| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpt clinic visit |
215,041 |
164,768 |
$14.44M |
| 99212 |
|
140,877 |
129,688 |
$12.95M |
| 99214 |
|
85,986 |
78,637 |
$9.10M |
| 99213 |
|
55,090 |
48,974 |
$5.76M |
| 99283 |
|
43,650 |
40,645 |
$4.74M |
| 99284 |
|
31,634 |
28,089 |
$3.71M |
| 99285 |
|
20,405 |
14,190 |
$2.13M |
| 97110 |
|
32,341 |
8,545 |
$2.08M |
| 99391 |
|
17,137 |
15,648 |
$1.66M |
| 99392 |
|
12,907 |
11,978 |
$1.36M |
| G0378 |
Hospital observation per hr |
23,456 |
8,119 |
$1.31M |
| 74177 |
|
5,236 |
3,790 |
$1.19M |
| 70450 |
|
5,532 |
4,191 |
$1.17M |
| 0241U |
|
9,956 |
7,967 |
$976K |
| 20610 |
|
7,187 |
5,215 |
$899K |
| U0003 |
Cov-19 amp prb hgh thruput |
4,330 |
4,281 |
$845K |
| 95886 |
|
4,681 |
3,906 |
$809K |
| 96366 |
|
3,483 |
1,580 |
$809K |
| 99282 |
|
7,762 |
6,945 |
$790K |
| 97530 |
|
11,288 |
3,579 |
$783K |
| 96365 |
|
5,785 |
3,565 |
$765K |
| 96361 |
|
2,299 |
1,449 |
$707K |
| 71275 |
|
2,867 |
2,059 |
$689K |
| 92507 |
|
10,316 |
3,327 |
$683K |
| 74176 |
|
3,124 |
2,331 |
$678K |
| 43239 |
|
2,049 |
1,691 |
$616K |
| 80053 |
|
58,965 |
45,628 |
$555K |
| 90834 |
|
4,478 |
3,391 |
$504K |
| 99393 |
|
5,232 |
4,900 |
$484K |
| 45385 |
|
1,077 |
804 |
$478K |
| 80048 |
|
55,751 |
43,009 |
$453K |
| 0202U |
|
3,194 |
2,655 |
$451K |
| J9271 |
Inj pembrolizumab |
120 |
54 |
$446K |
| 93306 |
|
2,158 |
1,707 |
$434K |
| 96413 |
|
4,690 |
2,414 |
$382K |
| 78452 |
|
1,064 |
767 |
$379K |
| 59025 |
|
2,254 |
1,093 |
$374K |
| 87081 |
|
18,387 |
16,936 |
$365K |
| 85025 |
|
124,627 |
97,136 |
$360K |
| 29848 |
|
324 |
202 |
$344K |
| J3490 |
Drugs unclassified injection |
30,734 |
13,372 |
$319K |
| 71046 |
|
8,240 |
7,240 |
$312K |
| 69436 |
|
224 |
169 |
$307K |
| 99281 |
|
2,765 |
2,420 |
$305K |
| 99395 |
|
2,795 |
2,471 |
$296K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
1,369 |
760 |
$290K |
| 90837 |
|
2,149 |
1,608 |
$287K |
| 20611 |
|
1,404 |
1,171 |
$285K |
| 73721 |
|
1,468 |
1,322 |
$285K |
| 84443 |
|
23,814 |
20,413 |
$280K |
| 99394 |
|
3,093 |
2,800 |
$279K |
| 95180 |
|
537 |
165 |
$259K |
| 90792 |
|
1,228 |
1,158 |
$253K |
| 64493 |
|
503 |
357 |
$250K |
| 45380 |
|
632 |
501 |
$240K |
| 96127 |
|
2,537 |
2,290 |
$239K |
| G0481 |
Drug test def 8-14 classes |
4,306 |
3,501 |
$238K |
| 96110 |
|
1,713 |
1,543 |
$232K |
| 99396 |
|
2,166 |
1,845 |
$221K |
| 36415 |
|
165,634 |
130,013 |
$220K |
| 45378 |
|
471 |
376 |
$218K |
| 95117 |
|
7,020 |
4,017 |
$214K |
| 72148 |
|
1,387 |
1,202 |
$212K |
| 93458 |
|
274 |
204 |
$207K |
| 70551 |
|
1,188 |
985 |
$198K |
| 78815 |
|
414 |
322 |
$197K |
| 80307 |
|
11,755 |
9,214 |
$191K |
| 11102 |
|
687 |
608 |
$191K |
| 70496 |
|
831 |
614 |
$189K |
| 80061 |
|
20,949 |
18,581 |
$186K |
| 96415 |
|
836 |
448 |
$184K |
| 97140 |
|
8,810 |
3,146 |
$179K |
| 47562 |
|
88 |
54 |
$178K |
| 17311 |
|
471 |
398 |
$176K |
| 76705 |
|
2,188 |
1,802 |
$176K |
| 94640 |
|
1,865 |
1,284 |
$170K |
| 83036 |
|
25,315 |
22,382 |
$166K |
| 11042 |
|
1,665 |
1,042 |
$161K |
| 82306 |
|
10,401 |
9,477 |
$154K |
| 17110 |
|
1,366 |
1,259 |
$153K |
| 99204 |
|
2,215 |
1,639 |
$151K |
| 87088 |
|
14,927 |
11,757 |
$148K |
| 70553 |
|
601 |
520 |
$144K |
| 76830 |
|
1,850 |
1,606 |
$141K |
| 77063 |
|
2,920 |
2,677 |
$140K |
| 73630 |
|
4,789 |
3,985 |
$138K |
| 64483 |
|
342 |
255 |
$137K |
| 82607 |
|
9,831 |
8,706 |
$123K |
| 71260 |
|
599 |
499 |
$122K |
| 64635 |
|
329 |
233 |
$121K |
| 96360 |
|
709 |
531 |
$120K |
| 99215 |
Prolong outpt/office vis |
1,370 |
1,136 |
$119K |
| 97161 |
|
2,166 |
1,655 |
$119K |
| 95811 |
|
201 |
180 |
$117K |
| J1050 |
Medroxyprogesterone acetate |
1,831 |
1,506 |
$115K |
| 92557 |
|
1,831 |
1,642 |
$114K |
| 90791 |
|
528 |
488 |
$114K |
| 76642 |
|
947 |
838 |
$111K |
| 76856 |
|
752 |
573 |
$111K |
| C9803 |
Hopd covid-19 spec collect |
3,091 |
3,007 |
$108K |
| 71045 |
|
20,308 |
16,525 |
$106K |
| 11721 |
|
4,703 |
4,391 |
$102K |
| 72141 |
|
674 |
581 |
$101K |
| 93017 |
|
1,440 |
1,086 |
$101K |
| 86850 |
|
5,450 |
4,376 |
$100K |
| 73221 |
|
540 |
496 |
$100K |
| 90686 |
|
9,782 |
8,533 |
$100K |
| 93005 |
|
37,560 |
29,135 |
$98K |
| 87801 |
|
6,378 |
5,078 |
$98K |
| 73610 |
|
3,083 |
2,539 |
$97K |
| 97162 |
|
1,968 |
1,627 |
$95K |
| 99203 |
|
1,415 |
1,081 |
$94K |
| 72100 |
|
4,363 |
3,690 |
$91K |
| 71250 |
|
1,200 |
1,014 |
$91K |
| 94060 |
|
820 |
712 |
$90K |
| 90648 |
|
11,134 |
10,299 |
$88K |
| 95806 |
|
304 |
277 |
$87K |
| 73130 |
|
2,691 |
2,176 |
$86K |
| 75574 |
|
266 |
248 |
$83K |
| 93975 |
|
980 |
731 |
$83K |
| 84484 |
|
25,847 |
16,380 |
$82K |
| 17000 |
|
970 |
895 |
$81K |
| 96367 |
|
1,549 |
843 |
$81K |
| 73562 |
|
2,511 |
2,204 |
$78K |
| Q3014 |
Telehealth facility fee |
7,059 |
6,567 |
$77K |
| 95810 |
|
124 |
103 |
$77K |
| 73110 |
|
2,716 |
2,084 |
$76K |
| 62323 |
|
236 |
195 |
$76K |
| 0352U |
|
4,122 |
3,446 |
$74K |
| 86780 |
|
4,750 |
4,211 |
$73K |
| 90677 |
|
2,872 |
2,488 |
$71K |
| 74174 |
|
1,111 |
815 |
$70K |
| 86900 |
|
5,544 |
4,456 |
$70K |
| 31575 |
|
517 |
458 |
$70K |
| 90670 |
|
9,549 |
8,843 |
$69K |
| 95909 |
|
867 |
794 |
$67K |
| 96372 |
|
15,438 |
9,691 |
$66K |
| 87086 |
|
8,589 |
8,158 |
$66K |
| 76770 |
|
489 |
390 |
$66K |
| 70491 |
|
296 |
220 |
$65K |
| 73030 |
|
2,812 |
2,337 |
$64K |
| 88305 |
|
10,759 |
7,347 |
$64K |
| 93971 |
|
998 |
795 |
$57K |
| 52000 |
|
141 |
129 |
$57K |
| 97165 |
|
955 |
655 |
$56K |
| 80069 |
|
3,408 |
2,799 |
$56K |
| 96161 |
|
489 |
460 |
$55K |
| 76536 |
|
555 |
500 |
$55K |
| 82728 |
|
6,825 |
5,868 |
$54K |
| 58661 |
|
32 |
24 |
$54K |
| 76816 |
|
1,445 |
1,273 |
$54K |
| 77336 |
|
563 |
230 |
$53K |
| C8929 |
Tte w or wo fol wcon,doppler |
342 |
219 |
$53K |
| 80076 |
|
9,282 |
8,403 |
$52K |
| 74018 |
|
2,130 |
1,644 |
$52K |
| 99211 |
|
901 |
415 |
$50K |
| 90460 |
|
26,223 |
24,304 |
$50K |
| 84439 |
|
4,882 |
4,046 |
$49K |
| 95911 |
|
277 |
248 |
$49K |
| 99385 |
|
764 |
637 |
$49K |
| 71271 |
|
254 |
237 |
$49K |
| 93225 |
|
531 |
387 |
$48K |
| 83970 |
|
2,221 |
1,941 |
$47K |
| 93970 |
|
407 |
345 |
$47K |
| 95816 |
|
322 |
244 |
$46K |
| 84466 |
|
7,402 |
6,449 |
$46K |
| 85027 |
|
9,212 |
6,284 |
$45K |
| 87389 |
|
4,278 |
3,764 |
$44K |
| C1889 |
Implant/insert device, noc |
1,215 |
847 |
$44K |
| 93922 |
|
626 |
554 |
$43K |
| 92567 |
|
3,148 |
2,873 |
$43K |
| 72040 |
|
1,604 |
1,330 |
$43K |
| 73564 |
|
1,930 |
1,546 |
$43K |
| 94726 |
|
699 |
601 |
$43K |
| 90471 |
|
11,241 |
9,285 |
$42K |
| J7307 |
Etonogestrel implant system |
36 |
27 |
$42K |
| 86803 |
|
2,899 |
2,586 |
$41K |
| 82565 |
|
9,662 |
6,907 |
$40K |
| 82570 |
|
6,584 |
5,070 |
$40K |
| 83540 |
|
7,778 |
6,785 |
$40K |
| 90633 |
|
4,958 |
4,420 |
$40K |
| 77334 |
|
137 |
76 |
$39K |
| G0260 |
Inj for sacroiliac jt anesth |
197 |
150 |
$38K |
| 90715 |
|
2,786 |
2,196 |
$38K |
| 87624 |
|
1,917 |
1,732 |
$37K |
| 43235 |
|
119 |
93 |
$37K |
| 20550 |
|
224 |
173 |
$37K |
| 93454 |
|
46 |
25 |
$37K |
| 87147 |
|
3,663 |
2,105 |
$36K |
| 77067 |
|
2,931 |
2,682 |
$34K |
| 86140 |
|
5,326 |
4,212 |
$34K |
| 87902 |
|
263 |
227 |
$33K |
| 90651 |
|
1,664 |
1,425 |
$33K |
| 77386 |
|
82 |
13 |
$32K |
| 94729 |
|
638 |
546 |
$32K |
| 76000 |
|
416 |
196 |
$32K |
| 83735 |
|
14,569 |
8,751 |
$31K |
| 93880 |
|
449 |
349 |
$30K |
| 87522 |
Neg quan hep c or qual rna |
1,673 |
1,406 |
$30K |
| 81001 |
|
27,741 |
22,973 |
$30K |
| 84702 |
|
3,071 |
2,094 |
$29K |
| 87340 |
|
2,548 |
2,222 |
$27K |
| 73140 |
|
1,058 |
823 |
$27K |
| J0585 |
Injection,onabotulinumtoxina |
140 |
123 |
$27K |
| 64494 |
|
461 |
323 |
$27K |
| 90832 |
|
276 |
238 |
$27K |
| 73080 |
|
989 |
805 |
$27K |
| 86762 |
|
1,577 |
1,349 |
$27K |
| 36430 |
|
312 |
143 |
$27K |
| 97012 |
|
836 |
284 |
$27K |
| J1756 |
Iron sucrose injection |
853 |
416 |
$27K |
| 87661 |
|
2,114 |
1,712 |
$26K |
| 72125 |
|
1,803 |
1,364 |
$26K |
| 29581 |
|
315 |
132 |
$26K |
| 88307 |
|
511 |
286 |
$26K |
| 73502 |
|
1,456 |
1,215 |
$26K |
| 42820 |
|
42 |
32 |
$25K |
| 72131 |
|
821 |
624 |
$25K |
| 85610 |
|
20,547 |
10,500 |
$25K |
| 97166 |
|
582 |
409 |
$24K |
| 97112 |
|
849 |
365 |
$24K |
| 88175 |
|
2,489 |
2,201 |
$24K |
| J7323 |
Euflexxa inj per dose |
359 |
147 |
$24K |
| 87186 |
|
4,661 |
3,616 |
$24K |
| 88341 |
|
463 |
188 |
$23K |
| 82248 |
|
15,775 |
10,385 |
$23K |
| 82043 |
|
4,925 |
4,446 |
$23K |
| 90723 |
|
4,242 |
3,736 |
$23K |
| C1894 |
Intro/sheath, non-laser |
692 |
452 |
$23K |
| 73701 |
|
93 |
67 |
$23K |
| 77065 |
Tomosynthesis, mammo |
693 |
531 |
$23K |
| 11100 |
|
145 |
138 |
$23K |
| 86901 |
|
5,546 |
4,456 |
$22K |
| 20552 |
|
213 |
195 |
$21K |
| 77066 |
Tomosynthesis, mammo |
594 |
524 |
$20K |
| 70498 |
|
881 |
655 |
$20K |
| 77300 |
|
64 |
39 |
$20K |
| 12001 |
|
114 |
102 |
$20K |
| 90680 |
|
3,566 |
3,119 |
$20K |
| 87491 |
|
1,254 |
1,131 |
$20K |
| 90853 |
|
176 |
48 |
$20K |
| 94618 |
|
427 |
393 |
$20K |
| 77080 |
|
311 |
266 |
$19K |
| 99205 |
Prolong outpt/office vis |
309 |
202 |
$19K |
| 86038 |
|
1,262 |
1,103 |
$19K |
| 71101 |
|
516 |
460 |
$19K |
| 83655 |
|
2,235 |
1,962 |
$19K |
| 99381 |
|
278 |
251 |
$18K |
| 87481 |
|
1,060 |
781 |
$18K |
| 82947 |
|
9,741 |
2,641 |
$18K |
| 82746 |
|
2,258 |
1,954 |
$18K |
| 97116 |
|
1,084 |
402 |
$18K |
| 29075 |
|
157 |
131 |
$17K |
| 90716 |
|
1,723 |
1,453 |
$17K |
| J7999 |
Compounded drug, noc |
1,578 |
992 |
$17K |
| 31231 |
|
78 |
69 |
$17K |
| 84403 |
|
1,345 |
1,100 |
$17K |
| 95165 |
|
725 |
506 |
$17K |
| 74019 |
|
495 |
435 |
$16K |
| 84460 |
|
3,389 |
2,798 |
$16K |
| 11104 |
|
48 |
38 |
$16K |
| J0702 |
Betamethasone acet&sod phosp |
1,627 |
1,256 |
$16K |
| 87591 |
|
1,269 |
1,141 |
$16K |
| 64636 |
|
319 |
226 |
$16K |
| 99384 |
|
253 |
211 |
$16K |
| 90707 |
|
3,466 |
3,057 |
$16K |
| 87070 |
|
1,898 |
1,454 |
$15K |
| 73222 |
|
50 |
39 |
$15K |
| 99386 |
|
289 |
249 |
$15K |
| 76805 |
|
468 |
414 |
$15K |
| 11056 |
|
126 |
108 |
$15K |
| 86480 |
|
618 |
569 |
$15K |
| 97016 |
|
566 |
201 |
$15K |
| 73590 |
|
798 |
605 |
$15K |
| 84153 |
|
1,605 |
1,451 |
$15K |
| 70486 |
|
487 |
392 |
$14K |
| 82948 |
|
9,020 |
2,857 |
$14K |
| 80074 |
|
1,583 |
1,308 |
$14K |
| 95004 |
|
974 |
851 |
$14K |
| 73090 |
|
568 |
459 |
$14K |
| 83525 |
|
909 |
807 |
$14K |
| 72072 |
|
508 |
443 |
$14K |
| 87507 |
|
232 |
188 |
$14K |
| 94660 |
|
169 |
59 |
$14K |
| 87510 |
|
746 |
710 |
$13K |
| U0002 |
Covid-19 lab test non-cdc |
1,624 |
1,474 |
$13K |
| 84703 |
|
8,170 |
5,907 |
$13K |
| 96374 |
|
20,534 |
16,201 |
$13K |
| 83690 |
|
15,258 |
11,776 |
$13K |
| 99202 |
|
166 |
151 |
$12K |
| 99291 |
|
230 |
184 |
$12K |
| 91322 |
|
340 |
289 |
$12K |
| 74183 |
|
40 |
37 |
$12K |
| 97802 |
|
131 |
125 |
$12K |
| 84156 |
|
2,792 |
2,318 |
$11K |
| 72128 |
|
549 |
418 |
$11K |
| P9016 |
Rbc leukocytes reduced |
41 |
24 |
$11K |
| J2469 |
Palonosetron hcl |
947 |
423 |
$11K |
| 97803 |
|
134 |
125 |
$11K |
| 87480 |
|
746 |
710 |
$11K |
| 90734 |
|
1,640 |
1,411 |
$11K |
| 90696 |
|
1,313 |
1,113 |
$11K |
| 76801 |
|
1,177 |
947 |
$11K |
| 84450 |
|
2,262 |
1,758 |
$11K |
| 86787 |
|
1,367 |
1,172 |
$11K |
| 83880 |
|
5,184 |
3,633 |
$10K |
| J0131 |
Inj, acetaminophen (nos) |
962 |
580 |
$10K |
| 73522 |
|
592 |
491 |
$10K |
| 86376 |
|
954 |
854 |
$10K |
| 81003 |
|
16,041 |
13,541 |
$10K |
| 96376 |
|
4,050 |
1,677 |
$10K |
| 93226 |
|
170 |
134 |
$10K |
| G0279 |
Tomosynthesis, mammo |
1,014 |
870 |
$10K |
| 96368 |
|
709 |
388 |
$10K |
| 99407 |
|
307 |
283 |
$10K |
| 83001 |
|
861 |
752 |
$10K |
| 85652 |
|
4,235 |
3,348 |
$10K |
| 73560 |
|
377 |
290 |
$10K |
| 99152 |
|
1,422 |
984 |
$9K |
| 82077 |
|
4,265 |
3,005 |
$9K |
| 99406 |
|
578 |
550 |
$9K |
| 90620 |
|
658 |
553 |
$9K |
| 93296 |
|
669 |
645 |
$9K |
| 85730 |
|
7,634 |
5,696 |
$9K |
| J7120 |
Ringers lactate infusion |
19,533 |
13,198 |
$9K |
| 92523 |
|
109 |
80 |
$9K |
| 84146 |
|
735 |
635 |
$9K |
| 96375 |
|
12,296 |
7,331 |
$9K |
| 80197 |
|
436 |
180 |
$9K |
| 72070 |
|
447 |
363 |
$9K |
| 82670 |
|
599 |
519 |
$9K |
| 87205 |
|
1,900 |
1,460 |
$8K |
| 82533 |
|
1,150 |
764 |
$8K |
| C1887 |
Catheter, guiding |
459 |
305 |
$8K |
| 11719 |
|
362 |
330 |
$8K |
| 72114 |
|
537 |
460 |
$8K |
| 81025 |
|
8,448 |
7,619 |
$8K |
| 95861 |
|
25 |
21 |
$8K |
| 84402 |
|
580 |
505 |
$8K |
| 87660 |
|
753 |
716 |
$8K |
| 76817 |
|
515 |
409 |
$8K |
| 86431 |
|
978 |
856 |
$8K |
| 82247 |
|
817 |
472 |
$8K |
| 83605 |
|
6,852 |
4,400 |
$7K |
| 77290 |
|
18 |
12 |
$7K |
| 11730 |
|
56 |
56 |
$7K |
| 82105 |
|
1,050 |
904 |
$7K |
| 36410 |
|
516 |
271 |
$7K |
| J7030 |
Normal saline solution infus |
10,954 |
7,268 |
$7K |
| 11750 |
|
20 |
13 |
$7K |
| 86706 |
|
525 |
444 |
$7K |
| 76815 |
|
229 |
189 |
$7K |
| 64615 |
|
38 |
38 |
$7K |
| 00840 |
|
606 |
384 |
$7K |
| 99383 |
|
98 |
86 |
$7K |
| 82950 |
|
1,037 |
908 |
$7K |
| 84550 |
|
1,951 |
1,528 |
$6K |
| 76811 |
|
124 |
115 |
$6K |
| 73700 |
|
66 |
58 |
$6K |
| 84481 |
|
799 |
705 |
$6K |
| 84520 |
|
1,613 |
1,231 |
$6K |
| 77412 |
|
123 |
12 |
$6K |
| 84480 |
|
753 |
691 |
$6K |
| 90700 |
|
1,288 |
1,025 |
$6K |
| 83002 |
|
614 |
531 |
$6K |
| 72110 |
|
348 |
312 |
$6K |
| 58300 |
|
70 |
50 |
$6K |
| 86160 |
|
921 |
453 |
$6K |
| 82550 |
|
1,652 |
1,173 |
$6K |
| J8501 |
Oral aprepitant |
435 |
278 |
$6K |
| 84270 |
|
443 |
388 |
$6K |
| 86200 |
|
692 |
615 |
$5K |
| J0561 |
Penicillin g benzathine inj |
20 |
13 |
$5K |
| 95885 |
|
47 |
43 |
$5K |
| 62370 |
|
154 |
116 |
$5K |
| 64450 |
|
97 |
67 |
$5K |
| 83516 |
|
558 |
322 |
$5K |
| 86800 |
|
661 |
593 |
$5K |
| 73060 |
|
248 |
212 |
$5K |
| 84100 |
|
2,366 |
1,497 |
$5K |
| 85018 |
|
3,982 |
3,318 |
$5K |
| 98926 |
|
121 |
84 |
$5K |
| J1100 |
Dexamethasone sodium phos |
20,282 |
14,788 |
$5K |
| 86256 |
|
566 |
479 |
$4K |
| 86592 |
|
349 |
307 |
$4K |
| 97035 |
|
52 |
27 |
$4K |
| 86334 |
|
591 |
494 |
$4K |
| J2543 |
Piperacillin/tazobactam |
2,633 |
524 |
$4K |
| 80143 |
|
2,932 |
2,065 |
$4K |
| C1769 |
Guide wire |
1,314 |
794 |
$4K |
| 80051 |
|
312 |
207 |
$4K |
| 87077 |
|
510 |
457 |
$4K |
| 86364 |
|
354 |
270 |
$4K |
| 69210 |
|
344 |
281 |
$4K |
| 82977 |
|
720 |
422 |
$4K |
| 73552 |
|
254 |
197 |
$4K |
| 87804 |
|
4,762 |
2,475 |
$4K |
| 74022 |
|
103 |
84 |
$4K |
| 82627 |
|
233 |
196 |
$4K |
| 83993 |
|
196 |
175 |
$4K |
| 90472 |
|
3,349 |
2,829 |
$4K |
| 95908 |
|
570 |
534 |
$4K |
| H1003 |
Prenatal at risk education |
669 |
384 |
$4K |
| A6196 |
Alginate dressing <=16 sq in |
828 |
360 |
$4K |
| Q0162 |
Ondansetron oral |
1,674 |
1,136 |
$4K |
| J2790 |
Rho d immune globulin inj |
63 |
28 |
$4K |
| C8924 |
2d tte w or w/o fol w/con,fu |
23 |
12 |
$4K |
| 88342 |
|
1,161 |
686 |
$4K |
| 99153 |
Mod sedat endo service >5yrs |
872 |
597 |
$4K |
| 90674 |
|
424 |
334 |
$4K |
| 96523 |
|
63 |
41 |
$3K |
| 84144 |
|
153 |
129 |
$3K |
| 86308 |
|
378 |
333 |
$3K |
| 72052 |
|
151 |
118 |
$3K |
| 88142 |
|
255 |
246 |
$3K |
| 82784 |
|
625 |
313 |
$3K |
| 87800 |
|
200 |
189 |
$3K |
| 86235 |
|
623 |
290 |
$3K |
| 62369 |
|
41 |
41 |
$3K |
| 82803 |
|
2,986 |
1,468 |
$3K |
| 84132 |
|
983 |
877 |
$3K |
| 80320 |
|
167 |
149 |
$3K |
| J1170 |
Hydromorphone injection |
5,442 |
2,836 |
$3K |
| 84165 |
|
860 |
704 |
$3K |
| 86694 |
|
299 |
193 |
$3K |
| 84145 |
|
642 |
377 |
$3K |
| 73040 |
|
15 |
15 |
$3K |
| 20526 |
|
16 |
13 |
$3K |
| 90661 |
|
348 |
346 |
$3K |
| 00170 |
|
372 |
274 |
$3K |
| 82951 |
|
160 |
137 |
$3K |
| G0108 |
Diab manage trn per indiv |
16 |
13 |
$3K |
| 87529 |
|
149 |
77 |
$3K |
| 83521 |
|
859 |
366 |
$3K |
| 85379 |
|
3,108 |
2,304 |
$3K |
| J1453 |
Fosaprepitant injection |
233 |
92 |
$3K |
| 87880 |
|
4,217 |
3,740 |
$3K |
| 11900 |
|
42 |
38 |
$3K |
| J1040 |
Methylprednisolone 80 mg inj |
3,970 |
3,619 |
$3K |
| 88304 |
|
1,473 |
948 |
$3K |
| 83615 |
|
1,135 |
885 |
$3K |
| 87040 |
|
3,244 |
1,180 |
$3K |
| J2272 |
Inj, morphine (fresenius) |
2,859 |
1,652 |
$3K |
| 84155 |
|
982 |
776 |
$3K |
| 86258 |
|
224 |
145 |
$3K |
| 86665 |
|
336 |
219 |
$3K |
| 86618 |
|
265 |
242 |
$2K |
| 76870 |
|
208 |
153 |
$2K |
| 83498 |
|
180 |
155 |
$2K |
| 81015 |
|
960 |
783 |
$2K |
| 20605 |
|
19 |
12 |
$2K |
| 90656 |
|
376 |
362 |
$2K |
| J0690 |
Cefazolin sodium injection |
6,758 |
3,325 |
$2K |
| 90710 |
|
475 |
439 |
$2K |
| 87635 |
|
267 |
260 |
$2K |
| 92551 |
|
27 |
25 |
$2K |
| 12011 |
|
15 |
15 |
$2K |
| 80179 |
|
2,894 |
2,045 |
$2K |
| J3370 |
Vancomycin hcl injection |
1,972 |
642 |
$2K |
| J2704 |
Inj, propofol, 10 mg |
25,918 |
17,633 |
$2K |
| 76981 |
|
165 |
152 |
$2K |
| 20600 |
|
16 |
14 |
$2K |
| 80164 |
|
208 |
155 |
$2K |
| 10060 |
|
22 |
13 |
$2K |
| 43249 |
|
16 |
16 |
$2K |
| 76641 |
|
19 |
15 |
$2K |
| 99195 |
|
178 |
117 |
$2K |
| 93270 |
|
14 |
13 |
$2K |
| 80202 |
|
93 |
28 |
$2K |
| 88184 |
|
22 |
14 |
$2K |
| 87798 |
|
132 |
86 |
$2K |
| 88185 |
|
44 |
14 |
$2K |
| 64415 |
|
32 |
16 |
$2K |
| 90461 |
|
6,120 |
5,431 |
$2K |
| 82150 |
|
1,863 |
1,468 |
$2K |
| 85014 |
|
806 |
456 |
$2K |
| J1650 |
Inj enoxaparin sodium |
1,806 |
623 |
$2K |
| 82040 |
|
207 |
139 |
$2K |
| 97163 |
|
42 |
40 |
$2K |
| 82952 |
|
135 |
118 |
$2K |
| 00731 |
|
1,406 |
1,120 |
$2K |
| 86003 |
|
230 |
150 |
$2K |
| 95115 |
|
37 |
12 |
$2K |
| J0134 |
Inj acetaminophen -fresenius |
3,551 |
2,317 |
$2K |
| 99382 |
|
27 |
24 |
$1K |
| 36416 |
|
4,920 |
2,105 |
$1K |
| 11720 |
|
83 |
73 |
$1K |
| J1644 |
Inj heparin sodium per 1000u |
4,885 |
1,723 |
$1K |
| 93288 |
|
132 |
130 |
$1K |
| J1642 |
Inj heparin sodium per 10 u |
3,478 |
1,849 |
$1K |
| 95024 |
|
140 |
108 |
$1K |
| 17003 |
|
608 |
557 |
$1K |
| 93298 |
|
92 |
76 |
$1K |
| 72146 |
|
16 |
13 |
$1K |
| J7050 |
Normal saline solution infus |
3,111 |
1,407 |
$1K |
| 80329 |
|
116 |
97 |
$1K |
| J3475 |
Inj magnesium sulfate |
1,650 |
926 |
$1K |
| 83721 |
|
168 |
145 |
$1K |
| 90688 |
|
133 |
131 |
$1K |
| 84478 |
|
312 |
266 |
$1K |
| J2795 |
Ropivacaine hcl injection |
1,301 |
591 |
$1K |
| 85520 |
|
784 |
147 |
$1K |
| J3301 |
Triamcinolone acet inj nos |
1,757 |
1,458 |
$1K |
| 82140 |
|
700 |
422 |
$996.00 |
| 11301 |
|
12 |
12 |
$994.18 |
| 72220 |
|
41 |
35 |
$975.12 |
| 90381 |
|
118 |
106 |
$971.95 |
| J3010 |
Fentanyl citrate injection |
20,185 |
13,286 |
$970.23 |
| 00811 |
|
665 |
504 |
$963.68 |
| J3420 |
Vitamin b12 injection |
1,899 |
1,155 |
$952.29 |
| J0737 |
Inj, clindamycin (baxter) |
530 |
346 |
$901.70 |
| 86704 |
|
80 |
76 |
$883.70 |
| 83921 |
|
277 |
245 |
$858.50 |
| 87106 |
|
524 |
456 |
$855.95 |
| 82103 |
|
118 |
90 |
$846.08 |
| 86580 |
|
43 |
28 |
$845.00 |
| 82010 |
|
708 |
414 |
$842.09 |
| J1885 |
Ketorolac tromethamine inj |
10,876 |
7,195 |
$806.08 |
| 82465 |
|
213 |
185 |
$770.32 |
| 93289 |
|
50 |
49 |
$720.63 |
| 86381 |
|
92 |
80 |
$707.76 |
| J0330 |
Succinycholine chloride inj |
3,334 |
2,197 |
$695.13 |
| J0696 |
Ceftriaxone sodium injection |
3,470 |
1,799 |
$679.88 |
| J7613 |
Albuterol non-comp unit |
666 |
522 |
$653.98 |
| 94010 |
|
13 |
12 |
$638.06 |
| 86147 |
|
19 |
12 |
$625.46 |
| 82378 |
|
226 |
139 |
$609.93 |
| 83010 |
|
100 |
72 |
$582.71 |
| 51798 |
|
286 |
247 |
$576.20 |
| 83520 |
|
31 |
28 |
$559.26 |
| G0008 |
Admin influenza virus vac |
1,016 |
924 |
$556.99 |
| 86696 |
|
46 |
41 |
$536.40 |
| 90474 |
|
906 |
779 |
$531.89 |
| 90380 |
|
64 |
59 |
$520.45 |
| J2920 |
Methylprednisolone injection |
251 |
68 |
$508.60 |
| 86039 |
|
70 |
58 |
$506.36 |
| G0480 |
Drug test def 1-7 classes |
60 |
40 |
$487.48 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
2,864 |
1,968 |
$480.41 |
| 76942 |
|
478 |
389 |
$464.52 |
| 90744 |
|
49 |
49 |
$455.40 |
| 73660 |
|
16 |
14 |
$443.21 |
| 82374 |
|
129 |
120 |
$440.23 |
| J0694 |
Cefoxitin sodium injection |
50 |
24 |
$439.90 |
| J2405 |
Ondansetron hcl injection |
18,322 |
11,358 |
$427.05 |
| 87581 |
|
29 |
27 |
$412.52 |
| J2930 |
Methylprednisolone injection |
1,458 |
854 |
$408.54 |
| 72050 |
|
18 |
15 |
$393.65 |
| A4648 |
Implantable tissue marker |
236 |
177 |
$374.38 |
| 96417 |
|
697 |
316 |
$369.59 |
| J0780 |
Prochlorperazine injection |
734 |
463 |
$346.17 |
| 82390 |
|
65 |
54 |
$344.20 |
| C9113 |
Inj pantoprazole sodium, via |
156 |
78 |
$324.76 |
| 01400 |
|
38 |
15 |
$317.64 |
| J2060 |
Lorazepam injection |
1,488 |
733 |
$298.07 |
| 82785 |
|
35 |
30 |
$292.81 |
| J0360 |
Hydralazine hcl injection |
355 |
188 |
$288.02 |
| 97535 |
|
25 |
12 |
$286.62 |
| J9045 |
Carboplatin injection |
36 |
13 |
$275.59 |
| J1030 |
Methylprednisolone 40 mg inj |
2,594 |
2,254 |
$267.04 |
| 90649 |
|
26 |
26 |
$265.30 |
| J2919 |
Inj, methylpred sod succ 5mg |
538 |
404 |
$261.80 |
| 84295 |
|
144 |
135 |
$256.12 |
| 84207 |
|
30 |
29 |
$249.51 |
| 90694 |
|
220 |
211 |
$248.37 |
| 87633 |
|
29 |
27 |
$245.00 |
| 88300 |
|
179 |
95 |
$241.19 |
| 84075 |
|
140 |
68 |
$236.72 |
| 87075 |
|
257 |
165 |
$231.71 |
| 82787 |
|
60 |
25 |
$229.08 |
| J2250 |
Inj midazolam hydrochloride |
13,619 |
9,691 |
$226.94 |
| 82435 |
|
129 |
120 |
$225.47 |
| 86757 |
|
23 |
12 |
$225.21 |
| J1200 |
Diphenhydramine hcl injectio |
3,301 |
1,857 |
$222.39 |
| J3480 |
Inj potassium chloride |
1,445 |
595 |
$221.22 |
| 90698 |
|
41 |
41 |
$218.76 |
| 87486 |
|
29 |
27 |
$213.28 |
| 86920 |
|
22 |
12 |
$210.46 |
| 86705 |
|
12 |
12 |
$209.88 |
| 85045 |
|
106 |
78 |
$207.80 |
| 85613 |
|
48 |
31 |
$199.17 |
| 87476 |
|
20 |
12 |
$190.87 |
| 90714 |
|
14 |
14 |
$190.78 |
| 82310 |
|
40 |
25 |
$189.60 |
| 87811 |
|
364 |
345 |
$175.00 |
| G0009 |
Admin pneumococcal vaccine |
295 |
265 |
$174.74 |
| J2360 |
Orphenadrine injection |
523 |
350 |
$164.60 |
| J0688 |
Inj cefazolin sodium, hikma |
1,476 |
1,027 |
$157.94 |
| 82652 |
|
24 |
15 |
$153.93 |
| 84630 |
|
30 |
29 |
$148.69 |
| J7040 |
Normal saline solution infus |
2,644 |
1,391 |
$140.02 |
| G0439 |
Ppps, subseq visit |
42 |
40 |
$129.00 |
| C2617 |
Stent, non-cor, tem w/o del |
115 |
49 |
$124.69 |
| 84134 |
|
29 |
24 |
$124.25 |
| J2471 |
Inj pantoprazole(hikma) 40mg |
120 |
64 |
$123.56 |
| 90653 |
|
127 |
118 |
$122.64 |
| J2550 |
Promethazine hcl injection |
395 |
191 |
$121.82 |
| J0171 |
Adrenalin epinephrine inject |
502 |
330 |
$120.88 |
| C1729 |
Cath, drainage |
148 |
66 |
$120.07 |
| J2765 |
Metoclopramide hcl injection |
1,519 |
952 |
$116.14 |
| 86812 |
|
15 |
15 |
$104.36 |
| 80177 |
|
15 |
12 |
$101.31 |
| A9585 |
Gadobutrol injection |
1,770 |
1,444 |
$99.60 |
| 72170 |
|
13 |
12 |
$97.29 |
| J7512 |
Prednisone ir or dr oral 1mg |
1,536 |
723 |
$96.06 |
| 82525 |
|
13 |
13 |
$91.84 |
| J2270 |
Morphine sulfate injection |
488 |
287 |
$91.69 |
| 82365 |
|
100 |
45 |
$91.07 |
| 84300 |
|
76 |
43 |
$85.48 |
| 87468 |
|
12 |
12 |
$77.95 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
173 |
57 |
$77.78 |
| 51702 |
|
37 |
27 |
$75.02 |
| J7620 |
Albuterol ipratrop non-comp |
881 |
503 |
$74.07 |
| J3360 |
Diazepam injection |
16 |
14 |
$70.63 |
| J3371 |
Inj, vancomycin hcl (mylan) |
25 |
13 |
$68.17 |
| J0456 |
Azithromycin |
252 |
90 |
$67.62 |
| J0137 |
Inj, acetaminophen (hikma) |
131 |
45 |
$66.64 |
| J1940 |
Furosemide injection |
602 |
184 |
$65.92 |
| 87430 |
|
150 |
146 |
$65.41 |
| J0571 |
Buprenorphine oral 1mg |
30 |
12 |
$64.05 |
| 83090 |
|
26 |
24 |
$61.11 |
| 88108 |
|
71 |
26 |
$57.16 |
| J0736 |
Inj, clindamycin phosp 300mg |
33 |
12 |
$57.01 |
| J3372 |
Inj, vancomycin hcl (xellia) |
90 |
12 |
$55.28 |
| J8540 |
Oral dexamethasone |
97 |
50 |
$53.86 |
| J1630 |
Haloperidol injection |
316 |
207 |
$53.62 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,257 |
910 |
$51.09 |
| 88173 |
|
25 |
15 |
$48.14 |
| 12032 |
|
13 |
12 |
$40.60 |
| 87469 |
|
12 |
12 |
$38.97 |
| 87484 |
|
12 |
12 |
$38.97 |
| 94375 |
|
49 |
39 |
$38.84 |
| J1836 |
Inj, metronidazole, 10 mg |
450 |
243 |
$37.67 |
| J2001 |
Lidocaine injection |
9,866 |
7,311 |
$33.75 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
10,600 |
7,774 |
$33.20 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
786 |
628 |
$32.79 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
200 |
156 |
$31.56 |
| J1956 |
Levofloxacin injection |
216 |
107 |
$28.52 |
| G2066 |
Inter devc remote 30d |
44 |
43 |
$28.17 |
| 82330 |
|
25 |
12 |
$26.43 |
| C1751 |
Cath, inf, per/cent/midline |
739 |
431 |
$25.83 |
| Q0164 |
Prochlorperazine maleate 5mg |
465 |
240 |
$24.19 |
| 90662 |
|
42 |
28 |
$22.75 |
| 99495 |
|
195 |
173 |
$17.64 |
| 83935 |
|
25 |
12 |
$16.78 |
| J1010 |
Inj, methylpred acetate 1 mg |
609 |
562 |
$16.25 |
| 86695 |
|
13 |
12 |
$16.08 |
| J1790 |
Droperidol injection |
245 |
195 |
$15.69 |
| 85347 |
|
36 |
26 |
$13.48 |
| J1920 |
Inj, labetalol hcl, 5mg |
420 |
258 |
$12.64 |
| 94760 |
|
1,982 |
1,832 |
$10.57 |
| P9612 |
Catheterize for urine spec |
403 |
317 |
$8.83 |
| J7510 |
Prednisolone oral per 5 mg |
38 |
29 |
$5.98 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
567 |
495 |
$4.39 |
| J2305 |
Inj, nitroglycerin, 5 mg |
267 |
217 |
$4.02 |
| J3590 |
Unclassified biologics |
12 |
12 |
$1.76 |
| C1758 |
Catheter, ureteral |
482 |
295 |
$1.25 |
| 94761 |
|
2,927 |
2,409 |
$0.07 |
| G1004 |
Cdsm ndsc |
1,873 |
998 |
$0.00 |
| 01810 |
|
774 |
517 |
$0.00 |
| 99218 |
|
137 |
70 |
$0.00 |
| 92504 |
|
136 |
124 |
$0.00 |
| 01830 |
|
228 |
131 |
$0.00 |
| 23350 |
|
15 |
15 |
$0.00 |
| 88302 |
|
35 |
24 |
$0.00 |
| 00812 |
|
147 |
120 |
$0.00 |
| 00400 |
|
32 |
13 |
$0.00 |
| 95874 |
|
13 |
12 |
$0.00 |
| 87420 |
|
16 |
16 |
$0.00 |
| 72202 |
|
49 |
40 |
$0.00 |
| 00918 |
|
47 |
24 |
$0.00 |
| 92579 |
|
15 |
15 |
$0.00 |
| A9552 |
F18 fdg |
16 |
14 |
$0.00 |
| Q9956 |
Inj octafluoropropane mic,ml |
14 |
13 |
$0.00 |
| Q9950 |
Inj sulf hexa lipid microsph |
19 |
13 |
$0.00 |
| C1773 |
Ret dev, insertable |
75 |
71 |
$0.00 |
| A9270 |
Non-covered item or service |
479 |
33 |
$0.00 |
| 72020 |
|
670 |
589 |
$0.00 |
| 00813 |
|
1,038 |
820 |
$0.00 |
| A9500 |
Tc99m sestamibi |
582 |
423 |
$0.00 |
| J2785 |
Regadenoson injection |
925 |
659 |
$0.00 |
| 87807 |
|
153 |
132 |
$0.00 |
| 99243 |
|
171 |
143 |
$0.00 |
| 77001 |
|
42 |
37 |
$0.00 |
| 00790 |
|
151 |
99 |
$0.00 |
| 00126 |
|
116 |
92 |
$0.00 |
| 90480 |
|
131 |
121 |
$0.00 |
| 95249 |
|
13 |
13 |
$0.00 |
| 96380 |
|
40 |
40 |
$0.00 |
| 01480 |
|
60 |
25 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
33 |
24 |
$0.00 |
| C1726 |
Cath, bal dil, non-vascular |
14 |
13 |
$0.00 |
| J7042 |
5% dextrose/normal saline |
24 |
13 |
$0.00 |
| 95910 |
|
17 |
13 |
$0.00 |
| M0243 |
Casirivi and imdevi inj |
12 |
12 |
$0.00 |