| Code | Description | Claims | Beneficiaries | Total Paid |
| J9271 |
Inj pembrolizumab |
749 |
630 |
$7.13M |
| 99213 |
|
18,483 |
16,072 |
$4.77M |
| 99212 |
|
16,200 |
14,131 |
$4.06M |
| 96413 |
|
10,345 |
5,817 |
$3.08M |
| 78815 |
|
1,407 |
1,399 |
$1.49M |
| 80053 |
|
35,061 |
22,264 |
$1.29M |
| 99214 |
|
4,581 |
4,186 |
$1.11M |
| 71260 |
|
5,022 |
4,976 |
$715K |
| 96365 |
|
2,214 |
1,599 |
$688K |
| 70553 |
|
2,160 |
2,075 |
$670K |
| 86850 |
|
7,495 |
5,313 |
$596K |
| 87635 |
|
3,018 |
2,753 |
$573K |
| 74177 |
|
3,885 |
3,830 |
$568K |
| 77336 |
|
2,330 |
1,205 |
$522K |
| 96372 |
|
3,102 |
2,079 |
$432K |
| P9040 |
Rbc leukoreduced irradiated |
1,800 |
1,434 |
$404K |
| J0185 |
Inj., aprepitant, 1 mg |
1,149 |
833 |
$362K |
| 77412 |
|
1,546 |
201 |
$347K |
| 36415 |
|
33,428 |
18,733 |
$330K |
| 31575 |
|
767 |
755 |
$320K |
| 96409 |
|
1,025 |
631 |
$303K |
| 96375 |
|
5,861 |
3,354 |
$269K |
| 96374 |
|
1,450 |
1,132 |
$240K |
| 96361 |
|
1,290 |
864 |
$239K |
| Q3014 |
Telehealth facility fee |
877 |
840 |
$222K |
| 77386 |
|
640 |
56 |
$216K |
| 96411 |
|
1,466 |
1,039 |
$202K |
| 82565 |
|
1,465 |
1,431 |
$200K |
| J9306 |
Injection, pertuzumab, 1 mg |
36 |
25 |
$197K |
| J2469 |
Palonosetron hcl |
2,478 |
1,513 |
$187K |
| 36430 |
|
1,844 |
1,274 |
$182K |
| G0463 |
Hospital outpt clinic visit |
3,766 |
2,944 |
$177K |
| 85025 |
|
31,822 |
20,794 |
$164K |
| 77067 |
|
2,268 |
2,268 |
$160K |
| 71250 |
|
1,381 |
1,370 |
$145K |
| J3490 |
Drugs unclassified injection |
2,182 |
1,333 |
$144K |
| 88185 |
|
1,340 |
1,146 |
$140K |
| A9552 |
F18 fdg |
730 |
722 |
$136K |
| 77049 |
|
426 |
425 |
$123K |
| 93306 |
|
950 |
924 |
$121K |
| 88305 |
|
4,549 |
4,250 |
$121K |
| 96402 |
|
473 |
443 |
$118K |
| 96360 |
|
355 |
291 |
$110K |
| 80048 |
|
1,641 |
1,506 |
$109K |
| Q5111 |
Injection, udenyca 0.5 mg |
28 |
26 |
$100K |
| 99215 |
Prolong outpt/office vis |
388 |
380 |
$98K |
| 96417 |
|
2,325 |
1,572 |
$97K |
| 88341 |
|
1,306 |
1,232 |
$96K |
| 96415 |
|
2,115 |
1,235 |
$92K |
| J1950 |
Leuprolide acetate /3.75 mg |
49 |
49 |
$88K |
| J9305 |
Inj. pemetrexed nos 10mg |
12 |
12 |
$87K |
| 77066 |
Tomosynthesis, mammo |
957 |
953 |
$84K |
| 77063 |
|
2,268 |
2,268 |
$82K |
| 93005 |
|
2,897 |
2,689 |
$81K |
| 77334 |
|
590 |
532 |
$72K |
| J9045 |
Carboplatin injection |
1,117 |
768 |
$67K |
| 77300 |
|
453 |
439 |
$67K |
| 86923 |
|
1,496 |
1,155 |
$65K |
| 96367 |
|
386 |
251 |
$65K |
| 11102 |
|
149 |
146 |
$64K |
| 97110 |
|
666 |
345 |
$62K |
| 70491 |
|
463 |
458 |
$60K |
| 87633 |
|
556 |
515 |
$57K |
| 0202U |
|
268 |
256 |
$50K |
| 83521 |
|
387 |
366 |
$50K |
| 76642 |
|
1,111 |
1,108 |
$47K |
| 0002A |
|
272 |
272 |
$46K |
| 87631 |
|
738 |
688 |
$44K |
| 76536 |
|
847 |
844 |
$42K |
| 36561 |
|
26 |
25 |
$41K |
| 83615 |
|
13,189 |
9,136 |
$37K |
| 77065 |
Tomosynthesis, mammo |
540 |
525 |
$37K |
| 96366 |
|
499 |
369 |
$33K |
| 77280 |
|
99 |
77 |
$31K |
| J9267 |
Paclitaxel injection |
475 |
261 |
$29K |
| 76942 |
|
392 |
388 |
$27K |
| J7050 |
Normal saline solution infus |
3,403 |
1,881 |
$27K |
| 88342 |
|
1,779 |
1,712 |
$27K |
| 85027 |
|
5,674 |
4,234 |
$26K |
| J9070 |
Cyclophosphamide 100 mg inj |
47 |
25 |
$26K |
| 82378 |
|
2,119 |
1,846 |
$26K |
| 84443 |
|
3,228 |
2,957 |
$25K |
| 45378 |
|
13 |
13 |
$24K |
| 82728 |
|
3,237 |
2,979 |
$24K |
| 84436 |
|
1,340 |
1,286 |
$24K |
| 43239 |
|
12 |
12 |
$24K |
| 86900 |
|
7,704 |
5,388 |
$22K |
| 82784 |
|
1,478 |
1,316 |
$22K |
| J7030 |
Normal saline solution infus |
3,889 |
2,396 |
$21K |
| 74183 |
|
52 |
52 |
$19K |
| 88184 |
|
1,324 |
1,141 |
$19K |
| J1642 |
Inj heparin sodium per 10 u |
2,079 |
1,363 |
$19K |
| 86901 |
|
7,707 |
5,388 |
$19K |
| 85007 |
|
5,820 |
3,598 |
$18K |
| 83735 |
|
5,945 |
3,272 |
$18K |
| 38222 |
|
53 |
52 |
$17K |
| 36593 |
|
59 |
53 |
$17K |
| 82306 |
|
1,676 |
1,663 |
$17K |
| 74178 |
|
94 |
94 |
$16K |
| 86304 |
|
581 |
539 |
$15K |
| 88360 |
|
473 |
466 |
$15K |
| 78306 |
|
119 |
118 |
$15K |
| 90471 |
|
1,171 |
1,163 |
$14K |
| 84550 |
|
5,651 |
3,270 |
$14K |
| J7060 |
5% dextrose/water |
2,109 |
1,190 |
$14K |
| 81025 |
|
1,403 |
1,331 |
$13K |
| 84100 |
|
4,930 |
3,078 |
$12K |
| 87486 |
|
480 |
443 |
$12K |
| 88307 |
|
455 |
445 |
$11K |
| 82948 |
|
264 |
216 |
$11K |
| 0001A |
|
91 |
91 |
$11K |
| 84432 |
|
108 |
103 |
$11K |
| 71046 |
|
636 |
616 |
$11K |
| J8540 |
Oral dexamethasone |
2,657 |
1,413 |
$11K |
| J2997 |
Alteplase recombinant |
56 |
52 |
$11K |
| 90686 |
|
569 |
567 |
$10K |
| 84153 |
|
410 |
390 |
$10K |
| G0279 |
Tomosynthesis, mammo |
306 |
305 |
$10K |
| 83020 |
|
1,598 |
1,438 |
$9K |
| J0640 |
Leucovorin calcium injection |
86 |
49 |
$9K |
| 87798 |
|
569 |
514 |
$9K |
| 93010 |
|
1,162 |
969 |
$9K |
| 87088 |
|
909 |
859 |
$8K |
| 94010 |
|
127 |
125 |
$8K |
| 86300 |
|
872 |
692 |
$8K |
| 80307 |
|
468 |
409 |
$8K |
| 86902 |
|
239 |
210 |
$7K |
| J2704 |
Inj, propofol, 10 mg |
2,476 |
2,254 |
$7K |
| J1100 |
Dexamethasone sodium phos |
3,881 |
2,768 |
$7K |
| 87496 |
|
513 |
272 |
$7K |
| J9370 |
Vincristine sulfate 1 mg inj |
578 |
411 |
$7K |
| 86334 |
|
530 |
498 |
$6K |
| 85610 |
|
1,534 |
1,322 |
$6K |
| 87497 |
|
95 |
38 |
$6K |
| 85045 |
|
3,544 |
3,139 |
$5K |
| 84484 |
|
802 |
631 |
$5K |
| 88112 |
|
197 |
193 |
$5K |
| 97140 |
|
80 |
39 |
$5K |
| 77295 |
|
24 |
24 |
$5K |
| 87581 |
|
481 |
444 |
$5K |
| 94729 |
|
215 |
210 |
$5K |
| 83880 |
|
231 |
217 |
$4K |
| 81003 |
|
2,216 |
2,082 |
$4K |
| J1200 |
Diphenhydramine hcl injectio |
2,373 |
1,482 |
$4K |
| 81206 |
|
40 |
38 |
$4K |
| 87040 |
|
504 |
446 |
$4K |
| 76641 |
|
66 |
66 |
$4K |
| 84480 |
|
1,406 |
1,350 |
$4K |
| J1170 |
Hydromorphone injection |
1,126 |
990 |
$4K |
| Q0162 |
Ondansetron oral |
2,318 |
1,235 |
$4K |
| C1788 |
Port, indwelling, imp |
24 |
24 |
$4K |
| 94726 |
|
170 |
166 |
$3K |
| 74176 |
|
47 |
46 |
$3K |
| J3489 |
Zoledronic acid 1mg |
41 |
39 |
$3K |
| J9201 |
In gemcitabine hcl nos 200mg |
42 |
25 |
$3K |
| J2545 |
Pentamidine non-comp unit |
19 |
17 |
$3K |
| J9000 |
Doxorubicin hcl injection |
55 |
37 |
$3K |
| 86704 |
|
394 |
379 |
$3K |
| 97162 |
|
42 |
41 |
$2K |
| 84165 |
|
584 |
548 |
$2K |
| J2405 |
Ondansetron hcl injection |
3,693 |
2,582 |
$2K |
| 83605 |
|
473 |
427 |
$2K |
| J3010 |
Fentanyl citrate injection |
3,232 |
3,078 |
$2K |
| 87070 |
|
333 |
316 |
$2K |
| 77080 |
|
57 |
57 |
$2K |
| 71271 |
|
52 |
52 |
$2K |
| 84439 |
|
128 |
123 |
$2K |
| 85046 |
|
817 |
731 |
$2K |
| 82105 |
|
185 |
170 |
$2K |
| 83883 |
|
102 |
95 |
$2K |
| 94060 |
|
24 |
24 |
$2K |
| 86803 |
|
435 |
422 |
$2K |
| 94640 |
|
118 |
96 |
$2K |
| 87340 |
|
403 |
391 |
$2K |
| 82607 |
|
265 |
260 |
$2K |
| 81450 |
|
41 |
38 |
$1K |
| 85097 |
|
63 |
62 |
$1K |
| J0131 |
Inj, acetaminophen (nos) |
100 |
94 |
$1K |
| J2250 |
Inj midazolam hydrochloride |
3,609 |
3,422 |
$1K |
| D0120 |
|
24 |
13 |
$1K |
| 85730 |
|
367 |
313 |
$1K |
| J1453 |
Fosaprepitant injection |
14 |
12 |
$1K |
| 86140 |
|
416 |
369 |
$1K |
| 77001 |
|
40 |
38 |
$1K |
| 86706 |
|
163 |
160 |
$1K |
| 83921 |
|
30 |
29 |
$1K |
| 70487 |
|
13 |
13 |
$957.26 |
| 83540 |
|
488 |
479 |
$949.36 |
| 83550 |
|
472 |
463 |
$911.24 |
| 76937 |
|
40 |
38 |
$867.26 |
| 71045 |
|
99 |
90 |
$852.04 |
| 87077 |
|
47 |
43 |
$751.14 |
| 88237 |
|
12 |
12 |
$728.88 |
| J7040 |
Normal saline solution infus |
77 |
48 |
$686.68 |
| J3475 |
Inj magnesium sulfate |
307 |
180 |
$685.30 |
| 82550 |
|
100 |
82 |
$684.90 |
| 85660 |
|
195 |
180 |
$675.15 |
| J0690 |
Cefazolin sodium injection |
394 |
351 |
$664.24 |
| J8499 |
Oral prescrip drug non chemo |
1,732 |
1,008 |
$656.04 |
| 86800 |
|
135 |
130 |
$649.78 |
| J1644 |
Inj heparin sodium per 1000u |
637 |
453 |
$622.52 |
| 88142 |
|
39 |
39 |
$614.38 |
| 90472 |
|
57 |
57 |
$496.64 |
| 81015 |
|
1,002 |
955 |
$409.01 |
| 87205 |
|
201 |
189 |
$321.11 |
| A9503 |
Tc99m medronate |
24 |
24 |
$313.40 |
| J9250 |
Methotrexate sodium inj |
169 |
84 |
$309.56 |
| 88162 |
|
53 |
53 |
$306.78 |
| 88108 |
|
29 |
27 |
$260.54 |
| 86301 |
|
25 |
25 |
$259.00 |
| 87799 |
|
14 |
12 |
$237.95 |
| 87624 |
|
13 |
13 |
$236.54 |
| J1720 |
Hydrocortisone sodium succ i |
18 |
13 |
$213.52 |
| 94642 |
|
17 |
15 |
$208.73 |
| 88311 |
|
38 |
38 |
$175.97 |
| 83090 |
|
17 |
17 |
$172.34 |
| 82668 |
|
14 |
14 |
$149.89 |
| 88313 |
|
12 |
12 |
$139.28 |
| J3420 |
Vitamin b12 injection |
40 |
36 |
$139.07 |
| 80061 |
|
29 |
27 |
$134.04 |
| 82248 |
|
58 |
27 |
$127.67 |
| 85651 |
|
157 |
141 |
$126.41 |
| 84157 |
|
81 |
66 |
$125.92 |
| 82945 |
|
83 |
68 |
$125.30 |
| 82570 |
|
67 |
64 |
$112.17 |
| 89050 |
|
82 |
68 |
$106.83 |
| 83021 |
|
14 |
13 |
$104.24 |
| 82747 |
|
12 |
12 |
$95.16 |
| 87389 |
|
13 |
13 |
$90.25 |
| 86703 |
|
17 |
17 |
$85.51 |
| 87186 |
|
15 |
13 |
$77.73 |
| 83690 |
|
31 |
24 |
$70.64 |
| 89051 |
|
31 |
28 |
$64.88 |
| Q0164 |
Prochlorperazine maleate 5mg |
116 |
77 |
$61.82 |
| J0330 |
Succinycholine chloride inj |
47 |
45 |
$60.97 |
| 85652 |
|
58 |
56 |
$54.21 |
| J1885 |
Ketorolac tromethamine inj |
69 |
52 |
$49.02 |
| 82150 |
|
31 |
24 |
$45.19 |
| Q0163 |
Diphenhydramine hcl 50mg |
1,215 |
799 |
$42.85 |
| S0028 |
Injection, famotidine, 20 mg |
46 |
32 |
$42.56 |
| 84156 |
|
14 |
12 |
$18.35 |
| J7613 |
Albuterol non-comp unit |
41 |
40 |
$2.52 |