| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J9271 |
Inj pembrolizumab |
3,651 |
2,776 |
$13.00M |
| G0463 |
Hospital outpt clinic visit |
102,498 |
62,631 |
$6.94M |
| J9299 |
Injection, nivolumab |
2,459 |
1,789 |
$4.44M |
| 96361 |
|
18,258 |
6,542 |
$4.31M |
| 96413 |
|
33,808 |
18,648 |
$3.08M |
| J2505 |
Injection, pegfilgrastim 6mg |
1,906 |
1,376 |
$2.70M |
| J9263 |
Oxaliplatin |
4,173 |
1,747 |
$2.33M |
| J9355 |
Inj trastuzumab excl biosimi |
1,955 |
1,106 |
$2.05M |
| J9035 |
Bevacizumab injection |
1,724 |
769 |
$1.95M |
| 96365 |
|
17,697 |
6,687 |
$1.71M |
| 96415 |
|
7,808 |
4,817 |
$1.55M |
| 36430 |
|
10,804 |
3,731 |
$1.44M |
| P9040 |
Rbc leukoreduced irradiated |
6,696 |
3,315 |
$1.27M |
| 77523 |
|
958 |
93 |
$1.24M |
| 96366 |
|
5,981 |
2,333 |
$1.17M |
| P9037 |
Plate pheres leukoredu irrad |
4,283 |
1,409 |
$1.16M |
| 74177 |
|
8,616 |
8,287 |
$1.07M |
| 77412 |
|
2,902 |
370 |
$1.07M |
| J2506 |
Inj pegfilgrast ex bio 0.5mg |
1,070 |
720 |
$900K |
| 78815 |
|
1,418 |
1,361 |
$723K |
| J9217 |
Leuprolide acetate suspnsion |
2,656 |
2,523 |
$589K |
| J9144 |
Daratumumab, hyaluronidase |
487 |
295 |
$581K |
| 36592 |
|
43,249 |
15,514 |
$580K |
| 38222 |
|
1,315 |
1,206 |
$546K |
| J9022 |
Inj, atezolizumab,10 mg |
57 |
40 |
$510K |
| 96360 |
|
7,892 |
3,008 |
$505K |
| 88185 |
|
4,661 |
3,721 |
$492K |
| J2469 |
Palonosetron hcl |
10,032 |
5,901 |
$487K |
| U0003 |
Cov-19 amp prb hgh thruput |
6,570 |
3,683 |
$418K |
| 36415 |
|
46,916 |
34,756 |
$411K |
| J1442 |
Inj filgrastim excl biosimil |
2,142 |
472 |
$407K |
| J9306 |
Injection, pertuzumab, 1 mg |
250 |
180 |
$407K |
| 81382 |
|
3,815 |
1,161 |
$380K |
| 80048 |
|
48,141 |
22,462 |
$371K |
| J0897 |
Denosumab injection |
1,278 |
1,160 |
$371K |
| Q5117 |
Inj., kanjinti, 10 mg |
233 |
148 |
$333K |
| 77336 |
|
3,740 |
1,769 |
$323K |
| 96372 |
|
14,832 |
7,692 |
$311K |
| 76642 |
|
4,435 |
3,765 |
$290K |
| 85025 |
|
116,031 |
57,461 |
$288K |
| 77387 |
|
6,348 |
685 |
$287K |
| 80053 |
|
49,163 |
33,765 |
$287K |
| 87497 |
|
8,365 |
3,395 |
$282K |
| J0185 |
Inj., aprepitant, 1 mg |
4,461 |
2,735 |
$275K |
| J9395 |
Injection, fulvestrant |
1,417 |
1,193 |
$273K |
| 36591 |
|
35,678 |
18,524 |
$262K |
| 96367 |
|
5,293 |
3,225 |
$250K |
| 77063 |
|
8,143 |
8,025 |
$247K |
| 70553 |
|
1,363 |
1,292 |
$244K |
| 96416 |
|
3,220 |
1,865 |
$225K |
| 71250 |
|
2,718 |
2,619 |
$217K |
| P9100 |
Pathogen test for platelets |
2,251 |
736 |
$208K |
| 38220 |
|
592 |
553 |
$208K |
| 80076 |
|
45,434 |
20,879 |
$202K |
| J9041 |
Injection, bortezomib, 0.1mg |
621 |
157 |
$189K |
| 99214 |
|
2,311 |
1,040 |
$183K |
| 77295 |
|
329 |
294 |
$165K |
| 71260 |
|
9,179 |
8,858 |
$155K |
| 81268 |
|
1,810 |
829 |
$151K |
| 78816 |
|
230 |
229 |
$147K |
| J1453 |
Fosaprepitant injection |
1,638 |
977 |
$145K |
| 77067 |
|
8,200 |
8,081 |
$135K |
| 83735 |
|
40,514 |
14,147 |
$134K |
| J9206 |
Irinotecan injection |
3,101 |
1,295 |
$116K |
| J9201 |
In gemcitabine hcl nos 200mg |
2,075 |
731 |
$114K |
| P9073 |
Platelets pheresis path redu |
426 |
207 |
$113K |
| 87633 |
|
1,326 |
1,076 |
$108K |
| 83615 |
|
49,149 |
24,320 |
$102K |
| 86923 |
|
5,919 |
2,793 |
$101K |
| 88264 |
|
2,101 |
1,952 |
$99K |
| 88237 |
|
2,433 |
2,253 |
$98K |
| J9264 |
Paclitaxel protein bound |
245 |
62 |
$92K |
| J9070 |
Cyclophosphamide 100 mg inj |
1,122 |
628 |
$92K |
| 86900 |
|
15,724 |
6,338 |
$90K |
| 70491 |
|
1,290 |
1,234 |
$89K |
| 88184 |
|
4,586 |
3,720 |
$85K |
| 84100 |
|
37,744 |
14,701 |
$82K |
| 77334 |
|
1,060 |
833 |
$82K |
| J9305 |
Inj. pemetrexed nos 10mg |
49 |
24 |
$78K |
| C8908 |
Mri w/o fol w/cont, breast, |
356 |
352 |
$75K |
| J9312 |
Inj., rituximab, 10 mg |
33 |
12 |
$75K |
| 96375 |
|
25,318 |
12,878 |
$73K |
| 77300 |
|
902 |
837 |
$70K |
| 88305 |
|
6,684 |
4,435 |
$70K |
| 77065 |
Tomosynthesis, mammo |
2,584 |
2,348 |
$67K |
| 87799 |
|
2,489 |
849 |
$66K |
| J9358 |
Inj fam-trastu deru-nxki 1mg |
38 |
26 |
$65K |
| 97140 |
|
2,533 |
1,383 |
$64K |
| 97110 |
|
2,360 |
1,509 |
$59K |
| Q3014 |
Telehealth facility fee |
2,922 |
2,650 |
$56K |
| 96523 |
|
1,441 |
947 |
$55K |
| J1447 |
Inj tbo filgrastim 1 microg |
269 |
63 |
$55K |
| 77066 |
Tomosynthesis, mammo |
1,971 |
1,866 |
$55K |
| C9803 |
Hopd covid-19 spec collect |
5,498 |
3,071 |
$54K |
| 96402 |
|
5,523 |
4,194 |
$54K |
| 86850 |
|
14,107 |
5,772 |
$53K |
| J2997 |
Alteplase recombinant |
1,114 |
936 |
$52K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
12,344 |
10,061 |
$49K |
| 77280 |
|
399 |
299 |
$47K |
| 96409 |
|
3,064 |
1,731 |
$46K |
| 96374 |
|
4,805 |
2,862 |
$45K |
| 88275 |
|
1,676 |
1,215 |
$44K |
| J3489 |
Zoledronic acid 1mg |
2,466 |
2,345 |
$44K |
| 36593 |
|
946 |
794 |
$43K |
| J1439 |
Inj ferric carboxymaltos 1mg |
456 |
377 |
$42K |
| J9310 |
Rituximab injection |
18 |
13 |
$42K |
| 71046 |
|
2,409 |
2,214 |
$41K |
| A9552 |
F18 fdg |
2,576 |
2,491 |
$41K |
| 77080 |
|
809 |
781 |
$40K |
| 82378 |
|
10,859 |
8,288 |
$39K |
| 81378 |
|
1,107 |
645 |
$39K |
| 82533 |
|
6,094 |
4,986 |
$38K |
| 74183 |
|
230 |
223 |
$38K |
| J1756 |
Iron sucrose injection |
2,405 |
1,336 |
$38K |
| 78306 |
|
251 |
244 |
$37K |
| 82784 |
|
5,520 |
3,383 |
$36K |
| 99215 |
Prolong outpt/office vis |
214 |
121 |
$35K |
| 86830 |
|
670 |
588 |
$35K |
| 86901 |
|
15,582 |
6,259 |
$34K |
| 80069 |
|
3,293 |
1,313 |
$34K |
| 19083 |
|
57 |
53 |
$34K |
| 94010 |
|
1,908 |
1,839 |
$31K |
| 96368 |
|
4,823 |
2,407 |
$31K |
| 80307 |
|
1,114 |
902 |
$30K |
| 94726 |
|
1,527 |
1,468 |
$29K |
| 96401 |
|
4,011 |
1,738 |
$29K |
| 36561 |
|
26 |
25 |
$29K |
| 86300 |
|
4,485 |
3,765 |
$29K |
| 88271 |
|
1,682 |
1,214 |
$29K |
| 88341 |
|
1,101 |
841 |
$27K |
| 94729 |
|
1,760 |
1,695 |
$27K |
| 86644 |
|
2,225 |
1,421 |
$26K |
| 81206 |
|
301 |
284 |
$26K |
| 82306 |
|
3,419 |
3,265 |
$25K |
| 97535 |
|
1,515 |
1,138 |
$25K |
| J7050 |
Normal saline solution infus |
24,088 |
11,904 |
$24K |
| 86301 |
|
3,812 |
2,579 |
$23K |
| 80197 |
|
1,947 |
527 |
$22K |
| 77290 |
|
109 |
98 |
$22K |
| G0498 |
Chemo extend iv infus w/pump |
1,007 |
599 |
$22K |
| 93005 |
|
2,536 |
2,098 |
$22K |
| 72197 |
|
110 |
105 |
$21K |
| 88342 |
|
1,897 |
1,711 |
$21K |
| 86831 |
|
733 |
641 |
$21K |
| 87040 |
|
1,377 |
1,033 |
$20K |
| J7030 |
Normal saline solution infus |
16,846 |
7,033 |
$20K |
| 82728 |
|
8,066 |
6,930 |
$20K |
| 99213 |
|
382 |
178 |
$20K |
| 78812 |
|
39 |
38 |
$20K |
| 96417 |
|
9,957 |
5,997 |
$19K |
| Q5107 |
Inj mvasi 10 mg |
59 |
24 |
$19K |
| 77001 |
|
273 |
257 |
$19K |
| 84443 |
|
10,789 |
9,347 |
$18K |
| 80158 |
|
1,625 |
302 |
$18K |
| 90686 |
|
1,571 |
1,531 |
$17K |
| 87635 |
|
336 |
268 |
$16K |
| 81455 |
|
69 |
64 |
$16K |
| G0279 |
Tomosynthesis, mammo |
3,705 |
3,492 |
$16K |
| 85730 |
|
6,755 |
4,876 |
$16K |
| 83001 |
|
1,505 |
1,428 |
$15K |
| 86920 |
|
2,009 |
949 |
$15K |
| J9171 |
Docetaxel injection |
72 |
54 |
$15K |
| 96411 |
|
4,708 |
2,949 |
$14K |
| 76937 |
|
255 |
242 |
$14K |
| 85610 |
|
8,043 |
5,591 |
$14K |
| 85049 |
|
5,427 |
2,327 |
$14K |
| G0481 |
Drug test def 8-14 classes |
657 |
538 |
$13K |
| 86704 |
|
3,347 |
2,534 |
$12K |
| 86803 |
|
3,028 |
2,217 |
$12K |
| 76536 |
|
188 |
186 |
$12K |
| 87340 |
|
3,392 |
2,575 |
$12K |
| 77301 |
|
29 |
28 |
$11K |
| 83520 |
|
3,633 |
1,714 |
$11K |
| 80061 |
|
1,755 |
1,651 |
$11K |
| 81267 |
|
167 |
158 |
$11K |
| 86703 |
|
2,224 |
1,501 |
$11K |
| 86999 |
|
792 |
742 |
$10K |
| 87536 |
|
290 |
264 |
$10K |
| 84439 |
|
7,749 |
6,590 |
$10K |
| 81001 |
|
4,643 |
3,799 |
$10K |
| 86334 |
|
1,716 |
1,537 |
$10K |
| 84466 |
|
4,865 |
4,568 |
$9K |
| C1751 |
Cath, inf, per/cent/midline |
8,017 |
5,768 |
$9K |
| 86688 |
|
2,221 |
1,501 |
$9K |
| 84403 |
|
1,130 |
1,059 |
$9K |
| 87631 |
|
435 |
219 |
$9K |
| J7040 |
Normal saline solution infus |
5,570 |
2,501 |
$9K |
| 86592 |
|
2,243 |
1,516 |
$9K |
| P9033 |
Platelets leukoreduced irrad |
84 |
44 |
$8K |
| 99212 |
|
133 |
70 |
$8K |
| A9579 |
Gad-base mr contrast nos,1ml |
4,729 |
4,357 |
$8K |
| 77338 |
|
42 |
40 |
$8K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
15,948 |
8,274 |
$8K |
| 82105 |
|
1,555 |
1,281 |
$7K |
| 85046 |
|
6,737 |
5,239 |
$7K |
| 88240 |
|
2,136 |
1,198 |
$7K |
| 86687 |
|
2,214 |
1,504 |
$7K |
| 84550 |
|
6,021 |
3,642 |
$7K |
| 83521 |
|
3,603 |
1,546 |
$7K |
| 88311 |
|
1,417 |
1,242 |
$7K |
| J3475 |
Inj magnesium sulfate |
9,194 |
1,576 |
$7K |
| 84165 |
|
3,863 |
3,381 |
$7K |
| 84153 |
|
2,404 |
2,155 |
$7K |
| J9145 |
Injection, daratumumab 10 mg |
16 |
12 |
$7K |
| 83540 |
|
4,938 |
4,637 |
$7K |
| 82670 |
|
597 |
570 |
$6K |
| 82248 |
|
3,261 |
2,771 |
$6K |
| 99195 |
|
260 |
218 |
$6K |
| 88313 |
|
481 |
408 |
$6K |
| 85027 |
|
2,955 |
2,203 |
$5K |
| J1950 |
Leuprolide acetate /3.75 mg |
13 |
13 |
$5K |
| J9370 |
Vincristine sulfate 1 mg inj |
1,052 |
792 |
$5K |
| 82977 |
|
2,363 |
1,932 |
$5K |
| Q5101 |
Injection, zarxio |
35 |
15 |
$5K |
| G0008 |
Admin influenza virus vac |
2,092 |
2,027 |
$5K |
| J2250 |
Inj midazolam hydrochloride |
2,603 |
2,296 |
$5K |
| 86304 |
|
1,626 |
1,346 |
$5K |
| J3010 |
Fentanyl citrate injection |
1,669 |
1,470 |
$4K |
| 82607 |
|
1,658 |
1,595 |
$4K |
| 84270 |
|
611 |
568 |
$4K |
| 86360 |
|
251 |
238 |
$4K |
| J3480 |
Inj potassium chloride |
3,678 |
898 |
$4K |
| 82570 |
|
1,732 |
1,456 |
$4K |
| 86922 |
|
164 |
65 |
$4K |
| 87081 |
|
38 |
36 |
$3K |
| J2405 |
Ondansetron hcl injection |
10,757 |
5,365 |
$3K |
| 96376 |
|
1,816 |
1,057 |
$3K |
| 86695 |
|
374 |
346 |
$3K |
| 86355 |
|
193 |
187 |
$3K |
| 86359 |
|
242 |
228 |
$3K |
| 78472 |
|
16 |
13 |
$3K |
| 82465 |
|
1,503 |
1,324 |
$3K |
| J9267 |
Paclitaxel injection |
3,393 |
1,333 |
$3K |
| 91320 |
|
203 |
197 |
$3K |
| 84432 |
|
311 |
297 |
$3K |
| J1200 |
Diphenhydramine hcl injectio |
2,547 |
1,521 |
$3K |
| 99001 |
|
263 |
171 |
$2K |
| 84703 |
|
899 |
802 |
$2K |
| 87086 |
|
1,347 |
1,199 |
$2K |
| 87517 |
|
168 |
157 |
$2K |
| 84478 |
|
1,850 |
1,540 |
$2K |
| 82746 |
|
1,220 |
1,181 |
$2K |
| U0002 |
Covid-19 lab test non-cdc |
181 |
147 |
$2K |
| 73720 |
|
14 |
12 |
$2K |
| 97162 |
|
45 |
43 |
$2K |
| 97530 |
|
93 |
66 |
$2K |
| J9000 |
Doxorubicin hcl injection |
1,109 |
688 |
$2K |
| J0640 |
Leucovorin calcium injection |
5,238 |
2,243 |
$2K |
| 86140 |
|
1,378 |
929 |
$2K |
| 82043 |
|
460 |
424 |
$2K |
| 86800 |
|
328 |
314 |
$2K |
| J9190 |
Fluorouracil injection |
6,511 |
2,720 |
$2K |
| 86696 |
|
383 |
353 |
$2K |
| J0881 |
Darbepoetin alfa, non-esrd |
28 |
13 |
$2K |
| 77332 |
|
25 |
24 |
$2K |
| 86317 |
|
150 |
98 |
$2K |
| 83036 |
|
1,358 |
1,296 |
$2K |
| 85525 |
|
267 |
216 |
$2K |
| 72156 |
|
13 |
12 |
$2K |
| 70355 |
|
65 |
64 |
$2K |
| 84156 |
|
799 |
642 |
$2K |
| J7060 |
5% dextrose/water |
7,465 |
2,897 |
$1K |
| 86787 |
|
425 |
393 |
$1K |
| 83002 |
|
173 |
166 |
$1K |
| J3490 |
Drugs unclassified injection |
1,230 |
763 |
$1K |
| 86141 |
|
819 |
640 |
$1K |
| 83690 |
|
1,910 |
1,526 |
$1K |
| A4648 |
Implantable tissue marker |
855 |
774 |
$1K |
| J1642 |
Inj heparin sodium per 10 u |
980 |
300 |
$1K |
| 80195 |
|
182 |
41 |
$1K |
| 86965 |
|
88 |
44 |
$1K |
| 76942 |
|
19 |
19 |
$1K |
| 90471 |
|
318 |
296 |
$1K |
| 84702 |
|
307 |
272 |
$1K |
| 90480 |
|
203 |
197 |
$1K |
| 82150 |
|
1,657 |
1,322 |
$1K |
| 86382 |
|
116 |
107 |
$1K |
| 82565 |
|
678 |
552 |
$1K |
| 87522 |
Neg quan hep c or qual rna |
63 |
63 |
$999.62 |
| 90662 |
|
452 |
425 |
$973.08 |
| 83010 |
|
229 |
186 |
$956.94 |
| 82232 |
|
98 |
94 |
$955.48 |
| 86706 |
|
766 |
742 |
$907.38 |
| 0241U |
|
262 |
233 |
$888.13 |
| 83021 |
|
101 |
80 |
$863.43 |
| 90656 |
|
94 |
94 |
$774.06 |
| G0480 |
Drug test def 1-7 classes |
59 |
53 |
$739.98 |
| 87390 |
|
116 |
107 |
$714.37 |
| 87205 |
|
549 |
511 |
$705.24 |
| 85651 |
|
726 |
677 |
$598.16 |
| J1100 |
Dexamethasone sodium phos |
8,575 |
4,785 |
$563.05 |
| 83721 |
|
474 |
455 |
$560.90 |
| J9045 |
Carboplatin injection |
1,753 |
1,073 |
$543.14 |
| 83880 |
|
81 |
68 |
$503.55 |
| C1894 |
Intro/sheath, non-laser |
241 |
228 |
$488.30 |
| 86778 |
|
41 |
37 |
$378.66 |
| 90670 |
|
26 |
25 |
$355.34 |
| M0220 |
Tixagev and cilgav inj |
77 |
67 |
$306.02 |
| 85384 |
|
343 |
169 |
$279.84 |
| 90739 |
|
14 |
13 |
$276.69 |
| J0461 |
Atropine sulfate injection |
2,406 |
1,331 |
$275.93 |
| 82550 |
|
196 |
109 |
$269.22 |
| 90472 |
|
108 |
97 |
$268.39 |
| 86902 |
|
65 |
39 |
$263.51 |
| 86480 |
|
28 |
24 |
$262.28 |
| 83718 |
|
269 |
261 |
$240.91 |
| 96377 |
|
90 |
66 |
$236.22 |
| 84484 |
|
100 |
79 |
$224.80 |
| 86481 |
|
16 |
15 |
$223.18 |
| 94760 |
|
139 |
133 |
$219.10 |
| A9560 |
Tc99m labeled rbc |
16 |
13 |
$213.18 |
| J1170 |
Hydromorphone injection |
728 |
420 |
$212.49 |
| 81479 |
|
15 |
12 |
$177.72 |
| 80299 |
|
21 |
13 |
$171.56 |
| 85379 |
|
32 |
13 |
$160.67 |
| 86777 |
|
28 |
24 |
$154.33 |
| 87624 |
|
12 |
12 |
$135.42 |
| 86880 |
|
61 |
50 |
$123.79 |
| 87103 |
|
24 |
14 |
$123.11 |
| 88142 |
|
12 |
12 |
$111.19 |
| 86316 |
|
43 |
39 |
$102.96 |
| J0780 |
Prochlorperazine injection |
463 |
324 |
$93.45 |
| J2704 |
Inj, propofol, 10 mg |
110 |
51 |
$92.02 |
| 82330 |
|
32 |
25 |
$91.21 |
| 88108 |
|
13 |
12 |
$85.26 |
| 82310 |
|
72 |
68 |
$66.84 |
| A9503 |
Tc99m medronate |
307 |
293 |
$61.38 |
| A9698 |
Non-rad contrast materialnoc |
2,274 |
2,176 |
$59.68 |
| G0009 |
Admin pneumococcal vaccine |
65 |
63 |
$58.26 |
| G0010 |
Admin hepatitis b vaccine |
15 |
14 |
$57.48 |
| 90834 |
|
13 |
12 |
$52.33 |
| J7120 |
Ringers lactate infusion |
25 |
12 |
$42.82 |
| Q0162 |
Ondansetron oral |
946 |
447 |
$40.74 |
| A9270 |
Non-covered item or service |
4,554 |
1,729 |
$40.01 |
| 90792 |
|
12 |
12 |
$34.91 |
| 87806 |
|
13 |
12 |
$31.38 |
| 84630 |
|
15 |
15 |
$30.93 |
| J3420 |
Vitamin b12 injection |
471 |
371 |
$21.82 |
| J8540 |
Oral dexamethasone |
2,016 |
657 |
$20.92 |
| 83605 |
|
16 |
15 |
$15.63 |
| 89051 |
|
13 |
12 |
$10.08 |
| 84157 |
|
13 |
12 |
$7.20 |
| 82945 |
|
13 |
12 |
$7.08 |
| 86870 |
|
22 |
13 |
$6.72 |
| 85014 |
|
29 |
25 |
$4.93 |
| 87186 |
|
27 |
25 |
$3.89 |
| Q0221 |
Tixagev and cilgav, 600mg |
30 |
25 |
$0.11 |
| Q0220 |
Tixagev and cilgav, 300mg |
15 |
12 |
$0.09 |
| G1004 |
Cdsm ndsc |
6,290 |
3,564 |
$0.07 |
| C8937 |
Cad breast mri |
412 |
404 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
48 |
32 |
$0.00 |
| C1788 |
Port, indwelling, imp |
50 |
49 |
$0.00 |
| J9060 |
Cisplatin 10 mg injection |
23 |
12 |
$0.00 |
| J2930 |
Methylprednisolone injection |
18 |
13 |
$0.00 |
| 87077 |
|
15 |
14 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
271 |
179 |
$0.00 |