| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
202,096 |
177,785 |
$21.73M |
| 99212 |
|
205,236 |
173,075 |
$14.92M |
| J9271 |
Inj pembrolizumab |
853 |
703 |
$11.66M |
| 99284 |
|
35,558 |
31,864 |
$11.55M |
| 87801 |
|
97,090 |
88,958 |
$7.28M |
| 76805 |
|
33,404 |
32,654 |
$4.85M |
| 81420 |
|
7,579 |
6,793 |
$4.39M |
| 99285 |
|
15,332 |
13,998 |
$4.11M |
| 99214 |
|
30,475 |
27,837 |
$3.32M |
| 86850 |
|
56,985 |
50,076 |
$2.66M |
| 87389 |
|
94,967 |
87,472 |
$2.60M |
| 74177 |
|
6,141 |
5,864 |
$1.97M |
| 93005 |
|
28,380 |
23,199 |
$1.91M |
| 99283 |
|
33,380 |
29,469 |
$1.80M |
| 76816 |
|
12,706 |
11,408 |
$1.64M |
| 90471 |
|
57,068 |
54,422 |
$1.52M |
| 99211 |
|
29,222 |
26,529 |
$1.48M |
| 86780 |
|
92,067 |
84,079 |
$1.44M |
| 93306 |
|
3,754 |
3,676 |
$1.44M |
| 99204 |
|
12,036 |
10,799 |
$1.18M |
| U0003 |
Cov-19 amp prb hgh thruput |
15,551 |
14,501 |
$1.14M |
| J9035 |
Bevacizumab injection |
278 |
129 |
$996K |
| 87084 |
|
42,125 |
36,792 |
$950K |
| 96413 |
|
6,007 |
4,103 |
$922K |
| 96365 |
|
6,643 |
6,032 |
$796K |
| 96361 |
|
7,377 |
5,738 |
$783K |
| 90715 |
|
23,124 |
22,547 |
$769K |
| 80053 |
|
63,172 |
51,077 |
$764K |
| 84702 |
|
32,286 |
27,759 |
$750K |
| 97110 |
|
9,264 |
4,719 |
$744K |
| J9312 |
Inj., rituximab, 10 mg |
132 |
105 |
$718K |
| J2505 |
Injection, pegfilgrastim 6mg |
114 |
82 |
$694K |
| J0585 |
Injection,onabotulinumtoxina |
427 |
324 |
$683K |
| 86762 |
|
42,187 |
37,005 |
$663K |
| G0463 |
Hospital outpt clinic visit |
51,595 |
41,265 |
$649K |
| 87340 |
|
52,376 |
46,533 |
$632K |
| 88175 |
|
23,265 |
21,830 |
$627K |
| 76817 |
|
6,536 |
6,003 |
$616K |
| 70553 |
|
1,325 |
1,306 |
$606K |
| 87536 |
|
5,891 |
5,734 |
$596K |
| 70450 |
|
4,919 |
4,617 |
$567K |
| 85025 |
|
70,605 |
57,348 |
$565K |
| 90677 |
|
1,470 |
1,440 |
$561K |
| 81003 |
|
126,545 |
106,312 |
$530K |
| 76811 |
|
2,788 |
2,695 |
$526K |
| 71260 |
|
2,588 |
2,553 |
$521K |
| 77067 |
|
4,813 |
4,783 |
$507K |
| 96366 |
|
3,956 |
2,822 |
$466K |
| 71275 |
|
1,897 |
1,802 |
$452K |
| 74183 |
|
950 |
938 |
$428K |
| J9144 |
Daratumumab, hyaluronidase |
73 |
40 |
$425K |
| 84703 |
|
43,049 |
38,209 |
$424K |
| 99281 |
|
10,632 |
7,797 |
$416K |
| 99215 |
Prolong outpt/office vis |
4,114 |
3,659 |
$415K |
| 99203 |
|
4,991 |
4,649 |
$414K |
| 90688 |
|
23,589 |
22,618 |
$403K |
| 80307 |
|
6,218 |
5,782 |
$398K |
| 88305 |
|
4,495 |
4,285 |
$385K |
| 81025 |
|
27,338 |
23,624 |
$384K |
| 83880 |
|
10,456 |
9,410 |
$364K |
| 80061 |
|
21,090 |
20,555 |
$362K |
| 99205 |
Prolong outpt/office vis |
3,730 |
3,242 |
$352K |
| J0185 |
Inj., aprepitant, 1 mg |
902 |
615 |
$347K |
| 86900 |
|
59,323 |
52,043 |
$343K |
| 84443 |
|
20,939 |
19,785 |
$341K |
| 83036 |
|
32,938 |
31,839 |
$338K |
| 82677 |
|
12,230 |
11,569 |
$335K |
| 82105 |
|
14,175 |
13,378 |
$333K |
| 76801 |
|
2,939 |
2,876 |
$331K |
| 86901 |
|
59,324 |
52,042 |
$327K |
| 96360 |
|
3,485 |
3,289 |
$326K |
| 0002A |
|
10,009 |
9,914 |
$319K |
| 74176 |
|
1,606 |
1,532 |
$318K |
| 71046 |
|
8,641 |
8,089 |
$312K |
| 76705 |
|
3,221 |
3,086 |
$312K |
| 82565 |
|
49,646 |
44,537 |
$308K |
| J1745 |
Infliximab not biosimil 10mg |
42 |
36 |
$295K |
| 85049 |
|
39,428 |
34,445 |
$294K |
| 82306 |
|
9,437 |
9,160 |
$293K |
| 85013 |
|
37,119 |
34,857 |
$289K |
| 86336 |
|
12,320 |
11,654 |
$268K |
| 80048 |
|
34,397 |
26,134 |
$267K |
| 77063 |
|
4,242 |
4,212 |
$263K |
| 82950 |
|
30,585 |
29,696 |
$259K |
| 85027 |
|
36,806 |
28,718 |
$257K |
| 84484 |
|
19,466 |
10,550 |
$256K |
| U0005 |
Infec agen detec ampli probe |
12,083 |
11,251 |
$255K |
| 82947 |
|
42,473 |
37,512 |
$244K |
| 0001A |
|
10,988 |
10,706 |
$242K |
| 71045 |
|
9,883 |
8,771 |
$237K |
| 99282 |
|
5,198 |
4,371 |
$234K |
| 87086 |
|
23,254 |
21,638 |
$234K |
| 71250 |
|
2,050 |
2,012 |
$229K |
| 20610 |
|
1,394 |
1,293 |
$226K |
| 93970 |
|
1,077 |
1,035 |
$225K |
| 85014 |
|
50,494 |
44,907 |
$212K |
| 87636 |
|
1,547 |
1,467 |
$205K |
| 86923 |
|
1,153 |
942 |
$204K |
| 87428 |
|
3,692 |
3,553 |
$199K |
| 11042 |
|
1,049 |
766 |
$198K |
| 45380 |
|
442 |
425 |
$198K |
| 96375 |
|
10,432 |
7,867 |
$188K |
| Q5107 |
Inj mvasi 10 mg |
65 |
26 |
$182K |
| 93971 |
|
1,437 |
1,361 |
$181K |
| 78815 |
|
110 |
110 |
$180K |
| 99391 |
|
10,956 |
9,165 |
$175K |
| 86361 |
|
5,523 |
5,384 |
$175K |
| 86481 |
|
1,868 |
1,809 |
$170K |
| P9016 |
Rbc leukocytes reduced |
1,033 |
829 |
$170K |
| J2506 |
Inj pegfilgrast ex bio 0.5mg |
39 |
28 |
$169K |
| 96416 |
|
921 |
569 |
$168K |
| 76830 |
|
1,038 |
1,017 |
$164K |
| 96367 |
|
2,237 |
1,849 |
$163K |
| 76770 |
|
1,304 |
1,257 |
$157K |
| 85018 |
|
18,142 |
16,920 |
$155K |
| 83655 |
|
14,683 |
14,350 |
$153K |
| 87624 |
|
4,157 |
4,009 |
$152K |
| 96374 |
|
7,304 |
6,641 |
$149K |
| 72148 |
|
565 |
553 |
$144K |
| 72125 |
|
1,234 |
1,184 |
$142K |
| 43239 |
|
455 |
441 |
$141K |
| 86803 |
|
13,121 |
12,093 |
$140K |
| 83970 |
|
3,879 |
3,765 |
$137K |
| 96417 |
|
1,698 |
1,216 |
$134K |
| 83735 |
|
22,621 |
15,117 |
$132K |
| 70551 |
|
515 |
496 |
$132K |
| 80050 |
|
747 |
711 |
$126K |
| 82728 |
|
7,629 |
7,347 |
$117K |
| 16020 |
|
925 |
789 |
$116K |
| 76642 |
|
1,275 |
1,200 |
$114K |
| 73630 |
|
2,966 |
2,706 |
$114K |
| 96415 |
|
1,969 |
1,471 |
$111K |
| J0561 |
Penicillin g benzathine inj |
241 |
167 |
$103K |
| 31575 |
|
960 |
919 |
$103K |
| 90670 |
|
1,618 |
1,523 |
$99K |
| 94640 |
|
2,592 |
2,200 |
$99K |
| 73560 |
|
2,541 |
2,335 |
$95K |
| 94060 |
|
508 |
502 |
$94K |
| 94729 |
|
1,032 |
1,017 |
$93K |
| 93308 |
|
756 |
725 |
$92K |
| 91320 |
|
1,040 |
927 |
$92K |
| 49083 |
|
182 |
122 |
$91K |
| 97162 |
|
1,572 |
1,469 |
$91K |
| 76857 |
|
1,222 |
1,184 |
$91K |
| 76825 |
|
303 |
274 |
$89K |
| 93017 |
|
341 |
338 |
$88K |
| 87210 |
|
13,505 |
12,552 |
$88K |
| 81220 |
|
178 |
167 |
$87K |
| 84460 |
|
15,511 |
14,881 |
$87K |
| 84450 |
|
16,441 |
15,622 |
$87K |
| 97161 |
|
2,062 |
1,893 |
$85K |
| 96372 |
|
11,893 |
8,618 |
$80K |
| 87522 |
Neg quan hep c or qual rna |
1,609 |
1,537 |
$80K |
| 82951 |
|
4,236 |
4,172 |
$79K |
| 95811 |
|
119 |
118 |
$77K |
| 90732 |
|
1,136 |
1,099 |
$77K |
| 73030 |
|
2,087 |
1,964 |
$77K |
| 92134 |
|
2,506 |
2,433 |
$74K |
| 90472 |
|
5,444 |
3,853 |
$74K |
| 73502 |
|
1,476 |
1,395 |
$72K |
| 92083 |
|
1,590 |
1,558 |
$72K |
| 83690 |
|
11,204 |
10,148 |
$70K |
| 81001 |
|
22,898 |
20,664 |
$70K |
| 72131 |
|
582 |
562 |
$69K |
| 73610 |
|
1,740 |
1,613 |
$67K |
| 97530 |
|
1,623 |
1,087 |
$67K |
| 76536 |
|
566 |
557 |
$66K |
| 92014 |
|
1,024 |
1,016 |
$65K |
| 96376 |
|
3,949 |
2,607 |
$65K |
| 97165 |
|
987 |
957 |
$64K |
| 77066 |
Tomosynthesis, mammo |
448 |
447 |
$64K |
| J0881 |
Darbepoetin alfa, non-esrd |
121 |
89 |
$64K |
| 84439 |
|
6,190 |
5,880 |
$63K |
| 92557 |
|
822 |
808 |
$62K |
| 86870 |
|
553 |
516 |
$62K |
| 85610 |
|
15,847 |
12,127 |
$61K |
| 72100 |
|
1,343 |
1,318 |
$61K |
| 87040 |
|
5,595 |
2,961 |
$60K |
| 90678 |
|
299 |
286 |
$59K |
| 51702 |
|
671 |
611 |
$59K |
| 84100 |
|
17,028 |
12,385 |
$59K |
| 82274 |
|
3,609 |
3,547 |
$58K |
| 73130 |
|
1,381 |
1,237 |
$58K |
| 83605 |
|
5,644 |
4,190 |
$56K |
| J0640 |
Leucovorin calcium injection |
568 |
237 |
$55K |
| 93923 |
|
336 |
332 |
$55K |
| 88720 |
|
11,200 |
10,649 |
$55K |
| 97166 |
|
631 |
612 |
$53K |
| 82803 |
|
2,302 |
1,904 |
$53K |
| 94010 |
|
547 |
532 |
$52K |
| 85660 |
|
6,589 |
5,804 |
$51K |
| J0696 |
Ceftriaxone sodium injection |
4,216 |
3,060 |
$51K |
| 94726 |
|
656 |
644 |
$51K |
| 67028 |
|
986 |
959 |
$51K |
| 70496 |
|
253 |
242 |
$50K |
| 82607 |
|
3,975 |
3,862 |
$50K |
| 70498 |
|
254 |
242 |
$49K |
| 76815 |
|
595 |
538 |
$49K |
| G0257 |
Unsched dialysis esrd pt hos |
368 |
181 |
$48K |
| J3370 |
Vancomycin hcl injection |
1,541 |
869 |
$48K |
| 87902 |
|
161 |
158 |
$47K |
| P9047 |
Albumin (human), 25%, 50ml |
210 |
134 |
$47K |
| 70491 |
|
232 |
225 |
$47K |
| 73110 |
|
1,019 |
915 |
$47K |
| 82247 |
|
10,464 |
8,603 |
$46K |
| 87635 |
|
637 |
593 |
$46K |
| 82570 |
|
8,738 |
7,964 |
$45K |
| J1050 |
Medroxyprogesterone acetate |
762 |
740 |
$45K |
| 88342 |
|
703 |
661 |
$44K |
| 72158 |
|
111 |
107 |
$42K |
| 90656 |
|
2,328 |
2,278 |
$42K |
| 90832 |
|
1,006 |
776 |
$42K |
| 59025 |
|
832 |
801 |
$42K |
| 66984 |
|
67 |
67 |
$41K |
| 92227 |
|
1,709 |
1,672 |
$39K |
| 73590 |
|
1,125 |
1,048 |
$37K |
| 83550 |
|
4,704 |
4,574 |
$37K |
| 87186 |
|
4,545 |
4,282 |
$36K |
| 58100 |
|
177 |
170 |
$36K |
| 84156 |
|
8,949 |
7,663 |
$36K |
| 92133 |
|
1,248 |
1,236 |
$36K |
| 51798 |
|
642 |
634 |
$36K |
| J2469 |
Palonosetron hcl |
413 |
263 |
$35K |
| 85379 |
|
1,668 |
1,574 |
$35K |
| 86140 |
|
6,852 |
6,339 |
$35K |
| 86704 |
|
2,678 |
2,571 |
$34K |
| 88341 |
|
232 |
213 |
$34K |
| 93922 |
|
230 |
227 |
$34K |
| 80051 |
|
5,203 |
4,999 |
$33K |
| J9190 |
Fluorouracil injection |
1,331 |
578 |
$33K |
| 90756 |
|
1,773 |
1,714 |
$33K |
| J1644 |
Inj heparin sodium per 1000u |
5,692 |
2,646 |
$33K |
| 78452 |
|
97 |
96 |
$32K |
| 72141 |
|
125 |
125 |
$32K |
| 78306 |
|
115 |
115 |
$31K |
| 87426 |
|
603 |
583 |
$31K |
| 85007 |
|
8,377 |
6,541 |
$31K |
| 0241U |
|
6,127 |
5,859 |
$31K |
| 88142 |
|
1,581 |
1,488 |
$30K |
| 97140 |
|
710 |
426 |
$30K |
| 71271 |
|
179 |
178 |
$30K |
| J1453 |
Fosaprepitant injection |
354 |
237 |
$30K |
| J1100 |
Dexamethasone sodium phos |
6,691 |
4,935 |
$30K |
| 96401 |
|
460 |
253 |
$29K |
| J9263 |
Oxaliplatin |
238 |
110 |
$28K |
| 73552 |
|
742 |
693 |
$28K |
| 97116 |
|
871 |
619 |
$28K |
| 86706 |
|
2,303 |
2,241 |
$27K |
| J1650 |
Inj enoxaparin sodium |
4,687 |
2,588 |
$27K |
| 82378 |
|
1,329 |
1,060 |
$27K |
| 87077 |
|
3,745 |
3,512 |
$27K |
| 84153 |
|
1,825 |
1,707 |
$27K |
| 82040 |
|
5,611 |
5,388 |
$27K |
| 84403 |
|
1,132 |
1,058 |
$26K |
| 74174 |
|
67 |
67 |
$26K |
| 0004A |
|
1,318 |
1,303 |
$26K |
| J2543 |
Piperacillin/tazobactam |
1,079 |
557 |
$26K |
| 84520 |
|
7,300 |
6,956 |
$26K |
| J1940 |
Furosemide injection |
4,072 |
2,012 |
$25K |
| 82952 |
|
4,206 |
4,144 |
$24K |
| 95810 |
|
42 |
42 |
$24K |
| 84075 |
|
5,218 |
4,905 |
$24K |
| J9045 |
Carboplatin injection |
471 |
312 |
$24K |
| 0003A |
|
1,241 |
1,230 |
$24K |
| 86160 |
|
977 |
917 |
$23K |
| J2916 |
Na ferric gluconate complex |
334 |
203 |
$23K |
| 96411 |
|
270 |
196 |
$23K |
| 82248 |
|
5,199 |
3,809 |
$23K |
| J9267 |
Paclitaxel injection |
459 |
244 |
$23K |
| 87661 |
|
636 |
614 |
$23K |
| J0290 |
Ampicillin 500 mg inj |
2,303 |
1,033 |
$22K |
| 96368 |
|
560 |
399 |
$22K |
| 45378 |
|
70 |
67 |
$22K |
| 90480 |
|
860 |
808 |
$22K |
| 82043 |
|
3,836 |
3,756 |
$21K |
| 72040 |
|
487 |
479 |
$21K |
| 0072A |
|
963 |
957 |
$21K |
| J3489 |
Zoledronic acid 1mg |
120 |
118 |
$21K |
| J1170 |
Hydromorphone injection |
5,051 |
3,172 |
$21K |
| 99202 |
|
583 |
561 |
$21K |
| 11721 |
|
291 |
285 |
$21K |
| 86708 |
|
1,507 |
1,463 |
$21K |
| 85730 |
|
4,033 |
3,443 |
$20K |
| 86592 |
|
4,332 |
4,151 |
$20K |
| 92025 |
|
303 |
300 |
$20K |
| 0071A |
|
949 |
936 |
$20K |
| 90746 |
|
224 |
214 |
$20K |
| 77065 |
Tomosynthesis, mammo |
266 |
260 |
$20K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
11,906 |
11,057 |
$19K |
| 86922 |
|
62 |
55 |
$19K |
| 0124A |
|
917 |
908 |
$18K |
| 93296 |
|
599 |
592 |
$18K |
| 51705 |
|
110 |
103 |
$18K |
| 80069 |
|
2,356 |
2,125 |
$18K |
| 45385 |
|
126 |
122 |
$18K |
| J2785 |
Regadenoson injection |
103 |
102 |
$18K |
| 90697 |
|
230 |
218 |
$17K |
| 84481 |
|
1,011 |
980 |
$17K |
| J2405 |
Ondansetron hcl injection |
11,949 |
8,770 |
$17K |
| 80197 |
|
1,591 |
946 |
$16K |
| 0054A |
|
690 |
681 |
$16K |
| 99392 |
|
1,008 |
983 |
$16K |
| J3475 |
Inj magnesium sulfate |
1,616 |
1,137 |
$16K |
| 80320 |
|
1,201 |
1,124 |
$16K |
| 73070 |
|
529 |
487 |
$16K |
| 86787 |
|
1,351 |
1,318 |
$15K |
| 74018 |
|
553 |
490 |
$15K |
| 83721 |
|
1,679 |
1,632 |
$15K |
| 73562 |
|
387 |
371 |
$14K |
| 97535 |
|
610 |
492 |
$14K |
| 0012A |
|
548 |
544 |
$14K |
| 82550 |
|
2,258 |
1,923 |
$14K |
| 77080 |
|
494 |
477 |
$14K |
| 36561 |
|
12 |
12 |
$14K |
| 83615 |
|
2,184 |
1,842 |
$14K |
| 87081 |
|
1,465 |
1,422 |
$14K |
| 11720 |
|
637 |
627 |
$13K |
| J3301 |
Triamcinolone acet inj nos |
1,329 |
1,284 |
$13K |
| 72128 |
|
108 |
107 |
$13K |
| 77091 |
|
616 |
582 |
$13K |
| G0382 |
Lev 3 hosp type b ed visit |
828 |
786 |
$13K |
| 88112 |
|
247 |
220 |
$13K |
| 85045 |
|
2,675 |
2,238 |
$13K |
| 96402 |
|
485 |
455 |
$13K |
| 52000 |
|
25 |
25 |
$12K |
| C1769 |
Guide wire |
958 |
900 |
$12K |
| 82977 |
|
1,635 |
1,587 |
$12K |
| 83540 |
|
1,782 |
1,729 |
$12K |
| 87880 |
|
407 |
398 |
$12K |
| 83020 |
|
860 |
684 |
$11K |
| 70486 |
|
92 |
90 |
$11K |
| 73060 |
|
376 |
316 |
$11K |
| 73521 |
|
276 |
268 |
$11K |
| 86696 |
|
587 |
559 |
$11K |
| A9500 |
Tc99m sestamibi |
150 |
148 |
$11K |
| 85384 |
|
1,315 |
1,176 |
$11K |
| 87205 |
|
2,444 |
2,146 |
$11K |
| 93289 |
|
354 |
349 |
$10K |
| 86038 |
|
852 |
831 |
$10K |
| 92567 |
|
483 |
472 |
$10K |
| 99381 |
|
589 |
584 |
$10K |
| 87633 |
|
26 |
25 |
$10K |
| 94660 |
|
35 |
25 |
$10K |
| J1885 |
Ketorolac tromethamine inj |
3,270 |
2,960 |
$10K |
| 64643 |
|
13 |
12 |
$10K |
| 87631 |
|
82 |
79 |
$10K |
| J0780 |
Prochlorperazine injection |
615 |
550 |
$10K |
| 0011A |
|
519 |
514 |
$10K |
| 74178 |
|
38 |
38 |
$9K |
| J3480 |
Inj potassium chloride |
668 |
448 |
$9K |
| 73565 |
|
235 |
231 |
$9K |
| 85651 |
|
2,299 |
2,165 |
$9K |
| 99152 |
|
358 |
345 |
$9K |
| 73090 |
|
296 |
281 |
$9K |
| J2270 |
Morphine sulfate injection |
3,348 |
2,770 |
$9K |
| 87070 |
|
1,166 |
1,012 |
$9K |
| 80177 |
|
521 |
506 |
$8K |
| 84165 |
|
924 |
867 |
$8K |
| 97803 |
|
262 |
256 |
$8K |
| 84132 |
|
2,285 |
2,173 |
$8K |
| 86705 |
|
714 |
687 |
$8K |
| 92136 |
|
214 |
211 |
$8K |
| 97163 |
|
84 |
75 |
$8K |
| 90680 |
|
299 |
278 |
$7K |
| 84155 |
|
2,183 |
2,064 |
$7K |
| G0378 |
Hospital observation per hr |
1,506 |
1,189 |
$7K |
| G0383 |
Lev 4 hosp type b ed visit |
399 |
372 |
$7K |
| J2930 |
Methylprednisolone injection |
468 |
423 |
$7K |
| 84550 |
|
1,673 |
1,585 |
$7K |
| J0131 |
Inj, acetaminophen (nos) |
733 |
667 |
$7K |
| J3411 |
Thiamine hcl 100 mg |
979 |
768 |
$7K |
| 97760 |
|
97 |
93 |
$6K |
| 90686 |
|
397 |
392 |
$6K |
| 80164 |
|
467 |
430 |
$6K |
| J1815 |
Insulin injection |
1,979 |
390 |
$6K |
| 86593 |
|
1,142 |
1,084 |
$6K |
| 86304 |
|
367 |
312 |
$6K |
| 10060 |
|
27 |
27 |
$6K |
| J0690 |
Cefazolin sodium injection |
1,406 |
1,180 |
$6K |
| 72156 |
|
13 |
12 |
$6K |
| 84300 |
|
1,307 |
1,197 |
$6K |
| 97802 |
|
100 |
99 |
$6K |
| 82310 |
|
1,361 |
1,310 |
$6K |
| 87493 |
|
158 |
152 |
$6K |
| 72157 |
|
14 |
13 |
$6K |
| 72197 |
|
12 |
12 |
$6K |
| 86695 |
|
438 |
417 |
$5K |
| 90687 |
|
1,370 |
1,337 |
$5K |
| 90662 |
|
648 |
640 |
$5K |
| 93325 |
|
24 |
24 |
$5K |
| 0064A |
|
236 |
236 |
$5K |
| 86225 |
|
353 |
340 |
$5K |
| 86301 |
|
283 |
233 |
$5K |
| Q0091 |
Obtaining screen pap smear |
850 |
773 |
$5K |
| 80143 |
|
290 |
274 |
$5K |
| 87075 |
|
639 |
542 |
$5K |
| 92550 |
|
104 |
104 |
$5K |
| J0692 |
Cefepime hcl for injection |
163 |
81 |
$5K |
| 49082 |
|
21 |
12 |
$5K |
| 82239 |
|
303 |
270 |
$5K |
| 41899 |
|
49 |
42 |
$5K |
| 72170 |
|
171 |
163 |
$5K |
| 84295 |
|
1,258 |
1,191 |
$5K |
| 76882 |
|
135 |
126 |
$5K |
| 87517 |
|
98 |
88 |
$4K |
| 83520 |
|
252 |
225 |
$4K |
| 86902 |
|
26 |
25 |
$4K |
| 90716 |
|
159 |
145 |
$4K |
| 0052A |
|
130 |
128 |
$4K |
| J1630 |
Haloperidol injection |
899 |
658 |
$4K |
| 78451 |
|
15 |
15 |
$4K |
| 82140 |
|
363 |
326 |
$4K |
| 83010 |
|
366 |
318 |
$4K |
| 82533 |
|
260 |
220 |
$4K |
| 99153 |
Mod sedat endo service >5yrs |
118 |
116 |
$4K |
| 95819 |
|
12 |
12 |
$4K |
| C1894 |
Intro/sheath, non-laser |
665 |
645 |
$4K |
| 87634 |
|
43 |
42 |
$4K |
| 76376 |
|
13 |
12 |
$4K |
| 36430 |
|
1,233 |
881 |
$4K |
| G0475 |
Hiv combination assay |
2,647 |
2,585 |
$4K |
| J2791 |
Rhophylac injection |
166 |
162 |
$3K |
| 0053A |
|
116 |
113 |
$3K |
| 93990 |
|
90 |
87 |
$3K |
| 80361 |
|
126 |
122 |
$3K |
| 87430 |
|
146 |
140 |
$3K |
| 80179 |
|
177 |
169 |
$3K |
| 0051A |
|
107 |
105 |
$3K |
| Q3014 |
Telehealth facility fee |
148 |
141 |
$3K |
| C9257 |
Bevacizumab injection |
605 |
588 |
$3K |
| 85652 |
|
1,221 |
1,158 |
$3K |
| 92610 |
|
50 |
50 |
$3K |
| 80047 |
|
235 |
228 |
$3K |
| 80365 |
|
138 |
134 |
$3K |
| 90791 |
|
45 |
40 |
$3K |
| 90633 |
|
470 |
426 |
$3K |
| A9585 |
Gadobutrol injection |
3,424 |
3,311 |
$3K |
| J3010 |
Fentanyl citrate injection |
4,290 |
3,741 |
$3K |
| J2060 |
Lorazepam injection |
1,302 |
979 |
$3K |
| 82374 |
|
668 |
645 |
$3K |
| 90651 |
|
30 |
28 |
$3K |
| 29125 |
|
38 |
36 |
$3K |
| J1200 |
Diphenhydramine hcl injectio |
1,547 |
1,120 |
$3K |
| 83935 |
|
431 |
400 |
$3K |
| 88304 |
|
26 |
24 |
$2K |
| 87338 |
|
217 |
216 |
$2K |
| 82435 |
|
663 |
646 |
$2K |
| 89051 |
|
585 |
447 |
$2K |
| 93321 |
|
26 |
26 |
$2K |
| 76870 |
|
27 |
25 |
$2K |
| 86431 |
|
431 |
418 |
$2K |
| J2800 |
Methocarbamol injection |
170 |
146 |
$2K |
| 83521 |
|
320 |
291 |
$2K |
| 87491 |
|
98 |
95 |
$2K |
| 84540 |
|
490 |
452 |
$2K |
| 92250 |
|
70 |
68 |
$2K |
| C2629 |
Intro/sheath, laser |
231 |
219 |
$2K |
| 98967 |
|
278 |
269 |
$2K |
| 96377 |
|
51 |
40 |
$2K |
| 90714 |
|
78 |
75 |
$2K |
| J2175 |
Meperidine hydrochl /100 mg |
493 |
402 |
$2K |
| J2250 |
Inj midazolam hydrochloride |
2,947 |
2,715 |
$2K |
| 11102 |
|
24 |
24 |
$2K |
| J3420 |
Vitamin b12 injection |
379 |
321 |
$2K |
| 86200 |
|
137 |
132 |
$2K |
| 76512 |
|
46 |
37 |
$2K |
| 90739 |
|
13 |
13 |
$2K |
| 72070 |
|
42 |
40 |
$2K |
| J2704 |
Inj, propofol, 10 mg |
4,644 |
3,364 |
$2K |
| 0134A |
|
67 |
65 |
$1K |
| 82784 |
|
135 |
127 |
$1K |
| 87045 |
|
148 |
141 |
$1K |
| 88307 |
|
39 |
39 |
$1K |
| 86256 |
|
89 |
83 |
$1K |
| 69210 |
|
26 |
26 |
$1K |
| 80202 |
|
124 |
100 |
$1K |
| 87529 |
|
12 |
12 |
$1K |
| 82088 |
|
37 |
37 |
$1K |
| Q0162 |
Ondansetron oral |
3,843 |
3,109 |
$1K |
| A9270 |
Non-covered item or service |
35,019 |
10,226 |
$1K |
| J0689 |
Inj cefazolin sodium, baxter |
193 |
150 |
$1K |
| 87209 |
|
71 |
68 |
$1K |
| J0171 |
Adrenalin epinephrine inject |
296 |
216 |
$1K |
| 87581 |
|
26 |
25 |
$1K |
| 87486 |
|
26 |
25 |
$1K |
| 82664 |
|
16 |
16 |
$1K |
| 82024 |
|
28 |
25 |
$1K |
| 85460 |
|
145 |
135 |
$1K |
| 57454 |
|
12 |
12 |
$1K |
| 84133 |
|
235 |
218 |
$989.21 |
| 82436 |
|
205 |
190 |
$982.21 |
| 76000 |
|
28 |
24 |
$950.70 |
| J1642 |
Inj heparin sodium per 10 u |
1,103 |
752 |
$895.91 |
| 82077 |
|
89 |
87 |
$887.16 |
| 91200 |
|
102 |
101 |
$858.26 |
| C1887 |
Catheter, guiding |
60 |
56 |
$851.18 |
| 83001 |
|
39 |
39 |
$835.50 |
| 97763 |
|
18 |
14 |
$823.93 |
| 73620 |
|
30 |
26 |
$804.03 |
| J2765 |
Metoclopramide hcl injection |
549 |
457 |
$788.20 |
| Q0169 |
Promethazine hcl 12.5mg oral |
1,487 |
1,389 |
$733.83 |
| 90734 |
|
42 |
39 |
$729.06 |
| 0081A |
|
13 |
13 |
$718.80 |
| J0330 |
Succinycholine chloride inj |
81 |
79 |
$711.97 |
| 90853 |
|
18 |
12 |
$676.96 |
| U0002 |
Covid-19 lab test non-cdc |
113 |
107 |
$674.87 |
| 86709 |
|
118 |
116 |
$671.10 |
| 90707 |
|
86 |
79 |
$661.70 |
| 87177 |
|
83 |
80 |
$647.95 |
| 86039 |
|
68 |
67 |
$635.79 |
| 90834 |
|
14 |
12 |
$627.33 |
| 82330 |
|
155 |
141 |
$626.21 |
| 83883 |
|
34 |
33 |
$612.04 |
| 73140 |
|
12 |
12 |
$598.68 |
| J0360 |
Hydralazine hcl injection |
74 |
65 |
$567.51 |
| 84146 |
|
26 |
26 |
$548.63 |
| J0610 |
Calcium glucon (fresenius) |
47 |
37 |
$510.21 |
| 80156 |
|
13 |
13 |
$463.43 |
| 76937 |
|
12 |
12 |
$447.80 |
| 82746 |
|
27 |
27 |
$446.00 |
| J0595 |
Butorphanol tartrate 1 mg |
75 |
57 |
$445.37 |
| 84157 |
|
148 |
121 |
$443.00 |
| 97597 |
|
36 |
24 |
$436.86 |
| 88185 |
|
16 |
16 |
$432.56 |
| 88184 |
|
16 |
16 |
$432.56 |
| G0480 |
Drug test def 1-7 classes |
280 |
265 |
$427.30 |
| 90647 |
|
528 |
512 |
$424.96 |
| 11900 |
|
12 |
12 |
$424.55 |
| 87116 |
|
44 |
24 |
$400.19 |
| 90673 |
|
91 |
90 |
$397.86 |
| J3490 |
Drugs unclassified injection |
89 |
72 |
$395.63 |
| 80329 |
|
28 |
27 |
$387.90 |
| 96379 |
|
28 |
24 |
$362.72 |
| A9503 |
Tc99m medronate |
16 |
16 |
$357.41 |
| 93288 |
|
24 |
24 |
$308.11 |
| 90474 |
|
132 |
132 |
$298.22 |
| 84466 |
|
25 |
25 |
$279.90 |
| 80354 |
|
14 |
13 |
$279.34 |
| J2370 |
Phenylephrine hcl injection |
669 |
596 |
$273.05 |
| 86300 |
|
13 |
12 |
$272.84 |
| J2710 |
Neostigmine methylslfte inj |
291 |
278 |
$265.02 |
| 86886 |
|
57 |
54 |
$242.52 |
| 86235 |
|
21 |
17 |
$238.65 |
| 80325 |
|
13 |
12 |
$228.44 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
170 |
162 |
$193.76 |
| 86702 |
|
14 |
14 |
$184.58 |
| 86701 |
|
28 |
27 |
$171.34 |
| 80359 |
|
13 |
12 |
$169.30 |
| 84134 |
|
13 |
13 |
$156.73 |
| 86880 |
|
26 |
26 |
$147.06 |
| G0380 |
Lev 1 hosp type b ed visit |
14 |
14 |
$140.56 |
| 87799 |
|
16 |
12 |
$137.70 |
| 92004 |
|
16 |
15 |
$122.75 |
| A6258 |
Transparent film >16<=48 in |
17 |
12 |
$115.78 |
| 82042 |
|
15 |
13 |
$114.88 |
| J2919 |
Inj, methylpred sod succ 5mg |
28 |
24 |
$113.29 |
| 83930 |
|
16 |
14 |
$111.83 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
142 |
137 |
$101.41 |
| 82010 |
|
17 |
12 |
$97.79 |
| G0279 |
Tomosynthesis, mammo |
29 |
29 |
$77.30 |
| J1836 |
Inj, metronidazole, 10 mg |
33 |
16 |
$70.62 |
| G0476 |
Hpv combo assay ca screen |
14 |
14 |
$61.03 |
| 83525 |
|
15 |
14 |
$60.84 |
| J2795 |
Ropivacaine hcl injection |
14 |
13 |
$48.35 |
| G0008 |
Admin influenza virus vac |
3,249 |
3,213 |
$46.71 |
| 90700 |
|
88 |
75 |
$42.70 |
| 82465 |
|
13 |
12 |
$30.63 |
| S0030 |
Injection, metronidazole |
40 |
24 |
$14.27 |
| G0009 |
Admin pneumococcal vaccine |
980 |
967 |
$6.80 |
| J7611 |
Albuterol non-comp con |
16 |
12 |
$4.96 |
| J7613 |
Albuterol non-comp unit |
30 |
26 |
$2.08 |
| 91300 |
|
18,253 |
15,990 |
$0.01 |
| 3078F |
|
5,389 |
5,016 |
$0.00 |
| G1004 |
Cdsm ndsc |
731 |
588 |
$0.00 |
| A9552 |
F18 fdg |
108 |
108 |
$0.00 |
| 90681 |
|
211 |
210 |
$0.00 |
| 77062 |
|
163 |
163 |
$0.00 |
| 91313 |
|
68 |
66 |
$0.00 |
| 91312 |
|
931 |
922 |
$0.00 |
| 91308 |
|
60 |
60 |
$0.00 |
| 90611 |
|
29 |
28 |
$0.00 |
| 98966 |
|
311 |
306 |
$0.00 |
| 99051 |
|
13 |
13 |
$0.00 |
| 77061 |
|
44 |
44 |
$0.00 |
| 90685 |
|
12 |
12 |
$0.00 |
| 98968 |
|
115 |
113 |
$0.00 |
| Q9957 |
Inj perflutren lip micros,ml |
15 |
15 |
$0.00 |
| 3074F |
|
5,295 |
4,936 |
$0.00 |
| C1889 |
Implant/insert device, noc |
29 |
28 |
$0.00 |
| G0103 |
Psa screening |
568 |
555 |
$0.00 |
| 3044F |
|
98 |
83 |
$0.00 |
| 91307 |
|
2,013 |
1,849 |
$0.00 |
| A9561 |
Tc99m oxidronate |
126 |
126 |
$0.00 |
| 91305 |
|
928 |
898 |
$0.00 |
| 90723 |
|
252 |
251 |
$0.00 |
| 91306 |
|
114 |
114 |
$0.00 |
| 91301 |
|
713 |
691 |
$0.00 |
| 90674 |
|
38 |
38 |
$0.00 |
| J7999 |
Compounded drug, noc |
317 |
299 |
$0.00 |
| G0108 |
Diab manage trn per indiv |
15 |
14 |
$0.00 |
| G0145 |
Scr c/v cyto,thinlayer,rescr |
56 |
55 |
$0.00 |
| 96110 |
|
129 |
107 |
$0.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
15 |
12 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
99 |
85 |
$0.00 |
| J3471 |
Ovine, up to 999 usp units |
39 |
39 |
$0.00 |
| V2632 |
Post chmbr intraocular lens |
15 |
15 |
$0.00 |
| 3075F |
|
13 |
12 |
$0.00 |
| 91318 |
|
28 |
27 |
$0.00 |
| J7644 |
Ipratropium bromide non-comp |
20 |
14 |
$0.00 |
| 3079F |
|
15 |
14 |
$0.00 |