| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
44,927 |
41,431 |
$8.19M |
| U0003 |
Cov-19 amp prb hgh thruput |
57,520 |
53,719 |
$5.05M |
| 99283 |
|
24,204 |
23,170 |
$3.25M |
| 99284 |
|
21,139 |
19,626 |
$2.99M |
| G0378 |
Hospital observation per hr |
2,595 |
2,434 |
$2.21M |
| T1015 |
Clinic service |
51,623 |
21,203 |
$2.11M |
| 81513 |
|
5,290 |
5,132 |
$556K |
| 87491 |
|
19,346 |
18,871 |
$497K |
| 0241U |
|
5,846 |
5,728 |
$475K |
| G0480 |
Drug test def 1-7 classes |
7,768 |
7,095 |
$470K |
| 80053 |
|
47,985 |
45,062 |
$458K |
| 74177 |
|
3,222 |
3,122 |
$438K |
| 87591 |
|
16,821 |
16,372 |
$380K |
| U0005 |
Infec agen detec ampli probe |
34,259 |
31,789 |
$377K |
| 77067 |
|
3,896 |
3,845 |
$342K |
| 36415 |
|
103,408 |
90,143 |
$339K |
| 85025 |
|
69,445 |
64,323 |
$322K |
| 0202U |
|
2,236 |
2,154 |
$321K |
| 76816 |
|
6,653 |
6,219 |
$306K |
| 80061 |
|
19,874 |
19,474 |
$285K |
| 80050 |
|
5,969 |
5,839 |
$282K |
| 99282 |
|
2,385 |
2,294 |
$254K |
| 93005 |
|
28,938 |
27,147 |
$243K |
| 88175 |
|
7,420 |
7,328 |
$241K |
| 84702 |
|
16,824 |
15,262 |
$217K |
| 96374 |
|
10,269 |
9,516 |
$211K |
| 87661 |
|
6,410 |
6,244 |
$208K |
| 82306 |
|
5,314 |
5,220 |
$206K |
| 80307 |
|
4,013 |
3,756 |
$202K |
| 87536 |
|
1,684 |
1,656 |
$197K |
| 97110 |
|
5,911 |
1,850 |
$194K |
| 84443 |
|
8,492 |
8,229 |
$191K |
| 87624 |
|
3,585 |
3,520 |
$151K |
| 70553 |
|
646 |
638 |
$151K |
| 87389 |
|
5,027 |
4,936 |
$147K |
| 80048 |
|
21,281 |
18,780 |
$147K |
| 71046 |
|
11,170 |
10,759 |
$146K |
| 76819 |
|
2,563 |
1,493 |
$141K |
| 87481 |
|
2,413 |
2,241 |
$137K |
| 76811 |
|
1,310 |
1,295 |
$132K |
| 62323 |
|
663 |
655 |
$131K |
| 92507 |
|
6,780 |
2,336 |
$125K |
| 83036 |
|
18,066 |
17,703 |
$125K |
| 97161 |
|
2,181 |
2,069 |
$124K |
| 80081 |
|
1,339 |
1,319 |
$119K |
| 70450 |
|
2,348 |
2,231 |
$116K |
| 87086 |
|
14,686 |
13,788 |
$116K |
| 71275 |
|
831 |
800 |
$111K |
| 95700 |
|
598 |
588 |
$106K |
| 86803 |
|
5,195 |
5,102 |
$105K |
| C9803 |
Hopd covid-19 spec collect |
9,327 |
8,684 |
$104K |
| 78815 |
|
104 |
102 |
$101K |
| J7307 |
Etonogestrel implant system |
261 |
250 |
$101K |
| 72148 |
|
595 |
587 |
$100K |
| 95708 |
|
654 |
568 |
$99K |
| 70551 |
|
477 |
464 |
$96K |
| 73721 |
|
341 |
334 |
$93K |
| 93306 |
|
1,210 |
1,189 |
$91K |
| 77063 |
|
3,895 |
3,844 |
$90K |
| 76830 |
|
1,913 |
1,832 |
$87K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
14,802 |
13,400 |
$83K |
| 72141 |
|
338 |
335 |
$80K |
| 87651 |
|
991 |
957 |
$78K |
| 94640 |
|
1,239 |
1,143 |
$77K |
| 96361 |
|
7,136 |
6,482 |
$75K |
| 96375 |
|
5,735 |
4,930 |
$72K |
| 87798 |
|
2,763 |
2,691 |
$70K |
| 76856 |
|
1,645 |
1,595 |
$68K |
| 87902 |
|
293 |
279 |
$66K |
| 95800 |
|
617 |
606 |
$63K |
| 73221 |
|
223 |
216 |
$61K |
| 81001 |
|
24,354 |
22,977 |
$60K |
| 76817 |
|
1,094 |
926 |
$59K |
| 78431 |
|
132 |
130 |
$59K |
| 76705 |
|
1,755 |
1,699 |
$57K |
| 97162 |
|
1,249 |
1,188 |
$56K |
| 93971 |
|
880 |
836 |
$56K |
| 96372 |
|
6,406 |
5,197 |
$56K |
| 88305 |
|
3,379 |
3,245 |
$54K |
| 64483 |
|
211 |
207 |
$51K |
| 96365 |
|
2,047 |
1,708 |
$48K |
| 99212 |
|
1,378 |
1,099 |
$47K |
| 84466 |
|
2,766 |
2,693 |
$46K |
| 93975 |
|
433 |
415 |
$45K |
| 70498 |
|
410 |
399 |
$43K |
| 71250 |
|
678 |
673 |
$43K |
| 73610 |
|
2,146 |
1,896 |
$42K |
| 73630 |
|
3,250 |
2,838 |
$42K |
| 74176 |
|
620 |
602 |
$41K |
| 84484 |
|
5,160 |
4,355 |
$41K |
| 85027 |
|
7,062 |
5,984 |
$41K |
| 77066 |
Tomosynthesis, mammo |
447 |
435 |
$41K |
| 86359 |
|
804 |
791 |
$41K |
| 70496 |
|
384 |
373 |
$41K |
| 76805 |
|
763 |
750 |
$40K |
| 87653 |
|
980 |
964 |
$40K |
| 93970 |
|
492 |
477 |
$40K |
| 71260 |
|
590 |
582 |
$40K |
| 96413 |
|
379 |
314 |
$39K |
| 11042 |
|
1,022 |
792 |
$39K |
| 82607 |
|
3,159 |
3,083 |
$39K |
| 86480 |
|
511 |
500 |
$39K |
| 76818 |
|
585 |
330 |
$38K |
| 97112 |
|
1,710 |
688 |
$38K |
| 76642 |
|
898 |
870 |
$38K |
| 97140 |
|
1,547 |
535 |
$38K |
| 76801 |
|
953 |
875 |
$37K |
| 81002 |
|
1,537 |
1,225 |
$37K |
| 83735 |
|
7,834 |
6,502 |
$37K |
| 83880 |
|
1,370 |
1,250 |
$37K |
| Q9957 |
Inj perflutren lip micros,ml |
1,461 |
1,430 |
$36K |
| 73564 |
|
1,704 |
1,471 |
$36K |
| 72125 |
|
698 |
662 |
$35K |
| 76536 |
|
681 |
666 |
$34K |
| 87633 |
|
61 |
60 |
$33K |
| 76813 |
|
597 |
590 |
$33K |
| 77065 |
Tomosynthesis, mammo |
478 |
437 |
$33K |
| 64493 |
|
162 |
143 |
$33K |
| 87636 |
|
304 |
304 |
$33K |
| 87522 |
Neg quan hep c or qual rna |
768 |
731 |
$32K |
| 95886 |
|
664 |
651 |
$32K |
| 85610 |
|
9,056 |
6,152 |
$32K |
| J1050 |
Medroxyprogesterone acetate |
926 |
924 |
$31K |
| 87799 |
|
402 |
387 |
$31K |
| 99213 |
|
1,101 |
1,019 |
$29K |
| 87563 |
|
903 |
872 |
$28K |
| 82570 |
|
3,875 |
3,711 |
$28K |
| 83690 |
|
7,308 |
6,854 |
$27K |
| 96360 |
|
1,328 |
1,194 |
$26K |
| G0108 |
Diab manage trn per indiv |
504 |
437 |
$26K |
| 93017 |
|
759 |
734 |
$26K |
| 83540 |
|
3,059 |
2,983 |
$25K |
| J2785 |
Regadenoson injection |
888 |
857 |
$25K |
| 95810 |
|
95 |
95 |
$25K |
| 87077 |
|
3,300 |
3,158 |
$25K |
| 12001 |
|
137 |
130 |
$25K |
| 86361 |
|
830 |
815 |
$25K |
| 95911 |
|
358 |
351 |
$25K |
| 96376 |
|
1,789 |
1,084 |
$25K |
| 97530 |
|
980 |
463 |
$24K |
| 84439 |
|
2,946 |
2,855 |
$24K |
| 76770 |
|
549 |
539 |
$24K |
| 87340 |
|
1,616 |
1,581 |
$24K |
| 19083 |
|
69 |
67 |
$24K |
| 82728 |
|
2,071 |
2,012 |
$24K |
| 0042T |
|
143 |
137 |
$24K |
| 82043 |
|
2,812 |
2,744 |
$23K |
| 86618 |
|
931 |
909 |
$23K |
| 75574 |
|
119 |
117 |
$23K |
| 74183 |
|
52 |
52 |
$22K |
| 83655 |
|
1,936 |
1,886 |
$22K |
| 87186 |
|
2,640 |
2,527 |
$22K |
| 95811 |
|
48 |
47 |
$22K |
| 76700 |
|
378 |
368 |
$22K |
| 84403 |
|
746 |
736 |
$22K |
| 73030 |
|
1,473 |
1,333 |
$22K |
| 97165 |
|
423 |
409 |
$21K |
| 94729 |
|
727 |
711 |
$21K |
| 88342 |
|
512 |
496 |
$20K |
| 72100 |
|
963 |
944 |
$20K |
| 83970 |
|
520 |
508 |
$20K |
| 70486 |
|
309 |
303 |
$20K |
| 83013 |
|
295 |
288 |
$19K |
| 72110 |
|
889 |
874 |
$19K |
| 87529 |
|
357 |
350 |
$19K |
| 84146 |
|
756 |
748 |
$19K |
| 86850 |
|
2,514 |
2,375 |
$19K |
| 86592 |
|
4,386 |
4,312 |
$18K |
| 73502 |
|
998 |
897 |
$18K |
| 82784 |
|
912 |
884 |
$18K |
| 76820 |
|
692 |
339 |
$18K |
| 87801 |
|
447 |
435 |
$17K |
| A9577 |
Inj multihance |
2,467 |
2,391 |
$17K |
| 93325 |
|
417 |
409 |
$17K |
| 86038 |
|
1,054 |
1,024 |
$17K |
| 94726 |
|
597 |
584 |
$16K |
| 87493 |
|
421 |
407 |
$16K |
| 82105 |
|
722 |
708 |
$15K |
| 84402 |
|
542 |
536 |
$15K |
| 87635 |
|
369 |
365 |
$15K |
| 73562 |
|
930 |
789 |
$14K |
| 12011 |
|
54 |
53 |
$14K |
| 86140 |
|
4,979 |
4,346 |
$14K |
| 82947 |
|
5,580 |
4,353 |
$14K |
| 71045 |
|
2,672 |
2,504 |
$14K |
| 85652 |
|
4,594 |
4,114 |
$13K |
| 83516 |
|
712 |
688 |
$13K |
| 73130 |
|
1,220 |
1,016 |
$13K |
| 84153 |
|
529 |
514 |
$13K |
| 74178 |
|
60 |
58 |
$12K |
| 70491 |
|
157 |
155 |
$12K |
| 86003 |
|
128 |
120 |
$12K |
| 76870 |
|
280 |
271 |
$12K |
| 80076 |
|
1,264 |
1,198 |
$12K |
| 95819 |
|
978 |
967 |
$12K |
| 72050 |
|
435 |
427 |
$11K |
| 82248 |
|
2,148 |
1,908 |
$11K |
| 87512 |
|
454 |
439 |
$11K |
| 83001 |
|
583 |
572 |
$11K |
| 82746 |
|
1,011 |
983 |
$10K |
| 87040 |
|
804 |
729 |
$10K |
| 86235 |
|
189 |
181 |
$10K |
| 73110 |
|
924 |
825 |
$10K |
| 84481 |
|
411 |
400 |
$10K |
| G0471 |
Ven blood coll snf/hha |
2,061 |
1,103 |
$10K |
| 77336 |
|
304 |
139 |
$10K |
| 93350 |
|
239 |
232 |
$10K |
| 81220 |
|
27 |
27 |
$10K |
| 86706 |
|
696 |
681 |
$10K |
| 74018 |
|
780 |
738 |
$10K |
| 77062 |
|
408 |
399 |
$10K |
| 85379 |
|
1,268 |
1,217 |
$9K |
| 82565 |
|
1,985 |
1,827 |
$9K |
| G0472 |
Hep c screen high risk/other |
442 |
435 |
$9K |
| 80074 |
|
170 |
166 |
$9K |
| 12002 |
|
30 |
27 |
$9K |
| 93880 |
|
115 |
113 |
$9K |
| 72197 |
|
25 |
24 |
$9K |
| 82803 |
|
561 |
521 |
$9K |
| 83605 |
|
1,904 |
1,714 |
$9K |
| 99211 |
|
240 |
230 |
$9K |
| 86765 |
|
683 |
667 |
$9K |
| 93320 |
|
262 |
253 |
$9K |
| 86900 |
|
2,497 |
2,236 |
$9K |
| 11981 |
|
38 |
38 |
$9K |
| 97166 |
|
277 |
267 |
$9K |
| C1769 |
Guide wire |
259 |
246 |
$9K |
| 86901 |
|
2,480 |
2,227 |
$8K |
| 86762 |
|
447 |
436 |
$8K |
| G0476 |
Hpv combo assay ca screen |
273 |
273 |
$8K |
| 90715 |
|
1,680 |
1,568 |
$8K |
| 97014 |
|
398 |
176 |
$8K |
| 87209 |
|
362 |
356 |
$8K |
| 95909 |
|
165 |
164 |
$8K |
| 82670 |
|
346 |
324 |
$8K |
| 82950 |
|
1,104 |
1,088 |
$8K |
| 86696 |
|
280 |
268 |
$8K |
| 85730 |
|
1,648 |
1,520 |
$8K |
| C1894 |
Intro/sheath, non-laser |
175 |
168 |
$7K |
| 77061 |
|
329 |
325 |
$7K |
| 81025 |
|
1,497 |
1,432 |
$7K |
| 86160 |
|
247 |
238 |
$7K |
| 80164 |
|
422 |
398 |
$7K |
| 73590 |
|
509 |
440 |
$7K |
| 81596 |
|
118 |
114 |
$7K |
| 80069 |
|
798 |
658 |
$7K |
| 73560 |
|
446 |
387 |
$7K |
| 94060 |
|
702 |
686 |
$7K |
| 77412 |
|
245 |
25 |
$7K |
| 72040 |
|
455 |
443 |
$7K |
| 43239 |
|
76 |
76 |
$7K |
| 93923 |
|
145 |
140 |
$7K |
| 86704 |
|
414 |
400 |
$7K |
| 86695 |
|
285 |
273 |
$7K |
| 82652 |
|
162 |
160 |
$7K |
| 87210 |
|
644 |
628 |
$7K |
| 96040 |
|
228 |
226 |
$6K |
| 82627 |
|
260 |
259 |
$6K |
| 99214 |
|
309 |
289 |
$6K |
| 82550 |
|
964 |
840 |
$6K |
| 83002 |
|
334 |
321 |
$6K |
| J2270 |
Morphine sulfate injection |
3,439 |
2,682 |
$6K |
| 84100 |
|
1,505 |
1,135 |
$6K |
| 83993 |
|
234 |
229 |
$6K |
| 87427 |
|
440 |
436 |
$5K |
| 77334 |
|
72 |
54 |
$5K |
| 71271 |
|
58 |
58 |
$5K |
| 72131 |
|
89 |
87 |
$5K |
| 86431 |
|
605 |
589 |
$5K |
| 99291 |
|
44 |
42 |
$5K |
| 84134 |
|
370 |
324 |
$5K |
| 83921 |
|
250 |
245 |
$5K |
| 74174 |
|
25 |
25 |
$5K |
| 73090 |
|
409 |
340 |
$5K |
| 73080 |
|
427 |
378 |
$5K |
| J1756 |
Iron sucrose injection |
1,429 |
697 |
$5K |
| 86708 |
|
283 |
274 |
$5K |
| 97164 |
|
119 |
116 |
$5K |
| 99281 |
|
72 |
71 |
$5K |
| 82805 |
|
198 |
182 |
$4K |
| 87640 |
|
108 |
105 |
$4K |
| 84550 |
|
694 |
652 |
$4K |
| G0463 |
Hospital outpt clinic visit |
522 |
476 |
$4K |
| 99215 |
Prolong outpt/office vis |
40 |
38 |
$4K |
| 86705 |
|
251 |
242 |
$4K |
| 82951 |
|
306 |
303 |
$4K |
| 84156 |
|
1,043 |
932 |
$4K |
| 83021 |
|
198 |
194 |
$4K |
| 72072 |
|
197 |
194 |
$4K |
| 87070 |
|
573 |
546 |
$4K |
| 86200 |
|
268 |
264 |
$4K |
| 36430 |
|
32 |
24 |
$4K |
| 76942 |
|
145 |
139 |
$4K |
| 77080 |
|
76 |
75 |
$4K |
| 86360 |
|
56 |
55 |
$4K |
| 83721 |
|
374 |
369 |
$4K |
| 86147 |
|
42 |
42 |
$4K |
| 76815 |
|
111 |
107 |
$4K |
| 75561 |
|
12 |
12 |
$4K |
| J1170 |
Hydromorphone injection |
1,505 |
951 |
$4K |
| 73140 |
|
449 |
420 |
$4K |
| 84520 |
|
1,196 |
1,091 |
$4K |
| 96366 |
|
595 |
415 |
$4K |
| 90471 |
|
552 |
514 |
$4K |
| 88312 |
|
71 |
69 |
$4K |
| 87150 |
|
86 |
86 |
$4K |
| 73552 |
|
258 |
233 |
$4K |
| 84165 |
|
247 |
238 |
$4K |
| 88341 |
|
96 |
92 |
$4K |
| G0008 |
Admin influenza virus vac |
599 |
589 |
$4K |
| 87339 |
|
271 |
269 |
$4K |
| 87081 |
|
682 |
671 |
$4K |
| 78452 |
|
14 |
13 |
$4K |
| 72146 |
|
24 |
24 |
$4K |
| 80051 |
|
823 |
780 |
$4K |
| 87328 |
|
240 |
235 |
$4K |
| 62321 |
|
12 |
12 |
$4K |
| A9585 |
Gadobutrol injection |
602 |
580 |
$4K |
| 72082 |
|
93 |
92 |
$4K |
| 73718 |
|
13 |
13 |
$3K |
| 96367 |
|
367 |
305 |
$3K |
| 83615 |
|
532 |
486 |
$3K |
| J3301 |
Triamcinolone acet inj nos |
1,246 |
1,163 |
$3K |
| 83020 |
|
275 |
269 |
$3K |
| 86039 |
|
212 |
205 |
$3K |
| 87045 |
|
444 |
440 |
$3K |
| 84425 |
|
430 |
425 |
$3K |
| 86255 |
|
180 |
173 |
$3K |
| 87329 |
|
240 |
235 |
$3K |
| 81329 |
|
25 |
25 |
$3K |
| 83498 |
|
137 |
137 |
$3K |
| 97802 |
|
41 |
39 |
$3K |
| 82977 |
|
342 |
291 |
$3K |
| 87177 |
|
360 |
354 |
$3K |
| 73100 |
|
221 |
187 |
$3K |
| 78434 |
|
132 |
130 |
$3K |
| 97535 |
|
109 |
55 |
$3K |
| 86800 |
|
146 |
142 |
$3K |
| 88142 |
|
150 |
145 |
$3K |
| J0780 |
Prochlorperazine injection |
2,311 |
1,998 |
$3K |
| J3490 |
Drugs unclassified injection |
3,237 |
1,197 |
$3K |
| 81003 |
|
779 |
766 |
$3K |
| J1885 |
Ketorolac tromethamine inj |
14,212 |
12,445 |
$3K |
| 83525 |
|
213 |
210 |
$3K |
| 92611 |
|
95 |
95 |
$3K |
| C1729 |
Cath, drainage |
67 |
46 |
$3K |
| 97163 |
|
53 |
50 |
$3K |
| 86787 |
|
120 |
117 |
$2K |
| 82533 |
|
210 |
202 |
$2K |
| 76882 |
|
331 |
321 |
$2K |
| J3475 |
Inj magnesium sulfate |
2,694 |
2,185 |
$2K |
| 84295 |
|
729 |
674 |
$2K |
| 87797 |
|
112 |
111 |
$2K |
| 76641 |
|
42 |
42 |
$2K |
| 80178 |
|
297 |
262 |
$2K |
| 84132 |
|
731 |
670 |
$2K |
| 96415 |
|
63 |
57 |
$2K |
| 86376 |
|
279 |
275 |
$2K |
| 86146 |
|
30 |
30 |
$2K |
| 84460 |
|
361 |
327 |
$2K |
| 87480 |
|
112 |
112 |
$2K |
| 87015 |
|
327 |
302 |
$2K |
| 82310 |
|
552 |
485 |
$2K |
| 84450 |
|
361 |
326 |
$2K |
| 87046 |
|
445 |
440 |
$2K |
| 82247 |
|
359 |
303 |
$2K |
| 93321 |
|
103 |
102 |
$2K |
| 86617 |
|
65 |
65 |
$2K |
| 87147 |
|
418 |
403 |
$2K |
| 87660 |
|
113 |
112 |
$2K |
| 94375 |
|
142 |
137 |
$2K |
| 82435 |
|
661 |
617 |
$2K |
| S9470 |
Nutritional counseling, diet |
93 |
91 |
$2K |
| 83520 |
|
139 |
131 |
$2K |
| 87205 |
|
457 |
440 |
$2K |
| J7030 |
Normal saline solution infus |
4,523 |
3,785 |
$2K |
| A9552 |
F18 fdg |
24 |
24 |
$2K |
| 88304 |
|
325 |
312 |
$2K |
| 71101 |
|
126 |
122 |
$2K |
| 80055 |
|
136 |
135 |
$2K |
| 93976 |
|
29 |
27 |
$2K |
| 73700 |
|
32 |
32 |
$2K |
| A4648 |
Implantable tissue marker |
14 |
14 |
$2K |
| 20553 |
|
67 |
66 |
$2K |
| 88313 |
|
26 |
25 |
$2K |
| 72070 |
|
102 |
101 |
$2K |
| 90686 |
|
612 |
600 |
$2K |
| T1001 |
Nursing assessment/evaluatn |
12 |
12 |
$2K |
| J2930 |
Methylprednisolone injection |
536 |
420 |
$2K |
| 95816 |
|
134 |
130 |
$2K |
| 85046 |
|
261 |
246 |
$2K |
| 82103 |
|
88 |
87 |
$2K |
| J1100 |
Dexamethasone sodium phos |
6,624 |
5,796 |
$2K |
| 87631 |
|
14 |
14 |
$2K |
| 84145 |
|
194 |
131 |
$2K |
| 73660 |
|
177 |
168 |
$2K |
| 72158 |
|
13 |
13 |
$2K |
| 84144 |
|
101 |
82 |
$2K |
| 85014 |
|
689 |
642 |
$1K |
| 82150 |
|
274 |
262 |
$1K |
| J0696 |
Ceftriaxone sodium injection |
2,458 |
2,015 |
$1K |
| 87517 |
|
36 |
34 |
$1K |
| 73060 |
|
148 |
132 |
$1K |
| 64494 |
|
49 |
26 |
$1K |
| J2704 |
Inj, propofol, 10 mg |
2,815 |
2,486 |
$1K |
| 88307 |
|
151 |
146 |
$1K |
| 82140 |
|
310 |
232 |
$1K |
| 51701 |
|
84 |
84 |
$1K |
| A9270 |
Non-covered item or service |
2,160 |
461 |
$1K |
| 73000 |
|
108 |
97 |
$1K |
| J2405 |
Ondansetron hcl injection |
11,219 |
9,040 |
$1K |
| 73200 |
|
12 |
12 |
$1K |
| 86308 |
|
167 |
165 |
$1K |
| 84480 |
|
131 |
130 |
$1K |
| 84305 |
|
39 |
39 |
$1K |
| 77073 |
|
48 |
48 |
$1K |
| 82952 |
|
304 |
300 |
$1K |
| 74230 |
|
56 |
56 |
$1K |
| 72170 |
|
134 |
129 |
$1K |
| 84155 |
|
264 |
253 |
$1K |
| 82274 |
|
317 |
310 |
$1K |
| 87075 |
|
129 |
121 |
$1K |
| 74019 |
|
78 |
76 |
$995.77 |
| 87350 |
|
98 |
96 |
$962.31 |
| 82390 |
|
89 |
87 |
$960.50 |
| 93308 |
|
54 |
51 |
$959.22 |
| 93304 |
|
50 |
50 |
$950.48 |
| 84432 |
|
39 |
36 |
$901.92 |
| 83986 |
|
53 |
53 |
$898.95 |
| 82040 |
|
322 |
299 |
$891.37 |
| G2023 |
Specimen collect covid-19 |
37 |
36 |
$883.75 |
| J1750 |
Inj iron dextran |
397 |
359 |
$878.20 |
| 94618 |
|
112 |
107 |
$853.59 |
| 80177 |
|
53 |
50 |
$849.92 |
| J1630 |
Haloperidol injection |
2,355 |
1,811 |
$832.39 |
| 82164 |
|
40 |
39 |
$821.87 |
| 84681 |
|
26 |
26 |
$812.59 |
| J0690 |
Cefazolin sodium injection |
1,020 |
710 |
$809.44 |
| 80175 |
|
64 |
63 |
$803.10 |
| 86304 |
|
39 |
37 |
$766.25 |
| 85384 |
|
98 |
89 |
$738.12 |
| A9555 |
Rb82 rubidium |
115 |
95 |
$713.20 |
| 88173 |
|
14 |
12 |
$709.36 |
| J1200 |
Diphenhydramine hcl injectio |
3,768 |
3,169 |
$688.84 |
| 86735 |
|
42 |
42 |
$681.98 |
| J1644 |
Inj heparin sodium per 1000u |
3,659 |
1,510 |
$668.06 |
| 89051 |
|
77 |
73 |
$662.12 |
| J3010 |
Fentanyl citrate injection |
3,664 |
2,726 |
$658.47 |
| 82010 |
|
194 |
171 |
$608.99 |
| J3370 |
Vancomycin hcl injection |
178 |
85 |
$607.73 |
| 84075 |
|
135 |
125 |
$573.89 |
| 86665 |
|
13 |
13 |
$564.11 |
| J1650 |
Inj enoxaparin sodium |
2,159 |
1,005 |
$561.59 |
| 80197 |
|
38 |
24 |
$553.54 |
| J1815 |
Insulin injection |
1,957 |
866 |
$545.12 |
| 73070 |
|
47 |
40 |
$532.26 |
| 80305 |
|
57 |
48 |
$528.45 |
| 82330 |
|
153 |
126 |
$527.92 |
| 0001A |
|
14 |
14 |
$521.17 |
| 74220 |
|
38 |
38 |
$511.70 |
| 73600 |
|
43 |
39 |
$486.36 |
| J2060 |
Lorazepam injection |
2,334 |
1,720 |
$478.32 |
| Q3014 |
Telehealth facility fee |
187 |
166 |
$476.44 |
| J2765 |
Metoclopramide hcl injection |
1,865 |
1,577 |
$469.75 |
| 77002 |
|
14 |
14 |
$467.07 |
| 82378 |
|
28 |
27 |
$466.65 |
| 74246 |
|
13 |
13 |
$426.39 |
| G0103 |
Psa screening |
27 |
27 |
$397.71 |
| J2795 |
Ropivacaine hcl injection |
68 |
63 |
$391.13 |
| J2550 |
Promethazine hcl injection |
531 |
374 |
$386.25 |
| 85018 |
|
117 |
113 |
$384.78 |
| J3480 |
Inj potassium chloride |
435 |
304 |
$382.66 |
| 86923 |
|
16 |
12 |
$382.20 |
| 86334 |
|
12 |
12 |
$375.20 |
| J1030 |
Methylprednisolone 40 mg inj |
505 |
494 |
$364.99 |
| 90688 |
|
44 |
44 |
$358.50 |
| 89055 |
|
77 |
77 |
$347.92 |
| 77280 |
|
14 |
12 |
$343.96 |
| 85613 |
|
28 |
26 |
$314.19 |
| 82374 |
|
62 |
62 |
$290.83 |
| Q0162 |
Ondansetron oral |
1,512 |
1,213 |
$288.37 |
| 88112 |
|
12 |
12 |
$287.18 |
| 84445 |
|
12 |
12 |
$276.00 |
| J2710 |
Neostigmine methylslfte inj |
347 |
243 |
$266.53 |
| J1720 |
Hydrocortisone sodium succ i |
27 |
24 |
$261.97 |
| 93922 |
|
13 |
12 |
$224.97 |
| 83883 |
|
13 |
13 |
$219.19 |
| 80047 |
|
128 |
99 |
$204.88 |
| 80183 |
|
13 |
12 |
$203.32 |
| 82785 |
|
17 |
15 |
$198.35 |
| 82272 |
|
88 |
85 |
$190.02 |
| A9503 |
Tc99m medronate |
15 |
15 |
$189.77 |
| 82656 |
|
13 |
12 |
$169.90 |
| C9113 |
Inj pantoprazole sodium, via |
240 |
145 |
$167.91 |
| J7512 |
Prednisone ir or dr oral 1mg |
2,199 |
1,706 |
$165.37 |
| 73650 |
|
16 |
13 |
$155.20 |
| 86870 |
|
14 |
14 |
$133.09 |
| 86593 |
|
24 |
24 |
$128.16 |
| J2250 |
Inj midazolam hydrochloride |
1,673 |
1,396 |
$123.57 |
| 87102 |
|
15 |
15 |
$107.23 |
| 76937 |
|
17 |
16 |
$98.98 |
| 90480 |
|
12 |
12 |
$94.27 |
| G0009 |
Admin pneumococcal vaccine |
12 |
12 |
$87.50 |
| J3411 |
Thiamine hcl 100 mg |
51 |
29 |
$70.31 |
| 84300 |
|
12 |
12 |
$62.16 |
| 88311 |
|
12 |
12 |
$47.98 |
| 82270 |
|
15 |
13 |
$47.03 |
| J7050 |
Normal saline solution infus |
1,692 |
1,083 |
$36.07 |
| 99152 |
|
12 |
12 |
$34.01 |
| J8597 |
Antiemetic drug oral nos |
90 |
78 |
$25.29 |
| 99395 |
|
28 |
28 |
$23.00 |
| J7510 |
Prednisolone oral per 5 mg |
65 |
58 |
$20.76 |
| J2920 |
Methylprednisolone injection |
55 |
40 |
$16.51 |
| J0330 |
Succinycholine chloride inj |
39 |
25 |
$15.82 |
| J0360 |
Hydralazine hcl injection |
14 |
12 |
$13.04 |
| J1940 |
Furosemide injection |
18 |
13 |
$1.38 |
| J7620 |
Albuterol ipratrop non-comp |
14 |
14 |
$1.01 |
| G1010 |
Cdsm stanson |
924 |
841 |
$0.07 |
| J3420 |
Vitamin b12 injection |
64 |
54 |
$0.00 |
| J2469 |
Palonosetron hcl |
144 |
94 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
29 |
15 |
$0.00 |
| J3590 |
Unclassified biologics |
25 |
13 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
68 |
28 |
$0.00 |
| J1010 |
Inj, methylpred acetate 1 mg |
94 |
94 |
$0.00 |
| 90677 |
|
83 |
75 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
12 |
12 |
$0.00 |
| A9500 |
Tc99m sestamibi |
29 |
29 |
$0.00 |
| J2272 |
Inj, morphine (fresenius) |
1,119 |
919 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,236 |
935 |
$0.00 |
| J7040 |
Normal saline solution infus |
252 |
216 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
133 |
98 |
$0.00 |
| 36592 |
|
16 |
15 |
$0.00 |
| 91320 |
|
66 |
66 |
$0.00 |
| J7120 |
Ringers lactate infusion |
108 |
84 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
39 |
25 |
$0.00 |
| J1953 |
Levetiracetam injection |
13 |
13 |
$0.00 |
| J9271 |
Inj pembrolizumab |
15 |
12 |
$0.00 |
| J1745 |
Infliximab not biosimil 10mg |
73 |
63 |
$0.00 |
| 90662 |
|
25 |
24 |
$0.00 |
| J1020 |
Methylprednisolone 20 mg inj |
69 |
65 |
$0.00 |