| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
75,024 |
61,984 |
$5.72M |
| 99283 |
|
50,055 |
45,279 |
$4.17M |
| 99285 |
|
31,518 |
27,382 |
$2.74M |
| 99284 |
|
45,997 |
39,731 |
$2.42M |
| 99214 |
|
33,607 |
27,205 |
$2.33M |
| 99212 |
|
28,527 |
24,393 |
$2.09M |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
16,014 |
13,776 |
$1.95M |
| A0431 |
Rotary wing air transport |
2,299 |
1,824 |
$1.43M |
| 80053 |
|
117,670 |
84,758 |
$1.29M |
| 74177 |
|
8,255 |
7,288 |
$1.11M |
| 99282 |
|
13,682 |
12,630 |
$1.10M |
| 76816 |
|
12,471 |
11,168 |
$867K |
| 59025 |
|
8,745 |
6,405 |
$805K |
| 99211 |
|
21,375 |
16,444 |
$745K |
| G0378 |
Hospital observation per hr |
37,755 |
16,192 |
$690K |
| 96365 |
|
12,075 |
6,840 |
$681K |
| U0003 |
Cov-19 amp prb hgh thruput |
33,449 |
28,541 |
$670K |
| 84703 |
|
29,323 |
25,574 |
$666K |
| 97110 |
|
10,827 |
3,047 |
$657K |
| J7050 |
Normal saline solution infus |
12,545 |
6,120 |
$651K |
| 81003 |
|
14,653 |
12,301 |
$562K |
| 96376 |
|
22,138 |
7,703 |
$544K |
| 76811 |
|
8,827 |
8,292 |
$537K |
| 96361 |
|
7,175 |
3,192 |
$480K |
| 97530 |
|
17,688 |
4,619 |
$440K |
| 71275 |
|
1,909 |
1,731 |
$427K |
| 96374 |
|
33,286 |
26,808 |
$424K |
| 41899 |
|
1,515 |
1,000 |
$403K |
| 92507 |
|
5,346 |
1,566 |
$391K |
| 70450 |
|
8,154 |
6,959 |
$386K |
| 99204 |
|
8,642 |
7,729 |
$386K |
| 99203 |
|
5,973 |
5,332 |
$382K |
| 86850 |
|
9,747 |
7,982 |
$377K |
| 93306 |
|
4,486 |
3,931 |
$369K |
| 85025 |
|
145,472 |
93,692 |
$346K |
| 96413 |
|
8,063 |
4,446 |
$335K |
| 87633 |
|
11,779 |
10,857 |
$328K |
| 96375 |
|
26,759 |
14,647 |
$313K |
| 76819 |
|
9,235 |
5,171 |
$303K |
| 96360 |
|
3,554 |
2,811 |
$288K |
| 95810 |
|
744 |
685 |
$278K |
| J1200 |
Diphenhydramine hcl injectio |
13,558 |
7,833 |
$277K |
| 78452 |
|
1,393 |
1,190 |
$268K |
| 77336 |
|
755 |
329 |
$260K |
| J9271 |
Inj pembrolizumab |
74 |
52 |
$256K |
| 96366 |
|
6,833 |
3,009 |
$256K |
| 74176 |
|
2,275 |
2,030 |
$246K |
| 96372 |
|
23,685 |
12,625 |
$221K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
973 |
842 |
$220K |
| 76815 |
|
7,404 |
6,177 |
$212K |
| 96415 |
|
4,057 |
1,872 |
$206K |
| A0436 |
Rotary wing air mileage |
2,257 |
1,794 |
$201K |
| 36416 |
|
3,133 |
2,639 |
$190K |
| 99281 |
|
2,398 |
2,230 |
$186K |
| 92551 |
|
5,163 |
4,409 |
$183K |
| A9577 |
Inj multihance |
1,752 |
1,473 |
$168K |
| 81001 |
|
58,553 |
46,289 |
$163K |
| J2405 |
Ondansetron hcl injection |
30,946 |
21,895 |
$160K |
| 90935 |
|
2,884 |
757 |
$159K |
| G0463 |
Hospital outpt clinic visit |
25,063 |
16,515 |
$156K |
| 99202 |
|
2,989 |
2,668 |
$155K |
| 76805 |
|
2,250 |
2,106 |
$148K |
| J2270 |
Morphine sulfate injection |
14,998 |
8,817 |
$143K |
| 66984 |
|
292 |
259 |
$140K |
| 85610 |
|
20,257 |
14,714 |
$131K |
| 43239 |
|
1,537 |
1,333 |
$121K |
| J3010 |
Fentanyl citrate injection |
23,095 |
16,124 |
$119K |
| 80048 |
|
26,191 |
15,385 |
$116K |
| J1885 |
Ketorolac tromethamine inj |
17,960 |
12,571 |
$114K |
| 87631 |
|
4,777 |
4,519 |
$114K |
| J7040 |
Normal saline solution infus |
1,194 |
724 |
$113K |
| 71046 |
|
13,354 |
11,778 |
$112K |
| J2001 |
Lidocaine injection |
21,489 |
16,105 |
$104K |
| 77386 |
|
687 |
68 |
$102K |
| 76705 |
|
5,840 |
4,580 |
$100K |
| 00731 |
|
1,589 |
1,389 |
$99K |
| J0610 |
Calcium glucon (fresenius) |
765 |
357 |
$96K |
| 88305 |
|
5,529 |
4,802 |
$95K |
| 96367 |
|
3,899 |
1,717 |
$93K |
| 36430 |
|
1,240 |
819 |
$91K |
| 97162 |
|
2,747 |
2,404 |
$91K |
| 76801 |
|
1,239 |
1,160 |
$87K |
| J7613 |
Albuterol non-comp unit |
1,130 |
952 |
$87K |
| J2250 |
Inj midazolam hydrochloride |
16,221 |
13,151 |
$83K |
| 83735 |
|
26,598 |
15,378 |
$80K |
| 76820 |
|
2,506 |
1,262 |
$80K |
| 72125 |
|
2,673 |
2,199 |
$79K |
| 83036 |
|
13,165 |
10,885 |
$78K |
| 87086 |
|
9,493 |
8,008 |
$74K |
| 47562 |
|
42 |
40 |
$71K |
| 85018 |
|
7,379 |
5,685 |
$68K |
| 97112 |
|
3,170 |
1,234 |
$65K |
| 94640 |
|
4,544 |
2,680 |
$65K |
| 84702 |
|
6,089 |
4,714 |
$62K |
| 86900 |
|
11,117 |
9,146 |
$61K |
| C1769 |
Guide wire |
3,880 |
3,276 |
$60K |
| 87801 |
|
4,912 |
4,405 |
$59K |
| C1894 |
Intro/sheath, non-laser |
3,592 |
3,049 |
$57K |
| 70553 |
|
603 |
521 |
$56K |
| J2704 |
Inj, propofol, 10 mg |
19,600 |
15,061 |
$54K |
| 70496 |
|
438 |
383 |
$52K |
| 94760 |
|
5,723 |
4,735 |
$52K |
| 76817 |
|
4,691 |
3,826 |
$51K |
| 93005 |
|
29,643 |
23,098 |
$50K |
| 85730 |
|
9,586 |
7,810 |
$50K |
| J1644 |
Inj heparin sodium per 1000u |
9,251 |
3,494 |
$49K |
| 70551 |
|
834 |
744 |
$48K |
| 97140 |
|
2,744 |
981 |
$48K |
| 85384 |
|
887 |
586 |
$47K |
| 87651 |
|
4,362 |
4,110 |
$46K |
| 49083 |
|
734 |
330 |
$46K |
| 86901 |
|
11,619 |
9,596 |
$45K |
| 92523 |
|
565 |
513 |
$44K |
| 73130 |
|
2,335 |
1,911 |
$43K |
| Q0163 |
Diphenhydramine hcl 50mg |
1,619 |
1,005 |
$43K |
| 82330 |
|
8,273 |
6,963 |
$43K |
| 97161 |
|
1,445 |
1,278 |
$43K |
| 76825 |
|
656 |
601 |
$42K |
| 80307 |
|
5,196 |
4,399 |
$42K |
| 84156 |
|
9,832 |
5,601 |
$41K |
| 87491 |
|
5,469 |
4,864 |
$41K |
| Q0162 |
Ondansetron oral |
9,071 |
6,334 |
$41K |
| 76830 |
|
2,776 |
2,557 |
$41K |
| 95714 |
|
189 |
110 |
$39K |
| 93970 |
|
1,858 |
1,647 |
$38K |
| J0485 |
Belatacept injection |
700 |
275 |
$38K |
| C1887 |
Catheter, guiding |
2,490 |
2,088 |
$38K |
| P9016 |
Rbc leukocytes reduced |
1,647 |
1,232 |
$37K |
| 82947 |
|
7,806 |
6,566 |
$37K |
| 84132 |
|
6,195 |
5,171 |
$36K |
| 90647 |
|
6,969 |
4,320 |
$36K |
| 84295 |
|
5,774 |
4,829 |
$35K |
| 75572 |
|
1,223 |
1,110 |
$35K |
| 71045 |
|
18,001 |
15,329 |
$35K |
| 87804 |
|
699 |
618 |
$34K |
| 73610 |
|
2,215 |
1,903 |
$34K |
| 87077 |
|
3,902 |
3,345 |
$34K |
| J2175 |
Meperidine hydrochl /100 mg |
743 |
262 |
$33K |
| 89051 |
|
1,368 |
813 |
$33K |
| J1756 |
Iron sucrose injection |
1,882 |
754 |
$32K |
| 70498 |
|
377 |
329 |
$32K |
| 95806 |
|
607 |
544 |
$32K |
| 94010 |
|
1,853 |
1,527 |
$31K |
| 80197 |
|
14,685 |
6,942 |
$31K |
| H2010 |
Comprehensive med svc 15 min |
2,761 |
1,347 |
$30K |
| 87210 |
|
6,736 |
6,066 |
$30K |
| 82435 |
|
5,202 |
4,379 |
$30K |
| 84484 |
|
22,573 |
15,629 |
$29K |
| 70486 |
|
595 |
522 |
$29K |
| 96417 |
|
1,867 |
961 |
$28K |
| 73110 |
|
1,692 |
1,384 |
$28K |
| 94664 |
|
323 |
301 |
$28K |
| 76775 |
|
1,247 |
1,098 |
$27K |
| J8540 |
Oral dexamethasone |
2,995 |
1,513 |
$27K |
| 97116 |
|
3,270 |
1,108 |
$27K |
| 99201 |
|
672 |
628 |
$27K |
| 73564 |
|
2,763 |
2,251 |
$27K |
| 00813 |
|
181 |
151 |
$27K |
| 87798 |
|
2,415 |
1,911 |
$26K |
| 97166 |
|
853 |
747 |
$25K |
| 93971 |
|
2,042 |
1,817 |
$25K |
| 87070 |
|
3,356 |
2,427 |
$25K |
| J2930 |
Methylprednisolone injection |
2,821 |
2,019 |
$25K |
| A9578 |
Inj multihance multipack |
93 |
83 |
$25K |
| 83880 |
|
11,621 |
9,483 |
$24K |
| 71250 |
|
824 |
704 |
$24K |
| 93975 |
|
1,600 |
1,360 |
$24K |
| 74018 |
|
2,179 |
1,926 |
$23K |
| 93797 |
|
706 |
125 |
$23K |
| 97163 |
|
362 |
326 |
$23K |
| 73630 |
|
2,292 |
1,903 |
$22K |
| 82570 |
|
14,068 |
8,355 |
$22K |
| 10060 |
|
378 |
337 |
$22K |
| J1100 |
Dexamethasone sodium phos |
13,174 |
10,886 |
$22K |
| 84443 |
|
11,187 |
9,286 |
$22K |
| 93017 |
|
1,900 |
1,603 |
$22K |
| 00840 |
|
956 |
759 |
$22K |
| J1815 |
Insulin injection |
8,091 |
4,211 |
$22K |
| 99205 |
Prolong outpt/office vis |
801 |
763 |
$21K |
| 73090 |
|
1,327 |
1,077 |
$21K |
| 76000 |
|
1,475 |
1,253 |
$21K |
| 70491 |
|
285 |
260 |
$21K |
| 77301 |
|
13 |
13 |
$20K |
| 88342 |
|
2,223 |
1,939 |
$20K |
| 94060 |
|
495 |
402 |
$20K |
| 00170 |
|
2,042 |
1,446 |
$20K |
| 88307 |
|
1,399 |
1,172 |
$19K |
| 92526 |
|
546 |
206 |
$19K |
| J0690 |
Cefazolin sodium injection |
6,830 |
5,119 |
$19K |
| 82803 |
|
8,541 |
7,337 |
$19K |
| 00400 |
|
622 |
569 |
$19K |
| 87591 |
|
5,476 |
4,870 |
$19K |
| 80061 |
|
8,962 |
7,361 |
$19K |
| J9035 |
Bevacizumab injection |
48 |
12 |
$19K |
| 83605 |
|
12,268 |
10,239 |
$18K |
| 95811 |
|
79 |
70 |
$18K |
| C1725 |
Cath, translumin non-laser |
779 |
643 |
$18K |
| 99188 |
|
2,874 |
2,615 |
$18K |
| 73080 |
|
1,023 |
863 |
$18K |
| 81025 |
|
9,332 |
8,305 |
$18K |
| 0241U |
|
1,513 |
1,433 |
$17K |
| 12011 |
|
187 |
169 |
$17K |
| 00300 |
|
281 |
257 |
$17K |
| J2370 |
Phenylephrine hcl injection |
4,490 |
3,525 |
$16K |
| P9047 |
Albumin (human), 25%, 50ml |
626 |
299 |
$16K |
| 16020 |
|
942 |
759 |
$15K |
| 87186 |
|
4,082 |
3,483 |
$15K |
| 94660 |
|
690 |
329 |
$15K |
| 88720 |
|
359 |
281 |
$15K |
| 71260 |
|
860 |
698 |
$14K |
| 73030 |
|
1,809 |
1,505 |
$14K |
| 73590 |
|
1,292 |
1,098 |
$14K |
| 76856 |
|
1,141 |
1,053 |
$14K |
| 99215 |
Prolong outpt/office vis |
441 |
393 |
$14K |
| 82728 |
|
5,099 |
4,230 |
$14K |
| 73552 |
|
971 |
828 |
$14K |
| 83690 |
|
19,187 |
16,591 |
$14K |
| 90686 |
|
13,599 |
8,551 |
$13K |
| 88304 |
|
1,170 |
1,070 |
$13K |
| 92651 |
|
383 |
307 |
$13K |
| 87502 |
|
700 |
655 |
$13K |
| 82105 |
|
1,129 |
979 |
$13K |
| 80321 |
|
4,124 |
3,522 |
$12K |
| 86304 |
|
1,087 |
828 |
$12K |
| J7070 |
D5w infusion |
305 |
113 |
$12K |
| 86803 |
|
10,762 |
9,707 |
$12K |
| 95819 |
|
221 |
187 |
$12K |
| 19318 |
|
12 |
12 |
$12K |
| 87641 |
|
3,411 |
2,905 |
$12K |
| 01922 |
|
103 |
87 |
$11K |
| 90791 |
|
362 |
336 |
$11K |
| J3475 |
Inj magnesium sulfate |
5,339 |
3,386 |
$11K |
| 85046 |
|
3,687 |
2,631 |
$11K |
| 82607 |
|
3,752 |
3,180 |
$11K |
| J0780 |
Prochlorperazine injection |
3,939 |
2,966 |
$11K |
| 87340 |
|
3,593 |
3,052 |
$11K |
| 82805 |
|
3,595 |
3,053 |
$11K |
| 80051 |
|
4,762 |
4,089 |
$11K |
| J0330 |
Succinycholine chloride inj |
4,015 |
3,070 |
$10K |
| 87497 |
|
3,440 |
2,441 |
$10K |
| 82550 |
|
5,771 |
4,269 |
$10K |
| 12001 |
|
153 |
147 |
$10K |
| J7120 |
Ringers lactate infusion |
1,251 |
959 |
$10K |
| 85660 |
|
613 |
492 |
$10K |
| G1004 |
Cdsm ndsc |
13,423 |
8,499 |
$10K |
| Q9957 |
Inj perflutren lip micros,ml |
137 |
117 |
$10K |
| 94729 |
|
1,171 |
1,013 |
$10K |
| 93325 |
|
907 |
823 |
$10K |
| 74022 |
|
961 |
890 |
$9K |
| 86706 |
|
2,162 |
1,791 |
$9K |
| 87389 |
|
13,634 |
12,471 |
$9K |
| 92567 |
|
155 |
115 |
$9K |
| 83540 |
|
4,020 |
3,427 |
$9K |
| 84100 |
|
7,514 |
4,456 |
$9K |
| 82306 |
|
3,075 |
2,529 |
$9K |
| 90472 |
|
9,991 |
6,882 |
$9K |
| 87653 |
|
981 |
883 |
$9K |
| J7611 |
Albuterol non-comp con |
115 |
100 |
$9K |
| Q9961 |
Hocm 250-299mg/ml iodine,1ml |
106 |
90 |
$8K |
| 86704 |
|
1,917 |
1,579 |
$8K |
| 72110 |
|
1,364 |
1,217 |
$8K |
| 86352 |
|
612 |
496 |
$8K |
| 92586 |
|
188 |
159 |
$8K |
| J0171 |
Adrenalin epinephrine inject |
1,930 |
1,621 |
$8K |
| 87205 |
|
2,968 |
2,150 |
$8K |
| 88142 |
|
567 |
486 |
$8K |
| J7620 |
Albuterol ipratrop non-comp |
2,981 |
1,927 |
$8K |
| 43235 |
|
163 |
144 |
$8K |
| 80069 |
|
989 |
680 |
$8K |
| 73502 |
|
1,746 |
1,390 |
$8K |
| 77300 |
|
45 |
37 |
$8K |
| 83550 |
|
3,693 |
3,161 |
$8K |
| 74019 |
|
351 |
328 |
$7K |
| 90715 |
|
5,926 |
3,644 |
$7K |
| J1650 |
Inj enoxaparin sodium |
9,053 |
4,297 |
$7K |
| 87536 |
|
472 |
401 |
$7K |
| M0243 |
Casirivi and imdevi inj |
273 |
146 |
$7K |
| 84439 |
|
3,260 |
2,823 |
$7K |
| 90471 |
|
37,025 |
19,945 |
$7K |
| 76604 |
|
309 |
269 |
$7K |
| 76700 |
|
289 |
252 |
$7K |
| J1453 |
Fosaprepitant injection |
425 |
257 |
$7K |
| A4690 |
Dialyzer, each |
2,150 |
665 |
$7K |
| A4570 |
Splint |
270 |
237 |
$7K |
| 97535 |
|
940 |
479 |
$7K |
| 00790 |
|
80 |
77 |
$7K |
| 88341 |
|
1,024 |
844 |
$7K |
| 96368 |
|
603 |
265 |
$7K |
| 85014 |
|
1,271 |
992 |
$7K |
| 82746 |
|
3,441 |
2,916 |
$7K |
| 90670 |
|
8,814 |
4,985 |
$6K |
| 86708 |
|
2,586 |
2,238 |
$6K |
| 97165 |
|
209 |
192 |
$6K |
| Q5105 |
Inj retacrit esrd on dialysi |
2,136 |
237 |
$6K |
| 86141 |
|
6,071 |
5,174 |
$6K |
| 90633 |
|
2,790 |
1,926 |
$6K |
| A4216 |
Sterile water/saline, 10 ml |
374 |
250 |
$6K |
| 96416 |
|
206 |
111 |
$6K |
| 86923 |
|
1,338 |
985 |
$6K |
| 88300 |
|
1,143 |
919 |
$6K |
| 90834 |
|
128 |
52 |
$6K |
| 87799 |
|
1,193 |
929 |
$6K |
| 92610 |
|
176 |
161 |
$6K |
| J0696 |
Ceftriaxone sodium injection |
5,682 |
4,073 |
$6K |
| G8978 |
Mobility current status |
478 |
350 |
$6K |
| 85652 |
|
4,132 |
3,606 |
$5K |
| G8979 |
Mobility goal status |
484 |
352 |
$5K |
| 85379 |
|
3,877 |
3,325 |
$5K |
| 73060 |
|
466 |
390 |
$5K |
| P9041 |
Albumin (human),5%, 50ml |
34 |
12 |
$5K |
| 45380 |
|
89 |
82 |
$5K |
| 87635 |
|
620 |
539 |
$5K |
| 76857 |
|
2,025 |
1,881 |
$5K |
| 94618 |
|
204 |
166 |
$5K |
| J1170 |
Hydromorphone injection |
998 |
472 |
$5K |
| 87040 |
|
2,986 |
2,601 |
$5K |
| 36415 |
|
2,306 |
1,804 |
$5K |
| 90651 |
|
1,294 |
917 |
$5K |
| 86592 |
|
716 |
626 |
$5K |
| 87507 |
|
352 |
287 |
$5K |
| 83615 |
|
2,303 |
1,695 |
$5K |
| J2765 |
Metoclopramide hcl injection |
2,650 |
2,210 |
$5K |
| 77001 |
|
413 |
352 |
$5K |
| 93350 |
|
61 |
50 |
$4K |
| 82375 |
|
1,159 |
1,018 |
$4K |
| 82553 |
|
2,534 |
1,799 |
$4K |
| U0002 |
Covid-19 lab test non-cdc |
169 |
164 |
$4K |
| 58661 |
|
27 |
12 |
$4K |
| 84550 |
|
1,147 |
917 |
$4K |
| 72148 |
|
215 |
192 |
$4K |
| 82043 |
|
2,919 |
2,168 |
$4K |
| G0480 |
Drug test def 1-7 classes |
2,254 |
1,697 |
$4K |
| 00142 |
|
168 |
156 |
$4K |
| 87880 |
|
174 |
164 |
$4K |
| 86807 |
|
513 |
426 |
$4K |
| 96401 |
|
168 |
86 |
$4K |
| 83970 |
|
1,529 |
1,183 |
$4K |
| 86021 |
|
482 |
382 |
$4K |
| 74183 |
|
81 |
67 |
$4K |
| 91300 |
|
405 |
319 |
$4K |
| J2272 |
Inj, morphine (fresenius) |
205 |
151 |
$3K |
| 92588 |
|
446 |
361 |
$3K |
| 87015 |
|
212 |
177 |
$3K |
| J0585 |
Injection,onabotulinumtoxina |
227 |
139 |
$3K |
| A9500 |
Tc99m sestamibi |
1,552 |
1,314 |
$3K |
| 29705 |
|
183 |
158 |
$3K |
| 86644 |
|
1,527 |
1,214 |
$3K |
| J0360 |
Hydralazine hcl injection |
1,669 |
1,194 |
$3K |
| J0248 |
Inj, remdesivir, 1 mg |
28 |
12 |
$3K |
| J2785 |
Regadenoson injection |
965 |
820 |
$3K |
| 76821 |
|
174 |
104 |
$3K |
| J9267 |
Paclitaxel injection |
112 |
50 |
$3K |
| G0390 |
Trauma respons w/hosp criti |
30 |
26 |
$3K |
| 76642 |
|
102 |
79 |
$3K |
| J9190 |
Fluorouracil injection |
273 |
113 |
$3K |
| 36591 |
|
754 |
539 |
$3K |
| 93880 |
|
127 |
108 |
$3K |
| 80329 |
|
1,592 |
1,253 |
$2K |
| 72100 |
|
345 |
291 |
$2K |
| 72146 |
|
15 |
13 |
$2K |
| 51798 |
|
1,548 |
968 |
$2K |
| 72170 |
|
955 |
795 |
$2K |
| 86480 |
|
1,010 |
857 |
$2K |
| 87522 |
Neg quan hep c or qual rna |
1,364 |
1,152 |
$2K |
| J2060 |
Lorazepam injection |
2,587 |
2,024 |
$2K |
| J3489 |
Zoledronic acid 1mg |
25 |
24 |
$2K |
| J3370 |
Vancomycin hcl injection |
1,945 |
1,204 |
$2K |
| 42820 |
|
21 |
16 |
$2K |
| 93451 |
|
18 |
13 |
$2K |
| 94726 |
|
775 |
661 |
$2K |
| H2019 |
Ther behav svc, per 15 min |
55 |
27 |
$2K |
| 82150 |
|
991 |
733 |
$2K |
| 84460 |
|
141 |
104 |
$2K |
| 86945 |
|
258 |
153 |
$2K |
| 82378 |
|
414 |
252 |
$2K |
| 93922 |
|
172 |
147 |
$2K |
| 76827 |
|
660 |
597 |
$2K |
| G8980 |
Mobility d/c status |
194 |
149 |
$2K |
| 95700 |
|
142 |
134 |
$2K |
| 90696 |
|
1,080 |
648 |
$2K |
| 84145 |
|
1,165 |
1,038 |
$2K |
| 93458 |
|
12 |
12 |
$2K |
| 85347 |
|
54 |
41 |
$2K |
| J2360 |
Orphenadrine injection |
351 |
242 |
$1K |
| 80076 |
|
521 |
391 |
$1K |
| 72072 |
|
151 |
136 |
$1K |
| 88184 |
|
263 |
167 |
$1K |
| 85027 |
|
404 |
306 |
$1K |
| 82977 |
|
1,000 |
757 |
$1K |
| 99291 |
|
14 |
12 |
$1K |
| 82784 |
|
262 |
211 |
$1K |
| 86762 |
|
682 |
588 |
$1K |
| J7512 |
Prednisone ir or dr oral 1mg |
3,650 |
1,863 |
$1K |
| 72141 |
|
93 |
77 |
$1K |
| 90837 |
|
75 |
26 |
$1K |
| 86038 |
|
368 |
320 |
$1K |
| 97542 |
|
18 |
16 |
$1K |
| 29125 |
|
340 |
276 |
$1K |
| 69436 |
|
18 |
14 |
$1K |
| J1953 |
Levetiracetam injection |
319 |
241 |
$1K |
| 70100 |
|
530 |
289 |
$1K |
| G0399 |
Home sleep test/type 3 porta |
12 |
12 |
$1K |
| J7030 |
Normal saline solution infus |
1,055 |
809 |
$1K |
| 87102 |
|
377 |
296 |
$1K |
| 0002A |
|
173 |
153 |
$1K |
| 86682 |
|
690 |
562 |
$992.83 |
| 96156 |
|
67 |
61 |
$986.74 |
| 84480 |
|
944 |
776 |
$982.96 |
| 82950 |
|
92 |
77 |
$975.07 |
| J0561 |
Penicillin g benzathine inj |
177 |
138 |
$960.83 |
| 72192 |
|
16 |
13 |
$892.29 |
| J9045 |
Carboplatin injection |
181 |
77 |
$889.84 |
| 90723 |
|
7,345 |
4,348 |
$881.92 |
| H2000 |
Comp multidisipln evaluation |
20 |
12 |
$878.69 |
| 86790 |
|
771 |
632 |
$850.21 |
| J3480 |
Inj potassium chloride |
1,072 |
571 |
$842.33 |
| 93016 |
|
430 |
323 |
$842.15 |
| 82565 |
|
312 |
263 |
$837.52 |
| 73140 |
|
62 |
54 |
$822.29 |
| 87529 |
|
148 |
136 |
$816.90 |
| 86832 |
|
274 |
214 |
$796.56 |
| V2632 |
Post chmbr intraocular lens |
106 |
94 |
$779.70 |
| 76870 |
|
127 |
112 |
$774.36 |
| G0008 |
Admin influenza virus vac |
936 |
761 |
$762.15 |
| 86780 |
|
224 |
182 |
$758.71 |
| 86695 |
|
722 |
592 |
$753.79 |
| 84436 |
|
713 |
590 |
$753.71 |
| 99173 |
|
5,479 |
4,441 |
$727.41 |
| 71101 |
|
46 |
39 |
$718.56 |
| J3420 |
Vitamin b12 injection |
389 |
244 |
$715.17 |
| M0239 |
Bamlanivimab-xxxx infusion |
18 |
13 |
$704.68 |
| 87116 |
|
216 |
181 |
$686.88 |
| 76813 |
|
117 |
112 |
$683.62 |
| J2920 |
Methylprednisolone injection |
293 |
156 |
$663.49 |
| 86787 |
|
718 |
589 |
$642.31 |
| 88112 |
|
110 |
87 |
$601.96 |
| 90734 |
|
704 |
453 |
$585.33 |
| 86735 |
|
644 |
523 |
$569.20 |
| 77063 |
|
38 |
33 |
$552.02 |
| 78582 |
|
27 |
13 |
$550.43 |
| 86777 |
|
685 |
561 |
$549.06 |
| 86665 |
|
756 |
628 |
$548.88 |
| 84481 |
|
174 |
154 |
$547.18 |
| 84153 |
|
135 |
118 |
$546.72 |
| 86765 |
|
639 |
523 |
$537.30 |
| 0001A |
|
114 |
106 |
$520.10 |
| J3471 |
Ovine, up to 999 usp units |
131 |
103 |
$500.50 |
| 90707 |
|
1,115 |
897 |
$496.75 |
| 87807 |
|
16 |
14 |
$494.09 |
| 88313 |
|
400 |
343 |
$491.36 |
| 86308 |
|
235 |
220 |
$488.74 |
| 90662 |
|
404 |
279 |
$487.26 |
| 70544 |
|
13 |
12 |
$482.91 |
| 86905 |
|
87 |
67 |
$464.08 |
| 84520 |
|
259 |
228 |
$455.51 |
| 99499 |
|
1,163 |
1,115 |
$440.02 |
| 80074 |
|
171 |
152 |
$438.68 |
| 87808 |
|
568 |
514 |
$423.28 |
| 82465 |
|
616 |
497 |
$422.22 |
| 90716 |
|
1,044 |
889 |
$415.42 |
| J2791 |
Rhophylac injection |
72 |
70 |
$410.90 |
| 87517 |
|
201 |
163 |
$402.73 |
| 87206 |
|
115 |
93 |
$391.64 |
| 73620 |
|
17 |
14 |
$390.49 |
| 99251 |
|
26 |
19 |
$383.47 |
| 94799 |
|
206 |
160 |
$380.56 |
| 90746 |
|
68 |
25 |
$372.54 |
| J2543 |
Piperacillin/tazobactam |
965 |
430 |
$369.88 |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
14 |
12 |
$359.60 |
| 82010 |
|
1,008 |
867 |
$352.26 |
| 90681 |
|
5,037 |
2,698 |
$344.22 |
| 77067 |
|
97 |
86 |
$342.33 |
| 64415 |
|
51 |
38 |
$341.97 |
| J3473 |
Hyaluronidase recombinant |
107 |
96 |
$335.53 |
| 11721 |
|
27 |
24 |
$323.64 |
| G0103 |
Psa screening |
95 |
78 |
$285.48 |
| 87088 |
|
342 |
288 |
$257.39 |
| 87147 |
|
91 |
79 |
$246.77 |
| J1940 |
Furosemide injection |
472 |
265 |
$239.90 |
| J1630 |
Haloperidol injection |
896 |
719 |
$235.95 |
| J2469 |
Palonosetron hcl |
720 |
393 |
$230.00 |
| J7510 |
Prednisolone oral per 5 mg |
270 |
235 |
$222.29 |
| J3411 |
Thiamine hcl 100 mg |
91 |
45 |
$220.26 |
| 87184 |
|
158 |
143 |
$216.07 |
| 87624 |
|
31 |
26 |
$214.00 |
| C9113 |
Inj pantoprazole sodium, via |
2,191 |
1,243 |
$208.75 |
| C1729 |
Cath, drainage |
54 |
46 |
$208.05 |
| L0172 |
Cerv col sr foam 2pc pre ots |
36 |
25 |
$197.40 |
| 74150 |
|
13 |
12 |
$188.13 |
| 72040 |
|
49 |
38 |
$184.95 |
| Q3014 |
Telehealth facility fee |
505 |
397 |
$173.89 |
| 90732 |
|
163 |
80 |
$167.24 |
| 82140 |
|
266 |
213 |
$148.61 |
| J1956 |
Levofloxacin injection |
614 |
457 |
$136.08 |
| 86361 |
|
30 |
29 |
$135.44 |
| 77338 |
|
13 |
13 |
$127.54 |
| 45378 |
|
13 |
12 |
$125.05 |
| 80164 |
|
51 |
36 |
$122.18 |
| 85651 |
|
367 |
331 |
$120.42 |
| 72131 |
|
16 |
13 |
$117.72 |
| 94761 |
|
38 |
32 |
$110.76 |
| 83050 |
|
191 |
167 |
$107.75 |
| 84311 |
|
190 |
166 |
$107.63 |
| 87181 |
|
62 |
55 |
$106.89 |
| 87075 |
|
34 |
25 |
$104.64 |
| 92611 |
|
14 |
12 |
$101.71 |
| 93925 |
|
52 |
41 |
$93.88 |
| 83520 |
|
15 |
12 |
$92.19 |
| 85007 |
|
146 |
104 |
$88.30 |
| 83516 |
|
13 |
12 |
$84.76 |
| 86593 |
|
115 |
100 |
$84.05 |
| 83020 |
|
174 |
155 |
$83.85 |
| 86769 |
|
116 |
100 |
$79.46 |
| 0053A |
|
98 |
58 |
$77.00 |
| 86300 |
|
20 |
13 |
$69.11 |
| J1580 |
Garamycin gentamicin inj |
134 |
89 |
$62.52 |
| 84160 |
|
75 |
51 |
$49.99 |
| 93010 |
|
12 |
12 |
$49.89 |
| 90700 |
|
2,026 |
1,006 |
$45.85 |
| 85576 |
|
17 |
13 |
$45.48 |
| 94762 |
|
36 |
29 |
$44.40 |
| 36600 |
|
80 |
65 |
$44.30 |
| 86870 |
|
30 |
25 |
$42.81 |
| 84165 |
|
51 |
39 |
$42.08 |
| 73560 |
|
46 |
36 |
$36.77 |
| J0692 |
Cefepime hcl for injection |
168 |
73 |
$32.78 |
| C9290 |
Inj, bupivacaine liposome |
84 |
76 |
$32.37 |
| 00910 |
|
42 |
39 |
$25.45 |
| 87081 |
|
33 |
28 |
$21.73 |
| J0702 |
Betamethasone acet&sod phosp |
25 |
14 |
$20.12 |
| J0456 |
Azithromycin |
63 |
36 |
$17.00 |
| C2617 |
Stent, non-cor, tem w/o del |
30 |
26 |
$16.60 |
| 90694 |
|
119 |
92 |
$16.50 |
| A9558 |
Xe133 xenon 10mci |
27 |
13 |
$10.36 |
| A9540 |
Tc99m maa |
27 |
13 |
$10.36 |
| 84157 |
|
25 |
16 |
$9.96 |
| J1720 |
Hydrocortisone sodium succ i |
73 |
48 |
$9.66 |
| A6512 |
Compres burn garment, noc |
12 |
12 |
$9.15 |
| 00902 |
|
28 |
24 |
$6.64 |
| C1781 |
Mesh (implantable) |
46 |
40 |
$6.64 |
| 82945 |
|
20 |
13 |
$6.64 |
| 82247 |
|
31 |
27 |
$5.55 |
| 00812 |
|
14 |
14 |
$3.32 |
| 1036F |
|
84 |
44 |
$0.00 |
| 90620 |
|
14 |
13 |
$0.00 |
| 82533 |
|
12 |
12 |
$0.00 |
| G0009 |
Admin pneumococcal vaccine |
67 |
58 |
$0.00 |
| 83883 |
|
19 |
12 |
$0.00 |
| 90677 |
|
68 |
59 |
$0.00 |
| A4351 |
Straight tip urine catheter |
91 |
78 |
$0.00 |
| G8419 |
Calc bmi out nrm param nof/u |
53 |
19 |
$0.00 |
| 0011A |
|
13 |
12 |
$0.00 |
| 36902 |
|
19 |
14 |
$0.00 |
| J1439 |
Inj ferric carboxymaltos 1mg |
78 |
53 |
$0.00 |
| 97802 |
|
16 |
14 |
$0.00 |
| 00320 |
|
21 |
17 |
$0.00 |
| 88331 |
|
17 |
12 |
$0.00 |
| 96409 |
|
23 |
12 |
$0.00 |
| 97804 |
|
46 |
37 |
$0.00 |
| 83051 |
|
17 |
12 |
$0.00 |
| 3017F |
|
15 |
12 |
$0.00 |
| 86255 |
|
12 |
12 |
$0.00 |
| 86702 |
|
14 |
13 |
$0.00 |
| J3360 |
Diazepam injection |
16 |
14 |
$0.00 |
| 86701 |
|
14 |
13 |
$0.00 |
| 82248 |
|
49 |
43 |
$0.00 |
| 83721 |
|
16 |
12 |
$0.00 |
| 90713 |
|
489 |
74 |
$0.00 |
| G8484 |
Flu immunize no admin |
46 |
17 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
376 |
327 |
$0.00 |
| 90710 |
|
1,085 |
661 |
$0.00 |
| 00402 |
|
12 |
12 |
$0.00 |
| 0003A |
|
207 |
160 |
$0.00 |
| 80305 |
|
18 |
12 |
$0.00 |
| 0124A |
|
15 |
12 |
$0.00 |
| 88302 |
|
101 |
83 |
$0.00 |
| C1751 |
Cath, inf, per/cent/midline |
24 |
24 |
$0.00 |
| 0013A |
|
40 |
27 |
$0.00 |
| 01830 |
|
12 |
12 |
$0.00 |
| C1760 |
Closure dev, vasc |
48 |
40 |
$0.00 |
| 69210 |
|
12 |
12 |
$0.00 |
| G8427 |
Docrev cur meds by elig clin |
54 |
20 |
$0.00 |
| 0479T |
|
59 |
12 |
$0.00 |
| J2550 |
Promethazine hcl injection |
16 |
12 |
$0.00 |
| 80195 |
|
15 |
12 |
$0.00 |
| 88344 |
|
15 |
13 |
$0.00 |