| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
88,504 |
80,262 |
$7.01M |
| 99284 |
|
43,550 |
38,521 |
$4.06M |
| 99285 |
|
29,202 |
23,836 |
$2.53M |
| 92507 |
|
14,989 |
4,694 |
$1.55M |
| 36415 |
|
73,366 |
56,209 |
$1.26M |
| 97530 |
|
23,708 |
7,436 |
$1.03M |
| 97110 |
|
23,675 |
6,672 |
$1.02M |
| 96361 |
|
15,120 |
10,266 |
$960K |
| 41899 |
|
2,621 |
2,220 |
$948K |
| 99282 |
|
9,994 |
9,451 |
$833K |
| 96365 |
|
8,625 |
5,589 |
$717K |
| 96375 |
|
23,211 |
15,255 |
$642K |
| U0003 |
Cov-19 amp prb hgh thruput |
15,627 |
12,231 |
$617K |
| 87633 |
|
10,721 |
9,838 |
$601K |
| 81001 |
|
52,592 |
44,270 |
$566K |
| 96367 |
|
6,008 |
3,302 |
$565K |
| 74177 |
|
5,420 |
4,677 |
$490K |
| 99281 |
|
4,649 |
4,356 |
$408K |
| 96413 |
|
11,815 |
6,122 |
$389K |
| 85025 |
|
118,606 |
86,670 |
$366K |
| 69436 |
|
931 |
854 |
$332K |
| 96374 |
|
25,437 |
19,625 |
$332K |
| 74176 |
|
2,686 |
2,291 |
$314K |
| 95810 |
|
658 |
626 |
$286K |
| 96372 |
|
16,455 |
11,871 |
$243K |
| 97112 |
|
5,692 |
1,877 |
$235K |
| 70450 |
|
7,725 |
6,391 |
$230K |
| 71046 |
|
20,221 |
17,738 |
$229K |
| 80053 |
|
73,179 |
53,687 |
$228K |
| 97010 |
|
6,211 |
2,082 |
$226K |
| G0463 |
Hospital outpt clinic visit |
31,211 |
21,772 |
$218K |
| 70553 |
|
1,783 |
1,598 |
$209K |
| 87486 |
|
10,766 |
9,879 |
$200K |
| 71275 |
|
1,492 |
1,257 |
$188K |
| 95782 |
|
403 |
392 |
$179K |
| 70551 |
|
1,677 |
1,524 |
$173K |
| 96360 |
|
5,593 |
4,501 |
$168K |
| 94640 |
|
7,726 |
5,648 |
$160K |
| 01999 |
|
14,337 |
13,002 |
$159K |
| 80307 |
|
10,554 |
9,132 |
$155K |
| 87502 |
|
8,717 |
8,146 |
$152K |
| 76770 |
|
2,056 |
1,905 |
$138K |
| 80048 |
|
39,929 |
29,855 |
$137K |
| 97162 |
|
2,192 |
1,875 |
$137K |
| 96415 |
|
2,573 |
1,534 |
$135K |
| 97161 |
|
1,679 |
1,490 |
$135K |
| J1642 |
Inj heparin sodium per 10 u |
18,525 |
8,936 |
$121K |
| 93306 |
|
2,473 |
1,896 |
$117K |
| 77386 |
|
863 |
77 |
$117K |
| A9270 |
Non-covered item or service |
33,730 |
16,036 |
$117K |
| 11042 |
|
1,883 |
726 |
$115K |
| 96366 |
|
3,538 |
2,144 |
$108K |
| 54161 |
|
124 |
120 |
$102K |
| 42830 |
|
256 |
234 |
$101K |
| J9271 |
Inj pembrolizumab |
67 |
39 |
$101K |
| 43239 |
|
698 |
590 |
$95K |
| 36430 |
|
1,443 |
1,008 |
$92K |
| 76700 |
|
1,436 |
1,294 |
$92K |
| 82728 |
|
7,358 |
6,342 |
$88K |
| 59025 |
|
2,670 |
2,168 |
$88K |
| 77336 |
|
612 |
231 |
$82K |
| 87081 |
|
4,267 |
3,991 |
$81K |
| 92523 |
|
1,170 |
1,095 |
$79K |
| 72148 |
|
1,170 |
1,033 |
$75K |
| 82962 |
|
12,637 |
7,597 |
$72K |
| J2405 |
Ondansetron hcl injection |
30,428 |
21,779 |
$71K |
| G0378 |
Hospital observation per hr |
9,102 |
4,321 |
$71K |
| 74018 |
|
3,764 |
3,438 |
$70K |
| 80074 |
|
1,773 |
1,622 |
$70K |
| 80076 |
|
11,109 |
9,407 |
$63K |
| 97140 |
|
6,344 |
2,090 |
$62K |
| 83615 |
|
6,222 |
4,862 |
$62K |
| 83735 |
|
17,746 |
10,742 |
$59K |
| 97016 |
|
2,064 |
627 |
$59K |
| 76816 |
|
1,276 |
1,121 |
$59K |
| J2001 |
Lidocaine injection |
14,157 |
9,555 |
$58K |
| 97165 |
|
724 |
672 |
$56K |
| 84443 |
|
19,186 |
16,306 |
$56K |
| 87070 |
|
3,916 |
3,371 |
$53K |
| 76705 |
|
2,699 |
2,416 |
$52K |
| G0283 |
Elec stim other than wound |
853 |
252 |
$52K |
| 72141 |
|
620 |
557 |
$52K |
| C1769 |
Guide wire |
1,795 |
1,313 |
$51K |
| 93005 |
|
21,400 |
16,874 |
$49K |
| 71260 |
|
1,394 |
1,202 |
$49K |
| 73721 |
|
447 |
402 |
$49K |
| J3010 |
Fentanyl citrate injection |
13,843 |
11,107 |
$49K |
| 97163 |
|
555 |
498 |
$48K |
| 87086 |
|
18,084 |
15,442 |
$47K |
| 84439 |
|
7,528 |
6,554 |
$47K |
| 87653 |
|
3,170 |
2,897 |
$47K |
| 86850 |
|
7,875 |
6,613 |
$46K |
| 99234 |
|
7,737 |
3,276 |
$45K |
| 97597 |
|
780 |
346 |
$44K |
| 70486 |
|
840 |
740 |
$43K |
| 74019 |
|
4,622 |
4,157 |
$43K |
| P9016 |
Rbc leukocytes reduced |
1,228 |
937 |
$43K |
| J2250 |
Inj midazolam hydrochloride |
7,117 |
5,656 |
$42K |
| 82306 |
|
8,835 |
7,717 |
$41K |
| 73610 |
|
2,374 |
1,998 |
$41K |
| 78452 |
|
300 |
213 |
$41K |
| 95819 |
|
404 |
383 |
$39K |
| 77067 |
|
2,026 |
1,811 |
$37K |
| 76536 |
|
848 |
750 |
$37K |
| 12011 |
|
679 |
620 |
$37K |
| 76811 |
|
616 |
567 |
$37K |
| J7120 |
Ringers lactate infusion |
16,719 |
12,422 |
$36K |
| 76819 |
|
1,350 |
879 |
$36K |
| 82378 |
|
2,446 |
1,709 |
$36K |
| 73564 |
|
3,036 |
2,276 |
$35K |
| 97168 |
|
401 |
386 |
$35K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
480 |
406 |
$34K |
| 95886 |
|
380 |
342 |
$34K |
| 86140 |
|
8,800 |
7,338 |
$33K |
| 76642 |
|
1,034 |
823 |
$32K |
| 36591 |
|
6,688 |
4,118 |
$31K |
| 73630 |
|
2,825 |
2,295 |
$31K |
| 95700 |
|
213 |
198 |
$30K |
| 71045 |
|
9,603 |
7,816 |
$30K |
| 87210 |
|
5,888 |
5,151 |
$30K |
| J1100 |
Dexamethasone sodium phos |
16,751 |
13,337 |
$30K |
| 96376 |
|
6,019 |
3,562 |
$29K |
| 87798 |
|
11,153 |
10,229 |
$29K |
| 73030 |
|
2,393 |
1,883 |
$28K |
| 93971 |
|
1,444 |
1,238 |
$28K |
| J1170 |
Hydromorphone injection |
6,120 |
4,167 |
$27K |
| J0690 |
Cefazolin sodium injection |
7,047 |
5,309 |
$27K |
| J7030 |
Normal saline solution infus |
9,854 |
7,316 |
$27K |
| 73130 |
|
1,897 |
1,541 |
$27K |
| 85027 |
|
9,704 |
7,230 |
$27K |
| 12001 |
|
477 |
444 |
$27K |
| 76856 |
|
753 |
688 |
$26K |
| J2550 |
Promethazine hcl injection |
3,619 |
2,249 |
$26K |
| 92526 |
|
1,415 |
656 |
$26K |
| 76820 |
|
472 |
261 |
$25K |
| 73140 |
|
878 |
770 |
$25K |
| 93975 |
|
1,445 |
1,310 |
$25K |
| 84484 |
|
14,093 |
10,046 |
$24K |
| J1756 |
Iron sucrose injection |
1,198 |
496 |
$24K |
| 82330 |
|
2,370 |
1,896 |
$24K |
| 73110 |
|
1,447 |
1,224 |
$24K |
| J1200 |
Diphenhydramine hcl injectio |
5,507 |
3,575 |
$24K |
| J2704 |
Inj, propofol, 10 mg |
14,222 |
11,892 |
$24K |
| 87077 |
|
8,787 |
7,408 |
$23K |
| 85610 |
|
10,082 |
7,539 |
$23K |
| 99213 |
|
3,349 |
2,147 |
$23K |
| 99214 |
|
5,642 |
3,539 |
$23K |
| 87491 |
|
5,458 |
4,903 |
$23K |
| 83880 |
|
5,496 |
4,269 |
$23K |
| 84703 |
|
11,420 |
10,141 |
$23K |
| 85730 |
|
7,456 |
5,882 |
$22K |
| 83690 |
|
12,341 |
10,443 |
$22K |
| 72100 |
|
1,790 |
1,551 |
$22K |
| 76801 |
|
1,906 |
1,672 |
$22K |
| J1644 |
Inj heparin sodium per 1000u |
1,381 |
753 |
$21K |
| 82607 |
|
5,257 |
4,431 |
$21K |
| 99291 |
|
158 |
128 |
$21K |
| 83970 |
|
1,712 |
1,391 |
$20K |
| 87651 |
|
4,411 |
4,178 |
$20K |
| 87634 |
|
1,603 |
1,526 |
$19K |
| 72125 |
|
2,346 |
1,919 |
$19K |
| U0005 |
Infec agen detec ampli probe |
4,802 |
3,831 |
$19K |
| 96416 |
|
832 |
453 |
$18K |
| 86900 |
|
10,420 |
8,644 |
$18K |
| 84702 |
|
5,821 |
4,448 |
$18K |
| J3490 |
Drugs unclassified injection |
5,740 |
3,762 |
$18K |
| 36561 |
|
53 |
39 |
$18K |
| 87637 |
|
4,061 |
3,884 |
$18K |
| 76830 |
|
1,217 |
1,063 |
$17K |
| 71250 |
|
721 |
602 |
$17K |
| 97164 |
|
402 |
386 |
$16K |
| 87635 |
|
2,794 |
2,602 |
$15K |
| J0897 |
Denosumab injection |
267 |
161 |
$15K |
| 77412 |
|
90 |
13 |
$15K |
| 72110 |
|
1,017 |
852 |
$15K |
| 96523 |
|
1,786 |
1,250 |
$15K |
| 81025 |
|
3,481 |
3,199 |
$15K |
| 84436 |
|
635 |
516 |
$15K |
| 76870 |
|
425 |
388 |
$14K |
| 72040 |
|
776 |
684 |
$14K |
| 77066 |
Tomosynthesis, mammo |
393 |
342 |
$14K |
| 82550 |
|
3,299 |
2,567 |
$14K |
| 95816 |
|
93 |
89 |
$13K |
| 82553 |
|
1,582 |
1,197 |
$13K |
| 73090 |
|
1,027 |
892 |
$13K |
| J2370 |
Phenylephrine hcl injection |
2,782 |
2,116 |
$13K |
| 99152 |
|
1,502 |
1,153 |
$13K |
| 84100 |
|
7,001 |
4,076 |
$13K |
| 84112 |
|
1,088 |
979 |
$13K |
| 87591 |
|
5,357 |
4,839 |
$12K |
| J0330 |
Succinycholine chloride inj |
3,154 |
2,667 |
$12K |
| J1885 |
Ketorolac tromethamine inj |
15,060 |
11,969 |
$12K |
| 85652 |
|
5,103 |
4,174 |
$12K |
| 97166 |
|
221 |
194 |
$12K |
| 73502 |
|
1,791 |
1,394 |
$12K |
| 82570 |
|
6,320 |
4,688 |
$12K |
| 70491 |
|
142 |
124 |
$12K |
| 87186 |
|
5,955 |
5,004 |
$12K |
| 86592 |
|
6,185 |
5,678 |
$12K |
| J3370 |
Vancomycin hcl injection |
1,407 |
706 |
$12K |
| 96411 |
|
1,834 |
1,054 |
$11K |
| 70360 |
|
412 |
379 |
$11K |
| 93017 |
|
545 |
424 |
$11K |
| 73080 |
|
737 |
647 |
$11K |
| 92610 |
|
198 |
181 |
$11K |
| 83036 |
|
11,227 |
9,508 |
$10K |
| 82565 |
|
2,970 |
2,532 |
$10K |
| U0002 |
Covid-19 lab test non-cdc |
2,076 |
1,929 |
$10K |
| J1650 |
Inj enoxaparin sodium |
2,598 |
1,050 |
$10K |
| 72050 |
|
382 |
326 |
$9K |
| 82950 |
|
1,616 |
1,494 |
$9K |
| J2930 |
Methylprednisolone injection |
2,182 |
1,629 |
$9K |
| 96368 |
|
1,268 |
705 |
$9K |
| 97116 |
|
1,277 |
652 |
$9K |
| G0480 |
Drug test def 1-7 classes |
584 |
470 |
$9K |
| 86901 |
|
10,483 |
8,702 |
$9K |
| 73590 |
|
1,120 |
896 |
$9K |
| 77063 |
|
760 |
699 |
$9K |
| 83540 |
|
5,519 |
4,695 |
$9K |
| 87880 |
|
2,570 |
2,385 |
$9K |
| 82784 |
|
1,885 |
1,550 |
$8K |
| 96417 |
|
2,857 |
1,599 |
$8K |
| 87040 |
|
5,627 |
4,701 |
$8K |
| C1887 |
Catheter, guiding |
517 |
362 |
$8K |
| 77300 |
|
68 |
50 |
$8K |
| 96521 |
|
329 |
91 |
$8K |
| 80061 |
|
9,561 |
8,234 |
$8K |
| 93970 |
|
436 |
359 |
$8K |
| 73562 |
|
656 |
404 |
$8K |
| 82375 |
|
2,521 |
1,991 |
$7K |
| 82805 |
|
2,462 |
1,940 |
$7K |
| 72082 |
|
228 |
216 |
$7K |
| G2023 |
Specimen collect covid-19 |
218 |
196 |
$7K |
| 83605 |
|
4,381 |
3,422 |
$7K |
| 85045 |
|
4,290 |
3,023 |
$7K |
| C1894 |
Intro/sheath, non-laser |
731 |
511 |
$7K |
| 87340 |
|
5,203 |
4,735 |
$7K |
| 82248 |
|
2,300 |
1,740 |
$6K |
| 87045 |
|
544 |
477 |
$6K |
| 82731 |
|
519 |
475 |
$6K |
| L8699 |
Prosthetic implant nos |
789 |
723 |
$6K |
| 76817 |
|
1,487 |
1,255 |
$6K |
| 83050 |
|
2,531 |
1,991 |
$6K |
| J3475 |
Inj magnesium sulfate |
1,294 |
814 |
$6K |
| 86803 |
|
4,724 |
4,279 |
$6K |
| 10060 |
|
185 |
164 |
$6K |
| G8978 |
Mobility current status |
326 |
269 |
$5K |
| J2270 |
Morphine sulfate injection |
6,450 |
4,842 |
$5K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
3,662 |
3,040 |
$5K |
| 86304 |
|
648 |
525 |
$5K |
| 86003 |
|
1,288 |
850 |
$5K |
| 97035 |
|
294 |
113 |
$5K |
| G8979 |
Mobility goal status |
360 |
289 |
$5K |
| J0696 |
Ceftriaxone sodium injection |
7,232 |
5,112 |
$5K |
| 73560 |
|
377 |
292 |
$5K |
| J2060 |
Lorazepam injection |
1,052 |
789 |
$5K |
| 82746 |
|
3,244 |
2,751 |
$5K |
| 87205 |
|
3,346 |
2,808 |
$5K |
| 86644 |
|
85 |
68 |
$5K |
| 99212 |
|
206 |
96 |
$5K |
| J2795 |
Ropivacaine hcl injection |
2,642 |
2,321 |
$4K |
| 82150 |
|
2,075 |
1,799 |
$4K |
| 76000 |
|
724 |
618 |
$4K |
| 82247 |
|
1,701 |
1,034 |
$4K |
| 94060 |
|
84 |
68 |
$4K |
| 87389 |
|
6,924 |
6,348 |
$4K |
| 74230 |
|
54 |
52 |
$4K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
1,540 |
1,356 |
$4K |
| J3301 |
Triamcinolone acet inj nos |
722 |
470 |
$4K |
| 77072 |
|
76 |
76 |
$4K |
| 84550 |
|
3,249 |
2,637 |
$4K |
| 99153 |
Mod sedat endo service >5yrs |
850 |
642 |
$4K |
| J0171 |
Adrenalin epinephrine inject |
130 |
106 |
$4K |
| 70250 |
|
118 |
112 |
$4K |
| 76882 |
|
107 |
101 |
$3K |
| 84466 |
|
4,650 |
3,968 |
$3K |
| 84146 |
|
377 |
337 |
$3K |
| J7040 |
Normal saline solution infus |
3,921 |
2,975 |
$3K |
| J3420 |
Vitamin b12 injection |
2,905 |
1,904 |
$3K |
| 87581 |
|
10,770 |
9,888 |
$3K |
| 77065 |
Tomosynthesis, mammo |
90 |
82 |
$3K |
| 81003 |
|
1,191 |
1,107 |
$3K |
| 96409 |
|
421 |
277 |
$3K |
| 85379 |
|
1,895 |
1,609 |
$3K |
| 87075 |
|
1,725 |
1,417 |
$3K |
| 76805 |
|
45 |
38 |
$3K |
| 72131 |
|
162 |
147 |
$3K |
| 82785 |
|
997 |
894 |
$3K |
| 74022 |
|
580 |
494 |
$3K |
| 95910 |
|
56 |
49 |
$3K |
| 73552 |
|
398 |
321 |
$3K |
| 95711 |
|
42 |
41 |
$2K |
| 83516 |
|
1,587 |
1,343 |
$2K |
| 83655 |
|
693 |
653 |
$2K |
| J9045 |
Carboplatin injection |
37 |
24 |
$2K |
| 80197 |
|
1,686 |
819 |
$2K |
| 76937 |
|
376 |
301 |
$2K |
| 84156 |
|
4,824 |
3,341 |
$2K |
| 54300 |
|
13 |
13 |
$2K |
| 78264 |
|
15 |
13 |
$2K |
| 86762 |
|
3,447 |
3,133 |
$2K |
| 42820 |
|
96 |
93 |
$2K |
| J3480 |
Inj potassium chloride |
1,121 |
599 |
$2K |
| 12002 |
|
48 |
43 |
$2K |
| 87522 |
Neg quan hep c or qual rna |
89 |
75 |
$2K |
| G0103 |
Psa screening |
181 |
157 |
$2K |
| 83550 |
|
4,028 |
3,507 |
$2K |
| G0279 |
Tomosynthesis, mammo |
49 |
41 |
$2K |
| 72146 |
|
12 |
12 |
$2K |
| P9604 |
One-way allow prorated trip |
2,200 |
1,389 |
$2K |
| 86301 |
|
340 |
242 |
$2K |
| 90471 |
|
1,556 |
1,235 |
$2K |
| 99217 |
|
91 |
70 |
$2K |
| 72070 |
|
210 |
194 |
$2K |
| 83020 |
|
1,991 |
1,817 |
$2K |
| 84153 |
|
244 |
200 |
$2K |
| Q9969 |
Non-heu tc-99m add-on/dose |
1,295 |
1,017 |
$2K |
| 29125 |
|
453 |
421 |
$2K |
| 82140 |
|
634 |
491 |
$2K |
| J1940 |
Furosemide injection |
1,167 |
571 |
$2K |
| 87015 |
|
138 |
109 |
$2K |
| J1815 |
Insulin injection |
424 |
233 |
$2K |
| 3044F |
|
51 |
47 |
$2K |
| J0360 |
Hydralazine hcl injection |
73 |
40 |
$2K |
| 86300 |
|
856 |
662 |
$2K |
| 90715 |
|
1,319 |
1,085 |
$2K |
| J7512 |
Prednisone ir or dr oral 1mg |
1,542 |
1,216 |
$1K |
| 86923 |
|
774 |
607 |
$1K |
| 80320 |
|
338 |
316 |
$1K |
| 93880 |
|
80 |
68 |
$1K |
| 82043 |
|
1,458 |
1,233 |
$1K |
| 83520 |
|
482 |
380 |
$1K |
| 82951 |
|
921 |
869 |
$1K |
| 99218 |
|
32 |
31 |
$1K |
| 77080 |
|
284 |
196 |
$1K |
| 72156 |
|
26 |
25 |
$1K |
| 84155 |
|
656 |
511 |
$1K |
| 80164 |
|
124 |
105 |
$1K |
| 84165 |
|
933 |
730 |
$1K |
| J2765 |
Metoclopramide hcl injection |
1,169 |
964 |
$1K |
| 87661 |
|
751 |
675 |
$1K |
| 80069 |
|
423 |
338 |
$1K |
| 82435 |
|
1,242 |
1,051 |
$1K |
| G2066 |
Inter devc remote 30d |
375 |
265 |
$1K |
| 95911 |
|
13 |
13 |
$1K |
| 74240 |
|
28 |
25 |
$995.60 |
| 99215 |
Prolong outpt/office vis |
277 |
148 |
$968.22 |
| 84481 |
|
452 |
372 |
$960.41 |
| 86706 |
|
1,635 |
1,490 |
$959.81 |
| 77334 |
|
27 |
13 |
$934.65 |
| 93325 |
|
12 |
12 |
$906.71 |
| 77001 |
|
87 |
68 |
$902.91 |
| 71101 |
|
47 |
39 |
$876.89 |
| 73620 |
|
61 |
51 |
$861.60 |
| 97167 |
|
14 |
12 |
$854.60 |
| 85384 |
|
187 |
126 |
$823.69 |
| 86695 |
|
1,367 |
1,260 |
$778.41 |
| 86920 |
|
169 |
117 |
$747.26 |
| J9190 |
Fluorouracil injection |
256 |
120 |
$742.14 |
| 88321 |
|
141 |
128 |
$729.58 |
| 20610 |
|
183 |
118 |
$725.98 |
| 99204 |
|
268 |
170 |
$720.70 |
| 70496 |
|
16 |
13 |
$688.29 |
| J0702 |
Betamethasone acet&sod phosp |
182 |
89 |
$685.06 |
| 82670 |
|
134 |
121 |
$681.51 |
| 84480 |
|
113 |
97 |
$675.91 |
| A9500 |
Tc99m sestamibi |
353 |
227 |
$675.62 |
| 86038 |
|
879 |
763 |
$664.04 |
| 76825 |
|
12 |
12 |
$662.09 |
| A4216 |
Sterile water/saline, 10 ml |
251 |
112 |
$633.62 |
| 86694 |
|
461 |
359 |
$612.10 |
| 83001 |
|
443 |
403 |
$605.44 |
| 96402 |
|
58 |
42 |
$601.34 |
| 87536 |
|
29 |
26 |
$594.62 |
| 86001 |
|
796 |
728 |
$583.91 |
| J2360 |
Orphenadrine injection |
814 |
699 |
$578.61 |
| 73660 |
|
14 |
12 |
$574.65 |
| J0185 |
Inj., aprepitant, 1 mg |
134 |
66 |
$564.73 |
| 84132 |
|
1,533 |
1,264 |
$564.12 |
| 86431 |
|
451 |
392 |
$498.93 |
| 87641 |
|
139 |
121 |
$498.72 |
| 84681 |
|
117 |
114 |
$491.34 |
| 84403 |
|
449 |
400 |
$469.48 |
| 82105 |
|
113 |
91 |
$467.57 |
| 93296 |
|
328 |
228 |
$449.65 |
| 85660 |
|
79 |
65 |
$445.41 |
| 82947 |
|
1,381 |
1,193 |
$432.88 |
| 85018 |
|
1,426 |
1,199 |
$428.21 |
| 76827 |
|
12 |
12 |
$417.63 |
| J2997 |
Alteplase recombinant |
14 |
12 |
$398.22 |
| 89051 |
|
205 |
159 |
$386.65 |
| 76775 |
|
14 |
13 |
$373.39 |
| 93270 |
|
29 |
24 |
$371.00 |
| 86696 |
|
1,367 |
1,260 |
$363.98 |
| J2710 |
Neostigmine methylslfte inj |
907 |
701 |
$340.78 |
| 72170 |
|
55 |
39 |
$323.18 |
| J9370 |
Vincristine sulfate 1 mg inj |
258 |
177 |
$313.10 |
| 74241 |
|
15 |
14 |
$309.48 |
| 84520 |
|
399 |
342 |
$295.50 |
| 80177 |
|
100 |
79 |
$291.12 |
| 94664 |
|
189 |
180 |
$282.12 |
| 86320 |
|
272 |
205 |
$281.57 |
| 86902 |
|
65 |
54 |
$278.18 |
| Q3014 |
Telehealth facility fee |
470 |
331 |
$250.63 |
| 87529 |
|
83 |
80 |
$248.50 |
| J0561 |
Penicillin g benzathine inj |
231 |
222 |
$228.97 |
| 88184 |
|
20 |
12 |
$228.47 |
| J1453 |
Fosaprepitant injection |
233 |
103 |
$219.42 |
| 82977 |
|
628 |
540 |
$214.12 |
| 82533 |
|
65 |
51 |
$206.34 |
| 86704 |
|
445 |
379 |
$196.96 |
| 87046 |
|
564 |
494 |
$194.78 |
| 82010 |
|
93 |
70 |
$187.87 |
| 83002 |
|
284 |
259 |
$184.17 |
| 84295 |
|
1,194 |
1,020 |
$180.74 |
| G0008 |
Admin influenza virus vac |
662 |
467 |
$174.66 |
| J0780 |
Prochlorperazine injection |
250 |
235 |
$168.75 |
| J2469 |
Palonosetron hcl |
23 |
15 |
$168.74 |
| 94762 |
|
495 |
344 |
$164.53 |
| 99203 |
|
46 |
27 |
$136.68 |
| 87147 |
|
411 |
376 |
$129.78 |
| 73521 |
|
14 |
12 |
$128.70 |
| 73060 |
|
95 |
77 |
$124.19 |
| 86709 |
|
411 |
349 |
$118.95 |
| 86780 |
|
470 |
425 |
$114.55 |
| 80202 |
|
33 |
13 |
$113.59 |
| 96401 |
|
54 |
27 |
$110.24 |
| C9803 |
Hopd covid-19 spec collect |
39 |
31 |
$109.96 |
| 86665 |
|
13 |
12 |
$107.86 |
| J7620 |
Albuterol ipratrop non-comp |
364 |
268 |
$103.03 |
| 88230 |
|
12 |
12 |
$102.39 |
| 87177 |
|
151 |
122 |
$100.96 |
| 83525 |
|
156 |
120 |
$91.32 |
| J0692 |
Cefepime hcl for injection |
27 |
12 |
$90.00 |
| C9113 |
Inj pantoprazole sodium, via |
155 |
83 |
$87.34 |
| 86787 |
|
85 |
75 |
$78.86 |
| 86922 |
|
78 |
67 |
$78.66 |
| 97022 |
|
52 |
14 |
$78.37 |
| J7050 |
Normal saline solution infus |
346 |
244 |
$77.47 |
| 76010 |
|
26 |
25 |
$73.54 |
| 94727 |
|
52 |
44 |
$68.77 |
| J0461 |
Atropine sulfate injection |
65 |
29 |
$54.67 |
| J0640 |
Leucovorin calcium injection |
130 |
54 |
$50.10 |
| 86308 |
|
71 |
66 |
$47.17 |
| 92611 |
|
25 |
25 |
$38.77 |
| 83993 |
|
15 |
14 |
$38.12 |
| 87899 |
|
1,022 |
484 |
$37.81 |
| 88305 |
|
69 |
62 |
$36.91 |
| 82274 |
|
31 |
26 |
$34.20 |
| 87640 |
|
32 |
27 |
$32.22 |
| A4351 |
Straight tip urine catheter |
33 |
32 |
$30.81 |
| J3535 |
Metered dose inhaler drug |
163 |
149 |
$30.42 |
| 85007 |
|
96 |
53 |
$29.42 |
| 86800 |
|
46 |
38 |
$25.30 |
| J7510 |
Prednisolone oral per 5 mg |
1,532 |
1,384 |
$20.02 |
| 87209 |
|
151 |
122 |
$19.10 |
| 86376 |
|
168 |
155 |
$18.34 |
| 88342 |
|
31 |
29 |
$13.64 |
| 86141 |
|
40 |
27 |
$13.63 |
| 88185 |
|
36 |
12 |
$12.48 |
| 90686 |
|
223 |
150 |
$12.01 |
| 76815 |
|
30 |
24 |
$11.45 |
| 84145 |
|
386 |
312 |
$7.68 |
| 84270 |
|
40 |
39 |
$6.75 |
| 82040 |
|
29 |
24 |
$6.30 |
| 86708 |
|
15 |
12 |
$5.42 |
| 87324 |
|
27 |
24 |
$4.64 |
| 84450 |
|
131 |
115 |
$3.85 |
| 86645 |
|
12 |
12 |
$3.30 |
| 82310 |
|
34 |
29 |
$3.15 |
| 84460 |
|
113 |
100 |
$2.37 |
| Q0162 |
Ondansetron oral |
47 |
44 |
$2.37 |
| J2920 |
Methylprednisolone injection |
26 |
12 |
$2.37 |
| 94729 |
|
54 |
46 |
$1.90 |
| A9541 |
Tc99m sulfur colloid |
28 |
26 |
$0.00 |
| 84305 |
|
26 |
24 |
$0.00 |
| 29505 |
|
33 |
33 |
$0.00 |
| 87076 |
|
16 |
14 |
$0.00 |
| S0028 |
Injection, famotidine, 20 mg |
220 |
125 |
$0.00 |
| 90662 |
|
130 |
76 |
$0.00 |
| A4314 |
Cath w/drainage 2-way latex |
60 |
55 |
$0.00 |
| 85460 |
|
27 |
26 |
$0.00 |
| G0498 |
Chemo extend iv infus w/pump |
30 |
12 |
$0.00 |
| 36600 |
|
34 |
28 |
$0.00 |
| 86663 |
|
13 |
12 |
$0.00 |
| 88262 |
|
12 |
12 |
$0.00 |
| J1953 |
Levetiracetam injection |
13 |
12 |
$0.00 |
| J2274 |
Inj morphine pf epid ithc |
12 |
12 |
$0.00 |
| J0153 |
Adenosine inj 1mg |
22 |
14 |
$0.00 |
| 85060 |
|
12 |
12 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
220 |
108 |
$0.00 |
| J7613 |
Albuterol non-comp unit |
157 |
118 |
$0.00 |
| C1889 |
Implant/insert device, noc |
43 |
42 |
$0.00 |
| 88291 |
|
12 |
12 |
$0.00 |
| M0243 |
Casirivi and imdevi inj |
17 |
17 |
$0.00 |
| 84134 |
|
17 |
13 |
$0.00 |
| J8540 |
Oral dexamethasone |
29 |
29 |
$0.00 |
| J0456 |
Azithromycin |
31 |
25 |
$0.00 |
| 88304 |
|
16 |
15 |
$0.00 |
| J0500 |
Dicyclomine injection |
25 |
24 |
$0.00 |
| 90674 |
|
18 |
17 |
$0.00 |
| Q2035 |
Afluria vacc, 3 yrs & >, im |
14 |
13 |
$0.00 |
| P9612 |
Catheterize for urine spec |
13 |
13 |
$0.00 |
| 97535 |
|
21 |
12 |
$0.00 |
| 82952 |
|
14 |
12 |
$0.00 |
| J1720 |
Hydrocortisone sodium succ i |
12 |
12 |
$0.00 |
| C9399 |
Unclassified drugs or biolog |
17 |
12 |
$0.00 |