| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpt clinic visit |
141,668 |
106,022 |
$13.09M |
| 96361 |
|
45,888 |
29,953 |
$12.15M |
| 99284 |
|
63,195 |
51,871 |
$10.34M |
| 99283 |
|
60,205 |
51,602 |
$9.83M |
| J9271 |
Inj pembrolizumab |
1,370 |
964 |
$6.07M |
| 97110 |
|
112,487 |
34,880 |
$5.49M |
| 99282 |
|
24,406 |
21,475 |
$3.89M |
| 99285 |
|
19,678 |
16,189 |
$2.77M |
| 43239 |
|
4,237 |
3,934 |
$2.63M |
| 74177 |
|
15,160 |
13,319 |
$2.63M |
| 45380 |
|
3,973 |
3,665 |
$2.57M |
| 70450 |
|
14,410 |
12,373 |
$2.52M |
| 45385 |
|
3,468 |
3,255 |
$2.08M |
| 96366 |
|
12,764 |
7,422 |
$1.98M |
| 93306 |
|
6,511 |
5,947 |
$1.91M |
| 66984 |
|
2,239 |
1,738 |
$1.89M |
| 96365 |
|
22,345 |
14,824 |
$1.84M |
| G0378 |
Hospital observation per hr |
11,808 |
9,431 |
$1.82M |
| 96413 |
|
15,856 |
8,433 |
$1.77M |
| 59025 |
|
10,137 |
7,351 |
$1.67M |
| 99281 |
|
8,615 |
8,003 |
$1.51M |
| 78452 |
|
2,609 |
2,346 |
$1.49M |
| 96360 |
|
11,439 |
9,248 |
$1.27M |
| 70553 |
|
3,829 |
3,515 |
$1.21M |
| 97161 |
|
10,377 |
9,379 |
$1.19M |
| 97162 |
|
9,781 |
9,118 |
$1.12M |
| 71275 |
|
4,922 |
4,349 |
$1.08M |
| J2505 |
Injection, pegfilgrastim 6mg |
670 |
406 |
$1.06M |
| 74176 |
|
5,646 |
4,912 |
$974K |
| J2506 |
Inj pegfilgrast ex bio 0.5mg |
684 |
456 |
$963K |
| 96415 |
|
4,728 |
2,947 |
$890K |
| 97530 |
|
21,299 |
11,592 |
$871K |
| 20610 |
|
5,010 |
3,847 |
$860K |
| 45378 |
|
1,201 |
1,131 |
$801K |
| J9355 |
Inj trastuzumab excl biosimi |
735 |
233 |
$769K |
| J0897 |
Denosumab injection |
2,038 |
1,628 |
$739K |
| 78815 |
|
828 |
746 |
$714K |
| 77412 |
|
1,319 |
128 |
$633K |
| 72148 |
|
3,079 |
2,870 |
$600K |
| 76642 |
|
4,916 |
4,574 |
$598K |
| 97140 |
|
27,680 |
11,426 |
$573K |
| 76705 |
|
5,828 |
5,443 |
$572K |
| 29581 |
|
2,940 |
701 |
$554K |
| 77063 |
|
9,824 |
9,481 |
$539K |
| J0585 |
Injection,onabotulinumtoxina |
2,638 |
1,609 |
$520K |
| 93017 |
|
4,008 |
3,620 |
$462K |
| 77067 |
|
15,255 |
14,695 |
$459K |
| 80307 |
|
11,874 |
9,895 |
$458K |
| 62323 |
|
1,086 |
1,013 |
$423K |
| 71046 |
|
25,348 |
22,279 |
$406K |
| 97112 |
|
14,449 |
6,524 |
$405K |
| 72141 |
|
2,015 |
1,894 |
$392K |
| 71260 |
|
5,207 |
4,676 |
$383K |
| 97598 |
|
1,036 |
530 |
$379K |
| 94640 |
|
8,300 |
6,209 |
$376K |
| 93971 |
|
3,610 |
3,227 |
$362K |
| 73721 |
|
1,597 |
1,500 |
$356K |
| 76830 |
|
3,408 |
3,183 |
$354K |
| 19083 |
|
297 |
268 |
$350K |
| 97113 |
|
6,852 |
2,328 |
$347K |
| 70551 |
|
1,774 |
1,581 |
$333K |
| 97597 |
|
4,441 |
2,469 |
$323K |
| 20611 |
|
852 |
621 |
$313K |
| 76536 |
|
2,831 |
2,681 |
$311K |
| 64483 |
|
490 |
440 |
$310K |
| G0121 |
Colon ca scrn not hi rsk ind |
388 |
373 |
$309K |
| 97165 |
|
3,880 |
3,418 |
$302K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
1,778 |
1,516 |
$295K |
| J9299 |
Injection, nivolumab |
125 |
48 |
$287K |
| J2469 |
Palonosetron hcl |
5,574 |
2,956 |
$284K |
| 58558 |
|
180 |
159 |
$267K |
| 70498 |
|
1,959 |
1,751 |
$266K |
| 92507 |
|
2,112 |
824 |
$261K |
| 96416 |
|
1,703 |
931 |
$259K |
| 64615 |
|
630 |
602 |
$248K |
| 73030 |
|
9,981 |
8,166 |
$242K |
| 87635 |
|
3,212 |
2,895 |
$236K |
| 80053 |
|
55,618 |
43,629 |
$228K |
| 95816 |
|
1,036 |
928 |
$213K |
| 97163 |
|
2,216 |
2,047 |
$211K |
| 93005 |
|
66,908 |
52,777 |
$210K |
| 96374 |
|
47,160 |
34,455 |
$210K |
| 77336 |
|
2,681 |
1,225 |
$209K |
| 94060 |
|
3,402 |
3,130 |
$207K |
| 95806 |
|
603 |
532 |
$206K |
| 76775 |
|
2,317 |
2,129 |
$205K |
| P9016 |
Rbc leukocytes reduced |
790 |
546 |
$202K |
| 73562 |
|
7,247 |
6,077 |
$202K |
| 70496 |
|
1,917 |
1,655 |
$197K |
| 99291 |
|
1,316 |
1,150 |
$196K |
| 73630 |
|
7,897 |
6,473 |
$194K |
| 72100 |
|
6,688 |
6,182 |
$192K |
| 43235 |
|
351 |
324 |
$192K |
| 71250 |
|
2,717 |
2,458 |
$182K |
| 52000 |
|
234 |
218 |
$176K |
| 77373 |
|
177 |
70 |
$174K |
| J1439 |
Inj ferric carboxymaltos 1mg |
1,769 |
1,021 |
$173K |
| 96367 |
|
6,090 |
3,899 |
$171K |
| 97750 |
|
4,189 |
3,719 |
$165K |
| 93321 |
|
545 |
495 |
$165K |
| 73130 |
|
6,597 |
5,043 |
$164K |
| 77334 |
|
1,828 |
864 |
$162K |
| 73610 |
|
6,445 |
5,404 |
$161K |
| 73221 |
|
775 |
731 |
$158K |
| 95886 |
|
1,446 |
1,341 |
$157K |
| J1453 |
Fosaprepitant injection |
1,478 |
755 |
$153K |
| 94726 |
|
4,549 |
4,197 |
$152K |
| 73560 |
|
7,029 |
5,755 |
$151K |
| 64493 |
|
179 |
166 |
$150K |
| 58661 |
|
56 |
38 |
$150K |
| C9803 |
Hopd covid-19 spec collect |
7,411 |
6,498 |
$148K |
| J0185 |
Inj., aprepitant, 1 mg |
1,329 |
802 |
$147K |
| 71271 |
|
1,340 |
1,295 |
$144K |
| 76815 |
|
3,396 |
2,966 |
$143K |
| 93970 |
|
1,265 |
1,128 |
$143K |
| 70491 |
|
925 |
853 |
$138K |
| 36430 |
|
964 |
680 |
$135K |
| 94729 |
|
4,671 |
4,293 |
$128K |
| 72040 |
|
3,672 |
3,410 |
$127K |
| 80048 |
|
34,691 |
27,329 |
$126K |
| 72125 |
|
5,807 |
5,076 |
$125K |
| 77066 |
Tomosynthesis, mammo |
2,853 |
2,673 |
$117K |
| 73502 |
|
4,996 |
4,424 |
$114K |
| 80047 |
|
38,372 |
31,361 |
$113K |
| 43248 |
|
185 |
173 |
$111K |
| 85025 |
|
114,143 |
82,395 |
$111K |
| 70486 |
|
2,444 |
2,240 |
$109K |
| 77080 |
|
1,811 |
1,722 |
$107K |
| 76817 |
|
2,195 |
1,894 |
$106K |
| J3380 |
Inj vedolizumab iv 1 mg |
44 |
39 |
$103K |
| 73110 |
|
3,973 |
3,226 |
$102K |
| 11042 |
|
571 |
404 |
$101K |
| 77065 |
Tomosynthesis, mammo |
2,473 |
2,131 |
$99K |
| 71045 |
|
30,653 |
25,528 |
$97K |
| 74018 |
|
4,182 |
3,635 |
$94K |
| 96372 |
|
31,614 |
18,070 |
$93K |
| 74183 |
|
267 |
244 |
$92K |
| 76882 |
|
990 |
899 |
$92K |
| J1756 |
Iron sucrose injection |
6,251 |
2,604 |
$90K |
| 76856 |
|
972 |
911 |
$88K |
| G0399 |
Home sleep test/type 3 porta |
1,342 |
1,119 |
$87K |
| J9035 |
Bevacizumab injection |
52 |
12 |
$87K |
| 72050 |
|
2,478 |
2,332 |
$86K |
| 73564 |
|
2,956 |
1,593 |
$82K |
| J3490 |
Drugs unclassified injection |
90,031 |
35,174 |
$80K |
| 0202U |
|
553 |
530 |
$75K |
| 96417 |
|
4,451 |
2,572 |
$74K |
| Q5116 |
Inj., trazimera, 10 mg |
35 |
25 |
$72K |
| 77295 |
|
104 |
89 |
$70K |
| 72110 |
|
2,200 |
1,997 |
$70K |
| 49083 |
|
140 |
77 |
$70K |
| 97035 |
|
1,496 |
750 |
$70K |
| 90832 |
|
2,184 |
545 |
$67K |
| 97164 |
|
893 |
818 |
$66K |
| 96523 |
|
1,312 |
920 |
$65K |
| J9306 |
Injection, pertuzumab, 1 mg |
33 |
24 |
$64K |
| 95810 |
|
155 |
135 |
$62K |
| 72070 |
|
2,181 |
2,016 |
$62K |
| 77290 |
|
217 |
185 |
$61K |
| 77300 |
|
891 |
489 |
$59K |
| 90935 |
|
360 |
175 |
$59K |
| 96402 |
|
1,853 |
1,526 |
$55K |
| 88305 |
|
18,936 |
13,132 |
$55K |
| 93325 |
|
838 |
759 |
$54K |
| 93308 |
|
312 |
282 |
$54K |
| 87591 |
|
7,995 |
7,207 |
$53K |
| 73590 |
|
2,839 |
2,347 |
$53K |
| 83880 |
|
6,929 |
5,587 |
$52K |
| 36415 |
|
54,746 |
42,929 |
$52K |
| 94010 |
|
1,292 |
1,172 |
$52K |
| 97802 |
|
918 |
879 |
$52K |
| 87040 |
|
7,791 |
3,792 |
$52K |
| 31575 |
|
449 |
406 |
$50K |
| 73140 |
|
1,913 |
1,605 |
$49K |
| 87510 |
|
5,559 |
5,020 |
$49K |
| G0108 |
Diab manage trn per indiv |
1,339 |
1,217 |
$49K |
| 95885 |
|
419 |
391 |
$46K |
| 92610 |
|
699 |
599 |
$46K |
| 97116 |
|
2,043 |
1,104 |
$46K |
| H0015 |
Alcohol and/or drug services |
508 |
72 |
$45K |
| 93458 |
|
36 |
31 |
$45K |
| G0283 |
Elec stim other than wound |
1,900 |
949 |
$44K |
| 93296 |
|
2,970 |
2,650 |
$43K |
| 64616 |
|
94 |
86 |
$43K |
| 74178 |
|
166 |
156 |
$42K |
| 84484 |
|
42,310 |
23,412 |
$41K |
| 90715 |
|
2,553 |
2,308 |
$40K |
| 73552 |
|
1,950 |
1,666 |
$40K |
| 76937 |
|
1,466 |
1,226 |
$39K |
| 36561 |
|
29 |
26 |
$39K |
| 80076 |
|
15,859 |
13,266 |
$38K |
| 73080 |
|
1,627 |
1,420 |
$38K |
| 82947 |
|
40,318 |
19,743 |
$36K |
| G0279 |
Tomosynthesis, mammo |
2,117 |
2,029 |
$36K |
| 20552 |
|
220 |
212 |
$36K |
| 73700 |
|
470 |
407 |
$35K |
| 73620 |
|
1,297 |
1,067 |
$34K |
| 90834 |
|
816 |
267 |
$34K |
| 72120 |
|
844 |
808 |
$34K |
| S0201 |
Partial hospitalization serv |
148 |
28 |
$34K |
| 93880 |
|
512 |
452 |
$33K |
| 78264 |
|
101 |
96 |
$33K |
| 84443 |
|
9,262 |
8,013 |
$32K |
| 95811 |
|
64 |
57 |
$31K |
| 72170 |
|
2,208 |
2,041 |
$30K |
| 81003 |
|
17,035 |
14,152 |
$30K |
| 90853 |
|
2,331 |
540 |
$30K |
| 93225 |
|
550 |
516 |
$29K |
| 76942 |
|
727 |
599 |
$29K |
| 81001 |
|
41,543 |
34,506 |
$29K |
| 93922 |
|
475 |
418 |
$29K |
| 72156 |
|
178 |
169 |
$29K |
| 82306 |
|
3,316 |
3,040 |
$27K |
| 43249 |
|
58 |
54 |
$26K |
| 88307 |
|
2,263 |
1,612 |
$26K |
| C8929 |
Tte w or wo fol wcon,doppler |
135 |
122 |
$26K |
| 62321 |
|
43 |
39 |
$26K |
| 76870 |
|
273 |
253 |
$26K |
| 96375 |
|
44,709 |
29,595 |
$26K |
| 87660 |
|
5,559 |
5,020 |
$25K |
| U0003 |
Cov-19 amp prb hgh thruput |
1,916 |
1,271 |
$25K |
| J3010 |
Fentanyl citrate injection |
29,794 |
21,012 |
$25K |
| 29125 |
|
184 |
160 |
$25K |
| 72158 |
|
112 |
110 |
$24K |
| J1642 |
Inj heparin sodium per 10 u |
14,145 |
7,022 |
$24K |
| 72114 |
|
730 |
689 |
$23K |
| 96401 |
|
1,794 |
685 |
$23K |
| 92557 |
|
586 |
529 |
$23K |
| J9202 |
Goserelin acetate implant |
43 |
36 |
$23K |
| C8923 |
2d tte w or w/o fol w/con,co |
103 |
91 |
$21K |
| 73120 |
|
741 |
604 |
$21K |
| Q0163 |
Diphenhydramine hcl 50mg |
5,352 |
3,269 |
$20K |
| G0390 |
Trauma respons w/hosp criti |
489 |
413 |
$20K |
| A9150 |
Misc/exper non-prescript dru |
194,858 |
44,732 |
$20K |
| J2323 |
Natalizumab injection |
15 |
13 |
$20K |
| 12011 |
|
127 |
108 |
$20K |
| G0297 |
Ldct for lung ca screen |
185 |
164 |
$20K |
| 83036 |
|
8,305 |
7,071 |
$20K |
| 77001 |
|
385 |
340 |
$19K |
| 85379 |
|
4,797 |
4,272 |
$19K |
| 84702 |
|
7,196 |
5,705 |
$19K |
| 95909 |
|
294 |
277 |
$19K |
| 12002 |
|
123 |
108 |
$18K |
| 85610 |
|
16,854 |
12,067 |
$18K |
| 73521 |
|
696 |
643 |
$18K |
| J2405 |
Ondansetron hcl injection |
38,810 |
28,638 |
$18K |
| 99232 |
|
575 |
173 |
$18K |
| 84145 |
|
2,487 |
1,837 |
$18K |
| 86885 |
|
8,971 |
7,800 |
$17K |
| 95911 |
|
246 |
235 |
$17K |
| 73600 |
|
1,008 |
808 |
$16K |
| 12001 |
|
94 |
81 |
$16K |
| 90791 |
|
190 |
158 |
$16K |
| J9263 |
Oxaliplatin |
905 |
225 |
$16K |
| 93226 |
|
291 |
264 |
$16K |
| 76700 |
|
121 |
115 |
$15K |
| 80061 |
|
5,418 |
4,756 |
$15K |
| 80069 |
|
5,542 |
3,685 |
$15K |
| J2704 |
Inj, propofol, 10 mg |
47,868 |
23,812 |
$15K |
| 73090 |
|
1,107 |
939 |
$15K |
| 83605 |
|
15,190 |
10,124 |
$14K |
| 51798 |
|
2,452 |
2,101 |
$14K |
| 69210 |
|
225 |
199 |
$14K |
| J1650 |
Inj enoxaparin sodium |
11,338 |
4,110 |
$14K |
| 93242 |
|
223 |
221 |
$13K |
| U0002 |
Covid-19 lab test non-cdc |
6,263 |
5,409 |
$13K |
| 97535 |
|
706 |
396 |
$13K |
| 97166 |
|
142 |
133 |
$13K |
| 86140 |
|
6,183 |
4,818 |
$12K |
| Q3014 |
Telehealth facility fee |
880 |
786 |
$12K |
| 97012 |
|
470 |
211 |
$12K |
| 20550 |
|
52 |
48 |
$12K |
| 83970 |
|
1,002 |
824 |
$11K |
| 73565 |
|
905 |
808 |
$11K |
| J1885 |
Ketorolac tromethamine inj |
23,764 |
16,915 |
$11K |
| J8540 |
Oral dexamethasone |
1,113 |
548 |
$11K |
| 81025 |
|
17,172 |
14,806 |
$11K |
| 85014 |
|
40,208 |
32,248 |
$10K |
| 64494 |
|
115 |
103 |
$10K |
| 88304 |
|
1,766 |
1,558 |
$10K |
| 95874 |
|
206 |
186 |
$10K |
| J7323 |
Euflexxa inj per dose |
119 |
57 |
$10K |
| 87086 |
|
17,183 |
14,608 |
$10K |
| G2066 |
Inter devc remote 30d |
462 |
445 |
$10K |
| 86900 |
|
10,576 |
9,205 |
$10K |
| G0109 |
Diab manage trn ind/group |
214 |
196 |
$9K |
| 72131 |
|
249 |
228 |
$9K |
| 74174 |
|
56 |
53 |
$9K |
| 84439 |
|
4,496 |
3,913 |
$9K |
| 83735 |
|
25,484 |
16,897 |
$9K |
| J2930 |
Methylprednisolone injection |
3,031 |
2,172 |
$9K |
| 76816 |
|
118 |
104 |
$9K |
| 82728 |
|
4,775 |
4,214 |
$8K |
| 86923 |
|
482 |
253 |
$8K |
| 87522 |
Neg quan hep c or qual rna |
424 |
373 |
$8K |
| 10060 |
|
115 |
95 |
$8K |
| 93298 |
|
339 |
319 |
$8K |
| 90471 |
|
3,716 |
3,291 |
$8K |
| 73060 |
|
533 |
455 |
$8K |
| 76811 |
|
103 |
96 |
$8K |
| 86235 |
|
1,858 |
518 |
$8K |
| C1769 |
Guide wire |
4,416 |
3,753 |
$7K |
| J9217 |
Leuprolide acetate suspnsion |
39 |
31 |
$7K |
| 76604 |
|
99 |
80 |
$7K |
| 94660 |
|
34 |
24 |
$7K |
| 80177 |
|
1,821 |
1,436 |
$7K |
| 73522 |
|
223 |
204 |
$7K |
| 82607 |
|
3,158 |
2,796 |
$7K |
| 99223 |
Prolong inpt eval add15 m |
78 |
74 |
$7K |
| 64450 |
|
51 |
41 |
$7K |
| A6257 |
Transparent film <= 16 sq in |
3,108 |
2,133 |
$6K |
| J1750 |
Inj iron dextran |
112 |
50 |
$6K |
| 51702 |
|
502 |
422 |
$6K |
| 93923 |
|
80 |
74 |
$6K |
| Q5106 |
Inj retacrit non-esrd use |
62 |
26 |
$6K |
| 93270 |
|
127 |
122 |
$6K |
| J2550 |
Promethazine hcl injection |
4,767 |
3,272 |
$6K |
| 76805 |
|
48 |
48 |
$6K |
| 97760 |
|
159 |
140 |
$6K |
| 85652 |
|
5,212 |
4,067 |
$6K |
| 86901 |
|
10,576 |
9,205 |
$6K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
31,390 |
25,514 |
$6K |
| A9552 |
F18 fdg |
960 |
794 |
$6K |
| 88342 |
|
3,343 |
2,584 |
$6K |
| 95819 |
|
28 |
26 |
$6K |
| G0260 |
Inj for sacroiliac jt anesth |
25 |
25 |
$6K |
| 99152 |
|
5,516 |
4,881 |
$6K |
| 86038 |
|
1,277 |
1,131 |
$6K |
| 90686 |
|
424 |
381 |
$5K |
| J0702 |
Betamethasone acet&sod phosp |
3,586 |
2,908 |
$5K |
| 74220 |
|
47 |
46 |
$5K |
| 84112 |
|
873 |
756 |
$5K |
| J9171 |
Docetaxel injection |
34 |
24 |
$5K |
| 87389 |
|
2,032 |
1,880 |
$5K |
| 94618 |
|
66 |
54 |
$5K |
| J2250 |
Inj midazolam hydrochloride |
23,072 |
18,610 |
$5K |
| 88341 |
|
1,725 |
927 |
$5K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
873 |
731 |
$5K |
| 83550 |
|
4,738 |
4,174 |
$5K |
| 20553 |
|
24 |
24 |
$5K |
| 82565 |
|
3,872 |
3,442 |
$5K |
| 96411 |
|
2,080 |
1,257 |
$5K |
| J0131 |
Inj, acetaminophen (nos) |
2,017 |
1,634 |
$4K |
| 82803 |
|
8,968 |
7,087 |
$4K |
| 77399 |
|
82 |
64 |
$4K |
| 86756 |
|
740 |
718 |
$4K |
| 87491 |
|
7,852 |
7,065 |
$4K |
| 87340 |
|
1,760 |
1,558 |
$4K |
| 90847 |
|
63 |
24 |
$4K |
| 99239 |
|
93 |
87 |
$4K |
| 90833 |
|
97 |
41 |
$4K |
| 82570 |
|
3,455 |
3,033 |
$4K |
| J0881 |
Darbepoetin alfa, non-esrd |
60 |
37 |
$4K |
| 76801 |
|
35 |
35 |
$4K |
| J0696 |
Ceftriaxone sodium injection |
9,643 |
5,773 |
$4K |
| 99222 |
|
67 |
64 |
$4K |
| 92567 |
|
380 |
352 |
$4K |
| 85027 |
|
2,751 |
2,074 |
$4K |
| 74022 |
|
575 |
486 |
$4K |
| J9206 |
Irinotecan injection |
59 |
12 |
$4K |
| 77002 |
|
30 |
26 |
$4K |
| 87077 |
|
7,108 |
5,272 |
$4K |
| 83540 |
|
4,828 |
4,245 |
$4K |
| 80143 |
|
892 |
766 |
$4K |
| J1100 |
Dexamethasone sodium phos |
26,224 |
16,672 |
$3K |
| J3480 |
Inj potassium chloride |
2,911 |
1,809 |
$3K |
| 96376 |
|
13,619 |
8,310 |
$3K |
| 73070 |
|
199 |
171 |
$3K |
| 96377 |
|
655 |
432 |
$3K |
| 95910 |
|
48 |
47 |
$3K |
| 83690 |
|
21,901 |
17,844 |
$3K |
| J0640 |
Leucovorin calcium injection |
2,909 |
906 |
$3K |
| 87070 |
|
2,608 |
2,008 |
$3K |
| C1894 |
Intro/sheath, non-laser |
2,907 |
2,473 |
$3K |
| 87798 |
|
345 |
255 |
$3K |
| 96368 |
|
3,280 |
2,064 |
$3K |
| J2270 |
Morphine sulfate injection |
11,988 |
8,669 |
$3K |
| 84703 |
|
11,232 |
9,760 |
$3K |
| A6402 |
Sterile gauze <= 16 sq in |
1,801 |
1,492 |
$3K |
| 78306 |
|
12 |
12 |
$3K |
| 86920 |
|
2,079 |
968 |
$3K |
| 86592 |
|
1,710 |
1,548 |
$3K |
| 80164 |
|
743 |
526 |
$3K |
| 99153 |
Mod sedat endo service >5yrs |
3,942 |
3,369 |
$3K |
| 88185 |
|
244 |
13 |
$3K |
| 90677 |
|
43 |
42 |
$3K |
| 87804 |
|
16,259 |
7,400 |
$3K |
| J2765 |
Metoclopramide hcl injection |
3,443 |
2,685 |
$2K |
| J1030 |
Methylprednisolone 40 mg inj |
2,809 |
2,431 |
$2K |
| 84550 |
|
2,763 |
2,332 |
$2K |
| 73100 |
|
124 |
107 |
$2K |
| J9395 |
Injection, fulvestrant |
13 |
12 |
$2K |
| 85018 |
|
2,922 |
1,812 |
$2K |
| J7620 |
Albuterol ipratrop non-comp |
3,439 |
2,373 |
$2K |
| 87186 |
|
6,192 |
4,573 |
$2K |
| J9190 |
Fluorouracil injection |
3,476 |
1,016 |
$2K |
| J3475 |
Inj magnesium sulfate |
7,911 |
4,916 |
$2K |
| 87081 |
|
4,298 |
3,928 |
$2K |
| 51784 |
|
26 |
26 |
$2K |
| 86803 |
|
444 |
400 |
$2K |
| Q0162 |
Ondansetron oral |
4,750 |
3,966 |
$2K |
| J9267 |
Paclitaxel injection |
1,024 |
379 |
$2K |
| 76770 |
|
14 |
14 |
$2K |
| 99238 |
|
57 |
56 |
$2K |
| 84100 |
|
4,001 |
2,916 |
$2K |
| J3301 |
Triamcinolone acet inj nos |
3,308 |
2,823 |
$2K |
| 80179 |
|
770 |
698 |
$2K |
| J0690 |
Cefazolin sodium injection |
10,960 |
7,320 |
$2K |
| J7321 |
Hyalgan supartz visco-3 dose |
36 |
12 |
$2K |
| 76981 |
|
21 |
20 |
$2K |
| 85730 |
|
5,004 |
4,193 |
$2K |
| 82077 |
|
6,086 |
5,183 |
$2K |
| 99231 |
|
232 |
89 |
$2K |
| 87480 |
|
5,452 |
4,913 |
$2K |
| 76999 |
|
14 |
13 |
$2K |
| C9399 |
Unclassified drugs or biolog |
177 |
128 |
$2K |
| C9290 |
Inj, bupivacaine liposome |
202 |
189 |
$2K |
| J2060 |
Lorazepam injection |
4,556 |
3,460 |
$1K |
| 87205 |
|
2,952 |
2,191 |
$1K |
| 93297 |
|
118 |
110 |
$1K |
| 82550 |
|
3,238 |
2,380 |
$1K |
| Q9957 |
Inj perflutren lip micros,ml |
519 |
461 |
$1K |
| 86225 |
|
645 |
541 |
$1K |
| 72190 |
|
32 |
28 |
$1K |
| A9585 |
Gadobutrol injection |
7,502 |
6,575 |
$1K |
| 88112 |
|
141 |
108 |
$1K |
| 86431 |
|
413 |
380 |
$1K |
| 90661 |
|
55 |
55 |
$1K |
| J1815 |
Insulin injection |
8,692 |
2,898 |
$1K |
| 17250 |
|
14 |
12 |
$1K |
| 82105 |
|
125 |
113 |
$1K |
| 84153 |
|
599 |
527 |
$1K |
| J1200 |
Diphenhydramine hcl injectio |
10,579 |
7,363 |
$1K |
| 87430 |
|
3,770 |
3,437 |
$1K |
| 83615 |
|
2,353 |
1,908 |
$1K |
| 84156 |
|
2,279 |
1,949 |
$1K |
| 82746 |
|
988 |
903 |
$1K |
| 82784 |
|
689 |
304 |
$1K |
| J0780 |
Prochlorperazine injection |
1,502 |
1,270 |
$1K |
| 82043 |
|
658 |
611 |
$1K |
| 87902 |
|
85 |
74 |
$999.73 |
| J1170 |
Hydromorphone injection |
11,768 |
6,828 |
$996.30 |
| 84403 |
|
139 |
126 |
$993.42 |
| J3471 |
Ovine, up to 999 usp units |
25 |
12 |
$990.72 |
| 64405 |
|
14 |
12 |
$985.19 |
| 95908 |
|
13 |
13 |
$929.72 |
| A9500 |
Tc99m sestamibi |
2,763 |
2,492 |
$905.63 |
| 36592 |
|
1,451 |
1,198 |
$842.52 |
| 83883 |
|
63 |
57 |
$812.36 |
| 95913 |
|
13 |
12 |
$810.67 |
| P9612 |
Catheterize for urine spec |
1,055 |
826 |
$804.51 |
| 89060 |
|
812 |
721 |
$790.76 |
| J0171 |
Adrenalin epinephrine inject |
649 |
443 |
$783.71 |
| 84132 |
|
1,124 |
863 |
$761.31 |
| 86704 |
|
189 |
163 |
$755.44 |
| 82248 |
|
1,425 |
1,193 |
$710.97 |
| 86706 |
|
251 |
218 |
$663.26 |
| 72128 |
|
30 |
25 |
$648.30 |
| J1644 |
Inj heparin sodium per 1000u |
5,645 |
3,145 |
$646.80 |
| J0330 |
Succinycholine chloride inj |
3,385 |
2,401 |
$645.13 |
| 82533 |
|
379 |
291 |
$641.03 |
| 36000 |
|
303 |
244 |
$626.60 |
| 00811 |
|
2,477 |
2,311 |
$623.97 |
| 00840 |
|
1,174 |
851 |
$623.65 |
| 88173 |
|
591 |
419 |
$615.69 |
| 84481 |
|
188 |
182 |
$603.15 |
| J2543 |
Piperacillin/tazobactam |
2,095 |
705 |
$598.48 |
| 82378 |
|
293 |
241 |
$581.84 |
| J1940 |
Furosemide injection |
2,060 |
1,061 |
$568.11 |
| J0173 |
Inj, epinephrine (belcher) |
287 |
196 |
$532.32 |
| 81002 |
|
2,983 |
2,558 |
$488.03 |
| 73000 |
|
14 |
12 |
$473.40 |
| 84480 |
|
375 |
272 |
$464.36 |
| 86709 |
|
144 |
129 |
$436.14 |
| 00731 |
|
4,003 |
3,683 |
$418.75 |
| 83010 |
|
75 |
69 |
$412.59 |
| 88360 |
|
66 |
40 |
$405.44 |
| J2785 |
Regadenoson injection |
2,033 |
1,813 |
$402.71 |
| 80305 |
|
408 |
379 |
$399.91 |
| 88175 |
|
26 |
26 |
$395.68 |
| 82140 |
|
739 |
591 |
$382.55 |
| J1580 |
Garamycin gentamicin inj |
309 |
260 |
$375.26 |
| J3370 |
Vancomycin hcl injection |
2,515 |
1,401 |
$370.76 |
| 88313 |
|
288 |
152 |
$358.75 |
| 87116 |
|
16 |
13 |
$337.95 |
| J7613 |
Albuterol non-comp unit |
1,632 |
1,302 |
$318.34 |
| 80323 |
|
14 |
12 |
$288.70 |
| 82330 |
|
449 |
343 |
$272.50 |
| 82172 |
|
60 |
55 |
$271.87 |
| 82977 |
|
107 |
96 |
$270.55 |
| 82553 |
|
72 |
37 |
$259.50 |
| J7644 |
Ipratropium bromide non-comp |
386 |
311 |
$257.43 |
| 36600 |
|
94 |
74 |
$256.83 |
| 88184 |
|
14 |
13 |
$250.26 |
| 86364 |
|
55 |
52 |
$229.04 |
| J2370 |
Phenylephrine hcl injection |
3,517 |
2,642 |
$228.45 |
| 85045 |
|
995 |
682 |
$228.11 |
| 83516 |
|
92 |
40 |
$228.05 |
| 00812 |
|
2,995 |
2,820 |
$212.60 |
| 86708 |
|
73 |
69 |
$212.00 |
| 00910 |
|
29 |
25 |
$200.17 |
| 71101 |
|
16 |
15 |
$190.59 |
| 93350 |
|
107 |
100 |
$178.83 |
| 86870 |
|
14 |
12 |
$162.14 |
| 99233 |
Prolong inpt eval add15 m |
25 |
13 |
$160.82 |
| A4351 |
Straight tip urine catheter |
1,365 |
1,083 |
$157.95 |
| A9270 |
Non-covered item or service |
23,619 |
4,123 |
$148.84 |
| J1630 |
Haloperidol injection |
2,091 |
1,638 |
$146.51 |
| G1004 |
Cdsm ndsc |
11,443 |
8,642 |
$135.91 |
| J0134 |
Inj acetaminophen -fresenius |
740 |
622 |
$132.66 |
| J1953 |
Levetiracetam injection |
795 |
509 |
$115.93 |
| 00170 |
|
99 |
92 |
$115.68 |
| J9045 |
Carboplatin injection |
787 |
423 |
$109.94 |
| 86300 |
|
264 |
242 |
$102.51 |
| J3420 |
Vitamin b12 injection |
1,589 |
1,195 |
$87.76 |
| 00940 |
|
61 |
55 |
$85.77 |
| 82010 |
|
683 |
533 |
$80.92 |
| 83993 |
|
12 |
12 |
$77.52 |
| J0360 |
Hydralazine hcl injection |
1,183 |
892 |
$69.37 |
| J3411 |
Thiamine hcl 100 mg |
1,040 |
610 |
$65.89 |
| 86200 |
|
14 |
12 |
$65.70 |
| 84165 |
|
13 |
12 |
$57.28 |
| 87206 |
|
138 |
68 |
$56.04 |
| 82040 |
|
15 |
12 |
$55.83 |
| 01480 |
|
93 |
79 |
$54.38 |
| 82247 |
|
15 |
12 |
$43.03 |
| J7512 |
Prednisone ir or dr oral 1mg |
1,857 |
1,182 |
$41.97 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,119 |
764 |
$41.58 |
| 00400 |
|
334 |
303 |
$41.32 |
| J2795 |
Ropivacaine hcl injection |
127 |
67 |
$39.22 |
| J2710 |
Neostigmine methylslfte inj |
655 |
319 |
$38.24 |
| A4312 |
Cath w/o bag 2-way silicone |
156 |
111 |
$36.38 |
| J0500 |
Dicyclomine injection |
280 |
250 |
$33.55 |
| 84155 |
|
30 |
25 |
$32.83 |
| A6220 |
Gauze >16 <=48 sq in w/bordr |
430 |
356 |
$32.24 |
| 87653 |
|
28 |
25 |
$30.50 |
| 00952 |
|
463 |
426 |
$29.79 |
| 00300 |
|
103 |
94 |
$29.62 |
| J2919 |
Inj, methylpred sod succ 5mg |
340 |
225 |
$28.92 |
| 00142 |
|
2,152 |
1,681 |
$26.83 |
| G8978 |
Mobility current status |
579 |
436 |
$26.71 |
| J0461 |
Atropine sulfate injection |
342 |
187 |
$25.35 |
| 84295 |
|
515 |
409 |
$24.02 |
| J0689 |
Inj cefazolin sodium, baxter |
442 |
369 |
$23.15 |
| C9113 |
Inj pantoprazole sodium, via |
850 |
414 |
$20.41 |
| 86308 |
|
14 |
12 |
$12.96 |
| 87075 |
|
80 |
63 |
$12.75 |
| J2175 |
Meperidine hydrochl /100 mg |
47 |
45 |
$8.53 |
| 87102 |
|
31 |
26 |
$8.50 |
| 87015 |
|
16 |
13 |
$8.50 |
| 85384 |
|
49 |
43 |
$6.41 |
| G8979 |
Mobility goal status |
641 |
481 |
$4.90 |
| J0744 |
Ciprofloxacin iv |
49 |
26 |
$4.44 |
| J0610 |
Calcium glucon (fresenius) |
100 |
58 |
$3.39 |
| 88300 |
|
77 |
67 |
$3.01 |
| J2720 |
Inj protamine sulfate/10 mg |
30 |
12 |
$2.30 |
| J1790 |
Droperidol injection |
672 |
587 |
$2.18 |
| C1726 |
Cath, bal dil, non-vascular |
306 |
280 |
$0.67 |
| A6258 |
Transparent film >16<=48 in |
594 |
358 |
$0.23 |
| A4320 |
Irrigation tray |
190 |
166 |
$0.21 |
| J0136 |
Inj, acetaminophen (b braun) |
556 |
502 |
$0.14 |
| J2272 |
Inj, morphine (fresenius) |
132 |
112 |
$0.13 |
| 87880 |
|
109 |
107 |
$0.00 |
| G8984 |
Carry current status |
78 |
67 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
225 |
151 |
$0.00 |
| 01810 |
|
30 |
29 |
$0.00 |
| G8985 |
Carry goal status |
101 |
86 |
$0.00 |
| A9541 |
Tc99m sulfur colloid |
105 |
97 |
$0.00 |
| C1788 |
Port, indwelling, imp |
44 |
38 |
$0.00 |
| 89051 |
|
16 |
12 |
$0.00 |
| A4327 |
Fem urinary collect dev cup |
445 |
246 |
$0.00 |
| C1751 |
Cath, inf, per/cent/midline |
621 |
521 |
$0.00 |
| C1760 |
Closure dev, vasc |
343 |
288 |
$0.00 |
| 88302 |
|
57 |
39 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
1,206 |
965 |
$0.00 |
| S9474 |
Enterostomal therapy by a re |
29 |
24 |
$0.00 |
| J8499 |
Oral prescrip drug non chemo |
651 |
287 |
$0.00 |
| C1887 |
Catheter, guiding |
192 |
149 |
$0.00 |
| Q0169 |
Promethazine hcl 12.5mg oral |
46 |
41 |
$0.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
108 |
27 |
$0.00 |
| J0692 |
Cefepime hcl for injection |
104 |
25 |
$0.00 |
| V2630 |
Anter chamber intraocul lens |
33 |
25 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
217 |
160 |
$0.00 |
| A6403 |
Sterile gauze>16 <= 48 sq in |
53 |
46 |
$0.00 |
| J2310 |
Inj naloxone hydrochloride |
30 |
25 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
80 |
69 |
$0.00 |
| A6250 |
Skin seal protect moisturizr |
38 |
26 |
$0.00 |
| 94664 |
|
17 |
13 |
$0.00 |
| 96549 |
|
12 |
12 |
$0.00 |
| A4357 |
Bedside drainage bag |
20 |
13 |
$0.00 |
| A4565 |
Slings |
13 |
12 |
$0.00 |
| C1758 |
Catheter, ureteral |
13 |
13 |
$0.00 |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
741 |
411 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
1,006 |
895 |
$0.00 |
| J2360 |
Orphenadrine injection |
26 |
25 |
$0.00 |
| J0613 |
Calcium glucon (wg critical) |
103 |
84 |
$0.00 |
| A6549 |
Grad com garm noc day use |
304 |
258 |
$0.00 |
| 94761 |
|
417 |
317 |
$0.00 |
| 00813 |
|
278 |
262 |
$0.00 |
| G8987 |
Self care current status |
24 |
12 |
$0.00 |
| V2632 |
Post chmbr intraocular lens |
1,663 |
1,304 |
$0.00 |
| J0456 |
Azithromycin |
106 |
86 |
$0.00 |
| J1010 |
Inj, methylpred acetate 1 mg |
306 |
280 |
$0.00 |
| C1725 |
Cath, translumin non-laser |
496 |
401 |
$0.00 |
| 00790 |
|
73 |
66 |
$0.00 |
| 00902 |
|
40 |
38 |
$0.00 |
| 99417 |
Prolong home eval add 15m |
221 |
210 |
$0.00 |
| Q9968 |
Visualization adjunct |
17 |
12 |
$0.00 |
| C1889 |
Implant/insert device, noc |
223 |
218 |
$0.00 |
| G0008 |
Admin influenza virus vac |
28 |
28 |
$0.00 |
| A9503 |
Tc99m medronate |
37 |
36 |
$0.00 |
| J0611 |
Calcium glucon (wg critical) |
17 |
15 |
$0.00 |
| C1750 |
Cath, hemodialysis,long-term |
16 |
12 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
899 |
762 |
$0.00 |
| A4648 |
Implantable tissue marker |
20 |
20 |
$0.00 |
| 51797 |
|
26 |
26 |
$0.00 |
| J7999 |
Compounded drug, noc |
81 |
67 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
118 |
61 |
$0.00 |
| A9579 |
Gad-base mr contrast nos,1ml |
45 |
37 |
$0.00 |
| G8980 |
Mobility d/c status |
36 |
28 |
$0.00 |
| C1781 |
Mesh (implantable) |
13 |
12 |
$0.00 |
| G8988 |
Self care goal status |
24 |
12 |
$0.00 |
| 88311 |
|
14 |
12 |
$0.00 |