| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
|
24,203 |
18,664 |
$6.70M |
| 74177 |
|
4,950 |
4,038 |
$2.16M |
| 99285 |
|
7,485 |
3,789 |
$2.09M |
| 74176 |
|
4,656 |
3,890 |
$1.50M |
| 99283 |
|
12,004 |
9,789 |
$1.27M |
| G0463 |
Hospital outpt clinic visit |
27,254 |
19,152 |
$1.02M |
| 96374 |
|
13,575 |
8,046 |
$770K |
| 70450 |
|
4,801 |
3,757 |
$733K |
| 41899 |
|
440 |
432 |
$708K |
| 93306 |
|
2,326 |
2,086 |
$624K |
| 71045 |
|
14,119 |
10,649 |
$563K |
| 80053 |
|
67,138 |
45,338 |
$558K |
| 96365 |
|
9,175 |
4,461 |
$506K |
| 99291 |
|
940 |
681 |
$503K |
| G0378 |
Hospital observation per hr |
4,336 |
2,568 |
$491K |
| 43239 |
|
1,829 |
1,047 |
$460K |
| 96361 |
|
11,476 |
5,682 |
$452K |
| 20610 |
|
4,129 |
2,553 |
$360K |
| 73721 |
|
960 |
855 |
$332K |
| 71275 |
|
1,294 |
1,018 |
$326K |
| 69436 |
|
327 |
320 |
$300K |
| U0003 |
Cov-19 amp prb hgh thruput |
5,199 |
4,490 |
$293K |
| 78452 |
|
1,484 |
691 |
$291K |
| 72125 |
|
1,506 |
1,300 |
$279K |
| 47562 |
|
152 |
99 |
$276K |
| 97110 |
|
5,180 |
1,064 |
$275K |
| 92507 |
|
5,139 |
1,836 |
$270K |
| 97530 |
|
4,400 |
1,484 |
$258K |
| 36415 |
|
67,543 |
32,825 |
$250K |
| 72148 |
|
708 |
658 |
$248K |
| 85025 |
|
57,988 |
47,479 |
$240K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
8,462 |
6,188 |
$231K |
| 93005 |
|
13,361 |
10,994 |
$226K |
| 59025 |
|
2,608 |
1,751 |
$224K |
| 71250 |
|
1,515 |
1,290 |
$221K |
| 96360 |
|
5,552 |
2,524 |
$218K |
| 71260 |
|
1,011 |
625 |
$210K |
| 82306 |
|
9,783 |
9,155 |
$203K |
| 99282 |
|
3,106 |
2,836 |
$201K |
| 84443 |
|
17,725 |
16,597 |
$200K |
| U0002 |
Covid-19 lab test non-cdc |
6,142 |
4,545 |
$193K |
| 76705 |
|
2,138 |
1,951 |
$184K |
| 96375 |
|
7,102 |
4,947 |
$178K |
| 72131 |
|
1,065 |
868 |
$175K |
| 42820 |
|
59 |
59 |
$174K |
| 73110 |
|
3,920 |
2,587 |
$174K |
| 87631 |
|
3,168 |
2,983 |
$169K |
| 76536 |
|
1,978 |
1,751 |
$167K |
| 80061 |
|
15,958 |
14,178 |
$161K |
| 73610 |
|
3,969 |
2,870 |
$159K |
| 71046 |
|
3,480 |
2,927 |
$147K |
| 73564 |
|
3,270 |
2,452 |
$142K |
| 80307 |
|
5,410 |
4,772 |
$141K |
| G0480 |
Drug test def 1-7 classes |
3,438 |
2,413 |
$129K |
| 96366 |
|
2,243 |
1,345 |
$124K |
| 73030 |
|
3,590 |
2,771 |
$123K |
| 73130 |
|
2,828 |
2,180 |
$118K |
| 77067 |
|
2,210 |
2,108 |
$114K |
| 70553 |
|
272 |
208 |
$114K |
| 73630 |
|
2,715 |
2,174 |
$103K |
| 73562 |
|
2,312 |
2,008 |
$102K |
| 70486 |
|
550 |
503 |
$95K |
| 82652 |
|
3,474 |
3,242 |
$94K |
| U0005 |
Infec agen detec ampli probe |
4,905 |
4,354 |
$94K |
| 80074 |
|
2,764 |
2,523 |
$94K |
| 82607 |
|
8,447 |
7,962 |
$84K |
| 73080 |
|
1,781 |
1,262 |
$78K |
| 96372 |
|
8,630 |
5,535 |
$78K |
| 99213 |
|
2,539 |
1,996 |
$75K |
| 93971 |
|
877 |
762 |
$72K |
| 83036 |
|
9,511 |
8,941 |
$60K |
| C9803 |
Hopd covid-19 spec collect |
10,276 |
7,451 |
$59K |
| 99214 |
|
1,884 |
1,504 |
$58K |
| 84484 |
|
9,588 |
7,955 |
$57K |
| 20550 |
|
1,058 |
668 |
$54K |
| 87522 |
Neg quan hep c or qual rna |
2,019 |
1,816 |
$53K |
| 72141 |
|
128 |
112 |
$53K |
| 88305 |
|
2,090 |
1,831 |
$52K |
| 45378 |
|
147 |
100 |
$51K |
| 93017 |
|
681 |
637 |
$50K |
| 66984 |
|
183 |
43 |
$49K |
| 83880 |
|
3,407 |
2,980 |
$48K |
| 99281 |
|
1,390 |
1,271 |
$47K |
| G2023 |
Specimen collect covid-19 |
2,654 |
2,166 |
$46K |
| 87491 |
|
1,558 |
1,474 |
$43K |
| 73590 |
|
1,134 |
909 |
$42K |
| 84439 |
|
5,926 |
5,612 |
$41K |
| 73502 |
|
1,479 |
1,140 |
$41K |
| D2930 |
|
318 |
129 |
$40K |
| 71271 |
|
190 |
181 |
$40K |
| 74018 |
|
1,199 |
1,085 |
$38K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
233 |
190 |
$37K |
| 76830 |
|
323 |
274 |
$36K |
| 87661 |
|
1,462 |
1,406 |
$36K |
| 87591 |
|
1,368 |
1,315 |
$35K |
| 73090 |
|
952 |
701 |
$35K |
| 82746 |
|
3,316 |
3,171 |
$34K |
| 70551 |
|
88 |
80 |
$33K |
| 83735 |
|
9,783 |
8,531 |
$33K |
| 87389 |
|
2,009 |
1,862 |
$32K |
| 99218 |
|
100 |
44 |
$32K |
| 87086 |
|
6,919 |
6,111 |
$32K |
| 96376 |
|
2,353 |
1,350 |
$29K |
| 29700 |
|
382 |
302 |
$28K |
| 81001 |
|
17,275 |
15,022 |
$28K |
| 45380 |
|
52 |
40 |
$28K |
| 94640 |
|
810 |
535 |
$28K |
| 96367 |
|
715 |
390 |
$27K |
| 87635 |
|
789 |
584 |
$27K |
| 87804 |
|
2,700 |
2,270 |
$27K |
| 97161 |
|
906 |
446 |
$27K |
| 76642 |
|
578 |
538 |
$26K |
| J1040 |
Methylprednisolone 80 mg inj |
1,925 |
1,597 |
$26K |
| 84403 |
|
1,417 |
1,330 |
$26K |
| 93041 |
|
3,339 |
2,912 |
$24K |
| 83690 |
|
8,982 |
7,973 |
$24K |
| 94060 |
|
232 |
156 |
$24K |
| 77065 |
Tomosynthesis, mammo |
494 |
407 |
$24K |
| 86900 |
|
2,251 |
1,682 |
$24K |
| 76775 |
|
650 |
508 |
$23K |
| 83655 |
|
2,332 |
2,282 |
$23K |
| 45385 |
|
55 |
36 |
$20K |
| 87633 |
|
111 |
101 |
$19K |
| D2391 |
|
235 |
89 |
$19K |
| 87040 |
|
3,703 |
3,336 |
$19K |
| 78227 |
|
68 |
56 |
$19K |
| 83516 |
|
676 |
642 |
$18K |
| G0283 |
Elec stim other than wound |
974 |
210 |
$18K |
| 84402 |
|
966 |
914 |
$18K |
| 82728 |
|
1,790 |
1,664 |
$17K |
| 84153 |
|
1,363 |
1,269 |
$17K |
| 72100 |
|
371 |
344 |
$17K |
| 77066 |
Tomosynthesis, mammo |
219 |
175 |
$16K |
| 81025 |
|
4,899 |
4,444 |
$16K |
| J2785 |
Regadenoson injection |
187 |
168 |
$16K |
| 84270 |
|
975 |
920 |
$15K |
| 87186 |
|
2,775 |
2,566 |
$14K |
| 80048 |
|
2,905 |
2,217 |
$14K |
| 96413 |
|
162 |
62 |
$14K |
| 83550 |
|
2,444 |
2,305 |
$14K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
866 |
777 |
$14K |
| 82150 |
|
4,673 |
4,198 |
$14K |
| 87880 |
|
2,360 |
2,233 |
$13K |
| 93225 |
|
96 |
79 |
$13K |
| 84481 |
|
1,116 |
1,026 |
$13K |
| 87651 |
|
1,104 |
1,065 |
$12K |
| 87077 |
|
2,449 |
1,875 |
$12K |
| 83540 |
|
2,759 |
2,581 |
$12K |
| 83605 |
|
3,045 |
2,717 |
$12K |
| 86038 |
|
1,414 |
1,321 |
$12K |
| 99204 |
|
345 |
302 |
$11K |
| 86140 |
|
3,906 |
3,499 |
$11K |
| 84702 |
|
1,783 |
1,478 |
$11K |
| 82550 |
|
4,289 |
3,806 |
$11K |
| A9502 |
Tc99m tetrofosmin |
395 |
356 |
$11K |
| 85610 |
|
5,057 |
4,282 |
$11K |
| 29075 |
|
137 |
110 |
$10K |
| 20551 |
|
193 |
114 |
$10K |
| 88304 |
|
850 |
764 |
$10K |
| 0012A |
|
530 |
503 |
$10K |
| 86200 |
|
1,077 |
1,029 |
$10K |
| 84436 |
|
2,037 |
1,910 |
$9K |
| G0379 |
Direct refer hospital observ |
155 |
127 |
$9K |
| 93242 |
|
505 |
471 |
$9K |
| 80076 |
|
983 |
766 |
$9K |
| J2405 |
Ondansetron hcl injection |
1,676 |
1,307 |
$8K |
| 87070 |
|
1,626 |
1,349 |
$8K |
| J1885 |
Ketorolac tromethamine inj |
7,410 |
6,074 |
$8K |
| 85730 |
|
3,319 |
2,924 |
$8K |
| 82043 |
|
2,141 |
1,922 |
$8K |
| 84703 |
|
2,077 |
1,877 |
$8K |
| 76817 |
|
108 |
95 |
$8K |
| 76815 |
|
115 |
106 |
$8K |
| 85378 |
|
2,405 |
2,194 |
$8K |
| 74178 |
|
17 |
14 |
$7K |
| 87502 |
|
203 |
189 |
$7K |
| J0131 |
Inj, acetaminophen (nos) |
843 |
662 |
$7K |
| D1208 |
|
30 |
30 |
$7K |
| 82172 |
|
363 |
353 |
$7K |
| 73000 |
|
118 |
81 |
$6K |
| 0100U |
|
96 |
90 |
$6K |
| C8929 |
Tte w or wo fol wcon,doppler |
12 |
12 |
$6K |
| 73222 |
|
12 |
12 |
$6K |
| 0011A |
|
610 |
566 |
$6K |
| 72110 |
|
105 |
89 |
$6K |
| J1815 |
Insulin injection |
127 |
50 |
$6K |
| C1776 |
Joint device (implantable) |
41 |
37 |
$6K |
| 82570 |
|
1,312 |
1,234 |
$6K |
| 88342 |
|
164 |
136 |
$6K |
| 87076 |
|
1,339 |
1,038 |
$6K |
| 73552 |
|
144 |
114 |
$5K |
| J1100 |
Dexamethasone sodium phos |
623 |
465 |
$5K |
| 76700 |
|
45 |
39 |
$5K |
| 82565 |
|
666 |
594 |
$5K |
| 84550 |
|
1,757 |
1,524 |
$5K |
| 86376 |
|
497 |
472 |
$5K |
| 93270 |
|
190 |
170 |
$5K |
| 85652 |
|
2,920 |
2,719 |
$5K |
| 77063 |
|
330 |
291 |
$5K |
| 99203 |
|
157 |
132 |
$5K |
| 83013 |
|
89 |
85 |
$5K |
| 80306 |
|
582 |
511 |
$4K |
| 82803 |
|
539 |
456 |
$4K |
| 90715 |
|
284 |
272 |
$4K |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
245 |
126 |
$4K |
| J3370 |
Vancomycin hcl injection |
80 |
40 |
$4K |
| J1170 |
Hydromorphone injection |
578 |
469 |
$4K |
| J2930 |
Methylprednisolone injection |
1,078 |
877 |
$4K |
| J2001 |
Lidocaine injection |
970 |
718 |
$4K |
| 95819 |
|
28 |
27 |
$4K |
| 93226 |
|
74 |
64 |
$4K |
| J7120 |
Ringers lactate infusion |
1,391 |
1,051 |
$4K |
| D7140 |
|
32 |
25 |
$4K |
| 93970 |
|
25 |
25 |
$4K |
| 84520 |
|
434 |
384 |
$4K |
| 86850 |
|
812 |
639 |
$3K |
| 86592 |
|
1,038 |
853 |
$3K |
| 83970 |
|
117 |
113 |
$3K |
| 36600 |
|
468 |
355 |
$3K |
| 84479 |
|
728 |
682 |
$3K |
| 90471 |
|
477 |
439 |
$3K |
| 82553 |
|
688 |
622 |
$3K |
| 96368 |
|
149 |
112 |
$3K |
| J1010 |
Inj, methylpred acetate 1 mg |
56 |
51 |
$3K |
| 86800 |
|
259 |
242 |
$3K |
| Q9969 |
Non-heu tc-99m add-on/dose |
470 |
449 |
$3K |
| 86702 |
|
379 |
360 |
$3K |
| D1120 |
|
30 |
30 |
$3K |
| 86431 |
|
764 |
729 |
$3K |
| J3490 |
Drugs unclassified injection |
356 |
290 |
$3K |
| J7030 |
Normal saline solution infus |
1,238 |
935 |
$3K |
| 83521 |
|
230 |
224 |
$3K |
| 87590 |
|
155 |
150 |
$3K |
| 99499 |
|
28 |
25 |
$3K |
| 73060 |
|
98 |
77 |
$3K |
| 83615 |
|
659 |
533 |
$3K |
| 83010 |
|
290 |
283 |
$3K |
| 25600 |
|
33 |
26 |
$3K |
| 84146 |
|
208 |
183 |
$3K |
| 82977 |
|
473 |
451 |
$2K |
| 86901 |
|
1,912 |
1,661 |
$2K |
| G0483 |
Drug test def 22+ classes |
38 |
32 |
$2K |
| J3010 |
Fentanyl citrate injection |
1,011 |
808 |
$2K |
| 76870 |
|
26 |
25 |
$2K |
| 77080 |
|
60 |
49 |
$2K |
| 76000 |
|
37 |
27 |
$2K |
| 81003 |
|
1,109 |
983 |
$2K |
| 86701 |
|
382 |
361 |
$2K |
| 92523 |
|
14 |
14 |
$2K |
| 82247 |
|
720 |
575 |
$2K |
| G0297 |
Ldct for lung ca screen |
15 |
14 |
$2K |
| 80143 |
|
242 |
233 |
$2K |
| 80348 |
|
176 |
156 |
$2K |
| J2270 |
Morphine sulfate injection |
643 |
421 |
$2K |
| 87807 |
|
442 |
425 |
$2K |
| 84145 |
|
215 |
196 |
$2K |
| 80069 |
|
315 |
227 |
$2K |
| J2806 |
Inj sincalide, maia, 5 mcg |
33 |
31 |
$2K |
| J7321 |
Hyalgan supartz visco-3 dose |
38 |
15 |
$2K |
| 76937 |
|
43 |
34 |
$2K |
| 82375 |
|
393 |
330 |
$2K |
| 81002 |
|
734 |
545 |
$2K |
| 94729 |
|
111 |
105 |
$2K |
| 76801 |
|
13 |
13 |
$2K |
| 86677 |
|
173 |
160 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
992 |
811 |
$2K |
| J0780 |
Prochlorperazine injection |
593 |
515 |
$2K |
| 87496 |
|
85 |
80 |
$2K |
| 93246 |
|
80 |
74 |
$2K |
| 74220 |
|
28 |
13 |
$1K |
| Q9956 |
Inj octafluoropropane mic,ml |
12 |
12 |
$1K |
| 87581 |
|
85 |
80 |
$1K |
| 86003 |
|
14 |
14 |
$1K |
| 87798 |
|
85 |
80 |
$1K |
| 29515 |
|
20 |
12 |
$1K |
| J0690 |
Cefazolin sodium injection |
1,045 |
668 |
$1K |
| 80050 |
|
71 |
63 |
$1K |
| 83001 |
|
95 |
89 |
$1K |
| 84100 |
|
389 |
354 |
$1K |
| 72052 |
|
15 |
12 |
$1K |
| 0241U |
|
17 |
13 |
$1K |
| 83002 |
|
85 |
79 |
$1K |
| J2543 |
Piperacillin/tazobactam |
40 |
27 |
$1K |
| 77002 |
|
16 |
16 |
$1K |
| 83525 |
|
123 |
119 |
$1K |
| C1769 |
Guide wire |
108 |
89 |
$1K |
| J2250 |
Inj midazolam hydrochloride |
765 |
616 |
$1K |
| 12001 |
|
51 |
39 |
$990.05 |
| J1956 |
Levofloxacin injection |
58 |
28 |
$944.92 |
| 93880 |
|
15 |
12 |
$932.87 |
| 74021 |
|
18 |
16 |
$913.22 |
| 99212 |
|
102 |
77 |
$859.78 |
| 84154 |
|
61 |
60 |
$828.81 |
| 84156 |
|
408 |
378 |
$827.42 |
| 93923 |
|
12 |
12 |
$775.85 |
| 85379 |
|
261 |
213 |
$775.40 |
| 94726 |
|
111 |
105 |
$773.11 |
| 83993 |
|
47 |
46 |
$697.52 |
| 86769 |
|
14 |
12 |
$674.29 |
| 76942 |
|
13 |
12 |
$660.68 |
| 82274 |
|
87 |
58 |
$648.87 |
| 29125 |
|
42 |
27 |
$647.44 |
| 96523 |
|
34 |
24 |
$643.64 |
| A9537 |
Tc99m mebrofenin |
58 |
54 |
$622.01 |
| 29105 |
|
23 |
14 |
$616.88 |
| 87209 |
|
43 |
42 |
$594.55 |
| G0279 |
Tomosynthesis, mammo |
70 |
63 |
$566.15 |
| 85651 |
|
286 |
249 |
$561.53 |
| 82533 |
|
52 |
47 |
$544.81 |
| 82653 |
|
51 |
33 |
$542.32 |
| 97010 |
|
87 |
29 |
$529.58 |
| 73620 |
|
13 |
12 |
$510.40 |
| 97140 |
|
31 |
12 |
$500.89 |
| 82627 |
|
33 |
28 |
$483.52 |
| 72040 |
|
15 |
12 |
$481.36 |
| 82140 |
|
87 |
67 |
$480.19 |
| 94618 |
|
14 |
13 |
$479.82 |
| 80349 |
|
73 |
68 |
$445.66 |
| 82947 |
|
170 |
100 |
$442.40 |
| J3301 |
Triamcinolone acet inj nos |
346 |
291 |
$406.00 |
| A9270 |
Non-covered item or service |
613 |
163 |
$399.07 |
| J2790 |
Rho d immune globulin inj |
14 |
14 |
$393.52 |
| J7050 |
Normal saline solution infus |
311 |
205 |
$389.96 |
| J2919 |
Inj, methylpred sod succ 5mg |
147 |
108 |
$372.82 |
| 82670 |
|
16 |
14 |
$343.41 |
| 84478 |
|
79 |
75 |
$342.63 |
| 84432 |
|
25 |
25 |
$336.44 |
| 84460 |
|
314 |
306 |
$323.01 |
| 80324 |
|
35 |
32 |
$322.99 |
| 87177 |
|
43 |
42 |
$321.34 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
413 |
365 |
$318.01 |
| J2920 |
Methylprednisolone injection |
127 |
64 |
$314.10 |
| 90686 |
|
32 |
29 |
$303.36 |
| 64450 |
|
23 |
17 |
$295.47 |
| 82672 |
|
17 |
17 |
$271.30 |
| 80337 |
|
84 |
75 |
$268.46 |
| 82626 |
|
18 |
12 |
$246.59 |
| J2710 |
Neostigmine methylslfte inj |
103 |
75 |
$246.17 |
| 84305 |
|
17 |
13 |
$240.03 |
| J1644 |
Inj heparin sodium per 1000u |
167 |
80 |
$237.36 |
| 80369 |
|
27 |
24 |
$235.34 |
| 86706 |
|
26 |
25 |
$223.46 |
| 82465 |
|
63 |
63 |
$210.38 |
| J1200 |
Diphenhydramine hcl injectio |
90 |
79 |
$200.89 |
| 83883 |
|
18 |
18 |
$197.74 |
| J7620 |
Albuterol ipratrop non-comp |
83 |
38 |
$187.45 |
| J3475 |
Inj magnesium sulfate |
60 |
44 |
$184.98 |
| J3480 |
Inj potassium chloride |
25 |
18 |
$183.95 |
| V2632 |
Post chmbr intraocular lens |
13 |
12 |
$164.24 |
| J1030 |
Methylprednisolone 40 mg inj |
119 |
98 |
$153.23 |
| 99406 |
|
17 |
14 |
$151.16 |
| 83992 |
|
39 |
34 |
$147.88 |
| 94760 |
|
50 |
32 |
$139.37 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
76 |
56 |
$128.68 |
| 87075 |
|
28 |
28 |
$110.99 |
| 80346 |
|
35 |
29 |
$102.72 |
| 84480 |
|
12 |
12 |
$101.75 |
| 80299 |
|
20 |
17 |
$94.13 |
| 82705 |
|
26 |
25 |
$91.56 |
| J0330 |
Succinycholine chloride inj |
17 |
13 |
$89.88 |
| 80361 |
|
82 |
73 |
$83.79 |
| 82248 |
|
19 |
14 |
$83.06 |
| 80365 |
|
64 |
55 |
$80.97 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
218 |
197 |
$80.66 |
| 80364 |
|
39 |
34 |
$79.40 |
| 87205 |
|
45 |
42 |
$76.01 |
| 99211 |
|
19 |
19 |
$75.00 |
| 80372 |
|
39 |
34 |
$68.80 |
| 80367 |
|
39 |
34 |
$66.16 |
| 80373 |
|
39 |
34 |
$66.16 |
| 80370 |
|
39 |
34 |
$65.92 |
| 80368 |
|
39 |
34 |
$62.88 |
| 80366 |
|
39 |
34 |
$60.84 |
| 84450 |
|
66 |
66 |
$48.30 |
| J2795 |
Ropivacaine hcl injection |
22 |
16 |
$46.64 |
| 82784 |
|
15 |
14 |
$46.50 |
| 80331 |
|
39 |
34 |
$41.28 |
| 80377 |
|
39 |
34 |
$40.80 |
| 80371 |
|
39 |
34 |
$39.52 |
| 80334 |
|
39 |
34 |
$36.50 |
| 80355 |
|
39 |
34 |
$36.18 |
| 80347 |
|
39 |
34 |
$34.58 |
| 80354 |
|
39 |
34 |
$33.08 |
| 80356 |
|
39 |
34 |
$33.08 |
| 80344 |
|
39 |
34 |
$31.78 |
| 80338 |
|
39 |
34 |
$30.42 |
| 85027 |
|
15 |
12 |
$29.70 |
| 80341 |
|
39 |
34 |
$28.24 |
| 80358 |
|
57 |
50 |
$27.76 |
| J2765 |
Metoclopramide hcl injection |
43 |
33 |
$26.71 |
| 80353 |
|
53 |
47 |
$25.76 |
| J1920 |
Inj, labetalol hcl, 5mg |
28 |
24 |
$25.56 |
| 80357 |
|
39 |
34 |
$24.98 |
| 80326 |
|
39 |
34 |
$23.72 |
| Q4010 |
Cast sup sht arm adult fbrgl |
16 |
12 |
$22.79 |
| 80359 |
|
44 |
38 |
$19.76 |
| 80360 |
|
39 |
34 |
$19.76 |
| 84132 |
|
13 |
12 |
$19.04 |
| J0171 |
Adrenalin epinephrine inject |
14 |
13 |
$17.12 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
14 |
12 |
$14.45 |
| 81015 |
|
15 |
12 |
$12.20 |
| J7999 |
Compounded drug, noc |
13 |
12 |
$12.00 |
| J2004 |
Inj, lidocaine w epinephrine |
13 |
13 |
$8.82 |
| 91301 |
|
45 |
37 |
$0.00 |
| Q0244 |
Casirivi and imdevi 1200 mg |
12 |
12 |
$0.00 |