| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
106,183 |
99,411 |
$12.01M |
| 96361 |
|
38,821 |
32,103 |
$11.09M |
| 99284 |
|
53,110 |
48,901 |
$6.39M |
| 99212 |
|
53,198 |
48,272 |
$4.71M |
| 99285 |
|
37,358 |
32,224 |
$4.57M |
| U0003 |
Cov-19 amp prb hgh thruput |
23,681 |
22,421 |
$4.39M |
| 99282 |
|
29,614 |
28,638 |
$3.25M |
| 74177 |
|
13,117 |
11,663 |
$2.99M |
| 97110 |
|
33,041 |
9,900 |
$2.43M |
| 99213 |
|
24,434 |
21,017 |
$2.34M |
| 70450 |
|
8,271 |
7,323 |
$1.67M |
| J9271 |
Inj pembrolizumab |
187 |
150 |
$1.45M |
| G0378 |
Hospital observation per hr |
20,839 |
10,107 |
$1.37M |
| 95810 |
|
2,519 |
2,439 |
$1.37M |
| 43239 |
|
5,054 |
4,740 |
$1.36M |
| 59025 |
|
8,007 |
3,343 |
$1.24M |
| 80053 |
|
90,637 |
78,871 |
$1.21M |
| 96365 |
|
10,483 |
7,499 |
$1.06M |
| 87651 |
|
34,875 |
31,851 |
$994K |
| 96360 |
|
5,599 |
4,346 |
$956K |
| 96366 |
|
4,115 |
2,114 |
$871K |
| 87491 |
|
19,546 |
17,723 |
$841K |
| 84443 |
|
42,475 |
38,174 |
$837K |
| 96413 |
|
8,418 |
4,650 |
$827K |
| 45380 |
|
2,502 |
2,332 |
$811K |
| 74176 |
|
2,919 |
2,563 |
$791K |
| 95811 |
|
1,641 |
1,591 |
$778K |
| 93306 |
|
3,407 |
3,160 |
$764K |
| 71275 |
|
2,777 |
2,383 |
$694K |
| 80048 |
|
89,904 |
75,664 |
$614K |
| 80061 |
|
38,289 |
35,556 |
$555K |
| 95886 |
|
2,319 |
2,222 |
$543K |
| 71260 |
|
2,471 |
2,223 |
$540K |
| 87591 |
|
19,540 |
17,749 |
$505K |
| 45385 |
|
877 |
776 |
$484K |
| 92507 |
|
6,866 |
2,480 |
$470K |
| 76856 |
|
2,764 |
2,481 |
$466K |
| 71046 |
|
14,330 |
13,348 |
$452K |
| 85025 |
|
156,297 |
129,139 |
$443K |
| H0015 |
Alcohol and/or drug services |
2,817 |
620 |
$416K |
| 70551 |
|
2,060 |
1,916 |
$365K |
| 97533 |
|
4,868 |
1,699 |
$364K |
| 62323 |
|
935 |
861 |
$361K |
| 87502 |
|
21,024 |
19,285 |
$355K |
| 93458 |
|
434 |
372 |
$342K |
| 78452 |
|
892 |
807 |
$341K |
| 87661 |
|
13,730 |
12,379 |
$327K |
| 80307 |
|
14,230 |
11,659 |
$306K |
| 69436 |
|
662 |
312 |
$291K |
| 36475 |
|
170 |
107 |
$289K |
| 97112 |
|
5,456 |
2,272 |
$289K |
| 47563 |
|
122 |
99 |
$278K |
| 30802 |
|
152 |
127 |
$266K |
| 87086 |
|
28,419 |
24,645 |
$260K |
| 94640 |
|
3,061 |
1,965 |
$259K |
| 76705 |
|
3,293 |
2,922 |
$251K |
| 87624 |
|
6,288 |
5,958 |
$251K |
| 78815 |
|
470 |
444 |
$248K |
| 88175 |
|
11,938 |
11,420 |
$241K |
| 45378 |
|
465 |
382 |
$237K |
| 36415 |
|
204,157 |
160,458 |
$234K |
| 85027 |
|
27,753 |
24,410 |
$232K |
| 93971 |
|
2,846 |
2,206 |
$227K |
| 82306 |
|
10,282 |
9,244 |
$226K |
| 70496 |
|
857 |
753 |
$226K |
| 94060 |
|
2,039 |
1,931 |
$219K |
| 42820 |
|
275 |
225 |
$216K |
| 84439 |
|
15,911 |
14,074 |
$210K |
| 97161 |
|
2,988 |
2,696 |
$207K |
| 87635 |
|
24,632 |
22,160 |
$205K |
| 96415 |
|
864 |
556 |
$200K |
| 93308 |
|
840 |
733 |
$197K |
| 73721 |
|
888 |
833 |
$193K |
| 97140 |
|
5,986 |
2,384 |
$192K |
| 70553 |
|
810 |
738 |
$192K |
| 72148 |
|
1,135 |
1,044 |
$190K |
| 71250 |
|
1,979 |
1,871 |
$189K |
| 93350 |
|
801 |
705 |
$185K |
| U0005 |
Infec agen detec ampli probe |
16,551 |
15,645 |
$179K |
| 82607 |
|
8,525 |
7,590 |
$179K |
| 0241U |
|
1,025 |
920 |
$178K |
| J0561 |
Penicillin g benzathine inj |
942 |
749 |
$176K |
| 77063 |
|
3,501 |
3,216 |
$172K |
| 93970 |
|
1,271 |
1,178 |
$162K |
| 73630 |
|
5,113 |
4,293 |
$154K |
| 84484 |
|
40,837 |
26,989 |
$154K |
| 76642 |
|
1,440 |
1,179 |
$145K |
| 74178 |
|
621 |
579 |
$144K |
| 83036 |
|
21,997 |
19,960 |
$140K |
| 11042 |
|
1,586 |
961 |
$138K |
| 71271 |
|
762 |
712 |
$135K |
| 83655 |
|
5,079 |
4,812 |
$133K |
| 87637 |
|
3,681 |
3,248 |
$132K |
| J0897 |
Denosumab injection |
159 |
142 |
$131K |
| 76536 |
|
1,307 |
1,218 |
$130K |
| 93017 |
|
1,991 |
1,790 |
$128K |
| 97162 |
|
2,013 |
1,798 |
$127K |
| 70491 |
|
476 |
418 |
$126K |
| J3490 |
Drugs unclassified injection |
85,639 |
36,616 |
$121K |
| 12001 |
|
806 |
676 |
$120K |
| 95816 |
|
919 |
878 |
$117K |
| 99281 |
|
965 |
871 |
$112K |
| 96367 |
|
2,593 |
1,847 |
$111K |
| 97597 |
|
1,816 |
1,245 |
$107K |
| 72141 |
|
659 |
597 |
$106K |
| G0463 |
Hospital outpt clinic visit |
11,876 |
10,138 |
$105K |
| 94729 |
|
2,114 |
2,004 |
$101K |
| 73221 |
|
523 |
478 |
$100K |
| 76775 |
|
1,141 |
1,065 |
$97K |
| 93270 |
|
1,300 |
1,194 |
$95K |
| 94726 |
|
1,863 |
1,763 |
$94K |
| 84481 |
|
5,955 |
5,318 |
$93K |
| 74018 |
|
2,268 |
2,025 |
$93K |
| 36430 |
|
474 |
294 |
$92K |
| J9299 |
Injection, nivolumab |
35 |
12 |
$91K |
| 93976 |
|
1,100 |
971 |
$91K |
| 99214 |
|
1,178 |
1,016 |
$90K |
| 82728 |
|
6,283 |
5,625 |
$90K |
| 43248 |
|
419 |
361 |
$90K |
| 94762 |
|
3,310 |
1,751 |
$89K |
| 76830 |
|
2,140 |
1,886 |
$87K |
| 88305 |
|
17,202 |
9,904 |
$86K |
| 76700 |
|
517 |
484 |
$85K |
| 84702 |
|
4,100 |
2,791 |
$85K |
| 86850 |
|
5,192 |
4,299 |
$84K |
| 80076 |
|
19,209 |
17,202 |
$83K |
| 73562 |
|
3,215 |
2,691 |
$83K |
| 73610 |
|
3,123 |
2,709 |
$82K |
| 74183 |
|
351 |
321 |
$80K |
| 93005 |
|
55,795 |
48,666 |
$79K |
| 80081 |
|
2,930 |
2,455 |
$77K |
| J1439 |
Inj ferric carboxymaltos 1mg |
118 |
76 |
$76K |
| 99211 |
|
1,018 |
744 |
$76K |
| 72110 |
|
1,722 |
1,583 |
$73K |
| 90853 |
|
1,819 |
485 |
$73K |
| 86780 |
|
3,163 |
2,655 |
$72K |
| 86703 |
|
3,346 |
2,827 |
$72K |
| 73130 |
|
3,082 |
2,624 |
$72K |
| 72100 |
|
1,998 |
1,815 |
$71K |
| P9016 |
Rbc leukocytes reduced |
409 |
264 |
$70K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
1,181 |
973 |
$69K |
| 73030 |
|
2,808 |
2,388 |
$66K |
| 81001 |
|
58,974 |
53,375 |
$65K |
| 20553 |
|
473 |
405 |
$64K |
| 76770 |
|
458 |
424 |
$64K |
| 97165 |
|
963 |
864 |
$64K |
| 76805 |
|
558 |
534 |
$63K |
| 90791 |
|
553 |
499 |
$62K |
| 12011 |
|
405 |
347 |
$61K |
| 86900 |
|
5,411 |
4,427 |
$59K |
| 64493 |
|
217 |
117 |
$59K |
| 99203 |
|
609 |
548 |
$59K |
| 10060 |
|
420 |
365 |
$59K |
| 80074 |
|
3,212 |
2,750 |
$59K |
| 87070 |
|
4,711 |
4,251 |
$58K |
| 95885 |
|
245 |
238 |
$57K |
| 97035 |
|
1,074 |
411 |
$57K |
| 43249 |
|
185 |
172 |
$56K |
| 93925 |
|
543 |
519 |
$56K |
| 86803 |
|
3,024 |
2,511 |
$56K |
| 83735 |
|
26,465 |
20,619 |
$54K |
| 80069 |
|
4,917 |
3,900 |
$54K |
| 73110 |
|
2,085 |
1,801 |
$54K |
| 90832 |
|
1,189 |
728 |
$52K |
| 71045 |
|
30,426 |
27,743 |
$52K |
| 70544 |
|
282 |
269 |
$51K |
| 92557 |
|
490 |
456 |
$51K |
| 75574 |
|
146 |
133 |
$49K |
| 93880 |
|
763 |
735 |
$48K |
| 95806 |
|
212 |
201 |
$48K |
| 72125 |
|
2,208 |
1,916 |
$47K |
| 27096 |
|
198 |
104 |
$46K |
| C9290 |
Inj, bupivacaine liposome |
507 |
371 |
$46K |
| 97116 |
|
1,639 |
797 |
$46K |
| 93922 |
|
710 |
680 |
$46K |
| 77067 |
|
3,475 |
3,217 |
$45K |
| 87633 |
|
628 |
510 |
$45K |
| 86140 |
|
6,833 |
6,083 |
$45K |
| 82565 |
|
6,972 |
6,267 |
$44K |
| 87077 |
|
4,745 |
4,095 |
$44K |
| 52260 |
|
46 |
39 |
$43K |
| 84153 |
|
2,604 |
2,311 |
$43K |
| 87798 |
|
2,356 |
1,832 |
$42K |
| 87636 |
|
1,365 |
1,151 |
$41K |
| 99215 |
Prolong outpt/office vis |
679 |
589 |
$41K |
| 72050 |
|
720 |
656 |
$41K |
| 70486 |
|
896 |
789 |
$41K |
| 82570 |
|
5,907 |
5,251 |
$41K |
| 96372 |
|
19,582 |
15,841 |
$40K |
| 72072 |
|
1,034 |
931 |
$39K |
| 97530 |
|
985 |
462 |
$39K |
| 87186 |
|
5,953 |
5,134 |
$38K |
| 76801 |
|
723 |
609 |
$38K |
| 29848 |
|
26 |
26 |
$38K |
| 72131 |
|
611 |
544 |
$38K |
| 76882 |
|
375 |
336 |
$38K |
| 95911 |
|
352 |
329 |
$37K |
| 72040 |
|
809 |
740 |
$37K |
| 86038 |
|
2,310 |
1,990 |
$37K |
| 73502 |
|
1,448 |
1,289 |
$36K |
| G0480 |
Drug test def 1-7 classes |
1,677 |
1,411 |
$35K |
| 82746 |
|
3,032 |
2,674 |
$35K |
| 83970 |
|
1,503 |
1,350 |
$35K |
| 87801 |
|
3,781 |
3,297 |
$35K |
| 12002 |
|
253 |
217 |
$34K |
| 97113 |
|
501 |
285 |
$34K |
| 77336 |
|
461 |
215 |
$34K |
| C1776 |
Joint device (implantable) |
128 |
101 |
$34K |
| 70498 |
|
915 |
815 |
$34K |
| 88112 |
|
888 |
807 |
$33K |
| M0243 |
Casirivi and imdevi inj |
82 |
82 |
$33K |
| 87522 |
Neg quan hep c or qual rna |
1,107 |
922 |
$33K |
| 74174 |
|
291 |
270 |
$32K |
| 83540 |
|
4,242 |
3,751 |
$32K |
| 88341 |
|
765 |
429 |
$32K |
| S9445 |
Pt education noc individ |
803 |
681 |
$31K |
| 52356 |
|
20 |
13 |
$31K |
| 87493 |
|
958 |
829 |
$30K |
| 84403 |
|
1,482 |
1,272 |
$30K |
| 84450 |
|
5,476 |
4,810 |
$30K |
| 93325 |
|
402 |
362 |
$30K |
| 87400 |
|
1,560 |
750 |
$30K |
| 86592 |
|
1,079 |
930 |
$29K |
| 85652 |
|
8,639 |
7,634 |
$28K |
| 96374 |
|
46,521 |
41,664 |
$28K |
| 73120 |
|
852 |
404 |
$28K |
| 83605 |
|
14,410 |
11,086 |
$28K |
| 85610 |
|
7,705 |
5,528 |
$28K |
| 84460 |
|
5,812 |
5,127 |
$28K |
| 97598 |
|
125 |
82 |
$27K |
| 87081 |
|
2,175 |
1,887 |
$27K |
| 77080 |
|
382 |
351 |
$27K |
| 43235 |
|
115 |
105 |
$27K |
| 82043 |
|
4,531 |
4,210 |
$26K |
| 80320 |
|
2,789 |
2,233 |
$26K |
| 77334 |
|
182 |
61 |
$26K |
| 84146 |
|
1,376 |
1,165 |
$26K |
| 96523 |
|
677 |
465 |
$26K |
| 64483 |
|
55 |
45 |
$25K |
| 87340 |
|
1,657 |
1,365 |
$25K |
| 90837 |
|
269 |
172 |
$25K |
| 74019 |
|
355 |
321 |
$25K |
| 90715 |
|
1,901 |
1,636 |
$25K |
| 73080 |
|
1,199 |
1,057 |
$24K |
| 88307 |
|
393 |
307 |
$23K |
| 47562 |
|
15 |
14 |
$23K |
| 83516 |
|
1,476 |
965 |
$23K |
| 84270 |
|
1,289 |
1,104 |
$23K |
| 86901 |
|
5,398 |
4,428 |
$23K |
| 86160 |
|
2,259 |
1,022 |
$23K |
| J2469 |
Palonosetron hcl |
1,870 |
1,037 |
$23K |
| 73140 |
|
740 |
657 |
$22K |
| 83001 |
|
981 |
823 |
$22K |
| 87902 |
|
156 |
130 |
$22K |
| 77065 |
Tomosynthesis, mammo |
589 |
473 |
$21K |
| J1756 |
Iron sucrose injection |
897 |
515 |
$20K |
| 64415 |
|
143 |
116 |
$20K |
| 97166 |
|
259 |
247 |
$20K |
| 27447 |
|
13 |
13 |
$19K |
| 86480 |
|
644 |
548 |
$19K |
| 82962 |
|
17,003 |
9,330 |
$18K |
| 82784 |
|
1,514 |
1,231 |
$18K |
| 82533 |
|
733 |
579 |
$18K |
| 77386 |
|
91 |
12 |
$18K |
| 82105 |
|
917 |
820 |
$17K |
| 83550 |
|
3,156 |
2,818 |
$17K |
| U0002 |
Covid-19 lab test non-cdc |
814 |
768 |
$17K |
| 73560 |
|
799 |
559 |
$17K |
| 73521 |
|
528 |
392 |
$17K |
| 82040 |
|
1,749 |
1,400 |
$16K |
| 86431 |
|
1,947 |
1,716 |
$16K |
| 82247 |
|
2,017 |
1,167 |
$16K |
| 64400 |
|
58 |
42 |
$16K |
| 73590 |
|
1,057 |
867 |
$15K |
| 86200 |
|
1,506 |
1,380 |
$15K |
| 93303 |
|
49 |
41 |
$15K |
| 86235 |
|
1,407 |
673 |
$15K |
| 92567 |
|
863 |
807 |
$15K |
| 88342 |
|
1,472 |
1,244 |
$15K |
| 80349 |
|
768 |
596 |
$15K |
| 20552 |
|
119 |
110 |
$15K |
| 87046 |
|
1,785 |
797 |
$14K |
| 86706 |
|
1,194 |
981 |
$14K |
| 93312 |
|
63 |
62 |
$14K |
| 88738 |
|
2,069 |
1,966 |
$14K |
| 83690 |
|
30,322 |
27,182 |
$14K |
| 82805 |
|
590 |
500 |
$14K |
| 86618 |
|
887 |
747 |
$14K |
| 82950 |
|
1,493 |
1,177 |
$14K |
| 76870 |
|
429 |
380 |
$14K |
| 82248 |
|
2,047 |
1,553 |
$13K |
| 95909 |
|
276 |
266 |
$13K |
| 97535 |
|
489 |
381 |
$13K |
| 83880 |
|
4,314 |
3,616 |
$13K |
| 86696 |
|
694 |
534 |
$13K |
| 71101 |
|
639 |
580 |
$13K |
| 78227 |
|
44 |
42 |
$13K |
| 20611 |
|
52 |
37 |
$13K |
| 94664 |
|
4,982 |
3,891 |
$12K |
| J1453 |
Fosaprepitant injection |
718 |
417 |
$12K |
| 87045 |
|
923 |
797 |
$12K |
| 77066 |
Tomosynthesis, mammo |
335 |
308 |
$12K |
| 73090 |
|
856 |
758 |
$12K |
| 94618 |
|
179 |
168 |
$12K |
| J2790 |
Rho d immune globulin inj |
168 |
141 |
$11K |
| 96375 |
|
37,733 |
30,065 |
$11K |
| 86376 |
|
638 |
551 |
$11K |
| 92523 |
|
168 |
157 |
$11K |
| 87205 |
|
5,304 |
4,007 |
$11K |
| 72052 |
|
232 |
218 |
$11K |
| 82550 |
|
2,265 |
1,830 |
$10K |
| C1725 |
Cath, translumin non-laser |
280 |
240 |
$10K |
| 96376 |
|
6,162 |
3,410 |
$10K |
| 86256 |
|
791 |
736 |
$10K |
| 93225 |
|
97 |
88 |
$10K |
| J0640 |
Leucovorin calcium injection |
314 |
127 |
$10K |
| 86704 |
|
596 |
461 |
$10K |
| 20610 |
|
107 |
71 |
$10K |
| 83002 |
|
655 |
543 |
$10K |
| 73700 |
|
88 |
79 |
$10K |
| 95913 |
|
232 |
217 |
$10K |
| 90834 |
|
163 |
108 |
$9K |
| 84550 |
|
2,515 |
1,997 |
$9K |
| 73200 |
|
85 |
79 |
$9K |
| 77300 |
|
71 |
23 |
$9K |
| 83721 |
|
829 |
756 |
$9K |
| 90471 |
|
2,522 |
2,103 |
$9K |
| 97150 |
|
297 |
117 |
$9K |
| 84480 |
|
702 |
598 |
$9K |
| 80197 |
|
597 |
269 |
$8K |
| 86695 |
|
512 |
417 |
$8K |
| 0240U |
|
47 |
38 |
$8K |
| 93799 |
|
450 |
79 |
$8K |
| G0279 |
Tomosynthesis, mammo |
730 |
643 |
$8K |
| 77295 |
|
14 |
12 |
$8K |
| 82627 |
|
287 |
229 |
$8K |
| 86920 |
|
355 |
226 |
$8K |
| 87147 |
|
1,499 |
1,309 |
$8K |
| 76817 |
|
191 |
150 |
$7K |
| 73060 |
|
446 |
402 |
$7K |
| 87328 |
|
698 |
596 |
$7K |
| 74160 |
|
74 |
70 |
$7K |
| 83525 |
|
300 |
261 |
$7K |
| 80164 |
|
484 |
404 |
$7K |
| 84100 |
|
1,861 |
1,453 |
$7K |
| C1769 |
Guide wire |
1,881 |
1,600 |
$6K |
| 72128 |
|
206 |
187 |
$6K |
| 87329 |
|
707 |
602 |
$6K |
| 81025 |
|
35,354 |
32,119 |
$6K |
| 94660 |
|
47 |
21 |
$6K |
| M0245 |
Bamlan and etesev infusion |
16 |
15 |
$6K |
| 84132 |
|
2,076 |
1,635 |
$6K |
| 81596 |
|
73 |
55 |
$6K |
| 80171 |
|
301 |
268 |
$6K |
| 84156 |
|
1,572 |
1,139 |
$6K |
| 73552 |
|
480 |
400 |
$6K |
| 82947 |
|
1,354 |
1,130 |
$5K |
| 82150 |
|
542 |
430 |
$5K |
| J7999 |
Compounded drug, noc |
4,353 |
2,765 |
$5K |
| 85018 |
|
1,878 |
1,274 |
$5K |
| 72082 |
|
64 |
55 |
$5K |
| 85014 |
|
1,425 |
1,002 |
$5K |
| 85379 |
|
3,939 |
3,408 |
$5K |
| 87088 |
|
706 |
608 |
$5K |
| 90686 |
|
400 |
361 |
$5K |
| 62321 |
|
15 |
12 |
$4K |
| 83520 |
|
219 |
185 |
$4K |
| J0500 |
Dicyclomine injection |
305 |
246 |
$4K |
| 86708 |
|
395 |
295 |
$4K |
| 72146 |
|
29 |
28 |
$4K |
| 87150 |
|
152 |
150 |
$4K |
| 93975 |
|
44 |
41 |
$4K |
| 83615 |
|
2,894 |
2,186 |
$4K |
| 82977 |
|
665 |
385 |
$4K |
| 77301 |
|
14 |
12 |
$4K |
| J8501 |
Oral aprepitant |
288 |
249 |
$4K |
| 82677 |
|
96 |
93 |
$4K |
| 80177 |
|
281 |
236 |
$4K |
| C1887 |
Catheter, guiding |
1,032 |
907 |
$4K |
| J1642 |
Inj heparin sodium per 10 u |
11,590 |
5,520 |
$4K |
| 82670 |
|
167 |
145 |
$4K |
| C1894 |
Intro/sheath, non-laser |
1,405 |
1,151 |
$4K |
| 84144 |
|
166 |
131 |
$4K |
| 84703 |
|
382 |
330 |
$4K |
| 97760 |
|
52 |
50 |
$3K |
| 84520 |
|
1,200 |
913 |
$3K |
| J7030 |
Normal saline solution infus |
52,535 |
44,280 |
$3K |
| 86308 |
|
542 |
455 |
$3K |
| 95908 |
|
86 |
86 |
$3K |
| 88304 |
|
1,525 |
1,252 |
$3K |
| 72170 |
|
941 |
810 |
$3K |
| 82140 |
|
567 |
466 |
$3K |
| 72158 |
|
13 |
13 |
$3K |
| 82951 |
|
128 |
112 |
$3K |
| 86147 |
|
135 |
50 |
$3K |
| 84445 |
|
116 |
99 |
$3K |
| 86334 |
|
154 |
126 |
$3K |
| 80324 |
|
128 |
106 |
$3K |
| 97014 |
|
65 |
38 |
$2K |
| C1893 |
Intro/sheath, fixed,non-peel |
49 |
38 |
$2K |
| 64450 |
|
45 |
32 |
$2K |
| 80051 |
|
291 |
215 |
$2K |
| 86665 |
|
119 |
46 |
$2K |
| 72156 |
|
12 |
12 |
$2K |
| 84075 |
|
551 |
321 |
$2K |
| 85730 |
|
1,947 |
1,463 |
$2K |
| 84681 |
|
159 |
132 |
$2K |
| 87040 |
|
3,641 |
1,887 |
$2K |
| 84145 |
|
2,798 |
2,363 |
$2K |
| 94010 |
|
27 |
24 |
$2K |
| J2704 |
Inj, propofol, 10 mg |
13,009 |
10,782 |
$2K |
| 82330 |
|
687 |
568 |
$2K |
| 81002 |
|
11,489 |
10,032 |
$2K |
| 85045 |
|
535 |
447 |
$2K |
| J1170 |
Hydromorphone injection |
7,163 |
4,255 |
$2K |
| 86225 |
|
140 |
114 |
$2K |
| 77002 |
|
25 |
17 |
$2K |
| C8929 |
Tte w or wo fol wcon,doppler |
40 |
40 |
$2K |
| 77470 |
|
15 |
13 |
$2K |
| 95910 |
|
74 |
71 |
$1K |
| 86694 |
|
120 |
91 |
$1K |
| J9045 |
Carboplatin injection |
158 |
99 |
$1K |
| 64447 |
|
29 |
25 |
$1K |
| 86705 |
|
113 |
78 |
$1K |
| G0260 |
Inj for sacroiliac jt anesth |
17 |
15 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
25,707 |
20,071 |
$1K |
| J2543 |
Piperacillin/tazobactam |
209 |
89 |
$1K |
| J0690 |
Cefazolin sodium injection |
5,494 |
3,902 |
$1K |
| 29125 |
|
545 |
474 |
$1K |
| T1002 |
Rn services up to 15 minutes |
54 |
38 |
$1K |
| 85597 |
|
20 |
12 |
$1K |
| 88142 |
|
66 |
65 |
$1K |
| 86709 |
|
136 |
97 |
$1K |
| 80178 |
|
125 |
114 |
$1K |
| 86336 |
|
96 |
93 |
$1K |
| 86762 |
|
55 |
50 |
$1K |
| J0736 |
Inj, clindamycin phosp 300mg |
899 |
662 |
$1K |
| 97803 |
|
12 |
12 |
$1K |
| 80359 |
|
114 |
94 |
$1K |
| 86880 |
|
136 |
116 |
$1K |
| J7040 |
Normal saline solution infus |
13,385 |
7,313 |
$1K |
| 84155 |
|
470 |
413 |
$1K |
| 86800 |
|
89 |
76 |
$1K |
| 36600 |
|
683 |
531 |
$1K |
| 84425 |
|
113 |
96 |
$1K |
| 82310 |
|
205 |
165 |
$987.18 |
| 97164 |
|
13 |
13 |
$981.14 |
| 86870 |
|
34 |
24 |
$927.14 |
| 92579 |
|
13 |
13 |
$922.64 |
| J1100 |
Dexamethasone sodium phos |
15,219 |
11,310 |
$919.69 |
| 77338 |
|
12 |
12 |
$918.74 |
| 87210 |
|
767 |
633 |
$908.31 |
| J0134 |
Inj acetaminophen -fresenius |
1,921 |
1,587 |
$907.23 |
| J3590 |
Unclassified biologics |
101 |
86 |
$901.71 |
| J0131 |
Inj, acetaminophen (nos) |
338 |
269 |
$874.82 |
| 85049 |
|
444 |
332 |
$853.59 |
| J7120 |
Ringers lactate infusion |
15,630 |
13,566 |
$850.76 |
| 74022 |
|
37 |
37 |
$836.27 |
| J2405 |
Ondansetron hcl injection |
34,977 |
29,535 |
$828.03 |
| J3535 |
Metered dose inhaler drug |
260 |
226 |
$817.83 |
| 83883 |
|
150 |
76 |
$777.89 |
| 29130 |
|
138 |
117 |
$756.16 |
| 72220 |
|
13 |
12 |
$751.36 |
| J3010 |
Fentanyl citrate injection |
13,328 |
11,153 |
$742.44 |
| 88173 |
|
116 |
87 |
$730.89 |
| 82803 |
|
777 |
599 |
$709.28 |
| Q0162 |
Ondansetron oral |
5,340 |
4,412 |
$690.56 |
| 86003 |
|
36 |
28 |
$690.46 |
| 76942 |
|
79 |
63 |
$684.18 |
| J2270 |
Morphine sulfate injection |
3,633 |
2,867 |
$680.25 |
| 36416 |
|
4,461 |
3,809 |
$668.67 |
| 70547 |
|
25 |
25 |
$657.75 |
| J1650 |
Inj enoxaparin sodium |
1,240 |
668 |
$656.83 |
| 85598 |
|
20 |
12 |
$656.10 |
| 96402 |
|
112 |
92 |
$655.71 |
| 00910 |
|
62 |
57 |
$649.68 |
| 96417 |
|
1,394 |
737 |
$619.99 |
| 80329 |
|
459 |
307 |
$612.86 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
28,856 |
24,639 |
$611.50 |
| J3370 |
Vancomycin hcl injection |
1,566 |
982 |
$604.24 |
| 00731 |
|
642 |
565 |
$587.53 |
| 00840 |
|
226 |
177 |
$586.38 |
| 00400 |
|
189 |
157 |
$585.25 |
| 82024 |
|
16 |
12 |
$560.88 |
| 00790 |
|
375 |
321 |
$553.97 |
| 29515 |
|
148 |
120 |
$546.61 |
| 86787 |
|
20 |
16 |
$545.39 |
| J1644 |
Inj heparin sodium per 1000u |
3,015 |
1,549 |
$479.58 |
| 81050 |
|
96 |
81 |
$452.19 |
| 73000 |
|
12 |
12 |
$428.23 |
| 77370 |
|
13 |
13 |
$426.98 |
| 71111 |
|
13 |
12 |
$419.94 |
| 83630 |
|
25 |
25 |
$413.69 |
| 82010 |
|
537 |
397 |
$399.78 |
| J2360 |
Orphenadrine injection |
1,394 |
1,158 |
$399.61 |
| 85635 |
|
20 |
12 |
$388.39 |
| C9113 |
Inj pantoprazole sodium, via |
1,028 |
691 |
$384.09 |
| 92610 |
|
13 |
13 |
$363.64 |
| 82553 |
|
20 |
12 |
$359.14 |
| 96368 |
|
226 |
158 |
$352.84 |
| 82378 |
|
76 |
62 |
$350.22 |
| J0696 |
Ceftriaxone sodium injection |
3,075 |
2,053 |
$349.96 |
| 85007 |
|
79 |
77 |
$349.00 |
| 88360 |
|
15 |
12 |
$337.48 |
| 90656 |
|
79 |
77 |
$333.91 |
| 82575 |
|
17 |
12 |
$331.49 |
| 00160 |
|
51 |
40 |
$321.69 |
| J7605 |
Arformoterol non-comp unit |
883 |
369 |
$320.01 |
| 99195 |
|
15 |
12 |
$312.50 |
| J2795 |
Ropivacaine hcl injection |
889 |
737 |
$300.21 |
| 51798 |
|
84 |
72 |
$267.77 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
389 |
212 |
$264.65 |
| J1250 |
Inj dobutamine hcl/250 mg |
208 |
182 |
$260.47 |
| 84295 |
|
690 |
542 |
$253.42 |
| 73660 |
|
15 |
13 |
$252.97 |
| 80354 |
|
76 |
64 |
$249.96 |
| 84305 |
|
15 |
12 |
$245.71 |
| 83993 |
|
18 |
16 |
$244.81 |
| J0171 |
Adrenalin epinephrine inject |
511 |
436 |
$218.90 |
| 82103 |
|
16 |
14 |
$207.53 |
| 85732 |
|
40 |
12 |
$204.22 |
| 80361 |
|
17 |
12 |
$202.54 |
| 85613 |
|
47 |
12 |
$196.22 |
| 85670 |
|
20 |
12 |
$187.34 |
| 82164 |
|
14 |
12 |
$181.26 |
| 84436 |
|
27 |
25 |
$178.19 |
| J1940 |
Furosemide injection |
970 |
576 |
$177.17 |
| 84466 |
|
14 |
12 |
$173.00 |
| J1953 |
Levetiracetam injection |
85 |
66 |
$170.44 |
| J2919 |
Inj, methylpred sod succ 5mg |
724 |
547 |
$168.65 |
| J2550 |
Promethazine hcl injection |
1,174 |
868 |
$161.70 |
| J1200 |
Diphenhydramine hcl injectio |
4,980 |
3,461 |
$157.43 |
| 82435 |
|
632 |
501 |
$157.06 |
| 80365 |
|
13 |
13 |
$151.03 |
| J3360 |
Diazepam injection |
146 |
114 |
$150.96 |
| J3475 |
Inj magnesium sulfate |
3,504 |
1,589 |
$143.55 |
| J2930 |
Methylprednisolone injection |
1,077 |
836 |
$141.50 |
| J2920 |
Methylprednisolone injection |
418 |
267 |
$131.65 |
| 82375 |
|
598 |
506 |
$128.04 |
| J0360 |
Hydralazine hcl injection |
282 |
229 |
$120.02 |
| J0780 |
Prochlorperazine injection |
848 |
691 |
$118.90 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
2,806 |
2,420 |
$118.20 |
| J3301 |
Triamcinolone acet inj nos |
956 |
871 |
$113.61 |
| J2765 |
Metoclopramide hcl injection |
1,880 |
1,407 |
$112.26 |
| J1030 |
Methylprednisolone 40 mg inj |
725 |
656 |
$111.97 |
| J2250 |
Inj midazolam hydrochloride |
13,740 |
12,023 |
$107.61 |
| J0692 |
Cefepime hcl for injection |
431 |
244 |
$107.19 |
| 85705 |
|
20 |
12 |
$102.11 |
| J2175 |
Meperidine hydrochl /100 mg |
4,872 |
4,517 |
$97.60 |
| J1580 |
Garamycin gentamicin inj |
776 |
611 |
$88.10 |
| J7512 |
Prednisone ir or dr oral 1mg |
2,221 |
1,667 |
$82.42 |
| J7510 |
Prednisolone oral per 5 mg |
653 |
518 |
$80.13 |
| 93321 |
|
14 |
14 |
$73.28 |
| J2060 |
Lorazepam injection |
1,043 |
767 |
$71.97 |
| J7050 |
Normal saline solution infus |
4,615 |
2,888 |
$71.72 |
| J1630 |
Haloperidol injection |
891 |
724 |
$67.62 |
| 89051 |
|
18 |
12 |
$57.33 |
| J3480 |
Inj potassium chloride |
994 |
481 |
$56.95 |
| 83050 |
|
593 |
502 |
$55.48 |
| J7620 |
Albuterol ipratrop non-comp |
4,164 |
2,632 |
$55.13 |
| 86146 |
|
20 |
12 |
$50.70 |
| J3420 |
Vitamin b12 injection |
112 |
77 |
$48.92 |
| J7060 |
5% dextrose/water |
1,111 |
603 |
$48.76 |
| J7070 |
D5w infusion |
764 |
305 |
$48.43 |
| J1040 |
Methylprednisolone 80 mg inj |
3,224 |
3,038 |
$38.77 |
| J0136 |
Inj, acetaminophen (b braun) |
115 |
104 |
$33.79 |
| 90472 |
|
12 |
12 |
$27.21 |
| J1335 |
Ertapenem injection |
24 |
14 |
$25.94 |
| J3411 |
Thiamine hcl 100 mg |
26 |
13 |
$22.99 |
| J0137 |
Inj, acetaminophen (hikma) |
61 |
50 |
$21.56 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
616 |
518 |
$20.31 |
| J2470 |
Inj pantoprazole sodium 40mg |
209 |
171 |
$19.29 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
2,030 |
1,638 |
$18.64 |
| J1010 |
Inj, methylpred acetate 1 mg |
473 |
445 |
$16.84 |
| J1956 |
Levofloxacin injection |
178 |
124 |
$15.96 |
| J2272 |
Inj, morphine (fresenius) |
15 |
15 |
$15.57 |
| 85347 |
|
85 |
69 |
$15.42 |
| J2710 |
Neostigmine methylslfte inj |
36 |
25 |
$14.77 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
1,080 |
794 |
$12.62 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
417 |
303 |
$11.52 |
| J7611 |
Albuterol non-comp con |
874 |
744 |
$9.35 |
| J9190 |
Fluorouracil injection |
184 |
67 |
$7.56 |
| J0461 |
Atropine sulfate injection |
49 |
27 |
$4.82 |
| J0456 |
Azithromycin |
161 |
107 |
$2.33 |
| J7613 |
Albuterol non-comp unit |
31 |
26 |
$2.22 |
| J1920 |
Inj, labetalol hcl, 5mg |
230 |
179 |
$1.71 |
| J1836 |
Inj, metronidazole, 10 mg |
40 |
26 |
$1.53 |
| J1805 |
Inj, esmolol hcl, 10mg |
14 |
13 |
$1.34 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
17 |
14 |
$0.90 |
| Q0245 |
Bamlanivimab and etesevima |
32 |
15 |
$0.29 |
| A9577 |
Inj multihance |
149 |
134 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
3,532 |
2,958 |
$0.00 |
| 01830 |
|
99 |
92 |
$0.00 |
| 00170 |
|
683 |
554 |
$0.00 |
| G1004 |
Cdsm ndsc |
565 |
374 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
133 |
125 |
$0.00 |
| 01810 |
|
368 |
324 |
$0.00 |
| 00811 |
|
112 |
87 |
$0.00 |
| Q9957 |
Inj perflutren lip micros,ml |
2,328 |
2,103 |
$0.00 |
| 82800 |
|
83 |
64 |
$0.00 |
| 76376 |
|
732 |
629 |
$0.00 |
| 00918 |
|
21 |
14 |
$0.00 |
| 20930 |
|
14 |
13 |
$0.00 |
| 95912 |
|
17 |
17 |
$0.00 |
| J2720 |
Inj protamine sulfate/10 mg |
12 |
12 |
$0.00 |
| 51702 |
|
26 |
24 |
$0.00 |
| 96549 |
|
181 |
65 |
$0.00 |
| Q0169 |
Promethazine hcl 12.5mg oral |
19 |
14 |
$0.00 |
| J8499 |
Oral prescrip drug non chemo |
26 |
25 |
$0.00 |
| 22853 |
|
26 |
13 |
$0.00 |
| 00300 |
|
57 |
43 |
$0.00 |
| 01402 |
|
14 |
14 |
$0.00 |
| J2785 |
Regadenoson injection |
713 |
658 |
$0.00 |
| A9270 |
Non-covered item or service |
2,000 |
1,515 |
$0.00 |
| 96411 |
|
482 |
244 |
$0.00 |
| 00813 |
|
558 |
495 |
$0.00 |
| C2617 |
Stent, non-cor, tem w/o del |
100 |
84 |
$0.00 |
| 88311 |
|
17 |
16 |
$0.00 |
| J0173 |
Inj, epinephrine (belcher) |
44 |
44 |
$0.00 |
| C1888 |
Endovas non-cardiac abl cath |
183 |
122 |
$0.00 |
| 01480 |
|
73 |
57 |
$0.00 |
| 93320 |
|
328 |
296 |
$0.00 |
| 77001 |
|
27 |
25 |
$0.00 |
| 00126 |
|
59 |
55 |
$0.00 |
| 64494 |
|
133 |
74 |
$0.00 |
| 00952 |
|
12 |
12 |
$0.00 |
| J9267 |
Paclitaxel injection |
25 |
12 |
$0.00 |
| J7042 |
5% dextrose/normal saline |
18 |
13 |
$0.00 |
| 01400 |
|
14 |
14 |
$0.00 |
| 95940 |
|
15 |
14 |
$0.00 |
| C1778 |
Lead, neurostimulator |
30 |
24 |
$0.00 |
| 95938 |
|
15 |
14 |
$0.00 |
| 94761 |
|
23 |
15 |
$0.00 |