| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
74,610 |
64,459 |
$35.58M |
| 99284 |
|
56,687 |
50,780 |
$18.17M |
| 99283 |
|
80,794 |
72,660 |
$17.99M |
| G0463 |
Hospital outpt clinic visit |
72,902 |
62,119 |
$7.29M |
| 96374 |
|
42,550 |
36,972 |
$6.24M |
| 43239 |
|
9,607 |
9,093 |
$4.82M |
| 99282 |
|
21,176 |
18,348 |
$2.79M |
| 74177 |
|
14,632 |
13,270 |
$2.65M |
| 45380 |
|
3,210 |
3,027 |
$2.33M |
| 11042 |
|
14,001 |
5,846 |
$2.32M |
| 99291 |
|
2,765 |
2,458 |
$2.31M |
| 93306 |
|
7,857 |
7,369 |
$2.19M |
| 47562 |
|
528 |
480 |
$2.15M |
| 71046 |
|
37,092 |
33,440 |
$2.08M |
| 45385 |
|
3,601 |
3,413 |
$2.04M |
| 96365 |
|
16,386 |
11,372 |
$1.99M |
| 70450 |
|
19,809 |
17,590 |
$1.97M |
| 78452 |
|
2,973 |
2,767 |
$1.95M |
| 96361 |
|
31,456 |
26,124 |
$1.88M |
| 97110 |
|
29,087 |
10,089 |
$1.81M |
| 95810 |
|
2,140 |
2,062 |
$1.80M |
| 45378 |
|
3,030 |
2,860 |
$1.77M |
| U0003 |
Cov-19 amp prb hgh thruput |
20,572 |
18,419 |
$1.47M |
| 96413 |
|
7,083 |
4,228 |
$1.45M |
| J9271 |
Inj pembrolizumab |
214 |
149 |
$1.40M |
| J2350 |
Injection, ocrelizumab, 1 mg |
88 |
73 |
$1.37M |
| 96375 |
|
31,766 |
25,262 |
$1.31M |
| 96360 |
|
8,886 |
7,991 |
$1.30M |
| 0241U |
|
10,121 |
9,433 |
$1.12M |
| 99281 |
|
14,977 |
12,185 |
$1000K |
| 77067 |
|
8,764 |
8,497 |
$948K |
| 93976 |
|
9,428 |
8,655 |
$882K |
| 95811 |
|
1,071 |
1,043 |
$868K |
| 97010 |
|
12,075 |
4,479 |
$810K |
| J0897 |
Denosumab injection |
1,114 |
913 |
$790K |
| 76700 |
|
7,488 |
6,986 |
$737K |
| 71045 |
|
16,309 |
14,151 |
$718K |
| 74176 |
|
4,740 |
4,355 |
$674K |
| 76705 |
|
5,580 |
5,115 |
$589K |
| 84443 |
|
56,938 |
51,732 |
$552K |
| 82306 |
|
30,559 |
27,861 |
$551K |
| 52356 |
|
168 |
156 |
$548K |
| 76856 |
|
5,718 |
5,258 |
$477K |
| 86900 |
|
12,831 |
10,928 |
$471K |
| Q0138 |
Ferumoxytol, non-esrd |
1,588 |
981 |
$446K |
| 71260 |
|
4,208 |
3,788 |
$436K |
| 70498 |
|
2,036 |
1,799 |
$385K |
| 87635 |
|
11,108 |
9,346 |
$380K |
| 70553 |
|
1,580 |
1,453 |
$376K |
| 76770 |
|
3,475 |
3,266 |
$373K |
| 85025 |
|
181,797 |
149,137 |
$353K |
| 70551 |
|
2,512 |
2,251 |
$315K |
| 76830 |
|
3,197 |
2,960 |
$314K |
| 83036 |
|
53,211 |
49,144 |
$312K |
| 66984 |
|
644 |
512 |
$298K |
| 83718 |
|
40,916 |
39,351 |
$293K |
| 76536 |
|
3,994 |
3,729 |
$291K |
| 11043 |
|
823 |
433 |
$288K |
| 94726 |
|
3,032 |
2,881 |
$287K |
| 93971 |
|
3,999 |
3,644 |
$287K |
| 87491 |
|
12,738 |
11,681 |
$267K |
| 87591 |
|
12,739 |
11,682 |
$266K |
| 82947 |
|
130,911 |
111,987 |
$264K |
| U0005 |
Infec agen detec ampli probe |
12,011 |
10,865 |
$260K |
| 76641 |
|
2,814 |
2,655 |
$254K |
| 82607 |
|
29,694 |
27,232 |
$251K |
| 71275 |
|
2,194 |
2,006 |
$249K |
| 93005 |
|
66,566 |
56,121 |
$242K |
| 96366 |
|
6,728 |
4,417 |
$235K |
| C8929 |
Tte w or wo fol wcon,doppler |
639 |
587 |
$222K |
| 76801 |
|
2,108 |
1,857 |
$219K |
| 93970 |
|
1,677 |
1,518 |
$217K |
| 72148 |
|
1,399 |
1,321 |
$215K |
| 0240U |
|
1,869 |
1,741 |
$213K |
| 94060 |
|
1,120 |
1,063 |
$206K |
| 82247 |
|
88,403 |
78,733 |
$203K |
| 95816 |
|
1,616 |
1,468 |
$197K |
| 76642 |
|
3,260 |
3,073 |
$191K |
| 82040 |
|
89,561 |
79,751 |
$190K |
| 72100 |
|
4,791 |
4,500 |
$189K |
| 77066 |
Tomosynthesis, mammo |
1,560 |
1,488 |
$188K |
| 73562 |
|
8,917 |
8,232 |
$187K |
| 36415 |
|
196,685 |
160,844 |
$185K |
| 93017 |
|
4,548 |
4,216 |
$174K |
| 96372 |
|
34,502 |
26,866 |
$170K |
| 71250 |
|
2,874 |
2,608 |
$165K |
| 84439 |
|
28,524 |
26,086 |
$156K |
| S9480 |
Intensive outpatient psychia |
1,203 |
179 |
$152K |
| 96415 |
|
2,057 |
1,509 |
$151K |
| H0015 |
Alcohol and/or drug services |
1,154 |
192 |
$147K |
| 72110 |
|
2,189 |
2,046 |
$144K |
| 49083 |
|
433 |
180 |
$142K |
| 77065 |
Tomosynthesis, mammo |
1,309 |
1,233 |
$140K |
| 73030 |
|
6,767 |
6,114 |
$138K |
| 87389 |
|
12,209 |
10,972 |
$134K |
| 73610 |
|
6,681 |
5,756 |
$134K |
| 77080 |
|
1,358 |
1,301 |
$132K |
| 96367 |
|
2,750 |
1,658 |
$119K |
| 10061 |
|
427 |
397 |
$117K |
| 73130 |
|
6,061 |
5,323 |
$114K |
| 81220 |
|
706 |
531 |
$111K |
| 82728 |
|
18,773 |
16,743 |
$108K |
| 86480 |
|
2,536 |
2,349 |
$107K |
| J1439 |
Inj ferric carboxymaltos 1mg |
260 |
156 |
$107K |
| 72141 |
|
839 |
762 |
$106K |
| 36430 |
|
760 |
528 |
$102K |
| 77063 |
|
7,069 |
6,843 |
$100K |
| 86803 |
|
11,657 |
10,443 |
$94K |
| 88305 |
|
19,232 |
17,841 |
$94K |
| 83550 |
|
20,940 |
19,092 |
$93K |
| 80307 |
|
20,784 |
17,918 |
$93K |
| 82310 |
|
129,859 |
110,969 |
$90K |
| 73110 |
|
4,111 |
3,482 |
$87K |
| 73630 |
|
5,713 |
5,253 |
$81K |
| 84403 |
|
4,174 |
3,756 |
$77K |
| 87086 |
|
52,639 |
46,333 |
$76K |
| 76882 |
|
1,534 |
1,421 |
$75K |
| 73502 |
|
4,271 |
3,874 |
$74K |
| 73721 |
|
355 |
317 |
$74K |
| 50590 |
|
30 |
28 |
$74K |
| 93225 |
|
1,299 |
1,235 |
$72K |
| 83540 |
|
21,295 |
19,423 |
$71K |
| 93458 |
|
58 |
52 |
$70K |
| 72050 |
|
879 |
807 |
$70K |
| 97161 |
|
1,794 |
1,578 |
$69K |
| 49650 |
|
16 |
15 |
$68K |
| 80061 |
|
20,347 |
17,280 |
$66K |
| 87624 |
|
2,439 |
2,333 |
$65K |
| 88142 |
|
5,456 |
5,137 |
$65K |
| 80053 |
|
30,918 |
24,350 |
$62K |
| 70486 |
|
2,479 |
2,254 |
$62K |
| 83970 |
|
3,067 |
2,779 |
$61K |
| 97597 |
|
849 |
532 |
$59K |
| 96417 |
|
1,062 |
641 |
$56K |
| 87633 |
|
2,132 |
1,947 |
$56K |
| 97162 |
|
1,795 |
1,553 |
$55K |
| C9803 |
Hopd covid-19 spec collect |
17,707 |
15,727 |
$54K |
| 73590 |
|
2,586 |
2,231 |
$53K |
| 97014 |
|
758 |
327 |
$52K |
| 82043 |
|
15,461 |
14,363 |
$52K |
| 87522 |
Neg quan hep c or qual rna |
1,709 |
1,569 |
$51K |
| 85027 |
|
27,742 |
23,382 |
$49K |
| G0103 |
Psa screening |
4,596 |
4,202 |
$49K |
| 82746 |
|
7,046 |
6,370 |
$49K |
| 82570 |
|
15,950 |
14,545 |
$48K |
| 87070 |
|
20,139 |
18,331 |
$47K |
| 10060 |
|
302 |
276 |
$47K |
| 72040 |
|
2,159 |
2,013 |
$47K |
| 86235 |
|
1,088 |
958 |
$44K |
| 93798 |
|
529 |
96 |
$44K |
| 93975 |
|
195 |
179 |
$41K |
| 73560 |
|
1,668 |
1,469 |
$41K |
| 19081 |
|
42 |
39 |
$40K |
| 72125 |
|
6,187 |
5,461 |
$40K |
| 73080 |
|
2,409 |
2,110 |
$40K |
| P9016 |
Rbc leukocytes reduced |
403 |
298 |
$39K |
| 80048 |
|
46,891 |
34,231 |
$38K |
| 81329 |
|
665 |
471 |
$38K |
| 76805 |
|
361 |
338 |
$37K |
| 82374 |
|
129,972 |
111,069 |
$36K |
| 70491 |
|
239 |
209 |
$34K |
| 88342 |
|
1,128 |
1,012 |
$34K |
| 88304 |
|
3,569 |
3,278 |
$33K |
| 86706 |
|
4,605 |
4,178 |
$33K |
| 72070 |
|
906 |
826 |
$32K |
| 83735 |
|
34,529 |
25,669 |
$31K |
| 86618 |
|
3,968 |
3,356 |
$30K |
| 86038 |
|
4,355 |
3,927 |
$30K |
| 93880 |
|
347 |
322 |
$30K |
| J2506 |
Inj pegfilgrast ex bio 0.5mg |
48 |
36 |
$30K |
| 73140 |
|
2,207 |
2,012 |
$30K |
| 84153 |
|
3,279 |
2,941 |
$30K |
| 80074 |
|
1,094 |
984 |
$29K |
| 43251 |
|
33 |
29 |
$29K |
| 86592 |
|
8,830 |
7,823 |
$29K |
| 84202 |
|
2,247 |
2,178 |
$29K |
| 87150 |
|
1,216 |
1,112 |
$29K |
| 74019 |
|
3,141 |
2,903 |
$29K |
| U0004 |
Cov-19 test non-cdc hgh thru |
669 |
393 |
$29K |
| 82465 |
|
41,014 |
39,433 |
$29K |
| 74018 |
|
2,180 |
1,971 |
$28K |
| 86003 |
|
492 |
436 |
$27K |
| 82652 |
|
919 |
875 |
$27K |
| 83655 |
|
2,575 |
2,506 |
$27K |
| 81003 |
|
47,216 |
42,031 |
$27K |
| 19301 |
|
12 |
12 |
$26K |
| 97165 |
|
496 |
437 |
$26K |
| 84702 |
|
11,489 |
9,638 |
$26K |
| 87661 |
|
1,841 |
1,722 |
$26K |
| 97166 |
|
552 |
492 |
$25K |
| 84481 |
|
2,656 |
2,392 |
$25K |
| 87340 |
|
5,948 |
5,131 |
$25K |
| 73090 |
|
1,490 |
1,258 |
$25K |
| 84146 |
|
2,015 |
1,780 |
$25K |
| 87186 |
|
12,246 |
10,991 |
$24K |
| 82105 |
|
2,185 |
1,975 |
$23K |
| 83001 |
|
1,820 |
1,582 |
$23K |
| 83525 |
|
2,644 |
2,413 |
$23K |
| 84480 |
|
2,582 |
2,354 |
$23K |
| J2505 |
Injection, pegfilgrastim 6mg |
21 |
14 |
$22K |
| 84402 |
|
1,192 |
1,072 |
$21K |
| G0480 |
Drug test def 1-7 classes |
5,515 |
4,807 |
$20K |
| 84270 |
|
1,193 |
1,066 |
$20K |
| 59025 |
|
131 |
114 |
$19K |
| 83002 |
|
1,464 |
1,266 |
$19K |
| 85610 |
|
35,555 |
29,758 |
$19K |
| 87338 |
|
1,769 |
1,613 |
$18K |
| 77085 |
|
302 |
292 |
$18K |
| 74183 |
|
72 |
69 |
$18K |
| 69436 |
|
15 |
15 |
$18K |
| 78306 |
|
87 |
79 |
$17K |
| 92507 |
|
195 |
54 |
$17K |
| 93923 |
|
311 |
291 |
$17K |
| 87536 |
|
305 |
276 |
$17K |
| J2469 |
Palonosetron hcl |
1,701 |
954 |
$16K |
| 82784 |
|
2,659 |
2,283 |
$16K |
| 72131 |
|
303 |
283 |
$16K |
| 97530 |
|
304 |
217 |
$15K |
| 77062 |
|
1,048 |
993 |
$14K |
| 86376 |
|
1,798 |
1,604 |
$14K |
| 83520 |
|
1,299 |
1,224 |
$14K |
| 82670 |
|
756 |
661 |
$14K |
| 74220 |
|
127 |
121 |
$14K |
| 86140 |
|
10,548 |
9,563 |
$14K |
| 82951 |
|
1,261 |
1,173 |
$14K |
| G0399 |
Home sleep test/type 3 porta |
134 |
120 |
$13K |
| 73221 |
|
67 |
63 |
$13K |
| 85652 |
|
11,064 |
9,947 |
$13K |
| 86762 |
|
3,335 |
2,739 |
$12K |
| 97035 |
|
182 |
94 |
$12K |
| 86200 |
|
1,790 |
1,656 |
$12K |
| 83880 |
|
10,407 |
9,285 |
$12K |
| 87798 |
|
401 |
371 |
$12K |
| 87088 |
|
5,283 |
4,773 |
$12K |
| 72170 |
|
1,696 |
1,527 |
$11K |
| 87077 |
|
6,418 |
5,788 |
$11K |
| 85730 |
|
9,214 |
7,866 |
$11K |
| 86225 |
|
1,299 |
1,175 |
$11K |
| 80076 |
|
18,418 |
14,817 |
$10K |
| 87506 |
|
98 |
91 |
$10K |
| 86160 |
|
752 |
686 |
$10K |
| 70496 |
|
1,123 |
995 |
$9K |
| 83516 |
|
1,457 |
1,151 |
$9K |
| 86364 |
|
825 |
757 |
$9K |
| 81001 |
|
15,873 |
14,156 |
$9K |
| 86800 |
|
1,046 |
953 |
$9K |
| 86696 |
|
625 |
589 |
$9K |
| 82533 |
|
1,034 |
863 |
$9K |
| 73551 |
|
577 |
518 |
$9K |
| 83690 |
|
41,453 |
36,111 |
$9K |
| 78014 |
|
28 |
27 |
$9K |
| 86430 |
|
2,806 |
2,588 |
$8K |
| 71101 |
|
778 |
717 |
$8K |
| 83993 |
|
610 |
529 |
$8K |
| 78264 |
|
25 |
25 |
$8K |
| G0121 |
Colon ca scrn not hi rsk ind |
12 |
12 |
$8K |
| 86920 |
|
751 |
591 |
$8K |
| 86787 |
|
741 |
684 |
$8K |
| 88112 |
|
373 |
325 |
$7K |
| 87147 |
|
4,632 |
4,307 |
$7K |
| 88307 |
|
665 |
604 |
$6K |
| 86695 |
|
625 |
589 |
$6K |
| 82627 |
|
387 |
340 |
$6K |
| G0379 |
Direct refer hospital observ |
12 |
12 |
$6K |
| 97116 |
|
135 |
110 |
$6K |
| 82248 |
|
38,687 |
34,632 |
$6K |
| 86765 |
|
589 |
540 |
$6K |
| 90675 |
|
24 |
12 |
$6K |
| 86769 |
|
163 |
154 |
$6K |
| 73060 |
|
516 |
454 |
$6K |
| 86255 |
|
685 |
576 |
$6K |
| 87493 |
|
323 |
280 |
$6K |
| 86334 |
|
1,028 |
876 |
$6K |
| 84165 |
|
2,193 |
1,859 |
$6K |
| 86735 |
|
535 |
488 |
$6K |
| 86704 |
|
807 |
695 |
$5K |
| 96411 |
|
87 |
55 |
$5K |
| 90686 |
|
338 |
322 |
$5K |
| 73564 |
|
90 |
84 |
$5K |
| 12011 |
|
1,650 |
1,522 |
$5K |
| 80164 |
|
1,087 |
909 |
$5K |
| 82785 |
|
429 |
382 |
$5K |
| 12001 |
|
2,285 |
2,132 |
$5K |
| 82150 |
|
2,309 |
2,035 |
$5K |
| 86141 |
|
825 |
749 |
$5K |
| 41899 |
|
34 |
27 |
$4K |
| 86360 |
|
144 |
129 |
$4K |
| 84156 |
|
2,576 |
2,216 |
$4K |
| 94010 |
|
1,723 |
1,634 |
$4K |
| 84207 |
|
288 |
258 |
$4K |
| 87075 |
|
3,988 |
3,234 |
$4K |
| G0378 |
Hospital observation per hr |
11,338 |
9,086 |
$4K |
| 73700 |
|
60 |
55 |
$3K |
| 87427 |
|
602 |
545 |
$3K |
| 83020 |
|
1,556 |
1,153 |
$3K |
| 77061 |
|
247 |
234 |
$3K |
| 84450 |
|
91,533 |
81,562 |
$3K |
| 88173 |
|
1,067 |
930 |
$3K |
| 82550 |
|
7,932 |
6,948 |
$3K |
| 87400 |
|
6,945 |
6,403 |
$3K |
| 81376 |
|
15 |
12 |
$3K |
| 29515 |
|
28 |
24 |
$3K |
| 83630 |
|
233 |
183 |
$3K |
| 87328 |
|
376 |
345 |
$3K |
| J0185 |
Inj., aprepitant, 1 mg |
46 |
25 |
$3K |
| 83521 |
|
909 |
764 |
$3K |
| 87045 |
|
602 |
545 |
$3K |
| 73100 |
|
42 |
36 |
$3K |
| 84478 |
|
41,044 |
39,432 |
$3K |
| 87046 |
|
601 |
545 |
$3K |
| 0011A |
|
358 |
183 |
$3K |
| 82565 |
|
132,567 |
113,269 |
$3K |
| 82140 |
|
1,260 |
1,042 |
$3K |
| 87329 |
|
352 |
321 |
$3K |
| 73660 |
|
359 |
328 |
$3K |
| 85045 |
|
3,261 |
2,876 |
$2K |
| 86258 |
|
161 |
141 |
$2K |
| 85379 |
|
7,734 |
6,962 |
$2K |
| 85018 |
|
3,085 |
2,466 |
$2K |
| 86850 |
|
12,646 |
10,768 |
$2K |
| 85014 |
|
2,886 |
2,285 |
$2K |
| 87205 |
|
3,689 |
2,971 |
$2K |
| 83010 |
|
876 |
759 |
$2K |
| 12002 |
|
563 |
525 |
$2K |
| 82523 |
|
210 |
190 |
$2K |
| 86780 |
|
172 |
170 |
$2K |
| 92950 |
|
13 |
13 |
$2K |
| 76857 |
|
112 |
106 |
$2K |
| 86381 |
|
118 |
100 |
$2K |
| 81025 |
|
15,448 |
14,100 |
$2K |
| 94618 |
|
285 |
268 |
$2K |
| P9604 |
One-way allow prorated trip |
1,953 |
1,231 |
$2K |
| 83090 |
|
205 |
175 |
$2K |
| 86617 |
|
233 |
196 |
$2K |
| 97112 |
|
47 |
27 |
$2K |
| 76817 |
|
1,097 |
973 |
$2K |
| 84550 |
|
3,657 |
3,235 |
$2K |
| 97140 |
|
161 |
71 |
$2K |
| 36591 |
|
27 |
24 |
$1K |
| 83721 |
|
259 |
222 |
$1K |
| 80178 |
|
410 |
357 |
$1K |
| 83883 |
|
485 |
394 |
$1K |
| 96402 |
|
88 |
65 |
$1K |
| 90471 |
|
6,036 |
5,234 |
$1K |
| 76816 |
|
13 |
12 |
$1K |
| 86355 |
|
144 |
129 |
$1K |
| 86359 |
|
144 |
129 |
$1K |
| 86357 |
|
144 |
129 |
$1K |
| 82378 |
|
846 |
655 |
$1K |
| 74241 |
|
14 |
13 |
$1K |
| 87040 |
|
11,152 |
9,486 |
$1K |
| 86705 |
|
156 |
127 |
$975.77 |
| 0004A |
|
27 |
26 |
$965.87 |
| 84100 |
|
14,888 |
11,020 |
$934.78 |
| 90715 |
|
4,599 |
4,282 |
$913.50 |
| 84460 |
|
91,281 |
81,412 |
$890.57 |
| 83498 |
|
44 |
40 |
$886.94 |
| 87653 |
|
28 |
28 |
$871.26 |
| 86901 |
|
12,832 |
10,929 |
$853.50 |
| 86709 |
|
119 |
96 |
$829.49 |
| 84484 |
|
39,155 |
32,187 |
$819.99 |
| 86015 |
|
101 |
87 |
$763.76 |
| 86694 |
|
65 |
63 |
$761.19 |
| 87081 |
|
146 |
141 |
$760.80 |
| 84132 |
|
131,319 |
112,121 |
$746.44 |
| 82977 |
|
946 |
860 |
$744.18 |
| 86708 |
|
97 |
85 |
$733.46 |
| 82653 |
|
76 |
75 |
$726.33 |
| 82435 |
|
129,974 |
111,071 |
$725.50 |
| 81596 |
|
31 |
29 |
$717.42 |
| 82805 |
|
2,021 |
1,784 |
$716.14 |
| 87651 |
|
1,799 |
1,722 |
$691.15 |
| 84080 |
|
98 |
90 |
$677.76 |
| 83605 |
|
13,779 |
11,436 |
$650.32 |
| 84590 |
|
92 |
81 |
$648.82 |
| 86231 |
|
83 |
71 |
$646.97 |
| J2359 |
Inj. olanzapine, 0.5mg |
52 |
45 |
$644.54 |
| 84410 |
|
12 |
12 |
$609.48 |
| 0001A |
|
90 |
42 |
$602.23 |
| 96376 |
|
9,755 |
6,561 |
$596.07 |
| 82705 |
|
157 |
145 |
$587.25 |
| 83615 |
|
4,028 |
3,253 |
$575.93 |
| 82390 |
|
79 |
68 |
$570.43 |
| 76981 |
|
13 |
13 |
$568.08 |
| 51701 |
|
2,813 |
2,561 |
$555.39 |
| 76377 |
|
7,463 |
6,624 |
$551.43 |
| 84630 |
|
58 |
56 |
$489.15 |
| 86665 |
|
44 |
39 |
$484.96 |
| 80051 |
|
237 |
217 |
$443.06 |
| 0064A |
|
13 |
13 |
$440.00 |
| 87529 |
|
67 |
65 |
$435.63 |
| 86308 |
|
580 |
540 |
$429.23 |
| 16020 |
|
29 |
24 |
$428.03 |
| 86039 |
|
63 |
63 |
$426.40 |
| 82103 |
|
46 |
40 |
$411.53 |
| 82656 |
|
51 |
45 |
$394.70 |
| 86304 |
|
40 |
39 |
$384.63 |
| 87625 |
|
14 |
12 |
$371.76 |
| 73522 |
|
15 |
15 |
$358.59 |
| J3490 |
Drugs unclassified injection |
74,835 |
37,261 |
$325.64 |
| J2310 |
Inj naloxone hydrochloride |
71 |
65 |
$319.99 |
| 82077 |
|
6,277 |
5,459 |
$314.72 |
| 94640 |
|
4,303 |
3,662 |
$306.32 |
| 82088 |
|
12 |
12 |
$305.80 |
| 84520 |
|
132,005 |
112,833 |
$295.81 |
| 86664 |
|
42 |
39 |
$292.20 |
| 73552 |
|
14 |
14 |
$288.15 |
| 83695 |
|
27 |
27 |
$274.18 |
| 76870 |
|
1,241 |
1,159 |
$271.90 |
| 84255 |
|
14 |
13 |
$268.18 |
| 89051 |
|
783 |
489 |
$262.56 |
| 86812 |
|
15 |
12 |
$246.50 |
| 29125 |
|
52 |
49 |
$221.03 |
| 84075 |
|
88,441 |
78,812 |
$213.71 |
| 82495 |
|
14 |
13 |
$213.07 |
| 82330 |
|
838 |
765 |
$211.34 |
| 87807 |
|
1,474 |
1,412 |
$209.97 |
| 84425 |
|
12 |
12 |
$206.33 |
| 83921 |
|
17 |
17 |
$204.36 |
| 93041 |
|
4,609 |
4,231 |
$160.93 |
| 86677 |
|
32 |
31 |
$152.46 |
| 80185 |
|
37 |
29 |
$139.26 |
| 86431 |
|
39 |
38 |
$135.50 |
| 84466 |
|
14 |
13 |
$134.09 |
| 80177 |
|
52 |
48 |
$125.41 |
| 87880 |
|
4,903 |
4,689 |
$101.70 |
| 86663 |
|
15 |
14 |
$100.24 |
| 84295 |
|
130,056 |
111,124 |
$98.91 |
| 83918 |
|
15 |
14 |
$94.32 |
| J0131 |
Inj, acetaminophen (nos) |
939 |
809 |
$81.41 |
| 84155 |
|
88,159 |
78,565 |
$63.74 |
| 86300 |
|
141 |
102 |
$59.61 |
| 88300 |
|
13 |
12 |
$55.32 |
| J1170 |
Hydromorphone injection |
14,794 |
9,196 |
$55.30 |
| 87502 |
|
38 |
36 |
$51.88 |
| 80047 |
|
151 |
127 |
$51.64 |
| 82553 |
|
1,412 |
1,262 |
$50.83 |
| 82948 |
|
4,438 |
3,920 |
$50.36 |
| 81243 |
|
770 |
579 |
$42.59 |
| 86403 |
|
5,015 |
4,662 |
$38.63 |
| 84703 |
|
12 |
12 |
$35.90 |
| 88312 |
|
9,059 |
8,557 |
$34.60 |
| 82232 |
|
29 |
26 |
$33.67 |
| 99152 |
|
1,641 |
1,495 |
$33.29 |
| 87076 |
|
14 |
12 |
$30.88 |
| J1100 |
Dexamethasone sodium phos |
23,404 |
19,888 |
$29.39 |
| 83935 |
|
14 |
12 |
$28.36 |
| J1885 |
Ketorolac tromethamine inj |
35,575 |
31,009 |
$28.10 |
| 80143 |
|
758 |
672 |
$26.84 |
| J2704 |
Inj, propofol, 10 mg |
37,905 |
26,837 |
$26.02 |
| J0736 |
Inj, clindamycin phosp 300mg |
22 |
13 |
$25.46 |
| 83930 |
|
15 |
13 |
$25.24 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
24,249 |
21,704 |
$23.50 |
| 51798 |
|
14 |
12 |
$22.56 |
| J2270 |
Morphine sulfate injection |
7,435 |
5,978 |
$21.88 |
| J2405 |
Ondansetron hcl injection |
31,526 |
26,529 |
$19.73 |
| J0696 |
Ceftriaxone sodium injection |
7,634 |
5,957 |
$19.18 |
| 81002 |
|
4,874 |
4,461 |
$16.69 |
| C1894 |
Intro/sheath, non-laser |
1,310 |
1,204 |
$13.65 |
| 80179 |
|
715 |
641 |
$13.42 |
| 71100 |
|
12 |
12 |
$12.49 |
| J2930 |
Methylprednisolone injection |
2,771 |
2,373 |
$9.11 |
| J1644 |
Inj heparin sodium per 1000u |
9,365 |
4,576 |
$8.32 |
| 99153 |
Mod sedat endo service >5yrs |
1,372 |
1,250 |
$7.22 |
| 82962 |
|
2,587 |
1,172 |
$6.87 |
| C9113 |
Inj pantoprazole sodium, via |
3,006 |
1,896 |
$6.70 |
| J0690 |
Cefazolin sodium injection |
9,729 |
7,826 |
$6.62 |
| J1953 |
Levetiracetam injection |
310 |
241 |
$5.34 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,756 |
1,538 |
$4.65 |
| J7512 |
Prednisone ir or dr oral 1mg |
5,177 |
4,340 |
$3.21 |
| J1200 |
Diphenhydramine hcl injectio |
7,613 |
6,217 |
$2.72 |
| 70360 |
|
27 |
24 |
$2.70 |
| J2250 |
Inj midazolam hydrochloride |
16,460 |
14,833 |
$2.45 |
| J7120 |
Ringers lactate infusion |
473 |
448 |
$2.42 |
| J2765 |
Metoclopramide hcl injection |
4,905 |
4,376 |
$2.42 |
| J3010 |
Fentanyl citrate injection |
18,338 |
16,493 |
$2.25 |
| J3475 |
Inj magnesium sulfate |
6,889 |
4,497 |
$2.07 |
| G8979 |
Mobility goal status |
546 |
478 |
$1.71 |
| G8978 |
Mobility current status |
496 |
442 |
$1.55 |
| J3480 |
Inj potassium chloride |
1,868 |
1,347 |
$1.10 |
| G8988 |
Self care goal status |
342 |
298 |
$1.05 |
| J2550 |
Promethazine hcl injection |
277 |
248 |
$1.00 |
| J1630 |
Haloperidol injection |
2,706 |
2,326 |
$1.00 |
| G8987 |
Self care current status |
326 |
283 |
$0.97 |
| J1940 |
Furosemide injection |
1,052 |
777 |
$0.80 |
| G0475 |
Hiv combination assay |
880 |
778 |
$0.77 |
| J1650 |
Inj enoxaparin sodium |
3,585 |
2,149 |
$0.66 |
| J8540 |
Oral dexamethasone |
475 |
380 |
$0.27 |
| J2060 |
Lorazepam injection |
4,165 |
3,365 |
$0.26 |
| J1836 |
Inj, metronidazole, 10 mg |
112 |
52 |
$0.25 |
| G8980 |
Mobility d/c status |
13 |
13 |
$0.03 |
| 93226 |
|
1,299 |
1,235 |
$0.00 |
| J3370 |
Vancomycin hcl injection |
2,206 |
1,448 |
$0.00 |
| 51702 |
|
145 |
129 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
2,800 |
2,240 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
328 |
248 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
390 |
353 |
$0.00 |
| J0780 |
Prochlorperazine injection |
476 |
425 |
$0.00 |
| Q0163 |
Diphenhydramine hcl 50mg |
2,649 |
2,128 |
$0.00 |
| Q9950 |
Inj sulf hexa lipid microsph |
199 |
186 |
$0.00 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
2,869 |
2,577 |
$0.00 |
| 94729 |
|
2,998 |
2,849 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
439 |
304 |
$0.00 |
| 90714 |
|
64 |
54 |
$0.00 |
| J3486 |
Ziprasidone mesylate |
50 |
39 |
$0.00 |
| 88313 |
|
2,206 |
2,075 |
$0.00 |
| Q0177 |
Hydroxyzine pamoate 25mg |
1,810 |
1,236 |
$0.00 |
| J1756 |
Iron sucrose injection |
2,352 |
977 |
$0.00 |
| 82272 |
|
143 |
138 |
$0.00 |
| J0694 |
Cefoxitin sodium injection |
815 |
419 |
$0.00 |
| J7510 |
Prednisolone oral per 5 mg |
97 |
94 |
$0.00 |
| 69209 |
|
116 |
93 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
222 |
194 |
$0.00 |
| A9531 |
I131 max 100uci |
14 |
14 |
$0.00 |
| A9541 |
Tc99m sulfur colloid |
170 |
160 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
561 |
490 |
$0.00 |
| 87804 |
|
2,201 |
2,010 |
$0.00 |
| S0077 |
Injection, clindamycin phosp |
199 |
173 |
$0.00 |
| 95957 |
|
35 |
32 |
$0.00 |
| 76942 |
|
45 |
43 |
$0.00 |
| J7030 |
Normal saline solution infus |
371 |
332 |
$0.00 |
| J1453 |
Fosaprepitant injection |
90 |
55 |
$0.00 |
| G0279 |
Tomosynthesis, mammo |
15 |
15 |
$0.00 |
| C1887 |
Catheter, guiding |
57 |
51 |
$0.00 |
| 76376 |
|
108 |
96 |
$0.00 |
| 81206 |
|
119 |
94 |
$0.00 |
| Q9957 |
Inj perflutren lip micros,ml |
142 |
135 |
$0.00 |
| J1580 |
Garamycin gentamicin inj |
94 |
75 |
$0.00 |
| J7040 |
Normal saline solution infus |
59 |
45 |
$0.00 |
| J0702 |
Betamethasone acet&sod phosp |
18 |
12 |
$0.00 |
| 84112 |
|
12 |
12 |
$0.00 |
| J3489 |
Zoledronic acid 1mg |
15 |
13 |
$0.00 |
| 91300 |
|
83 |
72 |
$0.00 |
| 81401 |
|
24 |
24 |
$0.00 |
| 82800 |
|
14 |
13 |
$0.00 |
| 77002 |
|
12 |
12 |
$0.00 |
| J2272 |
Inj, morphine (fresenius) |
19 |
16 |
$0.00 |
| 97803 |
|
46 |
44 |
$0.00 |
| 84145 |
|
12 |
12 |
$0.00 |
| C1776 |
Joint device (implantable) |
16 |
15 |
$0.00 |
| C1769 |
Guide wire |
2,748 |
2,505 |
$0.00 |
| C1781 |
Mesh (implantable) |
659 |
605 |
$0.00 |
| 83009 |
|
4,071 |
3,841 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
2,321 |
1,907 |
$0.00 |
| Q3014 |
Telehealth facility fee |
186 |
172 |
$0.00 |
| J2001 |
Lidocaine injection |
3,206 |
2,781 |
$0.00 |
| J3420 |
Vitamin b12 injection |
3,346 |
2,652 |
$0.00 |
| 96368 |
|
294 |
222 |
$0.00 |
| A9500 |
Tc99m sestamibi |
3,052 |
2,837 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
414 |
358 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
572 |
528 |
$0.00 |
| V2632 |
Post chmbr intraocular lens |
543 |
433 |
$0.00 |
| 94760 |
|
2,491 |
2,379 |
$0.00 |
| J2785 |
Regadenoson injection |
1,682 |
1,568 |
$0.00 |
| J1030 |
Methylprednisolone 40 mg inj |
20 |
14 |
$0.00 |
| 11045 |
|
2,539 |
1,263 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
301 |
270 |
$0.00 |
| 84157 |
|
17 |
12 |
$0.00 |
| J2360 |
Orphenadrine injection |
849 |
756 |
$0.00 |
| J3411 |
Thiamine hcl 100 mg |
1,118 |
830 |
$0.00 |
| 88341 |
|
346 |
313 |
$0.00 |
| J2305 |
Inj, nitroglycerin, 5 mg |
32 |
26 |
$0.00 |
| A9585 |
Gadobutrol injection |
510 |
450 |
$0.00 |
| A9503 |
Tc99m medronate |
130 |
122 |
$0.00 |
| J2920 |
Methylprednisolone injection |
127 |
70 |
$0.00 |
| 0352U |
|
68 |
65 |
$0.00 |
| J0500 |
Dicyclomine injection |
531 |
511 |
$0.00 |
| J0713 |
Inj ceftazidime per 500 mg |
42 |
36 |
$0.00 |
| C2617 |
Stent, non-cor, tem w/o del |
289 |
275 |
$0.00 |
| A4648 |
Implantable tissue marker |
41 |
38 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
202 |
110 |
$0.00 |
| G0472 |
Hep c screen high risk/other |
191 |
189 |
$0.00 |
| 85660 |
|
14 |
12 |
$0.00 |
| J9045 |
Carboplatin injection |
43 |
26 |
$0.00 |
| 88311 |
|
68 |
62 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
753 |
610 |
$0.00 |
| J0456 |
Azithromycin |
39 |
27 |
$0.00 |
| J1815 |
Insulin injection |
24 |
18 |
$0.00 |
| C9290 |
Inj, bupivacaine liposome |
63 |
61 |
$0.00 |
| J0280 |
Aminophyllin 250 mg inj |
40 |
37 |
$0.00 |
| J7050 |
Normal saline solution infus |
61 |
47 |
$0.00 |
| 96377 |
|
71 |
50 |
$0.00 |
| 91306 |
|
13 |
13 |
$0.00 |
| C1726 |
Cath, bal dil, non-vascular |
12 |
12 |
$0.00 |
| C1819 |
Tissue localization-excision |
13 |
13 |
$0.00 |
| 94644 |
|
16 |
14 |
$0.00 |
| A9512 |
Tc99m pertechnetate |
14 |
14 |
$0.00 |
| J9267 |
Paclitaxel injection |
58 |
24 |
$0.00 |
| 91301 |
|
188 |
175 |
$0.00 |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
15 |
13 |
$0.00 |
| C1766 |
Intro/sheath,strble,non-peel |
16 |
14 |
$0.00 |