| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
59,377 |
40,921 |
$27.91M |
| J9271 |
Inj pembrolizumab |
2,925 |
1,950 |
$19.23M |
| 99284 |
|
55,498 |
45,059 |
$12.18M |
| 99283 |
|
65,422 |
52,788 |
$8.54M |
| 74177 |
|
15,495 |
12,955 |
$6.17M |
| 96413 |
|
16,751 |
8,149 |
$6.10M |
| J9299 |
Injection, nivolumab |
981 |
482 |
$4.16M |
| 96375 |
|
28,092 |
17,997 |
$3.44M |
| 99282 |
|
34,244 |
27,166 |
$3.17M |
| 96365 |
|
16,203 |
8,413 |
$2.94M |
| 70450 |
|
19,279 |
16,090 |
$2.87M |
| 77386 |
|
4,349 |
378 |
$2.69M |
| 71260 |
|
11,252 |
9,759 |
$2.67M |
| C1713 |
Anchor/screw bn/bn,tis/bn |
2,204 |
1,768 |
$2.55M |
| G0463 |
Hospital outpt clinic visit |
59,798 |
43,693 |
$2.34M |
| 96417 |
|
3,663 |
2,049 |
$2.21M |
| 72125 |
|
11,969 |
9,870 |
$2.20M |
| 96374 |
|
34,795 |
23,020 |
$2.01M |
| G0378 |
Hospital observation per hr |
42,739 |
20,587 |
$1.97M |
| 70553 |
|
3,271 |
2,820 |
$1.88M |
| 45380 |
|
1,324 |
1,021 |
$1.86M |
| 80053 |
|
136,134 |
90,023 |
$1.76M |
| 43239 |
|
1,502 |
1,140 |
$1.75M |
| 80307 |
|
42,283 |
32,399 |
$1.52M |
| 96415 |
|
3,862 |
2,484 |
$1.34M |
| 96361 |
|
33,379 |
19,203 |
$1.21M |
| 71045 |
|
27,261 |
20,606 |
$1.15M |
| G0480 |
Drug test def 1-7 classes |
19,181 |
15,412 |
$1.11M |
| J0585 |
Injection,onabotulinumtoxina |
1,730 |
1,450 |
$1.11M |
| 96366 |
|
5,604 |
3,652 |
$1.03M |
| 78815 |
|
952 |
816 |
$999K |
| 71046 |
|
16,934 |
13,599 |
$939K |
| 74176 |
|
2,777 |
2,265 |
$907K |
| 70551 |
|
2,094 |
1,820 |
$903K |
| 85025 |
|
131,277 |
92,298 |
$897K |
| 97110 |
|
24,455 |
7,824 |
$827K |
| 70486 |
|
4,948 |
4,364 |
$825K |
| 88305 |
|
8,920 |
7,373 |
$778K |
| 58571 |
|
570 |
304 |
$777K |
| 93306 |
|
2,530 |
2,215 |
$774K |
| J2350 |
Injection, ocrelizumab, 1 mg |
44 |
36 |
$731K |
| 96372 |
|
27,068 |
17,004 |
$693K |
| 87631 |
|
6,560 |
5,902 |
$661K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
33,267 |
22,916 |
$652K |
| 99291 |
|
859 |
591 |
$650K |
| 96360 |
|
14,904 |
8,464 |
$641K |
| 93005 |
|
18,344 |
13,857 |
$633K |
| 76705 |
|
5,583 |
4,874 |
$624K |
| J1950 |
Leuprolide acetate /3.75 mg |
556 |
497 |
$604K |
| 70498 |
|
2,081 |
1,822 |
$592K |
| 77336 |
|
4,159 |
1,513 |
$576K |
| 99281 |
|
11,796 |
9,737 |
$565K |
| 96367 |
|
4,811 |
1,892 |
$564K |
| 45385 |
|
490 |
364 |
$537K |
| 59025 |
|
6,695 |
4,968 |
$532K |
| 93308 |
|
3,067 |
2,684 |
$522K |
| 45378 |
|
351 |
299 |
$469K |
| 73030 |
|
6,376 |
5,108 |
$469K |
| 36224 |
|
101 |
61 |
$467K |
| 96368 |
|
2,307 |
1,331 |
$442K |
| 36415 |
|
105,823 |
61,084 |
$430K |
| 97530 |
|
11,929 |
4,146 |
$409K |
| U0003 |
Cov-19 amp prb hgh thruput |
8,236 |
6,474 |
$406K |
| 73630 |
|
6,167 |
5,055 |
$399K |
| 77067 |
|
8,475 |
8,203 |
$392K |
| 70496 |
|
1,254 |
959 |
$382K |
| 76815 |
|
2,631 |
2,276 |
$374K |
| 71250 |
|
1,696 |
1,435 |
$370K |
| 87502 |
|
9,136 |
8,125 |
$369K |
| 93975 |
|
1,967 |
1,785 |
$369K |
| 93971 |
|
1,799 |
1,585 |
$365K |
| 70491 |
|
1,340 |
1,077 |
$364K |
| 73610 |
|
7,376 |
5,959 |
$351K |
| 87389 |
|
22,105 |
19,569 |
$349K |
| 73590 |
|
6,434 |
5,157 |
$345K |
| 73552 |
|
4,797 |
3,875 |
$341K |
| J2469 |
Palonosetron hcl |
4,355 |
2,386 |
$338K |
| Q5107 |
Inj mvasi 10 mg |
192 |
66 |
$327K |
| J1745 |
Infliximab not biosimil 10mg |
126 |
108 |
$317K |
| 73564 |
|
5,248 |
4,174 |
$315K |
| 96411 |
|
1,419 |
832 |
$312K |
| A9577 |
Inj multihance |
5,501 |
4,129 |
$297K |
| 73130 |
|
5,876 |
4,786 |
$289K |
| 97140 |
|
5,848 |
2,425 |
$284K |
| 77300 |
|
1,107 |
485 |
$280K |
| 73560 |
|
4,001 |
3,101 |
$275K |
| A9552 |
F18 fdg |
935 |
809 |
$273K |
| 76770 |
|
2,194 |
1,857 |
$271K |
| J2704 |
Inj, propofol, 10 mg |
21,081 |
15,180 |
$264K |
| 87491 |
|
10,236 |
8,981 |
$260K |
| 82947 |
|
39,982 |
26,213 |
$259K |
| 76830 |
|
976 |
860 |
$242K |
| 77334 |
|
958 |
585 |
$239K |
| 94640 |
|
5,910 |
3,830 |
$238K |
| 93970 |
|
817 |
711 |
$234K |
| J1756 |
Iron sucrose injection |
3,416 |
1,276 |
$232K |
| 84484 |
|
22,444 |
16,327 |
$228K |
| 88307 |
|
1,953 |
1,572 |
$226K |
| J1453 |
Fosaprepitant injection |
818 |
503 |
$223K |
| 36226 |
|
57 |
49 |
$222K |
| 72148 |
|
457 |
400 |
$219K |
| 76700 |
|
1,442 |
1,213 |
$217K |
| 73110 |
|
4,677 |
3,815 |
$210K |
| A9579 |
Gad-base mr contrast nos,1ml |
495 |
365 |
$203K |
| 87522 |
Neg quan hep c or qual rna |
6,755 |
5,985 |
$199K |
| 76642 |
|
2,706 |
2,321 |
$197K |
| 87634 |
|
6,485 |
5,870 |
$191K |
| 86803 |
|
20,205 |
17,856 |
$182K |
| 76000 |
|
2,912 |
2,438 |
$180K |
| J1200 |
Diphenhydramine hcl injectio |
10,536 |
7,449 |
$177K |
| 36430 |
|
887 |
515 |
$174K |
| 73090 |
|
3,914 |
3,170 |
$171K |
| J0185 |
Inj., aprepitant, 1 mg |
809 |
505 |
$169K |
| 73060 |
|
2,890 |
2,301 |
$167K |
| 20680 |
|
156 |
118 |
$163K |
| 73502 |
|
3,576 |
2,981 |
$161K |
| 81268 |
|
952 |
772 |
$161K |
| J3010 |
Fentanyl citrate injection |
23,321 |
19,057 |
$159K |
| 84443 |
|
11,657 |
9,455 |
$159K |
| 90715 |
|
6,404 |
5,629 |
$155K |
| J0131 |
Inj, acetaminophen (nos) |
7,243 |
6,126 |
$153K |
| J1100 |
Dexamethasone sodium phos |
18,338 |
12,758 |
$150K |
| 73080 |
|
2,672 |
2,272 |
$147K |
| 86850 |
|
16,061 |
13,149 |
$146K |
| 97161 |
|
3,022 |
2,565 |
$146K |
| 72131 |
|
850 |
769 |
$145K |
| 72170 |
|
2,407 |
1,935 |
$143K |
| 97162 |
|
3,668 |
2,774 |
$143K |
| G0483 |
Drug test def 22+ classes |
1,185 |
947 |
$139K |
| 88341 |
|
1,020 |
834 |
$138K |
| 66984 |
|
248 |
150 |
$134K |
| 87902 |
|
731 |
647 |
$134K |
| 77063 |
|
5,827 |
5,112 |
$134K |
| 80048 |
|
19,613 |
12,163 |
$133K |
| 99153 |
Mod sedat endo service >5yrs |
1,581 |
1,428 |
$132K |
| 72100 |
|
1,760 |
1,509 |
$131K |
| J7050 |
Normal saline solution infus |
10,089 |
5,380 |
$131K |
| 72190 |
|
1,074 |
959 |
$129K |
| 83690 |
|
28,265 |
24,055 |
$129K |
| J1170 |
Hydromorphone injection |
17,658 |
12,110 |
$126K |
| 87591 |
|
4,513 |
4,118 |
$125K |
| 81001 |
|
32,859 |
28,017 |
$123K |
| J2405 |
Ondansetron hcl injection |
28,684 |
21,929 |
$121K |
| 36591 |
|
2,712 |
1,970 |
$120K |
| 83880 |
|
4,478 |
3,512 |
$112K |
| 96376 |
|
4,516 |
3,519 |
$112K |
| 76817 |
|
490 |
438 |
$111K |
| 43235 |
|
175 |
111 |
$111K |
| 77066 |
Tomosynthesis, mammo |
2,308 |
1,841 |
$110K |
| 87633 |
|
402 |
343 |
$109K |
| J2710 |
Neostigmine methylslfte inj |
3,901 |
3,323 |
$108K |
| 84702 |
|
11,047 |
9,078 |
$104K |
| J1642 |
Inj heparin sodium per 10 u |
12,214 |
6,283 |
$103K |
| Q0162 |
Ondansetron oral |
11,607 |
8,995 |
$103K |
| C1769 |
Guide wire |
427 |
316 |
$101K |
| 85610 |
|
27,129 |
22,034 |
$100K |
| 84703 |
|
15,906 |
13,808 |
$98K |
| 91200 |
|
1,705 |
1,524 |
$97K |
| 64642 |
|
861 |
400 |
$97K |
| 97166 |
|
2,029 |
1,696 |
$95K |
| G0498 |
Chemo extend iv infus w/pump |
587 |
325 |
$95K |
| 76536 |
|
742 |
659 |
$95K |
| 88342 |
|
1,790 |
1,521 |
$94K |
| 96402 |
|
1,528 |
1,154 |
$94K |
| 73562 |
|
1,347 |
1,047 |
$93K |
| J3490 |
Drugs unclassified injection |
11,198 |
3,779 |
$92K |
| 83735 |
|
18,035 |
9,762 |
$92K |
| 88185 |
|
555 |
388 |
$91K |
| 76805 |
|
906 |
781 |
$91K |
| 64488 |
|
167 |
140 |
$90K |
| 10060 |
|
834 |
714 |
$89K |
| 85730 |
|
21,376 |
17,804 |
$87K |
| J7120 |
Ringers lactate infusion |
7,835 |
6,001 |
$86K |
| J0690 |
Cefazolin sodium injection |
10,644 |
7,442 |
$85K |
| J2250 |
Inj midazolam hydrochloride |
22,782 |
18,964 |
$84K |
| G0283 |
Elec stim other than wound |
4,292 |
1,751 |
$83K |
| 72141 |
|
261 |
219 |
$82K |
| 74018 |
|
1,963 |
1,647 |
$82K |
| 82805 |
|
1,621 |
1,265 |
$81K |
| 87808 |
|
8,122 |
7,304 |
$80K |
| J1885 |
Ketorolac tromethamine inj |
19,087 |
15,923 |
$79K |
| 64643 |
|
508 |
336 |
$78K |
| 36561 |
|
60 |
52 |
$77K |
| 36227 |
|
18 |
12 |
$76K |
| 90471 |
|
5,993 |
5,280 |
$74K |
| 73700 |
|
362 |
298 |
$73K |
| 87905 |
|
8,199 |
7,373 |
$72K |
| J1650 |
Inj enoxaparin sodium |
5,685 |
2,428 |
$70K |
| 12002 |
|
973 |
887 |
$68K |
| 97165 |
|
1,307 |
1,144 |
$67K |
| 99152 |
|
2,656 |
2,371 |
$67K |
| 77065 |
Tomosynthesis, mammo |
1,990 |
1,501 |
$64K |
| 87040 |
|
4,914 |
3,319 |
$63K |
| U0005 |
Infec agen detec ampli probe |
3,342 |
2,891 |
$62K |
| 80074 |
|
1,802 |
1,596 |
$61K |
| 97022 |
|
4,257 |
1,468 |
$60K |
| 97116 |
|
2,436 |
1,436 |
$60K |
| 97602 |
|
1,407 |
768 |
$59K |
| 82306 |
|
2,661 |
2,365 |
$58K |
| 86900 |
|
16,029 |
13,159 |
$56K |
| 81003 |
|
22,042 |
18,422 |
$56K |
| 64494 |
|
99 |
78 |
$56K |
| 76604 |
|
515 |
457 |
$55K |
| 82565 |
|
4,953 |
3,814 |
$55K |
| 97168 |
|
1,606 |
1,512 |
$55K |
| 85027 |
|
10,644 |
8,506 |
$53K |
| J0897 |
Denosumab injection |
28 |
24 |
$53K |
| 86920 |
|
810 |
682 |
$53K |
| P9016 |
Rbc leukocytes reduced |
400 |
278 |
$53K |
| 77301 |
|
29 |
25 |
$53K |
| 72128 |
|
263 |
248 |
$53K |
| J0640 |
Leucovorin calcium injection |
881 |
344 |
$52K |
| 82728 |
|
4,706 |
3,700 |
$52K |
| 76856 |
|
413 |
382 |
$52K |
| A9573 |
Inj, gadopiclenol, 1 ml |
971 |
735 |
$49K |
| 82607 |
|
4,536 |
3,753 |
$49K |
| 83605 |
|
5,700 |
4,580 |
$48K |
| 64493 |
|
131 |
94 |
$47K |
| 86901 |
|
15,977 |
13,158 |
$47K |
| J0171 |
Adrenalin epinephrine inject |
2,942 |
2,465 |
$47K |
| J0696 |
Ceftriaxone sodium injection |
6,296 |
5,149 |
$45K |
| 88304 |
|
1,019 |
895 |
$45K |
| J9190 |
Fluorouracil injection |
1,299 |
395 |
$45K |
| J1644 |
Inj heparin sodium per 1000u |
5,011 |
2,639 |
$44K |
| G0279 |
Tomosynthesis, mammo |
2,561 |
2,120 |
$43K |
| J0780 |
Prochlorperazine injection |
2,409 |
2,039 |
$42K |
| 80061 |
|
3,271 |
2,341 |
$42K |
| J2270 |
Morphine sulfate injection |
8,882 |
6,296 |
$42K |
| J2795 |
Ropivacaine hcl injection |
3,590 |
2,881 |
$42K |
| 84100 |
|
12,985 |
7,162 |
$42K |
| 12001 |
|
739 |
674 |
$40K |
| J2370 |
Phenylephrine hcl injection |
2,957 |
2,032 |
$40K |
| 87086 |
|
6,719 |
5,668 |
$40K |
| 84153 |
|
2,196 |
1,786 |
$39K |
| 87070 |
|
3,070 |
2,493 |
$39K |
| 74183 |
|
57 |
52 |
$39K |
| 87075 |
|
4,866 |
4,314 |
$39K |
| 82550 |
|
7,183 |
5,199 |
$37K |
| 87651 |
|
1,458 |
1,360 |
$37K |
| 70487 |
|
143 |
116 |
$37K |
| J3480 |
Inj potassium chloride |
2,367 |
1,511 |
$36K |
| 86780 |
|
3,277 |
2,771 |
$35K |
| 87210 |
|
7,944 |
7,160 |
$35K |
| J3475 |
Inj magnesium sulfate |
4,014 |
2,734 |
$34K |
| 77080 |
|
530 |
455 |
$34K |
| 72040 |
|
539 |
452 |
$33K |
| 41899 |
|
53 |
42 |
$33K |
| 87077 |
|
3,906 |
3,427 |
$32K |
| 82553 |
|
3,220 |
2,167 |
$32K |
| J7040 |
Normal saline solution infus |
2,351 |
1,512 |
$31K |
| 97535 |
|
1,531 |
986 |
$31K |
| V2790 |
Amniotic membrane |
16 |
14 |
$30K |
| 73070 |
|
700 |
552 |
$29K |
| 76870 |
|
259 |
223 |
$29K |
| J3370 |
Vancomycin hcl injection |
2,021 |
1,290 |
$29K |
| 82746 |
|
2,690 |
2,337 |
$28K |
| J2001 |
Lidocaine injection |
11,422 |
7,425 |
$28K |
| 84466 |
|
3,102 |
2,617 |
$27K |
| J2930 |
Methylprednisolone injection |
2,499 |
1,964 |
$27K |
| 88309 |
|
193 |
161 |
$27K |
| J9045 |
Carboplatin injection |
831 |
395 |
$26K |
| J1953 |
Levetiracetam injection |
1,268 |
947 |
$26K |
| J7030 |
Normal saline solution infus |
2,520 |
1,746 |
$25K |
| J1815 |
Insulin injection |
2,764 |
836 |
$25K |
| 87635 |
|
1,112 |
842 |
$24K |
| C1760 |
Closure dev, vasc |
131 |
114 |
$24K |
| 83036 |
|
3,622 |
3,236 |
$24K |
| 82378 |
|
1,526 |
1,205 |
$23K |
| 77001 |
|
329 |
279 |
$23K |
| Q0138 |
Ferumoxytol, non-esrd |
118 |
63 |
$23K |
| J1790 |
Droperidol injection |
3,339 |
2,846 |
$23K |
| 12011 |
|
354 |
312 |
$22K |
| 84439 |
|
2,223 |
1,837 |
$21K |
| 72156 |
|
48 |
38 |
$21K |
| 76937 |
|
182 |
157 |
$21K |
| 73721 |
|
50 |
39 |
$21K |
| 88184 |
|
575 |
391 |
$21K |
| 86923 |
|
436 |
310 |
$20K |
| 96523 |
|
1,112 |
773 |
$20K |
| J0330 |
Succinycholine chloride inj |
1,754 |
1,277 |
$20K |
| 83615 |
|
4,283 |
3,156 |
$19K |
| 86140 |
|
5,149 |
4,396 |
$19K |
| 76942 |
|
54 |
53 |
$19K |
| J2060 |
Lorazepam injection |
4,625 |
3,743 |
$19K |
| 83520 |
|
1,157 |
832 |
$19K |
| J7060 |
5% dextrose/water |
1,477 |
613 |
$19K |
| 36600 |
|
708 |
555 |
$19K |
| 86790 |
|
1,790 |
1,533 |
$18K |
| 85379 |
|
2,590 |
2,334 |
$18K |
| 87340 |
|
2,477 |
2,165 |
$18K |
| 94760 |
|
3,850 |
2,244 |
$18K |
| 87186 |
|
2,035 |
1,769 |
$18K |
| 64450 |
|
30 |
24 |
$17K |
| 73600 |
|
453 |
332 |
$17K |
| 83540 |
|
3,352 |
2,817 |
$17K |
| 76882 |
|
211 |
176 |
$17K |
| 94644 |
|
484 |
412 |
$17K |
| 97760 |
|
681 |
622 |
$17K |
| 86334 |
|
911 |
676 |
$16K |
| 86704 |
|
1,751 |
1,531 |
$16K |
| J2560 |
Phenobarbital sodium inj |
267 |
238 |
$16K |
| 74178 |
|
30 |
27 |
$16K |
| J9267 |
Paclitaxel injection |
527 |
224 |
$16K |
| 70480 |
|
90 |
80 |
$15K |
| 80164 |
|
1,649 |
1,256 |
$15K |
| 86706 |
|
1,924 |
1,725 |
$15K |
| 77338 |
|
63 |
50 |
$15K |
| J3301 |
Triamcinolone acet inj nos |
1,628 |
1,446 |
$15K |
| 85652 |
|
4,974 |
4,326 |
$14K |
| 77290 |
|
104 |
39 |
$14K |
| 95874 |
|
1,066 |
929 |
$14K |
| 71101 |
|
219 |
208 |
$13K |
| 80047 |
|
1,361 |
1,056 |
$13K |
| 64495 |
|
33 |
26 |
$13K |
| 87205 |
|
2,586 |
2,168 |
$13K |
| G0297 |
Ldct for lung ca screen |
54 |
54 |
$13K |
| 86480 |
|
243 |
226 |
$13K |
| 84165 |
|
1,214 |
928 |
$12K |
| 87653 |
|
388 |
359 |
$12K |
| 19083 |
|
12 |
12 |
$11K |
| 93017 |
|
87 |
79 |
$11K |
| L3808 |
Whfo, rigid w/o joints |
151 |
101 |
$11K |
| V2632 |
Post chmbr intraocular lens |
179 |
131 |
$11K |
| J1630 |
Haloperidol injection |
3,481 |
2,870 |
$11K |
| 82105 |
|
910 |
788 |
$10K |
| 74019 |
|
225 |
209 |
$10K |
| 97112 |
|
307 |
155 |
$9K |
| 82803 |
|
738 |
577 |
$9K |
| 64644 |
|
61 |
37 |
$9K |
| 88108 |
|
536 |
407 |
$9K |
| 86038 |
|
715 |
639 |
$8K |
| C9113 |
Inj pantoprazole sodium, via |
1,187 |
742 |
$8K |
| 71271 |
|
65 |
57 |
$8K |
| 20694 |
|
13 |
12 |
$8K |
| 87798 |
|
236 |
215 |
$8K |
| 82570 |
|
1,812 |
1,549 |
$8K |
| 73000 |
|
159 |
143 |
$8K |
| 97035 |
|
499 |
192 |
$7K |
| C1894 |
Intro/sheath, non-laser |
167 |
137 |
$7K |
| 88313 |
|
186 |
153 |
$7K |
| J0561 |
Penicillin g benzathine inj |
27 |
25 |
$7K |
| 11042 |
|
68 |
27 |
$7K |
| J3411 |
Thiamine hcl 100 mg |
618 |
268 |
$7K |
| 97016 |
|
380 |
135 |
$7K |
| 96409 |
|
35 |
13 |
$6K |
| 76001 |
|
30 |
28 |
$6K |
| A9500 |
Tc99m sestamibi |
28 |
26 |
$6K |
| 80178 |
|
989 |
749 |
$6K |
| 88331 |
|
131 |
97 |
$6K |
| 97763 |
|
248 |
204 |
$6K |
| M0245 |
Bamlan and etesev infusion |
39 |
34 |
$5K |
| 84156 |
|
1,952 |
1,627 |
$5K |
| 85384 |
|
746 |
558 |
$5K |
| 97018 |
|
330 |
157 |
$5K |
| 87426 |
|
306 |
250 |
$5K |
| J0295 |
Ampicillin sulbactam 1.5 gm |
522 |
276 |
$5K |
| J3360 |
Diazepam injection |
276 |
216 |
$5K |
| 84166 |
|
243 |
154 |
$5K |
| Q9968 |
Visualization adjunct |
21 |
12 |
$4K |
| 73565 |
|
81 |
77 |
$4K |
| 83721 |
|
436 |
421 |
$4K |
| 83970 |
|
109 |
100 |
$4K |
| 87102 |
|
607 |
499 |
$4K |
| J3420 |
Vitamin b12 injection |
634 |
452 |
$4K |
| 82784 |
|
216 |
189 |
$4K |
| J2310 |
Inj naloxone hydrochloride |
163 |
116 |
$4K |
| 84550 |
|
889 |
730 |
$4K |
| 86705 |
|
368 |
347 |
$3K |
| J2543 |
Piperacillin/tazobactam |
171 |
87 |
$3K |
| 87428 |
|
72 |
59 |
$3K |
| M0243 |
Casirivi and imdevi inj |
17 |
14 |
$3K |
| J2274 |
Inj morphine pf epid ithc |
267 |
206 |
$3K |
| 83550 |
|
1,794 |
1,545 |
$3K |
| C1874 |
Stent, coated/cov w/del sys |
69 |
58 |
$3K |
| 41800 |
|
47 |
45 |
$3K |
| 91065 |
|
13 |
13 |
$3K |
| 86235 |
|
39 |
38 |
$3K |
| 96416 |
|
25 |
15 |
$3K |
| C1788 |
Port, indwelling, imp |
14 |
13 |
$3K |
| A9578 |
Inj multihance multipack |
75 |
66 |
$3K |
| 85048 |
|
536 |
338 |
$3K |
| J7512 |
Prednisone ir or dr oral 1mg |
5,603 |
4,832 |
$3K |
| 73620 |
|
60 |
37 |
$2K |
| 93320 |
|
38 |
24 |
$2K |
| 97597 |
|
37 |
24 |
$2K |
| 86328 |
|
150 |
115 |
$2K |
| G0008 |
Admin influenza virus vac |
142 |
129 |
$2K |
| 64616 |
|
22 |
12 |
$2K |
| 86146 |
|
51 |
51 |
$2K |
| 82150 |
|
502 |
435 |
$2K |
| 85014 |
|
1,616 |
1,293 |
$2K |
| 87015 |
|
526 |
274 |
$2K |
| J2371 |
Inj phenylephrine hcl 20 mcg |
552 |
448 |
$2K |
| 87116 |
|
382 |
316 |
$2K |
| 86147 |
|
59 |
51 |
$2K |
| 97164 |
|
99 |
89 |
$2K |
| 87517 |
|
64 |
61 |
$2K |
| 29125 |
|
55 |
38 |
$2K |
| 73140 |
|
85 |
71 |
$2K |
| 77370 |
|
14 |
12 |
$2K |
| J2997 |
Alteplase recombinant |
13 |
12 |
$2K |
| 85045 |
|
593 |
423 |
$2K |
| J1171 |
Inj, hydromorphone, 0.1 mg |
339 |
233 |
$2K |
| 87641 |
|
88 |
76 |
$2K |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
335 |
282 |
$2K |
| A4648 |
Implantable tissue marker |
15 |
13 |
$2K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
604 |
527 |
$2K |
| 72070 |
|
26 |
24 |
$2K |
| 88302 |
|
55 |
49 |
$2K |
| J8540 |
Oral dexamethasone |
1,036 |
891 |
$2K |
| J9263 |
Oxaliplatin |
45 |
24 |
$1K |
| 93356 |
|
13 |
13 |
$1K |
| 0001A |
|
69 |
49 |
$1K |
| J3489 |
Zoledronic acid 1mg |
83 |
76 |
$1K |
| J2919 |
Inj, methylpred sod succ 5mg |
164 |
133 |
$1K |
| J2550 |
Promethazine hcl injection |
752 |
628 |
$1K |
| 86160 |
|
39 |
39 |
$1K |
| J9060 |
Cisplatin 10 mg injection |
80 |
28 |
$1K |
| 86922 |
|
13 |
12 |
$1K |
| J2920 |
Methylprednisolone injection |
143 |
122 |
$1K |
| 87081 |
|
157 |
146 |
$966.32 |
| 87206 |
|
351 |
291 |
$952.20 |
| 84145 |
|
62 |
56 |
$931.79 |
| 85049 |
|
355 |
243 |
$927.03 |
| 88173 |
|
60 |
48 |
$914.24 |
| J3486 |
Ziprasidone mesylate |
14 |
12 |
$837.20 |
| J2175 |
Meperidine hydrochl /100 mg |
297 |
270 |
$828.47 |
| 77417 |
|
28 |
12 |
$811.84 |
| 86200 |
|
44 |
44 |
$779.53 |
| 0031A |
|
27 |
22 |
$722.36 |
| 89051 |
|
114 |
74 |
$657.34 |
| 90686 |
|
249 |
203 |
$624.22 |
| 83010 |
|
82 |
65 |
$622.30 |
| 90674 |
|
76 |
64 |
$580.90 |
| J1920 |
Inj, labetalol hcl, 5mg |
72 |
53 |
$542.43 |
| J1805 |
Inj, esmolol hcl, 10mg |
81 |
68 |
$530.95 |
| 99426 |
|
15 |
14 |
$516.58 |
| J0735 |
Clonidine hydrochloride |
38 |
38 |
$497.05 |
| 88311 |
|
48 |
41 |
$490.20 |
| 94010 |
|
16 |
12 |
$470.80 |
| J2765 |
Metoclopramide hcl injection |
143 |
122 |
$435.41 |
| 95700 |
|
16 |
14 |
$410.23 |
| J1956 |
Levofloxacin injection |
31 |
26 |
$340.17 |
| 73100 |
|
16 |
14 |
$336.29 |
| 82248 |
|
76 |
55 |
$331.27 |
| 82140 |
|
41 |
38 |
$306.27 |
| 82010 |
|
55 |
45 |
$304.60 |
| Q0169 |
Promethazine hcl 12.5mg oral |
243 |
169 |
$304.48 |
| A6213 |
Foam drg >16<=48 sq in w/bdr |
19 |
12 |
$302.00 |
| 82247 |
|
58 |
43 |
$295.58 |
| 86255 |
|
46 |
44 |
$290.32 |
| 87640 |
|
14 |
13 |
$285.97 |
| 86787 |
|
36 |
27 |
$277.77 |
| 97150 |
|
20 |
14 |
$271.46 |
| 86141 |
|
45 |
42 |
$257.69 |
| 83497 |
|
25 |
24 |
$243.23 |
| J2359 |
Inj. olanzapine, 0.5mg |
17 |
12 |
$235.73 |
| 97139 |
|
39 |
25 |
$234.64 |
| G8978 |
Mobility current status |
114 |
53 |
$205.52 |
| 85018 |
|
62 |
38 |
$201.93 |
| J0670 |
Inj mepivacaine hcl/10 ml |
32 |
26 |
$196.89 |
| 87880 |
|
13 |
13 |
$187.70 |
| 51798 |
|
18 |
12 |
$185.01 |
| 87556 |
|
17 |
13 |
$180.02 |
| J1580 |
Garamycin gentamicin inj |
14 |
12 |
$173.71 |
| 87147 |
|
52 |
42 |
$166.08 |
| 12013 |
|
15 |
14 |
$164.16 |
| J0360 |
Hydralazine hcl injection |
28 |
24 |
$157.49 |
| 86709 |
|
14 |
14 |
$155.20 |
| 86376 |
|
13 |
13 |
$143.34 |
| 87449 |
|
19 |
13 |
$134.06 |
| A9270 |
Non-covered item or service |
1,946 |
461 |
$133.60 |
| L3931 |
Whfo nontorsion joint prefab |
93 |
88 |
$132.66 |
| J2780 |
Ranitidine hydrochloride inj |
33 |
32 |
$132.13 |
| 82525 |
|
20 |
13 |
$124.92 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
14 |
13 |
$82.16 |
| 86431 |
|
17 |
16 |
$72.35 |
| J1836 |
Inj, metronidazole, 10 mg |
18 |
14 |
$69.26 |
| 82945 |
|
12 |
12 |
$48.50 |
| 84157 |
|
12 |
12 |
$45.30 |
| Q0164 |
Prochlorperazine maleate 5mg |
59 |
48 |
$29.14 |
| G8979 |
Mobility goal status |
36 |
28 |
$25.20 |
| 80341 |
|
12 |
12 |
$14.83 |
| Q0163 |
Diphenhydramine hcl 50mg |
24 |
14 |
$10.03 |
| Q0244 |
Casirivi and imdevi 1200 mg |
18 |
12 |
$0.15 |
| Q0245 |
Bamlanivimab and etesevima |
44 |
39 |
$0.07 |
| G8984 |
Carry current status |
14 |
12 |
$0.00 |
| 91300 |
|
157 |
117 |
$0.00 |
| 80334 |
|
12 |
12 |
$0.00 |
| 80326 |
|
12 |
12 |
$0.00 |
| G8985 |
Carry goal status |
24 |
13 |
$0.00 |
| 80331 |
|
12 |
12 |
$0.00 |