| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J9271 |
Inj pembrolizumab |
955 |
763 |
$10.94M |
| 0450 |
|
133,327 |
116,580 |
$6.33M |
| 99283 |
|
102,044 |
91,085 |
$4.87M |
| G0463 |
Hospital outpt clinic visit |
154,251 |
119,515 |
$3.60M |
| 93975 |
|
18,734 |
18,271 |
$3.15M |
| 74177 |
|
15,221 |
14,911 |
$2.68M |
| 80053 |
|
138,528 |
122,174 |
$2.48M |
| 70450 |
|
15,906 |
15,410 |
$2.38M |
| 0510 |
|
206,231 |
155,549 |
$2.27M |
| 97110 |
|
83,787 |
18,972 |
$2.26M |
| J1568 |
Octagam injection |
1,085 |
207 |
$2.16M |
| 70553 |
|
2,379 |
2,354 |
$2.01M |
| Z7502 |
|
54,071 |
53,475 |
$2.00M |
| 96374 |
|
33,847 |
32,013 |
$1.93M |
| 85025 |
|
146,378 |
128,475 |
$1.85M |
| 0360 |
|
18,867 |
9,575 |
$1.79M |
| 78815 |
|
1,103 |
1,099 |
$1.74M |
| 93005 |
|
59,437 |
54,896 |
$1.62M |
| J9312 |
Inj., rituximab, 10 mg |
275 |
150 |
$1.36M |
| 93306 |
|
8,734 |
8,591 |
$1.34M |
| J0490 |
Belimumab injection |
685 |
321 |
$1.33M |
| 99221 |
|
9,112 |
7,597 |
$1.32M |
| 87798 |
|
22,270 |
21,635 |
$1.31M |
| 0121 |
|
235 |
209 |
$1.28M |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
26,812 |
24,961 |
$1.23M |
| J3490 |
Drugs unclassified injection |
159,326 |
71,372 |
$1.21M |
| 72148 |
|
2,204 |
2,174 |
$1.07M |
| 72125 |
|
5,206 |
5,108 |
$977K |
| 71260 |
|
3,897 |
3,837 |
$960K |
| J9035 |
Bevacizumab injection |
1,501 |
1,232 |
$937K |
| 99499 |
|
15,327 |
12,110 |
$929K |
| 77067 |
|
10,481 |
10,412 |
$928K |
| 80307 |
|
16,829 |
16,066 |
$900K |
| 97763 |
|
10,054 |
2,831 |
$874K |
| 86803 |
|
33,213 |
33,015 |
$842K |
| 96365 |
|
12,144 |
9,819 |
$776K |
| 73721 |
|
2,017 |
1,958 |
$774K |
| 99070 |
|
246,285 |
108,413 |
$768K |
| 70551 |
|
1,707 |
1,674 |
$724K |
| 96375 |
|
21,156 |
18,453 |
$705K |
| 84443 |
|
23,175 |
22,062 |
$698K |
| 99231 |
|
14,072 |
11,909 |
$695K |
| J2505 |
Injection, pegfilgrastim 6mg |
219 |
160 |
$659K |
| 72141 |
|
1,242 |
1,233 |
$647K |
| A4649 |
Surgical supplies |
20,441 |
14,278 |
$646K |
| Z7500 |
|
17,540 |
15,424 |
$594K |
| 70498 |
|
3,201 |
3,155 |
$583K |
| A4606 |
Oxygen probe used w oximeter |
33,600 |
30,321 |
$574K |
| 71046 |
|
32,581 |
31,504 |
$565K |
| 83036 |
|
33,938 |
33,326 |
$558K |
| Q5120 |
Inj pegfilgrastim-bmez 0.5mg |
332 |
238 |
$554K |
| 76705 |
|
11,177 |
10,881 |
$552K |
| 74176 |
|
5,784 |
5,687 |
$552K |
| A4306 |
Drug delivery system <=50 ml |
22,781 |
22,143 |
$549K |
| 0762 |
|
6,141 |
3,045 |
$541K |
| J1745 |
Infliximab not biosimil 10mg |
424 |
275 |
$538K |
| Q5111 |
Injection, udenyca 0.5 mg |
373 |
270 |
$529K |
| 87389 |
|
27,203 |
26,690 |
$528K |
| G0480 |
Drug test def 1-7 classes |
8,497 |
7,691 |
$528K |
| J0897 |
Denosumab injection |
256 |
243 |
$499K |
| 72131 |
|
2,831 |
2,791 |
$493K |
| 80048 |
|
34,298 |
32,193 |
$490K |
| 76856 |
|
8,440 |
8,289 |
$484K |
| 97750 |
|
12,060 |
10,723 |
$481K |
| 71250 |
|
2,466 |
2,418 |
$459K |
| 0241U |
|
3,812 |
3,735 |
$454K |
| 70486 |
|
2,671 |
2,636 |
$438K |
| L1990 |
Afo doub solid stirrup calf |
1,188 |
1,173 |
$429K |
| 80061 |
|
22,907 |
22,619 |
$421K |
| J0178 |
Aflibercept injection |
210 |
195 |
$420K |
| 99213 |
|
7,736 |
7,228 |
$416K |
| 84484 |
|
22,934 |
20,110 |
$411K |
| 96372 |
|
23,043 |
20,791 |
$410K |
| 72128 |
|
2,271 |
2,239 |
$360K |
| 99214 |
|
3,145 |
2,976 |
$358K |
| 99291 |
|
1,601 |
1,574 |
$345K |
| A4663 |
Dialysis blood pressure cuff |
16,273 |
14,633 |
$341K |
| 96413 |
|
10,040 |
6,196 |
$338K |
| 73221 |
|
934 |
912 |
$336K |
| 93971 |
|
3,652 |
3,534 |
$331K |
| 93970 |
|
2,179 |
2,142 |
$329K |
| 0700 |
|
7,630 |
6,498 |
$328K |
| 76770 |
|
4,845 |
4,740 |
$327K |
| Z7610 |
|
33,780 |
19,961 |
$319K |
| 0202U |
|
1,054 |
1,040 |
$317K |
| 76830 |
|
5,401 |
5,313 |
$309K |
| 85027 |
|
28,188 |
26,510 |
$306K |
| 83690 |
|
26,181 |
24,491 |
$303K |
| 88305 |
|
12,637 |
12,320 |
$303K |
| 71275 |
|
1,911 |
1,876 |
$302K |
| 77066 |
Tomosynthesis, mammo |
2,840 |
2,811 |
$299K |
| 87086 |
|
29,459 |
27,721 |
$298K |
| 73610 |
|
11,552 |
10,268 |
$276K |
| 73630 |
|
12,134 |
11,156 |
$275K |
| 97799 |
|
3,857 |
1,901 |
$270K |
| 76700 |
|
3,760 |
3,710 |
$253K |
| 0761 |
|
6,828 |
6,209 |
$249K |
| 93976 |
|
1,444 |
1,400 |
$248K |
| 73130 |
|
9,902 |
8,859 |
$248K |
| 99285 |
|
2,709 |
2,507 |
$246K |
| 71045 |
|
25,737 |
24,539 |
$240K |
| 81003 |
|
63,408 |
57,967 |
$239K |
| J3111 |
Inj. romosozumab-aqqg 1 mg |
156 |
146 |
$237K |
| 99218 |
|
1,589 |
1,334 |
$228K |
| 59425 |
|
2,879 |
1,754 |
$224K |
| Q5119 |
Inj ruxience, 10 mg |
164 |
78 |
$222K |
| 76815 |
|
4,263 |
3,013 |
$218K |
| 73030 |
|
8,636 |
8,192 |
$216K |
| 73110 |
|
9,038 |
7,793 |
$216K |
| J0131 |
Inj, acetaminophen (nos) |
9,503 |
8,531 |
$208K |
| 70496 |
|
1,400 |
1,378 |
$207K |
| 73562 |
|
8,272 |
7,884 |
$196K |
| 74178 |
|
1,012 |
997 |
$194K |
| G0378 |
Hospital observation per hr |
3,654 |
2,042 |
$194K |
| 83605 |
|
9,993 |
9,234 |
$193K |
| 90837 |
|
1,697 |
1,364 |
$192K |
| 76642 |
|
3,687 |
3,624 |
$188K |
| 96415 |
|
4,966 |
3,501 |
$188K |
| P9047 |
Albumin (human), 25%, 50ml |
982 |
475 |
$187K |
| 76801 |
|
3,827 |
3,446 |
$187K |
| 99232 |
|
3,084 |
3,058 |
$179K |
| 92507 |
|
2,960 |
1,338 |
$178K |
| J1453 |
Fosaprepitant injection |
3,052 |
1,982 |
$177K |
| J2506 |
Inj pegfilgrast ex bio 0.5mg |
246 |
179 |
$166K |
| 82803 |
|
4,644 |
4,477 |
$163K |
| 0206 |
|
18 |
12 |
$163K |
| 72100 |
|
6,117 |
6,012 |
$161K |
| 67028 |
|
2,968 |
2,700 |
$159K |
| 70491 |
|
797 |
786 |
$159K |
| 84702 |
|
7,649 |
6,421 |
$158K |
| 77065 |
Tomosynthesis, mammo |
1,931 |
1,872 |
$157K |
| Z9725 |
|
4,422 |
3,869 |
$155K |
| 74183 |
|
649 |
642 |
$154K |
| A9585 |
Gadobutrol injection |
5,787 |
5,019 |
$153K |
| 94640 |
|
7,399 |
6,260 |
$152K |
| 96417 |
|
3,754 |
2,382 |
$152K |
| 87040 |
|
4,798 |
4,561 |
$148K |
| 96367 |
|
4,742 |
3,122 |
$146K |
| 99152 |
|
3,387 |
3,369 |
$146K |
| 86850 |
|
12,451 |
11,928 |
$145K |
| 93325 |
|
1,460 |
1,445 |
$144K |
| 83735 |
|
12,646 |
10,007 |
$142K |
| 87340 |
|
7,490 |
7,418 |
$140K |
| 82947 |
|
15,705 |
12,261 |
$139K |
| J9355 |
Inj trastuzumab excl biosimi |
40 |
24 |
$138K |
| 99238 |
|
5,150 |
5,110 |
$138K |
| 83880 |
|
5,148 |
4,874 |
$132K |
| A9552 |
F18 fdg |
630 |
628 |
$131K |
| 76805 |
|
1,652 |
1,578 |
$130K |
| 76536 |
|
2,652 |
2,625 |
$128K |
| P9016 |
Rbc leukocytes reduced |
554 |
495 |
$127K |
| 85610 |
|
21,199 |
18,969 |
$127K |
| 90715 |
|
4,460 |
4,291 |
$127K |
| 84439 |
|
7,752 |
7,483 |
$123K |
| 94060 |
|
3,240 |
3,162 |
$123K |
| 82948 |
|
18,764 |
15,094 |
$123K |
| 87186 |
|
8,012 |
7,683 |
$122K |
| 0710 |
|
4,736 |
4,508 |
$122K |
| 85730 |
|
12,678 |
12,205 |
$119K |
| 82728 |
|
5,608 |
5,384 |
$117K |
| 96366 |
|
3,251 |
2,338 |
$115K |
| 66984 |
|
572 |
559 |
$113K |
| 93308 |
|
1,192 |
1,165 |
$112K |
| 86901 |
|
15,233 |
14,408 |
$110K |
| L3908 |
Who cock-up nonmolde pre ots |
1,511 |
1,496 |
$107K |
| 92134 |
|
9,212 |
8,652 |
$106K |
| 73560 |
|
5,995 |
5,555 |
$106K |
| 77062 |
|
778 |
778 |
$105K |
| 97802 |
|
3,395 |
3,237 |
$103K |
| 97803 |
|
4,361 |
4,098 |
$102K |
| 86140 |
|
11,938 |
11,364 |
$101K |
| 99215 |
Prolong outpt/office vis |
623 |
593 |
$99K |
| 49083 |
|
1,845 |
918 |
$98K |
| Z7504 |
|
1,983 |
1,778 |
$98K |
| 59025 |
|
5,155 |
3,650 |
$95K |
| 73590 |
|
4,783 |
4,367 |
$93K |
| 45385 |
|
2,881 |
2,865 |
$91K |
| 73080 |
|
3,463 |
3,249 |
$91K |
| 76870 |
|
1,697 |
1,639 |
$90K |
| 86920 |
|
1,314 |
1,183 |
$88K |
| 76817 |
|
1,676 |
1,533 |
$86K |
| J7120 |
Ringers lactate infusion |
26,206 |
23,054 |
$86K |
| 80047 |
|
11,090 |
10,474 |
$85K |
| 82607 |
|
3,293 |
3,197 |
$85K |
| 43239 |
|
2,919 |
2,908 |
$85K |
| 97597 |
|
2,094 |
707 |
$84K |
| 93320 |
|
1,369 |
1,358 |
$82K |
| J1439 |
Inj ferric carboxymaltos 1mg |
103 |
80 |
$79K |
| 72040 |
|
3,303 |
3,235 |
$77K |
| 97039 |
|
3,075 |
1,666 |
$77K |
| J7050 |
Normal saline solution infus |
57,213 |
28,703 |
$76K |
| 86900 |
|
15,245 |
14,422 |
$74K |
| 77061 |
|
567 |
567 |
$73K |
| 80076 |
|
5,290 |
5,173 |
$73K |
| 72170 |
|
3,429 |
3,358 |
$73K |
| 73090 |
|
3,754 |
3,335 |
$73K |
| 81025 |
|
10,411 |
9,903 |
$71K |
| 84100 |
|
9,900 |
8,271 |
$70K |
| 93351 |
|
607 |
600 |
$69K |
| 45378 |
|
2,050 |
2,039 |
$69K |
| 93226 |
|
1,322 |
1,320 |
$68K |
| 90686 |
|
4,543 |
4,509 |
$67K |
| 92235 |
|
987 |
982 |
$66K |
| 73700 |
|
344 |
342 |
$66K |
| 20610 |
|
2,797 |
2,724 |
$63K |
| J2469 |
Palonosetron hcl |
3,061 |
1,960 |
$63K |
| 82746 |
|
2,423 |
2,334 |
$61K |
| 99284 |
|
1,239 |
1,193 |
$61K |
| 82550 |
|
5,629 |
5,118 |
$61K |
| 74018 |
|
3,622 |
3,529 |
$59K |
| 82378 |
|
1,701 |
1,438 |
$58K |
| 86923 |
|
296 |
273 |
$58K |
| 85651 |
|
10,310 |
9,782 |
$57K |
| 72197 |
|
247 |
246 |
$56K |
| 76811 |
|
730 |
635 |
$56K |
| 93303 |
|
419 |
417 |
$56K |
| 73552 |
|
2,633 |
2,494 |
$55K |
| 97165 |
|
1,170 |
1,072 |
$55K |
| 86160 |
|
1,469 |
1,194 |
$53K |
| 73565 |
|
3,410 |
3,363 |
$53K |
| 93225 |
|
1,322 |
1,318 |
$52K |
| 95813 |
|
919 |
911 |
$52K |
| 73502 |
|
2,136 |
2,092 |
$52K |
| 86592 |
|
8,487 |
8,356 |
$52K |
| 80074 |
|
661 |
649 |
$52K |
| J7318 |
Inj, durolane 1 mg |
110 |
106 |
$51K |
| 94625 |
|
1,159 |
253 |
$50K |
| 94729 |
|
1,461 |
1,429 |
$50K |
| G0499 |
Hepb screen high risk indiv |
1,815 |
1,798 |
$50K |
| 72070 |
|
1,834 |
1,804 |
$50K |
| J0640 |
Leucovorin calcium injection |
1,714 |
515 |
$49K |
| 67228 |
|
817 |
767 |
$49K |
| 84153 |
|
1,516 |
1,480 |
$48K |
| 96523 |
|
1,798 |
1,468 |
$47K |
| 82570 |
|
6,450 |
6,188 |
$47K |
| 76000 |
|
2,220 |
2,177 |
$45K |
| 45380 |
|
1,829 |
1,822 |
$44K |
| J3010 |
Fentanyl citrate injection |
26,442 |
22,006 |
$44K |
| 93798 |
|
2,157 |
410 |
$43K |
| 87210 |
|
5,845 |
5,406 |
$43K |
| 73060 |
|
2,136 |
1,949 |
$42K |
| 82306 |
|
1,274 |
1,270 |
$42K |
| 77080 |
|
1,649 |
1,639 |
$42K |
| J1885 |
Ketorolac tromethamine inj |
34,021 |
31,238 |
$42K |
| 84703 |
|
3,381 |
3,298 |
$42K |
| 77075 |
|
810 |
803 |
$42K |
| 83550 |
|
3,421 |
3,341 |
$40K |
| 94760 |
|
5,603 |
4,509 |
$39K |
| 87591 |
|
578 |
568 |
$38K |
| 86703 |
|
2,370 |
2,316 |
$38K |
| 92250 |
|
2,716 |
2,482 |
$37K |
| 77063 |
|
1,743 |
1,740 |
$36K |
| Z1034 |
|
513 |
423 |
$36K |
| 76604 |
|
1,029 |
1,004 |
$35K |
| 99234 |
|
1,036 |
919 |
$35K |
| Q9957 |
Inj perflutren lip micros,ml |
541 |
529 |
$35K |
| 84145 |
|
1,785 |
1,637 |
$34K |
| 83540 |
|
3,427 |
3,335 |
$34K |
| J1170 |
Hydromorphone injection |
9,155 |
7,605 |
$34K |
| T1024 |
Team evaluation & management |
885 |
833 |
$34K |
| 73070 |
|
1,824 |
1,593 |
$33K |
| A4217 |
Sterile water/saline, 500 ml |
8,557 |
8,286 |
$32K |
| 92523 |
|
354 |
354 |
$32K |
| 87070 |
|
2,121 |
2,051 |
$32K |
| 97139 |
|
1,389 |
574 |
$32K |
| A9541 |
Tc99m sulfur colloid |
170 |
170 |
$32K |
| 99224 |
|
550 |
549 |
$31K |
| J0585 |
Injection,onabotulinumtoxina |
30 |
28 |
$31K |
| 87511 |
|
550 |
541 |
$31K |
| 73140 |
|
2,060 |
1,947 |
$31K |
| 87081 |
|
2,887 |
2,856 |
$30K |
| 82044 |
|
3,694 |
3,644 |
$30K |
| 86706 |
|
2,234 |
2,221 |
$30K |
| 85048 |
|
7,799 |
7,522 |
$29K |
| 93017 |
|
510 |
502 |
$29K |
| A4670 |
Automatic bp monitor, dial |
746 |
738 |
$28K |
| A9270 |
Non-covered item or service |
6,272 |
1,940 |
$28K |
| E0114 |
Crutch underarm pair no wood |
762 |
753 |
$28K |
| 83615 |
|
2,892 |
2,560 |
$28K |
| 90471 |
|
8,426 |
8,144 |
$28K |
| 73521 |
|
1,167 |
1,155 |
$27K |
| 78452 |
|
98 |
97 |
$27K |
| J0780 |
Prochlorperazine injection |
4,636 |
4,460 |
$26K |
| 73000 |
|
1,351 |
1,195 |
$26K |
| 72158 |
|
25 |
25 |
$26K |
| 83930 |
|
2,356 |
2,328 |
$25K |
| J2270 |
Morphine sulfate injection |
6,747 |
5,851 |
$25K |
| 85384 |
|
1,662 |
1,639 |
$25K |
| 87428 |
|
415 |
415 |
$25K |
| J2710 |
Neostigmine methylslfte inj |
1,356 |
1,318 |
$25K |
| 85379 |
|
1,414 |
1,369 |
$25K |
| 92133 |
|
2,283 |
2,248 |
$25K |
| 82010 |
|
1,818 |
1,720 |
$25K |
| J3301 |
Triamcinolone acet inj nos |
4,891 |
4,719 |
$25K |
| 82553 |
|
1,041 |
733 |
$24K |
| 88312 |
|
2,500 |
2,482 |
$24K |
| 76641 |
|
338 |
289 |
$23K |
| 96416 |
|
521 |
335 |
$23K |
| 93880 |
|
172 |
168 |
$23K |
| 0760 |
|
980 |
848 |
$23K |
| 0515 |
|
767 |
756 |
$23K |
| 96361 |
|
831 |
607 |
$23K |
| J1100 |
Dexamethasone sodium phos |
18,822 |
16,168 |
$23K |
| 82105 |
|
1,346 |
1,313 |
$22K |
| 72110 |
|
511 |
508 |
$22K |
| 12001 |
|
1,286 |
1,272 |
$22K |
| 84132 |
|
3,110 |
2,914 |
$22K |
| 73200 |
|
115 |
111 |
$21K |
| 86318 |
|
870 |
835 |
$21K |
| G0423 |
Intens cardiac rehab no exer |
257 |
48 |
$20K |
| J9267 |
Paclitaxel injection |
875 |
421 |
$20K |
| J2704 |
Inj, propofol, 10 mg |
18,621 |
12,732 |
$20K |
| 90791 |
|
140 |
134 |
$20K |
| 90670 |
|
1,656 |
1,592 |
$20K |
| 87653 |
|
628 |
619 |
$20K |
| 51701 |
|
1,435 |
1,406 |
$19K |
| 84550 |
|
2,700 |
2,472 |
$19K |
| 99225 |
|
328 |
327 |
$19K |
| 87563 |
|
567 |
558 |
$19K |
| 73501 |
|
1,094 |
1,060 |
$18K |
| J2405 |
Ondansetron hcl injection |
27,316 |
24,314 |
$18K |
| 94726 |
|
575 |
568 |
$18K |
| 0001A |
|
956 |
956 |
$18K |
| 82950 |
|
2,397 |
2,360 |
$18K |
| J7060 |
5% dextrose/water |
9,193 |
4,835 |
$17K |
| 87661 |
|
569 |
560 |
$17K |
| 76813 |
|
313 |
269 |
$17K |
| J2785 |
Regadenoson injection |
92 |
91 |
$16K |
| J1642 |
Inj heparin sodium per 10 u |
3,185 |
2,027 |
$16K |
| 90834 |
|
203 |
174 |
$16K |
| J9263 |
Oxaliplatin |
1,086 |
386 |
$16K |
| J0696 |
Ceftriaxone sodium injection |
8,053 |
7,563 |
$16K |
| 99153 |
Mod sedat endo service >5yrs |
1,516 |
1,507 |
$16K |
| 88304 |
|
1,277 |
1,266 |
$15K |
| 88307 |
|
532 |
531 |
$15K |
| S0020 |
Injection, bupivicaine hydro |
2,370 |
2,311 |
$15K |
| 92526 |
|
349 |
192 |
$15K |
| 93271 |
|
216 |
216 |
$15K |
| 71020 |
|
733 |
568 |
$15K |
| 73564 |
|
566 |
526 |
$15K |
| 99217 |
|
579 |
579 |
$15K |
| 96360 |
|
252 |
229 |
$15K |
| 12011 |
|
639 |
627 |
$14K |
| 74220 |
|
427 |
424 |
$14K |
| 93270 |
|
386 |
386 |
$14K |
| 82247 |
|
1,782 |
1,231 |
$14K |
| V5008 |
Hearing screening |
312 |
295 |
$14K |
| 36000 |
|
3,020 |
2,799 |
$13K |
| 84156 |
|
4,239 |
3,964 |
$13K |
| S0077 |
Injection, clindamycin phosp |
767 |
681 |
$13K |
| 87088 |
|
1,637 |
1,598 |
$13K |
| 90656 |
|
646 |
645 |
$13K |
| A9502 |
Tc99m tetrofosmin |
82 |
81 |
$13K |
| 95860 |
|
733 |
721 |
$13K |
| 52000 |
|
184 |
184 |
$12K |
| 67113 |
|
48 |
48 |
$12K |
| L3807 |
Whfo w/o joints pre cst |
97 |
97 |
$12K |
| J2370 |
Phenylephrine hcl injection |
1,560 |
1,501 |
$12K |
| J1790 |
Droperidol injection |
1,339 |
1,218 |
$12K |
| J9045 |
Carboplatin injection |
494 |
308 |
$12K |
| 83970 |
|
272 |
258 |
$12K |
| J0690 |
Cefazolin sodium injection |
7,967 |
7,408 |
$12K |
| 92551 |
|
898 |
865 |
$12K |
| 0002A |
|
384 |
384 |
$12K |
| J2250 |
Inj midazolam hydrochloride |
20,570 |
19,373 |
$11K |
| E0197 |
Air pressure pad for mattres |
84 |
78 |
$11K |
| 93925 |
|
129 |
128 |
$11K |
| 90723 |
|
1,263 |
1,206 |
$10K |
| 76001 |
|
129 |
117 |
$10K |
| 85060 |
|
559 |
514 |
$10K |
| 43235 |
|
342 |
340 |
$10K |
| 82140 |
|
606 |
589 |
$10K |
| A4209 |
5+ cc sterile syringe&needle |
283 |
283 |
$10K |
| 73100 |
|
525 |
467 |
$10K |
| J9217 |
Leuprolide acetate suspnsion |
25 |
25 |
$10K |
| 90662 |
|
325 |
320 |
$10K |
| 0270 |
|
2,213 |
1,168 |
$10K |
| 92653 |
|
129 |
111 |
$10K |
| 78215 |
|
113 |
113 |
$9K |
| J0171 |
Adrenalin epinephrine inject |
2,957 |
2,660 |
$9K |
| 29125 |
|
806 |
768 |
$9K |
| 73660 |
|
612 |
596 |
$9K |
| 12002 |
|
530 |
525 |
$9K |
| 94618 |
|
614 |
603 |
$9K |
| L1810 |
Ko elastic with joints |
91 |
90 |
$9K |
| 47563 |
|
48 |
48 |
$9K |
| J0561 |
Penicillin g benzathine inj |
34 |
28 |
$9K |
| J2930 |
Methylprednisolone injection |
1,516 |
1,095 |
$9K |
| 72146 |
|
27 |
27 |
$9K |
| 99443 |
|
94 |
65 |
$9K |
| G8510 |
Scr dep neg, no plan reqd |
6,025 |
5,920 |
$8K |
| 74174 |
|
44 |
44 |
$8K |
| A4355 |
Bladder irrigation tubing |
892 |
879 |
$8K |
| 83655 |
|
368 |
363 |
$8K |
| 90647 |
|
913 |
882 |
$8K |
| 76882 |
|
812 |
806 |
$8K |
| 85652 |
|
1,831 |
1,756 |
$8K |
| 29085 |
|
798 |
755 |
$8K |
| 51702 |
|
460 |
397 |
$7K |
| J1200 |
Diphenhydramine hcl injectio |
7,522 |
6,888 |
$7K |
| 87205 |
|
1,111 |
1,085 |
$7K |
| 87147 |
|
1,150 |
1,105 |
$7K |
| J9206 |
Irinotecan injection |
277 |
112 |
$7K |
| J2916 |
Na ferric gluconate complex |
364 |
204 |
$7K |
| 0361 |
|
65 |
63 |
$7K |
| 81000 |
|
1,679 |
1,214 |
$7K |
| 90633 |
|
837 |
800 |
$7K |
| 97140 |
|
844 |
376 |
$7K |
| 74181 |
|
12 |
12 |
$7K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
562 |
212 |
$7K |
| 86705 |
|
296 |
293 |
$6K |
| J1650 |
Inj enoxaparin sodium |
2,172 |
1,301 |
$6K |
| 86304 |
|
357 |
308 |
$6K |
| 99401 |
|
406 |
257 |
$6K |
| 36415 |
|
6,897 |
6,327 |
$6K |
| 73650 |
|
342 |
323 |
$6K |
| 87641 |
|
268 |
266 |
$6K |
| 74170 |
|
26 |
25 |
$6K |
| A4222 |
Infusion supplies with pump |
202 |
147 |
$6K |
| 70487 |
|
29 |
29 |
$6K |
| 97161 |
|
281 |
279 |
$6K |
| 92083 |
|
1,295 |
1,280 |
$6K |
| 85045 |
|
991 |
899 |
$6K |
| 96402 |
|
513 |
473 |
$6K |
| 74240 |
|
119 |
119 |
$6K |
| 78264 |
|
58 |
58 |
$6K |
| 88341 |
|
25 |
25 |
$6K |
| 99203 |
|
91 |
91 |
$6K |
| 85018 |
|
1,662 |
1,522 |
$6K |
| 29515 |
|
479 |
434 |
$6K |
| 72192 |
|
38 |
38 |
$5K |
| L1906 |
Afo multilig ank sup pre ots |
38 |
38 |
$5K |
| 95819 |
|
151 |
140 |
$5K |
| J0330 |
Succinycholine chloride inj |
1,981 |
1,749 |
$5K |
| J9070 |
Cyclophosphamide 100 mg inj |
28 |
12 |
$5K |
| A4301 |
Implantable access syst perc |
2,229 |
1,632 |
$5K |
| 72072 |
|
145 |
145 |
$5K |
| J1953 |
Levetiracetam injection |
466 |
432 |
$5K |
| 92019 |
|
59 |
58 |
$5K |
| A4364 |
Adhesive, liquid or equal |
1,994 |
1,957 |
$4K |
| 87077 |
|
682 |
636 |
$4K |
| A4215 |
Sterile needle |
4,495 |
3,078 |
$4K |
| 57288 |
|
38 |
38 |
$4K |
| 94727 |
|
184 |
175 |
$4K |
| J1644 |
Inj heparin sodium per 1000u |
3,594 |
2,070 |
$4K |
| 11750 |
|
139 |
135 |
$4K |
| 10060 |
|
202 |
197 |
$4K |
| 90707 |
|
426 |
406 |
$4K |
| U0003 |
Cov-19 amp prb hgh thruput |
53 |
53 |
$4K |
| A4353 |
Intermittent urinary cath |
409 |
404 |
$4K |
| J3475 |
Inj magnesium sulfate |
1,543 |
1,198 |
$4K |
| Q3014 |
Telehealth facility fee |
193 |
179 |
$4K |
| 86431 |
|
412 |
410 |
$4K |
| 80069 |
|
273 |
269 |
$4K |
| J2765 |
Metoclopramide hcl injection |
3,192 |
3,061 |
$4K |
| J2920 |
Methylprednisolone injection |
797 |
578 |
$4K |
| Q9968 |
Visualization adjunct |
177 |
148 |
$4K |
| 82310 |
|
478 |
461 |
$4K |
| J2543 |
Piperacillin/tazobactam |
814 |
691 |
$4K |
| 76816 |
|
82 |
68 |
$4K |
| J2795 |
Ropivacaine hcl injection |
3,739 |
2,573 |
$4K |
| L3260 |
Ambulatory surgical boot eac |
40 |
40 |
$4K |
| Z1032 |
|
25 |
25 |
$4K |
| 95251 |
|
137 |
137 |
$4K |
| 87804 |
|
404 |
370 |
$4K |
| 90681 |
|
403 |
395 |
$3K |
| 90716 |
|
398 |
385 |
$3K |
| 88720 |
|
750 |
568 |
$3K |
| A4344 |
Cath indw foley 2 way silicn |
254 |
246 |
$3K |
| 74160 |
|
14 |
14 |
$3K |
| J8540 |
Oral dexamethasone |
960 |
754 |
$3K |
| 90732 |
|
76 |
72 |
$3K |
| 81005 |
|
832 |
646 |
$3K |
| 71270 |
|
13 |
13 |
$3K |
| 70481 |
|
14 |
14 |
$3K |
| 44970 |
|
18 |
17 |
$3K |
| 0259 |
|
1,546 |
1,129 |
$3K |
| 58558 |
|
25 |
25 |
$3K |
| Q0144 |
Azithromycin dihydrate, oral |
479 |
457 |
$3K |
| 90700 |
|
354 |
344 |
$3K |
| J3370 |
Vancomycin hcl injection |
523 |
450 |
$3K |
| 76706 |
|
70 |
68 |
$3K |
| J1580 |
Garamycin gentamicin inj |
712 |
648 |
$3K |
| C9257 |
Bevacizumab injection |
12 |
12 |
$3K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
390 |
377 |
$3K |
| G0008 |
Admin influenza virus vac |
555 |
553 |
$3K |
| 90710 |
|
313 |
296 |
$3K |
| 90649 |
|
308 |
292 |
$2K |
| J0360 |
Hydralazine hcl injection |
557 |
518 |
$2K |
| 19083 |
|
106 |
105 |
$2K |
| 94664 |
|
218 |
218 |
$2K |
| 82270 |
|
419 |
414 |
$2K |
| A4356 |
Ext ureth clmp or compr dvc |
39 |
39 |
$2K |
| J2997 |
Alteplase recombinant |
12 |
12 |
$2K |
| J3489 |
Zoledronic acid 1mg |
90 |
85 |
$2K |
| J7030 |
Normal saline solution infus |
162 |
150 |
$2K |
| 90696 |
|
275 |
258 |
$2K |
| J3480 |
Inj potassium chloride |
822 |
554 |
$2K |
| 90734 |
|
263 |
251 |
$2K |
| 96411 |
|
90 |
70 |
$2K |
| J1940 |
Furosemide injection |
1,378 |
1,141 |
$2K |
| 97012 |
|
150 |
78 |
$2K |
| J2060 |
Lorazepam injection |
2,294 |
2,074 |
$2K |
| 99490 |
Ccm add 20min |
52 |
52 |
$2K |
| 90657 |
|
299 |
299 |
$2K |
| 86593 |
|
260 |
259 |
$2K |
| 45390 |
|
72 |
72 |
$2K |
| 82951 |
|
90 |
90 |
$2K |
| 86301 |
|
108 |
92 |
$2K |
| 90739 |
|
12 |
12 |
$2K |
| J2560 |
Phenobarbital sodium inj |
18 |
16 |
$2K |
| P9041 |
Albumin (human),5%, 50ml |
42 |
41 |
$2K |
| L1830 |
Ko immob canvas long pre ots |
25 |
24 |
$2K |
| 72052 |
|
39 |
38 |
$2K |
| 11721 |
|
180 |
177 |
$2K |
| A4212 |
Non coring needle or stylet |
37 |
37 |
$2K |
| J0461 |
Atropine sulfate injection |
533 |
337 |
$2K |
| 99281 |
|
95 |
93 |
$2K |
| 81001 |
|
300 |
243 |
$2K |
| 88173 |
|
52 |
52 |
$2K |
| 74230 |
|
37 |
37 |
$2K |
| J2800 |
Methocarbamol injection |
234 |
183 |
$2K |
| J0697 |
Sterile cefuroxime injection |
601 |
588 |
$2K |
| 96376 |
|
47 |
46 |
$2K |
| 66030 |
|
31 |
30 |
$1K |
| 95861 |
|
48 |
48 |
$1K |
| 86780 |
|
123 |
121 |
$1K |
| A4620 |
Variable concentration mask |
2,204 |
2,125 |
$1K |
| H1003 |
Prenatal at risk education |
111 |
94 |
$1K |
| 92610 |
|
39 |
39 |
$1K |
| 73120 |
|
83 |
82 |
$1K |
| A4461 |
Surgicl dress hold non-reuse |
734 |
726 |
$1K |
| 85007 |
|
254 |
234 |
$1K |
| G0202 |
Scr mammo bi incl cad |
22 |
12 |
$1K |
| A4615 |
Cannula nasal |
1,894 |
1,830 |
$1K |
| 85576 |
|
128 |
126 |
$1K |
| J2919 |
Inj, methylpred sod succ 5mg |
367 |
269 |
$1K |
| 97116 |
|
76 |
40 |
$1K |
| A6403 |
Sterile gauze>16 <= 48 sq in |
1,701 |
637 |
$1K |
| 78306 |
|
12 |
12 |
$1K |
| L4396 |
Static or dynami afo pre cst |
12 |
12 |
$1K |
| 0451 |
|
25 |
25 |
$1K |
| 99211 |
|
91 |
88 |
$1K |
| 71111 |
|
25 |
25 |
$1K |
| 81002 |
|
239 |
237 |
$1K |
| A4311 |
Catheter w/o bag 2-way latex |
67 |
66 |
$1K |
| 90651 |
|
15 |
15 |
$1K |
| 97804 |
|
55 |
55 |
$1K |
| 43237 |
|
12 |
12 |
$1K |
| 20553 |
|
65 |
65 |
$1K |
| 92611 |
|
36 |
36 |
$1K |
| 94799 |
|
14 |
14 |
$1K |
| 72220 |
|
43 |
42 |
$1K |
| J0694 |
Cefoxitin sodium injection |
86 |
85 |
$988.78 |
| 80164 |
|
56 |
50 |
$984.14 |
| A4556 |
Electrodes, pair |
85 |
85 |
$969.39 |
| 25605 |
|
15 |
14 |
$948.78 |
| 82565 |
|
134 |
131 |
$930.86 |
| 73620 |
|
57 |
54 |
$915.10 |
| 71010 |
|
64 |
60 |
$908.29 |
| 10005 |
|
24 |
24 |
$891.38 |
| 90688 |
|
97 |
96 |
$873.00 |
| 93926 |
|
14 |
12 |
$872.48 |
| 95910 |
|
12 |
12 |
$869.16 |
| 82533 |
|
25 |
25 |
$848.09 |
| J9190 |
Fluorouracil injection |
175 |
102 |
$817.32 |
| J9000 |
Doxorubicin hcl injection |
34 |
24 |
$752.50 |
| 43244 |
|
16 |
16 |
$740.49 |
| J7512 |
Prednisone ir or dr oral 1mg |
944 |
636 |
$711.55 |
| 29505 |
|
13 |
12 |
$710.86 |
| 11730 |
|
58 |
57 |
$698.79 |
| 76872 |
|
12 |
12 |
$698.64 |
| 74022 |
|
18 |
17 |
$685.73 |
| 82952 |
|
112 |
112 |
$658.88 |
| 87075 |
|
39 |
39 |
$650.36 |
| 71100 |
|
26 |
25 |
$638.54 |
| 84155 |
|
114 |
108 |
$634.73 |
| 76942 |
|
12 |
12 |
$633.61 |
| 85014 |
|
194 |
192 |
$631.17 |
| 90685 |
|
73 |
73 |
$621.00 |
| J2550 |
Promethazine hcl injection |
309 |
276 |
$617.95 |
| J1120 |
Acetazolamid sodium injectio |
25 |
24 |
$603.24 |
| 82150 |
|
55 |
52 |
$602.03 |
| 88342 |
|
25 |
25 |
$596.38 |
| 84436 |
|
48 |
48 |
$585.12 |
| 51798 |
|
30 |
30 |
$580.19 |
| 29405 |
|
48 |
42 |
$578.06 |
| 88108 |
|
39 |
39 |
$576.47 |
| 11102 |
|
45 |
45 |
$568.48 |
| 74000 |
|
35 |
29 |
$564.55 |
| 58100 |
|
27 |
27 |
$560.86 |
| A4628 |
Oropharyngeal suction cath |
116 |
116 |
$541.72 |
| 97162 |
|
27 |
27 |
$531.53 |
| 86580 |
|
64 |
56 |
$522.73 |
| 76937 |
|
38 |
38 |
$520.08 |
| A4246 |
Betadine/phisohex solution |
26 |
26 |
$510.69 |
| J7040 |
Normal saline solution infus |
373 |
240 |
$503.92 |
| 94010 |
|
25 |
25 |
$465.74 |
| 71101 |
|
12 |
12 |
$452.22 |
| 97003 |
|
12 |
12 |
$449.73 |
| 20552 |
|
30 |
28 |
$445.05 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
2,739 |
1,399 |
$375.59 |
| A7002 |
Tubing used w suction pump |
89 |
89 |
$365.79 |
| 90648 |
|
47 |
47 |
$360.00 |
| 72190 |
|
12 |
12 |
$352.08 |
| 86704 |
|
17 |
17 |
$336.60 |
| 90658 |
|
38 |
37 |
$330.18 |
| 83993 |
|
19 |
19 |
$298.30 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,550 |
1,046 |
$287.91 |
| 80185 |
|
13 |
12 |
$270.73 |
| 99188 |
|
15 |
15 |
$270.00 |
| J1805 |
Inj, esmolol hcl, 10mg |
597 |
322 |
$260.65 |
| 84520 |
|
41 |
41 |
$255.67 |
| A4616 |
Tubing (oxygen) per foot |
111 |
96 |
$255.04 |
| D1206 |
|
14 |
14 |
$252.00 |
| A6446 |
Conform band s w>=3" <5"/yd |
640 |
526 |
$243.11 |
| A4346 |
Cath indw foley 3 way |
14 |
14 |
$239.85 |
| 91010 |
|
12 |
12 |
$228.91 |
| A6402 |
Sterile gauze <= 16 sq in |
316 |
299 |
$224.84 |
| 29105 |
|
27 |
24 |
$220.37 |
| 12013 |
|
12 |
12 |
$216.00 |
| A4331 |
Extension drainage tubing |
58 |
58 |
$215.64 |
| 92552 |
|
13 |
13 |
$210.65 |
| 84300 |
|
31 |
30 |
$209.04 |
| J1741 |
Ibuprofen injection |
47 |
44 |
$203.10 |
| 89051 |
|
24 |
24 |
$201.42 |
| 86709 |
|
12 |
12 |
$190.35 |
| G8431 |
Pos clin depres scrn f/u doc |
931 |
911 |
$178.08 |
| 97112 |
|
18 |
13 |
$158.61 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
329 |
216 |
$148.50 |
| A4358 |
Urinary leg or abdomen bag |
12 |
12 |
$144.47 |
| A4221 |
Supp non-insulin inf cath/wk |
15 |
12 |
$138.00 |
| 87102 |
|
12 |
12 |
$130.80 |
| 51700 |
|
15 |
15 |
$130.00 |
| 87807 |
|
13 |
12 |
$122.57 |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
17 |
14 |
$113.63 |
| 90621 |
|
12 |
12 |
$108.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
17 |
12 |
$100.38 |
| 85390 |
|
96 |
94 |
$89.28 |
| 69209 |
|
14 |
14 |
$81.00 |
| J0736 |
Inj, clindamycin phosp 300mg |
26 |
25 |
$79.45 |
| 84460 |
|
13 |
12 |
$78.48 |
| 0271 |
|
13 |
12 |
$70.56 |
| A6407 |
Packing strips, non-impreg |
15 |
12 |
$70.11 |
| 29130 |
|
15 |
12 |
$66.00 |
| J1250 |
Inj dobutamine hcl/250 mg |
13 |
13 |
$63.50 |
| 90472 |
|
45 |
45 |
$57.25 |
| 88300 |
|
12 |
12 |
$44.40 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
58 |
29 |
$42.60 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
13 |
13 |
$42.56 |
| J3411 |
Thiamine hcl 100 mg |
12 |
12 |
$33.50 |
| J7510 |
Prednisolone oral per 5 mg |
16 |
12 |
$33.00 |
| J1630 |
Haloperidol injection |
42 |
35 |
$26.78 |
| A4760 |
Dialysate sol test kit, each |
94 |
49 |
$15.74 |
| J2252 |
Inj midazolam in 0.8% nacl |
22 |
12 |
$8.47 |
| 0258 |
|
160 |
152 |
$6.80 |
| J1836 |
Inj, metronidazole, 10 mg |
27 |
26 |
$3.63 |
| H0049 |
Alcohol/drug screening |
106 |
104 |
$0.00 |
| G8433 |
Scr for dep not cpt doc rsn |
449 |
429 |
$0.00 |
| 80320 |
|
216 |
187 |
$0.00 |
| 80329 |
|
120 |
99 |
$0.00 |
| 0636 |
|
17 |
14 |
$0.00 |
| 3052F |
|
24 |
24 |
$0.00 |
| 0250 |
|
19 |
14 |
$0.00 |
| A4550 |
Surgical trays |
276 |
237 |
$0.00 |
| G8511 |
Scr dep pos, no plan doc rng |
220 |
206 |
$0.00 |
| 3051F |
|
25 |
25 |
$0.00 |
| G1010 |
Cdsm stanson |
128 |
111 |
$0.00 |
| 3046F |
|
27 |
27 |
$0.00 |
| 0272 |
|
19 |
15 |
$0.00 |