| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
53,510 |
47,387 |
$10.52M |
| 99285 |
|
31,763 |
28,528 |
$9.96M |
| 99283 |
|
75,907 |
70,591 |
$9.42M |
| G0378 |
Hospital observation per hr |
21,497 |
13,480 |
$7.24M |
| 96374 |
|
38,365 |
32,200 |
$3.64M |
| 97110 |
|
79,159 |
25,121 |
$1.83M |
| G0463 |
Hospital outpt clinic visit |
26,135 |
20,778 |
$1.59M |
| 74177 |
|
10,079 |
9,799 |
$1.45M |
| 96365 |
|
15,197 |
11,115 |
$1.35M |
| 93306 |
|
11,366 |
8,150 |
$1.18M |
| 96413 |
|
6,845 |
4,449 |
$1.14M |
| 96375 |
|
33,022 |
25,368 |
$941K |
| 99282 |
|
13,113 |
12,822 |
$931K |
| 96361 |
|
27,092 |
22,108 |
$898K |
| 45380 |
|
1,755 |
1,736 |
$890K |
| 78452 |
|
3,377 |
2,271 |
$841K |
| 42820 |
|
276 |
275 |
$775K |
| 71046 |
|
19,823 |
18,806 |
$761K |
| 97112 |
|
31,002 |
13,250 |
$677K |
| U0003 |
Cov-19 amp prb hgh thruput |
12,560 |
12,120 |
$651K |
| 87636 |
|
8,443 |
8,276 |
$605K |
| 95810 |
|
1,180 |
1,173 |
$602K |
| 43239 |
|
1,747 |
1,737 |
$573K |
| 96360 |
|
5,823 |
5,407 |
$566K |
| 70450 |
|
6,811 |
6,512 |
$547K |
| 99214 |
|
8,290 |
8,064 |
$523K |
| 92507 |
|
11,796 |
4,045 |
$484K |
| 97140 |
|
29,736 |
11,855 |
$439K |
| 70553 |
|
2,105 |
2,089 |
$407K |
| 45385 |
|
861 |
842 |
$394K |
| 97530 |
|
16,245 |
7,612 |
$387K |
| 77067 |
|
7,809 |
7,801 |
$381K |
| 71045 |
|
9,497 |
8,957 |
$329K |
| 76805 |
|
5,449 |
5,414 |
$325K |
| 99291 |
|
943 |
844 |
$319K |
| 71260 |
|
2,368 |
2,349 |
$318K |
| 93975 |
|
2,481 |
2,415 |
$301K |
| 87491 |
|
20,208 |
19,801 |
$296K |
| 87591 |
|
20,189 |
19,787 |
$293K |
| 15275 |
|
312 |
141 |
$289K |
| 76816 |
|
5,660 |
5,389 |
$283K |
| 76830 |
|
4,822 |
4,730 |
$280K |
| 99281 |
|
7,126 |
6,921 |
$280K |
| 11042 |
|
1,476 |
1,000 |
$275K |
| 69436 |
|
567 |
561 |
$271K |
| 97162 |
|
5,573 |
5,509 |
$265K |
| 76705 |
|
4,698 |
4,587 |
$265K |
| 80061 |
|
23,781 |
23,591 |
$262K |
| 97161 |
|
5,431 |
5,341 |
$257K |
| 76801 |
|
4,407 |
4,109 |
$257K |
| 80053 |
|
114,637 |
96,986 |
$234K |
| 74176 |
|
2,127 |
2,097 |
$230K |
| 87633 |
|
4,498 |
4,415 |
$229K |
| 76856 |
|
4,529 |
4,454 |
$228K |
| 99213 |
|
5,193 |
5,058 |
$216K |
| 76700 |
|
3,425 |
3,383 |
$210K |
| 71275 |
|
2,500 |
2,444 |
$206K |
| 86900 |
|
7,197 |
6,893 |
$204K |
| 73721 |
|
1,672 |
1,626 |
$202K |
| 84443 |
|
29,134 |
28,651 |
$199K |
| 36415 |
|
163,904 |
130,506 |
$178K |
| 87637 |
|
2,171 |
2,158 |
$169K |
| G0108 |
Diab manage trn per indiv |
3,734 |
2,591 |
$167K |
| 72148 |
|
1,636 |
1,632 |
$166K |
| 85025 |
|
112,611 |
93,298 |
$163K |
| 93458 |
|
272 |
189 |
$150K |
| 76770 |
|
2,611 |
2,543 |
$148K |
| 82306 |
|
9,872 |
9,779 |
$138K |
| 96367 |
|
4,198 |
2,918 |
$137K |
| 94060 |
|
1,389 |
910 |
$132K |
| 97597 |
|
1,378 |
914 |
$128K |
| 93971 |
|
2,287 |
2,232 |
$128K |
| 96415 |
|
2,610 |
2,021 |
$127K |
| U0005 |
Infec agen detec ampli probe |
8,103 |
7,870 |
$126K |
| 47562 |
|
55 |
55 |
$123K |
| 99204 |
|
1,455 |
1,439 |
$118K |
| 87507 |
|
697 |
685 |
$112K |
| 80307 |
|
15,926 |
12,936 |
$110K |
| 76819 |
|
1,776 |
1,003 |
$108K |
| 96372 |
|
33,957 |
28,696 |
$107K |
| 10060 |
|
1,139 |
1,103 |
$104K |
| C9803 |
Hopd covid-19 spec collect |
23,273 |
22,291 |
$95K |
| 72141 |
|
625 |
621 |
$89K |
| 93005 |
|
36,061 |
31,143 |
$88K |
| S4005 |
Interim labor facility globa |
775 |
666 |
$85K |
| 92523 |
|
1,086 |
1,076 |
$85K |
| G0480 |
Drug test def 1-7 classes |
8,609 |
7,140 |
$84K |
| 97165 |
|
1,818 |
1,803 |
$83K |
| 92526 |
|
1,810 |
804 |
$82K |
| J2785 |
Regadenoson injection |
1,296 |
1,292 |
$81K |
| 99244 |
|
892 |
877 |
$81K |
| 72110 |
|
2,549 |
2,537 |
$81K |
| 76642 |
|
2,051 |
2,034 |
$80K |
| 99232 |
|
2,444 |
938 |
$77K |
| 83036 |
|
19,358 |
19,147 |
$77K |
| 96366 |
|
4,449 |
3,188 |
$75K |
| 88142 |
|
6,543 |
6,525 |
$75K |
| 78815 |
|
96 |
93 |
$73K |
| 99203 |
|
1,247 |
1,246 |
$72K |
| 87635 |
|
3,286 |
3,186 |
$72K |
| 59025 |
|
743 |
509 |
$70K |
| J9271 |
Inj pembrolizumab |
15 |
12 |
$69K |
| 76536 |
|
1,366 |
1,360 |
$68K |
| 70551 |
|
862 |
851 |
$68K |
| 87624 |
|
3,224 |
3,218 |
$63K |
| 71271 |
|
1,206 |
1,204 |
$63K |
| 71250 |
|
1,008 |
1,005 |
$62K |
| 99215 |
Prolong outpt/office vis |
635 |
618 |
$59K |
| 70491 |
|
528 |
518 |
$58K |
| 86850 |
|
8,450 |
8,208 |
$57K |
| 73562 |
|
1,922 |
1,917 |
$57K |
| 88305 |
|
8,628 |
8,192 |
$55K |
| 96417 |
|
1,330 |
925 |
$54K |
| 73030 |
|
4,054 |
3,982 |
$53K |
| 73221 |
|
424 |
414 |
$51K |
| 86480 |
|
1,617 |
1,607 |
$50K |
| 97166 |
|
1,454 |
1,419 |
$49K |
| 85027 |
|
21,663 |
20,370 |
$49K |
| 97535 |
|
3,016 |
1,910 |
$48K |
| 70496 |
|
1,152 |
1,126 |
$46K |
| 77063 |
|
3,585 |
3,585 |
$46K |
| 87088 |
|
25,386 |
23,585 |
$45K |
| 86780 |
|
6,069 |
6,037 |
$45K |
| 83970 |
|
2,337 |
2,297 |
$44K |
| 73630 |
|
4,605 |
4,520 |
$42K |
| 95811 |
|
81 |
80 |
$41K |
| 72100 |
|
1,723 |
1,712 |
$41K |
| 77066 |
Tomosynthesis, mammo |
697 |
694 |
$41K |
| 82728 |
|
7,070 |
6,886 |
$37K |
| 96523 |
|
1,588 |
1,246 |
$37K |
| 82607 |
|
6,240 |
6,149 |
$37K |
| 73130 |
|
4,192 |
4,068 |
$36K |
| J2469 |
Palonosetron hcl |
2,947 |
1,793 |
$36K |
| 97116 |
|
3,087 |
1,740 |
$36K |
| 76815 |
|
3,207 |
3,014 |
$36K |
| 87086 |
|
19,745 |
18,712 |
$34K |
| 93017 |
|
1,462 |
1,453 |
$34K |
| 90471 |
|
3,421 |
3,333 |
$32K |
| 87389 |
|
4,908 |
4,881 |
$32K |
| 80048 |
|
14,673 |
12,140 |
$31K |
| 73110 |
|
2,835 |
2,676 |
$31K |
| 93308 |
|
532 |
421 |
$31K |
| Q5111 |
Injection, udenyca 0.5 mg |
16 |
12 |
$30K |
| 84439 |
|
7,472 |
7,374 |
$30K |
| 99222 |
|
525 |
501 |
$30K |
| 73502 |
|
2,137 |
2,115 |
$30K |
| A9502 |
Tc99m tetrofosmin |
1,450 |
1,442 |
$29K |
| 74018 |
|
1,835 |
1,738 |
$29K |
| 73610 |
|
3,981 |
3,832 |
$28K |
| 70486 |
|
766 |
754 |
$27K |
| 36430 |
|
178 |
138 |
$26K |
| 73564 |
|
3,804 |
3,744 |
$25K |
| 80074 |
|
1,360 |
1,353 |
$25K |
| 87536 |
|
536 |
533 |
$25K |
| 72040 |
|
1,312 |
1,276 |
$25K |
| 77065 |
Tomosynthesis, mammo |
723 |
671 |
$25K |
| 93000 |
|
2,839 |
2,803 |
$24K |
| 87340 |
|
6,601 |
6,563 |
$24K |
| 87077 |
|
8,936 |
8,489 |
$23K |
| 93970 |
|
217 |
217 |
$23K |
| 97163 |
|
419 |
419 |
$22K |
| 99205 |
Prolong outpt/office vis |
211 |
210 |
$22K |
| 86803 |
|
4,270 |
4,257 |
$22K |
| 99254 |
|
261 |
249 |
$22K |
| 83550 |
|
6,928 |
6,756 |
$22K |
| 93798 |
|
335 |
48 |
$22K |
| 29580 |
|
240 |
127 |
$22K |
| 82947 |
|
1,588 |
1,084 |
$21K |
| G0121 |
Colon ca scrn not hi rsk ind |
52 |
52 |
$21K |
| P9016 |
Rbc leukocytes reduced |
260 |
204 |
$21K |
| 87186 |
|
8,766 |
8,394 |
$20K |
| 72156 |
|
127 |
127 |
$20K |
| 87905 |
|
10,070 |
9,820 |
$19K |
| 84153 |
|
2,190 |
2,169 |
$19K |
| 87808 |
|
9,453 |
9,225 |
$19K |
| 45378 |
|
62 |
62 |
$19K |
| 93015 |
|
725 |
724 |
$19K |
| 85610 |
|
15,844 |
12,080 |
$19K |
| 99212 |
|
673 |
673 |
$19K |
| A9500 |
Tc99m sestamibi |
378 |
374 |
$18K |
| 82043 |
|
5,865 |
5,830 |
$18K |
| 84702 |
|
14,867 |
12,999 |
$17K |
| 83540 |
|
7,093 |
6,915 |
$17K |
| G0472 |
Hep c screen high risk/other |
678 |
677 |
$17K |
| 72125 |
|
1,813 |
1,756 |
$16K |
| 72050 |
|
386 |
386 |
$16K |
| 77336 |
|
223 |
102 |
$15K |
| 99243 |
|
237 |
237 |
$15K |
| 99223 |
Prolong inpt eval add15 m |
161 |
149 |
$15K |
| 86140 |
|
8,114 |
7,272 |
$15K |
| 84403 |
|
1,085 |
1,070 |
$14K |
| 82746 |
|
2,304 |
2,279 |
$14K |
| 99233 |
Prolong inpt eval add15 m |
218 |
118 |
$13K |
| 93016 |
|
1,078 |
1,077 |
$13K |
| J7050 |
Normal saline solution infus |
35,473 |
21,127 |
$13K |
| 73140 |
|
1,909 |
1,861 |
$13K |
| 72072 |
|
534 |
532 |
$13K |
| 87651 |
|
5,398 |
5,338 |
$13K |
| G0297 |
Ldct for lung ca screen |
361 |
361 |
$13K |
| 93018 |
|
1,533 |
1,528 |
$13K |
| 83880 |
|
3,363 |
3,115 |
$12K |
| 86360 |
|
474 |
470 |
$12K |
| 76870 |
|
784 |
769 |
$12K |
| 80076 |
|
2,912 |
2,732 |
$12K |
| 72158 |
|
125 |
125 |
$12K |
| 76817 |
|
2,057 |
1,845 |
$11K |
| 93880 |
|
110 |
110 |
$11K |
| 86762 |
|
2,979 |
2,965 |
$11K |
| 83735 |
|
21,889 |
18,869 |
$11K |
| 81001 |
|
50,589 |
46,476 |
$11K |
| 74183 |
|
66 |
65 |
$11K |
| 88307 |
|
594 |
581 |
$11K |
| 73080 |
|
1,522 |
1,475 |
$11K |
| J0561 |
Penicillin g benzathine inj |
100 |
100 |
$11K |
| 97035 |
|
1,790 |
718 |
$11K |
| 86038 |
|
2,065 |
2,040 |
$11K |
| G0475 |
Hiv combination assay |
816 |
813 |
$10K |
| 86300 |
|
1,576 |
1,471 |
$10K |
| 82784 |
|
1,696 |
1,547 |
$10K |
| 0012A |
|
332 |
332 |
$10K |
| 87390 |
|
1,006 |
1,002 |
$10K |
| 86359 |
|
474 |
470 |
$10K |
| 87081 |
|
3,184 |
3,157 |
$10K |
| 84207 |
|
714 |
710 |
$10K |
| 86003 |
|
245 |
242 |
$10K |
| 84481 |
|
1,025 |
1,019 |
$8K |
| 80306 |
|
2,729 |
2,566 |
$8K |
| 99238 |
|
299 |
294 |
$8K |
| 87502 |
|
1,304 |
1,285 |
$8K |
| 81511 |
|
538 |
537 |
$8K |
| 82950 |
|
3,007 |
2,993 |
$8K |
| 85652 |
|
7,637 |
7,003 |
$8K |
| 29515 |
|
99 |
99 |
$8K |
| 83001 |
|
818 |
816 |
$8K |
| C8929 |
Tte w or wo fol wcon,doppler |
30 |
30 |
$7K |
| 85576 |
|
471 |
468 |
$7K |
| 88304 |
|
2,037 |
1,992 |
$7K |
| 95806 |
|
88 |
88 |
$7K |
| 83921 |
|
690 |
686 |
$7K |
| 93296 |
|
529 |
520 |
$7K |
| 86702 |
|
1,006 |
1,002 |
$7K |
| 84146 |
|
729 |
718 |
$7K |
| 99231 |
|
672 |
231 |
$7K |
| M0245 |
Bamlan and etesev infusion |
25 |
25 |
$7K |
| 97012 |
|
1,052 |
405 |
$7K |
| 88342 |
|
437 |
425 |
$7K |
| 84425 |
|
650 |
646 |
$7K |
| 99152 |
|
2,270 |
1,840 |
$7K |
| 0011A |
|
340 |
340 |
$7K |
| G0103 |
Psa screening |
618 |
618 |
$6K |
| 77080 |
|
103 |
103 |
$6K |
| 87070 |
|
2,723 |
2,602 |
$6K |
| 80050 |
|
226 |
226 |
$6K |
| 82570 |
|
3,386 |
3,103 |
$6K |
| 93925 |
|
66 |
66 |
$6K |
| 94640 |
|
8,124 |
6,750 |
$6K |
| 73590 |
|
999 |
963 |
$6K |
| 86376 |
|
981 |
969 |
$6K |
| G0123 |
Screen cerv/vag thin layer |
495 |
495 |
$5K |
| 93922 |
|
172 |
172 |
$5K |
| 43235 |
|
13 |
13 |
$5K |
| 99239 |
|
89 |
88 |
$5K |
| 83655 |
|
814 |
805 |
$5K |
| 90675 |
|
35 |
13 |
$5K |
| 96411 |
|
140 |
88 |
$5K |
| 70498 |
|
1,147 |
1,121 |
$5K |
| 74240 |
|
53 |
53 |
$5K |
| 83516 |
|
584 |
573 |
$5K |
| 86701 |
|
1,040 |
1,036 |
$5K |
| 93010 |
|
1,158 |
1,151 |
$5K |
| 80069 |
|
1,125 |
1,038 |
$4K |
| 93295 |
|
208 |
202 |
$4K |
| 87102 |
|
1,025 |
1,002 |
$4K |
| 97802 |
|
291 |
291 |
$4K |
| 94726 |
|
1,130 |
711 |
$4K |
| 85730 |
|
7,346 |
6,872 |
$4K |
| 87653 |
|
269 |
268 |
$4K |
| 73700 |
|
68 |
66 |
$4K |
| 80164 |
|
955 |
889 |
$4K |
| G0279 |
Tomosynthesis, mammo |
341 |
341 |
$4K |
| 86706 |
|
916 |
910 |
$4K |
| 97014 |
|
484 |
222 |
$4K |
| M0243 |
Casirivi and imdevi inj |
14 |
14 |
$4K |
| G2066 |
Inter devc remote 30d |
196 |
196 |
$4K |
| 93298 |
|
172 |
163 |
$4K |
| 0031A |
|
101 |
100 |
$4K |
| 96416 |
|
19 |
12 |
$4K |
| 73090 |
|
826 |
795 |
$4K |
| 93793 |
|
1,622 |
971 |
$4K |
| 83690 |
|
25,249 |
22,658 |
$3K |
| M0247 |
Sotrovimab infusion |
14 |
14 |
$3K |
| 72146 |
|
25 |
24 |
$3K |
| 84156 |
|
2,803 |
2,504 |
$3K |
| A9577 |
Inj multihance |
1,680 |
1,649 |
$3K |
| G8978 |
Mobility current status |
183 |
172 |
$3K |
| 86431 |
|
1,384 |
1,377 |
$3K |
| 82378 |
|
834 |
617 |
$3K |
| 86235 |
|
157 |
152 |
$3K |
| 83002 |
|
309 |
309 |
$3K |
| 82550 |
|
2,216 |
1,919 |
$3K |
| 84550 |
|
1,862 |
1,724 |
$3K |
| 94729 |
|
1,228 |
776 |
$3K |
| 97763 |
|
70 |
51 |
$3K |
| 84402 |
|
214 |
213 |
$3K |
| 93248 |
|
164 |
163 |
$2K |
| 86161 |
|
228 |
217 |
$2K |
| 29581 |
|
29 |
12 |
$2K |
| 0001A |
|
72 |
72 |
$2K |
| 97760 |
|
89 |
88 |
$2K |
| 87206 |
|
1,755 |
1,704 |
$2K |
| 83615 |
|
2,279 |
1,887 |
$2K |
| 73560 |
|
103 |
101 |
$2K |
| 82670 |
|
148 |
146 |
$2K |
| 86364 |
|
327 |
324 |
$2K |
| 87661 |
|
116 |
116 |
$2K |
| 84100 |
|
1,424 |
1,146 |
$2K |
| 95819 |
|
30 |
30 |
$2K |
| 82247 |
|
778 |
501 |
$2K |
| 71101 |
|
335 |
334 |
$2K |
| 84630 |
|
311 |
310 |
$2K |
| 99406 |
|
230 |
213 |
$2K |
| 87522 |
Neg quan hep c or qual rna |
93 |
91 |
$2K |
| 82533 |
|
233 |
220 |
$2K |
| M0239 |
Bamlanivimab-xxxx infusion |
12 |
12 |
$2K |
| 93246 |
|
162 |
159 |
$2K |
| 82525 |
|
282 |
280 |
$2K |
| 80329 |
|
45 |
43 |
$2K |
| 82951 |
|
218 |
215 |
$2K |
| 72157 |
|
24 |
24 |
$1K |
| 99255 |
|
14 |
13 |
$1K |
| 85055 |
|
146 |
91 |
$1K |
| 93351 |
|
12 |
12 |
$1K |
| 74022 |
|
239 |
234 |
$1K |
| 0002A |
|
36 |
36 |
$1K |
| 86225 |
|
218 |
216 |
$1K |
| 97803 |
|
135 |
131 |
$1K |
| U0004 |
Cov-19 test non-cdc hgh thru |
16 |
12 |
$1K |
| 81025 |
|
21,895 |
20,828 |
$1K |
| 86200 |
|
294 |
286 |
$1K |
| 86618 |
|
188 |
185 |
$1K |
| 84484 |
|
18,875 |
14,103 |
$1K |
| 85379 |
|
4,514 |
4,398 |
$923.60 |
| 87631 |
|
414 |
405 |
$918.26 |
| 87338 |
|
116 |
115 |
$914.43 |
| 00811 |
|
14 |
14 |
$900.42 |
| 85045 |
|
1,325 |
893 |
$897.23 |
| 99442 |
|
58 |
58 |
$892.99 |
| 72082 |
|
13 |
13 |
$845.65 |
| 86665 |
|
51 |
50 |
$841.01 |
| G0482 |
Drug test def 15-21 classes |
49 |
43 |
$811.80 |
| 87563 |
|
45 |
45 |
$805.98 |
| 93325 |
|
459 |
382 |
$796.17 |
| 87040 |
|
5,506 |
4,147 |
$794.88 |
| 73660 |
|
90 |
89 |
$791.01 |
| 82024 |
|
43 |
42 |
$739.27 |
| 80177 |
|
671 |
573 |
$736.73 |
| 0064A |
|
20 |
19 |
$721.04 |
| 86769 |
|
31 |
31 |
$705.84 |
| 86160 |
|
64 |
59 |
$679.32 |
| 82785 |
|
92 |
92 |
$663.39 |
| 86147 |
|
29 |
27 |
$638.38 |
| 87529 |
|
40 |
36 |
$628.74 |
| 93272 |
|
43 |
43 |
$602.84 |
| 90686 |
|
68 |
67 |
$585.62 |
| 99221 |
|
13 |
13 |
$576.40 |
| 84145 |
|
1,772 |
1,610 |
$560.37 |
| 76000 |
|
192 |
183 |
$552.94 |
| 84446 |
|
72 |
72 |
$548.56 |
| 86308 |
|
499 |
489 |
$533.77 |
| 72170 |
|
25 |
25 |
$519.77 |
| 0004A |
|
14 |
14 |
$506.07 |
| 12001 |
|
1,671 |
1,662 |
$505.97 |
| 92610 |
|
13 |
13 |
$500.47 |
| 94618 |
|
49 |
27 |
$479.28 |
| 84590 |
|
75 |
75 |
$462.86 |
| 84681 |
|
42 |
41 |
$459.06 |
| 76376 |
|
220 |
182 |
$438.32 |
| 82330 |
|
376 |
342 |
$437.04 |
| 82977 |
|
122 |
109 |
$435.58 |
| 86592 |
|
169 |
169 |
$384.53 |
| 84165 |
|
88 |
83 |
$380.56 |
| 93227 |
|
25 |
25 |
$372.09 |
| 94762 |
|
67 |
44 |
$354.49 |
| 82274 |
|
43 |
41 |
$350.24 |
| 85014 |
|
1,308 |
1,150 |
$348.77 |
| 85018 |
|
1,099 |
920 |
$347.01 |
| 73060 |
|
79 |
78 |
$340.05 |
| 82248 |
|
144 |
109 |
$335.50 |
| 82627 |
|
31 |
31 |
$331.44 |
| 73521 |
|
12 |
12 |
$330.68 |
| 84112 |
|
120 |
103 |
$322.02 |
| 83605 |
|
7,171 |
5,991 |
$314.71 |
| 12011 |
|
609 |
605 |
$305.04 |
| 73070 |
|
15 |
14 |
$285.89 |
| P9603 |
One-way allow prorated miles |
1,075 |
965 |
$285.59 |
| 0240U |
|
298 |
287 |
$285.26 |
| 86704 |
|
56 |
56 |
$276.46 |
| 87880 |
|
467 |
459 |
$275.11 |
| 99443 |
|
12 |
12 |
$270.96 |
| 94010 |
|
38 |
24 |
$255.43 |
| 86800 |
|
37 |
37 |
$245.90 |
| 87210 |
|
813 |
804 |
$242.83 |
| 96401 |
|
24 |
14 |
$242.32 |
| 83993 |
|
24 |
24 |
$231.43 |
| 87205 |
|
222 |
207 |
$226.98 |
| G0008 |
Admin influenza virus vac |
68 |
67 |
$214.22 |
| 76937 |
|
669 |
622 |
$211.76 |
| 82952 |
|
106 |
104 |
$208.51 |
| 93321 |
|
64 |
55 |
$208.42 |
| 86708 |
|
27 |
26 |
$188.62 |
| 93242 |
|
14 |
14 |
$180.45 |
| 93244 |
|
13 |
13 |
$179.36 |
| 86255 |
|
25 |
25 |
$169.20 |
| 93356 |
|
40 |
26 |
$166.71 |
| 82565 |
|
105 |
95 |
$157.76 |
| 82010 |
|
2,064 |
1,826 |
$155.09 |
| 87641 |
|
43 |
43 |
$138.96 |
| 80197 |
|
19 |
12 |
$136.68 |
| 99441 |
|
17 |
16 |
$134.64 |
| 82553 |
|
28 |
28 |
$121.52 |
| 86304 |
|
14 |
13 |
$117.72 |
| 86696 |
|
13 |
13 |
$108.00 |
| 82731 |
|
13 |
13 |
$106.40 |
| 83520 |
|
57 |
56 |
$103.95 |
| 85007 |
|
200 |
173 |
$99.84 |
| 84132 |
|
369 |
337 |
$99.12 |
| 73552 |
|
47 |
45 |
$96.47 |
| 82140 |
|
33 |
26 |
$95.60 |
| 86664 |
|
14 |
14 |
$94.71 |
| 90715 |
|
2,887 |
2,880 |
$91.86 |
| 85046 |
|
60 |
43 |
$84.79 |
| J1885 |
Ketorolac tromethamine inj |
36,327 |
32,054 |
$78.88 |
| 86735 |
|
12 |
12 |
$73.80 |
| 82105 |
|
12 |
12 |
$73.36 |
| 86765 |
|
12 |
12 |
$72.81 |
| 96376 |
|
12,367 |
7,325 |
$68.23 |
| 86695 |
|
13 |
13 |
$66.24 |
| J2405 |
Ondansetron hcl injection |
32,218 |
25,399 |
$52.02 |
| J3010 |
Fentanyl citrate injection |
8,349 |
7,236 |
$50.20 |
| 82150 |
|
14 |
14 |
$48.84 |
| 82803 |
|
732 |
661 |
$39.76 |
| 81003 |
|
593 |
424 |
$39.36 |
| 94664 |
|
1,811 |
1,392 |
$36.75 |
| 85660 |
|
12 |
12 |
$34.10 |
| 29125 |
|
853 |
838 |
$33.39 |
| 80178 |
|
14 |
13 |
$29.52 |
| J2250 |
Inj midazolam hydrochloride |
13,136 |
11,857 |
$27.71 |
| 86901 |
|
6,543 |
6,280 |
$20.50 |
| J7030 |
Normal saline solution infus |
9,848 |
8,337 |
$18.46 |
| J0696 |
Ceftriaxone sodium injection |
8,349 |
7,126 |
$18.13 |
| 84480 |
|
24 |
23 |
$17.82 |
| J0330 |
Succinycholine chloride inj |
2,863 |
2,803 |
$14.68 |
| 86787 |
|
15 |
15 |
$14.10 |
| J2360 |
Orphenadrine injection |
4,021 |
3,860 |
$12.24 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
11,866 |
11,180 |
$11.94 |
| J1644 |
Inj heparin sodium per 1000u |
6,270 |
2,948 |
$11.92 |
| 84295 |
|
155 |
145 |
$11.26 |
| J2001 |
Lidocaine injection |
4,596 |
4,170 |
$11.16 |
| J1100 |
Dexamethasone sodium phos |
19,525 |
17,446 |
$10.89 |
| J0131 |
Inj, acetaminophen (nos) |
8,547 |
7,923 |
$10.67 |
| 87075 |
|
15 |
15 |
$10.18 |
| 82077 |
|
579 |
515 |
$9.45 |
| A9270 |
Non-covered item or service |
4,650 |
2,350 |
$7.70 |
| J0171 |
Adrenalin epinephrine inject |
322 |
312 |
$7.40 |
| J1200 |
Diphenhydramine hcl injectio |
9,706 |
6,315 |
$5.05 |
| J8597 |
Antiemetic drug oral nos |
7,371 |
6,852 |
$3.90 |
| 91303 |
|
65 |
64 |
$1.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
3,046 |
2,520 |
$0.62 |
| J0780 |
Prochlorperazine injection |
4,070 |
3,691 |
$0.26 |
| J7613 |
Albuterol non-comp unit |
20 |
13 |
$0.24 |
| J2060 |
Lorazepam injection |
4,857 |
3,658 |
$0.20 |
| G1004 |
Cdsm ndsc |
3,084 |
2,867 |
$0.06 |
| Q0163 |
Diphenhydramine hcl 50mg |
2,528 |
2,354 |
$0.01 |
| J2370 |
Phenylephrine hcl injection |
1,176 |
1,115 |
$0.00 |
| J7620 |
Albuterol ipratrop non-comp |
1,234 |
946 |
$0.00 |
| J3490 |
Drugs unclassified injection |
3,140 |
2,449 |
$0.00 |
| J1940 |
Furosemide injection |
1,191 |
771 |
$0.00 |
| J1642 |
Inj heparin sodium per 10 u |
2,287 |
1,335 |
$0.00 |
| J1790 |
Droperidol injection |
1,505 |
1,262 |
$0.00 |
| Q0162 |
Ondansetron oral |
86 |
83 |
$0.00 |
| J1170 |
Hydromorphone injection |
2,450 |
1,618 |
$0.00 |
| J1815 |
Insulin injection |
2,628 |
1,390 |
$0.00 |
| C1769 |
Guide wire |
1,355 |
1,264 |
$0.00 |
| J8540 |
Oral dexamethasone |
1,442 |
1,402 |
$0.00 |
| J3480 |
Inj potassium chloride |
904 |
629 |
$0.00 |
| J1630 |
Haloperidol injection |
930 |
711 |
$0.00 |
| J2765 |
Metoclopramide hcl injection |
4,550 |
4,162 |
$0.00 |
| 12002 |
|
640 |
637 |
$0.00 |
| J7999 |
Compounded drug, noc |
840 |
830 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
3,206 |
2,757 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
160 |
105 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
611 |
242 |
$0.00 |
| J2920 |
Methylprednisolone injection |
302 |
258 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
1,677 |
1,647 |
$0.00 |
| 76377 |
|
362 |
361 |
$0.00 |
| J2175 |
Meperidine hydrochl /100 mg |
201 |
183 |
$0.00 |
| J3420 |
Vitamin b12 injection |
888 |
772 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
4,808 |
4,652 |
$0.00 |
| C1889 |
Implant/insert device, noc |
280 |
269 |
$0.00 |
| J3411 |
Thiamine hcl 100 mg |
1,057 |
733 |
$0.00 |
| 80051 |
|
29 |
26 |
$0.00 |
| 95886 |
|
12 |
12 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
205 |
197 |
$0.00 |
| J0360 |
Hydralazine hcl injection |
13 |
12 |
$0.00 |
| 74420 |
|
29 |
24 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
416 |
392 |
$0.00 |
| 99024 |
|
144 |
95 |
$0.00 |
| 88300 |
|
162 |
151 |
$0.00 |
| 36416 |
|
269 |
225 |
$0.00 |
| A9573 |
Inj, gadopiclenol, 1 ml |
383 |
372 |
$0.00 |
| J7060 |
5% dextrose/water |
210 |
112 |
$0.00 |
| 91301 |
|
684 |
616 |
$0.00 |
| A9585 |
Gadobutrol injection |
78 |
78 |
$0.00 |
| G8988 |
Self care goal status |
13 |
12 |
$0.00 |
| 96368 |
|
90 |
68 |
$0.00 |
| 88341 |
|
13 |
13 |
$0.00 |
| 97010 |
|
360 |
179 |
$0.00 |
| J7042 |
5% dextrose/normal saline |
33 |
28 |
$0.00 |
| 29130 |
|
65 |
65 |
$0.00 |
| J3360 |
Diazepam injection |
43 |
39 |
$0.00 |
| C2617 |
Stent, non-cor, tem w/o del |
17 |
14 |
$0.00 |
| J7611 |
Albuterol non-comp con |
82 |
67 |
$0.00 |
| G8987 |
Self care current status |
13 |
12 |
$0.00 |
| J0500 |
Dicyclomine injection |
39 |
37 |
$0.00 |
| C1726 |
Cath, bal dil, non-vascular |
12 |
12 |
$0.00 |
| 80320 |
|
59 |
56 |
$0.00 |
| 91306 |
|
19 |
19 |
$0.00 |
| C1781 |
Mesh (implantable) |
15 |
12 |
$0.00 |
| Q4196 |
Puraply am 1 sq cm |
137 |
63 |
$0.00 |
| J7644 |
Ipratropium bromide non-comp |
16 |
14 |
$0.00 |
| J9045 |
Carboplatin injection |
17 |
14 |
$0.00 |
| 30140 |
|
15 |
15 |
$0.00 |
| J7120 |
Ringers lactate infusion |
11,168 |
9,969 |
$0.00 |
| J1650 |
Inj enoxaparin sodium |
2,068 |
1,083 |
$0.00 |
| J3370 |
Vancomycin hcl injection |
991 |
546 |
$0.00 |
| G0500 |
Mod sedat endo service >5yrs |
1,985 |
1,959 |
$0.00 |
| J7040 |
Normal saline solution infus |
3,147 |
2,636 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
2,041 |
1,370 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
1,588 |
1,260 |
$0.00 |
| J2550 |
Promethazine hcl injection |
4,817 |
2,643 |
$0.00 |
| J2930 |
Methylprednisolone injection |
785 |
698 |
$0.00 |
| 91300 |
|
189 |
148 |
$0.00 |
| G8979 |
Mobility goal status |
213 |
199 |
$0.00 |
| J1756 |
Iron sucrose injection |
1,143 |
596 |
$0.00 |
| 76942 |
|
107 |
106 |
$0.00 |
| J1953 |
Levetiracetam injection |
147 |
115 |
$0.00 |
| C1758 |
Catheter, ureteral |
90 |
78 |
$0.00 |
| P9604 |
One-way allow prorated trip |
84 |
37 |
$0.00 |
| J7510 |
Prednisolone oral per 5 mg |
122 |
106 |
$0.00 |
| J2270 |
Morphine sulfate injection |
1,696 |
1,377 |
$0.00 |
| J2800 |
Methocarbamol injection |
87 |
84 |
$0.00 |
| J9190 |
Fluorouracil injection |
151 |
49 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
319 |
314 |
$0.00 |
| 86922 |
|
43 |
38 |
$0.00 |
| 0722T |
|
12 |
12 |
$0.00 |
| J0702 |
Betamethasone acet&sod phosp |
52 |
36 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
195 |
162 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
253 |
247 |
$0.00 |
| Q9957 |
Inj perflutren lip micros,ml |
53 |
53 |
$0.00 |
| C1887 |
Catheter, guiding |
62 |
61 |
$0.00 |
| 1124F |
|
256 |
230 |
$0.00 |
| 80143 |
|
351 |
334 |
$0.00 |
| 89051 |
|
18 |
12 |
$0.00 |
| A9552 |
F18 fdg |
56 |
54 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
81 |
81 |
$0.00 |
| J2916 |
Na ferric gluconate complex |
51 |
28 |
$0.00 |
| 0097U |
|
26 |
25 |
$0.00 |
| Q0245 |
Bamlanivimab and etesevima |
17 |
17 |
$0.00 |
| 80179 |
|
347 |
333 |
$0.00 |
| A9537 |
Tc99m mebrofenin |
14 |
12 |
$0.00 |
| J3105 |
Terbutaline sulfate inj |
17 |
12 |
$0.00 |
| J0640 |
Leucovorin calcium injection |
65 |
25 |
$0.00 |
| 0202U |
|
13 |
13 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
315 |
142 |
$0.00 |
| Q0243 |
Casirivimab and imdevimab |
27 |
24 |
$0.00 |
| J7070 |
D5w infusion |
63 |
27 |
$0.00 |