| Code | Description | Claims | Beneficiaries | Total Paid |
| 42820 |
|
979 |
966 |
$2.51M |
| J1745 |
Infliximab not biosimil 10mg |
756 |
649 |
$1.93M |
| 97530 |
|
25,735 |
10,061 |
$1.74M |
| G0463 |
Hospital outpt clinic visit |
86,012 |
64,431 |
$1.46M |
| 92507 |
|
22,066 |
7,637 |
$1.23M |
| 69436 |
|
1,007 |
998 |
$1.12M |
| 74177 |
|
5,930 |
5,609 |
$755K |
| 97110 |
|
19,455 |
8,133 |
$526K |
| 99283 |
|
7,151 |
6,228 |
$421K |
| 80053 |
|
62,872 |
51,958 |
$414K |
| 85025 |
|
82,292 |
64,988 |
$410K |
| 42830 |
|
263 |
262 |
$396K |
| J9312 |
Inj., rituximab, 10 mg |
205 |
111 |
$385K |
| 41899 |
|
342 |
322 |
$350K |
| 97112 |
|
10,182 |
4,411 |
$316K |
| 99284 |
|
5,715 |
5,013 |
$308K |
| G0480 |
Drug test def 1-7 classes |
4,194 |
3,642 |
$273K |
| J9310 |
Rituximab injection |
148 |
87 |
$259K |
| J0897 |
Denosumab injection |
447 |
436 |
$209K |
| U0003 |
Cov-19 amp prb hgh thruput |
3,839 |
3,504 |
$205K |
| 92523 |
|
1,406 |
1,376 |
$199K |
| J2469 |
Palonosetron hcl |
1,397 |
791 |
$192K |
| 70553 |
|
1,253 |
1,236 |
$191K |
| 84443 |
|
15,780 |
15,100 |
$188K |
| 70450 |
|
4,876 |
4,535 |
$186K |
| 99282 |
|
3,864 |
3,410 |
$176K |
| 71275 |
|
1,779 |
1,700 |
$175K |
| 92526 |
|
2,727 |
1,639 |
$161K |
| 87491 |
|
4,522 |
4,381 |
$157K |
| 87591 |
|
4,461 |
4,322 |
$155K |
| 76816 |
|
2,789 |
2,293 |
$153K |
| 97140 |
|
7,035 |
3,170 |
$144K |
| G0482 |
Drug test def 15-21 classes |
1,085 |
1,028 |
$140K |
| J0585 |
Injection,onabotulinumtoxina |
1,139 |
696 |
$140K |
| 76805 |
|
1,863 |
1,835 |
$129K |
| 71046 |
|
9,870 |
9,387 |
$122K |
| 62322 |
|
245 |
243 |
$116K |
| 70551 |
|
1,255 |
1,229 |
$116K |
| 97162 |
|
3,049 |
2,858 |
$113K |
| 99285 |
|
1,532 |
1,379 |
$111K |
| J2505 |
Injection, pegfilgrastim 6mg |
32 |
25 |
$110K |
| 36415 |
|
69,448 |
57,655 |
$110K |
| 78815 |
|
207 |
202 |
$105K |
| 96374 |
|
5,718 |
4,727 |
$102K |
| 76817 |
|
2,317 |
1,954 |
$99K |
| 76705 |
|
2,339 |
2,266 |
$99K |
| 82306 |
|
5,268 |
5,031 |
$96K |
| 76830 |
|
1,553 |
1,506 |
$92K |
| 74176 |
|
1,392 |
1,341 |
$89K |
| J0185 |
Inj., aprepitant, 1 mg |
484 |
307 |
$89K |
| 87086 |
|
15,079 |
13,677 |
$87K |
| 97116 |
|
4,362 |
1,659 |
$85K |
| 73721 |
|
707 |
690 |
$77K |
| 80061 |
|
9,271 |
8,869 |
$75K |
| 72148 |
|
890 |
878 |
$75K |
| G0378 |
Hospital observation per hr |
2,521 |
1,062 |
$74K |
| 44970 |
|
25 |
25 |
$74K |
| 70496 |
|
675 |
656 |
$74K |
| 87804 |
|
4,814 |
4,374 |
$73K |
| 76770 |
|
1,336 |
1,320 |
$70K |
| 96361 |
|
3,400 |
2,905 |
$68K |
| 97161 |
|
1,341 |
1,270 |
$68K |
| 80048 |
|
12,897 |
11,006 |
$65K |
| 71260 |
|
879 |
854 |
$63K |
| 72125 |
|
1,277 |
1,203 |
$62K |
| 96365 |
|
2,083 |
1,561 |
$62K |
| 47562 |
|
26 |
25 |
$61K |
| 77067 |
|
1,840 |
1,815 |
$61K |
| 83690 |
|
12,967 |
11,548 |
$60K |
| 76815 |
|
1,585 |
1,287 |
$60K |
| 97166 |
|
1,107 |
1,054 |
$59K |
| 87633 |
|
161 |
149 |
$58K |
| 84484 |
|
10,940 |
8,743 |
$55K |
| 70498 |
|
540 |
521 |
$54K |
| J1459 |
Inj ivig privigen 500 mg |
89 |
28 |
$53K |
| 96413 |
|
1,120 |
715 |
$53K |
| 97163 |
|
1,440 |
1,319 |
$52K |
| 72141 |
|
601 |
593 |
$52K |
| 92609 |
|
767 |
335 |
$51K |
| 78452 |
|
285 |
281 |
$50K |
| 84439 |
|
6,599 |
6,393 |
$49K |
| 87077 |
|
7,637 |
7,093 |
$49K |
| 11042 |
|
1,196 |
813 |
$49K |
| 87081 |
|
7,129 |
7,004 |
$47K |
| 87624 |
|
1,330 |
1,305 |
$47K |
| 76811 |
|
740 |
731 |
$46K |
| 83880 |
|
3,257 |
2,914 |
$46K |
| 87641 |
|
1,691 |
1,546 |
$45K |
| J1453 |
Fosaprepitant injection |
245 |
155 |
$45K |
| 87640 |
|
1,682 |
1,539 |
$45K |
| 81001 |
|
20,451 |
18,290 |
$44K |
| 81025 |
|
6,992 |
6,532 |
$43K |
| 97750 |
|
1,071 |
835 |
$42K |
| 96375 |
|
4,503 |
3,387 |
$41K |
| 83036 |
|
10,113 |
9,662 |
$41K |
| 71045 |
|
8,826 |
8,070 |
$41K |
| J7120 |
Ringers lactate infusion |
18,781 |
15,405 |
$38K |
| 96360 |
|
1,556 |
1,349 |
$37K |
| 83605 |
|
5,958 |
4,970 |
$37K |
| 74018 |
|
2,837 |
2,672 |
$36K |
| 87880 |
|
2,895 |
2,834 |
$36K |
| 82728 |
|
3,595 |
3,454 |
$36K |
| U0002 |
Covid-19 lab test non-cdc |
852 |
834 |
$36K |
| 73630 |
|
2,732 |
2,498 |
$36K |
| 77066 |
Tomosynthesis, mammo |
506 |
497 |
$35K |
| 83970 |
|
1,385 |
1,332 |
$35K |
| 76801 |
|
621 |
602 |
$34K |
| 97535 |
|
1,747 |
1,151 |
$34K |
| 83735 |
|
7,872 |
5,275 |
$33K |
| 76856 |
|
670 |
655 |
$33K |
| 87505 |
|
299 |
292 |
$33K |
| 80306 |
|
3,199 |
2,865 |
$32K |
| 76642 |
|
1,020 |
1,002 |
$32K |
| 73610 |
|
2,161 |
1,975 |
$31K |
| 87186 |
|
5,234 |
4,859 |
$30K |
| 84702 |
|
2,051 |
1,583 |
$30K |
| 73564 |
|
1,810 |
1,733 |
$30K |
| J0129 |
Abatacept injection |
28 |
24 |
$29K |
| 80047 |
|
3,116 |
1,976 |
$29K |
| 80076 |
|
3,836 |
2,661 |
$29K |
| 86140 |
|
9,215 |
8,082 |
$29K |
| 87040 |
|
3,609 |
2,321 |
$28K |
| 86003 |
|
447 |
408 |
$28K |
| 71250 |
|
640 |
629 |
$28K |
| 74230 |
|
446 |
439 |
$27K |
| 92611 |
|
462 |
453 |
$27K |
| 74183 |
|
190 |
185 |
$27K |
| 70491 |
|
303 |
297 |
$27K |
| J7030 |
Normal saline solution infus |
16,875 |
13,628 |
$26K |
| 76700 |
|
517 |
512 |
$26K |
| 86703 |
|
2,003 |
1,950 |
$26K |
| 86762 |
|
1,962 |
1,916 |
$25K |
| 92610 |
|
470 |
451 |
$25K |
| 93306 |
|
329 |
320 |
$25K |
| 82784 |
|
2,018 |
1,958 |
$25K |
| A9552 |
F18 fdg |
167 |
163 |
$24K |
| 86850 |
|
3,556 |
3,341 |
$24K |
| 87340 |
|
2,378 |
2,325 |
$23K |
| 85379 |
|
3,772 |
3,546 |
$23K |
| 73110 |
|
1,274 |
1,203 |
$23K |
| 97760 |
|
882 |
512 |
$23K |
| 72082 |
|
727 |
720 |
$23K |
| 84481 |
|
1,629 |
1,589 |
$22K |
| 93005 |
|
8,360 |
6,719 |
$22K |
| U0005 |
Infec agen detec ampli probe |
1,928 |
1,691 |
$21K |
| 87506 |
|
123 |
122 |
$21K |
| 42821 |
|
12 |
12 |
$21K |
| 87798 |
|
556 |
535 |
$21K |
| 87389 |
|
845 |
835 |
$21K |
| 83615 |
|
3,774 |
2,559 |
$21K |
| 20680 |
|
12 |
12 |
$20K |
| 70486 |
|
324 |
317 |
$20K |
| 83516 |
|
1,806 |
1,655 |
$20K |
| 73130 |
|
1,242 |
1,160 |
$20K |
| 82607 |
|
2,230 |
2,130 |
$19K |
| 84100 |
|
5,286 |
3,519 |
$19K |
| 73221 |
|
183 |
180 |
$19K |
| 82962 |
|
9,843 |
6,046 |
$19K |
| 73502 |
|
1,244 |
1,191 |
$19K |
| 87070 |
|
2,721 |
2,509 |
$19K |
| 73030 |
|
1,719 |
1,587 |
$18K |
| 85610 |
|
8,618 |
6,216 |
$18K |
| 84403 |
|
928 |
895 |
$18K |
| 82533 |
|
797 |
608 |
$18K |
| 96372 |
|
4,100 |
2,790 |
$17K |
| 84550 |
|
4,126 |
2,867 |
$17K |
| 72100 |
|
1,290 |
1,264 |
$17K |
| 76536 |
|
306 |
298 |
$17K |
| 77065 |
Tomosynthesis, mammo |
326 |
300 |
$16K |
| 86803 |
|
1,606 |
1,532 |
$16K |
| 97165 |
|
310 |
292 |
$16K |
| J7050 |
Normal saline solution infus |
32,199 |
18,017 |
$16K |
| 87420 |
|
1,191 |
1,176 |
$16K |
| 87635 |
|
2,078 |
1,803 |
$16K |
| G0481 |
Drug test def 8-14 classes |
136 |
132 |
$16K |
| 82803 |
|
908 |
784 |
$15K |
| J2704 |
Inj, propofol, 10 mg |
10,427 |
9,546 |
$15K |
| 81003 |
|
9,088 |
7,885 |
$15K |
| 85652 |
|
8,102 |
7,335 |
$14K |
| 97167 |
|
290 |
268 |
$14K |
| 73140 |
|
776 |
717 |
$14K |
| 73090 |
|
979 |
804 |
$14K |
| 84305 |
|
700 |
694 |
$13K |
| 76813 |
|
289 |
281 |
$13K |
| 64721 |
|
13 |
13 |
$13K |
| 76942 |
|
741 |
724 |
$12K |
| 83001 |
|
684 |
555 |
$12K |
| 83550 |
|
1,948 |
1,894 |
$12K |
| 73100 |
|
733 |
578 |
$12K |
| 73080 |
|
782 |
723 |
$12K |
| 86901 |
|
4,144 |
3,704 |
$12K |
| J3010 |
Fentanyl citrate injection |
15,977 |
11,578 |
$12K |
| 90471 |
|
1,323 |
1,213 |
$12K |
| 72170 |
|
774 |
755 |
$11K |
| 86235 |
|
171 |
164 |
$11K |
| 83540 |
|
2,546 |
2,455 |
$11K |
| 90715 |
|
877 |
842 |
$11K |
| J2785 |
Regadenoson injection |
111 |
111 |
$11K |
| 86593 |
|
2,611 |
2,552 |
$11K |
| 84703 |
|
1,464 |
1,426 |
$10K |
| 73590 |
|
837 |
752 |
$10K |
| 86900 |
|
3,643 |
3,299 |
$10K |
| 82746 |
|
1,043 |
1,010 |
$10K |
| 82570 |
|
3,711 |
3,401 |
$10K |
| J2997 |
Alteplase recombinant |
109 |
79 |
$10K |
| J1100 |
Dexamethasone sodium phos |
11,799 |
9,907 |
$9K |
| 36416 |
|
3,300 |
2,699 |
$9K |
| 86160 |
|
479 |
455 |
$9K |
| J0690 |
Cefazolin sodium injection |
5,249 |
4,108 |
$9K |
| A9500 |
Tc99m sestamibi |
142 |
142 |
$9K |
| J1170 |
Hydromorphone injection |
4,569 |
3,408 |
$9K |
| 73070 |
|
609 |
515 |
$9K |
| 84146 |
|
521 |
501 |
$9K |
| 72040 |
|
699 |
681 |
$9K |
| G0297 |
Ldct for lung ca screen |
160 |
154 |
$9K |
| 97763 |
|
236 |
154 |
$9K |
| J1885 |
Ketorolac tromethamine inj |
10,964 |
9,388 |
$9K |
| 76820 |
|
496 |
221 |
$9K |
| 80197 |
|
1,185 |
673 |
$9K |
| 82950 |
|
1,808 |
1,780 |
$9K |
| 73560 |
|
591 |
546 |
$9K |
| 86376 |
|
695 |
680 |
$9K |
| 84153 |
|
796 |
773 |
$9K |
| 80074 |
|
187 |
182 |
$8K |
| 87205 |
|
2,631 |
2,335 |
$8K |
| 85730 |
|
1,765 |
1,675 |
$8K |
| 82670 |
|
353 |
347 |
$8K |
| 72146 |
|
88 |
87 |
$8K |
| 99213 |
|
466 |
415 |
$8K |
| J2405 |
Ondansetron hcl injection |
17,330 |
14,415 |
$7K |
| 80069 |
|
1,224 |
1,044 |
$7K |
| 82550 |
|
1,511 |
1,366 |
$7K |
| 77080 |
|
728 |
725 |
$7K |
| J3490 |
Drugs unclassified injection |
59 |
55 |
$7K |
| 73562 |
|
466 |
454 |
$6K |
| J2930 |
Methylprednisolone injection |
1,082 |
898 |
$6K |
| G0439 |
Ppps, subseq visit |
2,822 |
2,592 |
$6K |
| 82731 |
|
95 |
89 |
$6K |
| 87449 |
|
629 |
594 |
$6K |
| 80164 |
|
630 |
598 |
$6K |
| 76819 |
|
164 |
82 |
$6K |
| 86481 |
|
79 |
77 |
$6K |
| J2550 |
Promethazine hcl injection |
2,691 |
2,273 |
$6K |
| G0008 |
Admin influenza virus vac |
2,906 |
2,732 |
$6K |
| 72081 |
|
317 |
315 |
$6K |
| 29581 |
|
1,526 |
467 |
$6K |
| 99212 |
|
522 |
418 |
$6K |
| 96415 |
|
191 |
157 |
$6K |
| 86038 |
|
641 |
623 |
$6K |
| J0780 |
Prochlorperazine injection |
845 |
763 |
$6K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
4,454 |
3,876 |
$5K |
| 74022 |
|
321 |
310 |
$5K |
| 86800 |
|
401 |
388 |
$5K |
| J1756 |
Iron sucrose injection |
205 |
101 |
$5K |
| 82247 |
|
936 |
549 |
$5K |
| J0696 |
Ceftriaxone sodium injection |
2,560 |
1,915 |
$5K |
| 87324 |
|
543 |
528 |
$5K |
| J9370 |
Vincristine sulfate 1 mg inj |
899 |
608 |
$5K |
| J1642 |
Inj heparin sodium per 10 u |
1,739 |
1,066 |
$5K |
| 78227 |
|
15 |
15 |
$5K |
| 87486 |
|
161 |
149 |
$5K |
| 87581 |
|
161 |
149 |
$5K |
| S9470 |
Nutritional counseling, diet |
243 |
237 |
$5K |
| 97164 |
|
152 |
145 |
$5K |
| 72070 |
|
366 |
360 |
$5K |
| 73552 |
|
322 |
294 |
$5K |
| 82043 |
|
1,871 |
1,799 |
$5K |
| J3489 |
Zoledronic acid 1mg |
184 |
170 |
$5K |
| 86920 |
|
243 |
183 |
$5K |
| 84156 |
|
1,593 |
1,360 |
$4K |
| 83002 |
|
389 |
311 |
$4K |
| 72131 |
|
76 |
75 |
$4K |
| 96366 |
|
129 |
73 |
$4K |
| J2795 |
Ropivacaine hcl injection |
1,406 |
1,316 |
$4K |
| 83520 |
|
292 |
269 |
$4K |
| 92522 |
|
58 |
58 |
$4K |
| 82378 |
|
309 |
271 |
$4K |
| 84480 |
|
309 |
303 |
$4K |
| 87210 |
|
919 |
890 |
$4K |
| 76885 |
|
85 |
85 |
$4K |
| 43239 |
|
26 |
26 |
$4K |
| J2270 |
Morphine sulfate injection |
2,169 |
1,812 |
$4K |
| 82024 |
|
133 |
130 |
$4K |
| 82951 |
|
295 |
264 |
$4K |
| 76870 |
|
161 |
154 |
$4K |
| 72156 |
|
25 |
24 |
$4K |
| 82977 |
|
539 |
427 |
$4K |
| 99214 |
|
267 |
247 |
$4K |
| 82010 |
|
551 |
490 |
$4K |
| G0279 |
Tomosynthesis, mammo |
254 |
252 |
$4K |
| J2250 |
Inj midazolam hydrochloride |
7,960 |
7,125 |
$4K |
| 82140 |
|
290 |
267 |
$3K |
| 74178 |
|
26 |
24 |
$3K |
| 97032 |
|
259 |
83 |
$3K |
| 82105 |
|
230 |
222 |
$3K |
| 82565 |
|
898 |
873 |
$3K |
| J3301 |
Triamcinolone acet inj nos |
991 |
917 |
$3K |
| 71101 |
|
213 |
209 |
$3K |
| 86706 |
|
341 |
334 |
$3K |
| S3620 |
Newborn metabolic screening |
59 |
58 |
$3K |
| 73522 |
|
146 |
146 |
$3K |
| 87660 |
|
120 |
112 |
$3K |
| J2001 |
Lidocaine injection |
5,952 |
5,313 |
$3K |
| J1200 |
Diphenhydramine hcl injectio |
5,449 |
4,584 |
$3K |
| 85045 |
|
710 |
578 |
$3K |
| 82077 |
|
875 |
690 |
$3K |
| J7040 |
Normal saline solution infus |
3,417 |
2,468 |
$3K |
| 77072 |
|
290 |
289 |
$3K |
| 83993 |
|
126 |
124 |
$3K |
| 51798 |
|
1,311 |
1,200 |
$3K |
| 97597 |
|
200 |
162 |
$2K |
| 83525 |
|
199 |
195 |
$2K |
| 89051 |
|
520 |
438 |
$2K |
| 82397 |
|
166 |
164 |
$2K |
| 85046 |
|
441 |
233 |
$2K |
| J1610 |
Glucagon hydrochloride/1 mg |
15 |
15 |
$2K |
| 87510 |
|
120 |
112 |
$2K |
| 87480 |
|
120 |
112 |
$2K |
| 77001 |
|
83 |
82 |
$2K |
| 87430 |
|
162 |
161 |
$2K |
| 72158 |
|
13 |
13 |
$2K |
| 52000 |
|
55 |
53 |
$2K |
| 73000 |
|
162 |
144 |
$2K |
| 96376 |
|
1,417 |
877 |
$2K |
| 84165 |
|
416 |
401 |
$2K |
| 94640 |
|
899 |
597 |
$2K |
| J9267 |
Paclitaxel injection |
146 |
67 |
$2K |
| 86431 |
|
423 |
411 |
$2K |
| 20610 |
|
917 |
691 |
$2K |
| 84134 |
|
232 |
209 |
$2K |
| J0330 |
Succinycholine chloride inj |
2,042 |
1,969 |
$2K |
| 72157 |
|
12 |
12 |
$2K |
| 87799 |
|
61 |
49 |
$2K |
| 84466 |
|
176 |
171 |
$2K |
| 82785 |
|
175 |
162 |
$2K |
| J1815 |
Insulin injection |
713 |
363 |
$2K |
| 99215 |
Prolong outpt/office vis |
65 |
63 |
$2K |
| 85018 |
|
1,207 |
1,088 |
$2K |
| A9577 |
Inj multihance |
337 |
315 |
$2K |
| 84402 |
|
74 |
73 |
$2K |
| 93971 |
|
64 |
63 |
$2K |
| J9175 |
Elliotts b solution per ml |
182 |
114 |
$2K |
| J2543 |
Piperacillin/tazobactam |
373 |
198 |
$2K |
| 74240 |
|
30 |
30 |
$2K |
| J7060 |
5% dextrose/water |
901 |
386 |
$2K |
| 74455 |
|
28 |
28 |
$1K |
| 92557 |
|
163 |
162 |
$1K |
| 73120 |
|
107 |
67 |
$1K |
| 82947 |
|
222 |
203 |
$1K |
| 82150 |
|
277 |
246 |
$1K |
| G0009 |
Admin pneumococcal vaccine |
505 |
472 |
$1K |
| 86039 |
|
138 |
131 |
$1K |
| 86147 |
|
40 |
37 |
$1K |
| 87075 |
|
146 |
130 |
$1K |
| 80178 |
|
241 |
224 |
$1K |
| J2060 |
Lorazepam injection |
1,756 |
1,488 |
$1K |
| J2805 |
Sincalide injection |
14 |
14 |
$1K |
| 93296 |
|
372 |
364 |
$1K |
| J9190 |
Fluorouracil injection |
227 |
65 |
$1K |
| 73660 |
|
110 |
103 |
$1K |
| 85014 |
|
733 |
637 |
$1K |
| 87015 |
|
163 |
151 |
$1K |
| 86255 |
|
80 |
77 |
$972.89 |
| 86225 |
|
78 |
74 |
$963.26 |
| 84145 |
|
51 |
44 |
$960.00 |
| J1650 |
Inj enoxaparin sodium |
560 |
286 |
$952.04 |
| J0171 |
Adrenalin epinephrine inject |
426 |
380 |
$940.65 |
| 90686 |
|
818 |
768 |
$933.61 |
| 76775 |
|
46 |
44 |
$924.28 |
| 64615 |
|
170 |
165 |
$922.13 |
| 86200 |
|
87 |
87 |
$920.97 |
| 88305 |
|
485 |
443 |
$908.53 |
| A9537 |
Tc99m mebrofenin |
16 |
16 |
$907.97 |
| 86256 |
|
72 |
70 |
$904.69 |
| J9263 |
Oxaliplatin |
55 |
12 |
$887.88 |
| 82310 |
|
234 |
210 |
$866.85 |
| J1644 |
Inj heparin sodium per 1000u |
1,070 |
587 |
$829.25 |
| S0119 |
Ondansetron 4 mg |
4,030 |
3,712 |
$798.28 |
| 86704 |
|
90 |
88 |
$777.64 |
| 87338 |
|
53 |
53 |
$745.88 |
| 77073 |
|
49 |
49 |
$743.41 |
| 83721 |
|
89 |
88 |
$735.84 |
| 73060 |
|
61 |
53 |
$723.26 |
| 80175 |
|
76 |
68 |
$707.57 |
| 84425 |
|
41 |
41 |
$687.83 |
| J0640 |
Leucovorin calcium injection |
59 |
14 |
$677.12 |
| J9045 |
Carboplatin injection |
33 |
24 |
$674.42 |
| 90656 |
|
477 |
466 |
$638.36 |
| 0450 |
|
20 |
18 |
$629.78 |
| 76937 |
|
91 |
84 |
$625.94 |
| 90662 |
|
831 |
783 |
$611.43 |
| 73620 |
|
58 |
50 |
$607.32 |
| 90670 |
|
26 |
26 |
$602.04 |
| 86360 |
|
13 |
13 |
$558.00 |
| 87522 |
Neg quan hep c or qual rna |
28 |
28 |
$540.95 |
| J2765 |
Metoclopramide hcl injection |
753 |
697 |
$540.54 |
| J3480 |
Inj potassium chloride |
631 |
317 |
$537.38 |
| 86308 |
|
102 |
100 |
$525.91 |
| J3475 |
Inj magnesium sulfate |
296 |
176 |
$510.02 |
| 87102 |
|
66 |
59 |
$501.74 |
| J3370 |
Vancomycin hcl injection |
195 |
109 |
$487.31 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
131 |
71 |
$482.31 |
| 72110 |
|
26 |
26 |
$459.85 |
| 86359 |
|
13 |
13 |
$455.13 |
| 86665 |
|
12 |
12 |
$443.52 |
| 77336 |
|
29 |
12 |
$438.40 |
| J9250 |
Methotrexate sodium inj |
304 |
123 |
$430.81 |
| 93922 |
|
44 |
43 |
$430.47 |
| G0500 |
Mod sedat endo service >5yrs |
283 |
273 |
$427.64 |
| 90732 |
|
87 |
84 |
$420.05 |
| 82248 |
|
109 |
101 |
$415.08 |
| 82627 |
|
29 |
28 |
$413.02 |
| C1769 |
Guide wire |
541 |
433 |
$405.29 |
| 99152 |
|
192 |
180 |
$398.36 |
| J2400 |
Chloroprocaine hcl injection |
18 |
18 |
$378.86 |
| J7512 |
Prednisone ir or dr oral 1mg |
855 |
632 |
$354.59 |
| 82139 |
|
24 |
24 |
$338.28 |
| 99153 |
Mod sedat endo service >5yrs |
201 |
196 |
$322.69 |
| 74019 |
|
19 |
15 |
$318.60 |
| 84630 |
|
39 |
37 |
$316.75 |
| 84590 |
|
29 |
29 |
$301.73 |
| J0702 |
Betamethasone acet&sod phosp |
33 |
27 |
$296.69 |
| 73600 |
|
12 |
12 |
$295.97 |
| J7611 |
Albuterol non-comp con |
588 |
530 |
$294.94 |
| 84270 |
|
18 |
17 |
$282.59 |
| 80143 |
|
206 |
176 |
$280.97 |
| J7620 |
Albuterol ipratrop non-comp |
1,358 |
1,230 |
$275.01 |
| 73521 |
|
14 |
14 |
$258.58 |
| 94726 |
|
74 |
73 |
$255.68 |
| J3420 |
Vitamin b12 injection |
157 |
126 |
$251.17 |
| 83789 |
|
14 |
12 |
$238.70 |
| 82379 |
|
17 |
16 |
$232.34 |
| 82274 |
|
14 |
14 |
$229.84 |
| 96367 |
|
36 |
27 |
$228.07 |
| 83883 |
|
24 |
24 |
$222.85 |
| 82952 |
|
60 |
55 |
$218.92 |
| 85240 |
|
13 |
13 |
$218.79 |
| 76882 |
|
13 |
13 |
$218.72 |
| 77002 |
|
12 |
12 |
$218.08 |
| J3105 |
Terbutaline sulfate inj |
130 |
105 |
$214.93 |
| 80179 |
|
193 |
164 |
$212.18 |
| G8991 |
Other pt/ot goal status |
626 |
503 |
$210.18 |
| G8990 |
Other pt/ot current status |
558 |
449 |
$205.11 |
| 85027 |
|
238 |
212 |
$186.68 |
| 36600 |
|
13 |
13 |
$186.62 |
| 70360 |
|
16 |
13 |
$184.78 |
| 83655 |
|
27 |
25 |
$184.57 |
| J7644 |
Ipratropium bromide non-comp |
105 |
98 |
$183.56 |
| 93017 |
|
13 |
13 |
$182.32 |
| 90834 |
|
35 |
24 |
$181.52 |
| 86304 |
|
14 |
13 |
$175.04 |
| J1720 |
Hydrocortisone sodium succ i |
18 |
15 |
$173.60 |
| 84446 |
|
12 |
12 |
$163.74 |
| J3230 |
Chlorpromazine hcl injection |
13 |
12 |
$154.14 |
| J1030 |
Methylprednisolone 40 mg inj |
53 |
52 |
$148.51 |
| 94010 |
|
12 |
12 |
$145.91 |
| J7121 |
5% dextrose in lac ringers |
241 |
203 |
$142.21 |
| J1956 |
Levofloxacin injection |
76 |
65 |
$136.04 |
| 82330 |
|
14 |
13 |
$124.82 |
| 89050 |
|
35 |
30 |
$123.75 |
| G8979 |
Mobility goal status |
1,258 |
982 |
$121.19 |
| J2300 |
Inj nalbuphine hydrochloride |
51 |
46 |
$119.46 |
| G8978 |
Mobility current status |
1,121 |
889 |
$117.63 |
| J1940 |
Furosemide injection |
33 |
28 |
$109.29 |
| C1894 |
Intro/sheath, non-laser |
60 |
54 |
$107.50 |
| J7613 |
Albuterol non-comp unit |
387 |
342 |
$78.48 |
| 93280 |
|
12 |
12 |
$72.49 |
| A9270 |
Non-covered item or service |
6,927 |
1,652 |
$68.26 |
| 77063 |
|
572 |
570 |
$67.48 |
| 91320 |
|
123 |
113 |
$56.08 |
| J1630 |
Haloperidol injection |
69 |
58 |
$55.94 |
| 36591 |
|
214 |
133 |
$48.18 |
| 80050 |
|
543 |
528 |
$47.62 |
| J0131 |
Inj, acetaminophen (nos) |
1,039 |
925 |
$39.12 |
| 84132 |
|
12 |
12 |
$35.98 |
| 96112 |
|
14 |
14 |
$34.19 |
| G1010 |
Cdsm stanson |
3,525 |
3,042 |
$33.75 |
| J7510 |
Prednisolone oral per 5 mg |
85 |
83 |
$33.52 |
| J1050 |
Medroxyprogesterone acetate |
12 |
12 |
$32.23 |
| 88342 |
|
45 |
42 |
$28.35 |
| 90792 |
|
12 |
12 |
$23.29 |
| 94729 |
|
106 |
105 |
$23.10 |
| 81002 |
|
104 |
97 |
$20.91 |
| J2710 |
Neostigmine methylslfte inj |
57 |
52 |
$14.88 |
| G8980 |
Mobility d/c status |
307 |
260 |
$11.47 |
| G8987 |
Self care current status |
167 |
128 |
$9.03 |
| G8988 |
Self care goal status |
164 |
133 |
$9.03 |
| 87071 |
|
40 |
33 |
$5.22 |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
148 |
90 |
$4.88 |
| G8985 |
Carry goal status |
14 |
12 |
$3.70 |
| A6207 |
Contact layer >16<= 48 sq in |
65 |
41 |
$2.69 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
20 |
16 |
$0.45 |
| G0103 |
Psa screening |
15 |
14 |
$0.00 |
| 0094A |
|
34 |
33 |
$0.00 |
| 99406 |
|
44 |
42 |
$0.00 |
| 92567 |
|
14 |
14 |
$0.00 |
| J1790 |
Droperidol injection |
12 |
12 |
$0.00 |
| 90480 |
|
123 |
113 |
$0.00 |
| 94761 |
|
14 |
12 |
$0.00 |
| 97130 |
|
30 |
17 |
$0.00 |
| A6222 |
Gauze <=16 in no w/sal w/o b |
17 |
12 |
$0.00 |
| 97533 |
|
91 |
66 |
$0.00 |
| 97127 |
|
41 |
24 |
$0.00 |
| S4990 |
Nicotine patch legend |
28 |
12 |
$0.00 |
| 90833 |
|
64 |
64 |
$0.00 |
| 0054A |
|
13 |
13 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
13 |
12 |
$0.00 |
| 97129 |
|
43 |
24 |
$0.00 |
| Q0163 |
Diphenhydramine hcl 50mg |
243 |
186 |
$0.00 |
| 99396 |
|
12 |
12 |
$0.00 |
| 94060 |
|
12 |
12 |
$0.00 |
| 0124A |
|
22 |
22 |
$0.00 |