| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
78,459 |
66,775 |
$4.83M |
| 96361 |
|
35,911 |
27,332 |
$4.41M |
| 99284 |
|
67,880 |
56,652 |
$3.61M |
| 99213 |
|
50,009 |
40,140 |
$2.30M |
| 99285 |
|
43,585 |
35,501 |
$2.21M |
| 99212 |
|
43,707 |
35,236 |
$2.04M |
| 80053 |
|
104,099 |
78,837 |
$1.98M |
| U0003 |
Cov-19 amp prb hgh thruput |
23,780 |
19,726 |
$1.90M |
| 87491 |
|
38,589 |
30,170 |
$1.29M |
| 80048 |
|
57,642 |
42,240 |
$1.12M |
| 99282 |
|
16,989 |
14,512 |
$1.12M |
| 87591 |
|
38,607 |
30,221 |
$1.11M |
| 85025 |
|
133,583 |
96,988 |
$1.08M |
| 96360 |
|
13,703 |
11,173 |
$1.01M |
| 70450 |
|
14,583 |
12,419 |
$977K |
| 99211 |
|
18,536 |
15,129 |
$957K |
| 96365 |
|
12,883 |
7,676 |
$941K |
| 99214 |
|
32,854 |
23,104 |
$890K |
| 80307 |
|
20,054 |
14,863 |
$885K |
| 87661 |
|
31,384 |
24,296 |
$837K |
| 74177 |
|
11,737 |
10,000 |
$776K |
| 76816 |
|
11,245 |
8,825 |
$714K |
| 87635 |
|
15,360 |
13,650 |
$664K |
| 87502 |
|
8,083 |
7,159 |
$640K |
| 97110 |
|
31,294 |
10,608 |
$638K |
| 59025 |
|
7,644 |
4,390 |
$588K |
| 43239 |
|
3,225 |
2,682 |
$531K |
| 76805 |
|
5,299 |
4,734 |
$518K |
| 93306 |
|
5,419 |
4,564 |
$517K |
| 96366 |
|
4,051 |
2,196 |
$462K |
| J9271 |
Inj pembrolizumab |
359 |
202 |
$453K |
| 76811 |
|
6,358 |
5,455 |
$449K |
| 94640 |
|
12,518 |
7,641 |
$444K |
| 87081 |
|
17,163 |
14,992 |
$430K |
| 90853 |
|
12,078 |
1,898 |
$413K |
| G0480 |
Drug test def 1-7 classes |
10,606 |
8,213 |
$401K |
| 80061 |
|
31,963 |
26,274 |
$387K |
| G0463 |
Hospital outpt clinic visit |
53,793 |
40,524 |
$382K |
| 45385 |
|
2,366 |
1,993 |
$382K |
| 96367 |
|
5,966 |
2,688 |
$378K |
| 87086 |
|
27,844 |
22,269 |
$356K |
| 81025 |
|
38,591 |
32,168 |
$341K |
| 82962 |
|
28,597 |
16,570 |
$336K |
| 84443 |
|
30,868 |
24,958 |
$324K |
| 76801 |
|
7,989 |
6,631 |
$318K |
| 99281 |
|
4,890 |
3,964 |
$311K |
| 71275 |
|
3,994 |
3,371 |
$295K |
| 45380 |
|
1,801 |
1,544 |
$290K |
| 96413 |
|
7,778 |
3,729 |
$285K |
| 84484 |
|
31,825 |
23,611 |
$283K |
| 78452 |
|
1,997 |
1,601 |
$279K |
| 87634 |
|
5,180 |
4,645 |
$276K |
| 83880 |
|
12,305 |
9,734 |
$267K |
| D1206 |
|
22,303 |
21,130 |
$265K |
| 87389 |
|
14,579 |
11,548 |
$262K |
| 97140 |
|
17,324 |
6,483 |
$261K |
| 74176 |
|
4,213 |
3,666 |
$260K |
| D1351 |
|
17,249 |
5,556 |
$255K |
| 82306 |
|
11,390 |
9,584 |
$249K |
| 76856 |
|
5,291 |
4,675 |
$237K |
| 97530 |
|
10,567 |
4,407 |
$228K |
| 87798 |
|
999 |
813 |
$220K |
| 83036 |
|
33,007 |
26,123 |
$210K |
| 45378 |
|
821 |
739 |
$205K |
| 84702 |
|
9,614 |
7,032 |
$198K |
| 76830 |
|
5,085 |
4,511 |
$198K |
| 81001 |
|
41,828 |
34,980 |
$193K |
| 93356 |
|
2,361 |
2,046 |
$192K |
| 88175 |
|
8,851 |
6,625 |
$186K |
| D0191 |
|
18,861 |
18,023 |
$178K |
| 99215 |
Prolong outpt/office vis |
4,602 |
3,454 |
$177K |
| G0378 |
Hospital observation per hr |
11,424 |
8,024 |
$177K |
| P9016 |
Rbc leukocytes reduced |
686 |
453 |
$169K |
| 85027 |
|
29,956 |
23,215 |
$168K |
| 81420 |
|
430 |
349 |
$163K |
| 96415 |
|
1,973 |
1,260 |
$152K |
| 77067 |
|
6,100 |
5,574 |
$150K |
| 83690 |
|
27,101 |
22,426 |
$148K |
| 85610 |
|
20,731 |
15,227 |
$148K |
| 87624 |
|
5,821 |
4,418 |
$146K |
| 87077 |
|
11,267 |
8,990 |
$146K |
| S9480 |
Intensive outpatient psychia |
2,989 |
452 |
$139K |
| 76642 |
|
3,732 |
2,929 |
$137K |
| 80081 |
|
2,028 |
1,263 |
$135K |
| 71260 |
|
2,647 |
2,237 |
$134K |
| 86901 |
|
11,058 |
8,895 |
$134K |
| 12001 |
|
1,608 |
1,480 |
$133K |
| 87880 |
|
8,557 |
7,742 |
$132K |
| 72125 |
|
4,186 |
3,661 |
$130K |
| 76705 |
|
3,577 |
3,111 |
$130K |
| 87804 |
|
4,351 |
3,763 |
$129K |
| 82728 |
|
8,907 |
7,305 |
$129K |
| 97112 |
|
6,466 |
2,579 |
$126K |
| 86850 |
|
8,394 |
6,628 |
$126K |
| 76815 |
|
2,541 |
2,151 |
$123K |
| 92507 |
|
3,048 |
1,128 |
$120K |
| H0015 |
Alcohol and/or drug services |
2,713 |
378 |
$117K |
| 86780 |
|
12,308 |
9,674 |
$117K |
| 70553 |
|
1,335 |
1,084 |
$115K |
| 76819 |
|
7,000 |
5,094 |
$115K |
| 71046 |
|
16,670 |
14,271 |
$113K |
| 87070 |
|
7,273 |
5,799 |
$112K |
| 86481 |
|
1,571 |
1,349 |
$108K |
| 86803 |
|
10,216 |
8,326 |
$106K |
| 97162 |
|
4,384 |
3,563 |
$104K |
| 70496 |
|
1,388 |
1,150 |
$97K |
| 0241U |
|
3,153 |
2,738 |
$96K |
| 71250 |
|
3,117 |
2,719 |
$95K |
| 70498 |
|
1,430 |
1,162 |
$93K |
| C9803 |
Hopd covid-19 spec collect |
5,830 |
4,949 |
$93K |
| U0005 |
Infec agen detec ampli probe |
8,132 |
6,794 |
$93K |
| 77063 |
|
5,981 |
5,457 |
$91K |
| 90791 |
|
2,588 |
1,829 |
$90K |
| 96110 |
|
570 |
477 |
$88K |
| 87210 |
|
8,361 |
7,229 |
$87K |
| 93971 |
|
2,686 |
2,365 |
$83K |
| 70551 |
|
1,312 |
1,110 |
$82K |
| 83735 |
|
20,741 |
13,253 |
$82K |
| 78815 |
|
547 |
418 |
$82K |
| 93017 |
|
2,256 |
1,840 |
$82K |
| 96372 |
|
24,023 |
17,670 |
$82K |
| 82565 |
|
6,352 |
4,768 |
$79K |
| 82607 |
|
6,794 |
5,514 |
$79K |
| 93970 |
|
1,942 |
1,670 |
$78K |
| 12011 |
|
898 |
825 |
$77K |
| 84153 |
|
4,510 |
3,822 |
$75K |
| 80076 |
|
7,165 |
6,217 |
$74K |
| 83605 |
|
9,366 |
7,316 |
$74K |
| 81003 |
|
22,342 |
18,615 |
$72K |
| 70486 |
|
2,103 |
1,893 |
$72K |
| 90834 |
|
2,971 |
1,274 |
$72K |
| 72148 |
|
1,181 |
1,055 |
$71K |
| 80047 |
|
1,570 |
1,399 |
$70K |
| 80143 |
|
4,083 |
3,323 |
$65K |
| 76817 |
|
5,972 |
4,691 |
$64K |
| D1120 |
|
3,172 |
2,987 |
$63K |
| 87186 |
|
9,320 |
7,560 |
$61K |
| 11042 |
|
1,125 |
717 |
$60K |
| 10060 |
|
804 |
697 |
$56K |
| 90837 |
|
2,023 |
916 |
$55K |
| 84439 |
|
6,708 |
5,310 |
$52K |
| 77066 |
Tomosynthesis, mammo |
2,064 |
1,847 |
$51K |
| 85379 |
|
6,729 |
5,735 |
$51K |
| 87340 |
|
6,317 |
5,041 |
$51K |
| 99202 |
|
1,099 |
1,002 |
$50K |
| 94060 |
|
1,578 |
1,383 |
$49K |
| 85007 |
|
13,848 |
10,764 |
$48K |
| 82950 |
|
3,977 |
3,105 |
$47K |
| 80050 |
|
2,043 |
1,524 |
$45K |
| 97803 |
|
4,585 |
4,112 |
$44K |
| 83970 |
|
1,803 |
1,428 |
$43K |
| 87040 |
|
3,949 |
3,074 |
$43K |
| 80179 |
|
3,968 |
3,251 |
$42K |
| 73630 |
|
6,325 |
5,382 |
$42K |
| 86480 |
|
717 |
605 |
$41K |
| D2150 |
|
970 |
641 |
$41K |
| 82746 |
|
4,405 |
3,630 |
$40K |
| 96417 |
|
1,002 |
522 |
$40K |
| 83655 |
|
3,655 |
2,707 |
$39K |
| 87147 |
|
6,963 |
5,581 |
$38K |
| 88305 |
|
12,345 |
9,783 |
$38K |
| 83615 |
|
7,577 |
5,089 |
$38K |
| 86762 |
|
3,052 |
2,447 |
$38K |
| 77336 |
|
1,723 |
592 |
$37K |
| 36430 |
|
523 |
362 |
$37K |
| 12002 |
|
451 |
409 |
$37K |
| 70491 |
|
565 |
483 |
$36K |
| 97163 |
|
1,142 |
1,006 |
$36K |
| 93005 |
|
52,403 |
41,730 |
$35K |
| 97161 |
|
1,753 |
1,369 |
$35K |
| 29581 |
|
753 |
191 |
$35K |
| 83550 |
|
6,348 |
5,131 |
$34K |
| 76770 |
|
844 |
743 |
$34K |
| 76536 |
|
946 |
838 |
$34K |
| 90715 |
|
4,999 |
4,047 |
$34K |
| 82570 |
|
7,887 |
5,826 |
$34K |
| D0150 |
|
1,701 |
1,599 |
$33K |
| 87653 |
|
1,269 |
1,088 |
$33K |
| 87522 |
Neg quan hep c or qual rna |
993 |
792 |
$33K |
| 74018 |
|
3,568 |
3,013 |
$32K |
| 86900 |
|
11,055 |
8,899 |
$32K |
| G0108 |
Diab manage trn per indiv |
850 |
697 |
$31K |
| 99391 |
|
1,194 |
956 |
$30K |
| 86592 |
|
2,025 |
1,526 |
$30K |
| 83540 |
|
6,848 |
5,526 |
$29K |
| 19083 |
|
116 |
94 |
$29K |
| 82043 |
|
6,298 |
5,068 |
$28K |
| H0005 |
Alcohol and/or drug services |
1,089 |
206 |
$28K |
| 77065 |
Tomosynthesis, mammo |
1,459 |
1,246 |
$28K |
| 86140 |
|
6,026 |
4,813 |
$27K |
| 99203 |
|
1,208 |
943 |
$26K |
| 96523 |
|
1,003 |
649 |
$25K |
| 84550 |
|
5,903 |
4,441 |
$25K |
| 97802 |
|
2,260 |
1,882 |
$25K |
| 82550 |
|
4,617 |
3,591 |
$25K |
| 97116 |
|
2,648 |
1,085 |
$24K |
| J2323 |
Natalizumab injection |
48 |
38 |
$24K |
| 77062 |
|
1,566 |
1,438 |
$23K |
| 84145 |
|
1,540 |
1,228 |
$22K |
| 84156 |
|
2,984 |
2,078 |
$22K |
| 85652 |
|
5,257 |
4,345 |
$21K |
| 86706 |
|
2,528 |
2,022 |
$21K |
| 85014 |
|
3,966 |
2,891 |
$21K |
| 94729 |
|
1,890 |
1,681 |
$21K |
| 96374 |
|
44,303 |
35,488 |
$21K |
| 84703 |
|
1,980 |
1,696 |
$20K |
| 84460 |
|
5,002 |
3,699 |
$19K |
| 71045 |
|
33,910 |
27,771 |
$19K |
| 85730 |
|
4,925 |
3,880 |
$19K |
| 84132 |
|
2,559 |
1,768 |
$19K |
| 76820 |
|
2,013 |
975 |
$19K |
| 97166 |
|
944 |
766 |
$18K |
| 87075 |
|
2,959 |
2,355 |
$18K |
| 87102 |
|
461 |
386 |
$18K |
| D2140 |
|
554 |
343 |
$18K |
| 73030 |
|
4,557 |
3,918 |
$18K |
| 84450 |
|
4,443 |
3,234 |
$18K |
| 93798 |
|
254 |
39 |
$18K |
| 72100 |
|
1,861 |
1,625 |
$17K |
| D1110 |
|
634 |
588 |
$17K |
| 99392 |
|
800 |
657 |
$16K |
| 99395 |
|
624 |
436 |
$16K |
| 83021 |
|
941 |
595 |
$16K |
| 87529 |
|
372 |
289 |
$16K |
| 36591 |
|
2,292 |
1,289 |
$16K |
| 82784 |
|
1,246 |
888 |
$15K |
| 80074 |
|
433 |
375 |
$15K |
| 82247 |
|
897 |
575 |
$15K |
| 86704 |
|
1,362 |
1,072 |
$15K |
| D0240 |
|
1,364 |
678 |
$15K |
| 82800 |
|
1,962 |
1,584 |
$15K |
| 94726 |
|
1,811 |
1,611 |
$14K |
| J2469 |
Palonosetron hcl |
1,977 |
994 |
$14K |
| Q3014 |
Telehealth facility fee |
2,428 |
2,032 |
$14K |
| 11721 |
|
4,070 |
3,138 |
$14K |
| 97035 |
|
1,859 |
689 |
$14K |
| 84100 |
|
4,664 |
3,104 |
$14K |
| 83516 |
|
860 |
631 |
$13K |
| D0210 |
|
317 |
300 |
$13K |
| 87633 |
|
51 |
44 |
$13K |
| 99396 |
|
654 |
396 |
$13K |
| 99000 |
|
4,219 |
3,471 |
$13K |
| 82010 |
|
2,082 |
1,682 |
$12K |
| 85046 |
|
2,797 |
1,685 |
$12K |
| 87205 |
|
4,036 |
3,136 |
$12K |
| 73610 |
|
4,254 |
3,746 |
$12K |
| 86235 |
|
226 |
152 |
$12K |
| 73502 |
|
2,726 |
2,354 |
$12K |
| 93296 |
|
428 |
379 |
$12K |
| 84481 |
|
1,040 |
787 |
$12K |
| 73564 |
|
5,087 |
4,429 |
$12K |
| 84403 |
|
571 |
486 |
$11K |
| 88307 |
|
1,070 |
829 |
$11K |
| 80164 |
|
764 |
589 |
$11K |
| 72141 |
|
209 |
187 |
$11K |
| 94660 |
|
146 |
67 |
$11K |
| D0272 |
|
873 |
827 |
$11K |
| 86003 |
|
173 |
144 |
$11K |
| 0240U |
|
318 |
282 |
$10K |
| 73130 |
|
3,973 |
3,517 |
$10K |
| 99393 |
|
425 |
360 |
$10K |
| 36415 |
|
129,343 |
91,767 |
$10K |
| 72110 |
|
2,223 |
1,983 |
$10K |
| 90471 |
|
6,766 |
5,210 |
$10K |
| D7140 |
|
259 |
183 |
$10K |
| 0042T |
|
196 |
151 |
$10K |
| 81511 |
|
96 |
63 |
$10K |
| 71271 |
|
186 |
171 |
$9K |
| 90670 |
|
1,118 |
820 |
$9K |
| 76937 |
|
968 |
725 |
$9K |
| 87631 |
|
86 |
77 |
$9K |
| 85018 |
|
4,229 |
3,082 |
$9K |
| 73110 |
|
2,165 |
1,934 |
$9K |
| 86038 |
|
873 |
697 |
$9K |
| 72040 |
|
580 |
534 |
$9K |
| 86923 |
|
606 |
413 |
$9K |
| J1756 |
Iron sucrose injection |
2,281 |
992 |
$8K |
| 82248 |
|
2,053 |
1,678 |
$8K |
| 93308 |
|
80 |
67 |
$8K |
| 83001 |
|
520 |
421 |
$8K |
| 74183 |
|
107 |
89 |
$8K |
| 84160 |
|
749 |
544 |
$8K |
| 73562 |
|
898 |
749 |
$8K |
| 86787 |
|
1,165 |
905 |
$8K |
| 94644 |
|
629 |
503 |
$8K |
| G2066 |
Inter devc remote 30d |
137 |
119 |
$7K |
| 96368 |
|
109 |
78 |
$7K |
| 99291 |
|
130 |
115 |
$7K |
| 84165 |
|
1,070 |
798 |
$7K |
| 96375 |
|
30,759 |
22,473 |
$7K |
| U0001 |
2019-ncov diagnostic p |
209 |
168 |
$7K |
| 93458 |
|
12 |
12 |
$7K |
| 83721 |
|
1,225 |
990 |
$7K |
| D0140 |
|
403 |
374 |
$6K |
| 82378 |
|
768 |
455 |
$6K |
| 97165 |
|
568 |
397 |
$6K |
| 87206 |
|
796 |
672 |
$6K |
| 51702 |
|
381 |
314 |
$6K |
| 80329 |
|
1,874 |
1,495 |
$6K |
| 86039 |
|
617 |
489 |
$6K |
| 90686 |
|
2,801 |
2,019 |
$6K |
| 87088 |
|
622 |
463 |
$6K |
| 88342 |
|
3,266 |
2,459 |
$5K |
| 90723 |
|
724 |
575 |
$5K |
| 83020 |
|
700 |
571 |
$5K |
| 77334 |
|
212 |
124 |
$5K |
| 97535 |
|
619 |
252 |
$5K |
| 84146 |
|
357 |
278 |
$5K |
| 82803 |
|
316 |
263 |
$5K |
| 73140 |
|
1,507 |
1,361 |
$5K |
| 81015 |
|
752 |
643 |
$5K |
| 93922 |
|
165 |
147 |
$5K |
| 29125 |
|
205 |
178 |
$5K |
| 76870 |
|
172 |
154 |
$5K |
| 73721 |
|
92 |
82 |
$5K |
| 90651 |
|
141 |
116 |
$5K |
| D0220 |
|
628 |
591 |
$5K |
| 90680 |
|
413 |
316 |
$4K |
| 11056 |
|
331 |
220 |
$4K |
| 83520 |
|
346 |
264 |
$4K |
| 87045 |
|
159 |
126 |
$4K |
| 99204 |
|
666 |
430 |
$4K |
| 20610 |
|
183 |
96 |
$4K |
| 77080 |
|
166 |
145 |
$4K |
| 82947 |
|
1,186 |
945 |
$4K |
| 82105 |
|
199 |
171 |
$4K |
| 86431 |
|
494 |
430 |
$4K |
| 99222 |
|
91 |
72 |
$4K |
| 92526 |
|
111 |
53 |
$3K |
| 99394 |
|
137 |
120 |
$3K |
| H2012 |
Behav hlth day treat, per hr |
213 |
14 |
$3K |
| 10061 |
|
45 |
41 |
$3K |
| 77061 |
|
300 |
281 |
$3K |
| H0022 |
Alcohol and/or drug interven |
150 |
75 |
$3K |
| 77412 |
|
160 |
12 |
$3K |
| 73560 |
|
279 |
225 |
$3K |
| 88304 |
|
1,562 |
1,285 |
$3K |
| 84520 |
|
1,080 |
881 |
$3K |
| 82652 |
|
173 |
146 |
$3K |
| 74022 |
|
714 |
593 |
$3K |
| 73080 |
|
1,141 |
1,018 |
$3K |
| 87505 |
|
28 |
26 |
$3K |
| 80177 |
|
203 |
172 |
$3K |
| 71101 |
|
1,421 |
1,267 |
$3K |
| 82805 |
|
101 |
81 |
$3K |
| J1453 |
Fosaprepitant injection |
445 |
215 |
$3K |
| 43235 |
|
18 |
15 |
$2K |
| 87338 |
|
77 |
64 |
$2K |
| 73590 |
|
1,044 |
916 |
$2K |
| 86769 |
|
56 |
47 |
$2K |
| 99232 |
|
207 |
73 |
$2K |
| G0176 |
Opps/php/iop; activity thrpy |
242 |
37 |
$2K |
| 90647 |
|
720 |
558 |
$2K |
| 87807 |
|
230 |
195 |
$2K |
| D4355 |
|
32 |
28 |
$2K |
| 90792 |
|
76 |
58 |
$2K |
| 85049 |
|
518 |
352 |
$2K |
| G0103 |
Psa screening |
205 |
162 |
$2K |
| 98960 |
|
736 |
496 |
$2K |
| 86364 |
|
258 |
230 |
$2K |
| 96156 |
|
113 |
79 |
$2K |
| 96376 |
|
10,906 |
5,658 |
$2K |
| 97597 |
|
35 |
25 |
$2K |
| 43249 |
|
13 |
12 |
$2K |
| U0002 |
Covid-19 lab test non-cdc |
1,291 |
1,033 |
$2K |
| 98962 |
|
314 |
36 |
$2K |
| 95806 |
|
49 |
40 |
$2K |
| 93246 |
|
110 |
91 |
$2K |
| D0230 |
|
342 |
309 |
$2K |
| 82670 |
|
83 |
66 |
$2K |
| 82330 |
|
161 |
128 |
$2K |
| 87427 |
|
144 |
115 |
$2K |
| 82951 |
|
60 |
41 |
$2K |
| 86225 |
|
144 |
108 |
$1K |
| 76700 |
|
29 |
26 |
$1K |
| 87328 |
|
43 |
39 |
$1K |
| 86430 |
|
301 |
234 |
$1K |
| 90472 |
|
1,225 |
983 |
$1K |
| 86255 |
|
48 |
39 |
$1K |
| 94002 |
|
22 |
13 |
$1K |
| 90832 |
|
97 |
48 |
$1K |
| 90633 |
|
389 |
311 |
$1K |
| 77300 |
|
48 |
36 |
$1K |
| 82274 |
|
16 |
13 |
$1K |
| 76942 |
|
22 |
15 |
$1K |
| 73700 |
|
28 |
24 |
$1K |
| 74019 |
|
95 |
80 |
$1K |
| 90674 |
|
451 |
318 |
$1K |
| 72072 |
|
171 |
152 |
$980.48 |
| 86593 |
|
131 |
109 |
$964.90 |
| 82140 |
|
91 |
68 |
$959.91 |
| 82533 |
|
38 |
36 |
$914.28 |
| 73660 |
|
92 |
81 |
$886.46 |
| 80178 |
|
29 |
26 |
$822.96 |
| 0004A |
|
128 |
119 |
$819.52 |
| 17110 |
|
22 |
12 |
$812.24 |
| 95800 |
|
12 |
12 |
$810.41 |
| G0177 |
Opps/php/iop; train & educ |
190 |
25 |
$807.49 |
| 87220 |
|
160 |
90 |
$784.49 |
| 87449 |
|
107 |
75 |
$773.48 |
| 74174 |
|
13 |
12 |
$714.01 |
| 93242 |
|
27 |
25 |
$705.01 |
| 99152 |
|
3,515 |
2,752 |
$699.39 |
| 83883 |
|
69 |
37 |
$692.60 |
| 88112 |
|
88 |
68 |
$672.63 |
| 82164 |
|
15 |
12 |
$661.48 |
| 94690 |
|
293 |
250 |
$660.19 |
| 86696 |
|
34 |
31 |
$645.98 |
| 93880 |
|
28 |
27 |
$645.66 |
| 90685 |
|
133 |
111 |
$640.04 |
| 97150 |
|
112 |
45 |
$635.68 |
| 36416 |
|
11,490 |
8,743 |
$629.32 |
| J1050 |
Medroxyprogesterone acetate |
1,432 |
1,125 |
$620.76 |
| D0330 |
|
22 |
19 |
$619.00 |
| 93325 |
|
30 |
26 |
$606.87 |
| 87563 |
|
30 |
26 |
$578.82 |
| 88341 |
|
695 |
489 |
$574.69 |
| 90710 |
|
201 |
167 |
$548.26 |
| 90734 |
|
53 |
41 |
$532.03 |
| 81002 |
|
387 |
274 |
$529.50 |
| A9270 |
Non-covered item or service |
72,036 |
32,474 |
$517.26 |
| 99406 |
|
288 |
211 |
$517.10 |
| 86200 |
|
61 |
53 |
$483.73 |
| 86308 |
|
99 |
91 |
$482.36 |
| 94375 |
|
32 |
26 |
$474.08 |
| 82977 |
|
15 |
15 |
$462.38 |
| 82150 |
|
110 |
82 |
$452.37 |
| 86694 |
|
20 |
12 |
$425.89 |
| 86695 |
|
33 |
30 |
$421.72 |
| 73090 |
|
389 |
353 |
$419.56 |
| 87280 |
|
41 |
39 |
$407.07 |
| 80320 |
|
4,498 |
3,799 |
$394.68 |
| 87046 |
|
159 |
126 |
$381.51 |
| 82040 |
|
41 |
26 |
$374.52 |
| J3475 |
Inj magnesium sulfate |
5,159 |
2,649 |
$371.70 |
| 90460 |
|
240 |
220 |
$344.47 |
| 90714 |
|
56 |
43 |
$330.79 |
| 83002 |
|
32 |
26 |
$328.65 |
| 86300 |
|
26 |
12 |
$328.54 |
| J7050 |
Normal saline solution infus |
592 |
299 |
$325.69 |
| A9500 |
Tc99m sestamibi |
1,833 |
1,461 |
$318.26 |
| 90656 |
|
139 |
91 |
$295.01 |
| J1885 |
Ketorolac tromethamine inj |
28,021 |
21,804 |
$291.05 |
| 93270 |
|
19 |
15 |
$285.70 |
| J1100 |
Dexamethasone sodium phos |
16,235 |
11,963 |
$285.27 |
| G0279 |
Tomosynthesis, mammo |
98 |
90 |
$271.02 |
| G1004 |
Cdsm ndsc |
1,275 |
1,021 |
$270.72 |
| 80349 |
|
115 |
68 |
$270.05 |
| J2405 |
Ondansetron hcl injection |
27,999 |
20,609 |
$264.15 |
| 99231 |
|
33 |
13 |
$244.51 |
| 86334 |
|
20 |
17 |
$237.50 |
| 88184 |
|
42 |
25 |
$225.37 |
| 98926 |
|
110 |
91 |
$223.65 |
| G0008 |
Admin influenza virus vac |
2,544 |
1,842 |
$223.29 |
| 86160 |
|
20 |
12 |
$209.98 |
| G0283 |
Elec stim other than wound |
22 |
12 |
$207.09 |
| J0360 |
Hydralazine hcl injection |
1,660 |
1,143 |
$207.02 |
| 90681 |
|
51 |
42 |
$205.15 |
| 84480 |
|
15 |
13 |
$199.41 |
| J3301 |
Triamcinolone acet inj nos |
488 |
296 |
$194.50 |
| 87329 |
|
27 |
25 |
$193.85 |
| 87107 |
|
20 |
14 |
$186.03 |
| 82785 |
|
14 |
12 |
$170.78 |
| J3010 |
Fentanyl citrate injection |
12,391 |
9,345 |
$169.19 |
| J0690 |
Cefazolin sodium injection |
7,071 |
5,123 |
$166.92 |
| 94150 |
|
282 |
251 |
$158.07 |
| 76882 |
|
12 |
12 |
$155.84 |
| 90700 |
|
44 |
40 |
$152.66 |
| 83525 |
|
14 |
12 |
$141.72 |
| 88312 |
|
58 |
42 |
$127.44 |
| J2704 |
Inj, propofol, 10 mg |
14,808 |
10,590 |
$123.63 |
| 99153 |
Mod sedat endo service >5yrs |
3,735 |
3,006 |
$123.56 |
| 0001A |
|
29 |
24 |
$114.48 |
| 83010 |
|
15 |
12 |
$106.34 |
| J1200 |
Diphenhydramine hcl injectio |
10,503 |
7,195 |
$106.23 |
| 90461 |
|
171 |
161 |
$105.70 |
| 85347 |
|
39 |
25 |
$102.10 |
| 99188 |
|
14 |
13 |
$100.80 |
| 98925 |
|
17 |
14 |
$99.18 |
| 73552 |
|
104 |
91 |
$98.82 |
| 72050 |
|
38 |
36 |
$98.23 |
| 69209 |
|
21 |
16 |
$95.10 |
| 72052 |
|
93 |
87 |
$93.57 |
| 93271 |
|
14 |
14 |
$93.52 |
| J2250 |
Inj midazolam hydrochloride |
13,189 |
10,096 |
$91.81 |
| 88185 |
|
42 |
25 |
$89.13 |
| 80175 |
|
14 |
13 |
$87.23 |
| J1650 |
Inj enoxaparin sodium |
4,360 |
1,378 |
$85.16 |
| Q0111 |
Wet mounts/ w preparations |
36 |
31 |
$85.12 |
| 85651 |
|
24 |
19 |
$71.01 |
| 93041 |
|
13 |
13 |
$69.48 |
| J7512 |
Prednisone ir or dr oral 1mg |
4,936 |
3,046 |
$67.52 |
| C1894 |
Intro/sheath, non-laser |
2,203 |
1,625 |
$64.64 |
| C1769 |
Guide wire |
3,165 |
2,187 |
$64.21 |
| 80361 |
|
26 |
16 |
$63.01 |
| J3420 |
Vitamin b12 injection |
203 |
106 |
$59.00 |
| 84155 |
|
31 |
26 |
$53.59 |
| J0696 |
Ceftriaxone sodium injection |
8,354 |
5,960 |
$50.07 |
| J1644 |
Inj heparin sodium per 1000u |
4,541 |
1,995 |
$42.13 |
| A9552 |
F18 fdg |
535 |
409 |
$39.96 |
| 94762 |
|
89 |
63 |
$39.66 |
| 86580 |
|
15 |
12 |
$32.08 |
| 90474 |
|
18 |
16 |
$26.36 |
| 90473 |
|
68 |
59 |
$26.36 |
| J1642 |
Inj heparin sodium per 10 u |
7,982 |
3,106 |
$25.94 |
| 90662 |
|
481 |
378 |
$19.13 |
| J3480 |
Inj potassium chloride |
1,745 |
1,030 |
$18.51 |
| J2765 |
Metoclopramide hcl injection |
5,972 |
4,662 |
$15.67 |
| 80365 |
|
26 |
16 |
$14.94 |
| J1815 |
Insulin injection |
6,335 |
2,118 |
$13.88 |
| J2785 |
Regadenoson injection |
795 |
633 |
$12.43 |
| J2060 |
Lorazepam injection |
3,543 |
2,718 |
$11.92 |
| 82310 |
|
30 |
15 |
$10.49 |
| A4648 |
Implantable tissue marker |
524 |
427 |
$10.24 |
| J2930 |
Methylprednisolone injection |
2,063 |
1,519 |
$9.93 |
| G0472 |
Hep c screen high risk/other |
204 |
150 |
$9.27 |
| G0500 |
Mod sedat endo service >5yrs |
1,066 |
942 |
$8.83 |
| A9502 |
Tc99m tetrofosmin |
160 |
144 |
$8.82 |
| 90732 |
|
42 |
28 |
$8.39 |
| J1170 |
Hydromorphone injection |
7,970 |
4,569 |
$8.17 |
| J3370 |
Vancomycin hcl injection |
378 |
195 |
$4.33 |
| J2270 |
Morphine sulfate injection |
8,403 |
5,848 |
$3.94 |
| 94760 |
|
452 |
393 |
$2.76 |
| J7060 |
5% dextrose/water |
1,043 |
535 |
$1.47 |
| J2370 |
Phenylephrine hcl injection |
1,152 |
829 |
$1.07 |
| J0171 |
Adrenalin epinephrine inject |
690 |
494 |
$0.92 |
| J3360 |
Diazepam injection |
329 |
243 |
$0.80 |
| J1630 |
Haloperidol injection |
621 |
467 |
$0.31 |
| S0119 |
Ondansetron 4 mg |
3,676 |
3,177 |
$0.19 |
| J0500 |
Dicyclomine injection |
278 |
232 |
$0.18 |
| J0780 |
Prochlorperazine injection |
2,080 |
1,646 |
$0.04 |
| C1887 |
Catheter, guiding |
528 |
359 |
$0.03 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
560 |
440 |
$0.00 |
| J1790 |
Droperidol injection |
1,688 |
1,360 |
$0.00 |
| J3490 |
Drugs unclassified injection |
1,105 |
878 |
$0.00 |
| 72170 |
|
60 |
52 |
$0.00 |
| G8988 |
Self care goal status |
252 |
179 |
$0.00 |
| G8991 |
Other pt/ot goal status |
200 |
177 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
15 |
13 |
$0.00 |
| J1940 |
Furosemide injection |
1,388 |
699 |
$0.00 |
| C9399 |
Unclassified drugs or biolog |
333 |
232 |
$0.00 |
| J8540 |
Oral dexamethasone |
506 |
433 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
238 |
151 |
$0.00 |
| D0603 |
|
32 |
32 |
$0.00 |
| D0120 |
|
15 |
15 |
$0.00 |
| G0009 |
Admin pneumococcal vaccine |
369 |
201 |
$0.00 |
| 76377 |
|
261 |
225 |
$0.00 |
| G8980 |
Mobility d/c status |
74 |
58 |
$0.00 |
| J1805 |
Inj, esmolol hcl, 10mg |
30 |
26 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
26 |
19 |
$0.00 |
| J2920 |
Methylprednisolone injection |
139 |
52 |
$0.00 |
| J1920 |
Inj, labetalol hcl, 5mg |
229 |
164 |
$0.00 |
| 94761 |
|
15 |
14 |
$0.00 |
| J1726 |
Makena, 10 mg |
208 |
50 |
$0.00 |
| G8987 |
Self care current status |
251 |
177 |
$0.00 |
| 51798 |
|
45 |
40 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
88 |
74 |
$0.00 |
| 99495 |
|
38 |
25 |
$0.00 |
| 99459 |
|
13 |
12 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
30 |
12 |
$0.00 |
| C1781 |
Mesh (implantable) |
42 |
37 |
$0.00 |
| 82435 |
|
27 |
12 |
$0.00 |
| J9045 |
Carboplatin injection |
19 |
12 |
$0.00 |
| 91307 |
|
13 |
13 |
$0.00 |
| J2001 |
Lidocaine injection |
54 |
26 |
$0.00 |
| Q9968 |
Visualization adjunct |
13 |
12 |
$0.00 |
| J7611 |
Albuterol non-comp con |
19 |
17 |
$0.00 |
| J1040 |
Methylprednisolone 80 mg inj |
15 |
12 |
$0.00 |
| 73060 |
|
15 |
12 |
$0.00 |
| G8979 |
Mobility goal status |
562 |
421 |
$0.00 |
| S0164 |
Injection pantroprazole |
1,565 |
975 |
$0.00 |
| 93319 |
|
83 |
79 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
268 |
197 |
$0.00 |
| S0028 |
Injection, famotidine, 20 mg |
1,578 |
1,256 |
$0.00 |
| J3489 |
Zoledronic acid 1mg |
34 |
27 |
$0.00 |
| 83037 |
|
99 |
92 |
$0.00 |
| G8978 |
Mobility current status |
514 |
389 |
$0.00 |
| 91312 |
|
13 |
13 |
$0.00 |
| G8990 |
Other pt/ot current status |
127 |
115 |
$0.00 |
| A4358 |
Urinary leg or abdomen bag |
118 |
92 |
$0.00 |
| C1760 |
Closure dev, vasc |
294 |
221 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
630 |
540 |
$0.00 |
| J1953 |
Levetiracetam injection |
168 |
130 |
$0.00 |
| C8929 |
Tte w or wo fol wcon,doppler |
14 |
12 |
$0.00 |
| J2272 |
Inj, morphine (fresenius) |
89 |
80 |
$0.00 |
| 69210 |
|
23 |
14 |
$0.00 |
| C1729 |
Cath, drainage |
15 |
12 |
$0.00 |
| 84295 |
|
27 |
12 |
$0.00 |
| A6212 |
Foam drg <=16 sq in w/border |
34 |
26 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
295 |
234 |
$0.00 |
| 82374 |
|
27 |
12 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
14 |
13 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
183 |
107 |
$0.00 |
| 0124A |
|
15 |
15 |
$0.00 |
| J2310 |
Inj naloxone hydrochloride |
14 |
12 |
$0.00 |
| 88173 |
|
35 |
24 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
37 |
12 |
$0.00 |