| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96361 |
|
35,078 |
26,833 |
$9.73M |
| 99214 |
|
114,817 |
98,697 |
$5.63M |
| 99283 |
|
47,942 |
44,165 |
$5.18M |
| G0463 |
Hospital outpt clinic visit |
109,376 |
67,192 |
$5.00M |
| 99284 |
|
51,162 |
46,818 |
$4.35M |
| 99285 |
|
63,859 |
58,238 |
$4.11M |
| 99213 |
|
65,076 |
57,659 |
$2.84M |
| 96366 |
|
12,615 |
6,628 |
$2.62M |
| 74177 |
|
16,711 |
15,988 |
$2.49M |
| 11042 |
|
28,162 |
11,702 |
$1.86M |
| H2012 |
Behav hlth day treat, per hr |
6,930 |
1,168 |
$1.84M |
| 70450 |
|
14,261 |
13,491 |
$1.76M |
| 96365 |
|
20,042 |
13,476 |
$1.39M |
| 99282 |
|
10,943 |
10,487 |
$1.19M |
| 96360 |
|
10,819 |
9,081 |
$1.07M |
| 99203 |
|
15,949 |
14,913 |
$1.03M |
| 87635 |
|
32,245 |
29,479 |
$799K |
| Q5001 |
Hospice or home hlth in home |
4,211 |
213 |
$766K |
| 97110 |
|
32,452 |
16,293 |
$713K |
| 74176 |
|
4,849 |
4,652 |
$706K |
| 70553 |
|
3,016 |
2,976 |
$658K |
| 76705 |
|
7,797 |
7,591 |
$644K |
| 71275 |
|
4,384 |
4,233 |
$636K |
| 80053 |
|
112,624 |
91,759 |
$578K |
| 87631 |
|
10,047 |
9,537 |
$564K |
| 59025 |
|
3,530 |
1,774 |
$553K |
| 76830 |
|
6,350 |
6,202 |
$546K |
| 42820 |
|
401 |
399 |
$526K |
| 88305 |
|
22,044 |
20,168 |
$516K |
| 97530 |
|
22,586 |
13,217 |
$516K |
| 45380 |
|
1,634 |
1,594 |
$510K |
| 43239 |
|
2,369 |
2,322 |
$506K |
| 64483 |
|
1,848 |
1,818 |
$475K |
| 11045 |
|
3,260 |
1,495 |
$459K |
| 45385 |
|
1,164 |
1,135 |
$447K |
| 70551 |
|
2,521 |
2,456 |
$396K |
| 69436 |
|
376 |
375 |
$384K |
| 70496 |
|
2,689 |
2,621 |
$383K |
| 99215 |
Prolong outpt/office vis |
6,524 |
5,321 |
$370K |
| 80307 |
|
8,174 |
7,103 |
$364K |
| 76816 |
|
5,431 |
4,913 |
$352K |
| 12001 |
|
1,754 |
1,717 |
$350K |
| 77067 |
|
8,539 |
8,494 |
$339K |
| 97112 |
|
15,201 |
7,812 |
$327K |
| 96415 |
|
1,447 |
986 |
$317K |
| 76641 |
|
3,487 |
3,406 |
$305K |
| 10060 |
|
1,691 |
1,561 |
$295K |
| 90834 |
|
4,382 |
2,745 |
$291K |
| 76856 |
|
6,936 |
6,768 |
$286K |
| 72148 |
|
2,231 |
2,187 |
$284K |
| 97140 |
|
16,165 |
8,149 |
$283K |
| 93971 |
|
3,588 |
3,412 |
$279K |
| G0378 |
Hospital observation per hr |
12,853 |
10,794 |
$277K |
| 99204 |
|
3,060 |
2,867 |
$265K |
| 90792 |
|
2,134 |
1,848 |
$262K |
| 76801 |
|
4,522 |
3,979 |
$260K |
| 76811 |
|
2,520 |
2,466 |
$260K |
| 76536 |
|
2,992 |
2,957 |
$258K |
| 78815 |
|
564 |
546 |
$256K |
| 78452 |
|
982 |
834 |
$247K |
| 36415 |
|
68,088 |
47,756 |
$244K |
| 93306 |
|
3,571 |
2,555 |
$240K |
| 96367 |
|
5,901 |
3,421 |
$238K |
| 97162 |
|
6,292 |
6,104 |
$220K |
| 76700 |
|
2,125 |
2,092 |
$216K |
| J2357 |
Omalizumab injection |
369 |
167 |
$202K |
| 99202 |
|
4,335 |
4,086 |
$193K |
| 12011 |
|
908 |
881 |
$191K |
| J1561 |
Gamunex-c/gammaked |
103 |
25 |
$184K |
| 76770 |
|
2,027 |
1,980 |
$182K |
| 84484 |
|
41,250 |
28,236 |
$165K |
| 71046 |
|
22,063 |
20,859 |
$164K |
| P9016 |
Rbc leukocytes reduced |
596 |
438 |
$161K |
| 71260 |
|
3,465 |
3,356 |
$158K |
| 72141 |
|
1,192 |
1,167 |
$154K |
| 97597 |
|
10,059 |
5,035 |
$153K |
| 29125 |
|
846 |
810 |
$153K |
| 99281 |
|
1,342 |
1,275 |
$148K |
| 96413 |
|
4,917 |
2,811 |
$145K |
| 71250 |
|
2,941 |
2,884 |
$142K |
| 93976 |
|
2,726 |
2,644 |
$139K |
| 64493 |
|
376 |
355 |
$139K |
| 76882 |
|
2,278 |
2,144 |
$131K |
| 20610 |
|
1,366 |
1,102 |
$129K |
| 12002 |
|
738 |
716 |
$128K |
| 76815 |
|
2,345 |
1,522 |
$127K |
| 70491 |
|
1,022 |
991 |
$122K |
| 76870 |
|
1,283 |
1,230 |
$119K |
| 87502 |
|
6,753 |
6,464 |
$119K |
| 76817 |
|
3,763 |
3,333 |
$118K |
| G0480 |
Drug test def 1-7 classes |
19,378 |
16,564 |
$118K |
| 97161 |
|
2,931 |
2,855 |
$118K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
30,416 |
28,435 |
$113K |
| 93005 |
|
50,862 |
45,093 |
$110K |
| 88307 |
|
2,648 |
2,457 |
$107K |
| 45378 |
|
190 |
188 |
$107K |
| 30520 |
|
68 |
66 |
$101K |
| 70486 |
|
2,352 |
2,285 |
$99K |
| 47562 |
|
53 |
52 |
$89K |
| 70498 |
|
2,802 |
2,715 |
$81K |
| 94640 |
|
11,262 |
7,212 |
$79K |
| 94660 |
|
365 |
170 |
$78K |
| 90837 |
|
889 |
573 |
$78K |
| 83605 |
|
14,725 |
13,129 |
$78K |
| 99391 |
|
787 |
764 |
$73K |
| 88342 |
|
6,011 |
5,523 |
$72K |
| 49083 |
|
186 |
103 |
$70K |
| 62323 |
|
342 |
335 |
$69K |
| 77063 |
|
1,824 |
1,819 |
$67K |
| 15271 |
|
130 |
62 |
$67K |
| 96372 |
|
35,490 |
21,691 |
$67K |
| 99212 |
|
4,534 |
3,454 |
$65K |
| 80048 |
|
17,323 |
12,903 |
$65K |
| C8929 |
Tte w or wo fol wcon,doppler |
422 |
411 |
$64K |
| G0515 |
Cognitive skills development |
237 |
107 |
$63K |
| 73721 |
|
435 |
428 |
$63K |
| J2469 |
Palonosetron hcl |
1,470 |
812 |
$60K |
| 93970 |
|
727 |
703 |
$60K |
| 90791 |
|
554 |
547 |
$59K |
| 77066 |
Tomosynthesis, mammo |
2,052 |
2,030 |
$59K |
| 66984 |
|
147 |
126 |
$59K |
| 90715 |
|
3,764 |
3,487 |
$55K |
| 72125 |
|
5,567 |
5,307 |
$55K |
| 85025 |
|
125,181 |
99,151 |
$53K |
| 76805 |
|
976 |
944 |
$52K |
| 71271 |
|
614 |
606 |
$52K |
| 81003 |
|
13,525 |
12,161 |
$49K |
| 81025 |
|
13,553 |
13,118 |
$48K |
| 11043 |
|
911 |
405 |
$48K |
| 93017 |
|
833 |
802 |
$47K |
| 62321 |
|
254 |
249 |
$47K |
| 73630 |
|
4,689 |
4,505 |
$47K |
| 97116 |
|
3,745 |
2,486 |
$45K |
| 97166 |
|
1,733 |
1,664 |
$45K |
| J1756 |
Iron sucrose injection |
3,284 |
1,580 |
$45K |
| H0031 |
Mh health assess by non-md |
781 |
719 |
$44K |
| 99392 |
|
435 |
432 |
$44K |
| 97129 |
|
678 |
345 |
$43K |
| 90847 |
|
562 |
385 |
$42K |
| 90853 |
|
641 |
115 |
$42K |
| 72100 |
|
2,510 |
2,440 |
$39K |
| 77065 |
Tomosynthesis, mammo |
1,335 |
1,315 |
$39K |
| 73562 |
|
3,515 |
3,389 |
$39K |
| 73030 |
|
3,684 |
3,533 |
$39K |
| 87591 |
|
3,417 |
3,293 |
$39K |
| 97113 |
|
789 |
389 |
$38K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
5,308 |
5,172 |
$38K |
| J1453 |
Fosaprepitant injection |
691 |
408 |
$37K |
| 87040 |
|
4,278 |
3,961 |
$37K |
| 90686 |
|
2,712 |
2,626 |
$37K |
| 77080 |
|
640 |
631 |
$36K |
| 73610 |
|
3,804 |
3,607 |
$36K |
| 83880 |
|
8,116 |
7,491 |
$36K |
| 29515 |
|
204 |
186 |
$36K |
| 76813 |
|
494 |
479 |
$35K |
| 62370 |
|
686 |
670 |
$35K |
| 36430 |
|
865 |
614 |
$34K |
| 97535 |
|
2,438 |
1,951 |
$34K |
| 73130 |
|
3,558 |
3,418 |
$33K |
| 64635 |
|
69 |
66 |
$33K |
| 72131 |
|
967 |
939 |
$31K |
| 96374 |
|
38,959 |
34,558 |
$31K |
| 77002 |
|
580 |
520 |
$31K |
| 97163 |
|
871 |
845 |
$31K |
| 99205 |
Prolong outpt/office vis |
367 |
325 |
$31K |
| 87880 |
|
3,185 |
3,098 |
$31K |
| 99238 |
|
785 |
676 |
$30K |
| 73110 |
|
2,647 |
2,542 |
$30K |
| 99232 |
|
1,330 |
384 |
$29K |
| 99479 |
|
384 |
126 |
$28K |
| 85379 |
|
5,390 |
5,197 |
$28K |
| 10061 |
|
124 |
114 |
$27K |
| 85610 |
|
24,391 |
20,211 |
$27K |
| G0260 |
Inj for sacroiliac jt anesth |
162 |
158 |
$26K |
| 80305 |
|
14,892 |
13,032 |
$25K |
| 99393 |
|
255 |
251 |
$25K |
| 76819 |
|
506 |
351 |
$25K |
| 71045 |
|
18,215 |
16,844 |
$25K |
| 83036 |
|
6,334 |
6,148 |
$24K |
| 96375 |
|
34,259 |
26,030 |
$23K |
| 20553 |
|
271 |
237 |
$23K |
| 81001 |
|
31,740 |
29,451 |
$23K |
| 99233 |
Prolong inpt eval add15 m |
582 |
213 |
$22K |
| 95251 |
|
1,417 |
1,326 |
$22K |
| 74018 |
|
1,765 |
1,659 |
$21K |
| 98926 |
|
1,055 |
742 |
$21K |
| 62369 |
|
444 |
438 |
$20K |
| 73502 |
|
2,050 |
1,933 |
$20K |
| G0155 |
Hhcp-svs of csw,ea 15 min |
401 |
224 |
$20K |
| 93798 |
|
3,135 |
571 |
$20K |
| 88341 |
|
1,763 |
1,582 |
$19K |
| 77336 |
|
346 |
160 |
$19K |
| 42821 |
|
13 |
13 |
$19K |
| 72040 |
|
1,000 |
967 |
$18K |
| 73140 |
|
1,333 |
1,292 |
$18K |
| 90471 |
|
8,303 |
7,884 |
$18K |
| 81002 |
|
5,763 |
5,600 |
$17K |
| 42826 |
|
13 |
13 |
$17K |
| 97804 |
|
790 |
523 |
$16K |
| 99460 |
|
192 |
185 |
$16K |
| 88304 |
|
3,825 |
3,694 |
$15K |
| A4648 |
Implantable tissue marker |
650 |
569 |
$15K |
| 83050 |
|
4,637 |
4,411 |
$14K |
| M0243 |
Casirivi and imdevi inj |
58 |
53 |
$14K |
| 87081 |
|
3,861 |
3,764 |
$14K |
| 74174 |
|
254 |
248 |
$14K |
| 84443 |
|
16,330 |
14,792 |
$13K |
| 73564 |
|
900 |
845 |
$13K |
| 84703 |
|
20,988 |
19,174 |
$13K |
| 93321 |
|
430 |
414 |
$12K |
| 73080 |
|
1,511 |
1,446 |
$12K |
| 70487 |
|
75 |
75 |
$12K |
| 97802 |
|
130 |
130 |
$12K |
| J2405 |
Ondansetron hcl injection |
34,231 |
28,031 |
$12K |
| 73221 |
|
78 |
77 |
$11K |
| 76942 |
|
180 |
168 |
$11K |
| 82728 |
|
2,972 |
2,790 |
$10K |
| 11046 |
|
22 |
12 |
$10K |
| 97130 |
|
640 |
324 |
$10K |
| 73590 |
|
1,468 |
1,409 |
$10K |
| 83690 |
|
31,707 |
28,629 |
$9K |
| 72158 |
|
76 |
76 |
$9K |
| A9552 |
F18 fdg |
618 |
596 |
$9K |
| 83735 |
|
14,404 |
11,021 |
$9K |
| 82962 |
|
3,876 |
3,786 |
$8K |
| 77334 |
|
103 |
65 |
$8K |
| 77012 |
|
183 |
176 |
$8K |
| 36561 |
|
13 |
13 |
$8K |
| 86923 |
|
494 |
416 |
$8K |
| 84112 |
|
962 |
872 |
$8K |
| 83060 |
|
4,452 |
4,231 |
$8K |
| J1750 |
Inj iron dextran |
162 |
157 |
$8K |
| 76642 |
|
90 |
90 |
$7K |
| 64400 |
|
29 |
27 |
$7K |
| 99469 |
|
31 |
12 |
$7K |
| G0297 |
Ldct for lung ca screen |
73 |
73 |
$7K |
| J3010 |
Fentanyl citrate injection |
23,340 |
20,846 |
$7K |
| 93308 |
|
48 |
37 |
$7K |
| 82565 |
|
5,234 |
4,954 |
$7K |
| 97165 |
|
243 |
230 |
$7K |
| 15275 |
|
36 |
16 |
$7K |
| 73090 |
|
1,111 |
1,056 |
$7K |
| 72110 |
|
240 |
237 |
$7K |
| J0897 |
Denosumab injection |
25 |
25 |
$6K |
| 99231 |
|
369 |
201 |
$6K |
| 86850 |
|
6,153 |
5,634 |
$6K |
| 85027 |
|
8,332 |
6,640 |
$6K |
| 74183 |
|
28 |
25 |
$6K |
| J2704 |
Inj, propofol, 10 mg |
19,392 |
18,381 |
$6K |
| 86900 |
|
6,244 |
5,713 |
$6K |
| 72156 |
|
41 |
41 |
$5K |
| 93793 |
|
5,022 |
4,239 |
$5K |
| 80061 |
|
1,609 |
1,543 |
$5K |
| 87633 |
|
216 |
209 |
$5K |
| 90670 |
|
279 |
276 |
$5K |
| M0247 |
Sotrovimab infusion |
20 |
19 |
$5K |
| 82607 |
|
1,267 |
1,215 |
$5K |
| 90688 |
|
331 |
328 |
$5K |
| 90677 |
|
94 |
93 |
$5K |
| G0108 |
Diab manage trn per indiv |
102 |
95 |
$5K |
| 97803 |
|
108 |
106 |
$5K |
| 74178 |
|
28 |
28 |
$5K |
| 73523 |
|
193 |
186 |
$4K |
| 93325 |
|
437 |
415 |
$4K |
| 90656 |
|
354 |
352 |
$4K |
| 87636 |
|
261 |
253 |
$4K |
| J1885 |
Ketorolac tromethamine inj |
25,995 |
21,886 |
$4K |
| 85060 |
|
375 |
323 |
$4K |
| J0475 |
Baclofen 10 mg injection |
67 |
67 |
$4K |
| 73700 |
|
65 |
62 |
$4K |
| 84702 |
|
4,631 |
4,234 |
$4K |
| S9436 |
Lamaze class |
65 |
65 |
$4K |
| 76376 |
|
3,901 |
2,107 |
$4K |
| 87491 |
|
3,412 |
3,287 |
$4K |
| G2211 |
Complex e/m visit add on |
2,660 |
2,573 |
$4K |
| 29105 |
|
16 |
14 |
$4K |
| J1170 |
Hydromorphone injection |
18,582 |
13,866 |
$4K |
| 83550 |
|
2,272 |
2,178 |
$4K |
| 83540 |
|
2,296 |
2,198 |
$3K |
| D0120 |
|
441 |
296 |
$3K |
| 99394 |
|
32 |
31 |
$3K |
| 96376 |
|
15,022 |
9,970 |
$3K |
| 88173 |
|
548 |
529 |
$3K |
| 72072 |
|
307 |
299 |
$3K |
| 87430 |
|
2,780 |
2,703 |
$3K |
| 99442 |
|
177 |
122 |
$3K |
| 87086 |
|
9,618 |
9,033 |
$3K |
| J1650 |
Inj enoxaparin sodium |
7,135 |
2,310 |
$3K |
| 86901 |
|
7,610 |
6,998 |
$3K |
| 74230 |
|
71 |
65 |
$3K |
| J2250 |
Inj midazolam hydrochloride |
12,425 |
11,733 |
$3K |
| 84439 |
|
2,817 |
2,621 |
$3K |
| 86140 |
|
3,802 |
3,303 |
$3K |
| 77001 |
|
64 |
62 |
$3K |
| 87798 |
|
282 |
273 |
$3K |
| 99188 |
|
187 |
180 |
$3K |
| 74220 |
|
102 |
101 |
$3K |
| 82330 |
|
6,771 |
6,397 |
$3K |
| J3301 |
Triamcinolone acet inj nos |
917 |
872 |
$2K |
| 99252 |
|
76 |
59 |
$2K |
| 36591 |
|
158 |
97 |
$2K |
| 75574 |
|
13 |
13 |
$2K |
| 96416 |
|
19 |
12 |
$2K |
| 72197 |
|
12 |
12 |
$2K |
| 87077 |
|
3,611 |
3,382 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
10,471 |
7,598 |
$2K |
| 96368 |
|
2,123 |
1,446 |
$2K |
| 95886 |
|
40 |
39 |
$2K |
| 88300 |
|
646 |
643 |
$2K |
| 99480 |
|
41 |
12 |
$2K |
| 87186 |
|
4,784 |
4,526 |
$2K |
| 99349 |
|
35 |
24 |
$2K |
| C1758 |
Catheter, ureteral |
1,648 |
1,622 |
$2K |
| 87070 |
|
2,185 |
2,053 |
$2K |
| 87486 |
|
151 |
145 |
$2K |
| 87581 |
|
209 |
198 |
$2K |
| 96040 |
|
79 |
71 |
$2K |
| 82746 |
|
1,074 |
1,030 |
$2K |
| 99291 |
|
19 |
19 |
$2K |
| 93246 |
|
445 |
409 |
$2K |
| 72128 |
|
103 |
100 |
$2K |
| 76881 |
|
28 |
26 |
$2K |
| 77300 |
|
46 |
38 |
$2K |
| J1644 |
Inj heparin sodium per 1000u |
16,603 |
7,133 |
$2K |
| 82803 |
|
4,655 |
4,287 |
$2K |
| J2060 |
Lorazepam injection |
7,495 |
5,582 |
$2K |
| 87420 |
|
67 |
64 |
$2K |
| U0003 |
Cov-19 amp prb hgh thruput |
18 |
18 |
$2K |
| J0690 |
Cefazolin sodium injection |
10,946 |
8,670 |
$2K |
| 85652 |
|
3,542 |
3,230 |
$2K |
| J1100 |
Dexamethasone sodium phos |
18,015 |
15,516 |
$2K |
| D9999 |
|
192 |
133 |
$1K |
| 93312 |
|
27 |
27 |
$1K |
| 92610 |
|
57 |
55 |
$1K |
| J3475 |
Inj magnesium sulfate |
2,637 |
1,803 |
$1K |
| 87210 |
|
2,660 |
2,568 |
$1K |
| 86780 |
|
296 |
283 |
$1K |
| 73560 |
|
67 |
63 |
$1K |
| 85014 |
|
2,276 |
1,921 |
$1K |
| 73660 |
|
92 |
91 |
$1K |
| 82375 |
|
4,689 |
4,459 |
$1K |
| 85018 |
|
2,643 |
2,266 |
$1K |
| 85730 |
|
3,327 |
2,980 |
$1K |
| 84100 |
|
4,137 |
3,325 |
$1K |
| 99254 |
|
12 |
12 |
$1K |
| 93010 |
|
310 |
259 |
$1K |
| 87808 |
|
2,567 |
2,481 |
$1K |
| J2270 |
Morphine sulfate injection |
5,724 |
4,821 |
$1K |
| 82247 |
|
1,139 |
971 |
$1K |
| J1642 |
Inj heparin sodium per 10 u |
11,306 |
3,854 |
$1K |
| J3490 |
Drugs unclassified injection |
729 |
551 |
$1K |
| 99443 |
|
122 |
69 |
$1K |
| A9609 |
F18 fdg, 15 millicuries |
24 |
24 |
$967.34 |
| J3489 |
Zoledronic acid 1mg |
26 |
25 |
$952.64 |
| 99253 |
|
13 |
13 |
$932.47 |
| 82550 |
|
2,145 |
1,932 |
$910.52 |
| J2930 |
Methylprednisolone injection |
2,233 |
1,885 |
$887.61 |
| 88312 |
|
69 |
66 |
$873.02 |
| Q3014 |
Telehealth facility fee |
105 |
62 |
$866.63 |
| 90472 |
|
567 |
566 |
$860.81 |
| 80164 |
|
125 |
110 |
$847.53 |
| 87147 |
|
1,981 |
1,876 |
$841.85 |
| 80306 |
|
709 |
680 |
$838.79 |
| J2785 |
Regadenoson injection |
525 |
515 |
$826.65 |
| 82570 |
|
1,442 |
1,203 |
$810.18 |
| J1439 |
Inj ferric carboxymaltos 1mg |
126 |
78 |
$807.55 |
| 99152 |
|
1,776 |
1,696 |
$792.64 |
| 87150 |
|
155 |
129 |
$782.00 |
| 74022 |
|
186 |
172 |
$768.60 |
| 84156 |
|
1,478 |
1,171 |
$733.85 |
| 87340 |
|
689 |
653 |
$705.46 |
| 98968 |
|
17 |
12 |
$704.43 |
| 0124A |
|
41 |
41 |
$680.00 |
| 99221 |
|
15 |
14 |
$675.12 |
| 82075 |
|
965 |
861 |
$673.13 |
| 82378 |
|
109 |
82 |
$671.29 |
| 93247 |
|
16 |
16 |
$646.98 |
| 87205 |
|
3,056 |
2,799 |
$621.06 |
| J2765 |
Metoclopramide hcl injection |
4,712 |
4,200 |
$614.27 |
| 82810 |
|
3,803 |
3,623 |
$601.97 |
| 99495 |
|
43 |
24 |
$568.20 |
| 72170 |
|
204 |
190 |
$563.99 |
| 87075 |
|
1,633 |
1,550 |
$559.60 |
| 93296 |
|
216 |
128 |
$530.26 |
| 76604 |
|
14 |
12 |
$530.15 |
| J1200 |
Diphenhydramine hcl injectio |
9,019 |
6,568 |
$526.67 |
| 87641 |
|
40 |
38 |
$520.18 |
| D1206 |
|
25 |
25 |
$511.04 |
| 88189 |
|
22 |
15 |
$496.02 |
| 85007 |
|
791 |
742 |
$490.58 |
| 80069 |
|
278 |
146 |
$489.12 |
| 99499 |
|
14 |
14 |
$486.64 |
| 76000 |
|
119 |
116 |
$460.84 |
| 84550 |
|
1,504 |
1,234 |
$460.81 |
| A9500 |
Tc99m sestamibi |
996 |
970 |
$426.20 |
| 90680 |
|
36 |
36 |
$397.35 |
| 99429 |
|
12 |
12 |
$387.94 |
| J0780 |
Prochlorperazine injection |
5,931 |
4,202 |
$381.83 |
| 82040 |
|
501 |
416 |
$367.23 |
| 87088 |
|
844 |
810 |
$366.50 |
| 99441 |
|
12 |
12 |
$356.65 |
| 72114 |
|
14 |
13 |
$356.44 |
| 73060 |
|
74 |
69 |
$345.97 |
| J2550 |
Promethazine hcl injection |
1,357 |
1,135 |
$337.89 |
| 92611 |
|
56 |
52 |
$307.42 |
| 85045 |
|
266 |
246 |
$302.58 |
| 82010 |
|
1,294 |
1,188 |
$300.67 |
| J1030 |
Methylprednisolone 40 mg inj |
2,766 |
2,686 |
$273.50 |
| 69209 |
|
32 |
32 |
$254.12 |
| 90697 |
|
12 |
12 |
$249.25 |
| 83615 |
|
220 |
179 |
$246.37 |
| 90723 |
|
12 |
12 |
$229.10 |
| 71101 |
|
12 |
12 |
$222.69 |
| 88112 |
|
99 |
89 |
$219.21 |
| J1630 |
Haloperidol injection |
2,117 |
1,800 |
$210.81 |
| J1940 |
Furosemide injection |
1,910 |
1,116 |
$188.57 |
| 84165 |
|
64 |
52 |
$188.02 |
| 84132 |
|
1,063 |
994 |
$170.69 |
| L4360 |
Pneumat walking boot pre cst |
131 |
124 |
$168.90 |
| 71100 |
|
27 |
27 |
$168.43 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
1,463 |
1,430 |
$163.78 |
| 90633 |
|
14 |
14 |
$155.33 |
| L1830 |
Ko immob canvas long pre ots |
459 |
440 |
$141.04 |
| 82140 |
|
425 |
379 |
$137.83 |
| 90647 |
|
12 |
12 |
$133.40 |
| 73552 |
|
49 |
47 |
$130.28 |
| 87389 |
|
276 |
267 |
$119.50 |
| 86803 |
|
183 |
177 |
$115.65 |
| 74019 |
|
12 |
12 |
$111.58 |
| 87899 |
|
164 |
161 |
$108.04 |
| G2012 |
Brief check in by md/qhp |
54 |
41 |
$107.73 |
| 0296T |
|
48 |
45 |
$95.27 |
| 99153 |
Mod sedat endo service >5yrs |
557 |
537 |
$92.43 |
| 86300 |
|
30 |
25 |
$80.04 |
| 84450 |
|
472 |
391 |
$79.97 |
| A9270 |
Non-covered item or service |
14,817 |
8,447 |
$79.91 |
| 80177 |
|
25 |
24 |
$79.00 |
| J2175 |
Meperidine hydrochl /100 mg |
1,661 |
1,608 |
$77.42 |
| 85049 |
|
110 |
51 |
$77.27 |
| J3370 |
Vancomycin hcl injection |
1,347 |
524 |
$73.26 |
| 90674 |
|
27 |
27 |
$73.08 |
| 94644 |
|
27 |
26 |
$71.61 |
| J1020 |
Methylprednisolone 20 mg inj |
417 |
395 |
$68.00 |
| C1894 |
Intro/sheath, non-laser |
1,740 |
1,657 |
$64.60 |
| 93280 |
|
212 |
112 |
$59.86 |
| 51798 |
|
87 |
82 |
$59.20 |
| 70360 |
|
12 |
12 |
$57.82 |
| 86705 |
|
52 |
50 |
$57.52 |
| 84295 |
|
478 |
456 |
$55.35 |
| Q0162 |
Ondansetron oral |
5,941 |
5,162 |
$55.20 |
| 77062 |
|
188 |
188 |
$51.30 |
| J0500 |
Dicyclomine injection |
165 |
150 |
$49.89 |
| 0297T |
|
48 |
45 |
$47.64 |
| L3807 |
Whfo w/o joints pre cst |
25 |
24 |
$47.00 |
| 86308 |
|
134 |
130 |
$41.01 |
| 86317 |
|
12 |
12 |
$37.92 |
| P9612 |
Catheterize for urine spec |
1,201 |
1,131 |
$36.85 |
| 90460 |
|
137 |
137 |
$36.11 |
| J7512 |
Prednisone ir or dr oral 1mg |
3,988 |
2,828 |
$34.80 |
| L3908 |
Who cock-up nonmolde pre ots |
273 |
258 |
$27.82 |
| 82947 |
|
424 |
399 |
$27.65 |
| L3260 |
Ambulatory surgical boot eac |
79 |
79 |
$23.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
895 |
355 |
$22.00 |
| J0171 |
Adrenalin epinephrine inject |
1,105 |
1,000 |
$18.23 |
| A4565 |
Slings |
677 |
657 |
$16.00 |
| 86765 |
|
15 |
15 |
$13.38 |
| J3360 |
Diazepam injection |
499 |
275 |
$12.86 |
| U0002 |
Covid-19 lab test non-cdc |
39 |
36 |
$12.68 |
| 99406 |
|
51 |
51 |
$11.03 |
| 86703 |
|
32 |
32 |
$10.71 |
| 82435 |
|
375 |
357 |
$10.71 |
| Q4049 |
Finger splint, static |
129 |
122 |
$6.00 |
| 86709 |
|
13 |
13 |
$4.04 |
| 89051 |
|
62 |
55 |
$0.00 |
| C1887 |
Catheter, guiding |
143 |
141 |
$0.00 |
| 96417 |
|
503 |
309 |
$0.00 |
| 0502F |
|
168 |
152 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
229 |
179 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
988 |
965 |
$0.00 |
| 77061 |
|
146 |
145 |
$0.00 |
| G8996 |
Swallow current status |
57 |
47 |
$0.00 |
| G8978 |
Mobility current status |
625 |
572 |
$0.00 |
| C1776 |
Joint device (implantable) |
141 |
138 |
$0.00 |
| J0689 |
Inj cefazolin sodium, baxter |
1,806 |
1,577 |
$0.00 |
| A9541 |
Tc99m sulfur colloid |
13 |
13 |
$0.00 |
| Q9957 |
Inj perflutren lip micros,ml |
808 |
755 |
$0.00 |
| J1460 |
Gamma globulin 1 cc inj |
16 |
16 |
$0.00 |
| G8979 |
Mobility goal status |
721 |
658 |
$0.00 |
| J2274 |
Inj morphine pf epid ithc |
68 |
63 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
191 |
147 |
$0.00 |
| 51702 |
|
59 |
49 |
$0.00 |
| C1760 |
Closure dev, vasc |
81 |
79 |
$0.00 |
| J0694 |
Cefoxitin sodium injection |
43 |
36 |
$0.00 |
| 85347 |
|
74 |
39 |
$0.00 |
| J0702 |
Betamethasone acet&sod phosp |
90 |
66 |
$0.00 |
| G8997 |
Swallow goal status |
57 |
47 |
$0.00 |
| 64636 |
|
28 |
26 |
$0.00 |
| Q0244 |
Casirivi and imdevi 1200 mg |
55 |
50 |
$0.00 |
| J9190 |
Fluorouracil injection |
119 |
50 |
$0.00 |
| J2272 |
Inj, morphine (fresenius) |
28 |
26 |
$0.00 |
| J7030 |
Normal saline solution infus |
38 |
38 |
$0.00 |
| J3372 |
Inj, vancomycin hcl (xellia) |
27 |
13 |
$0.00 |
| 88360 |
|
59 |
55 |
$0.00 |
| J2359 |
Inj. olanzapine, 0.5mg |
153 |
61 |
$0.00 |
| G8985 |
Carry goal status |
14 |
13 |
$0.00 |
| Q4101 |
Apligraf |
62 |
26 |
$0.00 |
| C1788 |
Port, indwelling, imp |
25 |
25 |
$0.00 |
| C1751 |
Cath, inf, per/cent/midline |
14 |
14 |
$0.00 |
| J1580 |
Garamycin gentamicin inj |
13 |
13 |
$0.00 |
| 88313 |
|
13 |
12 |
$0.00 |
| J1790 |
Droperidol injection |
593 |
540 |
$0.00 |
| C1769 |
Guide wire |
2,067 |
1,968 |
$0.00 |
| L8699 |
Prosthetic implant nos |
244 |
243 |
$0.00 |
| J1040 |
Methylprednisolone 80 mg inj |
509 |
496 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
374 |
364 |
$0.00 |
| C1781 |
Mesh (implantable) |
468 |
463 |
$0.00 |
| J1010 |
Inj, methylpred acetate 1 mg |
315 |
310 |
$0.00 |
| J3420 |
Vitamin b12 injection |
117 |
92 |
$0.00 |
| J0360 |
Hydralazine hcl injection |
628 |
530 |
$0.00 |
| 96411 |
|
61 |
38 |
$0.00 |
| 90474 |
|
12 |
12 |
$0.00 |
| A9585 |
Gadobutrol injection |
467 |
462 |
$0.00 |
| G0269 |
Occlusive device in vein art |
18 |
13 |
$0.00 |
| G0008 |
Admin influenza virus vac |
379 |
371 |
$0.00 |
| 64494 |
|
159 |
149 |
$0.00 |
| G8980 |
Mobility d/c status |
152 |
149 |
$0.00 |
| J7999 |
Compounded drug, noc |
77 |
77 |
$0.00 |
| G8988 |
Self care goal status |
58 |
55 |
$0.00 |
| 82945 |
|
12 |
12 |
$0.00 |
| L4350 |
Ankle control ortho pre ots |
46 |
43 |
$0.00 |
| V2632 |
Post chmbr intraocular lens |
186 |
157 |
$0.00 |
| C1725 |
Cath, translumin non-laser |
12 |
12 |
$0.00 |
| 0346T |
|
30 |
29 |
$0.00 |
| C1732 |
Cath, ep, diag/abl, 3d/vect |
12 |
12 |
$0.00 |
| 0241U |
|
214 |
210 |
$0.00 |
| C2617 |
Stent, non-cor, tem w/o del |
39 |
39 |
$0.00 |
| G0009 |
Admin pneumococcal vaccine |
20 |
20 |
$0.00 |
| G8987 |
Self care current status |
24 |
24 |
$0.00 |
| G8998 |
Swallow d/c status |
44 |
42 |
$0.00 |
| 90935 |
|
24 |
13 |
$0.00 |
| 85032 |
|
16 |
14 |
$0.00 |
| 84157 |
|
12 |
12 |
$0.00 |
| Q0247 |
Sotrovimab |
20 |
19 |
$0.00 |