| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpt clinic visit |
180,297 |
149,738 |
$16.63M |
| 99285 |
|
65,690 |
55,088 |
$9.31M |
| 99283 |
|
65,598 |
59,755 |
$7.71M |
| 99284 |
|
59,870 |
51,885 |
$7.70M |
| 96361 |
|
21,651 |
13,842 |
$7.21M |
| J9271 |
Inj pembrolizumab |
449 |
247 |
$3.38M |
| 97110 |
|
36,465 |
14,824 |
$2.86M |
| 70450 |
|
8,547 |
6,641 |
$2.28M |
| 74177 |
|
8,990 |
6,772 |
$2.19M |
| J1569 |
Gammagard liquid injection |
987 |
253 |
$1.63M |
| 96366 |
|
5,533 |
2,549 |
$1.31M |
| 96365 |
|
9,583 |
5,635 |
$1.30M |
| 90853 |
|
12,182 |
1,987 |
$1.26M |
| G0378 |
Hospital observation per hr |
14,891 |
6,232 |
$1.21M |
| 0241U |
|
8,252 |
6,485 |
$925K |
| 96413 |
|
7,037 |
3,812 |
$923K |
| 80053 |
|
82,220 |
65,078 |
$831K |
| 74176 |
|
2,873 |
2,180 |
$819K |
| 96360 |
|
4,271 |
2,995 |
$806K |
| 71260 |
|
3,738 |
2,847 |
$765K |
| 20610 |
|
4,360 |
2,453 |
$709K |
| 95886 |
|
2,534 |
2,377 |
$691K |
| 87491 |
|
15,457 |
13,206 |
$599K |
| 43239 |
|
1,558 |
1,241 |
$591K |
| 98941 |
|
10,253 |
5,970 |
$564K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
655 |
472 |
$562K |
| 93306 |
|
2,203 |
1,805 |
$562K |
| 99282 |
|
4,290 |
3,740 |
$509K |
| 20553 |
|
3,266 |
2,937 |
$456K |
| U0003 |
Cov-19 amp prb hgh thruput |
3,349 |
2,406 |
$436K |
| 78452 |
|
825 |
610 |
$385K |
| 87591 |
|
15,462 |
13,218 |
$343K |
| 70553 |
|
1,269 |
1,075 |
$333K |
| 62323 |
|
788 |
641 |
$328K |
| 90837 |
|
2,233 |
1,628 |
$323K |
| 59025 |
|
1,933 |
1,092 |
$318K |
| 64493 |
|
438 |
313 |
$312K |
| 84443 |
|
21,777 |
18,434 |
$304K |
| 70498 |
|
1,001 |
757 |
$303K |
| 76816 |
|
2,462 |
2,014 |
$300K |
| 97810 |
|
8,680 |
5,142 |
$294K |
| 76705 |
|
3,000 |
2,471 |
$279K |
| 52000 |
|
474 |
387 |
$276K |
| 85025 |
|
114,566 |
90,990 |
$273K |
| 97112 |
|
6,761 |
2,806 |
$273K |
| 97113 |
|
3,468 |
1,164 |
$261K |
| 36415 |
|
169,906 |
125,358 |
$253K |
| 71046 |
|
19,916 |
16,422 |
$252K |
| 96415 |
|
930 |
510 |
$249K |
| 78815 |
|
388 |
345 |
$245K |
| 80048 |
|
35,029 |
24,865 |
$240K |
| 70491 |
|
745 |
561 |
$237K |
| 97161 |
|
5,190 |
4,570 |
$231K |
| 97140 |
|
7,758 |
3,758 |
$229K |
| 94640 |
|
1,858 |
1,309 |
$223K |
| 96127 |
|
3,941 |
3,037 |
$222K |
| 82306 |
|
10,782 |
9,228 |
$210K |
| 99232 |
|
12,130 |
7,210 |
$197K |
| 80307 |
|
9,670 |
6,496 |
$187K |
| 76642 |
|
1,478 |
1,244 |
$187K |
| 99213 |
|
4,415 |
3,851 |
$181K |
| 97535 |
|
5,083 |
3,631 |
$178K |
| 90791 |
|
886 |
746 |
$177K |
| 80061 |
|
14,247 |
12,127 |
$176K |
| 76770 |
|
1,087 |
961 |
$172K |
| 90870 |
|
401 |
110 |
$163K |
| 73721 |
|
723 |
633 |
$162K |
| 72148 |
|
951 |
853 |
$158K |
| 97597 |
|
2,711 |
1,689 |
$158K |
| 86850 |
|
6,071 |
4,750 |
$153K |
| C1776 |
Joint device (implantable) |
96 |
69 |
$152K |
| 71250 |
|
1,556 |
1,405 |
$148K |
| 87086 |
|
16,136 |
13,155 |
$147K |
| 85027 |
|
24,742 |
18,103 |
$146K |
| 97811 |
|
8,569 |
5,073 |
$146K |
| 93975 |
|
1,520 |
1,128 |
$143K |
| 76536 |
|
1,336 |
1,178 |
$142K |
| 86780 |
|
5,543 |
4,731 |
$139K |
| 87624 |
|
3,471 |
2,915 |
$137K |
| 64483 |
|
280 |
236 |
$135K |
| 88142 |
|
6,422 |
5,750 |
$134K |
| 97530 |
|
4,253 |
1,969 |
$132K |
| 93971 |
|
1,757 |
1,443 |
$132K |
| 84702 |
|
5,788 |
4,240 |
$130K |
| J0897 |
Denosumab injection |
156 |
116 |
$127K |
| 99281 |
|
1,030 |
906 |
$126K |
| 70551 |
|
820 |
678 |
$126K |
| Q5104 |
Injection, renflexis |
91 |
63 |
$125K |
| 77067 |
|
3,619 |
3,147 |
$123K |
| C8929 |
Tte w or wo fol wcon,doppler |
539 |
453 |
$121K |
| 83036 |
|
16,275 |
13,992 |
$121K |
| 49083 |
|
261 |
112 |
$120K |
| 90677 |
|
753 |
603 |
$117K |
| 76819 |
|
1,355 |
594 |
$115K |
| 72141 |
|
661 |
580 |
$114K |
| 93970 |
|
796 |
665 |
$114K |
| 76801 |
|
823 |
736 |
$114K |
| 96367 |
|
1,961 |
1,113 |
$113K |
| 84439 |
|
7,672 |
6,697 |
$113K |
| 64635 |
|
175 |
128 |
$109K |
| 99396 |
|
1,059 |
915 |
$105K |
| 99395 |
|
1,012 |
875 |
$105K |
| 88305 |
|
6,280 |
5,268 |
$105K |
| 95811 |
|
175 |
148 |
$104K |
| 93017 |
|
1,171 |
897 |
$102K |
| 74183 |
|
448 |
387 |
$102K |
| 12001 |
|
627 |
529 |
$99K |
| 76830 |
|
1,409 |
1,042 |
$99K |
| 87389 |
|
6,039 |
4,976 |
$99K |
| 71275 |
|
322 |
253 |
$98K |
| 82607 |
|
5,061 |
4,112 |
$94K |
| 76805 |
|
679 |
609 |
$93K |
| 97802 |
|
1,364 |
1,082 |
$93K |
| 20550 |
|
589 |
345 |
$92K |
| 86140 |
|
7,704 |
6,621 |
$91K |
| 93321 |
|
520 |
420 |
$90K |
| 45380 |
|
352 |
318 |
$89K |
| 72125 |
|
3,491 |
2,793 |
$87K |
| 76811 |
|
770 |
677 |
$87K |
| 73221 |
|
418 |
377 |
$86K |
| C9803 |
Hopd covid-19 spec collect |
2,252 |
1,996 |
$86K |
| P9016 |
Rbc leukocytes reduced |
304 |
195 |
$84K |
| 86803 |
|
4,513 |
3,657 |
$84K |
| 11042 |
|
644 |
372 |
$83K |
| 86900 |
|
6,128 |
4,779 |
$82K |
| 77063 |
|
1,624 |
1,461 |
$81K |
| 99291 |
|
905 |
604 |
$78K |
| 82728 |
|
5,758 |
4,664 |
$78K |
| 72100 |
|
2,943 |
2,398 |
$78K |
| 10060 |
|
487 |
391 |
$78K |
| 97165 |
|
1,361 |
1,124 |
$77K |
| 87808 |
|
5,933 |
4,695 |
$77K |
| 72131 |
|
910 |
741 |
$75K |
| J7323 |
Euflexxa inj per dose |
592 |
192 |
$74K |
| 81513 |
|
626 |
555 |
$73K |
| 93325 |
|
801 |
670 |
$73K |
| 73630 |
|
4,331 |
3,578 |
$70K |
| 97162 |
|
2,030 |
1,711 |
$69K |
| 92507 |
|
1,192 |
443 |
$69K |
| 87905 |
|
6,131 |
4,893 |
$65K |
| 73030 |
|
3,439 |
2,751 |
$65K |
| 87340 |
|
3,052 |
2,526 |
$62K |
| 93798 |
|
1,061 |
155 |
$62K |
| 73130 |
|
3,297 |
2,647 |
$61K |
| 88307 |
|
575 |
365 |
$60K |
| 94060 |
|
460 |
420 |
$57K |
| 95810 |
|
85 |
80 |
$57K |
| 86762 |
|
1,861 |
1,642 |
$56K |
| 76815 |
|
1,196 |
884 |
$56K |
| 70486 |
|
1,033 |
813 |
$54K |
| 93005 |
|
31,488 |
25,463 |
$53K |
| 76700 |
|
298 |
258 |
$53K |
| 93308 |
|
188 |
151 |
$52K |
| 83970 |
|
1,905 |
1,507 |
$50K |
| 77336 |
|
499 |
216 |
$49K |
| J1756 |
Iron sucrose injection |
1,862 |
579 |
$49K |
| 84484 |
|
21,153 |
11,094 |
$48K |
| 36430 |
|
418 |
267 |
$48K |
| 80074 |
|
2,005 |
1,825 |
$47K |
| 87631 |
|
266 |
217 |
$47K |
| 19083 |
|
48 |
40 |
$46K |
| 78264 |
|
222 |
181 |
$46K |
| 83540 |
|
5,132 |
4,159 |
$45K |
| 73610 |
|
3,077 |
2,491 |
$45K |
| Q3014 |
Telehealth facility fee |
1,892 |
1,820 |
$44K |
| 72050 |
|
1,286 |
1,107 |
$44K |
| 73564 |
|
2,035 |
1,620 |
$44K |
| 81001 |
|
55,183 |
46,366 |
$43K |
| 72110 |
|
1,178 |
1,049 |
$42K |
| 86901 |
|
6,129 |
4,779 |
$41K |
| 76817 |
|
1,152 |
816 |
$40K |
| 27096 |
|
99 |
80 |
$40K |
| 62321 |
|
79 |
66 |
$39K |
| 83992 |
|
1,661 |
991 |
$39K |
| 0002A |
|
1,034 |
1,022 |
$39K |
| 96372 |
|
14,803 |
8,769 |
$39K |
| 74018 |
|
1,394 |
1,038 |
$39K |
| 82570 |
|
4,692 |
3,842 |
$38K |
| 99231 |
|
3,755 |
2,438 |
$38K |
| 0001A |
|
1,082 |
1,062 |
$38K |
| 12002 |
|
247 |
191 |
$37K |
| 97150 |
|
1,978 |
702 |
$37K |
| 97166 |
|
845 |
707 |
$37K |
| 80076 |
|
4,038 |
3,032 |
$37K |
| 99203 |
|
1,577 |
1,544 |
$37K |
| 77080 |
|
568 |
502 |
$36K |
| 87210 |
|
1,698 |
1,383 |
$36K |
| 74174 |
|
390 |
294 |
$36K |
| 76813 |
|
434 |
376 |
$35K |
| 98940 |
|
599 |
467 |
$35K |
| 83550 |
|
5,076 |
4,109 |
$35K |
| 73110 |
|
2,205 |
1,741 |
$35K |
| 72040 |
|
922 |
748 |
$34K |
| 94726 |
|
521 |
465 |
$34K |
| 93296 |
|
1,915 |
1,846 |
$33K |
| 73502 |
|
1,807 |
1,416 |
$33K |
| 90715 |
|
2,262 |
1,792 |
$32K |
| 83735 |
|
13,417 |
8,951 |
$32K |
| 87653 |
|
997 |
822 |
$32K |
| 70496 |
|
1,079 |
809 |
$30K |
| 94729 |
|
604 |
546 |
$30K |
| 86038 |
|
1,491 |
1,177 |
$29K |
| 87077 |
|
4,449 |
3,478 |
$29K |
| 86480 |
|
859 |
714 |
$29K |
| 73560 |
|
1,884 |
1,503 |
$29K |
| 96374 |
|
25,897 |
19,309 |
$28K |
| 20600 |
|
145 |
78 |
$28K |
| 99214 |
|
846 |
808 |
$28K |
| 45385 |
|
49 |
41 |
$28K |
| 86592 |
|
1,032 |
965 |
$27K |
| 97803 |
|
362 |
330 |
$26K |
| 77062 |
|
745 |
624 |
$26K |
| 80345 |
|
1,661 |
991 |
$26K |
| 90834 |
|
161 |
121 |
$26K |
| 82962 |
|
13,578 |
4,778 |
$26K |
| 90471 |
|
4,522 |
3,382 |
$26K |
| 97116 |
|
1,251 |
677 |
$25K |
| 76857 |
|
1,374 |
1,014 |
$25K |
| 90688 |
|
1,446 |
1,020 |
$25K |
| 76882 |
|
266 |
212 |
$25K |
| 82784 |
|
1,899 |
1,527 |
$25K |
| 85610 |
|
6,395 |
4,347 |
$24K |
| 87522 |
Neg quan hep c or qual rna |
789 |
630 |
$24K |
| 82805 |
|
838 |
605 |
$24K |
| 77061 |
|
608 |
517 |
$24K |
| 85652 |
|
7,168 |
6,177 |
$23K |
| 99152 |
|
663 |
495 |
$23K |
| 80197 |
|
1,576 |
845 |
$23K |
| 64450 |
|
117 |
91 |
$23K |
| 87661 |
|
2,602 |
2,143 |
$21K |
| 55250 |
|
14 |
13 |
$20K |
| 73700 |
|
179 |
147 |
$20K |
| 93246 |
|
259 |
225 |
$20K |
| 74178 |
|
79 |
68 |
$20K |
| 71045 |
|
6,300 |
4,733 |
$20K |
| 84153 |
|
1,421 |
1,213 |
$19K |
| 82746 |
|
2,413 |
1,938 |
$19K |
| 86706 |
|
1,183 |
958 |
$19K |
| 95813 |
|
17 |
12 |
$19K |
| 77300 |
|
45 |
29 |
$18K |
| 73140 |
|
1,007 |
822 |
$18K |
| 87497 |
|
689 |
343 |
$18K |
| 74019 |
|
460 |
392 |
$17K |
| G0480 |
Drug test def 1-7 classes |
1,320 |
965 |
$17K |
| 77065 |
Tomosynthesis, mammo |
900 |
736 |
$17K |
| 96523 |
|
416 |
289 |
$17K |
| 80069 |
|
1,167 |
883 |
$17K |
| 82043 |
|
2,932 |
2,506 |
$17K |
| 96368 |
|
709 |
436 |
$16K |
| 95913 |
|
129 |
116 |
$16K |
| 97164 |
|
256 |
230 |
$16K |
| 86364 |
|
842 |
682 |
$16K |
| 84481 |
|
1,727 |
1,508 |
$16K |
| 72170 |
|
1,455 |
1,134 |
$15K |
| 84403 |
|
1,007 |
866 |
$15K |
| 80346 |
|
1,705 |
1,029 |
$15K |
| 80348 |
|
1,675 |
1,003 |
$15K |
| 95819 |
|
90 |
69 |
$15K |
| 72128 |
|
325 |
267 |
$15K |
| 90833 |
|
159 |
136 |
$15K |
| 80349 |
|
1,660 |
991 |
$14K |
| 99233 |
Prolong inpt eval add15 m |
602 |
458 |
$14K |
| 72070 |
|
483 |
414 |
$14K |
| 80353 |
|
1,661 |
991 |
$14K |
| 51705 |
|
173 |
149 |
$14K |
| 86703 |
|
926 |
895 |
$14K |
| 72072 |
|
593 |
509 |
$14K |
| 84146 |
|
754 |
633 |
$14K |
| 93923 |
|
152 |
133 |
$13K |
| 82565 |
|
1,460 |
1,156 |
$13K |
| 80361 |
|
1,661 |
991 |
$13K |
| 80356 |
|
1,661 |
991 |
$13K |
| 80358 |
|
1,661 |
991 |
$13K |
| 80359 |
|
1,661 |
991 |
$12K |
| 84630 |
|
796 |
610 |
$12K |
| 86431 |
|
1,192 |
964 |
$12K |
| 70544 |
|
153 |
110 |
$12K |
| 83880 |
|
2,772 |
2,116 |
$12K |
| 82550 |
|
4,280 |
2,895 |
$12K |
| 82950 |
|
830 |
714 |
$12K |
| 93270 |
|
130 |
112 |
$12K |
| 20605 |
|
67 |
44 |
$12K |
| 81025 |
|
20,566 |
15,337 |
$11K |
| 72158 |
|
71 |
52 |
$11K |
| 87102 |
|
740 |
557 |
$11K |
| 71271 |
|
59 |
58 |
$11K |
| 83690 |
|
15,053 |
11,065 |
$11K |
| 72197 |
|
44 |
33 |
$11K |
| 86147 |
|
333 |
253 |
$11K |
| 84100 |
|
2,930 |
1,718 |
$11K |
| 86704 |
|
787 |
642 |
$11K |
| 86200 |
|
984 |
841 |
$11K |
| 82670 |
|
483 |
402 |
$11K |
| 96376 |
|
5,686 |
2,705 |
$10K |
| 87186 |
|
3,156 |
2,519 |
$10K |
| 20526 |
|
60 |
40 |
$10K |
| J0702 |
Betamethasone acet&sod phosp |
985 |
606 |
$10K |
| 73590 |
|
997 |
836 |
$10K |
| 51798 |
|
1,442 |
1,140 |
$10K |
| 73562 |
|
989 |
864 |
$10K |
| 82533 |
|
462 |
361 |
$10K |
| 87640 |
|
487 |
385 |
$10K |
| 86235 |
|
720 |
531 |
$10K |
| 91320 |
|
207 |
159 |
$10K |
| 88304 |
|
771 |
563 |
$10K |
| 93880 |
|
108 |
98 |
$10K |
| 83001 |
|
581 |
499 |
$10K |
| 12011 |
|
62 |
60 |
$9K |
| 96116 |
|
64 |
55 |
$9K |
| 86258 |
|
347 |
278 |
$9K |
| 84425 |
|
920 |
783 |
$9K |
| 77334 |
|
31 |
24 |
$9K |
| 10005 |
|
17 |
14 |
$9K |
| J0585 |
Injection,onabotulinumtoxina |
26 |
13 |
$9K |
| J2997 |
Alteplase recombinant |
59 |
39 |
$9K |
| 88341 |
|
110 |
70 |
$9K |
| 71101 |
|
650 |
520 |
$9K |
| 99153 |
Mod sedat endo service >5yrs |
394 |
305 |
$9K |
| 87641 |
|
488 |
385 |
$8K |
| 99221 |
|
442 |
404 |
$8K |
| 88342 |
|
795 |
611 |
$8K |
| 93225 |
|
56 |
40 |
$8K |
| 73552 |
|
611 |
511 |
$8K |
| 82627 |
|
308 |
249 |
$8K |
| 99252 |
|
281 |
257 |
$8K |
| 96375 |
|
15,363 |
8,684 |
$8K |
| 90792 |
|
40 |
32 |
$8K |
| 77066 |
Tomosynthesis, mammo |
827 |
690 |
$8K |
| 86225 |
|
917 |
702 |
$8K |
| 84156 |
|
1,922 |
1,500 |
$8K |
| 80321 |
|
438 |
299 |
$8K |
| 87070 |
|
1,261 |
872 |
$8K |
| 90651 |
|
43 |
33 |
$8K |
| 74220 |
|
118 |
114 |
$7K |
| 83516 |
|
358 |
331 |
$7K |
| 87493 |
|
294 |
228 |
$7K |
| 86376 |
|
461 |
378 |
$7K |
| 99406 |
|
238 |
204 |
$7K |
| 73080 |
|
824 |
691 |
$7K |
| 87799 |
|
414 |
265 |
$7K |
| 73070 |
|
337 |
270 |
$7K |
| 72114 |
|
152 |
135 |
$6K |
| 82330 |
|
3,404 |
2,319 |
$6K |
| 82977 |
|
754 |
424 |
$6K |
| 95816 |
|
46 |
38 |
$6K |
| 84480 |
|
541 |
460 |
$6K |
| 95910 |
|
96 |
81 |
$6K |
| 28470 |
|
21 |
14 |
$6K |
| 96130 |
|
34 |
26 |
$6K |
| 0124A |
|
230 |
164 |
$6K |
| 80323 |
|
319 |
236 |
$6K |
| 84402 |
|
374 |
321 |
$6K |
| 76825 |
|
90 |
83 |
$6K |
| 73090 |
|
577 |
479 |
$6K |
| 83020 |
|
300 |
233 |
$6K |
| 81596 |
|
34 |
25 |
$5K |
| 83525 |
|
242 |
203 |
$5K |
| 87635 |
|
1,483 |
1,112 |
$5K |
| 76870 |
|
415 |
332 |
$5K |
| J1750 |
Inj iron dextran |
35 |
14 |
$5K |
| 72200 |
|
191 |
168 |
$5K |
| 81003 |
|
7,245 |
6,362 |
$5K |
| 82105 |
|
345 |
295 |
$5K |
| J2469 |
Palonosetron hcl |
1,013 |
455 |
$5K |
| 93299 |
|
272 |
259 |
$5K |
| 84550 |
|
886 |
706 |
$5K |
| 97014 |
|
137 |
62 |
$5K |
| 74246 |
|
35 |
29 |
$5K |
| 86160 |
|
629 |
459 |
$5K |
| 83002 |
|
377 |
323 |
$5K |
| 99215 |
Prolong outpt/office vis |
92 |
88 |
$5K |
| 99212 |
|
340 |
331 |
$5K |
| U0005 |
Infec agen detec ampli probe |
3,035 |
2,090 |
$5K |
| 82077 |
|
4,387 |
3,215 |
$5K |
| 77002 |
|
330 |
246 |
$5K |
| 84460 |
|
531 |
466 |
$5K |
| 83993 |
|
281 |
229 |
$4K |
| 86800 |
|
423 |
354 |
$4K |
| 87651 |
|
3,005 |
2,385 |
$4K |
| 84590 |
|
429 |
331 |
$4K |
| 00104 |
|
395 |
110 |
$4K |
| 85730 |
|
2,841 |
1,994 |
$4K |
| 90480 |
|
207 |
159 |
$4K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
20,234 |
15,383 |
$4K |
| 72156 |
|
40 |
37 |
$4K |
| 76821 |
|
93 |
40 |
$4K |
| 88175 |
|
248 |
248 |
$4K |
| 84703 |
|
3,556 |
3,197 |
$4K |
| 90658 |
|
417 |
403 |
$4K |
| 86039 |
|
328 |
230 |
$4K |
| 99204 |
|
122 |
119 |
$4K |
| 87400 |
|
166 |
142 |
$4K |
| 20552 |
|
25 |
24 |
$4K |
| 90460 |
|
409 |
360 |
$4K |
| 78227 |
|
16 |
12 |
$4K |
| 80164 |
|
566 |
459 |
$4K |
| 94010 |
|
70 |
66 |
$3K |
| 51784 |
|
13 |
12 |
$3K |
| 86923 |
|
156 |
102 |
$3K |
| 99394 |
|
44 |
43 |
$3K |
| 83615 |
|
746 |
513 |
$3K |
| 36593 |
|
17 |
12 |
$3K |
| 93298 |
|
331 |
308 |
$3K |
| 86787 |
|
171 |
143 |
$3K |
| 76856 |
|
17 |
12 |
$3K |
| 00731 |
|
1,272 |
946 |
$3K |
| 11721 |
|
192 |
168 |
$3K |
| 99391 |
|
43 |
39 |
$3K |
| 83521 |
|
416 |
318 |
$3K |
| 85379 |
|
2,655 |
1,986 |
$3K |
| 76820 |
|
78 |
37 |
$3K |
| 83605 |
|
5,320 |
3,369 |
$3K |
| 76827 |
|
89 |
82 |
$3K |
| J3490 |
Drugs unclassified injection |
898 |
651 |
$3K |
| 87205 |
|
1,163 |
785 |
$3K |
| 82947 |
|
3,176 |
2,280 |
$3K |
| 73060 |
|
347 |
267 |
$3K |
| 80143 |
|
2,619 |
1,907 |
$3K |
| 82653 |
|
121 |
96 |
$3K |
| 73523 |
|
97 |
92 |
$3K |
| J2270 |
Morphine sulfate injection |
6,462 |
3,586 |
$3K |
| 87481 |
|
296 |
245 |
$3K |
| 73565 |
|
204 |
164 |
$2K |
| 90832 |
|
20 |
12 |
$2K |
| G0297 |
Ldct for lung ca screen |
12 |
12 |
$2K |
| 36591 |
|
405 |
257 |
$2K |
| 96132 |
|
31 |
27 |
$2K |
| 87637 |
|
71 |
58 |
$2K |
| J2543 |
Piperacillin/tazobactam |
777 |
356 |
$2K |
| 86308 |
|
500 |
388 |
$2K |
| 84132 |
|
3,419 |
2,467 |
$2K |
| 84155 |
|
601 |
467 |
$2K |
| J1650 |
Inj enoxaparin sodium |
2,413 |
913 |
$2K |
| 96416 |
|
62 |
24 |
$2K |
| J1815 |
Insulin injection |
246 |
156 |
$2K |
| 64636 |
|
173 |
126 |
$2K |
| U0004 |
Cov-19 test non-cdc hgh thru |
12 |
12 |
$2K |
| 96136 |
|
32 |
24 |
$2K |
| 84165 |
|
463 |
363 |
$2K |
| 82040 |
|
250 |
218 |
$2K |
| 83520 |
|
59 |
38 |
$2K |
| 85045 |
|
684 |
491 |
$2K |
| 86146 |
|
172 |
138 |
$2K |
| J1170 |
Hydromorphone injection |
3,777 |
1,871 |
$2K |
| 82103 |
|
160 |
124 |
$2K |
| 87338 |
|
100 |
85 |
$2K |
| 96146 |
|
14 |
14 |
$2K |
| 90746 |
|
116 |
94 |
$2K |
| 86705 |
|
43 |
43 |
$2K |
| J3489 |
Zoledronic acid 1mg |
104 |
76 |
$2K |
| 87040 |
|
1,657 |
744 |
$2K |
| 85018 |
|
1,235 |
848 |
$2K |
| 86334 |
|
115 |
95 |
$2K |
| J9263 |
Oxaliplatin |
90 |
37 |
$2K |
| 90739 |
|
138 |
116 |
$2K |
| 97012 |
|
34 |
12 |
$2K |
| 96402 |
|
171 |
119 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
16,239 |
10,270 |
$1K |
| 76942 |
|
361 |
275 |
$1K |
| 90472 |
|
535 |
381 |
$1K |
| 82951 |
|
55 |
53 |
$1K |
| 85014 |
|
255 |
183 |
$1K |
| 97032 |
|
24 |
12 |
$1K |
| 80179 |
|
2,570 |
1,879 |
$1K |
| 93922 |
|
14 |
12 |
$1K |
| 72146 |
|
12 |
12 |
$1K |
| 82378 |
|
187 |
137 |
$1K |
| 82150 |
|
233 |
181 |
$1K |
| 87536 |
|
42 |
39 |
$1K |
| 86317 |
|
50 |
50 |
$1K |
| 80178 |
|
180 |
131 |
$1K |
| 82375 |
|
2,773 |
2,005 |
$1K |
| 99401 |
|
16 |
16 |
$1K |
| 82310 |
|
149 |
120 |
$1K |
| A9502 |
Tc99m tetrofosmin |
839 |
622 |
$1K |
| 84134 |
|
112 |
81 |
$1K |
| C9113 |
Inj pantoprazole sodium, via |
697 |
340 |
$1K |
| 80177 |
|
208 |
173 |
$1K |
| 86256 |
|
63 |
45 |
$1K |
| 90662 |
|
192 |
169 |
$1K |
| 99253 |
|
32 |
29 |
$1K |
| 86695 |
|
50 |
41 |
$1K |
| 82803 |
|
2,036 |
1,448 |
$1K |
| J1644 |
Inj heparin sodium per 1000u |
3,707 |
1,329 |
$1K |
| 94618 |
|
14 |
13 |
$1K |
| 00840 |
|
413 |
229 |
$1K |
| 86709 |
|
59 |
59 |
$995.60 |
| 51729 |
|
13 |
12 |
$979.78 |
| 86708 |
|
37 |
25 |
$969.64 |
| J1453 |
Fosaprepitant injection |
79 |
43 |
$958.85 |
| J9045 |
Carboplatin injection |
109 |
52 |
$958.58 |
| 87798 |
|
110 |
83 |
$954.49 |
| J1642 |
Inj heparin sodium per 10 u |
4,185 |
2,049 |
$953.87 |
| 73600 |
|
83 |
56 |
$925.76 |
| 82785 |
|
82 |
72 |
$922.13 |
| 87045 |
|
52 |
41 |
$896.26 |
| 85041 |
|
251 |
170 |
$894.50 |
| J1030 |
Methylprednisolone 40 mg inj |
4,475 |
3,752 |
$879.57 |
| 99222 |
|
25 |
24 |
$857.12 |
| 77091 |
|
39 |
39 |
$838.80 |
| 86359 |
|
18 |
16 |
$817.49 |
| J1790 |
Droperidol injection |
1,663 |
1,105 |
$808.89 |
| 83050 |
|
2,408 |
1,751 |
$803.60 |
| 86696 |
|
50 |
41 |
$795.73 |
| 80354 |
|
825 |
479 |
$786.59 |
| 99254 |
|
13 |
13 |
$712.83 |
| A9552 |
F18 fdg |
399 |
353 |
$711.76 |
| 84295 |
|
2,951 |
2,110 |
$709.46 |
| 76818 |
|
17 |
12 |
$700.05 |
| 64494 |
|
420 |
307 |
$699.85 |
| 76937 |
|
74 |
64 |
$694.66 |
| J2704 |
Inj, propofol, 10 mg |
9,494 |
6,547 |
$693.06 |
| 84270 |
|
43 |
40 |
$678.02 |
| J1100 |
Dexamethasone sodium phos |
7,706 |
4,689 |
$674.84 |
| 82435 |
|
2,005 |
1,497 |
$666.87 |
| 73000 |
|
28 |
26 |
$655.53 |
| J7030 |
Normal saline solution infus |
4,896 |
3,692 |
$623.38 |
| 82248 |
|
65 |
51 |
$621.07 |
| J1720 |
Hydrocortisone sodium succ i |
258 |
142 |
$620.81 |
| 85613 |
|
39 |
37 |
$610.07 |
| 90686 |
|
48 |
39 |
$605.02 |
| 87529 |
|
17 |
13 |
$598.50 |
| 86765 |
|
30 |
25 |
$598.46 |
| 51700 |
|
24 |
13 |
$572.76 |
| J3370 |
Vancomycin hcl injection |
890 |
476 |
$571.50 |
| J0780 |
Prochlorperazine injection |
2,443 |
1,516 |
$568.68 |
| 84445 |
|
14 |
12 |
$517.13 |
| 72220 |
|
30 |
26 |
$494.80 |
| 82525 |
|
47 |
41 |
$475.03 |
| 86735 |
|
22 |
13 |
$468.84 |
| 87449 |
|
56 |
44 |
$465.57 |
| 87502 |
|
31 |
27 |
$465.45 |
| J3010 |
Fentanyl citrate injection |
9,381 |
5,247 |
$464.81 |
| 87046 |
|
52 |
41 |
$448.88 |
| 77001 |
|
64 |
54 |
$446.48 |
| 95909 |
|
25 |
25 |
$437.91 |
| 82140 |
|
91 |
75 |
$435.21 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
1,321 |
853 |
$434.38 |
| 90461 |
|
47 |
36 |
$423.73 |
| 99202 |
|
18 |
18 |
$412.85 |
| 84144 |
|
12 |
12 |
$377.65 |
| J2405 |
Ondansetron hcl injection |
16,994 |
9,677 |
$376.93 |
| 82952 |
|
25 |
24 |
$362.79 |
| 00811 |
|
148 |
101 |
$362.46 |
| 87880 |
|
137 |
108 |
$356.42 |
| 86361 |
|
13 |
12 |
$349.78 |
| J0696 |
Ceftriaxone sodium injection |
3,961 |
2,183 |
$346.72 |
| 73501 |
|
40 |
38 |
$336.60 |
| 99225 |
|
28 |
25 |
$331.27 |
| 84145 |
|
88 |
68 |
$326.09 |
| 51701 |
|
17 |
12 |
$323.02 |
| 92610 |
|
13 |
13 |
$309.91 |
| J0330 |
Succinycholine chloride inj |
1,611 |
855 |
$309.33 |
| 82390 |
|
17 |
13 |
$303.99 |
| J3475 |
Inj magnesium sulfate |
1,452 |
868 |
$290.06 |
| 85384 |
|
73 |
47 |
$289.43 |
| J1200 |
Diphenhydramine hcl injectio |
4,869 |
2,851 |
$285.86 |
| 87328 |
|
17 |
13 |
$276.22 |
| 51797 |
|
13 |
12 |
$267.33 |
| 88311 |
|
73 |
56 |
$257.00 |
| J2930 |
Methylprednisolone injection |
973 |
546 |
$247.05 |
| J2785 |
Regadenoson injection |
756 |
553 |
$244.60 |
| J0690 |
Cefazolin sodium injection |
3,465 |
1,922 |
$230.70 |
| 84681 |
|
14 |
12 |
$218.54 |
| 73660 |
|
13 |
13 |
$216.75 |
| 84207 |
|
18 |
18 |
$215.39 |
| 84450 |
|
46 |
42 |
$213.46 |
| 82010 |
|
387 |
292 |
$210.81 |
| 83090 |
|
20 |
13 |
$204.51 |
| 80175 |
|
16 |
13 |
$190.97 |
| 96417 |
|
808 |
387 |
$184.55 |
| J0694 |
Cefoxitin sodium injection |
77 |
33 |
$179.94 |
| 95912 |
|
40 |
40 |
$168.32 |
| J3420 |
Vitamin b12 injection |
242 |
145 |
$156.49 |
| J2060 |
Lorazepam injection |
1,293 |
786 |
$154.89 |
| 82274 |
|
22 |
13 |
$151.63 |
| 83721 |
|
48 |
44 |
$149.60 |
| 95911 |
|
40 |
38 |
$148.63 |
| J7512 |
Prednisone ir or dr oral 1mg |
3,715 |
1,897 |
$146.73 |
| Q9957 |
Inj perflutren lip micros,ml |
720 |
609 |
$137.36 |
| J1940 |
Furosemide injection |
628 |
297 |
$134.79 |
| 87075 |
|
73 |
62 |
$132.76 |
| J2919 |
Inj, methylpred sod succ 5mg |
465 |
310 |
$130.46 |
| 88112 |
|
98 |
66 |
$126.43 |
| 86301 |
|
21 |
16 |
$126.16 |
| J2250 |
Inj midazolam hydrochloride |
5,696 |
3,666 |
$126.01 |
| 86790 |
|
31 |
28 |
$124.56 |
| 87329 |
|
17 |
13 |
$119.32 |
| 82747 |
|
13 |
12 |
$112.56 |
| J2920 |
Methylprednisolone injection |
152 |
57 |
$110.57 |
| 84075 |
|
14 |
13 |
$103.00 |
| J2765 |
Metoclopramide hcl injection |
1,677 |
1,050 |
$97.60 |
| J1010 |
Inj, methylpred acetate 1 mg |
696 |
577 |
$97.13 |
| 96139 |
|
13 |
12 |
$85.06 |
| 80047 |
|
28 |
25 |
$84.40 |
| 88173 |
|
28 |
26 |
$81.99 |
| J7120 |
Ringers lactate infusion |
1,196 |
1,050 |
$80.56 |
| J3411 |
Thiamine hcl 100 mg |
70 |
38 |
$79.80 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
2,828 |
2,357 |
$69.01 |
| 81002 |
|
61 |
48 |
$68.73 |
| 86381 |
|
14 |
13 |
$67.06 |
| J3301 |
Triamcinolone acet inj nos |
2,873 |
1,915 |
$66.50 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
477 |
310 |
$65.67 |
| J3480 |
Inj potassium chloride |
1,016 |
598 |
$63.36 |
| 86304 |
|
20 |
12 |
$58.43 |
| U0002 |
Covid-19 lab test non-cdc |
13 |
12 |
$53.88 |
| 82365 |
|
40 |
24 |
$50.70 |
| 88302 |
|
15 |
12 |
$45.62 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
221 |
144 |
$37.48 |
| A9541 |
Tc99m sulfur colloid |
222 |
181 |
$36.48 |
| J2470 |
Inj pantoprazole sodium 40mg |
111 |
65 |
$35.08 |
| A9270 |
Non-covered item or service |
2,422 |
1,388 |
$33.50 |
| 86255 |
|
25 |
24 |
$29.61 |
| J0360 |
Hydralazine hcl injection |
131 |
72 |
$25.15 |
| C9290 |
Inj, bupivacaine liposome |
27 |
17 |
$23.52 |
| 91300 |
|
2,122 |
1,923 |
$20.80 |
| J7050 |
Normal saline solution infus |
4,905 |
2,423 |
$19.45 |
| J0744 |
Ciprofloxacin iv |
162 |
77 |
$17.98 |
| J2370 |
Phenylephrine hcl injection |
506 |
292 |
$17.37 |
| J2795 |
Ropivacaine hcl injection |
211 |
157 |
$13.20 |
| J7040 |
Normal saline solution infus |
847 |
453 |
$11.97 |
| J1630 |
Haloperidol injection |
77 |
45 |
$11.94 |
| J0689 |
Inj cefazolin sodium, baxter |
103 |
89 |
$10.37 |
| 85007 |
|
14 |
12 |
$9.45 |
| J2710 |
Neostigmine methylslfte inj |
27 |
14 |
$8.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
254 |
193 |
$5.97 |
| J2004 |
Inj, lidocaine w epinephrine |
62 |
59 |
$5.09 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
245 |
115 |
$3.72 |
| J0171 |
Adrenalin epinephrine inject |
233 |
154 |
$3.60 |
| Q9969 |
Non-heu tc-99m add-on/dose |
1,784 |
1,372 |
$2.94 |
| J0456 |
Azithromycin |
46 |
24 |
$2.72 |
| J7620 |
Albuterol ipratrop non-comp |
72 |
34 |
$2.68 |
| J2001 |
Lidocaine injection |
1,055 |
987 |
$1.18 |
| 91312 |
|
104 |
61 |
$0.73 |
| C1769 |
Guide wire |
996 |
684 |
$0.00 |
| 76377 |
|
130 |
116 |
$0.00 |
| 3074F |
|
459 |
444 |
$0.00 |
| 01480 |
|
16 |
12 |
$0.00 |
| 94760 |
|
1,212 |
529 |
$0.00 |
| 00813 |
|
63 |
52 |
$0.00 |
| 3079F |
|
57 |
55 |
$0.00 |
| G0008 |
Admin influenza virus vac |
252 |
219 |
$0.00 |
| 64484 |
|
45 |
42 |
$0.00 |
| A4648 |
Implantable tissue marker |
270 |
206 |
$0.00 |
| 36416 |
|
99 |
92 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
83 |
83 |
$0.00 |
| 87081 |
|
32 |
26 |
$0.00 |
| J7060 |
5% dextrose/water |
190 |
69 |
$0.00 |
| 00790 |
|
147 |
96 |
$0.00 |
| 96411 |
|
93 |
38 |
$0.00 |
| J1920 |
Inj, labetalol hcl, 5mg |
33 |
32 |
$0.00 |
| J1040 |
Methylprednisolone 80 mg inj |
38 |
27 |
$0.00 |
| A9537 |
Tc99m mebrofenin |
16 |
12 |
$0.00 |
| 3078F |
|
359 |
348 |
$0.00 |
| 0598T |
|
18 |
14 |
$0.00 |
| G1004 |
Cdsm ndsc |
520 |
475 |
$0.00 |
| 00910 |
|
43 |
39 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
60 |
57 |
$0.00 |
| 00918 |
|
20 |
12 |
$0.00 |
| 00400 |
|
54 |
41 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
33 |
26 |
$0.00 |
| 51741 |
|
13 |
12 |
$0.00 |
| 96133 |
|
15 |
13 |
$0.00 |
| C2625 |
Stent, non-cor, tem w/del sy |
33 |
24 |
$0.00 |
| J9190 |
Fluorouracil injection |
128 |
37 |
$0.00 |
| C1788 |
Port, indwelling, imp |
12 |
12 |
$0.00 |