| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpt clinic visit |
230,408 |
176,560 |
$13.85M |
| 99283 |
|
69,295 |
63,319 |
$6.80M |
| 99284 |
|
47,725 |
43,504 |
$6.10M |
| 99285 |
|
18,756 |
16,361 |
$5.90M |
| 99214 |
|
96,339 |
85,124 |
$3.10M |
| H2012 |
Behav hlth day treat, per hr |
40,954 |
1,610 |
$3.04M |
| 99213 |
|
74,777 |
60,434 |
$1.77M |
| 99282 |
|
20,936 |
19,469 |
$1.23M |
| 90792 |
|
18,945 |
17,793 |
$1.21M |
| 96374 |
|
11,409 |
9,955 |
$1.06M |
| A0427 |
Als1-emergency |
5,160 |
4,455 |
$944K |
| 87637 |
|
13,464 |
12,394 |
$877K |
| J0585 |
Injection,onabotulinumtoxina |
2,404 |
1,271 |
$811K |
| 74177 |
|
5,004 |
4,624 |
$733K |
| 99232 |
|
22,185 |
8,938 |
$728K |
| 20610 |
|
7,799 |
6,343 |
$608K |
| 97110 |
|
31,569 |
11,073 |
$548K |
| 11042 |
|
7,725 |
4,695 |
$548K |
| 95810 |
|
1,635 |
1,508 |
$522K |
| 96365 |
|
6,560 |
4,951 |
$494K |
| 29581 |
|
16,074 |
6,427 |
$483K |
| A0429 |
Bls-emergency |
2,760 |
2,298 |
$472K |
| 71046 |
|
13,181 |
12,175 |
$471K |
| 20553 |
|
5,767 |
5,103 |
$434K |
| 76819 |
|
6,892 |
4,329 |
$406K |
| A0425 |
Ground mileage |
13,217 |
8,358 |
$387K |
| 96361 |
|
10,022 |
8,392 |
$358K |
| 93306 |
|
2,091 |
2,011 |
$345K |
| 96413 |
|
3,042 |
1,918 |
$323K |
| 99223 |
Prolong inpt eval add15 m |
3,338 |
3,117 |
$317K |
| 99239 |
|
6,053 |
5,610 |
$311K |
| 43239 |
|
1,275 |
1,148 |
$310K |
| A0428 |
Bls |
4,884 |
2,761 |
$298K |
| 96360 |
|
3,503 |
2,996 |
$292K |
| 96375 |
|
9,800 |
7,892 |
$289K |
| 99222 |
|
4,026 |
3,804 |
$268K |
| 74176 |
|
2,819 |
2,622 |
$259K |
| 59025 |
|
2,371 |
1,537 |
$258K |
| 70450 |
|
4,835 |
4,414 |
$244K |
| 99203 |
|
7,161 |
6,574 |
$229K |
| 45385 |
|
544 |
504 |
$205K |
| 82306 |
|
12,368 |
11,787 |
$205K |
| 71045 |
|
6,396 |
5,717 |
$199K |
| 84443 |
|
25,913 |
24,354 |
$196K |
| 80053 |
|
67,599 |
58,338 |
$195K |
| 64493 |
|
674 |
574 |
$195K |
| 77067 |
|
3,621 |
3,517 |
$190K |
| 90870 |
|
1,833 |
874 |
$187K |
| 73721 |
|
1,309 |
1,219 |
$172K |
| 99204 |
|
3,399 |
3,188 |
$172K |
| 80061 |
|
23,715 |
22,754 |
$169K |
| 94060 |
|
1,965 |
1,878 |
$148K |
| 69436 |
|
191 |
177 |
$145K |
| 70551 |
|
1,061 |
1,030 |
$142K |
| 99233 |
Prolong inpt eval add15 m |
3,003 |
2,158 |
$141K |
| 90471 |
|
10,239 |
9,684 |
$139K |
| 76705 |
|
2,352 |
2,215 |
$137K |
| 72148 |
|
1,426 |
1,361 |
$136K |
| 87591 |
|
10,265 |
9,656 |
$135K |
| 87491 |
|
10,263 |
9,654 |
$135K |
| U0003 |
Cov-19 amp prb hgh thruput |
2,211 |
2,150 |
$131K |
| 76830 |
|
2,021 |
1,898 |
$131K |
| 99291 |
|
762 |
402 |
$130K |
| 29580 |
|
3,607 |
1,303 |
$129K |
| 99215 |
Prolong outpt/office vis |
2,416 |
2,165 |
$123K |
| 64615 |
|
1,421 |
1,186 |
$120K |
| 85025 |
|
67,354 |
56,249 |
$119K |
| 96372 |
|
14,413 |
11,223 |
$119K |
| 76801 |
|
1,490 |
1,373 |
$114K |
| 99281 |
|
2,767 |
2,569 |
$111K |
| 97140 |
|
7,878 |
3,471 |
$110K |
| 97530 |
|
5,627 |
2,056 |
$105K |
| 97161 |
|
3,581 |
3,262 |
$102K |
| 76856 |
|
1,588 |
1,494 |
$100K |
| 83036 |
|
24,152 |
22,997 |
$97K |
| 90899 |
|
4,157 |
567 |
$93K |
| 86481 |
|
2,109 |
1,987 |
$93K |
| 93971 |
|
2,083 |
1,912 |
$92K |
| 76816 |
|
4,871 |
4,273 |
$92K |
| 71260 |
|
1,191 |
1,123 |
$84K |
| 71275 |
|
1,215 |
1,128 |
$83K |
| 71250 |
|
2,208 |
2,120 |
$83K |
| 93010 |
|
18,621 |
16,419 |
$82K |
| 86900 |
|
3,891 |
3,401 |
$76K |
| 36415 |
|
111,235 |
89,137 |
$75K |
| 80307 |
|
10,497 |
8,501 |
$74K |
| U0002 |
Covid-19 lab test non-cdc |
2,686 |
2,548 |
$71K |
| 99231 |
|
3,630 |
2,083 |
$70K |
| 87389 |
|
6,250 |
5,880 |
$70K |
| 76805 |
|
912 |
871 |
$70K |
| 93005 |
|
19,577 |
16,743 |
$64K |
| 95811 |
|
184 |
175 |
$57K |
| 97162 |
|
2,119 |
1,975 |
$56K |
| 90686 |
|
4,794 |
4,601 |
$56K |
| 90677 |
|
363 |
336 |
$53K |
| 96366 |
|
2,099 |
1,402 |
$53K |
| 82728 |
|
7,530 |
6,996 |
$52K |
| 77063 |
|
2,193 |
2,127 |
$52K |
| 72141 |
|
434 |
418 |
$52K |
| 52000 |
|
328 |
299 |
$51K |
| 87426 |
|
2,176 |
1,937 |
$50K |
| 86803 |
|
8,079 |
7,613 |
$50K |
| 87635 |
|
2,258 |
1,993 |
$48K |
| 88175 |
|
3,785 |
3,600 |
$48K |
| 45380 |
|
116 |
108 |
$43K |
| 73630 |
|
5,135 |
4,615 |
$42K |
| 66984 |
|
126 |
85 |
$41K |
| 76642 |
|
1,045 |
958 |
$40K |
| C9803 |
Hopd covid-19 spec collect |
2,705 |
2,585 |
$40K |
| 87661 |
|
4,940 |
4,659 |
$40K |
| 72100 |
|
1,974 |
1,844 |
$39K |
| 74018 |
|
1,619 |
1,507 |
$39K |
| 96415 |
|
1,025 |
765 |
$39K |
| 87428 |
|
1,125 |
1,045 |
$38K |
| 90732 |
|
627 |
583 |
$38K |
| G0400 |
Home sleep test/type 4 porta |
250 |
238 |
$38K |
| J1745 |
Infliximab not biosimil 10mg |
13 |
12 |
$37K |
| Q0138 |
Ferumoxytol, non-esrd |
170 |
114 |
$35K |
| 86780 |
|
3,170 |
2,994 |
$34K |
| 87086 |
|
19,817 |
17,759 |
$33K |
| 97165 |
|
1,567 |
1,423 |
$33K |
| 73610 |
|
4,369 |
3,873 |
$32K |
| 86706 |
|
4,531 |
4,293 |
$32K |
| 82607 |
|
5,100 |
4,857 |
$31K |
| 76536 |
|
624 |
598 |
$31K |
| 86704 |
|
3,891 |
3,684 |
$31K |
| 87340 |
|
5,829 |
5,474 |
$31K |
| 76811 |
|
196 |
191 |
$30K |
| 96367 |
|
921 |
632 |
$30K |
| 73221 |
|
265 |
248 |
$30K |
| 64635 |
|
53 |
51 |
$29K |
| 73562 |
|
3,651 |
3,329 |
$29K |
| 64405 |
|
209 |
179 |
$29K |
| 62323 |
|
136 |
123 |
$28K |
| 10060 |
|
284 |
259 |
$28K |
| 73030 |
|
3,669 |
3,335 |
$27K |
| 86708 |
|
3,450 |
3,271 |
$26K |
| 73564 |
|
2,363 |
2,058 |
$26K |
| 83550 |
|
6,357 |
5,958 |
$26K |
| 85027 |
|
11,688 |
10,345 |
$26K |
| 71271 |
|
464 |
441 |
$26K |
| 83655 |
|
2,294 |
2,204 |
$25K |
| 70553 |
|
105 |
102 |
$25K |
| G0399 |
Home sleep test/type 3 porta |
398 |
376 |
$25K |
| U0005 |
Infec agen detec ampli probe |
1,643 |
1,606 |
$25K |
| 99212 |
|
1,471 |
1,314 |
$24K |
| 73110 |
|
3,166 |
2,621 |
$23K |
| 73130 |
|
3,335 |
2,819 |
$22K |
| 80048 |
|
13,273 |
10,840 |
$22K |
| 99396 |
|
396 |
375 |
$22K |
| 12001 |
|
514 |
495 |
$22K |
| 97112 |
|
2,004 |
935 |
$22K |
| 84702 |
|
3,571 |
2,452 |
$22K |
| 84439 |
|
5,389 |
5,073 |
$21K |
| 83540 |
|
6,513 |
6,104 |
$19K |
| 97035 |
|
4,129 |
1,786 |
$19K |
| 73502 |
|
2,635 |
2,443 |
$19K |
| 87070 |
|
5,428 |
5,015 |
$18K |
| 59430 |
|
228 |
211 |
$18K |
| 87798 |
|
501 |
443 |
$18K |
| 73140 |
|
1,862 |
1,568 |
$17K |
| 11721 |
|
4,422 |
3,935 |
$17K |
| 86480 |
|
438 |
409 |
$17K |
| 87502 |
|
1,818 |
1,727 |
$17K |
| 87081 |
|
14,931 |
13,934 |
$17K |
| 84153 |
|
2,780 |
2,680 |
$16K |
| T1017 |
Targeted case management |
341 |
187 |
$16K |
| 86787 |
|
1,645 |
1,519 |
$16K |
| C8929 |
Tte w or wo fol wcon,doppler |
88 |
86 |
$16K |
| 36591 |
|
1,489 |
851 |
$16K |
| 87209 |
|
1,096 |
1,035 |
$15K |
| 90853 |
|
321 |
54 |
$14K |
| 72110 |
|
642 |
615 |
$14K |
| 73620 |
|
871 |
747 |
$14K |
| 86709 |
|
1,751 |
1,658 |
$14K |
| 82746 |
|
2,393 |
2,276 |
$13K |
| 97802 |
|
235 |
232 |
$13K |
| 87880 |
|
11,304 |
10,618 |
$13K |
| 64490 |
|
27 |
24 |
$13K |
| 73600 |
|
518 |
442 |
$13K |
| Q3014 |
Telehealth facility fee |
923 |
873 |
$13K |
| 74174 |
|
85 |
81 |
$13K |
| 99202 |
|
437 |
415 |
$12K |
| 81001 |
|
19,549 |
17,524 |
$12K |
| 70486 |
|
204 |
185 |
$12K |
| 99395 |
|
230 |
224 |
$12K |
| 99205 |
Prolong outpt/office vis |
178 |
163 |
$12K |
| 99443 |
|
508 |
444 |
$12K |
| 82043 |
|
5,205 |
5,000 |
$11K |
| 84403 |
|
719 |
664 |
$11K |
| 94726 |
|
1,475 |
1,402 |
$11K |
| 83970 |
|
762 |
724 |
$11K |
| 76770 |
|
206 |
199 |
$11K |
| 80076 |
|
2,842 |
2,663 |
$11K |
| 87186 |
|
6,179 |
5,674 |
$11K |
| 86140 |
|
6,508 |
5,540 |
$10K |
| G0296 |
Visit to determ ldct elig |
309 |
292 |
$9K |
| 85610 |
|
11,821 |
7,941 |
$9K |
| 73080 |
|
1,176 |
1,014 |
$8K |
| 87205 |
|
7,221 |
6,680 |
$8K |
| 83880 |
|
2,758 |
2,492 |
$8K |
| 72125 |
|
980 |
893 |
$8K |
| 93925 |
|
106 |
102 |
$8K |
| 83735 |
|
9,847 |
8,124 |
$8K |
| 94640 |
|
5,259 |
3,950 |
$8K |
| 87088 |
|
4,663 |
4,336 |
$8K |
| 74178 |
|
39 |
37 |
$8K |
| 99220 |
|
81 |
77 |
$8K |
| 87522 |
Neg quan hep c or qual rna |
329 |
319 |
$8K |
| 80164 |
|
1,793 |
1,601 |
$7K |
| 87177 |
|
1,077 |
1,016 |
$7K |
| 87631 |
|
438 |
427 |
$7K |
| 99496 |
|
120 |
113 |
$7K |
| 80081 |
|
234 |
227 |
$7K |
| 76815 |
|
1,621 |
824 |
$6K |
| G0279 |
Tomosynthesis, mammo |
307 |
290 |
$6K |
| 85660 |
|
1,382 |
1,275 |
$6K |
| G0378 |
Hospital observation per hr |
10,807 |
5,599 |
$6K |
| 77065 |
Tomosynthesis, mammo |
145 |
137 |
$6K |
| 76817 |
|
486 |
416 |
$6K |
| 82784 |
|
1,203 |
1,041 |
$6K |
| 72050 |
|
223 |
208 |
$6K |
| 82950 |
|
1,388 |
1,307 |
$6K |
| 81025 |
|
12,097 |
11,097 |
$6K |
| 86038 |
|
908 |
850 |
$6K |
| 99442 |
|
441 |
405 |
$6K |
| 93017 |
|
202 |
199 |
$5K |
| 64450 |
|
39 |
34 |
$5K |
| 97014 |
|
709 |
393 |
$5K |
| 87150 |
|
1,459 |
1,388 |
$5K |
| 86762 |
|
1,704 |
1,611 |
$5K |
| 51798 |
|
3,467 |
3,284 |
$5K |
| 80069 |
|
2,280 |
2,115 |
$5K |
| 85652 |
|
5,744 |
5,125 |
$5K |
| 80050 |
|
177 |
162 |
$5K |
| 88305 |
|
3,530 |
3,233 |
$5K |
| 29125 |
|
440 |
393 |
$5K |
| G0008 |
Admin influenza virus vac |
2,410 |
2,361 |
$5K |
| 81003 |
|
11,393 |
10,133 |
$5K |
| 87624 |
|
306 |
291 |
$4K |
| 86592 |
|
1,293 |
1,214 |
$4K |
| 64494 |
|
528 |
445 |
$4K |
| 95800 |
|
177 |
167 |
$4K |
| 93350 |
|
39 |
38 |
$4K |
| 95816 |
|
43 |
43 |
$4K |
| 69209 |
|
753 |
705 |
$4K |
| 90656 |
|
297 |
296 |
$4K |
| 77066 |
Tomosynthesis, mammo |
54 |
51 |
$4K |
| 90791 |
|
40 |
14 |
$4K |
| 76000 |
|
458 |
412 |
$4K |
| 86003 |
|
106 |
100 |
$4K |
| 83690 |
|
10,497 |
9,234 |
$4K |
| 0134A |
|
317 |
301 |
$4K |
| 83001 |
|
375 |
357 |
$4K |
| 95806 |
|
142 |
132 |
$4K |
| 99406 |
|
354 |
323 |
$4K |
| 99495 |
|
60 |
58 |
$4K |
| 99221 |
|
69 |
15 |
$4K |
| 99238 |
|
124 |
115 |
$4K |
| 73590 |
|
399 |
343 |
$4K |
| 80178 |
|
1,309 |
1,167 |
$3K |
| 97803 |
|
101 |
99 |
$3K |
| 86618 |
|
764 |
725 |
$3K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
1,265 |
1,127 |
$3K |
| 0011A |
|
236 |
234 |
$3K |
| 20550 |
|
38 |
36 |
$3K |
| 99385 |
|
39 |
38 |
$3K |
| 93976 |
|
53 |
49 |
$3K |
| 86735 |
|
257 |
231 |
$3K |
| G0103 |
Psa screening |
451 |
436 |
$3K |
| 86705 |
|
388 |
356 |
$3K |
| 29075 |
|
28 |
24 |
$3K |
| 0012A |
|
218 |
218 |
$3K |
| G0009 |
Admin pneumococcal vaccine |
315 |
295 |
$3K |
| 78452 |
|
12 |
12 |
$3K |
| 82570 |
|
1,612 |
1,459 |
$3K |
| 84146 |
|
218 |
204 |
$2K |
| 84703 |
|
2,231 |
2,068 |
$2K |
| 76700 |
|
40 |
40 |
$2K |
| 86765 |
|
242 |
223 |
$2K |
| 77080 |
|
105 |
100 |
$2K |
| 72070 |
|
141 |
132 |
$2K |
| 87077 |
|
2,793 |
2,570 |
$2K |
| 70496 |
|
14 |
12 |
$2K |
| 95886 |
|
676 |
650 |
$2K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
9,580 |
8,673 |
$2K |
| 90662 |
|
1,117 |
1,069 |
$2K |
| 73090 |
|
183 |
145 |
$2K |
| 0124A |
|
165 |
158 |
$2K |
| J7324 |
Orthovisc inj per dose |
75 |
31 |
$2K |
| 84100 |
|
1,896 |
1,474 |
$2K |
| 73560 |
|
289 |
241 |
$2K |
| 94729 |
|
1,704 |
1,642 |
$2K |
| G0328 |
Fecal blood scrn immunoassay |
250 |
244 |
$2K |
| 64483 |
|
12 |
12 |
$2K |
| 85018 |
|
2,148 |
1,779 |
$2K |
| 70491 |
|
13 |
13 |
$2K |
| 87338 |
|
194 |
191 |
$2K |
| 93923 |
|
39 |
39 |
$2K |
| 99211 |
|
169 |
149 |
$2K |
| 76870 |
|
56 |
53 |
$2K |
| 0054A |
|
100 |
99 |
$2K |
| 86696 |
|
129 |
129 |
$2K |
| 0013A |
|
112 |
109 |
$2K |
| 85014 |
|
1,779 |
1,496 |
$2K |
| 82565 |
|
1,666 |
1,558 |
$2K |
| 95909 |
|
13 |
12 |
$1K |
| 83721 |
|
293 |
275 |
$1K |
| 86431 |
|
489 |
458 |
$1K |
| 85730 |
|
2,049 |
1,632 |
$1K |
| 93270 |
|
79 |
78 |
$1K |
| 0064A |
|
102 |
98 |
$1K |
| 83516 |
|
174 |
157 |
$1K |
| 80074 |
|
51 |
49 |
$1K |
| 84156 |
|
1,258 |
1,101 |
$1K |
| 84402 |
|
83 |
75 |
$1K |
| 12002 |
|
13 |
13 |
$1K |
| 86850 |
|
3,692 |
3,227 |
$1K |
| 84550 |
|
972 |
866 |
$1K |
| 71101 |
|
129 |
118 |
$1K |
| G2211 |
Complex e/m visit add on |
1,604 |
1,395 |
$1K |
| 81002 |
|
5,436 |
4,959 |
$1K |
| 76775 |
|
28 |
28 |
$1K |
| 86200 |
|
247 |
239 |
$1K |
| 85379 |
|
2,617 |
2,408 |
$1K |
| 86695 |
|
129 |
129 |
$1K |
| 85045 |
|
610 |
549 |
$1K |
| 73700 |
|
28 |
27 |
$1K |
| 82947 |
|
424 |
410 |
$1K |
| Q0091 |
Obtaining screen pap smear |
98 |
96 |
$1K |
| 17110 |
|
13 |
13 |
$976.71 |
| 86039 |
|
200 |
197 |
$966.90 |
| 87808 |
|
369 |
357 |
$923.22 |
| 76882 |
|
25 |
25 |
$914.21 |
| 83615 |
|
605 |
465 |
$912.39 |
| 58300 |
|
25 |
24 |
$908.67 |
| 90750 |
|
41 |
40 |
$893.70 |
| 96417 |
|
17 |
12 |
$874.03 |
| 90651 |
|
12 |
12 |
$860.20 |
| J1100 |
Dexamethasone sodium phos |
10,257 |
9,024 |
$854.39 |
| 84460 |
|
616 |
588 |
$850.15 |
| 69210 |
|
87 |
82 |
$835.83 |
| 82550 |
|
707 |
602 |
$812.27 |
| 84165 |
|
258 |
238 |
$801.67 |
| 87040 |
|
3,740 |
1,998 |
$799.15 |
| 94618 |
|
117 |
109 |
$780.82 |
| 80156 |
|
169 |
152 |
$743.58 |
| 12011 |
|
46 |
40 |
$719.25 |
| 84484 |
|
9,648 |
6,704 |
$686.32 |
| 81000 |
|
2,671 |
2,470 |
$663.82 |
| 98927 |
|
38 |
37 |
$652.10 |
| 31575 |
|
26 |
12 |
$647.93 |
| 73521 |
|
31 |
26 |
$636.90 |
| 99224 |
|
40 |
24 |
$621.61 |
| 96523 |
|
56 |
50 |
$605.16 |
| 86666 |
|
212 |
125 |
$600.48 |
| 00126 |
|
151 |
139 |
$579.62 |
| 72131 |
|
14 |
12 |
$552.38 |
| 83605 |
|
4,327 |
3,546 |
$537.50 |
| 82962 |
|
13,581 |
7,112 |
$522.98 |
| 86235 |
|
15 |
13 |
$487.70 |
| 81596 |
|
12 |
12 |
$454.77 |
| 84450 |
|
355 |
333 |
$444.03 |
| 87493 |
|
100 |
53 |
$431.82 |
| 97166 |
|
13 |
13 |
$428.44 |
| 86901 |
|
3,893 |
3,403 |
$427.10 |
| 87469 |
|
80 |
75 |
$423.94 |
| 82075 |
|
3,751 |
2,662 |
$402.61 |
| 64447 |
|
49 |
45 |
$394.57 |
| 82785 |
|
63 |
57 |
$377.62 |
| 82103 |
|
90 |
88 |
$373.63 |
| 86364 |
|
63 |
59 |
$363.02 |
| 00811 |
|
12 |
12 |
$357.41 |
| 86430 |
|
167 |
156 |
$357.36 |
| 11055 |
|
28 |
26 |
$351.44 |
| 87484 |
|
60 |
55 |
$336.79 |
| 87468 |
|
60 |
55 |
$336.79 |
| 99309 |
|
33 |
31 |
$335.64 |
| 88108 |
|
131 |
127 |
$314.89 |
| 86141 |
|
57 |
55 |
$274.54 |
| 85007 |
|
484 |
379 |
$272.39 |
| 90460 |
|
12 |
12 |
$262.48 |
| 36592 |
|
72 |
37 |
$257.26 |
| 82670 |
|
14 |
13 |
$251.46 |
| 82378 |
|
55 |
46 |
$250.31 |
| 86376 |
|
28 |
27 |
$246.53 |
| 82077 |
|
1,623 |
1,441 |
$245.97 |
| 90670 |
|
16 |
12 |
$239.45 |
| G0283 |
Elec stim other than wound |
144 |
75 |
$237.95 |
| 86753 |
|
101 |
89 |
$237.25 |
| 87045 |
|
56 |
54 |
$218.36 |
| 87046 |
|
56 |
54 |
$218.36 |
| 73660 |
|
41 |
39 |
$212.82 |
| 87801 |
|
26 |
25 |
$209.96 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
5,213 |
4,619 |
$206.12 |
| 82104 |
|
40 |
38 |
$197.45 |
| 90715 |
|
4,203 |
4,026 |
$193.42 |
| 73120 |
|
13 |
12 |
$188.97 |
| 99441 |
|
29 |
26 |
$188.63 |
| 84520 |
|
210 |
200 |
$186.79 |
| 0031A |
|
60 |
60 |
$183.47 |
| 83921 |
|
30 |
28 |
$162.53 |
| 0001A |
|
138 |
138 |
$158.80 |
| 99024 |
|
404 |
338 |
$150.45 |
| 82105 |
|
25 |
24 |
$138.99 |
| 82533 |
|
31 |
26 |
$130.40 |
| J7030 |
Normal saline solution infus |
13,119 |
9,644 |
$130.04 |
| 83021 |
|
13 |
12 |
$129.22 |
| 88112 |
|
14 |
12 |
$120.96 |
| 72275 |
|
289 |
281 |
$113.37 |
| 99308 |
|
12 |
12 |
$107.82 |
| 72170 |
|
22 |
17 |
$107.22 |
| 92504 |
|
56 |
54 |
$107.00 |
| 90734 |
|
12 |
12 |
$97.49 |
| J8540 |
Oral dexamethasone |
1,860 |
1,602 |
$96.19 |
| 82150 |
|
112 |
105 |
$95.92 |
| 80143 |
|
288 |
227 |
$93.20 |
| 86617 |
|
19 |
12 |
$92.94 |
| 83020 |
|
13 |
12 |
$92.12 |
| 76376 |
|
648 |
617 |
$88.67 |
| 87478 |
|
60 |
55 |
$87.72 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,100 |
945 |
$77.56 |
| 82803 |
|
304 |
257 |
$74.97 |
| J2405 |
Ondansetron hcl injection |
11,071 |
9,223 |
$72.70 |
| 83521 |
|
14 |
14 |
$72.54 |
| J7120 |
Ringers lactate infusion |
4,657 |
3,768 |
$70.95 |
| J1885 |
Ketorolac tromethamine inj |
11,338 |
9,614 |
$65.55 |
| 80175 |
|
12 |
12 |
$55.22 |
| J1644 |
Inj heparin sodium per 1000u |
1,525 |
582 |
$54.79 |
| 97116 |
|
58 |
24 |
$53.66 |
| 80179 |
|
189 |
166 |
$46.60 |
| 97597 |
|
15 |
13 |
$45.21 |
| J3301 |
Triamcinolone acet inj nos |
4,390 |
3,992 |
$40.39 |
| 88304 |
|
98 |
89 |
$36.58 |
| J0689 |
Inj cefazolin sodium, baxter |
901 |
789 |
$35.71 |
| J1030 |
Methylprednisolone 40 mg inj |
643 |
597 |
$35.70 |
| J3010 |
Fentanyl citrate injection |
7,893 |
6,169 |
$34.85 |
| 0004A |
|
36 |
36 |
$31.58 |
| 84132 |
|
13 |
12 |
$30.83 |
| J2704 |
Inj, propofol, 10 mg |
12,607 |
8,627 |
$30.48 |
| J1200 |
Diphenhydramine hcl injectio |
4,569 |
3,649 |
$29.87 |
| 98928 |
|
14 |
12 |
$26.23 |
| J0780 |
Prochlorperazine injection |
276 |
249 |
$25.91 |
| J0696 |
Ceftriaxone sodium injection |
2,197 |
1,896 |
$25.57 |
| 93356 |
|
139 |
124 |
$22.47 |
| J0690 |
Cefazolin sodium injection |
2,933 |
2,417 |
$21.50 |
| J7620 |
Albuterol ipratrop non-comp |
217 |
205 |
$21.37 |
| G0238 |
Oth resp proc, indiv |
15 |
14 |
$19.59 |
| J7040 |
Normal saline solution infus |
2,241 |
1,620 |
$12.79 |
| J2250 |
Inj midazolam hydrochloride |
5,311 |
4,639 |
$12.46 |
| J7512 |
Prednisone ir or dr oral 1mg |
1,009 |
833 |
$12.26 |
| 87075 |
|
25 |
24 |
$9.17 |
| J2270 |
Morphine sulfate injection |
2,423 |
1,941 |
$7.93 |
| 90472 |
|
1,572 |
1,478 |
$7.20 |
| J2060 |
Lorazepam injection |
1,493 |
1,190 |
$5.83 |
| 97010 |
|
1,361 |
721 |
$3.34 |
| J1170 |
Hydromorphone injection |
1,758 |
1,369 |
$2.76 |
| J1790 |
Droperidol injection |
617 |
529 |
$2.15 |
| J3490 |
Drugs unclassified injection |
2,376 |
1,667 |
$0.18 |
| J7609 |
Albuterol comp unit |
80 |
60 |
$0.03 |
| G8427 |
Docrev cur meds by elig clin |
5,328 |
4,999 |
$0.00 |
| J2930 |
Methylprednisolone injection |
737 |
582 |
$0.00 |
| G8484 |
Flu immunize no admin |
707 |
673 |
$0.00 |
| G8417 |
Calc bmi abv up param f/u |
1,986 |
1,853 |
$0.00 |
| G8979 |
Mobility goal status |
323 |
270 |
$0.00 |
| A9577 |
Inj multihance |
1,163 |
1,093 |
$0.00 |
| 1090F |
|
266 |
251 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
257 |
198 |
$0.00 |
| J1050 |
Medroxyprogesterone acetate |
1,078 |
1,055 |
$0.00 |
| 76942 |
|
197 |
175 |
$0.00 |
| 00812 |
|
428 |
403 |
$0.00 |
| A6451 |
Mod compres band w>=3"<5"/yd |
280 |
151 |
$0.00 |
| 3078F |
|
1,500 |
1,398 |
$0.00 |
| J1756 |
Iron sucrose injection |
168 |
88 |
$0.00 |
| 99152 |
|
212 |
196 |
$0.00 |
| J1020 |
Methylprednisolone 20 mg inj |
235 |
205 |
$0.00 |
| J2272 |
Inj, morphine (fresenius) |
175 |
165 |
$0.00 |
| 00170 |
|
35 |
27 |
$0.00 |
| Q9957 |
Inj perflutren lip micros,ml |
572 |
546 |
$0.00 |
| A4216 |
Sterile water/saline, 10 ml |
14 |
12 |
$0.00 |
| 91312 |
|
168 |
161 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
127 |
112 |
$0.00 |
| 3023F |
|
173 |
162 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
102 |
79 |
$0.00 |
| J3370 |
Vancomycin hcl injection |
365 |
245 |
$0.00 |
| 01810 |
|
25 |
25 |
$0.00 |
| 00731 |
|
92 |
74 |
$0.00 |
| A6210 |
Foam drg >16<=48 sq in w/o b |
155 |
93 |
$0.00 |
| 82010 |
|
217 |
182 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
245 |
226 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
88 |
61 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
186 |
150 |
$0.00 |
| G8978 |
Mobility current status |
317 |
274 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
54 |
47 |
$0.00 |
| 91313 |
|
318 |
300 |
$0.00 |
| 77002 |
|
145 |
135 |
$0.00 |
| 0002A |
|
125 |
124 |
$0.00 |
| 4004F |
|
59 |
55 |
$0.00 |
| 2022F |
|
183 |
166 |
$0.00 |
| A4248 |
Chlorhexidine antisept |
22 |
12 |
$0.00 |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
55 |
36 |
$0.00 |
| J1650 |
Inj enoxaparin sodium |
41 |
13 |
$0.00 |
| G0473 |
Group behave couns 2-10 |
60 |
39 |
$0.00 |
| 64636 |
|
27 |
26 |
$0.00 |
| 94664 |
|
32 |
30 |
$0.00 |
| 3046F |
|
65 |
59 |
$0.00 |
| 3077F |
|
69 |
58 |
$0.00 |
| 1160F |
|
14 |
13 |
$0.00 |
| 1159F |
|
58 |
56 |
$0.00 |
| G8400 |
Pt w/dxa no results doc |
31 |
27 |
$0.00 |
| J2550 |
Promethazine hcl injection |
28 |
24 |
$0.00 |
| 1123F |
|
2,432 |
2,213 |
$0.00 |
| 3074F |
|
1,103 |
1,039 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
983 |
697 |
$0.00 |
| 94760 |
|
941 |
625 |
$0.00 |
| 3017F |
|
2,233 |
2,074 |
$0.00 |
| 1036F |
|
3,047 |
2,846 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
1,612 |
945 |
$0.00 |
| 3079F |
|
346 |
328 |
$0.00 |
| J3420 |
Vitamin b12 injection |
753 |
596 |
$0.00 |
| 36416 |
|
501 |
425 |
$0.00 |
| J7050 |
Normal saline solution infus |
2,342 |
1,656 |
$0.00 |
| A9270 |
Non-covered item or service |
8,230 |
2,500 |
$0.00 |
| J1630 |
Haloperidol injection |
170 |
148 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
318 |
243 |
$0.00 |
| J1642 |
Inj heparin sodium per 10 u |
4,463 |
2,145 |
$0.00 |
| G8980 |
Mobility d/c status |
28 |
28 |
$0.00 |
| 96376 |
|
2,210 |
1,605 |
$0.00 |
| J2765 |
Metoclopramide hcl injection |
916 |
815 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
634 |
563 |
$0.00 |
| J1040 |
Methylprednisolone 80 mg inj |
1,220 |
1,103 |
$0.00 |
| 91305 |
|
181 |
177 |
$0.00 |
| C9290 |
Inj, bupivacaine liposome |
626 |
572 |
$0.00 |
| J3480 |
Inj potassium chloride |
141 |
91 |
$0.00 |
| A4217 |
Sterile water/saline, 500 ml |
131 |
126 |
$0.00 |
| 80359 |
|
26 |
25 |
$0.00 |
| 00813 |
|
181 |
157 |
$0.00 |
| G8428 |
Cur meds not document |
82 |
75 |
$0.00 |
| G8987 |
Self care current status |
32 |
29 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
81 |
75 |
$0.00 |
| C1769 |
Guide wire |
486 |
415 |
$0.00 |
| 3075F |
|
162 |
157 |
$0.00 |
| J1010 |
Inj, methylpred acetate 1 mg |
126 |
119 |
$0.00 |
| J2001 |
Lidocaine injection |
2,899 |
2,413 |
$0.00 |
| 36000 |
|
32 |
27 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
208 |
164 |
$0.00 |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
197 |
185 |
$0.00 |
| G0439 |
Ppps, subseq visit |
83 |
76 |
$0.00 |
| 91306 |
|
98 |
95 |
$0.00 |
| G8988 |
Self care goal status |
54 |
42 |
$0.00 |
| V2632 |
Post chmbr intraocular lens |
124 |
84 |
$0.00 |
| 70498 |
|
14 |
12 |
$0.00 |
| A9579 |
Gad-base mr contrast nos,1ml |
66 |
65 |
$0.00 |
| 94761 |
|
173 |
139 |
$0.00 |
| C9399 |
Unclassified drugs or biolog |
18 |
17 |
$0.00 |
| 95885 |
|
13 |
13 |
$0.00 |
| 3044F |
|
28 |
28 |
$0.00 |
| 80324 |
|
26 |
25 |
$0.00 |
| A9500 |
Tc99m sestamibi |
12 |
12 |
$0.00 |
| 88342 |
|
12 |
12 |
$0.00 |
| G8419 |
Calc bmi out nrm param nof/u |
15 |
14 |
$0.00 |
| 01480 |
|
59 |
57 |
$0.00 |
| J1815 |
Insulin injection |
91 |
26 |
$0.00 |
| 97535 |
|
55 |
14 |
$0.00 |