| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
46,022 |
39,502 |
$30.97M |
| 99284 |
|
56,881 |
49,082 |
$22.32M |
| 99283 |
|
68,480 |
60,469 |
$16.42M |
| G0378 |
Hospital observation per hr |
13,044 |
8,467 |
$9.97M |
| 74177 |
|
7,396 |
6,817 |
$5.99M |
| 41899 |
|
2,217 |
2,087 |
$5.03M |
| 93005 |
|
44,491 |
37,871 |
$3.14M |
| 70450 |
|
8,043 |
7,360 |
$3.00M |
| 96374 |
|
34,449 |
28,150 |
$2.61M |
| 71045 |
|
28,781 |
25,166 |
$2.42M |
| 96375 |
|
26,497 |
20,126 |
$2.39M |
| 74176 |
|
2,848 |
2,650 |
$1.93M |
| 96365 |
|
15,561 |
11,198 |
$1.81M |
| 93306 |
|
3,328 |
3,195 |
$1.56M |
| 97110 |
|
38,232 |
8,237 |
$1.56M |
| 43239 |
|
2,225 |
2,093 |
$1.50M |
| 99282 |
|
10,598 |
9,848 |
$1.36M |
| 96361 |
|
26,993 |
21,418 |
$1.35M |
| 0241U |
|
12,356 |
11,523 |
$1.32M |
| 97530 |
|
23,407 |
8,291 |
$1.30M |
| 99291 |
|
1,210 |
1,106 |
$1.29M |
| U0003 |
Cov-19 amp prb hgh thruput |
19,788 |
14,733 |
$1.24M |
| 88305 |
|
7,736 |
7,124 |
$1.19M |
| 96360 |
|
8,884 |
7,823 |
$1.05M |
| 71046 |
|
9,783 |
9,056 |
$1.01M |
| 71275 |
|
2,545 |
2,380 |
$991K |
| 92507 |
|
11,115 |
3,819 |
$928K |
| 80053 |
|
105,997 |
87,524 |
$848K |
| 96413 |
|
4,407 |
2,979 |
$798K |
| 72125 |
|
1,983 |
1,841 |
$779K |
| 94640 |
|
7,935 |
6,323 |
$752K |
| J3490 |
Drugs unclassified injection |
28,324 |
11,952 |
$716K |
| 70496 |
|
1,484 |
1,390 |
$710K |
| 85025 |
|
115,033 |
93,306 |
$669K |
| 96376 |
|
8,189 |
6,052 |
$659K |
| J1745 |
Infliximab not biosimil 10mg |
263 |
242 |
$654K |
| 80307 |
|
13,029 |
11,289 |
$651K |
| 97597 |
|
7,556 |
3,650 |
$650K |
| 70498 |
|
1,510 |
1,418 |
$634K |
| 70551 |
|
1,315 |
1,204 |
$631K |
| 97112 |
|
16,752 |
4,083 |
$590K |
| J8499 |
Oral prescrip drug non chemo |
70,969 |
26,008 |
$572K |
| J7030 |
Normal saline solution infus |
12,389 |
9,929 |
$542K |
| 96372 |
|
16,210 |
13,074 |
$537K |
| 88307 |
|
1,368 |
1,176 |
$452K |
| 76705 |
|
3,131 |
2,921 |
$401K |
| 36430 |
|
1,990 |
1,230 |
$400K |
| 71260 |
|
991 |
940 |
$395K |
| 99281 |
|
6,258 |
5,377 |
$385K |
| C1769 |
Guide wire |
5,525 |
4,667 |
$373K |
| 76856 |
|
1,417 |
1,312 |
$354K |
| 84443 |
|
24,937 |
23,356 |
$348K |
| 93971 |
|
1,781 |
1,645 |
$339K |
| G0463 |
Hospital outpt clinic visit |
15,764 |
10,329 |
$338K |
| 36902 |
|
1,199 |
1,087 |
$324K |
| 29581 |
|
4,276 |
1,467 |
$321K |
| 70553 |
|
427 |
392 |
$318K |
| 36591 |
|
4,838 |
2,538 |
$293K |
| 96366 |
|
5,763 |
4,012 |
$292K |
| 45380 |
|
554 |
525 |
$275K |
| 99153 |
Mod sedat endo service >5yrs |
3,033 |
2,712 |
$273K |
| 87491 |
|
8,137 |
7,625 |
$272K |
| 87591 |
|
8,188 |
7,627 |
$270K |
| 73610 |
|
2,163 |
1,982 |
$259K |
| U0005 |
Infec agen detec ampli probe |
12,807 |
9,302 |
$258K |
| 88342 |
|
2,494 |
2,289 |
$254K |
| 97116 |
|
8,729 |
3,179 |
$251K |
| 87502 |
|
3,106 |
2,972 |
$250K |
| 76801 |
|
1,092 |
1,006 |
$237K |
| 73562 |
|
1,982 |
1,835 |
$219K |
| J1885 |
Ketorolac tromethamine inj |
23,396 |
19,662 |
$218K |
| 82306 |
|
8,736 |
8,253 |
$217K |
| 73030 |
|
2,277 |
2,021 |
$217K |
| C1725 |
Cath, translumin non-laser |
2,630 |
2,127 |
$216K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
17,811 |
15,960 |
$216K |
| J2405 |
Ondansetron hcl injection |
30,861 |
23,647 |
$212K |
| 97140 |
|
6,079 |
2,482 |
$210K |
| J9271 |
Inj pembrolizumab |
19 |
14 |
$208K |
| J7120 |
Ringers lactate infusion |
4,454 |
3,553 |
$203K |
| 80061 |
|
17,025 |
16,264 |
$196K |
| 84484 |
|
27,789 |
20,572 |
$192K |
| 99152 |
|
3,756 |
3,369 |
$192K |
| C1894 |
Intro/sheath, non-laser |
5,666 |
4,665 |
$183K |
| 99213 |
|
2,696 |
2,060 |
$179K |
| 70486 |
|
603 |
557 |
$173K |
| 74018 |
|
1,846 |
1,595 |
$172K |
| C1887 |
Catheter, guiding |
1,926 |
1,547 |
$172K |
| 76817 |
|
1,166 |
1,077 |
$172K |
| 73130 |
|
1,727 |
1,532 |
$171K |
| J7050 |
Normal saline solution infus |
7,391 |
3,886 |
$165K |
| 83880 |
|
7,949 |
7,061 |
$163K |
| P9016 |
Rbc leukocytes reduced |
821 |
613 |
$159K |
| 97535 |
|
4,594 |
2,186 |
$158K |
| 73630 |
|
1,575 |
1,421 |
$156K |
| D2930 |
|
503 |
481 |
$155K |
| 87635 |
|
4,190 |
3,847 |
$153K |
| 96415 |
|
1,442 |
1,194 |
$150K |
| J2704 |
Inj, propofol, 10 mg |
13,609 |
11,823 |
$146K |
| H0007 |
Alcohol and/or drug services |
4,204 |
468 |
$144K |
| 83036 |
|
17,382 |
16,624 |
$142K |
| 76830 |
|
1,101 |
1,010 |
$141K |
| D7140 |
|
411 |
392 |
$135K |
| J3010 |
Fentanyl citrate injection |
18,623 |
14,529 |
$134K |
| D0150 |
|
443 |
418 |
$130K |
| 87389 |
|
6,110 |
5,780 |
$129K |
| 80048 |
|
22,561 |
18,841 |
$127K |
| 90853 |
|
8,416 |
540 |
$124K |
| 0240U |
|
1,177 |
1,130 |
$123K |
| 10061 |
|
720 |
678 |
$123K |
| C1766 |
Intro/sheath,strble,non-peel |
347 |
317 |
$123K |
| D1120 |
|
403 |
384 |
$122K |
| 72100 |
|
1,242 |
1,168 |
$122K |
| 83690 |
|
22,906 |
19,833 |
$118K |
| 99214 |
|
1,402 |
1,158 |
$116K |
| C1732 |
Cath, ep, diag/abl, 3d/vect |
54 |
50 |
$115K |
| J1100 |
Dexamethasone sodium phos |
14,212 |
12,576 |
$112K |
| 81001 |
|
44,091 |
39,084 |
$112K |
| 11042 |
|
471 |
281 |
$108K |
| 12001 |
|
1,047 |
1,002 |
$107K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
86 |
77 |
$107K |
| 81025 |
|
14,863 |
13,387 |
$104K |
| 87510 |
|
5,429 |
5,011 |
$103K |
| 87480 |
|
5,429 |
5,011 |
$103K |
| 87660 |
|
5,429 |
5,011 |
$103K |
| 86480 |
|
1,968 |
1,883 |
$101K |
| 97162 |
|
2,374 |
2,222 |
$97K |
| 86920 |
|
1,660 |
1,272 |
$95K |
| 90715 |
|
2,728 |
2,579 |
$94K |
| 87040 |
|
12,294 |
6,405 |
$93K |
| 87086 |
|
13,894 |
12,736 |
$91K |
| 84702 |
|
6,647 |
5,535 |
$90K |
| 85027 |
|
19,082 |
16,105 |
$90K |
| 87150 |
|
2,959 |
2,616 |
$90K |
| J2001 |
Lidocaine injection |
16,990 |
13,077 |
$89K |
| H0015 |
Alcohol and/or drug services |
2,993 |
184 |
$89K |
| 97129 |
|
1,096 |
339 |
$87K |
| 77336 |
|
830 |
366 |
$87K |
| 73590 |
|
783 |
685 |
$86K |
| J2270 |
Morphine sulfate injection |
9,194 |
7,262 |
$81K |
| 96367 |
|
2,936 |
2,024 |
$80K |
| 86141 |
|
7,618 |
6,628 |
$80K |
| 83970 |
|
2,516 |
2,271 |
$78K |
| 73110 |
|
956 |
886 |
$77K |
| 93458 |
|
25 |
25 |
$76K |
| 84439 |
|
9,836 |
9,198 |
$76K |
| 73502 |
|
1,059 |
966 |
$75K |
| 87077 |
|
11,029 |
8,102 |
$74K |
| 97161 |
|
1,762 |
1,654 |
$74K |
| J1170 |
Hydromorphone injection |
7,814 |
5,495 |
$74K |
| 88341 |
|
507 |
426 |
$73K |
| 88304 |
|
1,606 |
1,485 |
$72K |
| 82728 |
|
6,360 |
5,931 |
$72K |
| 83605 |
|
9,558 |
7,114 |
$69K |
| 80074 |
|
1,824 |
1,719 |
$68K |
| J2250 |
Inj midazolam hydrochloride |
10,099 |
8,872 |
$68K |
| D1206 |
|
236 |
222 |
$67K |
| D0220 |
|
270 |
260 |
$66K |
| 90791 |
|
811 |
579 |
$65K |
| D0230 |
|
263 |
254 |
$64K |
| 76815 |
|
471 |
380 |
$64K |
| 86780 |
|
5,629 |
5,305 |
$64K |
| J2060 |
Lorazepam injection |
6,620 |
4,971 |
$63K |
| D1351 |
|
212 |
203 |
$63K |
| 86803 |
|
4,984 |
4,722 |
$63K |
| 82077 |
|
5,077 |
4,288 |
$61K |
| 83735 |
|
13,047 |
9,912 |
$61K |
| 59025 |
|
649 |
403 |
$59K |
| 94726 |
|
833 |
780 |
$59K |
| 84466 |
|
5,317 |
5,037 |
$56K |
| 36415 |
|
117,264 |
95,717 |
$55K |
| 87633 |
|
113 |
106 |
$52K |
| 87651 |
|
1,716 |
1,634 |
$52K |
| 82607 |
|
4,325 |
4,107 |
$51K |
| 12011 |
|
523 |
490 |
$51K |
| J1200 |
Diphenhydramine hcl injectio |
7,231 |
4,837 |
$51K |
| J1756 |
Iron sucrose injection |
1,017 |
428 |
$51K |
| J0696 |
Ceftriaxone sodium injection |
6,326 |
5,026 |
$51K |
| 73560 |
|
443 |
412 |
$49K |
| 92526 |
|
1,000 |
473 |
$49K |
| 82962 |
|
27,926 |
13,149 |
$48K |
| 82803 |
|
3,290 |
2,755 |
$48K |
| 88108 |
|
785 |
649 |
$48K |
| 87070 |
|
6,850 |
6,086 |
$48K |
| J1644 |
Inj heparin sodium per 1000u |
9,918 |
5,508 |
$47K |
| 87186 |
|
5,538 |
5,130 |
$46K |
| 10060 |
|
410 |
395 |
$46K |
| J0561 |
Penicillin g benzathine inj |
289 |
279 |
$45K |
| 76700 |
|
289 |
276 |
$45K |
| 97130 |
|
859 |
265 |
$45K |
| D0240 |
|
191 |
186 |
$45K |
| 87426 |
|
1,446 |
347 |
$45K |
| 94729 |
|
951 |
893 |
$44K |
| J0690 |
Cefazolin sodium injection |
8,064 |
6,166 |
$43K |
| D0272 |
|
179 |
171 |
$43K |
| 86850 |
|
6,664 |
5,675 |
$42K |
| 93613 |
|
26 |
24 |
$40K |
| 94060 |
|
457 |
426 |
$40K |
| J7040 |
Normal saline solution infus |
1,354 |
1,102 |
$39K |
| 85610 |
|
15,069 |
13,162 |
$39K |
| 76818 |
|
200 |
134 |
$39K |
| J1815 |
Insulin injection |
2,421 |
1,326 |
$38K |
| A9150 |
Misc/exper non-prescript dru |
38,498 |
20,975 |
$38K |
| J0330 |
Succinycholine chloride inj |
4,644 |
3,653 |
$38K |
| 88175 |
|
1,515 |
1,458 |
$37K |
| 82570 |
|
8,292 |
7,440 |
$37K |
| 73140 |
|
493 |
463 |
$36K |
| 36907 |
|
90 |
77 |
$36K |
| 77334 |
|
65 |
52 |
$36K |
| 92523 |
|
432 |
394 |
$35K |
| A6196 |
Alginate dressing <=16 sq in |
2,548 |
1,352 |
$35K |
| J2560 |
Phenobarbital sodium inj |
1,258 |
935 |
$35K |
| 96409 |
|
255 |
140 |
$34K |
| 73090 |
|
306 |
267 |
$34K |
| D2330 |
|
116 |
107 |
$34K |
| 80069 |
|
5,623 |
4,205 |
$34K |
| 85379 |
|
4,471 |
4,164 |
$33K |
| 93325 |
|
182 |
167 |
$31K |
| 97166 |
|
723 |
677 |
$31K |
| 76937 |
|
537 |
452 |
$31K |
| 84112 |
|
349 |
320 |
$30K |
| 99215 |
Prolong outpt/office vis |
362 |
341 |
$30K |
| 83540 |
|
5,648 |
5,333 |
$30K |
| 12002 |
|
326 |
305 |
$30K |
| D3220 |
|
88 |
85 |
$29K |
| 93308 |
|
157 |
138 |
$29K |
| 97542 |
|
584 |
520 |
$29K |
| 90837 |
|
657 |
237 |
$29K |
| 93798 |
|
752 |
130 |
$28K |
| 73080 |
|
274 |
249 |
$28K |
| 87636 |
|
262 |
251 |
$28K |
| 84703 |
|
4,432 |
4,088 |
$28K |
| 97163 |
|
767 |
732 |
$28K |
| 82746 |
|
2,379 |
2,258 |
$28K |
| 87880 |
|
1,859 |
1,787 |
$28K |
| 84145 |
|
1,765 |
1,614 |
$27K |
| 86140 |
|
6,093 |
5,251 |
$27K |
| A9585 |
Gadobutrol injection |
1,566 |
1,397 |
$27K |
| J3475 |
Inj magnesium sulfate |
2,376 |
1,650 |
$27K |
| 85730 |
|
6,902 |
6,260 |
$27K |
| 82784 |
|
2,334 |
2,054 |
$26K |
| 99211 |
|
725 |
634 |
$26K |
| 87081 |
|
3,748 |
3,588 |
$26K |
| J1569 |
Gammagard liquid injection |
23 |
12 |
$26K |
| 87340 |
|
3,113 |
2,906 |
$25K |
| D2391 |
|
90 |
86 |
$24K |
| 97165 |
|
502 |
465 |
$23K |
| 82043 |
|
4,577 |
4,344 |
$23K |
| A6207 |
Contact layer >16<= 48 sq in |
4,042 |
2,022 |
$23K |
| J2370 |
Phenylephrine hcl injection |
3,886 |
3,276 |
$23K |
| 73620 |
|
295 |
268 |
$23K |
| 87205 |
|
6,720 |
5,821 |
$23K |
| 93976 |
|
100 |
94 |
$22K |
| 96417 |
|
265 |
195 |
$22K |
| 82075 |
|
1,145 |
960 |
$22K |
| C1889 |
Implant/insert device, noc |
284 |
228 |
$22K |
| J2765 |
Metoclopramide hcl injection |
2,638 |
2,256 |
$22K |
| J8540 |
Oral dexamethasone |
3,448 |
2,720 |
$22K |
| 84403 |
|
1,046 |
962 |
$22K |
| 87798 |
|
562 |
515 |
$21K |
| H2021 |
Com wrap-around sv, 15 min |
1,378 |
373 |
$21K |
| J0185 |
Inj., aprepitant, 1 mg |
77 |
49 |
$21K |
| J3480 |
Inj potassium chloride |
1,114 |
683 |
$21K |
| 94010 |
|
406 |
384 |
$21K |
| J2550 |
Promethazine hcl injection |
2,498 |
1,722 |
$20K |
| 87640 |
|
792 |
732 |
$20K |
| G0500 |
Mod sedat endo service >5yrs |
448 |
387 |
$20K |
| 87641 |
|
802 |
740 |
$20K |
| D2392 |
|
75 |
71 |
$20K |
| D4355 |
|
69 |
68 |
$20K |
| 85652 |
|
8,764 |
7,726 |
$20K |
| 87631 |
|
199 |
183 |
$20K |
| 87624 |
|
624 |
600 |
$19K |
| 76770 |
|
140 |
126 |
$19K |
| J1650 |
Inj enoxaparin sodium |
3,574 |
1,096 |
$19K |
| 86900 |
|
8,619 |
6,472 |
$19K |
| 86901 |
|
8,606 |
6,468 |
$19K |
| 74174 |
|
27 |
26 |
$19K |
| 87075 |
|
2,594 |
2,226 |
$19K |
| C9113 |
Inj pantoprazole sodium, via |
2,202 |
1,661 |
$18K |
| 72148 |
|
39 |
37 |
$18K |
| 90832 |
|
467 |
196 |
$18K |
| G0515 |
Cognitive skills development |
392 |
107 |
$18K |
| 80076 |
|
2,542 |
2,331 |
$18K |
| 84100 |
|
4,988 |
3,735 |
$17K |
| 83516 |
|
1,333 |
1,107 |
$17K |
| J1630 |
Haloperidol injection |
1,992 |
1,470 |
$17K |
| J2930 |
Methylprednisolone injection |
2,125 |
1,708 |
$17K |
| 80143 |
|
1,245 |
1,057 |
$17K |
| A4648 |
Implantable tissue marker |
135 |
119 |
$16K |
| 77295 |
|
12 |
12 |
$16K |
| J3370 |
Vancomycin hcl injection |
1,861 |
1,205 |
$16K |
| C1874 |
Stent, coated/cov w/del sys |
12 |
12 |
$16K |
| 99212 |
|
292 |
255 |
$16K |
| 82274 |
|
1,250 |
1,209 |
$16K |
| 80305 |
|
3,352 |
1,864 |
$15K |
| 80179 |
|
1,093 |
953 |
$15K |
| 86038 |
|
1,406 |
1,332 |
$15K |
| J7512 |
Prednisone ir or dr oral 1mg |
3,875 |
3,007 |
$15K |
| 72040 |
|
163 |
150 |
$15K |
| 93312 |
|
30 |
29 |
$14K |
| 80197 |
|
1,376 |
1,002 |
$14K |
| 87522 |
Neg quan hep c or qual rna |
355 |
345 |
$14K |
| J3411 |
Thiamine hcl 100 mg |
1,638 |
1,124 |
$14K |
| J1790 |
Droperidol injection |
1,598 |
1,345 |
$13K |
| 84481 |
|
903 |
855 |
$13K |
| 87653 |
|
297 |
289 |
$13K |
| 29125 |
|
127 |
113 |
$13K |
| 86762 |
|
873 |
816 |
$12K |
| 84156 |
|
3,907 |
3,447 |
$12K |
| 72170 |
|
114 |
109 |
$11K |
| J0171 |
Adrenalin epinephrine inject |
1,340 |
1,123 |
$11K |
| 82550 |
|
2,205 |
1,890 |
$11K |
| J0780 |
Prochlorperazine injection |
1,108 |
1,015 |
$11K |
| 74230 |
|
73 |
66 |
$10K |
| J1940 |
Furosemide injection |
1,856 |
1,434 |
$10K |
| 87799 |
|
312 |
180 |
$10K |
| 84550 |
|
2,836 |
2,574 |
$10K |
| J9370 |
Vincristine sulfate 1 mg inj |
108 |
78 |
$10K |
| 96368 |
|
426 |
260 |
$10K |
| 86706 |
|
1,045 |
977 |
$9K |
| 94760 |
|
477 |
379 |
$9K |
| 77300 |
|
14 |
12 |
$9K |
| 82140 |
|
819 |
679 |
$9K |
| 90935 |
|
54 |
25 |
$9K |
| 73120 |
|
99 |
85 |
$8K |
| 71101 |
|
69 |
66 |
$8K |
| 92611 |
|
59 |
52 |
$8K |
| A6212 |
Foam drg <=16 sq in w/border |
1,662 |
986 |
$8K |
| J1642 |
Inj heparin sodium per 10 u |
3,944 |
1,927 |
$8K |
| 90834 |
|
149 |
63 |
$8K |
| 86304 |
|
574 |
473 |
$8K |
| 0042T |
|
14 |
14 |
$8K |
| 70491 |
|
12 |
12 |
$8K |
| 84153 |
|
521 |
492 |
$7K |
| J0131 |
Inj, acetaminophen (nos) |
3,257 |
2,941 |
$7K |
| 97602 |
|
151 |
90 |
$7K |
| 90471 |
|
3,022 |
2,823 |
$7K |
| 81003 |
|
3,863 |
3,429 |
$7K |
| U0002 |
Covid-19 lab test non-cdc |
141 |
133 |
$6K |
| 99204 |
|
69 |
63 |
$6K |
| 82310 |
|
1,688 |
1,453 |
$6K |
| 82977 |
|
895 |
785 |
$6K |
| 84146 |
|
338 |
319 |
$6K |
| 73600 |
|
47 |
41 |
$6K |
| 97127 |
|
59 |
14 |
$6K |
| T1023 |
Program intake assessment |
367 |
284 |
$5K |
| 96450 |
|
14 |
13 |
$5K |
| 82150 |
|
945 |
874 |
$5K |
| 89051 |
|
1,228 |
1,001 |
$5K |
| 82657 |
|
187 |
113 |
$5K |
| 87493 |
|
187 |
169 |
$5K |
| 87497 |
|
180 |
119 |
$5K |
| 83615 |
|
1,143 |
884 |
$5K |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
668 |
518 |
$5K |
| J2371 |
Inj phenylephrine hcl 20 mcg |
1,140 |
874 |
$5K |
| C2617 |
Stent, non-cor, tem w/o del |
26 |
25 |
$5K |
| 82248 |
|
992 |
795 |
$5K |
| 80164 |
|
452 |
384 |
$4K |
| 82565 |
|
1,036 |
900 |
$4K |
| 87486 |
|
119 |
111 |
$4K |
| 87581 |
|
119 |
111 |
$4K |
| 87807 |
|
297 |
291 |
$4K |
| C1730 |
Cath, ep, 19 or few elect |
15 |
14 |
$4K |
| J1453 |
Fosaprepitant injection |
164 |
103 |
$4K |
| 78264 |
|
15 |
12 |
$4K |
| 71250 |
|
12 |
12 |
$4K |
| 36901 |
|
113 |
99 |
$4K |
| C1750 |
Cath, hemodialysis,long-term |
34 |
27 |
$4K |
| 92610 |
|
55 |
53 |
$4K |
| 85014 |
|
2,393 |
2,036 |
$4K |
| D2332 |
|
14 |
13 |
$4K |
| 84460 |
|
801 |
733 |
$4K |
| 85018 |
|
2,028 |
1,729 |
$4K |
| C1760 |
Closure dev, vasc |
44 |
43 |
$4K |
| 86376 |
|
302 |
286 |
$4K |
| 87427 |
|
289 |
135 |
$3K |
| 49083 |
|
16 |
12 |
$3K |
| 82330 |
|
448 |
238 |
$3K |
| 87147 |
|
588 |
555 |
$3K |
| J1836 |
Inj, metronidazole, 10 mg |
180 |
135 |
$3K |
| 87015 |
|
531 |
445 |
$3K |
| 83001 |
|
236 |
215 |
$3K |
| 82247 |
|
552 |
412 |
$3K |
| Q0162 |
Ondansetron oral |
591 |
353 |
$3K |
| C1788 |
Port, indwelling, imp |
12 |
12 |
$3K |
| A6457 |
Tubular dressing |
3,483 |
1,535 |
$3K |
| C2623 |
Cath, translumin, drug-coat |
46 |
39 |
$3K |
| 82533 |
|
211 |
170 |
$3K |
| 82105 |
|
207 |
192 |
$3K |
| 84132 |
|
1,199 |
922 |
$3K |
| 97605 |
|
62 |
28 |
$3K |
| 83520 |
|
169 |
163 |
$3K |
| 83655 |
|
230 |
221 |
$3K |
| 86431 |
|
508 |
488 |
$3K |
| 76870 |
|
13 |
13 |
$3K |
| 73070 |
|
37 |
33 |
$3K |
| J1171 |
Inj, hydromorphone, 0.1 mg |
207 |
160 |
$2K |
| 86800 |
|
184 |
174 |
$2K |
| 74019 |
|
30 |
27 |
$2K |
| 85384 |
|
410 |
273 |
$2K |
| 83993 |
|
118 |
111 |
$2K |
| 88173 |
|
15 |
12 |
$2K |
| 87899 |
|
157 |
141 |
$2K |
| A6213 |
Foam drg >16<=48 sq in w/bdr |
271 |
179 |
$2K |
| 83525 |
|
193 |
184 |
$2K |
| 84305 |
|
100 |
99 |
$2K |
| 82670 |
|
108 |
99 |
$2K |
| J9045 |
Carboplatin injection |
36 |
24 |
$2K |
| T1007 |
Treatment plan development |
13 |
13 |
$2K |
| 86200 |
|
133 |
123 |
$2K |
| Q0163 |
Diphenhydramine hcl 50mg |
2,512 |
1,954 |
$2K |
| 87046 |
|
169 |
154 |
$2K |
| 87045 |
|
168 |
154 |
$2K |
| 83002 |
|
101 |
96 |
$2K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
161 |
148 |
$2K |
| 86160 |
|
70 |
65 |
$1K |
| 82950 |
|
266 |
259 |
$1K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
352 |
224 |
$1K |
| J2004 |
Inj, lidocaine w epinephrine |
163 |
160 |
$1K |
| 87400 |
|
84 |
60 |
$1K |
| 73552 |
|
13 |
12 |
$1K |
| J9260 |
Inj methotrexate sodium 50mg |
23 |
13 |
$1K |
| J7060 |
5% dextrose/water |
33 |
26 |
$1K |
| 86704 |
|
133 |
127 |
$1K |
| J2175 |
Meperidine hydrochl /100 mg |
126 |
105 |
$1K |
| 85045 |
|
216 |
186 |
$980.23 |
| 82785 |
|
57 |
51 |
$932.02 |
| A9541 |
Tc99m sulfur colloid |
15 |
12 |
$924.90 |
| 84520 |
|
260 |
232 |
$788.85 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
75 |
43 |
$780.24 |
| 80178 |
|
135 |
110 |
$767.14 |
| 87536 |
|
12 |
12 |
$748.86 |
| 83013 |
|
13 |
12 |
$714.00 |
| 84450 |
|
166 |
156 |
$713.43 |
| H0046 |
Mental health service, nos |
621 |
398 |
$689.12 |
| 84295 |
|
213 |
164 |
$678.07 |
| J2720 |
Inj protamine sulfate/10 mg |
130 |
121 |
$625.73 |
| 86308 |
|
125 |
118 |
$596.14 |
| 84402 |
|
24 |
24 |
$591.76 |
| L1930 |
Afo plastic |
16 |
14 |
$544.52 |
| 85046 |
|
109 |
95 |
$541.38 |
| 86003 |
|
29 |
16 |
$508.44 |
| 86682 |
|
134 |
112 |
$489.18 |
| 82947 |
|
201 |
171 |
$485.21 |
| 82009 |
|
141 |
103 |
$482.36 |
| J7042 |
5% dextrose/normal saline |
15 |
12 |
$481.03 |
| A6199 |
Alginate drsg wound filler |
49 |
39 |
$456.24 |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
46 |
31 |
$437.52 |
| 84134 |
|
33 |
26 |
$429.38 |
| 87116 |
|
43 |
28 |
$395.08 |
| 85347 |
|
452 |
379 |
$379.51 |
| J0735 |
Clonidine hydrochloride |
15 |
13 |
$334.95 |
| 87209 |
|
28 |
14 |
$322.74 |
| L1836 |
Ko rigid w/o joints pre ots |
16 |
13 |
$322.65 |
| 86255 |
|
26 |
25 |
$322.44 |
| J1920 |
Inj, labetalol hcl, 5mg |
37 |
29 |
$306.39 |
| A9503 |
Tc99m medronate |
24 |
24 |
$281.16 |
| 82010 |
|
46 |
38 |
$269.61 |
| 87102 |
|
26 |
25 |
$263.40 |
| 90686 |
|
64 |
59 |
$261.92 |
| J7999 |
Compounded drug, noc |
752 |
611 |
$243.68 |
| J2919 |
Inj, methylpred sod succ 5mg |
267 |
205 |
$215.00 |
| 87338 |
|
16 |
12 |
$205.11 |
| 87177 |
|
28 |
14 |
$159.75 |
| 87206 |
|
45 |
28 |
$149.87 |
| 87420 |
|
15 |
13 |
$139.10 |
| 0202U |
|
302 |
287 |
$138.24 |
| 84165 |
|
17 |
13 |
$112.20 |
| 89060 |
|
15 |
12 |
$100.95 |
| J0456 |
Azithromycin |
15 |
13 |
$95.48 |
| J0360 |
Hydralazine hcl injection |
29 |
24 |
$91.55 |
| G0108 |
Diab manage trn per indiv |
17 |
12 |
$88.70 |
| 83014 |
|
13 |
12 |
$83.34 |
| J0692 |
Cefepime hcl for injection |
23 |
12 |
$81.84 |
| J7510 |
Prednisolone oral per 5 mg |
13 |
13 |
$78.36 |
| J2710 |
Neostigmine methylslfte inj |
2,149 |
1,921 |
$75.98 |
| 0353U |
|
2,429 |
2,194 |
$70.18 |
| J2470 |
Inj pantoprazole sodium 40mg |
154 |
117 |
$70.02 |
| Q0144 |
Azithromycin dihydrate, oral |
13 |
13 |
$60.48 |
| 82945 |
|
12 |
12 |
$47.16 |
| 84157 |
|
12 |
12 |
$44.02 |
| 84155 |
|
18 |
14 |
$42.06 |
| 87207 |
|
14 |
13 |
$41.33 |
| A9270 |
Non-covered item or service |
46,511 |
14,538 |
$8.01 |
| S2900 |
Robotic surgical system |
37 |
29 |
$3.28 |
| G1004 |
Cdsm ndsc |
12,406 |
9,096 |
$0.28 |
| G8980 |
Mobility d/c status |
139 |
135 |
$0.00 |
| 86364 |
|
718 |
690 |
$0.00 |
| 0352U |
|
1,763 |
1,631 |
$0.00 |
| 86258 |
|
82 |
80 |
$0.00 |
| G0008 |
Admin influenza virus vac |
214 |
213 |
$0.00 |
| M0243 |
Casirivi and imdevi inj |
88 |
64 |
$0.00 |
| 0099U |
|
12 |
12 |
$0.00 |
| G8988 |
Self care goal status |
167 |
138 |
$0.00 |
| G8982 |
Body pos goal status |
73 |
61 |
$0.00 |
| G8987 |
Self care current status |
141 |
119 |
$0.00 |
| 0031A |
|
84 |
69 |
$0.00 |
| 0011A |
|
33 |
19 |
$0.00 |
| 97802 |
|
38 |
36 |
$0.00 |
| G8981 |
Body pos current status |
38 |
32 |
$0.00 |
| G8979 |
Mobility goal status |
520 |
449 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
372 |
343 |
$0.00 |
| J0688 |
Inj cefazolin sodium, hikma |
81 |
79 |
$0.00 |
| M0222 |
Bebtelovimab injection |
49 |
48 |
$0.00 |
| G8978 |
Mobility current status |
470 |
412 |
$0.00 |
| 86231 |
|
97 |
95 |
$0.00 |
| 80348 |
|
80 |
69 |
$0.00 |
| 90662 |
|
87 |
86 |
$0.00 |