| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
54,056 |
48,698 |
$13.17M |
| 99284 |
|
52,536 |
45,803 |
$12.14M |
| 74177 |
|
25,881 |
24,190 |
$9.50M |
| 99285 |
|
18,716 |
15,955 |
$3.74M |
| 78452 |
|
2,595 |
2,338 |
$2.60M |
| 70450 |
|
21,671 |
19,797 |
$2.30M |
| 71260 |
|
11,514 |
10,763 |
$1.74M |
| 72125 |
|
6,407 |
5,881 |
$1.52M |
| 99282 |
|
13,843 |
12,826 |
$1.50M |
| 97110 |
|
48,464 |
18,558 |
$1.46M |
| 43239 |
|
1,640 |
1,562 |
$1.32M |
| 74176 |
|
3,591 |
3,242 |
$1.29M |
| G0378 |
Hospital observation per hr |
21,505 |
9,502 |
$1.19M |
| 0202U |
|
6,436 |
6,140 |
$1.18M |
| 95810 |
|
2,207 |
2,162 |
$1.10M |
| 94060 |
|
3,998 |
3,850 |
$991K |
| 95811 |
|
1,946 |
1,882 |
$963K |
| 70553 |
|
2,000 |
1,877 |
$762K |
| 88305 |
|
21,437 |
19,799 |
$744K |
| 70498 |
|
1,123 |
1,021 |
$736K |
| 93971 |
|
4,171 |
3,793 |
$702K |
| 93306 |
|
4,339 |
4,017 |
$695K |
| U0003 |
Cov-19 amp prb hgh thruput |
10,513 |
9,753 |
$684K |
| 74174 |
|
1,077 |
970 |
$647K |
| 80050 |
|
15,719 |
15,069 |
$603K |
| 99214 |
|
18,262 |
17,273 |
$600K |
| 99232 |
|
14,707 |
5,902 |
$589K |
| 80307 |
|
17,895 |
13,073 |
$583K |
| 77067 |
|
12,875 |
12,609 |
$555K |
| 72131 |
|
2,252 |
2,055 |
$554K |
| 93458 |
|
299 |
270 |
$515K |
| 93970 |
|
1,873 |
1,722 |
$488K |
| 59025 |
|
3,370 |
2,390 |
$473K |
| G0481 |
Drug test def 8-14 classes |
3,039 |
2,935 |
$434K |
| 71046 |
|
35,818 |
33,151 |
$432K |
| 93010 |
|
63,627 |
50,065 |
$431K |
| 71275 |
|
2,079 |
1,945 |
$419K |
| 87637 |
|
9,579 |
9,146 |
$410K |
| 99213 |
|
17,554 |
14,980 |
$389K |
| 97140 |
|
23,336 |
10,579 |
$387K |
| 88307 |
|
4,503 |
4,358 |
$363K |
| 78815 |
|
697 |
659 |
$300K |
| 71045 |
|
63,079 |
54,253 |
$279K |
| 45380 |
|
484 |
456 |
$270K |
| 72148 |
|
2,110 |
2,012 |
$263K |
| 80053 |
|
98,399 |
77,823 |
$251K |
| 76705 |
|
12,531 |
11,765 |
$239K |
| 76856 |
|
5,593 |
5,321 |
$238K |
| 87491 |
|
8,391 |
7,950 |
$223K |
| 72110 |
|
1,860 |
1,803 |
$222K |
| 73110 |
|
6,183 |
5,213 |
$220K |
| 97113 |
|
2,724 |
1,335 |
$220K |
| 99281 |
|
4,608 |
4,254 |
$217K |
| 99222 |
|
2,705 |
2,625 |
$217K |
| 87636 |
|
2,672 |
2,573 |
$217K |
| 73030 |
|
8,412 |
7,622 |
$202K |
| 76642 |
|
3,528 |
3,408 |
$201K |
| 71250 |
|
2,920 |
2,735 |
$199K |
| 92588 |
|
532 |
521 |
$197K |
| 96413 |
|
3,731 |
2,217 |
$196K |
| 70491 |
|
454 |
429 |
$195K |
| 73564 |
|
2,248 |
2,062 |
$191K |
| 97112 |
|
7,087 |
3,909 |
$190K |
| 93798 |
|
2,903 |
457 |
$189K |
| 72100 |
|
4,652 |
4,508 |
$187K |
| 73610 |
|
5,512 |
5,020 |
$186K |
| 97162 |
|
4,046 |
3,742 |
$184K |
| 93005 |
|
58,252 |
45,849 |
$174K |
| 96365 |
|
15,163 |
9,481 |
$172K |
| G0483 |
Drug test def 22+ classes |
800 |
766 |
$169K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
280 |
256 |
$161K |
| 73562 |
|
6,228 |
5,726 |
$157K |
| 72072 |
|
1,638 |
1,586 |
$154K |
| 73130 |
|
5,965 |
5,283 |
$153K |
| C8929 |
Tte w or wo fol wcon,doppler |
686 |
608 |
$150K |
| 87624 |
|
2,911 |
2,845 |
$150K |
| G0463 |
Hospital outpt clinic visit |
9,216 |
7,666 |
$146K |
| 76700 |
|
2,104 |
2,032 |
$141K |
| 77080 |
|
1,889 |
1,832 |
$141K |
| 77066 |
Tomosynthesis, mammo |
1,759 |
1,687 |
$141K |
| 72040 |
|
2,142 |
2,068 |
$137K |
| 73502 |
|
4,154 |
3,819 |
$136K |
| 88342 |
|
4,673 |
4,341 |
$131K |
| 45378 |
|
257 |
247 |
$131K |
| J0690 |
Cefazolin sodium injection |
5,690 |
3,997 |
$127K |
| 87340 |
|
1,662 |
1,620 |
$127K |
| 64493 |
|
166 |
148 |
$124K |
| 99233 |
Prolong inpt eval add15 m |
2,294 |
969 |
$117K |
| 92550 |
|
1,101 |
1,085 |
$116K |
| 77063 |
|
11,361 |
11,161 |
$114K |
| 73630 |
|
6,128 |
5,444 |
$114K |
| 97597 |
|
1,716 |
940 |
$113K |
| 72141 |
|
1,013 |
963 |
$111K |
| 73721 |
|
1,097 |
1,011 |
$108K |
| 82306 |
|
8,096 |
7,822 |
$106K |
| 84443 |
|
13,252 |
12,316 |
$104K |
| J3475 |
Inj magnesium sulfate |
4,607 |
2,665 |
$104K |
| 95816 |
|
1,241 |
1,180 |
$104K |
| 72128 |
|
1,340 |
1,228 |
$102K |
| 92557 |
|
2,905 |
2,849 |
$102K |
| 87651 |
|
4,279 |
4,185 |
$101K |
| 76536 |
|
2,170 |
2,081 |
$99K |
| 97530 |
|
6,318 |
3,676 |
$98K |
| 87536 |
|
621 |
600 |
$97K |
| 97161 |
|
5,525 |
5,283 |
$95K |
| 45385 |
|
140 |
136 |
$93K |
| 82652 |
|
1,916 |
1,847 |
$92K |
| 70551 |
|
898 |
833 |
$90K |
| 93880 |
|
1,016 |
930 |
$90K |
| 72050 |
|
952 |
921 |
$90K |
| 80048 |
|
17,041 |
12,032 |
$89K |
| 74178 |
|
363 |
337 |
$88K |
| 87086 |
|
16,185 |
14,578 |
$82K |
| J2250 |
Inj midazolam hydrochloride |
10,447 |
8,104 |
$81K |
| 99239 |
|
1,284 |
1,244 |
$80K |
| 80061 |
|
22,441 |
21,409 |
$76K |
| 96366 |
|
6,615 |
3,410 |
$73K |
| 12001 |
|
917 |
883 |
$72K |
| 84154 |
|
905 |
883 |
$68K |
| 99223 |
Prolong inpt eval add15 m |
623 |
603 |
$68K |
| 20553 |
|
452 |
423 |
$68K |
| 73221 |
|
641 |
609 |
$65K |
| 73080 |
|
2,241 |
2,003 |
$64K |
| 70486 |
|
1,403 |
1,313 |
$62K |
| 96360 |
|
4,545 |
3,739 |
$61K |
| 70496 |
|
1,000 |
906 |
$60K |
| Q4132 |
Grafix core, grafixpl core |
71 |
30 |
$58K |
| 80055 |
|
369 |
362 |
$58K |
| 99211 |
|
5,017 |
3,472 |
$54K |
| 76775 |
|
2,487 |
2,337 |
$54K |
| 99217 |
|
1,359 |
1,304 |
$53K |
| 73120 |
|
1,090 |
768 |
$53K |
| 99291 |
|
454 |
155 |
$53K |
| 99243 |
|
1,153 |
1,143 |
$51K |
| 83970 |
|
1,390 |
1,304 |
$50K |
| 87150 |
|
1,548 |
1,530 |
$48K |
| 86703 |
|
3,132 |
3,055 |
$48K |
| 71271 |
|
1,235 |
1,164 |
$48K |
| 99212 |
|
2,797 |
2,675 |
$47K |
| 86803 |
|
2,447 |
2,386 |
$47K |
| 87641 |
|
1,537 |
1,376 |
$47K |
| 81513 |
|
350 |
344 |
$46K |
| 87661 |
|
1,158 |
1,110 |
$43K |
| 73522 |
|
576 |
545 |
$42K |
| 74183 |
|
188 |
175 |
$41K |
| 76770 |
|
1,387 |
1,322 |
$39K |
| 84702 |
|
3,856 |
2,970 |
$38K |
| 84100 |
|
9,984 |
5,723 |
$37K |
| 93017 |
|
2,690 |
2,452 |
$36K |
| 85025 |
|
101,732 |
77,799 |
$36K |
| 96374 |
|
34,589 |
29,467 |
$35K |
| 87070 |
|
6,006 |
5,596 |
$35K |
| 92587 |
|
160 |
156 |
$34K |
| 20610 |
|
167 |
155 |
$34K |
| 97535 |
|
2,948 |
2,485 |
$34K |
| 82043 |
|
4,167 |
4,020 |
$33K |
| M0243 |
Casirivi and imdevi inj |
133 |
130 |
$33K |
| 82951 |
|
1,300 |
1,173 |
$32K |
| 99221 |
|
535 |
518 |
$32K |
| 99204 |
|
549 |
531 |
$32K |
| 87522 |
Neg quan hep c or qual rna |
838 |
800 |
$30K |
| 87081 |
|
5,299 |
5,006 |
$29K |
| 74018 |
|
2,021 |
1,892 |
$29K |
| 83880 |
|
8,789 |
7,245 |
$28K |
| 87186 |
|
6,494 |
5,935 |
$28K |
| 88142 |
|
1,197 |
1,174 |
$27K |
| 36415 |
|
158,924 |
116,240 |
$26K |
| 73590 |
|
1,320 |
1,155 |
$26K |
| 62323 |
|
85 |
78 |
$26K |
| 83721 |
|
850 |
819 |
$26K |
| 99219 |
|
362 |
351 |
$25K |
| 94729 |
|
4,045 |
3,903 |
$25K |
| 87507 |
|
171 |
162 |
$25K |
| 99238 |
|
563 |
553 |
$25K |
| 73140 |
|
961 |
868 |
$25K |
| 87480 |
|
2,377 |
2,280 |
$24K |
| 73560 |
|
959 |
864 |
$24K |
| 99215 |
Prolong outpt/office vis |
725 |
653 |
$23K |
| 86003 |
|
228 |
160 |
$23K |
| 96375 |
|
27,968 |
21,154 |
$23K |
| 77065 |
Tomosynthesis, mammo |
1,822 |
1,666 |
$22K |
| 73090 |
|
1,123 |
956 |
$22K |
| 99231 |
|
1,022 |
357 |
$21K |
| 99220 |
|
217 |
208 |
$19K |
| 86920 |
|
307 |
266 |
$19K |
| 80074 |
|
1,468 |
1,385 |
$18K |
| 72114 |
|
349 |
343 |
$18K |
| 99225 |
|
538 |
402 |
$18K |
| 74019 |
|
301 |
283 |
$18K |
| 76870 |
|
981 |
906 |
$18K |
| 84484 |
|
40,843 |
25,873 |
$17K |
| 73620 |
|
651 |
570 |
$17K |
| 74220 |
|
129 |
125 |
$17K |
| 64483 |
|
59 |
38 |
$16K |
| 88304 |
|
1,388 |
1,320 |
$16K |
| 76830 |
|
4,815 |
4,574 |
$16K |
| 87653 |
|
385 |
379 |
$16K |
| 82728 |
|
3,672 |
3,419 |
$16K |
| G0279 |
Tomosynthesis, mammo |
3,468 |
3,370 |
$16K |
| 96361 |
|
13,373 |
11,182 |
$15K |
| 12002 |
|
395 |
382 |
$14K |
| 84481 |
|
1,624 |
1,575 |
$14K |
| 88112 |
|
809 |
717 |
$14K |
| 86039 |
|
464 |
453 |
$14K |
| 97166 |
|
363 |
317 |
$14K |
| 95812 |
|
200 |
183 |
$13K |
| 93925 |
|
70 |
64 |
$13K |
| 85610 |
|
16,559 |
12,149 |
$13K |
| 12011 |
|
189 |
183 |
$12K |
| 83690 |
|
21,268 |
18,094 |
$12K |
| 87075 |
|
1,195 |
1,089 |
$12K |
| 88175 |
|
2,139 |
2,114 |
$12K |
| 84425 |
|
153 |
148 |
$12K |
| 87077 |
|
1,962 |
1,756 |
$12K |
| 84703 |
|
16,490 |
14,794 |
$12K |
| J1885 |
Ketorolac tromethamine inj |
35,779 |
20,141 |
$12K |
| 81025 |
|
5,660 |
5,195 |
$12K |
| 99205 |
Prolong outpt/office vis |
150 |
145 |
$12K |
| 83036 |
|
17,905 |
17,008 |
$12K |
| 0450 |
|
300 |
259 |
$11K |
| 76882 |
|
474 |
441 |
$11K |
| J1453 |
Fosaprepitant injection |
40 |
27 |
$11K |
| 19083 |
|
12 |
12 |
$11K |
| J0561 |
Penicillin g benzathine inj |
135 |
114 |
$11K |
| 81001 |
|
42,444 |
36,876 |
$11K |
| 10060 |
|
336 |
310 |
$10K |
| 84156 |
|
865 |
780 |
$10K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
28,688 |
24,569 |
$10K |
| 0352U |
|
314 |
288 |
$10K |
| 94726 |
|
3,656 |
3,532 |
$10K |
| 87635 |
|
732 |
708 |
$9K |
| 96372 |
|
18,739 |
13,377 |
$9K |
| 84153 |
|
1,700 |
1,616 |
$9K |
| G0103 |
Psa screening |
786 |
759 |
$9K |
| 82024 |
|
29 |
29 |
$9K |
| 77012 |
|
67 |
59 |
$9K |
| 95806 |
|
145 |
141 |
$9K |
| 77334 |
|
30 |
24 |
$8K |
| 83001 |
|
172 |
167 |
$8K |
| 82607 |
|
6,218 |
5,906 |
$8K |
| 84030 |
|
728 |
717 |
$8K |
| 99218 |
|
165 |
158 |
$8K |
| 84439 |
|
16,779 |
15,670 |
$8K |
| J1815 |
Insulin injection |
6,317 |
2,015 |
$7K |
| 29580 |
|
225 |
76 |
$7K |
| J3370 |
Vancomycin hcl injection |
1,039 |
678 |
$7K |
| J1642 |
Inj heparin sodium per 10 u |
11,952 |
3,275 |
$7K |
| 86592 |
|
3,259 |
3,145 |
$7K |
| 82803 |
|
2,075 |
1,746 |
$7K |
| 87591 |
|
8,391 |
7,943 |
$7K |
| 85027 |
|
12,616 |
10,721 |
$7K |
| J7120 |
Ringers lactate infusion |
6,350 |
4,984 |
$7K |
| G0297 |
Ldct for lung ca screen |
271 |
262 |
$7K |
| 75574 |
|
122 |
118 |
$6K |
| 84403 |
|
779 |
737 |
$6K |
| 87040 |
|
6,377 |
3,610 |
$6K |
| 97116 |
|
1,945 |
1,136 |
$6K |
| J7030 |
Normal saline solution infus |
13,588 |
9,764 |
$5K |
| 20611 |
|
34 |
27 |
$5K |
| 87426 |
|
800 |
765 |
$5K |
| 94640 |
|
9,560 |
5,387 |
$5K |
| 87045 |
|
227 |
205 |
$5K |
| 62321 |
|
15 |
12 |
$5K |
| 96523 |
|
160 |
133 |
$4K |
| 83605 |
|
15,261 |
11,536 |
$4K |
| J3490 |
Drugs unclassified injection |
13,787 |
9,091 |
$4K |
| 77427 |
|
43 |
13 |
$4K |
| 93926 |
|
13 |
12 |
$4K |
| 88341 |
|
322 |
278 |
$4K |
| 73700 |
|
12 |
12 |
$4K |
| 85060 |
|
225 |
214 |
$4K |
| 76376 |
|
5,523 |
5,104 |
$4K |
| 87205 |
|
2,923 |
2,645 |
$4K |
| 86900 |
|
5,670 |
4,992 |
$4K |
| 97165 |
|
387 |
346 |
$4K |
| J0688 |
Inj cefazolin sodium, hikma |
47 |
13 |
$4K |
| 87502 |
|
3,437 |
3,139 |
$4K |
| 82950 |
|
222 |
221 |
$4K |
| J0696 |
Ceftriaxone sodium injection |
6,640 |
4,287 |
$4K |
| 86787 |
|
1,651 |
1,610 |
$4K |
| 84480 |
|
215 |
209 |
$3K |
| 86235 |
|
259 |
253 |
$3K |
| 90715 |
|
3,306 |
3,142 |
$3K |
| 87880 |
|
8,941 |
8,537 |
$3K |
| 86850 |
|
5,188 |
4,606 |
$3K |
| P9016 |
Rbc leukocytes reduced |
84 |
65 |
$3K |
| 93922 |
|
107 |
104 |
$3K |
| 88300 |
|
519 |
492 |
$3K |
| 71101 |
|
366 |
336 |
$3K |
| 72202 |
|
68 |
64 |
$3K |
| 76942 |
|
29 |
26 |
$3K |
| J1100 |
Dexamethasone sodium phos |
12,411 |
9,841 |
$2K |
| J2405 |
Ondansetron hcl injection |
25,012 |
18,782 |
$2K |
| 82670 |
|
158 |
150 |
$2K |
| 86480 |
|
26 |
24 |
$2K |
| C1769 |
Guide wire |
3,033 |
2,605 |
$2K |
| 82247 |
|
1,023 |
666 |
$2K |
| A9502 |
Tc99m tetrofosmin |
2,582 |
2,324 |
$2K |
| 83615 |
|
396 |
339 |
$2K |
| 84132 |
|
1,739 |
1,506 |
$2K |
| 82746 |
|
3,972 |
3,765 |
$2K |
| 99226 |
|
46 |
38 |
$2K |
| 36591 |
|
467 |
284 |
$2K |
| 83735 |
|
16,959 |
10,136 |
$2K |
| 85378 |
|
4,116 |
3,749 |
$2K |
| 99152 |
|
811 |
731 |
$2K |
| A9585 |
Gadobutrol injection |
4,157 |
3,812 |
$2K |
| 84146 |
|
25 |
24 |
$2K |
| 36430 |
|
91 |
68 |
$2K |
| J2930 |
Methylprednisolone injection |
2,978 |
2,301 |
$2K |
| 82105 |
|
153 |
149 |
$2K |
| 76801 |
|
1,476 |
1,261 |
$2K |
| 86038 |
|
1,170 |
1,128 |
$2K |
| 80076 |
|
779 |
741 |
$2K |
| G0480 |
Drug test def 1-7 classes |
1,001 |
860 |
$2K |
| J2785 |
Regadenoson injection |
2,488 |
2,232 |
$2K |
| 82948 |
|
19,521 |
9,763 |
$2K |
| 76817 |
|
531 |
466 |
$2K |
| 86701 |
|
575 |
558 |
$2K |
| 83516 |
|
185 |
168 |
$1K |
| 73000 |
|
35 |
29 |
$1K |
| 85730 |
|
5,875 |
5,129 |
$1K |
| 86141 |
|
114 |
98 |
$1K |
| 82140 |
|
1,728 |
1,452 |
$1K |
| 86769 |
|
80 |
78 |
$1K |
| 85379 |
|
1,263 |
1,098 |
$1K |
| 96415 |
|
731 |
520 |
$1K |
| 87493 |
|
578 |
314 |
$1K |
| 29125 |
|
520 |
492 |
$1K |
| 82784 |
|
356 |
329 |
$1K |
| 86762 |
|
1,053 |
1,025 |
$1K |
| 84145 |
|
3,497 |
2,992 |
$1K |
| 82550 |
|
3,200 |
2,333 |
$1K |
| 83540 |
|
3,761 |
3,498 |
$1K |
| 96367 |
|
3,607 |
2,410 |
$1K |
| 84112 |
|
489 |
417 |
$993.21 |
| J1630 |
Haloperidol injection |
315 |
260 |
$987.47 |
| 82533 |
|
66 |
59 |
$973.21 |
| 76937 |
|
316 |
280 |
$969.10 |
| 85014 |
|
205 |
158 |
$913.95 |
| 73060 |
|
71 |
67 |
$905.13 |
| 80164 |
|
74 |
53 |
$871.75 |
| 73565 |
|
33 |
31 |
$816.59 |
| 88141 |
|
40 |
39 |
$815.13 |
| 86901 |
|
5,899 |
5,181 |
$811.98 |
| 82947 |
|
2,394 |
1,745 |
$789.57 |
| 87510 |
|
2,376 |
2,279 |
$767.23 |
| A6212 |
Foam drg <=16 sq in w/border |
2,712 |
1,250 |
$711.61 |
| 86376 |
|
298 |
291 |
$689.61 |
| 99242 |
|
43 |
42 |
$687.52 |
| P9047 |
Albumin (human), 25%, 50ml |
21 |
12 |
$661.08 |
| 86756 |
|
472 |
458 |
$655.36 |
| 84436 |
|
4,094 |
3,936 |
$638.15 |
| 97032 |
|
90 |
56 |
$620.03 |
| 97802 |
|
15 |
15 |
$602.19 |
| J2274 |
Inj morphine pf epid ithc |
1,913 |
1,483 |
$580.46 |
| 73552 |
|
46 |
41 |
$563.24 |
| J1650 |
Inj enoxaparin sodium |
4,427 |
2,006 |
$560.38 |
| 73100 |
|
15 |
13 |
$557.60 |
| J7040 |
Normal saline solution infus |
1,500 |
1,076 |
$523.19 |
| 81003 |
|
4,917 |
4,501 |
$506.03 |
| 87660 |
|
2,374 |
2,277 |
$490.83 |
| 86706 |
|
111 |
106 |
$465.82 |
| 82270 |
|
690 |
599 |
$446.67 |
| J1644 |
Inj heparin sodium per 1000u |
5,725 |
2,394 |
$446.54 |
| 82627 |
|
86 |
85 |
$442.16 |
| J1953 |
Levetiracetam injection |
83 |
67 |
$435.23 |
| 76815 |
|
132 |
121 |
$401.33 |
| 72170 |
|
74 |
71 |
$393.24 |
| 76881 |
|
43 |
32 |
$389.31 |
| 84295 |
|
1,502 |
1,329 |
$387.93 |
| 83655 |
|
54 |
54 |
$374.82 |
| 92579 |
|
12 |
12 |
$350.90 |
| 86200 |
|
135 |
133 |
$344.22 |
| J8540 |
Oral dexamethasone |
5,350 |
2,765 |
$343.64 |
| J2060 |
Lorazepam injection |
4,004 |
2,836 |
$336.90 |
| 86160 |
|
13 |
13 |
$328.08 |
| Q9950 |
Inj sulf hexa lipid microsph |
1,735 |
969 |
$302.25 |
| 86635 |
|
12 |
12 |
$295.12 |
| 97010 |
|
3,014 |
1,812 |
$285.99 |
| 86140 |
|
5,765 |
5,132 |
$283.88 |
| J0171 |
Adrenalin epinephrine inject |
320 |
201 |
$277.90 |
| J1170 |
Hydromorphone injection |
6,821 |
4,140 |
$258.14 |
| 83550 |
|
3,383 |
3,139 |
$250.60 |
| 96417 |
|
203 |
111 |
$244.39 |
| 82330 |
|
104 |
77 |
$236.48 |
| 86403 |
|
28 |
27 |
$236.26 |
| 99442 |
|
45 |
45 |
$235.48 |
| 97164 |
|
19 |
19 |
$229.87 |
| 86800 |
|
15 |
14 |
$223.63 |
| J0456 |
Azithromycin |
330 |
185 |
$213.85 |
| 96376 |
|
11,010 |
6,233 |
$196.45 |
| J2270 |
Morphine sulfate injection |
8,186 |
5,326 |
$195.73 |
| 82009 |
|
1,881 |
1,598 |
$194.37 |
| C1776 |
Joint device (implantable) |
1,682 |
1,522 |
$180.09 |
| L1906 |
Afo multilig ank sup pre ots |
98 |
96 |
$175.33 |
| A6213 |
Foam drg >16<=48 sq in w/bdr |
762 |
405 |
$161.46 |
| G0283 |
Elec stim other than wound |
196 |
105 |
$158.84 |
| U0005 |
Infec agen detec ampli probe |
6,743 |
6,262 |
$157.66 |
| 90471 |
|
3,440 |
3,214 |
$154.11 |
| J1200 |
Diphenhydramine hcl injectio |
6,149 |
4,697 |
$148.34 |
| J2765 |
Metoclopramide hcl injection |
3,251 |
2,744 |
$146.35 |
| 88313 |
|
17 |
13 |
$145.34 |
| 97035 |
|
245 |
161 |
$141.77 |
| J2360 |
Orphenadrine injection |
3,646 |
3,312 |
$140.87 |
| J3010 |
Fentanyl citrate injection |
17,251 |
12,903 |
$140.09 |
| J0131 |
Inj, acetaminophen (nos) |
2,155 |
1,762 |
$138.07 |
| Q3014 |
Telehealth facility fee |
473 |
433 |
$137.66 |
| 94762 |
|
1,971 |
972 |
$130.74 |
| 86780 |
|
28 |
28 |
$127.68 |
| 92567 |
|
690 |
672 |
$126.56 |
| A9270 |
Non-covered item or service |
4,300 |
1,794 |
$118.71 |
| J2919 |
Inj, methylpred sod succ 5mg |
222 |
151 |
$116.81 |
| 82565 |
|
276 |
253 |
$109.46 |
| C1729 |
Cath, drainage |
852 |
441 |
$107.64 |
| 82570 |
|
3,860 |
3,632 |
$104.68 |
| 85652 |
|
6,009 |
5,377 |
$101.79 |
| 77001 |
|
104 |
90 |
$99.21 |
| A9576 |
Inj prohance multipack |
110 |
101 |
$98.39 |
| 76377 |
|
237 |
221 |
$93.93 |
| J2704 |
Inj, propofol, 10 mg |
11,443 |
8,470 |
$92.80 |
| J7050 |
Normal saline solution infus |
10,872 |
7,575 |
$91.21 |
| 86308 |
|
28 |
28 |
$80.62 |
| J2543 |
Piperacillin/tazobactam |
858 |
511 |
$78.72 |
| J0702 |
Betamethasone acet&sod phosp |
202 |
166 |
$76.30 |
| 80177 |
|
27 |
25 |
$70.71 |
| 96368 |
|
800 |
490 |
$63.52 |
| 88311 |
|
15 |
12 |
$61.20 |
| 82785 |
|
68 |
58 |
$56.56 |
| 82010 |
|
492 |
398 |
$55.86 |
| 77002 |
|
34 |
29 |
$53.08 |
| 85007 |
|
3,020 |
2,612 |
$52.27 |
| 82435 |
|
1,491 |
1,311 |
$50.83 |
| 87899 |
|
396 |
243 |
$49.62 |
| J2550 |
Promethazine hcl injection |
1,919 |
1,433 |
$43.00 |
| C9803 |
Hopd covid-19 spec collect |
214 |
195 |
$42.95 |
| 94760 |
|
850 |
560 |
$42.18 |
| E0114 |
Crutch underarm pair no wood |
495 |
476 |
$37.75 |
| 88302 |
|
59 |
56 |
$36.27 |
| 84520 |
|
126 |
115 |
$35.99 |
| J1940 |
Furosemide injection |
1,537 |
779 |
$33.06 |
| 95012 |
|
93 |
93 |
$32.61 |
| J0330 |
Succinycholine chloride inj |
2,059 |
1,812 |
$31.41 |
| 84550 |
|
1,183 |
1,124 |
$30.02 |
| J0280 |
Aminophyllin 250 mg inj |
384 |
358 |
$27.84 |
| C9113 |
Inj pantoprazole sodium, via |
3,355 |
1,721 |
$27.31 |
| J1790 |
Droperidol injection |
832 |
727 |
$26.07 |
| 86431 |
|
1,106 |
1,078 |
$25.56 |
| C1894 |
Intro/sheath, non-laser |
2,165 |
1,945 |
$23.70 |
| 84479 |
|
2,284 |
2,228 |
$22.27 |
| 94668 |
|
14 |
12 |
$20.84 |
| A6021 |
Collagen dressing <=16 sq in |
700 |
349 |
$19.99 |
| 86702 |
|
576 |
559 |
$18.15 |
| 51702 |
|
372 |
304 |
$10.00 |
| J2710 |
Neostigmine methylslfte inj |
648 |
572 |
$9.10 |
| 81005 |
|
244 |
231 |
$7.19 |
| J0360 |
Hydralazine hcl injection |
730 |
505 |
$6.49 |
| J7512 |
Prednisone ir or dr oral 1mg |
1,453 |
968 |
$6.38 |
| A6257 |
Transparent film <= 16 sq in |
3,624 |
3,231 |
$5.59 |
| J2470 |
Inj pantoprazole sodium 40mg |
81 |
61 |
$4.78 |
| 85018 |
|
262 |
198 |
$2.07 |
| S0028 |
Injection, famotidine, 20 mg |
1,768 |
1,380 |
$1.90 |
| A4215 |
Sterile needle |
3,191 |
2,822 |
$1.65 |
| J7620 |
Albuterol ipratrop non-comp |
2,315 |
1,687 |
$0.90 |
| J3411 |
Thiamine hcl 100 mg |
993 |
415 |
$0.24 |
| J8597 |
Antiemetic drug oral nos |
323 |
265 |
$0.00 |
| 88738 |
|
2,051 |
1,965 |
$0.00 |
| J2001 |
Lidocaine injection |
5,609 |
3,333 |
$0.00 |
| J1920 |
Inj, labetalol hcl, 5mg |
370 |
253 |
$0.00 |
| 87640 |
|
1,181 |
1,061 |
$0.00 |
| 94761 |
|
1,355 |
535 |
$0.00 |
| 86593 |
|
277 |
267 |
$0.00 |
| J7611 |
Albuterol non-comp con |
441 |
437 |
$0.00 |
| 83002 |
|
41 |
40 |
$0.00 |
| C1726 |
Cath, bal dil, non-vascular |
61 |
61 |
$0.00 |
| 84402 |
|
442 |
424 |
$0.00 |
| J0610 |
Calcium glucon (fresenius) |
65 |
29 |
$0.00 |
| 84144 |
|
14 |
14 |
$0.00 |
| 64494 |
|
134 |
121 |
$0.00 |
| J3535 |
Metered dose inhaler drug |
298 |
295 |
$0.00 |
| 97014 |
|
38 |
26 |
$0.00 |
| A6222 |
Gauze <=16 in no w/sal w/o b |
408 |
387 |
$0.00 |
| C9399 |
Unclassified drugs or biolog |
197 |
145 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
531 |
493 |
$0.00 |
| A4648 |
Implantable tissue marker |
203 |
169 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
703 |
448 |
$0.00 |
| C9290 |
Inj, bupivacaine liposome |
474 |
448 |
$0.00 |
| 87015 |
|
73 |
68 |
$0.00 |
| G8980 |
Mobility d/c status |
259 |
208 |
$0.00 |
| J0500 |
Dicyclomine injection |
167 |
155 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
470 |
387 |
$0.00 |
| 97018 |
|
29 |
14 |
$0.00 |
| J7613 |
Albuterol non-comp unit |
57 |
51 |
$0.00 |
| J1836 |
Inj, metronidazole, 10 mg |
140 |
100 |
$0.00 |
| 97610 |
|
42 |
12 |
$0.00 |
| 87807 |
|
43 |
42 |
$0.00 |
| J2175 |
Meperidine hydrochl /100 mg |
20 |
12 |
$0.00 |
| 86704 |
|
21 |
19 |
$0.00 |
| U0002 |
Covid-19 lab test non-cdc |
78 |
64 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
140 |
122 |
$0.00 |
| 86225 |
|
13 |
13 |
$0.00 |
| J7060 |
5% dextrose/water |
33 |
17 |
$0.00 |
| J3480 |
Inj potassium chloride |
26 |
13 |
$0.00 |
| C1725 |
Cath, translumin non-laser |
42 |
36 |
$0.00 |
| 36471 |
|
21 |
12 |
$0.00 |
| A6260 |
Wound cleanser any type/size |
28 |
26 |
$0.00 |
| 74022 |
|
13 |
13 |
$0.00 |
| C1781 |
Mesh (implantable) |
13 |
13 |
$0.00 |
| J0583 |
Bivalirudin |
12 |
12 |
$0.00 |
| C1766 |
Intro/sheath,strble,non-peel |
14 |
12 |
$0.00 |
| J3360 |
Diazepam injection |
78 |
42 |
$0.00 |
| L4350 |
Ankle control ortho pre ots |
13 |
13 |
$0.00 |
| J2920 |
Methylprednisolone injection |
64 |
24 |
$0.00 |
| 87503 |
|
18 |
18 |
$0.00 |
| G0008 |
Admin influenza virus vac |
14 |
13 |
$0.00 |
| J1626 |
Granisetron hcl injection |
22 |
14 |
$0.00 |
| A9552 |
F18 fdg |
737 |
702 |
$0.00 |
| C1760 |
Closure dev, vasc |
563 |
506 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
1,325 |
1,170 |
$0.00 |
| S0077 |
Injection, clindamycin phosp |
359 |
227 |
$0.00 |
| 87535 |
|
15 |
14 |
$0.00 |
| G8985 |
Carry goal status |
70 |
57 |
$0.00 |
| 82248 |
|
182 |
126 |
$0.00 |
| J2800 |
Methocarbamol injection |
65 |
65 |
$0.00 |
| J0134 |
Inj acetaminophen -fresenius |
844 |
696 |
$0.00 |
| A6254 |
Absorpt drg <=16 sq in w/bdr |
183 |
164 |
$0.00 |
| 76000 |
|
89 |
82 |
$0.00 |
| 83525 |
|
26 |
26 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
282 |
224 |
$0.00 |
| 51701 |
|
24 |
24 |
$0.00 |
| A4216 |
Sterile water/saline, 10 ml |
45 |
41 |
$0.00 |
| C1887 |
Catheter, guiding |
525 |
472 |
$0.00 |
| 91040 |
|
31 |
31 |
$0.00 |
| G8979 |
Mobility goal status |
613 |
465 |
$0.00 |
| C1751 |
Cath, inf, per/cent/midline |
54 |
50 |
$0.00 |
| J0780 |
Prochlorperazine injection |
347 |
309 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
43 |
41 |
$0.00 |
| G8978 |
Mobility current status |
470 |
370 |
$0.00 |
| G8984 |
Carry current status |
15 |
13 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
305 |
134 |
$0.00 |
| A6457 |
Tubular dressing |
83 |
52 |
$0.00 |
| A4565 |
Slings |
243 |
223 |
$0.00 |
| 36600 |
|
50 |
43 |
$0.00 |
| J8499 |
Oral prescrip drug non chemo |
94 |
55 |
$0.00 |
| C1758 |
Catheter, ureteral |
172 |
153 |
$0.00 |
| J3372 |
Inj, vancomycin hcl (xellia) |
145 |
107 |
$0.00 |
| L1830 |
Ko immob canvas long pre ots |
98 |
92 |
$0.00 |
| Q0177 |
Hydroxyzine pamoate 25mg |
20 |
12 |
$0.00 |
| 77336 |
|
132 |
49 |
$0.00 |
| A6196 |
Alginate dressing <=16 sq in |
151 |
77 |
$0.00 |
| Q0244 |
Casirivi and imdevi 1200 mg |
131 |
130 |
$0.00 |
| 94669 |
|
31 |
12 |
$0.00 |
| 87804 |
|
57 |
41 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
15 |
14 |
$0.00 |
| 87538 |
|
15 |
14 |
$0.00 |
| J0737 |
Inj, clindamycin (baxter) |
34 |
26 |
$0.00 |
| J1956 |
Levofloxacin injection |
17 |
12 |
$0.00 |
| L0140 |
Cervical semi-rigid adjustab |
12 |
12 |
$0.00 |