| Code | Description | Claims | Beneficiaries | Total Paid |
| G0463 |
Hospital outpt clinic visit |
193,055 |
155,578 |
$16.59M |
| 99283 |
|
49,433 |
45,320 |
$6.12M |
| 96361 |
|
17,440 |
14,065 |
$5.17M |
| 99284 |
|
48,249 |
42,671 |
$4.14M |
| 74177 |
|
7,190 |
6,943 |
$1.40M |
| Q5103 |
Injection, inflectra |
1,356 |
1,260 |
$1.20M |
| 96365 |
|
12,705 |
9,912 |
$1.13M |
| 96415 |
|
4,589 |
3,405 |
$1.06M |
| 96366 |
|
5,179 |
3,217 |
$1.05M |
| J9271 |
Inj pembrolizumab |
275 |
215 |
$976K |
| 70450 |
|
5,564 |
5,258 |
$819K |
| 59025 |
|
4,677 |
2,856 |
$751K |
| C9257 |
Bevacizumab injection |
3,432 |
2,152 |
$729K |
| 42820 |
|
340 |
340 |
$715K |
| 96367 |
|
10,256 |
6,977 |
$701K |
| 96360 |
|
5,341 |
4,732 |
$700K |
| J0585 |
Injection,onabotulinumtoxina |
2,783 |
2,602 |
$696K |
| 93306 |
|
3,076 |
2,986 |
$672K |
| J0178 |
Aflibercept injection |
1,681 |
1,556 |
$613K |
| 99282 |
|
4,509 |
4,301 |
$601K |
| 96110 |
|
941 |
921 |
$531K |
| 67028 |
|
4,270 |
3,934 |
$528K |
| 96413 |
|
11,781 |
7,626 |
$507K |
| 76705 |
|
4,930 |
4,781 |
$474K |
| J9312 |
Inj., rituximab, 10 mg |
336 |
183 |
$469K |
| 64615 |
|
2,042 |
1,995 |
$449K |
| 29581 |
|
3,509 |
1,018 |
$398K |
| 74176 |
|
2,134 |
2,048 |
$384K |
| J9310 |
Rituximab injection |
280 |
149 |
$373K |
| 80053 |
|
73,639 |
63,185 |
$356K |
| 66984 |
|
756 |
637 |
$339K |
| 80307 |
|
9,217 |
8,306 |
$339K |
| G0378 |
Hospital observation per hr |
7,758 |
5,402 |
$311K |
| 99281 |
|
2,248 |
2,136 |
$303K |
| 71275 |
|
1,763 |
1,706 |
$293K |
| 97530 |
|
6,201 |
3,798 |
$281K |
| 76830 |
|
2,894 |
2,835 |
$253K |
| J7298 |
Mirena, 52 mg |
669 |
663 |
$247K |
| 44970 |
|
79 |
77 |
$240K |
| 87591 |
|
17,604 |
17,209 |
$238K |
| J2469 |
Palonosetron hcl |
3,582 |
2,190 |
$231K |
| 87635 |
|
5,518 |
5,126 |
$208K |
| 76856 |
|
3,212 |
3,145 |
$188K |
| 92507 |
|
3,882 |
1,771 |
$182K |
| 87426 |
|
28,585 |
26,518 |
$176K |
| 97597 |
|
2,847 |
1,476 |
$172K |
| 12001 |
|
752 |
748 |
$155K |
| 70553 |
|
607 |
592 |
$154K |
| 87491 |
|
17,609 |
17,211 |
$153K |
| J1745 |
Infliximab not biosimil 10mg |
118 |
108 |
$149K |
| 76816 |
|
2,241 |
2,110 |
$144K |
| 43239 |
|
446 |
442 |
$144K |
| 45385 |
|
445 |
439 |
$140K |
| 93971 |
|
1,715 |
1,646 |
$139K |
| 76817 |
|
3,565 |
3,138 |
$139K |
| 85025 |
|
88,608 |
75,195 |
$138K |
| 88305 |
|
10,390 |
10,014 |
$133K |
| 96374 |
|
21,947 |
19,432 |
$128K |
| 88142 |
|
9,283 |
9,175 |
$127K |
| 99285 |
|
1,085 |
1,018 |
$123K |
| 58300 |
|
975 |
965 |
$122K |
| 80048 |
|
25,297 |
22,412 |
$117K |
| J2505 |
Injection, pegfilgrastim 6mg |
74 |
55 |
$111K |
| J9035 |
Bevacizumab injection |
80 |
25 |
$111K |
| 80050 |
|
15,190 |
14,626 |
$108K |
| 83036 |
|
29,076 |
28,671 |
$100K |
| 76770 |
|
918 |
902 |
$99K |
| 84443 |
|
19,175 |
18,548 |
$98K |
| 93976 |
|
1,914 |
1,859 |
$98K |
| 71260 |
|
1,114 |
1,091 |
$96K |
| 52356 |
|
36 |
36 |
$95K |
| 87624 |
|
6,460 |
6,385 |
$95K |
| 97110 |
|
3,840 |
2,068 |
$94K |
| 97162 |
|
2,178 |
2,099 |
$92K |
| 82728 |
|
14,943 |
14,512 |
$90K |
| G0480 |
Drug test def 1-7 classes |
6,127 |
5,503 |
$89K |
| 96372 |
|
15,890 |
12,440 |
$89K |
| 78452 |
|
286 |
277 |
$88K |
| 90471 |
|
7,173 |
7,061 |
$88K |
| 87086 |
|
27,724 |
26,076 |
$88K |
| 87507 |
|
805 |
788 |
$87K |
| 70496 |
|
456 |
445 |
$87K |
| J1453 |
Fosaprepitant injection |
1,260 |
827 |
$86K |
| 95886 |
|
900 |
886 |
$85K |
| 86780 |
|
9,505 |
9,341 |
$85K |
| 45380 |
|
172 |
170 |
$83K |
| 80061 |
|
21,455 |
21,168 |
$81K |
| 92551 |
|
2,799 |
2,791 |
$78K |
| 76801 |
|
1,596 |
1,455 |
$71K |
| 93017 |
|
919 |
882 |
$70K |
| 90715 |
|
3,881 |
3,859 |
$70K |
| 64405 |
|
211 |
206 |
$69K |
| 52000 |
|
112 |
112 |
$68K |
| 20610 |
|
610 |
577 |
$68K |
| 78815 |
|
130 |
127 |
$62K |
| 47562 |
|
25 |
25 |
$62K |
| 87653 |
|
4,288 |
4,259 |
$60K |
| 11102 |
|
313 |
304 |
$59K |
| 82306 |
|
11,401 |
11,238 |
$59K |
| 82607 |
|
9,052 |
8,894 |
$55K |
| 92526 |
|
1,079 |
644 |
$54K |
| 97112 |
|
1,518 |
777 |
$54K |
| 97161 |
|
1,155 |
1,123 |
$53K |
| 93005 |
|
21,671 |
19,051 |
$53K |
| 96375 |
|
24,415 |
18,260 |
$52K |
| 96523 |
|
1,457 |
1,290 |
$52K |
| 84484 |
|
10,204 |
8,900 |
$51K |
| 36415 |
|
80,587 |
65,369 |
$49K |
| 84439 |
|
7,745 |
7,481 |
$49K |
| 90472 |
|
2,977 |
2,966 |
$49K |
| 71045 |
|
10,843 |
10,186 |
$47K |
| 76805 |
|
697 |
690 |
$47K |
| 99291 |
|
685 |
646 |
$47K |
| 87081 |
|
7,918 |
7,786 |
$46K |
| 94060 |
|
1,621 |
1,588 |
$45K |
| 87077 |
|
13,936 |
13,360 |
$45K |
| 86140 |
|
18,172 |
16,955 |
$40K |
| 0002A |
|
1,275 |
1,234 |
$39K |
| 72125 |
|
1,622 |
1,565 |
$39K |
| 90686 |
|
4,246 |
4,196 |
$38K |
| 71046 |
|
6,023 |
5,794 |
$37K |
| 0001A |
|
1,554 |
1,425 |
$37K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
1,234 |
1,161 |
$36K |
| 83540 |
|
11,288 |
11,049 |
$35K |
| 82570 |
|
11,152 |
10,702 |
$35K |
| 17110 |
|
302 |
298 |
$33K |
| 86900 |
|
8,547 |
8,035 |
$33K |
| J3490 |
Drugs unclassified injection |
23,237 |
12,646 |
$33K |
| 87040 |
|
4,074 |
2,923 |
$32K |
| 83605 |
|
6,071 |
5,442 |
$32K |
| 12011 |
|
152 |
150 |
$32K |
| 11104 |
|
131 |
130 |
$32K |
| 83970 |
|
2,190 |
2,129 |
$32K |
| 70498 |
|
496 |
483 |
$30K |
| 80074 |
|
4,087 |
4,026 |
$30K |
| 92550 |
|
698 |
690 |
$29K |
| G0008 |
Admin influenza virus vac |
5,278 |
5,211 |
$29K |
| 95117 |
|
1,414 |
564 |
$29K |
| 86706 |
|
6,417 |
6,279 |
$29K |
| 87651 |
|
2,287 |
2,249 |
$28K |
| 83880 |
|
3,846 |
3,523 |
$28K |
| 86703 |
|
6,790 |
6,653 |
$28K |
| G0101 |
Ca screen;pelvic/breast exam |
566 |
554 |
$27K |
| 86850 |
|
8,414 |
7,988 |
$27K |
| 36591 |
|
4,873 |
2,918 |
$27K |
| 76937 |
|
843 |
761 |
$26K |
| 87070 |
|
5,989 |
5,675 |
$25K |
| 70551 |
|
261 |
250 |
$24K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
15,440 |
13,784 |
$24K |
| 83001 |
|
1,882 |
1,838 |
$23K |
| 84481 |
|
4,083 |
3,975 |
$22K |
| 94726 |
|
1,575 |
1,544 |
$22K |
| Q5111 |
Injection, udenyca 0.5 mg |
20 |
12 |
$22K |
| 84146 |
|
1,914 |
1,854 |
$22K |
| 94729 |
|
2,037 |
1,996 |
$22K |
| G0328 |
Fecal blood scrn immunoassay |
2,992 |
2,983 |
$21K |
| 31575 |
|
294 |
293 |
$21K |
| 72148 |
|
146 |
143 |
$21K |
| 80047 |
|
9,864 |
9,021 |
$21K |
| 84702 |
|
3,990 |
2,896 |
$20K |
| 12002 |
|
126 |
123 |
$20K |
| 88307 |
|
778 |
744 |
$20K |
| 95115 |
|
923 |
351 |
$20K |
| 80076 |
|
8,605 |
8,079 |
$20K |
| 85379 |
|
3,940 |
3,820 |
$20K |
| 64483 |
|
43 |
43 |
$19K |
| 88342 |
|
2,118 |
2,002 |
$19K |
| 10060 |
|
105 |
99 |
$19K |
| 92587 |
|
451 |
448 |
$19K |
| 84153 |
|
3,409 |
3,299 |
$18K |
| 85652 |
|
14,317 |
13,713 |
$18K |
| 49083 |
|
49 |
24 |
$18K |
| 82784 |
|
2,996 |
2,766 |
$18K |
| 85027 |
|
10,659 |
9,103 |
$17K |
| 95004 |
|
533 |
530 |
$17K |
| 86480 |
|
936 |
917 |
$17K |
| 58301 |
|
149 |
147 |
$17K |
| C1776 |
Joint device (implantable) |
68 |
67 |
$16K |
| 69210 |
|
259 |
254 |
$16K |
| 87340 |
|
7,316 |
7,137 |
$16K |
| C8929 |
Tte w or wo fol wcon,doppler |
61 |
59 |
$16K |
| J1750 |
Inj iron dextran |
286 |
282 |
$16K |
| 87210 |
|
5,039 |
4,897 |
$16K |
| 69436 |
|
12 |
12 |
$16K |
| 83013 |
|
552 |
549 |
$16K |
| 86901 |
|
8,547 |
8,036 |
$16K |
| 71271 |
|
218 |
217 |
$16K |
| 86803 |
|
4,930 |
4,815 |
$15K |
| U0003 |
Cov-19 amp prb hgh thruput |
265 |
259 |
$15K |
| G0108 |
Diab manage trn per indiv |
512 |
465 |
$15K |
| 72100 |
|
2,274 |
2,199 |
$15K |
| 93296 |
|
1,790 |
1,731 |
$15K |
| 31231 |
|
195 |
190 |
$14K |
| 82247 |
|
1,869 |
1,387 |
$14K |
| 83735 |
|
10,863 |
8,716 |
$14K |
| 82043 |
|
9,455 |
9,246 |
$14K |
| 17000 |
|
297 |
291 |
$14K |
| 70486 |
|
295 |
289 |
$14K |
| 81001 |
|
19,369 |
18,007 |
$14K |
| 83690 |
|
17,998 |
16,251 |
$14K |
| 74018 |
|
2,031 |
1,958 |
$14K |
| 94640 |
|
1,302 |
843 |
$14K |
| 73630 |
|
1,612 |
1,490 |
$13K |
| 92083 |
|
821 |
806 |
$13K |
| 92557 |
|
724 |
711 |
$13K |
| 96376 |
|
6,248 |
4,808 |
$13K |
| 73564 |
|
1,849 |
1,710 |
$13K |
| 82533 |
|
985 |
919 |
$13K |
| 93226 |
|
369 |
354 |
$13K |
| 57454 |
|
40 |
40 |
$13K |
| 86762 |
|
4,908 |
4,809 |
$12K |
| 95885 |
|
129 |
125 |
$12K |
| 95165 |
|
258 |
258 |
$12K |
| 92579 |
|
279 |
277 |
$12K |
| 92567 |
|
1,012 |
999 |
$11K |
| 85610 |
|
10,082 |
7,963 |
$11K |
| 73610 |
|
2,033 |
1,835 |
$11K |
| 70491 |
|
52 |
51 |
$11K |
| 87502 |
|
795 |
780 |
$11K |
| 76815 |
|
188 |
177 |
$11K |
| 87428 |
|
3,786 |
3,719 |
$11K |
| 93970 |
|
111 |
109 |
$11K |
| 94010 |
|
445 |
439 |
$11K |
| 84403 |
|
1,186 |
1,154 |
$11K |
| 88304 |
|
1,794 |
1,747 |
$10K |
| 71250 |
|
228 |
223 |
$10K |
| 84466 |
|
2,405 |
2,342 |
$10K |
| 73110 |
|
1,359 |
1,197 |
$10K |
| 74420 |
|
72 |
70 |
$10K |
| 87798 |
|
530 |
526 |
$10K |
| 82746 |
|
2,700 |
2,646 |
$10K |
| 97140 |
|
489 |
283 |
$9K |
| 86003 |
|
977 |
675 |
$9K |
| 29075 |
|
59 |
56 |
$9K |
| J7307 |
Etonogestrel implant system |
27 |
27 |
$9K |
| 87147 |
|
3,471 |
3,395 |
$9K |
| 76536 |
|
98 |
96 |
$9K |
| 81025 |
|
15,090 |
14,016 |
$9K |
| 87186 |
|
5,825 |
5,528 |
$9K |
| G0257 |
Unsched dialysis esrd pt hos |
33 |
24 |
$9K |
| 85007 |
|
3,892 |
3,106 |
$9K |
| 11981 |
|
13 |
13 |
$8K |
| 82248 |
|
2,240 |
1,752 |
$8K |
| 73130 |
|
1,329 |
1,198 |
$8K |
| 83002 |
|
996 |
973 |
$8K |
| 95816 |
|
53 |
52 |
$8K |
| 92235 |
|
90 |
85 |
$8K |
| 73030 |
|
1,333 |
1,215 |
$8K |
| 72131 |
|
181 |
179 |
$8K |
| 85018 |
|
3,525 |
3,303 |
$8K |
| 92504 |
|
101 |
92 |
$8K |
| 83655 |
|
636 |
633 |
$7K |
| 87563 |
|
989 |
971 |
$7K |
| 45378 |
|
13 |
13 |
$7K |
| 82670 |
|
707 |
688 |
$7K |
| 85014 |
|
2,238 |
2,097 |
$7K |
| 72040 |
|
1,588 |
1,495 |
$7K |
| 87661 |
|
963 |
947 |
$6K |
| 92025 |
|
79 |
79 |
$6K |
| 97167 |
|
130 |
128 |
$6K |
| 73502 |
|
632 |
596 |
$6K |
| 88341 |
|
853 |
807 |
$6K |
| 97129 |
|
29 |
12 |
$6K |
| 92610 |
|
145 |
143 |
$6K |
| 17311 |
|
32 |
29 |
$6K |
| 73140 |
|
655 |
572 |
$6K |
| 99152 |
|
2,894 |
2,662 |
$6K |
| 86431 |
|
2,125 |
2,079 |
$6K |
| 87045 |
|
1,032 |
1,014 |
$5K |
| Q5118 |
Inj., zirabev, 10 mg |
25 |
12 |
$5K |
| 86038 |
|
992 |
940 |
$5K |
| 74174 |
|
15 |
15 |
$5K |
| 87338 |
|
791 |
790 |
$5K |
| 11900 |
|
39 |
39 |
$5K |
| 92552 |
|
232 |
232 |
$5K |
| 82075 |
|
1,433 |
1,254 |
$5K |
| 84145 |
|
885 |
834 |
$5K |
| 76819 |
|
80 |
57 |
$5K |
| 72110 |
|
296 |
292 |
$4K |
| 95910 |
|
93 |
90 |
$4K |
| 43235 |
|
13 |
13 |
$4K |
| 11750 |
|
13 |
12 |
$4K |
| 82565 |
|
2,052 |
1,866 |
$4K |
| 92020 |
|
41 |
38 |
$4K |
| 92136 |
|
471 |
458 |
$4K |
| 82962 |
|
13,984 |
8,989 |
$4K |
| G0498 |
Chemo extend iv infus w/pump |
344 |
206 |
$4K |
| 82627 |
|
287 |
282 |
$4K |
| 92134 |
|
7,609 |
7,111 |
$4K |
| V2632 |
Post chmbr intraocular lens |
946 |
799 |
$4K |
| 11055 |
|
79 |
76 |
$4K |
| 81003 |
|
7,843 |
7,388 |
$4K |
| 87631 |
|
187 |
187 |
$4K |
| 93922 |
|
120 |
115 |
$4K |
| 87899 |
|
1,593 |
897 |
$4K |
| 82950 |
|
2,651 |
2,631 |
$4K |
| 86677 |
|
341 |
335 |
$4K |
| 82378 |
|
1,826 |
1,401 |
$4K |
| 80164 |
|
549 |
519 |
$4K |
| 90651 |
|
1,052 |
1,050 |
$4K |
| 84100 |
|
3,111 |
2,656 |
$4K |
| C1894 |
Intro/sheath, non-laser |
2,339 |
2,155 |
$3K |
| C1769 |
Guide wire |
3,346 |
2,783 |
$3K |
| 84460 |
|
1,925 |
1,808 |
$3K |
| G0379 |
Direct refer hospital observ |
105 |
99 |
$3K |
| 87493 |
|
822 |
807 |
$3K |
| J7120 |
Ringers lactate infusion |
20,794 |
17,823 |
$3K |
| 90671 |
|
1,191 |
1,188 |
$3K |
| 92523 |
|
27 |
27 |
$3K |
| 84156 |
|
1,704 |
1,536 |
$3K |
| 73590 |
|
326 |
293 |
$3K |
| 82550 |
|
2,242 |
1,972 |
$3K |
| 76870 |
|
40 |
40 |
$3K |
| 82803 |
|
1,457 |
1,238 |
$3K |
| J2405 |
Ondansetron hcl injection |
25,528 |
20,032 |
$3K |
| 86258 |
|
453 |
441 |
$3K |
| 82785 |
|
240 |
238 |
$3K |
| A9579 |
Gad-base mr contrast nos,1ml |
1,867 |
1,809 |
$3K |
| 72197 |
|
13 |
13 |
$3K |
| J7030 |
Normal saline solution infus |
21,133 |
17,934 |
$3K |
| 92555 |
|
198 |
198 |
$3K |
| 81420 |
|
12 |
12 |
$3K |
| 95911 |
|
42 |
41 |
$2K |
| 84450 |
|
1,267 |
1,151 |
$2K |
| 95819 |
|
13 |
13 |
$2K |
| 84550 |
|
1,877 |
1,742 |
$2K |
| J2704 |
Inj, propofol, 10 mg |
15,084 |
10,689 |
$2K |
| 72158 |
|
13 |
13 |
$2K |
| 90656 |
|
744 |
740 |
$2K |
| 99153 |
Mod sedat endo service >5yrs |
2,888 |
2,696 |
$2K |
| G0500 |
Mod sedat endo service >5yrs |
1,038 |
1,017 |
$2K |
| 73120 |
|
383 |
187 |
$2K |
| 86364 |
|
508 |
496 |
$2K |
| J1100 |
Dexamethasone sodium phos |
21,369 |
15,366 |
$2K |
| 84144 |
|
301 |
287 |
$2K |
| 96368 |
|
822 |
620 |
$2K |
| J3010 |
Fentanyl citrate injection |
16,861 |
14,401 |
$2K |
| 95908 |
|
39 |
39 |
$2K |
| 80197 |
|
386 |
258 |
$2K |
| 87205 |
|
2,329 |
2,140 |
$2K |
| 81002 |
|
12,935 |
12,103 |
$2K |
| 83615 |
|
1,846 |
1,648 |
$2K |
| 86308 |
|
415 |
410 |
$2K |
| J1885 |
Ketorolac tromethamine inj |
18,565 |
14,456 |
$2K |
| 80069 |
|
406 |
336 |
$2K |
| 96411 |
|
1,765 |
1,108 |
$2K |
| 82947 |
|
919 |
868 |
$2K |
| 88175 |
|
177 |
176 |
$2K |
| 96402 |
|
181 |
166 |
$2K |
| C1725 |
Cath, translumin non-laser |
368 |
339 |
$2K |
| 80400 |
|
199 |
188 |
$2K |
| 86787 |
|
370 |
362 |
$2K |
| 72141 |
|
13 |
12 |
$2K |
| 83721 |
|
625 |
623 |
$2K |
| 51798 |
|
612 |
578 |
$2K |
| 97165 |
|
44 |
42 |
$2K |
| C1760 |
Closure dev, vasc |
285 |
272 |
$2K |
| 86160 |
|
448 |
402 |
$2K |
| 93246 |
|
27 |
27 |
$1K |
| J1200 |
Diphenhydramine hcl injectio |
10,752 |
8,074 |
$1K |
| J2250 |
Inj midazolam hydrochloride |
14,686 |
12,519 |
$1K |
| 86304 |
|
407 |
316 |
$1K |
| 88312 |
|
233 |
229 |
$1K |
| 97163 |
|
41 |
38 |
$1K |
| J1170 |
Hydromorphone injection |
13,071 |
9,182 |
$1K |
| 80178 |
|
188 |
168 |
$1K |
| 92133 |
|
1,713 |
1,678 |
$1K |
| 36416 |
|
1,426 |
807 |
$1K |
| 95909 |
|
31 |
31 |
$1K |
| J9217 |
Leuprolide acetate suspnsion |
14 |
13 |
$1K |
| J0561 |
Penicillin g benzathine inj |
12 |
12 |
$1K |
| 0012A |
|
48 |
48 |
$1K |
| 84270 |
|
181 |
176 |
$1K |
| 93798 |
|
270 |
42 |
$1K |
| 87075 |
|
1,154 |
1,052 |
$1K |
| 20550 |
|
13 |
12 |
$1K |
| 88173 |
|
113 |
103 |
$1K |
| 0011A |
|
56 |
56 |
$1K |
| A9552 |
F18 fdg |
186 |
182 |
$1K |
| 73090 |
|
143 |
132 |
$1K |
| 86334 |
|
233 |
209 |
$1K |
| 81015 |
|
606 |
599 |
$1K |
| 90474 |
|
817 |
816 |
$1K |
| 73080 |
|
163 |
154 |
$1K |
| 90678 |
|
81 |
81 |
$1K |
| 74178 |
|
13 |
13 |
$1K |
| 72070 |
|
111 |
109 |
$1K |
| 73560 |
|
106 |
94 |
$1K |
| C1887 |
Catheter, guiding |
1,179 |
1,078 |
$1K |
| 88172 |
|
41 |
39 |
$1K |
| Q9957 |
Inj perflutren lip micros,ml |
162 |
159 |
$988.80 |
| 83521 |
|
247 |
231 |
$980.79 |
| J7040 |
Normal saline solution infus |
2,698 |
2,054 |
$950.41 |
| 85046 |
|
344 |
326 |
$946.21 |
| 84165 |
|
361 |
336 |
$931.20 |
| 73700 |
|
15 |
14 |
$909.17 |
| 83520 |
|
89 |
77 |
$902.13 |
| 93225 |
|
27 |
26 |
$895.29 |
| 90480 |
|
54 |
49 |
$889.59 |
| 85730 |
|
688 |
658 |
$880.27 |
| J0690 |
Cefazolin sodium injection |
8,124 |
6,570 |
$878.45 |
| 86705 |
|
675 |
654 |
$811.90 |
| C2617 |
Stent, non-cor, tem w/o del |
249 |
239 |
$808.78 |
| 43248 |
|
15 |
15 |
$786.20 |
| 83516 |
|
122 |
95 |
$771.68 |
| 96381 |
|
51 |
51 |
$769.72 |
| J1050 |
Medroxyprogesterone acetate |
931 |
926 |
$764.39 |
| 87522 |
Neg quan hep c or qual rna |
68 |
67 |
$754.02 |
| J0696 |
Ceftriaxone sodium injection |
4,139 |
3,370 |
$743.28 |
| 73562 |
|
64 |
52 |
$714.98 |
| 82150 |
|
143 |
137 |
$707.77 |
| 74230 |
|
12 |
12 |
$696.62 |
| 11720 |
|
155 |
153 |
$694.71 |
| 93325 |
|
13 |
13 |
$689.82 |
| 86704 |
|
214 |
209 |
$677.68 |
| 96417 |
|
2,722 |
1,724 |
$666.12 |
| 94727 |
|
66 |
66 |
$656.19 |
| 82951 |
|
94 |
94 |
$654.01 |
| 84703 |
|
139 |
133 |
$653.81 |
| 82105 |
|
95 |
95 |
$641.84 |
| 99195 |
|
20 |
13 |
$637.96 |
| J7050 |
Normal saline solution infus |
4,887 |
3,662 |
$627.35 |
| 84132 |
|
1,199 |
1,089 |
$626.50 |
| 73100 |
|
371 |
199 |
$621.16 |
| 83993 |
|
68 |
68 |
$614.00 |
| 86709 |
|
635 |
614 |
$611.54 |
| J0330 |
Succinycholine chloride inj |
2,857 |
2,751 |
$609.01 |
| J9190 |
Fluorouracil injection |
1,258 |
321 |
$609.00 |
| 97166 |
|
16 |
15 |
$602.91 |
| 72202 |
|
25 |
25 |
$602.57 |
| J3475 |
Inj magnesium sulfate |
2,071 |
1,438 |
$586.81 |
| C1729 |
Cath, drainage |
269 |
137 |
$580.27 |
| 82330 |
|
554 |
514 |
$576.68 |
| 90832 |
|
408 |
337 |
$576.19 |
| 86235 |
|
33 |
27 |
$564.87 |
| G2212 |
Prolong outpt/office vis |
431 |
426 |
$558.09 |
| 51702 |
|
63 |
56 |
$553.66 |
| 87807 |
|
472 |
472 |
$546.07 |
| 86708 |
|
185 |
182 |
$545.93 |
| 83525 |
|
88 |
85 |
$543.59 |
| 84163 |
|
41 |
40 |
$530.19 |
| 92250 |
|
339 |
320 |
$529.36 |
| G0472 |
Hep c screen high risk/other |
4,321 |
4,274 |
$518.60 |
| A9500 |
Tc99m sestamibi |
153 |
149 |
$516.24 |
| J0131 |
Inj, acetaminophen (nos) |
598 |
569 |
$495.86 |
| J2785 |
Regadenoson injection |
147 |
141 |
$494.26 |
| J1630 |
Haloperidol injection |
2,580 |
2,226 |
$493.46 |
| J3301 |
Triamcinolone acet inj nos |
701 |
671 |
$469.06 |
| J2060 |
Lorazepam injection |
3,303 |
2,831 |
$468.08 |
| 92650 |
|
14 |
14 |
$434.09 |
| J0780 |
Prochlorperazine injection |
1,637 |
1,501 |
$433.99 |
| 87880 |
|
858 |
849 |
$426.90 |
| 90707 |
|
353 |
353 |
$421.11 |
| 17003 |
|
145 |
144 |
$410.18 |
| 73552 |
|
25 |
24 |
$406.38 |
| 86200 |
|
80 |
80 |
$399.89 |
| 92556 |
|
25 |
25 |
$373.40 |
| J2765 |
Metoclopramide hcl injection |
3,334 |
3,042 |
$372.60 |
| J1010 |
Inj, methylpred acetate 1 mg |
253 |
246 |
$367.22 |
| 93880 |
|
14 |
14 |
$365.19 |
| J3489 |
Zoledronic acid 1mg |
27 |
25 |
$363.22 |
| 87529 |
|
13 |
12 |
$357.78 |
| 88360 |
|
32 |
29 |
$348.71 |
| 87329 |
|
54 |
54 |
$326.63 |
| J2919 |
Inj, methylpred sod succ 5mg |
369 |
317 |
$307.75 |
| 72050 |
|
39 |
39 |
$305.56 |
| 82977 |
|
122 |
116 |
$305.00 |
| C1758 |
Catheter, ureteral |
453 |
433 |
$299.22 |
| 86300 |
|
48 |
38 |
$278.61 |
| J1642 |
Inj heparin sodium per 10 u |
575 |
314 |
$277.15 |
| J2270 |
Morphine sulfate injection |
3,149 |
2,662 |
$273.44 |
| 11721 |
|
74 |
74 |
$266.94 |
| 86141 |
|
88 |
87 |
$266.85 |
| 85049 |
|
290 |
281 |
$260.82 |
| 72170 |
|
31 |
28 |
$249.99 |
| J1644 |
Inj heparin sodium per 1000u |
3,022 |
1,917 |
$242.39 |
| J2930 |
Methylprednisolone injection |
2,192 |
1,671 |
$231.27 |
| 82310 |
|
108 |
100 |
$225.19 |
| 87804 |
|
951 |
940 |
$215.65 |
| 0296T |
|
15 |
15 |
$211.16 |
| J3480 |
Inj potassium chloride |
1,495 |
1,127 |
$208.39 |
| 84520 |
|
128 |
114 |
$193.56 |
| 87328 |
|
54 |
54 |
$191.61 |
| 86146 |
|
15 |
14 |
$187.68 |
| 73070 |
|
61 |
50 |
$181.20 |
| 88112 |
|
29 |
28 |
$180.06 |
| 95874 |
|
91 |
88 |
$173.16 |
| 82952 |
|
51 |
51 |
$169.61 |
| Q0111 |
Wet mounts/ w preparations |
13 |
13 |
$162.22 |
| J1040 |
Methylprednisolone 80 mg inj |
108 |
107 |
$149.87 |
| 90660 |
|
16 |
16 |
$149.83 |
| 90662 |
|
208 |
196 |
$148.06 |
| 87389 |
|
43 |
43 |
$130.11 |
| J1030 |
Methylprednisolone 40 mg inj |
130 |
128 |
$126.62 |
| 90756 |
|
22 |
21 |
$120.15 |
| 86225 |
|
15 |
14 |
$112.53 |
| 92611 |
|
25 |
24 |
$108.78 |
| 86147 |
|
15 |
14 |
$106.69 |
| 82140 |
|
55 |
49 |
$102.01 |
| 86036 |
|
13 |
13 |
$96.92 |
| J2550 |
Promethazine hcl injection |
697 |
638 |
$93.60 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
325 |
238 |
$87.53 |
| 84300 |
|
39 |
37 |
$85.29 |
| J2710 |
Neostigmine methylslfte inj |
2,705 |
2,578 |
$84.79 |
| 74019 |
|
16 |
15 |
$80.63 |
| G0103 |
Psa screening |
155 |
154 |
$72.88 |
| 85384 |
|
13 |
13 |
$68.84 |
| 86301 |
|
34 |
26 |
$68.58 |
| 29125 |
|
14 |
14 |
$65.48 |
| 84134 |
|
14 |
12 |
$63.21 |
| J0640 |
Leucovorin calcium injection |
445 |
199 |
$60.70 |
| J0171 |
Adrenalin epinephrine inject |
159 |
140 |
$55.23 |
| J1940 |
Furosemide injection |
238 |
168 |
$54.22 |
| J1650 |
Inj enoxaparin sodium |
45 |
25 |
$52.06 |
| 86376 |
|
12 |
12 |
$50.74 |
| U0002 |
Covid-19 lab test non-cdc |
17 |
17 |
$48.92 |
| J0136 |
Inj, acetaminophen (b braun) |
12 |
12 |
$39.36 |
| 86923 |
|
14 |
12 |
$36.33 |
| 99173 |
|
2,796 |
2,790 |
$35.49 |
| 90834 |
|
145 |
130 |
$35.10 |
| 0077U |
|
15 |
15 |
$29.09 |
| 11719 |
|
29 |
27 |
$28.08 |
| G0475 |
Hiv combination assay |
3,464 |
3,412 |
$26.36 |
| J3370 |
Vancomycin hcl injection |
272 |
186 |
$23.24 |
| 82365 |
|
12 |
12 |
$20.28 |
| J2920 |
Methylprednisolone injection |
1,649 |
1,496 |
$19.68 |
| 76376 |
|
31 |
30 |
$18.72 |
| J2800 |
Methocarbamol injection |
29 |
29 |
$17.89 |
| J7121 |
5% dextrose in lac ringers |
28 |
25 |
$17.55 |
| 88313 |
|
15 |
15 |
$16.65 |
| 0202U |
|
3,626 |
3,568 |
$16.11 |
| J2543 |
Piperacillin/tazobactam |
158 |
64 |
$10.54 |
| 82010 |
|
29 |
25 |
$3.47 |
| 73060 |
|
14 |
13 |
$3.27 |
| 90710 |
|
304 |
303 |
$0.01 |
| A9270 |
Non-covered item or service |
12,786 |
8,210 |
$0.01 |
| G1004 |
Cdsm ndsc |
2,192 |
1,777 |
$0.00 |
| A9576 |
Inj prohance multipack |
371 |
358 |
$0.00 |
| G8979 |
Mobility goal status |
101 |
86 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
298 |
210 |
$0.00 |
| A9502 |
Tc99m tetrofosmin |
174 |
161 |
$0.00 |
| G8978 |
Mobility current status |
80 |
68 |
$0.00 |
| J7699 |
Inhalation solution for dme |
28 |
27 |
$0.00 |
| 93356 |
|
72 |
71 |
$0.00 |
| 90633 |
|
787 |
785 |
$0.00 |
| Q0091 |
Obtaining screen pap smear |
28 |
25 |
$0.00 |
| J0694 |
Cefoxitin sodium injection |
22 |
14 |
$0.00 |
| J9263 |
Oxaliplatin |
221 |
66 |
$0.00 |
| 86328 |
|
15 |
15 |
$0.00 |
| 90672 |
|
21 |
21 |
$0.00 |
| G8990 |
Other pt/ot current status |
16 |
14 |
$0.00 |
| J7620 |
Albuterol ipratrop non-comp |
1,030 |
865 |
$0.00 |
| 90619 |
|
549 |
545 |
$0.00 |
| 90697 |
|
856 |
855 |
$0.00 |
| J7042 |
5% dextrose/normal saline |
153 |
117 |
$0.00 |
| 90680 |
|
837 |
836 |
$0.00 |
| 90620 |
|
121 |
121 |
$0.00 |
| 90696 |
|
284 |
283 |
$0.00 |
| 90698 |
|
306 |
305 |
$0.00 |
| 90716 |
|
366 |
365 |
$0.00 |
| J0360 |
Hydralazine hcl injection |
15 |
15 |
$0.00 |
| G8991 |
Other pt/ot goal status |
32 |
28 |
$0.00 |
| J3420 |
Vitamin b12 injection |
145 |
130 |
$0.00 |
| 94760 |
|
39 |
38 |
$0.00 |
| J7611 |
Albuterol non-comp con |
174 |
141 |
$0.00 |
| 90847 |
|
13 |
13 |
$0.00 |
| 0240U |
|
150 |
146 |
$0.00 |
| J1815 |
Insulin injection |
199 |
116 |
$0.00 |
| 74022 |
|
12 |
12 |
$0.00 |
| 0241U |
|
93 |
93 |
$0.00 |
| J9045 |
Carboplatin injection |
219 |
126 |
$0.00 |
| 90381 |
|
45 |
45 |
$0.00 |
| 81511 |
|
28 |
28 |
$0.00 |
| 94644 |
|
12 |
12 |
$0.00 |
| 71101 |
|
12 |
12 |
$0.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
79 |
71 |
$0.00 |
| J0697 |
Sterile cefuroxime injection |
57 |
47 |
$0.00 |
| 92285 |
|
19 |
15 |
$0.00 |