |
$0.00 |
| 87101 |
|
15 |
12 |
$0.00 |
| 99152 |
|
12 |
12 |
$0.00 |
| 88112 |
|
13 |
12 |
$0.00 |
| A9270 |
Non-covered item or service |
477 |
399 |
$0.00 |
| 94010 |
|
14 |
14 |
$0.00 |
| 87206 |
|
27 |
24 |
$0.00 |
| 99291 |
|
17 |
13 |
$0.00 |
| 91307 |
|
12 |
12 |
$0.00 |
| G0123 |
Screen cerv/vag thin layer |
29 |
27 |
$0.00 |
| 1126F |
|
61 |
55 |
$0.00 |
| 88342 |
|
45 |
44 |
$0.00 |
| 87015 |
|
27 |
24 |
$0.00 |
| 87116 |
|
27 |
24 |
$0.00 |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
42 |
12 |
$0.00 |