| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0378 |
Hospital observation per hr |
27,652 |
22,740 |
$25.31M |
| 99285 |
|
38,084 |
33,963 |
$15.20M |
| 99284 |
|
38,932 |
35,987 |
$14.86M |
| 99283 |
|
57,378 |
52,667 |
$14.36M |
| 96413 |
|
22,369 |
12,837 |
$8.45M |
| OP250 |
|
177,652 |
104,119 |
$7.79M |
| J1745 |
Infliximab not biosimil 10mg |
1,755 |
1,601 |
$7.00M |
| 99282 |
|
34,958 |
33,044 |
$6.73M |
| J9271 |
Inj pembrolizumab |
888 |
600 |
$5.39M |
| 43239 |
|
3,299 |
3,160 |
$4.16M |
| J2505 |
Injection, pegfilgrastim 6mg |
766 |
596 |
$3.75M |
| 41899 |
|
1,458 |
1,430 |
$2.75M |
| OP710 |
|
26,544 |
25,129 |
$2.58M |
| 96375 |
|
29,083 |
21,095 |
$2.34M |
| 80053 |
|
113,216 |
85,411 |
$2.23M |
| 42820 |
|
1,165 |
1,154 |
$2.06M |
| 77386 |
|
4,695 |
413 |
$1.82M |
| 45380 |
|
2,239 |
2,141 |
$1.77M |
| 77334 |
|
2,018 |
1,432 |
$1.72M |
| 96415 |
|
7,577 |
5,351 |
$1.64M |
| OP370 |
|
35,010 |
32,967 |
$1.61M |
| 96365 |
|
14,899 |
9,636 |
$1.58M |
| 36430 |
|
5,946 |
3,072 |
$1.44M |
| J1561 |
Gamunex-c/gammaked |
991 |
372 |
$1.31M |
| 69436 |
|
1,357 |
1,345 |
$1.28M |
| 93306 |
|
2,593 |
2,468 |
$1.23M |
| J2506 |
Inj pegfilgrast ex bio 0.5mg |
820 |
501 |
$1.16M |
| OP272 |
|
18,633 |
16,799 |
$1.09M |
| 74177 |
|
9,017 |
8,531 |
$1.08M |
| OP270 |
|
16,932 |
16,324 |
$1.02M |
| Q5119 |
Inj ruxience, 10 mg |
668 |
292 |
$986K |
| 96361 |
|
17,706 |
12,993 |
$971K |
| 85025 |
|
123,431 |
98,194 |
$954K |
| U0004 |
Cov-19 test non-cdc hgh thru |
15,362 |
14,032 |
$952K |
| J9355 |
Inj trastuzumab excl biosimi |
231 |
139 |
$906K |
| 97110 |
|
26,664 |
7,719 |
$903K |
| 96417 |
|
6,203 |
3,652 |
$882K |
| 96374 |
|
24,063 |
21,483 |
$868K |
| 54161 |
|
535 |
522 |
$852K |
| 88305 |
|
13,032 |
12,089 |
$810K |
| 99291 |
|
4,123 |
3,965 |
$805K |
| OP278 |
|
3,277 |
3,081 |
$795K |
| 96411 |
|
3,003 |
1,878 |
$793K |
| 45378 |
|
786 |
763 |
$770K |
| 93005 |
|
32,128 |
28,004 |
$728K |
| 77336 |
|
4,775 |
2,175 |
$717K |
| 70450 |
|
11,356 |
10,533 |
$687K |
| 77412 |
|
3,079 |
340 |
$679K |
| 92587 |
|
5,617 |
5,528 |
$666K |
| 59025 |
|
2,683 |
1,865 |
$664K |
| 96372 |
|
16,409 |
12,565 |
$647K |
| 87636 |
|
7,328 |
6,626 |
$626K |
| 11042 |
|
3,901 |
1,903 |
$577K |
| J9045 |
Carboplatin injection |
1,415 |
878 |
$560K |
| 77300 |
|
1,274 |
1,149 |
$537K |
| 96409 |
|
2,554 |
1,556 |
$522K |
| Q5116 |
Inj., trazimera, 10 mg |
257 |
158 |
$504K |
| Q5117 |
Inj., kanjinti, 10 mg |
221 |
145 |
$495K |
| 99211 |
|
27,981 |
23,841 |
$485K |
| 93975 |
|
6,285 |
5,864 |
$438K |
| 80048 |
|
51,195 |
41,496 |
$423K |
| 92567 |
|
7,123 |
6,983 |
$421K |
| J9306 |
Injection, pertuzumab, 1 mg |
123 |
78 |
$421K |
| 96366 |
|
7,068 |
3,742 |
$417K |
| 96360 |
|
5,627 |
4,756 |
$411K |
| 92557 |
|
3,326 |
3,262 |
$404K |
| 88185 |
|
1,582 |
1,190 |
$401K |
| G0463 |
Hospital outpt clinic visit |
32,731 |
25,216 |
$399K |
| 96367 |
|
6,390 |
3,814 |
$399K |
| 85027 |
|
44,621 |
33,045 |
$396K |
| 83735 |
|
51,503 |
32,687 |
$383K |
| P9040 |
Rbc leukoreduced irradiated |
2,797 |
1,597 |
$380K |
| 93970 |
|
2,076 |
1,980 |
$367K |
| 97140 |
|
10,984 |
3,413 |
$354K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
468 |
449 |
$352K |
| 77295 |
|
353 |
328 |
$348K |
| 86850 |
|
25,393 |
17,613 |
$332K |
| 71275 |
|
2,985 |
2,858 |
$327K |
| J9312 |
Inj., rituximab, 10 mg |
72 |
39 |
$325K |
| OP258 |
|
92,657 |
53,414 |
$324K |
| 70553 |
|
700 |
667 |
$324K |
| J2469 |
Palonosetron hcl |
6,108 |
3,198 |
$319K |
| P9016 |
Rbc leukocytes reduced |
1,923 |
1,505 |
$319K |
| 93017 |
|
1,647 |
1,563 |
$311K |
| J0897 |
Denosumab injection |
187 |
177 |
$307K |
| 71046 |
|
17,215 |
16,322 |
$306K |
| 99213 |
|
6,278 |
5,309 |
$294K |
| 99281 |
|
2,408 |
2,282 |
$286K |
| 93458 |
|
232 |
206 |
$283K |
| 92579 |
|
2,069 |
2,035 |
$282K |
| 64483 |
|
296 |
285 |
$278K |
| 74176 |
|
2,703 |
2,568 |
$267K |
| 94729 |
|
2,043 |
1,967 |
$264K |
| 72125 |
|
4,518 |
4,150 |
$260K |
| J9299 |
Injection, nivolumab |
53 |
27 |
$256K |
| 84443 |
|
12,456 |
10,966 |
$255K |
| 71045 |
|
15,734 |
13,899 |
$247K |
| 96416 |
|
1,069 |
588 |
$237K |
| 80307 |
|
11,938 |
10,370 |
$237K |
| 71260 |
|
2,421 |
2,265 |
$236K |
| 90791 |
|
8,177 |
7,131 |
$235K |
| A0427 |
Als1-emergency |
496 |
481 |
$231K |
| 78452 |
|
1,146 |
1,081 |
$228K |
| C8929 |
Tte w or wo fol wcon,doppler |
550 |
531 |
$225K |
| J9144 |
Daratumumab, hyaluronidase |
87 |
50 |
$223K |
| 42830 |
|
151 |
147 |
$211K |
| 94060 |
|
711 |
696 |
$208K |
| 82784 |
|
6,557 |
4,618 |
$206K |
| C1874 |
Stent, coated/cov w/del sys |
454 |
402 |
$203K |
| 99212 |
|
4,505 |
3,331 |
$200K |
| 77290 |
|
446 |
350 |
$199K |
| 36415 |
|
95,499 |
70,257 |
$197K |
| Q5107 |
Inj mvasi 10 mg |
165 |
52 |
$197K |
| 86900 |
|
26,488 |
18,890 |
$195K |
| 0002A |
|
6,365 |
6,361 |
$194K |
| Q5111 |
Injection, udenyca 0.5 mg |
53 |
41 |
$190K |
| 77387 |
|
2,503 |
297 |
$188K |
| C9600 |
Perc drug-el cor stent sing |
56 |
53 |
$182K |
| 87081 |
|
8,615 |
8,429 |
$178K |
| 96401 |
|
2,393 |
1,317 |
$177K |
| 83883 |
|
1,834 |
1,446 |
$176K |
| 80061 |
|
8,167 |
7,737 |
$175K |
| 92507 |
|
3,167 |
1,125 |
$174K |
| 82248 |
|
20,492 |
12,745 |
$171K |
| 81001 |
|
52,884 |
47,341 |
$170K |
| 0001A |
|
6,424 |
6,420 |
$168K |
| 87806 |
|
6,336 |
6,160 |
$167K |
| Q5118 |
Inj., zirabev, 10 mg |
302 |
95 |
$166K |
| 82378 |
|
6,069 |
4,560 |
$164K |
| 94640 |
|
7,488 |
5,925 |
$163K |
| 97112 |
|
4,483 |
1,672 |
$159K |
| 92582 |
|
1,013 |
1,005 |
$156K |
| 83615 |
|
20,656 |
11,608 |
$152K |
| A9270 |
Non-covered item or service |
31,191 |
16,109 |
$151K |
| 62323 |
|
154 |
148 |
$150K |
| 76705 |
|
4,005 |
3,817 |
$148K |
| 94726 |
|
1,320 |
1,270 |
$145K |
| 95812 |
|
431 |
428 |
$144K |
| 76815 |
|
1,811 |
1,601 |
$144K |
| 96402 |
|
1,894 |
1,683 |
$142K |
| 82962 |
|
25,606 |
18,703 |
$142K |
| 87497 |
|
5,728 |
3,119 |
$140K |
| 84100 |
|
25,107 |
14,769 |
$139K |
| G0480 |
Drug test def 1-7 classes |
7,035 |
6,162 |
$138K |
| U0005 |
Infec agen detec ampli probe |
10,647 |
9,594 |
$137K |
| 54640 |
|
99 |
95 |
$133K |
| J9263 |
Oxaliplatin |
401 |
151 |
$133K |
| OP720 |
|
901 |
759 |
$131K |
| C9290 |
Inj, bupivacaine liposome |
2,272 |
2,172 |
$130K |
| 86901 |
|
27,148 |
18,983 |
$129K |
| 36591 |
|
1,688 |
1,306 |
$126K |
| 76856 |
|
2,979 |
2,876 |
$126K |
| 88341 |
|
2,219 |
1,900 |
$125K |
| 96376 |
|
4,674 |
3,508 |
$120K |
| 85610 |
|
25,185 |
20,474 |
$118K |
| 70496 |
|
1,217 |
1,138 |
$115K |
| 82306 |
|
4,764 |
4,397 |
$115K |
| 87633 |
|
1,248 |
1,125 |
$115K |
| 85730 |
|
21,066 |
17,946 |
$112K |
| 20610 |
|
152 |
111 |
$111K |
| 70498 |
|
1,331 |
1,243 |
$110K |
| 85007 |
|
20,312 |
14,289 |
$109K |
| 73610 |
|
4,017 |
3,689 |
$106K |
| 93971 |
|
1,234 |
1,152 |
$105K |
| 82728 |
|
7,231 |
6,070 |
$105K |
| 76830 |
|
2,391 |
2,302 |
$104K |
| 87591 |
|
3,379 |
3,210 |
$103K |
| 31231 |
|
518 |
503 |
$102K |
| 73110 |
|
3,166 |
2,813 |
$99K |
| 70486 |
|
1,502 |
1,441 |
$99K |
| 97162 |
|
2,590 |
2,510 |
$99K |
| 73130 |
|
3,480 |
3,156 |
$98K |
| C1769 |
Guide wire |
4,331 |
3,906 |
$97K |
| 86481 |
|
1,601 |
1,503 |
$96K |
| 88342 |
|
4,027 |
3,541 |
$95K |
| 80076 |
|
16,151 |
13,740 |
$94K |
| 87086 |
|
15,824 |
14,308 |
$94K |
| 77280 |
|
301 |
236 |
$92K |
| 84439 |
|
8,196 |
6,928 |
$92K |
| 83036 |
|
8,596 |
8,039 |
$91K |
| 73630 |
|
3,349 |
3,136 |
$90K |
| 76817 |
|
2,681 |
2,389 |
$89K |
| J1453 |
Fosaprepitant injection |
2,636 |
1,319 |
$88K |
| 67311 |
|
52 |
52 |
$87K |
| 86923 |
|
3,572 |
2,342 |
$86K |
| 45385 |
|
213 |
195 |
$85K |
| 86334 |
|
4,004 |
3,027 |
$84K |
| 88307 |
|
1,962 |
1,805 |
$83K |
| 73590 |
|
2,901 |
2,652 |
$83K |
| G0379 |
Direct refer hospital observ |
2,132 |
1,812 |
$80K |
| 87798 |
|
2,142 |
2,082 |
$80K |
| 76770 |
|
1,136 |
1,090 |
$79K |
| 84702 |
|
5,956 |
4,921 |
$77K |
| J1756 |
Iron sucrose injection |
1,819 |
766 |
$76K |
| 97164 |
|
1,584 |
1,521 |
$75K |
| 97161 |
|
1,887 |
1,827 |
$74K |
| 69210 |
|
605 |
585 |
$73K |
| 97530 |
|
2,346 |
1,248 |
$73K |
| 87536 |
|
745 |
710 |
$72K |
| 84484 |
|
15,024 |
12,546 |
$69K |
| 73080 |
|
2,428 |
2,219 |
$67K |
| 0225U |
|
619 |
595 |
$66K |
| 73090 |
|
2,503 |
2,308 |
$66K |
| 94010 |
|
458 |
442 |
$65K |
| 87490 |
|
3,773 |
3,699 |
$64K |
| 97113 |
|
881 |
345 |
$59K |
| 86803 |
|
2,833 |
2,567 |
$58K |
| C1887 |
Catheter, guiding |
1,940 |
1,710 |
$58K |
| 88304 |
|
3,370 |
3,279 |
$57K |
| 81002 |
|
6,136 |
3,935 |
$57K |
| 76801 |
|
1,592 |
1,418 |
$56K |
| 88313 |
|
1,221 |
957 |
$55K |
| U0002 |
Covid-19 lab test non-cdc |
996 |
887 |
$53K |
| C9803 |
Hopd covid-19 spec collect |
4,498 |
3,915 |
$53K |
| 73030 |
|
2,451 |
2,263 |
$53K |
| 83550 |
|
6,547 |
5,792 |
$52K |
| 83880 |
|
5,511 |
4,918 |
$52K |
| 92526 |
|
798 |
339 |
$52K |
| 87635 |
|
3,284 |
3,052 |
$51K |
| J1200 |
Diphenhydramine hcl injectio |
5,902 |
4,432 |
$50K |
| 80197 |
|
7,122 |
3,092 |
$50K |
| 73562 |
|
2,036 |
1,886 |
$50K |
| 82607 |
|
2,454 |
2,264 |
$48K |
| 94727 |
|
453 |
452 |
$47K |
| 82232 |
|
3,234 |
2,363 |
$47K |
| 99292 |
|
230 |
216 |
$46K |
| 71250 |
|
541 |
519 |
$45K |
| 74174 |
|
242 |
226 |
$45K |
| 83540 |
|
6,826 |
5,954 |
$45K |
| 76937 |
|
1,231 |
1,181 |
$45K |
| 85045 |
|
7,275 |
5,938 |
$44K |
| 83690 |
|
16,150 |
13,772 |
$43K |
| 96377 |
|
972 |
694 |
$43K |
| 96450 |
|
124 |
79 |
$42K |
| 84481 |
|
1,862 |
1,487 |
$42K |
| 70551 |
|
165 |
154 |
$42K |
| A9502 |
Tc99m tetrofosmin |
1,070 |
974 |
$42K |
| J1439 |
Inj ferric carboxymaltos 1mg |
53 |
37 |
$41K |
| C1894 |
Intro/sheath, non-laser |
3,251 |
2,942 |
$40K |
| 87340 |
|
3,367 |
2,934 |
$40K |
| 88184 |
|
1,687 |
1,286 |
$40K |
| 73552 |
|
1,475 |
1,328 |
$39K |
| 83605 |
|
5,200 |
4,683 |
$38K |
| 54150 |
|
22 |
22 |
$38K |
| 86360 |
|
618 |
593 |
$38K |
| 87491 |
|
3,849 |
3,643 |
$37K |
| G0390 |
Trauma respons w/hosp criti |
136 |
126 |
$37K |
| J0696 |
Ceftriaxone sodium injection |
3,929 |
3,158 |
$37K |
| 82746 |
|
1,786 |
1,645 |
$37K |
| 87799 |
|
4,259 |
2,165 |
$36K |
| 88173 |
|
854 |
794 |
$35K |
| 88142 |
|
682 |
673 |
$35K |
| 86152 |
|
587 |
350 |
$35K |
| 87040 |
|
4,207 |
3,892 |
$34K |
| 84165 |
|
3,127 |
2,410 |
$34K |
| J0131 |
Inj, acetaminophen (nos) |
8,685 |
7,470 |
$34K |
| 86140 |
|
7,927 |
7,108 |
$34K |
| 81268 |
|
579 |
315 |
$34K |
| 73564 |
|
1,297 |
1,235 |
$33K |
| 88312 |
|
1,462 |
1,459 |
$33K |
| C1725 |
Cath, translumin non-laser |
573 |
495 |
$31K |
| 81025 |
|
18,710 |
15,113 |
$31K |
| 86769 |
|
1,104 |
968 |
$31K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
8,589 |
7,720 |
$31K |
| 87070 |
|
3,331 |
2,960 |
$30K |
| 74018 |
|
2,277 |
2,114 |
$30K |
| 83970 |
|
855 |
753 |
$29K |
| 31575 |
|
402 |
386 |
$29K |
| 38222 |
|
92 |
74 |
$29K |
| 73060 |
|
1,174 |
1,071 |
$29K |
| 73502 |
|
1,535 |
1,402 |
$29K |
| 90715 |
|
3,828 |
3,689 |
$29K |
| 86301 |
|
1,533 |
1,101 |
$28K |
| 12001 |
|
451 |
423 |
$28K |
| J1100 |
Dexamethasone sodium phos |
14,903 |
11,743 |
$28K |
| Q9957 |
Inj perflutren lip micros,ml |
739 |
589 |
$28K |
| 86902 |
|
592 |
383 |
$27K |
| 86160 |
|
321 |
287 |
$27K |
| 86706 |
|
2,238 |
1,968 |
$27K |
| 74019 |
|
1,907 |
1,852 |
$26K |
| J0640 |
Leucovorin calcium injection |
1,167 |
499 |
$26K |
| 86922 |
|
997 |
583 |
$26K |
| 83020 |
|
2,336 |
2,095 |
$26K |
| 90471 |
|
4,113 |
3,840 |
$25K |
| 96368 |
|
1,163 |
705 |
$25K |
| P9073 |
Platelets pheresis path redu |
192 |
52 |
$25K |
| 88271 |
|
513 |
343 |
$24K |
| 84153 |
|
1,458 |
1,289 |
$24K |
| 82150 |
|
3,693 |
2,450 |
$23K |
| 88360 |
|
530 |
405 |
$23K |
| 88275 |
|
424 |
303 |
$22K |
| 84156 |
|
7,184 |
5,185 |
$22K |
| 84703 |
|
3,614 |
3,327 |
$21K |
| 76377 |
|
496 |
472 |
$21K |
| 97802 |
|
287 |
275 |
$21K |
| J9267 |
Paclitaxel injection |
854 |
379 |
$21K |
| 36561 |
|
16 |
16 |
$21K |
| 77338 |
|
78 |
62 |
$21K |
| 86780 |
|
3,286 |
2,888 |
$20K |
| C1889 |
Implant/insert device, noc |
173 |
165 |
$20K |
| 99202 |
|
823 |
774 |
$20K |
| C9399 |
Unclassified drugs or biolog |
17 |
12 |
$19K |
| 86038 |
|
674 |
669 |
$19K |
| J0690 |
Cefazolin sodium injection |
4,877 |
4,016 |
$18K |
| 81003 |
|
4,795 |
3,974 |
$18K |
| 86300 |
|
1,376 |
1,022 |
$18K |
| 97116 |
|
1,207 |
869 |
$18K |
| 92583 |
|
299 |
298 |
$18K |
| J9070 |
Cyclophosphamide 100 mg inj |
58 |
25 |
$18K |
| C2617 |
Stent, non-cor, tem w/o del |
331 |
300 |
$18K |
| 83655 |
|
686 |
683 |
$18K |
| 76870 |
|
485 |
461 |
$18K |
| 64493 |
|
15 |
13 |
$18K |
| 82803 |
|
1,312 |
1,207 |
$18K |
| 44970 |
|
15 |
12 |
$17K |
| 85652 |
|
6,471 |
5,949 |
$17K |
| D0140 |
|
1,272 |
1,160 |
$17K |
| 86304 |
|
1,585 |
1,086 |
$17K |
| 73140 |
|
961 |
904 |
$17K |
| 84480 |
|
1,340 |
995 |
$17K |
| D7140 |
|
565 |
304 |
$16K |
| 95713 |
|
34 |
31 |
$16K |
| 76857 |
|
447 |
438 |
$16K |
| D1110 |
|
938 |
925 |
$16K |
| 86704 |
|
1,812 |
1,482 |
$16K |
| 82550 |
|
3,032 |
2,634 |
$15K |
| A0425 |
Ground mileage |
356 |
347 |
$15K |
| 77301 |
|
13 |
12 |
$15K |
| 85384 |
|
2,413 |
1,346 |
$14K |
| 12011 |
|
388 |
353 |
$14K |
| 85379 |
|
3,782 |
3,129 |
$14K |
| 82105 |
|
859 |
717 |
$13K |
| 84550 |
|
3,256 |
2,117 |
$13K |
| 82947 |
|
927 |
918 |
$13K |
| 88300 |
|
1,557 |
1,484 |
$13K |
| J3475 |
Inj magnesium sulfate |
5,768 |
2,892 |
$13K |
| 81265 |
|
584 |
315 |
$12K |
| OP259 |
|
2,824 |
2,487 |
$12K |
| 72131 |
|
279 |
254 |
$12K |
| G0108 |
Diab manage trn per indiv |
135 |
126 |
$12K |
| 87637 |
|
497 |
462 |
$12K |
| J2405 |
Ondansetron hcl injection |
18,605 |
15,923 |
$11K |
| 31579 |
|
84 |
75 |
$11K |
| J9217 |
Leuprolide acetate suspnsion |
38 |
33 |
$11K |
| C1781 |
Mesh (implantable) |
60 |
57 |
$11K |
| 82805 |
|
641 |
573 |
$11K |
| J1885 |
Ketorolac tromethamine inj |
17,319 |
14,896 |
$11K |
| 82043 |
|
1,190 |
1,178 |
$11K |
| 87205 |
|
2,574 |
2,347 |
$10K |
| 76700 |
|
113 |
109 |
$10K |
| 86905 |
|
134 |
111 |
$10K |
| J7307 |
Etonogestrel implant system |
12 |
12 |
$10K |
| J2704 |
Inj, propofol, 10 mg |
12,954 |
11,506 |
$10K |
| 94618 |
|
105 |
100 |
$10K |
| 81220 |
|
62 |
59 |
$9K |
| M0222 |
Bebtelovimab injection |
128 |
118 |
$9K |
| 97535 |
|
322 |
238 |
$9K |
| G0008 |
Admin influenza virus vac |
946 |
926 |
$9K |
| 87624 |
|
474 |
435 |
$9K |
| 88172 |
|
313 |
296 |
$9K |
| J3489 |
Zoledronic acid 1mg |
194 |
169 |
$8K |
| J1170 |
Hydromorphone injection |
4,797 |
3,609 |
$8K |
| 82977 |
|
598 |
332 |
$8K |
| OP637 |
|
4,866 |
2,095 |
$7K |
| 83521 |
|
1,526 |
1,038 |
$7K |
| 0241U |
|
124 |
123 |
$7K |
| 82565 |
|
1,045 |
1,012 |
$7K |
| 29125 |
|
172 |
162 |
$7K |
| J2543 |
Piperacillin/tazobactam |
524 |
304 |
$7K |
| J1644 |
Inj heparin sodium per 1000u |
1,784 |
1,096 |
$7K |
| 36592 |
|
146 |
117 |
$7K |
| 80055 |
|
47 |
47 |
$7K |
| D0120 |
|
442 |
433 |
$7K |
| 93923 |
|
41 |
40 |
$7K |
| 70491 |
|
70 |
66 |
$7K |
| 86708 |
|
697 |
517 |
$7K |
| C1760 |
Closure dev, vasc |
160 |
138 |
$7K |
| 77067 |
|
103 |
102 |
$7K |
| 85097 |
|
252 |
156 |
$7K |
| J9370 |
Vincristine sulfate 1 mg inj |
661 |
503 |
$6K |
| 43264 |
|
14 |
14 |
$6K |
| J2270 |
Morphine sulfate injection |
4,310 |
3,300 |
$6K |
| 84520 |
|
823 |
808 |
$6K |
| 76882 |
|
283 |
263 |
$6K |
| 92504 |
|
476 |
447 |
$6K |
| 74230 |
|
42 |
42 |
$6K |
| 97168 |
|
101 |
99 |
$6K |
| 88237 |
|
172 |
122 |
$6K |
| 87522 |
Neg quan hep c or qual rna |
128 |
105 |
$6K |
| 96523 |
|
68 |
67 |
$5K |
| C1726 |
Cath, bal dil, non-vascular |
87 |
81 |
$5K |
| 75561 |
|
13 |
12 |
$5K |
| 99214 |
|
195 |
180 |
$5K |
| 88112 |
|
290 |
277 |
$5K |
| 12002 |
|
83 |
76 |
$5K |
| J9202 |
Goserelin acetate implant |
12 |
12 |
$5K |
| D0220 |
|
1,403 |
1,311 |
$5K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
731 |
675 |
$5K |
| 86665 |
|
629 |
454 |
$5K |
| A9581 |
Gadoxetate disodium inj |
94 |
94 |
$5K |
| J2930 |
Methylprednisolone injection |
1,572 |
1,287 |
$5K |
| 86335 |
|
754 |
561 |
$5K |
| 99203 |
|
153 |
141 |
$5K |
| Q3014 |
Telehealth facility fee |
1,286 |
1,065 |
$5K |
| 90792 |
|
103 |
97 |
$5K |
| 76642 |
|
58 |
56 |
$5K |
| 80143 |
|
1,263 |
1,177 |
$5K |
| 87449 |
|
992 |
409 |
$4K |
| 86235 |
|
16 |
15 |
$4K |
| 92611 |
|
15 |
15 |
$4K |
| 87186 |
|
1,692 |
1,484 |
$4K |
| 86870 |
|
196 |
155 |
$4K |
| 77001 |
|
49 |
49 |
$4K |
| 87880 |
|
1,527 |
1,474 |
$4K |
| 80179 |
|
1,189 |
1,108 |
$4K |
| 97165 |
|
99 |
99 |
$4K |
| 92626 |
|
67 |
65 |
$4K |
| 10060 |
|
42 |
40 |
$4K |
| M0220 |
Tixagev and cilgav inj |
33 |
18 |
$4K |
| 77370 |
|
40 |
38 |
$4K |
| 83516 |
|
91 |
91 |
$4K |
| 88302 |
|
403 |
384 |
$4K |
| 77066 |
Tomosynthesis, mammo |
40 |
39 |
$4K |
| 84166 |
|
887 |
634 |
$4K |
| 52000 |
|
13 |
12 |
$4K |
| 80164 |
|
511 |
448 |
$4K |
| 80329 |
|
964 |
917 |
$4K |
| 86592 |
|
257 |
256 |
$4K |
| 76536 |
|
39 |
39 |
$4K |
| 88264 |
|
121 |
79 |
$3K |
| 84466 |
|
319 |
234 |
$3K |
| 84145 |
|
428 |
396 |
$3K |
| 82950 |
|
290 |
274 |
$3K |
| 81267 |
|
556 |
301 |
$3K |
| 86762 |
|
202 |
182 |
$3K |
| J3480 |
Inj potassium chloride |
1,869 |
762 |
$3K |
| 86664 |
|
550 |
396 |
$3K |
| 84460 |
|
286 |
280 |
$3K |
| 81329 |
|
84 |
63 |
$3K |
| 80320 |
|
966 |
897 |
$3K |
| 76376 |
|
199 |
179 |
$3K |
| J2765 |
Metoclopramide hcl injection |
4,504 |
4,109 |
$3K |
| 88311 |
|
646 |
488 |
$3K |
| 77063 |
|
102 |
101 |
$3K |
| J3010 |
Fentanyl citrate injection |
8,454 |
7,604 |
$3K |
| 0031A |
|
130 |
128 |
$3K |
| 94642 |
|
13 |
12 |
$3K |
| G0279 |
Tomosynthesis, mammo |
61 |
60 |
$3K |
| 93356 |
|
27 |
26 |
$3K |
| 93320 |
|
28 |
26 |
$3K |
| 25605 |
|
39 |
36 |
$3K |
| 85018 |
|
1,018 |
751 |
$3K |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
972 |
887 |
$3K |
| J0134 |
Inj acetaminophen -fresenius |
3,067 |
2,895 |
$3K |
| 82570 |
|
3,531 |
2,552 |
$3K |
| J2060 |
Lorazepam injection |
2,010 |
1,391 |
$3K |
| 86430 |
|
228 |
224 |
$3K |
| 89230 |
|
67 |
65 |
$3K |
| G0009 |
Admin pneumococcal vaccine |
272 |
267 |
$3K |
| OP279 |
|
6,340 |
5,070 |
$2K |
| M0239 |
Bamlanivimab-xxxx infusion |
20 |
20 |
$2K |
| 87533 |
|
415 |
119 |
$2K |
| Q0222 |
Bebtelovimab 175 mg |
128 |
117 |
$2K |
| Q0247 |
Sotrovimab |
13 |
13 |
$2K |
| 84450 |
|
236 |
230 |
$2K |
| OP229 |
|
47 |
45 |
$2K |
| 88346 |
|
24 |
13 |
$2K |
| 86225 |
|
41 |
41 |
$2K |
| 84403 |
|
280 |
248 |
$2K |
| 87088 |
|
1,614 |
1,428 |
$2K |
| 93325 |
|
30 |
28 |
$2K |
| J2272 |
Inj, morphine (fresenius) |
4,317 |
3,389 |
$2K |
| 90686 |
|
281 |
271 |
$2K |
| M0247 |
Sotrovimab infusion |
33 |
30 |
$2K |
| 73560 |
|
57 |
53 |
$2K |
| 77065 |
Tomosynthesis, mammo |
26 |
25 |
$2K |
| 81206 |
|
81 |
55 |
$2K |
| 89051 |
|
799 |
692 |
$2K |
| 87077 |
|
725 |
660 |
$2K |
| C1753 |
Cath, intravas ultrasound |
42 |
37 |
$2K |
| 72082 |
|
27 |
26 |
$2K |
| G8978 |
Mobility current status |
755 |
606 |
$2K |
| J2250 |
Inj midazolam hydrochloride |
7,179 |
6,479 |
$2K |
| J9201 |
In gemcitabine hcl nos 200mg |
146 |
50 |
$2K |
| 88108 |
|
82 |
67 |
$2K |
| 72170 |
|
51 |
50 |
$2K |
| 92978 |
|
49 |
39 |
$2K |
| 92523 |
|
44 |
40 |
$2K |
| 73000 |
|
65 |
57 |
$2K |
| 77080 |
|
24 |
24 |
$2K |
| J0330 |
Succinycholine chloride inj |
1,149 |
1,022 |
$2K |
| 86644 |
|
635 |
432 |
$2K |
| J9206 |
Irinotecan injection |
158 |
48 |
$2K |
| C1751 |
Cath, inf, per/cent/midline |
122 |
112 |
$2K |
| A9577 |
Inj multihance |
394 |
383 |
$2K |
| 81243 |
|
102 |
76 |
$2K |
| 11045 |
|
37 |
24 |
$2K |
| 0012A |
|
60 |
58 |
$2K |
| 86645 |
|
635 |
432 |
$2K |
| C1788 |
Port, indwelling, imp |
15 |
15 |
$2K |
| 92604 |
|
15 |
12 |
$1K |
| J1650 |
Inj enoxaparin sodium |
845 |
448 |
$1K |
| 0011A |
|
61 |
59 |
$1K |
| 83520 |
|
310 |
198 |
$1K |
| 90677 |
|
13 |
12 |
$1K |
| 90674 |
|
139 |
139 |
$1K |
| OP255 |
|
755 |
444 |
$1K |
| 87305 |
|
715 |
223 |
$1K |
| 97166 |
|
42 |
42 |
$1K |
| 75574 |
|
15 |
13 |
$1K |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
2,123 |
2,000 |
$1K |
| 88280 |
|
121 |
80 |
$1K |
| 86618 |
|
37 |
36 |
$1K |
| 80074 |
|
88 |
79 |
$1K |
| J0500 |
Dicyclomine injection |
409 |
380 |
$1K |
| 86828 |
|
53 |
39 |
$1K |
| 87075 |
|
202 |
186 |
$1K |
| J2919 |
Inj, methylpred sod succ 5mg |
347 |
270 |
$1K |
| 86787 |
|
182 |
147 |
$1K |
| 64494 |
|
19 |
13 |
$1K |
| J1790 |
Droperidol injection |
1,042 |
846 |
$1K |
| 86696 |
|
340 |
225 |
$1K |
| 86376 |
|
24 |
24 |
$1K |
| 0054A |
|
28 |
27 |
$1K |
| 83001 |
|
12 |
12 |
$997.48 |
| J1642 |
Inj heparin sodium per 10 u |
572 |
333 |
$941.04 |
| J9000 |
Doxorubicin hcl injection |
68 |
36 |
$915.09 |
| 85014 |
|
567 |
389 |
$912.52 |
| J7298 |
Mirena, 52 mg |
15 |
12 |
$911.28 |
| J7613 |
Albuterol non-comp unit |
668 |
588 |
$910.25 |
| 80069 |
|
417 |
203 |
$871.53 |
| G8979 |
Mobility goal status |
739 |
594 |
$858.52 |
| 86695 |
|
322 |
212 |
$856.90 |
| J3370 |
Vancomycin hcl injection |
177 |
128 |
$855.28 |
| 82785 |
|
12 |
12 |
$848.09 |
| 81380 |
|
15 |
12 |
$834.74 |
| 95886 |
|
17 |
15 |
$833.11 |
| 83010 |
|
179 |
102 |
$826.62 |
| C9113 |
Inj pantoprazole sodium, via |
54 |
31 |
$802.88 |
| 72110 |
|
12 |
12 |
$787.32 |
| 90662 |
|
54 |
49 |
$736.16 |
| 81401 |
|
15 |
14 |
$715.95 |
| 64484 |
|
58 |
55 |
$679.64 |
| 86800 |
|
13 |
13 |
$653.57 |
| J2785 |
Regadenoson injection |
28 |
26 |
$639.84 |
| 58300 |
|
14 |
14 |
$623.08 |
| 86359 |
|
53 |
44 |
$619.43 |
| 84436 |
|
66 |
62 |
$610.91 |
| P9604 |
One-way allow prorated trip |
924 |
416 |
$602.34 |
| G0103 |
Psa screening |
90 |
79 |
$579.80 |
| 90834 |
|
39 |
15 |
$550.06 |
| 86039 |
|
106 |
90 |
$502.68 |
| 90670 |
|
13 |
12 |
$499.92 |
| J0136 |
Inj, acetaminophen (b braun) |
425 |
384 |
$494.01 |
| 0064A |
|
15 |
15 |
$454.36 |
| 87184 |
|
84 |
77 |
$443.83 |
| 82657 |
|
78 |
53 |
$427.54 |
| 86663 |
|
58 |
52 |
$424.31 |
| J1630 |
Haloperidol injection |
1,529 |
1,019 |
$423.48 |
| 87045 |
|
58 |
53 |
$406.79 |
| 85240 |
|
56 |
40 |
$405.17 |
| 93308 |
|
12 |
12 |
$381.99 |
| 0004A |
|
13 |
13 |
$373.52 |
| 90732 |
|
78 |
78 |
$372.17 |
| 82247 |
|
117 |
109 |
$370.11 |
| J0171 |
Adrenalin epinephrine inject |
416 |
365 |
$348.38 |
| A9585 |
Gadobutrol injection |
14 |
13 |
$337.48 |
| J0461 |
Atropine sulfate injection |
272 |
180 |
$323.59 |
| J8540 |
Oral dexamethasone |
514 |
243 |
$323.41 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
509 |
460 |
$321.90 |
| D0210 |
|
12 |
12 |
$312.00 |
| 84146 |
|
27 |
25 |
$295.81 |
| 80195 |
|
101 |
66 |
$295.35 |
| 85660 |
|
121 |
90 |
$257.83 |
| 87177 |
|
109 |
88 |
$255.90 |
| 82272 |
|
53 |
52 |
$254.82 |
| 74328 |
|
13 |
13 |
$253.86 |
| 86682 |
|
56 |
53 |
$252.00 |
| J2920 |
Methylprednisolone injection |
187 |
119 |
$241.93 |
| 82330 |
|
51 |
49 |
$176.02 |
| J9250 |
Methotrexate sodium inj |
134 |
65 |
$171.58 |
| J1643 |
Inj heparin, pfizer, 1000u |
603 |
427 |
$169.15 |
| 81257 |
|
15 |
13 |
$168.52 |
| 82010 |
|
53 |
42 |
$163.86 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
635 |
603 |
$161.34 |
| 83050 |
|
80 |
79 |
$157.31 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
256 |
144 |
$152.58 |
| J1010 |
Inj, methylpred acetate 1 mg |
106 |
102 |
$150.03 |
| 88365 |
|
13 |
12 |
$149.06 |
| 86141 |
|
71 |
45 |
$139.31 |
| J0780 |
Prochlorperazine injection |
45 |
41 |
$129.52 |
| 82375 |
|
31 |
30 |
$114.01 |
| 82533 |
|
18 |
14 |
$113.91 |
| J7512 |
Prednisone ir or dr oral 1mg |
254 |
201 |
$111.54 |
| 84132 |
|
185 |
152 |
$106.14 |
| 83525 |
|
12 |
12 |
$106.12 |
| 90472 |
|
18 |
16 |
$100.00 |
| D0274 |
|
12 |
12 |
$99.00 |
| 85362 |
|
139 |
75 |
$94.30 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
125 |
102 |
$93.78 |
| J0737 |
Inj, clindamycin (baxter) |
99 |
81 |
$92.88 |
| 80051 |
|
77 |
76 |
$92.18 |
| C1729 |
Cath, drainage |
15 |
12 |
$90.69 |
| 82553 |
|
34 |
30 |
$89.72 |
| 85220 |
|
14 |
12 |
$74.16 |
| 84154 |
|
22 |
14 |
$73.50 |
| 85230 |
|
14 |
12 |
$70.26 |
| 85270 |
|
14 |
12 |
$69.87 |
| 87102 |
|
14 |
13 |
$69.74 |
| 85260 |
|
14 |
12 |
$68.88 |
| 84478 |
|
19 |
13 |
$67.78 |
| 87493 |
|
14 |
12 |
$67.47 |
| J1940 |
Furosemide injection |
117 |
79 |
$67.24 |
| 82955 |
|
29 |
13 |
$67.09 |
| 86317 |
|
14 |
13 |
$65.20 |
| 85250 |
|
14 |
12 |
$64.40 |
| 82310 |
|
54 |
51 |
$61.84 |
| 84155 |
|
380 |
268 |
$61.02 |
| 84681 |
|
28 |
12 |
$59.34 |
| J2795 |
Ropivacaine hcl injection |
91 |
90 |
$59.02 |
| 85210 |
|
14 |
12 |
$52.99 |
| 82652 |
|
13 |
12 |
$47.87 |
| J1040 |
Methylprednisolone 80 mg inj |
21 |
21 |
$46.96 |
| 82438 |
|
68 |
65 |
$44.74 |
| J1836 |
Inj, metronidazole, 10 mg |
61 |
46 |
$44.45 |
| D9310 |
|
27 |
25 |
$41.67 |
| J9190 |
Fluorouracil injection |
100 |
45 |
$40.18 |
| 84075 |
|
39 |
38 |
$37.77 |
| 81000 |
|
166 |
85 |
$36.32 |
| 86200 |
|
15 |
13 |
$32.92 |
| J2370 |
Phenylephrine hcl injection |
721 |
586 |
$29.94 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
870 |
696 |
$29.81 |
| J2004 |
Inj, lidocaine w epinephrine |
87 |
85 |
$28.76 |
| J3535 |
Metered dose inhaler drug |
146 |
121 |
$20.29 |
| 90656 |
|
12 |
12 |
$19.78 |
| 87324 |
|
13 |
12 |
$14.79 |
| J0360 |
Hydralazine hcl injection |
39 |
31 |
$12.06 |
| 91303 |
|
98 |
97 |
$10.00 |
| J1956 |
Levofloxacin injection |
43 |
38 |
$8.68 |
| J0687 |
Inj cefazolin (wg crit care) |
497 |
452 |
$6.47 |
| J2470 |
Inj pantoprazole sodium 40mg |
20 |
16 |
$5.90 |
| J3301 |
Triamcinolone acet inj nos |
15 |
14 |
$4.50 |
| 91300 |
|
6,033 |
5,235 |
$3.02 |
| Q0220 |
Tixagev and cilgav, 300mg |
32 |
18 |
$3.00 |
| J2372 |
Inj, biorphen, 20 micrograms |
102 |
89 |
$2.00 |
| 91306 |
|
12 |
12 |
$1.00 |
| 91305 |
|
28 |
27 |
$1.00 |
| J7620 |
Albuterol ipratrop non-comp |
17 |
14 |
$0.05 |
| 81269 |
|
42 |
28 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
13 |
12 |
$0.00 |
| Q0239 |
Bamlanivimab-xxxx |
12 |
12 |
$0.00 |
| G8987 |
Self care current status |
31 |
25 |
$0.00 |
| G8988 |
Self care goal status |
59 |
49 |
$0.00 |
| J1815 |
Insulin injection |
155 |
73 |
$0.00 |
| 91301 |
|
98 |
95 |
$0.00 |
| G8980 |
Mobility d/c status |
24 |
24 |
$0.00 |
| 84402 |
|
13 |
12 |
$0.00 |
| 82040 |
|
37 |
36 |
$0.00 |