| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
58,239 |
49,719 |
$24.93M |
| 99284 |
|
104,236 |
92,738 |
$18.22M |
| 99283 |
|
95,002 |
86,470 |
$9.09M |
| 41899 |
|
6,371 |
5,098 |
$7.25M |
| J9271 |
Inj pembrolizumab |
907 |
580 |
$4.97M |
| 74177 |
|
15,623 |
13,887 |
$4.12M |
| 85025 |
|
257,049 |
209,267 |
$3.76M |
| 36415 |
|
144,015 |
98,845 |
$2.82M |
| G0378 |
Hospital observation per hr |
6,926 |
5,721 |
$2.65M |
| J3010 |
Fentanyl citrate injection |
40,746 |
28,681 |
$2.58M |
| 83605 |
|
139,468 |
108,264 |
$2.52M |
| J2405 |
Ondansetron hcl injection |
59,235 |
43,397 |
$2.30M |
| 80047 |
|
115,392 |
99,175 |
$2.14M |
| 87633 |
|
8,019 |
7,052 |
$2.03M |
| J2704 |
Inj, propofol, 10 mg |
33,274 |
26,411 |
$1.99M |
| 80053 |
|
118,339 |
103,508 |
$1.93M |
| 96413 |
|
11,581 |
6,610 |
$1.81M |
| C1713 |
Anchor/screw bn/bn,tis/bn |
1,549 |
1,114 |
$1.81M |
| 99214 |
|
96,972 |
86,873 |
$1.78M |
| 93005 |
|
95,669 |
80,181 |
$1.72M |
| 70450 |
|
19,926 |
17,799 |
$1.65M |
| J1745 |
Infliximab not biosimil 10mg |
927 |
827 |
$1.62M |
| J1100 |
Dexamethasone sodium phos |
31,681 |
22,821 |
$1.61M |
| 93458 |
|
2,319 |
1,920 |
$1.54M |
| J2250 |
Inj midazolam hydrochloride |
20,070 |
15,899 |
$1.54M |
| 93306 |
|
11,731 |
10,944 |
$1.50M |
| A9552 |
F18 fdg |
1,958 |
1,842 |
$1.46M |
| 43239 |
|
5,216 |
4,739 |
$1.44M |
| 96374 |
|
43,641 |
36,780 |
$1.41M |
| 84484 |
|
59,175 |
34,900 |
$1.34M |
| 71046 |
|
46,582 |
41,760 |
$1.31M |
| 80307 |
|
23,140 |
18,519 |
$1.29M |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
31,627 |
23,921 |
$1.27M |
| J1885 |
Ketorolac tromethamine inj |
29,107 |
22,003 |
$1.24M |
| 84443 |
|
63,894 |
58,221 |
$1.22M |
| 81001 |
|
99,236 |
86,787 |
$1.21M |
| 80048 |
|
55,425 |
39,885 |
$1.15M |
| 99213 |
|
59,472 |
53,893 |
$1.15M |
| 96375 |
|
34,049 |
25,917 |
$1.14M |
| 80076 |
|
71,242 |
61,899 |
$1.14M |
| 88305 |
|
13,670 |
11,701 |
$1.14M |
| 77386 |
|
4,201 |
396 |
$1.13M |
| 81025 |
|
21,838 |
17,969 |
$1.07M |
| 70553 |
|
3,860 |
3,475 |
$1.04M |
| 78815 |
|
1,923 |
1,812 |
$1.02M |
| 74176 |
|
6,417 |
5,786 |
$983K |
| 82948 |
|
11,975 |
5,246 |
$979K |
| 96361 |
|
34,015 |
28,373 |
$976K |
| 47562 |
|
360 |
232 |
$924K |
| J0131 |
Inj, acetaminophen (nos) |
9,039 |
6,915 |
$879K |
| 78452 |
|
4,219 |
3,815 |
$872K |
| J0690 |
Cefazolin sodium injection |
12,431 |
8,642 |
$871K |
| C1874 |
Stent, coated/cov w/del sys |
470 |
359 |
$813K |
| 80074 |
|
16,695 |
15,649 |
$810K |
| 87591 |
|
21,548 |
19,640 |
$790K |
| 87491 |
|
21,529 |
19,619 |
$789K |
| 96365 |
|
15,950 |
11,524 |
$772K |
| 71260 |
|
4,033 |
3,640 |
$745K |
| 87635 |
|
15,889 |
14,875 |
$733K |
| 99215 |
Prolong outpt/office vis |
35,052 |
31,616 |
$720K |
| 71275 |
|
4,709 |
4,229 |
$680K |
| 85610 |
|
54,477 |
44,330 |
$677K |
| 83690 |
|
46,975 |
40,569 |
$669K |
| 85027 |
|
38,799 |
29,823 |
$665K |
| 72125 |
|
5,782 |
5,200 |
$642K |
| 83036 |
|
43,010 |
40,223 |
$631K |
| 80061 |
|
39,780 |
37,207 |
$623K |
| 99282 |
|
12,076 |
11,248 |
$622K |
| J3490 |
Drugs unclassified injection |
2,975 |
2,513 |
$615K |
| 84703 |
|
25,869 |
22,283 |
$558K |
| 96372 |
|
21,221 |
17,798 |
$544K |
| J1170 |
Hydromorphone injection |
10,338 |
6,181 |
$544K |
| 93975 |
|
3,025 |
2,746 |
$543K |
| 82306 |
|
23,465 |
22,124 |
$533K |
| J2710 |
Neostigmine methylslfte inj |
4,435 |
3,153 |
$525K |
| 43282 |
|
489 |
239 |
$492K |
| 88307 |
|
2,863 |
1,994 |
$477K |
| 87040 |
|
18,959 |
12,193 |
$471K |
| 87086 |
|
30,358 |
26,912 |
$469K |
| 96360 |
|
11,964 |
10,391 |
$465K |
| 81514 |
|
2,466 |
2,221 |
$456K |
| 0202U |
|
13,961 |
13,001 |
$443K |
| 71045 |
|
19,966 |
17,446 |
$440K |
| 99212 |
|
22,117 |
20,367 |
$439K |
| 70551 |
|
2,575 |
2,321 |
$436K |
| 76705 |
|
8,389 |
7,746 |
$435K |
| A9500 |
Tc99m sestamibi |
4,350 |
3,929 |
$434K |
| 83735 |
|
39,720 |
28,258 |
$429K |
| 72148 |
|
2,410 |
2,252 |
$422K |
| 87389 |
|
17,081 |
16,028 |
$420K |
| 76830 |
|
5,294 |
4,889 |
$405K |
| 86850 |
|
15,988 |
12,742 |
$401K |
| 88304 |
|
3,255 |
2,615 |
$394K |
| 73564 |
|
5,232 |
4,867 |
$387K |
| 88342 |
|
6,341 |
5,531 |
$383K |
| 59025 |
|
8,286 |
4,824 |
$373K |
| 77067 |
|
5,206 |
4,995 |
$362K |
| 74022 |
|
10,090 |
9,045 |
$361K |
| 86900 |
|
16,096 |
12,819 |
$345K |
| 87507 |
|
1,386 |
1,248 |
$343K |
| 86901 |
|
16,087 |
12,817 |
$342K |
| 85730 |
|
17,100 |
14,255 |
$338K |
| 96415 |
|
3,558 |
2,168 |
$327K |
| J2370 |
Phenylephrine hcl injection |
3,764 |
2,975 |
$325K |
| 69436 |
|
608 |
452 |
$324K |
| 87070 |
|
18,305 |
16,735 |
$322K |
| 86140 |
|
26,909 |
22,957 |
$318K |
| 71250 |
|
3,580 |
3,335 |
$312K |
| 94640 |
|
9,736 |
5,954 |
$299K |
| J1644 |
Inj heparin sodium per 1000u |
15,056 |
7,024 |
$299K |
| 80305 |
|
10,194 |
8,047 |
$297K |
| C1894 |
Intro/sheath, non-laser |
3,466 |
2,679 |
$296K |
| 87480 |
|
10,419 |
9,360 |
$295K |
| 87660 |
|
10,378 |
9,322 |
$295K |
| 87510 |
|
10,378 |
9,321 |
$294K |
| J0330 |
Succinycholine chloride inj |
5,880 |
4,363 |
$294K |
| 74178 |
|
827 |
739 |
$292K |
| 76826 |
|
2,648 |
2,396 |
$291K |
| 93971 |
|
3,722 |
3,448 |
$289K |
| 96417 |
|
2,634 |
1,596 |
$289K |
| J2270 |
Morphine sulfate injection |
8,942 |
6,058 |
$282K |
| 43775 |
|
616 |
319 |
$282K |
| 93017 |
|
4,494 |
4,077 |
$280K |
| 76817 |
|
4,112 |
3,218 |
$277K |
| 42820 |
|
290 |
214 |
$276K |
| 87502 |
|
3,787 |
3,506 |
$273K |
| Q9951 |
Locm >= 400 mg/ml iodine,1ml |
1,176 |
916 |
$273K |
| 84439 |
|
20,124 |
18,912 |
$270K |
| 96367 |
|
4,477 |
2,776 |
$269K |
| 99205 |
Prolong outpt/office vis |
12,344 |
11,766 |
$268K |
| 99204 |
|
14,669 |
13,983 |
$265K |
| 80320 |
|
6,178 |
4,750 |
$263K |
| 93880 |
|
3,823 |
3,534 |
$262K |
| 72141 |
|
1,027 |
964 |
$260K |
| 83880 |
|
8,167 |
7,066 |
$260K |
| J2550 |
Promethazine hcl injection |
4,353 |
3,034 |
$258K |
| 77336 |
|
2,297 |
1,097 |
$252K |
| J3370 |
Vancomycin hcl injection |
4,440 |
2,685 |
$247K |
| 82607 |
|
14,991 |
14,095 |
$245K |
| 59050 |
|
3,696 |
2,411 |
$243K |
| 76815 |
|
4,508 |
2,312 |
$233K |
| J1815 |
Insulin injection |
8,191 |
4,342 |
$231K |
| C1769 |
Guide wire |
4,059 |
3,078 |
$221K |
| 95816 |
|
1,203 |
1,113 |
$221K |
| 76536 |
|
3,425 |
3,266 |
$221K |
| 87651 |
|
7,754 |
7,457 |
$218K |
| 73721 |
|
907 |
840 |
$215K |
| J1453 |
Fosaprepitant injection |
1,974 |
1,219 |
$208K |
| 87205 |
|
7,894 |
6,552 |
$208K |
| 97110 |
|
6,327 |
1,722 |
$206K |
| 84100 |
|
12,346 |
8,790 |
$205K |
| J1650 |
Inj enoxaparin sodium |
7,238 |
3,234 |
$205K |
| 85379 |
|
9,678 |
8,669 |
$203K |
| 73130 |
|
5,200 |
4,728 |
$201K |
| 84702 |
|
6,918 |
5,567 |
$200K |
| 93970 |
|
2,044 |
1,863 |
$199K |
| 99203 |
|
9,778 |
9,434 |
$198K |
| J1200 |
Diphenhydramine hcl injectio |
7,942 |
5,521 |
$195K |
| 87186 |
|
10,294 |
9,287 |
$194K |
| 82803 |
|
7,755 |
6,290 |
$191K |
| 70498 |
|
1,178 |
1,036 |
$190K |
| 73030 |
|
5,585 |
5,001 |
$190K |
| 70486 |
|
1,282 |
1,188 |
$189K |
| A9579 |
Gad-base mr contrast nos,1ml |
1,888 |
1,716 |
$186K |
| J2785 |
Regadenoson injection |
2,362 |
2,148 |
$182K |
| 70491 |
|
1,250 |
1,108 |
$172K |
| 96366 |
|
5,843 |
4,279 |
$171K |
| 87902 |
|
911 |
857 |
$167K |
| 76825 |
|
1,080 |
1,038 |
$167K |
| 73610 |
|
5,635 |
5,023 |
$166K |
| G0463 |
Hospital outpt clinic visit |
19,236 |
16,529 |
$165K |
| 45380 |
|
262 |
233 |
$164K |
| J2505 |
Injection, pegfilgrastim 6mg |
139 |
96 |
$162K |
| 73630 |
|
5,567 |
5,108 |
$161K |
| C1758 |
Catheter, ureteral |
814 |
625 |
$154K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
1,917 |
1,548 |
$153K |
| 87522 |
Neg quan hep c or qual rna |
4,707 |
4,353 |
$153K |
| 95810 |
|
380 |
353 |
$152K |
| 72110 |
|
4,303 |
4,059 |
$146K |
| 84466 |
|
10,867 |
9,974 |
$144K |
| 86780 |
|
8,932 |
8,244 |
$142K |
| 87450 |
|
3,651 |
3,290 |
$141K |
| 81003 |
|
23,059 |
17,524 |
$140K |
| 88185 |
|
1,836 |
1,633 |
$139K |
| 73110 |
|
4,482 |
3,752 |
$139K |
| 96376 |
|
3,489 |
2,952 |
$139K |
| 86481 |
|
1,612 |
1,553 |
$137K |
| C1725 |
Cath, translumin non-laser |
1,322 |
1,052 |
$135K |
| 76000 |
|
1,085 |
900 |
$135K |
| 85652 |
|
15,585 |
13,763 |
$133K |
| 96411 |
|
814 |
459 |
$132K |
| 82728 |
|
9,063 |
8,353 |
$132K |
| 76805 |
|
1,217 |
1,144 |
$129K |
| 70496 |
|
747 |
648 |
$129K |
| J8501 |
Oral aprepitant |
865 |
587 |
$128K |
| 80329 |
|
1,516 |
1,251 |
$128K |
| 87075 |
|
1,541 |
1,196 |
$127K |
| 87880 |
|
6,312 |
5,770 |
$127K |
| 87077 |
|
6,347 |
5,610 |
$127K |
| 72158 |
|
269 |
241 |
$124K |
| J0696 |
Ceftriaxone sodium injection |
8,919 |
6,452 |
$124K |
| J0171 |
Adrenalin epinephrine inject |
767 |
564 |
$121K |
| 80335 |
|
1,430 |
1,195 |
$120K |
| 76770 |
|
1,850 |
1,739 |
$119K |
| 90471 |
|
8,735 |
7,799 |
$119K |
| 93925 |
|
1,324 |
1,261 |
$118K |
| 52356 |
|
100 |
85 |
$118K |
| J0897 |
Denosumab injection |
140 |
126 |
$116K |
| 84144 |
|
3,319 |
2,857 |
$114K |
| 76642 |
|
2,250 |
2,108 |
$110K |
| 10060 |
|
1,289 |
1,158 |
$110K |
| 96401 |
|
974 |
513 |
$107K |
| 93922 |
|
3,629 |
3,423 |
$107K |
| 74018 |
|
4,159 |
3,649 |
$107K |
| 96368 |
|
1,381 |
814 |
$104K |
| 83540 |
|
11,551 |
10,638 |
$104K |
| 84132 |
|
2,505 |
2,095 |
$103K |
| 73502 |
|
3,942 |
3,621 |
$102K |
| 76827 |
|
1,136 |
1,083 |
$100K |
| 82746 |
|
6,891 |
6,476 |
$99K |
| 76856 |
|
1,084 |
1,028 |
$99K |
| 20610 |
|
1,945 |
1,713 |
$97K |
| C1781 |
Mesh (implantable) |
507 |
348 |
$96K |
| 82330 |
|
4,165 |
3,050 |
$96K |
| J1756 |
Iron sucrose injection |
3,221 |
1,485 |
$94K |
| C2617 |
Stent, non-cor, tem w/o del |
520 |
404 |
$93K |
| 96402 |
|
354 |
319 |
$92K |
| 86920 |
|
1,641 |
1,274 |
$92K |
| 80050 |
|
2,827 |
2,777 |
$90K |
| 92012 |
|
2,696 |
2,467 |
$89K |
| C1887 |
Catheter, guiding |
1,644 |
1,276 |
$88K |
| 88175 |
|
4,187 |
3,966 |
$88K |
| 76700 |
|
1,308 |
1,279 |
$88K |
| J3301 |
Triamcinolone acet inj nos |
2,596 |
2,150 |
$85K |
| 72100 |
|
3,287 |
3,100 |
$84K |
| 77334 |
|
665 |
516 |
$84K |
| P9016 |
Rbc leukocytes reduced |
607 |
446 |
$83K |
| 77301 |
|
132 |
125 |
$82K |
| 76775 |
|
1,955 |
1,844 |
$80K |
| 36430 |
|
860 |
583 |
$79K |
| C1889 |
Implant/insert device, noc |
128 |
108 |
$79K |
| 80179 |
|
6,645 |
5,646 |
$78K |
| 87624 |
|
2,636 |
2,450 |
$78K |
| 58661 |
|
26 |
12 |
$78K |
| 70487 |
|
144 |
120 |
$74K |
| 77066 |
Tomosynthesis, mammo |
973 |
926 |
$74K |
| 12001 |
|
1,071 |
992 |
$72K |
| 84403 |
|
2,899 |
2,760 |
$72K |
| 82140 |
|
4,263 |
3,529 |
$72K |
| C1753 |
Cath, intravas ultrasound |
103 |
74 |
$72K |
| J0744 |
Ciprofloxacin iv |
523 |
330 |
$69K |
| 95819 |
|
258 |
242 |
$69K |
| 76870 |
|
1,062 |
990 |
$68K |
| 72156 |
|
170 |
154 |
$68K |
| 86803 |
|
3,120 |
2,886 |
$68K |
| 97161 |
|
1,706 |
1,473 |
$68K |
| 75574 |
|
854 |
779 |
$68K |
| 77300 |
|
385 |
361 |
$67K |
| 94729 |
|
2,555 |
2,361 |
$66K |
| 81596 |
|
667 |
564 |
$65K |
| 73090 |
|
1,657 |
1,415 |
$64K |
| 72072 |
|
1,779 |
1,677 |
$64K |
| J2469 |
Palonosetron hcl |
2,592 |
1,641 |
$64K |
| J0561 |
Penicillin g benzathine inj |
592 |
506 |
$62K |
| 80143 |
|
5,344 |
4,563 |
$62K |
| 82150 |
|
2,317 |
2,055 |
$62K |
| 92004 |
|
1,141 |
1,101 |
$61K |
| J2060 |
Lorazepam injection |
4,082 |
2,781 |
$61K |
| 74019 |
|
2,716 |
2,476 |
$61K |
| J2765 |
Metoclopramide hcl injection |
3,235 |
2,671 |
$61K |
| 94726 |
|
2,289 |
2,120 |
$61K |
| 76811 |
|
595 |
575 |
$60K |
| J2930 |
Methylprednisolone injection |
3,095 |
2,524 |
$60K |
| 70320 |
|
206 |
179 |
$60K |
| 82550 |
|
4,716 |
3,961 |
$58K |
| 73590 |
|
2,066 |
1,844 |
$57K |
| 90715 |
|
1,308 |
1,150 |
$57K |
| 82565 |
|
5,891 |
5,181 |
$56K |
| 88184 |
|
1,834 |
1,645 |
$56K |
| 88312 |
|
66 |
52 |
$56K |
| G0481 |
Drug test def 8-14 classes |
564 |
383 |
$54K |
| 87102 |
|
1,002 |
757 |
$54K |
| 83615 |
|
4,164 |
3,456 |
$54K |
| 82947 |
|
7,456 |
5,586 |
$54K |
| J9355 |
Inj trastuzumab excl biosimi |
28 |
12 |
$53K |
| 76816 |
|
1,228 |
1,116 |
$52K |
| G0480 |
Drug test def 1-7 classes |
573 |
487 |
$52K |
| 82784 |
|
3,707 |
3,426 |
$52K |
| 83970 |
|
1,881 |
1,718 |
$52K |
| D1208 |
|
68 |
57 |
$52K |
| 73080 |
|
1,583 |
1,476 |
$52K |
| 84145 |
|
2,942 |
2,458 |
$52K |
| 88341 |
|
704 |
578 |
$52K |
| 86038 |
|
3,163 |
2,932 |
$51K |
| 58571 |
|
38 |
26 |
$51K |
| 73221 |
|
280 |
260 |
$50K |
| 52000 |
|
280 |
247 |
$49K |
| 12011 |
|
349 |
316 |
$49K |
| J1642 |
Inj heparin sodium per 10 u |
4,559 |
2,726 |
$49K |
| J3420 |
Vitamin b12 injection |
585 |
358 |
$49K |
| 76001 |
|
124 |
85 |
$49K |
| J0295 |
Ampicillin sulbactam 1.5 gm |
428 |
194 |
$48K |
| J0360 |
Hydralazine hcl injection |
1,607 |
1,258 |
$47K |
| C1760 |
Closure dev, vasc |
288 |
236 |
$47K |
| 93976 |
|
707 |
549 |
$47K |
| 72040 |
|
1,452 |
1,398 |
$47K |
| 82570 |
|
6,558 |
5,492 |
$47K |
| 86706 |
|
2,819 |
2,544 |
$46K |
| J3480 |
Inj potassium chloride |
2,616 |
1,657 |
$46K |
| J3475 |
Inj magnesium sulfate |
4,019 |
2,782 |
$46K |
| J0585 |
Injection,onabotulinumtoxina |
133 |
127 |
$46K |
| 77338 |
|
213 |
195 |
$46K |
| 86762 |
|
1,640 |
1,511 |
$45K |
| J1580 |
Garamycin gentamicin inj |
509 |
355 |
$45K |
| 94060 |
|
1,613 |
1,397 |
$45K |
| 83520 |
|
1,904 |
1,457 |
$45K |
| M0243 |
Casirivi and imdevi inj |
154 |
153 |
$44K |
| 87338 |
|
2,636 |
2,403 |
$44K |
| J0640 |
Leucovorin calcium injection |
1,016 |
337 |
$44K |
| A9541 |
Tc99m sulfur colloid |
369 |
331 |
$43K |
| 84550 |
|
3,583 |
3,085 |
$43K |
| 84520 |
|
1,646 |
1,454 |
$42K |
| G0123 |
Screen cerv/vag thin layer |
1,505 |
1,433 |
$42K |
| 84153 |
|
1,912 |
1,796 |
$42K |
| 74183 |
|
178 |
173 |
$41K |
| J7512 |
Prednisone ir or dr oral 1mg |
2,981 |
2,216 |
$40K |
| 86708 |
|
1,497 |
1,348 |
$40K |
| 90686 |
|
3,142 |
2,826 |
$40K |
| 93926 |
|
553 |
520 |
$40K |
| 77065 |
Tomosynthesis, mammo |
823 |
784 |
$39K |
| 76801 |
|
551 |
505 |
$39K |
| 72050 |
|
787 |
737 |
$39K |
| 73562 |
|
1,150 |
1,075 |
$39K |
| M0245 |
Bamlan and etesev infusion |
91 |
90 |
$39K |
| 82270 |
|
2,471 |
2,240 |
$39K |
| 77080 |
|
650 |
634 |
$37K |
| J2360 |
Orphenadrine injection |
1,843 |
1,610 |
$37K |
| 86256 |
|
847 |
763 |
$37K |
| 86003 |
|
725 |
344 |
$36K |
| 78264 |
|
205 |
193 |
$36K |
| 93613 |
|
16 |
13 |
$35K |
| G0143 |
Scr c/v cyto,thinlayer,rescr |
1,186 |
1,121 |
$35K |
| G0297 |
Ldct for lung ca screen |
383 |
364 |
$35K |
| 92014 |
|
686 |
668 |
$34K |
| 80164 |
|
1,541 |
1,377 |
$34K |
| 82105 |
|
1,292 |
1,173 |
$34K |
| 97162 |
|
788 |
706 |
$33K |
| J9263 |
Oxaliplatin |
302 |
64 |
$33K |
| J9045 |
Carboplatin injection |
488 |
298 |
$33K |
| 69210 |
|
328 |
315 |
$33K |
| J1050 |
Medroxyprogesterone acetate |
674 |
632 |
$33K |
| 87340 |
|
2,112 |
1,931 |
$33K |
| 74420 |
|
348 |
292 |
$33K |
| 95886 |
|
542 |
515 |
$32K |
| 72052 |
|
583 |
565 |
$32K |
| 90714 |
|
1,909 |
1,757 |
$31K |
| 97140 |
|
1,117 |
377 |
$31K |
| 82378 |
|
1,137 |
1,023 |
$31K |
| C9113 |
Inj pantoprazole sodium, via |
1,910 |
1,206 |
$30K |
| 73552 |
|
927 |
865 |
$30K |
| 99281 |
|
1,378 |
1,265 |
$30K |
| 82977 |
|
1,974 |
1,746 |
$29K |
| J1720 |
Hydrocortisone sodium succ i |
268 |
218 |
$29K |
| 76937 |
|
663 |
571 |
$29K |
| 76820 |
|
531 |
370 |
$29K |
| 84156 |
|
3,774 |
3,031 |
$29K |
| 86704 |
|
1,763 |
1,597 |
$29K |
| 84295 |
|
1,208 |
1,037 |
$29K |
| 78227 |
|
110 |
102 |
$28K |
| 82043 |
|
3,239 |
3,022 |
$28K |
| 84146 |
|
985 |
940 |
$28K |
| A9537 |
Tc99m mebrofenin |
405 |
391 |
$28K |
| 83002 |
|
1,308 |
1,244 |
$28K |
| 86235 |
|
348 |
322 |
$28K |
| 86376 |
|
1,569 |
1,495 |
$27K |
| 84480 |
|
1,791 |
1,686 |
$26K |
| 80069 |
|
3,780 |
2,697 |
$26K |
| 99211 |
|
1,210 |
1,089 |
$25K |
| 90832 |
|
585 |
562 |
$25K |
| 73700 |
|
138 |
123 |
$25K |
| 84112 |
|
304 |
277 |
$25K |
| C8929 |
Tte w or wo fol wcon,doppler |
1,472 |
1,179 |
$25K |
| 88302 |
|
108 |
64 |
$24K |
| 88360 |
|
236 |
181 |
$24K |
| J9267 |
Paclitaxel injection |
311 |
134 |
$24K |
| 77072 |
|
1,019 |
988 |
$24K |
| 77063 |
|
1,436 |
1,370 |
$24K |
| 73140 |
|
667 |
611 |
$24K |
| 84481 |
|
1,297 |
1,197 |
$23K |
| A4314 |
Cath w/drainage 2-way latex |
974 |
752 |
$23K |
| 82670 |
|
782 |
746 |
$23K |
| 82533 |
|
679 |
542 |
$23K |
| 76819 |
|
387 |
273 |
$23K |
| 93798 |
|
937 |
171 |
$23K |
| 64483 |
|
91 |
56 |
$23K |
| A9577 |
Inj multihance |
2,050 |
1,837 |
$23K |
| 84450 |
|
909 |
723 |
$22K |
| J2543 |
Piperacillin/tazobactam |
2,152 |
1,173 |
$22K |
| 58558 |
|
75 |
56 |
$22K |
| 86225 |
|
1,135 |
1,061 |
$22K |
| 84460 |
|
894 |
710 |
$22K |
| 93270 |
|
356 |
307 |
$21K |
| J2175 |
Meperidine hydrochl /100 mg |
129 |
79 |
$21K |
| 12002 |
|
351 |
330 |
$21K |
| 76377 |
|
286 |
267 |
$21K |
| 87529 |
|
441 |
378 |
$21K |
| 11042 |
|
81 |
39 |
$20K |
| 73560 |
|
1,289 |
1,160 |
$20K |
| 86304 |
|
554 |
480 |
$20K |
| 45385 |
|
84 |
80 |
$20K |
| 29125 |
|
223 |
206 |
$20K |
| 94010 |
|
869 |
815 |
$20K |
| 93226 |
|
116 |
108 |
$19K |
| 83655 |
|
1,725 |
1,636 |
$19K |
| 84305 |
|
962 |
922 |
$19K |
| 86800 |
|
1,011 |
939 |
$19K |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
240 |
177 |
$19K |
| 82103 |
|
660 |
602 |
$19K |
| 54161 |
|
20 |
16 |
$18K |
| 82785 |
|
869 |
818 |
$18K |
| J9035 |
Bevacizumab injection |
33 |
12 |
$18K |
| 78226 |
|
115 |
114 |
$18K |
| 80197 |
|
2,706 |
1,428 |
$18K |
| 83001 |
|
817 |
771 |
$17K |
| J7510 |
Prednisolone oral per 5 mg |
681 |
489 |
$17K |
| 85014 |
|
1,435 |
1,066 |
$17K |
| 82397 |
|
620 |
413 |
$17K |
| J1940 |
Furosemide injection |
1,999 |
1,257 |
$17K |
| 73060 |
|
622 |
560 |
$17K |
| J0153 |
Adenosine inj 1mg |
241 |
187 |
$17K |
| 83525 |
|
995 |
956 |
$17K |
| 82040 |
|
31 |
25 |
$17K |
| 88142 |
|
505 |
485 |
$16K |
| 45378 |
|
206 |
196 |
$16K |
| 72131 |
|
31 |
26 |
$16K |
| 76882 |
|
389 |
364 |
$16K |
| 31575 |
|
227 |
216 |
$16K |
| 93978 |
|
316 |
299 |
$15K |
| 71101 |
|
357 |
343 |
$15K |
| 71271 |
|
276 |
263 |
$15K |
| 64493 |
|
53 |
44 |
$15K |
| 80055 |
|
441 |
407 |
$15K |
| 85044 |
|
1,671 |
1,509 |
$15K |
| 83516 |
|
1,218 |
886 |
$15K |
| 88173 |
|
406 |
335 |
$15K |
| 51798 |
|
1,227 |
1,150 |
$15K |
| M0247 |
Sotrovimab infusion |
36 |
35 |
$15K |
| 84436 |
|
986 |
914 |
$15K |
| 72146 |
|
74 |
65 |
$14K |
| Q9957 |
Inj perflutren lip micros,ml |
220 |
210 |
$14K |
| 36561 |
|
38 |
38 |
$14K |
| 86308 |
|
928 |
837 |
$14K |
| 82657 |
|
213 |
194 |
$14K |
| 73070 |
|
664 |
566 |
$14K |
| 72170 |
|
439 |
399 |
$14K |
| 86431 |
|
1,464 |
1,381 |
$13K |
| 96379 |
|
143 |
106 |
$13K |
| 82248 |
|
1,567 |
1,376 |
$13K |
| 43235 |
|
20 |
17 |
$13K |
| J2795 |
Ropivacaine hcl injection |
81 |
53 |
$12K |
| 64494 |
|
49 |
41 |
$12K |
| 0241U |
|
1,806 |
1,507 |
$12K |
| 87324 |
|
157 |
148 |
$12K |
| 86665 |
|
484 |
280 |
$12K |
| 78306 |
|
39 |
39 |
$11K |
| C1726 |
Cath, bal dil, non-vascular |
499 |
401 |
$11K |
| 10061 |
|
67 |
63 |
$11K |
| 86709 |
|
421 |
383 |
$11K |
| Q0163 |
Diphenhydramine hcl 50mg |
607 |
505 |
$11K |
| G0279 |
Tomosynthesis, mammo |
568 |
547 |
$11K |
| A9576 |
Inj prohance multipack |
240 |
209 |
$10K |
| J2997 |
Alteplase recombinant |
68 |
53 |
$10K |
| 96523 |
|
403 |
366 |
$10K |
| J0694 |
Cefoxitin sodium injection |
798 |
425 |
$10K |
| 88300 |
|
295 |
223 |
$10K |
| J1953 |
Levetiracetam injection |
199 |
160 |
$10K |
| 80202 |
|
242 |
112 |
$10K |
| 95956 |
|
16 |
16 |
$10K |
| 81599 |
|
168 |
157 |
$10K |
| 82652 |
|
316 |
298 |
$10K |
| 72081 |
|
383 |
365 |
$10K |
| 82390 |
|
450 |
414 |
$10K |
| 80177 |
|
290 |
255 |
$9K |
| 84134 |
|
374 |
308 |
$9K |
| 80178 |
|
347 |
299 |
$9K |
| 85018 |
|
1,065 |
779 |
$9K |
| 92083 |
|
394 |
387 |
$9K |
| 89051 |
|
520 |
409 |
$9K |
| 95716 |
|
18 |
12 |
$9K |
| 90472 |
|
490 |
432 |
$9K |
| 87206 |
|
705 |
510 |
$9K |
| Q0162 |
Ondansetron oral |
317 |
237 |
$8K |
| 82010 |
|
423 |
299 |
$8K |
| 74174 |
|
112 |
106 |
$8K |
| 51701 |
|
176 |
154 |
$8K |
| 88143 |
|
272 |
251 |
$8K |
| 86618 |
|
456 |
431 |
$8K |
| 76885 |
|
60 |
54 |
$8K |
| 86334 |
|
361 |
326 |
$7K |
| 87449 |
|
374 |
337 |
$7K |
| 87081 |
|
278 |
235 |
$7K |
| 83883 |
|
196 |
175 |
$7K |
| 95953 |
|
13 |
12 |
$7K |
| 93660 |
|
85 |
79 |
$7K |
| 86403 |
|
313 |
276 |
$7K |
| 93000 |
|
381 |
348 |
$7K |
| 83010 |
|
170 |
150 |
$7K |
| Q3014 |
Telehealth facility fee |
236 |
208 |
$7K |
| 64721 |
|
29 |
26 |
$7K |
| 84402 |
|
334 |
326 |
$6K |
| 84479 |
|
232 |
212 |
$6K |
| 83721 |
|
217 |
211 |
$6K |
| 88311 |
|
282 |
198 |
$6K |
| 86664 |
|
270 |
242 |
$6K |
| 90677 |
|
80 |
77 |
$6K |
| 82172 |
|
116 |
101 |
$6K |
| 52310 |
|
40 |
38 |
$6K |
| 87799 |
|
424 |
353 |
$6K |
| 84165 |
|
547 |
499 |
$6K |
| 86663 |
|
273 |
244 |
$6K |
| 76942 |
|
95 |
85 |
$6K |
| 49083 |
|
68 |
53 |
$5K |
| 92133 |
|
697 |
674 |
$5K |
| 94664 |
|
139 |
117 |
$5K |
| 86255 |
|
500 |
460 |
$5K |
| 71100 |
|
159 |
150 |
$5K |
| 87497 |
|
383 |
290 |
$5K |
| A9503 |
Tc99m medronate |
56 |
56 |
$5K |
| 86200 |
|
540 |
512 |
$5K |
| 99202 |
|
192 |
187 |
$5K |
| J9190 |
Fluorouracil injection |
160 |
73 |
$5K |
| 87641 |
|
234 |
222 |
$5K |
| 83993 |
|
169 |
167 |
$5K |
| 70360 |
|
261 |
241 |
$5K |
| 86696 |
|
286 |
274 |
$5K |
| J2920 |
Methylprednisolone injection |
133 |
82 |
$5K |
| J1630 |
Haloperidol injection |
302 |
239 |
$5K |
| 88112 |
|
138 |
114 |
$5K |
| 73120 |
|
166 |
155 |
$5K |
| 96409 |
|
88 |
50 |
$5K |
| 19083 |
|
27 |
26 |
$5K |
| 90636 |
|
93 |
85 |
$5K |
| 99152 |
|
1,112 |
967 |
$5K |
| J3364 |
Urokinase 5000 iu injection |
45 |
44 |
$5K |
| 70355 |
|
57 |
42 |
$5K |
| 73000 |
|
181 |
163 |
$5K |
| 93225 |
|
238 |
231 |
$4K |
| 73522 |
|
178 |
172 |
$4K |
| J9060 |
Cisplatin 10 mg injection |
39 |
26 |
$4K |
| 64495 |
|
17 |
14 |
$4K |
| 25600 |
|
26 |
26 |
$4K |
| S9445 |
Pt education noc individ |
474 |
355 |
$4K |
| 92557 |
|
80 |
78 |
$4K |
| 93312 |
|
83 |
66 |
$4K |
| 86160 |
|
193 |
178 |
$4K |
| 0003M |
|
90 |
90 |
$4K |
| 73718 |
|
16 |
13 |
$4K |
| A9270 |
Non-covered item or service |
26,427 |
4,378 |
$4K |
| 86364 |
|
427 |
397 |
$4K |
| 82044 |
|
260 |
245 |
$4K |
| 86300 |
|
103 |
80 |
$4K |
| 36600 |
|
185 |
166 |
$4K |
| 73620 |
|
133 |
130 |
$3K |
| 87150 |
|
17 |
13 |
$3K |
| 93882 |
|
40 |
39 |
$3K |
| 86695 |
|
286 |
274 |
$3K |
| J2310 |
Inj naloxone hydrochloride |
85 |
71 |
$3K |
| 99153 |
Mod sedat endo service >5yrs |
727 |
639 |
$3K |
| 72190 |
|
51 |
49 |
$3K |
| 93350 |
|
14 |
12 |
$3K |
| 97602 |
|
402 |
145 |
$3K |
| 97116 |
|
516 |
205 |
$3K |
| 90670 |
|
73 |
72 |
$3K |
| 62270 |
|
29 |
24 |
$3K |
| Q9950 |
Inj sulf hexa lipid microsph |
1,242 |
1,156 |
$3K |
| 31231 |
|
30 |
29 |
$3K |
| 90732 |
|
83 |
75 |
$3K |
| J0500 |
Dicyclomine injection |
75 |
63 |
$3K |
| J0461 |
Atropine sulfate injection |
241 |
123 |
$3K |
| 82627 |
|
112 |
109 |
$3K |
| 86147 |
|
68 |
64 |
$3K |
| J3411 |
Thiamine hcl 100 mg |
42 |
25 |
$3K |
| S9444 |
Parenting class |
273 |
172 |
$3K |
| 80081 |
|
40 |
40 |
$3K |
| 77280 |
|
19 |
13 |
$2K |
| G0103 |
Psa screening |
144 |
139 |
$2K |
| J9206 |
Irinotecan injection |
50 |
12 |
$2K |
| 82679 |
|
114 |
111 |
$2K |
| 84445 |
|
58 |
56 |
$2K |
| Q0138 |
Ferumoxytol, non-esrd |
24 |
14 |
$2K |
| 80230 |
|
91 |
78 |
$2K |
| 74220 |
|
73 |
72 |
$2K |
| 83630 |
|
99 |
95 |
$2K |
| 99195 |
|
47 |
38 |
$2K |
| 92611 |
|
26 |
24 |
$2K |
| 97165 |
|
101 |
97 |
$2K |
| 76813 |
|
33 |
25 |
$2K |
| 70480 |
|
12 |
12 |
$2K |
| 88313 |
|
29 |
24 |
$2K |
| 51702 |
|
59 |
52 |
$2K |
| 36590 |
|
16 |
12 |
$2K |
| 99201 |
|
45 |
43 |
$2K |
| C1729 |
Cath, drainage |
265 |
203 |
$2K |
| 74230 |
|
12 |
12 |
$2K |
| 95700 |
|
20 |
14 |
$2K |
| 82247 |
|
163 |
110 |
$2K |
| 93010 |
|
67 |
60 |
$2K |
| J0780 |
Prochlorperazine injection |
169 |
143 |
$2K |
| 86039 |
|
150 |
144 |
$2K |
| 87804 |
|
78 |
66 |
$2K |
| 92579 |
|
27 |
25 |
$2K |
| 72220 |
|
31 |
29 |
$2K |
| 77370 |
|
15 |
12 |
$2K |
| 92134 |
|
191 |
184 |
$1K |
| 96377 |
|
55 |
41 |
$1K |
| 97802 |
|
27 |
25 |
$1K |
| 82465 |
|
41 |
40 |
$1K |
| 83921 |
|
63 |
56 |
$1K |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
687 |
515 |
$1K |
| 80347 |
|
401 |
347 |
$1K |
| 80366 |
|
77 |
67 |
$1K |
| 84478 |
|
38 |
33 |
$1K |
| 77470 |
|
13 |
13 |
$1K |
| 87798 |
|
29 |
26 |
$1K |
| Q0144 |
Azithromycin dihydrate, oral |
34 |
25 |
$1K |
| J0702 |
Betamethasone acet&sod phosp |
33 |
12 |
$1K |
| 29515 |
|
12 |
12 |
$1K |
| 93289 |
|
143 |
138 |
$1K |
| 84300 |
|
145 |
120 |
$1K |
| 83521 |
|
120 |
110 |
$1K |
| 95913 |
|
12 |
12 |
$1K |
| J0610 |
Calcium glucon (fresenius) |
80 |
50 |
$988.87 |
| 97166 |
|
14 |
13 |
$986.03 |
| 81237 |
|
45 |
42 |
$980.00 |
| L1830 |
Ko immob canvas long pre ots |
14 |
12 |
$957.19 |
| 82610 |
|
57 |
57 |
$953.93 |
| 82024 |
|
28 |
28 |
$921.44 |
| 95911 |
|
17 |
15 |
$903.00 |
| 80156 |
|
32 |
27 |
$877.72 |
| 72114 |
|
12 |
12 |
$876.00 |
| J0456 |
Azithromycin |
123 |
94 |
$873.38 |
| 86146 |
|
12 |
12 |
$866.03 |
| 83021 |
|
14 |
12 |
$864.66 |
| 83704 |
|
39 |
37 |
$862.87 |
| P9047 |
Albumin (human), 25%, 50ml |
13 |
13 |
$852.25 |
| 82436 |
|
113 |
90 |
$850.76 |
| 83020 |
|
14 |
12 |
$848.60 |
| C1763 |
Conn tiss, non-human |
13 |
13 |
$839.00 |
| 83789 |
|
90 |
82 |
$836.38 |
| 86769 |
|
29 |
29 |
$836.21 |
| 87899 |
|
54 |
31 |
$834.20 |
| 86870 |
|
14 |
12 |
$809.54 |
| 84133 |
|
113 |
90 |
$792.56 |
| G8978 |
Mobility current status |
122 |
104 |
$764.61 |
| G8979 |
Mobility goal status |
131 |
110 |
$764.61 |
| 84432 |
|
40 |
37 |
$738.11 |
| 80364 |
|
185 |
156 |
$731.10 |
| 58100 |
|
12 |
12 |
$715.50 |
| V5264 |
Ear mold/insert |
18 |
18 |
$681.86 |
| 86812 |
|
31 |
30 |
$678.28 |
| 76506 |
|
12 |
12 |
$676.40 |
| 92552 |
|
39 |
38 |
$674.70 |
| 36000 |
|
44 |
43 |
$653.61 |
| 76818 |
|
22 |
14 |
$630.15 |
| 92567 |
|
41 |
39 |
$619.90 |
| 97530 |
|
215 |
91 |
$594.45 |
| 93288 |
|
119 |
109 |
$591.52 |
| 82077 |
|
3,132 |
2,609 |
$575.21 |
| 73565 |
|
25 |
25 |
$535.50 |
| 87653 |
|
17 |
17 |
$495.82 |
| 87517 |
|
14 |
12 |
$485.78 |
| 86301 |
|
28 |
26 |
$432.55 |
| 88108 |
|
21 |
12 |
$429.00 |
| 85597 |
|
24 |
24 |
$389.94 |
| 86593 |
|
94 |
89 |
$352.05 |
| 83550 |
|
63 |
44 |
$340.65 |
| 82668 |
|
31 |
28 |
$327.45 |
| 81015 |
|
107 |
106 |
$303.22 |
| 86677 |
|
12 |
12 |
$291.48 |
| 83498 |
|
13 |
13 |
$285.37 |
| J2919 |
Inj, methylpred sod succ 5mg |
249 |
161 |
$271.47 |
| 80051 |
|
88 |
88 |
$260.43 |
| 0077U |
|
325 |
291 |
$256.47 |
| 84630 |
|
27 |
25 |
$248.65 |
| 82951 |
|
15 |
14 |
$247.07 |
| 85613 |
|
27 |
26 |
$242.20 |
| 90656 |
|
33 |
33 |
$234.67 |
| 84425 |
|
12 |
12 |
$220.75 |
| 84410 |
|
14 |
13 |
$207.27 |
| J3489 |
Zoledronic acid 1mg |
14 |
13 |
$205.47 |
| 36902 |
|
13 |
12 |
$196.00 |
| 90662 |
|
123 |
119 |
$193.85 |
| 83090 |
|
13 |
13 |
$189.76 |
| 86625 |
|
17 |
14 |
$186.00 |
| 94760 |
|
149 |
129 |
$178.93 |
| 73100 |
|
20 |
17 |
$172.00 |
| 86705 |
|
14 |
13 |
$167.76 |
| 84446 |
|
12 |
12 |
$164.20 |
| J1610 |
Glucagon hydrochloride/1 mg |
13 |
13 |
$154.99 |
| 86787 |
|
15 |
13 |
$145.24 |
| 87116 |
|
17 |
13 |
$136.30 |
| 87045 |
|
17 |
14 |
$133.88 |
| 80299 |
|
32 |
27 |
$132.64 |
| 86231 |
|
14 |
12 |
$126.87 |
| 84155 |
|
26 |
25 |
$117.23 |
| 72070 |
|
12 |
12 |
$116.61 |
| 85384 |
|
15 |
14 |
$111.93 |
| 83695 |
|
33 |
24 |
$110.82 |
| 83930 |
|
18 |
17 |
$87.60 |
| 82340 |
|
16 |
15 |
$73.95 |
| D0140 |
|
22 |
15 |
$70.00 |
| 82310 |
|
15 |
12 |
$58.67 |
| 83935 |
|
17 |
16 |
$52.59 |
| 85347 |
|
44 |
26 |
$47.92 |
| J2305 |
Inj, nitroglycerin, 5 mg |
119 |
100 |
$35.66 |
| 82374 |
|
58 |
54 |
$26.80 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
793 |
646 |
$23.04 |
| J0134 |
Inj acetaminophen -fresenius |
767 |
718 |
$21.63 |
| 82435 |
|
57 |
53 |
$20.93 |
| G0008 |
Admin influenza virus vac |
15 |
15 |
$18.90 |
| J1643 |
Inj heparin, pfizer, 1000u |
205 |
108 |
$17.94 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
54 |
46 |
$13.66 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
170 |
119 |
$9.82 |
| G0498 |
Chemo extend iv infus w/pump |
21 |
13 |
$7.38 |
| 75571 |
|
31 |
27 |
$3.94 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
294 |
274 |
$3.77 |
| C1788 |
Port, indwelling, imp |
54 |
50 |
$3.17 |
| J0137 |
Inj, acetaminophen (hikma) |
61 |
55 |
$0.85 |
| J1920 |
Inj, labetalol hcl, 5mg |
26 |
26 |
$0.51 |
| J2598 |
Inj, vasopressin, 1 unit |
12 |
12 |
$0.18 |
| J2004 |
Inj, lidocaine w epinephrine |
28 |
28 |
$0.07 |
| 90674 |
|
13 |
12 |
$0.06 |
| 80354 |
|
110 |
87 |
$0.00 |
| J0184 |
Inj, amisulpride, 1 mg |
18 |
13 |
$0.00 |
| C9250 |
Artiss fibrin sealant |
32 |
13 |
$0.00 |
| 90935 |
|
17 |
13 |
$0.00 |