| Code | Description | Claims | Beneficiaries | Total Paid |
| J9271 |
Injection, pembrolizumab, 1 mg |
1,127 |
876 |
$2.32M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
9,232 |
8,900 |
$1.52M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
8,949 |
8,668 |
$1.40M |
| G0378 |
Hospital observation service, per hour |
1,936 |
1,695 |
$1.12M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
7,741 |
7,509 |
$1.09M |
| T1015 |
Clinic visit/encounter, all-inclusive |
14,246 |
12,681 |
$960K |
| J9035 |
Injection, bevacizumab, 10 mg |
325 |
110 |
$603K |
| J9299 |
Injection, nivolumab, 1 mg |
313 |
171 |
$430K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
3,466 |
2,080 |
$354K |
| J2505 |
Injection, pegfilgrastim, 6 mg |
109 |
76 |
$234K |
| Q5108 |
Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg |
83 |
62 |
$224K |
| J0897 |
Injection, denosumab, 1 mg |
420 |
385 |
$153K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
7,983 |
6,855 |
$139K |
| 80053 |
Comprehensive metabolic panel |
15,424 |
13,258 |
$109K |
| Q5111 |
Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg |
29 |
26 |
$103K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,024 |
996 |
$101K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
5,945 |
4,604 |
$91K |
| 96417 |
|
1,083 |
713 |
$83K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
23,495 |
19,643 |
$80K |
| J9355 |
Injection, trastuzumab, excludes biosimilar, 10 mg |
170 |
62 |
$77K |
| J0185 |
Injection, aprepitant, 1 mg |
976 |
672 |
$53K |
| 96416 |
|
335 |
203 |
$49K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
297 |
291 |
$43K |
| J1756 |
Injection, iron sucrose, 1 mg |
4,739 |
1,605 |
$39K |
| J9202 |
Goserelin acetate implant, per 3.6 mg |
111 |
105 |
$38K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,471 |
1,064 |
$38K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
176 |
121 |
$35K |
| 96415 |
|
740 |
445 |
$32K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,176 |
1,163 |
$32K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
292 |
279 |
$32K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,503 |
1,482 |
$30K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
503 |
495 |
$30K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
250 |
240 |
$30K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
446 |
439 |
$28K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,457 |
1,437 |
$28K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
563 |
550 |
$25K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
4,747 |
4,439 |
$25K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
3,189 |
1,894 |
$25K |
| 96411 |
|
420 |
280 |
$24K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,741 |
2,076 |
$21K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
2,150 |
1,697 |
$20K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
231 |
229 |
$20K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
278 |
278 |
$19K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
4,334 |
3,754 |
$19K |
| 86803 |
|
998 |
987 |
$18K |
| 84443 |
Thyroid stimulating hormone (TSH) |
905 |
877 |
$18K |
| 84702 |
|
1,926 |
1,710 |
$18K |
| 83735 |
|
3,387 |
2,156 |
$17K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
309 |
304 |
$17K |
| 70450 |
Computed tomography, head or brain; without contrast material |
432 |
408 |
$16K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
442 |
376 |
$16K |
| 84466 |
|
1,139 |
1,114 |
$15K |
| 96367 |
|
785 |
532 |
$15K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
279 |
268 |
$14K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
342 |
331 |
$13K |
| 80050 |
General health panel |
342 |
331 |
$13K |
| 76830 |
Ultrasound, transvaginal |
345 |
334 |
$13K |
| 84484 |
|
2,357 |
2,099 |
$12K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
211 |
207 |
$12K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
887 |
568 |
$12K |
| 82728 |
|
1,206 |
1,157 |
$12K |
| J1453 |
Injection, fosaprepitant, 1 mg |
377 |
251 |
$12K |
| 49452 |
|
525 |
456 |
$11K |
| 71046 |
Radiologic examination, chest; 2 views |
1,324 |
1,274 |
$11K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
543 |
393 |
$11K |
| J0640 |
Injection, leucovorin calcium, per 50 mg |
1,423 |
331 |
$11K |
| 86780 |
|
571 |
565 |
$10K |
| 80061 |
Lipid panel |
775 |
751 |
$10K |
| 87340 |
|
621 |
615 |
$10K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
342 |
315 |
$10K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
272 |
270 |
$9K |
| 83615 |
|
1,545 |
1,106 |
$9K |
| 88185 |
|
46 |
44 |
$9K |
| G0379 |
Direct admission of patient for hospital observation care |
72 |
70 |
$9K |
| 86762 |
|
391 |
388 |
$9K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,346 |
1,281 |
$9K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
244 |
240 |
$9K |
| 82784 |
|
465 |
375 |
$9K |
| 86850 |
|
1,354 |
1,263 |
$8K |
| 0002A |
|
172 |
172 |
$8K |
| 96402 |
|
281 |
257 |
$8K |
| 85027 |
|
1,172 |
1,092 |
$8K |
| 83540 |
|
1,135 |
1,113 |
$8K |
| 83690 |
|
2,848 |
2,696 |
$7K |
| 0001A |
|
160 |
160 |
$7K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,102 |
1,000 |
$7K |
| 82607 |
|
645 |
633 |
$7K |
| 81001 |
|
3,868 |
3,698 |
$6K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
160 |
148 |
$6K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
156 |
155 |
$6K |
| 36591 |
|
218 |
147 |
$6K |
| J2997 |
Injection, alteplase recombinant, 1 mg |
79 |
70 |
$6K |
| 86300 |
|
325 |
285 |
$6K |
| J9045 |
Injection, carboplatin, 50 mg |
774 |
502 |
$6K |
| 58571 |
|
12 |
12 |
$5K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
231 |
229 |
$5K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
836 |
815 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
617 |
543 |
$5K |
| 84100 |
|
1,218 |
779 |
$5K |
| 59025 |
Fetal non-stress test |
1,088 |
825 |
$5K |
| J3490 |
Unclassified drugs |
5,514 |
4,017 |
$5K |
| 71250 |
|
74 |
74 |
$5K |
| 86334 |
|
217 |
212 |
$5K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
150 |
146 |
$5K |
| 96401 |
|
267 |
156 |
$5K |
| 84550 |
|
898 |
625 |
$5K |
| 83880 |
|
312 |
294 |
$4K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
13 |
13 |
$4K |
| 86900 |
|
1,397 |
1,297 |
$4K |
| 93971 |
|
100 |
97 |
$4K |
| 96376 |
|
605 |
448 |
$4K |
| 86901 |
|
1,389 |
1,290 |
$4K |
| 81025 |
|
2,484 |
2,392 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
6,221 |
5,186 |
$4K |
| 80076 |
|
796 |
772 |
$4K |
| 76801 |
|
143 |
134 |
$4K |
| 82570 |
|
552 |
518 |
$4K |
| 71045 |
Radiologic examination, chest; single view |
987 |
939 |
$4K |
| 84439 |
|
507 |
481 |
$4K |
| G0476 |
Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test |
76 |
75 |
$3K |
| 93975 |
|
39 |
39 |
$3K |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
325 |
319 |
$3K |
| 82378 |
|
253 |
232 |
$3K |
| 82746 |
|
345 |
336 |
$3K |
| 83605 |
|
773 |
682 |
$3K |
| J9267 |
Injection, paclitaxel, 1 mg |
329 |
149 |
$3K |
| 89060 |
|
536 |
484 |
$3K |
| 36430 |
|
119 |
86 |
$3K |
| 87905 |
|
360 |
354 |
$3K |
| 87808 |
|
399 |
393 |
$3K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,135 |
1,935 |
$3K |
| 84165 |
|
222 |
219 |
$3K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
13 |
13 |
$3K |
| 85379 |
|
422 |
400 |
$3K |
| 88342 |
|
136 |
131 |
$2K |
| 70496 |
|
29 |
26 |
$2K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
39 |
39 |
$2K |
| 43235 |
|
12 |
12 |
$2K |
| 85610 |
|
1,049 |
801 |
$2K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
8,195 |
5,501 |
$2K |
| 87210 |
|
523 |
472 |
$2K |
| 82950 |
|
268 |
266 |
$2K |
| 83883 |
|
226 |
216 |
$2K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
11,484 |
8,123 |
$2K |
| 76642 |
|
43 |
40 |
$2K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
13 |
13 |
$2K |
| 73630 |
|
204 |
181 |
$2K |
| 85045 |
|
550 |
390 |
$2K |
| 70498 |
|
16 |
15 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
2,600 |
1,726 |
$2K |
| 87081 |
|
382 |
380 |
$2K |
| 85730 |
|
466 |
417 |
$2K |
| J2704 |
Injection, propofol, 10 mg |
8,250 |
5,070 |
$2K |
| 83010 |
|
156 |
123 |
$1K |
| 81003 |
|
760 |
729 |
$1K |
| 87186 |
|
256 |
247 |
$1K |
| 84156 |
|
423 |
369 |
$1K |
| 73130 |
|
172 |
139 |
$1K |
| 86140 |
|
569 |
507 |
$1K |
| 88184 |
|
46 |
44 |
$1K |
| 84153 |
|
56 |
53 |
$1K |
| 83021 |
|
52 |
52 |
$1K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
12 |
12 |
$1K |
| 96523 |
|
89 |
83 |
$1K |
| 36593 |
|
49 |
48 |
$1K |
| 82043 |
|
125 |
124 |
$1K |
| 84145 |
|
152 |
138 |
$1K |
| 86592 |
|
217 |
215 |
$981.00 |
| 87481 |
|
25 |
25 |
$951.69 |
| 82550 |
|
253 |
210 |
$942.70 |
| J7050 |
Infusion, normal saline solution, 250 cc |
6,960 |
3,953 |
$921.43 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
4,699 |
2,713 |
$915.18 |
| 87077 |
|
189 |
180 |
$889.06 |
| 96377 |
|
74 |
56 |
$882.38 |
| 85652 |
|
378 |
368 |
$876.04 |
| 77066 |
Tomosynthesis, mammo |
12 |
12 |
$831.69 |
| 87040 |
|
95 |
91 |
$828.71 |
| 70486 |
|
12 |
12 |
$825.15 |
| 86038 |
|
50 |
50 |
$820.26 |
| 73610 |
|
73 |
67 |
$745.03 |
| 83986 |
|
510 |
464 |
$742.80 |
| 87070 |
|
109 |
102 |
$720.41 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
26 |
25 |
$711.10 |
| 81002 |
|
292 |
285 |
$700.67 |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
18 |
18 |
$693.87 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
5,204 |
3,390 |
$691.24 |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
16 |
15 |
$690.28 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
44 |
43 |
$688.96 |
| J9263 |
Injection, oxaliplatin, 0.5 mg |
39 |
12 |
$676.72 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,286 |
2,140 |
$632.86 |
| 82962 |
|
946 |
596 |
$597.52 |
| 84163 |
|
29 |
29 |
$586.37 |
| 73562 |
|
59 |
56 |
$546.50 |
| 16020 |
|
20 |
14 |
$519.20 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
1,264 |
1,047 |
$500.17 |
| 87205 |
|
107 |
100 |
$463.21 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
6,917 |
5,609 |
$455.14 |
| J9190 |
Injection, fluorouracil, 500 mg |
204 |
115 |
$445.85 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
919 |
551 |
$411.96 |
| 82565 |
|
89 |
84 |
$389.48 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,707 |
1,721 |
$389.01 |
| 73030 |
|
39 |
37 |
$357.02 |
| 84403 |
|
12 |
12 |
$346.42 |
| 99195 |
|
40 |
37 |
$339.10 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
1,062 |
813 |
$328.17 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
5,630 |
3,968 |
$316.64 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
9,704 |
6,873 |
$279.55 |
| C1769 |
Guide wire |
220 |
201 |
$271.79 |
| 88142 |
|
13 |
13 |
$265.86 |
| 87147 |
|
95 |
91 |
$264.70 |
| 84999 |
|
136 |
124 |
$259.44 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
6,274 |
5,048 |
$250.73 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,233 |
1,719 |
$248.24 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
416 |
332 |
$238.19 |
| 93017 |
|
15 |
15 |
$225.29 |
| 90715 |
|
81 |
76 |
$224.21 |
| 86255 |
|
12 |
12 |
$215.69 |
| 86923 |
|
32 |
26 |
$214.20 |
| 86706 |
|
15 |
15 |
$213.92 |
| J1644 |
Injection, heparin sodium, per 1000 units |
2,400 |
1,182 |
$204.93 |
| 76937 |
|
30 |
28 |
$203.70 |
| 88307 |
|
97 |
91 |
$198.32 |
| 82977 |
|
39 |
26 |
$186.53 |
| J1720 |
Injection, hydrocortisone sodium succinate, up to 100 mg |
33 |
28 |
$176.99 |
| 72100 |
|
14 |
12 |
$170.11 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
302 |
232 |
$155.99 |
| 80320 |
|
18 |
18 |
$131.09 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
38 |
38 |
$129.43 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
991 |
780 |
$116.16 |
| C9113 |
Injection, pantoprazole sodium, per vial |
630 |
385 |
$106.02 |
| 86431 |
|
12 |
12 |
$102.65 |
| 97161 |
|
143 |
131 |
$95.42 |
| 97165 |
|
90 |
83 |
$92.60 |
| 87486 |
|
18 |
18 |
$87.50 |
| 99153 |
Mod sedat endo service >5yrs |
18 |
13 |
$83.49 |
| 85018 |
|
26 |
26 |
$76.52 |
| J3480 |
Injection, potassium chloride, per 2 meq |
300 |
144 |
$74.45 |
| J1815 |
Injection, insulin, per 5 units |
437 |
148 |
$74.33 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,091 |
833 |
$69.66 |
| 88304 |
|
29 |
29 |
$57.72 |
| 87088 |
|
12 |
12 |
$51.68 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,603 |
3,835 |
$42.02 |
| 88311 |
|
12 |
12 |
$39.99 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
42 |
41 |
$35.98 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
358 |
196 |
$33.39 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
14 |
$30.45 |
| 74018 |
|
12 |
12 |
$30.31 |
| J2060 |
Injection, lorazepam, 2 mg |
116 |
82 |
$22.46 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
84 |
75 |
$21.67 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
213 |
97 |
$18.46 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
358 |
247 |
$14.30 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
2,889 |
2,219 |
$11.92 |
| S0030 |
Injection, metronidazole, 500 mg |
113 |
74 |
$6.26 |
| A9270 |
Non-covered item or service |
26,405 |
9,980 |
$0.31 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
1,544 |
1,337 |
$0.01 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
19 |
14 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
368 |
320 |
$0.00 |
| Q5120 |
Injection, pegfilgrastim-bmez (ziextenzo), biosimilar, 0.5 mg |
178 |
135 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
14 |
13 |
$0.00 |
| C1726 |
Catheter, balloon dilatation, non-vascular |
16 |
12 |
$0.00 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
52 |
46 |
$0.00 |
| J1836 |
Injection, metronidazole, 10 mg |
138 |
118 |
$0.00 |
| 87581 |
|
18 |
18 |
$0.00 |
| J9312 |
Injection, rituximab, 10 mg |
20 |
13 |
$0.00 |
| J0461 |
Injection, atropine sulfate, 0.01 mg |
18 |
13 |
$0.00 |
| J1750 |
Injection, iron dextran, 50 mg |
194 |
152 |
$0.00 |
| J3380 |
Injection, vedolizumab, intravenous, 1 mg |
146 |
140 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
113 |
95 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
49 |
33 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
392 |
351 |
$0.00 |
| J1569 |
Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg |
24 |
14 |
$0.00 |
| J0670 |
Injection, mepivacaine hydrochloride, per 10 ml |
15 |
12 |
$0.00 |
| J3489 |
Injection, zoledronic acid, 1 mg |
17 |
16 |
$0.00 |
| 0100U |
|
15 |
15 |
$0.00 |