| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96361 |
|
49,534 |
40,819 |
$15.42M |
| 99283 |
|
115,736 |
107,666 |
$13.55M |
| 99284 |
|
91,896 |
84,596 |
$8.25M |
| J9271 |
Inj pembrolizumab |
2,006 |
1,488 |
$7.90M |
| G0463 |
Hospital outpt clinic visit |
114,067 |
77,667 |
$7.45M |
| 77412 |
|
14,108 |
1,410 |
$5.28M |
| 99285 |
|
63,117 |
58,594 |
$5.16M |
| 74177 |
|
17,758 |
17,002 |
$3.22M |
| 96366 |
|
10,024 |
7,242 |
$2.47M |
| 99282 |
|
28,073 |
26,251 |
$2.44M |
| J9263 |
Oxaliplatin |
2,941 |
913 |
$2.41M |
| 96365 |
|
23,157 |
18,104 |
$2.17M |
| 43239 |
|
5,711 |
5,577 |
$2.10M |
| J2350 |
Injection, ocrelizumab, 1 mg |
210 |
188 |
$2.03M |
| 96413 |
|
22,745 |
13,708 |
$1.90M |
| 70450 |
|
13,406 |
12,726 |
$1.87M |
| 96360 |
|
15,549 |
13,118 |
$1.70M |
| J1745 |
Infliximab not biosimil 10mg |
1,373 |
1,193 |
$1.58M |
| J2323 |
Natalizumab injection |
705 |
658 |
$1.48M |
| 45380 |
|
4,512 |
4,423 |
$1.40M |
| 96415 |
|
7,743 |
5,256 |
$1.36M |
| 59025 |
|
8,629 |
5,266 |
$1.24M |
| 99281 |
|
10,131 |
9,392 |
$1.23M |
| 45385 |
|
2,454 |
2,409 |
$1.14M |
| J2505 |
Injection, pegfilgrastim 6mg |
705 |
468 |
$1.09M |
| Q5111 |
Injection, udenyca 0.5 mg |
826 |
529 |
$1.06M |
| J9355 |
Inj trastuzumab excl biosimi |
999 |
574 |
$1.03M |
| 74176 |
|
5,779 |
5,603 |
$1.01M |
| 71275 |
|
5,596 |
5,412 |
$984K |
| J9035 |
Bevacizumab injection |
662 |
352 |
$789K |
| 76705 |
|
8,620 |
8,237 |
$772K |
| 80307 |
|
20,609 |
18,582 |
$727K |
| 10060 |
|
3,374 |
3,263 |
$704K |
| 90870 |
|
2,185 |
664 |
$557K |
| J2469 |
Palonosetron hcl |
8,551 |
5,128 |
$556K |
| 96416 |
|
2,632 |
1,526 |
$549K |
| 12001 |
|
2,587 |
2,542 |
$537K |
| 76815 |
|
10,352 |
6,745 |
$521K |
| 80053 |
|
121,503 |
97,685 |
$518K |
| J9306 |
Injection, pertuzumab, 1 mg |
378 |
269 |
$496K |
| 45378 |
|
1,169 |
1,156 |
$472K |
| 76642 |
|
5,622 |
5,210 |
$467K |
| 76830 |
|
5,656 |
5,475 |
$466K |
| U0003 |
Cov-19 amp prb hgh thruput |
5,873 |
5,498 |
$466K |
| Q5114 |
Inj ogivri 10 mg |
317 |
205 |
$463K |
| 76801 |
|
8,150 |
7,478 |
$419K |
| Q5118 |
Inj., zirabev, 10 mg |
1,932 |
842 |
$403K |
| 76805 |
|
6,797 |
6,621 |
$403K |
| 87631 |
|
5,470 |
5,279 |
$394K |
| 12011 |
|
1,663 |
1,636 |
$377K |
| 93970 |
|
3,639 |
3,519 |
$362K |
| J1950 |
Leuprolide acetate /3.75 mg |
204 |
193 |
$353K |
| 76856 |
|
6,462 |
6,277 |
$349K |
| 70498 |
|
3,360 |
3,265 |
$343K |
| 96367 |
|
5,868 |
4,145 |
$332K |
| 77067 |
|
7,970 |
7,878 |
$321K |
| 76770 |
|
2,490 |
2,441 |
$319K |
| J1453 |
Fosaprepitant injection |
3,852 |
2,390 |
$301K |
| 70496 |
|
3,365 |
3,268 |
$283K |
| 70553 |
|
1,329 |
1,300 |
$279K |
| 10061 |
|
1,524 |
1,472 |
$275K |
| 70551 |
|
1,952 |
1,899 |
$274K |
| 12002 |
|
1,396 |
1,372 |
$269K |
| 77334 |
|
1,861 |
1,320 |
$253K |
| G0378 |
Hospital observation per hr |
21,082 |
9,101 |
$246K |
| 77336 |
|
4,839 |
2,036 |
$243K |
| 93306 |
|
1,131 |
1,093 |
$240K |
| 76816 |
|
5,331 |
4,751 |
$239K |
| 93971 |
|
2,522 |
2,461 |
$228K |
| 76811 |
|
3,863 |
3,751 |
$217K |
| Q5120 |
Inj pegfilgrastim-bmez 0.5mg |
135 |
92 |
$210K |
| 76817 |
|
7,143 |
6,137 |
$193K |
| 97530 |
|
7,911 |
3,094 |
$191K |
| 70491 |
|
1,334 |
1,307 |
$186K |
| J9395 |
Injection, fulvestrant |
635 |
565 |
$185K |
| 80047 |
|
49,111 |
45,498 |
$177K |
| 84484 |
|
42,043 |
33,714 |
$174K |
| P9040 |
Rbc leukoreduced irradiated |
1,052 |
730 |
$172K |
| 76818 |
|
5,968 |
3,146 |
$170K |
| 36430 |
|
2,257 |
1,477 |
$166K |
| 97110 |
|
7,605 |
3,559 |
$165K |
| 19083 |
|
261 |
250 |
$157K |
| 87636 |
|
14,856 |
14,305 |
$147K |
| J1756 |
Iron sucrose injection |
4,789 |
2,564 |
$136K |
| J0185 |
Inj., aprepitant, 1 mg |
1,719 |
1,081 |
$132K |
| 64400 |
|
465 |
441 |
$131K |
| 43235 |
|
377 |
370 |
$128K |
| 94640 |
|
16,042 |
10,614 |
$125K |
| 77290 |
|
586 |
544 |
$122K |
| 77065 |
Tomosynthesis, mammo |
3,874 |
3,569 |
$117K |
| 83605 |
|
22,678 |
19,296 |
$117K |
| 80048 |
|
26,850 |
21,697 |
$115K |
| 93978 |
|
2,561 |
2,465 |
$114K |
| 76870 |
|
1,247 |
1,192 |
$112K |
| 29125 |
|
915 |
897 |
$109K |
| 77066 |
Tomosynthesis, mammo |
3,797 |
3,728 |
$109K |
| 99291 |
|
1,980 |
1,917 |
$108K |
| J9217 |
Leuprolide acetate suspnsion |
446 |
428 |
$107K |
| 80076 |
|
31,153 |
29,204 |
$106K |
| 77295 |
|
255 |
234 |
$102K |
| 77386 |
|
379 |
37 |
$101K |
| 87591 |
|
8,917 |
8,543 |
$97K |
| 64483 |
|
220 |
212 |
$88K |
| 87637 |
|
6,874 |
6,454 |
$88K |
| J9312 |
Inj., rituximab, 10 mg |
31 |
26 |
$87K |
| 97112 |
|
2,768 |
1,213 |
$87K |
| 71046 |
|
17,962 |
17,273 |
$86K |
| 90715 |
|
4,525 |
4,426 |
$85K |
| 72148 |
|
693 |
671 |
$82K |
| 93976 |
|
1,674 |
1,619 |
$79K |
| J9206 |
Irinotecan injection |
975 |
477 |
$78K |
| 36561 |
|
85 |
80 |
$78K |
| 36415 |
|
41,917 |
31,167 |
$78K |
| 70486 |
|
2,364 |
2,313 |
$78K |
| 96374 |
|
64,772 |
56,668 |
$74K |
| 77063 |
|
5,373 |
5,318 |
$71K |
| 87040 |
|
11,634 |
6,628 |
$69K |
| 76819 |
|
1,703 |
1,352 |
$69K |
| 85025 |
|
181,739 |
146,276 |
$67K |
| 77470 |
|
102 |
100 |
$65K |
| 71260 |
|
2,178 |
2,106 |
$63K |
| 77280 |
|
376 |
333 |
$58K |
| 97140 |
|
2,710 |
1,227 |
$56K |
| 87635 |
|
3,890 |
3,628 |
$54K |
| 87400 |
|
3,850 |
2,839 |
$53K |
| 84145 |
|
6,368 |
5,847 |
$51K |
| 74174 |
|
557 |
531 |
$48K |
| 86300 |
|
4,699 |
3,993 |
$46K |
| 97162 |
|
1,697 |
1,619 |
$46K |
| 96523 |
|
1,381 |
1,303 |
$46K |
| 93005 |
|
53,354 |
47,669 |
$46K |
| 83880 |
|
10,044 |
9,436 |
$45K |
| 96372 |
|
30,254 |
22,125 |
$45K |
| 76813 |
|
1,384 |
1,338 |
$44K |
| J0897 |
Denosumab injection |
350 |
312 |
$44K |
| 36591 |
|
7,874 |
6,348 |
$43K |
| 77300 |
|
969 |
863 |
$43K |
| 76820 |
|
1,647 |
846 |
$42K |
| 85379 |
|
8,353 |
8,102 |
$41K |
| G0480 |
Drug test def 1-7 classes |
4,996 |
4,671 |
$41K |
| G0108 |
Diab manage trn per indiv |
2,572 |
1,607 |
$40K |
| 76536 |
|
449 |
443 |
$37K |
| J1750 |
Inj iron dextran |
812 |
428 |
$37K |
| G0279 |
Tomosynthesis, mammo |
5,355 |
5,228 |
$37K |
| 73630 |
|
5,856 |
5,514 |
$34K |
| 73562 |
|
3,366 |
3,278 |
$33K |
| 54161 |
|
71 |
68 |
$32K |
| 97161 |
|
1,025 |
983 |
$32K |
| 44970 |
|
13 |
13 |
$32K |
| 71045 |
|
28,550 |
26,765 |
$32K |
| 72125 |
|
3,709 |
3,578 |
$32K |
| 73610 |
|
6,116 |
5,752 |
$31K |
| 47562 |
|
12 |
12 |
$28K |
| 76700 |
|
285 |
282 |
$27K |
| 82105 |
|
2,838 |
2,668 |
$26K |
| J3489 |
Zoledronic acid 1mg |
946 |
898 |
$24K |
| 84443 |
|
11,784 |
10,503 |
$24K |
| 87798 |
|
3,028 |
2,884 |
$24K |
| 77331 |
|
425 |
365 |
$23K |
| 87633 |
|
1,205 |
1,166 |
$23K |
| 73030 |
|
4,695 |
4,278 |
$23K |
| 72100 |
|
3,443 |
3,353 |
$22K |
| 71250 |
|
615 |
598 |
$22K |
| 73700 |
|
358 |
337 |
$22K |
| 97535 |
|
2,251 |
1,327 |
$22K |
| J2997 |
Alteplase recombinant |
572 |
485 |
$22K |
| 73130 |
|
4,608 |
4,309 |
$21K |
| 82784 |
|
4,221 |
2,819 |
$21K |
| 93975 |
|
268 |
261 |
$21K |
| 88307 |
|
1,625 |
1,473 |
$20K |
| 82728 |
|
7,383 |
6,924 |
$20K |
| 97116 |
|
2,401 |
1,399 |
$19K |
| 80197 |
|
2,668 |
1,294 |
$19K |
| 87158 |
|
1,659 |
1,416 |
$18K |
| 91200 |
|
205 |
198 |
$18K |
| 70487 |
|
87 |
87 |
$17K |
| 64493 |
|
33 |
26 |
$17K |
| J1439 |
Inj ferric carboxymaltos 1mg |
573 |
408 |
$17K |
| 97166 |
|
836 |
792 |
$17K |
| 19081 |
|
24 |
24 |
$17K |
| 76937 |
|
587 |
546 |
$17K |
| 97165 |
|
671 |
641 |
$17K |
| 85027 |
|
16,527 |
14,275 |
$17K |
| 43264 |
|
46 |
42 |
$17K |
| 83735 |
|
17,523 |
11,844 |
$17K |
| 96375 |
|
63,183 |
47,553 |
$16K |
| M0243 |
Casirivi and imdevi inj |
85 |
82 |
$16K |
| 77001 |
|
191 |
179 |
$16K |
| 82378 |
|
6,124 |
4,764 |
$16K |
| 74018 |
|
2,820 |
2,623 |
$16K |
| 73502 |
|
2,643 |
2,522 |
$15K |
| 86304 |
|
2,393 |
1,925 |
$15K |
| Q5101 |
Injection, zarxio |
97 |
30 |
$15K |
| 77387 |
|
2,438 |
239 |
$14K |
| 96368 |
|
3,593 |
2,288 |
$14K |
| 74183 |
|
64 |
63 |
$14K |
| 90686 |
|
1,291 |
1,254 |
$14K |
| 86923 |
|
1,567 |
1,193 |
$13K |
| 82306 |
|
1,996 |
1,920 |
$13K |
| J0515 |
Inj benztropine mesylate |
362 |
334 |
$13K |
| J9070 |
Cyclophosphamide 100 mg inj |
170 |
105 |
$13K |
| 73701 |
|
65 |
64 |
$13K |
| J0485 |
Belatacept injection |
277 |
112 |
$12K |
| J9201 |
In gemcitabine hcl nos 200mg |
70 |
25 |
$12K |
| 73110 |
|
3,609 |
3,390 |
$12K |
| 76882 |
|
162 |
145 |
$12K |
| 87517 |
|
755 |
737 |
$12K |
| 87522 |
Neg quan hep c or qual rna |
776 |
747 |
$11K |
| 86317 |
|
1,354 |
1,267 |
$10K |
| Q5107 |
Inj mvasi 10 mg |
32 |
13 |
$10K |
| 88185 |
|
442 |
397 |
$10K |
| 85610 |
|
23,112 |
17,806 |
$10K |
| 72040 |
|
926 |
904 |
$9K |
| 73564 |
|
2,938 |
2,745 |
$9K |
| 82607 |
|
2,849 |
2,741 |
$9K |
| 87486 |
|
1,210 |
1,171 |
$9K |
| 87581 |
|
1,210 |
1,171 |
$9K |
| 83883 |
|
1,724 |
819 |
$8K |
| 87641 |
|
1,564 |
1,428 |
$8K |
| 96402 |
|
2,912 |
2,662 |
$8K |
| 80061 |
|
1,755 |
1,732 |
$8K |
| 84703 |
|
36,709 |
34,554 |
$8K |
| 84702 |
|
9,914 |
9,009 |
$8K |
| J2405 |
Ondansetron hcl injection |
55,189 |
45,733 |
$8K |
| 72141 |
|
67 |
64 |
$8K |
| 73140 |
|
2,633 |
2,500 |
$8K |
| 82962 |
|
31,111 |
18,095 |
$7K |
| 80050 |
|
1,581 |
1,450 |
$7K |
| 72158 |
|
75 |
74 |
$7K |
| 87507 |
|
110 |
109 |
$7K |
| 87799 |
|
990 |
755 |
$7K |
| 0202U |
|
1,150 |
1,115 |
$7K |
| 88305 |
|
11,256 |
10,312 |
$7K |
| 84100 |
|
7,761 |
4,879 |
$6K |
| P9016 |
Rbc leukocytes reduced |
18 |
15 |
$6K |
| 87491 |
|
8,859 |
8,506 |
$6K |
| 83540 |
|
6,533 |
6,203 |
$6K |
| 81001 |
|
34,001 |
31,106 |
$6K |
| 12013 |
|
38 |
38 |
$6K |
| 96409 |
|
558 |
312 |
$6K |
| 73080 |
|
2,171 |
2,074 |
$6K |
| 87086 |
|
14,142 |
13,290 |
$6K |
| 83036 |
|
3,605 |
3,494 |
$6K |
| 73590 |
|
2,063 |
1,893 |
$6K |
| 83690 |
|
42,492 |
38,968 |
$6K |
| 96376 |
|
16,817 |
12,537 |
$6K |
| 87661 |
|
1,138 |
1,086 |
$6K |
| 82570 |
|
5,653 |
4,127 |
$6K |
| 86140 |
|
13,740 |
12,439 |
$6K |
| 81003 |
|
46,159 |
39,396 |
$6K |
| 86301 |
|
607 |
440 |
$6K |
| 94060 |
|
104 |
100 |
$5K |
| 97163 |
|
159 |
147 |
$5K |
| 90471 |
|
5,734 |
5,537 |
$5K |
| J0561 |
Penicillin g benzathine inj |
91 |
90 |
$5K |
| 71101 |
|
1,799 |
1,758 |
$5K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
33,104 |
31,427 |
$5K |
| 80143 |
|
495 |
469 |
$5K |
| 82553 |
|
633 |
594 |
$4K |
| 82565 |
|
4,312 |
3,739 |
$4K |
| 36593 |
|
156 |
145 |
$4K |
| 84156 |
|
5,619 |
4,024 |
$4K |
| 87389 |
|
3,328 |
3,231 |
$4K |
| 86803 |
|
1,999 |
1,933 |
$4K |
| 0001A |
|
164 |
162 |
$4K |
| 62323 |
|
12 |
12 |
$4K |
| 99195 |
|
102 |
86 |
$4K |
| 83970 |
|
349 |
234 |
$4K |
| 84466 |
|
2,392 |
2,301 |
$4K |
| 72072 |
|
492 |
486 |
$4K |
| 84439 |
|
3,786 |
3,304 |
$4K |
| C1781 |
Mesh (implantable) |
65 |
65 |
$4K |
| 86850 |
|
5,484 |
4,642 |
$4K |
| 20610 |
|
26 |
25 |
$4K |
| C1769 |
Guide wire |
3,176 |
2,815 |
$4K |
| 94729 |
|
159 |
153 |
$4K |
| 72131 |
|
109 |
105 |
$3K |
| 10160 |
|
16 |
14 |
$3K |
| 20553 |
|
63 |
53 |
$3K |
| 74330 |
|
27 |
25 |
$3K |
| 76942 |
|
57 |
54 |
$3K |
| 83615 |
|
6,944 |
5,502 |
$3K |
| 86901 |
|
8,920 |
6,794 |
$3K |
| 81420 |
|
134 |
126 |
$3K |
| 86900 |
|
7,430 |
5,332 |
$3K |
| 80305 |
|
10,561 |
10,066 |
$3K |
| 83521 |
|
604 |
470 |
$3K |
| 84165 |
|
2,116 |
1,922 |
$3K |
| 62369 |
|
116 |
115 |
$3K |
| 80179 |
|
2,436 |
2,297 |
$3K |
| 96417 |
|
6,647 |
4,256 |
$2K |
| 73090 |
|
1,234 |
1,143 |
$2K |
| 87340 |
|
2,939 |
2,810 |
$2K |
| 84153 |
|
717 |
665 |
$2K |
| 0241U |
|
8,895 |
8,395 |
$2K |
| 82746 |
|
1,789 |
1,729 |
$2K |
| J0640 |
Leucovorin calcium injection |
2,983 |
1,610 |
$2K |
| M0222 |
Bebtelovimab injection |
54 |
53 |
$2K |
| 96401 |
|
274 |
120 |
$2K |
| 36000 |
|
1,514 |
1,452 |
$2K |
| J1885 |
Ketorolac tromethamine inj |
34,903 |
30,772 |
$2K |
| 85014 |
|
3,963 |
3,297 |
$2K |
| 83550 |
|
2,482 |
2,336 |
$2K |
| 94726 |
|
71 |
69 |
$2K |
| 87081 |
|
3,009 |
2,854 |
$2K |
| 82075 |
|
3,107 |
2,734 |
$2K |
| J1100 |
Dexamethasone sodium phos |
32,481 |
24,869 |
$2K |
| 73660 |
|
469 |
453 |
$2K |
| 88184 |
|
481 |
417 |
$2K |
| J1170 |
Hydromorphone injection |
22,072 |
15,496 |
$2K |
| 97035 |
|
276 |
146 |
$2K |
| 87593 |
|
37 |
35 |
$2K |
| 87210 |
|
6,310 |
6,073 |
$2K |
| J2310 |
Inj naloxone hydrochloride |
209 |
176 |
$2K |
| 87640 |
|
465 |
442 |
$1K |
| 82803 |
|
7,958 |
6,939 |
$1K |
| 84550 |
|
3,671 |
2,758 |
$1K |
| 87801 |
|
922 |
880 |
$1K |
| 87426 |
|
1,770 |
1,681 |
$1K |
| 86592 |
|
1,357 |
1,310 |
$1K |
| 82550 |
|
3,373 |
3,006 |
$1K |
| J0690 |
Cefazolin sodium injection |
11,915 |
8,965 |
$1K |
| J7030 |
Normal saline solution infus |
20,749 |
17,037 |
$1K |
| 87205 |
|
5,875 |
5,249 |
$1K |
| 87880 |
|
5,680 |
5,571 |
$1K |
| J2001 |
Lidocaine injection |
15,410 |
12,638 |
$1K |
| 99152 |
|
2,161 |
2,030 |
$1K |
| 87186 |
|
4,929 |
4,676 |
$1K |
| 86704 |
|
1,710 |
1,647 |
$1K |
| J2704 |
Inj, propofol, 10 mg |
20,422 |
18,079 |
$1K |
| J2060 |
Lorazepam injection |
10,331 |
8,244 |
$1K |
| 87804 |
|
5,039 |
2,626 |
$1K |
| 87070 |
|
4,812 |
4,352 |
$1K |
| J3490 |
Drugs unclassified injection |
4,542 |
3,766 |
$1K |
| 77332 |
|
26 |
25 |
$1K |
| 72050 |
|
129 |
127 |
$1K |
| 85730 |
|
5,397 |
4,883 |
$1K |
| 87653 |
|
340 |
327 |
$1K |
| 72170 |
|
299 |
271 |
$997.17 |
| 86780 |
|
505 |
491 |
$970.64 |
| 85651 |
|
5,198 |
4,784 |
$933.48 |
| 80069 |
|
277 |
227 |
$915.19 |
| J3010 |
Fentanyl citrate injection |
27,191 |
22,370 |
$882.72 |
| J2250 |
Inj midazolam hydrochloride |
16,775 |
15,092 |
$879.74 |
| J0696 |
Ceftriaxone sodium injection |
14,144 |
11,849 |
$879.48 |
| 86334 |
|
305 |
265 |
$868.95 |
| 74019 |
|
206 |
203 |
$865.40 |
| 87497 |
|
115 |
81 |
$862.45 |
| 85652 |
|
2,870 |
2,713 |
$843.51 |
| 94770 |
|
12 |
12 |
$841.86 |
| 84163 |
|
70 |
68 |
$818.70 |
| 77080 |
|
14 |
14 |
$803.18 |
| 73560 |
|
183 |
177 |
$783.66 |
| J1200 |
Diphenhydramine hcl injectio |
15,689 |
12,028 |
$737.14 |
| J2270 |
Morphine sulfate injection |
13,539 |
11,401 |
$734.10 |
| 77417 |
|
727 |
367 |
$733.95 |
| 88342 |
|
2,624 |
2,491 |
$728.99 |
| 89051 |
|
695 |
553 |
$705.81 |
| 74220 |
|
28 |
26 |
$700.94 |
| 86480 |
|
86 |
83 |
$695.03 |
| 73552 |
|
165 |
151 |
$686.71 |
| 87902 |
|
27 |
26 |
$670.73 |
| C1726 |
Cath, bal dil, non-vascular |
537 |
465 |
$653.19 |
| 80051 |
|
625 |
495 |
$610.18 |
| 83010 |
|
104 |
93 |
$605.27 |
| 86038 |
|
464 |
441 |
$601.34 |
| G0379 |
Direct refer hospital observ |
128 |
125 |
$579.68 |
| 99153 |
Mod sedat endo service >5yrs |
3,158 |
3,047 |
$559.86 |
| 82248 |
|
1,226 |
1,136 |
$555.00 |
| J9171 |
Docetaxel injection |
17 |
12 |
$529.92 |
| J1720 |
Hydrocortisone sodium succ i |
85 |
54 |
$517.97 |
| 82150 |
|
2,868 |
2,704 |
$497.98 |
| 86706 |
|
477 |
465 |
$484.31 |
| 0031A |
|
15 |
14 |
$484.29 |
| 88341 |
|
1,082 |
1,011 |
$478.75 |
| J0780 |
Prochlorperazine injection |
4,321 |
3,683 |
$471.86 |
| 73100 |
|
15 |
13 |
$449.00 |
| A4648 |
Implantable tissue marker |
1,271 |
1,081 |
$415.23 |
| 90656 |
|
51 |
51 |
$400.81 |
| 87075 |
|
2,340 |
2,010 |
$384.56 |
| 87150 |
|
629 |
602 |
$377.84 |
| 73060 |
|
108 |
103 |
$376.25 |
| 82077 |
|
981 |
906 |
$364.36 |
| J9045 |
Carboplatin injection |
2,663 |
1,652 |
$362.51 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
848 |
788 |
$361.83 |
| J9267 |
Paclitaxel injection |
3,108 |
1,401 |
$359.94 |
| 91322 |
|
30 |
28 |
$351.65 |
| 87077 |
|
1,838 |
1,782 |
$340.85 |
| 91320 |
|
36 |
36 |
$339.20 |
| 84403 |
|
68 |
68 |
$337.31 |
| U0005 |
Infec agen detec ampli probe |
3,051 |
2,881 |
$336.62 |
| 85018 |
|
913 |
694 |
$326.95 |
| 87430 |
|
1,679 |
1,655 |
$320.30 |
| 86762 |
|
192 |
185 |
$310.78 |
| 84132 |
|
1,760 |
1,459 |
$309.17 |
| G0008 |
Admin influenza virus vac |
332 |
322 |
$298.47 |
| J3475 |
Inj magnesium sulfate |
4,754 |
2,803 |
$285.54 |
| J7120 |
Ringers lactate infusion |
16,935 |
14,090 |
$268.04 |
| 88304 |
|
1,401 |
1,368 |
$267.09 |
| A9270 |
Non-covered item or service |
27,429 |
6,400 |
$266.26 |
| 82533 |
|
55 |
41 |
$266.21 |
| A9585 |
Gadobutrol injection |
2,863 |
2,775 |
$262.19 |
| 86308 |
|
841 |
823 |
$262.06 |
| 87188 |
|
1,148 |
1,111 |
$258.24 |
| 81025 |
|
3,374 |
3,169 |
$249.09 |
| 84520 |
|
783 |
618 |
$248.95 |
| J2930 |
Methylprednisolone injection |
4,235 |
3,573 |
$244.33 |
| C1894 |
Intro/sheath, non-laser |
1,300 |
1,197 |
$241.77 |
| J7050 |
Normal saline solution infus |
22,360 |
10,123 |
$241.65 |
| 96411 |
|
3,939 |
2,411 |
$236.25 |
| 87147 |
|
1,198 |
1,073 |
$234.19 |
| 86708 |
|
303 |
287 |
$234.05 |
| 86336 |
|
84 |
82 |
$233.25 |
| 74175 |
|
13 |
13 |
$227.29 |
| G0498 |
Chemo extend iv infus w/pump |
51 |
37 |
$218.68 |
| 85045 |
|
400 |
358 |
$215.11 |
| 80074 |
|
67 |
63 |
$211.82 |
| 84450 |
|
768 |
626 |
$207.00 |
| 80202 |
|
32 |
26 |
$206.62 |
| 70360 |
|
40 |
39 |
$204.02 |
| 84155 |
|
757 |
701 |
$201.70 |
| 85046 |
|
660 |
594 |
$200.44 |
| C2617 |
Stent, non-cor, tem w/o del |
559 |
539 |
$196.65 |
| C9113 |
Inj pantoprazole sodium, via |
3,576 |
2,436 |
$183.37 |
| J1815 |
Insulin injection |
5,381 |
2,660 |
$180.32 |
| G0500 |
Mod sedat endo service >5yrs |
3,263 |
3,189 |
$175.74 |
| 83516 |
|
81 |
58 |
$170.10 |
| 82330 |
|
205 |
165 |
$163.51 |
| 74022 |
|
243 |
233 |
$162.43 |
| 85049 |
|
552 |
440 |
$155.24 |
| J2765 |
Metoclopramide hcl injection |
6,313 |
5,609 |
$154.19 |
| 87073 |
|
13 |
12 |
$150.20 |
| 72220 |
|
13 |
12 |
$147.51 |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
1,384 |
1,292 |
$143.55 |
| 87807 |
|
440 |
434 |
$142.31 |
| 84460 |
|
715 |
578 |
$139.20 |
| 86644 |
|
95 |
86 |
$138.17 |
| 80178 |
|
18 |
15 |
$135.60 |
| 87493 |
|
26 |
26 |
$129.60 |
| 99406 |
|
244 |
239 |
$129.41 |
| 82525 |
|
101 |
97 |
$128.03 |
| J1644 |
Inj heparin sodium per 1000u |
8,859 |
4,145 |
$120.10 |
| J3370 |
Vancomycin hcl injection |
5,717 |
3,614 |
$115.22 |
| 87116 |
|
15 |
13 |
$114.85 |
| 83021 |
|
12 |
12 |
$113.57 |
| 82140 |
|
212 |
191 |
$113.08 |
| J0171 |
Adrenalin epinephrine inject |
1,983 |
1,716 |
$112.16 |
| 90480 |
|
58 |
56 |
$111.57 |
| 82010 |
|
528 |
500 |
$110.53 |
| J0330 |
Succinycholine chloride inj |
6,354 |
4,064 |
$110.32 |
| 87481 |
|
261 |
205 |
$109.76 |
| 73070 |
|
26 |
25 |
$99.00 |
| J2560 |
Phenobarbital sodium inj |
262 |
192 |
$96.18 |
| 36592 |
|
27 |
25 |
$91.96 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
1,128 |
644 |
$87.26 |
| J1940 |
Furosemide injection |
1,414 |
1,120 |
$86.71 |
| 84481 |
|
53 |
50 |
$80.74 |
| 82670 |
|
12 |
12 |
$78.13 |
| J3480 |
Inj potassium chloride |
3,491 |
2,053 |
$76.02 |
| J3301 |
Triamcinolone acet inj nos |
227 |
218 |
$75.08 |
| 88311 |
|
45 |
37 |
$74.36 |
| 85384 |
|
157 |
135 |
$71.58 |
| 86787 |
|
69 |
64 |
$70.82 |
| J7512 |
Prednisone ir or dr oral 1mg |
6,248 |
4,722 |
$68.56 |
| 88313 |
|
91 |
85 |
$67.95 |
| C1729 |
Cath, drainage |
334 |
246 |
$57.06 |
| 85660 |
|
39 |
36 |
$54.24 |
| 82310 |
|
56 |
29 |
$53.42 |
| J9000 |
Doxorubicin hcl injection |
232 |
145 |
$51.23 |
| J1650 |
Inj enoxaparin sodium |
8,124 |
3,020 |
$50.95 |
| C1788 |
Port, indwelling, imp |
84 |
80 |
$48.66 |
| 97026 |
|
47 |
37 |
$46.98 |
| J7040 |
Normal saline solution infus |
3,260 |
2,412 |
$45.92 |
| 0353U |
|
686 |
670 |
$42.70 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
413 |
391 |
$40.45 |
| J2550 |
Promethazine hcl injection |
591 |
527 |
$35.04 |
| 83001 |
|
13 |
12 |
$33.58 |
| J8540 |
Oral dexamethasone |
1,560 |
960 |
$32.66 |
| 82247 |
|
14 |
14 |
$26.95 |
| 88312 |
|
54 |
51 |
$26.38 |
| J1642 |
Inj heparin sodium per 10 u |
711 |
426 |
$25.44 |
| J1790 |
Droperidol injection |
2,127 |
1,902 |
$25.39 |
| 82947 |
|
129 |
123 |
$24.69 |
| 86665 |
|
16 |
13 |
$23.88 |
| 87071 |
|
102 |
100 |
$23.11 |
| 94761 |
|
504 |
491 |
$22.91 |
| J3411 |
Thiamine hcl 100 mg |
1,736 |
1,180 |
$22.89 |
| 82950 |
|
36 |
36 |
$21.57 |
| 82043 |
|
13 |
13 |
$20.09 |
| 88112 |
|
93 |
86 |
$18.96 |
| J2795 |
Ropivacaine hcl injection |
749 |
593 |
$18.05 |
| J1630 |
Haloperidol injection |
1,928 |
1,649 |
$17.68 |
| 85007 |
|
62 |
55 |
$16.75 |
| G1004 |
Cdsm ndsc |
34,253 |
25,999 |
$15.34 |
| J2370 |
Phenylephrine hcl injection |
3,741 |
3,317 |
$14.84 |
| 86735 |
|
16 |
15 |
$12.21 |
| 86765 |
|
16 |
15 |
$12.21 |
| J7060 |
5% dextrose/water |
3,801 |
1,319 |
$11.22 |
| J9190 |
Fluorouracil injection |
5,642 |
1,827 |
$11.20 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
1,111 |
985 |
$9.84 |
| J0610 |
Calcium glucon (fresenius) |
142 |
103 |
$8.42 |
| J0131 |
Inj, acetaminophen (nos) |
123 |
112 |
$8.38 |
| J2710 |
Neostigmine methylslfte inj |
1,907 |
1,833 |
$7.30 |
| 85670 |
|
12 |
12 |
$5.61 |
| J3360 |
Diazepam injection |
461 |
433 |
$5.30 |
| 84295 |
|
62 |
53 |
$3.81 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
423 |
308 |
$3.50 |
| 86905 |
|
17 |
12 |
$3.19 |
| J1836 |
Inj, metronidazole, 10 mg |
698 |
569 |
$3.00 |
| J2272 |
Inj, morphine (fresenius) |
575 |
491 |
$1.46 |
| J1956 |
Levofloxacin injection |
338 |
301 |
$1.42 |
| Q9969 |
Non-heu tc-99m add-on/dose |
249 |
236 |
$1.00 |
| J1580 |
Garamycin gentamicin inj |
297 |
264 |
$0.41 |
| J0692 |
Cefepime hcl for injection |
1,420 |
841 |
$0.24 |
| J0461 |
Atropine sulfate injection |
824 |
473 |
$0.20 |
| Q0162 |
Ondansetron oral |
509 |
268 |
$0.17 |
| J3420 |
Vitamin b12 injection |
852 |
698 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
261 |
211 |
$0.00 |
| 0240U |
|
15 |
15 |
$0.00 |
| C1889 |
Implant/insert device, noc |
448 |
423 |
$0.00 |
| J7999 |
Compounded drug, noc |
892 |
729 |
$0.00 |
| 97814 |
|
47 |
37 |
$0.00 |
| G8988 |
Self care goal status |
328 |
285 |
$0.00 |
| J0456 |
Azithromycin |
198 |
168 |
$0.00 |
| J2920 |
Methylprednisolone injection |
194 |
169 |
$0.00 |
| S2900 |
Robotic surgical system |
247 |
242 |
$0.00 |
| G8987 |
Self care current status |
305 |
279 |
$0.00 |
| J0360 |
Hydralazine hcl injection |
153 |
123 |
$0.00 |
| 89060 |
|
12 |
12 |
$0.00 |
| J1597 |
Inj glycopyrrolate, glyrx-pf |
82 |
79 |
$0.00 |
| G8980 |
Mobility d/c status |
134 |
129 |
$0.00 |
| J1920 |
Inj, labetalol hcl, 5mg |
281 |
233 |
$0.00 |
| J7042 |
5% dextrose/normal saline |
39 |
29 |
$0.00 |
| 87206 |
|
15 |
13 |
$0.00 |
| C9463 |
Injection, aprepitant |
22 |
14 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
42 |
29 |
$0.00 |
| A9503 |
Tc99m medronate |
13 |
13 |
$0.00 |
| 87154 |
|
25 |
25 |
$0.00 |
| 85008 |
|
27 |
25 |
$0.00 |
| C9399 |
Unclassified drugs or biolog |
65 |
56 |
$0.00 |
| C1725 |
Cath, translumin non-laser |
13 |
12 |
$0.00 |
| 51798 |
|
15 |
14 |
$0.00 |
| 96377 |
|
17 |
12 |
$0.00 |
| G8991 |
Other pt/ot goal status |
15 |
12 |
$0.00 |
| 91303 |
|
14 |
14 |
$0.00 |
| 91035 |
|
12 |
12 |
$0.00 |
| Q0163 |
Diphenhydramine hcl 50mg |
238 |
229 |
$0.00 |
| G8978 |
Mobility current status |
718 |
669 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,328 |
1,127 |
$0.00 |
| 88360 |
|
41 |
39 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
506 |
455 |
$0.00 |
| 51702 |
|
136 |
121 |
$0.00 |
| J2359 |
Inj. olanzapine, 0.5mg |
190 |
161 |
$0.00 |
| Q0144 |
Azithromycin dihydrate, oral |
55 |
51 |
$0.00 |
| J0670 |
Inj mepivacaine hcl/10 ml |
39 |
37 |
$0.00 |
| 97813 |
|
47 |
37 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
12 |
12 |
$0.00 |
| G8989 |
Self care d/c status |
13 |
12 |
$0.00 |
| G8979 |
Mobility goal status |
783 |
707 |
$0.00 |
| G2215 |
Home supply nasal naloxone |
27 |
27 |
$0.00 |
| 96549 |
|
229 |
153 |
$0.00 |
| G8985 |
Carry goal status |
30 |
30 |
$0.00 |
| J0688 |
Inj cefazolin sodium, hikma |
202 |
179 |
$0.00 |
| 88333 |
|
14 |
12 |
$0.00 |
| A9541 |
Tc99m sulfur colloid |
81 |
77 |
$0.00 |
| C1776 |
Joint device (implantable) |
155 |
148 |
$0.00 |
| C1887 |
Catheter, guiding |
71 |
61 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
187 |
174 |
$0.00 |
| 88173 |
|
50 |
36 |
$0.00 |
| G8984 |
Carry current status |
28 |
28 |
$0.00 |
| 29515 |
|
26 |
24 |
$0.00 |
| J2916 |
Na ferric gluconate complex |
21 |
14 |
$0.00 |
| 90653 |
|
12 |
12 |
$0.00 |