| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
129,284 |
119,548 |
$10.73M |
| 99214 |
|
89,316 |
82,509 |
$8.61M |
| H2019 |
Ther behav svc, per 15 min |
5,783 |
5,774 |
$4.19M |
| 99284 |
|
31,784 |
29,411 |
$3.66M |
| 99285 |
|
28,715 |
26,573 |
$3.36M |
| 99283 |
|
28,219 |
26,471 |
$3.28M |
| 96361 |
|
16,765 |
14,160 |
$3.05M |
| 90834 |
|
22,366 |
15,625 |
$3.01M |
| 74177 |
|
12,418 |
11,945 |
$2.13M |
| 70450 |
|
11,566 |
10,939 |
$1.89M |
| U0003 |
Cov-19 amp prb hgh thruput |
19,773 |
17,322 |
$1.53M |
| 80053 |
|
78,339 |
65,930 |
$1.47M |
| 96110 |
|
10,390 |
10,382 |
$1.29M |
| 96365 |
|
7,665 |
6,100 |
$1.21M |
| 99203 |
|
10,548 |
10,435 |
$1.18M |
| 99392 |
|
11,374 |
10,993 |
$1.02M |
| 93975 |
|
2,294 |
2,201 |
$953K |
| 99391 |
|
10,375 |
9,418 |
$939K |
| 90832 |
|
8,940 |
7,477 |
$916K |
| 99393 |
|
9,757 |
9,594 |
$908K |
| 90791 |
|
5,222 |
4,493 |
$871K |
| 96360 |
|
5,306 |
4,808 |
$841K |
| 76856 |
|
5,877 |
5,614 |
$814K |
| 99204 |
|
6,712 |
6,588 |
$759K |
| H2018 |
Psysoc rehab svc, per diem |
1,630 |
1,630 |
$750K |
| 71275 |
|
2,847 |
2,721 |
$741K |
| 74176 |
|
3,339 |
3,213 |
$695K |
| 99215 |
Prolong outpt/office vis |
5,491 |
5,283 |
$620K |
| 99396 |
|
6,011 |
5,790 |
$615K |
| 99394 |
|
6,047 |
5,968 |
$615K |
| 92552 |
|
9,146 |
9,131 |
$550K |
| 99395 |
|
5,181 |
5,025 |
$547K |
| 77067 |
|
9,585 |
9,271 |
$490K |
| J2426 |
Inj, invega sustenna, 1 mg |
261 |
257 |
$483K |
| 99442 |
|
4,162 |
4,008 |
$420K |
| 99281 |
|
3,852 |
3,510 |
$415K |
| 99441 |
|
3,816 |
3,661 |
$400K |
| 87491 |
|
13,905 |
12,833 |
$396K |
| 90837 |
|
2,838 |
2,101 |
$383K |
| 96366 |
|
2,995 |
2,301 |
$363K |
| 43239 |
|
602 |
579 |
$344K |
| 99212 |
|
3,207 |
3,083 |
$316K |
| 76801 |
|
4,293 |
3,676 |
$302K |
| G0463 |
Hospital outpt clinic visit |
8,077 |
6,536 |
$284K |
| 99282 |
|
2,387 |
2,310 |
$280K |
| 99223 |
Prolong inpt eval add15 m |
2,356 |
2,290 |
$272K |
| 90686 |
|
12,272 |
12,205 |
$271K |
| 90833 |
|
5,202 |
4,988 |
$269K |
| U0005 |
Infec agen detec ampli probe |
13,873 |
12,442 |
$269K |
| 80061 |
|
19,635 |
17,728 |
$262K |
| 97110 |
|
4,133 |
1,304 |
$255K |
| 93306 |
|
1,278 |
1,264 |
$251K |
| 76705 |
|
7,323 |
7,086 |
$250K |
| 93970 |
|
640 |
615 |
$249K |
| 87636 |
|
3,528 |
3,453 |
$245K |
| 87591 |
|
13,757 |
12,712 |
$241K |
| 36415 |
|
78,321 |
62,487 |
$238K |
| G0444 |
Depression screen annual |
8,791 |
8,456 |
$235K |
| 82306 |
|
9,117 |
8,257 |
$231K |
| 96372 |
|
16,499 |
14,088 |
$225K |
| 12001 |
|
585 |
581 |
$216K |
| 76805 |
|
4,106 |
3,793 |
$216K |
| 99205 |
Prolong outpt/office vis |
1,827 |
1,788 |
$211K |
| 90847 |
|
1,004 |
780 |
$205K |
| 99232 |
|
5,559 |
2,126 |
$201K |
| 87635 |
|
4,412 |
4,248 |
$201K |
| 90853 |
|
3,314 |
1,190 |
$193K |
| 80307 |
|
5,700 |
5,379 |
$190K |
| 70551 |
|
668 |
618 |
$181K |
| 71046 |
|
30,244 |
29,222 |
$145K |
| 71250 |
|
1,569 |
1,427 |
$144K |
| 76830 |
|
5,355 |
5,151 |
$139K |
| 99173 |
|
8,800 |
8,776 |
$134K |
| 99233 |
Prolong inpt eval add15 m |
2,310 |
1,157 |
$131K |
| 90715 |
|
5,694 |
5,645 |
$131K |
| 99202 |
|
1,231 |
1,221 |
$130K |
| 80048 |
|
9,691 |
8,151 |
$129K |
| 70553 |
|
329 |
310 |
$119K |
| 97140 |
|
3,285 |
1,052 |
$119K |
| 86850 |
|
4,365 |
3,984 |
$117K |
| 93971 |
|
2,401 |
2,278 |
$117K |
| 88142 |
|
5,297 |
5,095 |
$115K |
| 12011 |
|
327 |
323 |
$113K |
| 90792 |
|
568 |
565 |
$112K |
| 93010 |
|
16,376 |
14,557 |
$111K |
| 86901 |
|
5,932 |
5,376 |
$110K |
| 0241U |
|
7,390 |
7,117 |
$109K |
| 87502 |
|
2,865 |
2,753 |
$107K |
| 76770 |
|
583 |
537 |
$105K |
| G0378 |
Hospital observation per hr |
2,022 |
1,872 |
$98K |
| 76817 |
|
2,064 |
1,748 |
$97K |
| 90670 |
|
4,899 |
4,891 |
$95K |
| 99406 |
|
3,097 |
2,967 |
$95K |
| 76816 |
|
2,935 |
2,565 |
$94K |
| 99443 |
|
910 |
891 |
$93K |
| 76700 |
|
584 |
564 |
$93K |
| 99385 |
|
918 |
895 |
$93K |
| 70496 |
|
417 |
393 |
$92K |
| 88305 |
|
3,258 |
3,196 |
$92K |
| 90651 |
|
2,876 |
2,865 |
$89K |
| 99188 |
|
1,893 |
1,891 |
$88K |
| 71045 |
|
20,797 |
18,315 |
$87K |
| C9803 |
Hopd covid-19 spec collect |
13,379 |
12,251 |
$85K |
| 99460 |
|
1,248 |
1,246 |
$84K |
| 94726 |
|
608 |
594 |
$84K |
| 86900 |
|
6,012 |
5,450 |
$83K |
| 94060 |
|
735 |
723 |
$83K |
| 77063 |
|
5,794 |
5,551 |
$79K |
| 83880 |
|
2,754 |
2,623 |
$78K |
| 90633 |
|
3,936 |
3,924 |
$76K |
| 99239 |
|
1,297 |
1,265 |
$74K |
| 99381 |
|
705 |
690 |
$73K |
| 99238 |
|
1,403 |
1,393 |
$72K |
| 90680 |
|
3,724 |
3,720 |
$72K |
| 90707 |
|
3,532 |
3,513 |
$69K |
| 84443 |
|
20,982 |
19,112 |
$69K |
| 96160 |
|
2,089 |
2,079 |
$68K |
| T1015 |
Clinic service |
266 |
266 |
$67K |
| 90716 |
|
3,173 |
3,159 |
$67K |
| 83036 |
|
19,931 |
17,804 |
$66K |
| 12002 |
|
175 |
173 |
$63K |
| 70486 |
|
1,140 |
1,103 |
$61K |
| 88342 |
|
981 |
978 |
$61K |
| 90734 |
|
2,827 |
2,819 |
$61K |
| 87624 |
|
2,058 |
1,902 |
$60K |
| 77066 |
Tomosynthesis, mammo |
956 |
912 |
$59K |
| 86480 |
|
1,200 |
1,111 |
$59K |
| D1110 |
|
1,036 |
708 |
$59K |
| 90677 |
|
1,164 |
1,162 |
$58K |
| 76811 |
|
787 |
759 |
$57K |
| 70491 |
|
216 |
202 |
$56K |
| 99177 |
|
3,668 |
3,659 |
$52K |
| 29125 |
|
288 |
281 |
$50K |
| 83655 |
|
4,147 |
4,064 |
$50K |
| 97803 |
|
1,687 |
1,567 |
$49K |
| 76641 |
|
1,716 |
1,486 |
$47K |
| 85025 |
|
68,569 |
58,528 |
$46K |
| 58661 |
|
32 |
29 |
$45K |
| 90723 |
|
2,337 |
2,332 |
$42K |
| 72125 |
|
1,828 |
1,712 |
$39K |
| 85610 |
|
12,140 |
10,747 |
$39K |
| 10060 |
|
146 |
145 |
$38K |
| 87389 |
|
5,565 |
5,043 |
$37K |
| 90697 |
|
1,660 |
1,658 |
$36K |
| 99383 |
|
343 |
332 |
$36K |
| 97161 |
|
426 |
423 |
$35K |
| 97802 |
|
1,220 |
1,220 |
$35K |
| 76642 |
|
1,481 |
1,387 |
$34K |
| 90696 |
|
1,683 |
1,678 |
$33K |
| 77065 |
Tomosynthesis, mammo |
499 |
441 |
$32K |
| 87536 |
|
410 |
404 |
$32K |
| 90648 |
|
1,761 |
1,756 |
$31K |
| 99231 |
|
1,828 |
1,175 |
$31K |
| 76775 |
|
561 |
533 |
$31K |
| 71260 |
|
473 |
458 |
$30K |
| 90647 |
|
1,529 |
1,527 |
$30K |
| 84439 |
|
8,550 |
7,836 |
$30K |
| 90700 |
|
1,530 |
1,527 |
$29K |
| 93458 |
|
24 |
24 |
$27K |
| 76536 |
|
1,079 |
998 |
$26K |
| 93005 |
|
30,074 |
24,993 |
$26K |
| 88304 |
|
909 |
903 |
$25K |
| 97597 |
|
119 |
66 |
$25K |
| 86780 |
|
4,715 |
4,329 |
$25K |
| 82803 |
|
1,341 |
1,254 |
$25K |
| 59025 |
|
143 |
116 |
$24K |
| J0401 |
Inj, abilify maintena, 1 mg |
13 |
12 |
$23K |
| 81025 |
|
7,256 |
7,080 |
$22K |
| 99291 |
|
166 |
154 |
$22K |
| H2011 |
Crisis interven svc, 15 min |
206 |
182 |
$22K |
| 31575 |
|
90 |
86 |
$21K |
| 94729 |
|
637 |
623 |
$21K |
| 87660 |
|
5,302 |
4,904 |
$21K |
| D0120 |
|
532 |
414 |
$21K |
| 96367 |
|
323 |
273 |
$21K |
| 97014 |
|
1,072 |
392 |
$20K |
| 87086 |
|
10,812 |
10,021 |
$19K |
| 87480 |
|
5,211 |
4,730 |
$19K |
| 82607 |
|
4,400 |
3,986 |
$19K |
| D7210 |
|
97 |
59 |
$18K |
| 90620 |
|
475 |
474 |
$18K |
| 87510 |
|
5,123 |
4,693 |
$18K |
| 82728 |
|
2,992 |
2,718 |
$18K |
| 99386 |
|
176 |
165 |
$18K |
| 71271 |
|
610 |
554 |
$18K |
| G0480 |
Drug test def 1-7 classes |
1,379 |
1,317 |
$18K |
| 97162 |
|
174 |
173 |
$17K |
| 59514 |
|
115 |
113 |
$17K |
| 69210 |
|
162 |
159 |
$17K |
| 99221 |
|
390 |
387 |
$16K |
| 88307 |
|
259 |
259 |
$16K |
| 87340 |
|
2,608 |
2,442 |
$16K |
| 93017 |
|
125 |
123 |
$15K |
| 85027 |
|
11,331 |
10,269 |
$15K |
| 84702 |
|
4,639 |
3,717 |
$15K |
| C1776 |
Joint device (implantable) |
13 |
13 |
$15K |
| 86803 |
|
4,071 |
3,647 |
$15K |
| 84153 |
|
1,210 |
1,153 |
$15K |
| 86762 |
|
1,822 |
1,665 |
$15K |
| 36430 |
|
41 |
38 |
$14K |
| 96374 |
|
16,510 |
15,056 |
$14K |
| 58558 |
|
14 |
14 |
$13K |
| 84403 |
|
856 |
758 |
$13K |
| 92250 |
|
176 |
173 |
$13K |
| 86360 |
|
330 |
322 |
$12K |
| 92557 |
|
196 |
195 |
$12K |
| G0108 |
Diab manage trn per indiv |
233 |
218 |
$11K |
| 92567 |
|
231 |
230 |
$10K |
| 90698 |
|
589 |
589 |
$10K |
| 70498 |
|
350 |
337 |
$10K |
| 86703 |
|
675 |
655 |
$10K |
| 86765 |
|
1,521 |
1,370 |
$10K |
| 82570 |
|
5,672 |
5,005 |
$9K |
| D0140 |
|
275 |
225 |
$9K |
| 96415 |
|
18 |
12 |
$9K |
| 90671 |
|
409 |
409 |
$9K |
| 90685 |
|
364 |
363 |
$9K |
| 83540 |
|
4,377 |
4,012 |
$9K |
| 76870 |
|
367 |
353 |
$9K |
| 83550 |
|
4,200 |
3,855 |
$8K |
| 82043 |
|
4,613 |
4,087 |
$8K |
| 90846 |
|
65 |
59 |
$8K |
| 90732 |
|
147 |
146 |
$7K |
| 76818 |
|
159 |
79 |
$7K |
| 84146 |
|
510 |
490 |
$7K |
| 97035 |
|
491 |
162 |
$7K |
| 82746 |
|
1,280 |
1,191 |
$7K |
| 87077 |
|
2,511 |
2,395 |
$7K |
| Q3014 |
Telehealth facility fee |
1,046 |
862 |
$7K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
3,107 |
3,017 |
$7K |
| D7140 |
|
75 |
56 |
$6K |
| D0274 |
|
169 |
144 |
$6K |
| A9576 |
Inj prohance multipack |
206 |
197 |
$6K |
| 87070 |
|
8,199 |
7,915 |
$6K |
| 86140 |
|
3,565 |
3,133 |
$6K |
| 96413 |
|
115 |
81 |
$6K |
| P9016 |
Rbc leukocytes reduced |
15 |
12 |
$6K |
| 87186 |
|
3,435 |
3,295 |
$6K |
| H0002 |
Alcohol and/or drug screenin |
29 |
29 |
$6K |
| 85048 |
|
1,836 |
1,342 |
$6K |
| 77080 |
|
122 |
103 |
$6K |
| 87798 |
|
158 |
102 |
$5K |
| 86885 |
|
249 |
220 |
$5K |
| 72100 |
|
1,861 |
1,765 |
$5K |
| 86787 |
|
1,148 |
1,037 |
$5K |
| 90619 |
|
213 |
212 |
$5K |
| 83735 |
|
9,367 |
8,336 |
$5K |
| 82784 |
|
433 |
402 |
$5K |
| 99222 |
|
54 |
53 |
$5K |
| 83970 |
|
141 |
136 |
$5K |
| J2916 |
Na ferric gluconate complex |
180 |
99 |
$5K |
| 74183 |
|
14 |
12 |
$4K |
| 85730 |
|
6,023 |
5,757 |
$4K |
| 90656 |
|
303 |
303 |
$4K |
| 84402 |
|
270 |
242 |
$4K |
| 73630 |
|
2,722 |
2,558 |
$4K |
| 86618 |
|
786 |
747 |
$4K |
| 76819 |
|
124 |
111 |
$4K |
| 94760 |
|
3,997 |
3,638 |
$4K |
| U0002 |
Covid-19 lab test non-cdc |
144 |
138 |
$4K |
| 86706 |
|
807 |
741 |
$4K |
| 82950 |
|
833 |
813 |
$4K |
| 81001 |
|
27,064 |
25,054 |
$4K |
| 90672 |
|
182 |
182 |
$4K |
| 84484 |
|
18,789 |
14,003 |
$4K |
| D2392 |
|
37 |
27 |
$4K |
| 84480 |
|
1,449 |
1,327 |
$4K |
| G0279 |
Tomosynthesis, mammo |
234 |
217 |
$3K |
| 81003 |
|
5,765 |
5,457 |
$3K |
| 74018 |
|
1,256 |
1,155 |
$3K |
| 99382 |
|
38 |
38 |
$3K |
| G0435 |
Oral hiv-1/hiv-2 screen |
253 |
242 |
$3K |
| 80076 |
|
402 |
396 |
$3K |
| 82248 |
|
834 |
771 |
$3K |
| 83021 |
|
171 |
136 |
$3K |
| 87150 |
|
199 |
182 |
$3K |
| 96375 |
|
12,823 |
11,066 |
$3K |
| 86580 |
|
590 |
551 |
$3K |
| 83001 |
|
262 |
240 |
$3K |
| 85651 |
|
3,151 |
2,939 |
$3K |
| 86038 |
|
847 |
799 |
$3K |
| 74021 |
|
1,004 |
958 |
$3K |
| 82105 |
|
448 |
437 |
$3K |
| 90836 |
|
35 |
34 |
$3K |
| 87088 |
|
1,506 |
1,463 |
$3K |
| 99384 |
|
26 |
26 |
$3K |
| D0330 |
|
56 |
39 |
$3K |
| 73564 |
|
1,601 |
1,477 |
$3K |
| 83002 |
|
238 |
217 |
$2K |
| 0001A |
|
117 |
116 |
$2K |
| 84436 |
|
940 |
877 |
$2K |
| 84425 |
|
496 |
458 |
$2K |
| 29130 |
|
12 |
12 |
$2K |
| 83690 |
|
16,538 |
15,286 |
$2K |
| 73610 |
|
2,326 |
2,224 |
$2K |
| 0012A |
|
85 |
85 |
$2K |
| 96368 |
|
57 |
44 |
$2K |
| 73502 |
|
814 |
709 |
$2K |
| 73130 |
|
2,347 |
2,236 |
$2K |
| J2405 |
Ondansetron hcl injection |
14,237 |
12,771 |
$2K |
| 73030 |
|
1,745 |
1,615 |
$2K |
| P9604 |
One-way allow prorated trip |
707 |
427 |
$2K |
| 96161 |
|
71 |
69 |
$2K |
| 86328 |
|
56 |
54 |
$2K |
| 82550 |
|
1,867 |
1,715 |
$2K |
| 83020 |
|
347 |
304 |
$2K |
| 76937 |
|
12 |
12 |
$2K |
| 84481 |
|
444 |
401 |
$2K |
| 84550 |
|
1,162 |
1,018 |
$2K |
| 86431 |
|
634 |
579 |
$2K |
| 0002A |
|
75 |
75 |
$2K |
| G0297 |
Ldct for lung ca screen |
24 |
24 |
$2K |
| 90658 |
|
66 |
66 |
$2K |
| 0011A |
|
91 |
91 |
$2K |
| 84100 |
|
1,447 |
1,269 |
$2K |
| 99051 |
|
150 |
148 |
$2K |
| 99211 |
|
190 |
189 |
$2K |
| 84703 |
|
11,868 |
11,222 |
$1K |
| 73560 |
|
811 |
716 |
$1K |
| C9399 |
Unclassified drugs or biolog |
761 |
756 |
$1K |
| 76820 |
|
80 |
61 |
$1K |
| G2211 |
Complex e/m visit add on |
155 |
152 |
$1K |
| 87205 |
|
1,469 |
1,391 |
$1K |
| 76882 |
|
57 |
51 |
$1K |
| 83615 |
|
794 |
624 |
$1K |
| 85018 |
|
5,746 |
5,673 |
$1K |
| 80305 |
|
1,385 |
1,280 |
$1K |
| 84156 |
|
931 |
802 |
$1K |
| 11042 |
|
17 |
12 |
$1K |
| 73110 |
|
1,374 |
1,309 |
$1K |
| D0210 |
|
29 |
24 |
$1K |
| 86255 |
|
291 |
261 |
$1K |
| J7040 |
Normal saline solution infus |
13,877 |
12,536 |
$1K |
| 87522 |
Neg quan hep c or qual rna |
24 |
24 |
$1K |
| 90660 |
|
40 |
40 |
$1K |
| 76815 |
|
17 |
12 |
$885.75 |
| J0696 |
Ceftriaxone sodium injection |
3,030 |
2,571 |
$845.10 |
| J1815 |
Insulin injection |
760 |
465 |
$818.49 |
| 82947 |
|
1,686 |
1,450 |
$810.23 |
| 99462 |
|
28 |
27 |
$785.51 |
| 90682 |
|
52 |
52 |
$782.19 |
| 90662 |
|
79 |
79 |
$766.21 |
| 90744 |
|
40 |
40 |
$747.45 |
| 80069 |
|
76 |
73 |
$738.27 |
| J7120 |
Ringers lactate infusion |
3,069 |
2,572 |
$720.58 |
| 81015 |
|
3,993 |
3,692 |
$693.65 |
| 74174 |
|
12 |
12 |
$686.14 |
| J0131 |
Inj, acetaminophen (nos) |
1,603 |
1,518 |
$677.94 |
| 11721 |
|
39 |
38 |
$677.83 |
| J0574 |
Bupren/nal 6.1 to 10mg bupre |
96 |
50 |
$659.46 |
| 76821 |
|
25 |
20 |
$659.05 |
| 87040 |
|
3,476 |
1,904 |
$650.40 |
| J3475 |
Inj magnesium sulfate |
971 |
855 |
$628.68 |
| D0220 |
|
17 |
14 |
$609.10 |
| 88738 |
|
62 |
58 |
$568.46 |
| Q0091 |
Obtaining screen pap smear |
981 |
943 |
$548.33 |
| 86704 |
|
97 |
92 |
$533.03 |
| 85378 |
|
3,037 |
2,967 |
$528.65 |
| 98960 |
|
14 |
14 |
$490.45 |
| 83605 |
|
4,396 |
3,974 |
$439.96 |
| 82677 |
|
26 |
26 |
$436.93 |
| 98968 |
|
21 |
16 |
$415.20 |
| 90713 |
|
15 |
15 |
$395.16 |
| 90710 |
|
15 |
15 |
$376.50 |
| 90471 |
|
9,116 |
8,938 |
$372.57 |
| 96127 |
|
9,501 |
9,374 |
$361.70 |
| 94618 |
|
13 |
13 |
$349.63 |
| 82565 |
|
107 |
104 |
$344.62 |
| 82247 |
|
140 |
105 |
$333.45 |
| 90681 |
|
17 |
17 |
$303.45 |
| 73590 |
|
454 |
430 |
$292.26 |
| 90460 |
|
3,397 |
3,309 |
$280.85 |
| 80164 |
|
59 |
54 |
$276.35 |
| 82670 |
|
14 |
13 |
$251.46 |
| G0008 |
Admin influenza virus vac |
107 |
107 |
$246.93 |
| 71101 |
|
262 |
254 |
$225.68 |
| 77085 |
|
19 |
15 |
$224.71 |
| 96376 |
|
3,669 |
2,867 |
$200.40 |
| 72070 |
|
110 |
105 |
$194.91 |
| 86708 |
|
25 |
25 |
$190.46 |
| 84520 |
|
65 |
63 |
$186.31 |
| 82150 |
|
90 |
84 |
$170.23 |
| 86336 |
|
26 |
26 |
$166.91 |
| 86735 |
|
47 |
39 |
$161.64 |
| G8510 |
Scr dep neg, no plan reqd |
220 |
218 |
$156.60 |
| 73080 |
|
330 |
319 |
$155.21 |
| J2704 |
Inj, propofol, 10 mg |
5,239 |
5,186 |
$150.81 |
| J1100 |
Dexamethasone sodium phos |
7,386 |
7,119 |
$135.76 |
| J1885 |
Ketorolac tromethamine inj |
14,651 |
13,242 |
$135.70 |
| 73140 |
|
539 |
531 |
$134.33 |
| 87807 |
|
644 |
631 |
$129.69 |
| 73090 |
|
343 |
327 |
$128.18 |
| 90472 |
|
723 |
712 |
$124.20 |
| J2930 |
Methylprednisolone injection |
859 |
808 |
$123.37 |
| 87880 |
|
3,735 |
3,670 |
$118.09 |
| 72040 |
|
74 |
72 |
$115.72 |
| 80320 |
|
2,712 |
2,576 |
$112.73 |
| 85014 |
|
128 |
122 |
$111.02 |
| 73620 |
|
30 |
25 |
$109.36 |
| 94640 |
|
322 |
206 |
$88.45 |
| 82140 |
|
58 |
52 |
$87.42 |
| J1170 |
Hydromorphone injection |
3,034 |
2,683 |
$83.36 |
| J1650 |
Inj enoxaparin sodium |
1,659 |
1,000 |
$81.40 |
| 70360 |
|
26 |
26 |
$80.23 |
| 90461 |
|
1,805 |
1,717 |
$79.22 |
| J0690 |
Cefazolin sodium injection |
1,941 |
1,830 |
$78.15 |
| 84460 |
|
29 |
27 |
$75.45 |
| 82951 |
|
12 |
12 |
$70.57 |
| J2270 |
Morphine sulfate injection |
5,183 |
4,447 |
$66.79 |
| G0103 |
Psa screening |
63 |
63 |
$64.88 |
| 86617 |
|
26 |
14 |
$61.96 |
| 85007 |
|
247 |
224 |
$61.49 |
| 87147 |
|
287 |
262 |
$56.76 |
| 73120 |
|
14 |
13 |
$56.00 |
| 72170 |
|
18 |
12 |
$52.47 |
| 87808 |
|
517 |
502 |
$41.91 |
| J1200 |
Diphenhydramine hcl injectio |
4,085 |
3,693 |
$41.37 |
| J3370 |
Vancomycin hcl injection |
211 |
186 |
$36.42 |
| 88302 |
|
78 |
78 |
$35.77 |
| J1644 |
Inj heparin sodium per 1000u |
690 |
530 |
$30.00 |
| 84479 |
|
12 |
12 |
$26.40 |
| 84165 |
|
16 |
12 |
$26.15 |
| J2550 |
Promethazine hcl injection |
1,136 |
978 |
$21.83 |
| C9113 |
Inj pantoprazole sodium, via |
1,551 |
1,204 |
$21.52 |
| J3010 |
Fentanyl citrate injection |
4,777 |
4,697 |
$18.92 |
| J2765 |
Metoclopramide hcl injection |
3,298 |
3,105 |
$17.31 |
| 88300 |
|
191 |
190 |
$16.78 |
| 87210 |
|
225 |
207 |
$15.06 |
| 71100 |
|
25 |
25 |
$15.00 |
| J2060 |
Lorazepam injection |
2,229 |
1,967 |
$14.49 |
| 86308 |
|
97 |
95 |
$13.09 |
| J2250 |
Inj midazolam hydrochloride |
4,770 |
4,667 |
$12.42 |
| 84132 |
|
12 |
12 |
$12.37 |
| 82962 |
|
45 |
41 |
$9.16 |
| 81002 |
|
133 |
125 |
$8.77 |
| 82010 |
|
504 |
472 |
$8.49 |
| J1630 |
Haloperidol injection |
1,398 |
1,178 |
$8.42 |
| J7512 |
Prednisone ir or dr oral 1mg |
1,290 |
1,172 |
$8.15 |
| J0171 |
Adrenalin epinephrine inject |
29 |
29 |
$6.74 |
| 87015 |
|
12 |
12 |
$6.50 |
| 87207 |
|
53 |
53 |
$5.99 |
| 84155 |
|
16 |
12 |
$4.40 |
| J1642 |
Inj heparin sodium per 10 u |
69 |
37 |
$1.00 |
| A9270 |
Non-covered item or service |
955 |
627 |
$0.14 |
| J0780 |
Prochlorperazine injection |
58 |
54 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
169 |
126 |
$0.00 |
| J1953 |
Levetiracetam injection |
40 |
30 |
$0.00 |
| 94664 |
|
28 |
26 |
$0.00 |
| A7002 |
Tubing used w suction pump |
16 |
16 |
$0.00 |
| S0028 |
Injection, famotidine, 20 mg |
31 |
30 |
$0.00 |
| 82075 |
|
243 |
207 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
54 |
45 |
$0.00 |
| C1769 |
Guide wire |
37 |
36 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
102 |
102 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
124 |
74 |
$0.00 |
| J3480 |
Inj potassium chloride |
31 |
25 |
$0.00 |
| 1036F |
|
127 |
125 |
$0.00 |
| 88341 |
|
13 |
13 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
116 |
85 |
$0.00 |
| J0360 |
Hydralazine hcl injection |
13 |
12 |
$0.00 |
| G0379 |
Direct refer hospital observ |
39 |
38 |
$0.00 |
| J3360 |
Diazepam injection |
25 |
25 |
$0.00 |
| J2001 |
Lidocaine injection |
14 |
14 |
$0.00 |
| G0399 |
Home sleep test/type 3 porta |
12 |
12 |
$0.00 |