| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
44,134 |
35,694 |
$22.44M |
| 99284 |
|
42,617 |
35,573 |
$12.66M |
| 99283 |
|
49,375 |
42,939 |
$10.44M |
| 97110 |
|
143,066 |
35,403 |
$8.61M |
| G0463 |
Hospital outpt clinic visit |
81,590 |
66,081 |
$7.97M |
| 96374 |
|
32,143 |
25,997 |
$4.34M |
| 99291 |
|
3,331 |
2,825 |
$4.17M |
| 74177 |
|
15,111 |
12,637 |
$2.78M |
| 93306 |
|
11,863 |
8,991 |
$2.35M |
| 45380 |
|
3,257 |
2,835 |
$2.32M |
| 77067 |
|
18,983 |
17,301 |
$1.86M |
| 96365 |
|
17,671 |
8,394 |
$1.83M |
| 87635 |
|
57,929 |
40,427 |
$1.79M |
| 70450 |
|
14,712 |
11,629 |
$1.76M |
| 99282 |
|
13,258 |
11,941 |
$1.69M |
| 92507 |
|
19,375 |
4,909 |
$1.61M |
| 93975 |
|
6,964 |
5,963 |
$1.38M |
| J1459 |
Inj ivig privigen 500 mg |
2,186 |
737 |
$1.31M |
| 43239 |
|
3,177 |
2,643 |
$1.30M |
| 64493 |
|
1,955 |
1,568 |
$1.21M |
| 71046 |
|
22,332 |
18,631 |
$1.20M |
| 96413 |
|
5,863 |
2,955 |
$1.17M |
| 71045 |
|
22,551 |
17,728 |
$1.06M |
| 45385 |
|
1,873 |
1,635 |
$1.04M |
| 76705 |
|
9,019 |
7,660 |
$936K |
| 78452 |
|
1,906 |
1,453 |
$930K |
| 97140 |
|
103,640 |
26,664 |
$884K |
| 76641 |
|
16,360 |
8,660 |
$848K |
| 45378 |
|
1,358 |
1,201 |
$842K |
| U0003 |
Cov-19 amp prb hgh thruput |
14,082 |
12,018 |
$823K |
| 76830 |
|
8,757 |
7,527 |
$817K |
| 76856 |
|
9,190 |
7,945 |
$807K |
| 82306 |
|
36,591 |
33,772 |
$796K |
| 87491 |
|
29,653 |
27,164 |
$794K |
| 84443 |
|
65,721 |
60,302 |
$793K |
| 87591 |
|
29,603 |
27,144 |
$792K |
| 80053 |
|
121,297 |
102,329 |
$719K |
| 11042 |
|
5,352 |
1,895 |
$708K |
| 80061 |
|
64,518 |
59,877 |
$667K |
| 97161 |
|
11,780 |
10,308 |
$648K |
| 96375 |
|
24,737 |
17,476 |
$648K |
| 86900 |
|
16,636 |
13,355 |
$632K |
| 95810 |
|
808 |
701 |
$606K |
| 76811 |
|
2,779 |
2,514 |
$591K |
| 70553 |
|
2,357 |
1,939 |
$585K |
| 85025 |
|
183,888 |
138,819 |
$543K |
| 76818 |
|
4,948 |
2,002 |
$524K |
| 59025 |
|
3,101 |
2,495 |
$515K |
| 97530 |
|
8,988 |
3,241 |
$490K |
| 71260 |
|
3,690 |
2,989 |
$487K |
| G0260 |
Inj for sacroiliac jt anesth |
1,570 |
1,170 |
$465K |
| 70551 |
|
3,070 |
2,538 |
$453K |
| 77065 |
Tomosynthesis, mammo |
4,307 |
3,398 |
$449K |
| 71275 |
|
3,686 |
3,068 |
$442K |
| 74176 |
|
3,587 |
2,872 |
$428K |
| 97112 |
|
13,059 |
4,066 |
$405K |
| 88342 |
|
8,213 |
5,480 |
$400K |
| 70496 |
|
2,007 |
1,674 |
$380K |
| 83036 |
|
54,449 |
50,239 |
$375K |
| 11043 |
|
2,475 |
751 |
$368K |
| 87624 |
|
12,606 |
12,127 |
$347K |
| 76536 |
|
4,601 |
3,859 |
$308K |
| 76801 |
|
3,139 |
2,618 |
$300K |
| 76816 |
|
5,409 |
4,200 |
$298K |
| 76642 |
|
5,518 |
4,288 |
$291K |
| 19083 |
|
259 |
227 |
$289K |
| 72148 |
|
2,206 |
1,866 |
$286K |
| 93798 |
|
6,366 |
775 |
$285K |
| 93351 |
|
945 |
768 |
$284K |
| 36415 |
|
271,035 |
198,194 |
$283K |
| 96367 |
|
4,701 |
2,396 |
$275K |
| 97162 |
|
6,180 |
5,110 |
$268K |
| 82607 |
|
24,680 |
22,629 |
$264K |
| 77066 |
Tomosynthesis, mammo |
2,277 |
2,028 |
$262K |
| 93971 |
|
3,978 |
3,220 |
$256K |
| 94726 |
|
3,009 |
2,296 |
$253K |
| 87637 |
|
1,924 |
1,821 |
$247K |
| 93970 |
|
2,178 |
1,763 |
$242K |
| 93458 |
|
175 |
132 |
$240K |
| 76700 |
|
2,559 |
2,199 |
$236K |
| 76770 |
|
3,054 |
2,515 |
$230K |
| 77063 |
|
18,972 |
17,293 |
$221K |
| 73721 |
|
1,235 |
1,051 |
$218K |
| 77080 |
|
2,619 |
2,332 |
$217K |
| 47562 |
|
47 |
40 |
$204K |
| 96366 |
|
5,752 |
3,098 |
$199K |
| 73630 |
|
8,188 |
6,467 |
$198K |
| C9803 |
Hopd covid-19 spec collect |
60,316 |
42,337 |
$190K |
| 88305 |
|
27,523 |
16,357 |
$184K |
| 84439 |
|
27,608 |
25,588 |
$183K |
| 93017 |
|
3,985 |
3,118 |
$177K |
| 86003 |
|
4,073 |
1,854 |
$176K |
| 82728 |
|
17,889 |
16,325 |
$170K |
| 73562 |
|
9,738 |
6,984 |
$168K |
| 96361 |
|
5,857 |
4,555 |
$166K |
| 74183 |
|
998 |
830 |
$165K |
| 73030 |
|
7,414 |
5,743 |
$163K |
| 87088 |
|
45,828 |
39,725 |
$157K |
| 96360 |
|
1,325 |
978 |
$156K |
| 86480 |
|
3,782 |
3,558 |
$155K |
| J2505 |
Injection, pegfilgrastim 6mg |
63 |
38 |
$151K |
| 76819 |
|
1,463 |
1,203 |
$149K |
| 87510 |
|
9,196 |
8,575 |
$148K |
| 87480 |
|
9,197 |
8,576 |
$148K |
| 87660 |
|
9,196 |
8,575 |
$148K |
| 71250 |
|
2,976 |
2,339 |
$146K |
| 96372 |
|
19,586 |
11,629 |
$145K |
| 82746 |
|
14,079 |
12,892 |
$143K |
| 86803 |
|
14,103 |
13,234 |
$140K |
| 93976 |
|
1,410 |
1,287 |
$137K |
| 72110 |
|
3,064 |
2,665 |
$131K |
| 72141 |
|
861 |
746 |
$131K |
| 97165 |
|
1,695 |
1,512 |
$122K |
| 92523 |
|
538 |
488 |
$117K |
| 88142 |
|
8,989 |
8,584 |
$116K |
| 87389 |
|
7,870 |
7,422 |
$115K |
| 62323 |
|
292 |
242 |
$114K |
| 97116 |
|
5,278 |
2,533 |
$110K |
| 88175 |
|
8,681 |
8,308 |
$108K |
| 73221 |
|
617 |
527 |
$106K |
| 83540 |
|
21,754 |
19,979 |
$103K |
| 84403 |
|
5,664 |
4,767 |
$102K |
| 93005 |
|
45,642 |
33,302 |
$102K |
| 86703 |
|
8,830 |
8,304 |
$97K |
| 72197 |
|
337 |
301 |
$96K |
| 94060 |
|
536 |
450 |
$91K |
| 78815 |
|
172 |
130 |
$91K |
| 96132 |
|
1,924 |
1,505 |
$91K |
| 84481 |
|
7,099 |
6,568 |
$88K |
| 83550 |
|
14,367 |
13,111 |
$86K |
| 86618 |
|
7,276 |
4,521 |
$85K |
| 80048 |
|
75,459 |
54,650 |
$84K |
| 72100 |
|
2,443 |
2,103 |
$84K |
| 86780 |
|
7,485 |
6,866 |
$83K |
| 99281 |
|
1,312 |
1,059 |
$83K |
| 82670 |
|
3,578 |
3,349 |
$82K |
| 86696 |
|
5,172 |
4,875 |
$82K |
| 76805 |
|
812 |
730 |
$81K |
| 94010 |
|
2,680 |
2,176 |
$80K |
| 74174 |
|
483 |
388 |
$80K |
| 83970 |
|
3,301 |
2,853 |
$79K |
| 87340 |
|
11,531 |
10,788 |
$77K |
| 96415 |
|
971 |
547 |
$75K |
| U0005 |
Infec agen detec ampli probe |
3,589 |
3,280 |
$74K |
| 85027 |
|
27,770 |
22,794 |
$73K |
| 86769 |
|
1,957 |
1,411 |
$71K |
| 83525 |
|
6,732 |
6,087 |
$70K |
| 73130 |
|
5,039 |
3,525 |
$69K |
| 87070 |
|
23,638 |
20,256 |
$66K |
| 83001 |
|
4,272 |
4,012 |
$65K |
| 81003 |
|
99,598 |
81,207 |
$64K |
| 44970 |
|
13 |
12 |
$63K |
| 96417 |
|
1,222 |
656 |
$62K |
| 95816 |
|
484 |
353 |
$62K |
| 36430 |
|
999 |
601 |
$61K |
| 83655 |
|
5,404 |
5,239 |
$59K |
| 86695 |
|
5,172 |
4,875 |
$56K |
| 83002 |
|
3,560 |
3,346 |
$55K |
| Q0138 |
Ferumoxytol, non-esrd |
230 |
129 |
$54K |
| 88307 |
|
1,565 |
1,050 |
$54K |
| 80307 |
|
10,476 |
8,867 |
$54K |
| 84152 |
|
3,409 |
3,283 |
$53K |
| 73110 |
|
3,514 |
2,829 |
$52K |
| 87633 |
|
1,513 |
1,314 |
$52K |
| 83013 |
|
965 |
909 |
$51K |
| 84702 |
|
11,184 |
8,465 |
$51K |
| P9016 |
Rbc leukocytes reduced |
608 |
398 |
$50K |
| 87661 |
|
1,702 |
1,579 |
$50K |
| 73610 |
|
5,015 |
4,266 |
$49K |
| G0379 |
Direct refer hospital observ |
173 |
112 |
$49K |
| 72050 |
|
802 |
703 |
$48K |
| 87798 |
|
5,808 |
4,424 |
$48K |
| 82570 |
|
13,253 |
11,574 |
$46K |
| 88313 |
|
8,120 |
5,519 |
$45K |
| 84146 |
|
3,709 |
3,331 |
$45K |
| 95806 |
|
421 |
330 |
$45K |
| 84270 |
|
2,487 |
2,271 |
$45K |
| 72070 |
|
1,265 |
1,100 |
$44K |
| 87631 |
|
3,328 |
3,005 |
$43K |
| C8908 |
Mri w/o fol w/cont, breast, |
189 |
160 |
$43K |
| 87625 |
|
1,583 |
1,540 |
$43K |
| 87536 |
|
684 |
635 |
$42K |
| 87186 |
|
13,728 |
10,745 |
$42K |
| 86141 |
|
3,990 |
3,716 |
$41K |
| 82105 |
|
3,144 |
2,932 |
$40K |
| 87077 |
|
13,777 |
10,771 |
$40K |
| 19081 |
|
28 |
26 |
$40K |
| 82652 |
|
1,453 |
1,332 |
$39K |
| 86038 |
|
4,345 |
4,020 |
$39K |
| 87081 |
|
9,910 |
8,008 |
$39K |
| 70486 |
|
2,057 |
1,706 |
$38K |
| 84153 |
|
3,816 |
3,367 |
$38K |
| 82043 |
|
9,207 |
8,513 |
$38K |
| 72125 |
|
5,641 |
4,523 |
$38K |
| 29505 |
|
703 |
639 |
$37K |
| 97535 |
|
1,458 |
1,023 |
$35K |
| 84144 |
|
2,299 |
1,892 |
$35K |
| 86706 |
|
4,483 |
4,173 |
$35K |
| 73502 |
|
2,701 |
2,183 |
$34K |
| 95811 |
|
47 |
41 |
$34K |
| 73140 |
|
2,874 |
2,464 |
$33K |
| 85651 |
|
17,981 |
15,408 |
$33K |
| 96402 |
|
1,024 |
791 |
$32K |
| 82784 |
|
5,553 |
3,175 |
$32K |
| 80076 |
|
33,949 |
27,775 |
$32K |
| 83516 |
|
3,226 |
2,202 |
$31K |
| 83880 |
|
16,503 |
13,254 |
$31K |
| 84425 |
|
1,981 |
1,824 |
$31K |
| 73080 |
|
2,485 |
1,981 |
$31K |
| 83735 |
|
26,210 |
16,008 |
$30K |
| 76815 |
|
2,550 |
2,070 |
$29K |
| 83520 |
|
2,695 |
2,389 |
$29K |
| 86140 |
|
14,288 |
12,053 |
$29K |
| 97113 |
|
812 |
215 |
$28K |
| 95700 |
|
209 |
185 |
$26K |
| 85730 |
|
23,041 |
17,876 |
$26K |
| 77061 |
|
3,846 |
3,084 |
$26K |
| 85610 |
|
37,723 |
24,714 |
$26K |
| 86709 |
|
3,027 |
2,815 |
$25K |
| 84466 |
|
2,501 |
2,344 |
$25K |
| 84402 |
|
1,851 |
1,625 |
$25K |
| 86787 |
|
3,431 |
3,134 |
$25K |
| 95250 |
|
568 |
324 |
$24K |
| 82378 |
|
2,705 |
2,248 |
$24K |
| 86592 |
|
6,717 |
6,288 |
$24K |
| 86762 |
|
3,812 |
3,567 |
$24K |
| 77090 |
|
692 |
547 |
$23K |
| 83020 |
|
3,840 |
3,579 |
$23K |
| 86406 |
|
2,869 |
2,690 |
$23K |
| 77091 |
|
692 |
547 |
$23K |
| 82627 |
|
1,248 |
1,164 |
$23K |
| 58558 |
|
15 |
13 |
$23K |
| 76882 |
|
410 |
339 |
$23K |
| 86850 |
|
15,593 |
12,722 |
$22K |
| 10060 |
|
167 |
152 |
$20K |
| 73560 |
|
1,447 |
831 |
$20K |
| 82533 |
|
1,741 |
1,463 |
$20K |
| 87147 |
|
9,838 |
7,530 |
$20K |
| 72131 |
|
474 |
395 |
$20K |
| 83615 |
|
9,428 |
7,716 |
$19K |
| 86235 |
|
879 |
430 |
$19K |
| 85007 |
|
15,632 |
13,305 |
$19K |
| 86255 |
|
1,797 |
1,154 |
$19K |
| 86800 |
|
1,667 |
1,389 |
$19K |
| 87501 |
|
5,902 |
3,858 |
$18K |
| 88312 |
|
4,000 |
3,154 |
$18K |
| 86376 |
|
1,836 |
1,695 |
$18K |
| 96118 |
|
306 |
252 |
$17K |
| 88112 |
|
1,140 |
873 |
$17K |
| 77062 |
|
2,160 |
1,931 |
$17K |
| 82985 |
|
1,634 |
1,502 |
$17K |
| 86360 |
|
538 |
485 |
$17K |
| 70491 |
|
155 |
121 |
$17K |
| 86694 |
|
1,420 |
1,325 |
$17K |
| 86920 |
|
689 |
422 |
$17K |
| J2469 |
Palonosetron hcl |
1,581 |
834 |
$16K |
| 86765 |
|
1,586 |
1,480 |
$16K |
| 10005 |
|
61 |
43 |
$16K |
| 88304 |
|
3,270 |
2,647 |
$16K |
| 80055 |
|
1,121 |
1,041 |
$15K |
| 87502 |
|
9,949 |
9,077 |
$15K |
| 82950 |
|
3,599 |
3,423 |
$15K |
| 87899 |
|
3,525 |
1,704 |
$15K |
| 86735 |
|
1,283 |
1,202 |
$14K |
| 86160 |
|
1,561 |
798 |
$14K |
| 84165 |
|
2,821 |
2,414 |
$13K |
| 86747 |
|
1,874 |
877 |
$13K |
| 86300 |
|
1,469 |
1,232 |
$13K |
| 86665 |
|
1,179 |
556 |
$13K |
| 87046 |
|
3,953 |
1,777 |
$13K |
| 71271 |
|
134 |
131 |
$13K |
| 82951 |
|
1,154 |
1,097 |
$13K |
| 86430 |
|
2,944 |
2,758 |
$13K |
| J9217 |
Leuprolide acetate suspnsion |
134 |
112 |
$12K |
| 87522 |
Neg quan hep c or qual rna |
435 |
380 |
$12K |
| 74019 |
|
484 |
373 |
$12K |
| 83690 |
|
36,893 |
29,731 |
$12K |
| 82550 |
|
6,017 |
4,855 |
$12K |
| 97166 |
|
277 |
207 |
$11K |
| 74018 |
|
2,917 |
2,564 |
$11K |
| 88300 |
|
1,824 |
1,442 |
$11K |
| 86413 |
|
228 |
130 |
$11K |
| 73590 |
|
1,803 |
1,423 |
$11K |
| 76817 |
|
968 |
700 |
$10K |
| 70498 |
|
1,852 |
1,536 |
$10K |
| 11044 |
|
41 |
12 |
$10K |
| 64635 |
|
21 |
13 |
$10K |
| 85044 |
|
4,005 |
3,527 |
$10K |
| 70544 |
|
210 |
157 |
$10K |
| 96133 |
|
226 |
164 |
$10K |
| G0480 |
Drug test def 1-7 classes |
8,544 |
7,051 |
$10K |
| 86617 |
|
966 |
451 |
$10K |
| 71101 |
|
666 |
578 |
$9K |
| 86225 |
|
912 |
842 |
$9K |
| 87478 |
|
514 |
466 |
$9K |
| 87484 |
|
514 |
466 |
$9K |
| 87469 |
|
514 |
466 |
$9K |
| 87468 |
|
514 |
466 |
$9K |
| 86334 |
|
1,223 |
1,026 |
$9K |
| 83498 |
|
396 |
379 |
$9K |
| 76870 |
|
1,148 |
1,011 |
$8K |
| 84550 |
|
5,584 |
4,861 |
$8K |
| 82024 |
|
340 |
292 |
$8K |
| 12001 |
|
1,385 |
1,245 |
$8K |
| 84156 |
|
3,967 |
3,242 |
$8K |
| 87338 |
|
808 |
770 |
$8K |
| 84100 |
|
21,288 |
13,284 |
$8K |
| 83883 |
|
1,684 |
707 |
$8K |
| 87651 |
|
14,696 |
13,423 |
$8K |
| 86256 |
|
712 |
534 |
$7K |
| G0378 |
Hospital observation per hr |
12,854 |
10,062 |
$7K |
| 87075 |
|
2,580 |
1,928 |
$7K |
| 80069 |
|
1,299 |
1,131 |
$7K |
| 90471 |
|
3,979 |
3,212 |
$7K |
| 87640 |
|
2,583 |
1,963 |
$7K |
| 94640 |
|
9,752 |
7,022 |
$7K |
| 86364 |
|
773 |
640 |
$7K |
| 29125 |
|
1,861 |
1,688 |
$7K |
| 87045 |
|
2,002 |
1,776 |
$7K |
| 12011 |
|
820 |
728 |
$7K |
| 81025 |
|
39,471 |
33,348 |
$6K |
| 84480 |
|
1,056 |
972 |
$6K |
| 99213 |
|
243 |
187 |
$6K |
| 76825 |
|
20 |
12 |
$6K |
| 86258 |
|
725 |
356 |
$6K |
| 81001 |
|
7,529 |
6,391 |
$6K |
| 93303 |
|
12 |
12 |
$6K |
| 84207 |
|
352 |
315 |
$6K |
| 83521 |
|
1,438 |
609 |
$6K |
| 86664 |
|
596 |
556 |
$6K |
| 93880 |
|
88 |
53 |
$6K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
22,116 |
18,437 |
$5K |
| 87177 |
|
1,587 |
1,343 |
$5K |
| 85018 |
|
3,062 |
2,825 |
$5K |
| 86359 |
|
544 |
496 |
$5K |
| 87185 |
|
13,749 |
12,334 |
$5K |
| 85014 |
|
3,019 |
2,784 |
$5K |
| 83721 |
|
806 |
749 |
$5K |
| 82150 |
|
1,348 |
1,229 |
$5K |
| 80164 |
|
942 |
691 |
$5K |
| 73090 |
|
987 |
791 |
$5K |
| 85379 |
|
5,455 |
4,629 |
$5K |
| 82248 |
|
2,781 |
2,094 |
$5K |
| 90686 |
|
374 |
340 |
$5K |
| 84703 |
|
2,107 |
1,912 |
$5K |
| 86663 |
|
596 |
556 |
$5K |
| 82947 |
|
1,589 |
1,441 |
$5K |
| 87493 |
|
485 |
399 |
$4K |
| 76813 |
|
2,775 |
2,384 |
$4K |
| 86901 |
|
16,545 |
13,247 |
$4K |
| 82247 |
|
1,126 |
688 |
$4K |
| 83090 |
|
356 |
318 |
$4K |
| 84436 |
|
948 |
893 |
$4K |
| 86231 |
|
408 |
268 |
$4K |
| 82952 |
|
1,197 |
1,127 |
$4K |
| 77336 |
|
87 |
26 |
$4K |
| 80177 |
|
864 |
672 |
$4K |
| 84154 |
|
307 |
282 |
$4K |
| 74220 |
|
31 |
25 |
$4K |
| 82977 |
|
900 |
830 |
$4K |
| 72114 |
|
63 |
53 |
$3K |
| 86708 |
|
333 |
318 |
$3K |
| 82565 |
|
1,250 |
1,084 |
$3K |
| 87641 |
|
1,079 |
884 |
$3K |
| 36416 |
|
38,692 |
19,965 |
$3K |
| 84484 |
|
36,950 |
22,752 |
$3K |
| 78306 |
|
16 |
13 |
$3K |
| 82677 |
|
161 |
145 |
$3K |
| 82785 |
|
260 |
234 |
$3K |
| 86304 |
|
253 |
202 |
$3K |
| 87811 |
|
82 |
74 |
$3K |
| 86677 |
|
176 |
96 |
$3K |
| 29105 |
|
47 |
41 |
$3K |
| 86200 |
|
303 |
280 |
$3K |
| 72040 |
|
127 |
114 |
$3K |
| 96376 |
|
8,184 |
4,549 |
$3K |
| 29130 |
|
824 |
756 |
$3K |
| 87040 |
|
10,462 |
5,822 |
$3K |
| U0002 |
Covid-19 lab test non-cdc |
92 |
79 |
$3K |
| 84305 |
|
142 |
136 |
$3K |
| 97597 |
|
37 |
12 |
$2K |
| 12002 |
|
187 |
160 |
$2K |
| 81050 |
|
1,358 |
714 |
$2K |
| 86336 |
|
176 |
160 |
$2K |
| 94618 |
|
363 |
261 |
$2K |
| 84450 |
|
1,419 |
1,298 |
$2K |
| 73660 |
|
348 |
304 |
$2K |
| 72170 |
|
97 |
80 |
$2K |
| 86704 |
|
167 |
155 |
$2K |
| 82465 |
|
397 |
384 |
$2K |
| 73700 |
|
16 |
15 |
$1K |
| 99203 |
|
12 |
12 |
$1K |
| M0220 |
Tixagev and cilgav inj |
26 |
14 |
$1K |
| 83993 |
|
119 |
111 |
$1K |
| 86039 |
|
158 |
146 |
$1K |
| 84181 |
|
106 |
48 |
$1K |
| 84145 |
|
3,184 |
2,576 |
$1K |
| 92610 |
|
30 |
25 |
$1K |
| 90715 |
|
2,715 |
2,292 |
$1K |
| 29515 |
|
13 |
12 |
$1K |
| 86146 |
|
71 |
25 |
$1K |
| 87205 |
|
1,959 |
1,292 |
$1K |
| 72052 |
|
15 |
12 |
$1K |
| 87254 |
|
69 |
64 |
$1K |
| 86301 |
|
119 |
102 |
$1K |
| J2543 |
Piperacillin/tazobactam |
1,442 |
428 |
$1K |
| 76857 |
|
16 |
14 |
$1K |
| 86147 |
|
63 |
25 |
$1K |
| 83010 |
|
199 |
169 |
$984.82 |
| 82166 |
|
39 |
38 |
$891.99 |
| 87880 |
|
5,678 |
5,213 |
$859.48 |
| 73060 |
|
264 |
226 |
$843.74 |
| 82232 |
|
182 |
146 |
$821.62 |
| G0279 |
Tomosynthesis, mammo |
278 |
200 |
$774.08 |
| 94762 |
|
34 |
13 |
$757.85 |
| 86308 |
|
476 |
439 |
$725.44 |
| 86645 |
|
55 |
51 |
$659.69 |
| 82948 |
|
39,282 |
15,895 |
$641.81 |
| 97163 |
|
14 |
12 |
$615.00 |
| G2024 |
Spec coll snf/lab covid-19 |
2,338 |
2,016 |
$614.55 |
| 73521 |
|
21 |
15 |
$613.80 |
| 86666 |
|
76 |
33 |
$583.20 |
| 96401 |
|
20 |
12 |
$578.67 |
| 86644 |
|
55 |
51 |
$563.75 |
| 88302 |
|
671 |
539 |
$538.73 |
| 84132 |
|
2,147 |
1,716 |
$512.73 |
| 83605 |
|
8,671 |
6,265 |
$482.32 |
| 82274 |
|
40 |
40 |
$471.24 |
| 87269 |
|
58 |
32 |
$469.45 |
| 86705 |
|
54 |
51 |
$461.25 |
| 87272 |
|
57 |
31 |
$458.00 |
| J0131 |
Inj, acetaminophen (nos) |
13,620 |
9,979 |
$449.68 |
| 83695 |
|
49 |
49 |
$444.96 |
| 82805 |
|
1,333 |
949 |
$438.22 |
| 87102 |
|
118 |
95 |
$425.06 |
| 87425 |
|
87 |
71 |
$412.20 |
| 85397 |
|
29 |
26 |
$394.38 |
| 82397 |
|
36 |
33 |
$377.72 |
| 80175 |
|
66 |
56 |
$367.14 |
| J3490 |
Drugs unclassified injection |
50,481 |
22,376 |
$357.34 |
| Q9969 |
Non-heu tc-99m add-on/dose |
662 |
539 |
$351.45 |
| 90656 |
|
22 |
22 |
$312.90 |
| 87563 |
|
14 |
13 |
$294.72 |
| J7040 |
Normal saline solution infus |
9,177 |
3,273 |
$284.41 |
| 86812 |
|
13 |
13 |
$271.15 |
| 84460 |
|
1,112 |
1,040 |
$261.71 |
| 84681 |
|
12 |
12 |
$238.44 |
| J1100 |
Dexamethasone sodium phos |
17,967 |
13,547 |
$217.95 |
| 90732 |
|
19 |
12 |
$215.50 |
| 85613 |
|
35 |
24 |
$201.08 |
| 76376 |
|
752 |
634 |
$200.00 |
| 71100 |
|
17 |
14 |
$170.23 |
| 82172 |
|
13 |
12 |
$162.80 |
| 84432 |
|
15 |
12 |
$153.40 |
| 85246 |
|
13 |
12 |
$153.37 |
| 85240 |
|
15 |
13 |
$136.80 |
| J7030 |
Normal saline solution infus |
7,959 |
6,344 |
$133.50 |
| J1650 |
Inj enoxaparin sodium |
4,119 |
1,682 |
$131.63 |
| 80156 |
|
16 |
13 |
$125.19 |
| A9270 |
Non-covered item or service |
92,168 |
68,094 |
$115.14 |
| J1885 |
Ketorolac tromethamine inj |
19,526 |
14,964 |
$110.76 |
| J7060 |
5% dextrose/water |
5,864 |
2,111 |
$110.00 |
| G0108 |
Diab manage trn per indiv |
1,205 |
647 |
$100.00 |
| 83519 |
|
15 |
12 |
$90.00 |
| 70360 |
|
47 |
39 |
$88.86 |
| 73600 |
|
61 |
52 |
$87.89 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
3,364 |
1,387 |
$87.70 |
| P9604 |
One-way allow prorated trip |
98 |
69 |
$87.15 |
| 82010 |
|
830 |
641 |
$84.86 |
| 85384 |
|
31 |
28 |
$81.10 |
| 81015 |
|
26,875 |
22,616 |
$79.14 |
| 89051 |
|
232 |
150 |
$78.90 |
| 82610 |
|
15 |
14 |
$77.88 |
| 82085 |
|
12 |
12 |
$75.90 |
| 82803 |
|
67 |
54 |
$67.44 |
| 88311 |
|
401 |
318 |
$67.21 |
| J3480 |
Inj potassium chloride |
592 |
345 |
$66.24 |
| 69209 |
|
243 |
220 |
$60.59 |
| J2270 |
Morphine sulfate injection |
8,026 |
5,825 |
$60.29 |
| 99212 |
|
63 |
48 |
$60.00 |
| J0696 |
Ceftriaxone sodium injection |
6,314 |
3,263 |
$56.88 |
| P9612 |
Catheterize for urine spec |
56 |
40 |
$54.60 |
| 82523 |
|
13 |
12 |
$53.55 |
| Q0144 |
Azithromycin dihydrate, oral |
472 |
420 |
$49.52 |
| 87184 |
|
30 |
26 |
$46.13 |
| A9585 |
Gadobutrol injection |
6,709 |
5,371 |
$44.36 |
| 87804 |
|
37 |
37 |
$34.35 |
| J8597 |
Antiemetic drug oral nos |
4,214 |
3,632 |
$30.41 |
| J3535 |
Metered dose inhaler drug |
2,980 |
2,407 |
$30.36 |
| J0780 |
Prochlorperazine injection |
755 |
607 |
$28.19 |
| 94664 |
|
1,123 |
468 |
$27.19 |
| J2405 |
Ondansetron hcl injection |
23,990 |
17,762 |
$21.62 |
| C9399 |
Unclassified drugs or biolog |
833 |
581 |
$15.64 |
| J2704 |
Inj, propofol, 10 mg |
23,980 |
16,675 |
$13.45 |
| S0028 |
Injection, famotidine, 20 mg |
7,485 |
5,331 |
$13.19 |
| J7512 |
Prednisone ir or dr oral 1mg |
2,641 |
2,050 |
$13.15 |
| J1170 |
Hydromorphone injection |
4,605 |
2,816 |
$11.25 |
| J2001 |
Lidocaine injection |
22,652 |
16,043 |
$11.21 |
| J1200 |
Diphenhydramine hcl injectio |
9,405 |
6,540 |
$10.27 |
| J7120 |
Ringers lactate infusion |
18,301 |
14,548 |
$10.19 |
| J2765 |
Metoclopramide hcl injection |
7,315 |
5,859 |
$9.38 |
| J2930 |
Methylprednisolone injection |
1,635 |
1,294 |
$9.02 |
| 94760 |
|
3,508 |
1,782 |
$8.65 |
| 82009 |
|
132 |
93 |
$8.62 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
630 |
494 |
$8.61 |
| J0690 |
Cefazolin sodium injection |
9,245 |
5,927 |
$8.48 |
| J2060 |
Lorazepam injection |
3,327 |
2,348 |
$8.16 |
| C9113 |
Inj pantoprazole sodium, via |
1,097 |
497 |
$7.94 |
| J2250 |
Inj midazolam hydrochloride |
15,134 |
11,775 |
$7.24 |
| 84520 |
|
53 |
43 |
$6.94 |
| J3475 |
Inj magnesium sulfate |
3,011 |
1,961 |
$6.81 |
| G8979 |
Mobility goal status |
1,131 |
607 |
$4.86 |
| J1836 |
Inj, metronidazole, 10 mg |
167 |
72 |
$4.50 |
| G8978 |
Mobility current status |
926 |
524 |
$3.87 |
| 85008 |
|
285 |
235 |
$3.02 |
| G0103 |
Psa screening |
49 |
43 |
$2.42 |
| J3010 |
Fentanyl citrate injection |
19,398 |
13,416 |
$2.18 |
| G8980 |
Mobility d/c status |
482 |
291 |
$1.88 |
| G8985 |
Carry goal status |
259 |
140 |
$1.13 |
| J1630 |
Haloperidol injection |
686 |
528 |
$0.91 |
| Q0162 |
Ondansetron oral |
1,628 |
1,452 |
$0.80 |
| G8984 |
Carry current status |
120 |
74 |
$0.55 |
| J7613 |
Albuterol non-comp unit |
1,703 |
1,177 |
$0.28 |
| J2370 |
Phenylephrine hcl injection |
1,630 |
1,129 |
$0.24 |
| J7050 |
Normal saline solution infus |
8,739 |
3,994 |
$0.00 |
| J1815 |
Insulin injection |
4,126 |
1,562 |
$0.00 |
| J2785 |
Regadenoson injection |
939 |
669 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
691 |
501 |
$0.00 |
| 64494 |
|
2,156 |
1,518 |
$0.00 |
| J3420 |
Vitamin b12 injection |
1,288 |
761 |
$0.00 |
| A9500 |
Tc99m sestamibi |
2,006 |
1,521 |
$0.00 |
| 88341 |
|
937 |
629 |
$0.00 |
| A4648 |
Implantable tissue marker |
1,188 |
923 |
$0.00 |
| C1769 |
Guide wire |
1,577 |
995 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
226 |
178 |
$0.00 |
| J1940 |
Furosemide injection |
341 |
192 |
$0.00 |
| 88172 |
|
96 |
75 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
639 |
451 |
$0.00 |
| J1030 |
Methylprednisolone 40 mg inj |
309 |
254 |
$0.00 |
| G9035 |
Oseltamivir phosp, brand |
48 |
45 |
$0.00 |
| G0472 |
Hep c screen high risk/other |
453 |
440 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
110 |
81 |
$0.00 |
| J1642 |
Inj heparin sodium per 10 u |
175 |
78 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
176 |
91 |
$0.00 |
| C1781 |
Mesh (implantable) |
58 |
49 |
$0.00 |
| 80050 |
|
89 |
82 |
$0.00 |
| 70547 |
|
15 |
12 |
$0.00 |
| 76820 |
|
199 |
52 |
$0.00 |
| J0360 |
Hydralazine hcl injection |
71 |
37 |
$0.00 |
| C1773 |
Ret dev, insertable |
22 |
12 |
$0.00 |
| A9503 |
Tc99m medronate |
32 |
25 |
$0.00 |
| S0020 |
Injection, bupivicaine hydro |
53 |
42 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
578 |
489 |
$0.00 |
| J0280 |
Aminophyllin 250 mg inj |
20 |
12 |
$0.00 |
| J2920 |
Methylprednisolone injection |
38 |
15 |
$0.00 |
| 76377 |
|
14 |
12 |
$0.00 |
| J0706 |
Caffeine citrate injection |
54 |
41 |
$0.00 |
| 94660 |
|
19 |
12 |
$0.00 |
| J0697 |
Sterile cefuroxime injection |
25 |
17 |
$0.00 |
| J3411 |
Thiamine hcl 100 mg |
116 |
52 |
$0.00 |
| J9045 |
Carboplatin injection |
24 |
12 |
$0.00 |
| 87449 |
|
22 |
12 |
$0.00 |
| 96368 |
|
22 |
14 |
$0.00 |
| 64495 |
|
1,422 |
1,059 |
$0.00 |
| Q0163 |
Diphenhydramine hcl 50mg |
3,189 |
2,240 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
1,304 |
1,009 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
4,715 |
3,226 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
463 |
330 |
$0.00 |
| 94729 |
|
2,884 |
2,233 |
$0.00 |
| 76827 |
|
12 |
12 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
418 |
265 |
$0.00 |
| J3489 |
Zoledronic acid 1mg |
318 |
240 |
$0.00 |
| C1887 |
Catheter, guiding |
161 |
98 |
$0.00 |
| 93325 |
|
606 |
480 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
85 |
66 |
$0.00 |
| 99152 |
|
1,131 |
860 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
9,665 |
3,812 |
$0.00 |
| 27096 |
|
848 |
760 |
$0.00 |
| C1776 |
Joint device (implantable) |
15 |
12 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
244 |
192 |
$0.00 |
| 0042T |
|
20 |
12 |
$0.00 |
| A9552 |
F18 fdg |
191 |
137 |
$0.00 |
| 88173 |
|
243 |
142 |
$0.00 |
| C1758 |
Catheter, ureteral |
38 |
25 |
$0.00 |
| J7510 |
Prednisolone oral per 5 mg |
181 |
153 |
$0.00 |
| J2916 |
Na ferric gluconate complex |
58 |
40 |
$0.00 |
| J0744 |
Ciprofloxacin iv |
15 |
12 |
$0.00 |
| C1788 |
Port, indwelling, imp |
53 |
39 |
$0.00 |
| 76942 |
|
82 |
55 |
$0.00 |
| 88360 |
|
24 |
13 |
$0.00 |
| 73551 |
|
16 |
13 |
$0.00 |
| C1760 |
Closure dev, vasc |
18 |
14 |
$0.00 |
| 77012 |
|
13 |
12 |
$0.00 |
| Q0220 |
Tixagev and cilgav, 300mg |
21 |
12 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
22 |
15 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
113 |
56 |
$0.00 |
| Q2038 |
Fluzone vacc, 3 yrs & >, im |
24 |
12 |
$0.00 |
| 73100 |
|
17 |
15 |
$0.00 |