| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
68,759 |
60,436 |
$37.43M |
| 99285 |
|
40,579 |
35,308 |
$35.81M |
| 99284 |
|
56,951 |
50,371 |
$35.36M |
| 74177 |
|
14,856 |
14,065 |
$12.09M |
| G0378 |
Hospital observation per hr |
18,999 |
13,371 |
$7.18M |
| 99282 |
|
14,897 |
13,662 |
$5.13M |
| 74176 |
|
6,147 |
5,847 |
$4.29M |
| 99291 |
|
2,894 |
2,671 |
$4.16M |
| 78815 |
|
2,258 |
2,185 |
$3.25M |
| 11042 |
|
26,929 |
10,678 |
$2.75M |
| J9271 |
Inj pembrolizumab |
434 |
298 |
$2.52M |
| G0463 |
Hospital outpt clinic visit |
49,303 |
40,778 |
$2.46M |
| 11045 |
|
6,091 |
2,866 |
$2.37M |
| 93306 |
|
9,955 |
9,679 |
$2.26M |
| 99281 |
|
6,424 |
5,730 |
$2.13M |
| 45380 |
|
3,473 |
3,401 |
$1.87M |
| 45385 |
|
2,311 |
2,245 |
$1.79M |
| 78452 |
|
2,209 |
2,143 |
$1.38M |
| 70498 |
|
1,458 |
1,398 |
$1.08M |
| S9480 |
Intensive outpatient psychia |
8,766 |
952 |
$1.08M |
| 43239 |
|
3,384 |
3,288 |
$1.07M |
| 70553 |
|
2,319 |
2,244 |
$1.06M |
| 77386 |
|
2,074 |
166 |
$906K |
| 74183 |
|
1,541 |
1,510 |
$880K |
| 99218 |
|
10,290 |
4,841 |
$853K |
| 74174 |
|
635 |
609 |
$819K |
| 77067 |
|
8,854 |
8,750 |
$797K |
| G0390 |
Trauma respons w/hosp criti |
279 |
240 |
$694K |
| 90853 |
|
10,685 |
1,593 |
$649K |
| 80307 |
|
22,541 |
18,292 |
$631K |
| 95811 |
|
875 |
855 |
$630K |
| 71250 |
|
4,414 |
4,278 |
$573K |
| 97112 |
|
15,173 |
6,896 |
$568K |
| 76700 |
|
5,703 |
5,614 |
$543K |
| 97140 |
|
13,534 |
6,195 |
$532K |
| 76642 |
|
4,131 |
3,804 |
$522K |
| 72148 |
|
1,479 |
1,441 |
$467K |
| 97110 |
|
18,688 |
8,522 |
$458K |
| 36902 |
|
384 |
344 |
$421K |
| 62321 |
|
1,212 |
1,170 |
$409K |
| 90870 |
|
1,677 |
627 |
$397K |
| 99212 |
|
14,979 |
10,990 |
$394K |
| 71046 |
|
20,621 |
19,657 |
$389K |
| 87491 |
|
4,226 |
3,976 |
$378K |
| 99221 |
|
4,068 |
2,179 |
$372K |
| 66984 |
|
394 |
349 |
$372K |
| 72125 |
|
6,179 |
5,689 |
$361K |
| 71275 |
|
5,345 |
5,023 |
$353K |
| 97161 |
|
6,503 |
6,242 |
$351K |
| 49450 |
|
964 |
920 |
$322K |
| 93005 |
|
61,568 |
52,793 |
$319K |
| 76705 |
|
5,814 |
5,630 |
$317K |
| 0002A |
|
7,930 |
7,647 |
$309K |
| 96365 |
|
13,169 |
7,719 |
$307K |
| 70551 |
|
2,348 |
2,253 |
$304K |
| 96361 |
|
17,294 |
14,439 |
$304K |
| 49083 |
|
719 |
393 |
$298K |
| 97597 |
|
4,316 |
2,938 |
$296K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
987 |
932 |
$292K |
| 96374 |
|
42,607 |
35,075 |
$289K |
| 99213 |
|
6,670 |
5,441 |
$287K |
| 99214 |
|
6,628 |
5,153 |
$287K |
| 96413 |
|
8,617 |
4,779 |
$286K |
| L8699 |
Prosthetic implant nos |
2,473 |
1,657 |
$286K |
| 0001A |
|
7,732 |
7,388 |
$283K |
| 62323 |
|
1,515 |
1,447 |
$267K |
| 29581 |
|
4,403 |
1,990 |
$264K |
| 76536 |
|
2,602 |
2,556 |
$257K |
| 76770 |
|
3,017 |
2,952 |
$255K |
| 94640 |
|
8,022 |
6,417 |
$240K |
| 36430 |
|
2,774 |
2,047 |
$235K |
| 94060 |
|
1,920 |
1,871 |
$231K |
| 70450 |
|
16,295 |
15,077 |
$229K |
| 71260 |
|
4,137 |
4,013 |
$226K |
| 70496 |
|
1,652 |
1,584 |
$213K |
| 80061 |
|
7,796 |
7,521 |
$209K |
| 99215 |
Prolong outpt/office vis |
1,826 |
1,565 |
$207K |
| J0885 |
Epoetin alfa, non-esrd |
1,630 |
1,070 |
$203K |
| 70491 |
|
1,460 |
1,405 |
$193K |
| 74175 |
|
809 |
790 |
$191K |
| 90834 |
|
4,086 |
2,394 |
$172K |
| 72141 |
|
780 |
737 |
$166K |
| 72131 |
|
1,567 |
1,484 |
$164K |
| 77066 |
Tomosynthesis, mammo |
2,654 |
2,591 |
$159K |
| 99211 |
|
6,848 |
5,064 |
$158K |
| 64483 |
|
421 |
412 |
$158K |
| 96415 |
|
2,210 |
1,473 |
$152K |
| 77301 |
|
40 |
38 |
$148K |
| 76830 |
|
2,455 |
2,373 |
$142K |
| 75574 |
|
327 |
320 |
$138K |
| Q5120 |
Inj pegfilgrastim-bmez 0.5mg |
76 |
54 |
$138K |
| 96375 |
|
29,015 |
23,249 |
$131K |
| 90471 |
|
7,275 |
7,013 |
$125K |
| 93975 |
|
1,000 |
966 |
$122K |
| 93458 |
|
90 |
84 |
$120K |
| 77080 |
|
2,013 |
1,992 |
$118K |
| 87502 |
|
16,844 |
16,072 |
$118K |
| 77334 |
|
174 |
152 |
$117K |
| 96360 |
|
7,315 |
6,042 |
$115K |
| 84443 |
|
7,312 |
6,904 |
$114K |
| 73721 |
|
213 |
200 |
$113K |
| 93017 |
|
3,700 |
3,592 |
$112K |
| 90792 |
|
1,593 |
1,448 |
$111K |
| 19083 |
|
141 |
131 |
$110K |
| 96366 |
|
5,243 |
3,353 |
$110K |
| 86803 |
|
1,525 |
1,478 |
$109K |
| 87186 |
|
14,557 |
10,338 |
$108K |
| 20610 |
|
677 |
640 |
$108K |
| 97530 |
|
10,708 |
6,187 |
$108K |
| 74178 |
|
126 |
122 |
$107K |
| 93246 |
|
1,750 |
1,701 |
$102K |
| 73562 |
|
5,144 |
4,658 |
$100K |
| 31575 |
|
669 |
599 |
$99K |
| 73110 |
|
3,119 |
2,811 |
$89K |
| 45378 |
|
130 |
130 |
$88K |
| 99203 |
|
1,300 |
1,045 |
$88K |
| 0012A |
|
2,643 |
2,578 |
$87K |
| 76811 |
|
375 |
365 |
$85K |
| 70486 |
|
2,977 |
2,825 |
$85K |
| 90837 |
|
985 |
569 |
$83K |
| Q5106 |
Inj retacrit non-esrd use |
1,056 |
638 |
$78K |
| 73610 |
|
4,095 |
3,767 |
$77K |
| 73502 |
|
2,659 |
2,472 |
$74K |
| P9016 |
Rbc leukocytes reduced |
2,317 |
1,844 |
$73K |
| 73030 |
|
5,032 |
4,564 |
$72K |
| 73630 |
|
5,708 |
5,161 |
$71K |
| 76856 |
|
2,774 |
2,681 |
$71K |
| 11043 |
|
274 |
141 |
$71K |
| 72110 |
|
1,171 |
1,142 |
$69K |
| 77065 |
Tomosynthesis, mammo |
3,052 |
2,823 |
$68K |
| 96372 |
|
17,934 |
14,512 |
$68K |
| 0004A |
|
1,973 |
1,804 |
$67K |
| J1453 |
Fosaprepitant injection |
1,767 |
1,142 |
$64K |
| 94726 |
|
831 |
486 |
$62K |
| 91322 |
|
408 |
403 |
$61K |
| 87389 |
|
1,556 |
1,473 |
$61K |
| 80048 |
|
87,952 |
67,188 |
$60K |
| 88305 |
|
17,524 |
11,728 |
$60K |
| 97162 |
|
759 |
731 |
$60K |
| 80053 |
|
34,963 |
31,195 |
$57K |
| 93925 |
|
271 |
268 |
$55K |
| 93971 |
|
1,757 |
1,697 |
$55K |
| 73130 |
|
4,338 |
3,837 |
$55K |
| 0011A |
|
2,147 |
2,073 |
$54K |
| 72100 |
|
2,722 |
2,637 |
$51K |
| 83036 |
|
13,436 |
12,951 |
$49K |
| 90791 |
|
450 |
438 |
$49K |
| 93923 |
|
964 |
937 |
$48K |
| 74018 |
|
2,205 |
2,014 |
$48K |
| 88341 |
|
1,900 |
1,617 |
$48K |
| 73700 |
|
286 |
260 |
$47K |
| 99202 |
|
1,028 |
815 |
$46K |
| 10005 |
|
105 |
92 |
$46K |
| 0054A |
|
1,266 |
1,195 |
$44K |
| 91200 |
|
643 |
617 |
$43K |
| 76816 |
|
221 |
199 |
$43K |
| 87340 |
|
1,614 |
1,540 |
$43K |
| 0071A |
|
1,057 |
1,002 |
$42K |
| 71271 |
|
380 |
379 |
$42K |
| 0072A |
|
976 |
948 |
$41K |
| 87591 |
|
4,280 |
4,037 |
$37K |
| 93970 |
|
587 |
563 |
$35K |
| 90832 |
|
1,884 |
1,196 |
$34K |
| 0064A |
|
1,105 |
1,029 |
$33K |
| 97165 |
|
1,534 |
1,467 |
$32K |
| 88175 |
|
404 |
399 |
$32K |
| 86923 |
|
3,265 |
1,644 |
$32K |
| J0897 |
Denosumab injection |
49 |
38 |
$30K |
| 72197 |
|
37 |
37 |
$30K |
| 49505 |
|
16 |
16 |
$28K |
| 0202U |
|
13 |
13 |
$27K |
| 99204 |
|
211 |
200 |
$27K |
| 83880 |
|
14,036 |
12,429 |
$26K |
| 72040 |
|
719 |
701 |
$26K |
| 95800 |
|
196 |
195 |
$25K |
| 94010 |
|
266 |
257 |
$23K |
| 71045 |
|
32,148 |
28,683 |
$22K |
| 0296T |
|
763 |
751 |
$22K |
| 70544 |
|
68 |
66 |
$21K |
| 75561 |
|
24 |
24 |
$21K |
| 73080 |
|
2,003 |
1,827 |
$21K |
| 87075 |
|
8,514 |
6,899 |
$19K |
| 73552 |
|
1,120 |
1,028 |
$18K |
| 10140 |
|
28 |
24 |
$18K |
| 92610 |
|
331 |
315 |
$18K |
| 96416 |
|
110 |
65 |
$18K |
| 88342 |
|
2,566 |
2,233 |
$18K |
| 73560 |
|
2,360 |
2,035 |
$17K |
| 10060 |
|
1,029 |
983 |
$17K |
| 11044 |
|
44 |
28 |
$16K |
| 77412 |
|
408 |
49 |
$16K |
| 78306 |
|
237 |
228 |
$15K |
| 73221 |
|
38 |
38 |
$15K |
| 31505 |
|
108 |
104 |
$15K |
| 92557 |
|
208 |
205 |
$15K |
| C1725 |
Cath, translumin non-laser |
1,398 |
1,235 |
$14K |
| 76805 |
|
82 |
81 |
$14K |
| 85610 |
|
23,305 |
20,332 |
$14K |
| 92526 |
|
546 |
396 |
$14K |
| 73590 |
|
2,741 |
2,491 |
$14K |
| 36561 |
|
19 |
13 |
$13K |
| 36821 |
|
17 |
14 |
$13K |
| 82607 |
|
942 |
883 |
$13K |
| 10160 |
|
46 |
40 |
$13K |
| C8929 |
Tte w or wo fol wcon,doppler |
40 |
40 |
$13K |
| 86850 |
|
9,882 |
9,007 |
$12K |
| 76882 |
|
301 |
260 |
$12K |
| 76641 |
|
112 |
83 |
$12K |
| 93350 |
|
38 |
38 |
$11K |
| 87480 |
|
819 |
790 |
$11K |
| U0002 |
Covid-19 lab test non-cdc |
17,543 |
13,871 |
$11K |
| M0243 |
Casirivi and imdevi inj |
32 |
29 |
$11K |
| 73564 |
|
193 |
165 |
$11K |
| 85025 |
|
105,115 |
84,498 |
$11K |
| 87651 |
|
3,668 |
3,558 |
$11K |
| 76813 |
|
79 |
78 |
$10K |
| 90472 |
|
435 |
429 |
$10K |
| C1726 |
Cath, bal dil, non-vascular |
169 |
146 |
$10K |
| 76801 |
|
315 |
300 |
$10K |
| G0121 |
Colon ca scrn not hi rsk ind |
14 |
14 |
$10K |
| 99152 |
|
804 |
749 |
$9K |
| 87086 |
|
13,145 |
12,093 |
$9K |
| G0399 |
Home sleep test/type 3 porta |
68 |
68 |
$9K |
| G0008 |
Admin influenza virus vac |
194 |
188 |
$9K |
| 0124A |
|
700 |
658 |
$9K |
| 82728 |
|
879 |
824 |
$8K |
| 0031A |
|
271 |
260 |
$8K |
| 87624 |
|
330 |
313 |
$8K |
| 99205 |
Prolong outpt/office vis |
27 |
27 |
$8K |
| 31579 |
|
19 |
13 |
$8K |
| 82962 |
|
42,501 |
22,944 |
$8K |
| 76870 |
|
424 |
404 |
$8K |
| 73140 |
|
1,167 |
1,071 |
$8K |
| 88142 |
|
478 |
456 |
$8K |
| 10061 |
|
107 |
104 |
$7K |
| 76942 |
|
357 |
310 |
$7K |
| 92550 |
|
71 |
68 |
$7K |
| 96160 |
|
42,338 |
37,007 |
$7K |
| 82803 |
|
15,669 |
12,465 |
$6K |
| 82306 |
|
112 |
108 |
$6K |
| 0052A |
|
132 |
130 |
$6K |
| Q5117 |
Inj., kanjinti, 10 mg |
74 |
49 |
$6K |
| 83970 |
|
82 |
71 |
$5K |
| 11404 |
|
18 |
15 |
$5K |
| 94729 |
|
1,786 |
1,737 |
$5K |
| 93312 |
|
24 |
24 |
$5K |
| 72050 |
|
92 |
89 |
$5K |
| 80076 |
|
27,194 |
24,113 |
$5K |
| 43235 |
|
14 |
14 |
$5K |
| 71101 |
|
920 |
896 |
$5K |
| 87635 |
|
7,918 |
7,387 |
$5K |
| 82378 |
|
201 |
172 |
$5K |
| 84702 |
|
2,033 |
1,848 |
$4K |
| 96523 |
|
585 |
408 |
$4K |
| 73090 |
|
1,798 |
1,606 |
$4K |
| 11721 |
|
134 |
131 |
$4K |
| 96367 |
|
4,709 |
2,839 |
$4K |
| Q9957 |
Inj perflutren lip micros,ml |
1,169 |
1,117 |
$4K |
| G0480 |
Drug test def 1-7 classes |
3,991 |
3,488 |
$4K |
| 82043 |
|
2,114 |
2,050 |
$4K |
| 97150 |
|
1,626 |
486 |
$4K |
| 74019 |
|
501 |
441 |
$4K |
| 87076 |
|
2,970 |
1,796 |
$4K |
| 99201 |
|
124 |
124 |
$4K |
| 0154A |
|
97 |
90 |
$3K |
| 0051A |
|
74 |
72 |
$3K |
| 73522 |
|
28 |
27 |
$3K |
| 88361 |
|
19 |
17 |
$3K |
| U0003 |
Cov-19 amp prb hgh thruput |
1,555 |
1,399 |
$3K |
| 74230 |
|
30 |
29 |
$3K |
| 85027 |
|
10,660 |
8,964 |
$3K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
34,683 |
31,677 |
$3K |
| G0260 |
Inj for sacroiliac jt anesth |
20 |
13 |
$3K |
| 88304 |
|
2,802 |
2,468 |
$3K |
| J0561 |
Penicillin g benzathine inj |
21 |
15 |
$2K |
| 0074A |
|
56 |
56 |
$2K |
| 90651 |
|
32 |
32 |
$2K |
| 88143 |
|
15 |
12 |
$2K |
| 87077 |
|
12,417 |
7,106 |
$2K |
| 84484 |
|
41,706 |
27,073 |
$2K |
| 73060 |
|
686 |
619 |
$2K |
| 85379 |
|
5,359 |
5,072 |
$2K |
| 92507 |
|
53 |
28 |
$2K |
| A4648 |
Implantable tissue marker |
722 |
643 |
$2K |
| 12001 |
|
1,101 |
1,066 |
$2K |
| 80069 |
|
967 |
767 |
$2K |
| 82947 |
|
5,574 |
4,922 |
$2K |
| 96411 |
|
182 |
111 |
$2K |
| 81001 |
|
33,353 |
30,423 |
$2K |
| 84145 |
|
5,996 |
5,358 |
$2K |
| 73000 |
|
83 |
77 |
$2K |
| 81025 |
|
14,988 |
13,400 |
$2K |
| 72170 |
|
1,719 |
1,609 |
$2K |
| 70487 |
|
13 |
13 |
$2K |
| 72072 |
|
40 |
40 |
$2K |
| 72128 |
|
339 |
319 |
$2K |
| 12002 |
|
850 |
816 |
$2K |
| 84134 |
|
3,871 |
3,722 |
$1K |
| 96401 |
|
40 |
25 |
$1K |
| 87070 |
|
11,358 |
9,277 |
$1K |
| G0108 |
Diab manage trn per indiv |
49 |
36 |
$1K |
| 0003A |
|
40 |
40 |
$1K |
| 90715 |
|
4,495 |
4,339 |
$1K |
| 87798 |
|
71 |
70 |
$1K |
| 86704 |
|
653 |
638 |
$1K |
| 73660 |
|
319 |
295 |
$1K |
| 96040 |
|
26 |
26 |
$1K |
| 76815 |
|
15 |
12 |
$1K |
| 97535 |
|
552 |
413 |
$1K |
| 93922 |
|
445 |
437 |
$1K |
| 76817 |
|
328 |
296 |
$1K |
| 90480 |
|
544 |
539 |
$1K |
| 88333 |
|
322 |
299 |
$1K |
| 83605 |
|
18,767 |
14,403 |
$1K |
| 85730 |
|
15,876 |
14,567 |
$1K |
| 29125 |
|
325 |
313 |
$1K |
| 73120 |
|
41 |
32 |
$1K |
| 87040 |
|
13,421 |
6,491 |
$1K |
| 87510 |
|
806 |
779 |
$1K |
| J3490 |
Drugs unclassified injection |
4,633 |
4,126 |
$1K |
| 83690 |
|
24,359 |
21,774 |
$1K |
| 93296 |
|
62 |
59 |
$979.33 |
| 86900 |
|
10,162 |
9,262 |
$837.18 |
| 87660 |
|
807 |
779 |
$832.84 |
| 90836 |
|
187 |
132 |
$757.41 |
| 36591 |
|
91 |
62 |
$750.00 |
| 82330 |
|
8,001 |
7,063 |
$746.18 |
| 88172 |
|
919 |
785 |
$712.75 |
| 82270 |
|
123 |
122 |
$702.62 |
| J2405 |
Ondansetron hcl injection |
31,191 |
25,575 |
$623.80 |
| 0134A |
|
24 |
22 |
$589.16 |
| 96376 |
|
5,370 |
4,765 |
$545.88 |
| 81002 |
|
11,763 |
11,036 |
$527.13 |
| 82746 |
|
453 |
432 |
$517.09 |
| 80320 |
|
2,283 |
2,039 |
$509.77 |
| 77336 |
|
2,359 |
999 |
$493.08 |
| 93225 |
|
15 |
14 |
$481.52 |
| C1769 |
Guide wire |
4,320 |
3,933 |
$470.92 |
| G0297 |
Ldct for lung ca screen |
13 |
12 |
$441.33 |
| 83550 |
|
671 |
637 |
$434.42 |
| 86706 |
|
891 |
859 |
$432.92 |
| C1887 |
Catheter, guiding |
1,259 |
1,148 |
$427.20 |
| 86140 |
|
8,915 |
8,136 |
$420.54 |
| A9500 |
Tc99m sestamibi |
2,321 |
2,250 |
$416.16 |
| 93880 |
|
12 |
12 |
$389.85 |
| 99153 |
Mod sedat endo service >5yrs |
384 |
361 |
$387.39 |
| 96161 |
|
3,398 |
3,257 |
$381.71 |
| 82570 |
|
2,731 |
2,485 |
$379.20 |
| 84132 |
|
10,655 |
9,374 |
$372.84 |
| 84550 |
|
1,750 |
1,647 |
$342.16 |
| 85670 |
|
2,302 |
2,088 |
$337.47 |
| 74022 |
|
25 |
24 |
$336.99 |
| 85014 |
|
15,129 |
13,709 |
$335.03 |
| J1885 |
Ketorolac tromethamine inj |
17,269 |
15,163 |
$325.76 |
| 83735 |
|
9,432 |
7,183 |
$313.66 |
| J2785 |
Regadenoson injection |
1,947 |
1,887 |
$286.03 |
| J2270 |
Morphine sulfate injection |
9,734 |
8,102 |
$280.69 |
| 82550 |
|
3,287 |
2,777 |
$264.37 |
| 93280 |
|
27 |
26 |
$264.10 |
| 77012 |
|
13 |
12 |
$253.69 |
| J1200 |
Diphenhydramine hcl injectio |
5,864 |
4,561 |
$246.05 |
| J0131 |
Inj, acetaminophen (nos) |
6,834 |
6,249 |
$240.91 |
| 82565 |
|
11,440 |
10,727 |
$238.98 |
| J0134 |
Inj acetaminophen -fresenius |
3,730 |
3,481 |
$231.02 |
| 88307 |
|
1,809 |
1,424 |
$229.11 |
| 12011 |
|
337 |
327 |
$225.10 |
| 97116 |
|
480 |
318 |
$223.54 |
| 93976 |
|
143 |
139 |
$221.93 |
| 86359 |
|
12 |
12 |
$213.93 |
| 88312 |
|
896 |
760 |
$208.50 |
| 84703 |
|
2,712 |
2,542 |
$203.40 |
| 87210 |
|
963 |
927 |
$195.67 |
| A9577 |
Inj multihance |
2,866 |
2,729 |
$189.24 |
| 73620 |
|
35 |
29 |
$185.21 |
| 86901 |
|
10,181 |
9,280 |
$184.97 |
| 84295 |
|
7,596 |
6,976 |
$180.67 |
| A9270 |
Non-covered item or service |
47,951 |
14,003 |
$166.50 |
| 85652 |
|
7,934 |
7,258 |
$165.69 |
| J3010 |
Fentanyl citrate injection |
34,216 |
28,310 |
$164.34 |
| J0696 |
Ceftriaxone sodium injection |
11,278 |
7,773 |
$164.14 |
| 87088 |
|
6,518 |
5,550 |
$159.63 |
| 86735 |
|
29 |
13 |
$156.61 |
| 90785 |
|
17 |
15 |
$156.00 |
| 86592 |
|
1,511 |
1,418 |
$154.95 |
| 82140 |
|
239 |
207 |
$146.69 |
| 76376 |
|
1,131 |
1,072 |
$146.49 |
| 77300 |
|
376 |
342 |
$145.33 |
| J0780 |
Prochlorperazine injection |
1,873 |
1,755 |
$127.95 |
| 87807 |
|
829 |
806 |
$116.53 |
| J1100 |
Dexamethasone sodium phos |
16,594 |
13,282 |
$116.42 |
| 84100 |
|
2,752 |
2,199 |
$109.08 |
| 86920 |
|
86 |
43 |
$106.17 |
| 94727 |
|
1,373 |
1,276 |
$94.13 |
| J2930 |
Methylprednisolone injection |
2,229 |
1,865 |
$92.24 |
| Q3014 |
Telehealth facility fee |
17 |
13 |
$83.16 |
| 87811 |
|
191 |
181 |
$81.93 |
| L4386 |
Non-pneum walk boot pre cst |
73 |
71 |
$73.82 |
| A9585 |
Gadobutrol injection |
3,295 |
3,127 |
$73.80 |
| 87205 |
|
11,240 |
9,165 |
$71.71 |
| 87116 |
|
17 |
14 |
$69.62 |
| 36415 |
|
36,025 |
29,076 |
$69.03 |
| J2704 |
Inj, propofol, 10 mg |
22,878 |
19,188 |
$69.02 |
| J1170 |
Hydromorphone injection |
3,429 |
2,974 |
$63.85 |
| J2060 |
Lorazepam injection |
4,030 |
3,436 |
$63.05 |
| 87880 |
|
510 |
494 |
$60.94 |
| J2765 |
Metoclopramide hcl injection |
4,135 |
3,779 |
$58.12 |
| 84439 |
|
1,842 |
1,737 |
$47.61 |
| J3301 |
Triamcinolone acet inj nos |
4,860 |
4,612 |
$42.48 |
| J3475 |
Inj magnesium sulfate |
3,035 |
2,031 |
$42.25 |
| 90833 |
|
428 |
320 |
$42.15 |
| 82010 |
|
1,745 |
1,554 |
$40.19 |
| J0692 |
Cefepime hcl for injection |
916 |
604 |
$37.48 |
| J0690 |
Cefazolin sodium injection |
13,076 |
10,479 |
$36.58 |
| L1830 |
Ko immob canvas long pre ots |
84 |
83 |
$34.72 |
| J0330 |
Succinycholine chloride inj |
5,140 |
3,538 |
$30.55 |
| A9561 |
Tc99m oxidronate |
333 |
321 |
$30.00 |
| J0360 |
Hydralazine hcl injection |
1,732 |
1,515 |
$29.95 |
| C1729 |
Cath, drainage |
2,520 |
2,213 |
$26.02 |
| 90686 |
|
1,367 |
1,339 |
$25.98 |
| U0005 |
Infec agen detec ampli probe |
568 |
513 |
$25.00 |
| J1790 |
Droperidol injection |
558 |
473 |
$24.15 |
| 92524 |
|
20 |
13 |
$23.57 |
| 96368 |
|
1,744 |
1,077 |
$22.78 |
| J1630 |
Haloperidol injection |
1,978 |
1,649 |
$21.08 |
| 94761 |
|
94 |
91 |
$20.50 |
| 92567 |
|
197 |
197 |
$20.45 |
| J0137 |
Inj, acetaminophen (hikma) |
177 |
172 |
$20.16 |
| 87147 |
|
209 |
189 |
$19.93 |
| J1650 |
Inj enoxaparin sodium |
2,888 |
1,304 |
$19.16 |
| 86701 |
|
649 |
620 |
$19.08 |
| 87390 |
|
643 |
618 |
$16.50 |
| 93325 |
|
930 |
891 |
$15.93 |
| J2370 |
Phenylephrine hcl injection |
3,344 |
2,824 |
$14.40 |
| 87081 |
|
467 |
452 |
$14.27 |
| J8540 |
Oral dexamethasone |
1,441 |
1,016 |
$14.26 |
| 85018 |
|
268 |
248 |
$12.70 |
| 86702 |
|
648 |
619 |
$11.81 |
| 96417 |
|
3,054 |
1,922 |
$10.18 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
2,623 |
1,962 |
$8.46 |
| J1642 |
Inj heparin sodium per 10 u |
2,085 |
985 |
$8.00 |
| J0171 |
Adrenalin epinephrine inject |
3,759 |
3,375 |
$7.01 |
| J2550 |
Promethazine hcl injection |
227 |
192 |
$6.65 |
| J1940 |
Furosemide injection |
4,266 |
3,075 |
$6.55 |
| J7999 |
Compounded drug, noc |
257 |
220 |
$6.38 |
| J2250 |
Inj midazolam hydrochloride |
22,916 |
20,252 |
$4.34 |
| J7512 |
Prednisone ir or dr oral 1mg |
5,874 |
4,762 |
$3.77 |
| J1626 |
Granisetron hcl injection |
332 |
186 |
$2.86 |
| C1894 |
Intro/sheath, non-laser |
3,427 |
3,116 |
$2.64 |
| C9113 |
Inj pantoprazole sodium, via |
1,201 |
833 |
$2.26 |
| J0744 |
Ciprofloxacin iv |
587 |
494 |
$1.24 |
| 88300 |
|
423 |
397 |
$0.00 |
| 88311 |
|
475 |
445 |
$0.00 |
| 77063 |
|
4,880 |
4,827 |
$0.00 |
| J7050 |
Normal saline solution infus |
1,194 |
694 |
$0.00 |
| 76377 |
|
113 |
107 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
52 |
36 |
$0.00 |
| 88738 |
|
436 |
422 |
$0.00 |
| 93320 |
|
73 |
72 |
$0.00 |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
1,734 |
1,602 |
$0.00 |
| V2632 |
Post chmbr intraocular lens |
599 |
534 |
$0.00 |
| 84157 |
|
15 |
14 |
$0.00 |
| 99406 |
|
72 |
71 |
$0.00 |
| J2305 |
Inj, nitroglycerin, 5 mg |
108 |
95 |
$0.00 |
| J3411 |
Thiamine hcl 100 mg |
61 |
50 |
$0.00 |
| 72020 |
|
246 |
234 |
$0.00 |
| 80329 |
|
187 |
167 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
345 |
325 |
$0.00 |
| J3480 |
Inj potassium chloride |
242 |
141 |
$0.00 |
| J9045 |
Carboplatin injection |
489 |
323 |
$0.00 |
| 94760 |
|
395 |
374 |
$0.00 |
| 95012 |
|
12 |
12 |
$0.00 |
| J1920 |
Inj, labetalol hcl, 5mg |
631 |
289 |
$0.00 |
| 90656 |
|
341 |
341 |
$0.00 |
| C2617 |
Stent, non-cor, tem w/o del |
80 |
77 |
$0.00 |
| J7042 |
5% dextrose/normal saline |
123 |
110 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
1,147 |
958 |
$0.00 |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
82 |
75 |
$0.00 |
| 82150 |
|
321 |
301 |
$0.00 |
| 12013 |
|
52 |
51 |
$0.00 |
| J0173 |
Inj, epinephrine (belcher) |
12 |
12 |
$0.00 |
| 77001 |
|
32 |
26 |
$0.00 |
| C1781 |
Mesh (implantable) |
105 |
103 |
$0.00 |
| J1815 |
Insulin injection |
75 |
48 |
$0.00 |
| 88108 |
|
55 |
44 |
$0.00 |
| 82950 |
|
12 |
12 |
$0.00 |
| J0610 |
Calcium glucon (fresenius) |
17 |
13 |
$0.00 |
| 90935 |
|
19 |
14 |
$0.00 |
| 88334 |
|
43 |
38 |
$0.00 |
| J1030 |
Methylprednisolone 40 mg inj |
71 |
65 |
$0.00 |
| J0456 |
Azithromycin |
15 |
12 |
$0.00 |
| 83615 |
|
100 |
43 |
$0.00 |
| J3360 |
Diazepam injection |
13 |
12 |
$0.00 |
| A4344 |
Cath indw foley 2 way silicn |
57 |
52 |
$0.00 |
| J2471 |
Inj pantoprazole(hikma) 40mg |
37 |
32 |
$0.00 |
| 87206 |
|
43 |
26 |
$0.00 |
| J0461 |
Atropine sulfate injection |
15 |
13 |
$0.00 |
| 86762 |
|
13 |
13 |
$0.00 |
| J1836 |
Inj, metronidazole, 10 mg |
31 |
26 |
$0.00 |
| 88331 |
|
15 |
12 |
$0.00 |
| 64484 |
|
27 |
27 |
$0.00 |
| A9581 |
Gadoxetate disodium inj |
39 |
39 |
$0.00 |
| 81003 |
|
32 |
31 |
$0.00 |
| J7040 |
Normal saline solution infus |
331 |
201 |
$0.00 |
| 88173 |
|
1,070 |
904 |
$0.00 |
| J1580 |
Garamycin gentamicin inj |
714 |
657 |
$0.00 |
| G0279 |
Tomosynthesis, mammo |
270 |
264 |
$0.00 |
| J0670 |
Inj mepivacaine hcl/10 ml |
277 |
250 |
$0.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
757 |
471 |
$0.00 |
| 89051 |
|
310 |
238 |
$0.00 |
| 51702 |
|
73 |
65 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
3,523 |
2,281 |
$0.00 |
| 80179 |
|
245 |
216 |
$0.00 |
| A9552 |
F18 fdg |
2,298 |
2,222 |
$0.00 |
| J7030 |
Normal saline solution infus |
554 |
293 |
$0.00 |
| 0042T |
|
14 |
13 |
$0.00 |
| 76937 |
|
1,017 |
924 |
$0.00 |
| J9190 |
Fluorouracil injection |
416 |
154 |
$0.00 |
| 83540 |
|
694 |
650 |
$0.00 |
| J0640 |
Leucovorin calcium injection |
153 |
78 |
$0.00 |
| G1004 |
Cdsm ndsc |
1,835 |
1,305 |
$0.00 |
| J3370 |
Vancomycin hcl injection |
1,935 |
1,156 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
526 |
495 |
$0.00 |
| C1760 |
Closure dev, vasc |
561 |
512 |
$0.00 |
| 91321 |
|
68 |
68 |
$0.00 |
| 80143 |
|
265 |
228 |
$0.00 |
| C1751 |
Cath, inf, per/cent/midline |
2,456 |
2,286 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
528 |
395 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
203 |
199 |
$0.00 |
| 94799 |
|
119 |
116 |
$0.00 |
| C1758 |
Catheter, ureteral |
87 |
84 |
$0.00 |
| 88313 |
|
448 |
362 |
$0.00 |
| J3372 |
Inj, vancomycin hcl (xellia) |
478 |
363 |
$0.00 |
| 96402 |
|
113 |
111 |
$0.00 |
| 90714 |
|
28 |
24 |
$0.00 |
| A6251 |
Absorpt drg <=16 sq in w/o b |
46 |
42 |
$0.00 |
| 77338 |
|
56 |
50 |
$0.00 |
| 87641 |
|
40 |
39 |
$0.00 |
| 85347 |
|
82 |
50 |
$0.00 |
| J2598 |
Inj, vasopressin, 1 unit |
25 |
13 |
$0.00 |
| J2310 |
Inj naloxone hydrochloride |
29 |
25 |
$0.00 |
| J2720 |
Inj protamine sulfate/10 mg |
27 |
26 |
$0.00 |
| J9263 |
Oxaliplatin |
171 |
78 |
$0.00 |
| 90662 |
|
257 |
249 |
$0.00 |
| Q0244 |
Casirivi and imdevi 1200 mg |
27 |
26 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
229 |
199 |
$0.00 |
| J9201 |
In gemcitabine hcl nos 200mg |
111 |
36 |
$0.00 |
| 92611 |
|
30 |
29 |
$0.00 |
| 90734 |
|
29 |
27 |
$0.00 |
| 77061 |
|
28 |
28 |
$0.00 |
| J1953 |
Levetiracetam injection |
61 |
49 |
$0.00 |
| J0136 |
Inj, acetaminophen (b braun) |
31 |
30 |
$0.00 |
| 82272 |
|
14 |
13 |
$0.00 |
| J3260 |
Tobramycin sulfate injection |
13 |
13 |
$0.00 |
| J9171 |
Docetaxel injection |
23 |
12 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
124 |
103 |
$0.00 |
| A9541 |
Tc99m sulfur colloid |
15 |
15 |
$0.00 |
| 94664 |
|
13 |
13 |
$0.00 |
| 90746 |
|
27 |
24 |
$0.00 |
| C1788 |
Port, indwelling, imp |
19 |
13 |
$0.00 |
| 88360 |
|
13 |
13 |
$0.00 |
| 80164 |
|
15 |
13 |
$0.00 |