| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
88,509 |
86,652 |
$11.83M |
| A4649 |
Surgical supplies |
2,948 |
2,603 |
$5.71M |
| J9271 |
Inj pembrolizumab |
584 |
454 |
$4.98M |
| 0450 |
|
79,021 |
70,924 |
$4.56M |
| 99284 |
|
44,269 |
43,453 |
$4.16M |
| 99283 |
|
63,913 |
58,852 |
$3.93M |
| 70450 |
|
11,411 |
11,092 |
$2.82M |
| 74176 |
|
14,177 |
13,741 |
$2.55M |
| 0241U |
|
12,946 |
12,449 |
$2.16M |
| 74178 |
|
6,217 |
6,092 |
$2.08M |
| 80053 |
|
102,919 |
86,772 |
$2.01M |
| 0510 |
|
43,082 |
35,542 |
$1.82M |
| 96374 |
|
25,482 |
23,389 |
$1.76M |
| 93005 |
|
50,771 |
46,378 |
$1.75M |
| 97110 |
|
69,250 |
15,457 |
$1.68M |
| G0463 |
Hospital outpt clinic visit |
108,265 |
82,133 |
$1.60M |
| 85025 |
|
115,572 |
95,664 |
$1.58M |
| 99233 |
Prolong inpt eval add15 m |
20,425 |
8,701 |
$1.52M |
| 96361 |
|
22,465 |
18,802 |
$1.21M |
| 96375 |
|
25,215 |
20,145 |
$1.19M |
| 99291 |
|
6,296 |
5,277 |
$1.13M |
| 99221 |
|
5,950 |
5,677 |
$1.11M |
| 96365 |
|
17,710 |
12,239 |
$1.08M |
| 80307 |
|
14,443 |
10,028 |
$953K |
| 99223 |
Prolong inpt eval add15 m |
8,323 |
8,046 |
$953K |
| 87633 |
|
2,062 |
2,026 |
$938K |
| 0360 |
|
6,836 |
3,866 |
$916K |
| 72125 |
|
2,757 |
2,709 |
$822K |
| 96372 |
|
30,444 |
24,731 |
$696K |
| 99215 |
Prolong outpt/office vis |
7,850 |
6,749 |
$646K |
| 99239 |
|
8,341 |
8,070 |
$642K |
| 99214 |
|
14,555 |
14,094 |
$627K |
| L8699 |
Prosthetic implant nos |
153 |
151 |
$614K |
| J0897 |
Denosumab injection |
629 |
621 |
$613K |
| 99499 |
|
3,405 |
2,817 |
$596K |
| J0131 |
Inj, acetaminophen (nos) |
5,153 |
4,890 |
$594K |
| 76705 |
|
5,938 |
5,727 |
$575K |
| 0361 |
|
3,039 |
2,546 |
$555K |
| 93010 |
|
71,197 |
59,881 |
$535K |
| 71275 |
|
2,217 |
2,175 |
$520K |
| 96360 |
|
7,749 |
6,802 |
$516K |
| 84484 |
|
19,234 |
16,052 |
$513K |
| 99232 |
|
8,817 |
4,413 |
$494K |
| 71045 |
|
25,297 |
24,022 |
$437K |
| 71046 |
|
14,774 |
14,380 |
$413K |
| 76856 |
|
3,557 |
3,404 |
$371K |
| 83690 |
|
25,887 |
24,276 |
$362K |
| U0003 |
Cov-19 amp prb hgh thruput |
4,682 |
4,424 |
$358K |
| 81001 |
|
53,011 |
48,955 |
$357K |
| 96366 |
|
5,651 |
3,619 |
$351K |
| 72131 |
|
1,171 |
1,160 |
$338K |
| 99231 |
|
7,108 |
6,594 |
$337K |
| 20610 |
|
11,461 |
8,515 |
$335K |
| J7323 |
Euflexxa inj per dose |
2,466 |
1,191 |
$326K |
| 93971 |
|
2,144 |
2,094 |
$325K |
| 84703 |
|
19,747 |
18,571 |
$319K |
| 0710 |
|
5,612 |
5,402 |
$317K |
| 99222 |
|
2,848 |
2,720 |
$291K |
| 88305 |
|
5,015 |
3,816 |
$291K |
| 76830 |
|
2,736 |
2,611 |
$285K |
| 97750 |
|
4,396 |
3,867 |
$282K |
| 93306 |
|
4,803 |
4,705 |
$269K |
| 84702 |
|
10,832 |
9,705 |
$262K |
| 70551 |
|
442 |
436 |
$248K |
| 73564 |
|
6,576 |
5,118 |
$247K |
| 73610 |
|
6,424 |
5,618 |
$246K |
| 73630 |
|
6,759 |
5,727 |
$242K |
| J3490 |
Drugs unclassified injection |
51,653 |
25,506 |
$233K |
| 74177 |
|
675 |
669 |
$216K |
| Z7502 |
|
6,582 |
6,361 |
$211K |
| 73110 |
|
5,307 |
4,468 |
$208K |
| 0762 |
|
2,433 |
1,272 |
$201K |
| 96413 |
|
5,743 |
3,421 |
$200K |
| 73030 |
|
5,852 |
5,246 |
$199K |
| 87631 |
|
2,473 |
2,449 |
$198K |
| S9976 |
Lodging per diem |
3,757 |
1,734 |
$198K |
| 83735 |
|
19,141 |
14,158 |
$190K |
| 87491 |
|
2,384 |
2,261 |
$165K |
| 87591 |
|
2,384 |
2,260 |
$165K |
| 94799 |
|
1,920 |
1,599 |
$161K |
| 70486 |
|
525 |
518 |
$158K |
| 99238 |
|
4,096 |
4,046 |
$158K |
| 99218 |
|
857 |
823 |
$157K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
14,980 |
14,469 |
$153K |
| 73130 |
|
3,987 |
3,455 |
$153K |
| 70496 |
|
696 |
691 |
$152K |
| 87507 |
|
403 |
394 |
$152K |
| 74174 |
|
491 |
488 |
$147K |
| 80048 |
|
10,172 |
9,250 |
$145K |
| 84443 |
|
6,021 |
5,637 |
$143K |
| 87040 |
|
7,459 |
4,112 |
$143K |
| 82947 |
|
17,626 |
10,744 |
$142K |
| 94640 |
|
6,128 |
5,395 |
$140K |
| 93976 |
|
422 |
407 |
$139K |
| 96367 |
|
3,307 |
2,467 |
$134K |
| 71250 |
|
529 |
525 |
$134K |
| 70498 |
|
786 |
782 |
$130K |
| 83880 |
|
5,198 |
4,827 |
$128K |
| 78452 |
|
1,026 |
1,015 |
$128K |
| 97799 |
|
4,194 |
1,550 |
$125K |
| 83605 |
|
6,240 |
5,492 |
$124K |
| 87086 |
|
11,478 |
10,878 |
$124K |
| 88304 |
|
2,320 |
2,154 |
$120K |
| 87635 |
|
1,958 |
1,832 |
$119K |
| 73562 |
|
3,762 |
3,451 |
$117K |
| 76801 |
|
1,357 |
1,218 |
$116K |
| J1439 |
Inj ferric carboxymaltos 1mg |
203 |
133 |
$108K |
| 87651 |
|
1,686 |
1,659 |
$106K |
| C9290 |
Inj, bupivacaine liposome |
419 |
409 |
$106K |
| 0272 |
|
798 |
733 |
$105K |
| 99213 |
|
2,309 |
2,287 |
$102K |
| 97763 |
|
2,393 |
990 |
$102K |
| P9016 |
Rbc leukocytes reduced |
494 |
418 |
$102K |
| 86850 |
|
7,370 |
6,705 |
$101K |
| 76817 |
|
1,114 |
1,009 |
$99K |
| 88342 |
|
1,219 |
1,000 |
$97K |
| 86923 |
|
806 |
487 |
$96K |
| 73502 |
|
2,749 |
2,683 |
$93K |
| 85730 |
|
9,723 |
8,960 |
$92K |
| J0885 |
Epoetin alfa, non-esrd |
1,187 |
691 |
$89K |
| 97139 |
|
3,431 |
588 |
$85K |
| 72110 |
|
1,250 |
1,221 |
$85K |
| 94664 |
|
5,689 |
4,778 |
$84K |
| 99070 |
|
3,786 |
2,540 |
$83K |
| 85610 |
|
17,041 |
13,461 |
$82K |
| 87081 |
|
7,154 |
7,045 |
$78K |
| 36415 |
|
21,420 |
16,573 |
$76K |
| 93308 |
|
561 |
555 |
$74K |
| 87186 |
|
4,927 |
4,210 |
$73K |
| 97140 |
|
7,160 |
2,703 |
$71K |
| J2785 |
Regadenoson injection |
950 |
943 |
$71K |
| J7120 |
Ringers lactate infusion |
8,011 |
7,226 |
$69K |
| J0585 |
Injection,onabotulinumtoxina |
255 |
134 |
$69K |
| 71270 |
|
203 |
202 |
$66K |
| 72100 |
|
1,553 |
1,527 |
$65K |
| G0378 |
Hospital observation per hr |
1,371 |
992 |
$59K |
| 93970 |
|
224 |
221 |
$58K |
| 62323 |
|
739 |
730 |
$57K |
| 87641 |
|
1,833 |
1,807 |
$57K |
| 96415 |
|
2,063 |
1,373 |
$57K |
| 72128 |
|
230 |
229 |
$57K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
31 |
24 |
$56K |
| 86901 |
|
7,339 |
6,677 |
$56K |
| 83036 |
|
5,148 |
5,057 |
$56K |
| 81025 |
|
6,278 |
6,023 |
$56K |
| J8501 |
Oral aprepitant |
1,411 |
1,381 |
$55K |
| J0702 |
Betamethasone acet&sod phosp |
4,774 |
4,430 |
$54K |
| 73140 |
|
2,067 |
1,847 |
$54K |
| 86140 |
|
6,084 |
5,682 |
$52K |
| 87070 |
|
3,036 |
2,903 |
$52K |
| 96523 |
|
1,254 |
898 |
$51K |
| 64450 |
|
704 |
687 |
$50K |
| 73070 |
|
1,473 |
1,233 |
$49K |
| 97165 |
|
1,030 |
958 |
$48K |
| 0637 |
|
3,414 |
2,164 |
$47K |
| 87077 |
|
6,511 |
5,220 |
$47K |
| 94060 |
|
1,202 |
1,166 |
$47K |
| J1815 |
Insulin injection |
2,324 |
1,640 |
$46K |
| 76870 |
|
434 |
414 |
$46K |
| 90715 |
|
1,485 |
1,458 |
$45K |
| J1756 |
Iron sucrose injection |
1,852 |
877 |
$44K |
| Q3014 |
Telehealth facility fee |
5,477 |
4,912 |
$43K |
| 99217 |
|
687 |
682 |
$43K |
| 85379 |
|
1,954 |
1,928 |
$42K |
| 27447 |
|
53 |
51 |
$41K |
| 73590 |
|
1,213 |
1,101 |
$40K |
| J1437 |
Inj. fe derisomaltose 10 mg |
27 |
27 |
$40K |
| A9500 |
Tc99m sestamibi |
688 |
683 |
$40K |
| 86900 |
|
7,349 |
6,689 |
$38K |
| J7030 |
Normal saline solution infus |
11,044 |
9,739 |
$37K |
| 87880 |
|
1,987 |
1,933 |
$37K |
| 73080 |
|
909 |
852 |
$37K |
| 64483 |
|
991 |
980 |
$36K |
| J2704 |
Inj, propofol, 10 mg |
11,841 |
11,243 |
$35K |
| 82550 |
|
2,927 |
2,666 |
$35K |
| 96417 |
|
985 |
606 |
$34K |
| 87075 |
|
1,960 |
1,789 |
$33K |
| 11042 |
|
565 |
279 |
$32K |
| 87804 |
|
3,010 |
2,890 |
$32K |
| 49083 |
|
485 |
288 |
$31K |
| J1885 |
Ketorolac tromethamine inj |
19,657 |
18,294 |
$30K |
| J1170 |
Hydromorphone injection |
8,169 |
6,513 |
$29K |
| 94729 |
|
934 |
915 |
$29K |
| 73560 |
|
1,087 |
986 |
$29K |
| 73090 |
|
834 |
702 |
$29K |
| J1100 |
Dexamethasone sodium phos |
18,273 |
15,461 |
$29K |
| 99224 |
|
338 |
323 |
$28K |
| 84439 |
|
2,285 |
2,053 |
$26K |
| J1030 |
Methylprednisolone 40 mg inj |
3,160 |
2,862 |
$26K |
| J2270 |
Morphine sulfate injection |
7,438 |
6,452 |
$26K |
| J0690 |
Cefazolin sodium injection |
8,072 |
7,268 |
$26K |
| 64493 |
|
576 |
561 |
$25K |
| J7050 |
Normal saline solution infus |
18,646 |
9,139 |
$25K |
| J7060 |
5% dextrose/water |
10,655 |
6,308 |
$25K |
| 88313 |
|
418 |
271 |
$25K |
| 87636 |
|
194 |
193 |
$24K |
| 0100U |
|
184 |
177 |
$24K |
| 87205 |
|
3,232 |
2,917 |
$23K |
| 77002 |
|
625 |
613 |
$23K |
| J2405 |
Ondansetron hcl injection |
23,581 |
20,594 |
$23K |
| 84100 |
|
4,190 |
3,297 |
$23K |
| U0002 |
Covid-19 lab test non-cdc |
342 |
335 |
$22K |
| 94726 |
|
762 |
749 |
$22K |
| 80061 |
|
3,054 |
2,986 |
$21K |
| J2795 |
Ropivacaine hcl injection |
4,037 |
3,842 |
$20K |
| 77067 |
|
199 |
195 |
$20K |
| 97162 |
|
1,087 |
1,076 |
$19K |
| 20550 |
|
1,348 |
1,126 |
$19K |
| 99454 |
|
1,813 |
1,812 |
$19K |
| C9088 |
Instill, bupivac and meloxic |
64 |
62 |
$19K |
| 97530 |
|
3,701 |
1,711 |
$19K |
| 81003 |
|
5,514 |
5,116 |
$18K |
| 74018 |
|
666 |
632 |
$18K |
| 72170 |
|
499 |
492 |
$18K |
| 99443 |
|
291 |
277 |
$18K |
| J0696 |
Ceftriaxone sodium injection |
6,873 |
5,512 |
$18K |
| 93017 |
|
347 |
340 |
$18K |
| 96368 |
|
849 |
630 |
$17K |
| 82805 |
|
322 |
302 |
$17K |
| J1642 |
Inj heparin sodium per 10 u |
4,122 |
2,080 |
$17K |
| J3301 |
Triamcinolone acet inj nos |
2,544 |
2,439 |
$17K |
| 85652 |
|
4,350 |
4,043 |
$16K |
| 70492 |
|
55 |
54 |
$16K |
| 88307 |
|
171 |
157 |
$16K |
| 87389 |
|
811 |
809 |
$15K |
| 94760 |
|
3,178 |
2,641 |
$15K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
4,441 |
4,282 |
$15K |
| 76604 |
|
362 |
350 |
$15K |
| 82728 |
|
2,132 |
2,062 |
$15K |
| 92507 |
|
325 |
152 |
$15K |
| 0250 |
|
534 |
453 |
$15K |
| 72040 |
|
361 |
344 |
$15K |
| 82607 |
|
2,056 |
2,024 |
$14K |
| J3010 |
Fentanyl citrate injection |
10,966 |
9,850 |
$14K |
| 84145 |
|
653 |
640 |
$14K |
| 64494 |
|
520 |
507 |
$14K |
| 77065 |
Tomosynthesis, mammo |
214 |
204 |
$13K |
| 99225 |
|
156 |
151 |
$13K |
| C9145 |
Inj, aponvie, 1 mg |
275 |
273 |
$13K |
| 99211 |
|
1,336 |
1,222 |
$13K |
| Q0163 |
Diphenhydramine hcl 50mg |
3,121 |
2,738 |
$13K |
| 70488 |
|
39 |
38 |
$13K |
| Q0162 |
Ondansetron oral |
7,863 |
7,543 |
$12K |
| 82746 |
|
1,190 |
1,172 |
$12K |
| 74240 |
|
111 |
109 |
$12K |
| 29405 |
|
517 |
405 |
$12K |
| 88311 |
|
772 |
737 |
$11K |
| 76805 |
|
76 |
72 |
$11K |
| J2003 |
Inj, lidocaine hcl, 1 mg |
350 |
290 |
$11K |
| 59025 |
|
467 |
422 |
$11K |
| 73000 |
|
290 |
250 |
$11K |
| 87071 |
|
1,868 |
1,756 |
$10K |
| 82306 |
|
1,197 |
1,177 |
$10K |
| 93880 |
|
136 |
135 |
$10K |
| 77066 |
Tomosynthesis, mammo |
130 |
125 |
$10K |
| J3370 |
Vancomycin hcl injection |
1,941 |
1,555 |
$10K |
| J2469 |
Palonosetron hcl |
620 |
380 |
$10K |
| 76642 |
|
163 |
159 |
$10K |
| J1626 |
Granisetron hcl injection |
4,414 |
2,120 |
$10K |
| J1040 |
Methylprednisolone 80 mg inj |
1,156 |
1,135 |
$10K |
| J2930 |
Methylprednisolone injection |
1,586 |
1,369 |
$9K |
| 86803 |
|
452 |
451 |
$9K |
| J1453 |
Fosaprepitant injection |
322 |
224 |
$9K |
| 74241 |
|
85 |
84 |
$9K |
| J2765 |
Metoclopramide hcl injection |
5,365 |
4,919 |
$8K |
| J7327 |
Monovisc inj per dose |
12 |
12 |
$8K |
| 82010 |
|
504 |
469 |
$8K |
| 90471 |
|
1,835 |
1,762 |
$8K |
| 97112 |
|
1,757 |
851 |
$8K |
| 87088 |
|
791 |
743 |
$8K |
| 82248 |
|
870 |
854 |
$8K |
| 29125 |
|
542 |
506 |
$8K |
| J7040 |
Normal saline solution infus |
2,524 |
1,857 |
$8K |
| 96376 |
|
889 |
671 |
$8K |
| J0171 |
Adrenalin epinephrine inject |
1,187 |
1,091 |
$8K |
| 73700 |
|
26 |
26 |
$7K |
| 82375 |
|
331 |
313 |
$7K |
| 83550 |
|
1,691 |
1,643 |
$7K |
| 73100 |
|
240 |
174 |
$7K |
| 87340 |
|
559 |
557 |
$7K |
| G0108 |
Diab manage trn per indiv |
236 |
201 |
$7K |
| 51798 |
|
393 |
366 |
$7K |
| 97116 |
|
1,003 |
592 |
$6K |
| J2370 |
Phenylephrine hcl injection |
885 |
861 |
$6K |
| 76770 |
|
62 |
62 |
$6K |
| J2272 |
Inj, morphine (fresenius) |
987 |
829 |
$6K |
| J0136 |
Inj, acetaminophen (b braun) |
548 |
529 |
$6K |
| 20611 |
|
247 |
185 |
$6K |
| J2250 |
Inj midazolam hydrochloride |
9,761 |
9,469 |
$6K |
| J1200 |
Diphenhydramine hcl injectio |
6,016 |
4,562 |
$6K |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
2,507 |
2,281 |
$5K |
| 99457 |
|
698 |
696 |
$5K |
| 86706 |
|
329 |
329 |
$5K |
| J3475 |
Inj magnesium sulfate |
2,318 |
1,441 |
$5K |
| C1769 |
Guide wire |
64 |
55 |
$5K |
| J1644 |
Inj heparin sodium per 1000u |
2,827 |
1,688 |
$5K |
| J2543 |
Piperacillin/tazobactam |
1,033 |
688 |
$5K |
| 26055 |
|
32 |
24 |
$5K |
| 76942 |
|
136 |
107 |
$5K |
| 99442 |
|
109 |
106 |
$5K |
| 29881 |
|
24 |
24 |
$4K |
| 86780 |
|
312 |
286 |
$4K |
| 88300 |
|
201 |
188 |
$4K |
| 29075 |
|
313 |
286 |
$4K |
| 87428 |
|
592 |
579 |
$4K |
| 87807 |
|
379 |
363 |
$4K |
| 83050 |
|
319 |
301 |
$4K |
| 77063 |
|
123 |
120 |
$4K |
| 82570 |
|
1,074 |
936 |
$4K |
| J2060 |
Lorazepam injection |
3,152 |
2,657 |
$4K |
| 29515 |
|
301 |
245 |
$4K |
| 64635 |
|
39 |
39 |
$4K |
| 87147 |
|
450 |
399 |
$4K |
| 90837 |
|
245 |
149 |
$4K |
| 99281 |
|
906 |
843 |
$3K |
| A9585 |
Gadobutrol injection |
170 |
170 |
$3K |
| J0561 |
Penicillin g benzathine inj |
12 |
12 |
$3K |
| J2001 |
Lidocaine injection |
6,416 |
6,318 |
$3K |
| J1650 |
Inj enoxaparin sodium |
1,388 |
892 |
$3K |
| 83615 |
|
954 |
863 |
$3K |
| 64488 |
|
59 |
36 |
$3K |
| 51701 |
|
47 |
47 |
$3K |
| 64636 |
|
54 |
50 |
$3K |
| 29827 |
|
12 |
12 |
$3K |
| J7318 |
Inj, durolane 1 mg |
12 |
12 |
$3K |
| J3420 |
Vitamin b12 injection |
4,732 |
4,142 |
$3K |
| 88341 |
|
36 |
26 |
$3K |
| 88112 |
|
77 |
66 |
$3K |
| G0480 |
Drug test def 1-7 classes |
224 |
175 |
$3K |
| 93296 |
|
264 |
263 |
$3K |
| 84132 |
|
61 |
60 |
$3K |
| 86704 |
|
155 |
155 |
$3K |
| 20526 |
|
240 |
237 |
$3K |
| G2211 |
Complex e/m visit add on |
284 |
274 |
$3K |
| 87210 |
|
285 |
281 |
$3K |
| J3480 |
Inj potassium chloride |
1,972 |
1,127 |
$3K |
| J1010 |
Inj, methylpred acetate 1 mg |
492 |
485 |
$2K |
| 96416 |
|
40 |
25 |
$2K |
| 86308 |
|
231 |
228 |
$2K |
| 12001 |
|
142 |
138 |
$2K |
| 99204 |
|
37 |
37 |
$2K |
| 01400 |
|
13 |
13 |
$2K |
| 10060 |
|
98 |
92 |
$2K |
| 43239 |
|
50 |
50 |
$2K |
| 86592 |
|
355 |
342 |
$2K |
| 87798 |
|
28 |
24 |
$2K |
| 71101 |
|
24 |
24 |
$2K |
| 20605 |
|
50 |
48 |
$2K |
| 84550 |
|
372 |
319 |
$2K |
| 96521 |
|
92 |
24 |
$2K |
| J0640 |
Leucovorin calcium injection |
80 |
25 |
$2K |
| 99497 |
|
32 |
28 |
$2K |
| 51702 |
|
73 |
64 |
$2K |
| 0097U |
|
13 |
13 |
$1K |
| 84156 |
|
431 |
330 |
$1K |
| 76376 |
|
286 |
284 |
$1K |
| 76937 |
|
29 |
28 |
$1K |
| 29848 |
|
13 |
13 |
$1K |
| J2919 |
Inj, methylpred sod succ 5mg |
249 |
204 |
$1K |
| 99024 |
|
436 |
363 |
$1K |
| 64490 |
|
24 |
24 |
$1K |
| 99308 |
|
36 |
25 |
$1K |
| J9190 |
Fluorouracil injection |
181 |
41 |
$1K |
| 99152 |
|
68 |
61 |
$1K |
| J2371 |
Inj phenylephrine hcl 20 mcg |
510 |
491 |
$1K |
| 62321 |
|
39 |
39 |
$1K |
| 73521 |
|
50 |
49 |
$1K |
| 83970 |
|
27 |
27 |
$1K |
| G1004 |
Cdsm ndsc |
2,421 |
1,979 |
$1K |
| 76882 |
|
38 |
37 |
$1K |
| 82272 |
|
395 |
378 |
$980.08 |
| 90686 |
|
184 |
184 |
$959.26 |
| J8540 |
Oral dexamethasone |
416 |
351 |
$883.49 |
| 97166 |
|
40 |
40 |
$861.76 |
| 73503 |
|
22 |
22 |
$810.30 |
| 99219 |
|
14 |
14 |
$780.00 |
| 88302 |
|
13 |
12 |
$767.99 |
| J3411 |
Thiamine hcl 100 mg |
208 |
166 |
$739.98 |
| J1580 |
Garamycin gentamicin inj |
269 |
241 |
$734.49 |
| 96402 |
|
55 |
50 |
$730.56 |
| 73552 |
|
29 |
29 |
$710.80 |
| 97535 |
|
117 |
63 |
$710.38 |
| 87015 |
|
60 |
56 |
$671.44 |
| J0688 |
Inj cefazolin sodium, hikma |
41 |
41 |
$655.40 |
| G2066 |
Inter devc remote 30d |
60 |
55 |
$597.97 |
| 99203 |
|
12 |
12 |
$577.72 |
| 12011 |
|
25 |
24 |
$549.21 |
| J0670 |
Inj mepivacaine hcl/10 ml |
179 |
175 |
$545.91 |
| 25600 |
|
27 |
24 |
$537.65 |
| 93356 |
|
25 |
25 |
$532.68 |
| J7512 |
Prednisone ir or dr oral 1mg |
1,195 |
1,018 |
$521.83 |
| J0360 |
Hydralazine hcl injection |
191 |
169 |
$516.37 |
| 84300 |
|
98 |
89 |
$501.72 |
| 80320 |
|
385 |
361 |
$490.26 |
| 97014 |
|
148 |
52 |
$481.48 |
| 86709 |
|
25 |
25 |
$472.00 |
| 85027 |
|
47 |
39 |
$464.50 |
| J1940 |
Furosemide injection |
526 |
354 |
$453.75 |
| 97163 |
|
16 |
16 |
$442.69 |
| J1953 |
Levetiracetam injection |
76 |
66 |
$399.70 |
| 29065 |
|
19 |
16 |
$399.01 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
127 |
95 |
$362.78 |
| J0330 |
Succinycholine chloride inj |
109 |
108 |
$347.25 |
| 64484 |
|
48 |
48 |
$333.20 |
| J1790 |
Droperidol injection |
29 |
26 |
$306.82 |
| 87106 |
|
14 |
13 |
$305.22 |
| J3360 |
Diazepam injection |
45 |
45 |
$298.87 |
| G0279 |
Tomosynthesis, mammo |
64 |
64 |
$288.94 |
| 99195 |
|
12 |
12 |
$273.39 |
| 86880 |
|
36 |
28 |
$257.07 |
| 82378 |
|
12 |
12 |
$251.40 |
| C9113 |
Inj pantoprazole sodium, via |
54 |
38 |
$231.00 |
| J2175 |
Meperidine hydrochl /100 mg |
30 |
29 |
$225.90 |
| 99458 |
|
12 |
12 |
$225.49 |
| 83520 |
|
27 |
25 |
$225.20 |
| 84403 |
|
29 |
29 |
$205.59 |
| J2470 |
Inj pantoprazole sodium 40mg |
45 |
27 |
$205.54 |
| 84165 |
|
25 |
25 |
$193.55 |
| 97161 |
|
13 |
13 |
$189.36 |
| J1956 |
Levofloxacin injection |
107 |
94 |
$171.15 |
| 89051 |
|
15 |
14 |
$152.80 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
232 |
231 |
$151.68 |
| 82784 |
|
32 |
24 |
$138.55 |
| 82043 |
|
164 |
160 |
$128.56 |
| 0003A |
|
12 |
12 |
$120.00 |
| 96401 |
|
30 |
12 |
$119.38 |
| J0737 |
Inj, clindamycin (baxter) |
14 |
12 |
$118.82 |
| 29085 |
|
14 |
12 |
$117.60 |
| 0451 |
|
801 |
768 |
$114.85 |
| J0280 |
Aminophyllin 250 mg inj |
26 |
26 |
$113.40 |
| 84153 |
|
12 |
12 |
$112.72 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
130 |
105 |
$100.15 |
| 20552 |
|
12 |
12 |
$98.69 |
| J1920 |
Inj, labetalol hcl, 5mg |
132 |
120 |
$91.96 |
| 64615 |
|
13 |
12 |
$91.01 |
| 64491 |
|
12 |
12 |
$88.20 |
| G0008 |
Admin influenza virus vac |
311 |
311 |
$77.55 |
| J1630 |
Haloperidol injection |
54 |
50 |
$71.28 |
| J0290 |
Ampicillin 500 mg inj |
41 |
41 |
$51.31 |
| G0283 |
Elec stim other than wound |
23 |
12 |
$43.70 |
| J2004 |
Inj, lidocaine w epinephrine |
37 |
35 |
$34.10 |
| 90653 |
|
28 |
28 |
$33.57 |
| 99453 |
|
26 |
26 |
$24.88 |
| 87426 |
|
50 |
50 |
$24.45 |
| 85045 |
|
12 |
12 |
$19.72 |
| 86359 |
|
12 |
12 |
$19.57 |
| 86360 |
|
12 |
12 |
$17.77 |
| J1836 |
Inj, metronidazole, 10 mg |
17 |
13 |
$17.00 |
| 87185 |
|
14 |
12 |
$13.16 |
| J7510 |
Prednisolone oral per 5 mg |
25 |
25 |
$6.78 |
| Q0177 |
Hydroxyzine pamoate 25mg |
27 |
25 |
$3.30 |
| G8979 |
Mobility goal status |
102 |
85 |
$0.01 |
| G8978 |
Mobility current status |
86 |
73 |
$0.01 |
| 91300 |
|
66 |
65 |
$0.00 |
| 0002A |
|
30 |
29 |
$0.00 |
| 1160F |
|
13 |
12 |
$0.00 |
| G9744 |
Pt not eli d/t act dig htn |
14 |
13 |
$0.00 |
| 3288F |
|
13 |
12 |
$0.00 |
| 94761 |
|
12 |
12 |
$0.00 |
| 90694 |
|
92 |
92 |
$0.00 |
| 3008F |
|
13 |
12 |
$0.00 |
| P9612 |
Catheterize for urine spec |
62 |
61 |
$0.00 |
| G8982 |
Body pos goal status |
14 |
13 |
$0.00 |
| 0001A |
|
28 |
28 |
$0.00 |
| 1170F |
|
13 |
12 |
$0.00 |
| 80329 |
|
100 |
48 |
$0.00 |
| 0270 |
|
17 |
13 |
$0.00 |
| Q4051 |
Splint supplies misc |
17 |
17 |
$0.00 |