| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99211 |
|
244,360 |
194,888 |
$17.36M |
| 99212 |
|
122,463 |
104,341 |
$8.23M |
| 96361 |
|
54,372 |
37,991 |
$7.44M |
| 99284 |
|
95,415 |
79,738 |
$5.75M |
| 99283 |
|
75,516 |
64,637 |
$5.01M |
| 80048 |
|
168,391 |
121,389 |
$4.81M |
| 80053 |
|
114,062 |
79,426 |
$4.20M |
| J9271 |
Inj pembrolizumab |
2,283 |
1,652 |
$3.45M |
| P9016 |
Rbc leukocytes reduced |
4,928 |
3,915 |
$3.45M |
| 96365 |
|
39,534 |
25,428 |
$3.29M |
| 92012 |
|
59,814 |
49,299 |
$2.88M |
| 77386 |
|
12,543 |
1,192 |
$2.12M |
| 96366 |
|
19,035 |
9,935 |
$2.05M |
| 70450 |
|
24,696 |
21,754 |
$2.04M |
| 74177 |
|
24,087 |
21,367 |
$1.88M |
| 96413 |
|
28,229 |
17,139 |
$1.83M |
| 99213 |
|
24,993 |
21,524 |
$1.78M |
| 99282 |
|
22,625 |
20,092 |
$1.67M |
| J0585 |
Injection,onabotulinumtoxina |
15,135 |
10,083 |
$1.61M |
| J1569 |
Gammagard liquid injection |
3,433 |
1,001 |
$1.61M |
| 97110 |
|
59,839 |
22,550 |
$1.42M |
| 96360 |
|
16,786 |
13,047 |
$1.33M |
| Q3014 |
Telehealth facility fee |
32,407 |
27,894 |
$1.30M |
| J1745 |
Infliximab not biosimil 10mg |
3,101 |
2,552 |
$1.25M |
| 85025 |
|
209,167 |
149,458 |
$1.24M |
| 96415 |
|
10,306 |
7,342 |
$1.21M |
| J2505 |
Injection, pegfilgrastim 6mg |
1,543 |
1,075 |
$1.07M |
| 70553 |
|
9,000 |
7,934 |
$986K |
| 87491 |
|
26,388 |
23,405 |
$941K |
| 43239 |
|
4,502 |
3,890 |
$895K |
| Q5103 |
Injection, inflectra |
2,201 |
1,810 |
$852K |
| 80307 |
|
16,688 |
13,733 |
$849K |
| 96367 |
|
10,796 |
7,027 |
$842K |
| 87636 |
|
12,041 |
10,408 |
$837K |
| 71260 |
|
11,930 |
10,707 |
$833K |
| U0004 |
Cov-19 test non-cdc hgh thru |
13,597 |
11,724 |
$832K |
| 87591 |
|
26,429 |
23,458 |
$828K |
| 85610 |
|
56,934 |
36,675 |
$808K |
| 77412 |
|
6,247 |
840 |
$805K |
| 93306 |
|
7,824 |
7,032 |
$801K |
| G0463 |
Hospital outpt clinic visit |
135,466 |
93,190 |
$774K |
| 36512 |
|
1,811 |
1,516 |
$738K |
| 99214 |
|
9,442 |
8,056 |
$711K |
| 52000 |
|
2,444 |
2,228 |
$705K |
| 36430 |
|
6,520 |
3,564 |
$694K |
| G0378 |
Hospital observation per hr |
26,680 |
22,081 |
$690K |
| J9299 |
Injection, nivolumab |
930 |
535 |
$674K |
| J1459 |
Inj ivig privigen 500 mg |
1,622 |
638 |
$660K |
| 78452 |
|
3,645 |
3,221 |
$615K |
| 71275 |
|
7,001 |
6,193 |
$610K |
| 78815 |
|
2,549 |
2,243 |
$584K |
| 99285 |
|
8,994 |
7,956 |
$575K |
| 99215 |
Prolong outpt/office vis |
8,765 |
7,696 |
$566K |
| J3380 |
Inj vedolizumab iv 1 mg |
520 |
455 |
$518K |
| 45380 |
|
2,738 |
2,357 |
$514K |
| C8929 |
Tte w or wo fol wcon,doppler |
5,056 |
4,545 |
$497K |
| J0475 |
Baclofen 10 mg injection |
2,257 |
2,148 |
$494K |
| 64643 |
|
3,810 |
3,507 |
$461K |
| 76816 |
|
11,645 |
9,517 |
$451K |
| 97140 |
|
24,561 |
10,231 |
$439K |
| 82306 |
|
19,376 |
17,423 |
$422K |
| 94640 |
|
11,104 |
6,239 |
$409K |
| 87637 |
|
4,290 |
3,837 |
$405K |
| 96372 |
|
65,697 |
40,343 |
$403K |
| 85027 |
|
81,460 |
60,234 |
$399K |
| 80076 |
|
36,064 |
30,151 |
$398K |
| C9257 |
Bevacizumab injection |
2,497 |
2,192 |
$392K |
| 74176 |
|
5,245 |
4,717 |
$391K |
| 97530 |
|
21,660 |
7,833 |
$386K |
| 72125 |
|
10,815 |
9,766 |
$382K |
| 84484 |
|
54,552 |
27,118 |
$382K |
| 80081 |
|
3,596 |
3,144 |
$376K |
| 87077 |
|
18,571 |
16,051 |
$367K |
| 82962 |
|
14,108 |
12,187 |
$365K |
| 87389 |
|
18,795 |
16,843 |
$362K |
| 93308 |
|
2,969 |
2,574 |
$359K |
| 95810 |
|
1,567 |
1,477 |
$347K |
| 96910 |
|
6,125 |
1,239 |
$336K |
| 64615 |
|
3,712 |
3,383 |
$328K |
| 83735 |
|
78,295 |
46,727 |
$325K |
| 83036 |
|
35,760 |
31,957 |
$323K |
| 76856 |
|
5,988 |
5,452 |
$320K |
| 49083 |
|
2,063 |
949 |
$317K |
| 77336 |
|
5,921 |
2,644 |
$310K |
| J0741 |
Inj, cabote rilpivir 2mg 3mg |
274 |
248 |
$310K |
| 87086 |
|
31,204 |
27,039 |
$309K |
| 83021 |
|
11,022 |
7,361 |
$306K |
| 84443 |
|
27,351 |
24,084 |
$305K |
| J2506 |
Inj pegfilgrast ex bio 0.5mg |
717 |
515 |
$303K |
| 96417 |
|
5,808 |
3,419 |
$299K |
| 76705 |
|
7,281 |
6,484 |
$297K |
| 20610 |
|
5,137 |
4,196 |
$295K |
| 72148 |
|
4,393 |
3,939 |
$294K |
| 74183 |
|
3,040 |
2,672 |
$292K |
| 76819 |
|
9,924 |
4,282 |
$277K |
| 83880 |
|
13,227 |
11,133 |
$273K |
| 95874 |
|
7,214 |
6,610 |
$273K |
| 81025 |
|
20,197 |
17,470 |
$268K |
| 70551 |
|
3,919 |
3,538 |
$267K |
| 80061 |
|
18,218 |
16,266 |
$266K |
| 76830 |
|
6,164 |
5,563 |
$266K |
| 76811 |
|
4,957 |
4,430 |
$255K |
| 87536 |
|
4,210 |
3,572 |
$252K |
| G0480 |
Drug test def 1-7 classes |
6,744 |
5,576 |
$251K |
| 97162 |
|
9,311 |
7,871 |
$248K |
| J2357 |
Omalizumab injection |
2,357 |
847 |
$244K |
| 95806 |
|
2,077 |
1,968 |
$244K |
| 70496 |
|
2,563 |
2,286 |
$244K |
| 76642 |
|
6,006 |
4,992 |
$238K |
| 97112 |
|
10,550 |
5,204 |
$236K |
| 64644 |
|
3,930 |
3,642 |
$236K |
| 81001 |
|
64,716 |
55,439 |
$235K |
| 45385 |
|
1,327 |
1,138 |
$233K |
| 51705 |
|
3,488 |
2,849 |
$232K |
| J0485 |
Belatacept injection |
3,293 |
1,498 |
$232K |
| J9312 |
Inj., rituximab, 10 mg |
303 |
172 |
$230K |
| 84702 |
|
9,561 |
7,491 |
$229K |
| 82728 |
|
19,454 |
16,389 |
$225K |
| 83970 |
|
8,897 |
7,679 |
$220K |
| 72131 |
|
6,070 |
5,484 |
$218K |
| 73721 |
|
2,890 |
2,475 |
$209K |
| 95811 |
|
1,025 |
950 |
$207K |
| 67028 |
|
4,191 |
3,662 |
$206K |
| 87624 |
|
5,987 |
5,001 |
$205K |
| 43235 |
|
1,032 |
914 |
$201K |
| 95886 |
|
2,895 |
2,687 |
$200K |
| 76801 |
|
6,776 |
5,892 |
$195K |
| 87502 |
|
2,794 |
2,473 |
$193K |
| 93971 |
|
6,025 |
5,364 |
$193K |
| 70498 |
|
2,396 |
2,133 |
$191K |
| 36561 |
|
433 |
382 |
$191K |
| 72141 |
|
2,811 |
2,545 |
$190K |
| 70486 |
|
4,664 |
4,234 |
$188K |
| 71250 |
|
5,118 |
4,560 |
$183K |
| 76817 |
|
12,185 |
10,230 |
$181K |
| 87210 |
|
13,725 |
12,278 |
$181K |
| 88175 |
|
7,118 |
6,153 |
$180K |
| 96368 |
|
3,356 |
1,899 |
$179K |
| 90686 |
|
10,357 |
9,431 |
$177K |
| 64616 |
|
1,909 |
1,734 |
$175K |
| 76770 |
|
3,106 |
2,867 |
$175K |
| 92014 |
|
3,507 |
3,200 |
$170K |
| 72128 |
|
4,725 |
4,262 |
$170K |
| Q5115 |
Inj truxima 10 mg |
203 |
76 |
$169K |
| 77067 |
|
5,714 |
5,270 |
$168K |
| 87661 |
|
5,480 |
4,886 |
$164K |
| 93017 |
|
4,023 |
3,568 |
$163K |
| 72197 |
|
1,543 |
1,333 |
$163K |
| 86480 |
|
3,357 |
2,915 |
$161K |
| 66984 |
|
947 |
758 |
$160K |
| 83690 |
|
28,918 |
23,915 |
$157K |
| J1930 |
Lanreotide injection |
209 |
190 |
$152K |
| 70491 |
|
2,079 |
1,879 |
$151K |
| 94660 |
|
2,535 |
1,283 |
$147K |
| 82565 |
|
10,051 |
8,324 |
$145K |
| 82805 |
|
6,571 |
5,391 |
$145K |
| 76805 |
|
2,254 |
2,104 |
$143K |
| 71046 |
|
45,418 |
38,901 |
$142K |
| 84100 |
|
54,235 |
31,330 |
$142K |
| 97116 |
|
9,508 |
4,146 |
$139K |
| J9144 |
Daratumumab, hyaluronidase |
274 |
158 |
$139K |
| 11042 |
|
1,369 |
1,040 |
$137K |
| 17250 |
|
1,708 |
1,325 |
$137K |
| J9355 |
Inj trastuzumab excl biosimi |
356 |
145 |
$136K |
| 82607 |
|
10,515 |
9,409 |
$136K |
| 64642 |
|
2,318 |
2,100 |
$135K |
| 84439 |
|
14,080 |
12,185 |
$134K |
| J0178 |
Aflibercept injection |
1,117 |
998 |
$128K |
| 76813 |
|
3,637 |
3,262 |
$127K |
| 72156 |
|
1,137 |
1,034 |
$127K |
| 86832 |
|
1,892 |
1,533 |
$126K |
| 31575 |
|
2,478 |
2,187 |
$126K |
| 77301 |
|
595 |
509 |
$126K |
| 93296 |
|
4,001 |
3,761 |
$126K |
| 77290 |
|
1,245 |
768 |
$124K |
| 00731 |
|
3,190 |
2,733 |
$124K |
| 93451 |
|
226 |
186 |
$124K |
| 96416 |
|
950 |
588 |
$123K |
| U0005 |
Infec agen detec ampli probe |
10,339 |
8,875 |
$123K |
| 38222 |
|
702 |
463 |
$123K |
| 90715 |
|
9,969 |
9,083 |
$122K |
| 87070 |
|
7,178 |
5,728 |
$119K |
| 92507 |
|
3,918 |
1,329 |
$118K |
| 73221 |
|
1,830 |
1,618 |
$118K |
| 84132 |
|
8,972 |
7,274 |
$117K |
| 80197 |
|
11,406 |
6,517 |
$115K |
| 97163 |
|
5,612 |
4,415 |
$114K |
| 93005 |
|
83,347 |
66,862 |
$113K |
| 80050 |
|
6,358 |
5,480 |
$112K |
| 77300 |
|
2,044 |
1,438 |
$111K |
| 83615 |
|
29,544 |
16,009 |
$111K |
| 10060 |
|
1,393 |
1,207 |
$111K |
| 93356 |
|
1,126 |
1,003 |
$110K |
| 82784 |
|
7,763 |
6,388 |
$108K |
| 76700 |
|
1,927 |
1,770 |
$108K |
| 94010 |
|
7,934 |
6,744 |
$108K |
| 86803 |
|
9,493 |
8,294 |
$108K |
| C8930 |
Tte w or w/o contr, cont ecg |
1,020 |
927 |
$107K |
| 86850 |
|
16,857 |
13,122 |
$106K |
| 93976 |
|
2,341 |
2,124 |
$106K |
| 76536 |
|
2,446 |
2,242 |
$106K |
| 97161 |
|
3,001 |
2,631 |
$105K |
| 87088 |
|
17,054 |
15,110 |
$105K |
| 62370 |
|
2,154 |
2,055 |
$105K |
| 86900 |
|
20,510 |
16,155 |
$104K |
| 83605 |
|
11,407 |
9,268 |
$102K |
| 82105 |
|
5,747 |
4,945 |
$101K |
| 87635 |
|
2,652 |
2,384 |
$101K |
| 87081 |
|
6,268 |
5,676 |
$101K |
| 93321 |
|
942 |
787 |
$100K |
| J1453 |
Fosaprepitant injection |
3,690 |
2,372 |
$99K |
| 86833 |
|
1,833 |
1,487 |
$98K |
| 97166 |
|
4,169 |
3,356 |
$98K |
| 19083 |
|
360 |
296 |
$98K |
| Q5106 |
Inj retacrit non-esrd use |
2,637 |
1,563 |
$98K |
| 77080 |
|
1,656 |
1,541 |
$96K |
| 64645 |
|
989 |
922 |
$96K |
| 77334 |
|
2,290 |
1,695 |
$96K |
| 96374 |
|
67,453 |
54,237 |
$96K |
| 77066 |
Tomosynthesis, mammo |
3,887 |
3,458 |
$95K |
| 86140 |
|
15,562 |
13,167 |
$95K |
| 87497 |
|
3,750 |
2,294 |
$93K |
| 82570 |
|
12,219 |
9,957 |
$92K |
| 87186 |
|
13,590 |
11,695 |
$91K |
| 97165 |
|
2,985 |
2,514 |
$91K |
| 77065 |
Tomosynthesis, mammo |
4,378 |
3,596 |
$91K |
| 36902 |
|
270 |
224 |
$90K |
| 77063 |
|
4,486 |
4,128 |
$90K |
| 93798 |
|
2,062 |
402 |
$90K |
| J9217 |
Leuprolide acetate suspnsion |
1,253 |
1,060 |
$88K |
| 86923 |
|
7,365 |
4,184 |
$86K |
| 86592 |
|
10,731 |
9,443 |
$86K |
| 86902 |
|
3,027 |
2,372 |
$86K |
| 94060 |
|
3,694 |
3,355 |
$85K |
| 76882 |
|
2,010 |
1,822 |
$84K |
| Q0138 |
Ferumoxytol, non-esrd |
1,593 |
962 |
$84K |
| 72158 |
|
964 |
869 |
$82K |
| 93970 |
|
1,787 |
1,615 |
$82K |
| 93922 |
|
3,647 |
3,315 |
$82K |
| 76512 |
|
2,062 |
1,716 |
$82K |
| 97535 |
|
7,332 |
3,605 |
$81K |
| 12002 |
|
992 |
915 |
$81K |
| J0588 |
Incobotulinumtoxin a |
668 |
467 |
$81K |
| 84550 |
|
29,346 |
16,396 |
$80K |
| 31579 |
|
553 |
515 |
$80K |
| 74174 |
|
1,109 |
977 |
$79K |
| 12001 |
|
971 |
882 |
$79K |
| 20611 |
|
693 |
592 |
$78K |
| 83550 |
|
14,751 |
13,055 |
$77K |
| 82950 |
|
3,915 |
3,595 |
$76K |
| 82746 |
|
7,596 |
6,841 |
$76K |
| 74160 |
|
1,140 |
1,031 |
$76K |
| 82947 |
|
4,375 |
3,616 |
$75K |
| 83540 |
|
17,220 |
15,283 |
$74K |
| 87798 |
|
3,216 |
1,863 |
$72K |
| 31231 |
|
1,203 |
1,072 |
$72K |
| 72157 |
|
712 |
646 |
$70K |
| 90471 |
|
12,487 |
11,200 |
$67K |
| 92004 |
|
1,386 |
1,246 |
$67K |
| 91322 |
|
1,159 |
983 |
$67K |
| J0586 |
Abobotulinumtoxina |
706 |
485 |
$66K |
| G0008 |
Admin influenza virus vac |
14,409 |
12,956 |
$65K |
| 43762 |
|
956 |
845 |
$65K |
| 84153 |
|
4,327 |
3,564 |
$64K |
| 82533 |
|
3,801 |
2,829 |
$64K |
| Q5107 |
Inj mvasi 10 mg |
291 |
119 |
$64K |
| 74230 |
|
1,076 |
961 |
$64K |
| J2323 |
Natalizumab injection |
83 |
74 |
$64K |
| J2350 |
Injection, ocrelizumab, 1 mg |
13 |
12 |
$62K |
| 82024 |
|
1,951 |
1,679 |
$62K |
| 84403 |
|
3,272 |
2,883 |
$62K |
| 86360 |
|
1,824 |
1,569 |
$61K |
| P9040 |
Rbc leukoreduced irradiated |
810 |
370 |
$61K |
| Q0222 |
Bebtelovimab 175 mg |
68 |
54 |
$59K |
| 29581 |
|
722 |
203 |
$59K |
| 87040 |
|
8,992 |
3,675 |
$58K |
| 87522 |
Neg quan hep c or qual rna |
1,599 |
1,412 |
$58K |
| 92557 |
|
2,772 |
2,512 |
$58K |
| 82670 |
|
2,161 |
1,882 |
$57K |
| J1756 |
Iron sucrose injection |
5,446 |
2,776 |
$57K |
| 86160 |
|
3,222 |
2,800 |
$56K |
| 86334 |
|
5,594 |
4,560 |
$55K |
| 74018 |
|
7,263 |
6,274 |
$55K |
| 80177 |
|
3,354 |
2,951 |
$55K |
| 82043 |
|
4,990 |
4,508 |
$54K |
| 86359 |
|
1,892 |
1,612 |
$54K |
| 01922 |
|
703 |
574 |
$53K |
| 85379 |
|
7,034 |
5,983 |
$53K |
| 73700 |
|
1,205 |
1,047 |
$52K |
| 87799 |
|
2,492 |
1,686 |
$51K |
| 64612 |
|
672 |
611 |
$51K |
| J9310 |
Rituximab injection |
70 |
52 |
$51K |
| 82378 |
|
4,227 |
3,371 |
$51K |
| 77001 |
|
2,308 |
1,970 |
$50K |
| 77062 |
|
2,927 |
2,661 |
$50K |
| 77061 |
|
2,995 |
2,511 |
$49K |
| 82330 |
|
3,546 |
2,540 |
$49K |
| 85730 |
|
13,538 |
11,561 |
$49K |
| J7298 |
Mirena, 52 mg |
286 |
243 |
$49K |
| 97167 |
|
3,117 |
2,307 |
$48K |
| 82550 |
|
6,910 |
5,408 |
$48K |
| J0885 |
Epoetin alfa, non-esrd |
1,056 |
692 |
$48K |
| 52287 |
|
262 |
239 |
$46K |
| 87880 |
|
2,725 |
2,491 |
$46K |
| 92134 |
|
13,849 |
12,217 |
$46K |
| 82375 |
|
2,655 |
2,214 |
$45K |
| 47562 |
|
28 |
26 |
$44K |
| J0897 |
Denosumab injection |
433 |
390 |
$44K |
| 82077 |
|
4,376 |
3,732 |
$44K |
| 92002 |
|
729 |
658 |
$44K |
| 73030 |
|
11,185 |
9,503 |
$43K |
| 73560 |
|
13,784 |
11,571 |
$43K |
| 11900 |
|
697 |
616 |
$43K |
| 77002 |
|
959 |
881 |
$43K |
| 86706 |
|
6,353 |
5,421 |
$41K |
| 80164 |
|
2,126 |
1,788 |
$41K |
| 83516 |
|
3,952 |
2,925 |
$41K |
| 87340 |
|
6,938 |
5,908 |
$41K |
| 93325 |
|
1,517 |
1,281 |
$41K |
| 51702 |
|
3,014 |
2,495 |
$40K |
| 12011 |
|
580 |
521 |
$40K |
| 80069 |
|
1,524 |
1,343 |
$40K |
| 77295 |
|
202 |
157 |
$40K |
| 80143 |
|
3,094 |
2,673 |
$40K |
| 86039 |
|
4,085 |
3,560 |
$39K |
| 97597 |
|
796 |
599 |
$39K |
| 87450 |
|
3,801 |
3,466 |
$38K |
| 92083 |
|
7,234 |
6,513 |
$38K |
| 92611 |
|
942 |
769 |
$38K |
| 70543 |
|
338 |
311 |
$37K |
| 73630 |
|
10,880 |
9,031 |
$36K |
| 84146 |
|
2,277 |
2,019 |
$36K |
| J1610 |
Glucagon hydrochloride/1 mg |
1,185 |
992 |
$35K |
| 80175 |
|
1,687 |
1,462 |
$35K |
| 87493 |
|
1,327 |
1,159 |
$35K |
| 88307 |
|
5,267 |
3,028 |
$35K |
| 82150 |
|
4,037 |
2,936 |
$35K |
| 87632 |
|
261 |
222 |
$34K |
| M0243 |
Casirivi and imdevi inj |
99 |
92 |
$34K |
| 11104 |
|
303 |
271 |
$34K |
| 88264 |
|
537 |
382 |
$34K |
| 83001 |
|
2,217 |
1,967 |
$34K |
| J0791 |
Inj crizanlizumab-tmca 5mg |
112 |
80 |
$33K |
| 45378 |
|
141 |
128 |
$33K |
| 87641 |
|
836 |
742 |
$33K |
| 36821 |
|
57 |
40 |
$33K |
| J9035 |
Bevacizumab injection |
48 |
26 |
$33K |
| G0257 |
Unsched dialysis esrd pt hos |
1,489 |
958 |
$33K |
| 86301 |
|
2,952 |
2,343 |
$33K |
| 72100 |
|
4,905 |
4,491 |
$33K |
| 84703 |
|
2,712 |
2,291 |
$33K |
| 83883 |
|
3,421 |
2,801 |
$33K |
| 58661 |
|
35 |
27 |
$32K |
| J2353 |
Octreotide injection, depot |
57 |
53 |
$32K |
| 81003 |
|
6,986 |
6,196 |
$32K |
| 86304 |
|
2,313 |
1,745 |
$32K |
| 70544 |
|
294 |
265 |
$32K |
| 80179 |
|
2,948 |
2,564 |
$32K |
| 58300 |
|
646 |
538 |
$32K |
| 76942 |
|
3,251 |
2,667 |
$31K |
| 86235 |
|
408 |
336 |
$31K |
| 41899 |
|
102 |
85 |
$31K |
| 84156 |
|
12,270 |
9,935 |
$31K |
| 00811 |
|
1,265 |
1,098 |
$30K |
| 83010 |
|
3,174 |
2,353 |
$30K |
| 92235 |
|
563 |
504 |
$30K |
| 73610 |
|
11,540 |
9,673 |
$30K |
| G0108 |
Diab manage trn per indiv |
1,066 |
929 |
$30K |
| 76937 |
|
3,331 |
2,754 |
$30K |
| 59025 |
|
284 |
187 |
$29K |
| 86704 |
|
3,149 |
2,719 |
$29K |
| 11100 |
|
250 |
218 |
$29K |
| 86901 |
|
15,700 |
12,340 |
$29K |
| 84165 |
|
5,837 |
4,775 |
$29K |
| 85097 |
|
951 |
621 |
$29K |
| 93880 |
|
1,206 |
1,105 |
$29K |
| 88275 |
|
772 |
560 |
$28K |
| J0881 |
Darbepoetin alfa, non-esrd |
524 |
340 |
$28K |
| 82040 |
|
2,191 |
1,933 |
$28K |
| 73502 |
|
7,394 |
6,543 |
$28K |
| 58100 |
|
265 |
221 |
$28K |
| 91010 |
|
199 |
183 |
$27K |
| 51728 |
|
250 |
230 |
$27K |
| 86225 |
|
2,838 |
2,475 |
$27K |
| 72040 |
|
1,807 |
1,592 |
$27K |
| 84425 |
|
1,869 |
1,699 |
$26K |
| 82248 |
|
5,542 |
4,071 |
$26K |
| J2997 |
Alteplase recombinant |
1,548 |
1,207 |
$26K |
| 00813 |
|
796 |
682 |
$26K |
| 93225 |
|
1,322 |
1,203 |
$26K |
| 77470 |
|
252 |
208 |
$26K |
| 84630 |
|
3,594 |
3,296 |
$26K |
| 90935 |
|
113 |
64 |
$25K |
| J0875 |
Injection, dalbavancin |
36 |
24 |
$25K |
| 81002 |
|
1,146 |
851 |
$25K |
| 84145 |
|
1,813 |
1,511 |
$25K |
| 77338 |
|
518 |
481 |
$25K |
| 43760 |
|
207 |
177 |
$24K |
| 85018 |
|
6,419 |
5,171 |
$24K |
| 93320 |
|
228 |
199 |
$24K |
| 84481 |
|
2,194 |
1,909 |
$24K |
| 76519 |
|
601 |
536 |
$23K |
| 76870 |
|
658 |
597 |
$23K |
| 85049 |
|
1,647 |
1,440 |
$23K |
| 36592 |
|
13,178 |
7,416 |
$23K |
| 36591 |
|
18,118 |
10,540 |
$23K |
| 64400 |
|
174 |
161 |
$23K |
| 90670 |
|
988 |
885 |
$23K |
| P9047 |
Albumin (human), 25%, 50ml |
204 |
89 |
$22K |
| 17110 |
|
376 |
338 |
$22K |
| 11102 |
|
227 |
204 |
$21K |
| 94726 |
|
3,463 |
3,035 |
$21K |
| 86708 |
|
2,195 |
1,894 |
$21K |
| 71045 |
|
29,405 |
25,151 |
$21K |
| 94770 |
|
409 |
243 |
$21K |
| 88112 |
|
2,297 |
1,950 |
$21K |
| G0422 |
Intens cardiac rehab w/exerc |
1,028 |
177 |
$21K |
| 92133 |
|
8,291 |
7,544 |
$20K |
| J3471 |
Ovine, up to 999 usp units |
1,528 |
1,207 |
$20K |
| 76000 |
|
2,308 |
1,810 |
$20K |
| 87075 |
|
3,216 |
2,567 |
$20K |
| 96375 |
|
55,529 |
39,798 |
$20K |
| 73130 |
|
8,261 |
6,592 |
$20K |
| 83521 |
|
1,591 |
1,220 |
$20K |
| 84466 |
|
2,267 |
2,095 |
$20K |
| 76815 |
|
1,276 |
1,155 |
$20K |
| 96900 |
|
1,165 |
257 |
$20K |
| 86705 |
|
2,406 |
2,039 |
$20K |
| 36415 |
|
95,386 |
67,546 |
$19K |
| 00400 |
|
326 |
237 |
$19K |
| 85045 |
|
7,886 |
5,934 |
$19K |
| 88271 |
|
732 |
541 |
$19K |
| 82140 |
|
882 |
742 |
$19K |
| 72146 |
|
282 |
258 |
$18K |
| 78431 |
|
61 |
54 |
$18K |
| 88305 |
|
33,754 |
16,748 |
$18K |
| 88237 |
|
572 |
412 |
$18K |
| 76820 |
|
1,562 |
632 |
$18K |
| 85652 |
|
10,505 |
9,085 |
$18K |
| 90480 |
|
1,189 |
1,007 |
$18K |
| 84450 |
|
3,752 |
3,147 |
$18K |
| 64646 |
|
391 |
349 |
$18K |
| 87205 |
|
6,450 |
5,227 |
$17K |
| 85014 |
|
3,479 |
2,872 |
$17K |
| 82948 |
|
550 |
468 |
$17K |
| 87529 |
|
288 |
256 |
$17K |
| 84460 |
|
3,564 |
2,876 |
$17K |
| 97542 |
|
1,646 |
1,264 |
$17K |
| 83002 |
|
1,259 |
1,140 |
$17K |
| 87102 |
|
2,157 |
1,726 |
$16K |
| 92523 |
|
479 |
362 |
$16K |
| 96523 |
|
541 |
454 |
$16K |
| 87430 |
|
621 |
562 |
$16K |
| 92020 |
|
1,036 |
925 |
$16K |
| 96402 |
|
2,269 |
1,892 |
$15K |
| 75561 |
|
157 |
131 |
$15K |
| G0103 |
Psa screening |
1,175 |
1,036 |
$15K |
| 84305 |
|
1,085 |
979 |
$15K |
| 95885 |
|
236 |
215 |
$15K |
| Q5122 |
Inj, nyvepria |
14 |
12 |
$15K |
| 87640 |
|
299 |
267 |
$14K |
| 51741 |
|
354 |
323 |
$14K |
| 93926 |
|
873 |
778 |
$14K |
| G0009 |
Admin pneumococcal vaccine |
3,875 |
3,408 |
$14K |
| 87015 |
|
861 |
649 |
$14K |
| J9070 |
Cyclophosphamide 100 mg inj |
560 |
237 |
$14K |
| Q5111 |
Injection, udenyca 0.5 mg |
39 |
28 |
$14K |
| 94762 |
|
445 |
400 |
$14K |
| 83921 |
|
887 |
812 |
$13K |
| 72050 |
|
1,041 |
953 |
$13K |
| 86316 |
|
1,043 |
898 |
$13K |
| 88184 |
|
2,388 |
1,768 |
$13K |
| 86922 |
|
2,028 |
613 |
$13K |
| 90732 |
|
1,538 |
1,384 |
$13K |
| 87206 |
|
2,735 |
2,112 |
$13K |
| 87808 |
|
954 |
865 |
$12K |
| 73110 |
|
5,230 |
4,268 |
$12K |
| 86361 |
|
580 |
500 |
$12K |
| 73562 |
|
3,414 |
3,017 |
$12K |
| 94618 |
|
1,706 |
1,501 |
$12K |
| 73552 |
|
5,384 |
4,792 |
$12K |
| 20605 |
|
146 |
130 |
$12K |
| 74019 |
|
1,660 |
1,508 |
$12K |
| 90662 |
|
2,946 |
2,508 |
$11K |
| 92610 |
|
592 |
455 |
$11K |
| 36000 |
|
10,308 |
9,134 |
$11K |
| 86644 |
|
1,072 |
793 |
$11K |
| 51798 |
|
5,651 |
5,016 |
$11K |
| P9045 |
Albumin (human), 5%, 250 ml |
237 |
96 |
$11K |
| 20680 |
|
16 |
12 |
$11K |
| 36832 |
|
14 |
12 |
$11K |
| 83520 |
|
750 |
660 |
$11K |
| 94729 |
|
4,699 |
4,164 |
$11K |
| 10005 |
|
59 |
49 |
$11K |
| M0222 |
Bebtelovimab injection |
74 |
57 |
$11K |
| 00790 |
|
113 |
93 |
$11K |
| 93270 |
|
575 |
518 |
$11K |
| 95816 |
|
83 |
76 |
$10K |
| 00840 |
|
148 |
115 |
$10K |
| 88280 |
|
706 |
511 |
$10K |
| 92250 |
|
5,175 |
4,529 |
$10K |
| 73590 |
|
6,349 |
5,356 |
$10K |
| 96401 |
|
1,515 |
739 |
$10K |
| 90651 |
|
239 |
215 |
$10K |
| 88185 |
|
2,233 |
1,640 |
$10K |
| 78306 |
|
129 |
119 |
$10K |
| 92567 |
|
1,042 |
936 |
$10K |
| 90677 |
|
1,055 |
895 |
$9K |
| 80165 |
|
899 |
794 |
$9K |
| 86800 |
|
838 |
714 |
$9K |
| 0124A |
|
762 |
623 |
$9K |
| 87633 |
|
50 |
42 |
$9K |
| 72072 |
|
1,508 |
1,370 |
$9K |
| 85651 |
|
3,776 |
3,207 |
$9K |
| 0399T |
|
303 |
255 |
$9K |
| 67228 |
|
47 |
41 |
$9K |
| 73080 |
|
3,660 |
3,147 |
$8K |
| 89051 |
|
1,323 |
1,000 |
$8K |
| 45300 |
|
43 |
36 |
$8K |
| 0003A |
|
424 |
361 |
$8K |
| 86780 |
|
918 |
822 |
$8K |
| 75574 |
|
78 |
66 |
$8K |
| 76498 |
|
181 |
129 |
$8K |
| 82010 |
|
1,191 |
1,007 |
$8K |
| 85007 |
|
5,216 |
3,173 |
$8K |
| 73564 |
|
1,841 |
1,643 |
$8K |
| 90791 |
|
216 |
183 |
$8K |
| 01844 |
|
90 |
84 |
$8K |
| 82103 |
|
664 |
599 |
$8K |
| 86769 |
|
270 |
237 |
$8K |
| 80235 |
|
407 |
360 |
$8K |
| 58301 |
|
147 |
129 |
$7K |
| 43249 |
|
31 |
26 |
$7K |
| 87517 |
|
269 |
228 |
$7K |
| 82088 |
|
247 |
193 |
$7K |
| 90656 |
|
963 |
893 |
$7K |
| 96409 |
|
1,700 |
750 |
$7K |
| 82310 |
|
940 |
761 |
$7K |
| 80051 |
|
274 |
220 |
$7K |
| J1650 |
Inj enoxaparin sodium |
16,455 |
6,014 |
$7K |
| 20553 |
|
132 |
110 |
$7K |
| U0002 |
Covid-19 lab test non-cdc |
226 |
171 |
$6K |
| 87521 |
Neg quan hep c or qual rna |
273 |
248 |
$6K |
| 51797 |
|
612 |
566 |
$6K |
| 87902 |
|
26 |
25 |
$6K |
| 95911 |
|
143 |
133 |
$6K |
| 74178 |
|
95 |
86 |
$6K |
| 01480 |
|
104 |
81 |
$6K |
| 29405 |
|
77 |
64 |
$6K |
| C1725 |
Cath, translumin non-laser |
2,055 |
1,622 |
$6K |
| 73521 |
|
779 |
717 |
$6K |
| 82610 |
|
656 |
562 |
$6K |
| 82747 |
|
532 |
495 |
$6K |
| 0001A |
|
225 |
198 |
$6K |
| J3489 |
Zoledronic acid 1mg |
1,212 |
1,081 |
$6K |
| 86431 |
|
1,521 |
1,334 |
$6K |
| C1776 |
Joint device (implantable) |
197 |
174 |
$6K |
| 0002A |
|
220 |
203 |
$6K |
| 82977 |
|
1,005 |
766 |
$6K |
| 93750 |
|
339 |
241 |
$6K |
| 93242 |
|
294 |
271 |
$6K |
| 94799 |
|
5,885 |
3,780 |
$6K |
| 88342 |
|
3,873 |
3,035 |
$6K |
| J9041 |
Injection, bortezomib, 0.1mg |
50 |
12 |
$6K |
| 88360 |
|
524 |
412 |
$6K |
| 87106 |
|
827 |
698 |
$5K |
| 86355 |
|
206 |
184 |
$5K |
| 92504 |
|
667 |
573 |
$5K |
| 87045 |
|
418 |
342 |
$5K |
| P9037 |
Plate pheres leukoredu irrad |
27 |
13 |
$5K |
| 82785 |
|
292 |
259 |
$5K |
| 86665 |
|
375 |
290 |
$5K |
| 73090 |
|
2,964 |
2,538 |
$5K |
| 71271 |
|
111 |
94 |
$5K |
| 93975 |
|
110 |
101 |
$5K |
| 95819 |
|
39 |
36 |
$5K |
| 88341 |
|
1,172 |
964 |
$5K |
| 96376 |
|
24,896 |
15,602 |
$5K |
| 86787 |
|
839 |
697 |
$5K |
| 36589 |
|
30 |
28 |
$5K |
| 83050 |
|
2,213 |
1,831 |
$5K |
| 86255 |
|
618 |
518 |
$5K |
| 70546 |
|
52 |
50 |
$5K |
| 90739 |
|
566 |
503 |
$5K |
| 94667 |
|
320 |
282 |
$4K |
| 00142 |
|
112 |
90 |
$4K |
| 11721 |
|
274 |
244 |
$4K |
| 72170 |
|
2,339 |
2,077 |
$4K |
| 86880 |
|
1,209 |
935 |
$4K |
| 93990 |
|
751 |
600 |
$4K |
| 92136 |
|
943 |
870 |
$4K |
| 89050 |
|
769 |
625 |
$4K |
| 72190 |
|
1,762 |
1,548 |
$4K |
| 88172 |
|
708 |
591 |
$4K |
| 87116 |
|
676 |
516 |
$4K |
| 82951 |
|
85 |
84 |
$4K |
| 36558 |
|
17 |
12 |
$4K |
| 74170 |
|
87 |
80 |
$4K |
| G0423 |
Intens cardiac rehab no exer |
540 |
108 |
$4K |
| 86762 |
|
321 |
292 |
$4K |
| L2112 |
Afo tibial fracture soft |
329 |
301 |
$4K |
| 86147 |
|
260 |
214 |
$4K |
| 86870 |
|
247 |
177 |
$4K |
| 95970 |
|
146 |
136 |
$4K |
| 64999 |
|
43 |
13 |
$4K |
| 95909 |
|
57 |
52 |
$4K |
| 85520 |
|
76 |
51 |
$4K |
| 84432 |
|
291 |
245 |
$4K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
55,531 |
44,145 |
$4K |
| 36593 |
|
381 |
305 |
$4K |
| G0010 |
Admin hepatitis b vaccine |
1,020 |
914 |
$4K |
| 80158 |
|
114 |
62 |
$4K |
| 95912 |
|
112 |
96 |
$4K |
| 73140 |
|
1,330 |
1,107 |
$3K |
| P9073 |
Platelets pheresis path redu |
30 |
12 |
$3K |
| 00140 |
|
69 |
65 |
$3K |
| 82104 |
|
360 |
322 |
$3K |
| 80185 |
|
258 |
218 |
$3K |
| L2114 |
Afo tib fx semi-rigid |
442 |
394 |
$3K |
| 90740 |
|
75 |
71 |
$3K |
| J1442 |
Inj filgrastim excl biosimil |
48 |
14 |
$3K |
| M0239 |
Bamlanivimab-xxxx infusion |
15 |
13 |
$3K |
| 99291 |
|
55 |
50 |
$3K |
| 80201 |
|
263 |
241 |
$3K |
| 86357 |
|
123 |
114 |
$3K |
| 82542 |
|
161 |
138 |
$3K |
| 11982 |
|
17 |
12 |
$3K |
| 73060 |
|
2,731 |
2,262 |
$3K |
| 83519 |
|
145 |
118 |
$3K |
| 91120 |
|
58 |
51 |
$3K |
| 86200 |
|
369 |
333 |
$3K |
| 19081 |
|
15 |
13 |
$3K |
| 78816 |
|
12 |
12 |
$3K |
| 87563 |
|
132 |
118 |
$3K |
| 84244 |
|
186 |
151 |
$3K |
| 97802 |
|
63 |
52 |
$3K |
| 84134 |
|
327 |
280 |
$3K |
| Q0243 |
Casirivimab and imdevimab |
93 |
88 |
$3K |
| 87181 |
|
135 |
113 |
$3K |
| J7307 |
Etonogestrel implant system |
12 |
12 |
$3K |
| 87631 |
|
60 |
48 |
$3K |
| 72110 |
|
256 |
232 |
$3K |
| J7325 |
Synvisc or synvisc-one |
79 |
46 |
$3K |
| 82627 |
|
207 |
172 |
$3K |
| 95910 |
|
43 |
38 |
$3K |
| 94664 |
|
249 |
232 |
$3K |
| 78582 |
|
17 |
12 |
$3K |
| G0279 |
Tomosynthesis, mammo |
1,258 |
1,083 |
$3K |
| 29075 |
|
75 |
53 |
$3K |
| 84207 |
|
159 |
144 |
$3K |
| J1726 |
Makena, 10 mg |
125 |
52 |
$3K |
| 00145 |
|
40 |
37 |
$3K |
| 86335 |
|
203 |
161 |
$3K |
| 80183 |
|
207 |
188 |
$3K |
| 52310 |
|
12 |
12 |
$3K |
| 81511 |
|
16 |
15 |
$3K |
| 86381 |
|
249 |
219 |
$3K |
| 92060 |
|
616 |
550 |
$3K |
| 85347 |
|
223 |
193 |
$2K |
| 36901 |
|
19 |
17 |
$2K |
| A9585 |
Gadobutrol injection |
17,203 |
14,922 |
$2K |
| 76514 |
|
402 |
369 |
$2K |
| L3908 |
Who cock-up nonmolde pre ots |
1,040 |
941 |
$2K |
| A9502 |
Tc99m tetrofosmin |
3,795 |
3,269 |
$2K |
| Q5121 |
Inj. avsola, 10 mg |
14 |
12 |
$2K |
| 72193 |
|
33 |
28 |
$2K |
| 88304 |
|
2,414 |
2,143 |
$2K |
| J0561 |
Penicillin g benzathine inj |
101 |
76 |
$2K |
| 92526 |
|
180 |
65 |
$2K |
| 36556 |
|
18 |
14 |
$2K |
| 0054A |
|
201 |
163 |
$2K |
| 90750 |
|
307 |
271 |
$2K |
| 86709 |
|
218 |
198 |
$2K |
| 36590 |
|
13 |
12 |
$2K |
| Q9956 |
Inj octafluoropropane mic,ml |
6,461 |
5,746 |
$2K |
| 62368 |
|
17 |
13 |
$2K |
| 91122 |
|
58 |
51 |
$2K |
| 85384 |
|
334 |
234 |
$2K |
| 84166 |
|
223 |
192 |
$2K |
| J2785 |
Regadenoson injection |
3,528 |
3,126 |
$2K |
| 84080 |
|
314 |
274 |
$2K |
| J9263 |
Oxaliplatin |
449 |
220 |
$2K |
| 87046 |
|
419 |
343 |
$2K |
| 81220 |
|
16 |
14 |
$2K |
| 86308 |
|
197 |
181 |
$2K |
| 86015 |
|
261 |
233 |
$2K |
| 29515 |
|
69 |
62 |
$2K |
| 36416 |
|
18,072 |
10,355 |
$2K |
| 81206 |
|
19 |
13 |
$2K |
| 92604 |
|
129 |
105 |
$2K |
| 69210 |
|
222 |
196 |
$2K |
| 95913 |
|
133 |
129 |
$2K |
| C1769 |
Guide wire |
6,696 |
5,434 |
$2K |
| 93986 |
|
230 |
201 |
$2K |
| 82800 |
|
219 |
194 |
$2K |
| 29125 |
|
187 |
170 |
$2K |
| 84300 |
|
441 |
374 |
$2K |
| J3010 |
Fentanyl citrate injection |
46,020 |
34,347 |
$2K |
| 87147 |
|
350 |
309 |
$2K |
| 87486 |
|
77 |
58 |
$2K |
| C8924 |
2d tte w or w/o fol w/con,fu |
18 |
12 |
$2K |
| 84446 |
|
197 |
171 |
$2K |
| 80074 |
|
46 |
39 |
$2K |
| 77049 |
|
12 |
12 |
$1K |
| 86003 |
|
30 |
28 |
$1K |
| 97035 |
|
122 |
57 |
$1K |
| 81403 |
|
32 |
28 |
$1K |
| J1642 |
Inj heparin sodium per 10 u |
29,855 |
13,189 |
$1K |
| 86256 |
|
93 |
76 |
$1K |
| 99195 |
|
114 |
85 |
$1K |
| A9552 |
F18 fdg |
2,779 |
2,452 |
$1K |
| 97760 |
|
120 |
102 |
$1K |
| 87581 |
|
77 |
58 |
$1K |
| 73000 |
|
394 |
331 |
$1K |
| C9053 |
Inj, crizanlizumab-tmca |
19 |
12 |
$1K |
| 86593 |
|
387 |
345 |
$1K |
| 97803 |
|
21 |
14 |
$1K |
| 12013 |
|
17 |
14 |
$1K |
| 90620 |
|
48 |
40 |
$1K |
| 84590 |
|
173 |
151 |
$1K |
| 85613 |
|
135 |
102 |
$1K |
| P9604 |
One-way allow prorated trip |
2,461 |
1,207 |
$1K |
| 84270 |
|
70 |
59 |
$1K |
| 88313 |
|
3,644 |
1,545 |
$1K |
| 93246 |
|
35 |
32 |
$1K |
| 20550 |
|
14 |
13 |
$1K |
| C1887 |
Catheter, guiding |
4,368 |
3,481 |
$1K |
| G0444 |
Depression screen annual |
30 |
28 |
$1K |
| 85660 |
|
240 |
171 |
$1K |
| 99496 |
|
35 |
30 |
$1K |
| 90678 |
|
151 |
135 |
$1K |
| 36600 |
|
381 |
328 |
$1K |
| J1170 |
Hydromorphone injection |
26,050 |
17,759 |
$1K |
| 0004A |
|
106 |
88 |
$999.10 |
| 90746 |
|
82 |
67 |
$977.91 |
| 70487 |
|
14 |
12 |
$968.17 |
| 92591 |
|
66 |
56 |
$959.89 |
| 84075 |
|
211 |
178 |
$930.10 |
| 80156 |
|
27 |
26 |
$929.28 |
| 80186 |
|
119 |
91 |
$917.97 |
| 80169 |
|
89 |
52 |
$917.94 |
| 82390 |
|
114 |
101 |
$915.66 |
| 82553 |
|
189 |
129 |
$912.19 |
| J9171 |
Docetaxel injection |
76 |
49 |
$904.54 |
| 87184 |
|
174 |
160 |
$879.32 |
| 90472 |
|
191 |
161 |
$855.04 |
| 96411 |
|
2,300 |
1,481 |
$821.83 |
| J2250 |
Inj midazolam hydrochloride |
21,550 |
17,872 |
$803.85 |
| 93299 |
|
16 |
13 |
$793.09 |
| J9073 |
Inj cyclophos dr reddys 5 mg |
25 |
13 |
$768.06 |
| 84157 |
|
156 |
137 |
$765.07 |
| 86376 |
|
64 |
61 |
$757.28 |
| 86146 |
|
62 |
48 |
$754.78 |
| 80203 |
|
42 |
36 |
$740.54 |
| J2405 |
Ondansetron hcl injection |
57,680 |
40,740 |
$739.50 |
| 77091 |
|
111 |
103 |
$724.93 |
| 92025 |
|
284 |
257 |
$722.80 |
| 72082 |
|
12 |
12 |
$684.71 |
| 92285 |
|
77 |
75 |
$657.03 |
| 80195 |
|
50 |
24 |
$652.05 |
| 87427 |
|
68 |
60 |
$645.02 |
| 83835 |
|
35 |
25 |
$644.42 |
| C1894 |
Intro/sheath, non-laser |
5,000 |
4,000 |
$641.66 |
| 17000 |
|
30 |
24 |
$639.88 |
| 87899 |
|
51 |
37 |
$638.04 |
| 73523 |
|
248 |
236 |
$612.59 |
| 0031A |
|
24 |
20 |
$606.33 |
| 88173 |
|
1,009 |
848 |
$582.10 |
| 88312 |
|
2,846 |
1,340 |
$531.19 |
| J1050 |
Medroxyprogesterone acetate |
5,076 |
4,849 |
$530.65 |
| 85732 |
|
92 |
67 |
$529.08 |
| 84295 |
|
54 |
51 |
$506.53 |
| J1200 |
Diphenhydramine hcl injectio |
17,222 |
12,099 |
$498.45 |
| 82945 |
|
60 |
54 |
$498.01 |
| 93280 |
|
185 |
167 |
$488.71 |
| J1885 |
Ketorolac tromethamine inj |
38,552 |
29,218 |
$483.66 |
| J7120 |
Ringers lactate infusion |
4,728 |
3,598 |
$478.94 |
| G8987 |
Self care current status |
404 |
350 |
$473.05 |
| C9113 |
Inj pantoprazole sodium, via |
3,033 |
1,477 |
$465.97 |
| J9395 |
Injection, fulvestrant |
35 |
24 |
$456.45 |
| 95992 |
|
23 |
12 |
$435.53 |
| J1100 |
Dexamethasone sodium phos |
28,279 |
20,421 |
$433.64 |
| 92593 |
|
28 |
26 |
$430.57 |
| 74246 |
|
14 |
13 |
$428.64 |
| J1644 |
Inj heparin sodium per 1000u |
14,861 |
7,066 |
$426.56 |
| 86618 |
|
17 |
13 |
$422.61 |
| G0296 |
Visit to determ ldct elig |
93 |
82 |
$408.26 |
| 71100 |
|
199 |
184 |
$395.03 |
| 0052A |
|
12 |
12 |
$381.60 |
| 82164 |
|
45 |
38 |
$375.81 |
| 84480 |
|
36 |
28 |
$370.35 |
| 94150 |
|
1,253 |
776 |
$360.58 |
| 87076 |
|
40 |
26 |
$352.72 |
| G1004 |
Cdsm ndsc |
7,596 |
4,922 |
$351.23 |
| 94761 |
|
3,139 |
2,872 |
$348.61 |
| C1750 |
Cath, hemodialysis,long-term |
63 |
50 |
$338.34 |
| 91200 |
|
124 |
108 |
$327.97 |
| 70250 |
|
70 |
67 |
$322.17 |
| 98960 |
|
79 |
50 |
$319.92 |
| J0780 |
Prochlorperazine injection |
6,143 |
4,799 |
$313.62 |
| J2704 |
Inj, propofol, 10 mg |
19,272 |
15,709 |
$264.16 |
| Q0239 |
Bamlanivimab-xxxx |
15 |
13 |
$261.86 |
| 97763 |
|
19 |
12 |
$253.35 |
| 0352U |
|
333 |
306 |
$252.10 |
| G0283 |
Elec stim other than wound |
32 |
15 |
$248.05 |
| J0696 |
Ceftriaxone sodium injection |
11,325 |
8,392 |
$245.77 |
| J0131 |
Inj, acetaminophen (nos) |
2,751 |
2,293 |
$245.58 |
| 87209 |
|
14 |
13 |
$239.96 |
| 82436 |
|
80 |
64 |
$239.73 |
| 82247 |
|
98 |
75 |
$238.25 |
| 84478 |
|
61 |
40 |
$234.14 |
| J2790 |
Rho d immune globulin inj |
13 |
12 |
$226.80 |
| J3475 |
Inj magnesium sulfate |
9,316 |
5,424 |
$224.43 |
| 86905 |
|
40 |
30 |
$218.04 |
| 82435 |
|
68 |
61 |
$216.84 |
| 93282 |
|
49 |
39 |
$215.92 |
| P9612 |
Catheterize for urine spec |
1,123 |
1,009 |
$210.05 |
| 84133 |
|
80 |
64 |
$207.52 |
| 83993 |
|
15 |
13 |
$203.81 |
| J2060 |
Lorazepam injection |
5,762 |
4,203 |
$195.27 |
| 85598 |
|
16 |
12 |
$189.52 |
| 85597 |
|
17 |
12 |
$188.59 |
| J0171 |
Adrenalin epinephrine inject |
4,445 |
2,783 |
$172.39 |
| 46600 |
|
218 |
185 |
$168.74 |
| J0330 |
Succinycholine chloride inj |
2,845 |
2,383 |
$167.36 |
| 84155 |
|
88 |
77 |
$164.12 |
| J0173 |
Inj, epinephrine (belcher) |
835 |
479 |
$160.98 |
| G0145 |
Scr c/v cyto,thinlayer,rescr |
173 |
146 |
$159.71 |
| J0134 |
Inj acetaminophen -fresenius |
1,113 |
944 |
$158.85 |
| C1766 |
Intro/sheath,strble,non-peel |
299 |
255 |
$157.95 |
| J0690 |
Cefazolin sodium injection |
13,786 |
10,016 |
$156.53 |
| 90734 |
|
13 |
13 |
$154.16 |
| 88311 |
|
1,186 |
842 |
$150.41 |
| J2765 |
Metoclopramide hcl injection |
9,608 |
7,717 |
$140.37 |
| 90632 |
|
13 |
13 |
$135.59 |
| 82525 |
|
18 |
12 |
$130.14 |
| 96377 |
|
1,055 |
756 |
$126.30 |
| 87177 |
|
14 |
13 |
$124.71 |
| 85525 |
|
17 |
12 |
$124.13 |
| Q9954 |
Oral mr contrast, 100 ml |
567 |
523 |
$117.12 |
| J3480 |
Inj potassium chloride |
2,501 |
1,685 |
$109.88 |
| 72070 |
|
15 |
14 |
$107.47 |
| J0702 |
Betamethasone acet&sod phosp |
2,214 |
1,754 |
$100.73 |
| 82009 |
|
17 |
16 |
$100.30 |
| 0202U |
|
49 |
38 |
$97.61 |
| J3301 |
Triamcinolone acet inj nos |
4,460 |
3,846 |
$90.43 |
| 86906 |
|
37 |
27 |
$89.13 |
| J0360 |
Hydralazine hcl injection |
3,520 |
2,665 |
$87.30 |
| 71101 |
|
62 |
55 |
$86.55 |
| J1720 |
Hydrocortisone sodium succ i |
2,905 |
1,871 |
$83.71 |
| L3933 |
Fo w/o joints cf |
83 |
64 |
$82.81 |
| Q0111 |
Wet mounts/ w preparations |
15 |
13 |
$77.47 |
| J1939 |
Inj, bumetanide, 0.5 mg |
129 |
86 |
$77.07 |
| 89060 |
|
14 |
12 |
$72.63 |
| J0640 |
Leucovorin calcium injection |
1,666 |
804 |
$70.09 |
| J9201 |
In gemcitabine hcl nos 200mg |
613 |
282 |
$69.62 |
| Q9957 |
Inj perflutren lip micros,ml |
100 |
88 |
$65.80 |
| J3420 |
Vitamin b12 injection |
3,080 |
2,616 |
$65.12 |
| L0172 |
Cerv col sr foam 2pc pre ots |
59 |
48 |
$54.03 |
| 73070 |
|
76 |
68 |
$53.80 |
| 82340 |
|
12 |
12 |
$51.60 |
| 85048 |
|
47 |
38 |
$49.15 |
| 84540 |
|
15 |
13 |
$46.29 |
| 84520 |
|
16 |
14 |
$39.01 |
| J1940 |
Furosemide injection |
3,005 |
1,838 |
$38.12 |
| 82952 |
|
12 |
12 |
$36.54 |
| V2632 |
Post chmbr intraocular lens |
1,606 |
1,306 |
$35.07 |
| C1729 |
Cath, drainage |
1,260 |
724 |
$34.96 |
| C1751 |
Cath, inf, per/cent/midline |
395 |
328 |
$30.26 |
| L3906 |
Who w/o joints cf |
15 |
14 |
$28.27 |
| J2270 |
Morphine sulfate injection |
5,355 |
4,220 |
$27.62 |
| J9190 |
Fluorouracil injection |
2,192 |
1,142 |
$27.54 |
| A9541 |
Tc99m sulfur colloid |
46 |
39 |
$24.81 |
| 77417 |
|
623 |
375 |
$24.16 |
| J2930 |
Methylprednisolone injection |
3,757 |
2,517 |
$22.57 |
| J0610 |
Calcium glucon (fresenius) |
634 |
290 |
$22.10 |
| J0461 |
Atropine sulfate injection |
1,095 |
757 |
$19.81 |
| G2066 |
Inter devc remote 30d |
13 |
12 |
$18.18 |
| J9045 |
Carboplatin injection |
2,231 |
1,329 |
$17.96 |
| J7512 |
Prednisone ir or dr oral 1mg |
9,062 |
5,285 |
$17.89 |
| G0328 |
Fecal blood scrn immunoassay |
169 |
161 |
$17.50 |
| G8979 |
Mobility goal status |
1,091 |
892 |
$16.55 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
2,816 |
2,221 |
$15.86 |
| J8540 |
Oral dexamethasone |
6,725 |
3,122 |
$15.67 |
| J0612 |
Inj, calcium gluconate, nos |
360 |
168 |
$15.33 |
| J1805 |
Inj, esmolol hcl, 10mg |
409 |
346 |
$14.90 |
| J3370 |
Vancomycin hcl injection |
2,247 |
1,524 |
$14.45 |
| 72020 |
|
26 |
25 |
$14.42 |
| 77387 |
|
433 |
93 |
$12.08 |
| A9503 |
Tc99m medronate |
822 |
735 |
$10.64 |
| C1726 |
Cath, bal dil, non-vascular |
326 |
274 |
$9.88 |
| Q0162 |
Ondansetron oral |
12,150 |
9,099 |
$9.05 |
| J9267 |
Paclitaxel injection |
1,440 |
604 |
$8.37 |
| Q9969 |
Non-heu tc-99m add-on/dose |
341 |
308 |
$8.28 |
| 91312 |
|
375 |
305 |
$7.82 |
| J1790 |
Droperidol injection |
3,071 |
2,599 |
$6.94 |
| J1630 |
Haloperidol injection |
2,031 |
1,497 |
$6.29 |
| G8978 |
Mobility current status |
894 |
775 |
$5.77 |
| C1760 |
Closure dev, vasc |
599 |
464 |
$3.70 |
| J3411 |
Thiamine hcl 100 mg |
1,465 |
911 |
$3.54 |
| J3473 |
Hyaluronidase recombinant |
150 |
116 |
$3.07 |
| A4648 |
Implantable tissue marker |
59 |
48 |
$3.03 |
| 86790 |
|
14 |
12 |
$2.87 |
| J1953 |
Levetiracetam injection |
839 |
624 |
$1.51 |
| J0697 |
Sterile cefuroxime injection |
1,003 |
799 |
$1.12 |
| J2370 |
Phenylephrine hcl injection |
487 |
389 |
$0.99 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
332 |
292 |
$0.64 |
| J1836 |
Inj, metronidazole, 10 mg |
496 |
352 |
$0.30 |
| 91305 |
|
204 |
177 |
$0.14 |
| J0280 |
Aminophyllin 250 mg inj |
157 |
141 |
$0.07 |
| 91303 |
|
23 |
19 |
$0.02 |
| 88365 |
|
16 |
14 |
$0.00 |
| C1758 |
Catheter, ureteral |
663 |
573 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
2,558 |
2,207 |
$0.00 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
152 |
137 |
$0.00 |
| C1788 |
Port, indwelling, imp |
442 |
392 |
$0.00 |
| G8996 |
Swallow current status |
108 |
90 |
$0.00 |
| 73100 |
|
31 |
25 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
422 |
282 |
$0.00 |
| 73551 |
|
13 |
12 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
458 |
339 |
$0.00 |
| J9999 |
Chemotherapy drug |
329 |
159 |
$0.00 |
| 91300 |
|
761 |
657 |
$0.00 |
| G8985 |
Carry goal status |
308 |
274 |
$0.00 |
| 88346 |
|
35 |
26 |
$0.00 |
| 88302 |
|
86 |
62 |
$0.00 |
| J0744 |
Ciprofloxacin iv |
265 |
197 |
$0.00 |
| G8984 |
Carry current status |
231 |
208 |
$0.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
502 |
198 |
$0.00 |
| C2625 |
Stent, non-cor, tem w/del sy |
261 |
243 |
$0.00 |
| G8997 |
Swallow goal status |
110 |
90 |
$0.00 |
| 73010 |
|
25 |
24 |
$0.00 |
| 92081 |
|
17 |
13 |
$0.00 |
| G8990 |
Other pt/ot current status |
18 |
12 |
$0.00 |
| G8989 |
Self care d/c status |
225 |
204 |
$0.00 |
| J0692 |
Cefepime hcl for injection |
146 |
50 |
$0.00 |
| J0137 |
Inj, acetaminophen (hikma) |
111 |
98 |
$0.00 |
| 77012 |
|
64 |
51 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
109 |
98 |
$0.00 |
| 0441U |
|
50 |
47 |
$0.00 |
| J1580 |
Garamycin gentamicin inj |
75 |
48 |
$0.00 |
| J9000 |
Doxorubicin hcl injection |
52 |
24 |
$0.00 |
| C1752 |
Cath,hemodialysis,short-term |
16 |
13 |
$0.00 |
| L0140 |
Cervical semi-rigid adjustab |
12 |
12 |
$0.00 |
| 0100U |
|
24 |
24 |
$0.00 |
| J1071 |
Inj testosterone cypionate |
17 |
13 |
$0.00 |
| J2310 |
Inj naloxone hydrochloride |
15 |
12 |
$0.00 |
| J9060 |
Cisplatin 10 mg injection |
24 |
12 |
$0.00 |
| A9270 |
Non-covered item or service |
492 |
459 |
$0.00 |
| J2920 |
Methylprednisolone injection |
359 |
289 |
$0.00 |
| G8981 |
Body pos current status |
109 |
89 |
$0.00 |
| G8988 |
Self care goal status |
472 |
384 |
$0.00 |
| J0706 |
Caffeine citrate injection |
14 |
13 |
$0.00 |
| A9555 |
Rb82 rubidium |
116 |
103 |
$0.00 |
| G8980 |
Mobility d/c status |
465 |
402 |
$0.00 |
| C1830 |
Power bone marrow bx needle |
53 |
38 |
$0.00 |
| J3360 |
Diazepam injection |
134 |
108 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
494 |
296 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
74 |
38 |
$0.00 |
| J1920 |
Inj, labetalol hcl, 5mg |
531 |
376 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
823 |
363 |
$0.00 |
| G9172 |
Voice goal status |
14 |
12 |
$0.00 |
| C9290 |
Inj, bupivacaine liposome |
145 |
131 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
110 |
57 |
$0.00 |
| L3808 |
Whfo, rigid w/o joints |
66 |
59 |
$0.00 |
| 76377 |
|
59 |
48 |
$0.00 |
| C1781 |
Mesh (implantable) |
49 |
41 |
$0.00 |
| G8983 |
Body pos d/c status |
31 |
25 |
$0.00 |
| J1030 |
Methylprednisolone 40 mg inj |
14 |
14 |
$0.00 |
| G8982 |
Body pos goal status |
144 |
123 |
$0.00 |
| G8991 |
Other pt/ot goal status |
19 |
13 |
$0.00 |
| J8501 |
Oral aprepitant |
30 |
26 |
$0.00 |
| G8986 |
Carry d/c status |
13 |
13 |
$0.00 |
| A9540 |
Tc99m maa |
47 |
41 |
$0.00 |
| G8998 |
Swallow d/c status |
42 |
35 |
$0.00 |
| 88350 |
|
35 |
26 |
$0.00 |
| J7507 |
Tacrolimus imme rel oral 1mg |
46 |
14 |
$0.00 |
| C1889 |
Implant/insert device, noc |
29 |
27 |
$0.00 |
| G0472 |
Hep c screen high risk/other |
14 |
14 |
$0.00 |
| J0500 |
Dicyclomine injection |
32 |
29 |
$0.00 |
| J1040 |
Methylprednisolone 80 mg inj |
35 |
34 |
$0.00 |
| 73600 |
|
19 |
12 |
$0.00 |
| L4350 |
Ankle control ortho pre ots |
43 |
41 |
$0.00 |
| 88300 |
|
12 |
12 |
$0.00 |
| J2471 |
Inj pantoprazole(hikma) 40mg |
26 |
12 |
$0.00 |
| C1893 |
Intro/sheath, fixed,non-peel |
21 |
19 |
$0.00 |