| Code | Description | Claims | Beneficiaries | Total Paid |
| 99285 |
|
80,146 |
72,191 |
$25.64M |
| 99284 |
|
110,819 |
102,035 |
$20.64M |
| 96374 |
|
36,256 |
31,348 |
$3.04M |
| 99291 |
|
4,909 |
4,524 |
$2.24M |
| G0378 |
Hospital observation per hr |
15,414 |
14,795 |
$2.10M |
| 99283 |
|
16,262 |
15,864 |
$1.94M |
| 43239 |
|
5,571 |
5,253 |
$1.72M |
| 82947 |
|
43,012 |
28,438 |
$1.67M |
| 97530 |
|
47,781 |
12,528 |
$1.49M |
| 96361 |
|
44,736 |
33,211 |
$1.47M |
| 97110 |
|
62,625 |
18,513 |
$1.26M |
| 45380 |
|
2,691 |
2,557 |
$1.26M |
| 87637 |
|
16,392 |
15,852 |
$1.17M |
| 96365 |
|
15,067 |
12,202 |
$1.07M |
| 74177 |
|
8,832 |
8,562 |
$1.03M |
| U0003 |
Cov-19 amp prb hgh thruput |
24,840 |
23,889 |
$990K |
| 96360 |
|
11,552 |
10,382 |
$950K |
| 80061 |
|
34,319 |
33,966 |
$913K |
| 71045 |
|
25,533 |
24,012 |
$834K |
| 96413 |
|
5,465 |
3,158 |
$799K |
| 96375 |
|
35,624 |
26,770 |
$795K |
| 71046 |
|
23,868 |
22,837 |
$737K |
| 70450 |
|
11,938 |
11,549 |
$728K |
| 95810 |
|
1,577 |
1,507 |
$714K |
| 76705 |
|
12,304 |
12,007 |
$707K |
| 97112 |
|
31,899 |
9,809 |
$629K |
| 74176 |
|
5,772 |
5,577 |
$550K |
| 92507 |
|
13,728 |
3,834 |
$542K |
| 45385 |
|
1,452 |
1,371 |
$522K |
| G0463 |
Hospital outpt clinic visit |
8,913 |
6,886 |
$510K |
| 59025 |
|
5,826 |
3,402 |
$475K |
| 93306 |
|
3,649 |
3,585 |
$458K |
| 87491 |
|
32,753 |
31,769 |
$452K |
| 87591 |
|
32,276 |
31,323 |
$444K |
| 47562 |
|
170 |
167 |
$425K |
| 77067 |
|
8,547 |
8,530 |
$398K |
| 76856 |
|
7,856 |
7,562 |
$379K |
| 76830 |
|
6,850 |
6,591 |
$375K |
| 70553 |
|
2,057 |
2,024 |
$368K |
| 99282 |
|
4,885 |
4,821 |
$335K |
| 58661 |
|
124 |
115 |
$314K |
| 78815 |
|
480 |
478 |
$299K |
| 76770 |
|
5,695 |
5,589 |
$297K |
| 87636 |
|
3,946 |
3,925 |
$287K |
| 71275 |
|
3,406 |
3,332 |
$268K |
| 71260 |
|
2,216 |
2,187 |
$263K |
| 95816 |
|
2,437 |
2,342 |
$258K |
| 97140 |
|
17,897 |
7,021 |
$251K |
| 97162 |
|
5,746 |
5,684 |
$249K |
| 73721 |
|
2,154 |
2,067 |
$242K |
| 80053 |
|
143,028 |
123,490 |
$237K |
| 84443 |
|
45,820 |
44,210 |
$230K |
| 70551 |
|
2,167 |
2,148 |
$228K |
| 97161 |
|
4,862 |
4,817 |
$226K |
| U0005 |
Infec agen detec ampli probe |
17,418 |
16,775 |
$217K |
| 72148 |
|
2,442 |
2,411 |
$212K |
| 93458 |
|
241 |
214 |
$204K |
| 82306 |
|
16,823 |
16,665 |
$203K |
| 92526 |
|
4,759 |
1,725 |
$200K |
| 76801 |
|
3,462 |
3,193 |
$195K |
| 99281 |
|
4,660 |
4,588 |
$185K |
| 85025 |
|
164,101 |
134,601 |
$182K |
| 93971 |
|
3,811 |
3,699 |
$181K |
| 72141 |
|
1,415 |
1,392 |
$167K |
| 99214 |
|
3,023 |
2,861 |
$157K |
| 93970 |
|
1,608 |
1,578 |
$148K |
| 99213 |
|
3,950 |
3,612 |
$141K |
| 94060 |
|
1,175 |
1,150 |
$139K |
| 80307 |
|
23,119 |
21,444 |
$138K |
| 64400 |
|
1,058 |
937 |
$133K |
| 76642 |
|
3,548 |
3,504 |
$130K |
| 76536 |
|
2,729 |
2,714 |
$128K |
| C9803 |
Hopd covid-19 spec collect |
23,200 |
22,337 |
$124K |
| 95811 |
|
313 |
292 |
$123K |
| 96366 |
|
7,420 |
5,138 |
$122K |
| 36415 |
|
236,161 |
174,528 |
$117K |
| 87480 |
|
22,302 |
21,453 |
$116K |
| 87660 |
|
22,302 |
21,454 |
$116K |
| 86900 |
|
16,923 |
15,880 |
$113K |
| 58571 |
|
27 |
24 |
$113K |
| 87510 |
|
21,804 |
20,969 |
$108K |
| 10061 |
|
651 |
641 |
$107K |
| 77063 |
|
8,336 |
8,328 |
$100K |
| 99204 |
|
1,147 |
1,126 |
$98K |
| 92523 |
|
886 |
884 |
$98K |
| 99232 |
|
2,795 |
787 |
$95K |
| 87801 |
|
3,899 |
3,748 |
$90K |
| 43235 |
|
299 |
275 |
$89K |
| 73221 |
|
747 |
719 |
$89K |
| 58558 |
|
77 |
76 |
$87K |
| 97597 |
|
1,122 |
753 |
$87K |
| 83036 |
|
21,426 |
21,207 |
$86K |
| C8928 |
Tte w or w/o fol w/con,stres |
766 |
762 |
$84K |
| 78452 |
|
962 |
937 |
$84K |
| 93005 |
|
65,887 |
56,227 |
$83K |
| 29799 |
|
1,298 |
1,277 |
$83K |
| 96367 |
|
3,031 |
2,197 |
$83K |
| 70496 |
|
713 |
699 |
$82K |
| 76881 |
|
1,505 |
1,483 |
$82K |
| 97166 |
|
1,734 |
1,708 |
$80K |
| 11042 |
|
533 |
346 |
$79K |
| 95913 |
|
306 |
302 |
$76K |
| 87624 |
|
4,625 |
4,611 |
$76K |
| 83970 |
|
5,068 |
4,906 |
$75K |
| 95782 |
|
150 |
149 |
$75K |
| 36430 |
|
569 |
453 |
$71K |
| 87389 |
|
7,929 |
7,887 |
$67K |
| 88305 |
|
15,892 |
15,023 |
$67K |
| 71250 |
|
1,433 |
1,419 |
$66K |
| 77065 |
Tomosynthesis, mammo |
1,673 |
1,541 |
$66K |
| 87635 |
|
2,500 |
2,355 |
$63K |
| 87086 |
|
38,239 |
36,193 |
$63K |
| 96415 |
|
1,366 |
940 |
$62K |
| G0145 |
Scr c/v cyto,thinlayer,rescr |
4,960 |
4,949 |
$61K |
| Q5104 |
Injection, renflexis |
71 |
64 |
$61K |
| 77066 |
Tomosynthesis, mammo |
1,141 |
1,121 |
$61K |
| 97165 |
|
1,377 |
1,347 |
$58K |
| 95909 |
|
408 |
402 |
$56K |
| 93017 |
|
3,053 |
2,996 |
$56K |
| 73564 |
|
3,938 |
3,840 |
$55K |
| 95910 |
|
422 |
408 |
$54K |
| 45378 |
|
259 |
231 |
$54K |
| 76700 |
|
915 |
905 |
$53K |
| 97116 |
|
4,222 |
1,704 |
$52K |
| 70491 |
|
583 |
571 |
$52K |
| 87661 |
|
4,327 |
4,166 |
$51K |
| 74178 |
|
379 |
376 |
$51K |
| 72110 |
|
2,690 |
2,670 |
$51K |
| 74019 |
|
5,176 |
5,034 |
$51K |
| 29515 |
|
764 |
744 |
$50K |
| 80048 |
|
31,028 |
26,310 |
$49K |
| 71271 |
|
917 |
917 |
$49K |
| 86780 |
|
7,263 |
7,209 |
$49K |
| 96372 |
|
41,865 |
34,610 |
$48K |
| 82728 |
|
9,432 |
9,150 |
$46K |
| 36591 |
|
2,745 |
1,665 |
$46K |
| 87481 |
|
3,886 |
3,737 |
$45K |
| G0480 |
Drug test def 1-7 classes |
9,591 |
8,451 |
$44K |
| 88342 |
|
8,567 |
6,566 |
$42K |
| 96417 |
|
1,101 |
647 |
$42K |
| 82607 |
|
8,257 |
8,136 |
$41K |
| 99203 |
|
744 |
738 |
$41K |
| 76870 |
|
1,575 |
1,538 |
$40K |
| 99233 |
Prolong inpt eval add15 m |
816 |
328 |
$40K |
| 94726 |
|
1,955 |
1,898 |
$38K |
| 84439 |
|
13,616 |
13,316 |
$38K |
| G0108 |
Diab manage trn per indiv |
584 |
507 |
$34K |
| 87653 |
|
3,146 |
3,116 |
$34K |
| 85027 |
|
19,736 |
17,996 |
$33K |
| 84702 |
|
10,853 |
8,204 |
$32K |
| 80074 |
|
1,733 |
1,725 |
$31K |
| 83550 |
|
8,951 |
8,809 |
$30K |
| 77336 |
|
559 |
236 |
$30K |
| 77080 |
|
541 |
540 |
$29K |
| 76882 |
|
667 |
656 |
$29K |
| 73030 |
|
4,215 |
3,958 |
$28K |
| 70486 |
|
1,272 |
1,263 |
$28K |
| 82746 |
|
5,846 |
5,743 |
$27K |
| 99223 |
Prolong inpt eval add15 m |
272 |
250 |
$27K |
| 19083 |
|
39 |
39 |
$26K |
| 77412 |
|
230 |
25 |
$26K |
| J2505 |
Injection, pegfilgrastim 6mg |
19 |
13 |
$25K |
| G0279 |
Tomosynthesis, mammo |
2,466 |
2,390 |
$25K |
| 72125 |
|
2,764 |
2,719 |
$24K |
| 99239 |
|
456 |
431 |
$24K |
| 87507 |
|
250 |
245 |
$24K |
| 87186 |
|
11,173 |
10,338 |
$24K |
| C8929 |
Tte w or wo fol wcon,doppler |
275 |
269 |
$24K |
| 83540 |
|
9,156 |
9,003 |
$23K |
| 74018 |
|
2,252 |
2,146 |
$22K |
| 97022 |
|
4,055 |
1,223 |
$22K |
| 90670 |
|
141 |
138 |
$21K |
| 82043 |
|
8,549 |
8,390 |
$21K |
| 73130 |
|
3,797 |
3,631 |
$20K |
| P9016 |
Rbc leukocytes reduced |
261 |
215 |
$20K |
| 73630 |
|
4,075 |
3,920 |
$19K |
| 99222 |
|
301 |
263 |
$19K |
| 86803 |
|
3,730 |
3,710 |
$19K |
| 82570 |
|
10,385 |
9,553 |
$19K |
| 84403 |
|
1,569 |
1,550 |
$19K |
| 83735 |
|
43,936 |
35,652 |
$18K |
| 86480 |
|
683 |
677 |
$18K |
| 90686 |
|
1,315 |
1,295 |
$18K |
| 87340 |
|
5,540 |
5,503 |
$18K |
| 78227 |
|
75 |
75 |
$18K |
| 86140 |
|
30,523 |
26,734 |
$16K |
| 93880 |
|
232 |
227 |
$16K |
| 41899 |
|
158 |
154 |
$16K |
| 81001 |
|
57,414 |
52,617 |
$15K |
| 72050 |
|
407 |
402 |
$15K |
| 86850 |
|
15,004 |
14,150 |
$15K |
| 73610 |
|
3,717 |
3,528 |
$15K |
| 87651 |
|
5,743 |
5,669 |
$14K |
| 86038 |
|
2,809 |
2,785 |
$14K |
| 88341 |
|
2,035 |
1,419 |
$14K |
| 87077 |
|
6,523 |
5,783 |
$14K |
| 84146 |
|
2,664 |
2,611 |
$14K |
| 97163 |
|
318 |
316 |
$13K |
| 73502 |
|
1,937 |
1,884 |
$13K |
| 77334 |
|
44 |
25 |
$13K |
| 72072 |
|
701 |
696 |
$13K |
| 85610 |
|
20,989 |
16,842 |
$13K |
| J1453 |
Fosaprepitant injection |
399 |
241 |
$12K |
| 88175 |
|
1,070 |
1,068 |
$12K |
| 88307 |
|
1,563 |
1,337 |
$12K |
| 73700 |
|
255 |
255 |
$12K |
| 87522 |
Neg quan hep c or qual rna |
663 |
646 |
$12K |
| 83516 |
|
1,150 |
1,021 |
$12K |
| 86762 |
|
3,026 |
2,993 |
$12K |
| 87070 |
|
5,044 |
4,686 |
$12K |
| 87081 |
|
6,298 |
6,153 |
$12K |
| 84481 |
|
1,697 |
1,675 |
$12K |
| 86003 |
|
299 |
287 |
$11K |
| M0245 |
Bamlan and etesev infusion |
47 |
47 |
$11K |
| 84153 |
|
1,432 |
1,410 |
$11K |
| 72100 |
|
350 |
344 |
$11K |
| 82248 |
|
7,535 |
6,459 |
$11K |
| 83001 |
|
1,247 |
1,242 |
$11K |
| 96523 |
|
617 |
546 |
$11K |
| 92610 |
|
409 |
399 |
$11K |
| G0103 |
Psa screening |
1,281 |
1,278 |
$11K |
| 73110 |
|
2,283 |
2,187 |
$11K |
| 97535 |
|
1,429 |
991 |
$10K |
| 87631 |
|
5,457 |
5,328 |
$10K |
| 83880 |
|
5,792 |
5,327 |
$10K |
| 87502 |
|
3,227 |
3,153 |
$9K |
| 72158 |
|
74 |
74 |
$9K |
| J0561 |
Penicillin g benzathine inj |
93 |
92 |
$9K |
| 82565 |
|
9,274 |
8,043 |
$9K |
| 83655 |
|
1,424 |
1,421 |
$8K |
| 97035 |
|
1,799 |
723 |
$8K |
| 93308 |
|
96 |
95 |
$8K |
| 20610 |
|
156 |
136 |
$8K |
| G0008 |
Admin influenza virus vac |
1,165 |
1,149 |
$8K |
| 80076 |
|
3,033 |
2,859 |
$8K |
| 84550 |
|
7,081 |
6,589 |
$8K |
| 84100 |
|
17,672 |
14,943 |
$8K |
| 86364 |
|
1,361 |
782 |
$8K |
| 82784 |
|
1,568 |
1,459 |
$8K |
| 93225 |
|
410 |
405 |
$8K |
| U0002 |
Covid-19 lab test non-cdc |
291 |
286 |
$8K |
| 83002 |
|
795 |
793 |
$7K |
| 70498 |
|
630 |
619 |
$7K |
| 72040 |
|
507 |
505 |
$7K |
| 84156 |
|
6,338 |
5,639 |
$6K |
| 86258 |
|
1,069 |
537 |
$6K |
| C9145 |
Inj, aponvie, 1 mg |
360 |
355 |
$6K |
| 82950 |
|
2,850 |
2,834 |
$6K |
| 88304 |
|
2,651 |
2,516 |
$6K |
| 10060 |
|
76 |
73 |
$6K |
| 99221 |
|
124 |
111 |
$6K |
| 43450 |
|
30 |
30 |
$6K |
| 29505 |
|
88 |
87 |
$6K |
| 82670 |
|
439 |
436 |
$6K |
| 87088 |
|
2,180 |
2,135 |
$6K |
| 77300 |
|
43 |
38 |
$6K |
| 76885 |
|
142 |
141 |
$6K |
| 86769 |
|
171 |
86 |
$5K |
| G0297 |
Ldct for lung ca screen |
157 |
157 |
$5K |
| 87640 |
|
539 |
533 |
$5K |
| 87899 |
|
831 |
607 |
$5K |
| 82247 |
|
2,243 |
1,716 |
$5K |
| 76000 |
|
779 |
744 |
$5K |
| 84460 |
|
3,654 |
3,331 |
$5K |
| 86870 |
|
57 |
54 |
$5K |
| 84450 |
|
3,604 |
3,298 |
$5K |
| 84134 |
|
1,151 |
1,089 |
$5K |
| 87641 |
|
537 |
531 |
$5K |
| 87205 |
|
5,264 |
4,636 |
$5K |
| 94640 |
|
11,993 |
8,402 |
$5K |
| 82550 |
|
12,522 |
10,641 |
$5K |
| 81003 |
|
31,814 |
30,167 |
$5K |
| 72131 |
|
128 |
126 |
$4K |
| 80069 |
|
1,257 |
1,104 |
$4K |
| 80164 |
|
1,472 |
1,372 |
$4K |
| 83020 |
|
4,404 |
4,157 |
$4K |
| 86430 |
|
1,612 |
1,605 |
$4K |
| J2405 |
Ondansetron hcl injection |
40,841 |
31,493 |
$4K |
| 83690 |
|
34,432 |
30,816 |
$4K |
| 73080 |
|
1,066 |
1,048 |
$4K |
| 84703 |
|
8,004 |
7,775 |
$4K |
| 86901 |
|
16,929 |
15,882 |
$4K |
| 85652 |
|
4,734 |
4,395 |
$4K |
| 85730 |
|
9,420 |
8,594 |
$4K |
| 74183 |
|
26 |
24 |
$4K |
| 90471 |
|
497 |
471 |
$4K |
| 82378 |
|
787 |
668 |
$4K |
| 84480 |
|
726 |
716 |
$4K |
| G0121 |
Colon ca scrn not hi rsk ind |
16 |
15 |
$4K |
| J3010 |
Fentanyl citrate injection |
24,255 |
18,218 |
$4K |
| 73590 |
|
1,503 |
1,443 |
$4K |
| 73140 |
|
960 |
922 |
$4K |
| 82105 |
|
590 |
586 |
$4K |
| 82330 |
|
5,490 |
4,916 |
$4K |
| 95886 |
|
3,130 |
3,036 |
$4K |
| 84425 |
|
462 |
460 |
$4K |
| 83021 |
|
635 |
633 |
$4K |
| 97014 |
|
472 |
199 |
$3K |
| 76815 |
|
4,138 |
3,648 |
$3K |
| 84520 |
|
2,338 |
2,188 |
$3K |
| 86160 |
|
492 |
442 |
$3K |
| 83615 |
|
4,971 |
4,207 |
$3K |
| 71101 |
|
505 |
498 |
$3K |
| 93923 |
|
66 |
65 |
$3K |
| 87634 |
|
155 |
155 |
$3K |
| 99215 |
Prolong outpt/office vis |
39 |
37 |
$3K |
| 82951 |
|
509 |
509 |
$3K |
| 84402 |
|
234 |
232 |
$3K |
| 83993 |
|
338 |
336 |
$3K |
| 88142 |
|
272 |
272 |
$3K |
| L4350 |
Ankle control ortho pre ots |
60 |
59 |
$3K |
| 86200 |
|
487 |
486 |
$3K |
| 82274 |
|
514 |
504 |
$3K |
| 81025 |
|
40,163 |
37,463 |
$2K |
| A9502 |
Tc99m tetrofosmin |
970 |
945 |
$2K |
| C8925 |
2d tee w or w/o fol w/con,in |
13 |
13 |
$2K |
| 72170 |
|
973 |
947 |
$2K |
| 82150 |
|
2,920 |
2,827 |
$2K |
| 93798 |
|
41 |
12 |
$2K |
| 87040 |
|
6,952 |
4,433 |
$2K |
| G0109 |
Diab manage trn ind/group |
82 |
55 |
$2K |
| 77290 |
|
12 |
12 |
$2K |
| 99238 |
|
53 |
53 |
$2K |
| 73090 |
|
1,255 |
1,160 |
$2K |
| 82140 |
|
1,408 |
1,268 |
$2K |
| 87880 |
|
3,685 |
3,611 |
$2K |
| 87493 |
|
296 |
290 |
$2K |
| 94729 |
|
2,040 |
1,980 |
$2K |
| 80197 |
|
325 |
188 |
$2K |
| J0585 |
Injection,onabotulinumtoxina |
12 |
12 |
$2K |
| 80051 |
|
859 |
829 |
$2K |
| 76641 |
|
39 |
38 |
$2K |
| 86235 |
|
113 |
63 |
$2K |
| 74022 |
|
3,221 |
3,128 |
$2K |
| 97033 |
|
228 |
93 |
$2K |
| 82533 |
|
282 |
264 |
$2K |
| 72146 |
|
16 |
16 |
$2K |
| 86706 |
|
371 |
366 |
$2K |
| 84165 |
|
442 |
434 |
$2K |
| 87046 |
|
607 |
592 |
$2K |
| 85046 |
|
1,752 |
1,334 |
$2K |
| 87045 |
|
607 |
592 |
$2K |
| 86765 |
|
469 |
238 |
$2K |
| 93350 |
|
12 |
12 |
$2K |
| 83013 |
|
51 |
51 |
$2K |
| 88104 |
|
236 |
225 |
$1K |
| 82785 |
|
194 |
193 |
$1K |
| 87015 |
|
766 |
741 |
$1K |
| 85651 |
|
1,799 |
1,654 |
$1K |
| 72156 |
|
13 |
13 |
$1K |
| 87075 |
|
924 |
852 |
$1K |
| 76604 |
|
153 |
153 |
$1K |
| 85379 |
|
5,874 |
5,685 |
$1K |
| 95819 |
|
14 |
13 |
$1K |
| 0241U |
|
5,198 |
5,067 |
$1K |
| 93000 |
|
140 |
135 |
$1K |
| 97167 |
|
24 |
24 |
$1K |
| 73522 |
|
52 |
50 |
$1K |
| 84145 |
|
10,338 |
9,566 |
$1K |
| 73560 |
|
1,044 |
994 |
$1K |
| 86147 |
|
37 |
30 |
$1K |
| 86403 |
|
1,262 |
1,233 |
$1K |
| Q9969 |
Non-heu tc-99m add-on/dose |
308 |
305 |
$1K |
| 83521 |
|
161 |
77 |
$1K |
| 99394 |
|
14 |
14 |
$1K |
| 84484 |
|
40,796 |
29,848 |
$1K |
| 76805 |
|
17 |
16 |
$990.58 |
| 76818 |
|
17 |
13 |
$990.42 |
| 90715 |
|
2,953 |
2,935 |
$943.44 |
| 95806 |
|
12 |
12 |
$892.65 |
| 94010 |
|
1,166 |
1,142 |
$892.53 |
| 87328 |
|
215 |
207 |
$890.34 |
| J7050 |
Normal saline solution infus |
54,209 |
27,040 |
$852.90 |
| 85018 |
|
2,074 |
1,628 |
$848.22 |
| 86787 |
|
234 |
232 |
$808.45 |
| 87329 |
|
217 |
208 |
$803.63 |
| 87529 |
|
40 |
38 |
$800.47 |
| 86376 |
|
120 |
120 |
$789.30 |
| 86694 |
|
118 |
117 |
$734.57 |
| 99231 |
|
52 |
14 |
$703.68 |
| 86304 |
|
163 |
146 |
$683.86 |
| 73552 |
|
314 |
288 |
$680.53 |
| J2785 |
Regadenoson injection |
184 |
174 |
$678.76 |
| 84132 |
|
4,706 |
4,235 |
$667.60 |
| 82952 |
|
366 |
366 |
$649.23 |
| 82553 |
|
8,970 |
7,463 |
$632.96 |
| 84155 |
|
506 |
498 |
$622.49 |
| 93320 |
|
1,319 |
1,286 |
$611.88 |
| 86225 |
|
100 |
98 |
$602.51 |
| G0009 |
Admin pneumococcal vaccine |
93 |
92 |
$602.00 |
| 84590 |
|
181 |
180 |
$598.87 |
| 82077 |
|
11,552 |
10,138 |
$588.22 |
| 86920 |
|
686 |
429 |
$546.95 |
| 99202 |
|
14 |
14 |
$539.41 |
| 29125 |
|
1,044 |
1,014 |
$508.60 |
| J1040 |
Methylprednisolone 80 mg inj |
53 |
52 |
$497.88 |
| 82805 |
|
3,743 |
3,433 |
$446.34 |
| 88184 |
|
12 |
12 |
$445.93 |
| 0001A |
|
14 |
14 |
$426.35 |
| 51798 |
|
2,074 |
1,993 |
$418.77 |
| 90656 |
|
24 |
24 |
$411.75 |
| 87798 |
|
18 |
14 |
$392.11 |
| 94760 |
|
22,703 |
20,844 |
$391.32 |
| 84144 |
|
38 |
37 |
$378.72 |
| 93226 |
|
319 |
315 |
$368.30 |
| 83605 |
|
18,991 |
15,341 |
$351.75 |
| J0558 |
Peng benzathine/procaine inj |
12 |
12 |
$333.85 |
| 82977 |
|
129 |
119 |
$330.33 |
| 99212 |
|
15 |
15 |
$304.87 |
| 86665 |
|
34 |
27 |
$301.93 |
| J1885 |
Ketorolac tromethamine inj |
34,927 |
30,313 |
$294.87 |
| 87209 |
|
99 |
95 |
$293.41 |
| 12002 |
|
683 |
679 |
$278.83 |
| 87177 |
|
98 |
94 |
$274.66 |
| 73060 |
|
172 |
168 |
$271.60 |
| 85384 |
|
2,063 |
1,810 |
$271.08 |
| 84630 |
|
70 |
69 |
$253.35 |
| 80178 |
|
113 |
110 |
$248.10 |
| 86696 |
|
38 |
37 |
$247.83 |
| 80177 |
|
83 |
80 |
$240.98 |
| 70360 |
|
80 |
79 |
$238.09 |
| 90472 |
|
24 |
24 |
$237.65 |
| 88302 |
|
255 |
230 |
$224.55 |
| J3490 |
Drugs unclassified injection |
49,063 |
24,521 |
$212.75 |
| 86800 |
|
26 |
26 |
$208.29 |
| 86923 |
|
52 |
38 |
$204.57 |
| 73562 |
|
15 |
14 |
$191.68 |
| 86704 |
|
42 |
41 |
$185.29 |
| 83014 |
|
51 |
51 |
$177.84 |
| 93325 |
|
1,452 |
1,411 |
$177.81 |
| 12011 |
|
995 |
987 |
$172.00 |
| 12001 |
|
1,643 |
1,632 |
$172.00 |
| 76817 |
|
2,369 |
2,227 |
$171.45 |
| 86695 |
|
38 |
37 |
$169.81 |
| 82310 |
|
82 |
80 |
$169.13 |
| 85014 |
|
507 |
413 |
$165.77 |
| 82040 |
|
125 |
114 |
$162.41 |
| G0123 |
Screen cerv/vag thin layer |
16 |
16 |
$158.34 |
| J2250 |
Inj midazolam hydrochloride |
14,775 |
13,378 |
$148.87 |
| 97012 |
|
24 |
12 |
$147.99 |
| 87252 |
|
12 |
12 |
$147.40 |
| 83525 |
|
24 |
24 |
$145.74 |
| 82575 |
|
40 |
40 |
$143.17 |
| J7030 |
Normal saline solution infus |
34,657 |
29,498 |
$138.65 |
| 82627 |
|
13 |
13 |
$134.00 |
| 86039 |
|
26 |
26 |
$128.40 |
| 85613 |
|
40 |
39 |
$127.40 |
| 83930 |
|
609 |
594 |
$125.03 |
| 82731 |
|
12 |
12 |
$123.16 |
| 94664 |
|
5,257 |
4,711 |
$112.30 |
| 84295 |
|
3,403 |
3,205 |
$108.44 |
| 82088 |
|
12 |
12 |
$107.38 |
| 85576 |
|
90 |
56 |
$107.34 |
| 86677 |
|
15 |
15 |
$102.64 |
| 94799 |
|
8,154 |
7,667 |
$99.14 |
| Q9957 |
Inj perflutren lip micros,ml |
1,655 |
1,636 |
$98.28 |
| 82010 |
|
2,113 |
1,888 |
$88.79 |
| 85460 |
|
1,379 |
1,318 |
$80.29 |
| 84466 |
|
14 |
14 |
$77.73 |
| J2704 |
Inj, propofol, 10 mg |
18,589 |
17,842 |
$76.00 |
| 82103 |
|
15 |
15 |
$69.10 |
| 94150 |
|
1,062 |
1,018 |
$68.93 |
| J7120 |
Ringers lactate infusion |
15,488 |
13,375 |
$64.23 |
| 73660 |
|
24 |
24 |
$63.21 |
| 93041 |
|
726 |
656 |
$56.82 |
| 83630 |
|
41 |
40 |
$55.42 |
| 89051 |
|
144 |
120 |
$54.66 |
| 84244 |
|
12 |
12 |
$54.29 |
| 86255 |
|
27 |
27 |
$51.59 |
| 82270 |
|
31 |
29 |
$46.83 |
| 82747 |
|
12 |
12 |
$42.56 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
17,699 |
16,988 |
$41.63 |
| J1100 |
Dexamethasone sodium phos |
21,698 |
18,837 |
$41.11 |
| 85660 |
|
13 |
13 |
$38.02 |
| J2930 |
Methylprednisolone injection |
2,832 |
2,339 |
$36.51 |
| 83520 |
|
15 |
14 |
$35.88 |
| 96376 |
|
11,230 |
8,021 |
$34.32 |
| 80143 |
|
1,333 |
1,265 |
$34.27 |
| 51702 |
|
1,539 |
1,487 |
$29.64 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
677 |
668 |
$28.42 |
| J2360 |
Orphenadrine injection |
1,476 |
1,444 |
$25.05 |
| 83090 |
|
14 |
14 |
$24.68 |
| J0696 |
Ceftriaxone sodium injection |
8,974 |
7,244 |
$20.48 |
| J2270 |
Morphine sulfate injection |
14,241 |
10,956 |
$19.12 |
| 77002 |
|
81 |
80 |
$15.85 |
| J1200 |
Diphenhydramine hcl injectio |
10,472 |
9,058 |
$13.08 |
| J3480 |
Inj potassium chloride |
3,726 |
2,538 |
$12.31 |
| J0780 |
Prochlorperazine injection |
2,934 |
2,731 |
$11.31 |
| 80179 |
|
1,196 |
1,163 |
$11.09 |
| J0280 |
Aminophyllin 250 mg inj |
349 |
342 |
$10.00 |
| J0690 |
Cefazolin sodium injection |
9,709 |
7,327 |
$9.04 |
| J2550 |
Promethazine hcl injection |
1,628 |
1,337 |
$8.12 |
| 82375 |
|
27 |
24 |
$6.94 |
| J1630 |
Haloperidol injection |
2,488 |
2,171 |
$6.07 |
| A9270 |
Non-covered item or service |
22,756 |
4,849 |
$5.95 |
| 82435 |
|
3,326 |
3,156 |
$5.55 |
| J2765 |
Metoclopramide hcl injection |
4,040 |
3,524 |
$3.48 |
| J1642 |
Inj heparin sodium per 10 u |
10,109 |
4,176 |
$2.50 |
| J1790 |
Droperidol injection |
3,003 |
2,715 |
$0.57 |
| J3535 |
Metered dose inhaler drug |
58 |
58 |
$0.52 |
| J1170 |
Hydromorphone injection |
19,298 |
12,877 |
$0.39 |
| J2060 |
Lorazepam injection |
4,185 |
3,456 |
$0.21 |
| C1751 |
Cath, inf, per/cent/midline |
779 |
743 |
$0.00 |
| J1756 |
Iron sucrose injection |
3,084 |
1,237 |
$0.00 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
3,754 |
3,669 |
$0.00 |
| 76937 |
|
100 |
93 |
$0.00 |
| J7040 |
Normal saline solution infus |
1,157 |
832 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
6,632 |
3,205 |
$0.00 |
| 82800 |
|
844 |
785 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
5,456 |
4,187 |
$0.00 |
| A9552 |
F18 fdg |
255 |
253 |
$0.00 |
| J3370 |
Vancomycin hcl injection |
1,600 |
945 |
$0.00 |
| J1580 |
Garamycin gentamicin inj |
131 |
111 |
$0.00 |
| C1887 |
Catheter, guiding |
694 |
663 |
$0.00 |
| J1245 |
Dipyridamole injection |
320 |
316 |
$0.00 |
| G8978 |
Mobility current status |
232 |
189 |
$0.00 |
| 0353U |
|
875 |
839 |
$0.00 |
| A9537 |
Tc99m mebrofenin |
73 |
73 |
$0.00 |
| 3078F |
|
1,075 |
987 |
$0.00 |
| 88173 |
|
40 |
37 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
1,157 |
1,062 |
$0.00 |
| 76981 |
|
193 |
191 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
84 |
81 |
$0.00 |
| C1758 |
Catheter, ureteral |
24 |
24 |
$0.00 |
| J3250 |
Trimethobenzamide hcl inj |
158 |
151 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
281 |
227 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
128 |
127 |
$0.00 |
| J0702 |
Betamethasone acet&sod phosp |
331 |
190 |
$0.00 |
| G1004 |
Cdsm ndsc |
700 |
468 |
$0.00 |
| 85347 |
|
75 |
70 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
559 |
457 |
$0.00 |
| 76942 |
|
153 |
148 |
$0.00 |
| J1953 |
Levetiracetam injection |
234 |
183 |
$0.00 |
| A9541 |
Tc99m sulfur colloid |
43 |
43 |
$0.00 |
| J0737 |
Inj, clindamycin (baxter) |
65 |
57 |
$0.00 |
| G8979 |
Mobility goal status |
278 |
225 |
$0.00 |
| C1729 |
Cath, drainage |
250 |
151 |
$0.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
188 |
78 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
66 |
66 |
$0.00 |
| 97150 |
|
12 |
12 |
$0.00 |
| 86922 |
|
38 |
24 |
$0.00 |
| C1776 |
Joint device (implantable) |
38 |
38 |
$0.00 |
| 93356 |
|
26 |
26 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
319 |
238 |
$0.00 |
| A4556 |
Electrodes, pair |
919 |
914 |
$0.00 |
| 96368 |
|
861 |
642 |
$0.00 |
| J7999 |
Compounded drug, noc |
5,798 |
4,693 |
$0.00 |
| J3360 |
Diazepam injection |
368 |
313 |
$0.00 |
| J0500 |
Dicyclomine injection |
746 |
722 |
$0.00 |
| J0360 |
Hydralazine hcl injection |
613 |
453 |
$0.00 |
| J7060 |
5% dextrose/water |
1,438 |
524 |
$0.00 |
| C1769 |
Guide wire |
1,249 |
1,204 |
$0.00 |
| 0352U |
|
1,711 |
1,653 |
$0.00 |
| J3411 |
Thiamine hcl 100 mg |
371 |
295 |
$0.00 |
| J2001 |
Lidocaine injection |
2,861 |
2,820 |
$0.00 |
| 94660 |
|
108 |
51 |
$0.00 |
| J2920 |
Methylprednisolone injection |
248 |
120 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
383 |
336 |
$0.00 |
| J1626 |
Granisetron hcl injection |
712 |
340 |
$0.00 |
| J7042 |
5% dextrose/normal saline |
254 |
179 |
$0.00 |
| 3075F |
|
86 |
86 |
$0.00 |
| 3079F |
|
220 |
215 |
$0.00 |
| 3074F |
|
1,074 |
993 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
179 |
92 |
$0.00 |
| J2175 |
Meperidine hydrochl /100 mg |
102 |
94 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
87 |
87 |
$0.00 |
| 0346T |
|
96 |
95 |
$0.00 |
| J2805 |
Sincalide injection |
49 |
49 |
$0.00 |
| 82945 |
|
29 |
26 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
97 |
38 |
$0.00 |
| J1940 |
Furosemide injection |
168 |
104 |
$0.00 |
| 29130 |
|
56 |
55 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
469 |
453 |
$0.00 |
| 86921 |
|
58 |
36 |
$0.00 |
| 3008F |
|
79 |
76 |
$0.00 |
| 36416 |
|
19 |
18 |
$0.00 |
| 64402 |
|
20 |
13 |
$0.00 |
| 84157 |
|
41 |
38 |
$0.00 |
| A4217 |
Sterile water/saline, 500 ml |
143 |
101 |
$0.00 |
| 0240U |
|
28 |
28 |
$0.00 |
| J1250 |
Inj dobutamine hcl/250 mg |
12 |
12 |
$0.00 |
| 88185 |
|
18 |
12 |
$0.00 |
| 96377 |
|
16 |
12 |
$0.00 |