| Code | Description | Claims | Beneficiaries | Total Paid |
| 99283 |
|
89,448 |
80,404 |
$36.07M |
| G0378 |
Hospital observation per hr |
11,605 |
7,164 |
$7.27M |
| 99284 |
|
12,126 |
11,521 |
$7.12M |
| 74177 |
|
10,072 |
9,771 |
$2.67M |
| 99291 |
|
2,846 |
2,779 |
$2.65M |
| 99282 |
|
8,280 |
8,072 |
$2.00M |
| 66984 |
|
600 |
583 |
$1.68M |
| 88305 |
|
28,802 |
21,095 |
$1.21M |
| 78452 |
|
1,924 |
1,911 |
$1.08M |
| 70553 |
|
3,254 |
3,210 |
$1.01M |
| 70450 |
|
9,971 |
9,559 |
$895K |
| 78815 |
|
1,017 |
1,007 |
$878K |
| 0450 |
|
13,688 |
12,195 |
$799K |
| 84443 |
|
50,811 |
49,844 |
$722K |
| 71045 |
|
17,633 |
16,419 |
$721K |
| 71046 |
|
14,333 |
13,802 |
$713K |
| 85025 |
|
141,607 |
118,769 |
$627K |
| 76705 |
|
7,474 |
7,267 |
$622K |
| 86900 |
|
11,192 |
10,404 |
$616K |
| 87636 |
|
21,901 |
21,142 |
$572K |
| 99499 |
|
2,663 |
2,399 |
$508K |
| 70551 |
|
2,819 |
2,779 |
$504K |
| 82306 |
|
17,995 |
17,822 |
$489K |
| 76856 |
|
5,151 |
5,065 |
$468K |
| 82565 |
|
151,237 |
125,322 |
$460K |
| 74176 |
|
2,881 |
2,824 |
$454K |
| 86885 |
|
6,309 |
5,985 |
$448K |
| 77067 |
|
3,771 |
3,756 |
$446K |
| 83036 |
|
55,292 |
54,516 |
$432K |
| 80061 |
|
37,063 |
36,707 |
$432K |
| 76830 |
|
4,668 |
4,589 |
$426K |
| 85027 |
|
77,629 |
75,082 |
$423K |
| 87491 |
|
13,337 |
12,350 |
$421K |
| 87591 |
|
13,347 |
12,358 |
$420K |
| 80051 |
|
118,786 |
95,857 |
$395K |
| 72148 |
|
2,101 |
2,086 |
$391K |
| 86480 |
|
6,028 |
5,948 |
$355K |
| 73721 |
|
1,588 |
1,518 |
$346K |
| 84460 |
|
89,965 |
80,838 |
$325K |
| 80307 |
|
8,281 |
6,740 |
$293K |
| 96374 |
|
19,914 |
17,556 |
$288K |
| 73630 |
|
4,632 |
4,411 |
$257K |
| 83970 |
|
7,367 |
7,209 |
$237K |
| 87389 |
|
10,293 |
10,175 |
$230K |
| 87505 |
|
2,654 |
2,618 |
$230K |
| 82728 |
|
20,022 |
19,635 |
$229K |
| 76770 |
|
2,650 |
2,593 |
$226K |
| 83880 |
|
15,573 |
13,549 |
$221K |
| 71275 |
|
1,417 |
1,404 |
$215K |
| 81220 |
|
793 |
790 |
$208K |
| 76805 |
|
1,895 |
1,885 |
$208K |
| 84702 |
|
30,106 |
26,976 |
$207K |
| 73562 |
|
3,815 |
3,578 |
$203K |
| 86901 |
|
11,225 |
10,433 |
$198K |
| 71260 |
|
1,243 |
1,232 |
$194K |
| 73610 |
|
3,562 |
3,375 |
$192K |
| 70544 |
|
1,037 |
1,019 |
$190K |
| 76801 |
|
1,909 |
1,670 |
$189K |
| 72141 |
|
966 |
957 |
$189K |
| 86780 |
|
14,117 |
13,956 |
$189K |
| 82247 |
|
63,857 |
55,603 |
$184K |
| 76817 |
|
1,844 |
1,617 |
$184K |
| 84075 |
|
61,725 |
53,921 |
$181K |
| J0131 |
Inj, acetaminophen (nos) |
9,017 |
8,254 |
$179K |
| 99281 |
|
3,485 |
3,188 |
$170K |
| 73221 |
|
745 |
710 |
$165K |
| 72100 |
|
1,917 |
1,886 |
$160K |
| 73030 |
|
2,938 |
2,791 |
$160K |
| 84520 |
|
98,151 |
78,676 |
$155K |
| 82607 |
|
12,154 |
12,041 |
$152K |
| 86141 |
|
16,482 |
15,564 |
$152K |
| 72125 |
|
1,496 |
1,465 |
$147K |
| 93971 |
|
947 |
925 |
$147K |
| 83550 |
|
19,847 |
19,602 |
$146K |
| 73130 |
|
2,608 |
2,442 |
$142K |
| 84450 |
|
50,050 |
44,082 |
$138K |
| 83735 |
|
35,539 |
29,231 |
$133K |
| 76816 |
|
1,225 |
1,199 |
$133K |
| 96375 |
|
13,334 |
11,791 |
$132K |
| 82947 |
|
82,935 |
72,061 |
$131K |
| 73110 |
|
2,236 |
2,119 |
$121K |
| 93970 |
|
512 |
495 |
$119K |
| 86803 |
|
8,904 |
8,804 |
$118K |
| 93017 |
|
871 |
869 |
$112K |
| 83540 |
|
20,206 |
19,958 |
$107K |
| 88342 |
|
806 |
794 |
$107K |
| 99285 |
|
140 |
137 |
$105K |
| 83690 |
|
34,266 |
31,342 |
$103K |
| 74183 |
|
306 |
304 |
$96K |
| 87536 |
|
1,246 |
1,234 |
$96K |
| 77080 |
|
879 |
856 |
$93K |
| 85610 |
|
39,487 |
28,999 |
$91K |
| 87088 |
|
20,037 |
19,122 |
$91K |
| 82310 |
|
28,478 |
25,393 |
$90K |
| A9552 |
F18 fdg |
601 |
597 |
$89K |
| A9585 |
Gadobutrol injection |
2,435 |
2,335 |
$89K |
| 70486 |
|
833 |
827 |
$88K |
| 76536 |
|
960 |
955 |
$87K |
| 62323 |
|
152 |
150 |
$87K |
| 76870 |
|
1,002 |
983 |
$86K |
| 86923 |
|
890 |
793 |
$86K |
| 87340 |
|
9,562 |
9,427 |
$86K |
| 73502 |
|
1,586 |
1,520 |
$84K |
| 74018 |
|
1,424 |
1,315 |
$84K |
| 82746 |
|
6,806 |
6,752 |
$82K |
| 93880 |
|
194 |
191 |
$82K |
| 0710 |
|
1,529 |
1,499 |
$80K |
| A9500 |
Tc99m sestamibi |
1,460 |
1,364 |
$79K |
| 93005 |
|
6,285 |
5,647 |
$77K |
| J2785 |
Regadenoson injection |
1,010 |
999 |
$77K |
| 84132 |
|
18,701 |
17,907 |
$77K |
| 88304 |
|
2,051 |
1,901 |
$76K |
| 73140 |
|
1,340 |
1,249 |
$76K |
| 81003 |
|
57,069 |
52,663 |
$74K |
| 84484 |
|
27,190 |
20,238 |
$72K |
| J7030 |
Normal saline solution infus |
34,121 |
27,626 |
$71K |
| 81513 |
|
914 |
898 |
$69K |
| 83655 |
|
6,059 |
6,034 |
$67K |
| 84295 |
|
15,405 |
15,006 |
$67K |
| 83520 |
|
5,417 |
3,517 |
$66K |
| 84403 |
|
2,614 |
2,589 |
$63K |
| 82043 |
|
13,596 |
13,343 |
$62K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
11,020 |
10,514 |
$62K |
| 73564 |
|
527 |
488 |
$61K |
| 84439 |
|
8,416 |
7,989 |
$59K |
| 82040 |
|
16,069 |
15,449 |
$57K |
| 86762 |
|
3,823 |
3,766 |
$57K |
| J7120 |
Ringers lactate infusion |
6,961 |
6,285 |
$57K |
| 87633 |
|
1,324 |
1,310 |
$57K |
| 96365 |
|
4,785 |
4,225 |
$56K |
| 73080 |
|
1,088 |
1,028 |
$56K |
| 0637 |
|
141,731 |
35,808 |
$56K |
| 84153 |
|
3,883 |
3,822 |
$54K |
| 82570 |
|
10,886 |
9,772 |
$53K |
| 72197 |
|
151 |
151 |
$52K |
| 73590 |
|
964 |
906 |
$52K |
| 86787 |
|
3,968 |
3,908 |
$52K |
| 93306 |
|
1,008 |
996 |
$51K |
| 88312 |
|
822 |
819 |
$48K |
| 90686 |
|
4,187 |
4,153 |
$47K |
| U0003 |
Cov-19 amp prb hgh thruput |
2,065 |
1,991 |
$47K |
| 77066 |
Tomosynthesis, mammo |
297 |
297 |
$46K |
| 85652 |
|
20,655 |
19,909 |
$46K |
| 87040 |
|
16,563 |
8,531 |
$45K |
| 82670 |
|
1,583 |
1,554 |
$45K |
| 99199 |
|
2,179 |
1,997 |
$44K |
| 84100 |
|
17,353 |
14,720 |
$41K |
| 87497 |
|
1,143 |
971 |
$40K |
| 70491 |
|
204 |
204 |
$39K |
| 86665 |
|
2,334 |
1,163 |
$39K |
| 82105 |
|
2,887 |
2,799 |
$39K |
| 71101 |
|
394 |
387 |
$38K |
| 96372 |
|
4,593 |
4,062 |
$37K |
| 72050 |
|
327 |
323 |
$37K |
| 84156 |
|
10,531 |
9,291 |
$36K |
| 86038 |
|
3,460 |
3,405 |
$36K |
| 83001 |
|
1,844 |
1,826 |
$35K |
| 76641 |
|
336 |
334 |
$34K |
| 87481 |
|
1,073 |
1,050 |
$34K |
| 82248 |
|
10,747 |
10,106 |
$33K |
| 87661 |
|
914 |
898 |
$33K |
| 80197 |
|
2,972 |
2,419 |
$33K |
| 86003 |
|
737 |
635 |
$33K |
| 87210 |
|
7,672 |
7,443 |
$32K |
| 72156 |
|
113 |
113 |
$32K |
| 84146 |
|
1,662 |
1,654 |
$31K |
| 73090 |
|
595 |
552 |
$31K |
| 72158 |
|
99 |
99 |
$31K |
| J1100 |
Dexamethasone sodium phos |
3,769 |
3,278 |
$30K |
| 87449 |
|
3,083 |
2,966 |
$30K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
3,392 |
2,121 |
$29K |
| 83021 |
|
1,510 |
1,491 |
$29K |
| 81420 |
|
74 |
72 |
$28K |
| 71250 |
|
245 |
244 |
$28K |
| 83721 |
|
3,117 |
3,099 |
$27K |
| J2405 |
Ondansetron hcl injection |
16,292 |
14,028 |
$27K |
| 73100 |
|
426 |
335 |
$27K |
| 83605 |
|
10,619 |
8,453 |
$26K |
| 84550 |
|
7,218 |
6,887 |
$26K |
| 84134 |
|
2,458 |
2,392 |
$26K |
| 85730 |
|
6,831 |
6,153 |
$26K |
| 84165 |
|
3,037 |
2,964 |
$26K |
| 70498 |
|
179 |
177 |
$25K |
| 88341 |
|
421 |
414 |
$25K |
| 82784 |
|
1,333 |
1,270 |
$25K |
| 70496 |
|
167 |
165 |
$24K |
| J3010 |
Fentanyl citrate injection |
2,015 |
1,888 |
$24K |
| 73660 |
|
384 |
369 |
$24K |
| P9021 |
Red blood cells unit |
594 |
486 |
$24K |
| 96361 |
|
3,545 |
3,385 |
$24K |
| 72070 |
|
229 |
228 |
$24K |
| J1885 |
Ketorolac tromethamine inj |
11,986 |
11,051 |
$23K |
| J0690 |
Cefazolin sodium injection |
1,416 |
1,207 |
$22K |
| 85379 |
|
5,530 |
5,335 |
$22K |
| 80076 |
|
3,915 |
3,643 |
$22K |
| 87624 |
|
706 |
703 |
$22K |
| 86704 |
|
2,248 |
2,225 |
$21K |
| 87324 |
|
2,642 |
2,579 |
$20K |
| 73522 |
|
179 |
177 |
$20K |
| J2270 |
Morphine sulfate injection |
7,247 |
6,159 |
$19K |
| 82330 |
|
2,077 |
1,884 |
$18K |
| 88307 |
|
168 |
134 |
$18K |
| 80164 |
|
1,939 |
1,819 |
$18K |
| 82950 |
|
3,776 |
3,753 |
$18K |
| 86317 |
|
1,386 |
1,363 |
$18K |
| 83615 |
|
3,921 |
3,485 |
$17K |
| 85014 |
|
9,132 |
8,670 |
$17K |
| 82077 |
|
3,038 |
2,752 |
$17K |
| 86225 |
|
1,387 |
1,350 |
$17K |
| 0370 |
|
2,245 |
2,201 |
$17K |
| J1170 |
Hydromorphone injection |
4,630 |
3,443 |
$17K |
| 76380 |
|
244 |
242 |
$17K |
| 64483 |
|
13 |
13 |
$17K |
| 86664 |
|
1,170 |
1,163 |
$16K |
| 96360 |
|
1,556 |
1,528 |
$16K |
| 82977 |
|
2,342 |
2,246 |
$16K |
| 74170 |
|
68 |
68 |
$16K |
| 82550 |
|
4,581 |
4,222 |
$15K |
| J0696 |
Ceftriaxone sodium injection |
7,782 |
6,254 |
$15K |
| 83993 |
|
729 |
723 |
$14K |
| 83002 |
|
742 |
740 |
$14K |
| 83718 |
|
1,984 |
1,966 |
$13K |
| 84163 |
|
856 |
841 |
$13K |
| 87502 |
|
695 |
680 |
$13K |
| 86431 |
|
2,256 |
2,223 |
$12K |
| 87081 |
|
2,766 |
2,650 |
$12K |
| 87637 |
|
951 |
934 |
$12K |
| 80306 |
|
1,786 |
1,708 |
$12K |
| 73552 |
|
195 |
185 |
$12K |
| 86160 |
|
447 |
422 |
$10K |
| 85046 |
|
2,065 |
1,999 |
$10K |
| 70543 |
|
27 |
27 |
$10K |
| 82150 |
|
1,848 |
1,797 |
$10K |
| 85018 |
|
5,751 |
5,455 |
$10K |
| 86360 |
|
362 |
354 |
$10K |
| 86677 |
|
908 |
899 |
$10K |
| A9609 |
F18 fdg, 15 millicuries |
211 |
210 |
$10K |
| G0008 |
Admin influenza virus vac |
3,436 |
3,406 |
$10K |
| 82951 |
|
653 |
649 |
$10K |
| 87635 |
|
514 |
493 |
$10K |
| 94640 |
|
387 |
203 |
$9K |
| 84480 |
|
843 |
821 |
$9K |
| 73560 |
|
140 |
117 |
$9K |
| 87070 |
|
2,239 |
1,891 |
$9K |
| 76813 |
|
93 |
93 |
$9K |
| 73700 |
|
93 |
91 |
$9K |
| 87205 |
|
3,439 |
3,107 |
$9K |
| 80179 |
|
1,505 |
1,433 |
$8K |
| 84155 |
|
2,167 |
2,126 |
$8K |
| 82465 |
|
2,275 |
2,258 |
$8K |
| 86359 |
|
362 |
354 |
$8K |
| 74174 |
|
27 |
27 |
$8K |
| 87186 |
|
2,336 |
2,272 |
$8K |
| J2250 |
Inj midazolam hydrochloride |
1,666 |
1,613 |
$8K |
| 0250 |
|
13,582 |
8,139 |
$7K |
| 82627 |
|
305 |
305 |
$7K |
| 84270 |
|
341 |
329 |
$7K |
| 74022 |
|
80 |
76 |
$7K |
| 96367 |
|
870 |
791 |
$7K |
| 87804 |
|
1,511 |
748 |
$7K |
| 86308 |
|
1,497 |
1,486 |
$7K |
| J3490 |
Drugs unclassified injection |
8,186 |
6,283 |
$7K |
| Z7502 |
|
598 |
563 |
$6K |
| 86765 |
|
519 |
518 |
$6K |
| 72110 |
|
52 |
50 |
$6K |
| J3475 |
Inj magnesium sulfate |
2,967 |
2,651 |
$6K |
| J1815 |
Insulin injection |
5,497 |
2,278 |
$6K |
| 96366 |
|
634 |
610 |
$6K |
| 82785 |
|
371 |
359 |
$6K |
| 73060 |
|
115 |
109 |
$6K |
| 72170 |
|
57 |
55 |
$6K |
| 77072 |
|
59 |
59 |
$6K |
| 86140 |
|
2,064 |
1,979 |
$6K |
| J3360 |
Diazepam injection |
930 |
839 |
$6K |
| 82378 |
|
488 |
452 |
$6K |
| J1650 |
Inj enoxaparin sodium |
2,129 |
1,283 |
$6K |
| 87522 |
Neg quan hep c or qual rna |
208 |
203 |
$6K |
| 82805 |
|
865 |
766 |
$6K |
| 72040 |
|
94 |
90 |
$6K |
| J2765 |
Metoclopramide hcl injection |
3,719 |
3,277 |
$5K |
| 86769 |
|
256 |
252 |
$5K |
| J1200 |
Diphenhydramine hcl injectio |
4,174 |
3,670 |
$5K |
| 74178 |
|
13 |
12 |
$5K |
| C1769 |
Guide wire |
277 |
264 |
$5K |
| J1644 |
Inj heparin sodium per 1000u |
3,834 |
1,895 |
$5K |
| 97161 |
|
587 |
584 |
$5K |
| V2632 |
Post chmbr intraocular lens |
297 |
294 |
$4K |
| 80321 |
|
108 |
102 |
$4K |
| 80178 |
|
929 |
837 |
$4K |
| 86364 |
|
361 |
361 |
$4K |
| 87517 |
|
106 |
102 |
$4K |
| 86708 |
|
391 |
387 |
$4K |
| J0780 |
Prochlorperazine injection |
1,929 |
1,820 |
$4K |
| J2930 |
Methylprednisolone injection |
1,372 |
1,245 |
$4K |
| 76706 |
|
242 |
242 |
$3K |
| 72081 |
|
61 |
61 |
$3K |
| 73718 |
|
12 |
12 |
$3K |
| 87631 |
|
151 |
147 |
$3K |
| J2060 |
Lorazepam injection |
2,408 |
2,008 |
$3K |
| 82962 |
|
4,232 |
2,851 |
$3K |
| 84145 |
|
1,415 |
1,289 |
$3K |
| 90749 |
|
185 |
183 |
$3K |
| 86709 |
|
381 |
375 |
$3K |
| 86256 |
|
193 |
186 |
$3K |
| 82952 |
|
623 |
619 |
$3K |
| 82140 |
|
605 |
543 |
$3K |
| 89051 |
|
713 |
513 |
$3K |
| 90656 |
|
715 |
715 |
$3K |
| 76815 |
|
13 |
13 |
$3K |
| 76700 |
|
25 |
24 |
$2K |
| 82272 |
|
599 |
595 |
$2K |
| 86376 |
|
170 |
167 |
$2K |
| 80156 |
|
237 |
213 |
$2K |
| 73000 |
|
29 |
28 |
$2K |
| 90688 |
|
170 |
170 |
$2K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
237 |
232 |
$2K |
| 82533 |
|
127 |
124 |
$2K |
| 97530 |
|
286 |
192 |
$2K |
| 80162 |
|
129 |
122 |
$2K |
| 82677 |
|
55 |
55 |
$2K |
| 84425 |
|
81 |
79 |
$2K |
| 81015 |
|
513 |
507 |
$1K |
| 86635 |
|
148 |
73 |
$1K |
| 73070 |
|
25 |
24 |
$1K |
| 90791 |
|
77 |
75 |
$1K |
| 88184 |
|
12 |
12 |
$1K |
| J3480 |
Inj potassium chloride |
1,921 |
1,322 |
$1K |
| 80359 |
|
142 |
133 |
$1K |
| 85045 |
|
424 |
410 |
$1K |
| 86039 |
|
166 |
158 |
$1K |
| 77063 |
|
62 |
62 |
$1K |
| 80324 |
|
142 |
133 |
$1K |
| 0258 |
|
2,572 |
2,141 |
$1K |
| 74230 |
|
13 |
13 |
$1K |
| 86235 |
|
27 |
27 |
$1K |
| J1940 |
Furosemide injection |
2,334 |
1,367 |
$1K |
| 86336 |
|
55 |
55 |
$973.00 |
| 86335 |
|
25 |
25 |
$805.57 |
| 90471 |
|
1,173 |
1,169 |
$803.21 |
| 83935 |
|
275 |
260 |
$721.30 |
| 72220 |
|
13 |
13 |
$712.90 |
| 90662 |
|
424 |
423 |
$689.31 |
| 87102 |
|
107 |
96 |
$688.30 |
| 83930 |
|
297 |
284 |
$676.54 |
| 86334 |
|
57 |
57 |
$641.07 |
| 86735 |
|
57 |
56 |
$634.21 |
| J2001 |
Lidocaine injection |
24 |
24 |
$621.37 |
| 87807 |
|
262 |
254 |
$575.12 |
| 84478 |
|
125 |
114 |
$567.00 |
| 74240 |
|
13 |
13 |
$558.00 |
| 85613 |
|
65 |
63 |
$535.66 |
| 0255 |
|
174 |
116 |
$532.14 |
| J7060 |
5% dextrose/water |
147 |
108 |
$493.42 |
| 80048 |
|
88 |
87 |
$480.43 |
| 97162 |
|
128 |
127 |
$470.81 |
| J1836 |
Inj, metronidazole, 10 mg |
451 |
293 |
$469.49 |
| 87116 |
|
51 |
37 |
$449.76 |
| J2550 |
Promethazine hcl injection |
362 |
301 |
$437.54 |
| 87075 |
|
88 |
66 |
$406.00 |
| 87045 |
|
62 |
62 |
$404.50 |
| J2919 |
Inj, methylpred sod succ 5mg |
281 |
204 |
$404.09 |
| 80185 |
|
28 |
26 |
$395.39 |
| 0272 |
|
237 |
232 |
$386.31 |
| C1894 |
Intro/sheath, non-laser |
60 |
59 |
$362.08 |
| J1630 |
Haloperidol injection |
195 |
155 |
$350.57 |
| Q9957 |
Inj perflutren lip micros,ml |
37 |
30 |
$342.66 |
| 85384 |
|
111 |
90 |
$339.42 |
| 90674 |
|
15 |
15 |
$325.90 |
| 86880 |
|
13 |
12 |
$306.99 |
| 90715 |
|
42 |
40 |
$304.44 |
| J3370 |
Vancomycin hcl injection |
193 |
118 |
$298.31 |
| 84590 |
|
54 |
54 |
$282.69 |
| J2272 |
Inj, morphine (fresenius) |
223 |
201 |
$279.35 |
| C9113 |
Inj pantoprazole sodium, via |
805 |
539 |
$269.70 |
| 97116 |
|
182 |
156 |
$267.37 |
| J0360 |
Hydralazine hcl injection |
139 |
116 |
$256.68 |
| J2175 |
Meperidine hydrochl /100 mg |
71 |
68 |
$251.42 |
| C1729 |
Cath, drainage |
27 |
26 |
$237.91 |
| C1725 |
Cath, translumin non-laser |
88 |
84 |
$225.57 |
| 87327 |
|
17 |
15 |
$213.13 |
| 85049 |
|
52 |
52 |
$206.86 |
| 87046 |
|
13 |
13 |
$200.00 |
| 87206 |
|
43 |
37 |
$185.87 |
| 87149 |
|
113 |
110 |
$174.41 |
| 83525 |
|
13 |
13 |
$158.00 |
| 83010 |
|
12 |
12 |
$148.00 |
| 82705 |
|
26 |
26 |
$141.00 |
| J3371 |
Inj, vancomycin hcl (mylan) |
42 |
27 |
$140.28 |
| 87426 |
|
18 |
16 |
$138.50 |
| 12001 |
|
30 |
30 |
$134.69 |
| 82390 |
|
12 |
12 |
$120.00 |
| G0480 |
Drug test def 1-7 classes |
48 |
42 |
$112.00 |
| 87338 |
|
12 |
12 |
$88.00 |
| 80175 |
|
13 |
12 |
$83.72 |
| J7512 |
Prednisone ir or dr oral 1mg |
1,627 |
1,143 |
$72.32 |
| 85670 |
|
14 |
12 |
$70.00 |
| J1335 |
Ertapenem injection |
28 |
15 |
$56.52 |
| Q0144 |
Azithromycin dihydrate, oral |
30 |
27 |
$45.07 |
| J2470 |
Inj pantoprazole sodium 40mg |
190 |
138 |
$40.26 |
| J3411 |
Thiamine hcl 100 mg |
44 |
36 |
$34.75 |
| J7042 |
5% dextrose/normal saline |
67 |
51 |
$34.10 |
| 80320 |
|
49 |
44 |
$33.00 |
| 87184 |
|
17 |
17 |
$32.85 |
| J0456 |
Azithromycin |
65 |
53 |
$20.47 |
| 29125 |
|
28 |
27 |
$17.17 |
| J7040 |
Normal saline solution infus |
29 |
26 |
$5.81 |
| C1758 |
Catheter, ureteral |
60 |
58 |
$4.97 |
| J8540 |
Oral dexamethasone |
28 |
25 |
$1.53 |
| 3052F |
|
175 |
172 |
$0.01 |
| 3046F |
|
362 |
358 |
$0.00 |
| 93010 |
|
166 |
165 |
$0.00 |
| 3051F |
|
384 |
383 |
$0.00 |
| 3078F |
|
120 |
118 |
$0.00 |
| 76942 |
|
12 |
12 |
$0.00 |
| 92012 |
|
38 |
38 |
$0.00 |
| 11721 |
|
55 |
55 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
177 |
126 |
$0.00 |
| 92134 |
|
47 |
25 |
$0.00 |
| 82274 |
|
364 |
363 |
$0.00 |
| 92015 |
|
29 |
29 |
$0.00 |
| J0692 |
Cefepime hcl for injection |
24 |
13 |
$0.00 |
| 92610 |
|
15 |
14 |
$0.00 |
| 99204 |
|
13 |
12 |
$0.00 |
| 87255 |
|
14 |
14 |
$0.00 |
| 99213 |
|
257 |
254 |
$0.00 |
| 86592 |
|
12 |
12 |
$0.00 |
| 3044F |
|
6,547 |
6,514 |
$0.00 |
| J2280 |
Inj, moxifloxacin 100 mg |
160 |
159 |
$0.00 |
| 88185 |
|
12 |
12 |
$0.00 |
| 11055 |
|
14 |
14 |
$0.00 |
| 3074F |
|
149 |
147 |
$0.00 |
| 90935 |
|
38 |
26 |
$0.00 |
| 83921 |
|
27 |
27 |
$0.00 |
| G0145 |
Scr c/v cyto,thinlayer,rescr |
62 |
62 |
$0.00 |
| 99214 |
|
54 |
53 |
$0.00 |
| 92227 |
|
208 |
208 |
$0.00 |
| J8501 |
Oral aprepitant |
13 |
13 |
$0.00 |
| 80329 |
|
37 |
19 |
$0.00 |