| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpt clinic visit |
377,050 |
310,562 |
$31.71M |
| 99283 |
|
117,675 |
110,898 |
$13.96M |
| 99214 |
|
240,161 |
228,502 |
$11.78M |
| 99213 |
|
193,321 |
185,262 |
$8.20M |
| 96361 |
|
26,319 |
23,111 |
$7.99M |
| 99284 |
|
69,187 |
64,105 |
$6.40M |
| 99285 |
|
41,662 |
38,621 |
$3.59M |
| J9271 |
Inj pembrolizumab |
695 |
526 |
$2.84M |
| 74177 |
|
13,239 |
12,800 |
$2.29M |
| 99282 |
|
21,020 |
20,189 |
$1.88M |
| 92507 |
|
39,284 |
16,641 |
$1.72M |
| 99392 |
|
20,558 |
20,454 |
$1.64M |
| 96365 |
|
16,489 |
11,604 |
$1.62M |
| 97110 |
|
56,140 |
22,580 |
$1.57M |
| 97530 |
|
38,363 |
18,196 |
$1.45M |
| 93306 |
|
15,148 |
14,498 |
$1.45M |
| 99281 |
|
10,488 |
10,185 |
$1.41M |
| 96413 |
|
17,786 |
11,003 |
$1.35M |
| 99391 |
|
17,365 |
17,034 |
$1.27M |
| 70450 |
|
9,138 |
8,770 |
$1.24M |
| 44970 |
|
381 |
378 |
$1.17M |
| 99233 |
Prolong inpt eval add15 m |
29,160 |
12,728 |
$1.13M |
| 96360 |
|
7,996 |
7,328 |
$1.07M |
| 96366 |
|
4,420 |
3,129 |
$1.05M |
| 74176 |
|
5,408 |
5,260 |
$947K |
| 76705 |
|
10,524 |
10,264 |
$918K |
| 99232 |
|
31,326 |
11,893 |
$882K |
| 11042 |
|
7,816 |
3,306 |
$865K |
| 99215 |
Prolong outpt/office vis |
12,228 |
11,619 |
$859K |
| 43239 |
|
4,549 |
4,321 |
$794K |
| 99393 |
|
9,232 |
9,208 |
$769K |
| 99479 |
|
9,948 |
2,160 |
$737K |
| 78452 |
|
2,254 |
2,157 |
$710K |
| 96415 |
|
3,763 |
2,700 |
$704K |
| U0003 |
Cov-19 amp prb hgh thruput |
10,112 |
9,659 |
$704K |
| 70553 |
|
3,074 |
3,023 |
$681K |
| 99203 |
|
11,279 |
11,139 |
$627K |
| 76830 |
|
8,920 |
8,696 |
$598K |
| 99223 |
Prolong inpt eval add15 m |
7,883 |
7,623 |
$575K |
| 71275 |
|
3,612 |
3,512 |
$555K |
| 76816 |
|
9,756 |
8,714 |
$547K |
| J0585 |
Injection,onabotulinumtoxina |
2,870 |
2,387 |
$537K |
| 99204 |
|
7,650 |
7,511 |
$533K |
| 17110 |
|
3,067 |
2,804 |
$529K |
| 12001 |
|
2,573 |
2,545 |
$521K |
| 99480 |
|
5,853 |
1,569 |
$425K |
| 80053 |
|
92,593 |
78,321 |
$422K |
| 97140 |
|
19,802 |
8,601 |
$421K |
| 96367 |
|
6,485 |
3,992 |
$415K |
| 70551 |
|
2,263 |
2,211 |
$409K |
| 62323 |
|
2,965 |
2,690 |
$403K |
| 64615 |
|
2,460 |
2,401 |
$401K |
| 97112 |
|
14,183 |
6,471 |
$392K |
| 90960 |
|
6,152 |
6,005 |
$380K |
| 99291 |
|
5,063 |
3,383 |
$376K |
| 80307 |
|
11,746 |
10,795 |
$362K |
| 12011 |
|
1,620 |
1,602 |
$356K |
| 76856 |
|
3,928 |
3,823 |
$356K |
| 97113 |
|
7,227 |
2,941 |
$353K |
| 76775 |
|
4,347 |
4,280 |
$352K |
| 76819 |
|
6,827 |
3,967 |
$347K |
| 78815 |
|
807 |
791 |
$345K |
| G0378 |
Hospital observation per hr |
18,394 |
9,030 |
$333K |
| 72148 |
|
2,817 |
2,788 |
$332K |
| 59025 |
|
4,620 |
3,410 |
$332K |
| 76642 |
|
4,141 |
3,871 |
$323K |
| J2323 |
Natalizumab injection |
311 |
272 |
$322K |
| J0129 |
Abatacept injection |
549 |
470 |
$319K |
| 96110 |
|
11,979 |
11,248 |
$315K |
| 76817 |
|
6,442 |
5,808 |
$311K |
| 99238 |
|
6,534 |
6,384 |
$307K |
| 93971 |
|
3,794 |
3,652 |
$302K |
| 97161 |
|
6,865 |
6,692 |
$301K |
| 99469 |
|
1,259 |
319 |
$299K |
| 76805 |
|
4,428 |
4,375 |
$279K |
| 92523 |
|
2,236 |
2,212 |
$278K |
| 90686 |
|
19,639 |
19,517 |
$275K |
| 92588 |
|
2,307 |
2,196 |
$272K |
| 52000 |
|
503 |
488 |
$267K |
| 99239 |
|
6,526 |
6,306 |
$266K |
| 96416 |
|
1,150 |
633 |
$265K |
| 31575 |
|
1,869 |
1,839 |
$264K |
| 99460 |
|
3,508 |
3,420 |
$254K |
| 76811 |
|
2,716 |
2,659 |
$245K |
| 76536 |
|
2,792 |
2,770 |
$237K |
| 76815 |
|
4,390 |
4,150 |
$235K |
| 92557 |
|
5,663 |
5,549 |
$225K |
| 36902 |
|
200 |
190 |
$217K |
| 76801 |
|
4,698 |
4,440 |
$217K |
| J2469 |
Palonosetron hcl |
4,107 |
2,515 |
$208K |
| 93017 |
|
2,415 |
2,340 |
$197K |
| 87426 |
|
6,142 |
6,052 |
$193K |
| 95819 |
|
964 |
947 |
$193K |
| 87631 |
|
4,148 |
4,056 |
$188K |
| 70498 |
|
1,615 |
1,559 |
$181K |
| 87651 |
|
12,898 |
12,687 |
$180K |
| 99394 |
|
1,878 |
1,875 |
$178K |
| 77067 |
|
5,946 |
5,907 |
$176K |
| 29105 |
|
864 |
841 |
$173K |
| 90670 |
|
11,987 |
11,901 |
$164K |
| 72141 |
|
1,376 |
1,365 |
$162K |
| 10060 |
|
766 |
746 |
$159K |
| 47563 |
|
77 |
74 |
$159K |
| 92526 |
|
3,277 |
2,028 |
$158K |
| 97535 |
|
6,467 |
5,144 |
$157K |
| 71046 |
|
27,943 |
26,811 |
$156K |
| 93970 |
|
1,789 |
1,743 |
$148K |
| 29125 |
|
836 |
808 |
$147K |
| 73721 |
|
1,243 |
1,205 |
$146K |
| G6015 |
Radiation tx delivery imrt |
937 |
144 |
$146K |
| 76870 |
|
1,618 |
1,566 |
$144K |
| 99212 |
|
4,385 |
4,231 |
$144K |
| 70496 |
|
1,667 |
1,612 |
$142K |
| 70491 |
|
1,198 |
1,167 |
$139K |
| 74183 |
|
643 |
630 |
$137K |
| 92567 |
|
10,577 |
10,233 |
$136K |
| 11045 |
|
510 |
257 |
$135K |
| J1602 |
Golimumab for iv use 1mg |
289 |
154 |
$134K |
| 45380 |
|
648 |
630 |
$133K |
| 12002 |
|
659 |
655 |
$130K |
| J1453 |
Fosaprepitant injection |
1,519 |
978 |
$123K |
| 87635 |
|
4,338 |
4,179 |
$121K |
| 99244 |
|
1,106 |
1,103 |
$118K |
| 84484 |
|
27,684 |
22,004 |
$112K |
| 87880 |
|
13,403 |
13,247 |
$107K |
| 87804 |
|
10,251 |
5,973 |
$106K |
| 95886 |
|
1,705 |
1,602 |
$106K |
| 99205 |
Prolong outpt/office vis |
946 |
923 |
$105K |
| 71250 |
|
2,209 |
2,177 |
$105K |
| 90834 |
|
1,708 |
1,288 |
$102K |
| 90680 |
|
7,259 |
7,207 |
$100K |
| 94726 |
|
3,181 |
3,126 |
$99K |
| 93303 |
|
857 |
832 |
$98K |
| 90961 |
|
1,340 |
1,312 |
$95K |
| 94060 |
|
3,941 |
3,879 |
$95K |
| 97162 |
|
2,356 |
2,301 |
$95K |
| 77063 |
|
5,943 |
5,904 |
$92K |
| 11102 |
|
598 |
566 |
$92K |
| 20553 |
|
969 |
741 |
$92K |
| 45385 |
|
304 |
294 |
$90K |
| 97165 |
|
1,950 |
1,902 |
$87K |
| 70486 |
|
1,661 |
1,634 |
$85K |
| 90698 |
|
5,848 |
5,806 |
$84K |
| 36430 |
|
895 |
595 |
$83K |
| 20610 |
|
1,029 |
913 |
$80K |
| J1745 |
Infliximab not biosimil 10mg |
72 |
62 |
$80K |
| 99222 |
|
1,517 |
1,466 |
$78K |
| 76882 |
|
1,067 |
972 |
$78K |
| 92579 |
|
1,744 |
1,687 |
$77K |
| 87502 |
|
5,064 |
4,975 |
$74K |
| 94640 |
|
8,299 |
7,255 |
$72K |
| 76700 |
|
701 |
692 |
$72K |
| 90471 |
|
7,260 |
7,121 |
$71K |
| 95816 |
|
429 |
421 |
$71K |
| 90633 |
|
4,822 |
4,799 |
$66K |
| 99243 |
|
942 |
938 |
$65K |
| 87040 |
|
8,500 |
5,499 |
$65K |
| 76937 |
|
2,329 |
2,112 |
$65K |
| 77066 |
Tomosynthesis, mammo |
2,585 |
2,562 |
$65K |
| 77014 |
|
2,014 |
324 |
$64K |
| 73630 |
|
10,238 |
8,526 |
$63K |
| 71260 |
|
3,468 |
3,385 |
$63K |
| 93005 |
|
46,316 |
41,807 |
$63K |
| 74018 |
|
5,458 |
5,179 |
$62K |
| 97802 |
|
1,170 |
1,157 |
$62K |
| 80048 |
|
14,775 |
12,230 |
$61K |
| 94729 |
|
3,390 |
3,333 |
$60K |
| J3490 |
Drugs unclassified injection |
3,731 |
2,454 |
$60K |
| 47562 |
|
44 |
40 |
$60K |
| 76825 |
|
393 |
372 |
$59K |
| 97803 |
|
1,692 |
1,243 |
$57K |
| 10061 |
|
287 |
281 |
$57K |
| 96372 |
|
28,332 |
21,806 |
$55K |
| 69210 |
|
2,414 |
2,353 |
$54K |
| P9016 |
Rbc leukocytes reduced |
163 |
129 |
$54K |
| J0185 |
Inj., aprepitant, 1 mg |
768 |
483 |
$53K |
| 72125 |
|
3,265 |
3,169 |
$51K |
| 76821 |
|
1,003 |
437 |
$50K |
| G0480 |
Drug test def 1-7 classes |
5,592 |
5,090 |
$50K |
| 92508 |
|
3,769 |
1,655 |
$50K |
| 58300 |
|
156 |
154 |
$50K |
| 77065 |
Tomosynthesis, mammo |
1,897 |
1,763 |
$49K |
| 31231 |
|
330 |
327 |
$49K |
| 90715 |
|
2,816 |
2,773 |
$49K |
| 11100 |
|
240 |
227 |
$47K |
| 83605 |
|
9,362 |
8,027 |
$46K |
| 90832 |
|
1,208 |
949 |
$46K |
| 72100 |
|
4,529 |
4,459 |
$45K |
| 87591 |
|
3,835 |
3,756 |
$45K |
| 76820 |
|
1,790 |
1,010 |
$44K |
| 36561 |
|
40 |
40 |
$43K |
| 96374 |
|
47,177 |
41,141 |
$42K |
| 82553 |
|
6,004 |
5,438 |
$42K |
| 85025 |
|
103,589 |
85,187 |
$41K |
| 93975 |
|
552 |
542 |
$40K |
| 58662 |
|
14 |
13 |
$40K |
| 29515 |
|
213 |
204 |
$40K |
| 92585 |
|
165 |
153 |
$40K |
| 95911 |
|
364 |
334 |
$39K |
| 45378 |
|
157 |
152 |
$39K |
| 93010 |
|
12,300 |
10,715 |
$38K |
| 99381 |
|
558 |
547 |
$38K |
| 73030 |
|
4,843 |
4,515 |
$38K |
| J7298 |
Mirena, 52 mg |
47 |
46 |
$37K |
| 90744 |
|
2,457 |
2,434 |
$37K |
| 96375 |
|
40,071 |
31,612 |
$36K |
| 93880 |
|
965 |
940 |
$36K |
| 76813 |
|
548 |
533 |
$35K |
| 73562 |
|
4,975 |
4,829 |
$35K |
| 72110 |
|
1,597 |
1,582 |
$35K |
| 97116 |
|
2,246 |
1,169 |
$34K |
| 73610 |
|
6,691 |
6,282 |
$33K |
| 85379 |
|
6,479 |
6,293 |
$33K |
| 36415 |
|
36,983 |
25,169 |
$33K |
| 11750 |
|
122 |
84 |
$33K |
| 71045 |
|
22,465 |
21,107 |
$33K |
| 73110 |
|
4,395 |
4,113 |
$32K |
| 74230 |
|
391 |
386 |
$32K |
| 92610 |
|
823 |
805 |
$31K |
| 96040 |
|
765 |
732 |
$30K |
| 77427 |
|
457 |
228 |
$29K |
| 74174 |
|
148 |
141 |
$29K |
| 99202 |
|
750 |
739 |
$27K |
| 99462 |
|
801 |
687 |
$27K |
| 97129 |
|
141 |
59 |
$26K |
| 72040 |
|
2,324 |
2,289 |
$26K |
| 97166 |
|
500 |
494 |
$25K |
| 73130 |
|
4,102 |
3,791 |
$24K |
| G0108 |
Diab manage trn per indiv |
879 |
821 |
$24K |
| 90677 |
|
1,566 |
1,558 |
$24K |
| 90723 |
|
2,135 |
2,115 |
$23K |
| 93922 |
|
706 |
687 |
$23K |
| 59400 |
|
13 |
13 |
$23K |
| 90472 |
|
976 |
967 |
$23K |
| 99211 |
|
180 |
168 |
$23K |
| 90648 |
|
1,807 |
1,798 |
$22K |
| 96127 |
|
9,255 |
7,116 |
$22K |
| 73221 |
|
222 |
219 |
$22K |
| 83880 |
|
5,298 |
4,944 |
$22K |
| 17000 |
|
172 |
167 |
$22K |
| 84145 |
|
2,446 |
2,301 |
$21K |
| 99309 |
|
3,665 |
2,199 |
$21K |
| 93320 |
|
767 |
747 |
$21K |
| 92587 |
|
130 |
126 |
$21K |
| 87632 |
|
438 |
430 |
$20K |
| 90966 |
|
260 |
258 |
$20K |
| 11900 |
|
83 |
81 |
$19K |
| 87641 |
|
2,160 |
2,091 |
$19K |
| G0279 |
Tomosynthesis, mammo |
3,000 |
2,974 |
$19K |
| 93798 |
|
3,215 |
603 |
$18K |
| 99254 |
|
171 |
170 |
$17K |
| 76827 |
|
420 |
398 |
$17K |
| 20550 |
|
156 |
139 |
$16K |
| 88307 |
|
923 |
906 |
$16K |
| 73502 |
|
2,173 |
2,128 |
$16K |
| 95909 |
|
247 |
234 |
$15K |
| 87633 |
|
986 |
965 |
$15K |
| J9190 |
Fluorouracil injection |
1,209 |
656 |
$14K |
| 72131 |
|
272 |
265 |
$14K |
| 19083 |
|
27 |
25 |
$14K |
| 77336 |
|
492 |
252 |
$14K |
| J2505 |
Injection, pegfilgrastim 6mg |
18 |
14 |
$14K |
| 99152 |
|
7,388 |
6,687 |
$14K |
| 80050 |
|
2,680 |
2,605 |
$14K |
| 81001 |
|
56,693 |
51,957 |
$14K |
| 58558 |
|
13 |
13 |
$13K |
| 72197 |
|
76 |
76 |
$13K |
| 88305 |
|
6,450 |
6,195 |
$13K |
| 90647 |
|
1,258 |
1,245 |
$13K |
| 74178 |
|
89 |
87 |
$13K |
| 87420 |
|
1,445 |
1,425 |
$12K |
| 71271 |
|
170 |
169 |
$12K |
| 90716 |
|
1,064 |
1,057 |
$12K |
| 72158 |
|
107 |
104 |
$12K |
| 99220 |
|
187 |
181 |
$12K |
| 72146 |
|
57 |
55 |
$12K |
| 93296 |
|
1,411 |
1,395 |
$12K |
| 81025 |
|
15,743 |
15,127 |
$12K |
| 90707 |
|
996 |
990 |
$12K |
| 84112 |
|
1,570 |
1,407 |
$12K |
| 87486 |
|
1,080 |
1,052 |
$11K |
| 90962 |
|
266 |
260 |
$11K |
| 83735 |
|
14,832 |
10,686 |
$11K |
| 93000 |
|
1,311 |
1,281 |
$11K |
| 72072 |
|
1,145 |
1,132 |
$11K |
| 59820 |
|
12 |
12 |
$11K |
| 99383 |
|
126 |
125 |
$11K |
| 82247 |
|
1,929 |
1,306 |
$11K |
| 77080 |
|
233 |
230 |
$11K |
| 92551 |
|
1,395 |
1,384 |
$11K |
| 90651 |
|
763 |
758 |
$10K |
| 73140 |
|
2,726 |
2,638 |
$10K |
| J0561 |
Penicillin g benzathine inj |
1,309 |
1,280 |
$10K |
| 76770 |
|
125 |
123 |
$10K |
| 64493 |
|
46 |
38 |
$10K |
| 73560 |
|
997 |
940 |
$10K |
| 86850 |
|
6,926 |
5,724 |
$9K |
| 96111 |
|
52 |
39 |
$9K |
| 87798 |
|
1,142 |
1,103 |
$9K |
| 92611 |
|
365 |
359 |
$9K |
| 90697 |
|
475 |
474 |
$9K |
| 76857 |
|
203 |
198 |
$9K |
| 87581 |
|
1,080 |
1,052 |
$9K |
| 93976 |
|
257 |
253 |
$9K |
| 29075 |
|
174 |
162 |
$9K |
| 0071A |
|
233 |
233 |
$8K |
| 99443 |
|
179 |
164 |
$8K |
| 85027 |
|
6,979 |
6,008 |
$8K |
| 73080 |
|
1,809 |
1,751 |
$8K |
| 64483 |
|
24 |
24 |
$8K |
| 87661 |
|
1,538 |
1,512 |
$8K |
| 58301 |
|
72 |
71 |
$8K |
| J0897 |
Denosumab injection |
65 |
63 |
$7K |
| 93325 |
|
1,308 |
1,251 |
$7K |
| 72050 |
|
394 |
387 |
$7K |
| 73590 |
|
1,850 |
1,721 |
$7K |
| 93270 |
|
203 |
202 |
$7K |
| 90710 |
|
509 |
506 |
$7K |
| 90935 |
|
387 |
194 |
$7K |
| 92550 |
|
71 |
71 |
$7K |
| 0072A |
|
184 |
183 |
$7K |
| 86900 |
|
9,333 |
7,765 |
$7K |
| 96376 |
|
10,050 |
7,184 |
$6K |
| 93926 |
|
218 |
204 |
$6K |
| 90460 |
|
570 |
562 |
$6K |
| 99242 |
|
112 |
109 |
$6K |
| 93016 |
|
610 |
602 |
$6K |
| 92522 |
|
97 |
97 |
$6K |
| 86140 |
|
15,512 |
14,080 |
$6K |
| 62321 |
|
58 |
52 |
$5K |
| 84703 |
|
17,369 |
16,442 |
$5K |
| 86901 |
|
9,339 |
7,766 |
$5K |
| 90685 |
|
663 |
658 |
$5K |
| 85055 |
|
1,867 |
1,473 |
$5K |
| 93925 |
|
122 |
122 |
$5K |
| 99221 |
|
123 |
118 |
$5K |
| 78227 |
|
26 |
26 |
$5K |
| 73120 |
|
380 |
272 |
$5K |
| 83690 |
|
31,945 |
29,077 |
$5K |
| 85018 |
|
2,432 |
2,049 |
$5K |
| 90791 |
|
52 |
52 |
$5K |
| 36589 |
|
12 |
12 |
$5K |
| 74019 |
|
833 |
820 |
$5K |
| 95910 |
|
68 |
65 |
$5K |
| 42820 |
|
26 |
26 |
$5K |
| 81003 |
|
10,363 |
9,934 |
$4K |
| 73620 |
|
532 |
477 |
$4K |
| 87086 |
|
11,844 |
11,358 |
$4K |
| 99310 |
Prolong nursin fac eval 15m |
342 |
238 |
$4K |
| 80061 |
|
1,376 |
1,316 |
$4K |
| 76942 |
|
67 |
64 |
$4K |
| 57454 |
|
12 |
12 |
$4K |
| 85610 |
|
30,653 |
23,401 |
$4K |
| 90619 |
|
231 |
231 |
$4K |
| 83036 |
|
3,689 |
3,597 |
$4K |
| J3489 |
Zoledronic acid 1mg |
189 |
177 |
$4K |
| 0001A |
|
109 |
107 |
$4K |
| 99442 |
|
136 |
121 |
$4K |
| 76999 |
|
49 |
48 |
$4K |
| 0002A |
|
109 |
106 |
$4K |
| 84443 |
|
7,580 |
7,226 |
$4K |
| G2211 |
Complex e/m visit add on |
1,091 |
1,048 |
$4K |
| 99395 |
|
50 |
50 |
$3K |
| 90696 |
|
244 |
243 |
$3K |
| 93458 |
|
13 |
12 |
$3K |
| 90688 |
|
328 |
328 |
$3K |
| 62270 |
|
13 |
12 |
$3K |
| 74022 |
|
1,585 |
1,552 |
$3K |
| 90656 |
|
933 |
933 |
$3K |
| 99231 |
|
129 |
79 |
$3K |
| 99177 |
|
1,073 |
1,072 |
$3K |
| 90734 |
|
266 |
266 |
$3K |
| 73564 |
|
278 |
251 |
$3K |
| 0054A |
|
124 |
121 |
$3K |
| 93990 |
|
81 |
76 |
$3K |
| 80179 |
|
1,854 |
1,718 |
$3K |
| 71101 |
|
1,077 |
1,056 |
$3K |
| 72170 |
|
816 |
761 |
$3K |
| 84702 |
|
7,090 |
6,403 |
$3K |
| 64400 |
|
14 |
12 |
$3K |
| 96402 |
|
416 |
389 |
$3K |
| 99173 |
|
1,838 |
1,826 |
$3K |
| J9070 |
Cyclophosphamide 100 mg inj |
43 |
27 |
$3K |
| 90700 |
|
250 |
250 |
$3K |
| 73090 |
|
1,449 |
1,359 |
$3K |
| 76886 |
|
26 |
26 |
$3K |
| J3301 |
Triamcinolone acet inj nos |
4,435 |
4,156 |
$3K |
| 64721 |
|
13 |
12 |
$3K |
| 70360 |
|
324 |
319 |
$3K |
| 82962 |
|
10,547 |
5,076 |
$3K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
24,264 |
23,109 |
$3K |
| 0004A |
|
130 |
129 |
$3K |
| 72082 |
|
70 |
70 |
$3K |
| 93246 |
|
74 |
72 |
$3K |
| 97150 |
|
274 |
127 |
$3K |
| J1050 |
Medroxyprogesterone acetate |
292 |
290 |
$3K |
| C8929 |
Tte w or wo fol wcon,doppler |
12 |
12 |
$2K |
| 99218 |
|
44 |
41 |
$2K |
| 73660 |
|
595 |
578 |
$2K |
| 92250 |
|
68 |
68 |
$2K |
| 95800 |
|
26 |
26 |
$2K |
| 84100 |
|
4,888 |
3,991 |
$2K |
| 82565 |
|
1,961 |
1,836 |
$2K |
| 73521 |
|
167 |
163 |
$2K |
| G0260 |
Inj for sacroiliac jt anesth |
26 |
26 |
$2K |
| 73700 |
|
27 |
26 |
$2K |
| 82550 |
|
8,479 |
7,600 |
$2K |
| 90461 |
|
196 |
195 |
$2K |
| 51702 |
|
213 |
188 |
$2K |
| 99495 |
|
125 |
125 |
$2K |
| 82077 |
|
3,574 |
3,264 |
$2K |
| J0702 |
Betamethasone acet&sod phosp |
833 |
738 |
$2K |
| A9500 |
Tc99m sestamibi |
1,934 |
1,848 |
$2K |
| 93018 |
|
348 |
330 |
$2K |
| 73100 |
|
154 |
133 |
$2K |
| 85730 |
|
10,749 |
9,957 |
$2K |
| J7030 |
Normal saline solution infus |
35,268 |
27,091 |
$2K |
| J2405 |
Ondansetron hcl injection |
29,635 |
24,463 |
$2K |
| J2785 |
Regadenoson injection |
1,252 |
1,211 |
$2K |
| 93299 |
|
245 |
240 |
$2K |
| 85014 |
|
2,056 |
1,637 |
$2K |
| 90837 |
|
21 |
12 |
$2K |
| 96161 |
|
884 |
870 |
$2K |
| 87491 |
|
3,839 |
3,764 |
$2K |
| 72157 |
|
14 |
14 |
$1K |
| 90672 |
|
98 |
97 |
$1K |
| 93242 |
|
37 |
36 |
$1K |
| 99493 |
|
16 |
12 |
$1K |
| 69436 |
|
15 |
14 |
$1K |
| 95885 |
|
38 |
34 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
36,022 |
30,992 |
$1K |
| 99292 |
|
31 |
26 |
$1K |
| 90474 |
|
112 |
109 |
$1K |
| 73552 |
|
169 |
158 |
$1K |
| 99396 |
|
12 |
12 |
$1K |
| 96523 |
|
21 |
18 |
$1K |
| 85652 |
|
4,570 |
4,024 |
$1K |
| G0379 |
Direct refer hospital observ |
25 |
25 |
$1K |
| 0241U |
|
2,975 |
2,894 |
$1K |
| 20526 |
|
36 |
24 |
$1K |
| 87636 |
|
3,058 |
2,995 |
$1K |
| A9552 |
F18 fdg |
982 |
967 |
$1K |
| A9585 |
Gadobutrol injection |
6,017 |
5,856 |
$1K |
| 58571 |
|
13 |
13 |
$1K |
| 59514 |
|
14 |
12 |
$1K |
| 88304 |
|
2,337 |
2,304 |
$1K |
| J2790 |
Rho d immune globulin inj |
25 |
25 |
$1K |
| 74240 |
|
12 |
12 |
$1K |
| 92555 |
|
13 |
13 |
$1K |
| 86923 |
|
249 |
206 |
$1K |
| 0051A |
|
30 |
30 |
$1K |
| J1100 |
Dexamethasone sodium phos |
22,740 |
19,200 |
$998.51 |
| 99308 |
|
197 |
123 |
$985.99 |
| 84439 |
|
2,408 |
2,317 |
$981.39 |
| 93295 |
|
100 |
93 |
$977.62 |
| J2001 |
Lidocaine injection |
13,555 |
11,922 |
$969.54 |
| 87186 |
|
5,430 |
5,239 |
$955.46 |
| 90480 |
|
27 |
27 |
$947.20 |
| 85007 |
|
241 |
190 |
$939.17 |
| 0111A |
|
24 |
24 |
$916.83 |
| 99241 |
|
32 |
31 |
$900.05 |
| 87070 |
|
3,790 |
3,589 |
$878.63 |
| 0052A |
|
32 |
30 |
$876.80 |
| J1756 |
Iron sucrose injection |
107 |
52 |
$846.19 |
| 88300 |
|
50 |
44 |
$826.96 |
| J3010 |
Fentanyl citrate injection |
24,112 |
18,864 |
$826.79 |
| 99382 |
|
12 |
12 |
$825.08 |
| 81002 |
|
4,042 |
3,879 |
$782.65 |
| 93923 |
|
26 |
26 |
$782.47 |
| 96411 |
|
1,302 |
818 |
$773.91 |
| J2270 |
Morphine sulfate injection |
10,450 |
8,508 |
$761.29 |
| 77263 |
|
14 |
14 |
$740.63 |
| 82248 |
|
321 |
274 |
$732.30 |
| 99306 |
Prolong nursin fac eval 15m |
29 |
28 |
$724.34 |
| 77300 |
|
16 |
13 |
$721.52 |
| 93225 |
|
27 |
27 |
$715.31 |
| Q4010 |
Cast sup sht arm adult fbrgl |
38 |
36 |
$704.48 |
| 99305 |
|
74 |
56 |
$697.18 |
| 29065 |
|
13 |
12 |
$690.45 |
| 97163 |
|
15 |
15 |
$683.98 |
| Q2038 |
Fluzone vacc, 3 yrs & >, im |
90 |
89 |
$678.82 |
| 77334 |
|
19 |
15 |
$678.12 |
| 83615 |
|
909 |
790 |
$648.93 |
| J1170 |
Hydromorphone injection |
14,002 |
10,004 |
$623.44 |
| 99354 |
|
12 |
12 |
$612.75 |
| 87205 |
|
2,672 |
2,437 |
$610.44 |
| 87077 |
|
4,180 |
4,011 |
$608.83 |
| 20611 |
|
13 |
13 |
$598.87 |
| 73070 |
|
173 |
161 |
$595.83 |
| 73000 |
|
63 |
61 |
$585.85 |
| J2704 |
Inj, propofol, 10 mg |
11,432 |
10,202 |
$564.78 |
| 94010 |
|
15 |
15 |
$533.41 |
| J1200 |
Diphenhydramine hcl injectio |
12,289 |
9,608 |
$520.88 |
| 87210 |
|
2,401 |
2,359 |
$520.75 |
| 30901 |
|
33 |
30 |
$509.88 |
| A9577 |
Inj multihance |
770 |
747 |
$507.94 |
| 88342 |
|
915 |
881 |
$502.76 |
| 90687 |
|
65 |
65 |
$499.86 |
| J2550 |
Promethazine hcl injection |
2,864 |
2,371 |
$485.77 |
| 96417 |
|
3,124 |
1,978 |
$483.62 |
| 87088 |
|
2,491 |
2,412 |
$476.38 |
| 76828 |
|
30 |
16 |
$466.81 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
1,135 |
1,082 |
$464.44 |
| J2765 |
Metoclopramide hcl injection |
6,895 |
6,068 |
$425.46 |
| 82570 |
|
513 |
445 |
$420.53 |
| 86920 |
|
490 |
382 |
$402.14 |
| 99217 |
|
12 |
12 |
$393.45 |
| V5275 |
Ear impression |
15 |
12 |
$393.13 |
| 96409 |
|
41 |
26 |
$380.76 |
| 90732 |
|
171 |
128 |
$379.83 |
| 93321 |
|
30 |
26 |
$377.48 |
| J2250 |
Inj midazolam hydrochloride |
11,661 |
10,863 |
$373.20 |
| G0180 |
Md certification hha patient |
14 |
14 |
$346.61 |
| 73565 |
|
15 |
15 |
$318.14 |
| 74220 |
|
12 |
12 |
$305.80 |
| 82150 |
|
790 |
766 |
$302.52 |
| 82803 |
|
1,534 |
1,356 |
$302.37 |
| 96380 |
|
31 |
31 |
$297.57 |
| 93288 |
|
70 |
65 |
$292.07 |
| 72220 |
|
48 |
48 |
$287.73 |
| 99153 |
Mod sedat endo service >5yrs |
1,124 |
1,072 |
$277.93 |
| 69209 |
|
73 |
73 |
$271.00 |
| 99451 |
|
12 |
12 |
$257.52 |
| 82009 |
|
1,282 |
1,113 |
$252.80 |
| 64494 |
|
29 |
26 |
$247.27 |
| 96401 |
|
79 |
37 |
$246.79 |
| 93280 |
|
57 |
53 |
$245.43 |
| 73600 |
|
33 |
28 |
$244.37 |
| 82728 |
|
87 |
83 |
$243.59 |
| 73060 |
|
117 |
113 |
$242.09 |
| J3480 |
Inj potassium chloride |
2,888 |
1,820 |
$242.07 |
| 80305 |
|
1,172 |
1,133 |
$240.57 |
| 84132 |
|
586 |
462 |
$232.66 |
| J1644 |
Inj heparin sodium per 1000u |
5,682 |
3,413 |
$216.42 |
| 92504 |
|
48 |
45 |
$208.21 |
| J7040 |
Normal saline solution infus |
1,554 |
1,489 |
$200.45 |
| 84156 |
|
380 |
330 |
$200.22 |
| 84550 |
|
391 |
348 |
$197.12 |
| 93289 |
|
54 |
50 |
$189.99 |
| J1650 |
Inj enoxaparin sodium |
5,426 |
2,853 |
$181.59 |
| 36591 |
|
109 |
83 |
$178.92 |
| J0696 |
Ceftriaxone sodium injection |
8,302 |
6,460 |
$178.08 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
2,913 |
2,634 |
$176.78 |
| J3475 |
Inj magnesium sulfate |
3,196 |
2,119 |
$176.18 |
| 97022 |
|
27 |
12 |
$167.52 |
| 76000 |
|
30 |
27 |
$148.46 |
| 99401 |
|
47 |
46 |
$147.03 |
| J2060 |
Lorazepam injection |
4,920 |
4,070 |
$144.12 |
| J8540 |
Oral dexamethasone |
4,253 |
3,940 |
$140.06 |
| 97016 |
|
26 |
12 |
$137.99 |
| 87075 |
|
1,129 |
1,044 |
$124.28 |
| 77001 |
|
13 |
12 |
$112.45 |
| C1887 |
Catheter, guiding |
1,561 |
1,328 |
$111.80 |
| J2710 |
Neostigmine methylslfte inj |
4,930 |
4,801 |
$111.65 |
| 80069 |
|
67 |
38 |
$109.67 |
| 92582 |
|
12 |
12 |
$106.96 |
| 88312 |
|
46 |
44 |
$93.83 |
| 17003 |
|
13 |
12 |
$90.31 |
| J0690 |
Cefazolin sodium injection |
6,322 |
5,227 |
$88.30 |
| G0009 |
Admin pneumococcal vaccine |
375 |
312 |
$86.05 |
| 87045 |
|
198 |
194 |
$85.92 |
| 87324 |
|
125 |
122 |
$83.77 |
| 99406 |
|
448 |
430 |
$82.37 |
| 93297 |
|
24 |
24 |
$82.35 |
| 84450 |
|
60 |
50 |
$80.44 |
| G1004 |
Cdsm ndsc |
30,316 |
23,381 |
$79.80 |
| J1815 |
Insulin injection |
4,364 |
1,717 |
$79.46 |
| 84520 |
|
78 |
61 |
$76.17 |
| 80076 |
|
41 |
39 |
$74.83 |
| 84460 |
|
77 |
65 |
$71.90 |
| 82140 |
|
181 |
160 |
$70.46 |
| 86308 |
|
805 |
798 |
$69.67 |
| 0240U |
|
1,495 |
1,454 |
$66.00 |
| J0694 |
Cefoxitin sodium injection |
966 |
553 |
$62.22 |
| 83540 |
|
68 |
66 |
$62.04 |
| 87807 |
|
385 |
379 |
$56.15 |
| J0780 |
Prochlorperazine injection |
507 |
454 |
$55.20 |
| 83550 |
|
51 |
50 |
$54.48 |
| Q0162 |
Ondansetron oral |
5,623 |
5,476 |
$53.30 |
| J0330 |
Succinycholine chloride inj |
3,539 |
3,432 |
$52.40 |
| 94760 |
|
164 |
153 |
$50.70 |
| 36416 |
|
5,619 |
3,568 |
$48.00 |
| 87899 |
|
206 |
196 |
$46.04 |
| 36600 |
|
52 |
50 |
$44.80 |
| 96160 |
|
13 |
12 |
$43.26 |
| 87046 |
|
198 |
194 |
$43.01 |
| 87449 |
|
126 |
123 |
$41.97 |
| J3360 |
Diazepam injection |
657 |
595 |
$40.66 |
| J3370 |
Vancomycin hcl injection |
1,086 |
534 |
$39.30 |
| 73650 |
|
15 |
13 |
$38.90 |
| C9113 |
Inj pantoprazole sodium, via |
1,258 |
694 |
$38.52 |
| J0171 |
Adrenalin epinephrine inject |
334 |
307 |
$38.52 |
| J1940 |
Furosemide injection |
896 |
651 |
$38.52 |
| J2370 |
Phenylephrine hcl injection |
2,187 |
1,979 |
$38.52 |
| J2795 |
Ropivacaine hcl injection |
2,066 |
854 |
$38.52 |
| 82330 |
|
55 |
46 |
$37.40 |
| J1642 |
Inj heparin sodium per 10 u |
4,312 |
2,510 |
$36.58 |
| 93294 |
|
12 |
12 |
$36.21 |
| J0360 |
Hydralazine hcl injection |
1,027 |
831 |
$35.48 |
| J1790 |
Droperidol injection |
552 |
500 |
$34.20 |
| U0005 |
Infec agen detec ampli probe |
7,900 |
7,496 |
$32.50 |
| J7050 |
Normal saline solution infus |
8,596 |
4,888 |
$29.16 |
| G0008 |
Admin influenza virus vac |
1,443 |
1,416 |
$28.03 |
| 81000 |
|
277 |
274 |
$25.75 |
| 82947 |
|
77 |
70 |
$20.86 |
| J7120 |
Ringers lactate infusion |
2,202 |
1,837 |
$20.69 |
| J2175 |
Meperidine hydrochl /100 mg |
1,666 |
1,551 |
$16.93 |
| J2930 |
Methylprednisolone injection |
2,592 |
2,137 |
$16.65 |
| 80143 |
|
729 |
682 |
$14.91 |
| 83037 |
|
374 |
367 |
$14.73 |
| J7512 |
Prednisone ir or dr oral 1mg |
4,302 |
3,566 |
$13.56 |
| 85046 |
|
13 |
12 |
$10.83 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
978 |
841 |
$8.98 |
| 84295 |
|
49 |
45 |
$7.24 |
| 82010 |
|
221 |
199 |
$5.40 |
| J0744 |
Ciprofloxacin iv |
155 |
94 |
$5.10 |
| 85384 |
|
17 |
14 |
$5.02 |
| Q0163 |
Diphenhydramine hcl 50mg |
2,233 |
1,880 |
$2.18 |
| 99072 |
|
3,584 |
3,239 |
$0.98 |
| J1920 |
Inj, labetalol hcl, 5mg |
85 |
75 |
$0.07 |
| 3078F |
|
14,002 |
13,090 |
$0.00 |
| A9502 |
Tc99m tetrofosmin |
41 |
41 |
$0.00 |
| C1760 |
Closure dev, vasc |
14 |
12 |
$0.00 |
| A9541 |
Tc99m sulfur colloid |
41 |
39 |
$0.00 |
| 90662 |
|
248 |
245 |
$0.00 |
| J0689 |
Inj cefazolin sodium, baxter |
1,683 |
1,389 |
$0.00 |
| J0640 |
Leucovorin calcium injection |
915 |
503 |
$0.00 |
| C1776 |
Joint device (implantable) |
162 |
159 |
$0.00 |
| 91311 |
|
49 |
49 |
$0.00 |
| J7510 |
Prednisolone oral per 5 mg |
163 |
142 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
3,165 |
2,935 |
$0.00 |
| 91300 |
|
255 |
243 |
$0.00 |
| G0500 |
Mod sedat endo service >5yrs |
257 |
252 |
$0.00 |
| C1729 |
Cath, drainage |
419 |
286 |
$0.00 |
| J0688 |
Inj cefazolin sodium, hikma |
155 |
140 |
$0.00 |
| 3077F |
|
127 |
124 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
553 |
541 |
$0.00 |
| G8978 |
Mobility current status |
385 |
369 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
266 |
234 |
$0.00 |
| 0353U |
|
372 |
366 |
$0.00 |
| A6021 |
Collagen dressing <=16 sq in |
1,288 |
736 |
$0.00 |
| A9537 |
Tc99m mebrofenin |
26 |
26 |
$0.00 |
| C1788 |
Port, indwelling, imp |
40 |
40 |
$0.00 |
| G8979 |
Mobility goal status |
421 |
400 |
$0.00 |
| 82272 |
|
26 |
26 |
$0.00 |
| 4004F |
|
13 |
12 |
$0.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
395 |
120 |
$0.00 |
| J2916 |
Na ferric gluconate complex |
95 |
41 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
55 |
53 |
$0.00 |
| 88112 |
|
17 |
17 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
214 |
159 |
$0.00 |
| J9000 |
Doxorubicin hcl injection |
21 |
12 |
$0.00 |
| 89051 |
|
25 |
25 |
$0.00 |
| Q9957 |
Inj perflutren lip micros,ml |
26 |
26 |
$0.00 |
| Q4133 |
Grafix stravix prime pl sqcm |
44 |
12 |
$0.00 |
| Q0144 |
Azithromycin dihydrate, oral |
29 |
27 |
$0.00 |
| 90653 |
|
54 |
54 |
$0.00 |
| S0028 |
Injection, famotidine, 20 mg |
130 |
70 |
$0.00 |
| 0202U |
|
14 |
14 |
$0.00 |
| C1758 |
Catheter, ureteral |
12 |
12 |
$0.00 |
| 77012 |
|
13 |
13 |
$0.00 |
| J3486 |
Ziprasidone mesylate |
23 |
18 |
$0.00 |
| 3074F |
|
15,863 |
14,880 |
$0.00 |
| J1836 |
Inj, metronidazole, 10 mg |
215 |
167 |
$0.00 |
| 3079F |
|
492 |
477 |
$0.00 |
| A9270 |
Non-covered item or service |
24,566 |
6,426 |
$0.00 |
| G8510 |
Scr dep neg, no plan reqd |
1,170 |
1,146 |
$0.00 |
| C1725 |
Cath, translumin non-laser |
1,209 |
1,026 |
$0.00 |
| H0049 |
Alcohol/drug screening |
260 |
260 |
$0.00 |
| C1769 |
Guide wire |
4,040 |
3,633 |
$0.00 |
| J1630 |
Haloperidol injection |
376 |
313 |
$0.00 |
| C1889 |
Implant/insert device, noc |
390 |
355 |
$0.00 |
| J7644 |
Ipratropium bromide non-comp |
32 |
32 |
$0.00 |
| C1726 |
Cath, bal dil, non-vascular |
694 |
640 |
$0.00 |
| C1781 |
Mesh (implantable) |
158 |
148 |
$0.00 |
| J2920 |
Methylprednisolone injection |
270 |
231 |
$0.00 |
| J3420 |
Vitamin b12 injection |
164 |
148 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
897 |
335 |
$0.00 |
| J7999 |
Compounded drug, noc |
589 |
537 |
$0.00 |
| J1030 |
Methylprednisolone 40 mg inj |
554 |
539 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
110 |
61 |
$0.00 |
| A4648 |
Implantable tissue marker |
341 |
307 |
$0.00 |
| J9045 |
Carboplatin injection |
502 |
333 |
$0.00 |
| 96368 |
|
548 |
360 |
$0.00 |
| J9267 |
Paclitaxel injection |
348 |
153 |
$0.00 |
| 91307 |
|
461 |
428 |
$0.00 |
| 0352U |
|
12 |
12 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
632 |
600 |
$0.00 |
| J1010 |
Inj, methylpred acetate 1 mg |
78 |
77 |
$0.00 |
| J3411 |
Thiamine hcl 100 mg |
54 |
25 |
$0.00 |
| 3075F |
|
77 |
72 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
93 |
91 |
$0.00 |
| J7611 |
Albuterol non-comp con |
16 |
16 |
$0.00 |
| 97130 |
|
102 |
40 |
$0.00 |
| J0461 |
Atropine sulfate injection |
20 |
12 |
$0.00 |
| 87081 |
|
29 |
29 |
$0.00 |
| G8980 |
Mobility d/c status |
24 |
24 |
$0.00 |
| 91305 |
|
137 |
135 |
$0.00 |
| 90694 |
|
32 |
31 |
$0.00 |
| C2617 |
Stent, non-cor, tem w/o del |
26 |
25 |
$0.00 |
| 81015 |
|
22 |
21 |
$0.00 |
| S2900 |
Robotic surgical system |
14 |
12 |
$0.00 |
| Q4131 |
Epifix or epicord |
25 |
12 |
$0.00 |