| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
71,128 |
62,449 |
$8.97M |
| 99283 |
|
64,882 |
61,472 |
$7.26M |
| 96361 |
|
25,073 |
17,831 |
$6.90M |
| G0463 |
Hospital outpt clinic visit |
60,599 |
49,731 |
$4.99M |
| 99284 |
|
39,573 |
36,309 |
$4.62M |
| 0241U |
|
22,954 |
20,553 |
$3.06M |
| G0378 |
Hospital observation per hr |
29,431 |
13,807 |
$2.24M |
| J9271 |
Inj pembrolizumab |
263 |
133 |
$2.10M |
| 70450 |
|
5,989 |
4,911 |
$1.43M |
| 99282 |
|
10,113 |
9,609 |
$1.08M |
| 74177 |
|
5,101 |
4,214 |
$1.03M |
| U0003 |
Cov-19 amp prb hgh thruput |
7,493 |
6,561 |
$993K |
| 96366 |
|
5,166 |
2,497 |
$907K |
| 96365 |
|
7,135 |
5,333 |
$883K |
| 96360 |
|
3,648 |
3,086 |
$767K |
| 96110 |
|
3,412 |
2,836 |
$657K |
| 94640 |
|
5,074 |
4,027 |
$618K |
| 97110 |
|
8,798 |
4,189 |
$542K |
| 80053 |
|
86,178 |
68,195 |
$537K |
| 99392 |
|
5,729 |
4,857 |
$527K |
| 59025 |
|
3,440 |
2,393 |
$509K |
| 99391 |
|
5,905 |
4,869 |
$505K |
| 71260 |
|
2,652 |
2,174 |
$457K |
| J2350 |
Injection, ocrelizumab, 1 mg |
24 |
15 |
$455K |
| 74176 |
|
1,438 |
1,189 |
$350K |
| C9803 |
Hopd covid-19 spec collect |
9,171 |
8,796 |
$343K |
| 93975 |
|
2,615 |
2,195 |
$339K |
| 76705 |
|
3,758 |
2,959 |
$273K |
| 96413 |
|
2,829 |
1,539 |
$265K |
| 93306 |
|
1,132 |
958 |
$256K |
| 99393 |
|
2,582 |
2,273 |
$235K |
| 70498 |
|
910 |
733 |
$222K |
| 87631 |
|
2,307 |
2,184 |
$216K |
| 96415 |
|
710 |
459 |
$209K |
| 90839 |
|
1,488 |
1,171 |
$188K |
| 99213 |
|
4,773 |
4,229 |
$177K |
| 70491 |
|
534 |
449 |
$160K |
| 76770 |
|
1,035 |
891 |
$158K |
| 81513 |
|
1,195 |
946 |
$153K |
| 70553 |
|
625 |
537 |
$150K |
| 93458 |
|
139 |
113 |
$145K |
| 58661 |
|
88 |
53 |
$143K |
| 78452 |
|
375 |
296 |
$132K |
| 96127 |
|
1,442 |
1,213 |
$130K |
| 93799 |
|
21,399 |
8,035 |
$114K |
| 97140 |
|
4,257 |
2,038 |
$109K |
| 76642 |
|
893 |
808 |
$105K |
| 43239 |
|
303 |
221 |
$105K |
| 93005 |
|
43,614 |
34,502 |
$103K |
| 42820 |
|
79 |
67 |
$102K |
| 96367 |
|
1,980 |
1,304 |
$101K |
| 70551 |
|
706 |
580 |
$101K |
| 0202U |
|
743 |
683 |
$99K |
| J0585 |
Injection,onabotulinumtoxina |
227 |
150 |
$94K |
| 69436 |
|
61 |
50 |
$93K |
| 78815 |
|
185 |
169 |
$91K |
| 85025 |
|
85,628 |
69,885 |
$85K |
| 58558 |
|
67 |
49 |
$85K |
| 86850 |
|
4,616 |
3,696 |
$85K |
| 84484 |
|
25,848 |
15,536 |
$81K |
| 80307 |
|
5,848 |
4,590 |
$80K |
| 0002A |
|
2,109 |
2,095 |
$79K |
| 0001A |
|
2,122 |
2,078 |
$77K |
| 93970 |
|
662 |
540 |
$76K |
| 80048 |
|
13,146 |
8,495 |
$74K |
| 99394 |
|
677 |
582 |
$74K |
| 97161 |
|
2,303 |
1,874 |
$72K |
| 96161 |
|
463 |
416 |
$71K |
| 99214 |
|
1,575 |
1,413 |
$70K |
| 97535 |
|
2,863 |
1,768 |
$69K |
| 99231 |
|
4,990 |
3,749 |
$69K |
| 71250 |
|
844 |
772 |
$68K |
| 93798 |
|
1,450 |
235 |
$68K |
| 99291 |
|
560 |
460 |
$67K |
| 12001 |
|
429 |
372 |
$65K |
| 93971 |
|
1,139 |
979 |
$63K |
| 36415 |
|
86,693 |
54,406 |
$62K |
| 99281 |
|
430 |
400 |
$62K |
| 71046 |
|
9,351 |
8,261 |
$61K |
| 99222 |
|
1,540 |
1,483 |
$60K |
| J1050 |
Medroxyprogesterone acetate |
668 |
549 |
$59K |
| 90471 |
|
10,399 |
9,035 |
$58K |
| 97112 |
|
1,856 |
809 |
$53K |
| 74183 |
|
277 |
235 |
$53K |
| 12011 |
|
334 |
300 |
$52K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
183 |
131 |
$52K |
| 44970 |
|
24 |
14 |
$50K |
| 99232 |
|
2,650 |
1,543 |
$48K |
| 77067 |
|
1,570 |
1,440 |
$48K |
| 76536 |
|
477 |
437 |
$44K |
| J1756 |
Iron sucrose injection |
1,357 |
557 |
$43K |
| 86900 |
|
4,668 |
3,723 |
$43K |
| 85027 |
|
17,873 |
11,647 |
$43K |
| 96160 |
|
215 |
174 |
$39K |
| 92551 |
|
769 |
672 |
$39K |
| 88307 |
|
410 |
317 |
$39K |
| 99395 |
|
331 |
283 |
$38K |
| 71275 |
|
130 |
117 |
$37K |
| 54150 |
|
835 |
806 |
$36K |
| 90651 |
|
729 |
597 |
$36K |
| 84443 |
|
4,765 |
3,882 |
$35K |
| 19083 |
|
51 |
38 |
$35K |
| 96374 |
|
29,056 |
24,658 |
$34K |
| 92507 |
|
717 |
315 |
$34K |
| 77063 |
|
683 |
641 |
$33K |
| 71045 |
|
15,304 |
12,996 |
$32K |
| 96372 |
|
8,925 |
5,343 |
$32K |
| 82962 |
|
22,650 |
7,292 |
$32K |
| 97165 |
|
936 |
758 |
$30K |
| 82805 |
|
1,127 |
849 |
$30K |
| J7298 |
Mirena, 52 mg |
28 |
24 |
$28K |
| 76830 |
|
1,259 |
1,056 |
$27K |
| 87491 |
|
3,802 |
3,109 |
$27K |
| 97530 |
|
1,191 |
678 |
$27K |
| 97802 |
|
607 |
478 |
$26K |
| C9290 |
Inj, bupivacaine liposome |
291 |
217 |
$26K |
| 90670 |
|
3,741 |
3,303 |
$26K |
| J0561 |
Penicillin g benzathine inj |
147 |
106 |
$26K |
| 83735 |
|
26,938 |
18,989 |
$25K |
| 99152 |
|
1,752 |
1,360 |
$25K |
| 36561 |
|
28 |
26 |
$25K |
| 90686 |
|
3,632 |
3,017 |
$24K |
| 87591 |
|
3,807 |
3,110 |
$24K |
| 82306 |
|
1,623 |
1,390 |
$24K |
| 80061 |
|
2,474 |
2,091 |
$23K |
| 99219 |
|
667 |
647 |
$23K |
| 74018 |
|
1,423 |
1,213 |
$23K |
| 87086 |
|
8,941 |
7,544 |
$22K |
| 93017 |
|
344 |
268 |
$22K |
| 10060 |
|
140 |
125 |
$21K |
| 77336 |
|
260 |
125 |
$21K |
| 84702 |
|
5,055 |
4,062 |
$21K |
| 72125 |
|
2,578 |
2,134 |
$21K |
| 97116 |
|
1,053 |
649 |
$21K |
| 70486 |
|
838 |
709 |
$21K |
| 82728 |
|
1,774 |
1,486 |
$20K |
| 76882 |
|
209 |
182 |
$20K |
| 77062 |
|
509 |
468 |
$20K |
| 73610 |
|
1,708 |
1,450 |
$20K |
| 81001 |
|
40,096 |
35,208 |
$19K |
| Q3014 |
Telehealth facility fee |
729 |
700 |
$19K |
| 84439 |
|
1,702 |
1,379 |
$19K |
| 99233 |
Prolong inpt eval add15 m |
851 |
555 |
$18K |
| 72131 |
|
355 |
297 |
$18K |
| 86140 |
|
3,953 |
3,252 |
$18K |
| 86780 |
|
1,727 |
1,502 |
$18K |
| 77061 |
|
464 |
421 |
$18K |
| 87505 |
|
151 |
115 |
$17K |
| 90715 |
|
1,690 |
1,276 |
$17K |
| 64615 |
|
89 |
76 |
$16K |
| 36430 |
|
71 |
60 |
$16K |
| 90460 |
|
4,477 |
3,431 |
$16K |
| 72148 |
|
123 |
112 |
$16K |
| 90648 |
|
2,064 |
1,774 |
$15K |
| 83036 |
|
1,938 |
1,552 |
$15K |
| 97162 |
|
531 |
460 |
$15K |
| 72100 |
|
962 |
852 |
$14K |
| 94060 |
|
240 |
220 |
$14K |
| 87340 |
|
1,118 |
924 |
$14K |
| 73630 |
|
1,583 |
1,380 |
$13K |
| 73130 |
|
1,307 |
1,106 |
$13K |
| 83540 |
|
1,871 |
1,587 |
$13K |
| 73564 |
|
872 |
778 |
$13K |
| 70496 |
|
951 |
767 |
$13K |
| 90633 |
|
1,626 |
1,364 |
$12K |
| 36591 |
|
426 |
313 |
$12K |
| 86803 |
|
791 |
694 |
$12K |
| 77065 |
Tomosynthesis, mammo |
686 |
590 |
$12K |
| 73110 |
|
1,084 |
920 |
$12K |
| 86762 |
|
430 |
378 |
$12K |
| P9016 |
Rbc leukocytes reduced |
65 |
51 |
$11K |
| 96416 |
|
105 |
51 |
$11K |
| 72197 |
|
58 |
49 |
$11K |
| 73030 |
|
1,477 |
1,188 |
$11K |
| 90698 |
|
1,765 |
1,563 |
$11K |
| 87502 |
|
670 |
571 |
$11K |
| 96376 |
|
7,503 |
3,660 |
$11K |
| 99212 |
|
514 |
483 |
$11K |
| 76857 |
|
716 |
612 |
$10K |
| 90935 |
|
74 |
38 |
$10K |
| 49083 |
|
24 |
13 |
$10K |
| 83550 |
|
1,852 |
1,573 |
$10K |
| 82607 |
|
1,125 |
894 |
$10K |
| 76817 |
|
1,098 |
877 |
$10K |
| 86901 |
|
4,668 |
3,723 |
$10K |
| 74019 |
|
1,026 |
887 |
$10K |
| 72141 |
|
74 |
65 |
$10K |
| 87389 |
|
819 |
707 |
$10K |
| 85610 |
|
12,135 |
7,475 |
$10K |
| 87481 |
|
1,082 |
853 |
$10K |
| 90472 |
|
5,086 |
4,634 |
$10K |
| 88175 |
|
1,200 |
1,010 |
$9K |
| 76856 |
|
67 |
58 |
$9K |
| 71271 |
|
81 |
71 |
$9K |
| 77300 |
|
14 |
14 |
$9K |
| 96368 |
|
652 |
412 |
$9K |
| 90680 |
|
2,261 |
1,974 |
$9K |
| 96112 |
|
30 |
30 |
$9K |
| 87624 |
|
623 |
557 |
$8K |
| 99153 |
Mod sedat endo service >5yrs |
1,147 |
875 |
$8K |
| 94660 |
|
141 |
58 |
$8K |
| 96375 |
|
13,089 |
8,767 |
$8K |
| 87661 |
|
2,702 |
2,208 |
$8K |
| 99221 |
|
292 |
283 |
$8K |
| 73502 |
|
970 |
805 |
$8K |
| 52000 |
|
12 |
12 |
$8K |
| 82533 |
|
737 |
496 |
$8K |
| 90677 |
|
363 |
338 |
$8K |
| 43235 |
|
12 |
12 |
$8K |
| 83880 |
|
3,734 |
2,928 |
$7K |
| 73560 |
|
1,188 |
963 |
$7K |
| 92552 |
|
100 |
74 |
$7K |
| 82024 |
|
548 |
379 |
$7K |
| 80069 |
|
709 |
468 |
$7K |
| 77066 |
Tomosynthesis, mammo |
574 |
525 |
$7K |
| 73590 |
|
956 |
797 |
$7K |
| 82784 |
|
766 |
642 |
$7K |
| 82570 |
|
1,210 |
971 |
$6K |
| 90688 |
|
530 |
403 |
$6K |
| 76801 |
|
391 |
326 |
$6K |
| 0004A |
|
181 |
174 |
$6K |
| 90723 |
|
1,561 |
1,333 |
$6K |
| 80076 |
|
745 |
576 |
$6K |
| 51798 |
|
862 |
690 |
$6K |
| A9270 |
Non-covered item or service |
4,359 |
1,722 |
$6K |
| 99223 |
Prolong inpt eval add15 m |
124 |
119 |
$5K |
| 99217 |
|
213 |
213 |
$5K |
| 12002 |
|
35 |
29 |
$5K |
| J2543 |
Piperacillin/tazobactam |
1,480 |
600 |
$5K |
| 88341 |
|
119 |
85 |
$5K |
| J0702 |
Betamethasone acet&sod phosp |
245 |
191 |
$5K |
| 87633 |
|
96 |
81 |
$5K |
| 87510 |
|
280 |
224 |
$5K |
| 84100 |
|
2,316 |
1,392 |
$5K |
| 87077 |
|
2,351 |
1,910 |
$5K |
| U0005 |
Infec agen detec ampli probe |
5,091 |
4,224 |
$5K |
| S9443 |
Lactation class |
101 |
83 |
$4K |
| 82077 |
|
4,250 |
3,155 |
$4K |
| 0054A |
|
283 |
280 |
$4K |
| J2469 |
Palonosetron hcl |
913 |
463 |
$4K |
| 0124A |
|
140 |
132 |
$4K |
| 97166 |
|
192 |
157 |
$4K |
| 83690 |
|
11,197 |
9,273 |
$4K |
| 00840 |
|
891 |
595 |
$4K |
| 58300 |
|
31 |
25 |
$4K |
| 88305 |
|
2,132 |
1,664 |
$4K |
| 86923 |
|
121 |
93 |
$4K |
| 87635 |
|
1,168 |
932 |
$4K |
| 86706 |
|
521 |
412 |
$4K |
| 99396 |
|
37 |
25 |
$4K |
| 0071A |
|
115 |
114 |
$4K |
| 74174 |
|
65 |
52 |
$4K |
| 25600 |
|
13 |
12 |
$4K |
| 83970 |
|
185 |
138 |
$4K |
| 77080 |
|
67 |
60 |
$3K |
| J1815 |
Insulin injection |
342 |
231 |
$3K |
| 83655 |
|
179 |
154 |
$3K |
| 94729 |
|
155 |
145 |
$3K |
| 76870 |
|
343 |
280 |
$3K |
| J3490 |
Drugs unclassified injection |
222 |
156 |
$3K |
| J1610 |
Glucagon hydrochloride/1 mg |
35 |
25 |
$3K |
| 73080 |
|
472 |
402 |
$3K |
| 0072A |
|
92 |
90 |
$3K |
| 99253 |
|
74 |
73 |
$3K |
| 73090 |
|
668 |
557 |
$3K |
| 99239 |
|
82 |
81 |
$3K |
| 73140 |
|
423 |
360 |
$3K |
| 85652 |
|
1,123 |
958 |
$3K |
| 73552 |
|
529 |
427 |
$3K |
| 90480 |
|
153 |
125 |
$3K |
| 81025 |
|
10,314 |
8,712 |
$3K |
| 87660 |
|
283 |
225 |
$3K |
| 93880 |
|
29 |
29 |
$3K |
| 87070 |
|
1,991 |
1,743 |
$3K |
| 90685 |
|
407 |
326 |
$3K |
| 82950 |
|
190 |
175 |
$2K |
| 90744 |
|
505 |
421 |
$2K |
| 64450 |
|
19 |
12 |
$2K |
| 73700 |
|
25 |
25 |
$2K |
| 82550 |
|
2,151 |
1,462 |
$2K |
| 84156 |
|
953 |
730 |
$2K |
| 87653 |
|
163 |
134 |
$2K |
| 72170 |
|
1,086 |
893 |
$2K |
| 81003 |
|
3,369 |
2,779 |
$2K |
| 99203 |
|
57 |
57 |
$2K |
| 90697 |
|
255 |
237 |
$2K |
| 90619 |
|
195 |
166 |
$2K |
| 73060 |
|
491 |
383 |
$2K |
| 0003A |
|
57 |
57 |
$2K |
| 73721 |
|
13 |
13 |
$2K |
| 86038 |
|
128 |
99 |
$2K |
| 80320 |
|
389 |
352 |
$2K |
| 82746 |
|
618 |
491 |
$2K |
| 85730 |
|
3,263 |
2,279 |
$2K |
| 85018 |
|
1,387 |
1,061 |
$2K |
| 86364 |
|
136 |
118 |
$2K |
| 83605 |
|
3,620 |
2,341 |
$2K |
| 96523 |
|
44 |
28 |
$2K |
| 90696 |
|
248 |
209 |
$2K |
| 90474 |
|
1,278 |
1,178 |
$2K |
| 87186 |
|
1,640 |
1,333 |
$2K |
| 99220 |
|
28 |
26 |
$2K |
| 74220 |
|
31 |
31 |
$2K |
| G0296 |
Visit to determ ldct elig |
42 |
38 |
$2K |
| 90461 |
|
1,817 |
1,548 |
$2K |
| 90710 |
|
379 |
311 |
$2K |
| 72050 |
|
49 |
43 |
$2K |
| J3475 |
Inj magnesium sulfate |
2,867 |
1,862 |
$2K |
| 87493 |
|
123 |
90 |
$2K |
| 82947 |
|
1,220 |
936 |
$2K |
| 86258 |
|
97 |
81 |
$2K |
| J2270 |
Morphine sulfate injection |
4,446 |
2,873 |
$1K |
| J1453 |
Fosaprepitant injection |
115 |
64 |
$1K |
| 84145 |
|
845 |
692 |
$1K |
| 87040 |
|
1,921 |
1,527 |
$1K |
| 90656 |
|
190 |
188 |
$1K |
| 99254 |
|
27 |
27 |
$1K |
| 72040 |
|
89 |
80 |
$1K |
| 85379 |
|
2,931 |
2,419 |
$1K |
| 72128 |
|
42 |
36 |
$1K |
| 90716 |
|
232 |
175 |
$1K |
| 00731 |
|
598 |
451 |
$1K |
| 82330 |
|
1,347 |
951 |
$1K |
| J1650 |
Inj enoxaparin sodium |
1,213 |
496 |
$1K |
| 83615 |
|
371 |
303 |
$1K |
| 71101 |
|
186 |
140 |
$1K |
| 84703 |
|
2,587 |
2,113 |
$1K |
| 99215 |
Prolong outpt/office vis |
30 |
29 |
$1K |
| 86003 |
|
28 |
27 |
$1K |
| 82565 |
|
178 |
135 |
$1K |
| 87205 |
|
1,094 |
864 |
$1K |
| 99252 |
|
41 |
38 |
$1K |
| 86703 |
|
755 |
639 |
$1K |
| 99238 |
|
52 |
51 |
$1K |
| 84132 |
|
1,899 |
1,472 |
$1K |
| 82105 |
|
84 |
73 |
$1K |
| 99381 |
|
92 |
50 |
$1K |
| J1170 |
Hydromorphone injection |
1,722 |
911 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
17,555 |
13,232 |
$1K |
| 96402 |
|
114 |
77 |
$925.74 |
| 82043 |
|
179 |
156 |
$925.53 |
| 87480 |
|
280 |
224 |
$902.57 |
| J1644 |
Inj heparin sodium per 1000u |
6,146 |
2,507 |
$882.17 |
| 86308 |
|
424 |
365 |
$865.59 |
| 82375 |
|
1,517 |
1,173 |
$833.99 |
| 84153 |
|
102 |
90 |
$830.91 |
| 82150 |
|
1,033 |
855 |
$821.94 |
| 80143 |
|
476 |
382 |
$814.94 |
| J1100 |
Dexamethasone sodium phos |
9,240 |
6,646 |
$797.81 |
| G0480 |
Drug test def 1-7 classes |
75 |
53 |
$790.89 |
| 82553 |
|
275 |
168 |
$786.59 |
| 01844 |
|
19 |
12 |
$774.66 |
| 74230 |
|
13 |
12 |
$773.97 |
| 76815 |
|
105 |
96 |
$720.74 |
| C9113 |
Inj pantoprazole sodium, via |
716 |
315 |
$717.56 |
| 86704 |
|
79 |
64 |
$716.39 |
| 87522 |
Neg quan hep c or qual rna |
31 |
26 |
$709.18 |
| 84146 |
|
77 |
65 |
$645.85 |
| 00170 |
|
391 |
326 |
$644.13 |
| 84550 |
|
219 |
181 |
$608.92 |
| 73070 |
|
58 |
51 |
$607.91 |
| 94726 |
|
13 |
12 |
$580.15 |
| 87486 |
|
96 |
81 |
$575.92 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
10,352 |
8,388 |
$575.07 |
| 93321 |
|
17 |
13 |
$540.02 |
| J2704 |
Inj, propofol, 10 mg |
7,779 |
4,783 |
$536.16 |
| 0064A |
|
22 |
21 |
$533.28 |
| 90707 |
|
165 |
143 |
$528.31 |
| 82435 |
|
1,051 |
798 |
$524.00 |
| 86870 |
|
14 |
13 |
$500.43 |
| 36416 |
|
2,672 |
2,071 |
$497.24 |
| 82378 |
|
88 |
77 |
$496.06 |
| 85045 |
|
211 |
164 |
$484.56 |
| 84165 |
|
134 |
109 |
$480.09 |
| J3010 |
Fentanyl citrate injection |
9,008 |
5,851 |
$458.95 |
| 83521 |
|
69 |
56 |
$456.67 |
| 72072 |
|
101 |
87 |
$452.62 |
| 92526 |
|
17 |
12 |
$450.01 |
| 90658 |
|
46 |
46 |
$432.12 |
| 84403 |
|
30 |
25 |
$429.48 |
| 84155 |
|
159 |
141 |
$409.88 |
| J2920 |
Methylprednisolone injection |
424 |
208 |
$398.06 |
| J0360 |
Hydralazine hcl injection |
413 |
283 |
$393.85 |
| 99218 |
|
12 |
12 |
$387.06 |
| 92611 |
|
13 |
12 |
$385.01 |
| J9045 |
Carboplatin injection |
45 |
26 |
$384.63 |
| 86334 |
|
31 |
24 |
$355.01 |
| 87420 |
|
17 |
12 |
$351.79 |
| J0696 |
Ceftriaxone sodium injection |
3,428 |
1,910 |
$349.25 |
| J2405 |
Ondansetron hcl injection |
15,945 |
11,115 |
$343.51 |
| 84450 |
|
104 |
89 |
$342.27 |
| 84460 |
|
109 |
93 |
$333.34 |
| 90700 |
|
73 |
55 |
$332.75 |
| 80179 |
|
454 |
356 |
$327.59 |
| 87581 |
|
100 |
82 |
$320.07 |
| 00811 |
|
76 |
65 |
$317.22 |
| 84295 |
|
1,117 |
843 |
$285.37 |
| 82977 |
|
23 |
12 |
$284.86 |
| 99442 |
|
14 |
13 |
$283.53 |
| 83050 |
|
1,140 |
852 |
$278.52 |
| J1940 |
Furosemide injection |
585 |
262 |
$274.45 |
| 99441 |
|
27 |
26 |
$272.21 |
| 0052A |
|
30 |
30 |
$269.26 |
| J2785 |
Regadenoson injection |
294 |
220 |
$261.72 |
| 88304 |
|
581 |
458 |
$258.34 |
| 00400 |
|
127 |
86 |
$250.10 |
| 86355 |
|
42 |
27 |
$244.10 |
| J0690 |
Cefazolin sodium injection |
3,155 |
1,981 |
$239.25 |
| 88342 |
|
385 |
295 |
$236.80 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
811 |
356 |
$225.98 |
| 77001 |
|
137 |
107 |
$217.28 |
| 82010 |
|
631 |
497 |
$215.23 |
| J2919 |
Inj, methylpred sod succ 5mg |
438 |
295 |
$208.07 |
| 73000 |
|
16 |
12 |
$205.98 |
| 87808 |
|
90 |
73 |
$203.27 |
| 0051A |
|
23 |
23 |
$190.18 |
| 82140 |
|
105 |
78 |
$186.73 |
| 82525 |
|
48 |
39 |
$180.74 |
| J0780 |
Prochlorperazine injection |
795 |
553 |
$172.85 |
| 80177 |
|
109 |
92 |
$168.40 |
| J1200 |
Diphenhydramine hcl injectio |
2,278 |
1,452 |
$165.80 |
| J3370 |
Vancomycin hcl injection |
702 |
410 |
$159.94 |
| J2930 |
Methylprednisolone injection |
875 |
619 |
$142.19 |
| J7120 |
Ringers lactate infusion |
3,516 |
2,609 |
$137.68 |
| 85014 |
|
16 |
13 |
$133.96 |
| J0171 |
Adrenalin epinephrine inject |
412 |
314 |
$126.86 |
| J2060 |
Lorazepam injection |
1,131 |
769 |
$122.56 |
| 84630 |
|
22 |
16 |
$120.58 |
| 80164 |
|
50 |
39 |
$119.80 |
| 84481 |
|
32 |
27 |
$117.82 |
| 82270 |
|
222 |
183 |
$111.22 |
| 87641 |
|
87 |
64 |
$109.73 |
| 94760 |
|
7,079 |
3,925 |
$107.28 |
| 90734 |
|
29 |
26 |
$105.60 |
| J1790 |
Droperidol injection |
1,073 |
826 |
$103.59 |
| 74022 |
|
13 |
12 |
$102.02 |
| 96417 |
|
802 |
422 |
$94.57 |
| 87430 |
|
24 |
22 |
$92.04 |
| 84425 |
|
16 |
13 |
$87.66 |
| 91300 |
|
4,537 |
4,145 |
$85.25 |
| 87640 |
|
87 |
64 |
$84.60 |
| J2765 |
Metoclopramide hcl injection |
1,405 |
1,068 |
$83.88 |
| J7512 |
Prednisone ir or dr oral 1mg |
1,752 |
894 |
$82.18 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
667 |
483 |
$74.57 |
| 86665 |
|
15 |
12 |
$69.03 |
| J0131 |
Inj, acetaminophen (nos) |
77 |
65 |
$68.79 |
| J2250 |
Inj midazolam hydrochloride |
6,851 |
5,068 |
$67.86 |
| J3480 |
Inj potassium chloride |
1,397 |
901 |
$66.92 |
| J2710 |
Neostigmine methylslfte inj |
1,431 |
1,006 |
$64.78 |
| C1894 |
Intro/sheath, non-laser |
990 |
751 |
$56.53 |
| 87798 |
|
36 |
36 |
$55.59 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
1,435 |
1,242 |
$55.37 |
| 82040 |
|
12 |
12 |
$50.66 |
| J2470 |
Inj pantoprazole sodium 40mg |
149 |
79 |
$46.06 |
| J2360 |
Orphenadrine injection |
119 |
108 |
$41.80 |
| 81002 |
|
558 |
353 |
$39.31 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
628 |
549 |
$38.74 |
| J7030 |
Normal saline solution infus |
705 |
371 |
$38.29 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
647 |
478 |
$36.70 |
| C1769 |
Guide wire |
1,225 |
941 |
$33.65 |
| J7999 |
Compounded drug, noc |
15 |
12 |
$33.59 |
| 80175 |
|
13 |
12 |
$30.78 |
| C1725 |
Cath, translumin non-laser |
297 |
204 |
$29.75 |
| C1729 |
Cath, drainage |
236 |
153 |
$26.82 |
| J7040 |
Normal saline solution infus |
785 |
491 |
$26.25 |
| 94761 |
|
64 |
50 |
$22.94 |
| 87529 |
|
12 |
12 |
$19.59 |
| 87088 |
|
45 |
44 |
$17.82 |
| J0330 |
Succinycholine chloride inj |
424 |
304 |
$17.06 |
| J0689 |
Inj cefazolin sodium, baxter |
117 |
107 |
$15.87 |
| J7050 |
Normal saline solution infus |
2,344 |
1,004 |
$14.70 |
| J2001 |
Lidocaine injection |
3,828 |
2,661 |
$14.20 |
| J3301 |
Triamcinolone acet inj nos |
788 |
676 |
$12.29 |
| J1920 |
Inj, labetalol hcl, 5mg |
15 |
14 |
$9.01 |
| J0744 |
Ciprofloxacin iv |
87 |
40 |
$6.54 |
| J0456 |
Azithromycin |
282 |
135 |
$5.98 |
| J1630 |
Haloperidol injection |
40 |
26 |
$5.66 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
40 |
39 |
$5.35 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
103 |
76 |
$5.00 |
| Q9969 |
Non-heu tc-99m add-on/dose |
1,138 |
935 |
$4.12 |
| J2370 |
Phenylephrine hcl injection |
254 |
152 |
$3.51 |
| 91307 |
|
319 |
299 |
$2.54 |
| J7620 |
Albuterol ipratrop non-comp |
96 |
38 |
$2.52 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
119 |
114 |
$1.81 |
| 91305 |
|
359 |
353 |
$1.39 |
| J2004 |
Inj, lidocaine w epinephrine |
57 |
56 |
$1.03 |
| 91312 |
|
100 |
100 |
$0.55 |
| 91306 |
|
20 |
20 |
$0.14 |
| 3079F |
|
199 |
177 |
$0.00 |
| A4648 |
Implantable tissue marker |
204 |
163 |
$0.00 |
| 3074F |
|
2,459 |
2,284 |
$0.00 |
| 00790 |
|
229 |
174 |
$0.00 |
| C1781 |
Mesh (implantable) |
21 |
13 |
$0.00 |
| 00126 |
|
18 |
14 |
$0.00 |
| 3075F |
|
206 |
191 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
99 |
57 |
$0.00 |
| 76377 |
|
52 |
50 |
$0.00 |
| C1726 |
Cath, bal dil, non-vascular |
64 |
56 |
$0.00 |
| J2305 |
Inj, nitroglycerin, 5 mg |
34 |
33 |
$0.00 |
| 00142 |
|
13 |
12 |
$0.00 |
| 87651 |
|
43 |
34 |
$0.00 |
| 00952 |
|
94 |
65 |
$0.00 |
| 3044F |
|
29 |
26 |
$0.00 |
| 3077F |
|
304 |
267 |
$0.00 |
| 3078F |
|
2,902 |
2,687 |
$0.00 |
| 87220 |
|
47 |
42 |
$0.00 |
| A9552 |
F18 fdg |
242 |
219 |
$0.00 |
| A9502 |
Tc99m tetrofosmin |
391 |
309 |
$0.00 |
| C1760 |
Closure dev, vasc |
14 |
12 |
$0.00 |
| U0001 |
2019-ncov diagnostic p |
12 |
12 |
$0.00 |
| C2625 |
Stent, non-cor, tem w/del sy |
117 |
87 |
$0.00 |
| C1887 |
Catheter, guiding |
234 |
168 |
$0.00 |
| G1004 |
Cdsm ndsc |
282 |
247 |
$0.00 |
| 88112 |
|
54 |
48 |
$0.00 |
| J9190 |
Fluorouracil injection |
107 |
51 |
$0.00 |
| 88302 |
|
20 |
12 |
$0.00 |
| 87210 |
|
49 |
43 |
$0.00 |
| C1788 |
Port, indwelling, imp |
45 |
39 |
$0.00 |
| 29125 |
|
17 |
12 |
$0.00 |
| 00910 |
|
17 |
12 |
$0.00 |