| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
48,483 |
42,832 |
$12.91M |
| 99285 |
|
41,700 |
34,922 |
$11.70M |
| 99283 |
|
47,275 |
42,342 |
$9.54M |
| 74177 |
|
9,821 |
9,075 |
$5.02M |
| 96361 |
|
34,088 |
19,412 |
$3.90M |
| 0202U |
|
14,831 |
14,040 |
$3.70M |
| G0378 |
Hospital observation per hr |
37,511 |
14,089 |
$2.64M |
| A0427 |
Als1-emergency |
21,567 |
15,285 |
$2.55M |
| 69436 |
|
1,952 |
1,916 |
$2.49M |
| A0429 |
Bls-emergency |
18,586 |
13,497 |
$2.08M |
| 70450 |
|
11,358 |
10,215 |
$1.92M |
| 71046 |
|
19,963 |
18,221 |
$1.86M |
| D9420 |
|
1,126 |
1,101 |
$1.81M |
| 80053 |
|
100,827 |
79,315 |
$1.71M |
| 74176 |
|
2,900 |
2,712 |
$1.28M |
| 42820 |
|
665 |
655 |
$1.23M |
| 85025 |
|
109,665 |
76,357 |
$1.18M |
| G0463 |
Hospital outpt clinic visit |
26,046 |
18,590 |
$1.04M |
| 71045 |
|
24,604 |
20,063 |
$946K |
| 93005 |
|
32,913 |
25,253 |
$944K |
| 80307 |
|
16,587 |
13,661 |
$807K |
| A0425 |
Ground mileage |
46,121 |
29,648 |
$794K |
| 96372 |
|
38,466 |
23,583 |
$777K |
| 96375 |
|
27,248 |
19,257 |
$676K |
| 0240U |
|
6,275 |
5,818 |
$651K |
| 59025 |
|
10,513 |
6,885 |
$627K |
| 0241U |
|
5,099 |
4,894 |
$614K |
| 83880 |
|
26,709 |
21,022 |
$606K |
| 96365 |
|
12,165 |
8,811 |
$600K |
| 94640 |
|
16,776 |
8,228 |
$586K |
| 96374 |
|
34,517 |
25,727 |
$565K |
| 72125 |
|
3,570 |
3,294 |
$559K |
| 97110 |
|
34,984 |
7,938 |
$531K |
| 93306 |
|
3,348 |
2,764 |
$516K |
| 96366 |
|
7,989 |
3,644 |
$504K |
| 76705 |
|
3,024 |
2,715 |
$481K |
| 99282 |
|
5,405 |
5,115 |
$436K |
| 96360 |
|
7,099 |
5,667 |
$430K |
| 87081 |
|
36,232 |
33,199 |
$378K |
| 87804 |
|
24,667 |
11,011 |
$362K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
7,139 |
6,445 |
$344K |
| 71275 |
|
2,338 |
2,009 |
$340K |
| 76801 |
|
2,716 |
2,295 |
$329K |
| 71260 |
|
2,236 |
2,048 |
$324K |
| 84484 |
|
28,845 |
20,666 |
$313K |
| 78452 |
|
1,143 |
867 |
$307K |
| 76642 |
|
2,482 |
2,277 |
$281K |
| 81001 |
|
37,012 |
31,756 |
$273K |
| 93458 |
|
800 |
591 |
$257K |
| 87086 |
|
26,876 |
23,904 |
$251K |
| 84443 |
|
19,525 |
17,667 |
$250K |
| 74018 |
|
3,982 |
3,644 |
$246K |
| 87635 |
|
5,068 |
4,643 |
$229K |
| 96376 |
|
15,477 |
7,456 |
$222K |
| J2405 |
Ondansetron hcl injection |
30,236 |
24,995 |
$219K |
| D0150 |
|
569 |
557 |
$210K |
| 80048 |
|
31,063 |
18,147 |
$210K |
| 81025 |
|
16,658 |
14,753 |
$208K |
| 70553 |
|
834 |
754 |
$206K |
| 47562 |
|
84 |
79 |
$200K |
| G0480 |
Drug test def 1-7 classes |
4,380 |
3,933 |
$195K |
| 83690 |
|
17,882 |
15,204 |
$192K |
| 87040 |
|
10,958 |
9,196 |
$183K |
| 76817 |
|
2,492 |
2,103 |
$182K |
| 99212 |
|
12,199 |
10,056 |
$177K |
| 93971 |
|
2,024 |
1,880 |
$174K |
| 73630 |
|
2,520 |
2,342 |
$165K |
| C9803 |
Hopd covid-19 spec collect |
13,763 |
12,660 |
$163K |
| 93041 |
|
16,353 |
4,213 |
$162K |
| 99281 |
|
2,468 |
1,828 |
$156K |
| 72110 |
|
1,537 |
1,446 |
$155K |
| 99213 |
|
5,699 |
4,469 |
$154K |
| 99291 |
|
405 |
351 |
$153K |
| 73610 |
|
2,291 |
2,166 |
$152K |
| 73030 |
|
2,539 |
2,371 |
$148K |
| 77067 |
|
3,284 |
3,104 |
$147K |
| 74019 |
|
1,672 |
1,572 |
$145K |
| 80061 |
|
22,589 |
19,769 |
$140K |
| 87430 |
|
7,364 |
7,103 |
$140K |
| 86140 |
|
14,149 |
12,074 |
$139K |
| 88305 |
|
3,056 |
2,717 |
$136K |
| 90791 |
|
3,027 |
2,624 |
$130K |
| 72148 |
|
621 |
578 |
$129K |
| 73564 |
|
1,844 |
1,735 |
$128K |
| 87880 |
|
8,241 |
7,651 |
$126K |
| 36592 |
|
10,496 |
6,891 |
$122K |
| 87633 |
|
615 |
591 |
$121K |
| 85730 |
|
24,728 |
18,318 |
$121K |
| 82306 |
|
5,050 |
4,676 |
$117K |
| 70486 |
|
814 |
763 |
$116K |
| 93017 |
|
1,442 |
1,163 |
$114K |
| 85610 |
|
34,829 |
26,041 |
$113K |
| D1208 |
|
270 |
269 |
$111K |
| D1120 |
|
495 |
490 |
$110K |
| 73130 |
|
1,736 |
1,612 |
$108K |
| 73110 |
|
1,611 |
1,528 |
$105K |
| 88304 |
|
2,609 |
2,488 |
$104K |
| 84702 |
|
6,570 |
5,013 |
$102K |
| D2930 |
|
429 |
424 |
$100K |
| 76805 |
|
888 |
804 |
$98K |
| 85027 |
|
15,340 |
12,032 |
$96K |
| 87491 |
|
3,936 |
3,623 |
$95K |
| 73721 |
|
202 |
192 |
$93K |
| 95810 |
|
117 |
115 |
$91K |
| 96367 |
|
2,857 |
1,723 |
$90K |
| 76856 |
|
916 |
877 |
$89K |
| A0428 |
Bls |
4,237 |
2,362 |
$87K |
| 72100 |
|
1,373 |
1,297 |
$85K |
| 83036 |
|
13,570 |
11,736 |
$84K |
| 87807 |
|
4,526 |
4,115 |
$83K |
| 76830 |
|
440 |
422 |
$82K |
| 87591 |
|
3,934 |
3,619 |
$82K |
| 93975 |
|
329 |
313 |
$82K |
| 99214 |
|
2,713 |
1,751 |
$79K |
| 76942 |
|
900 |
812 |
$78K |
| 87077 |
|
7,773 |
6,953 |
$76K |
| J0696 |
Ceftriaxone sodium injection |
8,720 |
6,533 |
$74K |
| APT17 |
|
5,105 |
4,921 |
$73K |
| 80320 |
|
6,286 |
5,127 |
$71K |
| 87186 |
|
8,011 |
7,230 |
$70K |
| 97597 |
|
2,409 |
1,444 |
$70K |
| 73502 |
|
1,746 |
1,623 |
$70K |
| 83605 |
|
8,318 |
5,845 |
$68K |
| 86901 |
|
9,370 |
7,666 |
$68K |
| 84703 |
|
5,301 |
4,878 |
$66K |
| 96413 |
|
1,372 |
760 |
$66K |
| 76770 |
|
612 |
527 |
$64K |
| 81003 |
|
17,224 |
14,905 |
$63K |
| 82607 |
|
5,825 |
5,275 |
$61K |
| 97140 |
|
10,246 |
3,299 |
$61K |
| J7120 |
Ringers lactate infusion |
10,891 |
9,417 |
$60K |
| 83735 |
|
14,146 |
8,055 |
$59K |
| 99211 |
|
2,104 |
1,606 |
$59K |
| 97530 |
|
9,020 |
2,920 |
$58K |
| 86850 |
|
6,381 |
5,129 |
$58K |
| 73590 |
|
978 |
895 |
$56K |
| 93320 |
|
789 |
641 |
$55K |
| 93325 |
|
918 |
755 |
$54K |
| 72170 |
|
943 |
884 |
$54K |
| 77066 |
Tomosynthesis, mammo |
1,394 |
1,314 |
$54K |
| 87389 |
|
2,773 |
2,493 |
$53K |
| 82553 |
|
5,538 |
4,176 |
$53K |
| J7030 |
Normal saline solution infus |
15,157 |
10,724 |
$50K |
| 80074 |
|
1,404 |
1,188 |
$50K |
| 70551 |
|
578 |
495 |
$47K |
| 97161 |
|
3,674 |
3,341 |
$47K |
| G0379 |
Direct refer hospital observ |
1,264 |
1,029 |
$46K |
| 82728 |
|
4,587 |
3,995 |
$46K |
| 73090 |
|
653 |
632 |
$46K |
| APT15 |
|
3,918 |
3,222 |
$45K |
| J1100 |
Dexamethasone sodium phos |
18,084 |
16,700 |
$45K |
| 85379 |
|
4,427 |
3,796 |
$43K |
| 97112 |
|
5,676 |
2,017 |
$43K |
| 90853 |
|
1,054 |
98 |
$42K |
| J2357 |
Omalizumab injection |
45 |
24 |
$41K |
| 93351 |
|
213 |
182 |
$40K |
| 74021 |
|
637 |
553 |
$39K |
| G0390 |
Trauma respons w/hosp criti |
38 |
37 |
$39K |
| D3220 |
|
155 |
154 |
$37K |
| 84439 |
|
4,984 |
4,600 |
$37K |
| 82803 |
|
3,057 |
2,018 |
$37K |
| 82550 |
|
12,075 |
9,640 |
$36K |
| 12001 |
|
343 |
333 |
$34K |
| S9443 |
Lactation class |
895 |
687 |
$34K |
| 42830 |
|
24 |
24 |
$33K |
| 77063 |
|
2,925 |
2,790 |
$33K |
| 73080 |
|
556 |
526 |
$32K |
| APT16 |
|
2,223 |
2,110 |
$31K |
| 99215 |
Prolong outpt/office vis |
1,110 |
755 |
$31K |
| 83718 |
|
2,595 |
2,494 |
$29K |
| J1885 |
Ketorolac tromethamine inj |
11,760 |
10,210 |
$29K |
| 87070 |
|
3,465 |
2,993 |
$29K |
| 97010 |
|
7,217 |
2,050 |
$29K |
| 82948 |
|
7,701 |
4,026 |
$28K |
| 84145 |
|
1,647 |
1,266 |
$28K |
| 86900 |
|
7,559 |
6,110 |
$28K |
| 73562 |
|
803 |
751 |
$27K |
| 80143 |
|
1,567 |
1,409 |
$26K |
| J2704 |
Inj, propofol, 10 mg |
9,990 |
9,244 |
$26K |
| 87631 |
|
335 |
323 |
$25K |
| 97016 |
|
1,966 |
614 |
$24K |
| 83550 |
|
3,715 |
3,315 |
$24K |
| 80179 |
|
1,500 |
1,362 |
$24K |
| 90715 |
|
1,328 |
1,167 |
$23K |
| J2785 |
Regadenoson injection |
388 |
347 |
$23K |
| 36415 |
|
72,617 |
45,578 |
$22K |
| J3010 |
Fentanyl citrate injection |
12,767 |
11,850 |
$22K |
| J0690 |
Cefazolin sodium injection |
5,607 |
4,733 |
$21K |
| 88307 |
|
270 |
246 |
$21K |
| 36600 |
|
3,573 |
2,505 |
$21K |
| 84146 |
|
1,040 |
916 |
$21K |
| 83540 |
|
4,086 |
3,637 |
$20K |
| 87088 |
|
2,587 |
2,427 |
$19K |
| 76870 |
|
83 |
76 |
$19K |
| 93880 |
|
264 |
209 |
$18K |
| 12002 |
|
160 |
152 |
$18K |
| 84112 |
|
379 |
342 |
$18K |
| 85007 |
|
4,694 |
3,968 |
$17K |
| 72050 |
|
212 |
192 |
$17K |
| 84153 |
|
1,014 |
977 |
$16K |
| 85652 |
|
4,011 |
3,584 |
$16K |
| 88175 |
|
734 |
702 |
$15K |
| A0426 |
Als 1 |
352 |
273 |
$15K |
| 82805 |
|
889 |
650 |
$15K |
| 87205 |
|
3,552 |
3,063 |
$15K |
| J1170 |
Hydromorphone injection |
7,052 |
5,089 |
$15K |
| 71101 |
|
227 |
219 |
$15K |
| 82043 |
|
4,005 |
3,303 |
$15K |
| 82746 |
|
1,862 |
1,594 |
$14K |
| 80076 |
|
1,040 |
840 |
$14K |
| 82150 |
|
1,698 |
1,489 |
$14K |
| 51701 |
|
1,051 |
858 |
$14K |
| 83970 |
|
575 |
497 |
$13K |
| 80329 |
|
441 |
312 |
$13K |
| 97014 |
|
2,009 |
572 |
$13K |
| 76818 |
|
185 |
146 |
$13K |
| 90471 |
|
4,060 |
3,390 |
$13K |
| 12011 |
|
150 |
147 |
$13K |
| 76536 |
|
81 |
80 |
$12K |
| 72141 |
|
89 |
85 |
$12K |
| 93970 |
|
108 |
98 |
$12K |
| A9577 |
Inj multihance |
615 |
588 |
$12K |
| P9016 |
Rbc leukocytes reduced |
219 |
118 |
$12K |
| 10061 |
|
107 |
94 |
$12K |
| 82010 |
|
1,478 |
1,269 |
$12K |
| 86920 |
|
413 |
239 |
$12K |
| 90686 |
|
1,272 |
1,143 |
$11K |
| 72040 |
|
246 |
234 |
$11K |
| J0131 |
Inj, acetaminophen (nos) |
3,181 |
2,880 |
$11K |
| J3480 |
Inj potassium chloride |
3,288 |
1,783 |
$11K |
| 82247 |
|
1,842 |
1,125 |
$11K |
| 86803 |
|
1,312 |
1,219 |
$11K |
| J7050 |
Normal saline solution infus |
4,168 |
2,864 |
$11K |
| 76819 |
|
96 |
80 |
$10K |
| 73140 |
|
179 |
168 |
$9K |
| 87507 |
|
44 |
43 |
$9K |
| J0595 |
Butorphanol tartrate 1 mg |
1,228 |
959 |
$9K |
| J1980 |
Hyoscyamine sulfate inj |
343 |
326 |
$9K |
| 29581 |
|
497 |
150 |
$9K |
| 87661 |
|
644 |
587 |
$8K |
| A0433 |
Als 2 |
104 |
68 |
$8K |
| 97162 |
|
1,065 |
973 |
$8K |
| J2270 |
Morphine sulfate injection |
3,524 |
2,626 |
$8K |
| J2930 |
Methylprednisolone injection |
2,178 |
1,681 |
$8K |
| J7040 |
Normal saline solution infus |
2,808 |
2,421 |
$8K |
| 76000 |
|
453 |
386 |
$8K |
| 86592 |
|
1,997 |
1,777 |
$8K |
| J7042 |
5% dextrose/normal saline |
1,853 |
935 |
$8K |
| 95811 |
|
13 |
12 |
$7K |
| 72072 |
|
143 |
132 |
$7K |
| 82570 |
|
1,631 |
1,477 |
$7K |
| 82248 |
|
1,533 |
1,030 |
$7K |
| J2250 |
Inj midazolam hydrochloride |
8,837 |
8,209 |
$7K |
| 94644 |
|
686 |
545 |
$6K |
| 84550 |
|
1,418 |
1,266 |
$6K |
| J1650 |
Inj enoxaparin sodium |
5,274 |
2,032 |
$6K |
| U0003 |
Cov-19 amp prb hgh thruput |
72 |
67 |
$6K |
| 84481 |
|
369 |
350 |
$6K |
| 97116 |
|
1,307 |
578 |
$5K |
| G0279 |
Tomosynthesis, mammo |
769 |
735 |
$5K |
| M0243 |
Casirivi and imdevi inj |
67 |
64 |
$5K |
| 87798 |
|
139 |
118 |
$5K |
| 86038 |
|
496 |
435 |
$5K |
| G0410 |
Grp psych php/iop 45-50 |
122 |
12 |
$5K |
| 97535 |
|
1,484 |
986 |
$5K |
| J2795 |
Ropivacaine hcl injection |
648 |
602 |
$5K |
| M0222 |
Bebtelovimab injection |
51 |
49 |
$5K |
| G0283 |
Elec stim other than wound |
1,255 |
415 |
$5K |
| J1200 |
Diphenhydramine hcl injectio |
5,189 |
3,996 |
$5K |
| 87340 |
|
603 |
547 |
$5K |
| J2060 |
Lorazepam injection |
1,971 |
1,574 |
$5K |
| 84156 |
|
852 |
637 |
$5K |
| J2550 |
Promethazine hcl injection |
3,153 |
2,090 |
$5K |
| U0002 |
Covid-19 lab test non-cdc |
685 |
623 |
$5K |
| 36430 |
|
338 |
194 |
$5K |
| J1815 |
Insulin injection |
4,472 |
1,707 |
$4K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
362 |
342 |
$4K |
| 90688 |
|
412 |
365 |
$4K |
| 73560 |
|
142 |
130 |
$4K |
| J1644 |
Inj heparin sodium per 1000u |
6,456 |
2,520 |
$4K |
| 73552 |
|
96 |
92 |
$4K |
| J0461 |
Atropine sulfate injection |
626 |
581 |
$4K |
| 90460 |
|
359 |
309 |
$4K |
| 80164 |
|
376 |
310 |
$4K |
| J1741 |
Ibuprofen injection |
1,844 |
1,584 |
$4K |
| 82272 |
|
1,091 |
951 |
$4K |
| 86308 |
|
314 |
300 |
$4K |
| 84403 |
|
143 |
135 |
$4K |
| 87641 |
|
415 |
402 |
$4K |
| S0077 |
Injection, clindamycin phosp |
317 |
239 |
$3K |
| 71250 |
|
29 |
17 |
$3K |
| 84100 |
|
3,088 |
2,065 |
$3K |
| J1756 |
Iron sucrose injection |
111 |
43 |
$3K |
| 70498 |
|
41 |
39 |
$3K |
| 70496 |
|
28 |
26 |
$3K |
| 82565 |
|
1,274 |
887 |
$3K |
| 95816 |
|
26 |
25 |
$3K |
| J0171 |
Adrenalin epinephrine inject |
558 |
530 |
$3K |
| J1940 |
Furosemide injection |
4,040 |
1,815 |
$3K |
| J0360 |
Hydralazine hcl injection |
940 |
692 |
$3K |
| 94668 |
|
159 |
43 |
$3K |
| 76815 |
|
20 |
16 |
$2K |
| 72081 |
|
28 |
28 |
$2K |
| 97598 |
|
16 |
12 |
$2K |
| 80069 |
|
557 |
328 |
$2K |
| D7140 |
|
13 |
13 |
$2K |
| 77062 |
|
196 |
190 |
$2K |
| APT11 |
|
223 |
184 |
$2K |
| D2392 |
|
14 |
13 |
$2K |
| 74420 |
|
13 |
12 |
$2K |
| J3360 |
Diazepam injection |
352 |
325 |
$2K |
| Q0111 |
Wet mounts/ w preparations |
244 |
228 |
$2K |
| 85018 |
|
1,436 |
947 |
$2K |
| 83615 |
|
1,036 |
766 |
$2K |
| 82950 |
|
414 |
400 |
$2K |
| 87486 |
|
87 |
78 |
$2K |
| 86762 |
|
245 |
208 |
$2K |
| 87581 |
|
87 |
78 |
$2K |
| D2331 |
|
15 |
15 |
$2K |
| APT10 |
|
207 |
171 |
$2K |
| 87210 |
|
265 |
250 |
$2K |
| 72131 |
|
14 |
13 |
$2K |
| 87147 |
|
311 |
297 |
$2K |
| J3301 |
Triamcinolone acet inj nos |
271 |
249 |
$2K |
| 73060 |
|
39 |
39 |
$2K |
| J2370 |
Phenylephrine hcl injection |
1,492 |
1,346 |
$2K |
| 29505 |
|
92 |
89 |
$2K |
| J2919 |
Inj, methylpred sod succ 5mg |
355 |
298 |
$2K |
| G0257 |
Unsched dialysis esrd pt hos |
222 |
65 |
$2K |
| A9500 |
Tc99m sestamibi |
248 |
222 |
$2K |
| 29125 |
|
59 |
58 |
$2K |
| A9585 |
Gadobutrol injection |
172 |
151 |
$2K |
| J2360 |
Orphenadrine injection |
312 |
288 |
$2K |
| 77065 |
Tomosynthesis, mammo |
95 |
87 |
$2K |
| J3490 |
Drugs unclassified injection |
3,536 |
1,759 |
$2K |
| 70491 |
|
12 |
12 |
$1K |
| C8930 |
Tte w or w/o contr, cont ecg |
34 |
27 |
$1K |
| 91322 |
|
12 |
12 |
$1K |
| 17250 |
|
72 |
52 |
$1K |
| D2934 |
|
13 |
13 |
$1K |
| 90656 |
|
80 |
76 |
$1K |
| 64450 |
|
26 |
26 |
$1K |
| 82140 |
|
244 |
140 |
$1K |
| 85014 |
|
880 |
540 |
$1K |
| 11721 |
|
233 |
198 |
$1K |
| 93308 |
|
19 |
14 |
$1K |
| J2543 |
Piperacillin/tazobactam |
294 |
133 |
$1K |
| 97165 |
|
247 |
220 |
$1K |
| J2765 |
Metoclopramide hcl injection |
934 |
814 |
$1K |
| U0005 |
Infec agen detec ampli probe |
56 |
51 |
$989.89 |
| 87426 |
|
30 |
26 |
$976.94 |
| 90732 |
|
12 |
12 |
$954.00 |
| J0736 |
Inj, clindamycin phosp 300mg |
215 |
153 |
$933.55 |
| 73070 |
|
31 |
26 |
$885.14 |
| 10060 |
|
25 |
24 |
$846.33 |
| 85049 |
|
531 |
348 |
$802.81 |
| C9113 |
Inj pantoprazole sodium, via |
1,277 |
652 |
$781.11 |
| 94729 |
|
13 |
13 |
$777.19 |
| Q3014 |
Telehealth facility fee |
67 |
51 |
$722.31 |
| 82105 |
|
127 |
114 |
$720.13 |
| 88313 |
|
25 |
24 |
$708.97 |
| 83655 |
|
88 |
77 |
$701.20 |
| 71271 |
|
12 |
12 |
$701.03 |
| 97150 |
|
3,646 |
1,416 |
$684.41 |
| 11720 |
|
47 |
46 |
$672.06 |
| 87899 |
|
56 |
25 |
$644.22 |
| 86376 |
|
54 |
49 |
$638.98 |
| 82330 |
|
157 |
142 |
$638.82 |
| 84132 |
|
379 |
308 |
$606.76 |
| J0330 |
Succinycholine chloride inj |
111 |
104 |
$585.91 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
425 |
253 |
$585.37 |
| 84402 |
|
25 |
24 |
$574.36 |
| 88342 |
|
29 |
25 |
$567.92 |
| A6210 |
Foam drg >16<=48 sq in w/o b |
1,663 |
827 |
$556.26 |
| J3370 |
Vancomycin hcl injection |
145 |
84 |
$543.73 |
| 11042 |
|
15 |
13 |
$521.03 |
| J2920 |
Methylprednisolone injection |
189 |
86 |
$512.83 |
| S0166 |
Inj olanzapine 2.5mg |
23 |
16 |
$512.28 |
| 88312 |
|
15 |
12 |
$503.41 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
582 |
509 |
$479.35 |
| 90670 |
|
104 |
87 |
$475.22 |
| A9502 |
Tc99m tetrofosmin |
121 |
116 |
$472.50 |
| 96401 |
|
53 |
26 |
$471.20 |
| 82962 |
|
205 |
191 |
$459.96 |
| 85045 |
|
160 |
151 |
$447.83 |
| J0780 |
Prochlorperazine injection |
204 |
178 |
$438.34 |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
1,201 |
451 |
$402.38 |
| 87046 |
|
63 |
55 |
$400.92 |
| G2023 |
Specimen collect covid-19 |
55 |
50 |
$396.61 |
| 87801 |
|
12 |
12 |
$386.40 |
| 83986 |
|
81 |
75 |
$367.46 |
| 84436 |
|
103 |
91 |
$362.41 |
| 86923 |
|
38 |
27 |
$361.25 |
| 90480 |
|
12 |
12 |
$358.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
413 |
383 |
$340.73 |
| P9612 |
Catheterize for urine spec |
103 |
65 |
$328.78 |
| 87045 |
|
61 |
53 |
$320.29 |
| J3475 |
Inj magnesium sulfate |
233 |
135 |
$313.78 |
| J1920 |
Inj, labetalol hcl, 5mg |
232 |
133 |
$312.97 |
| Q9957 |
Inj perflutren lip micros,ml |
13 |
12 |
$306.51 |
| 86696 |
|
12 |
12 |
$296.00 |
| 87209 |
|
16 |
12 |
$276.08 |
| J1956 |
Levofloxacin injection |
43 |
28 |
$269.02 |
| 87425 |
|
16 |
14 |
$268.13 |
| Q9969 |
Non-heu tc-99m add-on/dose |
491 |
475 |
$257.19 |
| 86431 |
|
29 |
28 |
$250.29 |
| 92610 |
|
13 |
12 |
$245.64 |
| 83525 |
|
27 |
25 |
$240.71 |
| 80347 |
|
17 |
16 |
$227.07 |
| J1010 |
Inj, methylpred acetate 1 mg |
27 |
27 |
$226.16 |
| 29105 |
|
12 |
12 |
$212.68 |
| 11056 |
|
14 |
14 |
$209.14 |
| 86695 |
|
12 |
12 |
$208.29 |
| APT09 |
|
15 |
14 |
$178.65 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
239 |
227 |
$177.41 |
| 90662 |
|
25 |
25 |
$164.24 |
| 81050 |
|
41 |
36 |
$155.63 |
| J1953 |
Levetiracetam injection |
17 |
14 |
$152.79 |
| 99406 |
|
81 |
80 |
$145.97 |
| J2470 |
Inj pantoprazole sodium 40mg |
203 |
140 |
$140.60 |
| J2710 |
Neostigmine methylslfte inj |
47 |
44 |
$135.59 |
| 87015 |
|
45 |
38 |
$133.41 |
| 87449 |
|
17 |
16 |
$133.11 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
139 |
112 |
$130.65 |
| 87427 |
|
17 |
16 |
$122.45 |
| J1642 |
Inj heparin sodium per 10 u |
675 |
174 |
$113.76 |
| 3044F |
|
91 |
87 |
$113.17 |
| 87177 |
|
16 |
12 |
$109.25 |
| 84520 |
|
49 |
49 |
$94.13 |
| J8499 |
Oral prescrip drug non chemo |
89 |
68 |
$92.86 |
| 51702 |
|
17 |
12 |
$86.23 |
| 96160 |
|
131 |
119 |
$77.16 |
| 84466 |
|
17 |
17 |
$76.11 |
| 80178 |
|
15 |
13 |
$74.47 |
| J0688 |
Inj cefazolin sodium, hikma |
80 |
39 |
$71.25 |
| 97166 |
|
27 |
26 |
$70.70 |
| 82465 |
|
13 |
12 |
$69.30 |
| J3105 |
Terbutaline sulfate inj |
16 |
13 |
$53.07 |
| 82977 |
|
14 |
12 |
$52.62 |
| 84460 |
|
13 |
12 |
$49.77 |
| 97164 |
|
15 |
13 |
$47.16 |
| J2004 |
Inj, lidocaine w epinephrine |
43 |
43 |
$45.65 |
| 87493 |
|
15 |
12 |
$42.48 |
| J2300 |
Inj nalbuphine hydrochloride |
19 |
14 |
$38.85 |
| J3420 |
Vitamin b12 injection |
64 |
44 |
$36.58 |
| J0456 |
Azithromycin |
38 |
25 |
$34.25 |
| 84295 |
|
18 |
13 |
$31.88 |
| 99173 |
|
79 |
65 |
$30.60 |
| 90658 |
|
16 |
15 |
$26.12 |
| J1630 |
Haloperidol injection |
24 |
14 |
$24.35 |
| 92551 |
|
59 |
47 |
$22.07 |
| Q0247 |
Sotrovimab |
26 |
25 |
$17.20 |
| 70544 |
|
19 |
12 |
$16.97 |
| G0008 |
Admin influenza virus vac |
550 |
503 |
$11.74 |
| 96127 |
|
17 |
16 |
$8.56 |
| Q0244 |
Casirivi and imdevi 1200 mg |
177 |
159 |
$7.85 |
| 36416 |
|
14 |
12 |
$5.36 |
| J7512 |
Prednisone ir or dr oral 1mg |
101 |
40 |
$4.74 |
| 96161 |
|
17 |
14 |
$2.86 |
| Q0222 |
Bebtelovimab 175 mg |
33 |
32 |
$1.12 |
| G8979 |
Mobility goal status |
209 |
179 |
$0.00 |
| G8978 |
Mobility current status |
208 |
179 |
$0.00 |
| G1004 |
Cdsm ndsc |
1,061 |
800 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |
| G8985 |
Carry goal status |
27 |
26 |
$0.00 |
| 64447 |
|
13 |
13 |
$0.00 |
| G8984 |
Carry current status |
28 |
27 |
$0.00 |
| 80354 |
|
17 |
16 |
$0.00 |
| 80348 |
|
17 |
16 |
$0.00 |
| Q0245 |
Bamlanivimab and etesevima |
15 |
13 |
$0.00 |
| 90734 |
|
14 |
14 |
$0.00 |
| A9270 |
Non-covered item or service |
17,862 |
6,546 |
$0.00 |
| 90651 |
|
25 |
23 |
$0.00 |
| 90620 |
|
17 |
17 |
$0.00 |
| 99495 |
|
13 |
13 |
$0.00 |
| G8510 |
Scr dep neg, no plan reqd |
12 |
12 |
$0.00 |
| G8981 |
Body pos current status |
14 |
13 |
$0.00 |
| G8982 |
Body pos goal status |
15 |
14 |
$0.00 |
| 90647 |
|
26 |
18 |
$0.00 |
| 80050 |
|
30 |
30 |
$0.00 |
| 90723 |
|
29 |
22 |
$0.00 |
| 41899 |
|
12 |
12 |
$0.00 |
| C1769 |
Guide wire |
13 |
12 |
$0.00 |
| 87640 |
|
14 |
13 |
$0.00 |