| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J9271 |
Inj pembrolizumab |
2,263 |
1,801 |
$13.36M |
| G0463 |
Hospital outpt clinic visit |
69,653 |
52,644 |
$4.46M |
| 96413 |
|
17,319 |
10,400 |
$2.86M |
| 77386 |
|
7,228 |
648 |
$1.98M |
| 78815 |
|
2,493 |
2,473 |
$1.92M |
| J9299 |
Injection, nivolumab |
370 |
259 |
$1.79M |
| 77412 |
|
12,115 |
1,370 |
$1.49M |
| J9355 |
Inj trastuzumab excl biosimi |
560 |
329 |
$1.13M |
| 77067 |
|
18,672 |
18,601 |
$912K |
| 74177 |
|
4,881 |
4,824 |
$881K |
| J2505 |
Injection, pegfilgrastim 6mg |
374 |
296 |
$826K |
| 19083 |
|
1,013 |
985 |
$774K |
| 77334 |
|
2,140 |
1,705 |
$663K |
| J9035 |
Bevacizumab injection |
290 |
161 |
$645K |
| Q5111 |
Injection, udenyca 0.5 mg |
313 |
239 |
$608K |
| 96375 |
|
12,299 |
7,162 |
$491K |
| 71260 |
|
6,266 |
6,192 |
$394K |
| 77336 |
|
5,490 |
2,433 |
$359K |
| 77300 |
|
1,615 |
1,514 |
$314K |
| P9016 |
Rbc leukocytes reduced |
532 |
419 |
$270K |
| 70553 |
|
1,376 |
1,353 |
$269K |
| 77295 |
|
429 |
381 |
$247K |
| J2506 |
Inj pegfilgrast ex bio 0.5mg |
345 |
269 |
$236K |
| 36512 |
|
400 |
299 |
$235K |
| 96417 |
|
5,852 |
3,975 |
$227K |
| 96365 |
|
2,600 |
1,735 |
$222K |
| 70491 |
|
1,535 |
1,517 |
$212K |
| Q5117 |
Inj., kanjinti, 10 mg |
129 |
89 |
$198K |
| 76642 |
|
7,101 |
6,054 |
$196K |
| 77066 |
Tomosynthesis, mammo |
3,266 |
3,210 |
$191K |
| J9070 |
Cyclophosphamide 100 mg inj |
906 |
463 |
$189K |
| 36430 |
|
1,002 |
570 |
$188K |
| 77065 |
Tomosynthesis, mammo |
3,890 |
3,586 |
$173K |
| J0185 |
Inj., aprepitant, 1 mg |
1,253 |
903 |
$155K |
| 31575 |
|
1,886 |
1,827 |
$148K |
| 96415 |
|
2,853 |
2,036 |
$140K |
| 80053 |
|
35,178 |
23,708 |
$140K |
| 96374 |
|
1,549 |
1,240 |
$136K |
| G0379 |
Direct refer hospital observ |
120 |
112 |
$131K |
| 96361 |
|
3,821 |
1,952 |
$127K |
| 96416 |
|
841 |
508 |
$124K |
| 96367 |
|
3,425 |
2,523 |
$122K |
| 78306 |
|
647 |
646 |
$122K |
| 36556 |
|
259 |
188 |
$121K |
| 77063 |
|
8,584 |
8,583 |
$119K |
| J1950 |
Leuprolide acetate /3.75 mg |
123 |
118 |
$117K |
| 85025 |
|
38,105 |
24,946 |
$112K |
| 77290 |
|
550 |
497 |
$89K |
| 96360 |
|
884 |
524 |
$88K |
| 96372 |
|
4,507 |
3,149 |
$78K |
| 36561 |
|
57 |
54 |
$73K |
| 77338 |
|
392 |
366 |
$68K |
| 96411 |
|
1,700 |
1,188 |
$65K |
| 72197 |
|
216 |
216 |
$58K |
| 77301 |
|
85 |
81 |
$56K |
| 88307 |
|
396 |
388 |
$55K |
| 77385 |
|
237 |
12 |
$55K |
| J0897 |
Denosumab injection |
41 |
38 |
$53K |
| J9217 |
Leuprolide acetate suspnsion |
148 |
145 |
$49K |
| 88305 |
|
3,311 |
3,208 |
$48K |
| J9306 |
Injection, pertuzumab, 1 mg |
22 |
12 |
$48K |
| 88341 |
|
759 |
741 |
$47K |
| 84443 |
|
6,588 |
5,762 |
$45K |
| Q5107 |
Inj mvasi 10 mg |
51 |
24 |
$43K |
| Q3014 |
Telehealth facility fee |
2,422 |
2,303 |
$39K |
| 71250 |
|
641 |
637 |
$36K |
| 96402 |
|
2,062 |
1,966 |
$35K |
| 83735 |
|
11,346 |
6,605 |
$30K |
| 78816 |
|
37 |
37 |
$29K |
| U0003 |
Cov-19 amp prb hgh thruput |
516 |
492 |
$26K |
| 96366 |
|
1,132 |
773 |
$24K |
| 86300 |
|
3,004 |
1,329 |
$24K |
| 82784 |
|
3,110 |
2,503 |
$22K |
| 71046 |
|
553 |
539 |
$20K |
| 88342 |
|
815 |
800 |
$20K |
| 77280 |
|
282 |
250 |
$19K |
| 83615 |
|
8,396 |
6,044 |
$19K |
| 86900 |
|
5,177 |
3,620 |
$18K |
| 82378 |
|
2,199 |
1,918 |
$16K |
| 84153 |
|
2,276 |
2,112 |
$16K |
| 86850 |
|
4,850 |
3,368 |
$16K |
| 83521 |
|
1,129 |
1,024 |
$15K |
| 86334 |
|
1,672 |
1,532 |
$14K |
| J1453 |
Fosaprepitant injection |
294 |
217 |
$14K |
| J9045 |
Carboplatin injection |
2,209 |
1,464 |
$14K |
| 86304 |
|
1,345 |
1,153 |
$12K |
| 80048 |
|
3,188 |
2,170 |
$10K |
| 76536 |
|
256 |
253 |
$10K |
| J9171 |
Docetaxel injection |
271 |
135 |
$9K |
| U0002 |
Covid-19 lab test non-cdc |
281 |
268 |
$9K |
| 84165 |
|
1,985 |
1,810 |
$9K |
| 38505 |
|
12 |
12 |
$8K |
| C8908 |
Mri w/o fol w/cont, breast, |
41 |
41 |
$8K |
| 84439 |
|
2,005 |
1,875 |
$8K |
| J2405 |
Ondansetron hcl injection |
10,555 |
6,809 |
$7K |
| J9267 |
Paclitaxel injection |
2,636 |
1,167 |
$7K |
| 76641 |
|
276 |
199 |
$7K |
| 96409 |
|
73 |
50 |
$7K |
| 87496 |
|
582 |
249 |
$6K |
| 82728 |
|
1,014 |
851 |
$6K |
| 82565 |
|
3,022 |
2,963 |
$6K |
| 84100 |
|
2,722 |
1,778 |
$6K |
| 84703 |
|
1,747 |
1,466 |
$5K |
| 86901 |
|
5,175 |
3,619 |
$5K |
| C9463 |
Injection, aprepitant |
45 |
27 |
$5K |
| 84403 |
|
474 |
441 |
$5K |
| 86301 |
|
570 |
496 |
$5K |
| 82306 |
|
350 |
340 |
$5K |
| 74183 |
|
39 |
39 |
$5K |
| J3489 |
Zoledronic acid 1mg |
395 |
369 |
$5K |
| 85610 |
|
2,789 |
2,449 |
$4K |
| 77080 |
|
77 |
77 |
$4K |
| 87086 |
|
1,137 |
1,035 |
$3K |
| G0378 |
Hospital observation per hr |
257 |
225 |
$3K |
| 94726 |
|
129 |
128 |
$3K |
| 82607 |
|
390 |
376 |
$3K |
| 83540 |
|
462 |
451 |
$3K |
| 85730 |
|
1,358 |
1,163 |
$3K |
| 96401 |
|
172 |
74 |
$3K |
| 78472 |
|
16 |
15 |
$3K |
| J1750 |
Inj iron dextran |
21 |
12 |
$3K |
| 84702 |
|
334 |
275 |
$2K |
| 84550 |
|
1,031 |
635 |
$2K |
| 36415 |
|
14,781 |
11,957 |
$2K |
| 85027 |
|
932 |
737 |
$2K |
| 86923 |
|
212 |
156 |
$2K |
| 86769 |
|
57 |
56 |
$1K |
| 94060 |
|
14 |
14 |
$1K |
| 85046 |
|
508 |
381 |
$1K |
| 81001 |
|
1,021 |
926 |
$1K |
| G0123 |
Screen cerv/vag thin layer |
108 |
108 |
$1K |
| J9000 |
Doxorubicin hcl injection |
303 |
177 |
$1K |
| 82746 |
|
147 |
146 |
$1K |
| 90671 |
|
12 |
12 |
$933.94 |
| 87305 |
|
322 |
147 |
$885.07 |
| 36591 |
|
63 |
59 |
$830.30 |
| 76856 |
|
12 |
12 |
$780.68 |
| 76830 |
|
12 |
12 |
$780.68 |
| 90472 |
|
12 |
12 |
$776.82 |
| 87625 |
|
40 |
39 |
$614.60 |
| 74160 |
|
43 |
40 |
$566.69 |
| 90471 |
|
42 |
41 |
$515.05 |
| 82533 |
|
50 |
40 |
$505.54 |
| 86800 |
|
61 |
61 |
$487.72 |
| 93005 |
|
340 |
278 |
$468.35 |
| 82570 |
|
167 |
138 |
$445.28 |
| 94760 |
|
623 |
488 |
$441.18 |
| 86706 |
|
109 |
108 |
$437.78 |
| 80307 |
|
13 |
13 |
$424.60 |
| 81003 |
|
401 |
387 |
$356.94 |
| J9263 |
Oxaliplatin |
529 |
239 |
$344.98 |
| 84432 |
|
26 |
26 |
$225.39 |
| 36592 |
|
41 |
37 |
$194.37 |
| 77062 |
|
1,576 |
1,574 |
$190.40 |
| 87389 |
|
12 |
12 |
$183.73 |
| 84295 |
|
240 |
231 |
$175.99 |
| 84132 |
|
250 |
239 |
$170.04 |
| 83036 |
|
28 |
28 |
$156.03 |
| 87799 |
|
17 |
13 |
$150.04 |
| 86140 |
|
72 |
39 |
$143.43 |
| J2704 |
Inj, propofol, 10 mg |
3,279 |
3,046 |
$128.69 |
| 84481 |
|
12 |
12 |
$100.27 |
| 85014 |
|
274 |
263 |
$99.03 |
| 84156 |
|
59 |
48 |
$97.22 |
| J3490 |
Drugs unclassified injection |
24,765 |
8,744 |
$93.35 |
| G0480 |
Drug test def 1-7 classes |
21 |
21 |
$76.68 |
| 77061 |
|
899 |
897 |
$74.10 |
| 84166 |
|
12 |
12 |
$72.69 |
| J1642 |
Inj heparin sodium per 10 u |
7,324 |
4,517 |
$71.71 |
| J8540 |
Oral dexamethasone |
4,915 |
2,718 |
$50.14 |
| 96549 |
|
640 |
394 |
$42.65 |
| J2250 |
Inj midazolam hydrochloride |
2,672 |
2,527 |
$28.27 |
| 88142 |
|
79 |
76 |
$24.14 |
| 81025 |
|
17 |
13 |
$22.56 |
| 96368 |
|
1,110 |
784 |
$21.69 |
| J7050 |
Normal saline solution infus |
6,724 |
4,179 |
$8.63 |
| 82330 |
|
56 |
51 |
$8.59 |
| J1720 |
Hydrocortisone sodium succ i |
557 |
372 |
$8.31 |
| 87070 |
|
13 |
12 |
$4.75 |
| J1200 |
Diphenhydramine hcl injectio |
6,515 |
3,926 |
$3.80 |
| J1100 |
Dexamethasone sodium phos |
5,154 |
3,634 |
$3.33 |
| J7040 |
Normal saline solution infus |
5,237 |
3,269 |
$2.93 |
| J0330 |
Succinycholine chloride inj |
496 |
481 |
$0.94 |
| J2270 |
Morphine sulfate injection |
687 |
572 |
$0.00 |
| C1752 |
Cath,hemodialysis,short-term |
231 |
165 |
$0.00 |
| A9552 |
F18 fdg |
2,510 |
2,494 |
$0.00 |
| A4216 |
Sterile water/saline, 10 ml |
307 |
198 |
$0.00 |
| J7030 |
Normal saline solution infus |
3,797 |
2,143 |
$0.00 |
| J9190 |
Fluorouracil injection |
971 |
471 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
7,264 |
7,073 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
1,252 |
759 |
$0.00 |
| J0640 |
Leucovorin calcium injection |
581 |
345 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
1,280 |
677 |
$0.00 |
| S5000 |
Prescription drug, generic |
1,808 |
1,026 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
541 |
450 |
$0.00 |
| 76937 |
|
910 |
785 |
$0.00 |
| J9201 |
In gemcitabine hcl nos 200mg |
24 |
12 |
$0.00 |
| J1756 |
Iron sucrose injection |
319 |
169 |
$0.00 |
| 76942 |
|
27 |
26 |
$0.00 |
| 94729 |
|
131 |
130 |
$0.00 |
| 82542 |
|
105 |
66 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
12 |
12 |
$0.00 |
| 90713 |
|
12 |
12 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
27 |
25 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
40 |
36 |
$0.00 |
| J0688 |
Inj cefazolin sodium, hikma |
17 |
13 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
37 |
37 |
$0.00 |
| A4648 |
Implantable tissue marker |
1,418 |
1,391 |
$0.00 |
| C1769 |
Guide wire |
788 |
681 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
2,923 |
2,674 |
$0.00 |
| 77417 |
|
534 |
326 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
1,243 |
861 |
$0.00 |
| J3480 |
Inj potassium chloride |
424 |
267 |
$0.00 |
| J7060 |
5% dextrose/water |
2,977 |
1,941 |
$0.00 |
| Q0162 |
Ondansetron oral |
1,257 |
668 |
$0.00 |
| J1170 |
Hydromorphone injection |
712 |
511 |
$0.00 |
| A9503 |
Tc99m medronate |
503 |
502 |
$0.00 |
| J2060 |
Lorazepam injection |
204 |
135 |
$0.00 |
| A9585 |
Gadobutrol injection |
1,295 |
1,258 |
$0.00 |
| J2765 |
Metoclopramide hcl injection |
203 |
85 |
$0.00 |
| 77001 |
|
354 |
290 |
$0.00 |
| C1892 |
Intro/sheath,fixed,peel-away |
108 |
97 |
$0.00 |
| 83883 |
|
89 |
80 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
85 |
74 |
$0.00 |
| J9074 |
Inj, cyclophosphamd, sandoz |
18 |
12 |
$0.00 |
| 36410 |
|
14 |
14 |
$0.00 |
| J0610 |
Calcium glucon (fresenius) |
362 |
232 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
27 |
26 |
$0.00 |
| J2001 |
Lidocaine injection |
13 |
12 |
$0.00 |
| 96376 |
|
83 |
57 |
$0.00 |
| A9579 |
Gad-base mr contrast nos,1ml |
50 |
47 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
25 |
24 |
$0.00 |
| J9202 |
Goserelin acetate implant |
12 |
12 |
$0.00 |
| J7613 |
Albuterol non-comp unit |
16 |
12 |
$0.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
22 |
12 |
$0.00 |
| A9560 |
Tc99m labeled rbc |
13 |
12 |
$0.00 |