| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
150,193 |
131,609 |
$9.90M |
| 99284 |
|
120,814 |
106,095 |
$7.25M |
| 96361 |
|
45,316 |
36,073 |
$6.55M |
| 99211 |
|
57,437 |
40,813 |
$3.88M |
| 99285 |
|
66,690 |
57,954 |
$3.75M |
| 97110 |
|
95,526 |
27,009 |
$3.65M |
| 99213 |
|
47,478 |
42,701 |
$2.54M |
| 87491 |
|
56,882 |
50,837 |
$2.22M |
| 80053 |
|
95,478 |
80,470 |
$2.10M |
| 87591 |
|
56,881 |
50,843 |
$1.91M |
| 87502 |
|
17,255 |
16,024 |
$1.62M |
| 87661 |
|
49,571 |
44,313 |
$1.58M |
| 99282 |
|
21,953 |
19,947 |
$1.52M |
| 87635 |
|
29,636 |
27,298 |
$1.47M |
| 96365 |
|
17,061 |
12,661 |
$1.46M |
| 70450 |
|
18,080 |
16,224 |
$1.43M |
| 99214 |
|
25,427 |
23,176 |
$1.29M |
| 96360 |
|
13,016 |
11,235 |
$1.24M |
| 99212 |
|
22,295 |
18,209 |
$1.18M |
| 59025 |
|
16,228 |
8,078 |
$1.17M |
| 80048 |
|
53,675 |
43,700 |
$1.11M |
| U0003 |
Cov-19 amp prb hgh thruput |
13,606 |
12,522 |
$1.09M |
| 97140 |
|
48,512 |
16,474 |
$1.09M |
| 94640 |
|
21,641 |
16,899 |
$1.05M |
| G0480 |
Drug test def 1-7 classes |
18,733 |
16,103 |
$924K |
| 99281 |
|
13,151 |
11,749 |
$918K |
| 81001 |
|
66,210 |
58,237 |
$908K |
| 74177 |
|
11,659 |
10,519 |
$866K |
| 85025 |
|
124,938 |
102,270 |
$821K |
| 80307 |
|
15,752 |
13,764 |
$791K |
| 81025 |
|
69,102 |
61,597 |
$741K |
| 96366 |
|
6,470 |
4,640 |
$723K |
| G0378 |
Hospital observation per hr |
16,082 |
13,651 |
$699K |
| 93306 |
|
6,264 |
5,633 |
$645K |
| 43239 |
|
3,220 |
2,955 |
$604K |
| 82962 |
|
38,881 |
26,664 |
$547K |
| 87081 |
|
21,975 |
20,350 |
$514K |
| 76816 |
|
11,442 |
9,280 |
$480K |
| 45380 |
|
2,661 |
2,438 |
$466K |
| 78452 |
|
2,607 |
2,206 |
$438K |
| 97112 |
|
15,494 |
6,398 |
$413K |
| 45385 |
|
2,013 |
1,850 |
$412K |
| 81420 |
|
1,176 |
932 |
$410K |
| 81003 |
|
39,292 |
35,331 |
$409K |
| P9016 |
Rbc leukocytes reduced |
809 |
663 |
$389K |
| 84484 |
|
37,235 |
28,876 |
$369K |
| 71275 |
|
4,405 |
3,958 |
$368K |
| 87880 |
|
20,955 |
19,675 |
$354K |
| 74176 |
|
4,760 |
4,310 |
$344K |
| 97530 |
|
13,971 |
5,975 |
$332K |
| 76811 |
|
6,562 |
5,735 |
$331K |
| 20610 |
|
3,570 |
2,885 |
$323K |
| 12001 |
|
3,457 |
3,248 |
$309K |
| 87086 |
|
29,211 |
25,649 |
$303K |
| 97162 |
|
7,327 |
6,706 |
$297K |
| 77067 |
|
9,986 |
9,470 |
$283K |
| 84702 |
|
12,145 |
8,987 |
$281K |
| 45378 |
|
1,220 |
1,140 |
$272K |
| 76801 |
|
8,290 |
7,122 |
$258K |
| 92507 |
|
5,858 |
2,308 |
$251K |
| 76856 |
|
4,950 |
4,594 |
$243K |
| 76830 |
|
5,762 |
5,369 |
$240K |
| 83880 |
|
9,789 |
8,412 |
$235K |
| 87389 |
|
11,458 |
9,937 |
$235K |
| 84443 |
|
17,368 |
15,416 |
$233K |
| 12011 |
|
2,440 |
2,322 |
$231K |
| 99291 |
|
4,684 |
4,099 |
$224K |
| 10060 |
|
2,504 |
2,334 |
$218K |
| 87634 |
|
3,616 |
3,392 |
$218K |
| 85027 |
|
32,763 |
27,272 |
$208K |
| 82306 |
|
8,305 |
7,526 |
$203K |
| 12002 |
|
2,332 |
2,161 |
$200K |
| 80061 |
|
15,130 |
13,722 |
$191K |
| 71046 |
|
26,776 |
24,557 |
$188K |
| 83690 |
|
32,637 |
28,337 |
$188K |
| 72125 |
|
5,210 |
4,716 |
$187K |
| 82728 |
|
9,351 |
8,065 |
$187K |
| 99215 |
Prolong outpt/office vis |
3,899 |
3,483 |
$184K |
| 86780 |
|
16,766 |
14,700 |
$179K |
| 76819 |
|
10,511 |
7,239 |
$177K |
| 88175 |
|
6,696 |
5,833 |
$167K |
| 83036 |
|
17,948 |
15,959 |
$160K |
| 70496 |
|
1,989 |
1,774 |
$160K |
| C9803 |
Hopd covid-19 spec collect |
5,725 |
5,271 |
$159K |
| 76705 |
|
4,128 |
3,793 |
$157K |
| 87653 |
|
4,520 |
4,003 |
$155K |
| 93971 |
|
4,572 |
4,181 |
$154K |
| 97161 |
|
3,797 |
3,379 |
$151K |
| 84112 |
|
1,737 |
1,538 |
$147K |
| 96372 |
|
42,275 |
33,865 |
$145K |
| 71260 |
|
2,206 |
2,000 |
$144K |
| 70498 |
|
2,018 |
1,792 |
$141K |
| 76642 |
|
3,779 |
3,236 |
$141K |
| 93017 |
|
3,064 |
2,607 |
$139K |
| 87624 |
|
4,151 |
3,573 |
$135K |
| 76805 |
|
2,308 |
2,035 |
$130K |
| 76817 |
|
8,087 |
6,562 |
$129K |
| 82950 |
|
5,663 |
5,095 |
$121K |
| 72148 |
|
1,853 |
1,708 |
$119K |
| 82607 |
|
7,278 |
6,519 |
$116K |
| 97163 |
|
2,988 |
2,756 |
$115K |
| 77063 |
|
8,590 |
8,121 |
$115K |
| 96367 |
|
2,081 |
1,533 |
$115K |
| 70553 |
|
1,100 |
1,000 |
$110K |
| 73721 |
|
1,405 |
1,252 |
$107K |
| 70486 |
|
2,699 |
2,482 |
$104K |
| 99391 |
|
1,968 |
1,797 |
$103K |
| 70551 |
|
1,468 |
1,315 |
$102K |
| 78815 |
|
511 |
445 |
$101K |
| 97166 |
|
2,680 |
2,410 |
$99K |
| 86762 |
|
7,045 |
5,987 |
$98K |
| 36430 |
|
835 |
692 |
$96K |
| 93970 |
|
1,767 |
1,644 |
$95K |
| 82565 |
|
6,524 |
5,126 |
$92K |
| 97116 |
|
5,668 |
3,065 |
$92K |
| 87210 |
|
11,281 |
10,330 |
$90K |
| 73630 |
|
11,204 |
9,856 |
$88K |
| 96413 |
|
2,309 |
1,226 |
$87K |
| 83605 |
|
9,532 |
7,856 |
$85K |
| 86850 |
|
13,702 |
11,774 |
$85K |
| 83735 |
|
16,272 |
12,609 |
$84K |
| 93356 |
|
833 |
760 |
$84K |
| G0463 |
Hospital outpt clinic visit |
11,678 |
8,893 |
$84K |
| 90715 |
|
10,426 |
9,530 |
$83K |
| 80143 |
|
5,334 |
4,602 |
$80K |
| 76536 |
|
1,764 |
1,648 |
$78K |
| 87340 |
|
8,184 |
6,946 |
$76K |
| 29125 |
|
1,860 |
1,698 |
$72K |
| 87077 |
|
6,562 |
5,892 |
$72K |
| 87186 |
|
9,080 |
8,139 |
$70K |
| 76770 |
|
1,375 |
1,277 |
$70K |
| 86803 |
|
5,851 |
4,891 |
$69K |
| 94060 |
|
2,869 |
2,615 |
$69K |
| 99392 |
|
1,705 |
1,524 |
$69K |
| 76815 |
|
2,171 |
1,806 |
$68K |
| G0108 |
Diab manage trn per indiv |
1,958 |
1,675 |
$68K |
| 85610 |
|
14,830 |
12,032 |
$66K |
| 83655 |
|
3,027 |
2,739 |
$61K |
| 80179 |
|
5,296 |
4,575 |
$61K |
| 83970 |
|
2,047 |
1,865 |
$60K |
| 77066 |
Tomosynthesis, mammo |
2,466 |
2,281 |
$60K |
| 86481 |
|
741 |
656 |
$59K |
| 99395 |
|
1,694 |
1,583 |
$59K |
| 10061 |
|
759 |
699 |
$58K |
| 84703 |
|
7,519 |
6,905 |
$58K |
| 85379 |
|
7,164 |
6,479 |
$56K |
| 72100 |
|
6,656 |
6,241 |
$56K |
| 71250 |
|
1,633 |
1,486 |
$56K |
| T1016 |
Case management |
12,073 |
3,542 |
$55K |
| 94660 |
|
852 |
568 |
$53K |
| 77065 |
Tomosynthesis, mammo |
2,410 |
2,052 |
$52K |
| 80074 |
|
1,112 |
1,003 |
$52K |
| 87040 |
|
4,216 |
3,558 |
$51K |
| 90670 |
|
3,266 |
3,088 |
$49K |
| 97165 |
|
1,629 |
1,416 |
$49K |
| 36475 |
|
82 |
63 |
$49K |
| 99393 |
|
967 |
894 |
$48K |
| J1726 |
Makena, 10 mg |
1,181 |
366 |
$48K |
| 97035 |
|
4,221 |
1,697 |
$48K |
| 87636 |
|
387 |
361 |
$47K |
| 82746 |
|
3,952 |
3,538 |
$47K |
| 80171 |
|
1,907 |
1,754 |
$46K |
| 94729 |
|
2,414 |
2,224 |
$46K |
| 72141 |
|
628 |
554 |
$45K |
| 87147 |
|
8,113 |
7,433 |
$44K |
| 80076 |
|
4,674 |
4,175 |
$44K |
| 86901 |
|
15,265 |
12,920 |
$44K |
| 81511 |
|
317 |
296 |
$44K |
| 87070 |
|
2,734 |
2,302 |
$43K |
| 86900 |
|
13,720 |
11,601 |
$42K |
| 76820 |
|
4,041 |
1,922 |
$42K |
| 70491 |
|
568 |
518 |
$41K |
| 83020 |
|
3,173 |
2,711 |
$41K |
| 90651 |
|
1,077 |
998 |
$40K |
| 99396 |
|
1,395 |
1,291 |
$38K |
| 76700 |
|
688 |
642 |
$38K |
| 73030 |
|
8,740 |
7,906 |
$38K |
| 41899 |
|
109 |
98 |
$38K |
| 82570 |
|
6,202 |
5,209 |
$37K |
| 82550 |
|
6,517 |
5,468 |
$37K |
| 86703 |
|
2,101 |
1,843 |
$36K |
| 93005 |
|
62,917 |
53,300 |
$36K |
| 73562 |
|
8,264 |
7,445 |
$35K |
| 99204 |
|
850 |
740 |
$35K |
| 87529 |
|
616 |
555 |
$34K |
| 97535 |
|
2,990 |
1,500 |
$34K |
| 85730 |
|
7,731 |
6,628 |
$33K |
| 76870 |
|
887 |
791 |
$32K |
| 96374 |
|
54,535 |
45,823 |
$32K |
| 81002 |
|
1,229 |
1,120 |
$32K |
| 84153 |
|
1,528 |
1,397 |
$30K |
| 93458 |
|
57 |
53 |
$30K |
| 83550 |
|
4,408 |
3,924 |
$30K |
| 84439 |
|
2,972 |
2,609 |
$29K |
| 90686 |
|
4,459 |
3,954 |
$29K |
| J1750 |
Inj iron dextran |
933 |
452 |
$28K |
| G0008 |
Admin influenza virus vac |
6,048 |
5,437 |
$28K |
| 90472 |
|
3,985 |
3,714 |
$28K |
| U0004 |
Cov-19 test non-cdc hgh thru |
329 |
289 |
$28K |
| 83540 |
|
5,068 |
4,513 |
$28K |
| 82800 |
|
3,127 |
2,387 |
$27K |
| 90471 |
|
10,477 |
9,560 |
$27K |
| 73130 |
|
8,846 |
7,952 |
$26K |
| 74018 |
|
4,232 |
3,899 |
$26K |
| 90834 |
|
471 |
273 |
$25K |
| 85007 |
|
7,998 |
6,562 |
$25K |
| 99203 |
|
560 |
505 |
$25K |
| 84550 |
|
5,544 |
4,477 |
$25K |
| 0042T |
|
447 |
388 |
$24K |
| 0002A |
|
1,641 |
1,207 |
$24K |
| 86787 |
|
3,491 |
2,942 |
$24K |
| 73610 |
|
8,823 |
7,993 |
$23K |
| 73560 |
|
4,149 |
3,499 |
$23K |
| 83615 |
|
4,221 |
3,287 |
$23K |
| 85014 |
|
4,347 |
3,753 |
$22K |
| 0001A |
|
1,789 |
1,298 |
$22K |
| 73502 |
|
4,627 |
4,276 |
$21K |
| 29515 |
|
413 |
373 |
$21K |
| 71045 |
|
44,916 |
38,938 |
$21K |
| 93922 |
|
565 |
515 |
$20K |
| 77062 |
|
1,759 |
1,640 |
$20K |
| 72040 |
|
2,373 |
2,243 |
$20K |
| 82010 |
|
2,888 |
2,338 |
$19K |
| 87088 |
|
2,504 |
2,269 |
$19K |
| 84450 |
|
3,763 |
2,893 |
$19K |
| 82951 |
|
384 |
347 |
$19K |
| 84460 |
|
3,785 |
2,915 |
$18K |
| 99394 |
|
350 |
336 |
$18K |
| J7307 |
Etonogestrel implant system |
116 |
98 |
$18K |
| 73221 |
|
288 |
275 |
$17K |
| 97803 |
|
1,460 |
1,270 |
$17K |
| 95816 |
|
164 |
153 |
$17K |
| 82077 |
|
1,722 |
1,476 |
$17K |
| 97113 |
|
223 |
79 |
$17K |
| 87075 |
|
2,142 |
1,808 |
$16K |
| 82043 |
|
1,909 |
1,733 |
$15K |
| 86480 |
|
201 |
194 |
$15K |
| 82553 |
|
2,786 |
2,376 |
$15K |
| 12013 |
|
175 |
162 |
$15K |
| 84163 |
|
341 |
282 |
$14K |
| 77080 |
|
344 |
319 |
$13K |
| J1756 |
Iron sucrose injection |
2,856 |
1,407 |
$13K |
| 86140 |
|
3,356 |
2,840 |
$13K |
| 77061 |
|
1,148 |
1,066 |
$13K |
| 64400 |
|
103 |
86 |
$13K |
| 73110 |
|
4,786 |
4,309 |
$12K |
| 82105 |
|
327 |
268 |
$12K |
| 84156 |
|
3,302 |
2,709 |
$12K |
| 97533 |
|
509 |
232 |
$11K |
| 84520 |
|
3,077 |
2,377 |
$11K |
| 80164 |
|
702 |
602 |
$11K |
| 85018 |
|
4,728 |
3,979 |
$10K |
| 82803 |
|
558 |
487 |
$10K |
| 94726 |
|
1,531 |
1,411 |
$10K |
| 85049 |
|
2,405 |
1,787 |
$10K |
| 85652 |
|
2,924 |
2,535 |
$10K |
| 87205 |
|
2,679 |
2,245 |
$9K |
| H1002 |
Carecoordination prenatal |
388 |
255 |
$9K |
| G0009 |
Admin pneumococcal vaccine |
3,961 |
3,716 |
$9K |
| 84132 |
|
1,797 |
1,132 |
$9K |
| H1000 |
Prenatal care atrisk assessm |
430 |
295 |
$9K |
| G0283 |
Elec stim other than wound |
719 |
335 |
$9K |
| U0005 |
Infec agen detec ampli probe |
703 |
626 |
$8K |
| 84100 |
|
2,459 |
1,960 |
$8K |
| 72070 |
|
1,576 |
1,483 |
$8K |
| 99406 |
|
1,133 |
999 |
$8K |
| 86923 |
|
648 |
526 |
$8K |
| 96368 |
|
135 |
122 |
$8K |
| U0001 |
2019-ncov diagnostic p |
243 |
214 |
$8K |
| 97802 |
|
770 |
682 |
$8K |
| 90710 |
|
1,373 |
1,287 |
$8K |
| 19083 |
|
28 |
25 |
$8K |
| 29105 |
|
67 |
61 |
$8K |
| 90648 |
|
1,364 |
1,304 |
$7K |
| 73564 |
|
1,344 |
1,179 |
$7K |
| 96415 |
|
94 |
57 |
$7K |
| 92523 |
|
142 |
128 |
$7K |
| 87015 |
|
31 |
31 |
$7K |
| 31500 |
|
35 |
27 |
$7K |
| 76813 |
|
400 |
321 |
$6K |
| 86038 |
|
581 |
490 |
$6K |
| 73140 |
|
3,977 |
3,707 |
$6K |
| 99385 |
|
207 |
196 |
$6K |
| 90633 |
|
1,525 |
1,441 |
$6K |
| 97012 |
|
330 |
134 |
$6K |
| 90698 |
|
1,731 |
1,654 |
$6K |
| 90674 |
|
638 |
575 |
$6K |
| 84704 |
|
341 |
282 |
$6K |
| 88307 |
|
946 |
792 |
$6K |
| 73080 |
|
2,297 |
2,143 |
$6K |
| 88305 |
|
10,844 |
9,826 |
$5K |
| 73565 |
|
1,945 |
1,819 |
$5K |
| 82140 |
|
592 |
494 |
$5K |
| 96375 |
|
38,526 |
31,663 |
$5K |
| 93798 |
|
64 |
25 |
$5K |
| G0382 |
Lev 3 hosp type b ed visit |
531 |
483 |
$5K |
| 80177 |
|
413 |
366 |
$5K |
| 43249 |
|
32 |
26 |
$5K |
| 94618 |
|
150 |
134 |
$5K |
| J1745 |
Infliximab not biosimil 10mg |
14 |
12 |
$5K |
| 73590 |
|
2,819 |
2,501 |
$5K |
| Q0091 |
Obtaining screen pap smear |
1,747 |
1,541 |
$4K |
| 87252 |
|
108 |
97 |
$4K |
| 90681 |
|
1,409 |
1,343 |
$4K |
| 82247 |
|
163 |
101 |
$4K |
| 77049 |
|
29 |
29 |
$4K |
| 97167 |
|
109 |
98 |
$4K |
| 90474 |
|
1,298 |
1,237 |
$4K |
| 87631 |
|
30 |
28 |
$4K |
| 87207 |
|
71 |
67 |
$4K |
| 76942 |
|
363 |
322 |
$4K |
| 86593 |
|
228 |
193 |
$3K |
| 90656 |
|
436 |
411 |
$3K |
| 88738 |
|
255 |
221 |
$3K |
| 74183 |
|
41 |
37 |
$3K |
| M0245 |
Bamlan and etesev infusion |
15 |
13 |
$3K |
| G0109 |
Diab manage trn ind/group |
130 |
93 |
$3K |
| 74178 |
|
42 |
39 |
$3K |
| 99381 |
|
44 |
42 |
$3K |
| 73090 |
|
2,117 |
1,922 |
$3K |
| 86706 |
|
329 |
279 |
$3K |
| 90792 |
|
67 |
49 |
$3K |
| 73552 |
|
1,180 |
1,099 |
$3K |
| 87505 |
|
26 |
26 |
$3K |
| 99188 |
|
56 |
53 |
$3K |
| 69209 |
|
467 |
430 |
$3K |
| 91300 |
|
784 |
523 |
$2K |
| 36415 |
|
63,444 |
49,053 |
$2K |
| 90723 |
|
1,333 |
1,276 |
$2K |
| 93880 |
|
38 |
38 |
$2K |
| 71101 |
|
2,713 |
2,544 |
$2K |
| 73060 |
|
914 |
830 |
$2K |
| 90677 |
|
175 |
165 |
$2K |
| 11981 |
|
32 |
24 |
$2K |
| 71271 |
|
26 |
26 |
$2K |
| 86235 |
|
29 |
27 |
$2K |
| 90837 |
|
67 |
37 |
$2K |
| G0279 |
Tomosynthesis, mammo |
327 |
303 |
$2K |
| 73660 |
|
591 |
557 |
$2K |
| 87449 |
|
165 |
152 |
$2K |
| 86431 |
|
288 |
255 |
$2K |
| 74019 |
|
2,100 |
1,939 |
$1K |
| 93308 |
|
13 |
13 |
$1K |
| 87522 |
Neg quan hep c or qual rna |
31 |
25 |
$1K |
| 80185 |
|
106 |
78 |
$1K |
| 36591 |
|
1,065 |
563 |
$1K |
| 86580 |
|
91 |
88 |
$1K |
| 31720 |
|
50 |
44 |
$1K |
| 96376 |
|
9,234 |
6,951 |
$1K |
| 73120 |
|
184 |
133 |
$1K |
| 83516 |
|
80 |
65 |
$1K |
| 76818 |
|
66 |
56 |
$1K |
| 72170 |
|
922 |
843 |
$1K |
| A9500 |
Tc99m sestamibi |
2,316 |
1,971 |
$1K |
| 84481 |
|
99 |
87 |
$1K |
| 99386 |
|
72 |
62 |
$1K |
| 73700 |
|
30 |
26 |
$1K |
| 73620 |
|
188 |
121 |
$1K |
| 82248 |
|
273 |
169 |
$1K |
| 90734 |
|
131 |
119 |
$1K |
| 94150 |
|
2,404 |
2,043 |
$972.18 |
| 84146 |
|
62 |
55 |
$968.87 |
| 94727 |
|
300 |
274 |
$927.21 |
| U0002 |
Covid-19 lab test non-cdc |
1,181 |
1,006 |
$925.83 |
| 97018 |
|
65 |
24 |
$873.29 |
| 95886 |
|
15 |
13 |
$871.53 |
| 84165 |
|
136 |
110 |
$855.17 |
| 90678 |
|
151 |
134 |
$838.20 |
| 85046 |
|
174 |
121 |
$833.21 |
| 83001 |
|
62 |
51 |
$799.35 |
| 84145 |
|
44 |
40 |
$792.61 |
| 86704 |
|
92 |
76 |
$792.15 |
| J2785 |
Regadenoson injection |
1,930 |
1,637 |
$777.31 |
| 73070 |
|
91 |
80 |
$772.82 |
| 99292 |
|
1,900 |
1,656 |
$745.55 |
| 82952 |
|
176 |
157 |
$731.54 |
| 99205 |
Prolong outpt/office vis |
15 |
12 |
$683.61 |
| 90744 |
|
300 |
284 |
$681.65 |
| 86200 |
|
55 |
50 |
$679.77 |
| J2704 |
Inj, propofol, 10 mg |
20,616 |
15,190 |
$673.94 |
| 90685 |
|
256 |
251 |
$622.77 |
| 90750 |
|
47 |
38 |
$614.85 |
| H1003 |
Prenatal at risk education |
109 |
59 |
$607.69 |
| 92610 |
|
17 |
17 |
$585.72 |
| 94762 |
|
3,735 |
2,827 |
$575.05 |
| 85660 |
|
13 |
13 |
$564.50 |
| 72050 |
|
28 |
24 |
$542.87 |
| 90680 |
|
45 |
42 |
$539.94 |
| 97602 |
|
32 |
12 |
$516.16 |
| J2930 |
Methylprednisolone injection |
3,322 |
2,762 |
$493.44 |
| 93321 |
|
12 |
12 |
$483.99 |
| 87110 |
|
30 |
26 |
$467.18 |
| 95806 |
|
12 |
12 |
$452.44 |
| A9552 |
F18 fdg |
508 |
440 |
$442.23 |
| 70480 |
|
14 |
13 |
$441.73 |
| 86308 |
|
81 |
76 |
$438.20 |
| 85045 |
|
125 |
101 |
$415.41 |
| 88360 |
|
13 |
13 |
$384.67 |
| 90696 |
|
163 |
149 |
$376.02 |
| 97022 |
|
44 |
12 |
$364.94 |
| 80050 |
|
115 |
108 |
$363.57 |
| 96402 |
|
14 |
13 |
$348.35 |
| G0383 |
Lev 4 hosp type b ed visit |
46 |
40 |
$345.97 |
| 90688 |
|
71 |
64 |
$334.40 |
| 87563 |
|
14 |
12 |
$312.69 |
| 76828 |
|
41 |
26 |
$303.40 |
| J0561 |
Penicillin g benzathine inj |
20 |
12 |
$287.96 |
| J2791 |
Rhophylac injection |
16 |
13 |
$287.45 |
| 88342 |
|
2,593 |
2,307 |
$282.28 |
| 82805 |
|
15 |
14 |
$279.37 |
| 86039 |
|
31 |
24 |
$239.06 |
| J1170 |
Hydromorphone injection |
10,428 |
7,709 |
$193.57 |
| 82375 |
|
17 |
13 |
$185.66 |
| J0690 |
Cefazolin sodium injection |
7,305 |
5,697 |
$183.01 |
| G0010 |
Admin hepatitis b vaccine |
274 |
253 |
$181.72 |
| J1885 |
Ketorolac tromethamine inj |
33,604 |
28,458 |
$179.31 |
| 84403 |
|
13 |
12 |
$175.74 |
| 76825 |
|
18 |
14 |
$175.20 |
| J2405 |
Ondansetron hcl injection |
33,078 |
26,321 |
$168.60 |
| J3475 |
Inj magnesium sulfate |
4,755 |
3,594 |
$166.15 |
| 96401 |
|
42 |
24 |
$164.25 |
| 51701 |
|
84 |
75 |
$151.64 |
| 88304 |
|
1,668 |
1,504 |
$150.96 |
| J1050 |
Medroxyprogesterone acetate |
6,821 |
6,480 |
$144.81 |
| 87140 |
|
30 |
26 |
$130.86 |
| 86870 |
|
41 |
37 |
$127.76 |
| 90732 |
|
28 |
26 |
$112.54 |
| 93325 |
|
12 |
12 |
$112.52 |
| 88341 |
|
216 |
188 |
$107.79 |
| J0500 |
Dicyclomine injection |
683 |
636 |
$103.04 |
| 85384 |
|
17 |
14 |
$100.40 |
| 72220 |
|
27 |
24 |
$97.34 |
| 76827 |
|
18 |
14 |
$87.65 |
| J0696 |
Ceftriaxone sodium injection |
10,901 |
8,978 |
$85.33 |
| 82378 |
|
15 |
12 |
$70.45 |
| 51798 |
|
178 |
162 |
$68.94 |
| J1030 |
Methylprednisolone 40 mg inj |
1,159 |
1,072 |
$65.50 |
| J1200 |
Diphenhydramine hcl injectio |
6,773 |
5,581 |
$59.91 |
| 82947 |
|
15 |
13 |
$57.00 |
| 99152 |
|
1,401 |
1,232 |
$55.53 |
| J2270 |
Morphine sulfate injection |
11,671 |
9,797 |
$48.21 |
| J2765 |
Metoclopramide hcl injection |
10,172 |
8,805 |
$42.28 |
| 98960 |
|
47 |
40 |
$39.54 |
| 81015 |
|
19 |
14 |
$37.99 |
| 88300 |
|
140 |
125 |
$32.43 |
| J1790 |
Droperidol injection |
3,600 |
3,003 |
$29.92 |
| J0360 |
Hydralazine hcl injection |
1,791 |
1,421 |
$28.91 |
| 0011A |
|
62 |
52 |
$26.51 |
| J2370 |
Phenylephrine hcl injection |
642 |
560 |
$25.92 |
| J3480 |
Inj potassium chloride |
3,141 |
2,083 |
$19.39 |
| 70360 |
|
106 |
95 |
$18.69 |
| P9612 |
Catheterize for urine spec |
284 |
260 |
$18.60 |
| 91305 |
|
33 |
25 |
$18.58 |
| J1100 |
Dexamethasone sodium phos |
15,738 |
13,563 |
$17.30 |
| 99153 |
Mod sedat endo service >5yrs |
859 |
753 |
$15.66 |
| J1630 |
Haloperidol injection |
2,219 |
1,899 |
$13.62 |
| J1940 |
Furosemide injection |
2,037 |
1,338 |
$13.37 |
| J3010 |
Fentanyl citrate injection |
8,097 |
6,680 |
$11.53 |
| J2060 |
Lorazepam injection |
5,674 |
4,696 |
$11.34 |
| 90662 |
|
15 |
12 |
$9.56 |
| J1650 |
Inj enoxaparin sodium |
4,451 |
1,973 |
$9.37 |
| J2250 |
Inj midazolam hydrochloride |
10,453 |
9,125 |
$8.35 |
| J0131 |
Inj, acetaminophen (nos) |
322 |
284 |
$7.82 |
| 94760 |
|
3,385 |
2,687 |
$4.04 |
| J3420 |
Vitamin b12 injection |
907 |
551 |
$4.00 |
| J1642 |
Inj heparin sodium per 10 u |
4,570 |
1,967 |
$1.09 |
| J3301 |
Triamcinolone acet inj nos |
586 |
533 |
$0.86 |
| J1920 |
Inj, labetalol hcl, 5mg |
252 |
211 |
$0.74 |
| J1644 |
Inj heparin sodium per 1000u |
4,320 |
1,790 |
$0.42 |
| A4550 |
Surgical trays |
238 |
215 |
$0.31 |
| A9270 |
Non-covered item or service |
27,990 |
22,393 |
$0.00 |
| J3490 |
Drugs unclassified injection |
820 |
718 |
$0.00 |
| G8980 |
Mobility d/c status |
255 |
234 |
$0.00 |
| J2175 |
Meperidine hydrochl /100 mg |
367 |
342 |
$0.00 |
| Q0162 |
Ondansetron oral |
471 |
455 |
$0.00 |
| G8988 |
Self care goal status |
146 |
127 |
$0.00 |
| J3411 |
Thiamine hcl 100 mg |
877 |
668 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
349 |
287 |
$0.00 |
| C1726 |
Cath, bal dil, non-vascular |
137 |
113 |
$0.00 |
| J1040 |
Methylprednisolone 80 mg inj |
656 |
626 |
$0.00 |
| C1769 |
Guide wire |
1,168 |
912 |
$0.00 |
| 0012A |
|
32 |
27 |
$0.00 |
| A4364 |
Adhesive, liquid or equal |
37 |
28 |
$0.00 |
| C9399 |
Unclassified drugs or biolog |
274 |
235 |
$0.00 |
| J3360 |
Diazepam injection |
364 |
319 |
$0.00 |
| J1010 |
Inj, methylpred acetate 1 mg |
41 |
40 |
$0.00 |
| C9290 |
Inj, bupivacaine liposome |
186 |
160 |
$0.00 |
| 97010 |
|
227 |
135 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
63 |
50 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
43 |
26 |
$0.00 |
| 74022 |
|
25 |
25 |
$0.00 |
| A9503 |
Tc99m medronate |
14 |
13 |
$0.00 |
| J1836 |
Inj, metronidazole, 10 mg |
55 |
37 |
$0.00 |
| J0456 |
Azithromycin |
14 |
14 |
$0.00 |
| J1805 |
Inj, esmolol hcl, 10mg |
55 |
41 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
62 |
55 |
$0.00 |
| C1781 |
Mesh (implantable) |
40 |
38 |
$0.00 |
| G8987 |
Self care current status |
112 |
98 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
132 |
113 |
$0.00 |
| J7611 |
Albuterol non-comp con |
107 |
94 |
$0.00 |
| A9540 |
Tc99m maa |
14 |
12 |
$0.00 |
| J2310 |
Inj naloxone hydrochloride |
396 |
304 |
$0.00 |
| J1953 |
Levetiracetam injection |
1,474 |
1,183 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
695 |
611 |
$0.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
88 |
49 |
$0.00 |
| G8984 |
Carry current status |
47 |
40 |
$0.00 |
| G1004 |
Cdsm ndsc |
3,662 |
3,020 |
$0.00 |
| J0780 |
Prochlorperazine injection |
1,048 |
860 |
$0.00 |
| J1729 |
Inj hydroxyprogst capoat nos |
780 |
250 |
$0.00 |
| G8978 |
Mobility current status |
686 |
609 |
$0.00 |
| A9502 |
Tc99m tetrofosmin |
299 |
253 |
$0.00 |
| G8979 |
Mobility goal status |
801 |
699 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
30 |
30 |
$0.00 |
| G8985 |
Carry goal status |
82 |
70 |
$0.00 |
| J0702 |
Betamethasone acet&sod phosp |
129 |
68 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
336 |
287 |
$0.00 |
| C1760 |
Closure dev, vasc |
291 |
246 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
645 |
564 |
$0.00 |
| J1580 |
Garamycin gentamicin inj |
58 |
51 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
237 |
209 |
$0.00 |
| J3370 |
Vancomycin hcl injection |
220 |
106 |
$0.00 |
| 88312 |
|
114 |
104 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
129 |
119 |
$0.00 |
| 94681 |
|
14 |
12 |
$0.00 |
| 73000 |
|
16 |
12 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
54 |
46 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
120 |
90 |
$0.00 |
| 94690 |
|
82 |
59 |
$0.00 |
| Q0245 |
Bamlanivimab and etesevima |
15 |
13 |
$0.00 |
| 94664 |
|
12 |
12 |
$0.00 |
| 16020 |
|
12 |
12 |
$0.00 |
| 51702 |
|
15 |
12 |
$0.00 |