| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
54,416 |
42,450 |
$23.65M |
| 99284 |
|
51,112 |
42,412 |
$12.84M |
| 99283 |
|
67,461 |
57,724 |
$12.62M |
| 97110 |
|
93,711 |
26,966 |
$5.23M |
| 96374 |
|
36,926 |
29,934 |
$4.79M |
| H2019 |
Ther behav svc, per 15 min |
14,530 |
2,551 |
$3.66M |
| S9480 |
Intensive outpatient psychia |
24,109 |
4,083 |
$2.56M |
| 90834 |
|
35,020 |
18,132 |
$2.49M |
| 74177 |
|
12,882 |
10,927 |
$2.20M |
| 99291 |
|
2,880 |
2,448 |
$1.49M |
| U0003 |
Cov-19 amp prb hgh thruput |
26,078 |
21,546 |
$1.46M |
| T1017 |
Targeted case management |
11,519 |
2,477 |
$1.45M |
| 70450 |
|
15,775 |
12,940 |
$1.39M |
| 96360 |
|
11,387 |
9,519 |
$1.37M |
| 99282 |
|
12,361 |
10,984 |
$1.36M |
| G0463 |
Hospital outpt clinic visit |
28,916 |
16,880 |
$1.35M |
| 96361 |
|
30,575 |
23,973 |
$1.28M |
| 71046 |
|
27,177 |
23,114 |
$1.26M |
| 96365 |
|
11,575 |
7,209 |
$1.23M |
| 99213 |
|
21,831 |
18,998 |
$1.19M |
| J0585 |
Injection,onabotulinumtoxina |
2,794 |
1,568 |
$1.01M |
| 77067 |
|
10,290 |
9,489 |
$1.01M |
| 97140 |
|
55,358 |
16,770 |
$1.00M |
| 90791 |
|
10,580 |
8,699 |
$978K |
| 96375 |
|
26,003 |
20,012 |
$975K |
| 99214 |
|
10,441 |
8,900 |
$920K |
| 95810 |
|
1,161 |
1,023 |
$739K |
| 43239 |
|
2,288 |
1,965 |
$727K |
| 74176 |
|
6,257 |
5,314 |
$719K |
| 70553 |
|
2,925 |
2,528 |
$708K |
| 71045 |
|
14,470 |
11,452 |
$601K |
| 97161 |
|
10,801 |
9,516 |
$537K |
| 76641 |
|
6,267 |
5,597 |
$490K |
| 93975 |
|
2,499 |
2,215 |
$473K |
| 76705 |
|
5,397 |
4,626 |
$423K |
| 71260 |
|
3,032 |
2,598 |
$404K |
| U0005 |
Infec agen detec ampli probe |
22,064 |
18,351 |
$398K |
| 97035 |
|
5,886 |
2,143 |
$397K |
| 45380 |
|
808 |
715 |
$388K |
| 0240U |
|
3,556 |
3,311 |
$387K |
| 90853 |
|
23,059 |
7,964 |
$386K |
| 71275 |
|
3,436 |
2,881 |
$385K |
| 80053 |
|
103,914 |
83,178 |
$353K |
| 90832 |
|
7,175 |
4,951 |
$348K |
| 88342 |
|
5,350 |
4,568 |
$345K |
| H0035 |
Mh partial hosp tx under 24h |
1,913 |
369 |
$345K |
| 84443 |
|
36,318 |
32,008 |
$339K |
| 86900 |
|
10,572 |
6,176 |
$335K |
| 72148 |
|
2,574 |
2,181 |
$329K |
| 77065 |
Tomosynthesis, mammo |
3,681 |
3,043 |
$327K |
| 80061 |
|
38,635 |
33,516 |
$312K |
| 87491 |
|
12,015 |
10,843 |
$306K |
| 87591 |
|
11,974 |
10,810 |
$305K |
| 73721 |
|
1,842 |
1,540 |
$302K |
| 80307 |
|
22,573 |
16,116 |
$297K |
| 90792 |
|
2,805 |
2,561 |
$288K |
| 77066 |
Tomosynthesis, mammo |
2,861 |
2,539 |
$280K |
| 99215 |
Prolong outpt/office vis |
2,396 |
2,081 |
$277K |
| 85025 |
|
149,525 |
110,585 |
$274K |
| 92507 |
|
3,110 |
1,067 |
$273K |
| 76830 |
|
2,897 |
2,619 |
$266K |
| 82306 |
|
15,712 |
13,648 |
$259K |
| 88305 |
|
12,905 |
11,063 |
$251K |
| 94060 |
|
1,632 |
1,440 |
$248K |
| 97165 |
|
4,404 |
3,856 |
$240K |
| 71250 |
|
4,920 |
4,103 |
$235K |
| 93971 |
|
4,117 |
3,437 |
$234K |
| 74183 |
|
1,259 |
1,069 |
$226K |
| 76536 |
|
3,486 |
2,972 |
$221K |
| 76642 |
|
4,092 |
3,578 |
$212K |
| 97162 |
|
5,093 |
4,303 |
$206K |
| 97535 |
|
13,139 |
7,205 |
$203K |
| 45385 |
|
572 |
503 |
$203K |
| 70551 |
|
1,850 |
1,569 |
$196K |
| 76700 |
|
2,419 |
2,116 |
$195K |
| 72141 |
|
1,094 |
938 |
$182K |
| 59025 |
|
1,312 |
845 |
$179K |
| 97530 |
|
3,962 |
1,346 |
$176K |
| 70496 |
|
1,160 |
989 |
$161K |
| 76856 |
|
1,974 |
1,745 |
$156K |
| 64615 |
|
954 |
848 |
$146K |
| G0480 |
Drug test def 1-7 classes |
7,234 |
4,644 |
$146K |
| 87624 |
|
5,052 |
4,784 |
$137K |
| 90847 |
|
1,457 |
914 |
$137K |
| 77063 |
|
10,274 |
9,475 |
$134K |
| 76801 |
|
1,404 |
1,170 |
$134K |
| 0241U |
|
1,411 |
1,296 |
$130K |
| 36415 |
|
172,780 |
120,560 |
$128K |
| 90837 |
|
1,433 |
998 |
$127K |
| 97112 |
|
5,202 |
2,432 |
$126K |
| 78815 |
|
238 |
197 |
$122K |
| 95811 |
|
184 |
164 |
$115K |
| 83036 |
|
23,237 |
20,068 |
$113K |
| 87635 |
|
3,724 |
3,232 |
$111K |
| 76770 |
|
1,957 |
1,580 |
$107K |
| 73221 |
|
684 |
594 |
$106K |
| 29515 |
|
864 |
807 |
$104K |
| 96366 |
|
2,675 |
1,939 |
$103K |
| 99212 |
|
2,682 |
2,384 |
$100K |
| 97014 |
|
1,246 |
457 |
$99K |
| 77080 |
|
1,271 |
1,055 |
$98K |
| 72110 |
|
1,606 |
1,432 |
$96K |
| 73564 |
|
1,475 |
1,325 |
$96K |
| G0123 |
Screen cerv/vag thin layer |
7,168 |
6,753 |
$93K |
| 87389 |
|
6,858 |
6,175 |
$93K |
| 97113 |
|
1,515 |
473 |
$92K |
| 71271 |
|
1,004 |
889 |
$89K |
| 93005 |
|
45,329 |
34,149 |
$83K |
| 82607 |
|
11,117 |
9,610 |
$83K |
| 95819 |
|
642 |
542 |
$79K |
| 87660 |
|
4,748 |
4,322 |
$77K |
| 87510 |
|
4,748 |
4,322 |
$77K |
| 87480 |
|
4,748 |
4,322 |
$77K |
| 86803 |
|
8,455 |
7,430 |
$75K |
| 86618 |
|
6,579 |
4,386 |
$74K |
| 93970 |
|
705 |
590 |
$73K |
| 82728 |
|
11,130 |
9,527 |
$73K |
| 93306 |
|
991 |
856 |
$73K |
| 0001A |
|
2,380 |
1,997 |
$72K |
| 0002A |
|
2,033 |
1,880 |
$72K |
| 72125 |
|
6,159 |
5,150 |
$67K |
| 86780 |
|
6,242 |
5,584 |
$65K |
| 29505 |
|
606 |
551 |
$65K |
| 72100 |
|
3,022 |
2,621 |
$64K |
| 73030 |
|
4,731 |
3,988 |
$62K |
| 84439 |
|
12,861 |
10,905 |
$60K |
| 87086 |
|
20,464 |
17,145 |
$59K |
| 76811 |
|
284 |
261 |
$57K |
| 97116 |
|
4,037 |
1,707 |
$56K |
| 87426 |
|
2,247 |
1,938 |
$54K |
| 90846 |
|
534 |
436 |
$53K |
| 73630 |
|
4,906 |
4,292 |
$52K |
| 74019 |
|
1,547 |
1,270 |
$50K |
| 83970 |
|
2,708 |
2,309 |
$47K |
| 73502 |
|
3,525 |
2,974 |
$45K |
| G0103 |
Psa screening |
3,921 |
3,470 |
$44K |
| 86480 |
|
1,192 |
1,023 |
$44K |
| 87070 |
|
13,140 |
11,607 |
$43K |
| 80048 |
|
47,616 |
35,756 |
$43K |
| 96372 |
|
15,975 |
10,395 |
$41K |
| 95911 |
|
107 |
95 |
$41K |
| 73610 |
|
4,507 |
3,935 |
$40K |
| C9803 |
Hopd covid-19 spec collect |
3,164 |
2,861 |
$39K |
| 82746 |
|
5,745 |
4,918 |
$38K |
| 82947 |
|
20,398 |
12,167 |
$38K |
| 70491 |
|
240 |
223 |
$37K |
| 84403 |
|
1,957 |
1,763 |
$37K |
| 77336 |
|
829 |
274 |
$36K |
| 70486 |
|
1,441 |
1,236 |
$36K |
| 10061 |
|
126 |
121 |
$35K |
| 96367 |
|
1,324 |
812 |
$35K |
| 73130 |
|
3,712 |
3,225 |
$34K |
| 87502 |
|
5,754 |
4,724 |
$29K |
| 73110 |
|
3,035 |
2,596 |
$29K |
| 72070 |
|
747 |
661 |
$28K |
| 83540 |
|
8,970 |
7,572 |
$28K |
| 86038 |
|
3,939 |
3,445 |
$27K |
| 77062 |
|
2,374 |
2,118 |
$27K |
| 86235 |
|
697 |
596 |
$27K |
| 77061 |
|
2,447 |
2,182 |
$27K |
| 83550 |
|
6,737 |
5,637 |
$27K |
| 73562 |
|
4,380 |
3,832 |
$27K |
| G2083 |
Visit esketamine, > 56m |
35 |
12 |
$25K |
| 86617 |
|
2,007 |
1,361 |
$25K |
| 82784 |
|
3,566 |
2,968 |
$25K |
| 87186 |
|
8,709 |
7,303 |
$25K |
| 74018 |
|
1,226 |
969 |
$25K |
| 93880 |
|
327 |
289 |
$25K |
| 87340 |
|
4,987 |
4,427 |
$25K |
| 76775 |
|
563 |
539 |
$24K |
| 72052 |
|
318 |
285 |
$24K |
| 10060 |
|
148 |
134 |
$23K |
| 87077 |
|
8,190 |
6,981 |
$23K |
| 77334 |
|
67 |
38 |
$22K |
| 86753 |
|
1,907 |
1,279 |
$21K |
| 73140 |
|
2,204 |
1,932 |
$21K |
| 73700 |
|
469 |
389 |
$20K |
| 86140 |
|
9,475 |
7,838 |
$20K |
| 86666 |
|
2,426 |
1,633 |
$19K |
| 84146 |
|
1,414 |
1,232 |
$19K |
| G0297 |
Ldct for lung ca screen |
305 |
276 |
$18K |
| 83735 |
|
21,661 |
15,489 |
$18K |
| 98968 |
|
354 |
200 |
$17K |
| 98967 |
|
460 |
244 |
$17K |
| 86200 |
|
2,339 |
2,055 |
$17K |
| 96137 |
|
180 |
152 |
$17K |
| 19083 |
|
33 |
14 |
$17K |
| 72040 |
|
963 |
857 |
$16K |
| 95806 |
|
166 |
133 |
$16K |
| 84702 |
|
3,466 |
2,384 |
$16K |
| 84480 |
|
1,656 |
1,485 |
$15K |
| 72197 |
|
60 |
53 |
$15K |
| G0399 |
Home sleep test/type 3 porta |
160 |
135 |
$15K |
| 82043 |
|
5,233 |
4,503 |
$14K |
| 92610 |
|
398 |
336 |
$14K |
| 73080 |
|
1,685 |
1,460 |
$14K |
| 71101 |
|
924 |
822 |
$14K |
| 83516 |
|
1,624 |
1,193 |
$13K |
| 87147 |
|
5,223 |
4,764 |
$13K |
| 80076 |
|
5,563 |
4,816 |
$13K |
| 84425 |
|
922 |
842 |
$13K |
| 97166 |
|
345 |
293 |
$12K |
| 74246 |
|
85 |
78 |
$12K |
| 87081 |
|
3,243 |
2,679 |
$12K |
| 87631 |
|
133 |
127 |
$12K |
| 85027 |
|
4,328 |
3,675 |
$12K |
| 96413 |
|
53 |
38 |
$11K |
| 76882 |
|
247 |
225 |
$11K |
| 83655 |
|
1,035 |
997 |
$11K |
| 80164 |
|
2,058 |
1,666 |
$11K |
| 70498 |
|
1,061 |
898 |
$11K |
| 85652 |
|
8,766 |
7,450 |
$10K |
| 82570 |
|
5,271 |
4,333 |
$10K |
| 92523 |
|
68 |
60 |
$10K |
| 86376 |
|
1,216 |
1,079 |
$10K |
| 96131 |
|
51 |
51 |
$10K |
| 88304 |
|
1,653 |
1,450 |
$10K |
| 86430 |
|
3,219 |
2,774 |
$9K |
| 83690 |
|
26,574 |
21,699 |
$9K |
| 97010 |
|
131 |
62 |
$9K |
| 88307 |
|
404 |
309 |
$9K |
| G0378 |
Hospital observation per hr |
28,885 |
9,973 |
$9K |
| 84481 |
|
968 |
811 |
$9K |
| 81001 |
|
26,486 |
21,714 |
$8K |
| G0279 |
Tomosynthesis, mammo |
399 |
379 |
$8K |
| 86706 |
|
1,248 |
1,103 |
$8K |
| 99281 |
|
158 |
115 |
$8K |
| 83880 |
|
4,981 |
4,002 |
$8K |
| 80074 |
|
257 |
232 |
$8K |
| 85610 |
|
24,048 |
14,734 |
$8K |
| 87625 |
|
272 |
265 |
$8K |
| 86800 |
|
782 |
713 |
$7K |
| 83001 |
|
545 |
487 |
$7K |
| 87899 |
|
881 |
573 |
$7K |
| 84165 |
|
1,822 |
1,469 |
$7K |
| 93308 |
|
59 |
54 |
$7K |
| 84550 |
|
4,977 |
4,095 |
$7K |
| 90833 |
|
148 |
95 |
$7K |
| 96130 |
|
101 |
94 |
$7K |
| 82105 |
|
655 |
579 |
$7K |
| 93798 |
|
73 |
12 |
$6K |
| M0245 |
Bamlan and etesev infusion |
18 |
17 |
$6K |
| 72131 |
|
114 |
101 |
$6K |
| 84402 |
|
329 |
287 |
$6K |
| 86762 |
|
1,814 |
1,605 |
$6K |
| 87522 |
Neg quan hep c or qual rna |
215 |
197 |
$6K |
| 86364 |
|
693 |
641 |
$6K |
| 73560 |
|
522 |
414 |
$6K |
| 86769 |
|
189 |
161 |
$6K |
| 74220 |
|
55 |
52 |
$6K |
| 82550 |
|
3,546 |
2,643 |
$5K |
| 86334 |
|
698 |
537 |
$5K |
| 76805 |
|
44 |
43 |
$5K |
| 11042 |
|
24 |
14 |
$5K |
| 73590 |
|
840 |
727 |
$5K |
| P9016 |
Rbc leukocytes reduced |
92 |
53 |
$5K |
| 82950 |
|
1,273 |
1,178 |
$5K |
| 99406 |
|
1,008 |
959 |
$5K |
| 83615 |
|
2,699 |
2,040 |
$5K |
| 85730 |
|
5,432 |
4,438 |
$5K |
| 87046 |
|
765 |
663 |
$5K |
| 86039 |
|
684 |
615 |
$5K |
| 81003 |
|
17,389 |
14,806 |
$4K |
| 81025 |
|
8,869 |
7,732 |
$4K |
| 80178 |
|
1,283 |
1,059 |
$4K |
| 36430 |
|
75 |
40 |
$4K |
| 87205 |
|
3,976 |
3,188 |
$4K |
| U0002 |
Covid-19 lab test non-cdc |
137 |
124 |
$4K |
| 82565 |
|
4,961 |
4,014 |
$4K |
| 82248 |
|
2,046 |
1,686 |
$4K |
| 83721 |
|
802 |
713 |
$4K |
| 74021 |
|
79 |
73 |
$4K |
| 82247 |
|
3,518 |
2,836 |
$4K |
| 74230 |
|
63 |
54 |
$4K |
| 84100 |
|
6,060 |
4,288 |
$4K |
| 96136 |
|
115 |
109 |
$3K |
| 86787 |
|
419 |
338 |
$3K |
| 87045 |
|
765 |
663 |
$3K |
| 87209 |
|
447 |
323 |
$3K |
| 84153 |
|
391 |
344 |
$3K |
| 86225 |
|
388 |
341 |
$3K |
| 84450 |
|
3,746 |
3,080 |
$3K |
| 82533 |
|
282 |
259 |
$3K |
| 83002 |
|
213 |
188 |
$3K |
| 83520 |
|
379 |
258 |
$3K |
| 87493 |
|
216 |
195 |
$3K |
| 0004A |
|
81 |
76 |
$3K |
| 73660 |
|
291 |
262 |
$2K |
| 94640 |
|
10,973 |
6,756 |
$2K |
| 76815 |
|
28 |
26 |
$2K |
| 84703 |
|
15,315 |
13,070 |
$2K |
| 0012A |
|
96 |
77 |
$2K |
| 95910 |
|
17 |
12 |
$2K |
| 99442 |
|
321 |
289 |
$2K |
| 82670 |
|
97 |
93 |
$2K |
| 0064A |
|
57 |
56 |
$2K |
| 87177 |
|
447 |
323 |
$2K |
| P9604 |
One-way allow prorated trip |
1,468 |
898 |
$2K |
| 84156 |
|
1,885 |
1,451 |
$2K |
| 25600 |
|
17 |
12 |
$2K |
| 87015 |
|
647 |
557 |
$2K |
| 87075 |
|
1,344 |
1,124 |
$2K |
| 84630 |
|
279 |
248 |
$2K |
| 82150 |
|
515 |
460 |
$2K |
| S0119 |
Ondansetron 4 mg |
1,895 |
1,682 |
$2K |
| 84590 |
|
253 |
234 |
$2K |
| 0011A |
|
252 |
110 |
$2K |
| 87469 |
|
92 |
84 |
$2K |
| 74247 |
|
12 |
12 |
$2K |
| 82040 |
|
3,064 |
2,616 |
$2K |
| 83525 |
|
185 |
174 |
$2K |
| 73090 |
|
268 |
228 |
$2K |
| 82525 |
|
211 |
191 |
$2K |
| 92611 |
|
49 |
42 |
$2K |
| 82140 |
|
772 |
614 |
$2K |
| 86160 |
|
150 |
135 |
$2K |
| 82310 |
|
3,002 |
2,511 |
$1K |
| 0071A |
|
38 |
38 |
$1K |
| 87400 |
|
2,140 |
1,751 |
$1K |
| 85014 |
|
2,016 |
1,498 |
$1K |
| 85379 |
|
5,348 |
4,544 |
$1K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
23,233 |
19,004 |
$1K |
| 80050 |
|
1,569 |
912 |
$1K |
| J3490 |
Drugs unclassified injection |
60,140 |
22,585 |
$1K |
| 0072A |
|
30 |
30 |
$1K |
| 73521 |
|
40 |
37 |
$1K |
| 85018 |
|
2,310 |
1,629 |
$1K |
| 90839 |
|
1,702 |
1,416 |
$1K |
| 86255 |
|
175 |
137 |
$1K |
| 84484 |
|
26,797 |
15,228 |
$1K |
| 80051 |
|
842 |
681 |
$985.71 |
| 86850 |
|
7,347 |
6,004 |
$942.60 |
| 84134 |
|
243 |
210 |
$904.80 |
| 73120 |
|
28 |
25 |
$833.37 |
| 86003 |
|
14 |
12 |
$811.74 |
| C9399 |
Unclassified drugs or biolog |
519 |
414 |
$808.03 |
| G8979 |
Mobility goal status |
1,072 |
898 |
$753.00 |
| 86765 |
|
70 |
67 |
$750.91 |
| 12001 |
|
1,918 |
1,685 |
$750.57 |
| 86735 |
|
69 |
64 |
$747.60 |
| 86308 |
|
496 |
449 |
$714.06 |
| 83883 |
|
69 |
64 |
$661.98 |
| G8978 |
Mobility current status |
951 |
801 |
$650.00 |
| 84436 |
|
221 |
183 |
$644.26 |
| 87207 |
|
710 |
636 |
$624.00 |
| 87040 |
|
7,824 |
3,514 |
$566.99 |
| 84155 |
|
1,796 |
1,517 |
$563.03 |
| 87880 |
|
3,456 |
3,116 |
$549.13 |
| 87427 |
|
58 |
53 |
$547.84 |
| 86923 |
|
33 |
25 |
$519.72 |
| 70544 |
|
27 |
26 |
$517.83 |
| 82378 |
|
41 |
26 |
$507.36 |
| 80159 |
|
28 |
24 |
$459.16 |
| 90471 |
|
3,834 |
3,059 |
$450.71 |
| Q3014 |
Telehealth facility fee |
28 |
26 |
$360.52 |
| 86705 |
|
82 |
63 |
$360.00 |
| 84075 |
|
2,739 |
2,314 |
$356.42 |
| 84460 |
|
3,858 |
3,169 |
$355.22 |
| 82627 |
|
26 |
25 |
$318.45 |
| 84112 |
|
18 |
13 |
$307.60 |
| 96376 |
|
10,470 |
6,428 |
$305.71 |
| 83993 |
|
17 |
15 |
$300.00 |
| 12002 |
|
797 |
692 |
$296.95 |
| 99443 |
|
60 |
46 |
$285.58 |
| 82977 |
|
93 |
85 |
$277.76 |
| J7030 |
Normal saline solution infus |
40,768 |
30,950 |
$275.63 |
| J1650 |
Inj enoxaparin sodium |
5,724 |
2,324 |
$263.04 |
| 86696 |
|
12 |
12 |
$258.72 |
| J2405 |
Ondansetron hcl injection |
26,204 |
19,540 |
$256.01 |
| 84520 |
|
2,790 |
2,356 |
$254.07 |
| 83605 |
|
8,837 |
6,188 |
$232.49 |
| 74175 |
|
24 |
24 |
$223.92 |
| 90714 |
|
3,347 |
2,902 |
$217.87 |
| 87651 |
|
521 |
493 |
$216.54 |
| 83521 |
|
15 |
12 |
$197.76 |
| 85045 |
|
135 |
120 |
$194.82 |
| 82747 |
|
16 |
12 |
$181.94 |
| 86304 |
|
17 |
14 |
$178.83 |
| 86695 |
|
12 |
12 |
$176.40 |
| 87338 |
|
12 |
12 |
$151.03 |
| 87449 |
|
19 |
17 |
$148.85 |
| 86704 |
|
14 |
14 |
$138.12 |
| 84132 |
|
267 |
206 |
$132.56 |
| 72170 |
|
41 |
38 |
$122.61 |
| 0054A |
|
33 |
28 |
$120.00 |
| 86141 |
|
13 |
13 |
$111.24 |
| 82010 |
|
1,173 |
927 |
$101.40 |
| 84295 |
|
2,620 |
2,167 |
$98.76 |
| 82803 |
|
1,348 |
1,026 |
$94.62 |
| 87807 |
|
82 |
71 |
$93.25 |
| 88300 |
|
14 |
12 |
$77.61 |
| 80175 |
|
12 |
12 |
$75.96 |
| 88313 |
|
1,647 |
1,414 |
$73.89 |
| 88173 |
|
61 |
39 |
$55.57 |
| 80177 |
|
16 |
12 |
$50.64 |
| J7613 |
Albuterol non-comp unit |
1,567 |
1,362 |
$47.24 |
| G8980 |
Mobility d/c status |
69 |
64 |
$47.00 |
| 88108 |
|
157 |
131 |
$44.46 |
| 29125 |
|
850 |
774 |
$41.58 |
| 82800 |
|
133 |
110 |
$40.40 |
| G0177 |
Opps/php/iop; train & educ |
1,685 |
352 |
$39.30 |
| J2765 |
Metoclopramide hcl injection |
5,086 |
4,084 |
$37.42 |
| C1769 |
Guide wire |
831 |
599 |
$37.02 |
| J1885 |
Ketorolac tromethamine inj |
20,395 |
16,098 |
$30.80 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
3,931 |
3,061 |
$26.80 |
| J1170 |
Hydromorphone injection |
9,923 |
6,085 |
$26.39 |
| 82435 |
|
2,096 |
1,754 |
$26.30 |
| J1200 |
Diphenhydramine hcl injectio |
4,074 |
3,284 |
$22.98 |
| J7512 |
Prednisone ir or dr oral 1mg |
6,639 |
4,640 |
$22.97 |
| 86901 |
|
10,580 |
6,175 |
$21.63 |
| J2270 |
Morphine sulfate injection |
6,624 |
4,715 |
$17.40 |
| A9270 |
Non-covered item or service |
6,956 |
4,511 |
$16.67 |
| J7050 |
Normal saline solution infus |
24,797 |
17,238 |
$15.74 |
| 85049 |
|
60 |
51 |
$14.96 |
| J1815 |
Insulin injection |
4,903 |
1,611 |
$14.82 |
| 86703 |
|
555 |
526 |
$13.71 |
| 84145 |
|
203 |
156 |
$12.90 |
| J1100 |
Dexamethasone sodium phos |
7,245 |
5,589 |
$12.30 |
| J7620 |
Albuterol ipratrop non-comp |
2,053 |
1,687 |
$12.13 |
| 82374 |
|
2,082 |
1,742 |
$12.01 |
| 87210 |
|
17 |
14 |
$11.70 |
| J2060 |
Lorazepam injection |
5,457 |
4,107 |
$9.36 |
| J0696 |
Ceftriaxone sodium injection |
4,830 |
2,989 |
$8.89 |
| J2920 |
Methylprednisolone injection |
721 |
417 |
$8.16 |
| J3360 |
Diazepam injection |
1,045 |
775 |
$8.01 |
| G8988 |
Self care goal status |
15 |
12 |
$8.00 |
| J0690 |
Cefazolin sodium injection |
8,092 |
5,114 |
$7.74 |
| J1644 |
Inj heparin sodium per 1000u |
6,170 |
2,603 |
$7.54 |
| J7120 |
Ringers lactate infusion |
15,973 |
11,757 |
$6.87 |
| J2930 |
Methylprednisolone injection |
1,762 |
1,435 |
$6.11 |
| J3010 |
Fentanyl citrate injection |
11,870 |
8,715 |
$5.25 |
| J2250 |
Inj midazolam hydrochloride |
9,589 |
7,831 |
$4.97 |
| 89050 |
|
16 |
14 |
$4.52 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
711 |
463 |
$3.89 |
| 94727 |
|
1,462 |
1,290 |
$2.64 |
| J2001 |
Lidocaine injection |
2,148 |
1,917 |
$2.40 |
| 94729 |
|
1,484 |
1,312 |
$1.97 |
| J7040 |
Normal saline solution infus |
7,853 |
5,899 |
$1.94 |
| J1940 |
Furosemide injection |
671 |
368 |
$1.32 |
| G1004 |
Cdsm ndsc |
9,185 |
6,457 |
$0.02 |
| 88341 |
|
1,966 |
1,618 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
11,589 |
9,464 |
$0.00 |
| A9585 |
Gadobutrol injection |
3,726 |
2,710 |
$0.00 |
| J1630 |
Haloperidol injection |
1,827 |
1,343 |
$0.00 |
| 95886 |
|
1,600 |
1,408 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
4,051 |
2,705 |
$0.00 |
| A4648 |
Implantable tissue marker |
348 |
262 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
576 |
460 |
$0.00 |
| C9290 |
Inj, bupivacaine liposome |
377 |
272 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
488 |
340 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
731 |
259 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
417 |
360 |
$0.00 |
| J8540 |
Oral dexamethasone |
630 |
477 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
168 |
130 |
$0.00 |
| J3411 |
Thiamine hcl 100 mg |
214 |
67 |
$0.00 |
| 91301 |
|
308 |
186 |
$0.00 |
| J1920 |
Inj, labetalol hcl, 5mg |
18 |
13 |
$0.00 |
| J3480 |
Inj potassium chloride |
411 |
234 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
461 |
258 |
$0.00 |
| 0204U |
|
64 |
59 |
$0.00 |
| J2471 |
Inj pantoprazole(hikma) 40mg |
134 |
72 |
$0.00 |
| 36410 |
|
292 |
209 |
$0.00 |
| 36000 |
|
49 |
28 |
$0.00 |
| 91305 |
|
64 |
31 |
$0.00 |
| 91306 |
|
24 |
24 |
$0.00 |
| 29130 |
|
13 |
13 |
$0.00 |
| 91307 |
|
69 |
69 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
25 |
12 |
$0.00 |
| J1642 |
Inj heparin sodium per 10 u |
110 |
66 |
$0.00 |
| J0456 |
Azithromycin |
95 |
68 |
$0.00 |
| C1726 |
Cath, bal dil, non-vascular |
15 |
12 |
$0.00 |
| J7060 |
5% dextrose/water |
17 |
15 |
$0.00 |
| C2617 |
Stent, non-cor, tem w/o del |
16 |
15 |
$0.00 |
| 73060 |
|
15 |
15 |
$0.00 |
| J3370 |
Vancomycin hcl injection |
2,496 |
1,214 |
$0.00 |
| 91300 |
|
4,396 |
3,525 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
302 |
241 |
$0.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
201 |
113 |
$0.00 |
| 12011 |
|
756 |
701 |
$0.00 |
| 99152 |
|
727 |
585 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
2,820 |
2,002 |
$0.00 |
| J1580 |
Garamycin gentamicin inj |
523 |
372 |
$0.00 |
| Q0163 |
Diphenhydramine hcl 50mg |
50 |
46 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
371 |
313 |
$0.00 |
| 76937 |
|
114 |
101 |
$0.00 |
| 76376 |
|
66 |
61 |
$0.00 |
| J1953 |
Levetiracetam injection |
16 |
13 |
$0.00 |
| C1751 |
Cath, inf, per/cent/midline |
628 |
494 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
1,973 |
962 |
$0.00 |
| J2274 |
Inj morphine pf epid ithc |
20 |
16 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
315 |
259 |
$0.00 |
| J2550 |
Promethazine hcl injection |
1,746 |
1,364 |
$0.00 |
| J0688 |
Inj cefazolin sodium, hikma |
1,346 |
923 |
$0.00 |
| A9552 |
F18 fdg |
158 |
146 |
$0.00 |
| 51701 |
|
579 |
525 |
$0.00 |
| 85520 |
|
70 |
49 |
$0.00 |
| J2916 |
Na ferric gluconate complex |
60 |
26 |
$0.00 |
| 76942 |
|
26 |
25 |
$0.00 |
| 51702 |
|
15 |
13 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
19 |
17 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
220 |
148 |
$0.00 |
| C1758 |
Catheter, ureteral |
63 |
52 |
$0.00 |
| 99211 |
|
14 |
14 |
$0.00 |
| J7510 |
Prednisolone oral per 5 mg |
36 |
27 |
$0.00 |
| 76000 |
|
61 |
43 |
$0.00 |
| J0780 |
Prochlorperazine injection |
15 |
13 |
$0.00 |