| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpt clinic visit |
191,373 |
153,053 |
$17.85M |
| 99213 |
|
118,442 |
110,278 |
$7.87M |
| 96361 |
|
20,922 |
14,759 |
$6.42M |
| 99285 |
|
49,296 |
40,593 |
$6.34M |
| 99284 |
|
48,375 |
42,921 |
$5.62M |
| 99283 |
|
42,376 |
39,130 |
$4.58M |
| 99212 |
|
43,741 |
40,586 |
$4.46M |
| 99214 |
|
39,614 |
37,666 |
$2.73M |
| 70450 |
|
11,337 |
9,335 |
$2.67M |
| 97110 |
|
26,704 |
8,115 |
$2.01M |
| 74177 |
|
8,569 |
6,614 |
$2.01M |
| 41899 |
|
1,198 |
929 |
$986K |
| 96365 |
|
6,768 |
4,391 |
$972K |
| 0241U |
|
7,279 |
5,657 |
$883K |
| U0003 |
Cov-19 amp prb hgh thruput |
7,782 |
6,898 |
$811K |
| 80053 |
|
58,537 |
45,930 |
$785K |
| 96360 |
|
3,508 |
2,734 |
$706K |
| 96366 |
|
3,126 |
1,386 |
$659K |
| G0378 |
Hospital observation per hr |
7,845 |
3,025 |
$592K |
| 71260 |
|
2,679 |
1,977 |
$530K |
| 80048 |
|
65,115 |
53,346 |
$521K |
| 99202 |
|
8,020 |
7,479 |
$498K |
| 78452 |
|
1,094 |
790 |
$461K |
| 99203 |
|
6,874 |
6,405 |
$453K |
| 0202U |
|
2,571 |
2,478 |
$453K |
| 74176 |
|
1,493 |
1,070 |
$400K |
| 52000 |
|
668 |
536 |
$381K |
| 62323 |
|
1,024 |
867 |
$363K |
| 93306 |
|
1,458 |
1,159 |
$356K |
| 94640 |
|
2,773 |
2,052 |
$338K |
| C9803 |
Hopd covid-19 spec collect |
10,794 |
10,066 |
$330K |
| 84443 |
|
20,302 |
17,683 |
$301K |
| 82306 |
|
13,499 |
12,037 |
$285K |
| 99282 |
|
2,571 |
2,064 |
$280K |
| 96127 |
|
3,954 |
2,923 |
$278K |
| 97140 |
|
9,833 |
3,489 |
$276K |
| 85025 |
|
97,340 |
78,617 |
$267K |
| 80061 |
|
23,589 |
21,033 |
$260K |
| 20610 |
|
1,369 |
987 |
$213K |
| 97530 |
|
4,845 |
2,185 |
$207K |
| D2930 |
|
368 |
71 |
$199K |
| 97161 |
|
3,161 |
2,706 |
$191K |
| 11042 |
|
1,536 |
634 |
$190K |
| 99396 |
|
1,721 |
1,316 |
$186K |
| 99395 |
|
1,508 |
1,158 |
$178K |
| 36415 |
|
155,564 |
117,151 |
$174K |
| 70498 |
|
613 |
460 |
$172K |
| 59025 |
|
1,064 |
545 |
$169K |
| 83036 |
|
12,937 |
11,136 |
$165K |
| 93458 |
|
155 |
95 |
$162K |
| 71046 |
|
17,959 |
15,334 |
$161K |
| 84484 |
|
34,838 |
24,961 |
$157K |
| 97112 |
|
3,429 |
1,345 |
$155K |
| 81003 |
|
38,381 |
34,844 |
$154K |
| 95810 |
|
248 |
216 |
$152K |
| 95811 |
|
225 |
178 |
$146K |
| 99211 |
|
1,102 |
970 |
$139K |
| 70491 |
|
430 |
320 |
$138K |
| 93975 |
|
957 |
696 |
$137K |
| 76642 |
|
1,364 |
919 |
$134K |
| J3490 |
Drugs unclassified injection |
32,396 |
20,010 |
$131K |
| 70553 |
|
518 |
442 |
$129K |
| 76705 |
|
1,437 |
999 |
$127K |
| 92507 |
|
1,634 |
516 |
$125K |
| 76700 |
|
728 |
592 |
$123K |
| 80307 |
|
8,998 |
6,985 |
$123K |
| 51700 |
|
484 |
196 |
$113K |
| 96367 |
|
1,535 |
831 |
$110K |
| 93005 |
|
46,096 |
35,863 |
$106K |
| 20553 |
|
836 |
676 |
$105K |
| 90677 |
|
622 |
473 |
$99K |
| 93017 |
|
1,199 |
901 |
$98K |
| C8929 |
Tte w or wo fol wcon,doppler |
454 |
357 |
$96K |
| 85027 |
|
21,444 |
15,729 |
$95K |
| 90839 |
|
725 |
563 |
$90K |
| 93971 |
|
2,024 |
1,710 |
$89K |
| 94060 |
|
915 |
799 |
$89K |
| 77067 |
|
2,772 |
2,244 |
$87K |
| 80076 |
|
18,258 |
16,387 |
$87K |
| 96413 |
|
982 |
396 |
$85K |
| 93970 |
|
1,280 |
1,094 |
$85K |
| 97162 |
|
1,678 |
1,430 |
$81K |
| 76770 |
|
521 |
435 |
$81K |
| 84439 |
|
4,046 |
3,395 |
$78K |
| 72148 |
|
463 |
396 |
$76K |
| 87081 |
|
3,380 |
3,290 |
$73K |
| 72100 |
|
2,376 |
1,934 |
$70K |
| 71250 |
|
777 |
688 |
$69K |
| 97535 |
|
2,207 |
1,430 |
$68K |
| 76536 |
|
630 |
533 |
$67K |
| 10060 |
|
385 |
289 |
$66K |
| 82607 |
|
3,831 |
3,137 |
$66K |
| 76830 |
|
1,287 |
971 |
$65K |
| 93798 |
|
1,109 |
182 |
$64K |
| 97113 |
|
845 |
274 |
$63K |
| 97014 |
|
1,749 |
601 |
$62K |
| 82728 |
|
5,195 |
4,295 |
$58K |
| 95886 |
|
178 |
146 |
$57K |
| 86850 |
|
2,871 |
2,104 |
$56K |
| 74018 |
|
2,151 |
1,648 |
$54K |
| 77063 |
|
1,090 |
876 |
$51K |
| 86140 |
|
2,979 |
2,366 |
$49K |
| 73564 |
|
2,425 |
1,883 |
$49K |
| 87086 |
|
17,446 |
14,277 |
$48K |
| 73721 |
|
233 |
201 |
$47K |
| 76805 |
|
354 |
305 |
$47K |
| 96372 |
|
20,805 |
14,577 |
$46K |
| 12001 |
|
281 |
223 |
$45K |
| 50590 |
|
19 |
12 |
$45K |
| 99281 |
|
335 |
295 |
$44K |
| 97016 |
|
1,520 |
467 |
$43K |
| 83540 |
|
5,981 |
4,976 |
$42K |
| 72131 |
|
430 |
339 |
$42K |
| 94729 |
|
959 |
848 |
$42K |
| 73630 |
|
2,974 |
2,263 |
$42K |
| 86803 |
|
2,349 |
1,921 |
$41K |
| 87070 |
|
3,270 |
2,731 |
$40K |
| 90715 |
|
2,551 |
1,811 |
$40K |
| 97165 |
|
734 |
586 |
$40K |
| 72050 |
|
960 |
793 |
$39K |
| 70551 |
|
230 |
181 |
$38K |
| 82805 |
|
1,444 |
961 |
$37K |
| 87491 |
|
6,157 |
4,885 |
$37K |
| 73030 |
|
2,313 |
1,667 |
$37K |
| 86900 |
|
3,127 |
2,281 |
$36K |
| 97116 |
|
1,682 |
687 |
$34K |
| 94726 |
|
633 |
557 |
$33K |
| 73130 |
|
2,258 |
1,657 |
$33K |
| 83550 |
|
5,721 |
4,773 |
$33K |
| 87633 |
|
316 |
251 |
$32K |
| 72125 |
|
2,378 |
1,770 |
$32K |
| 76817 |
|
791 |
573 |
$31K |
| 73610 |
|
2,533 |
1,948 |
$31K |
| D1110 |
|
571 |
379 |
$31K |
| 71045 |
|
10,349 |
8,369 |
$30K |
| 87389 |
|
2,142 |
1,664 |
$30K |
| 83735 |
|
11,696 |
7,163 |
$29K |
| 97802 |
|
480 |
376 |
$29K |
| 71271 |
|
217 |
180 |
$29K |
| 99291 |
|
228 |
176 |
$29K |
| 87591 |
|
6,165 |
4,889 |
$27K |
| 87804 |
|
4,696 |
2,439 |
$27K |
| 96374 |
|
29,284 |
23,941 |
$27K |
| 77080 |
|
444 |
364 |
$27K |
| 76856 |
|
166 |
137 |
$27K |
| 84436 |
|
1,803 |
1,625 |
$26K |
| 88305 |
|
1,863 |
1,346 |
$26K |
| 97166 |
|
451 |
360 |
$25K |
| 87637 |
|
506 |
503 |
$25K |
| J0702 |
Betamethasone acet&sod phosp |
1,579 |
1,095 |
$24K |
| D0120 |
|
761 |
494 |
$21K |
| 70486 |
|
791 |
595 |
$21K |
| 83992 |
|
1,631 |
1,485 |
$21K |
| 72110 |
|
572 |
496 |
$21K |
| 99204 |
|
303 |
273 |
$20K |
| 73110 |
|
1,552 |
1,185 |
$20K |
| 84702 |
|
1,944 |
1,256 |
$20K |
| 85610 |
|
7,884 |
5,034 |
$20K |
| 73502 |
|
1,186 |
927 |
$20K |
| 64493 |
|
40 |
25 |
$20K |
| 80326 |
|
1,633 |
1,486 |
$20K |
| 72141 |
|
112 |
101 |
$19K |
| 81001 |
|
18,345 |
13,360 |
$19K |
| 93799 |
|
3,891 |
1,119 |
$19K |
| 99394 |
|
161 |
129 |
$19K |
| 82570 |
|
2,285 |
1,925 |
$18K |
| 93880 |
|
229 |
177 |
$18K |
| 80338 |
|
1,759 |
1,582 |
$18K |
| G0296 |
Visit to determ ldct elig |
334 |
272 |
$17K |
| 80370 |
|
1,758 |
1,583 |
$17K |
| 80373 |
|
1,759 |
1,583 |
$17K |
| 80355 |
|
1,760 |
1,583 |
$17K |
| 80367 |
|
1,759 |
1,583 |
$17K |
| 80372 |
|
1,758 |
1,582 |
$17K |
| 80366 |
|
1,758 |
1,582 |
$17K |
| 80368 |
|
1,758 |
1,582 |
$17K |
| 80357 |
|
1,758 |
1,582 |
$17K |
| 83970 |
|
648 |
534 |
$17K |
| 87880 |
|
4,034 |
3,970 |
$17K |
| 12011 |
|
105 |
81 |
$17K |
| 84153 |
|
1,545 |
1,283 |
$17K |
| 80331 |
|
1,633 |
1,486 |
$17K |
| 86038 |
|
784 |
598 |
$16K |
| 80337 |
|
1,632 |
1,485 |
$16K |
| 80334 |
|
1,632 |
1,485 |
$16K |
| 74178 |
|
71 |
64 |
$16K |
| 99460 |
|
230 |
207 |
$16K |
| 80377 |
|
1,633 |
1,486 |
$16K |
| 80341 |
|
1,633 |
1,486 |
$16K |
| 80344 |
|
1,632 |
1,485 |
$16K |
| 83880 |
|
3,187 |
2,365 |
$16K |
| D0274 |
|
519 |
347 |
$16K |
| 99393 |
|
155 |
125 |
$16K |
| 86780 |
|
1,331 |
1,036 |
$16K |
| 80346 |
|
1,760 |
1,583 |
$16K |
| 77062 |
|
455 |
367 |
$16K |
| 80361 |
|
1,759 |
1,583 |
$15K |
| 80365 |
|
1,760 |
1,584 |
$15K |
| 80348 |
|
1,760 |
1,583 |
$15K |
| 80354 |
|
1,760 |
1,583 |
$15K |
| 80359 |
|
1,758 |
1,582 |
$15K |
| 80358 |
|
1,759 |
1,583 |
$15K |
| 77336 |
|
185 |
81 |
$15K |
| 71275 |
|
43 |
42 |
$15K |
| U0005 |
Infec agen detec ampli probe |
4,315 |
3,575 |
$15K |
| 90688 |
|
862 |
552 |
$15K |
| 80364 |
|
1,632 |
1,486 |
$14K |
| 80353 |
|
1,633 |
1,486 |
$14K |
| 80360 |
|
1,631 |
1,485 |
$14K |
| 80371 |
|
1,631 |
1,485 |
$14K |
| 99215 |
Prolong outpt/office vis |
150 |
148 |
$14K |
| 82043 |
|
2,464 |
2,082 |
$14K |
| 81002 |
|
4,105 |
2,754 |
$14K |
| 84481 |
|
1,284 |
1,072 |
$14K |
| 99391 |
|
155 |
109 |
$13K |
| 88307 |
|
98 |
50 |
$13K |
| 99232 |
|
713 |
317 |
$13K |
| D7140 |
|
24 |
12 |
$13K |
| 87635 |
|
2,076 |
1,590 |
$13K |
| 12002 |
|
93 |
63 |
$13K |
| 87340 |
|
1,050 |
801 |
$12K |
| 19083 |
|
19 |
14 |
$12K |
| 82962 |
|
9,218 |
2,824 |
$12K |
| 99406 |
|
491 |
422 |
$12K |
| 99392 |
|
104 |
77 |
$12K |
| 97602 |
|
94 |
49 |
$12K |
| 70496 |
|
640 |
483 |
$11K |
| 82746 |
|
1,548 |
1,260 |
$11K |
| 72040 |
|
373 |
295 |
$11K |
| 80320 |
|
1,338 |
1,212 |
$11K |
| 72072 |
|
401 |
342 |
$11K |
| 90471 |
|
3,743 |
2,579 |
$11K |
| 88341 |
|
166 |
115 |
$11K |
| 97164 |
|
148 |
118 |
$11K |
| 77061 |
|
296 |
227 |
$10K |
| 51798 |
|
2,293 |
1,795 |
$10K |
| D2392 |
|
115 |
64 |
$10K |
| 83690 |
|
14,878 |
11,937 |
$10K |
| 73140 |
|
1,035 |
783 |
$10K |
| 87507 |
|
109 |
86 |
$10K |
| 77065 |
Tomosynthesis, mammo |
634 |
502 |
$10K |
| 73221 |
|
50 |
40 |
$10K |
| 80069 |
|
527 |
417 |
$10K |
| 78815 |
|
16 |
16 |
$10K |
| 90792 |
|
44 |
44 |
$9K |
| P9016 |
Rbc leukocytes reduced |
21 |
12 |
$9K |
| 96375 |
|
17,973 |
13,540 |
$9K |
| 86901 |
|
3,125 |
2,280 |
$9K |
| 49083 |
|
26 |
13 |
$9K |
| 73560 |
|
887 |
654 |
$9K |
| 94010 |
|
114 |
102 |
$9K |
| 45380 |
|
17 |
12 |
$8K |
| 87077 |
|
2,567 |
1,984 |
$8K |
| 86706 |
|
509 |
411 |
$8K |
| J1756 |
Iron sucrose injection |
335 |
111 |
$8K |
| 99152 |
|
1,007 |
710 |
$8K |
| 80197 |
|
602 |
255 |
$8K |
| D1206 |
|
323 |
210 |
$8K |
| 82784 |
|
586 |
433 |
$8K |
| 86762 |
|
509 |
388 |
$8K |
| 99238 |
|
277 |
243 |
$8K |
| 84403 |
|
555 |
427 |
$7K |
| 81025 |
|
7,675 |
6,013 |
$7K |
| 85652 |
|
2,139 |
1,518 |
$7K |
| 87522 |
Neg quan hep c or qual rna |
395 |
283 |
$7K |
| 86431 |
|
603 |
488 |
$7K |
| 96376 |
|
4,158 |
1,815 |
$7K |
| 64635 |
|
19 |
12 |
$7K |
| 93225 |
|
75 |
54 |
$7K |
| 73590 |
|
790 |
560 |
$7K |
| 84100 |
|
1,571 |
844 |
$6K |
| 87651 |
|
4,317 |
3,421 |
$6K |
| 82550 |
|
2,504 |
1,595 |
$6K |
| 87486 |
|
166 |
107 |
$6K |
| 93010 |
|
1,839 |
1,314 |
$6K |
| 71101 |
|
545 |
430 |
$6K |
| 76981 |
|
156 |
126 |
$6K |
| 90686 |
|
683 |
637 |
$6K |
| 73080 |
|
624 |
480 |
$6K |
| 62321 |
|
14 |
12 |
$6K |
| 99223 |
Prolong inpt eval add15 m |
92 |
76 |
$5K |
| D0140 |
|
135 |
91 |
$5K |
| 80164 |
|
559 |
439 |
$5K |
| 76816 |
|
53 |
51 |
$5K |
| 76870 |
|
184 |
130 |
$5K |
| 87536 |
|
105 |
74 |
$5K |
| 84550 |
|
1,014 |
699 |
$5K |
| 84703 |
|
8,994 |
7,146 |
$5K |
| 64430 |
|
17 |
12 |
$5K |
| 87430 |
|
4,299 |
3,416 |
$5K |
| 86480 |
|
135 |
110 |
$5K |
| 82077 |
|
5,215 |
3,536 |
$5K |
| 86359 |
|
73 |
46 |
$5K |
| 86364 |
|
247 |
176 |
$5K |
| 77066 |
Tomosynthesis, mammo |
494 |
405 |
$5K |
| 86235 |
|
292 |
168 |
$5K |
| 76815 |
|
65 |
55 |
$5K |
| 83615 |
|
687 |
484 |
$4K |
| 87186 |
|
2,779 |
2,190 |
$4K |
| 73090 |
|
550 |
414 |
$4K |
| 86141 |
|
162 |
141 |
$4K |
| 87640 |
|
279 |
238 |
$4K |
| 85651 |
|
867 |
817 |
$4K |
| 88142 |
|
884 |
756 |
$4K |
| 86703 |
|
253 |
241 |
$4K |
| 86787 |
|
337 |
256 |
$4K |
| 93270 |
|
35 |
25 |
$4K |
| 73700 |
|
36 |
25 |
$4K |
| H1000 |
Prenatal care atrisk assessm |
57 |
52 |
$4K |
| 87661 |
|
1,216 |
947 |
$4K |
| 91320 |
|
45 |
45 |
$4K |
| 76801 |
|
46 |
43 |
$3K |
| G0480 |
Drug test def 1-7 classes |
232 |
175 |
$3K |
| 82330 |
|
1,815 |
1,143 |
$3K |
| 84402 |
|
199 |
155 |
$3K |
| 82670 |
|
149 |
104 |
$3K |
| 87493 |
|
225 |
180 |
$3K |
| 96368 |
|
247 |
149 |
$3K |
| 83605 |
|
5,594 |
3,475 |
$3K |
| 99153 |
Mod sedat endo service >5yrs |
738 |
520 |
$3K |
| 97803 |
|
43 |
40 |
$3K |
| G0483 |
Drug test def 22+ classes |
420 |
377 |
$3K |
| 93296 |
|
208 |
197 |
$3K |
| 87636 |
|
267 |
209 |
$3K |
| 80074 |
|
152 |
95 |
$3K |
| 87210 |
|
1,140 |
882 |
$3K |
| 84630 |
|
148 |
110 |
$3K |
| 82565 |
|
497 |
391 |
$3K |
| 90658 |
|
336 |
326 |
$3K |
| 73562 |
|
74 |
67 |
$3K |
| 87497 |
|
175 |
62 |
$3K |
| 87581 |
|
165 |
107 |
$3K |
| 88342 |
|
537 |
366 |
$3K |
| 97035 |
|
26 |
12 |
$3K |
| 87624 |
|
479 |
351 |
$3K |
| 82977 |
|
370 |
203 |
$3K |
| 82947 |
|
1,562 |
1,096 |
$3K |
| D0220 |
|
309 |
195 |
$2K |
| 87147 |
|
1,047 |
734 |
$2K |
| 87641 |
|
280 |
238 |
$2K |
| 86376 |
|
123 |
84 |
$2K |
| J2270 |
Morphine sulfate injection |
10,732 |
7,171 |
$2K |
| 85379 |
|
1,789 |
1,301 |
$2K |
| 82533 |
|
138 |
112 |
$2K |
| 84156 |
|
607 |
446 |
$2K |
| 85730 |
|
3,342 |
2,131 |
$2K |
| 74022 |
|
270 |
194 |
$2K |
| 87040 |
|
2,468 |
1,080 |
$2K |
| 73552 |
|
292 |
191 |
$2K |
| 88304 |
|
469 |
304 |
$2K |
| 82950 |
|
262 |
210 |
$2K |
| 82140 |
|
303 |
206 |
$2K |
| 87205 |
|
1,134 |
907 |
$2K |
| 84480 |
|
125 |
87 |
$2K |
| 90674 |
|
91 |
91 |
$2K |
| 80321 |
|
127 |
97 |
$2K |
| 86160 |
|
193 |
100 |
$2K |
| 73620 |
|
66 |
64 |
$2K |
| 83001 |
|
114 |
94 |
$2K |
| 84132 |
|
3,154 |
2,192 |
$2K |
| 90833 |
|
16 |
16 |
$2K |
| 82677 |
|
57 |
54 |
$2K |
| D1120 |
|
70 |
40 |
$2K |
| 82105 |
|
115 |
94 |
$2K |
| 73660 |
|
162 |
136 |
$2K |
| 86258 |
|
48 |
25 |
$2K |
| J2543 |
Piperacillin/tazobactam |
669 |
269 |
$2K |
| 86200 |
|
181 |
167 |
$2K |
| J1644 |
Inj heparin sodium per 1000u |
4,691 |
1,538 |
$2K |
| J2272 |
Inj, morphine (fresenius) |
1,121 |
474 |
$2K |
| 84144 |
|
45 |
26 |
$2K |
| 77334 |
|
14 |
12 |
$2K |
| 84145 |
|
1,613 |
1,131 |
$2K |
| 90480 |
|
45 |
45 |
$2K |
| 82248 |
|
157 |
91 |
$1K |
| 86704 |
|
91 |
63 |
$1K |
| 73070 |
|
79 |
60 |
$1K |
| 82103 |
|
82 |
46 |
$1K |
| 80333 |
|
127 |
97 |
$1K |
| 80345 |
|
127 |
97 |
$1K |
| 85018 |
|
1,937 |
1,263 |
$1K |
| 95806 |
|
18 |
15 |
$1K |
| 80363 |
|
127 |
97 |
$1K |
| Q3014 |
Telehealth facility fee |
723 |
652 |
$1K |
| 96523 |
|
24 |
24 |
$1K |
| 87905 |
|
1,137 |
918 |
$1K |
| 84134 |
|
102 |
83 |
$1K |
| 99233 |
Prolong inpt eval add15 m |
53 |
19 |
$1K |
| 73060 |
|
121 |
95 |
$1K |
| 90460 |
|
369 |
248 |
$1K |
| D0330 |
|
19 |
18 |
$1K |
| 83002 |
|
92 |
72 |
$1K |
| 83520 |
|
57 |
54 |
$1K |
| 85045 |
|
824 |
699 |
$1K |
| 76857 |
|
54 |
52 |
$1K |
| 84450 |
|
1,189 |
859 |
$1K |
| 99201 |
|
12 |
12 |
$1K |
| 72170 |
|
320 |
254 |
$1K |
| 82951 |
|
68 |
67 |
$998.82 |
| 99442 |
|
27 |
27 |
$981.79 |
| 99441 |
|
87 |
82 |
$979.08 |
| J1885 |
Ketorolac tromethamine inj |
14,074 |
10,765 |
$913.99 |
| D0150 |
|
18 |
17 |
$906.30 |
| 86618 |
|
172 |
139 |
$898.94 |
| 86225 |
|
88 |
79 |
$873.87 |
| J3301 |
Triamcinolone acet inj nos |
2,820 |
2,174 |
$872.78 |
| 83020 |
|
106 |
79 |
$865.43 |
| 99239 |
|
27 |
24 |
$860.68 |
| 88312 |
|
16 |
16 |
$845.31 |
| 86308 |
|
162 |
124 |
$843.87 |
| J3486 |
Ziprasidone mesylate |
45 |
27 |
$832.69 |
| 82247 |
|
51 |
25 |
$829.56 |
| J1815 |
Insulin injection |
156 |
108 |
$821.84 |
| 84425 |
|
55 |
41 |
$798.71 |
| 84165 |
|
85 |
66 |
$773.49 |
| 80336 |
|
71 |
56 |
$771.98 |
| J1650 |
Inj enoxaparin sodium |
1,060 |
343 |
$770.23 |
| 77002 |
|
13 |
12 |
$765.63 |
| 97163 |
|
14 |
12 |
$761.61 |
| 85014 |
|
173 |
106 |
$744.76 |
| 81374 |
|
15 |
15 |
$709.19 |
| 86039 |
|
70 |
68 |
$708.37 |
| 83525 |
|
28 |
13 |
$697.08 |
| 00170 |
|
1,389 |
1,068 |
$690.22 |
| 90662 |
|
127 |
112 |
$684.57 |
| 72202 |
|
27 |
26 |
$682.75 |
| J1170 |
Hydromorphone injection |
1,751 |
897 |
$679.59 |
| 86003 |
|
42 |
25 |
$651.82 |
| 73120 |
|
21 |
21 |
$647.98 |
| 93246 |
|
12 |
12 |
$638.74 |
| 84520 |
|
424 |
310 |
$635.96 |
| 99222 |
|
17 |
14 |
$632.33 |
| 76819 |
|
18 |
12 |
$617.59 |
| 72070 |
|
41 |
40 |
$613.09 |
| 87808 |
|
1,143 |
913 |
$611.02 |
| 84460 |
|
149 |
95 |
$597.01 |
| 82375 |
|
1,453 |
973 |
$591.29 |
| 76775 |
|
20 |
13 |
$583.38 |
| 99244 |
|
12 |
12 |
$580.38 |
| 84155 |
|
118 |
79 |
$559.24 |
| 80177 |
|
45 |
41 |
$548.96 |
| J2469 |
Palonosetron hcl |
197 |
77 |
$539.08 |
| J7040 |
Normal saline solution infus |
19,206 |
16,497 |
$504.60 |
| D0230 |
|
117 |
25 |
$501.22 |
| 84146 |
|
72 |
64 |
$467.26 |
| 92610 |
|
16 |
14 |
$451.36 |
| 84295 |
|
1,392 |
962 |
$449.97 |
| J3475 |
Inj magnesium sulfate |
1,574 |
887 |
$449.60 |
| J2405 |
Ondansetron hcl injection |
26,094 |
19,015 |
$449.58 |
| 76000 |
|
12 |
12 |
$448.53 |
| 80143 |
|
741 |
553 |
$446.73 |
| 76820 |
|
22 |
15 |
$438.60 |
| 87088 |
|
242 |
237 |
$438.29 |
| A9502 |
Tc99m tetrofosmin |
1,103 |
798 |
$433.33 |
| 90472 |
|
297 |
222 |
$430.59 |
| Q0111 |
Wet mounts/ w preparations |
57 |
57 |
$414.89 |
| 80047 |
|
176 |
132 |
$413.78 |
| C9113 |
Inj pantoprazole sodium, via |
755 |
345 |
$379.69 |
| 83655 |
|
12 |
12 |
$372.14 |
| 00840 |
|
43 |
20 |
$359.56 |
| J2930 |
Methylprednisolone injection |
877 |
523 |
$353.92 |
| 82378 |
|
18 |
13 |
$339.72 |
| 83050 |
|
1,457 |
967 |
$338.92 |
| J2360 |
Orphenadrine injection |
683 |
481 |
$327.33 |
| 86256 |
|
21 |
13 |
$320.95 |
| 87102 |
|
603 |
457 |
$312.76 |
| 93283 |
|
17 |
12 |
$307.49 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
13,521 |
10,550 |
$298.17 |
| J2001 |
Lidocaine injection |
4,785 |
3,646 |
$289.20 |
| 86360 |
|
12 |
12 |
$281.18 |
| 93280 |
|
47 |
40 |
$280.34 |
| 80179 |
|
703 |
528 |
$263.85 |
| 83021 |
|
16 |
15 |
$233.03 |
| J0696 |
Ceftriaxone sodium injection |
3,221 |
1,639 |
$232.83 |
| J0360 |
Hydralazine hcl injection |
320 |
184 |
$230.81 |
| 84590 |
|
20 |
12 |
$229.05 |
| 94760 |
|
1,975 |
1,217 |
$215.89 |
| 84479 |
|
39 |
33 |
$201.27 |
| J1040 |
Methylprednisolone 80 mg inj |
1,547 |
1,377 |
$200.04 |
| 80335 |
|
18 |
13 |
$199.30 |
| J2310 |
Inj naloxone hydrochloride |
23 |
12 |
$189.21 |
| 82150 |
|
41 |
29 |
$187.46 |
| 82040 |
|
16 |
12 |
$186.10 |
| 85380 |
|
14 |
13 |
$175.58 |
| J2919 |
Inj, methylpred sod succ 5mg |
475 |
342 |
$156.30 |
| 84478 |
|
62 |
39 |
$143.16 |
| 90656 |
|
17 |
17 |
$140.74 |
| J2704 |
Inj, propofol, 10 mg |
5,408 |
3,660 |
$138.79 |
| J1790 |
Droperidol injection |
921 |
579 |
$137.94 |
| 70320 |
|
460 |
416 |
$125.25 |
| J1953 |
Levetiracetam injection |
27 |
13 |
$124.19 |
| J0690 |
Cefazolin sodium injection |
2,951 |
1,664 |
$123.43 |
| J2250 |
Inj midazolam hydrochloride |
5,809 |
4,027 |
$111.17 |
| 90694 |
|
12 |
12 |
$105.03 |
| J2060 |
Lorazepam injection |
857 |
548 |
$102.03 |
| J1100 |
Dexamethasone sodium phos |
6,242 |
4,098 |
$93.38 |
| J3370 |
Vancomycin hcl injection |
350 |
155 |
$89.94 |
| J3010 |
Fentanyl citrate injection |
7,121 |
4,188 |
$89.49 |
| G0008 |
Admin influenza virus vac |
326 |
286 |
$76.99 |
| J1200 |
Diphenhydramine hcl injectio |
2,154 |
1,283 |
$66.58 |
| G2211 |
Complex e/m visit add on |
293 |
284 |
$66.31 |
| J7120 |
Ringers lactate infusion |
2,444 |
1,623 |
$64.41 |
| J2785 |
Regadenoson injection |
748 |
544 |
$60.58 |
| J2765 |
Metoclopramide hcl injection |
1,177 |
710 |
$55.42 |
| 82948 |
|
47 |
36 |
$52.92 |
| 87653 |
|
14 |
14 |
$41.20 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
265 |
117 |
$36.28 |
| J1920 |
Inj, labetalol hcl, 5mg |
105 |
82 |
$35.77 |
| J1940 |
Furosemide injection |
137 |
53 |
$35.59 |
| G0482 |
Drug test def 15-21 classes |
21 |
20 |
$33.79 |
| J7512 |
Prednisone ir or dr oral 1mg |
881 |
441 |
$33.29 |
| 82270 |
|
12 |
12 |
$31.77 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
687 |
479 |
$31.57 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
3,376 |
2,388 |
$30.14 |
| J3480 |
Inj potassium chloride |
223 |
132 |
$29.45 |
| A4649 |
Surgical supplies |
3,917 |
3,705 |
$26.79 |
| 82465 |
|
33 |
26 |
$25.17 |
| 85041 |
|
20 |
17 |
$25.01 |
| J1030 |
Methylprednisolone 40 mg inj |
685 |
509 |
$23.93 |
| J2916 |
Na ferric gluconate complex |
83 |
42 |
$21.40 |
| J2795 |
Ropivacaine hcl injection |
302 |
214 |
$21.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
97 |
74 |
$20.63 |
| J2370 |
Phenylephrine hcl injection |
376 |
208 |
$20.51 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
1,015 |
858 |
$17.66 |
| J0330 |
Succinycholine chloride inj |
779 |
502 |
$15.84 |
| 82010 |
|
124 |
79 |
$15.15 |
| J2920 |
Methylprednisolone injection |
50 |
13 |
$12.60 |
| Q9957 |
Inj perflutren lip micros,ml |
589 |
467 |
$10.66 |
| C1765 |
Adhesion barrier |
16 |
14 |
$9.51 |
| J0171 |
Adrenalin epinephrine inject |
81 |
52 |
$7.23 |
| J2004 |
Inj, lidocaine w epinephrine |
33 |
31 |
$6.29 |
| J7050 |
Normal saline solution infus |
2,157 |
1,057 |
$6.04 |
| J0780 |
Prochlorperazine injection |
118 |
79 |
$5.28 |
| J0689 |
Inj cefazolin sodium, baxter |
66 |
58 |
$5.04 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
106 |
70 |
$4.95 |
| J7030 |
Normal saline solution infus |
791 |
501 |
$2.54 |
| J7620 |
Albuterol ipratrop non-comp |
38 |
14 |
$2.26 |
| J1630 |
Haloperidol injection |
14 |
13 |
$2.09 |
| J1642 |
Inj heparin sodium per 10 u |
562 |
420 |
$1.68 |
| J1010 |
Inj, methylpred acetate 1 mg |
209 |
181 |
$1.30 |
| A6449 |
Lt compres band >=3" <5"/yd |
14 |
14 |
$1.29 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
92 |
82 |
$1.03 |
| A9270 |
Non-covered item or service |
2,072 |
1,131 |
$0.77 |
| 36591 |
|
44 |
26 |
$0.48 |
| 3078F |
|
8,670 |
7,650 |
$0.00 |
| 00811 |
|
141 |
95 |
$0.00 |
| J2550 |
Promethazine hcl injection |
101 |
89 |
$0.00 |
| G1004 |
Cdsm ndsc |
295 |
265 |
$0.00 |
| 00400 |
|
17 |
12 |
$0.00 |
| 3077F |
|
3,371 |
2,989 |
$0.00 |
| Q9958 |
Hocm <=149 mg/ml iodine, 1ml |
269 |
228 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
363 |
249 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
65 |
65 |
$0.00 |
| 96417 |
|
126 |
41 |
$0.00 |
| 90461 |
|
19 |
13 |
$0.00 |
| G0444 |
Depression screen annual |
13 |
13 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
608 |
431 |
$0.00 |
| C1887 |
Catheter, guiding |
18 |
14 |
$0.00 |
| C1729 |
Cath, drainage |
53 |
24 |
$0.00 |
| A9552 |
F18 fdg |
15 |
15 |
$0.00 |
| J1580 |
Garamycin gentamicin inj |
36 |
25 |
$0.00 |
| J0688 |
Inj cefazolin sodium, hikma |
25 |
14 |
$0.00 |
| 3075F |
|
2,259 |
2,004 |
$0.00 |
| 3080F |
|
2,223 |
1,952 |
$0.00 |
| Q9969 |
Non-heu tc-99m add-on/dose |
185 |
177 |
$0.00 |
| 3079F |
|
4,889 |
4,446 |
$0.00 |
| 3074F |
|
10,475 |
9,343 |
$0.00 |
| A4648 |
Implantable tissue marker |
77 |
57 |
$0.00 |
| C1769 |
Guide wire |
868 |
634 |
$0.00 |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
252 |
172 |
$0.00 |
| G0009 |
Admin pneumococcal vaccine |
39 |
25 |
$0.00 |
| 94761 |
|
78 |
70 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
166 |
125 |
$0.00 |
| 64494 |
|
27 |
12 |
$0.00 |