| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
65,401 |
52,176 |
$8.57M |
| 99283 |
|
61,944 |
52,259 |
$8.33M |
| 96361 |
|
35,437 |
25,175 |
$8.20M |
| 99285 |
|
36,756 |
28,851 |
$4.34M |
| 70450 |
|
20,400 |
16,866 |
$2.68M |
| 99282 |
|
18,485 |
16,543 |
$2.62M |
| 96365 |
|
25,851 |
14,653 |
$2.30M |
| 74177 |
|
11,130 |
9,577 |
$1.77M |
| 0241U |
|
23,636 |
20,897 |
$1.49M |
| G0378 |
Hospital observation per hr |
9,920 |
7,348 |
$1.39M |
| 96366 |
|
10,448 |
6,605 |
$1.35M |
| 74176 |
|
8,736 |
7,397 |
$1.30M |
| 99281 |
|
8,404 |
7,660 |
$1.29M |
| 71275 |
|
4,364 |
3,784 |
$718K |
| 96360 |
|
7,731 |
6,386 |
$679K |
| 43239 |
|
2,042 |
1,731 |
$616K |
| 93306 |
|
3,052 |
2,666 |
$612K |
| 80053 |
|
138,245 |
101,380 |
$571K |
| 78452 |
|
1,457 |
1,270 |
$558K |
| 42820 |
|
272 |
249 |
$551K |
| 80307 |
|
24,702 |
18,946 |
$535K |
| 94640 |
|
12,945 |
8,615 |
$512K |
| 36475 |
|
388 |
256 |
$511K |
| C9803 |
Hopd covid-19 spec collect |
20,360 |
17,703 |
$440K |
| 11042 |
|
3,071 |
1,675 |
$407K |
| P9016 |
Rbc leukocytes reduced |
2,658 |
1,756 |
$402K |
| 96367 |
|
6,379 |
2,921 |
$351K |
| 69436 |
|
336 |
284 |
$315K |
| 93970 |
|
3,315 |
2,835 |
$288K |
| 93971 |
|
3,730 |
2,973 |
$281K |
| G0463 |
Hospital outpt clinic visit |
9,115 |
4,766 |
$275K |
| 78815 |
|
385 |
334 |
$270K |
| 85025 |
|
155,279 |
108,967 |
$261K |
| 82306 |
|
15,939 |
14,598 |
$255K |
| 76705 |
|
3,311 |
2,972 |
$254K |
| 96413 |
|
4,869 |
2,236 |
$250K |
| 96375 |
|
37,364 |
25,661 |
$240K |
| 97110 |
|
8,848 |
2,059 |
$225K |
| 45380 |
|
687 |
583 |
$219K |
| 76700 |
|
1,961 |
1,807 |
$210K |
| 36430 |
|
2,665 |
1,841 |
$203K |
| 45385 |
|
396 |
352 |
$195K |
| 10060 |
|
1,436 |
1,221 |
$181K |
| 76830 |
|
2,081 |
1,899 |
$179K |
| 70551 |
|
1,145 |
1,000 |
$168K |
| 80050 |
|
2,968 |
2,954 |
$165K |
| 80061 |
|
23,949 |
21,894 |
$164K |
| 84443 |
|
31,729 |
27,931 |
$164K |
| G0121 |
Colon ca scrn not hi rsk ind |
214 |
206 |
$161K |
| 12001 |
|
813 |
748 |
$159K |
| 72148 |
|
805 |
742 |
$153K |
| 76856 |
|
2,513 |
2,286 |
$148K |
| 47562 |
|
52 |
49 |
$146K |
| 83036 |
|
19,362 |
17,520 |
$145K |
| J7120 |
Ringers lactate infusion |
4,160 |
3,363 |
$135K |
| 97161 |
|
2,777 |
2,274 |
$132K |
| U0003 |
Cov-19 amp prb hgh thruput |
7,245 |
6,175 |
$131K |
| 72125 |
|
6,767 |
5,753 |
$121K |
| 45378 |
|
259 |
235 |
$120K |
| 71260 |
|
2,518 |
2,202 |
$110K |
| 93017 |
|
1,559 |
1,360 |
$108K |
| 83880 |
|
18,813 |
14,689 |
$108K |
| 82607 |
|
10,525 |
9,475 |
$107K |
| 76770 |
|
1,134 |
1,004 |
$107K |
| 36415 |
|
47,803 |
35,568 |
$104K |
| 80048 |
|
26,159 |
19,667 |
$103K |
| 71046 |
|
6,799 |
5,927 |
$93K |
| 76801 |
|
2,036 |
1,729 |
$91K |
| 11043 |
|
535 |
259 |
$91K |
| 71250 |
|
2,187 |
1,889 |
$91K |
| 87086 |
|
26,583 |
22,615 |
$90K |
| C8929 |
Tte w or wo fol wcon,doppler |
377 |
332 |
$86K |
| 99212 |
|
904 |
622 |
$82K |
| J9271 |
Inj pembrolizumab |
16 |
12 |
$80K |
| 96372 |
|
27,544 |
20,940 |
$79K |
| 71045 |
|
52,899 |
41,212 |
$77K |
| 77412 |
|
243 |
24 |
$77K |
| 77063 |
|
2,337 |
2,181 |
$73K |
| 77067 |
|
2,890 |
2,706 |
$72K |
| 77336 |
|
922 |
351 |
$71K |
| 87040 |
|
22,236 |
13,284 |
$68K |
| 86235 |
|
979 |
808 |
$68K |
| 87591 |
|
6,567 |
5,843 |
$67K |
| J2469 |
Palonosetron hcl |
781 |
401 |
$66K |
| 70496 |
|
355 |
315 |
$65K |
| 97530 |
|
3,678 |
1,400 |
$63K |
| 84439 |
|
10,380 |
9,248 |
$63K |
| 72131 |
|
967 |
852 |
$60K |
| 76642 |
|
629 |
563 |
$60K |
| 12002 |
|
349 |
318 |
$59K |
| 93005 |
|
66,410 |
46,703 |
$57K |
| 82728 |
|
7,601 |
6,567 |
$56K |
| 29125 |
|
1,015 |
910 |
$53K |
| 87491 |
|
6,555 |
5,833 |
$49K |
| 87081 |
|
11,321 |
10,507 |
$48K |
| 97165 |
|
1,041 |
860 |
$48K |
| 72100 |
|
3,810 |
3,326 |
$47K |
| 84145 |
|
11,218 |
9,047 |
$47K |
| 96374 |
|
42,586 |
33,307 |
$47K |
| 87502 |
|
4,035 |
3,549 |
$46K |
| 70491 |
|
255 |
232 |
$46K |
| 86703 |
|
3,228 |
2,945 |
$46K |
| 76536 |
|
509 |
469 |
$46K |
| 70486 |
|
1,648 |
1,470 |
$46K |
| 86003 |
|
1,018 |
743 |
$45K |
| 71271 |
|
513 |
460 |
$44K |
| 66984 |
|
203 |
148 |
$44K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
18,810 |
16,256 |
$43K |
| 12011 |
|
229 |
212 |
$42K |
| 73721 |
|
180 |
177 |
$42K |
| 76815 |
|
620 |
550 |
$40K |
| 88175 |
|
2,061 |
1,933 |
$38K |
| 93975 |
|
456 |
416 |
$38K |
| 85652 |
|
7,074 |
5,293 |
$37K |
| 90715 |
|
2,769 |
2,541 |
$37K |
| 74018 |
|
3,975 |
3,367 |
$36K |
| 82247 |
|
3,293 |
1,819 |
$36K |
| 82746 |
|
6,026 |
5,351 |
$34K |
| 83540 |
|
9,034 |
7,975 |
$33K |
| Q0138 |
Ferumoxytol, non-esrd |
214 |
121 |
$33K |
| 93880 |
|
547 |
460 |
$31K |
| 81001 |
|
62,491 |
50,349 |
$31K |
| 96415 |
|
159 |
103 |
$30K |
| 84466 |
|
4,564 |
4,035 |
$30K |
| 88305 |
|
7,509 |
6,369 |
$30K |
| 99213 |
|
254 |
189 |
$29K |
| 76817 |
|
1,606 |
1,367 |
$29K |
| 97116 |
|
1,750 |
863 |
$29K |
| 84702 |
|
10,128 |
8,261 |
$28K |
| 84484 |
|
40,275 |
26,835 |
$28K |
| 87077 |
|
9,075 |
7,559 |
$28K |
| 97162 |
|
371 |
310 |
$28K |
| 88342 |
|
2,752 |
2,231 |
$27K |
| 86803 |
|
2,013 |
1,819 |
$26K |
| 85027 |
|
12,335 |
8,453 |
$26K |
| 83735 |
|
26,974 |
18,398 |
$25K |
| 73030 |
|
3,467 |
2,911 |
$25K |
| 85379 |
|
6,323 |
5,500 |
$25K |
| 70498 |
|
367 |
330 |
$24K |
| 80055 |
|
447 |
411 |
$24K |
| 73630 |
|
3,448 |
2,902 |
$23K |
| 43248 |
|
46 |
40 |
$23K |
| 29515 |
|
487 |
444 |
$23K |
| 87624 |
|
626 |
583 |
$22K |
| 87880 |
|
4,460 |
4,164 |
$22K |
| 73610 |
|
3,110 |
2,666 |
$22K |
| 73130 |
|
2,966 |
2,547 |
$22K |
| 97140 |
|
1,434 |
490 |
$20K |
| 82553 |
|
13,017 |
9,627 |
$20K |
| 82962 |
|
31,368 |
15,909 |
$20K |
| 72141 |
|
103 |
89 |
$20K |
| 31500 |
|
83 |
68 |
$20K |
| 76870 |
|
228 |
195 |
$20K |
| 43235 |
|
40 |
37 |
$19K |
| 96376 |
|
10,334 |
6,654 |
$19K |
| 93976 |
|
363 |
310 |
$19K |
| 73560 |
|
3,894 |
3,067 |
$19K |
| 82570 |
|
5,871 |
5,335 |
$19K |
| 93798 |
|
146 |
24 |
$16K |
| 87186 |
|
8,897 |
7,409 |
$16K |
| J1815 |
Insulin injection |
6,061 |
4,001 |
$16K |
| 83690 |
|
28,722 |
22,924 |
$16K |
| 87503 |
|
3,969 |
3,502 |
$16K |
| 82043 |
|
5,157 |
4,763 |
$15K |
| 86900 |
|
7,171 |
5,733 |
$15K |
| 77334 |
|
108 |
75 |
$15K |
| 80074 |
|
1,111 |
1,009 |
$14K |
| 86140 |
|
3,575 |
2,792 |
$14K |
| J7040 |
Normal saline solution infus |
1,842 |
1,332 |
$14K |
| 87070 |
|
3,726 |
3,159 |
$14K |
| G0103 |
Psa screening |
1,188 |
1,100 |
$14K |
| 86780 |
|
2,213 |
2,019 |
$14K |
| 73502 |
|
2,400 |
1,969 |
$14K |
| 80076 |
|
2,236 |
1,933 |
$13K |
| 88360 |
|
836 |
629 |
$13K |
| 97602 |
|
184 |
99 |
$13K |
| 97535 |
|
949 |
546 |
$13K |
| 96368 |
|
2,104 |
1,509 |
$13K |
| 51702 |
|
1,267 |
967 |
$13K |
| J7030 |
Normal saline solution infus |
14,256 |
10,074 |
$13K |
| G0279 |
Tomosynthesis, mammo |
305 |
276 |
$12K |
| U0005 |
Infec agen detec ampli probe |
4,281 |
3,700 |
$12K |
| 85610 |
|
37,609 |
28,864 |
$12K |
| 86225 |
|
927 |
810 |
$12K |
| 88185 |
|
197 |
148 |
$11K |
| 83605 |
|
19,509 |
14,750 |
$11K |
| 81025 |
|
14,129 |
12,264 |
$11K |
| 84550 |
|
5,088 |
4,444 |
$11K |
| 97597 |
|
235 |
181 |
$11K |
| 70553 |
|
29 |
28 |
$10K |
| 83516 |
|
778 |
654 |
$10K |
| 82677 |
|
179 |
166 |
$10K |
| J2704 |
Inj, propofol, 10 mg |
11,907 |
10,241 |
$9K |
| 83655 |
|
912 |
888 |
$9K |
| 81000 |
|
4,235 |
3,121 |
$9K |
| 73110 |
|
1,580 |
1,349 |
$9K |
| 87147 |
|
1,595 |
1,422 |
$9K |
| 82784 |
|
1,365 |
850 |
$8K |
| 36600 |
|
12,398 |
9,517 |
$8K |
| 59025 |
|
62 |
46 |
$8K |
| 83550 |
|
2,479 |
2,159 |
$8K |
| 82977 |
|
1,186 |
1,046 |
$8K |
| 99214 |
|
76 |
55 |
$8K |
| 87210 |
|
4,652 |
4,097 |
$8K |
| 92507 |
|
37 |
14 |
$7K |
| 90471 |
|
2,843 |
2,435 |
$7K |
| 83615 |
|
3,514 |
2,694 |
$7K |
| 77065 |
Tomosynthesis, mammo |
178 |
137 |
$7K |
| 80047 |
|
3,294 |
2,612 |
$7K |
| 73080 |
|
1,021 |
878 |
$7K |
| 94726 |
|
83 |
71 |
$7K |
| 84112 |
|
316 |
270 |
$7K |
| 76805 |
|
121 |
107 |
$6K |
| 72040 |
|
261 |
237 |
$6K |
| 82550 |
|
25,348 |
18,896 |
$6K |
| 87637 |
|
172 |
167 |
$6K |
| 77066 |
Tomosynthesis, mammo |
218 |
199 |
$6K |
| 84153 |
|
787 |
678 |
$6K |
| 87804 |
|
2,184 |
1,318 |
$6K |
| 29581 |
|
177 |
65 |
$6K |
| 92950 |
|
15 |
12 |
$6K |
| J0885 |
Epoetin alfa, non-esrd |
604 |
213 |
$6K |
| 87340 |
|
953 |
848 |
$5K |
| 73590 |
|
1,389 |
1,123 |
$5K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
45 |
36 |
$5K |
| 86850 |
|
6,221 |
4,935 |
$5K |
| 73562 |
|
497 |
418 |
$5K |
| 96402 |
|
63 |
55 |
$5K |
| 85730 |
|
25,976 |
20,434 |
$5K |
| J0171 |
Adrenalin epinephrine inject |
1,796 |
1,438 |
$5K |
| 64400 |
|
16 |
12 |
$5K |
| 77280 |
|
21 |
12 |
$5K |
| P9612 |
Catheterize for urine spec |
1,821 |
1,485 |
$5K |
| 88304 |
|
1,885 |
1,660 |
$5K |
| 84481 |
|
554 |
513 |
$5K |
| 82248 |
|
1,019 |
666 |
$5K |
| 87150 |
|
524 |
449 |
$4K |
| 83525 |
|
565 |
530 |
$4K |
| 84165 |
|
1,080 |
901 |
$4K |
| 82785 |
|
492 |
431 |
$4K |
| 72050 |
|
364 |
324 |
$4K |
| 86920 |
|
3,090 |
1,807 |
$4K |
| J7050 |
Normal saline solution infus |
1,261 |
701 |
$4K |
| J1642 |
Inj heparin sodium per 10 u |
7,639 |
3,149 |
$4K |
| 84100 |
|
7,278 |
4,455 |
$4K |
| J2405 |
Ondansetron hcl injection |
29,733 |
22,459 |
$4K |
| M0243 |
Casirivi and imdevi inj |
15 |
14 |
$4K |
| 80164 |
|
1,032 |
796 |
$3K |
| 80177 |
|
498 |
400 |
$3K |
| 74230 |
|
96 |
76 |
$3K |
| 86901 |
|
7,171 |
5,731 |
$3K |
| 97016 |
|
209 |
55 |
$3K |
| 86431 |
|
436 |
400 |
$3K |
| 78306 |
|
12 |
12 |
$3K |
| 87633 |
|
34 |
30 |
$3K |
| 83883 |
|
381 |
253 |
$3K |
| 70487 |
|
16 |
13 |
$3K |
| 94010 |
|
88 |
76 |
$3K |
| 86038 |
|
337 |
294 |
$3K |
| Q5106 |
Inj retacrit non-esrd use |
212 |
103 |
$3K |
| J9217 |
Leuprolide acetate suspnsion |
16 |
12 |
$3K |
| 73090 |
|
667 |
580 |
$3K |
| 99211 |
|
20 |
13 |
$3K |
| 84703 |
|
3,419 |
3,017 |
$3K |
| 88184 |
|
194 |
147 |
$3K |
| 95816 |
|
17 |
15 |
$3K |
| 82805 |
|
12,839 |
9,783 |
$3K |
| 73564 |
|
117 |
97 |
$3K |
| 10061 |
|
14 |
14 |
$3K |
| J1650 |
Inj enoxaparin sodium |
3,302 |
1,935 |
$2K |
| 73140 |
|
193 |
175 |
$2K |
| J2001 |
Lidocaine injection |
7,817 |
6,270 |
$2K |
| 86300 |
|
319 |
220 |
$2K |
| G0283 |
Elec stim other than wound |
156 |
38 |
$2K |
| 83704 |
|
502 |
457 |
$2K |
| 82565 |
|
1,086 |
905 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
14,295 |
9,156 |
$2K |
| Q0244 |
Casirivi and imdevi 1200 mg |
14 |
12 |
$2K |
| 86008 |
|
362 |
322 |
$2K |
| 87507 |
|
27 |
24 |
$2K |
| 97112 |
|
241 |
76 |
$2K |
| 86706 |
|
210 |
182 |
$2K |
| 82140 |
|
3,964 |
3,094 |
$2K |
| 84630 |
|
360 |
317 |
$2K |
| 86618 |
|
269 |
240 |
$2K |
| J8540 |
Oral dexamethasone |
722 |
442 |
$2K |
| 83021 |
|
475 |
434 |
$2K |
| 87581 |
|
34 |
30 |
$2K |
| J3010 |
Fentanyl citrate injection |
13,573 |
11,353 |
$2K |
| 74022 |
|
909 |
740 |
$2K |
| 87536 |
|
15 |
14 |
$2K |
| 76818 |
|
17 |
14 |
$1K |
| 72070 |
|
77 |
72 |
$1K |
| J0561 |
Penicillin g benzathine inj |
60 |
44 |
$1K |
| C1776 |
Joint device (implantable) |
17 |
12 |
$1K |
| 82947 |
|
326 |
299 |
$1K |
| U0002 |
Covid-19 lab test non-cdc |
114 |
92 |
$1K |
| 85045 |
|
704 |
505 |
$1K |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
321 |
246 |
$1K |
| 94150 |
|
88 |
76 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
18,585 |
15,418 |
$1K |
| 86757 |
|
122 |
104 |
$1K |
| 84403 |
|
141 |
125 |
$1K |
| 0011A |
|
66 |
65 |
$1K |
| 94729 |
|
85 |
73 |
$1K |
| 87205 |
|
1,394 |
1,061 |
$1K |
| 77300 |
|
19 |
12 |
$1K |
| 74019 |
|
106 |
98 |
$1K |
| V2632 |
Post chmbr intraocular lens |
214 |
156 |
$1K |
| 84207 |
|
218 |
187 |
$1K |
| J1100 |
Dexamethasone sodium phos |
12,975 |
9,717 |
$1K |
| J2543 |
Piperacillin/tazobactam |
1,760 |
1,254 |
$1K |
| 87088 |
|
735 |
666 |
$1K |
| 77080 |
|
31 |
24 |
$1K |
| 0012A |
|
50 |
49 |
$1K |
| 73060 |
|
178 |
141 |
$1K |
| 76981 |
|
27 |
27 |
$1K |
| 87899 |
|
54 |
42 |
$989.64 |
| 81003 |
|
6,930 |
5,396 |
$976.89 |
| 82105 |
|
276 |
255 |
$917.32 |
| 72192 |
|
16 |
13 |
$909.13 |
| 0001A |
|
43 |
43 |
$853.55 |
| 90686 |
|
88 |
67 |
$817.56 |
| 86336 |
|
179 |
166 |
$792.28 |
| 86141 |
|
97 |
71 |
$788.32 |
| 43760 |
|
45 |
25 |
$779.15 |
| J7512 |
Prednisone ir or dr oral 1mg |
4,055 |
3,277 |
$767.16 |
| 87798 |
|
34 |
30 |
$752.37 |
| 94644 |
|
377 |
322 |
$742.90 |
| 0002A |
|
29 |
28 |
$737.36 |
| 88341 |
|
76 |
59 |
$736.57 |
| 73700 |
|
14 |
12 |
$734.58 |
| 84425 |
|
157 |
137 |
$721.82 |
| 87807 |
|
772 |
703 |
$693.18 |
| J2270 |
Morphine sulfate injection |
9,881 |
7,258 |
$692.57 |
| 86592 |
|
73 |
65 |
$692.27 |
| Q0162 |
Ondansetron oral |
8,685 |
6,969 |
$691.09 |
| 73552 |
|
204 |
172 |
$688.37 |
| G0008 |
Admin influenza virus vac |
121 |
95 |
$678.88 |
| 92611 |
|
64 |
50 |
$673.64 |
| 86704 |
|
53 |
41 |
$670.93 |
| J2930 |
Methylprednisolone injection |
5,739 |
4,544 |
$667.62 |
| 86677 |
|
12 |
12 |
$661.90 |
| 87486 |
|
34 |
30 |
$643.79 |
| J2795 |
Ropivacaine hcl injection |
652 |
552 |
$637.50 |
| 80069 |
|
324 |
283 |
$628.09 |
| 82950 |
|
382 |
364 |
$619.73 |
| 86787 |
|
112 |
100 |
$605.93 |
| 96523 |
|
46 |
27 |
$561.70 |
| 82274 |
|
510 |
445 |
$557.94 |
| 82180 |
|
127 |
116 |
$545.97 |
| 96417 |
|
669 |
351 |
$530.72 |
| J1756 |
Iron sucrose injection |
562 |
291 |
$524.61 |
| 72170 |
|
508 |
426 |
$520.26 |
| 82378 |
|
200 |
165 |
$497.60 |
| 82150 |
|
180 |
165 |
$482.46 |
| 92526 |
|
25 |
17 |
$476.96 |
| J2250 |
Inj midazolam hydrochloride |
8,404 |
7,188 |
$469.87 |
| 87389 |
|
26 |
24 |
$469.70 |
| 83521 |
|
204 |
89 |
$464.41 |
| 82172 |
|
29 |
25 |
$458.51 |
| G0145 |
Scr c/v cyto,thinlayer,rescr |
28 |
27 |
$457.29 |
| J0690 |
Cefazolin sodium injection |
4,932 |
3,894 |
$448.80 |
| J1170 |
Hydromorphone injection |
6,408 |
4,667 |
$443.86 |
| 72128 |
|
31 |
26 |
$438.48 |
| 71101 |
|
58 |
55 |
$425.91 |
| J2360 |
Orphenadrine injection |
1,973 |
1,686 |
$425.77 |
| 92610 |
|
14 |
12 |
$395.29 |
| A9500 |
Tc99m sestamibi |
1,503 |
1,306 |
$393.90 |
| Q9957 |
Inj perflutren lip micros,ml |
614 |
546 |
$385.54 |
| 87102 |
|
83 |
79 |
$382.86 |
| 86696 |
|
27 |
25 |
$367.55 |
| J1200 |
Diphenhydramine hcl injectio |
6,913 |
5,112 |
$365.43 |
| J2404 |
Inj, nicardipine 0.1 mg |
18 |
13 |
$355.67 |
| J0330 |
Succinycholine chloride inj |
2,608 |
2,270 |
$350.40 |
| J3490 |
Drugs unclassified injection |
408 |
156 |
$335.44 |
| C9113 |
Inj pantoprazole sodium, via |
6,614 |
4,958 |
$315.00 |
| J7060 |
5% dextrose/water |
836 |
391 |
$299.67 |
| J1644 |
Inj heparin sodium per 1000u |
5,833 |
3,042 |
$293.30 |
| 84132 |
|
613 |
462 |
$270.82 |
| J2060 |
Lorazepam injection |
4,298 |
3,339 |
$256.82 |
| 84436 |
|
21 |
21 |
$253.27 |
| 86308 |
|
29 |
29 |
$250.84 |
| A9552 |
F18 fdg |
413 |
362 |
$245.12 |
| J0153 |
Adenosine inj 1mg |
148 |
122 |
$240.86 |
| 86695 |
|
29 |
26 |
$239.88 |
| J2765 |
Metoclopramide hcl injection |
4,439 |
3,590 |
$237.16 |
| 87522 |
Neg quan hep c or qual rna |
33 |
29 |
$230.99 |
| J0780 |
Prochlorperazine injection |
2,004 |
1,709 |
$226.16 |
| 83001 |
|
28 |
25 |
$220.06 |
| 86334 |
|
81 |
64 |
$214.96 |
| 87101 |
|
26 |
26 |
$214.55 |
| 84155 |
|
123 |
103 |
$212.96 |
| 82010 |
|
1,512 |
1,198 |
$198.95 |
| J1953 |
Levetiracetam injection |
1,302 |
1,025 |
$193.91 |
| 70360 |
|
12 |
12 |
$177.91 |
| 87045 |
|
44 |
40 |
$170.80 |
| J3370 |
Vancomycin hcl injection |
1,976 |
1,106 |
$170.20 |
| J2785 |
Regadenoson injection |
205 |
177 |
$164.27 |
| J3475 |
Inj magnesium sulfate |
3,731 |
2,390 |
$148.13 |
| J1940 |
Furosemide injection |
2,282 |
1,524 |
$140.51 |
| 84146 |
|
18 |
13 |
$136.69 |
| 84479 |
|
12 |
12 |
$131.98 |
| 84156 |
|
77 |
65 |
$130.80 |
| 87075 |
|
176 |
146 |
$122.87 |
| J0360 |
Hydralazine hcl injection |
3,574 |
2,749 |
$122.87 |
| 82525 |
|
16 |
14 |
$117.82 |
| 87046 |
|
45 |
40 |
$117.03 |
| J3480 |
Inj potassium chloride |
2,954 |
1,959 |
$114.88 |
| J2550 |
Promethazine hcl injection |
2,377 |
1,867 |
$112.85 |
| J2710 |
Neostigmine methylslfte inj |
1,227 |
1,080 |
$103.95 |
| C1758 |
Catheter, ureteral |
1,831 |
1,525 |
$100.37 |
| 91301 |
|
12 |
12 |
$95.36 |
| 84402 |
|
13 |
12 |
$91.40 |
| 83695 |
|
37 |
32 |
$90.67 |
| G0480 |
Drug test def 1-7 classes |
32 |
21 |
$90.00 |
| 80178 |
|
48 |
37 |
$88.21 |
| 87015 |
|
32 |
25 |
$88.18 |
| 87426 |
|
367 |
286 |
$83.84 |
| G8978 |
Mobility current status |
446 |
285 |
$77.57 |
| 72072 |
|
15 |
13 |
$71.87 |
| J1790 |
Droperidol injection |
1,247 |
991 |
$66.83 |
| 36416 |
|
71 |
51 |
$64.82 |
| 88112 |
|
18 |
12 |
$60.70 |
| 99152 |
|
118 |
100 |
$55.34 |
| 84480 |
|
46 |
37 |
$55.07 |
| 84154 |
|
18 |
12 |
$52.96 |
| 88307 |
|
45 |
37 |
$49.72 |
| 82077 |
|
865 |
768 |
$48.12 |
| 84295 |
|
26 |
23 |
$41.61 |
| J1956 |
Levofloxacin injection |
807 |
551 |
$40.33 |
| C1894 |
Intro/sheath, non-laser |
1,251 |
862 |
$39.81 |
| J2920 |
Methylprednisolone injection |
505 |
324 |
$38.80 |
| 84450 |
|
42 |
37 |
$29.88 |
| J7342 |
Ciprofloxacin otic susp 6 mg |
39 |
13 |
$28.28 |
| J1040 |
Methylprednisolone 80 mg inj |
203 |
168 |
$27.27 |
| J2175 |
Meperidine hydrochl /100 mg |
834 |
626 |
$25.73 |
| 88313 |
|
17 |
12 |
$23.16 |
| 80185 |
|
16 |
12 |
$19.72 |
| A9270 |
Non-covered item or service |
16,852 |
10,755 |
$19.17 |
| J0456 |
Azithromycin |
685 |
472 |
$13.73 |
| 87428 |
|
181 |
155 |
$13.14 |
| 87493 |
|
39 |
30 |
$13.00 |
| J2370 |
Phenylephrine hcl injection |
262 |
204 |
$12.91 |
| J7042 |
5% dextrose/normal saline |
228 |
166 |
$11.97 |
| 87811 |
|
35 |
31 |
$8.94 |
| J3411 |
Thiamine hcl 100 mg |
179 |
146 |
$8.72 |
| 89051 |
|
13 |
12 |
$6.02 |
| J3420 |
Vitamin b12 injection |
22 |
13 |
$2.40 |
| J0610 |
Calcium glucon (fresenius) |
27 |
24 |
$0.43 |
| J0461 |
Atropine sulfate injection |
24 |
13 |
$0.21 |
| G8979 |
Mobility goal status |
461 |
291 |
$0.00 |
| J3372 |
Inj, vancomycin hcl (xellia) |
551 |
374 |
$0.00 |
| J0736 |
Inj, clindamycin phosp 300mg |
166 |
129 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
69 |
62 |
$0.00 |
| 80179 |
|
208 |
192 |
$0.00 |
| J2916 |
Na ferric gluconate complex |
374 |
178 |
$0.00 |
| J2310 |
Inj naloxone hydrochloride |
341 |
294 |
$0.00 |
| G8997 |
Swallow goal status |
83 |
55 |
$0.00 |
| 80143 |
|
197 |
184 |
$0.00 |
| C1760 |
Closure dev, vasc |
51 |
44 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
736 |
653 |
$0.00 |
| G8996 |
Swallow current status |
83 |
55 |
$0.00 |
| J7510 |
Prednisolone oral per 5 mg |
60 |
50 |
$0.00 |
| J2272 |
Inj, morphine (fresenius) |
2,229 |
1,748 |
$0.00 |
| J3486 |
Ziprasidone mesylate |
276 |
184 |
$0.00 |
| 70250 |
|
12 |
12 |
$0.00 |
| A9576 |
Inj prohance multipack |
137 |
125 |
$0.00 |
| J0692 |
Cefepime hcl for injection |
35 |
26 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
38 |
35 |
$0.00 |
| J1630 |
Haloperidol injection |
19 |
12 |
$0.00 |
| J1920 |
Inj, labetalol hcl, 5mg |
421 |
355 |
$0.00 |
| C1769 |
Guide wire |
1,577 |
1,128 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
452 |
390 |
$0.00 |
| A9579 |
Gad-base mr contrast nos,1ml |
73 |
64 |
$0.00 |
| A9585 |
Gadobutrol injection |
69 |
54 |
$0.00 |
| C1888 |
Endovas non-cardiac abl cath |
210 |
136 |
$0.00 |
| G8998 |
Swallow d/c status |
46 |
29 |
$0.00 |
| A9503 |
Tc99m medronate |
58 |
49 |
$0.00 |
| 82803 |
|
215 |
173 |
$0.00 |
| G8980 |
Mobility d/c status |
42 |
26 |
$0.00 |
| C1781 |
Mesh (implantable) |
31 |
26 |
$0.00 |
| 88311 |
|
49 |
39 |
$0.00 |
| C1892 |
Intro/sheath,fixed,peel-away |
43 |
38 |
$0.00 |
| J9045 |
Carboplatin injection |
24 |
12 |
$0.00 |
| J0613 |
Calcium glucon (wg critical) |
30 |
25 |
$0.00 |
| J1836 |
Inj, metronidazole, 10 mg |
33 |
27 |
$0.00 |
| J3360 |
Diazepam injection |
17 |
13 |
$0.00 |
| J0687 |
Inj cefazolin (wg crit care) |
13 |
12 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
14 |
13 |
$0.00 |
| 94660 |
|
18 |
12 |
$0.00 |