| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0378 |
Hospital observation per hr |
15,233 |
13,297 |
$16.71M |
| 99284 |
|
46,123 |
41,346 |
$16.60M |
| 99283 |
|
52,151 |
46,370 |
$15.69M |
| 99282 |
|
23,475 |
20,083 |
$4.45M |
| 96413 |
|
4,820 |
2,974 |
$4.07M |
| S9480 |
Intensive outpatient psychia |
4,979 |
4,252 |
$4.07M |
| 99285 |
|
16,262 |
14,778 |
$3.91M |
| 41899 |
|
3,979 |
3,884 |
$3.51M |
| 97110 |
|
47,806 |
12,465 |
$3.41M |
| H0035 |
Mh partial hosp tx under 24h |
10,376 |
1,252 |
$2.97M |
| 99213 |
|
12,330 |
10,769 |
$2.07M |
| 93306 |
|
2,173 |
2,066 |
$1.88M |
| OP370 |
|
16,995 |
14,587 |
$1.76M |
| 11042 |
|
3,402 |
1,492 |
$1.68M |
| OP710 |
|
16,728 |
14,930 |
$1.66M |
| 90832 |
|
15,993 |
7,361 |
$1.57M |
| 69436 |
|
1,253 |
1,155 |
$1.54M |
| 96375 |
|
16,169 |
13,003 |
$1.44M |
| 97140 |
|
23,731 |
6,162 |
$1.29M |
| 92507 |
|
13,539 |
4,861 |
$1.19M |
| G0330 |
Facility svs dental rehab |
526 |
484 |
$1.14M |
| 99214 |
|
4,071 |
3,784 |
$985K |
| 96365 |
|
10,716 |
9,224 |
$969K |
| 74177 |
|
7,540 |
7,068 |
$860K |
| 93005 |
|
34,401 |
28,916 |
$860K |
| 70553 |
|
1,703 |
1,638 |
$828K |
| OP278 |
|
1,057 |
927 |
$822K |
| 43239 |
|
1,011 |
959 |
$815K |
| 76819 |
|
9,110 |
6,179 |
$795K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
605 |
515 |
$770K |
| 99211 |
|
11,126 |
9,787 |
$756K |
| 95816 |
|
1,436 |
1,399 |
$744K |
| 99281 |
|
5,096 |
4,640 |
$702K |
| 42820 |
|
402 |
396 |
$688K |
| 96415 |
|
1,463 |
1,037 |
$667K |
| 70450 |
|
11,451 |
10,516 |
$606K |
| 80053 |
|
88,680 |
64,147 |
$587K |
| 96374 |
|
18,752 |
16,728 |
$571K |
| 96361 |
|
11,788 |
10,458 |
$563K |
| 70551 |
|
1,616 |
1,553 |
$563K |
| 36430 |
|
931 |
582 |
$517K |
| 76816 |
|
8,385 |
7,301 |
$505K |
| 76811 |
|
2,179 |
2,120 |
$505K |
| 92587 |
|
2,070 |
2,006 |
$490K |
| 99212 |
|
3,545 |
3,309 |
$471K |
| 96372 |
|
14,761 |
10,640 |
$461K |
| 95810 |
|
208 |
202 |
$433K |
| 90853 |
|
14,252 |
4,648 |
$429K |
| 95819 |
|
660 |
639 |
$418K |
| S9484 |
Crisis intervention per hour |
540 |
513 |
$405K |
| 85025 |
|
97,626 |
70,267 |
$399K |
| G0463 |
Hospital outpt clinic visit |
11,083 |
7,967 |
$378K |
| 93976 |
|
2,834 |
2,692 |
$352K |
| 96360 |
|
5,286 |
4,775 |
$335K |
| 36591 |
|
2,275 |
1,138 |
$325K |
| 71046 |
|
22,140 |
20,425 |
$321K |
| 92567 |
|
2,719 |
2,584 |
$320K |
| OP250 |
|
131,973 |
63,496 |
$313K |
| 96366 |
|
4,029 |
3,223 |
$305K |
| 0202U |
|
6,651 |
6,382 |
$304K |
| 92557 |
|
880 |
848 |
$275K |
| U0003 |
Cov-19 amp prb hgh thruput |
4,241 |
4,046 |
$268K |
| 96367 |
|
1,922 |
1,440 |
$265K |
| 87635 |
|
8,531 |
5,875 |
$261K |
| OP272 |
|
20,279 |
18,489 |
$261K |
| 76805 |
|
2,570 |
2,463 |
$240K |
| 99391 |
|
2,537 |
2,317 |
$237K |
| 76815 |
|
5,339 |
3,902 |
$227K |
| 59025 |
|
934 |
720 |
$227K |
| 97112 |
|
4,283 |
1,674 |
$220K |
| 99215 |
Prolong outpt/office vis |
923 |
813 |
$215K |
| 80307 |
|
12,642 |
10,031 |
$213K |
| 90791 |
|
5,157 |
4,333 |
$212K |
| 0241U |
|
9,561 |
8,890 |
$211K |
| 71275 |
|
2,427 |
2,291 |
$208K |
| 99392 |
|
1,598 |
1,444 |
$206K |
| 72125 |
|
3,793 |
3,524 |
$203K |
| 97161 |
|
3,745 |
3,519 |
$198K |
| 97530 |
|
3,450 |
1,703 |
$195K |
| 74176 |
|
2,734 |
2,586 |
$192K |
| 93017 |
|
681 |
633 |
$190K |
| 76817 |
|
2,581 |
2,170 |
$188K |
| H0046 |
Mental health service, nos |
3,791 |
2,939 |
$186K |
| OP259 |
|
15,498 |
10,912 |
$182K |
| 76705 |
|
5,395 |
5,043 |
$178K |
| 92579 |
|
661 |
614 |
$170K |
| 93458 |
|
109 |
108 |
$165K |
| 93970 |
|
1,207 |
1,136 |
$164K |
| 99291 |
|
361 |
331 |
$161K |
| 76813 |
|
1,765 |
1,724 |
$160K |
| 97010 |
|
18,887 |
5,169 |
$155K |
| 90870 |
|
617 |
164 |
$152K |
| 71260 |
|
1,664 |
1,551 |
$151K |
| 36415 |
|
79,813 |
62,487 |
$137K |
| 99204 |
|
512 |
476 |
$132K |
| 99393 |
|
874 |
820 |
$120K |
| 92526 |
|
1,655 |
751 |
$118K |
| OP379 |
|
3,083 |
3,074 |
$116K |
| 70486 |
|
1,229 |
1,152 |
$114K |
| 95782 |
|
26 |
26 |
$113K |
| 94640 |
|
7,851 |
6,249 |
$111K |
| 76801 |
|
1,796 |
1,651 |
$109K |
| J0131 |
Inj, acetaminophen (nos) |
16,606 |
13,936 |
$104K |
| 76770 |
|
1,550 |
1,483 |
$103K |
| 76820 |
|
1,765 |
904 |
$100K |
| 84484 |
|
21,543 |
15,377 |
$98K |
| 93971 |
|
2,067 |
1,948 |
$96K |
| 78452 |
|
403 |
372 |
$88K |
| 71045 |
|
6,052 |
5,540 |
$87K |
| 96376 |
|
4,394 |
3,380 |
$85K |
| 45380 |
|
155 |
141 |
$85K |
| 76821 |
|
1,194 |
594 |
$82K |
| 76830 |
|
1,504 |
1,457 |
$79K |
| 99394 |
|
554 |
516 |
$75K |
| 90460 |
|
4,323 |
4,005 |
$73K |
| 84443 |
|
9,101 |
8,170 |
$72K |
| J1745 |
Infliximab not biosimil 10mg |
29 |
24 |
$71K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
11,632 |
10,456 |
$71K |
| 76856 |
|
1,879 |
1,815 |
$71K |
| 71250 |
|
930 |
876 |
$70K |
| 96417 |
|
207 |
131 |
$70K |
| 97165 |
|
1,248 |
1,184 |
$66K |
| U0002 |
Covid-19 lab test non-cdc |
9,372 |
8,133 |
$64K |
| 97162 |
|
1,025 |
936 |
$58K |
| 80048 |
|
9,833 |
7,973 |
$56K |
| 94762 |
|
351 |
342 |
$55K |
| 80061 |
|
6,240 |
5,766 |
$53K |
| 97116 |
|
2,603 |
1,574 |
$52K |
| 86885 |
|
8,914 |
7,794 |
$51K |
| J3490 |
Drugs unclassified injection |
6,878 |
5,342 |
$51K |
| 76536 |
|
836 |
802 |
$50K |
| G0379 |
Direct refer hospital observ |
418 |
405 |
$50K |
| 99381 |
|
413 |
392 |
$48K |
| 99203 |
|
256 |
242 |
$48K |
| 92523 |
|
297 |
294 |
$48K |
| OP258 |
|
55,311 |
36,922 |
$47K |
| 83735 |
|
18,292 |
11,318 |
$47K |
| 42830 |
|
37 |
37 |
$47K |
| 88305 |
|
3,598 |
3,358 |
$47K |
| 90792 |
|
2,591 |
2,035 |
$45K |
| 93975 |
|
512 |
504 |
$45K |
| OP270 |
|
9,630 |
8,861 |
$44K |
| 69421 |
|
38 |
35 |
$43K |
| 81003 |
|
20,155 |
18,506 |
$43K |
| C1769 |
Guide wire |
2,076 |
1,579 |
$42K |
| 87491 |
|
3,611 |
3,438 |
$42K |
| 87591 |
|
3,612 |
3,439 |
$42K |
| 0002A |
|
1,302 |
1,300 |
$42K |
| 90715 |
|
2,255 |
2,116 |
$41K |
| 90834 |
|
1,141 |
522 |
$39K |
| 85610 |
|
11,961 |
9,653 |
$38K |
| C9290 |
Inj, bupivacaine liposome |
718 |
606 |
$38K |
| 0001A |
|
1,305 |
1,299 |
$38K |
| 74018 |
|
3,742 |
3,504 |
$37K |
| 77336 |
|
270 |
129 |
$37K |
| 82306 |
|
2,059 |
1,875 |
$36K |
| 87633 |
|
913 |
902 |
$35K |
| 82962 |
|
14,249 |
9,068 |
$33K |
| 73030 |
|
1,995 |
1,882 |
$32K |
| 93041 |
|
381 |
363 |
$32K |
| 83036 |
|
6,559 |
5,999 |
$32K |
| P9040 |
Rbc leukoreduced irradiated |
55 |
38 |
$31K |
| 97535 |
|
790 |
572 |
$31K |
| J2704 |
Inj, propofol, 10 mg |
14,363 |
12,019 |
$31K |
| 83690 |
|
13,719 |
12,214 |
$31K |
| 76700 |
|
501 |
485 |
$31K |
| 83880 |
|
4,910 |
4,078 |
$30K |
| 86901 |
|
11,008 |
9,249 |
$30K |
| 73630 |
|
2,361 |
2,196 |
$30K |
| 86900 |
|
10,669 |
9,053 |
$30K |
| 85730 |
|
8,160 |
7,176 |
$29K |
| 73610 |
|
2,384 |
2,152 |
$29K |
| 70498 |
|
372 |
339 |
$28K |
| OP279 |
|
4,102 |
3,902 |
$28K |
| 87040 |
|
3,297 |
2,785 |
$28K |
| 92610 |
|
107 |
105 |
$28K |
| 82077 |
|
6,479 |
5,436 |
$28K |
| 58558 |
|
25 |
24 |
$27K |
| G0480 |
Drug test def 1-7 classes |
1,541 |
1,374 |
$27K |
| OP682 |
|
114 |
113 |
$27K |
| 87086 |
|
10,757 |
9,918 |
$26K |
| 81001 |
|
16,710 |
15,168 |
$26K |
| 72131 |
|
504 |
467 |
$25K |
| 90471 |
|
3,547 |
3,246 |
$25K |
| 81025 |
|
12,351 |
11,303 |
$25K |
| J1170 |
Hydromorphone injection |
5,156 |
3,598 |
$23K |
| 87070 |
|
7,035 |
6,612 |
$23K |
| A9500 |
Tc99m sestamibi |
449 |
405 |
$23K |
| 84100 |
|
11,868 |
7,395 |
$23K |
| OP229 |
|
463 |
415 |
$23K |
| 84439 |
|
3,883 |
3,512 |
$23K |
| 70496 |
|
303 |
273 |
$23K |
| 90670 |
|
806 |
695 |
$23K |
| J1644 |
Inj heparin sodium per 1000u |
7,969 |
3,642 |
$23K |
| 72141 |
|
101 |
95 |
$22K |
| 84145 |
|
2,694 |
2,379 |
$22K |
| J2405 |
Ondansetron hcl injection |
21,228 |
17,428 |
$22K |
| 82728 |
|
3,045 |
2,478 |
$22K |
| 85027 |
|
6,547 |
5,254 |
$21K |
| C1894 |
Intro/sheath, non-laser |
1,551 |
1,300 |
$21K |
| 73562 |
|
1,766 |
1,658 |
$20K |
| 73130 |
|
1,771 |
1,676 |
$20K |
| J3010 |
Fentanyl citrate injection |
13,173 |
12,054 |
$19K |
| 72110 |
|
812 |
777 |
$19K |
| 90677 |
|
589 |
557 |
$19K |
| J1100 |
Dexamethasone sodium phos |
15,340 |
12,979 |
$19K |
| 86923 |
|
1,469 |
1,105 |
$19K |
| 83605 |
|
3,859 |
3,254 |
$18K |
| 84703 |
|
8,639 |
7,807 |
$18K |
| 73110 |
|
1,294 |
1,211 |
$17K |
| 83789 |
|
3,456 |
2,985 |
$17K |
| J1439 |
Inj ferric carboxymaltos 1mg |
19 |
12 |
$17K |
| 99153 |
Mod sedat endo service >5yrs |
1,258 |
1,145 |
$17K |
| J2250 |
Inj midazolam hydrochloride |
8,715 |
7,748 |
$16K |
| 82607 |
|
2,496 |
2,268 |
$16K |
| J1756 |
Iron sucrose injection |
155 |
83 |
$16K |
| C1889 |
Implant/insert device, noc |
33 |
26 |
$16K |
| J1885 |
Ketorolac tromethamine inj |
15,248 |
12,342 |
$16K |
| 84702 |
|
3,451 |
2,979 |
$16K |
| 73590 |
|
1,155 |
1,060 |
$16K |
| 72148 |
|
72 |
70 |
$15K |
| 88304 |
|
1,569 |
1,480 |
$15K |
| 86140 |
|
8,863 |
7,464 |
$15K |
| 77072 |
|
368 |
357 |
$14K |
| G0390 |
Trauma respons w/hosp criti |
86 |
79 |
$14K |
| 90686 |
|
2,340 |
2,105 |
$14K |
| 87088 |
|
2,860 |
2,772 |
$14K |
| 93303 |
|
13 |
13 |
$13K |
| 82803 |
|
1,863 |
1,597 |
$13K |
| 54640 |
|
14 |
13 |
$13K |
| 76870 |
|
514 |
485 |
$13K |
| 97022 |
|
538 |
163 |
$12K |
| 92550 |
|
85 |
77 |
$12K |
| 83550 |
|
2,827 |
2,355 |
$12K |
| 87186 |
|
2,835 |
2,532 |
$12K |
| 0004A |
|
351 |
336 |
$12K |
| 76818 |
|
245 |
214 |
$11K |
| 96401 |
|
33 |
26 |
$11K |
| J0185 |
Inj., aprepitant, 1 mg |
36 |
26 |
$11K |
| 73502 |
|
991 |
938 |
$11K |
| 95716 |
|
20 |
13 |
$11K |
| C8929 |
Tte w or wo fol wcon,doppler |
13 |
13 |
$10K |
| 92611 |
|
36 |
36 |
$10K |
| 74174 |
|
103 |
92 |
$10K |
| 92588 |
|
31 |
27 |
$10K |
| 73564 |
|
618 |
568 |
$10K |
| 87077 |
|
3,071 |
2,616 |
$10K |
| 85379 |
|
3,151 |
2,888 |
$9K |
| 82550 |
|
2,917 |
2,445 |
$9K |
| 95700 |
|
35 |
29 |
$9K |
| 82746 |
|
1,626 |
1,476 |
$9K |
| J1200 |
Diphenhydramine hcl injectio |
3,951 |
2,894 |
$9K |
| 54830 |
|
12 |
12 |
$9K |
| 80143 |
|
1,815 |
1,590 |
$8K |
| G0008 |
Admin influenza virus vac |
479 |
469 |
$8K |
| 85651 |
|
4,361 |
3,890 |
$8K |
| 87804 |
|
3,365 |
3,307 |
$8K |
| 85045 |
|
2,468 |
1,998 |
$8K |
| 99152 |
|
1,359 |
1,257 |
$8K |
| P9016 |
Rbc leukocytes reduced |
46 |
38 |
$8K |
| 80179 |
|
1,743 |
1,529 |
$8K |
| G0451 |
Devlopment test interpt&rep |
311 |
308 |
$8K |
| 83540 |
|
2,624 |
2,127 |
$8K |
| J2270 |
Morphine sulfate injection |
5,333 |
4,078 |
$8K |
| 88307 |
|
355 |
312 |
$8K |
| J0696 |
Ceftriaxone sodium injection |
2,583 |
2,024 |
$7K |
| 99202 |
|
35 |
35 |
$7K |
| C1760 |
Closure dev, vasc |
282 |
235 |
$7K |
| J2785 |
Regadenoson injection |
65 |
53 |
$7K |
| 76000 |
|
424 |
408 |
$7K |
| 87389 |
|
630 |
562 |
$7K |
| J2060 |
Lorazepam injection |
2,887 |
2,059 |
$7K |
| C1725 |
Cath, translumin non-laser |
95 |
79 |
$7K |
| J1815 |
Insulin injection |
1,047 |
433 |
$7K |
| 80164 |
|
834 |
733 |
$6K |
| 99395 |
|
154 |
144 |
$6K |
| J7050 |
Normal saline solution infus |
539 |
318 |
$6K |
| 82570 |
|
2,291 |
1,971 |
$6K |
| 88313 |
|
1,266 |
1,189 |
$6K |
| 88342 |
|
653 |
589 |
$6K |
| J0134 |
Inj acetaminophen -fresenius |
2,806 |
1,918 |
$6K |
| J2930 |
Methylprednisolone injection |
1,344 |
1,156 |
$6K |
| 76825 |
|
13 |
13 |
$6K |
| 87798 |
|
939 |
920 |
$6K |
| 70491 |
|
86 |
80 |
$6K |
| A9585 |
Gadobutrol injection |
660 |
647 |
$6K |
| 90651 |
|
98 |
92 |
$6K |
| 94770 |
|
38 |
38 |
$6K |
| 83615 |
|
3,360 |
2,068 |
$5K |
| 73080 |
|
474 |
446 |
$5K |
| 82784 |
|
650 |
450 |
$5K |
| 87581 |
|
910 |
899 |
$5K |
| 87486 |
|
910 |
899 |
$5K |
| 96523 |
|
44 |
37 |
$5K |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,521 |
1,357 |
$5K |
| 73090 |
|
442 |
401 |
$5K |
| 96127 |
|
896 |
855 |
$5K |
| 82248 |
|
1,173 |
730 |
$5K |
| 76775 |
|
129 |
127 |
$5K |
| 95800 |
|
17 |
15 |
$5K |
| J0330 |
Succinycholine chloride inj |
2,677 |
1,294 |
$5K |
| 45385 |
|
14 |
12 |
$4K |
| 72100 |
|
303 |
295 |
$4K |
| 97166 |
|
41 |
41 |
$4K |
| 74019 |
|
392 |
385 |
$4K |
| L8699 |
Prosthetic implant nos |
263 |
248 |
$4K |
| 72170 |
|
285 |
273 |
$4K |
| J0136 |
Inj, acetaminophen (b braun) |
1,943 |
1,477 |
$4K |
| J0690 |
Cefazolin sodium injection |
4,243 |
2,965 |
$4K |
| 84550 |
|
2,892 |
1,728 |
$4K |
| 86480 |
|
95 |
89 |
$4K |
| 12001 |
|
124 |
118 |
$4K |
| 0064A |
|
121 |
118 |
$4K |
| 29580 |
|
34 |
13 |
$4K |
| 90734 |
|
74 |
64 |
$4K |
| J3480 |
Inj potassium chloride |
1,773 |
1,079 |
$4K |
| 87880 |
|
1,310 |
1,259 |
$3K |
| 88312 |
|
1,083 |
1,038 |
$3K |
| 74022 |
|
294 |
287 |
$3K |
| C1887 |
Catheter, guiding |
700 |
614 |
$3K |
| J2543 |
Piperacillin/tazobactam |
707 |
412 |
$3K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
1,479 |
1,318 |
$3K |
| J7512 |
Prednisone ir or dr oral 1mg |
3,027 |
1,887 |
$3K |
| 87999 |
|
1,254 |
1,229 |
$3K |
| 90688 |
|
221 |
219 |
$3K |
| 84156 |
|
1,616 |
1,324 |
$3K |
| 80320 |
|
451 |
398 |
$3K |
| 0071A |
|
73 |
73 |
$3K |
| 88300 |
|
1,354 |
1,327 |
$3K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
791 |
753 |
$3K |
| 0072A |
|
64 |
63 |
$3K |
| 84480 |
|
224 |
212 |
$3K |
| 73552 |
|
230 |
200 |
$3K |
| 93880 |
|
39 |
37 |
$3K |
| 76604 |
|
129 |
121 |
$3K |
| Q9957 |
Inj perflutren lip micros,ml |
47 |
36 |
$3K |
| 80047 |
|
2,003 |
1,817 |
$3K |
| 0012A |
|
94 |
94 |
$3K |
| 87205 |
|
696 |
630 |
$3K |
| 82010 |
|
1,010 |
882 |
$3K |
| 73140 |
|
289 |
277 |
$3K |
| 99396 |
|
62 |
58 |
$2K |
| 97018 |
|
51 |
13 |
$2K |
| J3370 |
Vancomycin hcl injection |
481 |
287 |
$2K |
| 0011A |
|
86 |
84 |
$2K |
| 90723 |
|
645 |
601 |
$2K |
| M0239 |
Bamlanivimab-xxxx infusion |
19 |
19 |
$2K |
| 90681 |
|
801 |
709 |
$2K |
| J7042 |
5% dextrose/normal saline |
2,037 |
1,475 |
$2K |
| J3475 |
Inj magnesium sulfate |
1,509 |
1,047 |
$2K |
| G0283 |
Elec stim other than wound |
30 |
12 |
$2K |
| J1650 |
Inj enoxaparin sodium |
2,364 |
1,171 |
$2K |
| 74230 |
|
36 |
36 |
$2K |
| 97035 |
|
33 |
12 |
$2K |
| 99442 |
|
36 |
36 |
$2K |
| 90656 |
|
316 |
291 |
$2K |
| 82247 |
|
472 |
292 |
$2K |
| 82378 |
|
135 |
119 |
$2K |
| 86780 |
|
117 |
114 |
$2K |
| 29125 |
|
77 |
77 |
$2K |
| 85055 |
|
59 |
24 |
$1K |
| C9113 |
Inj pantoprazole sodium, via |
2,104 |
1,445 |
$1K |
| J0295 |
Ampicillin sulbactam 1.5 gm |
1,131 |
457 |
$1K |
| 94760 |
|
35 |
32 |
$1K |
| J2272 |
Inj, morphine (fresenius) |
588 |
447 |
$1K |
| D1110 |
|
139 |
139 |
$1K |
| 73700 |
|
40 |
37 |
$1K |
| 86308 |
|
471 |
446 |
$1K |
| M0243 |
Casirivi and imdevi inj |
45 |
45 |
$1K |
| J1630 |
Haloperidol injection |
1,162 |
842 |
$1K |
| 80074 |
|
85 |
84 |
$1K |
| 90847 |
|
33 |
13 |
$1K |
| J2765 |
Metoclopramide hcl injection |
2,112 |
1,795 |
$1K |
| M0222 |
Bebtelovimab injection |
16 |
16 |
$1K |
| 10060 |
|
46 |
42 |
$1K |
| 12002 |
|
41 |
39 |
$1K |
| 82043 |
|
429 |
393 |
$1K |
| 87641 |
|
253 |
220 |
$1K |
| G1004 |
Cdsm ndsc |
1,367 |
885 |
$1K |
| J3360 |
Diazepam injection |
331 |
226 |
$1K |
| 76998 |
|
18 |
12 |
$1K |
| 90472 |
|
82 |
82 |
$1K |
| 87420 |
|
580 |
575 |
$1K |
| 86618 |
|
203 |
184 |
$985.70 |
| D0120 |
|
110 |
110 |
$983.50 |
| 86592 |
|
509 |
442 |
$973.70 |
| 88173 |
|
27 |
27 |
$930.26 |
| M0245 |
Bamlan and etesev infusion |
21 |
21 |
$927.72 |
| J0360 |
Hydralazine hcl injection |
602 |
406 |
$910.38 |
| 76857 |
|
12 |
12 |
$892.31 |
| 86803 |
|
135 |
112 |
$884.07 |
| 88341 |
|
27 |
25 |
$882.93 |
| 86850 |
|
177 |
166 |
$873.24 |
| 76001 |
|
42 |
41 |
$871.16 |
| 85014 |
|
2,094 |
1,862 |
$855.15 |
| 87640 |
|
259 |
228 |
$840.30 |
| 73560 |
|
87 |
81 |
$830.74 |
| 85378 |
|
191 |
186 |
$818.18 |
| 87147 |
|
631 |
605 |
$798.15 |
| 97164 |
|
12 |
12 |
$789.02 |
| J3411 |
Thiamine hcl 100 mg |
165 |
98 |
$777.92 |
| 80076 |
|
216 |
201 |
$747.52 |
| 0124A |
|
28 |
27 |
$741.86 |
| 83520 |
|
48 |
39 |
$725.60 |
| 84132 |
|
272 |
229 |
$690.04 |
| 82977 |
|
904 |
366 |
$685.47 |
| 87340 |
|
197 |
172 |
$683.86 |
| 82150 |
|
333 |
314 |
$678.85 |
| 88175 |
|
40 |
37 |
$671.18 |
| Q3014 |
Telehealth facility fee |
55 |
49 |
$627.36 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
605 |
410 |
$602.91 |
| J1940 |
Furosemide injection |
149 |
87 |
$597.31 |
| Q9953 |
Inj fe-based mr contrast,1ml |
25 |
25 |
$596.07 |
| 86617 |
|
71 |
71 |
$585.94 |
| 84560 |
|
268 |
247 |
$577.98 |
| J2919 |
Inj, methylpred sod succ 5mg |
299 |
239 |
$566.88 |
| 86141 |
|
398 |
356 |
$542.52 |
| 82140 |
|
179 |
122 |
$541.53 |
| 96040 |
|
13 |
13 |
$539.82 |
| J3371 |
Inj, vancomycin hcl (mylan) |
72 |
52 |
$513.83 |
| 0031A |
|
16 |
16 |
$510.64 |
| 86038 |
|
82 |
62 |
$507.72 |
| 84481 |
|
44 |
42 |
$507.59 |
| 86870 |
|
17 |
12 |
$496.41 |
| 80177 |
|
69 |
63 |
$492.62 |
| J2710 |
Neostigmine methylslfte inj |
762 |
684 |
$488.27 |
| J2469 |
Palonosetron hcl |
46 |
25 |
$478.09 |
| 97799 |
|
58 |
40 |
$454.74 |
| 90716 |
|
76 |
61 |
$453.00 |
| J0500 |
Dicyclomine injection |
57 |
38 |
$437.66 |
| 90697 |
|
569 |
543 |
$430.81 |
| 12011 |
|
24 |
24 |
$428.68 |
| J0171 |
Adrenalin epinephrine inject |
178 |
154 |
$418.31 |
| J1642 |
Inj heparin sodium per 10 u |
458 |
343 |
$416.77 |
| J0137 |
Inj, acetaminophen (hikma) |
397 |
314 |
$413.63 |
| 84153 |
|
62 |
52 |
$406.37 |
| J2790 |
Rho d immune globulin inj |
14 |
13 |
$398.27 |
| J7030 |
Normal saline solution infus |
616 |
436 |
$383.71 |
| 84146 |
|
14 |
12 |
$365.89 |
| 90647 |
|
331 |
271 |
$354.59 |
| 72040 |
|
27 |
24 |
$330.49 |
| J1920 |
Inj, labetalol hcl, 5mg |
349 |
186 |
$294.67 |
| 90707 |
|
115 |
92 |
$292.69 |
| J2370 |
Phenylephrine hcl injection |
446 |
355 |
$272.12 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
534 |
462 |
$261.01 |
| A9579 |
Gad-base mr contrast nos,1ml |
44 |
42 |
$254.60 |
| 87899 |
|
101 |
94 |
$249.81 |
| 86706 |
|
69 |
55 |
$241.99 |
| 82565 |
|
678 |
627 |
$237.23 |
| 73060 |
|
28 |
26 |
$234.89 |
| 88112 |
|
21 |
14 |
$230.14 |
| 83970 |
|
25 |
19 |
$217.66 |
| 88172 |
|
12 |
12 |
$209.64 |
| J0780 |
Prochlorperazine injection |
114 |
92 |
$207.92 |
| 86704 |
|
54 |
42 |
$181.14 |
| J0689 |
Inj cefazolin sodium, baxter |
144 |
90 |
$177.40 |
| 85384 |
|
118 |
50 |
$177.23 |
| OP637 |
|
19,885 |
2,730 |
$176.19 |
| 87076 |
|
28 |
28 |
$160.60 |
| 82533 |
|
16 |
13 |
$160.16 |
| Q2038 |
Fluzone vacc, 3 yrs & >, im |
14 |
13 |
$156.98 |
| J7040 |
Normal saline solution infus |
66 |
39 |
$151.42 |
| 87390 |
|
12 |
12 |
$148.14 |
| J1953 |
Levetiracetam injection |
64 |
46 |
$141.52 |
| 86665 |
|
33 |
27 |
$139.77 |
| 84436 |
|
27 |
27 |
$137.82 |
| 86769 |
|
16 |
12 |
$131.05 |
| J7620 |
Albuterol ipratrop non-comp |
403 |
304 |
$122.49 |
| 80069 |
|
18 |
14 |
$119.82 |
| 90633 |
|
479 |
402 |
$118.59 |
| J2920 |
Methylprednisolone injection |
78 |
40 |
$111.38 |
| C1770 |
Imaging coil, mr, insertable |
14 |
12 |
$107.91 |
| J2310 |
Inj naloxone hydrochloride |
28 |
16 |
$97.82 |
| 87426 |
|
69 |
57 |
$96.89 |
| 90671 |
|
115 |
104 |
$96.00 |
| 87015 |
|
97 |
89 |
$90.48 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
158 |
92 |
$76.86 |
| J2470 |
Inj pantoprazole sodium 40mg |
226 |
147 |
$75.16 |
| 86431 |
|
15 |
12 |
$64.81 |
| 86364 |
|
15 |
12 |
$64.23 |
| 84165 |
|
13 |
12 |
$52.06 |
| 86664 |
|
15 |
12 |
$50.10 |
| 82270 |
|
13 |
13 |
$49.32 |
| 99151 |
|
12 |
12 |
$48.98 |
| J0290 |
Ampicillin 500 mg inj |
39 |
14 |
$48.71 |
| 73070 |
|
23 |
12 |
$43.91 |
| J3420 |
Vitamin b12 injection |
27 |
14 |
$38.54 |
| 87045 |
|
40 |
38 |
$36.00 |
| 87536 |
|
14 |
14 |
$35.60 |
| J0737 |
Inj, clindamycin (baxter) |
16 |
12 |
$34.91 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
36 |
26 |
$34.27 |
| D1206 |
|
26 |
24 |
$33.00 |
| J3590 |
Unclassified biologics |
203 |
197 |
$31.50 |
| J7510 |
Prednisolone oral per 5 mg |
169 |
153 |
$29.32 |
| 84300 |
|
13 |
12 |
$28.80 |
| J2550 |
Promethazine hcl injection |
118 |
114 |
$26.58 |
| J2004 |
Inj, lidocaine w epinephrine |
85 |
81 |
$23.86 |
| J8540 |
Oral dexamethasone |
56 |
46 |
$15.98 |
| 90380 |
|
32 |
32 |
$15.57 |
| Q0239 |
Bamlanivimab-xxxx |
17 |
17 |
$14.00 |
| 90381 |
|
28 |
27 |
$12.47 |
| J7613 |
Albuterol non-comp unit |
160 |
114 |
$10.63 |
| 84155 |
|
15 |
13 |
$9.04 |
| 91300 |
|
2,484 |
2,204 |
$9.01 |
| 90700 |
|
36 |
30 |
$3.00 |
| J3372 |
Inj, vancomycin hcl (xellia) |
22 |
16 |
$1.31 |
| G8979 |
Mobility goal status |
109 |
105 |
$1.00 |
| G8978 |
Mobility current status |
99 |
96 |
$1.00 |
| Q0244 |
Casirivi and imdevi 1200 mg |
47 |
44 |
$0.00 |
| Q0245 |
Bamlanivimab and etesevima |
23 |
19 |
$0.00 |
| 91312 |
|
28 |
27 |
$0.00 |
| 91301 |
|
192 |
190 |
$0.00 |
| 91306 |
|
110 |
106 |
$0.00 |
| 87507 |
|
12 |
12 |
$0.00 |
| 86361 |
|
16 |
12 |
$0.00 |
| 91307 |
|
119 |
104 |
$0.00 |
| Q0222 |
Bebtelovimab 175 mg |
18 |
18 |
$0.00 |
| J0687 |
Inj cefazolin (wg crit care) |
69 |
44 |
$0.00 |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
12 |
12 |
$0.00 |