| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
89,599 |
85,237 |
$23.81M |
| 99284 |
|
80,963 |
77,045 |
$20.53M |
| G0378 |
Hospital observation per hr |
6,244 |
5,753 |
$9.96M |
| 99214 |
|
60,947 |
58,805 |
$4.50M |
| 43239 |
|
3,492 |
3,412 |
$3.47M |
| J9271 |
Inj pembrolizumab |
1,382 |
1,080 |
$3.36M |
| 99285 |
|
16,056 |
15,069 |
$3.03M |
| 99235 |
|
3,067 |
2,382 |
$2.66M |
| 97110 |
|
15,261 |
5,677 |
$2.53M |
| U0003 |
Cov-19 amp prb hgh thruput |
27,250 |
23,700 |
$1.79M |
| 99204 |
|
17,439 |
17,096 |
$1.77M |
| 99281 |
|
9,933 |
9,161 |
$1.74M |
| 77067 |
|
17,055 |
16,861 |
$1.62M |
| 45380 |
|
1,561 |
1,511 |
$1.53M |
| 45378 |
|
1,051 |
1,024 |
$1.37M |
| 93306 |
|
8,910 |
8,677 |
$1.28M |
| 45385 |
|
1,496 |
1,466 |
$1.25M |
| 99213 |
|
22,514 |
21,894 |
$1.12M |
| 99282 |
|
5,721 |
5,488 |
$1.02M |
| 99215 |
Prolong outpt/office vis |
9,548 |
9,182 |
$957K |
| 11102 |
|
3,475 |
3,380 |
$863K |
| 78815 |
|
807 |
738 |
$754K |
| 96365 |
|
12,227 |
6,187 |
$679K |
| J9299 |
Injection, nivolumab |
190 |
127 |
$662K |
| 95811 |
|
930 |
917 |
$661K |
| 74183 |
|
1,607 |
1,567 |
$627K |
| 96413 |
|
6,874 |
3,962 |
$572K |
| 97162 |
|
2,310 |
2,207 |
$547K |
| 70553 |
|
1,818 |
1,779 |
$524K |
| 49083 |
|
802 |
385 |
$494K |
| 62323 |
|
1,164 |
1,144 |
$459K |
| 77386 |
|
1,451 |
116 |
$434K |
| 76830 |
|
7,275 |
7,148 |
$419K |
| 71250 |
|
5,715 |
5,565 |
$403K |
| J9312 |
Inj., rituximab, 10 mg |
101 |
54 |
$389K |
| 74177 |
|
3,810 |
3,690 |
$388K |
| 76816 |
|
7,958 |
7,545 |
$388K |
| 76642 |
|
6,907 |
5,830 |
$383K |
| 36591 |
|
4,445 |
2,419 |
$381K |
| 77066 |
Tomosynthesis, mammo |
3,266 |
3,206 |
$373K |
| 11104 |
|
1,460 |
1,419 |
$371K |
| 17110 |
|
1,448 |
1,385 |
$371K |
| 97140 |
|
4,614 |
1,888 |
$366K |
| G0121 |
Colon ca scrn not hi rsk ind |
314 |
309 |
$360K |
| 73721 |
|
1,221 |
1,190 |
$356K |
| 76856 |
|
7,586 |
7,456 |
$350K |
| 11900 |
|
1,345 |
1,231 |
$333K |
| J9022 |
Inj, atezolizumab,10 mg |
136 |
87 |
$321K |
| 77063 |
|
12,262 |
12,150 |
$308K |
| 95810 |
|
707 |
688 |
$292K |
| 78452 |
|
1,288 |
1,242 |
$286K |
| 77065 |
Tomosynthesis, mammo |
3,190 |
3,091 |
$259K |
| 93005 |
|
42,799 |
38,581 |
$258K |
| J1745 |
Infliximab not biosimil 10mg |
242 |
217 |
$245K |
| 70450 |
|
6,541 |
6,209 |
$245K |
| 72148 |
|
1,153 |
1,140 |
$236K |
| 43235 |
|
258 |
252 |
$222K |
| G0399 |
Home sleep test/type 3 porta |
1,707 |
1,668 |
$219K |
| J9035 |
Bevacizumab injection |
115 |
42 |
$218K |
| 76817 |
|
4,185 |
3,852 |
$217K |
| 71046 |
|
13,859 |
13,381 |
$205K |
| 10005 |
|
304 |
298 |
$201K |
| 97112 |
|
3,079 |
1,288 |
$195K |
| 59025 |
|
3,897 |
2,268 |
$194K |
| 76811 |
|
1,676 |
1,653 |
$192K |
| 72197 |
|
446 |
436 |
$192K |
| 70551 |
|
773 |
763 |
$188K |
| 99205 |
Prolong outpt/office vis |
1,722 |
1,699 |
$188K |
| 80053 |
|
20,130 |
14,448 |
$160K |
| 99203 |
|
2,399 |
2,368 |
$147K |
| 90792 |
|
701 |
604 |
$147K |
| 76705 |
|
3,113 |
3,064 |
$144K |
| 99212 |
|
3,149 |
2,972 |
$142K |
| 93017 |
|
2,307 |
2,213 |
$137K |
| 93970 |
|
1,354 |
1,318 |
$135K |
| 76805 |
|
2,016 |
2,000 |
$130K |
| J0897 |
Denosumab injection |
226 |
216 |
$129K |
| 76700 |
|
2,223 |
2,171 |
$124K |
| 76770 |
|
2,302 |
2,263 |
$123K |
| 93451 |
|
83 |
74 |
$122K |
| 20610 |
|
954 |
839 |
$122K |
| 97530 |
|
1,055 |
458 |
$120K |
| 76815 |
|
3,261 |
2,256 |
$120K |
| 76813 |
|
2,105 |
2,080 |
$117K |
| G2066 |
Inter devc remote 30d |
2,936 |
2,836 |
$116K |
| 74178 |
|
429 |
421 |
$111K |
| J2785 |
Regadenoson injection |
1,857 |
1,833 |
$110K |
| 76536 |
|
1,837 |
1,807 |
$109K |
| A9502 |
Tc99m tetrofosmin |
1,343 |
1,301 |
$109K |
| 85025 |
|
46,033 |
35,242 |
$108K |
| 96372 |
|
13,030 |
11,504 |
$107K |
| 97161 |
|
453 |
436 |
$106K |
| 58558 |
|
92 |
92 |
$105K |
| 96375 |
|
4,179 |
2,345 |
$104K |
| 88305 |
|
9,052 |
8,307 |
$103K |
| 77336 |
|
2,402 |
1,036 |
$102K |
| J1439 |
Inj ferric carboxymaltos 1mg |
317 |
219 |
$100K |
| 73221 |
|
383 |
374 |
$99K |
| 93975 |
|
1,091 |
1,067 |
$99K |
| 86833 |
|
1,038 |
957 |
$95K |
| 71260 |
|
1,178 |
1,153 |
$95K |
| 77080 |
|
2,019 |
1,987 |
$94K |
| 80048 |
|
25,204 |
19,396 |
$92K |
| J9217 |
Leuprolide acetate suspnsion |
825 |
804 |
$91K |
| G0463 |
Hospital outpt clinic visit |
16,588 |
14,992 |
$91K |
| 94660 |
|
822 |
780 |
$86K |
| 73564 |
|
4,437 |
3,117 |
$86K |
| 99202 |
|
1,723 |
1,705 |
$84K |
| G0105 |
Colorectal scrn; hi risk ind |
82 |
77 |
$81K |
| 72141 |
|
309 |
307 |
$80K |
| 77062 |
|
2,579 |
2,539 |
$77K |
| 78832 |
|
149 |
134 |
$76K |
| 73630 |
|
5,354 |
4,505 |
$74K |
| 97535 |
|
814 |
707 |
$73K |
| 88172 |
|
518 |
497 |
$71K |
| 94729 |
|
2,116 |
2,070 |
$69K |
| Q5107 |
Inj mvasi 10 mg |
96 |
52 |
$68K |
| Q5111 |
Injection, udenyca 0.5 mg |
18 |
12 |
$68K |
| 77334 |
|
649 |
460 |
$65K |
| 76801 |
|
1,271 |
1,232 |
$65K |
| 74176 |
|
962 |
940 |
$64K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
173 |
168 |
$63K |
| 86832 |
|
687 |
614 |
$63K |
| G0108 |
Diab manage trn per indiv |
923 |
851 |
$62K |
| 73030 |
|
3,875 |
3,309 |
$61K |
| 66984 |
|
98 |
95 |
$60K |
| J1756 |
Iron sucrose injection |
9,227 |
3,737 |
$59K |
| 94726 |
|
1,941 |
1,896 |
$57K |
| 72100 |
|
2,248 |
2,223 |
$57K |
| 11103 |
|
838 |
807 |
$56K |
| 76376 |
|
5,735 |
5,547 |
$55K |
| 99291 |
|
215 |
207 |
$54K |
| 94640 |
|
2,639 |
2,335 |
$54K |
| 94618 |
|
2,149 |
2,089 |
$54K |
| 93976 |
|
636 |
627 |
$54K |
| 77061 |
|
1,868 |
1,835 |
$54K |
| 71271 |
|
528 |
516 |
$54K |
| 94060 |
|
2,114 |
2,061 |
$50K |
| 93923 |
|
838 |
814 |
$50K |
| 77412 |
|
1,044 |
133 |
$49K |
| A9270 |
Non-covered item or service |
38,149 |
17,657 |
$46K |
| 93880 |
|
473 |
462 |
$46K |
| U0001 |
2019-ncov diagnostic p |
2,914 |
2,460 |
$45K |
| 64615 |
|
217 |
214 |
$45K |
| H0047 |
Alcohol/drug abuse svc nos |
926 |
816 |
$44K |
| J2505 |
Injection, pegfilgrastim 6mg |
50 |
37 |
$44K |
| 74246 |
|
839 |
825 |
$44K |
| 84703 |
|
11,733 |
11,077 |
$44K |
| 96367 |
|
2,133 |
1,286 |
$42K |
| 76819 |
|
679 |
422 |
$41K |
| 71045 |
|
10,734 |
9,852 |
$41K |
| 97163 |
|
276 |
263 |
$41K |
| 96417 |
|
988 |
636 |
$41K |
| 73610 |
|
2,721 |
2,417 |
$40K |
| 93226 |
|
1,013 |
997 |
$40K |
| 11042 |
|
502 |
312 |
$39K |
| 88173 |
|
522 |
500 |
$39K |
| 82948 |
|
23,507 |
17,720 |
$38K |
| 96415 |
|
1,300 |
842 |
$37K |
| 91010 |
|
298 |
286 |
$36K |
| 0002A |
|
883 |
753 |
$35K |
| OP250 |
|
3,577 |
671 |
$35K |
| Q3014 |
Telehealth facility fee |
4,865 |
4,601 |
$34K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
14,127 |
13,573 |
$34K |
| 83735 |
|
10,753 |
6,145 |
$33K |
| 71275 |
|
611 |
587 |
$33K |
| 96411 |
|
496 |
292 |
$31K |
| 93971 |
|
536 |
515 |
$31K |
| 91034 |
|
177 |
170 |
$31K |
| 95819 |
|
793 |
772 |
$30K |
| 72110 |
|
1,069 |
1,044 |
$30K |
| 73130 |
|
2,635 |
2,231 |
$30K |
| 70486 |
|
665 |
647 |
$29K |
| 36561 |
|
28 |
26 |
$28K |
| 93225 |
|
1,024 |
1,008 |
$27K |
| 72125 |
|
1,300 |
1,236 |
$26K |
| 76818 |
|
385 |
306 |
$26K |
| 0001A |
|
954 |
869 |
$26K |
| 77301 |
|
37 |
37 |
$26K |
| A9579 |
Gad-base mr contrast nos,1ml |
2,178 |
2,077 |
$26K |
| 76820 |
|
738 |
275 |
$24K |
| 81003 |
|
12,968 |
8,643 |
$24K |
| J1453 |
Fosaprepitant injection |
736 |
440 |
$23K |
| 93296 |
|
1,082 |
1,023 |
$23K |
| 96402 |
|
1,014 |
935 |
$23K |
| 97116 |
|
737 |
469 |
$23K |
| 82803 |
|
1,890 |
1,740 |
$22K |
| 93456 |
|
15 |
15 |
$21K |
| 77300 |
|
308 |
282 |
$21K |
| 10060 |
|
210 |
207 |
$21K |
| 0241U |
|
1,019 |
812 |
$21K |
| 84484 |
|
13,230 |
10,992 |
$21K |
| Q0138 |
Ferumoxytol, non-esrd |
304 |
200 |
$21K |
| 87631 |
|
1,136 |
738 |
$21K |
| 78264 |
|
185 |
185 |
$20K |
| 73560 |
|
1,129 |
855 |
$20K |
| 0003A |
|
706 |
650 |
$20K |
| 88313 |
|
812 |
760 |
$19K |
| 78454 |
|
169 |
156 |
$19K |
| 85027 |
|
6,759 |
5,548 |
$19K |
| 92526 |
|
61 |
30 |
$19K |
| 76981 |
|
412 |
406 |
$18K |
| 81025 |
|
3,359 |
3,299 |
$18K |
| 70491 |
|
213 |
212 |
$18K |
| 88177 |
|
518 |
497 |
$17K |
| G0390 |
Trauma respons w/hosp criti |
381 |
369 |
$17K |
| J0185 |
Inj., aprepitant, 1 mg |
528 |
337 |
$17K |
| 43237 |
|
14 |
14 |
$17K |
| 64721 |
|
26 |
25 |
$17K |
| 76775 |
|
333 |
331 |
$17K |
| 93922 |
|
534 |
511 |
$16K |
| 97010 |
|
1,025 |
366 |
$16K |
| Q5108 |
Injection, fulphila |
40 |
27 |
$15K |
| 73502 |
|
860 |
814 |
$15K |
| 94010 |
|
793 |
775 |
$14K |
| 86803 |
|
5,931 |
5,700 |
$14K |
| 96366 |
|
806 |
575 |
$14K |
| 97032 |
|
208 |
97 |
$14K |
| 72050 |
|
427 |
419 |
$14K |
| 93000 |
|
793 |
773 |
$13K |
| 92610 |
|
92 |
87 |
$13K |
| 19083 |
|
26 |
26 |
$13K |
| 80307 |
|
754 |
701 |
$13K |
| 96401 |
|
264 |
104 |
$12K |
| 73523 |
|
308 |
299 |
$12K |
| Q0092 |
Set up port xray equipment |
3,101 |
2,986 |
$12K |
| 76870 |
|
293 |
289 |
$11K |
| 97035 |
|
335 |
95 |
$11K |
| 78306 |
|
187 |
176 |
$11K |
| C1729 |
Cath, drainage |
95 |
77 |
$10K |
| 73700 |
|
189 |
183 |
$10K |
| 73110 |
|
1,075 |
914 |
$10K |
| 93041 |
|
1,333 |
1,251 |
$10K |
| 72131 |
|
177 |
176 |
$10K |
| 73120 |
|
584 |
327 |
$10K |
| 64405 |
|
57 |
56 |
$10K |
| 80365 |
|
1,158 |
1,077 |
$9K |
| 97164 |
|
81 |
80 |
$9K |
| 90471 |
|
2,106 |
1,936 |
$9K |
| 74230 |
|
293 |
283 |
$9K |
| 0072A |
|
372 |
372 |
$9K |
| J0640 |
Leucovorin calcium injection |
481 |
226 |
$9K |
| 82962 |
|
4,396 |
4,292 |
$9K |
| 86849 |
|
881 |
780 |
$9K |
| G0480 |
Drug test def 1-7 classes |
657 |
604 |
$9K |
| 73562 |
|
452 |
382 |
$8K |
| 36430 |
|
339 |
217 |
$8K |
| 88341 |
|
1,615 |
1,544 |
$8K |
| 86850 |
|
3,512 |
3,064 |
$8K |
| 72040 |
|
416 |
408 |
$8K |
| 99024 |
|
451 |
407 |
$8K |
| 74174 |
|
57 |
55 |
$7K |
| S0028 |
Injection, famotidine, 20 mg |
3,118 |
2,273 |
$7K |
| 87389 |
|
1,665 |
1,596 |
$7K |
| 73590 |
|
664 |
574 |
$7K |
| 29125 |
|
45 |
44 |
$7K |
| 45390 |
|
19 |
15 |
$7K |
| 38222 |
|
18 |
14 |
$6K |
| 88312 |
|
267 |
248 |
$6K |
| 72070 |
|
273 |
266 |
$6K |
| 76882 |
|
340 |
283 |
$6K |
| 87491 |
|
2,068 |
1,947 |
$6K |
| 36600 |
|
471 |
453 |
$6K |
| 92611 |
|
144 |
140 |
$6K |
| C1751 |
Cath, inf, per/cent/midline |
106 |
97 |
$6K |
| 72114 |
|
214 |
206 |
$6K |
| 70544 |
|
27 |
27 |
$6K |
| 80361 |
|
1,020 |
945 |
$6K |
| J9045 |
Carboplatin injection |
568 |
388 |
$6K |
| 0004A |
|
379 |
377 |
$5K |
| 78315 |
|
53 |
53 |
$5K |
| 86900 |
|
3,911 |
3,256 |
$5K |
| 88185 |
|
22 |
18 |
$5K |
| J3489 |
Zoledronic acid 1mg |
313 |
294 |
$5K |
| 74420 |
|
54 |
51 |
$5K |
| P9016 |
Rbc leukocytes reduced |
108 |
87 |
$5K |
| 87591 |
|
2,047 |
1,925 |
$5K |
| A9552 |
F18 fdg |
240 |
230 |
$5K |
| 72156 |
|
17 |
17 |
$5K |
| 70498 |
|
45 |
45 |
$5K |
| 87040 |
|
849 |
756 |
$5K |
| 86901 |
|
3,891 |
3,235 |
$5K |
| 85610 |
|
3,724 |
3,166 |
$5K |
| 70496 |
|
45 |
44 |
$5K |
| 0071A |
|
441 |
438 |
$5K |
| 97166 |
|
31 |
30 |
$4K |
| 84100 |
|
3,432 |
2,108 |
$4K |
| 85730 |
|
2,378 |
2,095 |
$4K |
| 96360 |
|
108 |
39 |
$4K |
| 77290 |
|
77 |
60 |
$4K |
| 97802 |
|
69 |
68 |
$4K |
| 93351 |
|
13 |
13 |
$4K |
| J7030 |
Normal saline solution infus |
6,785 |
6,184 |
$4K |
| 74170 |
|
29 |
28 |
$4K |
| 93298 |
|
250 |
236 |
$4K |
| 96368 |
|
552 |
312 |
$4K |
| 73080 |
|
463 |
439 |
$4K |
| 81001 |
|
3,655 |
3,317 |
$4K |
| J2930 |
Methylprednisolone injection |
1,642 |
1,315 |
$4K |
| 83880 |
|
1,206 |
1,088 |
$4K |
| 90715 |
|
2,077 |
2,037 |
$3K |
| 73552 |
|
278 |
243 |
$3K |
| 74018 |
|
295 |
270 |
$3K |
| J2469 |
Palonosetron hcl |
543 |
325 |
$3K |
| 74160 |
|
25 |
25 |
$3K |
| 73620 |
|
190 |
129 |
$3K |
| C1769 |
Guide wire |
397 |
365 |
$3K |
| 77295 |
|
15 |
13 |
$3K |
| 84443 |
|
1,376 |
1,284 |
$3K |
| G0109 |
Diab manage trn ind/group |
21 |
16 |
$3K |
| C1887 |
Catheter, guiding |
67 |
62 |
$3K |
| 72052 |
|
86 |
83 |
$3K |
| 85007 |
|
1,499 |
1,022 |
$3K |
| 83605 |
|
1,784 |
1,578 |
$3K |
| 80197 |
|
406 |
162 |
$3K |
| J1100 |
Dexamethasone sodium phos |
9,765 |
7,423 |
$3K |
| J2704 |
Inj, propofol, 10 mg |
11,422 |
10,774 |
$3K |
| J1170 |
Hydromorphone injection |
6,488 |
4,121 |
$3K |
| 83615 |
|
1,485 |
774 |
$3K |
| 87086 |
|
1,724 |
1,524 |
$3K |
| J9267 |
Paclitaxel injection |
178 |
94 |
$3K |
| 80354 |
|
618 |
583 |
$3K |
| T1015 |
Clinic service |
45 |
26 |
$3K |
| 84702 |
|
1,153 |
1,000 |
$2K |
| 87522 |
Neg quan hep c or qual rna |
337 |
323 |
$2K |
| 93248 |
|
240 |
236 |
$2K |
| 78803 |
|
28 |
26 |
$2K |
| 73140 |
|
253 |
238 |
$2K |
| 97597 |
|
73 |
37 |
$2K |
| 73100 |
|
144 |
127 |
$2K |
| J9070 |
Cyclophosphamide 100 mg inj |
88 |
41 |
$2K |
| 73090 |
|
469 |
420 |
$2K |
| 80061 |
|
1,107 |
1,058 |
$2K |
| 97602 |
|
93 |
76 |
$2K |
| J3301 |
Triamcinolone acet inj nos |
1,611 |
1,525 |
$2K |
| 93295 |
|
110 |
104 |
$2K |
| 83036 |
|
1,919 |
1,827 |
$2K |
| 95812 |
|
28 |
27 |
$2K |
| 86923 |
|
175 |
148 |
$2K |
| 83690 |
|
2,939 |
2,669 |
$2K |
| 82728 |
|
657 |
546 |
$2K |
| J2405 |
Ondansetron hcl injection |
15,673 |
12,300 |
$2K |
| J2790 |
Rho d immune globulin inj |
47 |
42 |
$2K |
| 31575 |
|
30 |
24 |
$2K |
| 82570 |
|
596 |
389 |
$2K |
| 75635 |
|
12 |
12 |
$2K |
| J8540 |
Oral dexamethasone |
3,288 |
1,922 |
$2K |
| 86780 |
|
1,000 |
958 |
$2K |
| 73060 |
|
255 |
219 |
$2K |
| 93926 |
|
24 |
24 |
$2K |
| 77280 |
|
46 |
38 |
$2K |
| 99152 |
|
617 |
574 |
$2K |
| 99153 |
Mod sedat endo service >5yrs |
548 |
504 |
$2K |
| 73070 |
|
127 |
102 |
$2K |
| 71101 |
|
211 |
209 |
$2K |
| 73200 |
|
27 |
25 |
$1K |
| 80076 |
|
1,639 |
1,346 |
$1K |
| J2710 |
Neostigmine methylslfte inj |
704 |
677 |
$1K |
| A9503 |
Tc99m medronate |
127 |
124 |
$1K |
| 88112 |
|
138 |
129 |
$1K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
439 |
428 |
$1K |
| 82784 |
|
229 |
136 |
$1K |
| A9580 |
Sodium fluoride f-18 |
16 |
14 |
$1K |
| 90688 |
|
206 |
206 |
$1K |
| J9190 |
Fluorouracil injection |
358 |
172 |
$1K |
| 76641 |
|
16 |
15 |
$1K |
| J9206 |
Irinotecan injection |
49 |
24 |
$1K |
| J2270 |
Morphine sulfate injection |
3,024 |
2,518 |
$1K |
| 90656 |
|
51 |
51 |
$1K |
| J3490 |
Drugs unclassified injection |
10,498 |
6,203 |
$1K |
| J0690 |
Cefazolin sodium injection |
2,776 |
2,397 |
$1K |
| 83540 |
|
459 |
384 |
$1K |
| 85379 |
|
958 |
873 |
$1K |
| 87186 |
|
809 |
766 |
$1K |
| 84156 |
|
481 |
272 |
$981.45 |
| J3370 |
Vancomycin hcl injection |
1,427 |
875 |
$980.59 |
| 76825 |
|
13 |
13 |
$972.51 |
| 96523 |
|
69 |
68 |
$955.88 |
| J0330 |
Succinycholine chloride inj |
816 |
790 |
$908.20 |
| C1894 |
Intro/sheath, non-laser |
397 |
367 |
$863.20 |
| A9541 |
Tc99m sulfur colloid |
104 |
103 |
$838.53 |
| 87077 |
|
916 |
849 |
$819.40 |
| 20552 |
|
13 |
13 |
$758.25 |
| 88307 |
|
388 |
379 |
$757.00 |
| 73600 |
|
55 |
42 |
$731.49 |
| 84153 |
|
94 |
85 |
$723.07 |
| 92523 |
|
12 |
12 |
$704.54 |
| 76937 |
|
256 |
231 |
$678.44 |
| 94727 |
|
30 |
30 |
$676.03 |
| 99211 |
|
28 |
28 |
$662.34 |
| G0279 |
Tomosynthesis, mammo |
86 |
86 |
$655.51 |
| 93246 |
|
15 |
13 |
$655.29 |
| 36415 |
|
451 |
435 |
$640.92 |
| 0012A |
|
14 |
14 |
$636.40 |
| 76942 |
|
52 |
50 |
$635.07 |
| J1650 |
Inj enoxaparin sodium |
5,972 |
2,980 |
$628.37 |
| 83550 |
|
447 |
370 |
$622.71 |
| J1200 |
Diphenhydramine hcl injectio |
5,140 |
3,794 |
$610.34 |
| 93325 |
|
13 |
12 |
$585.42 |
| 84550 |
|
213 |
137 |
$577.84 |
| 90686 |
|
124 |
118 |
$572.31 |
| 0011A |
|
67 |
67 |
$554.40 |
| J1815 |
Insulin injection |
3,373 |
1,433 |
$549.59 |
| J1644 |
Inj heparin sodium per 1000u |
4,280 |
2,130 |
$531.13 |
| J3010 |
Fentanyl citrate injection |
7,512 |
6,830 |
$512.85 |
| 88342 |
|
160 |
144 |
$504.00 |
| P9040 |
Rbc leukoreduced irradiated |
16 |
12 |
$481.91 |
| 82550 |
|
762 |
643 |
$467.04 |
| 82607 |
|
275 |
258 |
$464.97 |
| 90746 |
|
26 |
25 |
$461.24 |
| 87497 |
|
39 |
24 |
$459.39 |
| 85384 |
|
193 |
169 |
$458.56 |
| C9113 |
Inj pantoprazole sodium, via |
850 |
544 |
$453.62 |
| 87070 |
|
530 |
501 |
$423.52 |
| J1885 |
Ketorolac tromethamine inj |
10,826 |
9,675 |
$410.42 |
| 83883 |
|
36 |
26 |
$409.85 |
| J0131 |
Inj, acetaminophen (nos) |
126 |
111 |
$409.50 |
| 90662 |
|
47 |
46 |
$408.28 |
| J3480 |
Inj potassium chloride |
1,082 |
764 |
$407.51 |
| J2370 |
Phenylephrine hcl injection |
1,152 |
1,037 |
$405.85 |
| 88184 |
|
22 |
18 |
$395.98 |
| 72202 |
|
17 |
17 |
$393.35 |
| 77002 |
|
25 |
25 |
$384.58 |
| 87205 |
|
441 |
423 |
$369.19 |
| 86022 |
|
55 |
54 |
$360.01 |
| 72170 |
|
37 |
36 |
$358.70 |
| 76857 |
|
13 |
13 |
$353.09 |
| 70487 |
|
13 |
12 |
$340.67 |
| 87340 |
|
95 |
88 |
$321.88 |
| J2250 |
Inj midazolam hydrochloride |
6,642 |
6,111 |
$313.55 |
| 86140 |
|
548 |
476 |
$309.89 |
| 96374 |
|
15 |
13 |
$290.86 |
| J2795 |
Ropivacaine hcl injection |
358 |
348 |
$279.31 |
| 82746 |
|
143 |
139 |
$271.64 |
| 80320 |
|
265 |
253 |
$269.88 |
| 73660 |
|
29 |
27 |
$267.54 |
| J3420 |
Vitamin b12 injection |
672 |
561 |
$252.89 |
| J9263 |
Oxaliplatin |
60 |
39 |
$237.30 |
| J0696 |
Ceftriaxone sodium injection |
3,393 |
2,950 |
$227.48 |
| A9540 |
Tc99m maa |
13 |
13 |
$227.03 |
| 87661 |
|
28 |
28 |
$224.13 |
| 87400 |
|
107 |
104 |
$218.52 |
| 86334 |
|
32 |
27 |
$206.79 |
| 88309 |
|
78 |
74 |
$206.52 |
| 94644 |
|
126 |
116 |
$201.40 |
| 85651 |
|
181 |
168 |
$200.86 |
| J0171 |
Adrenalin epinephrine inject |
186 |
169 |
$195.95 |
| J2765 |
Metoclopramide hcl injection |
2,156 |
1,969 |
$192.74 |
| J1630 |
Haloperidol injection |
708 |
644 |
$179.33 |
| J3475 |
Inj magnesium sulfate |
1,078 |
751 |
$177.18 |
| J0461 |
Atropine sulfate injection |
41 |
25 |
$176.69 |
| 88304 |
|
175 |
173 |
$171.91 |
| 87426 |
|
69 |
63 |
$167.09 |
| 86706 |
|
27 |
27 |
$165.94 |
| 84439 |
|
135 |
134 |
$162.89 |
| 94760 |
|
395 |
377 |
$155.13 |
| 80368 |
|
74 |
73 |
$147.52 |
| 94799 |
|
149 |
118 |
$146.78 |
| 93010 |
|
29 |
27 |
$144.00 |
| 82105 |
|
14 |
12 |
$140.57 |
| 88311 |
|
48 |
43 |
$140.47 |
| J0670 |
Inj mepivacaine hcl/10 ml |
197 |
195 |
$140.30 |
| 93294 |
|
15 |
12 |
$130.90 |
| J1030 |
Methylprednisolone 40 mg inj |
27 |
26 |
$129.60 |
| 84165 |
|
67 |
41 |
$123.62 |
| 87075 |
|
94 |
88 |
$112.26 |
| 84132 |
|
76 |
71 |
$110.64 |
| 77001 |
|
13 |
13 |
$109.97 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
489 |
426 |
$102.43 |
| 81000 |
|
250 |
228 |
$100.67 |
| 94761 |
|
470 |
427 |
$99.72 |
| Q0162 |
Ondansetron oral |
2,657 |
1,962 |
$97.40 |
| 82248 |
|
27 |
26 |
$96.78 |
| 87210 |
|
264 |
262 |
$96.46 |
| J7512 |
Prednisone ir or dr oral 1mg |
2,673 |
1,845 |
$90.04 |
| 82306 |
|
29 |
29 |
$87.90 |
| J2543 |
Piperacillin/tazobactam |
859 |
411 |
$75.12 |
| 80164 |
|
17 |
12 |
$72.14 |
| 99406 |
|
25 |
25 |
$54.93 |
| J2060 |
Lorazepam injection |
988 |
801 |
$44.14 |
| 87081 |
|
115 |
109 |
$41.24 |
| J7613 |
Albuterol non-comp unit |
1,458 |
1,133 |
$41.02 |
| 87116 |
|
18 |
16 |
$36.38 |
| 94762 |
|
18 |
16 |
$34.96 |
| G0008 |
Admin influenza virus vac |
58 |
57 |
$31.25 |
| 84155 |
|
32 |
27 |
$29.79 |
| 87102 |
|
15 |
14 |
$27.65 |
| 82330 |
|
13 |
12 |
$26.20 |
| 82013 |
|
15 |
12 |
$25.87 |
| 85018 |
|
37 |
33 |
$24.55 |
| 82043 |
|
29 |
29 |
$23.87 |
| 84478 |
|
35 |
34 |
$20.49 |
| J0360 |
Hydralazine hcl injection |
64 |
62 |
$18.34 |
| J1940 |
Furosemide injection |
346 |
236 |
$17.84 |
| C1758 |
Catheter, ureteral |
35 |
31 |
$16.97 |
| 0064A |
|
67 |
67 |
$16.60 |
| 87206 |
|
19 |
16 |
$14.55 |
| 90472 |
|
16 |
12 |
$13.65 |
| 80345 |
|
12 |
12 |
$12.46 |
| J2004 |
Inj, lidocaine w epinephrine |
98 |
97 |
$10.27 |
| J7620 |
Albuterol ipratrop non-comp |
1,691 |
1,249 |
$8.98 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
261 |
183 |
$8.75 |
| 86870 |
|
12 |
12 |
$8.45 |
| J7644 |
Ipratropium bromide non-comp |
1,549 |
1,272 |
$7.18 |
| G9920 |
Scrning perf and negative |
1,048 |
917 |
$4.01 |
| 86592 |
|
15 |
15 |
$4.00 |
| 82270 |
|
13 |
13 |
$3.47 |
| 88300 |
|
49 |
47 |
$2.92 |
| G9919 |
Scrn nd pos nd prov of rec |
228 |
209 |
$0.43 |
| J2471 |
Inj pantoprazole(hikma) 40mg |
80 |
43 |
$0.00 |
| J1817 |
Insulin for insulin pump use |
1,145 |
507 |
$0.00 |
| C9399 |
Unclassified drugs or biolog |
141 |
133 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
301 |
287 |
$0.00 |
| J3411 |
Thiamine hcl 100 mg |
37 |
24 |
$0.00 |
| J2350 |
Injection, ocrelizumab, 1 mg |
76 |
74 |
$0.00 |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
401 |
385 |
$0.00 |
| J1790 |
Droperidol injection |
207 |
199 |
$0.00 |
| S0020 |
Injection, bupivicaine hydro |
26 |
26 |
$0.00 |
| Q5115 |
Inj truxima 10 mg |
24 |
13 |
$0.00 |
| J2001 |
Lidocaine injection |
1,197 |
1,132 |
$0.00 |
| Q5120 |
Inj pegfilgrastim-bmez 0.5mg |
65 |
54 |
$0.00 |
| 90375 |
|
14 |
12 |
$0.00 |
| J2305 |
Inj, nitroglycerin, 5 mg |
12 |
12 |
$0.00 |
| J1920 |
Inj, labetalol hcl, 5mg |
13 |
13 |
$0.00 |
| J2404 |
Inj, nicardipine 0.1 mg |
12 |
12 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
20 |
16 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
1,074 |
1,052 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,220 |
1,187 |
$0.00 |
| J2310 |
Inj naloxone hydrochloride |
38 |
36 |
$0.00 |
| J2506 |
Inj pegfilgrast ex bio 0.5mg |
54 |
39 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
284 |
224 |
$0.00 |
| J9305 |
Inj. pemetrexed nos 10mg |
101 |
49 |
$0.00 |
| J1953 |
Levetiracetam injection |
164 |
132 |
$0.00 |
| J0688 |
Inj cefazolin sodium, hikma |
34 |
25 |
$0.00 |
| J2916 |
Na ferric gluconate complex |
298 |
145 |
$0.00 |
| J9041 |
Injection, bortezomib, 0.1mg |
430 |
145 |
$0.00 |
| 87633 |
|
37 |
37 |
$0.00 |
| J0741 |
Inj, cabote rilpivir 2mg 3mg |
158 |
158 |
$0.00 |
| J0736 |
Inj, clindamycin phosp 300mg |
14 |
14 |
$0.00 |
| J8499 |
Oral prescrip drug non chemo |
53 |
37 |
$0.00 |
| 90791 |
|
55 |
48 |
$0.00 |
| J0137 |
Inj, acetaminophen (hikma) |
17 |
14 |
$0.00 |
| 88302 |
|
28 |
24 |
$0.00 |
| 0013A |
|
47 |
47 |
$0.00 |
| J3250 |
Trimethobenzamide hcl inj |
16 |
13 |
$0.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
25 |
14 |
$0.00 |
| 89051 |
|
26 |
25 |
$0.00 |