| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
130,701 |
117,315 |
$48.52M |
| 99284 |
|
99,901 |
89,103 |
$45.31M |
| 99285 |
|
57,361 |
49,035 |
$21.66M |
| G0378 |
Hospital observation per hr |
30,276 |
21,333 |
$14.72M |
| H0035 |
Mh partial hosp tx under 24h |
25,089 |
2,845 |
$7.90M |
| A0427 |
Als1-emergency |
21,220 |
19,607 |
$6.32M |
| 99282 |
|
30,424 |
28,483 |
$5.95M |
| S9480 |
Intensive outpatient psychia |
6,409 |
5,761 |
$5.27M |
| 59025 |
|
7,043 |
3,204 |
$3.53M |
| 74177 |
|
12,752 |
12,213 |
$2.97M |
| A0429 |
Bls-emergency |
14,238 |
11,865 |
$2.80M |
| 76811 |
|
5,616 |
5,548 |
$2.11M |
| 70450 |
|
19,752 |
18,447 |
$2.01M |
| A0425 |
Ground mileage |
44,023 |
36,925 |
$1.98M |
| A0434 |
Specialty care transport |
3,686 |
3,485 |
$1.75M |
| 99281 |
|
7,890 |
7,207 |
$1.44M |
| 96413 |
|
3,935 |
2,141 |
$1.33M |
| 96375 |
|
23,056 |
19,318 |
$1.25M |
| 43239 |
|
680 |
653 |
$1.22M |
| OP250 |
|
392,842 |
153,924 |
$1.20M |
| 93306 |
|
2,449 |
2,376 |
$1.15M |
| 41899 |
|
410 |
410 |
$1.15M |
| 76817 |
|
7,905 |
7,062 |
$1.03M |
| 74176 |
|
5,622 |
5,387 |
$1.02M |
| 77067 |
|
7,283 |
7,234 |
$920K |
| 76801 |
|
9,646 |
8,394 |
$907K |
| OP370 |
|
6,543 |
6,089 |
$830K |
| 93005 |
|
50,270 |
43,688 |
$784K |
| 90935 |
|
1,501 |
157 |
$749K |
| 71275 |
|
3,742 |
3,607 |
$708K |
| 76856 |
|
7,198 |
6,984 |
$674K |
| 71046 |
|
36,475 |
34,793 |
$660K |
| 76816 |
|
7,174 |
6,911 |
$655K |
| OP710 |
|
8,056 |
6,575 |
$642K |
| 72125 |
|
6,033 |
5,664 |
$637K |
| 70553 |
|
787 |
759 |
$607K |
| 80307 |
|
22,520 |
19,966 |
$603K |
| 76830 |
|
6,465 |
6,295 |
$566K |
| 76700 |
|
5,959 |
5,819 |
$555K |
| 76813 |
|
3,836 |
3,779 |
$554K |
| 76815 |
|
6,697 |
4,542 |
$493K |
| 85025 |
|
103,355 |
87,353 |
$488K |
| 96374 |
|
37,232 |
33,256 |
$475K |
| 93017 |
|
1,649 |
1,593 |
$469K |
| 0241U |
|
16,743 |
15,603 |
$465K |
| 93970 |
|
3,532 |
3,396 |
$465K |
| 70551 |
|
1,406 |
1,337 |
$435K |
| 71260 |
|
2,305 |
2,195 |
$429K |
| 93971 |
|
3,524 |
3,377 |
$422K |
| J9271 |
Inj pembrolizumab |
38 |
24 |
$402K |
| 80048 |
|
110,592 |
88,400 |
$381K |
| 77063 |
|
6,684 |
6,634 |
$377K |
| 70486 |
|
2,325 |
2,248 |
$366K |
| 96361 |
|
4,107 |
3,435 |
$353K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
20,108 |
18,764 |
$340K |
| 78452 |
|
1,139 |
1,111 |
$311K |
| OP272 |
|
8,268 |
4,857 |
$299K |
| 71045 |
|
21,634 |
19,889 |
$292K |
| C8929 |
Tte w or wo fol wcon,doppler |
1,331 |
1,267 |
$282K |
| 71250 |
|
1,596 |
1,537 |
$264K |
| 96365 |
|
8,628 |
7,329 |
$263K |
| 76770 |
|
2,463 |
2,362 |
$261K |
| 77066 |
Tomosynthesis, mammo |
1,301 |
1,286 |
$235K |
| 80053 |
|
21,459 |
16,928 |
$234K |
| 96372 |
|
17,117 |
14,751 |
$223K |
| 76642 |
|
2,467 |
2,284 |
$222K |
| 97597 |
|
974 |
540 |
$218K |
| 93976 |
|
1,229 |
1,184 |
$213K |
| 77336 |
|
1,891 |
765 |
$210K |
| A0433 |
Als 2 |
565 |
554 |
$206K |
| 77412 |
|
2,680 |
255 |
$202K |
| 72148 |
|
448 |
439 |
$200K |
| 78815 |
|
150 |
143 |
$197K |
| 90853 |
|
665 |
77 |
$184K |
| G0177 |
Opps/php/iop; train & educ |
2,650 |
306 |
$182K |
| 93458 |
|
124 |
111 |
$178K |
| 76805 |
|
1,133 |
1,125 |
$178K |
| 72100 |
|
5,283 |
5,165 |
$173K |
| 96417 |
|
605 |
355 |
$161K |
| 73562 |
|
6,619 |
6,402 |
$154K |
| 76705 |
|
2,512 |
2,403 |
$150K |
| A0998 |
Ambulance response/treatment |
777 |
752 |
$146K |
| 77065 |
Tomosynthesis, mammo |
1,184 |
1,145 |
$141K |
| A0428 |
Bls |
7,433 |
6,036 |
$140K |
| 87426 |
|
11,125 |
10,350 |
$132K |
| G0279 |
Tomosynthesis, mammo |
2,380 |
2,320 |
$131K |
| G0463 |
Hospital outpt clinic visit |
10,624 |
6,876 |
$130K |
| 96360 |
|
1,454 |
1,301 |
$130K |
| 87428 |
|
13,277 |
12,752 |
$128K |
| 99214 |
|
9,286 |
8,150 |
$125K |
| 73630 |
|
6,227 |
6,019 |
$125K |
| 96415 |
|
327 |
209 |
$124K |
| 90791 |
|
4,349 |
3,692 |
$120K |
| 76536 |
|
1,051 |
1,036 |
$119K |
| J2406 |
Injection, oritavancin 10 mg |
120 |
108 |
$117K |
| 73030 |
|
4,952 |
4,768 |
$116K |
| OP270 |
|
8,963 |
6,754 |
$115K |
| 80320 |
|
7,411 |
6,452 |
$114K |
| 36415 |
|
40,165 |
30,863 |
$111K |
| J2469 |
Palonosetron hcl |
1,212 |
675 |
$109K |
| 99211 |
|
13,517 |
10,313 |
$108K |
| 73130 |
|
5,117 |
4,928 |
$107K |
| 94640 |
|
12,392 |
9,050 |
$102K |
| 73610 |
|
5,479 |
5,264 |
$100K |
| 76818 |
|
660 |
477 |
$98K |
| 72131 |
|
693 |
678 |
$98K |
| 77080 |
|
1,015 |
1,004 |
$94K |
| 84484 |
|
30,945 |
24,958 |
$94K |
| 88305 |
|
3,816 |
3,626 |
$92K |
| OP379 |
|
2,045 |
1,808 |
$90K |
| 76376 |
|
3,443 |
3,299 |
$89K |
| 94060 |
|
265 |
260 |
$84K |
| 76857 |
|
2,291 |
2,196 |
$84K |
| 76870 |
|
1,231 |
1,185 |
$82K |
| 85027 |
|
33,290 |
27,056 |
$80K |
| 74022 |
|
4,137 |
3,996 |
$79K |
| 99213 |
|
7,498 |
6,016 |
$79K |
| Q9957 |
Inj perflutren lip micros,ml |
1,551 |
1,477 |
$76K |
| 87491 |
|
7,879 |
7,662 |
$75K |
| 84443 |
|
7,431 |
6,880 |
$75K |
| 70491 |
|
434 |
418 |
$73K |
| J1815 |
Insulin injection |
5,235 |
3,290 |
$71K |
| 82948 |
|
42,395 |
30,993 |
$71K |
| 10060 |
|
1,645 |
1,540 |
$70K |
| 58558 |
|
26 |
25 |
$68K |
| A9502 |
Tc99m tetrofosmin |
1,158 |
1,079 |
$66K |
| 87591 |
|
7,879 |
7,661 |
$66K |
| 11042 |
|
1,021 |
569 |
$65K |
| 85610 |
|
23,008 |
17,922 |
$64K |
| 84703 |
|
56,008 |
50,963 |
$64K |
| 73110 |
|
2,985 |
2,905 |
$62K |
| 80076 |
|
29,033 |
26,271 |
$60K |
| 81220 |
|
541 |
541 |
$57K |
| G0480 |
Drug test def 1-7 classes |
840 |
683 |
$57K |
| 74018 |
|
3,051 |
2,823 |
$56K |
| 82077 |
|
11,311 |
9,672 |
$53K |
| 71271 |
|
558 |
550 |
$53K |
| J7030 |
Normal saline solution infus |
47,581 |
40,559 |
$53K |
| 76820 |
|
682 |
499 |
$52K |
| 72040 |
|
1,958 |
1,884 |
$52K |
| 77334 |
|
99 |
57 |
$52K |
| 93880 |
|
257 |
245 |
$51K |
| 12001 |
|
1,276 |
1,201 |
$50K |
| G0410 |
Grp psych php/iop 45-50 |
1,244 |
201 |
$48K |
| 90715 |
|
5,147 |
5,043 |
$48K |
| 99215 |
Prolong outpt/office vis |
3,285 |
2,671 |
$48K |
| 93460 |
|
30 |
24 |
$46K |
| 81001 |
|
53,362 |
49,382 |
$43K |
| 73502 |
|
2,407 |
2,325 |
$42K |
| J1885 |
Ketorolac tromethamine inj |
30,826 |
28,132 |
$40K |
| 0202U |
|
535 |
504 |
$39K |
| J2785 |
Regadenoson injection |
270 |
258 |
$39K |
| 94644 |
|
2,505 |
2,253 |
$38K |
| 73080 |
|
1,856 |
1,801 |
$37K |
| C1769 |
Guide wire |
1,790 |
1,554 |
$36K |
| 87502 |
|
2,092 |
2,065 |
$35K |
| 12011 |
|
924 |
844 |
$34K |
| J2704 |
Inj, propofol, 10 mg |
8,231 |
7,579 |
$33K |
| 83690 |
|
25,992 |
23,739 |
$32K |
| J1644 |
Inj heparin sodium per 1000u |
9,849 |
5,223 |
$32K |
| 71101 |
|
1,609 |
1,564 |
$31K |
| 73721 |
|
37 |
37 |
$31K |
| 76775 |
|
379 |
371 |
$31K |
| 80061 |
|
4,589 |
4,466 |
$30K |
| 83735 |
|
17,614 |
13,828 |
$30K |
| 96376 |
|
2,759 |
2,458 |
$28K |
| P9016 |
Rbc leukocytes reduced |
419 |
327 |
$28K |
| 85007 |
|
10,007 |
8,758 |
$27K |
| J1100 |
Dexamethasone sodium phos |
15,924 |
14,150 |
$26K |
| 73590 |
|
1,477 |
1,413 |
$25K |
| 87631 |
|
1,008 |
993 |
$25K |
| 87070 |
|
9,354 |
9,088 |
$25K |
| 83880 |
|
4,654 |
4,162 |
$24K |
| 86703 |
|
1,356 |
1,353 |
$24K |
| 70498 |
|
183 |
177 |
$24K |
| J2405 |
Ondansetron hcl injection |
27,276 |
24,187 |
$24K |
| J7307 |
Etonogestrel implant system |
32 |
27 |
$24K |
| J1642 |
Inj heparin sodium per 10 u |
2,617 |
1,719 |
$23K |
| J3010 |
Fentanyl citrate injection |
8,598 |
7,846 |
$23K |
| 83036 |
|
7,227 |
6,821 |
$23K |
| 70496 |
|
142 |
139 |
$23K |
| J0131 |
Inj, acetaminophen (nos) |
4,552 |
4,253 |
$22K |
| 84702 |
|
5,609 |
4,777 |
$22K |
| 85730 |
|
12,861 |
11,819 |
$22K |
| 99212 |
|
2,075 |
1,905 |
$21K |
| 95819 |
|
89 |
85 |
$21K |
| J0882 |
Darbepoetin alfa, esrd use |
481 |
120 |
$20K |
| 94729 |
|
255 |
250 |
$20K |
| 83605 |
|
6,050 |
5,392 |
$20K |
| 73140 |
|
1,722 |
1,684 |
$20K |
| 73090 |
|
1,102 |
1,072 |
$19K |
| 86900 |
|
6,459 |
6,012 |
$19K |
| 87186 |
|
3,484 |
3,325 |
$19K |
| 86885 |
|
5,519 |
5,142 |
$19K |
| 80047 |
|
6,725 |
6,317 |
$19K |
| 29515 |
|
1,162 |
1,093 |
$18K |
| A9579 |
Gad-base mr contrast nos,1ml |
1,090 |
1,057 |
$18K |
| 49083 |
|
81 |
40 |
$18K |
| 87880 |
|
8,058 |
7,889 |
$18K |
| J0897 |
Denosumab injection |
25 |
25 |
$18K |
| 29125 |
|
1,435 |
1,328 |
$18K |
| J0185 |
Inj., aprepitant, 1 mg |
137 |
84 |
$17K |
| 77290 |
|
70 |
54 |
$17K |
| 82805 |
|
4,259 |
3,883 |
$17K |
| Q0138 |
Ferumoxytol, non-esrd |
23 |
14 |
$16K |
| 12002 |
|
478 |
450 |
$16K |
| J2250 |
Inj midazolam hydrochloride |
7,315 |
6,901 |
$16K |
| 97161 |
|
1,536 |
1,402 |
$16K |
| 72052 |
|
179 |
176 |
$16K |
| J2060 |
Lorazepam injection |
6,758 |
5,818 |
$16K |
| 87635 |
|
1,123 |
1,086 |
$15K |
| 82728 |
|
1,876 |
1,736 |
$15K |
| 86787 |
|
648 |
647 |
$15K |
| 81003 |
|
15,319 |
14,607 |
$15K |
| 87086 |
|
5,736 |
5,488 |
$15K |
| 87077 |
|
3,711 |
3,539 |
$15K |
| 87088 |
|
8,992 |
8,557 |
$15K |
| 77300 |
|
45 |
26 |
$14K |
| 90471 |
|
2,300 |
2,119 |
$14K |
| J1200 |
Diphenhydramine hcl injectio |
9,708 |
8,218 |
$14K |
| 94727 |
|
227 |
222 |
$13K |
| 84100 |
|
7,979 |
6,377 |
$13K |
| J3370 |
Vancomycin hcl injection |
2,156 |
1,294 |
$13K |
| 82550 |
|
6,420 |
5,164 |
$13K |
| J7050 |
Normal saline solution infus |
4,278 |
2,817 |
$13K |
| 96366 |
|
313 |
223 |
$13K |
| 99205 |
Prolong outpt/office vis |
679 |
613 |
$12K |
| J1650 |
Inj enoxaparin sodium |
5,721 |
3,121 |
$12K |
| J2270 |
Morphine sulfate injection |
7,851 |
5,772 |
$12K |
| J1953 |
Levetiracetam injection |
1,299 |
980 |
$11K |
| J7040 |
Normal saline solution infus |
3,445 |
2,813 |
$11K |
| 86901 |
|
6,467 |
6,024 |
$11K |
| 87040 |
|
3,159 |
2,928 |
$11K |
| 86803 |
|
767 |
762 |
$11K |
| 72070 |
|
376 |
366 |
$11K |
| 99204 |
|
815 |
802 |
$11K |
| J1270 |
Injection, doxercalciferol |
579 |
68 |
$11K |
| 80329 |
|
408 |
391 |
$10K |
| J7512 |
Prednisone ir or dr oral 1mg |
10,037 |
8,908 |
$10K |
| 84145 |
|
2,958 |
2,252 |
$10K |
| 96523 |
|
108 |
101 |
$10K |
| 99203 |
|
758 |
727 |
$10K |
| 88304 |
|
853 |
798 |
$10K |
| 82607 |
|
1,626 |
1,514 |
$10K |
| J0134 |
Inj acetaminophen -fresenius |
2,887 |
2,542 |
$10K |
| J2310 |
Inj naloxone hydrochloride |
1,430 |
1,190 |
$10K |
| 95816 |
|
15 |
15 |
$10K |
| 86710 |
|
4,404 |
4,342 |
$10K |
| 76000 |
|
472 |
433 |
$9K |
| 85380 |
|
6,714 |
6,490 |
$9K |
| 93571 |
|
13 |
12 |
$9K |
| J1170 |
Hydromorphone injection |
4,854 |
3,526 |
$9K |
| 74174 |
|
58 |
55 |
$9K |
| 70360 |
|
457 |
449 |
$9K |
| S2900 |
Robotic surgical system |
181 |
146 |
$9K |
| 74246 |
|
57 |
55 |
$8K |
| J1756 |
Iron sucrose injection |
389 |
118 |
$8K |
| 82306 |
|
571 |
565 |
$8K |
| J2543 |
Piperacillin/tazobactam |
1,282 |
720 |
$8K |
| 96411 |
|
45 |
24 |
$8K |
| 74247 |
|
42 |
42 |
$8K |
| C1725 |
Cath, translumin non-laser |
147 |
141 |
$8K |
| 76819 |
|
70 |
66 |
$7K |
| 72141 |
|
26 |
24 |
$7K |
| 31505 |
|
261 |
153 |
$7K |
| 73560 |
|
177 |
160 |
$7K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
1,181 |
1,081 |
$7K |
| J3475 |
Inj magnesium sulfate |
2,847 |
2,125 |
$7K |
| 99202 |
|
900 |
862 |
$7K |
| 83540 |
|
1,911 |
1,756 |
$7K |
| J1630 |
Haloperidol injection |
3,092 |
2,684 |
$6K |
| 73564 |
|
264 |
253 |
$6K |
| C9803 |
Hopd covid-19 spec collect |
115 |
113 |
$6K |
| C1887 |
Catheter, guiding |
358 |
303 |
$6K |
| 74183 |
|
16 |
16 |
$6K |
| J2930 |
Methylprednisolone injection |
2,046 |
1,902 |
$6K |
| J0696 |
Ceftriaxone sodium injection |
7,877 |
6,608 |
$6K |
| 87205 |
|
1,912 |
1,815 |
$6K |
| 74019 |
|
351 |
345 |
$6K |
| 83519 |
|
1,342 |
1,279 |
$6K |
| 80164 |
|
426 |
378 |
$6K |
| 96367 |
|
379 |
300 |
$5K |
| 87641 |
|
286 |
254 |
$5K |
| OP279 |
|
1,897 |
1,881 |
$5K |
| 82746 |
|
920 |
864 |
$5K |
| 78582 |
|
78 |
78 |
$5K |
| 36430 |
|
369 |
265 |
$5K |
| 97162 |
|
437 |
395 |
$5K |
| 93325 |
|
12 |
12 |
$5K |
| J2765 |
Metoclopramide hcl injection |
7,523 |
6,850 |
$4K |
| C9113 |
Inj pantoprazole sodium, via |
1,933 |
1,158 |
$4K |
| 99201 |
|
396 |
396 |
$4K |
| 97116 |
|
1,313 |
965 |
$4K |
| 58300 |
|
147 |
137 |
$4K |
| 83615 |
|
927 |
806 |
$4K |
| 86140 |
|
4,223 |
4,005 |
$4K |
| 99152 |
|
403 |
332 |
$4K |
| 82553 |
|
1,229 |
969 |
$4K |
| 83020 |
|
633 |
633 |
$4K |
| 78580 |
|
64 |
60 |
$3K |
| 90792 |
|
102 |
86 |
$3K |
| 84550 |
|
617 |
588 |
$3K |
| 84439 |
|
1,031 |
994 |
$3K |
| OP278 |
|
44 |
39 |
$3K |
| 72110 |
|
43 |
43 |
$3K |
| 84144 |
|
168 |
167 |
$3K |
| 88341 |
|
74 |
65 |
$3K |
| A9552 |
F18 fdg |
173 |
155 |
$3K |
| 88307 |
|
174 |
159 |
$3K |
| J0690 |
Cefazolin sodium injection |
2,884 |
2,336 |
$3K |
| OP258 |
|
1,676 |
1,153 |
$3K |
| J0500 |
Dicyclomine injection |
473 |
456 |
$3K |
| J0360 |
Hydralazine hcl injection |
1,089 |
914 |
$3K |
| 88342 |
|
497 |
451 |
$3K |
| 82248 |
|
527 |
490 |
$3K |
| S9484 |
Crisis intervention per hour |
160 |
89 |
$3K |
| J7120 |
Ringers lactate infusion |
3,185 |
2,528 |
$3K |
| C1751 |
Cath, inf, per/cent/midline |
101 |
88 |
$2K |
| 73552 |
|
197 |
194 |
$2K |
| 11981 |
|
26 |
25 |
$2K |
| 90375 |
|
12 |
12 |
$2K |
| 72128 |
|
27 |
25 |
$2K |
| 84132 |
|
1,650 |
1,489 |
$2K |
| 86706 |
|
232 |
229 |
$2K |
| 87340 |
|
1,069 |
1,062 |
$2K |
| 82330 |
|
772 |
713 |
$2K |
| 85045 |
|
912 |
739 |
$2K |
| 72170 |
|
170 |
156 |
$2K |
| M0243 |
Casirivi and imdevi inj |
87 |
83 |
$2K |
| C9290 |
Inj, bupivacaine liposome |
46 |
42 |
$2K |
| 73060 |
|
90 |
88 |
$2K |
| 86762 |
|
726 |
726 |
$2K |
| 84156 |
|
977 |
799 |
$2K |
| A9540 |
Tc99m maa |
151 |
140 |
$2K |
| 88312 |
|
594 |
569 |
$2K |
| 72072 |
|
145 |
135 |
$1K |
| J2370 |
Phenylephrine hcl injection |
512 |
385 |
$1K |
| J1940 |
Furosemide injection |
1,022 |
661 |
$1K |
| 86923 |
|
220 |
173 |
$1K |
| 99153 |
Mod sedat endo service >5yrs |
85 |
70 |
$1K |
| 82274 |
|
980 |
934 |
$1K |
| 85651 |
|
1,909 |
1,801 |
$1K |
| 36600 |
|
167 |
161 |
$1K |
| 90686 |
|
175 |
172 |
$1K |
| 94726 |
|
16 |
16 |
$1K |
| J2920 |
Methylprednisolone injection |
811 |
548 |
$1K |
| 86756 |
|
804 |
797 |
$1K |
| J0290 |
Ampicillin 500 mg inj |
510 |
502 |
$1K |
| 86480 |
|
29 |
29 |
$991.60 |
| 83970 |
|
123 |
116 |
$989.55 |
| OP255 |
|
1,648 |
1,504 |
$970.66 |
| M0247 |
Sotrovimab infusion |
56 |
49 |
$864.45 |
| 80074 |
|
76 |
71 |
$857.98 |
| 88173 |
|
25 |
24 |
$816.00 |
| 73523 |
|
13 |
13 |
$807.58 |
| 97535 |
|
241 |
174 |
$801.61 |
| OP271 |
|
105 |
98 |
$766.75 |
| 97530 |
|
320 |
211 |
$754.13 |
| A9558 |
Xe133 xenon 10mci |
78 |
78 |
$744.55 |
| 90675 |
|
34 |
16 |
$739.52 |
| J2919 |
Inj, methylpred sod succ 5mg |
571 |
353 |
$720.67 |
| 80305 |
|
55 |
24 |
$666.48 |
| J3480 |
Inj potassium chloride |
509 |
357 |
$656.84 |
| 82150 |
|
280 |
276 |
$629.65 |
| U0001 |
2019-ncov diagnostic p |
76 |
74 |
$615.52 |
| J0574 |
Bupren/nal 6.1 to 10mg bupre |
403 |
271 |
$596.44 |
| J2471 |
Inj pantoprazole(hikma) 40mg |
367 |
191 |
$580.88 |
| 29505 |
|
40 |
40 |
$545.26 |
| J7042 |
5% dextrose/normal saline |
782 |
583 |
$532.52 |
| M0245 |
Bamlan and etesev infusion |
27 |
27 |
$527.72 |
| J3420 |
Vitamin b12 injection |
134 |
96 |
$500.88 |
| 76937 |
|
80 |
63 |
$478.41 |
| 82378 |
|
31 |
24 |
$461.09 |
| 86708 |
|
39 |
39 |
$456.00 |
| 82570 |
|
695 |
627 |
$448.59 |
| C1894 |
Intro/sheath, non-laser |
46 |
39 |
$433.49 |
| J3411 |
Thiamine hcl 100 mg |
251 |
161 |
$425.40 |
| 85576 |
|
12 |
12 |
$408.12 |
| 86704 |
|
29 |
29 |
$405.00 |
| 0031A |
|
19 |
19 |
$398.73 |
| 86780 |
|
124 |
120 |
$368.61 |
| 82043 |
|
368 |
365 |
$363.06 |
| 86592 |
|
1,323 |
1,313 |
$343.71 |
| J2274 |
Inj morphine pf epid ithc |
459 |
399 |
$340.59 |
| 12013 |
|
16 |
14 |
$323.18 |
| Q0247 |
Sotrovimab |
55 |
48 |
$307.95 |
| J2305 |
Inj, nitroglycerin, 5 mg |
98 |
92 |
$302.79 |
| 29130 |
|
57 |
52 |
$285.65 |
| 96368 |
|
19 |
13 |
$284.00 |
| J8540 |
Oral dexamethasone |
443 |
376 |
$275.69 |
| J0744 |
Ciprofloxacin iv |
99 |
66 |
$273.38 |
| 83550 |
|
40 |
40 |
$273.06 |
| J3486 |
Ziprasidone mesylate |
13 |
12 |
$249.34 |
| J1790 |
Droperidol injection |
222 |
198 |
$247.78 |
| 85347 |
|
155 |
134 |
$242.74 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
557 |
500 |
$233.32 |
| J1920 |
Inj, labetalol hcl, 5mg |
246 |
213 |
$232.55 |
| 97165 |
|
24 |
24 |
$199.74 |
| J0703 |
Inj, cefepime hcl (b braun) |
94 |
44 |
$190.91 |
| J2710 |
Neostigmine methylslfte inj |
462 |
339 |
$180.14 |
| 84481 |
|
26 |
25 |
$165.50 |
| 82803 |
|
40 |
38 |
$165.00 |
| 87493 |
|
24 |
24 |
$163.01 |
| 97166 |
|
34 |
31 |
$154.02 |
| J0736 |
Inj, clindamycin phosp 300mg |
18 |
13 |
$144.45 |
| 82947 |
|
808 |
746 |
$129.19 |
| 73660 |
|
30 |
28 |
$129.09 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
509 |
393 |
$104.33 |
| 85384 |
|
24 |
24 |
$96.00 |
| 94660 |
|
16 |
12 |
$85.50 |
| 82950 |
|
26 |
26 |
$78.00 |
| J7620 |
Albuterol ipratrop non-comp |
114 |
90 |
$74.57 |
| 82108 |
|
16 |
16 |
$73.74 |
| 86308 |
|
119 |
117 |
$68.02 |
| 84295 |
|
605 |
557 |
$50.60 |
| J0688 |
Inj cefazolin sodium, hikma |
471 |
423 |
$48.92 |
| 83930 |
|
65 |
60 |
$47.61 |
| 82310 |
|
122 |
101 |
$44.98 |
| 80202 |
|
40 |
28 |
$43.32 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
89 |
71 |
$42.99 |
| 87045 |
|
25 |
24 |
$40.65 |
| 82435 |
|
543 |
494 |
$34.85 |
| J7613 |
Albuterol non-comp unit |
140 |
106 |
$32.70 |
| 90656 |
|
19 |
18 |
$32.10 |
| J0780 |
Prochlorperazine injection |
24 |
24 |
$31.44 |
| 82140 |
|
51 |
40 |
$31.13 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
47 |
30 |
$30.91 |
| J0572 |
Bupren/nal up to 3mg bupreno |
15 |
12 |
$26.49 |
| J1836 |
Inj, metronidazole, 10 mg |
20 |
13 |
$22.44 |
| J2001 |
Lidocaine injection |
86 |
75 |
$19.42 |
| 84520 |
|
154 |
128 |
$16.50 |
| J3360 |
Diazepam injection |
42 |
39 |
$8.32 |
| J0456 |
Azithromycin |
24 |
12 |
$7.93 |
| 88300 |
|
18 |
14 |
$7.23 |
| 88302 |
|
14 |
12 |
$5.34 |
| Q0244 |
Casirivi and imdevi 1200 mg |
88 |
84 |
$5.00 |
| 84300 |
|
17 |
14 |
$4.05 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
301 |
210 |
$3.37 |
| J7070 |
D5w infusion |
12 |
12 |
$3.32 |
| 90585 |
|
20 |
15 |
$3.00 |
| 91303 |
|
18 |
18 |
$1.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
783 |
744 |
$0.01 |
| G0237 |
Therapeutic procd strg endur |
23 |
13 |
$0.00 |
| OP911 |
|
31 |
26 |
$0.00 |
| 90472 |
|
13 |
12 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
202 |
152 |
$0.00 |
| J1030 |
Methylprednisolone 40 mg inj |
100 |
75 |
$0.00 |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
857 |
827 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
12 |
12 |
$0.00 |