| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 93306 |
|
31,652 |
30,317 |
$9.48M |
| 43239 |
|
6,996 |
6,625 |
$7.41M |
| 99285 |
|
27,862 |
25,078 |
$5.19M |
| J9271 |
Inj pembrolizumab |
848 |
618 |
$5.01M |
| OP279 |
|
25,790 |
23,454 |
$4.74M |
| 96365 |
|
21,414 |
12,917 |
$3.97M |
| 93017 |
|
20,002 |
18,935 |
$3.39M |
| OP278 |
|
1,659 |
1,487 |
$3.28M |
| 78452 |
|
13,143 |
12,343 |
$2.78M |
| 99283 |
|
13,462 |
12,772 |
$2.68M |
| 80053 |
|
201,758 |
180,418 |
$2.51M |
| 74177 |
|
8,521 |
7,994 |
$2.35M |
| 99284 |
|
10,989 |
10,337 |
$2.14M |
| OP710 |
|
23,710 |
21,666 |
$2.10M |
| 96413 |
|
9,083 |
5,189 |
$2.07M |
| G0378 |
Hospital observation per hr |
3,153 |
2,474 |
$1.87M |
| 84443 |
|
86,229 |
83,531 |
$1.83M |
| 96375 |
|
18,063 |
13,069 |
$1.73M |
| 88305 |
|
17,846 |
16,627 |
$1.72M |
| 80061 |
|
94,285 |
91,603 |
$1.53M |
| 45378 |
|
2,860 |
2,682 |
$1.50M |
| 85025 |
|
203,328 |
177,288 |
$1.37M |
| 78815 |
|
1,296 |
1,202 |
$1.33M |
| 99282 |
|
12,151 |
11,678 |
$1.31M |
| 45380 |
|
3,502 |
3,194 |
$1.27M |
| 77067 |
|
16,420 |
16,012 |
$1.22M |
| 93970 |
|
5,260 |
5,010 |
$1.22M |
| 93458 |
|
812 |
742 |
$1.13M |
| OP379 |
|
25,031 |
22,630 |
$1.03M |
| J2505 |
Injection, pegfilgrastim 6mg |
514 |
362 |
$971K |
| Q5111 |
Injection, udenyca 0.5 mg |
557 |
358 |
$941K |
| J2785 |
Regadenoson injection |
8,172 |
7,618 |
$917K |
| OP259 |
|
73,379 |
50,357 |
$891K |
| 76641 |
|
11,547 |
9,583 |
$868K |
| A0429 |
Bls-emergency |
5,379 |
4,332 |
$837K |
| 96360 |
|
4,727 |
2,754 |
$817K |
| 70553 |
|
1,956 |
1,821 |
$805K |
| J1439 |
Inj ferric carboxymaltos 1mg |
1,052 |
691 |
$797K |
| J2506 |
Inj pegfilgrast ex bio 0.5mg |
486 |
333 |
$757K |
| 96417 |
|
2,671 |
1,728 |
$757K |
| 10005 |
|
2,417 |
2,267 |
$747K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
17,142 |
15,850 |
$722K |
| J0897 |
Denosumab injection |
705 |
643 |
$721K |
| 87591 |
|
16,398 |
15,728 |
$702K |
| 93880 |
|
6,004 |
5,683 |
$699K |
| U0002 |
Covid-19 lab test non-cdc |
14,780 |
13,498 |
$686K |
| 76816 |
|
6,622 |
5,887 |
$685K |
| 87502 |
|
10,724 |
10,215 |
$666K |
| 93925 |
|
4,790 |
4,542 |
$661K |
| 73721 |
|
2,372 |
2,223 |
$661K |
| 99281 |
|
6,489 |
6,185 |
$619K |
| 76830 |
|
5,069 |
4,908 |
$606K |
| 82306 |
|
16,477 |
16,312 |
$603K |
| 76536 |
|
6,457 |
6,237 |
$600K |
| 93226 |
|
2,939 |
2,828 |
$591K |
| 75574 |
|
1,274 |
1,223 |
$588K |
| 76819 |
|
5,091 |
2,668 |
$558K |
| 83036 |
|
69,152 |
67,074 |
$547K |
| 71260 |
|
3,987 |
3,785 |
$526K |
| 72148 |
|
2,411 |
2,270 |
$526K |
| 70551 |
|
2,238 |
2,093 |
$509K |
| 45385 |
|
2,270 |
2,128 |
$492K |
| 87491 |
|
13,789 |
13,280 |
$457K |
| 87635 |
|
19,785 |
17,540 |
$457K |
| 96374 |
|
12,516 |
11,317 |
$448K |
| J1453 |
Fosaprepitant injection |
1,647 |
1,056 |
$439K |
| A9502 |
Tc99m tetrofosmin |
12,777 |
11,522 |
$438K |
| 93971 |
|
2,621 |
2,471 |
$419K |
| 96361 |
|
8,974 |
6,196 |
$416K |
| 86235 |
|
3,222 |
2,675 |
$413K |
| 74176 |
|
3,114 |
2,919 |
$400K |
| 84439 |
|
37,096 |
35,956 |
$399K |
| 93225 |
|
2,910 |
2,806 |
$396K |
| 77080 |
|
6,291 |
5,968 |
$390K |
| 86803 |
|
21,006 |
20,391 |
$387K |
| 95806 |
|
131 |
129 |
$385K |
| 59025 |
|
2,218 |
1,831 |
$382K |
| A0427 |
Als1-emergency |
2,158 |
1,969 |
$373K |
| 77412 |
|
3,945 |
345 |
$368K |
| 96372 |
|
13,638 |
9,001 |
$365K |
| C9290 |
Inj, bupivacaine liposome |
1,890 |
1,692 |
$365K |
| J1756 |
Iron sucrose injection |
8,484 |
3,152 |
$359K |
| 62323 |
|
564 |
499 |
$355K |
| 70450 |
|
6,179 |
5,671 |
$355K |
| 76817 |
|
3,318 |
2,742 |
$355K |
| J2469 |
Palonosetron hcl |
3,964 |
2,585 |
$337K |
| 76856 |
|
4,521 |
4,358 |
$333K |
| 97140 |
|
10,610 |
3,051 |
$328K |
| 87633 |
|
1,002 |
939 |
$323K |
| 76811 |
|
1,576 |
1,526 |
$318K |
| J0131 |
Inj, acetaminophen (nos) |
16,600 |
14,011 |
$316K |
| 88173 |
|
3,465 |
3,289 |
$307K |
| 87481 |
|
4,447 |
4,224 |
$303K |
| J9395 |
Injection, fulvestrant |
310 |
253 |
$291K |
| 88312 |
|
6,982 |
6,660 |
$290K |
| J9045 |
Carboplatin injection |
568 |
369 |
$290K |
| 72197 |
|
773 |
694 |
$287K |
| 97110 |
|
15,608 |
4,145 |
$284K |
| 76700 |
|
5,190 |
4,969 |
$282K |
| 93005 |
|
25,535 |
21,821 |
$280K |
| 71046 |
|
14,552 |
13,726 |
$266K |
| 64483 |
|
252 |
235 |
$265K |
| 84480 |
|
15,989 |
15,476 |
$261K |
| 99234 |
|
1,829 |
1,501 |
$259K |
| 74183 |
|
711 |
662 |
$258K |
| 77049 |
|
749 |
722 |
$257K |
| 73221 |
|
889 |
830 |
$246K |
| 87624 |
|
9,526 |
9,218 |
$236K |
| 82728 |
|
23,518 |
21,767 |
$236K |
| 80048 |
|
37,889 |
33,583 |
$236K |
| 83883 |
|
2,634 |
2,493 |
$232K |
| 96411 |
|
1,202 |
717 |
$231K |
| 76801 |
|
2,209 |
2,010 |
$231K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
91 |
83 |
$230K |
| 77066 |
Tomosynthesis, mammo |
2,639 |
2,547 |
$216K |
| 93978 |
|
1,460 |
1,377 |
$207K |
| 71250 |
|
2,822 |
2,602 |
$204K |
| 77065 |
Tomosynthesis, mammo |
4,224 |
4,006 |
$202K |
| 81003 |
|
57,019 |
53,898 |
$201K |
| 88175 |
|
10,018 |
9,677 |
$201K |
| 87899 |
|
12,794 |
12,420 |
$200K |
| 72141 |
|
877 |
816 |
$197K |
| 81001 |
|
45,047 |
40,698 |
$190K |
| 96376 |
|
3,073 |
2,119 |
$189K |
| C1725 |
Cath, translumin non-laser |
931 |
790 |
$183K |
| 93922 |
|
2,840 |
2,687 |
$182K |
| 86480 |
|
3,677 |
3,539 |
$179K |
| 86003 |
|
491 |
470 |
$179K |
| 72110 |
|
3,072 |
2,911 |
$172K |
| 76770 |
|
2,359 |
2,254 |
$167K |
| 73564 |
|
4,621 |
3,932 |
$165K |
| 96415 |
|
1,826 |
1,154 |
$164K |
| 95810 |
|
107 |
102 |
$161K |
| 71275 |
|
590 |
531 |
$160K |
| J9267 |
Paclitaxel injection |
138 |
63 |
$160K |
| 82607 |
|
13,795 |
13,051 |
$159K |
| 96416 |
|
512 |
277 |
$156K |
| 88307 |
|
1,856 |
1,641 |
$155K |
| 88304 |
|
3,625 |
3,335 |
$152K |
| 87661 |
|
5,457 |
5,183 |
$150K |
| 82378 |
|
8,514 |
7,356 |
$147K |
| 77091 |
|
2,554 |
2,371 |
$143K |
| 76705 |
|
4,083 |
3,884 |
$138K |
| 93923 |
|
1,564 |
1,471 |
$137K |
| 96402 |
|
1,376 |
1,182 |
$135K |
| 82043 |
|
23,672 |
23,046 |
$132K |
| 70486 |
|
1,100 |
1,062 |
$130K |
| 83550 |
|
25,836 |
24,033 |
$129K |
| 86618 |
|
2,086 |
2,012 |
$129K |
| 86769 |
|
4,950 |
4,470 |
$127K |
| 36415 |
|
79,567 |
68,676 |
$127K |
| 86300 |
|
4,143 |
3,776 |
$124K |
| 97161 |
|
1,969 |
1,847 |
$122K |
| 83970 |
|
4,030 |
3,827 |
$122K |
| 76813 |
|
1,032 |
1,007 |
$122K |
| C1760 |
Closure dev, vasc |
1,041 |
918 |
$118K |
| 87536 |
|
1,056 |
1,029 |
$116K |
| G0399 |
Home sleep test/type 3 porta |
457 |
426 |
$115K |
| A4648 |
Implantable tissue marker |
864 |
731 |
$115K |
| 84146 |
|
3,850 |
3,680 |
$113K |
| 86200 |
|
3,716 |
3,341 |
$113K |
| 84153 |
|
6,837 |
6,382 |
$112K |
| 88172 |
|
3,413 |
3,228 |
$111K |
| 77336 |
|
1,682 |
677 |
$110K |
| J2405 |
Ondansetron hcl injection |
15,996 |
13,031 |
$109K |
| 84402 |
|
2,506 |
2,430 |
$108K |
| 73630 |
|
3,506 |
2,978 |
$107K |
| 47562 |
|
95 |
91 |
$107K |
| A0425 |
Ground mileage |
10,564 |
8,425 |
$106K |
| 87340 |
|
7,982 |
7,649 |
$106K |
| 82670 |
|
2,773 |
2,694 |
$105K |
| 88185 |
|
545 |
517 |
$105K |
| J9263 |
Oxaliplatin |
126 |
77 |
$105K |
| C8929 |
Tte w or wo fol wcon,doppler |
966 |
871 |
$104K |
| J1950 |
Leuprolide acetate /3.75 mg |
165 |
153 |
$103K |
| 86147 |
|
1,858 |
1,251 |
$102K |
| A9585 |
Gadobutrol injection |
5,825 |
5,396 |
$101K |
| 82652 |
|
2,177 |
2,148 |
$101K |
| 84403 |
|
2,865 |
2,783 |
$99K |
| 83001 |
|
3,725 |
3,627 |
$97K |
| 73130 |
|
2,728 |
2,287 |
$97K |
| 82627 |
|
2,185 |
2,116 |
$96K |
| 97112 |
|
3,494 |
1,348 |
$94K |
| 71045 |
|
8,692 |
7,838 |
$94K |
| C1769 |
Guide wire |
1,771 |
1,458 |
$92K |
| 86696 |
|
2,722 |
2,623 |
$92K |
| 86038 |
|
7,349 |
6,962 |
$91K |
| 83540 |
|
26,633 |
24,799 |
$91K |
| 83002 |
|
3,469 |
3,384 |
$90K |
| 77387 |
|
2,268 |
240 |
$89K |
| C1887 |
Catheter, guiding |
798 |
659 |
$86K |
| 82746 |
|
6,688 |
6,440 |
$86K |
| 87798 |
|
1,248 |
1,184 |
$85K |
| 96367 |
|
3,420 |
2,334 |
$83K |
| 86706 |
|
5,884 |
5,714 |
$82K |
| 80076 |
|
12,125 |
11,363 |
$81K |
| 96366 |
|
2,198 |
1,733 |
$81K |
| 87184 |
|
6,972 |
6,497 |
$79K |
| 87070 |
|
7,646 |
7,236 |
$79K |
| 73030 |
|
3,107 |
2,826 |
$78K |
| 77334 |
|
585 |
368 |
$78K |
| J2250 |
Inj midazolam hydrochloride |
11,540 |
10,481 |
$76K |
| 74246 |
|
462 |
447 |
$75K |
| 74178 |
|
212 |
202 |
$74K |
| 87088 |
|
24,017 |
22,489 |
$74K |
| A9552 |
F18 fdg |
967 |
844 |
$74K |
| 86703 |
|
3,993 |
3,896 |
$74K |
| 86140 |
|
12,874 |
12,323 |
$73K |
| 84484 |
|
10,692 |
9,147 |
$72K |
| 73610 |
|
2,432 |
2,152 |
$71K |
| 82570 |
|
25,600 |
24,740 |
$69K |
| 76981 |
|
303 |
289 |
$68K |
| C1874 |
Stent, coated/cov w/del sys |
74 |
67 |
$68K |
| 72125 |
|
1,535 |
1,395 |
$67K |
| 72052 |
|
949 |
916 |
$67K |
| 83690 |
|
14,712 |
13,473 |
$67K |
| 0002A |
|
2,741 |
2,729 |
$66K |
| 85610 |
|
18,091 |
14,753 |
$65K |
| 83880 |
|
4,319 |
3,998 |
$65K |
| 84425 |
|
1,789 |
1,743 |
$64K |
| 86800 |
|
4,035 |
3,906 |
$63K |
| 81025 |
|
7,551 |
6,659 |
$63K |
| 69436 |
|
57 |
52 |
$62K |
| 86431 |
|
7,735 |
6,820 |
$62K |
| 70491 |
|
324 |
309 |
$61K |
| 80307 |
|
1,123 |
975 |
$61K |
| 82550 |
|
10,979 |
9,861 |
$61K |
| 97803 |
|
1,865 |
1,774 |
$61K |
| 0001A |
|
2,764 |
2,750 |
$61K |
| J0875 |
Injection, dalbavancin |
17 |
12 |
$61K |
| 86704 |
|
4,152 |
4,006 |
$60K |
| 87634 |
|
1,533 |
1,467 |
$58K |
| 87651 |
|
2,688 |
2,577 |
$58K |
| 86146 |
|
1,802 |
1,188 |
$58K |
| 84481 |
|
3,252 |
3,120 |
$57K |
| 80074 |
|
1,574 |
1,524 |
$57K |
| 93976 |
|
305 |
289 |
$57K |
| 93312 |
|
268 |
221 |
$56K |
| 86376 |
|
4,724 |
4,586 |
$55K |
| 83735 |
|
18,887 |
15,385 |
$55K |
| 82784 |
|
3,476 |
3,192 |
$54K |
| 52000 |
|
425 |
396 |
$53K |
| 73110 |
|
1,520 |
1,315 |
$53K |
| 86695 |
|
2,713 |
2,613 |
$53K |
| 87799 |
|
477 |
442 |
$52K |
| 30140 |
|
28 |
26 |
$52K |
| 84550 |
|
11,004 |
10,484 |
$51K |
| 83520 |
|
3,293 |
2,950 |
$50K |
| 71271 |
|
709 |
675 |
$49K |
| 84445 |
|
1,647 |
1,601 |
$48K |
| 83921 |
|
2,981 |
2,872 |
$48K |
| 87077 |
|
9,067 |
8,498 |
$48K |
| 64493 |
|
27 |
27 |
$47K |
| A0428 |
Bls |
2,449 |
1,999 |
$46K |
| 86850 |
|
7,516 |
6,573 |
$46K |
| 83516 |
|
2,161 |
1,782 |
$45K |
| 85730 |
|
11,421 |
10,266 |
$43K |
| 74019 |
|
1,251 |
1,171 |
$42K |
| 87521 |
Neg quan hep c or qual rna |
958 |
902 |
$41K |
| 88184 |
|
570 |
539 |
$41K |
| 86255 |
|
2,531 |
2,464 |
$40K |
| Q5106 |
Inj retacrit non-esrd use |
559 |
287 |
$40K |
| 85652 |
|
16,177 |
15,595 |
$40K |
| OP229 |
|
772 |
713 |
$39K |
| 83498 |
|
929 |
904 |
$39K |
| 99212 |
|
1,497 |
940 |
$39K |
| 76815 |
|
463 |
424 |
$39K |
| 86735 |
|
1,621 |
1,588 |
$39K |
| 97802 |
|
589 |
579 |
$39K |
| 83615 |
|
9,394 |
8,394 |
$38K |
| 86225 |
|
2,171 |
1,969 |
$38K |
| J1885 |
Ketorolac tromethamine inj |
7,402 |
6,598 |
$38K |
| 82172 |
|
2,031 |
1,976 |
$37K |
| 10022 |
|
306 |
275 |
$37K |
| 76805 |
|
316 |
310 |
$37K |
| 86039 |
|
2,355 |
2,184 |
$36K |
| 86762 |
|
2,551 |
2,456 |
$36K |
| 94640 |
|
1,454 |
1,152 |
$35K |
| 72131 |
|
742 |
675 |
$35K |
| G0108 |
Diab manage trn per indiv |
626 |
519 |
$35K |
| 83010 |
|
1,621 |
1,558 |
$35K |
| Q5118 |
Inj., zirabev, 10 mg |
110 |
50 |
$34K |
| 93975 |
|
164 |
155 |
$34K |
| 86592 |
|
11,031 |
10,698 |
$33K |
| 87506 |
|
287 |
272 |
$33K |
| G0330 |
Facility svs dental rehab |
12 |
12 |
$32K |
| J1100 |
Dexamethasone sodium phos |
13,279 |
10,504 |
$31K |
| J9217 |
Leuprolide acetate suspnsion |
211 |
182 |
$29K |
| 73502 |
|
1,845 |
1,583 |
$29K |
| J3010 |
Fentanyl citrate injection |
13,495 |
11,376 |
$29K |
| 82533 |
|
1,923 |
1,724 |
$29K |
| J0696 |
Ceftriaxone sodium injection |
2,320 |
1,667 |
$28K |
| 83021 |
|
1,485 |
1,408 |
$27K |
| 82330 |
|
898 |
834 |
$27K |
| 86765 |
|
2,388 |
2,296 |
$27K |
| 87486 |
|
1,046 |
992 |
$27K |
| 86787 |
|
1,308 |
1,265 |
$27K |
| 85027 |
|
6,323 |
5,787 |
$27K |
| 87581 |
|
1,046 |
992 |
$27K |
| 83605 |
|
4,355 |
3,849 |
$26K |
| 82962 |
|
7,138 |
4,975 |
$26K |
| OP258 |
|
16,741 |
12,907 |
$26K |
| 93308 |
|
137 |
132 |
$25K |
| 87430 |
|
2,144 |
2,109 |
$25K |
| 82977 |
|
2,857 |
2,705 |
$25K |
| 86901 |
|
7,608 |
6,630 |
$24K |
| 94060 |
|
256 |
221 |
$24K |
| 82553 |
|
4,931 |
4,389 |
$23K |
| 87040 |
|
3,138 |
2,825 |
$23K |
| 74174 |
|
107 |
95 |
$23K |
| 86160 |
|
1,267 |
1,190 |
$23K |
| 88187 |
|
256 |
249 |
$22K |
| 86334 |
|
1,271 |
1,204 |
$21K |
| 84702 |
|
1,748 |
1,442 |
$20K |
| 96377 |
|
698 |
465 |
$20K |
| 83525 |
|
1,545 |
1,497 |
$19K |
| 82024 |
|
499 |
475 |
$19K |
| 87517 |
|
465 |
441 |
$19K |
| 86900 |
|
7,521 |
6,599 |
$19K |
| 84100 |
|
8,890 |
7,695 |
$18K |
| 19081 |
|
29 |
27 |
$18K |
| 97162 |
|
209 |
206 |
$18K |
| 84144 |
|
509 |
484 |
$18K |
| 83993 |
|
507 |
488 |
$18K |
| J2916 |
Na ferric gluconate complex |
380 |
180 |
$18K |
| 84134 |
|
1,073 |
1,047 |
$18K |
| 85045 |
|
8,462 |
7,661 |
$17K |
| 87512 |
|
470 |
437 |
$17K |
| 76857 |
|
768 |
721 |
$17K |
| 76942 |
|
293 |
274 |
$16K |
| 84165 |
|
3,001 |
2,844 |
$16K |
| 76870 |
|
243 |
230 |
$16K |
| 74018 |
|
494 |
458 |
$15K |
| 82157 |
|
346 |
333 |
$15K |
| C1768 |
Graft, vascular |
13 |
12 |
$15K |
| 82150 |
|
1,947 |
1,873 |
$15K |
| J1644 |
Inj heparin sodium per 1000u |
2,803 |
2,174 |
$14K |
| C1732 |
Cath, ep, diag/abl, 3d/vect |
17 |
12 |
$13K |
| 85378 |
|
3,281 |
3,149 |
$13K |
| 84681 |
|
595 |
567 |
$13K |
| G0480 |
Drug test def 1-7 classes |
479 |
404 |
$13K |
| 0004A |
|
531 |
516 |
$13K |
| 86304 |
|
963 |
672 |
$12K |
| 84154 |
|
1,142 |
1,116 |
$12K |
| 10021 |
|
345 |
326 |
$12K |
| 97530 |
|
474 |
133 |
$12K |
| 88108 |
|
648 |
564 |
$12K |
| 77300 |
|
164 |
127 |
$12K |
| 66984 |
|
30 |
27 |
$11K |
| 90471 |
|
676 |
587 |
$11K |
| 82985 |
|
1,619 |
1,551 |
$11K |
| C9600 |
Perc drug-el cor stent sing |
35 |
26 |
$11K |
| 82397 |
|
454 |
440 |
$11K |
| 82105 |
|
739 |
705 |
$10K |
| 99213 |
|
273 |
226 |
$10K |
| 86361 |
|
472 |
461 |
$10K |
| 87081 |
|
1,072 |
999 |
$10K |
| 83721 |
|
1,757 |
1,713 |
$9K |
| 82274 |
|
1,146 |
1,129 |
$9K |
| G0463 |
Hospital outpt clinic visit |
1,643 |
973 |
$9K |
| 94760 |
|
1,219 |
956 |
$9K |
| 88142 |
|
256 |
256 |
$9K |
| Q9957 |
Inj perflutren lip micros,ml |
127 |
115 |
$9K |
| 73080 |
|
306 |
278 |
$9K |
| 82166 |
|
235 |
218 |
$9K |
| 84478 |
|
1,011 |
983 |
$9K |
| 70498 |
|
43 |
41 |
$8K |
| 72100 |
|
255 |
242 |
$8K |
| C1894 |
Intro/sheath, non-laser |
811 |
662 |
$8K |
| 86021 |
|
197 |
191 |
$8K |
| 84432 |
|
468 |
444 |
$8K |
| 86256 |
|
559 |
529 |
$8K |
| 0011A |
|
362 |
360 |
$8K |
| 82232 |
|
843 |
776 |
$8K |
| J1650 |
Inj enoxaparin sodium |
1,299 |
729 |
$8K |
| J3301 |
Triamcinolone acet inj nos |
245 |
237 |
$8K |
| 90715 |
|
490 |
456 |
$8K |
| 82247 |
|
2,302 |
1,991 |
$8K |
| 80320 |
|
1,166 |
1,072 |
$7K |
| 36591 |
|
237 |
174 |
$7K |
| 0012A |
|
263 |
262 |
$7K |
| 94729 |
|
377 |
304 |
$7K |
| 84630 |
|
466 |
460 |
$7K |
| 84305 |
|
295 |
287 |
$7K |
| Q0138 |
Ferumoxytol, non-esrd |
58 |
33 |
$7K |
| 72170 |
|
352 |
308 |
$7K |
| 96523 |
|
210 |
151 |
$7K |
| 88313 |
|
238 |
193 |
$7K |
| A9500 |
Tc99m sestamibi |
105 |
104 |
$7K |
| 86364 |
|
565 |
296 |
$7K |
| 93351 |
|
39 |
39 |
$7K |
| J9190 |
Fluorouracil injection |
853 |
331 |
$7K |
| 90870 |
|
38 |
12 |
$6K |
| 80050 |
|
176 |
174 |
$6K |
| 96368 |
|
57 |
40 |
$6K |
| 87529 |
|
102 |
91 |
$6K |
| 87338 |
|
680 |
671 |
$6K |
| 87426 |
|
297 |
283 |
$6K |
| 76000 |
|
693 |
631 |
$6K |
| 83695 |
|
662 |
648 |
$6K |
| 84460 |
|
1,693 |
1,596 |
$6K |
| 84450 |
|
1,664 |
1,567 |
$5K |
| 11042 |
|
47 |
37 |
$5K |
| 82465 |
|
1,017 |
989 |
$5K |
| J0885 |
Epoetin alfa, non-esrd |
335 |
178 |
$5K |
| 78306 |
|
79 |
74 |
$5K |
| 88311 |
|
762 |
684 |
$5K |
| M0243 |
Casirivi and imdevi inj |
28 |
28 |
$5K |
| 84703 |
|
714 |
670 |
$5K |
| 82947 |
|
1,332 |
1,234 |
$5K |
| J0690 |
Cefazolin sodium injection |
3,880 |
2,959 |
$5K |
| 86430 |
|
782 |
780 |
$5K |
| 86481 |
|
86 |
86 |
$5K |
| 82088 |
|
120 |
112 |
$5K |
| 93798 |
|
230 |
24 |
$5K |
| 0003A |
|
213 |
212 |
$5K |
| 76775 |
|
103 |
98 |
$5K |
| 72070 |
|
117 |
112 |
$5K |
| 88342 |
|
131 |
105 |
$4K |
| 86340 |
|
183 |
176 |
$4K |
| 81490 |
|
12 |
12 |
$4K |
| 84166 |
|
289 |
281 |
$4K |
| 82565 |
|
856 |
794 |
$4K |
| 80299 |
|
488 |
450 |
$4K |
| 80143 |
|
428 |
382 |
$4K |
| 82785 |
|
236 |
228 |
$4K |
| 80179 |
|
784 |
698 |
$4K |
| 77280 |
|
58 |
50 |
$4K |
| 29125 |
|
67 |
61 |
$4K |
| 75635 |
|
40 |
38 |
$4K |
| 97165 |
|
99 |
80 |
$4K |
| 93990 |
|
25 |
25 |
$4K |
| G1004 |
Cdsm ndsc |
6,819 |
4,773 |
$4K |
| 87147 |
|
742 |
720 |
$3K |
| 77003 |
|
947 |
892 |
$3K |
| 84156 |
|
1,291 |
1,212 |
$3K |
| 82787 |
|
55 |
49 |
$3K |
| 77417 |
|
172 |
78 |
$3K |
| 73140 |
|
118 |
114 |
$3K |
| 73718 |
|
15 |
12 |
$3K |
| 12001 |
|
25 |
24 |
$3K |
| C1730 |
Cath, ep, 19 or few elect |
19 |
13 |
$3K |
| 87625 |
|
302 |
253 |
$3K |
| 0064A |
|
114 |
113 |
$3K |
| 93926 |
|
44 |
38 |
$3K |
| 84520 |
|
664 |
622 |
$3K |
| 82950 |
|
775 |
749 |
$3K |
| 85613 |
|
231 |
221 |
$3K |
| 0071A |
|
105 |
104 |
$3K |
| 80177 |
|
124 |
121 |
$3K |
| 87209 |
|
291 |
279 |
$3K |
| 86341 |
|
39 |
30 |
$3K |
| G0103 |
Psa screening |
47 |
47 |
$3K |
| 84244 |
|
90 |
84 |
$3K |
| 86335 |
|
106 |
99 |
$2K |
| 74240 |
|
12 |
12 |
$2K |
| M0239 |
Bamlanivimab-xxxx infusion |
21 |
19 |
$2K |
| 0124A |
|
120 |
103 |
$2K |
| 88341 |
|
31 |
24 |
$2K |
| 88302 |
|
116 |
102 |
$2K |
| 0072A |
|
92 |
92 |
$2K |
| 86708 |
|
125 |
121 |
$2K |
| 81050 |
|
402 |
372 |
$2K |
| M0245 |
Bamlan and etesev infusion |
16 |
16 |
$2K |
| 29515 |
|
40 |
39 |
$2K |
| 87324 |
|
642 |
586 |
$2K |
| 73590 |
|
90 |
80 |
$2K |
| 74220 |
|
95 |
90 |
$2K |
| 74021 |
|
66 |
64 |
$2K |
| 73560 |
|
81 |
71 |
$2K |
| 84436 |
|
473 |
461 |
$2K |
| 87177 |
|
291 |
279 |
$2K |
| 82656 |
|
106 |
101 |
$2K |
| 86148 |
|
96 |
89 |
$2K |
| 71100 |
|
68 |
64 |
$2K |
| 85041 |
|
1,498 |
1,365 |
$1K |
| 86617 |
|
28 |
27 |
$1K |
| 85384 |
|
170 |
144 |
$1K |
| 96409 |
|
29 |
15 |
$1K |
| 85014 |
|
1,703 |
1,529 |
$1K |
| 84235 |
|
32 |
32 |
$1K |
| J0640 |
Leucovorin calcium injection |
37 |
24 |
$1K |
| 73700 |
|
13 |
13 |
$1K |
| OP276 |
|
28 |
25 |
$1K |
| 85018 |
|
1,621 |
1,468 |
$1K |
| 82164 |
|
45 |
43 |
$1K |
| J3420 |
Vitamin b12 injection |
1,681 |
989 |
$1K |
| 83835 |
|
100 |
93 |
$1K |
| 70480 |
|
14 |
12 |
$1K |
| 83519 |
|
29 |
25 |
$1K |
| 84270 |
|
51 |
50 |
$1K |
| 72050 |
|
15 |
13 |
$1K |
| 94726 |
|
70 |
54 |
$1K |
| 93613 |
|
17 |
12 |
$1K |
| 86329 |
|
81 |
79 |
$1K |
| 80069 |
|
243 |
220 |
$1K |
| 94727 |
|
61 |
55 |
$1K |
| 86774 |
|
72 |
69 |
$955.47 |
| 86709 |
|
62 |
62 |
$951.46 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,256 |
1,159 |
$945.10 |
| 82248 |
|
117 |
85 |
$936.55 |
| J2765 |
Metoclopramide hcl injection |
2,059 |
1,839 |
$928.88 |
| Q9950 |
Inj sulf hexa lipid microsph |
46 |
43 |
$926.64 |
| P9016 |
Rbc leukocytes reduced |
13 |
12 |
$924.76 |
| 84590 |
|
55 |
55 |
$863.11 |
| 84482 |
|
29 |
29 |
$863.07 |
| 87420 |
|
60 |
59 |
$848.41 |
| 85303 |
|
42 |
40 |
$842.57 |
| J1741 |
Ibuprofen injection |
73 |
62 |
$817.32 |
| 87563 |
|
45 |
44 |
$806.23 |
| 36430 |
|
14 |
13 |
$786.34 |
| 83704 |
|
30 |
28 |
$785.89 |
| A9581 |
Gadoxetate disodium inj |
30 |
27 |
$782.87 |
| 76098 |
|
55 |
52 |
$761.96 |
| 87045 |
|
78 |
74 |
$703.26 |
| 72082 |
|
13 |
12 |
$608.34 |
| A9503 |
Tc99m medronate |
76 |
62 |
$553.70 |
| 82085 |
|
39 |
38 |
$525.04 |
| J2060 |
Lorazepam injection |
367 |
298 |
$523.09 |
| 86780 |
|
37 |
36 |
$504.87 |
| 87205 |
|
71 |
66 |
$496.16 |
| 82668 |
|
55 |
50 |
$492.69 |
| 75571 |
|
338 |
308 |
$477.94 |
| 82310 |
|
111 |
88 |
$413.75 |
| A9579 |
Gad-base mr contrast nos,1ml |
32 |
31 |
$397.77 |
| 80164 |
|
54 |
50 |
$392.25 |
| 36416 |
|
169 |
107 |
$350.54 |
| 87046 |
|
91 |
87 |
$350.10 |
| 85576 |
|
16 |
15 |
$333.45 |
| 87075 |
|
64 |
48 |
$302.65 |
| 84132 |
|
275 |
230 |
$289.96 |
| 86615 |
|
13 |
12 |
$279.36 |
| 88300 |
|
32 |
27 |
$263.18 |
| 82040 |
|
646 |
590 |
$246.56 |
| 85300 |
|
15 |
14 |
$233.52 |
| 86705 |
|
15 |
15 |
$232.08 |
| 87185 |
|
48 |
39 |
$169.86 |
| J3360 |
Diazepam injection |
12 |
12 |
$154.50 |
| 87341 |
|
13 |
12 |
$146.28 |
| 82803 |
|
15 |
12 |
$143.16 |
| 86593 |
|
28 |
28 |
$137.53 |
| 77081 |
|
13 |
12 |
$127.96 |
| 0054A |
|
14 |
14 |
$125.63 |
| 83655 |
|
13 |
13 |
$121.24 |
| 82270 |
|
132 |
130 |
$117.21 |
| 86308 |
|
14 |
13 |
$116.63 |
| 81015 |
|
1,845 |
1,798 |
$104.68 |
| 97116 |
|
17 |
12 |
$99.66 |
| 83020 |
|
13 |
13 |
$85.33 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
601 |
503 |
$77.87 |
| 84157 |
|
15 |
14 |
$77.17 |
| 84300 |
|
26 |
25 |
$71.77 |
| 84479 |
|
595 |
579 |
$65.73 |
| 82542 |
|
12 |
12 |
$64.99 |
| J2370 |
Phenylephrine hcl injection |
76 |
76 |
$55.58 |
| 86922 |
|
14 |
13 |
$43.96 |
| 82340 |
|
12 |
12 |
$27.97 |
| J2919 |
Inj, methylpred sod succ 5mg |
109 |
84 |
$20.53 |
| J3490 |
Drugs unclassified injection |
22 |
22 |
$9.30 |
| 64494 |
|
27 |
27 |
$7.00 |
| 84295 |
|
16 |
13 |
$6.70 |
| S2900 |
Robotic surgical system |
30 |
29 |
$6.00 |
| J0360 |
Hydralazine hcl injection |
17 |
12 |
$5.24 |
| J0670 |
Inj mepivacaine hcl/10 ml |
13 |
13 |
$3.57 |