| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpt clinic visit |
258,588 |
221,277 |
$22.45M |
| 96361 |
|
62,162 |
47,623 |
$17.89M |
| 99284 |
|
129,913 |
113,164 |
$17.84M |
| 99283 |
|
147,752 |
135,068 |
$17.45M |
| 99285 |
|
73,480 |
60,186 |
$11.70M |
| 90853 |
|
82,003 |
8,590 |
$5.03M |
| 74177 |
|
14,073 |
10,711 |
$3.82M |
| 70450 |
|
13,062 |
10,343 |
$3.35M |
| 43239 |
|
7,332 |
6,181 |
$3.02M |
| G0378 |
Hospital observation per hr |
35,709 |
12,404 |
$2.92M |
| 97110 |
|
37,111 |
12,328 |
$2.68M |
| 96365 |
|
14,453 |
7,705 |
$2.48M |
| J9271 |
Inj pembrolizumab |
228 |
133 |
$2.24M |
| 96360 |
|
10,238 |
8,318 |
$1.93M |
| 74176 |
|
6,894 |
5,113 |
$1.90M |
| U0004 |
Cov-19 test non-cdc hgh thru |
10,497 |
8,181 |
$1.39M |
| 96366 |
|
6,477 |
2,926 |
$1.35M |
| 90791 |
|
6,530 |
5,858 |
$1.35M |
| 80053 |
|
131,471 |
104,731 |
$1.18M |
| 45380 |
|
2,926 |
2,460 |
$1.07M |
| 99282 |
|
10,720 |
10,073 |
$1.04M |
| 47562 |
|
462 |
338 |
$989K |
| 45385 |
|
1,806 |
1,478 |
$930K |
| 80307 |
|
44,961 |
30,108 |
$927K |
| 71275 |
|
3,105 |
2,295 |
$865K |
| 94640 |
|
7,523 |
4,042 |
$853K |
| 95810 |
|
1,218 |
1,054 |
$786K |
| 97530 |
|
15,577 |
7,242 |
$711K |
| 99281 |
|
5,993 |
5,035 |
$699K |
| 58571 |
|
330 |
207 |
$698K |
| 93306 |
|
2,853 |
2,427 |
$698K |
| 80048 |
|
95,516 |
76,861 |
$695K |
| 87491 |
|
20,732 |
17,513 |
$693K |
| 95886 |
|
1,908 |
1,661 |
$688K |
| 76816 |
|
5,119 |
4,248 |
$682K |
| 77386 |
|
1,942 |
174 |
$667K |
| 95811 |
|
1,045 |
922 |
$632K |
| 58661 |
|
386 |
228 |
$615K |
| 11042 |
|
5,221 |
2,575 |
$548K |
| U0003 |
Cov-19 amp prb hgh thruput |
3,425 |
3,257 |
$530K |
| 96374 |
|
74,646 |
60,745 |
$522K |
| 90834 |
|
6,708 |
2,768 |
$518K |
| 70553 |
|
1,971 |
1,675 |
$508K |
| 76700 |
|
2,881 |
2,627 |
$502K |
| 93005 |
|
93,510 |
74,732 |
$483K |
| 76817 |
|
7,220 |
5,988 |
$481K |
| 76830 |
|
4,996 |
4,090 |
$463K |
| 87633 |
|
3,057 |
2,211 |
$431K |
| 96375 |
|
52,059 |
38,249 |
$424K |
| 64488 |
|
2,565 |
1,791 |
$415K |
| 29848 |
|
334 |
230 |
$415K |
| 96367 |
|
4,389 |
2,245 |
$397K |
| 97140 |
|
10,181 |
4,305 |
$396K |
| 87591 |
|
20,787 |
17,531 |
$372K |
| 85025 |
|
169,887 |
133,656 |
$370K |
| 71260 |
|
1,737 |
1,421 |
$361K |
| 59025 |
|
2,459 |
1,193 |
$359K |
| 76642 |
|
3,005 |
2,604 |
$351K |
| 76805 |
|
3,049 |
2,916 |
$351K |
| 96413 |
|
4,865 |
2,456 |
$350K |
| 71045 |
|
46,359 |
38,931 |
$346K |
| 70491 |
|
1,051 |
792 |
$327K |
| 74240 |
|
2,112 |
1,953 |
$318K |
| 88305 |
|
28,232 |
15,488 |
$312K |
| 70496 |
|
1,282 |
980 |
$309K |
| 94060 |
|
2,423 |
2,107 |
$307K |
| 96415 |
|
1,059 |
618 |
$307K |
| 84484 |
|
62,401 |
41,300 |
$304K |
| 36415 |
|
306,232 |
242,890 |
$302K |
| 87637 |
|
16,867 |
12,979 |
$300K |
| 77063 |
|
6,594 |
5,702 |
$300K |
| 11045 |
|
968 |
494 |
$296K |
| 97161 |
|
4,819 |
4,036 |
$291K |
| 71046 |
|
13,252 |
11,535 |
$290K |
| 45378 |
|
569 |
381 |
$288K |
| 87661 |
|
11,879 |
10,279 |
$273K |
| 76705 |
|
3,176 |
2,463 |
$270K |
| 58558 |
|
225 |
151 |
$269K |
| 76801 |
|
2,149 |
2,008 |
$258K |
| 94760 |
|
73,301 |
67,913 |
$251K |
| 49083 |
|
656 |
274 |
$247K |
| 76819 |
|
2,491 |
1,211 |
$245K |
| 52356 |
|
119 |
88 |
$242K |
| 71271 |
|
1,515 |
1,353 |
$235K |
| 87624 |
|
5,686 |
4,977 |
$235K |
| C8929 |
Tte w or wo fol wcon,doppler |
1,061 |
909 |
$231K |
| 78452 |
|
569 |
445 |
$230K |
| 71250 |
|
2,575 |
2,284 |
$230K |
| 78815 |
|
358 |
321 |
$224K |
| G0121 |
Colon ca scrn not hi rsk ind |
386 |
269 |
$221K |
| 97162 |
|
4,198 |
3,452 |
$218K |
| 96372 |
|
42,573 |
28,226 |
$210K |
| 96146 |
|
1,648 |
1,487 |
$208K |
| 90832 |
|
2,307 |
1,843 |
$205K |
| 76770 |
|
1,363 |
1,163 |
$203K |
| 95813 |
|
253 |
215 |
$199K |
| 76811 |
|
1,467 |
1,367 |
$197K |
| 80061 |
|
22,274 |
20,059 |
$197K |
| 86850 |
|
8,655 |
6,751 |
$188K |
| 76813 |
|
1,698 |
1,592 |
$186K |
| 93971 |
|
2,342 |
1,912 |
$185K |
| 85027 |
|
51,751 |
42,013 |
$184K |
| 84443 |
|
18,180 |
15,937 |
$182K |
| 93970 |
|
1,271 |
1,048 |
$182K |
| 72148 |
|
1,055 |
950 |
$174K |
| 70551 |
|
1,009 |
876 |
$173K |
| 88142 |
|
9,131 |
7,923 |
$171K |
| 81514 |
|
758 |
439 |
$168K |
| 0202U |
|
1,418 |
1,119 |
$168K |
| 70498 |
|
1,231 |
944 |
$168K |
| P9016 |
Rbc leukocytes reduced |
705 |
403 |
$167K |
| J1439 |
Inj ferric carboxymaltos 1mg |
236 |
85 |
$165K |
| 94727 |
|
2,499 |
2,162 |
$160K |
| 73721 |
|
684 |
614 |
$153K |
| 76856 |
|
865 |
749 |
$150K |
| 87086 |
|
17,930 |
14,791 |
$150K |
| 76536 |
|
1,485 |
1,356 |
$148K |
| 82607 |
|
8,585 |
7,767 |
$148K |
| 77336 |
|
1,569 |
720 |
$145K |
| 88307 |
|
1,856 |
981 |
$142K |
| 94729 |
|
2,693 |
2,333 |
$140K |
| 83036 |
|
26,110 |
23,354 |
$140K |
| 95806 |
|
425 |
408 |
$137K |
| 82306 |
|
8,289 |
7,519 |
$135K |
| J7307 |
Etonogestrel implant system |
155 |
77 |
$135K |
| 90677 |
|
940 |
809 |
$133K |
| 87631 |
|
896 |
878 |
$132K |
| 12001 |
|
880 |
751 |
$130K |
| 99291 |
|
1,072 |
824 |
$129K |
| 74183 |
|
498 |
445 |
$125K |
| 19083 |
|
169 |
144 |
$125K |
| 72141 |
|
737 |
641 |
$125K |
| G0480 |
Drug test def 1-7 classes |
14,331 |
10,566 |
$123K |
| 87102 |
|
6,150 |
5,346 |
$122K |
| 77300 |
|
424 |
183 |
$119K |
| 86900 |
|
9,599 |
7,447 |
$116K |
| 86592 |
|
5,456 |
4,739 |
$110K |
| 80320 |
|
5,397 |
4,586 |
$108K |
| 82728 |
|
8,621 |
7,740 |
$107K |
| 93017 |
|
1,108 |
912 |
$107K |
| 10060 |
|
697 |
574 |
$103K |
| 73630 |
|
4,217 |
3,539 |
$103K |
| 36430 |
|
827 |
439 |
$103K |
| 29580 |
|
954 |
397 |
$101K |
| 93798 |
|
1,980 |
443 |
$96K |
| 84630 |
|
5,211 |
4,875 |
$96K |
| 97113 |
|
1,234 |
422 |
$92K |
| 70486 |
|
1,411 |
1,141 |
$92K |
| 93270 |
|
869 |
757 |
$89K |
| 90837 |
|
796 |
381 |
$88K |
| 86803 |
|
7,183 |
6,204 |
$87K |
| 74174 |
|
513 |
410 |
$87K |
| Q3014 |
Telehealth facility fee |
7,797 |
7,461 |
$85K |
| 93458 |
|
75 |
51 |
$85K |
| 73221 |
|
416 |
385 |
$82K |
| 73030 |
|
3,653 |
2,888 |
$81K |
| 88341 |
|
1,217 |
932 |
$81K |
| 87205 |
|
8,563 |
7,139 |
$81K |
| 72100 |
|
2,510 |
2,068 |
$79K |
| C8930 |
Tte w or w/o contr, cont ecg |
308 |
238 |
$77K |
| J2315 |
Naltrexone, depot form |
66 |
62 |
$77K |
| 43235 |
|
186 |
132 |
$77K |
| 86361 |
|
1,837 |
1,708 |
$76K |
| 87389 |
|
8,542 |
7,352 |
$76K |
| 73560 |
|
2,071 |
1,623 |
$75K |
| 12002 |
|
538 |
454 |
$75K |
| 90670 |
|
414 |
291 |
$72K |
| 77067 |
|
6,599 |
5,706 |
$72K |
| G0239 |
Oth resp proc, group |
2,247 |
509 |
$71K |
| 84702 |
|
12,710 |
8,706 |
$69K |
| 87536 |
|
1,633 |
1,547 |
$66K |
| 90686 |
|
4,538 |
4,350 |
$66K |
| 76870 |
|
815 |
634 |
$66K |
| 97166 |
|
1,354 |
1,011 |
$65K |
| 72158 |
|
300 |
239 |
$64K |
| 83690 |
|
38,957 |
31,026 |
$64K |
| 83735 |
|
22,797 |
16,780 |
$63K |
| 73130 |
|
3,951 |
3,161 |
$62K |
| 83540 |
|
8,576 |
7,667 |
$61K |
| 77066 |
Tomosynthesis, mammo |
1,806 |
1,564 |
$61K |
| U0005 |
Infec agen detec ampli probe |
10,971 |
8,640 |
$60K |
| 95912 |
|
651 |
587 |
$60K |
| 90636 |
|
227 |
165 |
$60K |
| 90715 |
|
3,855 |
3,115 |
$59K |
| 84439 |
|
4,019 |
3,432 |
$59K |
| 72110 |
|
1,055 |
925 |
$59K |
| 90674 |
|
3,248 |
2,695 |
$58K |
| 77334 |
|
255 |
133 |
$57K |
| 76815 |
|
973 |
613 |
$56K |
| J9299 |
Injection, nivolumab |
20 |
12 |
$56K |
| 99396 |
|
531 |
448 |
$55K |
| 99395 |
|
530 |
455 |
$55K |
| 81001 |
|
65,190 |
54,078 |
$54K |
| 97165 |
|
902 |
689 |
$53K |
| 87340 |
|
3,942 |
3,463 |
$52K |
| 72125 |
|
3,948 |
3,062 |
$51K |
| 97112 |
|
1,165 |
522 |
$51K |
| 74018 |
|
1,780 |
1,397 |
$50K |
| 80076 |
|
7,495 |
7,017 |
$50K |
| 75574 |
|
172 |
146 |
$50K |
| 81025 |
|
30,905 |
24,854 |
$50K |
| J1050 |
Medroxyprogesterone acetate |
640 |
244 |
$49K |
| 87507 |
|
495 |
391 |
$49K |
| 90651 |
|
556 |
468 |
$48K |
| 82746 |
|
6,209 |
5,716 |
$47K |
| 77049 |
|
138 |
124 |
$47K |
| 86762 |
|
2,463 |
2,181 |
$47K |
| 86593 |
|
4,568 |
3,874 |
$47K |
| 96376 |
|
11,198 |
5,158 |
$47K |
| 77080 |
|
731 |
649 |
$46K |
| 74178 |
|
194 |
173 |
$46K |
| 73502 |
|
1,944 |
1,570 |
$45K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
1,328 |
872 |
$44K |
| 77065 |
Tomosynthesis, mammo |
1,209 |
996 |
$44K |
| G0257 |
Unsched dialysis esrd pt hos |
230 |
91 |
$43K |
| 97116 |
|
1,591 |
832 |
$43K |
| 72050 |
|
735 |
636 |
$43K |
| 64418 |
|
278 |
187 |
$43K |
| 94625 |
|
1,071 |
250 |
$42K |
| 86140 |
|
4,778 |
3,562 |
$40K |
| J1756 |
Iron sucrose injection |
2,320 |
863 |
$40K |
| 93880 |
|
537 |
480 |
$40K |
| C9803 |
Hopd covid-19 spec collect |
1,183 |
1,127 |
$40K |
| 72040 |
|
1,132 |
923 |
$39K |
| 87077 |
|
5,954 |
4,771 |
$38K |
| 11043 |
|
187 |
107 |
$38K |
| 87653 |
|
1,367 |
1,136 |
$38K |
| 86901 |
|
9,604 |
7,449 |
$37K |
| 73562 |
|
2,830 |
2,263 |
$37K |
| J0574 |
Bupren/nal 6.1 to 10mg bupre |
737 |
304 |
$37K |
| 88342 |
|
2,891 |
2,238 |
$36K |
| 93923 |
|
541 |
475 |
$36K |
| 70544 |
|
239 |
167 |
$36K |
| 82947 |
|
18,157 |
6,115 |
$36K |
| 12011 |
|
242 |
206 |
$36K |
| 73610 |
|
2,677 |
2,202 |
$36K |
| 93225 |
|
329 |
297 |
$33K |
| 76820 |
|
530 |
187 |
$33K |
| 72156 |
|
171 |
134 |
$33K |
| 00731 |
|
5,360 |
4,376 |
$30K |
| J3490 |
Drugs unclassified injection |
17,231 |
8,950 |
$30K |
| J2791 |
Rhophylac injection |
431 |
294 |
$30K |
| 95909 |
|
337 |
296 |
$29K |
| G0008 |
Admin influenza virus vac |
9,969 |
9,204 |
$29K |
| 73565 |
|
884 |
808 |
$29K |
| 82950 |
|
2,261 |
1,982 |
$29K |
| 73564 |
|
746 |
640 |
$29K |
| 84425 |
|
3,004 |
2,785 |
$28K |
| 0352U |
|
4,189 |
3,667 |
$27K |
| 72131 |
|
383 |
304 |
$27K |
| 90734 |
|
369 |
323 |
$27K |
| 73700 |
|
237 |
193 |
$27K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
28,271 |
22,330 |
$27K |
| 87522 |
Neg quan hep c or qual rna |
836 |
744 |
$27K |
| 94660 |
|
258 |
107 |
$26K |
| 73110 |
|
1,859 |
1,481 |
$26K |
| P9047 |
Albumin (human), 25%, 50ml |
153 |
85 |
$26K |
| G0279 |
Tomosynthesis, mammo |
2,701 |
2,335 |
$26K |
| 85610 |
|
23,568 |
14,644 |
$25K |
| 97535 |
|
1,240 |
659 |
$25K |
| 83880 |
|
6,507 |
4,968 |
$25K |
| 70487 |
|
75 |
52 |
$25K |
| 95911 |
|
435 |
370 |
$24K |
| 99394 |
|
276 |
263 |
$24K |
| 37799 |
|
26 |
16 |
$24K |
| 88304 |
|
1,864 |
1,288 |
$24K |
| 93356 |
|
1,309 |
1,145 |
$24K |
| 77301 |
|
38 |
34 |
$23K |
| 99392 |
|
242 |
212 |
$23K |
| 72072 |
|
786 |
629 |
$23K |
| 82570 |
|
4,605 |
3,872 |
$22K |
| 92134 |
|
412 |
381 |
$21K |
| 83605 |
|
8,733 |
6,153 |
$21K |
| 87651 |
|
5,292 |
3,885 |
$20K |
| 78227 |
|
79 |
44 |
$19K |
| 78264 |
|
83 |
73 |
$19K |
| 67028 |
|
85 |
76 |
$19K |
| 85055 |
|
1,960 |
1,542 |
$19K |
| 87338 |
|
972 |
886 |
$19K |
| 97035 |
|
264 |
123 |
$18K |
| 87902 |
|
128 |
110 |
$18K |
| J7297 |
Liletta, 52 mg |
38 |
14 |
$18K |
| 83020 |
|
925 |
844 |
$17K |
| 84403 |
|
973 |
875 |
$17K |
| 82105 |
|
887 |
763 |
$17K |
| 99393 |
|
190 |
175 |
$17K |
| 86480 |
|
507 |
450 |
$17K |
| 80069 |
|
984 |
811 |
$17K |
| 93226 |
|
320 |
290 |
$17K |
| J2469 |
Palonosetron hcl |
1,666 |
760 |
$17K |
| 97163 |
|
338 |
293 |
$17K |
| S9472 |
Cardiac rehabilitation progr |
281 |
58 |
$17K |
| 99391 |
|
170 |
159 |
$16K |
| 81003 |
|
13,370 |
11,654 |
$16K |
| J1453 |
Fosaprepitant injection |
987 |
452 |
$15K |
| 95012 |
|
377 |
326 |
$15K |
| 86923 |
|
738 |
452 |
$15K |
| 84146 |
|
1,086 |
853 |
$15K |
| 36591 |
|
994 |
540 |
$14K |
| 88312 |
|
784 |
645 |
$14K |
| 99152 |
|
892 |
667 |
$14K |
| 73080 |
|
692 |
587 |
$13K |
| 93922 |
|
157 |
141 |
$13K |
| 87070 |
|
2,634 |
2,065 |
$13K |
| 72197 |
|
47 |
40 |
$13K |
| 87106 |
|
1,017 |
819 |
$13K |
| 90471 |
|
4,149 |
3,265 |
$13K |
| 87186 |
|
4,548 |
3,578 |
$12K |
| 87426 |
|
6,236 |
4,474 |
$12K |
| 74230 |
|
108 |
98 |
$12K |
| 73620 |
|
695 |
549 |
$12K |
| 86706 |
|
1,390 |
1,174 |
$12K |
| 83516 |
|
598 |
541 |
$12K |
| C9290 |
Inj, bupivacaine liposome |
147 |
97 |
$11K |
| 83550 |
|
3,144 |
2,599 |
$11K |
| 95819 |
|
82 |
54 |
$11K |
| 45381 |
|
17 |
12 |
$11K |
| 73120 |
|
300 |
224 |
$11K |
| 86704 |
|
727 |
653 |
$11K |
| J1650 |
Inj enoxaparin sodium |
10,613 |
3,757 |
$11K |
| 82550 |
|
6,185 |
4,221 |
$11K |
| 82670 |
|
335 |
325 |
$10K |
| 82248 |
|
8,091 |
5,483 |
$10K |
| D0330 |
|
366 |
358 |
$10K |
| 83021 |
|
397 |
354 |
$10K |
| 83615 |
|
2,418 |
1,579 |
$10K |
| 00811 |
|
1,454 |
1,160 |
$10K |
| 73590 |
|
1,231 |
965 |
$10K |
| J1815 |
Insulin injection |
9,023 |
2,071 |
$10K |
| J0500 |
Dicyclomine injection |
720 |
475 |
$10K |
| 83970 |
|
489 |
423 |
$10K |
| J1170 |
Hydromorphone injection |
9,870 |
4,986 |
$10K |
| 98926 |
|
233 |
206 |
$10K |
| J0561 |
Penicillin g benzathine inj |
25 |
12 |
$9K |
| 90661 |
|
1,041 |
1,037 |
$9K |
| 26055 |
|
14 |
12 |
$9K |
| J2805 |
Sincalide injection |
77 |
42 |
$9K |
| 85652 |
|
4,376 |
3,405 |
$9K |
| 92083 |
|
246 |
225 |
$9K |
| J2543 |
Piperacillin/tazobactam |
2,334 |
893 |
$9K |
| 80074 |
|
836 |
680 |
$9K |
| C1776 |
Joint device (implantable) |
347 |
232 |
$8K |
| J2704 |
Inj, propofol, 10 mg |
28,870 |
22,096 |
$8K |
| 72170 |
|
1,383 |
1,067 |
$8K |
| 86038 |
|
523 |
432 |
$8K |
| 96368 |
|
1,062 |
371 |
$8K |
| 88112 |
|
610 |
479 |
$8K |
| 82043 |
|
3,095 |
2,684 |
$8K |
| 93242 |
|
97 |
97 |
$8K |
| 90750 |
|
48 |
40 |
$8K |
| 84153 |
|
717 |
631 |
$7K |
| 00812 |
|
1,663 |
1,220 |
$7K |
| G0009 |
Admin pneumococcal vaccine |
1,354 |
1,106 |
$7K |
| 82784 |
|
830 |
647 |
$7K |
| 93924 |
|
69 |
61 |
$7K |
| 64486 |
|
63 |
39 |
$7K |
| 10061 |
|
42 |
38 |
$7K |
| 74246 |
|
43 |
38 |
$7K |
| 77338 |
|
42 |
34 |
$7K |
| 73070 |
|
526 |
398 |
$7K |
| 73552 |
|
530 |
424 |
$7K |
| 71101 |
|
801 |
650 |
$6K |
| 36592 |
|
977 |
498 |
$6K |
| D1110 |
|
196 |
186 |
$6K |
| J2270 |
Morphine sulfate injection |
12,501 |
8,894 |
$6K |
| 73090 |
|
762 |
628 |
$6K |
| J1885 |
Ketorolac tromethamine inj |
41,171 |
29,362 |
$6K |
| 93246 |
|
75 |
75 |
$6K |
| 84156 |
|
1,562 |
1,219 |
$6K |
| 84481 |
|
799 |
671 |
$6K |
| 85014 |
|
2,532 |
1,653 |
$6K |
| 31624 |
|
50 |
40 |
$6K |
| 84100 |
|
3,344 |
1,891 |
$6K |
| 84703 |
|
3,582 |
2,850 |
$6K |
| 95913 |
|
63 |
54 |
$5K |
| 73600 |
|
367 |
293 |
$5K |
| G0424 |
Pulmonary rehab w exer |
188 |
50 |
$5K |
| 86334 |
|
311 |
254 |
$5K |
| 84145 |
|
1,378 |
927 |
$5K |
| 90849 |
|
112 |
51 |
$5K |
| D0140 |
|
224 |
220 |
$5K |
| 98927 |
|
165 |
152 |
$5K |
| 87040 |
|
4,602 |
1,700 |
$5K |
| Q9957 |
Inj perflutren lip micros,ml |
879 |
729 |
$5K |
| 92611 |
|
95 |
86 |
$5K |
| 85379 |
|
4,636 |
3,477 |
$5K |
| J1805 |
Inj, esmolol hcl, 10mg |
5,189 |
3,863 |
$5K |
| Q2039 |
Influenza virus vaccine, nos |
974 |
926 |
$5K |
| 76775 |
|
68 |
60 |
$5K |
| 82565 |
|
660 |
548 |
$5K |
| 87075 |
|
1,651 |
1,310 |
$4K |
| 86431 |
|
415 |
344 |
$4K |
| J0640 |
Leucovorin calcium injection |
125 |
25 |
$4K |
| 73140 |
|
196 |
176 |
$4K |
| 99153 |
Mod sedat endo service >5yrs |
458 |
341 |
$4K |
| 00940 |
|
354 |
268 |
$4K |
| 83001 |
|
234 |
210 |
$4K |
| 73060 |
|
426 |
345 |
$4K |
| 01810 |
|
940 |
699 |
$4K |
| 29125 |
|
523 |
416 |
$4K |
| 86708 |
|
358 |
332 |
$3K |
| 82803 |
|
2,500 |
1,765 |
$3K |
| 97014 |
|
73 |
31 |
$3K |
| G0105 |
Colorectal scrn; hi risk ind |
14 |
13 |
$3K |
| 80202 |
|
516 |
292 |
$3K |
| D7140 |
|
55 |
38 |
$3K |
| 85730 |
|
3,605 |
2,602 |
$3K |
| 93976 |
|
17 |
12 |
$3K |
| 87502 |
|
315 |
308 |
$3K |
| 96523 |
|
60 |
36 |
$3K |
| J2272 |
Inj, morphine (fresenius) |
4,182 |
2,107 |
$3K |
| 90746 |
|
252 |
233 |
$3K |
| 64445 |
|
14 |
12 |
$3K |
| 85018 |
|
2,560 |
1,659 |
$3K |
| D0120 |
|
158 |
157 |
$3K |
| 20610 |
|
17 |
13 |
$3K |
| J2405 |
Ondansetron hcl injection |
54,582 |
37,984 |
$3K |
| 95816 |
|
25 |
16 |
$3K |
| Q2038 |
Fluzone vacc, 3 yrs & >, im |
859 |
785 |
$3K |
| 00790 |
|
600 |
448 |
$3K |
| 00910 |
|
211 |
156 |
$3K |
| D0274 |
|
217 |
212 |
$3K |
| J9045 |
Carboplatin injection |
201 |
92 |
$3K |
| 84550 |
|
685 |
572 |
$3K |
| 87529 |
|
215 |
172 |
$3K |
| 84165 |
|
443 |
360 |
$3K |
| 90732 |
|
92 |
89 |
$3K |
| 29581 |
|
40 |
24 |
$2K |
| 84155 |
|
360 |
308 |
$2K |
| D0150 |
|
90 |
84 |
$2K |
| 97150 |
|
58 |
40 |
$2K |
| D0220 |
|
481 |
461 |
$2K |
| 11721 |
|
52 |
52 |
$2K |
| C9113 |
Inj pantoprazole sodium, via |
1,473 |
635 |
$2K |
| 88360 |
|
29 |
26 |
$2K |
| 86304 |
|
147 |
116 |
$2K |
| J1642 |
Inj heparin sodium per 10 u |
5,191 |
1,760 |
$2K |
| 80164 |
|
527 |
396 |
$2K |
| M0243 |
Casirivi and imdevi inj |
14 |
12 |
$2K |
| 82330 |
|
451 |
340 |
$2K |
| 72083 |
|
28 |
23 |
$2K |
| J3370 |
Vancomycin hcl injection |
2,679 |
1,269 |
$2K |
| 88172 |
|
41 |
28 |
$2K |
| 82040 |
|
719 |
604 |
$2K |
| 76818 |
|
28 |
15 |
$2K |
| C1781 |
Mesh (implantable) |
216 |
147 |
$2K |
| 94664 |
|
442 |
277 |
$2K |
| 84163 |
|
75 |
71 |
$2K |
| J0690 |
Cefazolin sodium injection |
4,045 |
2,597 |
$2K |
| J3475 |
Inj magnesium sulfate |
2,262 |
1,436 |
$2K |
| 92610 |
|
48 |
38 |
$2K |
| 82010 |
|
1,683 |
1,118 |
$2K |
| J1953 |
Levetiracetam injection |
186 |
99 |
$2K |
| G0390 |
Trauma respons w/hosp criti |
222 |
167 |
$2K |
| 93926 |
|
16 |
12 |
$2K |
| 86160 |
|
89 |
70 |
$2K |
| 94010 |
|
13 |
13 |
$2K |
| 00840 |
|
1,695 |
1,119 |
$1K |
| 86200 |
|
87 |
81 |
$1K |
| 96103 |
|
14 |
13 |
$1K |
| D0210 |
|
24 |
24 |
$1K |
| G0297 |
Ldct for lung ca screen |
14 |
12 |
$1K |
| 64413 |
|
14 |
14 |
$1K |
| 51701 |
|
396 |
304 |
$1K |
| 73100 |
|
52 |
36 |
$1K |
| 64999 |
|
12 |
12 |
$1K |
| 92133 |
|
58 |
58 |
$1K |
| 82533 |
|
103 |
71 |
$1K |
| C1769 |
Guide wire |
475 |
370 |
$1K |
| 80177 |
|
352 |
256 |
$1K |
| 86225 |
|
80 |
68 |
$1K |
| 78306 |
|
14 |
12 |
$1K |
| 90648 |
|
115 |
102 |
$1K |
| 84132 |
|
479 |
355 |
$1K |
| J7050 |
Normal saline solution infus |
6,284 |
2,916 |
$1K |
| 87493 |
|
76 |
62 |
$1K |
| J1100 |
Dexamethasone sodium phos |
19,606 |
12,530 |
$1K |
| 84270 |
|
70 |
63 |
$1K |
| 90472 |
|
569 |
491 |
$967.49 |
| 94762 |
|
964 |
748 |
$958.54 |
| 86308 |
|
439 |
302 |
$945.52 |
| 89051 |
|
243 |
157 |
$932.33 |
| 86870 |
|
70 |
34 |
$929.09 |
| 00400 |
|
381 |
271 |
$924.37 |
| 90694 |
|
77 |
65 |
$912.99 |
| 88173 |
|
450 |
360 |
$880.81 |
| 86364 |
|
86 |
77 |
$880.13 |
| 86235 |
|
51 |
39 |
$878.86 |
| 84402 |
|
70 |
63 |
$872.20 |
| J1644 |
Inj heparin sodium per 1000u |
3,359 |
1,421 |
$866.09 |
| 82140 |
|
294 |
216 |
$863.57 |
| 97010 |
|
21 |
13 |
$834.47 |
| 51702 |
|
229 |
183 |
$831.57 |
| 72202 |
|
12 |
12 |
$806.44 |
| J1200 |
Diphenhydramine hcl injectio |
8,319 |
4,986 |
$804.45 |
| J0696 |
Ceftriaxone sodium injection |
6,033 |
3,368 |
$801.23 |
| J2360 |
Orphenadrine injection |
2,030 |
1,380 |
$783.82 |
| 97597 |
|
24 |
13 |
$757.95 |
| 0054A |
|
27 |
27 |
$744.30 |
| J2930 |
Methylprednisolone injection |
1,705 |
974 |
$743.76 |
| D2392 |
|
15 |
12 |
$737.10 |
| J2795 |
Ropivacaine hcl injection |
1,033 |
499 |
$730.47 |
| J0360 |
Hydralazine hcl injection |
794 |
470 |
$726.85 |
| 90656 |
|
84 |
83 |
$713.05 |
| J2550 |
Promethazine hcl injection |
2,056 |
1,173 |
$700.35 |
| J0780 |
Prochlorperazine injection |
2,236 |
1,394 |
$658.16 |
| A9552 |
F18 fdg |
373 |
337 |
$625.90 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
978 |
358 |
$605.76 |
| 76942 |
|
126 |
100 |
$604.93 |
| 76098 |
|
27 |
15 |
$604.24 |
| A9270 |
Non-covered item or service |
25,173 |
2,523 |
$600.87 |
| 82378 |
|
76 |
62 |
$586.98 |
| J2060 |
Lorazepam injection |
4,686 |
2,884 |
$584.46 |
| 90632 |
|
19 |
19 |
$573.90 |
| J2310 |
Inj naloxone hydrochloride |
43 |
24 |
$536.82 |
| 90723 |
|
104 |
83 |
$530.12 |
| 76937 |
|
78 |
58 |
$510.30 |
| 84480 |
|
144 |
131 |
$496.96 |
| 80323 |
|
24 |
24 |
$495.14 |
| 01965 |
|
110 |
79 |
$495.04 |
| 74022 |
|
38 |
27 |
$493.92 |
| J2765 |
Metoclopramide hcl injection |
4,399 |
2,600 |
$483.27 |
| 00813 |
|
870 |
635 |
$482.46 |
| 86705 |
|
27 |
27 |
$481.48 |
| 93325 |
|
14 |
12 |
$476.17 |
| 85045 |
|
359 |
211 |
$475.30 |
| 80178 |
|
60 |
54 |
$469.97 |
| 72220 |
|
26 |
15 |
$448.44 |
| C1894 |
Intro/sheath, non-laser |
652 |
507 |
$440.45 |
| J0134 |
Inj acetaminophen -fresenius |
734 |
472 |
$431.22 |
| 87081 |
|
39 |
39 |
$424.08 |
| J0689 |
Inj cefazolin sodium, baxter |
4,449 |
2,937 |
$420.46 |
| J7030 |
Normal saline solution infus |
1,766 |
921 |
$418.38 |
| C1760 |
Closure dev, vasc |
445 |
329 |
$417.10 |
| 87449 |
|
220 |
160 |
$413.09 |
| 80051 |
|
119 |
108 |
$409.26 |
| J0736 |
Inj, clindamycin phosp 300mg |
121 |
66 |
$408.00 |
| 82272 |
|
343 |
254 |
$392.16 |
| 87641 |
|
329 |
290 |
$389.51 |
| 94618 |
|
14 |
13 |
$388.15 |
| J0702 |
Betamethasone acet&sod phosp |
18 |
12 |
$381.15 |
| 83520 |
|
13 |
12 |
$368.04 |
| J1940 |
Furosemide injection |
1,225 |
598 |
$363.51 |
| J3010 |
Fentanyl citrate injection |
6,707 |
4,629 |
$358.53 |
| 90633 |
|
41 |
29 |
$354.60 |
| J3411 |
Thiamine hcl 100 mg |
578 |
254 |
$353.13 |
| 92015 |
|
136 |
131 |
$346.85 |
| J1250 |
Inj dobutamine hcl/250 mg |
49 |
37 |
$346.32 |
| A9585 |
Gadobutrol injection |
3,881 |
3,251 |
$334.35 |
| 88302 |
|
383 |
244 |
$330.99 |
| J2920 |
Methylprednisolone injection |
621 |
296 |
$328.74 |
| J8540 |
Oral dexamethasone |
846 |
440 |
$318.40 |
| 84450 |
|
52 |
51 |
$311.95 |
| 87517 |
|
14 |
14 |
$309.52 |
| 83525 |
|
36 |
29 |
$301.16 |
| 90653 |
|
90 |
87 |
$292.91 |
| 96402 |
|
13 |
12 |
$282.84 |
| J1630 |
Haloperidol injection |
1,979 |
1,244 |
$280.65 |
| 87899 |
|
235 |
182 |
$269.46 |
| J2250 |
Inj midazolam hydrochloride |
12,945 |
9,413 |
$268.42 |
| J2919 |
Inj, methylpred sod succ 5mg |
788 |
524 |
$260.49 |
| 88313 |
|
139 |
105 |
$256.98 |
| 87116 |
|
162 |
129 |
$243.89 |
| 36416 |
|
741 |
608 |
$243.87 |
| 36600 |
|
42 |
17 |
$243.20 |
| 82652 |
|
18 |
15 |
$234.47 |
| 73521 |
|
13 |
12 |
$224.86 |
| J7120 |
Ringers lactate infusion |
808 |
582 |
$221.16 |
| Q0091 |
Obtaining screen pap smear |
667 |
555 |
$208.78 |
| 87206 |
|
196 |
150 |
$205.91 |
| J3420 |
Vitamin b12 injection |
535 |
307 |
$199.02 |
| 84300 |
|
194 |
146 |
$197.54 |
| A4648 |
Implantable tissue marker |
462 |
374 |
$196.89 |
| 84460 |
|
52 |
51 |
$187.41 |
| J0131 |
Inj, acetaminophen (nos) |
45 |
36 |
$185.34 |
| 00952 |
|
321 |
216 |
$178.14 |
| J0737 |
Inj, clindamycin (baxter) |
321 |
221 |
$175.85 |
| J1580 |
Garamycin gentamicin inj |
288 |
169 |
$169.33 |
| J7060 |
5% dextrose/water |
572 |
249 |
$168.82 |
| 87076 |
|
78 |
65 |
$158.43 |
| J0692 |
Cefepime hcl for injection |
324 |
156 |
$157.50 |
| 86146 |
|
12 |
12 |
$152.29 |
| J3480 |
Inj potassium chloride |
1,241 |
677 |
$151.51 |
| 94761 |
|
722 |
604 |
$151.28 |
| C2617 |
Stent, non-cor, tem w/o del |
467 |
354 |
$147.30 |
| J7040 |
Normal saline solution infus |
862 |
454 |
$137.45 |
| J0171 |
Adrenalin epinephrine inject |
1,217 |
790 |
$133.95 |
| 84520 |
|
41 |
40 |
$133.14 |
| 80175 |
|
35 |
25 |
$131.48 |
| 82088 |
|
16 |
14 |
$127.91 |
| A4565 |
Slings |
694 |
509 |
$127.02 |
| 87880 |
|
45 |
45 |
$126.49 |
| 91322 |
|
33 |
33 |
$123.06 |
| 90662 |
|
12 |
12 |
$118.72 |
| 82977 |
|
15 |
14 |
$116.07 |
| 83002 |
|
12 |
12 |
$101.72 |
| 88333 |
|
106 |
78 |
$95.28 |
| 86618 |
|
19 |
13 |
$91.92 |
| 29130 |
|
17 |
12 |
$90.63 |
| D0230 |
|
22 |
12 |
$84.00 |
| 84436 |
|
16 |
13 |
$83.08 |
| 85384 |
|
20 |
13 |
$82.85 |
| C1758 |
Catheter, ureteral |
2,458 |
1,719 |
$78.28 |
| Q9956 |
Inj octafluoropropane mic,ml |
723 |
615 |
$73.25 |
| J1030 |
Methylprednisolone 40 mg inj |
121 |
114 |
$66.59 |
| J2001 |
Lidocaine injection |
39 |
39 |
$65.34 |
| 87635 |
|
44 |
38 |
$64.58 |
| J0330 |
Succinycholine chloride inj |
950 |
608 |
$64.55 |
| 84134 |
|
47 |
44 |
$62.72 |
| J2470 |
Inj pantoprazole sodium 40mg |
328 |
197 |
$58.42 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
633 |
393 |
$54.91 |
| J3301 |
Triamcinolone acet inj nos |
336 |
249 |
$53.55 |
| 84244 |
|
15 |
14 |
$50.68 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
1,889 |
1,396 |
$42.70 |
| 90480 |
|
32 |
32 |
$41.54 |
| C1729 |
Cath, drainage |
574 |
406 |
$34.10 |
| J1790 |
Droperidol injection |
312 |
197 |
$33.82 |
| J1920 |
Inj, labetalol hcl, 5mg |
688 |
442 |
$31.74 |
| 81002 |
|
574 |
515 |
$31.46 |
| G0010 |
Admin hepatitis b vaccine |
253 |
234 |
$28.54 |
| 82365 |
|
45 |
39 |
$20.39 |
| Q0114 |
Fern test |
12 |
12 |
$20.16 |
| J0461 |
Atropine sulfate injection |
77 |
28 |
$19.94 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
735 |
542 |
$13.58 |
| J1598 |
Inj glycopyrrolate fres kabi |
393 |
369 |
$11.20 |
| J0456 |
Azithromycin |
36 |
29 |
$8.66 |
| J2175 |
Meperidine hydrochl /100 mg |
152 |
87 |
$7.51 |
| J1836 |
Inj, metronidazole, 10 mg |
60 |
38 |
$5.76 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
265 |
228 |
$5.62 |
| J0744 |
Ciprofloxacin iv |
65 |
39 |
$3.98 |
| J2370 |
Phenylephrine hcl injection |
80 |
55 |
$3.10 |
| J7512 |
Prednisone ir or dr oral 1mg |
64 |
33 |
$2.53 |
| 91305 |
|
36 |
36 |
$0.39 |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
206 |
191 |
$0.00 |
| 80050 |
|
34 |
27 |
$0.00 |
| C9250 |
Artiss fibrin sealant |
148 |
91 |
$0.00 |
| 96411 |
|
318 |
128 |
$0.00 |
| A9500 |
Tc99m sestamibi |
638 |
499 |
$0.00 |
| 51798 |
|
59 |
42 |
$0.00 |
| 80047 |
|
78 |
54 |
$0.00 |
| 82962 |
|
192 |
171 |
$0.00 |
| J2785 |
Regadenoson injection |
478 |
364 |
$0.00 |
| 01480 |
|
137 |
92 |
$0.00 |
| J1720 |
Hydrocortisone sodium succ i |
24 |
13 |
$0.00 |
| A9698 |
Non-rad contrast materialnoc |
112 |
94 |
$0.00 |
| 00142 |
|
20 |
14 |
$0.00 |
| 84157 |
|
35 |
25 |
$0.00 |
| 95910 |
|
33 |
24 |
$0.00 |
| 77001 |
|
12 |
12 |
$0.00 |
| 00160 |
|
61 |
38 |
$0.00 |
| G0439 |
Ppps, subseq visit |
19 |
17 |
$0.00 |
| Q9968 |
Visualization adjunct |
19 |
13 |
$0.00 |
| 31629 |
|
35 |
25 |
$0.00 |
| 95249 |
|
19 |
17 |
$0.00 |
| 00902 |
|
30 |
25 |
$0.00 |
| A9503 |
Tc99m medronate |
14 |
12 |
$0.00 |
| J9267 |
Paclitaxel injection |
31 |
12 |
$0.00 |
| A9573 |
Inj, gadopiclenol, 1 ml |
42 |
42 |
$0.00 |
| 31654 |
|
23 |
14 |
$0.00 |
| C1726 |
Cath, bal dil, non-vascular |
12 |
12 |
$0.00 |
| 69209 |
|
34 |
30 |
$0.00 |
| 00918 |
|
269 |
204 |
$0.00 |
| 00300 |
|
172 |
110 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
275 |
219 |
$0.00 |
| 96417 |
|
1,045 |
490 |
$0.00 |
| J0670 |
Inj mepivacaine hcl/10 ml |
111 |
68 |
$0.00 |
| A9541 |
Tc99m sulfur colloid |
82 |
72 |
$0.00 |
| A9537 |
Tc99m mebrofenin |
51 |
32 |
$0.00 |
| 00520 |
|
67 |
46 |
$0.00 |
| J1020 |
Methylprednisolone 20 mg inj |
100 |
66 |
$0.00 |
| 01830 |
|
45 |
24 |
$0.00 |
| 76376 |
|
13 |
12 |
$0.00 |
| 01402 |
|
30 |
12 |
$0.00 |