| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
|
85,162 |
73,146 |
$3.91M |
| 74174 |
|
18,144 |
16,695 |
$1.27M |
| 99205 |
Prolong outpt/office vis |
10,957 |
9,883 |
$1.17M |
| 70450 |
|
22,420 |
20,388 |
$762K |
| 93005 |
|
81,920 |
68,740 |
$530K |
| 99283 |
|
58,174 |
55,235 |
$459K |
| 99215 |
Prolong outpt/office vis |
25,989 |
23,841 |
$446K |
| 99284 |
|
33,213 |
31,874 |
$426K |
| 0111 |
|
17,614 |
4,034 |
$400K |
| 0241U |
|
9,506 |
8,747 |
$374K |
| 72125 |
|
5,907 |
5,492 |
$373K |
| 71260 |
|
6,490 |
6,146 |
$352K |
| G9008 |
Mccd,phys coor-care ovrsght |
16,364 |
11,447 |
$352K |
| G0378 |
Hospital observation per hr |
1,501 |
908 |
$330K |
| 0510 |
|
21,021 |
18,121 |
$326K |
| 99199 |
|
6,623 |
6,038 |
$324K |
| 0200 |
|
4,823 |
1,253 |
$276K |
| 80048 |
|
57,175 |
47,777 |
$241K |
| 85025 |
|
80,747 |
67,564 |
$234K |
| U0003 |
Cov-19 amp prb hgh thruput |
9,510 |
8,543 |
$232K |
| J9271 |
Inj pembrolizumab |
2,631 |
1,870 |
$218K |
| 71045 |
|
54,060 |
43,796 |
$209K |
| G0463 |
Hospital outpt clinic visit |
5,436 |
4,600 |
$182K |
| 80076 |
|
30,197 |
26,794 |
$148K |
| 70486 |
|
2,327 |
2,161 |
$139K |
| 76700 |
|
6,401 |
6,051 |
$132K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
10,711 |
9,971 |
$123K |
| 0760 |
|
6,747 |
5,751 |
$121K |
| 99285 |
|
5,341 |
5,219 |
$118K |
| G9012 |
Other specified case mgmt |
535 |
382 |
$114K |
| 87491 |
|
11,483 |
10,674 |
$114K |
| 87591 |
|
11,868 |
11,103 |
$114K |
| J0741 |
Inj, cabote rilpivir 2mg 3mg |
554 |
482 |
$108K |
| 71046 |
|
24,260 |
22,543 |
$107K |
| 99282 |
|
48,737 |
45,624 |
$105K |
| 93010 |
|
11,133 |
9,180 |
$102K |
| 93971 |
|
5,369 |
4,903 |
$101K |
| 83880 |
|
5,924 |
5,376 |
$100K |
| 83690 |
|
19,761 |
17,506 |
$88K |
| 74177 |
|
1,667 |
1,645 |
$88K |
| 70498 |
|
1,684 |
1,557 |
$86K |
| 84484 |
|
11,643 |
10,161 |
$86K |
| 93970 |
|
3,403 |
3,050 |
$85K |
| 0250 |
|
60,532 |
44,220 |
$83K |
| 71275 |
|
2,270 |
2,121 |
$82K |
| 80053 |
|
47,118 |
39,370 |
$80K |
| U0005 |
Infec agen detec ampli probe |
17,856 |
15,822 |
$71K |
| J7030 |
Normal saline solution infus |
36,466 |
28,300 |
$68K |
| 96365 |
|
1,517 |
1,310 |
$68K |
| 0202U |
|
1,275 |
1,191 |
$65K |
| 83605 |
|
9,004 |
7,287 |
$65K |
| 93306 |
|
7,018 |
6,457 |
$63K |
| 73610 |
|
8,113 |
7,065 |
$63K |
| 73564 |
|
6,398 |
5,901 |
$62K |
| J1569 |
Gammagard liquid injection |
3,773 |
1,591 |
$60K |
| 70553 |
|
963 |
909 |
$59K |
| 86780 |
|
8,834 |
8,158 |
$58K |
| 73110 |
|
6,775 |
5,624 |
$56K |
| J2270 |
Morphine sulfate injection |
17,414 |
13,053 |
$50K |
| 76856 |
|
2,564 |
2,402 |
$46K |
| 76705 |
|
2,699 |
2,477 |
$45K |
| 87522 |
Neg quan hep c or qual rna |
6,240 |
5,963 |
$45K |
| 85610 |
|
31,424 |
25,266 |
$45K |
| J1885 |
Ketorolac tromethamine inj |
22,871 |
19,298 |
$44K |
| 86703 |
|
9,659 |
9,122 |
$44K |
| 70496 |
|
603 |
549 |
$44K |
| 73030 |
|
5,636 |
5,093 |
$43K |
| 73590 |
|
5,485 |
4,903 |
$42K |
| 99221 |
|
1,156 |
988 |
$40K |
| J2405 |
Ondansetron hcl injection |
32,927 |
25,141 |
$40K |
| 73130 |
|
5,313 |
4,747 |
$40K |
| 73080 |
|
3,845 |
3,432 |
$40K |
| J9306 |
Injection, pertuzumab, 1 mg |
996 |
653 |
$39K |
| 99281 |
|
11,111 |
10,521 |
$39K |
| P9016 |
Rbc leukocytes reduced |
2,037 |
1,495 |
$38K |
| 90715 |
|
4,926 |
4,272 |
$36K |
| 73090 |
|
4,364 |
3,762 |
$36K |
| 86141 |
|
8,538 |
7,801 |
$35K |
| S5551 |
Insulin most rapid 5 u |
7,809 |
2,619 |
$35K |
| 76801 |
|
2,272 |
1,927 |
$35K |
| 73630 |
|
5,619 |
5,141 |
$33K |
| 87536 |
|
2,978 |
2,915 |
$33K |
| J9145 |
Injection, daratumumab 10 mg |
862 |
518 |
$33K |
| J7120 |
Ringers lactate infusion |
23,932 |
18,351 |
$32K |
| J9041 |
Injection, bortezomib, 0.1mg |
1,847 |
617 |
$32K |
| 77066 |
Tomosynthesis, mammo |
1,547 |
1,503 |
$31K |
| 99232 |
|
1,028 |
356 |
$31K |
| 90792 |
|
6,123 |
5,191 |
$31K |
| J0696 |
Ceftriaxone sodium injection |
15,082 |
8,852 |
$31K |
| 86850 |
|
9,657 |
8,719 |
$31K |
| J1950 |
Leuprolide acetate /3.75 mg |
543 |
466 |
$30K |
| 0100 |
|
601 |
208 |
$29K |
| 92012 |
|
3,839 |
3,402 |
$29K |
| 87040 |
|
3,342 |
2,870 |
$28K |
| 80047 |
|
7,895 |
6,983 |
$28K |
| 82550 |
|
5,919 |
5,037 |
$27K |
| 84702 |
|
4,029 |
3,429 |
$26K |
| 88305 |
|
20,746 |
19,679 |
$25K |
| 81001 |
|
20,463 |
18,391 |
$25K |
| 80305 |
|
5,084 |
4,699 |
$25K |
| 87086 |
|
10,012 |
8,854 |
$25K |
| 73120 |
|
3,290 |
3,049 |
$23K |
| 85730 |
|
8,786 |
7,554 |
$23K |
| 70491 |
|
549 |
512 |
$22K |
| 76642 |
|
2,118 |
1,938 |
$22K |
| 86480 |
|
4,671 |
4,367 |
$22K |
| 76770 |
|
1,574 |
1,514 |
$22K |
| 36415 |
|
432,721 |
316,074 |
$22K |
| 87661 |
|
3,036 |
2,736 |
$21K |
| 86901 |
|
10,961 |
9,498 |
$21K |
| 73620 |
|
3,343 |
3,116 |
$21K |
| 73562 |
|
2,638 |
2,440 |
$20K |
| 71250 |
|
700 |
680 |
$20K |
| 82306 |
|
11,200 |
10,891 |
$20K |
| 73700 |
|
639 |
602 |
$19K |
| 76870 |
|
1,698 |
1,551 |
$19K |
| 86900 |
|
10,310 |
8,942 |
$19K |
| 99391 |
|
7,964 |
7,134 |
$19K |
| 73060 |
|
2,357 |
2,038 |
$18K |
| 99212 |
|
108,995 |
94,950 |
$18K |
| 59025 |
|
8,318 |
3,999 |
$17K |
| 83036 |
|
27,591 |
26,307 |
$17K |
| 19083 |
|
1,614 |
1,471 |
$17K |
| 80061 |
|
17,103 |
16,662 |
$16K |
| 88182 |
|
1,026 |
1,007 |
$16K |
| J2250 |
Inj midazolam hydrochloride |
16,498 |
15,462 |
$15K |
| 78452 |
|
405 |
385 |
$15K |
| 76830 |
|
833 |
744 |
$15K |
| 72100 |
|
2,332 |
2,206 |
$15K |
| J2560 |
Phenobarbital sodium inj |
263 |
209 |
$15K |
| J2704 |
Inj, propofol, 10 mg |
7,360 |
6,826 |
$15K |
| Q5118 |
Inj., zirabev, 10 mg |
2,553 |
1,300 |
$14K |
| 73552 |
|
1,946 |
1,758 |
$14K |
| 94760 |
|
10,125 |
5,515 |
$13K |
| 85027 |
|
16,382 |
13,362 |
$13K |
| 70551 |
|
268 |
262 |
$13K |
| 74176 |
|
441 |
413 |
$13K |
| Q5116 |
Inj., trazimera, 10 mg |
1,558 |
978 |
$13K |
| 99213 |
|
127,686 |
116,485 |
$13K |
| 74018 |
|
3,433 |
2,463 |
$13K |
| U0002 |
Covid-19 lab test non-cdc |
352 |
305 |
$12K |
| J1170 |
Hydromorphone injection |
10,711 |
6,567 |
$12K |
| 99381 |
|
1,626 |
1,497 |
$12K |
| J1630 |
Haloperidol injection |
7,620 |
6,143 |
$11K |
| 77065 |
Tomosynthesis, mammo |
523 |
514 |
$11K |
| 94640 |
|
1,564 |
1,288 |
$11K |
| 90677 |
|
3,452 |
2,827 |
$11K |
| J0178 |
Aflibercept injection |
439 |
421 |
$11K |
| 86360 |
|
1,634 |
1,563 |
$11K |
| 72148 |
|
149 |
136 |
$11K |
| J2001 |
Lidocaine injection |
4,863 |
4,519 |
$10K |
| 81000 |
|
24,741 |
20,253 |
$10K |
| 83735 |
|
8,674 |
5,127 |
$10K |
| J7297 |
Liletta, 52 mg |
229 |
225 |
$10K |
| J9299 |
Injection, nivolumab |
1,166 |
638 |
$10K |
| 72170 |
|
1,387 |
1,279 |
$10K |
| 80074 |
|
763 |
735 |
$10K |
| 99231 |
|
782 |
516 |
$9K |
| 97161 |
|
13,162 |
11,827 |
$9K |
| J1100 |
Dexamethasone sodium phos |
9,165 |
7,080 |
$9K |
| 88342 |
|
2,696 |
2,563 |
$9K |
| 86593 |
|
5,362 |
4,885 |
$9K |
| J0690 |
Cefazolin sodium injection |
6,717 |
5,290 |
$9K |
| J0561 |
Penicillin g benzathine inj |
252 |
177 |
$9K |
| 87186 |
|
2,685 |
2,480 |
$9K |
| 92557 |
|
4,018 |
3,737 |
$8K |
| J3010 |
Fentanyl citrate injection |
21,392 |
19,874 |
$8K |
| 0516 |
|
467 |
424 |
$8K |
| Q0162 |
Ondansetron oral |
28,601 |
19,275 |
$8K |
| 86592 |
|
5,245 |
4,703 |
$8K |
| 76815 |
|
843 |
641 |
$8K |
| 99222 |
|
132 |
127 |
$8K |
| 73502 |
|
882 |
815 |
$8K |
| 84443 |
|
3,717 |
3,583 |
$8K |
| P9011 |
Blood split unit |
838 |
588 |
$8K |
| 72141 |
|
82 |
79 |
$8K |
| 90750 |
|
3,430 |
2,755 |
$8K |
| 96374 |
|
496 |
456 |
$8K |
| J0780 |
Prochlorperazine injection |
3,498 |
3,144 |
$8K |
| 96413 |
|
3,856 |
2,532 |
$7K |
| 87340 |
|
4,000 |
3,818 |
$7K |
| 93017 |
|
1,735 |
1,634 |
$7K |
| J0490 |
Belimumab injection |
855 |
676 |
$7K |
| 99238 |
|
209 |
200 |
$7K |
| 87624 |
|
4,742 |
4,359 |
$7K |
| 86920 |
|
3,247 |
2,420 |
$7K |
| 84100 |
|
8,621 |
5,204 |
$6K |
| 70487 |
|
158 |
145 |
$6K |
| J1953 |
Levetiracetam injection |
2,546 |
1,685 |
$6K |
| J7050 |
Normal saline solution infus |
47,456 |
28,368 |
$6K |
| J0129 |
Abatacept injection |
757 |
629 |
$6K |
| 90791 |
|
1,128 |
1,023 |
$6K |
| J1750 |
Inj iron dextran |
499 |
443 |
$6K |
| 93303 |
|
1,239 |
1,172 |
$6K |
| 76805 |
|
478 |
345 |
$6K |
| J2765 |
Metoclopramide hcl injection |
4,985 |
3,869 |
$6K |
| 73501 |
|
560 |
529 |
$6K |
| 85378 |
|
1,558 |
1,450 |
$6K |
| 84439 |
|
4,610 |
4,357 |
$6K |
| 73140 |
|
1,777 |
1,603 |
$6K |
| J7040 |
Normal saline solution infus |
17,439 |
10,912 |
$6K |
| 96415 |
|
2,257 |
1,600 |
$5K |
| J2357 |
Omalizumab injection |
1,954 |
1,209 |
$5K |
| 90471 |
|
36,130 |
30,538 |
$5K |
| J9217 |
Leuprolide acetate suspnsion |
1,648 |
1,382 |
$5K |
| Q3014 |
Telehealth facility fee |
1,040 |
913 |
$5K |
| 87088 |
|
4,860 |
4,412 |
$5K |
| J1650 |
Inj enoxaparin sodium |
12,160 |
2,962 |
$5K |
| 67028 |
|
17 |
15 |
$5K |
| J3262 |
Tocilizumab injection |
486 |
380 |
$5K |
| J2060 |
Lorazepam injection |
6,273 |
4,845 |
$5K |
| 81003 |
|
6,329 |
5,728 |
$5K |
| 99202 |
|
6,352 |
6,192 |
$5K |
| 96110 |
|
4,912 |
4,321 |
$5K |
| J3475 |
Inj magnesium sulfate |
7,841 |
5,211 |
$5K |
| 0113 |
|
191 |
54 |
$5K |
| 77067 |
|
3,013 |
2,824 |
$5K |
| 97110 |
|
24,622 |
14,959 |
$5K |
| 82962 |
|
12,956 |
10,433 |
$5K |
| 99243 |
|
2,510 |
2,417 |
$5K |
| J9267 |
Paclitaxel injection |
2,755 |
1,233 |
$5K |
| J2997 |
Alteplase recombinant |
98 |
75 |
$5K |
| 81015 |
|
5,731 |
5,340 |
$5K |
| 96372 |
|
982 |
898 |
$4K |
| 99244 |
|
932 |
905 |
$4K |
| 73503 |
|
347 |
316 |
$4K |
| 85652 |
|
5,483 |
5,164 |
$4K |
| J1642 |
Inj heparin sodium per 10 u |
3,461 |
1,778 |
$4K |
| 73000 |
|
571 |
497 |
$4K |
| J1644 |
Inj heparin sodium per 1000u |
10,465 |
3,403 |
$4K |
| Q0144 |
Azithromycin dihydrate, oral |
1,911 |
1,572 |
$4K |
| 80422 |
|
1,020 |
872 |
$4K |
| 76811 |
|
1,038 |
879 |
$4K |
| 88187 |
|
9,850 |
8,841 |
$4K |
| J3370 |
Vancomycin hcl injection |
4,541 |
1,958 |
$4K |
| 90723 |
|
1,109 |
922 |
$4K |
| 74181 |
|
37 |
36 |
$4K |
| 51702 |
|
1,822 |
1,706 |
$4K |
| 90651 |
|
1,685 |
1,454 |
$4K |
| 73070 |
|
841 |
707 |
$4K |
| C9803 |
Hopd covid-19 spec collect |
393 |
370 |
$4K |
| 90935 |
|
1,475 |
555 |
$4K |
| 82140 |
|
436 |
409 |
$4K |
| 99442 |
|
61,793 |
56,164 |
$4K |
| J1200 |
Diphenhydramine hcl injectio |
7,199 |
6,007 |
$4K |
| 87210 |
|
3,845 |
3,566 |
$3K |
| 99395 |
|
1,591 |
1,464 |
$3K |
| 83970 |
|
1,173 |
1,133 |
$3K |
| J1940 |
Furosemide injection |
4,286 |
2,494 |
$3K |
| 82607 |
|
2,177 |
2,127 |
$3K |
| 73100 |
|
1,218 |
1,047 |
$3K |
| 82728 |
|
3,271 |
3,212 |
$3K |
| J3480 |
Inj potassium chloride |
3,387 |
1,769 |
$3K |
| 83026 |
|
3,654 |
3,423 |
$3K |
| 86705 |
|
2,022 |
1,984 |
$3K |
| A4216 |
Sterile water/saline, 10 ml |
1,563 |
1,103 |
$3K |
| 96375 |
|
273 |
237 |
$3K |
| 86706 |
|
2,743 |
2,673 |
$3K |
| J0585 |
Injection,onabotulinumtoxina |
1,032 |
986 |
$3K |
| J2182 |
Injection, mepolizumab, 1mg |
81 |
64 |
$3K |
| 92134 |
|
3,853 |
3,450 |
$3K |
| S0164 |
Injection pantroprazole |
4,905 |
1,286 |
$3K |
| 88341 |
|
250 |
240 |
$3K |
| 84703 |
|
1,517 |
1,296 |
$3K |
| 95810 |
|
1,207 |
1,094 |
$3K |
| 72040 |
|
727 |
691 |
$3K |
| J8540 |
Oral dexamethasone |
12,414 |
6,288 |
$3K |
| 99392 |
|
9,927 |
8,892 |
$3K |
| 88304 |
|
2,449 |
2,379 |
$3K |
| 72158 |
|
38 |
38 |
$3K |
| 87633 |
|
12 |
12 |
$3K |
| 74170 |
|
66 |
64 |
$3K |
| 88142 |
|
8,891 |
8,240 |
$3K |
| 99203 |
|
22,598 |
21,472 |
$3K |
| 87205 |
|
2,693 |
2,372 |
$3K |
| 85007 |
|
2,752 |
2,192 |
$3K |
| J9171 |
Docetaxel injection |
550 |
357 |
$3K |
| 90680 |
|
655 |
528 |
$3K |
| 29075 |
|
1,770 |
1,592 |
$3K |
| 93880 |
|
406 |
371 |
$3K |
| 99291 |
|
20 |
12 |
$3K |
| 82746 |
|
1,307 |
1,281 |
$3K |
| 84153 |
|
2,400 |
2,209 |
$3K |
| 92250 |
|
2,852 |
2,588 |
$3K |
| J1050 |
Medroxyprogesterone acetate |
2,348 |
2,098 |
$2K |
| 92235 |
|
2,162 |
1,773 |
$2K |
| 29705 |
|
2,192 |
1,907 |
$2K |
| J7307 |
Etonogestrel implant system |
17 |
15 |
$2K |
| J2930 |
Methylprednisolone injection |
2,504 |
1,841 |
$2K |
| 90670 |
|
647 |
531 |
$2K |
| 83550 |
|
3,220 |
3,167 |
$2K |
| 93922 |
|
697 |
614 |
$2K |
| 81002 |
|
3,648 |
3,515 |
$2K |
| 92014 |
|
1,259 |
1,095 |
$2K |
| 96417 |
|
906 |
678 |
$2K |
| 99393 |
|
4,736 |
4,372 |
$2K |
| J1580 |
Garamycin gentamicin inj |
633 |
574 |
$2K |
| 90686 |
|
7,404 |
6,193 |
$2K |
| 88309 |
|
50 |
48 |
$2K |
| 78815 |
|
13 |
13 |
$2K |
| 87635 |
|
292 |
269 |
$2K |
| 99242 |
|
360 |
349 |
$2K |
| 83540 |
|
3,326 |
3,267 |
$2K |
| 86762 |
|
528 |
503 |
$2K |
| 0300 |
|
7,887 |
6,885 |
$2K |
| 87070 |
|
1,779 |
1,595 |
$2K |
| 73600 |
|
395 |
356 |
$2K |
| 94660 |
|
607 |
230 |
$2K |
| J9070 |
Cyclophosphamide 100 mg inj |
347 |
232 |
$2K |
| 76536 |
|
228 |
211 |
$2K |
| 95811 |
|
966 |
863 |
$2K |
| 51798 |
|
861 |
833 |
$2K |
| 92550 |
|
1,446 |
1,347 |
$2K |
| 84403 |
|
676 |
643 |
$2K |
| 83615 |
|
2,271 |
1,853 |
$2K |
| 86160 |
|
826 |
795 |
$2K |
| J2315 |
Naltrexone, depot form |
43 |
41 |
$2K |
| 95909 |
|
1,230 |
1,141 |
$2K |
| 99394 |
|
3,033 |
2,822 |
$1K |
| 99396 |
|
500 |
475 |
$1K |
| 99211 |
|
228,745 |
156,184 |
$1K |
| 82248 |
|
2,132 |
1,939 |
$1K |
| 99443 |
|
28,224 |
25,968 |
$1K |
| 92591 |
|
453 |
425 |
$1K |
| G0390 |
Trauma respons w/hosp criti |
51 |
50 |
$1K |
| 99254 |
|
31 |
26 |
$1K |
| 81025 |
|
5,257 |
4,375 |
$1K |
| J9190 |
Fluorouracil injection |
4,611 |
2,301 |
$1K |
| J0461 |
Atropine sulfate injection |
1,519 |
797 |
$1K |
| J7642 |
Glycopyrrolate comp con |
1,432 |
1,354 |
$1K |
| 97165 |
|
1,428 |
1,299 |
$1K |
| 80329 |
|
2,187 |
2,000 |
$1K |
| 82105 |
|
674 |
640 |
$1K |
| 87147 |
|
491 |
452 |
$1K |
| 89050 |
|
908 |
778 |
$1K |
| 99441 |
|
28,742 |
25,841 |
$1K |
| J3411 |
Thiamine hcl 100 mg |
1,102 |
680 |
$1K |
| 73560 |
|
318 |
301 |
$1K |
| J3360 |
Diazepam injection |
793 |
606 |
$1K |
| 90472 |
|
3,278 |
2,971 |
$1K |
| 90648 |
|
1,539 |
1,281 |
$1K |
| 82570 |
|
3,657 |
3,319 |
$1K |
| 82378 |
|
514 |
487 |
$1K |
| 92002 |
|
859 |
746 |
$1K |
| 86039 |
|
532 |
513 |
$997.54 |
| 51700 |
|
347 |
260 |
$976.16 |
| G0279 |
Tomosynthesis, mammo |
276 |
269 |
$953.43 |
| 85008 |
|
1,926 |
1,821 |
$952.35 |
| P9040 |
Rbc leukoreduced irradiated |
220 |
139 |
$943.91 |
| 82043 |
|
4,445 |
4,340 |
$917.57 |
| G9920 |
Scrning perf and negative |
1,749 |
1,535 |
$910.72 |
| 97530 |
|
2,076 |
1,395 |
$882.56 |
| 95911 |
|
665 |
598 |
$881.44 |
| J9263 |
Oxaliplatin |
2,718 |
1,415 |
$873.45 |
| 86304 |
|
1,231 |
1,062 |
$845.12 |
| 86708 |
|
502 |
487 |
$844.08 |
| 72131 |
|
15 |
12 |
$835.36 |
| 88173 |
|
923 |
884 |
$816.58 |
| Q0163 |
Diphenhydramine hcl 50mg |
23,724 |
15,190 |
$810.81 |
| 92133 |
|
1,120 |
1,019 |
$809.74 |
| 82010 |
|
163 |
143 |
$800.79 |
| 96366 |
|
422 |
347 |
$790.24 |
| 84146 |
|
299 |
286 |
$777.69 |
| J7611 |
Albuterol non-comp con |
1,328 |
1,165 |
$765.87 |
| 94726 |
|
410 |
396 |
$738.93 |
| 92567 |
|
2,509 |
2,332 |
$727.97 |
| 82565 |
|
4,875 |
4,396 |
$718.57 |
| 95910 |
|
87 |
80 |
$717.73 |
| 90739 |
|
1,497 |
1,247 |
$716.73 |
| 93926 |
|
139 |
122 |
$707.80 |
| S5550 |
Insulin rapid 5 u |
2,002 |
1,257 |
$702.28 |
| 31720 |
|
584 |
164 |
$696.57 |
| 74183 |
|
12 |
12 |
$694.04 |
| 82540 |
|
4,535 |
4,394 |
$685.59 |
| 87081 |
|
2,099 |
1,909 |
$673.73 |
| 99201 |
|
3,407 |
3,339 |
$656.48 |
| 94010 |
|
3,770 |
3,387 |
$652.48 |
| 82784 |
|
540 |
512 |
$646.39 |
| 78816 |
|
13 |
13 |
$637.94 |
| 97803 |
|
189 |
173 |
$633.60 |
| 94729 |
|
695 |
654 |
$626.20 |
| 90710 |
|
463 |
379 |
$607.05 |
| J7613 |
Albuterol non-comp unit |
5,709 |
3,306 |
$599.76 |
| 88307 |
|
687 |
661 |
$590.93 |
| 84145 |
|
194 |
118 |
$587.87 |
| 93247 |
|
844 |
795 |
$587.64 |
| 97802 |
|
130 |
118 |
$581.27 |
| J3489 |
Zoledronic acid 1mg |
2,746 |
2,286 |
$580.56 |
| 87798 |
|
14 |
14 |
$576.17 |
| J7060 |
5% dextrose/water |
9,314 |
3,989 |
$563.67 |
| 90716 |
|
513 |
433 |
$563.03 |
| J7512 |
Prednisone ir or dr oral 1mg |
2,714 |
1,573 |
$561.55 |
| 88112 |
|
521 |
500 |
$555.63 |
| 92227 |
|
3,559 |
3,074 |
$544.85 |
| 97162 |
|
1,359 |
1,259 |
$543.28 |
| 87880 |
|
639 |
631 |
$518.74 |
| 97760 |
|
1,297 |
1,161 |
$511.81 |
| 87581 |
|
26 |
26 |
$511.18 |
| 92083 |
|
943 |
860 |
$508.21 |
| 92228 |
|
294 |
244 |
$507.34 |
| 87116 |
|
1,067 |
531 |
$486.16 |
| J9035 |
Bevacizumab injection |
1,276 |
1,143 |
$483.05 |
| J7644 |
Ipratropium bromide non-comp |
4,659 |
2,455 |
$473.10 |
| 92004 |
|
885 |
760 |
$470.05 |
| 80320 |
|
3,064 |
2,845 |
$437.31 |
| 95886 |
|
28 |
27 |
$425.80 |
| 86225 |
|
489 |
473 |
$403.17 |
| 87535 |
|
220 |
207 |
$393.40 |
| 87338 |
|
2,048 |
1,785 |
$392.00 |
| 99204 |
|
11,498 |
11,031 |
$390.41 |
| 97116 |
|
402 |
372 |
$386.86 |
| 72190 |
|
51 |
50 |
$385.20 |
| 92015 |
|
4,657 |
4,138 |
$384.71 |
| 80164 |
|
72 |
65 |
$379.14 |
| S5553 |
Insulin long acting 5 u |
1,003 |
558 |
$373.34 |
| 90633 |
|
1,031 |
864 |
$369.29 |
| 92551 |
|
2,560 |
2,353 |
$368.24 |
| J9060 |
Cisplatin 10 mg injection |
458 |
190 |
$365.68 |
| 99214 |
|
55,220 |
50,488 |
$362.17 |
| 83001 |
|
190 |
180 |
$361.57 |
| 90734 |
|
948 |
821 |
$356.83 |
| 84550 |
|
761 |
598 |
$356.43 |
| 99091 |
|
2,782 |
2,537 |
$350.10 |
| P9047 |
Albumin (human), 25%, 50ml |
616 |
273 |
$342.83 |
| 99382 |
|
727 |
683 |
$335.96 |
| 97164 |
|
182 |
168 |
$335.41 |
| 70480 |
|
13 |
13 |
$330.04 |
| 85384 |
|
148 |
75 |
$329.98 |
| J0640 |
Leucovorin calcium injection |
4,576 |
2,265 |
$329.40 |
| 92504 |
|
1,169 |
994 |
$328.49 |
| 88312 |
|
28 |
25 |
$326.77 |
| 97166 |
|
649 |
595 |
$322.26 |
| 97010 |
|
2,301 |
1,157 |
$321.30 |
| 99385 |
|
477 |
439 |
$319.48 |
| 90707 |
|
567 |
472 |
$316.47 |
| 99383 |
|
518 |
485 |
$313.81 |
| 86800 |
|
178 |
165 |
$312.57 |
| 94060 |
|
146 |
136 |
$308.05 |
| J1720 |
Hydrocortisone sodium succ i |
997 |
674 |
$305.63 |
| 97140 |
|
630 |
405 |
$303.25 |
| 87900 |
|
26 |
24 |
$301.24 |
| 85044 |
|
598 |
549 |
$296.60 |
| J1815 |
Insulin injection |
825 |
211 |
$289.58 |
| A7030 |
Cpap full face mask |
405 |
362 |
$287.86 |
| 95806 |
|
1,673 |
1,573 |
$282.86 |
| 0124A |
|
334 |
291 |
$279.20 |
| 92579 |
|
1,182 |
1,060 |
$272.53 |
| 88141 |
|
1,084 |
1,026 |
$267.21 |
| 87517 |
|
69 |
66 |
$266.69 |
| J9000 |
Doxorubicin hcl injection |
305 |
180 |
$262.85 |
| 84165 |
|
297 |
283 |
$261.69 |
| 55700 |
|
154 |
151 |
$255.48 |
| J0456 |
Azithromycin |
429 |
223 |
$254.99 |
| 99234 |
|
38 |
30 |
$238.70 |
| 90700 |
|
551 |
463 |
$231.15 |
| 94618 |
|
1,055 |
924 |
$228.43 |
| 90653 |
|
820 |
734 |
$220.91 |
| 99024 |
|
3,324 |
2,900 |
$218.21 |
| 87529 |
|
13 |
12 |
$202.44 |
| 0002A |
|
65 |
65 |
$200.00 |
| J0689 |
Inj cefazolin sodium, baxter |
15 |
15 |
$197.29 |
| 90746 |
|
163 |
149 |
$196.87 |
| J3490 |
Drugs unclassified injection |
1,126 |
1,066 |
$196.65 |
| 93308 |
|
51 |
44 |
$182.82 |
| 0001A |
|
77 |
76 |
$176.94 |
| 96900 |
|
385 |
126 |
$173.44 |
| 94770 |
|
17 |
14 |
$170.15 |
| 85060 |
|
1,174 |
1,023 |
$164.66 |
| J9206 |
Irinotecan injection |
1,470 |
746 |
$164.40 |
| 0004A |
|
15 |
15 |
$160.00 |
| 83721 |
|
288 |
282 |
$154.34 |
| 86021 |
|
15 |
13 |
$142.92 |
| 93990 |
|
115 |
103 |
$140.20 |
| 90834 |
|
8,765 |
3,702 |
$134.32 |
| J9045 |
Carboplatin injection |
1,559 |
1,053 |
$132.27 |
| 84481 |
|
93 |
90 |
$131.32 |
| 86431 |
|
120 |
115 |
$128.59 |
| 96367 |
|
31 |
27 |
$123.27 |
| J1956 |
Levofloxacin injection |
119 |
88 |
$119.00 |
| 0636 |
|
10,963 |
9,953 |
$116.25 |
| 92136 |
|
365 |
356 |
$111.01 |
| J2919 |
Inj, methylpred sod succ 5mg |
27 |
25 |
$110.08 |
| 90696 |
|
398 |
327 |
$109.59 |
| 94002 |
|
235 |
52 |
$109.06 |
| S0028 |
Injection, famotidine, 20 mg |
630 |
555 |
$104.24 |
| 96360 |
|
126 |
121 |
$101.58 |
| J1453 |
Fosaprepitant injection |
1,889 |
991 |
$101.14 |
| 73020 |
|
17 |
15 |
$98.86 |
| 10021 |
|
118 |
115 |
$96.08 |
| J7042 |
5% dextrose/normal saline |
824 |
500 |
$95.78 |
| 73660 |
|
27 |
27 |
$89.88 |
| A7034 |
Nasal application device |
205 |
182 |
$88.95 |
| 99384 |
|
253 |
244 |
$88.74 |
| 92610 |
|
152 |
136 |
$81.09 |
| 85014 |
|
106 |
101 |
$76.64 |
| 3078F |
|
43,808 |
36,919 |
$75.00 |
| 87102 |
|
123 |
102 |
$74.78 |
| 76098 |
|
351 |
335 |
$73.71 |
| 85018 |
|
102 |
98 |
$72.28 |
| 73650 |
|
15 |
12 |
$70.92 |
| 84166 |
|
56 |
53 |
$66.18 |
| 92285 |
|
139 |
127 |
$65.33 |
| 93975 |
|
14 |
12 |
$65.08 |
| 92025 |
|
194 |
188 |
$64.26 |
| 96361 |
|
102 |
98 |
$63.79 |
| 87206 |
|
67 |
49 |
$63.67 |
| 83993 |
|
52 |
44 |
$62.54 |
| 92582 |
|
683 |
606 |
$60.26 |
| 86036 |
|
16 |
13 |
$59.89 |
| 76000 |
|
211 |
208 |
$59.75 |
| J3420 |
Vitamin b12 injection |
903 |
738 |
$58.25 |
| 86376 |
|
32 |
31 |
$57.40 |
| 88175 |
|
258 |
235 |
$56.99 |
| 86922 |
|
138 |
106 |
$55.34 |
| J1071 |
Inj testosterone cypionate |
1,534 |
797 |
$55.12 |
| P9045 |
Albumin (human), 5%, 250 ml |
894 |
592 |
$51.00 |
| J0571 |
Buprenorphine oral 1mg |
249 |
154 |
$50.40 |
| 84540 |
|
396 |
345 |
$49.97 |
| J9370 |
Vincristine sulfate 1 mg inj |
554 |
346 |
$48.74 |
| 86301 |
|
45 |
41 |
$48.69 |
| 51705 |
|
169 |
156 |
$47.06 |
| J0171 |
Adrenalin epinephrine inject |
32 |
28 |
$44.42 |
| J2370 |
Phenylephrine hcl injection |
80 |
58 |
$42.53 |
| 94200 |
|
138 |
132 |
$41.91 |
| 88300 |
|
229 |
220 |
$40.59 |
| S0030 |
Injection, metronidazole |
1,308 |
570 |
$39.58 |
| 98966 |
|
639 |
605 |
$37.59 |
| J2590 |
Oxytocin injection |
168 |
138 |
$36.08 |
| 88313 |
|
57 |
54 |
$34.49 |
| 83727 |
|
12 |
12 |
$32.30 |
| 89220 |
|
42 |
26 |
$30.78 |
| J2354 |
Octreotide inj, non-depot |
38 |
13 |
$30.06 |
| 3074F |
|
30,805 |
25,258 |
$25.00 |
| 3077F |
|
7,132 |
6,068 |
$25.00 |
| 82247 |
|
36 |
25 |
$24.44 |
| 86787 |
|
13 |
13 |
$23.91 |
| 82274 |
|
7,202 |
7,136 |
$23.80 |
| 96409 |
|
20 |
18 |
$22.45 |
| 31575 |
|
428 |
401 |
$22.08 |
| 87389 |
|
326 |
294 |
$20.26 |
| 86701 |
|
150 |
139 |
$19.54 |
| J1030 |
Methylprednisolone 40 mg inj |
110 |
94 |
$18.67 |
| 84155 |
|
204 |
185 |
$18.63 |
| 86300 |
|
107 |
93 |
$18.50 |
| 97535 |
|
80 |
62 |
$16.35 |
| 83516 |
|
13 |
13 |
$14.22 |
| 86702 |
|
149 |
138 |
$11.81 |
| 82945 |
|
66 |
50 |
$10.52 |
| 84300 |
|
53 |
41 |
$9.33 |
| 86765 |
|
13 |
12 |
$9.16 |
| 88160 |
|
55 |
52 |
$9.08 |
| J3301 |
Triamcinolone acet inj nos |
117 |
113 |
$8.69 |
| 99173 |
|
510 |
462 |
$8.15 |
| 87045 |
|
12 |
12 |
$7.55 |
| J0360 |
Hydralazine hcl injection |
21 |
16 |
$7.04 |
| 98967 |
|
90 |
83 |
$5.99 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
63 |
41 |
$5.63 |
| 0401 |
|
15 |
15 |
$4.61 |
| J0610 |
Calcium glucon (fresenius) |
192 |
143 |
$2.38 |
| 87046 |
|
12 |
12 |
$2.09 |
| J2710 |
Neostigmine methylslfte inj |
263 |
255 |
$0.50 |
| 91300 |
|
3,395 |
2,778 |
$0.03 |
| 91307 |
|
426 |
365 |
$0.00 |
| 0110 |
|
5,173 |
1,545 |
$0.00 |
| 45380 |
|
42 |
42 |
$0.00 |
| 99406 |
|
232 |
99 |
$0.00 |
| 3052F |
|
1,441 |
1,181 |
$0.00 |
| 91305 |
|
117 |
103 |
$0.00 |
| 59414 |
|
234 |
211 |
$0.00 |
| 0710 |
|
40 |
39 |
$0.00 |
| T1014 |
Telehealth transmit, per min |
3,291 |
2,997 |
$0.00 |
| 99241 |
|
52 |
52 |
$0.00 |
| 92526 |
|
55 |
39 |
$0.00 |
| 0771 |
|
11,772 |
10,657 |
$0.00 |
| G8839 |
Sleep apnea assess |
3,566 |
3,246 |
$0.00 |
| 90694 |
|
146 |
120 |
$0.00 |
| 3079F |
|
7,690 |
7,209 |
$0.00 |
| 0173A |
|
33 |
28 |
$0.00 |
| Q5103 |
Injection, inflectra |
1,668 |
1,418 |
$0.00 |
| 3080F |
|
2,516 |
2,360 |
$0.00 |
| 96161 |
|
747 |
643 |
$0.00 |
| 99386 |
|
29 |
29 |
$0.00 |
| 86481 |
|
22 |
19 |
$0.00 |
| J2175 |
Meperidine hydrochl /100 mg |
26 |
26 |
$0.00 |
| 90632 |
|
33 |
26 |
$0.00 |
| J7312 |
Dexamethasone intra implant |
134 |
134 |
$0.00 |
| J9250 |
Methotrexate sodium inj |
18 |
12 |
$0.00 |
| 91315 |
|
139 |
126 |
$0.00 |
| 90732 |
|
39 |
31 |
$0.00 |
| 3044F |
|
12,398 |
10,431 |
$0.00 |
| 90889 |
|
242 |
236 |
$0.00 |
| 99465 |
|
45 |
27 |
$0.00 |
| 0206 |
|
398 |
144 |
$0.00 |
| J3357 |
Ustekinumab sub cu inj, 1 mg |
76 |
68 |
$0.00 |
| 96111 |
|
103 |
103 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
89 |
68 |
$0.00 |
| 3075F |
|
7,792 |
6,855 |
$0.00 |
| 52000 |
|
16 |
16 |
$0.00 |
| 59410 |
|
27 |
27 |
$0.00 |
| 31231 |
|
60 |
55 |
$0.00 |
| J3430 |
Vitamin k phytonadione inj |
29 |
25 |
$0.00 |
| 1111F |
|
17,676 |
14,538 |
$0.00 |
| 90620 |
|
170 |
157 |
$0.00 |
| 93930 |
|
38 |
30 |
$0.00 |
| 90674 |
|
346 |
286 |
$0.00 |
| J9395 |
Injection, fulvestrant |
303 |
226 |
$0.00 |
| 99464 |
|
75 |
52 |
$0.00 |
| A9152 |
Single vitamin nos |
266 |
209 |
$0.00 |
| 95860 |
|
105 |
105 |
$0.00 |
| 0370 |
|
39 |
38 |
$0.00 |
| 91317 |
|
188 |
164 |
$0.00 |
| J2920 |
Methylprednisolone injection |
61 |
12 |
$0.00 |
| 92507 |
|
116 |
66 |
$0.00 |
| 0074A |
|
21 |
19 |
$0.00 |
| 82670 |
|
26 |
24 |
$0.00 |
| 90743 |
|
24 |
19 |
$0.00 |
| 86704 |
|
20 |
17 |
$0.00 |
| H0033 |
Oral med adm direct observe |
14 |
13 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
33 |
13 |
$0.00 |
| 84436 |
|
14 |
14 |
$0.00 |
| J0574 |
Bupren/nal 6.1 to 10mg bupre |
48 |
25 |
$0.00 |
| 99606 |
|
13 |
13 |
$0.00 |
| 86803 |
|
20 |
17 |
$0.00 |
| 90656 |
|
2,894 |
2,557 |
$0.00 |
| 88108 |
|
25 |
24 |
$0.00 |
| 82985 |
|
12 |
12 |
$0.00 |
| 0112 |
|
52 |
24 |
$0.00 |
| 82330 |
|
20 |
20 |
$0.00 |
| 0761 |
|
37 |
33 |
$0.00 |
| 51736 |
|
16 |
15 |
$0.00 |
| 36410 |
|
76 |
74 |
$0.00 |
| 45378 |
|
12 |
12 |
$0.00 |
| 87801 |
|
17 |
17 |
$0.00 |
| 91303 |
|
23 |
20 |
$0.00 |
| 74420 |
|
14 |
14 |
$0.00 |
| 93307 |
|
27 |
25 |
$0.00 |
| J0897 |
Denosumab injection |
304 |
259 |
$0.00 |
| 98968 |
|
629 |
591 |
$0.00 |
| 98960 |
|
9,267 |
6,281 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
211 |
202 |
$0.00 |
| J2916 |
Na ferric gluconate complex |
45 |
24 |
$0.00 |
| A9901 |
Delivery/set up/dispensing |
352 |
318 |
$0.00 |
| 90837 |
|
1,202 |
740 |
$0.00 |
| H2010 |
Comprehensive med svc 15 min |
331 |
272 |
$0.00 |
| 90611 |
|
193 |
164 |
$0.00 |
| H0032 |
Mh svc plan dev by non-md |
68 |
58 |
$0.00 |
| 3046F |
|
2,145 |
1,758 |
$0.00 |
| 77062 |
|
218 |
217 |
$0.00 |
| 90832 |
|
1,330 |
906 |
$0.00 |
| 77080 |
|
719 |
719 |
$0.00 |
| 90853 |
|
982 |
703 |
$0.00 |
| 97168 |
|
260 |
196 |
$0.00 |
| J9305 |
Inj. pemetrexed nos 10mg |
41 |
25 |
$0.00 |
| 81479 |
|
285 |
268 |
$0.00 |
| 92611 |
|
134 |
116 |
$0.00 |
| C9257 |
Bevacizumab injection |
693 |
676 |
$0.00 |
| 3051F |
|
2,340 |
1,916 |
$0.00 |
| 0120 |
|
1,103 |
379 |
$0.00 |
| 82947 |
|
53 |
47 |
$0.00 |
| 90473 |
|
499 |
475 |
$0.00 |
| 0731 |
|
45 |
45 |
$0.00 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
659 |
644 |
$0.00 |
| 93224 |
|
41 |
41 |
$0.00 |
| 91312 |
|
826 |
748 |
$0.00 |
| 36600 |
|
904 |
756 |
$0.00 |
| H0046 |
Mental health service, nos |
675 |
371 |
$0.00 |
| 76942 |
|
88 |
85 |
$0.00 |
| J0692 |
Cefepime hcl for injection |
96 |
26 |
$0.00 |
| 93041 |
|
596 |
342 |
$0.00 |
| 94621 |
|
15 |
12 |
$0.00 |
| 90658 |
|
13 |
13 |
$0.00 |
| 43235 |
|
42 |
42 |
$0.00 |
| 83655 |
|
126 |
126 |
$0.00 |
| A9552 |
F18 fdg |
25 |
25 |
$0.00 |
| 77427 |
|
307 |
168 |
$0.00 |
| S0197 |
Prenatal vitamins 30 day |
349 |
147 |
$0.00 |
| 43239 |
|
30 |
30 |
$0.00 |
| C1758 |
Catheter, ureteral |
12 |
12 |
$0.00 |
| J9355 |
Inj trastuzumab excl biosimi |
150 |
111 |
$0.00 |
| 88302 |
|
12 |
12 |
$0.00 |
| J2274 |
Inj morphine pf epid ithc |
103 |
87 |
$0.00 |
| J9303 |
Panitumumab injection |
60 |
38 |
$0.00 |
| 91308 |
|
162 |
129 |
$0.00 |
| 90460 |
|
20 |
20 |
$0.00 |
| 0762 |
|
58 |
25 |
$0.00 |
| 84156 |
|
13 |
12 |
$0.00 |
| 80202 |
|
31 |
13 |
$0.00 |
| 95816 |
|
12 |
12 |
$0.00 |
| J3380 |
Inj vedolizumab iv 1 mg |
54 |
48 |
$0.00 |
| A4248 |
Chlorhexidine antisept |
137 |
28 |
$0.00 |
| J1745 |
Infliximab not biosimil 10mg |
15 |
15 |
$0.00 |
| 90661 |
|
659 |
597 |
$0.00 |
| 36555 |
|
33 |
16 |
$0.00 |
| J9201 |
In gemcitabine hcl nos 200mg |
23 |
12 |
$0.00 |
| 90836 |
|
24 |
14 |
$0.00 |
| J3260 |
Tobramycin sulfate injection |
21 |
21 |
$0.00 |
| J9310 |
Rituximab injection |
15 |
15 |
$0.00 |
| J2185 |
Meropenem |
60 |
12 |
$0.00 |
| J9264 |
Paclitaxel protein bound |
22 |
12 |
$0.00 |