| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpt clinic visit |
894,326 |
705,845 |
$43.60M |
| 8888888 |
|
175,319 |
59,760 |
$42.78M |
| J3490 |
Drugs unclassified injection |
165,489 |
64,129 |
$15.85M |
| 36415 |
|
190,874 |
162,291 |
$13.73M |
| C9803 |
Hopd covid-19 spec collect |
70,578 |
60,484 |
$6.57M |
| J8499 |
Oral prescrip drug non chemo |
102,204 |
29,882 |
$6.21M |
| J1100 |
Dexamethasone sodium phos |
19,430 |
15,582 |
$4.92M |
| J0690 |
Cefazolin sodium injection |
10,187 |
7,893 |
$4.74M |
| J2704 |
Inj, propofol, 10 mg |
16,344 |
11,823 |
$3.39M |
| J1885 |
Ketorolac tromethamine inj |
22,441 |
18,515 |
$3.24M |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
22,337 |
19,521 |
$2.90M |
| J2250 |
Inj midazolam hydrochloride |
15,494 |
13,003 |
$2.85M |
| A9576 |
Inj prohance multipack |
7,161 |
6,573 |
$2.76M |
| A9270 |
Non-covered item or service |
18,962 |
7,239 |
$2.61M |
| J2930 |
Methylprednisolone injection |
2,786 |
2,040 |
$2.39M |
| J2405 |
Ondansetron hcl injection |
31,557 |
22,541 |
$1.74M |
| 36416 |
|
32,018 |
25,862 |
$1.66M |
| J0330 |
Succinycholine chloride inj |
3,751 |
3,150 |
$1.63M |
| J1200 |
Diphenhydramine hcl injectio |
5,566 |
4,430 |
$1.60M |
| 99283 |
|
30,405 |
24,479 |
$1.38M |
| J1170 |
Hydromorphone injection |
9,403 |
6,655 |
$1.27M |
| A0431 |
Rotary wing air transport |
493 |
389 |
$1.14M |
| J0696 |
Ceftriaxone sodium injection |
4,871 |
4,064 |
$1.12M |
| V2020 |
Vision svcs frames purchases |
10,883 |
10,801 |
$1.04M |
| J2270 |
Morphine sulfate injection |
6,566 |
5,025 |
$1.03M |
| 80053 |
|
135,186 |
110,830 |
$989K |
| A9552 |
F18 fdg |
1,048 |
964 |
$988K |
| C1751 |
Cath, inf, per/cent/midline |
28,697 |
24,214 |
$985K |
| J0131 |
Inj, acetaminophen (nos) |
2,092 |
1,741 |
$982K |
| 99284 |
|
39,026 |
33,773 |
$871K |
| J0585 |
Injection,onabotulinumtoxina |
3,498 |
2,942 |
$859K |
| 93306 |
|
5,321 |
4,936 |
$823K |
| 81002 |
|
38,809 |
34,457 |
$813K |
| 87651 |
|
22,656 |
21,964 |
$810K |
| 82330 |
|
13,950 |
9,533 |
$802K |
| J8540 |
Oral dexamethasone |
2,006 |
1,002 |
$770K |
| J0780 |
Prochlorperazine injection |
2,018 |
1,723 |
$764K |
| 87088 |
|
24,329 |
21,295 |
$761K |
| 80305 |
|
9,921 |
7,917 |
$760K |
| J2060 |
Lorazepam injection |
3,842 |
3,029 |
$744K |
| J0171 |
Adrenalin epinephrine inject |
2,911 |
2,235 |
$718K |
| 96365 |
|
12,654 |
9,314 |
$706K |
| 71046 |
|
20,498 |
18,428 |
$668K |
| Q0162 |
Ondansetron oral |
7,087 |
5,839 |
$629K |
| J3301 |
Triamcinolone acet inj nos |
6,960 |
6,300 |
$622K |
| 97110 |
|
28,482 |
15,913 |
$618K |
| J1453 |
Fosaprepitant injection |
791 |
493 |
$599K |
| J2469 |
Palonosetron hcl |
1,245 |
773 |
$578K |
| J7298 |
Mirena, 52 mg |
980 |
943 |
$560K |
| 81025 |
|
27,094 |
24,551 |
$552K |
| A0436 |
Rotary wing air mileage |
488 |
387 |
$536K |
| 87502 |
|
9,873 |
9,464 |
$514K |
| J1790 |
Droperidol injection |
2,235 |
1,998 |
$512K |
| 77336 |
|
2,053 |
903 |
$502K |
| 80307 |
|
18,164 |
15,496 |
$495K |
| J0475 |
Baclofen 10 mg injection |
2,593 |
2,292 |
$446K |
| Q9957 |
Inj perflutren lip micros,ml |
2,126 |
1,937 |
$434K |
| 87491 |
|
23,275 |
21,057 |
$388K |
| J1030 |
Methylprednisolone 40 mg inj |
2,356 |
2,192 |
$377K |
| A9577 |
Inj multihance |
1,045 |
942 |
$371K |
| 90686 |
|
42,392 |
40,916 |
$370K |
| 95810 |
|
559 |
538 |
$366K |
| 88305 |
|
12,735 |
11,185 |
$346K |
| J1050 |
Medroxyprogesterone acetate |
4,305 |
4,117 |
$335K |
| 95811 |
|
657 |
618 |
$335K |
| J3489 |
Zoledronic acid 1mg |
392 |
352 |
$322K |
| 76811 |
|
2,241 |
2,160 |
$317K |
| J7620 |
Albuterol ipratrop non-comp |
4,008 |
3,174 |
$313K |
| 64615 |
|
1,382 |
1,316 |
$308K |
| 76830 |
|
3,083 |
2,945 |
$303K |
| C9399 |
Unclassified drugs or biolog |
6,896 |
5,363 |
$300K |
| 73610 |
|
5,804 |
5,194 |
$291K |
| 76816 |
|
3,863 |
3,485 |
$290K |
| 73630 |
|
7,615 |
6,838 |
$288K |
| 86850 |
|
10,109 |
8,574 |
$283K |
| J3420 |
Vitamin b12 injection |
4,713 |
3,925 |
$283K |
| 73562 |
|
6,275 |
5,783 |
$282K |
| 87661 |
|
4,604 |
4,397 |
$270K |
| 72148 |
|
2,629 |
2,486 |
$267K |
| 80076 |
|
8,547 |
7,356 |
$262K |
| J1815 |
Insulin injection |
3,077 |
1,563 |
$258K |
| 76805 |
|
2,820 |
2,695 |
$253K |
| 77386 |
|
1,370 |
130 |
$247K |
| 83986 |
|
2,758 |
2,005 |
$245K |
| J3475 |
Inj magnesium sulfate |
2,026 |
1,258 |
$242K |
| 77063 |
|
3,609 |
3,513 |
$238K |
| 87081 |
|
3,987 |
3,818 |
$238K |
| 76815 |
|
3,065 |
2,406 |
$236K |
| J7512 |
Prednisone ir or dr oral 1mg |
1,400 |
786 |
$234K |
| 0001A |
|
11,626 |
7,927 |
$233K |
| 87653 |
|
3,046 |
2,940 |
$227K |
| 87480 |
|
5,550 |
5,215 |
$226K |
| 87086 |
|
7,895 |
7,255 |
$222K |
| 73030 |
|
5,708 |
5,173 |
$219K |
| 76700 |
|
3,020 |
2,851 |
$217K |
| 87070 |
|
5,738 |
4,747 |
$210K |
| A9152 |
Single vitamin nos |
1,549 |
694 |
$210K |
| 73110 |
|
4,640 |
3,966 |
$208K |
| 97161 |
|
3,709 |
3,581 |
$198K |
| J3010 |
Fentanyl citrate injection |
33,143 |
24,642 |
$198K |
| 59025 |
|
7,107 |
3,627 |
$191K |
| 73130 |
|
5,479 |
4,880 |
$191K |
| 99173 |
|
8,642 |
8,398 |
$180K |
| 72141 |
|
1,368 |
1,292 |
$179K |
| 72100 |
|
4,964 |
4,537 |
$177K |
| 80048 |
|
37,256 |
29,698 |
$176K |
| 73721 |
|
1,253 |
1,183 |
$175K |
| 72110 |
|
2,942 |
2,801 |
$174K |
| J0461 |
Atropine sulfate injection |
127 |
95 |
$169K |
| A9153 |
Multi-vitamin nos |
1,287 |
779 |
$162K |
| A6257 |
Transparent film <= 16 sq in |
6,209 |
5,087 |
$160K |
| 95885 |
|
871 |
822 |
$158K |
| 87624 |
|
5,057 |
4,825 |
$157K |
| 76801 |
|
3,043 |
2,615 |
$156K |
| J2795 |
Ropivacaine hcl injection |
3,253 |
2,940 |
$153K |
| 70551 |
|
2,026 |
1,887 |
$151K |
| 95886 |
|
1,056 |
1,012 |
$149K |
| 97162 |
|
2,963 |
2,821 |
$147K |
| 87880 |
|
5,112 |
4,871 |
$144K |
| J1720 |
Hydrocortisone sodium succ i |
462 |
375 |
$142K |
| 77300 |
|
442 |
386 |
$141K |
| A9500 |
Tc99m sestamibi |
265 |
238 |
$134K |
| J1630 |
Haloperidol injection |
2,098 |
1,769 |
$129K |
| 73560 |
|
4,213 |
3,602 |
$128K |
| 97140 |
|
13,443 |
7,569 |
$128K |
| 94010 |
|
2,756 |
2,495 |
$125K |
| 73140 |
|
2,093 |
1,893 |
$125K |
| J1745 |
Infliximab not biosimil 10mg |
193 |
175 |
$124K |
| 64642 |
|
275 |
243 |
$123K |
| 70450 |
|
5,619 |
4,997 |
$121K |
| J0572 |
Bupren/nal up to 3mg bupreno |
508 |
431 |
$121K |
| 73502 |
|
3,588 |
3,285 |
$120K |
| 17110 |
|
2,245 |
2,021 |
$120K |
| 72040 |
|
2,465 |
2,258 |
$118K |
| A9579 |
Gad-base mr contrast nos,1ml |
390 |
359 |
$118K |
| J7307 |
Etonogestrel implant system |
765 |
736 |
$116K |
| 72050 |
|
1,741 |
1,649 |
$115K |
| 99285 |
|
13,740 |
11,935 |
$113K |
| 77334 |
|
897 |
585 |
$111K |
| 81001 |
|
45,102 |
38,190 |
$111K |
| 77062 |
|
1,138 |
1,106 |
$111K |
| G0008 |
Admin influenza virus vac |
52,904 |
50,956 |
$109K |
| J1650 |
Inj enoxaparin sodium |
2,768 |
1,379 |
$108K |
| 87631 |
|
936 |
906 |
$107K |
| 87077 |
|
4,276 |
3,769 |
$105K |
| 31231 |
|
1,926 |
1,795 |
$104K |
| 94060 |
|
885 |
835 |
$102K |
| 82962 |
|
25,206 |
15,015 |
$101K |
| 77412 |
|
1,541 |
212 |
$100K |
| 0002A |
|
4,078 |
3,115 |
$98K |
| 71250 |
|
1,992 |
1,841 |
$97K |
| 95004 |
|
211 |
198 |
$97K |
| J0574 |
Bupren/nal 6.1 to 10mg bupre |
423 |
362 |
$94K |
| 73080 |
|
1,596 |
1,472 |
$91K |
| J0295 |
Ampicillin sulbactam 1.5 gm |
206 |
115 |
$91K |
| J1040 |
Methylprednisolone 80 mg inj |
457 |
416 |
$90K |
| 74176 |
|
1,702 |
1,553 |
$89K |
| 93356 |
|
597 |
559 |
$84K |
| 83013 |
|
2,330 |
2,247 |
$84K |
| 93005 |
|
45,397 |
35,064 |
$82K |
| J1756 |
Iron sucrose injection |
1,604 |
825 |
$81K |
| 76376 |
|
652 |
619 |
$81K |
| 69210 |
|
1,684 |
1,582 |
$79K |
| 74018 |
|
2,804 |
2,474 |
$78K |
| 76536 |
|
1,251 |
1,195 |
$78K |
| 77080 |
|
919 |
877 |
$77K |
| 85610 |
|
27,748 |
19,345 |
$77K |
| J0178 |
Aflibercept injection |
1,590 |
1,299 |
$73K |
| 77067 |
|
4,985 |
4,812 |
$72K |
| 90651 |
|
8,020 |
7,866 |
$72K |
| 96374 |
|
24,933 |
20,330 |
$71K |
| 85025 |
|
152,007 |
121,506 |
$69K |
| 67028 |
|
3,395 |
2,926 |
$69K |
| 97530 |
|
4,401 |
2,687 |
$67K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
4,431 |
3,977 |
$67K |
| 73590 |
|
2,152 |
1,891 |
$66K |
| 76770 |
|
1,385 |
1,267 |
$65K |
| 90648 |
|
16,480 |
16,227 |
$64K |
| 97112 |
|
3,621 |
2,215 |
$64K |
| 72072 |
|
1,778 |
1,625 |
$64K |
| 93321 |
|
2,250 |
2,042 |
$63K |
| 72082 |
|
1,308 |
1,204 |
$62K |
| 88142 |
|
7,107 |
6,805 |
$60K |
| 73221 |
|
469 |
448 |
$60K |
| 91200 |
|
1,048 |
1,001 |
$60K |
| 74177 |
|
10,247 |
9,307 |
$60K |
| 93971 |
|
2,682 |
2,406 |
$60K |
| 96375 |
|
22,195 |
16,321 |
$60K |
| J2765 |
Metoclopramide hcl injection |
1,184 |
1,022 |
$58K |
| 87340 |
|
10,180 |
9,483 |
$55K |
| 71045 |
|
9,492 |
8,130 |
$55K |
| G0481 |
Drug test def 8-14 classes |
659 |
615 |
$54K |
| 90633 |
|
8,505 |
8,385 |
$53K |
| 92557 |
|
1,644 |
1,553 |
$53K |
| 0053A |
|
2,398 |
2,184 |
$53K |
| 70486 |
|
1,169 |
1,101 |
$52K |
| 76705 |
|
2,070 |
1,894 |
$51K |
| J0561 |
Penicillin g benzathine inj |
200 |
176 |
$51K |
| 76642 |
|
2,020 |
1,758 |
$50K |
| 73090 |
|
1,498 |
1,363 |
$49K |
| 96413 |
|
9,233 |
5,607 |
$49K |
| 96402 |
|
516 |
444 |
$48K |
| 77280 |
|
94 |
79 |
$47K |
| 92083 |
|
2,818 |
2,576 |
$47K |
| 0241U |
|
993 |
988 |
$47K |
| J1250 |
Inj dobutamine hcl/250 mg |
356 |
322 |
$47K |
| 96361 |
|
20,542 |
16,009 |
$47K |
| U0002 |
Covid-19 lab test non-cdc |
9,366 |
8,575 |
$44K |
| J1071 |
Inj testosterone cypionate |
949 |
535 |
$43K |
| 87210 |
|
3,572 |
3,183 |
$43K |
| 77295 |
|
29 |
27 |
$43K |
| 94640 |
|
7,498 |
5,303 |
$42K |
| 95806 |
|
453 |
443 |
$40K |
| 77290 |
|
104 |
88 |
$40K |
| 0071A |
|
1,404 |
1,229 |
$39K |
| T1015 |
Clinic service |
4,035 |
1,736 |
$39K |
| 88304 |
|
867 |
769 |
$39K |
| 69209 |
|
788 |
734 |
$39K |
| 97165 |
|
651 |
612 |
$39K |
| J3480 |
Inj potassium chloride |
625 |
421 |
$39K |
| 0003A |
|
1,631 |
1,445 |
$38K |
| 82043 |
|
7,407 |
6,921 |
$37K |
| 73600 |
|
677 |
622 |
$36K |
| 77301 |
|
52 |
50 |
$36K |
| 90471 |
|
29,919 |
29,196 |
$36K |
| 74019 |
|
1,362 |
1,239 |
$35K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
6,041 |
5,991 |
$35K |
| 86832 |
|
442 |
375 |
$35K |
| 82274 |
|
1,093 |
1,057 |
$34K |
| 76882 |
|
1,002 |
934 |
$34K |
| J2370 |
Phenylephrine hcl injection |
3,844 |
3,135 |
$34K |
| J3411 |
Thiamine hcl 100 mg |
489 |
309 |
$34K |
| 73564 |
|
543 |
526 |
$33K |
| 20610 |
|
4,744 |
4,165 |
$32K |
| 12001 |
|
921 |
893 |
$32K |
| 82565 |
|
7,453 |
6,805 |
$32K |
| 71101 |
|
629 |
583 |
$32K |
| J7613 |
Albuterol non-comp unit |
639 |
524 |
$31K |
| U0003 |
Cov-19 amp prb hgh thruput |
60,130 |
49,887 |
$31K |
| J1642 |
Inj heparin sodium per 10 u |
515 |
176 |
$30K |
| 99282 |
|
565 |
473 |
$30K |
| 31575 |
|
827 |
761 |
$29K |
| 0072A |
|
820 |
812 |
$29K |
| 73552 |
|
1,181 |
1,042 |
$29K |
| 11981 |
|
673 |
648 |
$29K |
| 92558 |
|
348 |
342 |
$28K |
| 73660 |
|
534 |
502 |
$28K |
| 20611 |
|
2,202 |
1,957 |
$27K |
| 83993 |
|
784 |
754 |
$27K |
| 90685 |
|
3,001 |
2,974 |
$27K |
| 92136 |
|
974 |
869 |
$27K |
| G0009 |
Admin pneumococcal vaccine |
22,706 |
21,993 |
$27K |
| 92550 |
|
511 |
480 |
$27K |
| 87635 |
|
1,405 |
1,283 |
$27K |
| 17000 |
|
860 |
762 |
$26K |
| 95812 |
|
167 |
154 |
$26K |
| 10060 |
|
1,355 |
1,255 |
$26K |
| 93970 |
|
519 |
475 |
$26K |
| J0897 |
Denosumab injection |
66 |
52 |
$26K |
| 97163 |
|
400 |
390 |
$26K |
| 91320 |
|
474 |
469 |
$26K |
| 76856 |
|
3,487 |
3,333 |
$25K |
| 93308 |
|
1,367 |
1,225 |
$25K |
| 93296 |
|
1,441 |
1,320 |
$25K |
| 90688 |
|
5,024 |
4,775 |
$25K |
| 78815 |
|
927 |
847 |
$25K |
| 90715 |
|
12,922 |
12,455 |
$25K |
| 84156 |
|
6,899 |
5,882 |
$25K |
| A9503 |
Tc99m medronate |
39 |
37 |
$24K |
| 97116 |
|
1,604 |
752 |
$24K |
| 51798 |
|
4,397 |
3,678 |
$24K |
| 97166 |
|
481 |
451 |
$24K |
| J1644 |
Inj heparin sodium per 1000u |
3,836 |
1,994 |
$24K |
| 0202U |
|
2,607 |
2,431 |
$23K |
| J3370 |
Vancomycin hcl injection |
1,792 |
1,112 |
$23K |
| A0430 |
Fixed wing air transport |
22 |
15 |
$22K |
| 70553 |
|
4,670 |
4,326 |
$22K |
| 87045 |
|
695 |
667 |
$22K |
| 83036 |
|
66,210 |
61,457 |
$22K |
| 72170 |
|
1,472 |
1,236 |
$21K |
| 96372 |
|
36,399 |
27,440 |
$21K |
| 76000 |
|
1,874 |
1,616 |
$21K |
| 0052A |
|
800 |
755 |
$20K |
| 96360 |
|
7,846 |
6,463 |
$20K |
| 93923 |
|
427 |
395 |
$20K |
| A0435 |
Fixed wing air mileage |
22 |
15 |
$20K |
| 51705 |
|
754 |
673 |
$20K |
| 93017 |
|
626 |
561 |
$20K |
| 96158 |
|
691 |
464 |
$20K |
| 78264 |
|
79 |
77 |
$19K |
| 82731 |
|
142 |
130 |
$19K |
| 0054A |
|
1,064 |
982 |
$19K |
| 76870 |
|
366 |
347 |
$19K |
| J0702 |
Betamethasone acet&sod phosp |
132 |
108 |
$18K |
| 72125 |
|
1,634 |
1,453 |
$17K |
| 84484 |
|
14,830 |
11,001 |
$17K |
| 73521 |
|
419 |
403 |
$17K |
| 80061 |
|
34,911 |
32,866 |
$17K |
| 73070 |
|
753 |
656 |
$17K |
| 87040 |
|
3,779 |
1,896 |
$16K |
| V2784 |
Lens polycarb or equal |
3,874 |
3,841 |
$16K |
| 73000 |
|
280 |
253 |
$16K |
| 90670 |
|
17,792 |
17,357 |
$16K |
| 88720 |
|
518 |
369 |
$15K |
| 99188 |
|
683 |
650 |
$15K |
| 87426 |
|
518 |
468 |
$15K |
| 88184 |
|
1,028 |
799 |
$15K |
| 82805 |
|
13,670 |
9,455 |
$15K |
| J7050 |
Normal saline solution infus |
738 |
372 |
$15K |
| 96366 |
|
6,129 |
4,155 |
$15K |
| 92134 |
|
6,522 |
5,871 |
$15K |
| 82728 |
|
19,022 |
17,817 |
$15K |
| 99211 |
|
3,790 |
3,012 |
$14K |
| A4344 |
Cath indw foley 2 way silicn |
121 |
110 |
$14K |
| 90480 |
|
841 |
836 |
$14K |
| Q3014 |
Telehealth facility fee |
11,671 |
8,262 |
$14K |
| C9257 |
Bevacizumab injection |
1,467 |
978 |
$14K |
| 90696 |
|
3,496 |
3,442 |
$14K |
| 99201 |
|
1,356 |
1,298 |
$14K |
| 87632 |
|
266 |
256 |
$14K |
| 86900 |
|
10,986 |
9,078 |
$14K |
| 92507 |
|
416 |
171 |
$14K |
| 77061 |
|
172 |
170 |
$14K |
| 82306 |
|
20,275 |
19,082 |
$13K |
| 86769 |
|
474 |
441 |
$13K |
| 0051A |
|
644 |
596 |
$13K |
| 87507 |
|
407 |
396 |
$13K |
| 86592 |
|
11,838 |
11,220 |
$13K |
| 72146 |
|
111 |
104 |
$13K |
| 54150 |
|
377 |
359 |
$13K |
| 52000 |
|
500 |
464 |
$13K |
| 93325 |
|
2,355 |
2,139 |
$12K |
| 73700 |
|
200 |
185 |
$12K |
| 84132 |
|
12,996 |
9,333 |
$12K |
| J1569 |
Gammagard liquid injection |
1,169 |
373 |
$12K |
| 85651 |
|
11,323 |
10,250 |
$12K |
| 71260 |
|
5,386 |
4,913 |
$12K |
| 76942 |
|
2,426 |
2,119 |
$12K |
| J9271 |
Inj pembrolizumab |
220 |
179 |
$12K |
| 11976 |
|
82 |
81 |
$12K |
| 83550 |
|
10,746 |
10,066 |
$11K |
| 73060 |
|
535 |
450 |
$11K |
| J1940 |
Furosemide injection |
46 |
38 |
$11K |
| 84702 |
|
4,391 |
3,258 |
$11K |
| G0480 |
Drug test def 1-7 classes |
3,613 |
3,099 |
$11K |
| 84443 |
|
49,815 |
46,214 |
$11K |
| 97535 |
|
769 |
479 |
$11K |
| 92250 |
|
1,655 |
1,504 |
$10K |
| 88307 |
|
1,305 |
1,065 |
$10K |
| 88342 |
|
2,590 |
2,232 |
$10K |
| 76937 |
|
5,121 |
4,153 |
$10K |
| 90677 |
|
2,024 |
2,008 |
$10K |
| 83540 |
|
12,779 |
11,962 |
$10K |
| 20553 |
|
1,096 |
938 |
$10K |
| J3360 |
Diazepam injection |
79 |
68 |
$10K |
| 31720 |
|
182 |
167 |
$10K |
| 96159 |
|
618 |
401 |
$10K |
| 96401 |
|
18 |
12 |
$9K |
| 90750 |
|
65 |
64 |
$9K |
| 85027 |
|
22,682 |
19,127 |
$9K |
| 58301 |
|
775 |
746 |
$9K |
| 90732 |
|
3,481 |
3,222 |
$9K |
| 80069 |
|
4,838 |
4,108 |
$9K |
| 96367 |
|
2,237 |
1,564 |
$9K |
| 58300 |
|
1,610 |
1,538 |
$9K |
| 87338 |
|
660 |
645 |
$9K |
| 77077 |
|
1,151 |
1,096 |
$9K |
| A4565 |
Slings |
229 |
200 |
$9K |
| 11721 |
|
769 |
685 |
$9K |
| 82247 |
|
2,175 |
1,349 |
$9K |
| 82570 |
|
8,089 |
7,519 |
$9K |
| 92552 |
|
117 |
117 |
$9K |
| 87205 |
|
5,799 |
4,703 |
$9K |
| G2023 |
Specimen collect covid-19 |
112 |
110 |
$8K |
| 74183 |
|
644 |
605 |
$8K |
| 92133 |
|
2,841 |
2,572 |
$8K |
| 0073A |
|
224 |
222 |
$8K |
| 87798 |
|
556 |
513 |
$8K |
| G0378 |
Hospital observation per hr |
5,527 |
4,079 |
$8K |
| 64643 |
|
92 |
82 |
$8K |
| 16020 |
|
885 |
619 |
$8K |
| 80164 |
|
2,075 |
1,849 |
$8K |
| 71271 |
|
108 |
106 |
$8K |
| 62370 |
|
1,875 |
1,672 |
$8K |
| 72131 |
|
324 |
292 |
$7K |
| 80050 |
|
2,343 |
2,249 |
$7K |
| 0399T |
|
81 |
70 |
$7K |
| 90734 |
|
5,670 |
5,556 |
$7K |
| 86480 |
|
2,914 |
2,770 |
$7K |
| J0485 |
Belatacept injection |
197 |
64 |
$7K |
| 86140 |
|
13,898 |
12,414 |
$7K |
| 81015 |
|
1,587 |
1,501 |
$7K |
| 43239 |
|
4,098 |
3,815 |
$7K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
2,040 |
2,027 |
$6K |
| 80178 |
|
3,553 |
3,177 |
$6K |
| 82670 |
|
2,024 |
1,913 |
$6K |
| G2066 |
Inter devc remote 30d |
214 |
207 |
$6K |
| 87186 |
|
10,931 |
9,858 |
$6K |
| 87536 |
|
5,269 |
4,976 |
$6K |
| 87324 |
|
841 |
799 |
$6K |
| 94760 |
|
118 |
113 |
$6K |
| 93297 |
|
208 |
200 |
$6K |
| 82550 |
|
3,026 |
2,582 |
$5K |
| 83735 |
|
15,327 |
10,013 |
$5K |
| 90707 |
|
3,937 |
3,867 |
$5K |
| 87147 |
|
4,943 |
4,526 |
$5K |
| 99202 |
|
279 |
265 |
$5K |
| 86833 |
|
387 |
330 |
$5K |
| 87102 |
|
747 |
569 |
$5K |
| 92551 |
|
72 |
70 |
$5K |
| 90656 |
|
2,091 |
2,089 |
$5K |
| 90680 |
|
11,225 |
11,059 |
$5K |
| 87799 |
|
1,449 |
878 |
$5K |
| 51703 |
|
336 |
281 |
$5K |
| 12011 |
|
174 |
169 |
$5K |
| 82607 |
|
16,023 |
14,811 |
$5K |
| P9016 |
Rbc leukocytes reduced |
174 |
133 |
$5K |
| 86235 |
|
1,737 |
1,402 |
$5K |
| A9698 |
Non-rad contrast materialnoc |
869 |
702 |
$5K |
| 90700 |
|
3,907 |
3,838 |
$5K |
| 85379 |
|
4,050 |
3,687 |
$5K |
| 52310 |
|
52 |
50 |
$5K |
| 93270 |
|
735 |
711 |
$5K |
| 90472 |
|
39,173 |
37,808 |
$5K |
| 45380 |
|
3,168 |
2,929 |
$5K |
| 87529 |
|
313 |
278 |
$4K |
| 88173 |
|
70 |
65 |
$4K |
| 93225 |
|
304 |
271 |
$4K |
| 82784 |
|
4,860 |
4,244 |
$4K |
| 83690 |
|
12,889 |
11,129 |
$4K |
| 70491 |
|
961 |
892 |
$4K |
| 87497 |
|
1,881 |
942 |
$4K |
| 83516 |
|
5,141 |
3,960 |
$4K |
| 90716 |
|
3,835 |
3,768 |
$4K |
| 80197 |
|
4,753 |
2,391 |
$4K |
| 86803 |
|
15,938 |
15,278 |
$4K |
| U0005 |
Infec agen detec ampli probe |
34,475 |
30,373 |
$4K |
| 87389 |
|
17,036 |
16,322 |
$4K |
| 93660 |
|
14 |
12 |
$4K |
| 73650 |
|
83 |
77 |
$4K |
| 94762 |
|
45 |
41 |
$4K |
| V2100 |
Lens spher single plano 4.00 |
2,511 |
2,490 |
$4K |
| 87177 |
|
249 |
225 |
$4K |
| 29125 |
|
364 |
350 |
$4K |
| 87075 |
|
1,473 |
1,087 |
$4K |
| G1004 |
Cdsm ndsc |
5,521 |
3,763 |
$4K |
| 84100 |
|
9,554 |
6,194 |
$4K |
| 82040 |
|
826 |
785 |
$4K |
| 86304 |
|
1,073 |
880 |
$4K |
| 81513 |
|
4,397 |
4,207 |
$4K |
| 83880 |
|
6,346 |
5,523 |
$4K |
| 96376 |
|
8,990 |
6,110 |
$4K |
| 97542 |
|
58 |
51 |
$4K |
| 76510 |
|
40 |
38 |
$4K |
| 83655 |
|
2,143 |
2,090 |
$3K |
| 72220 |
|
90 |
88 |
$3K |
| 66982 |
|
264 |
228 |
$3K |
| 84439 |
|
10,258 |
9,529 |
$3K |
| 83520 |
|
1,760 |
1,565 |
$3K |
| 82340 |
|
60 |
54 |
$3K |
| 87015 |
|
22 |
15 |
$3K |
| 82103 |
|
261 |
237 |
$3K |
| 90636 |
|
520 |
490 |
$3K |
| 86901 |
|
10,993 |
9,072 |
$3K |
| 66984 |
|
1,453 |
1,063 |
$3K |
| 83615 |
|
8,660 |
5,647 |
$3K |
| G0108 |
Diab manage trn per indiv |
1,007 |
870 |
$3K |
| 85018 |
|
3,320 |
2,982 |
$3K |
| 86317 |
|
3,473 |
3,166 |
$3K |
| 82653 |
|
26 |
26 |
$3K |
| 0031A |
|
449 |
412 |
$3K |
| 97763 |
|
67 |
58 |
$3K |
| 73620 |
|
276 |
250 |
$3K |
| 83605 |
|
4,337 |
3,306 |
$3K |
| 84165 |
|
2,525 |
2,223 |
$3K |
| 92567 |
|
944 |
889 |
$3K |
| 95813 |
|
12 |
12 |
$3K |
| 11100 |
|
268 |
235 |
$3K |
| 82378 |
|
2,030 |
1,639 |
$3K |
| Q5104 |
Injection, renflexis |
626 |
567 |
$3K |
| 85007 |
|
1,332 |
615 |
$3K |
| 94761 |
|
101 |
90 |
$3K |
| 70496 |
|
1,131 |
1,038 |
$3K |
| 11720 |
|
449 |
395 |
$3K |
| 84703 |
|
2,141 |
1,944 |
$2K |
| 11750 |
|
54 |
39 |
$2K |
| 90710 |
|
4,115 |
4,065 |
$2K |
| 45378 |
|
604 |
557 |
$2K |
| 94727 |
|
2,662 |
2,482 |
$2K |
| 87522 |
Neg quan hep c or qual rna |
3,363 |
3,069 |
$2K |
| C1729 |
Cath, drainage |
705 |
524 |
$2K |
| 80156 |
|
231 |
205 |
$2K |
| G0257 |
Unsched dialysis esrd pt hos |
4,458 |
756 |
$2K |
| 85045 |
|
1,138 |
884 |
$2K |
| 84153 |
|
3,162 |
2,922 |
$2K |
| 36000 |
|
3,655 |
2,923 |
$2K |
| 87591 |
|
8,402 |
7,731 |
$2K |
| 82310 |
|
1,307 |
1,155 |
$2K |
| 81511 |
|
819 |
784 |
$2K |
| 82533 |
|
833 |
721 |
$2K |
| 66821 |
|
16 |
14 |
$2K |
| 93976 |
|
517 |
484 |
$2K |
| 86923 |
|
1,179 |
838 |
$2K |
| 87493 |
|
389 |
365 |
$2K |
| C1769 |
Guide wire |
2,995 |
2,426 |
$2K |
| 70498 |
|
979 |
905 |
$2K |
| 36430 |
|
809 |
502 |
$2K |
| 99153 |
Mod sedat endo service >5yrs |
7,173 |
6,443 |
$2K |
| 99152 |
|
5,901 |
5,420 |
$2K |
| 46600 |
|
167 |
165 |
$2K |
| 82105 |
|
2,500 |
2,270 |
$2K |
| 0082A |
|
375 |
322 |
$2K |
| 87633 |
|
29 |
27 |
$2K |
| 86003 |
|
344 |
301 |
$2K |
| 64493 |
|
700 |
594 |
$2K |
| 96152 |
|
50 |
38 |
$2K |
| 76817 |
|
1,879 |
1,617 |
$2K |
| C8930 |
Tte w or w/o contr, cont ecg |
152 |
139 |
$2K |
| 90713 |
|
614 |
603 |
$2K |
| 86334 |
|
1,937 |
1,666 |
$2K |
| 92025 |
|
85 |
79 |
$2K |
| 64483 |
|
1,442 |
1,342 |
$2K |
| 90687 |
|
526 |
518 |
$2K |
| 43235 |
|
890 |
840 |
$2K |
| 86361 |
|
3,127 |
2,992 |
$2K |
| 77066 |
Tomosynthesis, mammo |
1,243 |
1,165 |
$2K |
| 11104 |
|
531 |
500 |
$2K |
| 64450 |
|
727 |
627 |
$2K |
| 80177 |
|
475 |
441 |
$2K |
| 95117 |
|
637 |
336 |
$2K |
| 11730 |
|
27 |
26 |
$2K |
| 88185 |
|
1,368 |
810 |
$2K |
| 71275 |
|
586 |
532 |
$2K |
| 90723 |
|
12,882 |
12,676 |
$2K |
| 86160 |
|
1,634 |
1,459 |
$2K |
| Q9961 |
Hocm 250-299mg/ml iodine,1ml |
264 |
232 |
$2K |
| 78452 |
|
208 |
183 |
$2K |
| 77081 |
|
471 |
454 |
$2K |
| 86706 |
|
986 |
953 |
$2K |
| 83970 |
|
4,580 |
4,207 |
$1K |
| 97802 |
|
1,112 |
1,087 |
$1K |
| 82948 |
|
180 |
152 |
$1K |
| 96156 |
|
51 |
44 |
$1K |
| 77065 |
Tomosynthesis, mammo |
295 |
279 |
$1K |
| Q0114 |
Fern test |
1,991 |
1,737 |
$1K |
| 86038 |
|
3,208 |
3,045 |
$1K |
| 29130 |
|
98 |
94 |
$1K |
| 84295 |
|
12,823 |
9,231 |
$1K |
| A4648 |
Implantable tissue marker |
16 |
14 |
$1K |
| 80143 |
|
2,281 |
2,067 |
$1K |
| 97803 |
|
1,305 |
1,221 |
$1K |
| 82950 |
|
3,171 |
3,073 |
$1K |
| 82977 |
|
2,791 |
2,032 |
$1K |
| 77002 |
|
468 |
428 |
$1K |
| 96415 |
|
3,537 |
2,495 |
$1K |
| 76881 |
|
15 |
13 |
$1K |
| 84160 |
|
632 |
544 |
$1K |
| 80074 |
|
1,200 |
1,131 |
$1K |
| 95970 |
|
315 |
279 |
$1K |
| 84134 |
|
2,002 |
1,790 |
$1K |
| 94729 |
|
2,686 |
2,504 |
$1K |
| 11102 |
|
681 |
638 |
$1K |
| 51700 |
|
136 |
85 |
$1K |
| 96416 |
|
448 |
261 |
$1K |
| 82746 |
|
7,429 |
6,989 |
$1K |
| 86922 |
|
119 |
75 |
$1K |
| 82785 |
|
540 |
511 |
$1K |
| 92285 |
|
617 |
587 |
$1K |
| 93351 |
|
727 |
688 |
$1K |
| J0360 |
Hydralazine hcl injection |
14 |
13 |
$1K |
| 93990 |
|
276 |
223 |
$1K |
| 72128 |
|
121 |
115 |
$978.70 |
| 12002 |
|
99 |
94 |
$945.52 |
| 90744 |
|
423 |
414 |
$944.30 |
| 85014 |
|
1,660 |
1,475 |
$940.15 |
| 82077 |
|
2,763 |
2,463 |
$935.40 |
| 96164 |
|
97 |
37 |
$925.48 |
| 74178 |
|
190 |
176 |
$920.15 |
| L4360 |
Pneumat walking boot pre cst |
15 |
14 |
$916.38 |
| 86703 |
|
540 |
484 |
$902.58 |
| 82525 |
|
1,608 |
1,523 |
$902.20 |
| 88313 |
|
492 |
404 |
$899.10 |
| 72156 |
|
611 |
575 |
$886.95 |
| 95910 |
|
112 |
110 |
$876.08 |
| 11719 |
|
79 |
77 |
$871.54 |
| 88240 |
|
1,112 |
958 |
$853.02 |
| 86255 |
|
440 |
400 |
$849.12 |
| 84403 |
|
4,420 |
4,104 |
$842.31 |
| 0081A |
|
760 |
682 |
$826.67 |
| 85730 |
|
6,098 |
5,235 |
$825.49 |
| J7507 |
Tacrolimus imme rel oral 1mg |
38 |
13 |
$825.41 |
| 83883 |
|
553 |
440 |
$816.24 |
| 83861 |
|
1,827 |
1,679 |
$812.78 |
| 86765 |
|
547 |
510 |
$811.03 |
| 84146 |
|
2,299 |
2,175 |
$786.79 |
| 86704 |
|
2,747 |
2,607 |
$780.32 |
| 49083 |
|
30 |
13 |
$775.80 |
| 74160 |
|
48 |
42 |
$744.43 |
| 90662 |
|
470 |
390 |
$696.72 |
| 94618 |
|
40 |
37 |
$690.13 |
| 89051 |
|
1,357 |
1,023 |
$672.55 |
| 93288 |
|
26 |
24 |
$661.76 |
| 86300 |
|
352 |
300 |
$651.03 |
| 84270 |
|
2,253 |
2,065 |
$639.02 |
| 90739 |
|
118 |
110 |
$612.66 |
| 51741 |
|
819 |
760 |
$611.36 |
| 84550 |
|
3,048 |
2,665 |
$600.28 |
| 94660 |
|
142 |
115 |
$583.71 |
| 87305 |
|
212 |
102 |
$549.87 |
| 58100 |
|
109 |
104 |
$549.45 |
| 95911 |
|
55 |
53 |
$546.66 |
| J7325 |
Synvisc or synvisc-one |
18 |
12 |
$540.83 |
| 74230 |
|
84 |
73 |
$529.50 |
| 86141 |
|
2,178 |
1,970 |
$518.81 |
| C8929 |
Tte w or wo fol wcon,doppler |
259 |
221 |
$518.51 |
| 38222 |
|
42 |
38 |
$518.22 |
| 90694 |
|
580 |
530 |
$514.97 |
| 86200 |
|
1,912 |
1,808 |
$509.51 |
| 95908 |
|
105 |
102 |
$506.39 |
| G8978 |
Mobility current status |
292 |
221 |
$504.96 |
| 90746 |
|
50 |
46 |
$500.38 |
| 73200 |
|
14 |
12 |
$499.96 |
| 86762 |
|
3,983 |
3,757 |
$498.15 |
| 93242 |
|
73 |
70 |
$477.86 |
| J2785 |
Regadenoson injection |
266 |
237 |
$467.50 |
| 86256 |
|
753 |
712 |
$464.09 |
| 87427 |
|
765 |
730 |
$460.42 |
| 86308 |
|
69 |
69 |
$450.35 |
| 87481 |
|
4,306 |
4,140 |
$448.05 |
| 72080 |
|
13 |
13 |
$447.32 |
| 83001 |
|
2,269 |
2,164 |
$445.40 |
| 87449 |
|
939 |
841 |
$445.28 |
| 64447 |
|
206 |
177 |
$442.75 |
| 87902 |
|
539 |
471 |
$432.47 |
| 86580 |
|
13 |
12 |
$420.61 |
| 36591 |
|
4,434 |
2,826 |
$417.02 |
| 94799 |
|
99 |
53 |
$408.16 |
| 86376 |
|
967 |
926 |
$407.29 |
| 45385 |
|
1,562 |
1,425 |
$404.50 |
| 86039 |
|
1,469 |
1,229 |
$402.99 |
| 82150 |
|
1,050 |
850 |
$400.62 |
| 88341 |
|
61 |
51 |
$398.99 |
| 84425 |
|
1,960 |
1,875 |
$396.13 |
| 93280 |
|
142 |
121 |
$383.62 |
| 87660 |
|
5,559 |
5,222 |
$379.11 |
| 96165 |
|
98 |
37 |
$366.38 |
| 86309 |
|
157 |
146 |
$362.80 |
| 92553 |
|
12 |
12 |
$358.75 |
| 82384 |
|
45 |
27 |
$358.23 |
| J2280 |
Inj, moxifloxacin 100 mg |
819 |
598 |
$354.37 |
| 90935 |
|
190 |
65 |
$352.98 |
| 62368 |
|
30 |
25 |
$340.24 |
| 93289 |
|
14 |
13 |
$326.52 |
| 87046 |
|
754 |
699 |
$316.59 |
| 0124A |
|
2,976 |
2,927 |
$308.55 |
| 95971 |
|
91 |
88 |
$300.67 |
| 84402 |
|
1,582 |
1,483 |
$294.20 |
| 90714 |
|
66 |
57 |
$289.25 |
| 87517 |
|
436 |
404 |
$283.02 |
| 64494 |
|
660 |
410 |
$282.56 |
| M0220 |
Tixagev and cilgav inj |
53 |
47 |
$282.09 |
| 70544 |
|
16 |
15 |
$275.52 |
| 96138 |
|
53 |
50 |
$273.61 |
| 86708 |
|
1,804 |
1,713 |
$273.08 |
| G0472 |
Hep c screen high risk/other |
826 |
732 |
$263.44 |
| 88312 |
|
717 |
643 |
$259.95 |
| 86694 |
|
367 |
250 |
$255.52 |
| J9190 |
Fluorouracil injection |
720 |
338 |
$252.29 |
| 92235 |
|
29 |
24 |
$244.31 |
| 84450 |
|
1,778 |
1,639 |
$237.15 |
| 86146 |
|
183 |
167 |
$236.00 |
| Q0221 |
Tixagev and cilgav, 600mg |
16 |
14 |
$235.30 |
| 86147 |
|
285 |
264 |
$228.86 |
| 87252 |
|
13 |
12 |
$223.24 |
| G0010 |
Admin hepatitis b vaccine |
1,427 |
1,369 |
$222.92 |
| 84466 |
|
1,587 |
1,508 |
$222.05 |
| 80175 |
|
526 |
477 |
$220.17 |
| 72157 |
|
235 |
227 |
$220.10 |
| 82390 |
|
459 |
427 |
$217.35 |
| V2025 |
Eyeglasses delux frames |
563 |
560 |
$213.31 |
| 82140 |
|
582 |
518 |
$204.03 |
| 90474 |
|
11,136 |
10,966 |
$192.84 |
| 86431 |
|
2,694 |
2,539 |
$186.98 |
| 82810 |
|
150 |
80 |
$182.02 |
| 90632 |
|
26 |
26 |
$180.06 |
| 84590 |
|
1,131 |
1,093 |
$179.86 |
| 82248 |
|
1,155 |
869 |
$179.63 |
| 84155 |
|
1,870 |
1,571 |
$179.61 |
| 77001 |
|
204 |
178 |
$177.40 |
| 84207 |
|
444 |
424 |
$177.40 |
| 86665 |
|
247 |
174 |
$170.02 |
| C1887 |
Catheter, guiding |
301 |
256 |
$167.87 |
| 87510 |
|
5,549 |
5,214 |
$161.96 |
| 84255 |
|
875 |
851 |
$154.77 |
| G0500 |
Mod sedat endo service >5yrs |
5,975 |
5,342 |
$154.75 |
| 83021 |
|
110 |
88 |
$154.62 |
| A6258 |
Transparent film >16<=48 in |
107 |
93 |
$151.05 |
| 17003 |
|
270 |
242 |
$150.90 |
| 0083A |
|
98 |
94 |
$150.28 |
| 36592 |
|
589 |
249 |
$145.82 |
| 97164 |
|
28 |
28 |
$144.41 |
| 88360 |
|
14 |
14 |
$143.07 |
| 84630 |
|
1,486 |
1,430 |
$130.30 |
| 87206 |
|
43 |
27 |
$126.94 |
| 83519 |
|
23 |
13 |
$123.54 |
| V2107 |
Spherocylinder 4.25d/12-2d |
254 |
254 |
$121.43 |
| 82951 |
|
163 |
162 |
$120.16 |
| J2790 |
Rho d immune globulin inj |
52 |
50 |
$118.12 |
| 90674 |
|
14 |
14 |
$117.66 |
| 91307 |
|
316 |
237 |
$116.19 |
| 20605 |
|
13 |
13 |
$115.18 |
| 76775 |
|
27 |
26 |
$114.94 |
| 0296T |
|
28 |
27 |
$113.69 |
| 82652 |
|
40 |
38 |
$110.32 |
| C1894 |
Intro/sheath, non-laser |
251 |
219 |
$106.74 |
| 86036 |
|
39 |
38 |
$104.43 |
| 76377 |
|
15 |
14 |
$100.03 |
| 83002 |
|
1,516 |
1,431 |
$99.08 |
| 99454 |
|
47 |
47 |
$98.66 |
| 80179 |
|
2,156 |
1,956 |
$97.79 |
| 86787 |
|
299 |
246 |
$97.22 |
| G0283 |
Elec stim other than wound |
183 |
103 |
$97.00 |
| 83721 |
|
1,910 |
1,775 |
$95.96 |
| A9541 |
Tc99m sulfur colloid |
137 |
133 |
$88.42 |
| Q0091 |
Obtaining screen pap smear |
6,087 |
5,860 |
$86.58 |
| 84460 |
|
1,878 |
1,726 |
$84.49 |
| 83921 |
|
833 |
784 |
$76.36 |
| 86644 |
|
32 |
24 |
$71.36 |
| 86800 |
|
575 |
544 |
$70.72 |
| 77338 |
|
52 |
50 |
$68.90 |
| 86335 |
|
85 |
70 |
$60.55 |
| 82947 |
|
2,716 |
2,156 |
$59.64 |
| 82610 |
|
500 |
465 |
$58.36 |
| 83525 |
|
1,357 |
1,330 |
$58.01 |
| 90653 |
|
13 |
13 |
$57.76 |
| 62369 |
|
265 |
250 |
$55.44 |
| 83521 |
|
418 |
344 |
$53.40 |
| C1892 |
Intro/sheath,fixed,peel-away |
470 |
403 |
$53.30 |
| 86301 |
|
323 |
279 |
$46.20 |
| 86663 |
|
13 |
13 |
$45.00 |
| 72158 |
|
258 |
243 |
$40.34 |
| 86780 |
|
514 |
477 |
$38.56 |
| L0140 |
Cervical semi-rigid adjustab |
33 |
26 |
$38.55 |
| 99408 |
|
179 |
147 |
$38.33 |
| 84480 |
|
343 |
323 |
$31.52 |
| 82945 |
|
165 |
141 |
$28.62 |
| 87116 |
|
29 |
26 |
$27.69 |
| 84157 |
|
169 |
148 |
$26.73 |
| 82365 |
|
12 |
12 |
$24.71 |
| 84481 |
|
1,081 |
1,026 |
$23.39 |
| 86880 |
|
78 |
60 |
$21.85 |
| 96417 |
|
1,966 |
1,188 |
$21.59 |
| 85613 |
|
232 |
199 |
$21.30 |
| G8987 |
Self care current status |
107 |
88 |
$16.60 |
| 84133 |
|
232 |
196 |
$15.17 |
| 86735 |
|
43 |
42 |
$14.50 |
| 87209 |
|
244 |
224 |
$14.38 |
| 86707 |
|
56 |
51 |
$12.85 |
| 87350 |
|
94 |
89 |
$12.81 |
| 86364 |
|
723 |
703 |
$10.76 |
| G0109 |
Diab manage trn ind/group |
53 |
49 |
$10.66 |
| 20560 |
|
468 |
366 |
$9.39 |
| 92060 |
|
44 |
42 |
$8.59 |
| 86593 |
|
521 |
500 |
$7.83 |
| 95974 |
|
45 |
42 |
$7.45 |
| 84145 |
|
216 |
169 |
$7.32 |
| 20561 |
|
566 |
393 |
$6.31 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
44 |
40 |
$5.78 |
| J2001 |
Lidocaine injection |
24 |
24 |
$5.49 |
| 80235 |
|
15 |
14 |
$3.17 |
| 83930 |
|
81 |
76 |
$0.44 |
| S9455 |
Diabetic management program, |
104 |
98 |
$0.09 |
| 64484 |
|
92 |
89 |
$0.00 |
| V2632 |
Post chmbr intraocular lens |
1,945 |
1,442 |
$0.00 |
| 86258 |
|
139 |
136 |
$0.00 |
| 84154 |
|
523 |
486 |
$0.00 |
| 41899 |
|
685 |
475 |
$0.00 |
| 84432 |
|
28 |
26 |
$0.00 |
| 86812 |
|
13 |
13 |
$0.00 |
| 74174 |
|
83 |
78 |
$0.00 |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
142 |
141 |
$0.00 |
| 20550 |
|
805 |
622 |
$0.00 |
| 64405 |
|
223 |
211 |
$0.00 |
| 64635 |
|
105 |
100 |
$0.00 |
| J9045 |
Carboplatin injection |
175 |
110 |
$0.00 |
| J9267 |
Paclitaxel injection |
107 |
53 |
$0.00 |
| 91065 |
|
143 |
133 |
$0.00 |
| G0103 |
Psa screening |
87 |
69 |
$0.00 |
| 84144 |
|
92 |
82 |
$0.00 |
| 86381 |
|
128 |
125 |
$0.00 |
| 82952 |
|
151 |
150 |
$0.00 |
| J2175 |
Meperidine hydrochl /100 mg |
167 |
145 |
$0.00 |
| 97804 |
|
68 |
68 |
$0.00 |
| 96040 |
|
191 |
184 |
$0.00 |
| 99156 |
|
80 |
70 |
$0.00 |
| 81599 |
|
12 |
12 |
$0.00 |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
75 |
63 |
$0.00 |
| 84446 |
|
49 |
49 |
$0.00 |
| 86664 |
|
41 |
40 |
$0.00 |
| 96368 |
|
111 |
85 |
$0.00 |
| 74420 |
|
124 |
103 |
$0.00 |
| G8988 |
Self care goal status |
106 |
89 |
$0.00 |
| 96411 |
|
154 |
96 |
$0.00 |
| 86695 |
|
76 |
71 |
$0.00 |
| 70543 |
|
13 |
12 |
$0.00 |
| 81332 |
|
13 |
12 |
$0.00 |
| 11900 |
|
77 |
74 |
$0.00 |
| 86870 |
|
126 |
104 |
$0.00 |
| 90620 |
|
14 |
14 |
$0.00 |
| 88311 |
|
96 |
77 |
$0.00 |
| 84300 |
|
120 |
112 |
$0.00 |
| 96110 |
|
15 |
15 |
$0.00 |
| 96139 |
|
41 |
38 |
$0.00 |
| 86225 |
|
140 |
133 |
$0.00 |
| 73720 |
|
18 |
14 |
$0.00 |
| 86341 |
|
20 |
12 |
$0.00 |
| V2744 |
Tint photochromatic lens/es |
13 |
13 |
$0.00 |
| 57454 |
|
69 |
66 |
$0.00 |
| G8980 |
Mobility d/c status |
46 |
40 |
$0.00 |
| 52287 |
|
29 |
25 |
$0.00 |
| C1726 |
Cath, bal dil, non-vascular |
96 |
84 |
$0.00 |
| A4615 |
Cannula nasal |
27 |
26 |
$0.00 |
| V2755 |
Uv lens/es |
12 |
12 |
$0.00 |
| J3471 |
Ovine, up to 999 usp units |
51 |
42 |
$0.00 |
| J1097 |
Phenylep ketorolac opth soln |
33 |
27 |
$0.00 |
| J8501 |
Oral aprepitant |
14 |
12 |
$0.00 |
| 82575 |
|
14 |
12 |
$0.00 |
| P9612 |
Catheterize for urine spec |
18 |
12 |
$0.00 |
| 87184 |
|
28 |
26 |
$0.00 |
| 88108 |
|
14 |
12 |
$0.00 |
| 82024 |
|
36 |
36 |
$0.00 |
| 76820 |
|
15 |
12 |
$0.00 |
| 77470 |
|
15 |
12 |
$0.00 |
| 97597 |
|
43 |
13 |
$0.00 |
| 82436 |
|
26 |
26 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
18 |
13 |
$0.00 |
| 87506 |
|
20 |
12 |
$0.00 |
| 64445 |
|
22 |
15 |
$0.00 |
| M0221 |
Tixagev and cilgav inj hm |
15 |
13 |
$0.00 |
| J0185 |
Inj., aprepitant, 1 mg |
24 |
15 |
$0.00 |
| 80354 |
|
340 |
286 |
$0.00 |
| J3473 |
Hyaluronidase recombinant |
252 |
216 |
$0.00 |
| 95873 |
|
723 |
642 |
$0.00 |
| 99177 |
|
798 |
787 |
$0.00 |
| 87899 |
|
374 |
360 |
$0.00 |
| J9035 |
Bevacizumab injection |
91 |
72 |
$0.00 |
| 72197 |
|
102 |
97 |
$0.00 |
| 82085 |
|
55 |
53 |
$0.00 |
| G8979 |
Mobility goal status |
291 |
223 |
$0.00 |
| C1776 |
Joint device (implantable) |
616 |
494 |
$0.00 |
| 80169 |
|
459 |
265 |
$0.00 |
| 74220 |
|
27 |
27 |
$0.00 |
| 88237 |
|
34 |
27 |
$0.00 |
| 86015 |
|
54 |
52 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
395 |
345 |
$0.00 |
| G0260 |
Inj for sacroiliac jt anesth |
12 |
12 |
$0.00 |
| 82595 |
|
12 |
12 |
$0.00 |
| 20552 |
|
58 |
53 |
$0.00 |
| J9263 |
Oxaliplatin |
21 |
13 |
$0.00 |
| J0735 |
Clonidine hydrochloride |
58 |
50 |
$0.00 |
| 86753 |
|
220 |
212 |
$0.00 |
| J1750 |
Inj iron dextran |
495 |
465 |
$0.00 |
| 84305 |
|
72 |
70 |
$0.00 |
| G8989 |
Self care d/c status |
13 |
12 |
$0.00 |
| 64636 |
|
122 |
99 |
$0.00 |
| J9206 |
Irinotecan injection |
19 |
12 |
$0.00 |
| 82627 |
|
80 |
76 |
$0.00 |
| 95909 |
|
12 |
12 |
$0.00 |
| 95923 |
|
37 |
32 |
$0.00 |
| 85060 |
|
101 |
94 |
$0.00 |
| V2750 |
Anti-reflective coating |
74 |
74 |
$0.00 |
| 95921 |
|
14 |
12 |
$0.00 |
| 84166 |
|
16 |
14 |
$0.00 |
| 90681 |
|
29 |
28 |
$0.00 |
| Q5119 |
Inj ruxience, 10 mg |
46 |
24 |
$0.00 |
| 86682 |
|
112 |
91 |
$0.00 |
| A4306 |
Drug delivery system <=50 ml |
111 |
64 |
$0.00 |
| 62323 |
|
41 |
39 |
$0.00 |
| 91308 |
|
21 |
17 |
$0.00 |
| 95874 |
|
56 |
50 |
$0.00 |
| 86696 |
|
78 |
73 |
$0.00 |
| V2410 |
Lens variab asphericity sing |
13 |
13 |
$0.00 |
| 82042 |
|
68 |
42 |
$0.00 |
| 84681 |
|
30 |
30 |
$0.00 |
| 84445 |
|
12 |
12 |
$0.00 |
| 36600 |
|
42 |
39 |
$0.00 |
| 82747 |
|
13 |
12 |
$0.00 |
| 99157 |
|
48 |
40 |
$0.00 |
| 96549 |
|
24 |
12 |
$0.00 |
| J1095 |
Injection, dexamethasone 9% |
21 |
12 |
$0.00 |
| 43249 |
|
16 |
15 |
$0.00 |