| Code | Description | Claims | Beneficiaries | Total Paid |
| 99285 |
|
64,833 |
60,613 |
$26.71M |
| 99284 |
|
34,124 |
33,103 |
$7.65M |
| G0463 |
Hospital outpt clinic visit |
84,281 |
77,530 |
$6.14M |
| 96374 |
|
35,301 |
33,055 |
$2.88M |
| 43239 |
|
7,092 |
7,072 |
$2.87M |
| 99283 |
|
19,864 |
19,269 |
$2.83M |
| 45380 |
|
2,936 |
2,927 |
$1.61M |
| 74177 |
|
9,087 |
8,966 |
$1.12M |
| 93306 |
|
5,646 |
5,631 |
$1.09M |
| 71046 |
|
23,339 |
22,815 |
$968K |
| 97112 |
|
39,591 |
10,750 |
$930K |
| 80061 |
|
42,146 |
41,949 |
$865K |
| 97110 |
|
46,419 |
12,213 |
$856K |
| 78452 |
|
1,814 |
1,799 |
$827K |
| 92507 |
|
20,406 |
5,598 |
$795K |
| 77067 |
|
15,496 |
15,460 |
$737K |
| 93975 |
|
6,922 |
6,691 |
$736K |
| 96361 |
|
19,047 |
15,059 |
$721K |
| 97530 |
|
19,606 |
6,667 |
$636K |
| 82947 |
|
15,721 |
11,034 |
$604K |
| G0378 |
Hospital observation per hr |
18,724 |
16,890 |
$576K |
| 70450 |
|
9,002 |
8,826 |
$550K |
| 96375 |
|
26,434 |
22,179 |
$545K |
| 96365 |
|
7,977 |
7,216 |
$528K |
| 45385 |
|
1,125 |
1,121 |
$527K |
| 76700 |
|
8,064 |
8,044 |
$519K |
| 74176 |
|
5,048 |
4,987 |
$484K |
| 82306 |
|
29,106 |
28,969 |
$478K |
| 70553 |
|
2,478 |
2,467 |
$447K |
| 99282 |
|
5,433 |
5,308 |
$443K |
| 84443 |
|
48,202 |
47,500 |
$414K |
| 95810 |
|
829 |
827 |
$411K |
| 76830 |
|
7,174 |
7,096 |
$404K |
| 96360 |
|
4,450 |
4,377 |
$401K |
| U0003 |
Cov-19 amp prb hgh thruput |
10,355 |
10,057 |
$398K |
| 76856 |
|
8,707 |
8,607 |
$397K |
| 62323 |
|
1,220 |
1,205 |
$382K |
| 45378 |
|
918 |
916 |
$370K |
| 97140 |
|
25,897 |
7,430 |
$370K |
| G0121 |
Colon ca scrn not hi rsk ind |
836 |
833 |
$362K |
| 80053 |
|
102,664 |
91,552 |
$358K |
| 71260 |
|
2,447 |
2,430 |
$347K |
| 73721 |
|
2,504 |
2,463 |
$323K |
| 72148 |
|
3,208 |
3,197 |
$301K |
| 78815 |
|
413 |
402 |
$300K |
| 71045 |
|
8,318 |
7,994 |
$285K |
| 87637 |
|
3,750 |
3,694 |
$277K |
| 76770 |
|
4,621 |
4,574 |
$274K |
| 97162 |
|
4,687 |
4,633 |
$263K |
| 70551 |
|
2,280 |
2,274 |
$261K |
| 76705 |
|
4,737 |
4,655 |
$258K |
| 47562 |
|
74 |
74 |
$257K |
| 85025 |
|
123,553 |
108,540 |
$230K |
| 87491 |
|
13,212 |
13,023 |
$227K |
| 59025 |
|
2,684 |
1,761 |
$225K |
| 76536 |
|
4,320 |
4,311 |
$218K |
| 87591 |
|
12,819 |
12,634 |
$213K |
| 76801 |
|
3,615 |
3,369 |
$202K |
| 74183 |
|
1,116 |
1,113 |
$193K |
| 72141 |
|
1,571 |
1,565 |
$190K |
| 76816 |
|
3,963 |
3,623 |
$189K |
| 76642 |
|
4,770 |
4,728 |
$189K |
| 87633 |
|
1,069 |
1,057 |
$181K |
| 73221 |
|
1,354 |
1,337 |
$179K |
| 19083 |
|
222 |
221 |
$177K |
| 83036 |
|
35,202 |
35,025 |
$174K |
| 93971 |
|
3,262 |
3,148 |
$169K |
| 77066 |
Tomosynthesis, mammo |
2,897 |
2,870 |
$164K |
| 71275 |
|
2,069 |
2,050 |
$156K |
| 76805 |
|
2,634 |
2,619 |
$155K |
| 77065 |
Tomosynthesis, mammo |
3,490 |
3,242 |
$151K |
| 90471 |
|
15,187 |
14,968 |
$148K |
| 82607 |
|
18,910 |
18,793 |
$144K |
| 71250 |
|
2,291 |
2,285 |
$131K |
| 77080 |
|
2,237 |
2,233 |
$129K |
| 93970 |
|
1,289 |
1,280 |
$125K |
| 86003 |
|
2,633 |
2,522 |
$122K |
| 87389 |
|
9,464 |
9,409 |
$117K |
| 72110 |
|
4,791 |
4,769 |
$117K |
| 84466 |
|
15,587 |
15,413 |
$105K |
| 90651 |
|
913 |
911 |
$103K |
| 97535 |
|
7,084 |
4,617 |
$101K |
| 95811 |
|
207 |
207 |
$99K |
| 74178 |
|
565 |
562 |
$97K |
| 82728 |
|
14,302 |
14,108 |
$96K |
| 93350 |
|
428 |
422 |
$95K |
| 87651 |
|
6,077 |
6,017 |
$93K |
| 87631 |
|
7,250 |
7,169 |
$91K |
| 97161 |
|
1,766 |
1,742 |
$90K |
| 84439 |
|
19,049 |
18,735 |
$89K |
| 80048 |
|
41,722 |
37,187 |
$88K |
| 80074 |
|
3,865 |
3,836 |
$88K |
| G0480 |
Drug test def 1-7 classes |
8,990 |
7,977 |
$88K |
| 90670 |
|
1,503 |
1,502 |
$87K |
| 90472 |
|
5,287 |
5,242 |
$85K |
| U0005 |
Infec agen detec ampli probe |
7,104 |
6,915 |
$85K |
| 82746 |
|
10,256 |
10,183 |
$82K |
| 90686 |
|
5,403 |
5,391 |
$79K |
| 84481 |
|
8,250 |
8,082 |
$77K |
| 97116 |
|
7,180 |
3,296 |
$77K |
| 87661 |
|
3,601 |
3,567 |
$73K |
| 85027 |
|
32,441 |
29,340 |
$73K |
| 93880 |
|
991 |
989 |
$72K |
| 86480 |
|
1,942 |
1,931 |
$71K |
| 73564 |
|
3,354 |
3,257 |
$70K |
| 74019 |
|
3,721 |
3,655 |
$67K |
| 97166 |
|
1,371 |
1,343 |
$66K |
| 36415 |
|
95,042 |
83,221 |
$61K |
| 87086 |
|
24,756 |
23,823 |
$61K |
| 70486 |
|
1,424 |
1,417 |
$59K |
| 87480 |
|
5,411 |
5,325 |
$59K |
| 87636 |
|
995 |
978 |
$59K |
| 99281 |
|
1,374 |
1,332 |
$59K |
| 83013 |
|
1,414 |
1,411 |
$56K |
| 74018 |
|
2,771 |
2,594 |
$56K |
| 83540 |
|
16,149 |
15,965 |
$55K |
| 86900 |
|
10,200 |
9,502 |
$55K |
| 87660 |
|
5,150 |
5,064 |
$55K |
| 93017 |
|
3,179 |
3,157 |
$55K |
| 96372 |
|
11,871 |
8,872 |
$53K |
| 87510 |
|
5,010 |
4,937 |
$52K |
| 71271 |
|
935 |
935 |
$51K |
| 84403 |
|
3,213 |
3,160 |
$49K |
| 83970 |
|
2,240 |
2,182 |
$48K |
| 77063 |
|
3,801 |
3,800 |
$47K |
| 80307 |
|
7,528 |
7,205 |
$45K |
| 96366 |
|
3,073 |
1,980 |
$45K |
| 90750 |
|
309 |
308 |
$44K |
| 94726 |
|
947 |
945 |
$43K |
| 84702 |
|
26,732 |
24,496 |
$43K |
| 93005 |
|
33,375 |
30,802 |
$42K |
| 90732 |
|
407 |
406 |
$40K |
| 86803 |
|
4,855 |
4,829 |
$39K |
| 73030 |
|
2,982 |
2,917 |
$39K |
| 94060 |
|
257 |
255 |
$36K |
| 73630 |
|
3,412 |
3,339 |
$36K |
| 92523 |
|
315 |
315 |
$35K |
| 90677 |
|
200 |
200 |
$34K |
| 82670 |
|
2,027 |
2,008 |
$32K |
| 73610 |
|
2,915 |
2,861 |
$32K |
| 73130 |
|
2,625 |
2,559 |
$32K |
| 86038 |
|
4,862 |
4,822 |
$31K |
| 88305 |
|
14,497 |
13,599 |
$30K |
| 86780 |
|
3,171 |
3,145 |
$30K |
| 82784 |
|
3,783 |
3,710 |
$29K |
| 83001 |
|
2,596 |
2,581 |
$27K |
| 72070 |
|
1,277 |
1,266 |
$27K |
| 76819 |
|
455 |
233 |
$26K |
| 44970 |
|
12 |
12 |
$25K |
| 84550 |
|
10,305 |
10,118 |
$25K |
| 73502 |
|
1,989 |
1,930 |
$25K |
| 97165 |
|
582 |
575 |
$25K |
| 82785 |
|
2,682 |
2,630 |
$24K |
| 84146 |
|
2,218 |
2,201 |
$24K |
| 84153 |
|
2,556 |
2,542 |
$24K |
| 86696 |
|
2,186 |
2,176 |
$24K |
| 72125 |
|
2,387 |
2,354 |
$24K |
| 83735 |
|
19,737 |
16,313 |
$24K |
| 10005 |
|
67 |
67 |
$23K |
| Q0111 |
Wet mounts/ w preparations |
1,068 |
1,047 |
$23K |
| 73110 |
|
2,090 |
2,044 |
$22K |
| 83002 |
|
2,111 |
2,097 |
$22K |
| 72050 |
|
444 |
444 |
$22K |
| 86352 |
|
279 |
279 |
$21K |
| 86376 |
|
2,590 |
2,581 |
$21K |
| 86769 |
|
1,038 |
1,034 |
$20K |
| G0103 |
Psa screening |
1,428 |
1,427 |
$20K |
| 84402 |
|
1,409 |
1,394 |
$20K |
| 72052 |
|
519 |
515 |
$20K |
| G0472 |
Hep c screen high risk/other |
1,304 |
1,301 |
$19K |
| 70491 |
|
195 |
193 |
$19K |
| 87632 |
|
636 |
630 |
$19K |
| 88175 |
|
1,620 |
1,618 |
$19K |
| 86140 |
|
9,505 |
9,047 |
$18K |
| 87186 |
|
5,747 |
5,625 |
$18K |
| 87077 |
|
5,723 |
5,594 |
$18K |
| 83880 |
|
4,015 |
3,881 |
$17K |
| 76881 |
|
302 |
300 |
$17K |
| 87340 |
|
3,431 |
3,403 |
$17K |
| G0105 |
Colorectal scrn; hi risk ind |
39 |
39 |
$17K |
| 73562 |
|
851 |
790 |
$17K |
| 83516 |
|
2,666 |
2,532 |
$17K |
| 86160 |
|
1,250 |
1,237 |
$16K |
| 85610 |
|
14,205 |
12,045 |
$16K |
| 86695 |
|
2,186 |
2,176 |
$16K |
| 99395 |
|
230 |
229 |
$16K |
| 74022 |
|
2,169 |
2,110 |
$16K |
| 17110 |
|
176 |
142 |
$16K |
| 99396 |
|
223 |
221 |
$15K |
| 71101 |
|
812 |
804 |
$15K |
| 80076 |
|
5,103 |
4,942 |
$15K |
| 83655 |
|
2,369 |
2,364 |
$15K |
| 91322 |
|
109 |
109 |
$15K |
| 83993 |
|
1,400 |
1,394 |
$15K |
| 73590 |
|
1,574 |
1,545 |
$15K |
| 86800 |
|
1,642 |
1,636 |
$15K |
| 86235 |
|
704 |
666 |
$14K |
| 94640 |
|
8,698 |
4,864 |
$14K |
| 87624 |
|
976 |
975 |
$14K |
| 84144 |
|
1,120 |
1,072 |
$14K |
| 87070 |
|
5,037 |
4,923 |
$14K |
| 88184 |
|
336 |
325 |
$14K |
| 81003 |
|
27,177 |
25,155 |
$13K |
| G0279 |
Tomosynthesis, mammo |
1,172 |
1,172 |
$13K |
| 82043 |
|
4,490 |
4,457 |
$13K |
| 82627 |
|
1,034 |
1,028 |
$13K |
| 82248 |
|
6,953 |
5,870 |
$13K |
| 87502 |
|
289 |
289 |
$12K |
| 81001 |
|
22,534 |
21,443 |
$12K |
| 97163 |
|
204 |
203 |
$12K |
| 86850 |
|
9,753 |
9,063 |
$12K |
| 99391 |
|
170 |
158 |
$12K |
| 87427 |
|
1,344 |
1,305 |
$12K |
| 86762 |
|
1,580 |
1,573 |
$11K |
| C8929 |
Tte w or wo fol wcon,doppler |
52 |
51 |
$11K |
| 86147 |
|
271 |
268 |
$11K |
| 82570 |
|
4,854 |
4,610 |
$11K |
| 87635 |
|
660 |
650 |
$11K |
| 80069 |
|
2,561 |
2,301 |
$11K |
| 81025 |
|
9,040 |
8,808 |
$11K |
| 87046 |
|
1,434 |
1,386 |
$11K |
| 76815 |
|
860 |
769 |
$10K |
| 86592 |
|
3,227 |
3,213 |
$10K |
| 82550 |
|
5,658 |
5,281 |
$10K |
| 83021 |
|
1,042 |
1,035 |
$10K |
| 49083 |
|
21 |
12 |
$10K |
| 99291 |
|
13 |
13 |
$10K |
| 85652 |
|
8,961 |
8,662 |
$10K |
| 10060 |
|
125 |
119 |
$10K |
| 82533 |
|
1,075 |
1,029 |
$10K |
| 83690 |
|
21,688 |
20,118 |
$10K |
| 87147 |
|
3,166 |
3,077 |
$9K |
| 87880 |
|
5,540 |
5,453 |
$9K |
| 82565 |
|
3,861 |
3,676 |
$9K |
| 84445 |
|
260 |
260 |
$9K |
| 87653 |
|
714 |
708 |
$9K |
| 76870 |
|
986 |
975 |
$9K |
| 78227 |
|
40 |
39 |
$9K |
| 86787 |
|
1,211 |
1,194 |
$9K |
| 96367 |
|
719 |
644 |
$9K |
| 82105 |
|
1,012 |
984 |
$9K |
| 82247 |
|
3,914 |
2,809 |
$9K |
| 72100 |
|
284 |
283 |
$8K |
| 86200 |
|
1,078 |
1,064 |
$8K |
| 86706 |
|
1,461 |
1,454 |
$8K |
| Q0138 |
Ferumoxytol, non-esrd |
76 |
50 |
$8K |
| 85730 |
|
8,501 |
7,895 |
$8K |
| 73080 |
|
896 |
890 |
$8K |
| 81514 |
|
42 |
42 |
$7K |
| 87338 |
|
987 |
983 |
$7K |
| 84100 |
|
6,965 |
5,789 |
$7K |
| 99392 |
|
103 |
103 |
$7K |
| 90837 |
|
89 |
60 |
$7K |
| 86225 |
|
932 |
919 |
$7K |
| 90739 |
|
56 |
56 |
$7K |
| 73090 |
|
1,212 |
1,189 |
$7K |
| 90716 |
|
185 |
184 |
$7K |
| 75574 |
|
90 |
90 |
$7K |
| 87428 |
|
353 |
350 |
$7K |
| 84425 |
|
556 |
555 |
$7K |
| 84520 |
|
3,483 |
3,332 |
$6K |
| 90734 |
|
275 |
274 |
$6K |
| 73140 |
|
353 |
347 |
$6K |
| 86431 |
|
2,061 |
2,051 |
$6K |
| 83615 |
|
3,046 |
2,767 |
$6K |
| U0002 |
Covid-19 lab test non-cdc |
196 |
190 |
$6K |
| 84165 |
|
1,222 |
1,176 |
$6K |
| 99394 |
|
88 |
88 |
$6K |
| 82378 |
|
599 |
526 |
$6K |
| 90474 |
|
1,124 |
1,124 |
$6K |
| 84460 |
|
2,708 |
2,531 |
$6K |
| 88342 |
|
1,470 |
1,437 |
$6K |
| 84450 |
|
3,280 |
3,088 |
$6K |
| 99393 |
|
85 |
85 |
$6K |
| 82465 |
|
1,053 |
1,037 |
$6K |
| 0124A |
|
184 |
184 |
$5K |
| 83525 |
|
826 |
819 |
$5K |
| 70360 |
|
356 |
355 |
$5K |
| 86300 |
|
412 |
375 |
$5K |
| 87209 |
|
683 |
676 |
$5K |
| 86146 |
|
196 |
193 |
$5K |
| 87522 |
Neg quan hep c or qual rna |
236 |
234 |
$5K |
| 77336 |
|
76 |
37 |
$5K |
| 86665 |
|
399 |
386 |
$5K |
| 82652 |
|
224 |
224 |
$5K |
| 86162 |
|
366 |
366 |
$5K |
| 80305 |
|
1,106 |
1,028 |
$5K |
| 87045 |
|
1,411 |
1,388 |
$5K |
| 82274 |
|
601 |
596 |
$4K |
| 84432 |
|
425 |
424 |
$4K |
| 76817 |
|
3,262 |
2,978 |
$4K |
| 69436 |
|
12 |
12 |
$4K |
| 86704 |
|
653 |
648 |
$4K |
| 85379 |
|
4,566 |
4,483 |
$4K |
| 86039 |
|
769 |
760 |
$4K |
| 90671 |
|
110 |
110 |
$4K |
| 82950 |
|
1,636 |
1,610 |
$4K |
| 90480 |
|
110 |
110 |
$4K |
| 82150 |
|
2,182 |
2,106 |
$4K |
| 72040 |
|
234 |
231 |
$4K |
| 80197 |
|
477 |
381 |
$4K |
| 84156 |
|
2,610 |
2,380 |
$4K |
| 87634 |
|
112 |
111 |
$4K |
| 10022 |
|
17 |
12 |
$4K |
| 98929 |
|
319 |
316 |
$4K |
| 86901 |
|
9,667 |
8,999 |
$4K |
| 0054A |
|
111 |
111 |
$4K |
| 84478 |
|
120 |
105 |
$4K |
| 96376 |
|
13,994 |
8,143 |
$3K |
| 90656 |
|
217 |
217 |
$3K |
| 88304 |
|
2,039 |
2,021 |
$3K |
| 36430 |
|
28 |
24 |
$3K |
| 87449 |
|
912 |
893 |
$3K |
| 73523 |
|
62 |
61 |
$3K |
| 72131 |
|
81 |
81 |
$3K |
| 87324 |
|
822 |
810 |
$3K |
| 87426 |
|
266 |
264 |
$3K |
| 73700 |
|
52 |
52 |
$3K |
| 86334 |
|
289 |
276 |
$3K |
| 80051 |
|
1,215 |
1,177 |
$3K |
| 82977 |
|
723 |
705 |
$3K |
| G0297 |
Ldct for lung ca screen |
71 |
71 |
$3K |
| 86256 |
|
249 |
245 |
$3K |
| 84484 |
|
23,535 |
19,983 |
$3K |
| 87177 |
|
683 |
676 |
$3K |
| 80050 |
|
194 |
194 |
$3K |
| 0004A |
|
73 |
73 |
$3K |
| 72197 |
|
13 |
12 |
$2K |
| 84134 |
|
397 |
380 |
$2K |
| 84630 |
|
402 |
399 |
$2K |
| 20610 |
|
15 |
15 |
$2K |
| 80081 |
|
74 |
74 |
$2K |
| 85046 |
|
1,268 |
1,185 |
$2K |
| 95816 |
|
24 |
24 |
$2K |
| 88185 |
|
87 |
76 |
$2K |
| 82040 |
|
1,547 |
1,402 |
$2K |
| G0475 |
Hiv combination assay |
175 |
175 |
$2K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
16,307 |
15,933 |
$2K |
| 70496 |
|
54 |
52 |
$2K |
| 87328 |
|
298 |
296 |
$2K |
| 86304 |
|
197 |
186 |
$2K |
| 76882 |
|
40 |
40 |
$2K |
| 87329 |
|
331 |
329 |
$2K |
| 81002 |
|
1,880 |
1,504 |
$2K |
| 87205 |
|
2,352 |
2,271 |
$2K |
| P9016 |
Rbc leukocytes reduced |
28 |
24 |
$2K |
| 77300 |
|
12 |
12 |
$2K |
| 86664 |
|
298 |
292 |
$2K |
| J7042 |
5% dextrose/normal saline |
3,182 |
2,180 |
$2K |
| 76641 |
|
30 |
30 |
$2K |
| 86364 |
|
264 |
261 |
$2K |
| 84305 |
|
151 |
151 |
$1K |
| 90460 |
|
30 |
30 |
$1K |
| 74174 |
|
12 |
12 |
$1K |
| 86663 |
|
298 |
293 |
$1K |
| 99214 |
|
29 |
29 |
$1K |
| 82525 |
|
216 |
216 |
$1K |
| 87641 |
|
102 |
100 |
$1K |
| 82310 |
|
696 |
676 |
$1K |
| 99213 |
|
33 |
33 |
$1K |
| 84075 |
|
797 |
708 |
$1K |
| 0241U |
|
1,503 |
1,478 |
$1K |
| 88312 |
|
1,005 |
1,004 |
$1K |
| 87081 |
|
388 |
384 |
$1K |
| 86255 |
|
155 |
152 |
$1K |
| 99385 |
|
17 |
17 |
$1K |
| 87798 |
|
40 |
39 |
$1K |
| 90746 |
|
16 |
16 |
$1K |
| 83090 |
|
117 |
117 |
$983.79 |
| 87640 |
|
75 |
73 |
$982.10 |
| 94010 |
|
139 |
136 |
$926.38 |
| 87040 |
|
1,828 |
1,695 |
$851.60 |
| 88112 |
|
119 |
112 |
$809.10 |
| 72146 |
|
13 |
13 |
$775.26 |
| 82962 |
|
3,194 |
2,357 |
$768.64 |
| 0001A |
|
20 |
20 |
$763.04 |
| 97014 |
|
86 |
26 |
$753.07 |
| 0002A |
|
19 |
17 |
$719.15 |
| 73552 |
|
98 |
97 |
$691.45 |
| 90647 |
|
1,073 |
1,072 |
$691.20 |
| 12011 |
|
444 |
442 |
$684.89 |
| 73060 |
|
157 |
155 |
$683.94 |
| 82951 |
|
96 |
96 |
$683.18 |
| 88307 |
|
173 |
172 |
$677.21 |
| 98928 |
|
54 |
52 |
$666.98 |
| 86005 |
|
62 |
62 |
$638.82 |
| 72082 |
|
12 |
12 |
$618.84 |
| 96127 |
|
101 |
101 |
$606.10 |
| 70498 |
|
36 |
36 |
$598.91 |
| 85018 |
|
2,096 |
1,752 |
$589.72 |
| U0001 |
2019-ncov diagnostic p |
23 |
23 |
$563.76 |
| 84155 |
|
585 |
506 |
$557.16 |
| 86308 |
|
1,533 |
1,520 |
$554.42 |
| 88341 |
|
253 |
245 |
$549.72 |
| 83605 |
|
8,351 |
7,601 |
$524.32 |
| 86301 |
|
40 |
39 |
$509.15 |
| 0052A |
|
13 |
13 |
$487.89 |
| A9500 |
Tc99m sestamibi |
1,777 |
1,762 |
$472.31 |
| 84145 |
|
2,258 |
2,192 |
$467.62 |
| 83550 |
|
166 |
160 |
$447.89 |
| 98927 |
|
37 |
36 |
$447.08 |
| 72072 |
|
24 |
24 |
$436.92 |
| 86765 |
|
90 |
89 |
$434.12 |
| 94618 |
|
25 |
25 |
$399.51 |
| 82024 |
|
16 |
16 |
$388.61 |
| 85014 |
|
842 |
675 |
$385.45 |
| 12001 |
|
576 |
571 |
$371.75 |
| 86735 |
|
41 |
41 |
$347.22 |
| 83521 |
|
34 |
25 |
$341.51 |
| 80164 |
|
81 |
76 |
$339.21 |
| 84132 |
|
497 |
478 |
$337.17 |
| 87075 |
|
193 |
184 |
$327.17 |
| 82103 |
|
52 |
52 |
$312.84 |
| 82088 |
|
12 |
12 |
$311.79 |
| 84703 |
|
4,901 |
4,700 |
$307.48 |
| 82390 |
|
43 |
41 |
$282.92 |
| 87184 |
|
54 |
54 |
$244.10 |
| C1769 |
Guide wire |
873 |
834 |
$241.99 |
| 73000 |
|
24 |
24 |
$237.90 |
| G0008 |
Admin influenza virus vac |
52 |
52 |
$237.70 |
| 83630 |
|
42 |
41 |
$236.90 |
| 82805 |
|
27 |
27 |
$234.20 |
| J1885 |
Ketorolac tromethamine inj |
25,631 |
22,337 |
$230.76 |
| 86141 |
|
32 |
31 |
$230.41 |
| 83695 |
|
27 |
27 |
$227.20 |
| 83010 |
|
55 |
53 |
$215.07 |
| P9612 |
Catheterize for urine spec |
13 |
12 |
$208.30 |
| J1100 |
Dexamethasone sodium phos |
10,250 |
9,406 |
$201.98 |
| 89051 |
|
127 |
121 |
$187.92 |
| 87804 |
|
69 |
68 |
$182.63 |
| J2272 |
Inj, morphine (fresenius) |
2,052 |
1,522 |
$168.52 |
| 86215 |
|
17 |
17 |
$151.61 |
| 69209 |
|
13 |
13 |
$133.94 |
| 82952 |
|
62 |
62 |
$131.96 |
| 85384 |
|
145 |
134 |
$118.28 |
| 82140 |
|
42 |
38 |
$118.19 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
305 |
303 |
$115.18 |
| 88173 |
|
279 |
279 |
$114.65 |
| 93010 |
|
25 |
21 |
$114.00 |
| J3490 |
Drugs unclassified injection |
1,580 |
1,536 |
$113.71 |
| 82010 |
|
452 |
422 |
$85.84 |
| 83930 |
|
321 |
297 |
$74.51 |
| 85613 |
|
12 |
12 |
$70.50 |
| 92250 |
|
13 |
13 |
$64.79 |
| 90715 |
|
3,195 |
3,190 |
$61.53 |
| 88720 |
|
37 |
35 |
$60.50 |
| 72170 |
|
29 |
29 |
$59.64 |
| 92610 |
|
16 |
15 |
$48.91 |
| J0696 |
Ceftriaxone sodium injection |
4,325 |
3,180 |
$41.26 |
| 82542 |
|
63 |
62 |
$38.33 |
| 82365 |
|
39 |
39 |
$34.92 |
| 88313 |
|
17 |
12 |
$27.35 |
| 82077 |
|
401 |
369 |
$26.36 |
| 87210 |
|
1,468 |
1,434 |
$25.26 |
| 85007 |
|
15 |
15 |
$24.34 |
| J0780 |
Prochlorperazine injection |
803 |
727 |
$19.80 |
| J1170 |
Hydromorphone injection |
11,753 |
7,744 |
$16.77 |
| J3411 |
Thiamine hcl 100 mg |
787 |
402 |
$14.56 |
| 82948 |
|
15 |
14 |
$13.28 |
| J0689 |
Inj cefazolin sodium, baxter |
592 |
501 |
$12.69 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
520 |
503 |
$12.67 |
| J2270 |
Morphine sulfate injection |
7,927 |
5,565 |
$11.01 |
| J2930 |
Methylprednisolone injection |
3,932 |
3,222 |
$10.10 |
| J3010 |
Fentanyl citrate injection |
12,996 |
10,413 |
$9.54 |
| J1040 |
Methylprednisolone 80 mg inj |
1,245 |
1,216 |
$9.38 |
| 87808 |
|
1,041 |
1,018 |
$7.60 |
| 82800 |
|
325 |
310 |
$6.67 |
| J2704 |
Inj, propofol, 10 mg |
17,870 |
17,302 |
$6.22 |
| J7120 |
Ringers lactate infusion |
24,474 |
22,273 |
$5.94 |
| J0690 |
Cefazolin sodium injection |
4,605 |
4,024 |
$5.84 |
| 84295 |
|
16 |
15 |
$5.20 |
| Q9957 |
Inj perflutren lip micros,ml |
131 |
116 |
$5.10 |
| J1200 |
Diphenhydramine hcl injectio |
8,446 |
7,607 |
$4.94 |
| J1836 |
Inj, metronidazole, 10 mg |
224 |
106 |
$4.62 |
| 93325 |
|
124 |
120 |
$3.56 |
| J2405 |
Ondansetron hcl injection |
28,485 |
23,176 |
$2.53 |
| J1644 |
Inj heparin sodium per 1000u |
8,619 |
3,811 |
$2.40 |
| J3370 |
Vancomycin hcl injection |
165 |
79 |
$1.16 |
| C9113 |
Inj pantoprazole sodium, via |
4,840 |
2,311 |
$1.00 |
| J2060 |
Lorazepam injection |
5,981 |
3,871 |
$1.00 |
| J2250 |
Inj midazolam hydrochloride |
9,378 |
8,807 |
$0.25 |
| 36416 |
|
732 |
578 |
$0.10 |
| A9577 |
Inj multihance |
4,437 |
4,376 |
$0.01 |
| J1756 |
Iron sucrose injection |
283 |
149 |
$0.00 |
| 94729 |
|
929 |
927 |
$0.00 |
| 90700 |
|
586 |
586 |
$0.00 |
| 90707 |
|
186 |
185 |
$0.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
2,113 |
804 |
$0.00 |
| J1650 |
Inj enoxaparin sodium |
291 |
115 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
470 |
461 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
388 |
370 |
$0.00 |
| J0744 |
Ciprofloxacin iv |
259 |
157 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
787 |
782 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
59 |
59 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
1,501 |
1,269 |
$0.00 |
| 80179 |
|
177 |
173 |
$0.00 |
| J2550 |
Promethazine hcl injection |
2,169 |
1,436 |
$0.00 |
| 90713 |
|
115 |
115 |
$0.00 |
| 76942 |
|
722 |
703 |
$0.00 |
| J7040 |
Normal saline solution infus |
350 |
329 |
$0.00 |
| 90633 |
|
562 |
561 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
807 |
799 |
$0.00 |
| 80143 |
|
181 |
176 |
$0.00 |
| 99173 |
|
340 |
340 |
$0.00 |
| 91312 |
|
184 |
184 |
$0.00 |
| A9552 |
F18 fdg |
287 |
272 |
$0.00 |
| J7030 |
Normal saline solution infus |
1,777 |
1,451 |
$0.00 |
| 29125 |
|
39 |
39 |
$0.00 |
| 90714 |
|
61 |
61 |
$0.00 |
| G1004 |
Cdsm ndsc |
1,557 |
1,499 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
471 |
350 |
$0.00 |
| 99152 |
|
15 |
15 |
$0.00 |
| 93356 |
|
55 |
54 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
49 |
49 |
$0.00 |
| A9541 |
Tc99m sulfur colloid |
24 |
24 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
332 |
184 |
$0.00 |
| C1887 |
Catheter, guiding |
55 |
53 |
$0.00 |
| 76125 |
|
17 |
16 |
$0.00 |
| A9537 |
Tc99m mebrofenin |
54 |
54 |
$0.00 |
| 90685 |
|
32 |
32 |
$0.00 |
| 91300 |
|
121 |
119 |
$0.00 |
| 94760 |
|
1,180 |
1,083 |
$0.00 |
| J7060 |
5% dextrose/water |
1,358 |
742 |
$0.00 |
| J2765 |
Metoclopramide hcl injection |
2,965 |
2,562 |
$0.00 |
| 90680 |
|
964 |
964 |
$0.00 |
| A4648 |
Implantable tissue marker |
834 |
795 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
448 |
447 |
$0.00 |
| J1630 |
Haloperidol injection |
1,015 |
782 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
589 |
503 |
$0.00 |
| J2785 |
Regadenoson injection |
378 |
372 |
$0.00 |
| 94200 |
|
535 |
534 |
$0.00 |
| 90723 |
|
942 |
942 |
$0.00 |
| J2920 |
Methylprednisolone injection |
377 |
197 |
$0.00 |
| A9270 |
Non-covered item or service |
1,027 |
236 |
$0.00 |
| A9573 |
Inj, gadopiclenol, 1 ml |
385 |
381 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
346 |
162 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
717 |
588 |
$0.00 |
| J3420 |
Vitamin b12 injection |
439 |
353 |
$0.00 |
| J3360 |
Diazepam injection |
348 |
264 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
83 |
29 |
$0.00 |
| 74420 |
|
122 |
116 |
$0.00 |
| C1889 |
Implant/insert device, noc |
350 |
349 |
$0.00 |
| 91305 |
|
225 |
223 |
$0.00 |
| J2790 |
Rho d immune globulin inj |
13 |
12 |
$0.00 |
| 84270 |
|
45 |
42 |
$0.00 |
| J1940 |
Furosemide injection |
89 |
54 |
$0.00 |
| 94761 |
|
113 |
101 |
$0.00 |
| 83520 |
|
52 |
52 |
$0.00 |
| 12002 |
|
25 |
25 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
13 |
13 |
$0.00 |
| 36000 |
|
65 |
64 |
$0.00 |
| 90632 |
|
135 |
135 |
$0.00 |
| J3480 |
Inj potassium chloride |
349 |
238 |
$0.00 |
| J7050 |
Normal saline solution infus |
1,343 |
1,159 |
$0.00 |
| C1725 |
Cath, translumin non-laser |
26 |
25 |
$0.00 |
| G0283 |
Elec stim other than wound |
238 |
78 |
$0.00 |
| J7121 |
5% dextrose in lac ringers |
25 |
16 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
44 |
43 |
$0.00 |
| C2617 |
Stent, non-cor, tem w/o del |
58 |
55 |
$0.00 |
| 64450 |
|
12 |
12 |
$0.00 |
| J0360 |
Hydralazine hcl injection |
15 |
12 |
$0.00 |