| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpt clinic visit |
100,184 |
80,772 |
$11.48M |
| 99283 |
|
46,380 |
40,411 |
$7.58M |
| 99284 |
|
40,141 |
33,736 |
$6.54M |
| 96361 |
|
19,260 |
15,197 |
$5.23M |
| 99285 |
|
21,822 |
18,742 |
$3.90M |
| 99282 |
|
13,450 |
12,095 |
$2.01M |
| 74177 |
|
8,812 |
7,898 |
$1.80M |
| 87635 |
|
27,618 |
25,876 |
$1.52M |
| 70450 |
|
8,277 |
7,345 |
$1.40M |
| 97110 |
|
27,141 |
8,253 |
$1.27M |
| 43239 |
|
2,320 |
2,117 |
$1.13M |
| 96360 |
|
6,874 |
5,900 |
$1.12M |
| 45380 |
|
1,400 |
1,301 |
$810K |
| 74176 |
|
4,424 |
3,965 |
$784K |
| 93306 |
|
2,534 |
2,303 |
$773K |
| 96365 |
|
7,565 |
5,305 |
$728K |
| 96366 |
|
3,451 |
2,097 |
$674K |
| G0379 |
Direct refer hospital observ |
4,245 |
2,905 |
$603K |
| G0378 |
Hospital observation per hr |
13,529 |
6,750 |
$592K |
| 59025 |
|
3,785 |
2,555 |
$576K |
| 97163 |
|
4,589 |
4,219 |
$522K |
| 71275 |
|
1,904 |
1,762 |
$458K |
| 76705 |
|
4,150 |
3,777 |
$442K |
| 99291 |
|
2,109 |
1,933 |
$431K |
| 80053 |
|
80,453 |
64,462 |
$420K |
| 45385 |
|
645 |
604 |
$380K |
| 78452 |
|
557 |
468 |
$275K |
| 93971 |
|
2,991 |
2,637 |
$259K |
| 72148 |
|
1,280 |
1,206 |
$251K |
| 12001 |
|
1,088 |
1,035 |
$241K |
| 62323 |
|
488 |
457 |
$229K |
| 76642 |
|
1,951 |
1,835 |
$225K |
| 96413 |
|
2,394 |
1,182 |
$223K |
| 69436 |
|
164 |
150 |
$206K |
| 77063 |
|
3,894 |
3,805 |
$204K |
| 71046 |
|
13,904 |
12,091 |
$193K |
| 84443 |
|
22,317 |
20,493 |
$190K |
| J0585 |
Injection,onabotulinumtoxina |
1,266 |
645 |
$189K |
| 76775 |
|
2,320 |
2,093 |
$189K |
| 95886 |
|
951 |
909 |
$188K |
| 97140 |
|
11,890 |
4,331 |
$183K |
| 66984 |
|
232 |
207 |
$178K |
| 96367 |
|
2,032 |
1,206 |
$169K |
| 76830 |
|
1,891 |
1,710 |
$159K |
| 82306 |
|
8,585 |
7,958 |
$159K |
| 74018 |
|
4,584 |
3,925 |
$152K |
| U0003 |
Cov-19 amp prb hgh thruput |
4,824 |
4,381 |
$147K |
| 70553 |
|
523 |
476 |
$144K |
| 95806 |
|
239 |
237 |
$143K |
| 85025 |
|
70,059 |
55,567 |
$136K |
| 87491 |
|
6,308 |
5,907 |
$134K |
| 87591 |
|
6,396 |
5,983 |
$131K |
| 76817 |
|
1,372 |
1,179 |
$125K |
| 41899 |
|
68 |
67 |
$113K |
| 71260 |
|
1,706 |
1,580 |
$112K |
| 77067 |
|
5,265 |
5,113 |
$108K |
| 10060 |
|
727 |
649 |
$105K |
| 58661 |
|
34 |
27 |
$102K |
| 94640 |
|
3,308 |
2,175 |
$96K |
| 80061 |
|
16,083 |
15,038 |
$89K |
| 93017 |
|
1,041 |
923 |
$85K |
| 80048 |
|
20,799 |
16,744 |
$84K |
| 76536 |
|
698 |
667 |
$82K |
| 72141 |
|
348 |
337 |
$79K |
| 85027 |
|
26,002 |
21,610 |
$77K |
| 87081 |
|
17,072 |
15,870 |
$77K |
| 0241U |
|
1,212 |
1,181 |
$77K |
| 78815 |
|
96 |
91 |
$76K |
| 36415 |
|
54,813 |
45,504 |
$75K |
| 97530 |
|
2,295 |
962 |
$75K |
| 71250 |
|
1,089 |
969 |
$75K |
| 87389 |
|
5,806 |
5,522 |
$72K |
| 83036 |
|
14,632 |
13,648 |
$71K |
| 87430 |
|
11,120 |
10,527 |
$71K |
| 72125 |
|
2,104 |
1,940 |
$68K |
| 64483 |
|
107 |
96 |
$67K |
| 20610 |
|
326 |
288 |
$66K |
| 87086 |
|
21,524 |
18,817 |
$64K |
| 73610 |
|
3,911 |
3,555 |
$62K |
| 20552 |
|
337 |
303 |
$62K |
| 83880 |
|
5,380 |
4,491 |
$62K |
| 29125 |
|
387 |
363 |
$60K |
| 73721 |
|
302 |
287 |
$59K |
| 93296 |
|
2,720 |
2,491 |
$58K |
| 73630 |
|
3,973 |
3,542 |
$58K |
| 93970 |
|
469 |
436 |
$57K |
| E1390 |
Oxygen concentrator |
1,913 |
1,195 |
$53K |
| 71271 |
|
470 |
453 |
$51K |
| 90715 |
|
2,292 |
2,176 |
$48K |
| 77065 |
Tomosynthesis, mammo |
1,233 |
1,030 |
$47K |
| 93005 |
|
36,840 |
28,319 |
$47K |
| 64615 |
|
146 |
121 |
$46K |
| 73564 |
|
3,513 |
3,032 |
$46K |
| 86803 |
|
5,256 |
4,949 |
$45K |
| 97161 |
|
690 |
597 |
$45K |
| 87798 |
|
3,524 |
2,458 |
$44K |
| 87400 |
|
7,092 |
3,306 |
$44K |
| 97113 |
|
986 |
383 |
$44K |
| 84439 |
|
7,565 |
7,041 |
$42K |
| 73130 |
|
2,723 |
2,414 |
$42K |
| 82728 |
|
5,229 |
4,833 |
$38K |
| 73030 |
|
2,928 |
2,554 |
$38K |
| 81025 |
|
18,247 |
15,905 |
$37K |
| 80306 |
|
8,182 |
7,232 |
$36K |
| 84484 |
|
21,615 |
13,574 |
$36K |
| 73110 |
|
2,371 |
2,137 |
$35K |
| 96372 |
|
17,071 |
13,935 |
$34K |
| 72100 |
|
1,197 |
1,116 |
$34K |
| 12002 |
|
165 |
154 |
$33K |
| 70496 |
|
127 |
114 |
$32K |
| 97116 |
|
1,752 |
684 |
$32K |
| 82607 |
|
4,642 |
4,322 |
$32K |
| 72110 |
|
2,129 |
1,966 |
$32K |
| 29581 |
|
356 |
114 |
$31K |
| 77066 |
Tomosynthesis, mammo |
1,002 |
946 |
$30K |
| 74420 |
|
195 |
176 |
$30K |
| 70551 |
|
139 |
125 |
$30K |
| 73140 |
|
1,415 |
1,317 |
$30K |
| 87077 |
|
9,372 |
8,150 |
$28K |
| G2066 |
Inter devc remote 30d |
1,220 |
1,126 |
$28K |
| 86780 |
|
2,999 |
2,833 |
$28K |
| 81001 |
|
30,696 |
25,937 |
$26K |
| 83690 |
|
20,939 |
17,259 |
$26K |
| 87186 |
|
9,124 |
8,054 |
$26K |
| 96374 |
|
31,462 |
25,595 |
$25K |
| 86140 |
|
7,257 |
6,371 |
$25K |
| 20553 |
|
176 |
132 |
$25K |
| 84466 |
|
4,912 |
4,551 |
$24K |
| 97112 |
|
996 |
410 |
$24K |
| 82248 |
|
8,106 |
7,287 |
$23K |
| 77080 |
|
456 |
426 |
$22K |
| C1751 |
Cath, inf, per/cent/midline |
25,081 |
20,276 |
$22K |
| 73502 |
|
2,011 |
1,791 |
$21K |
| 84702 |
|
3,977 |
2,921 |
$21K |
| 70491 |
|
157 |
148 |
$20K |
| 72040 |
|
549 |
519 |
$20K |
| 12011 |
|
85 |
83 |
$18K |
| 85379 |
|
4,934 |
4,521 |
$18K |
| 97165 |
|
321 |
273 |
$18K |
| 87340 |
|
3,287 |
3,043 |
$18K |
| G0297 |
Ldct for lung ca screen |
202 |
186 |
$18K |
| 83735 |
|
10,449 |
7,739 |
$17K |
| 83540 |
|
5,523 |
5,068 |
$17K |
| 11042 |
|
173 |
77 |
$17K |
| 85652 |
|
6,643 |
5,905 |
$17K |
| 74019 |
|
874 |
775 |
$17K |
| 94060 |
|
327 |
291 |
$16K |
| 97162 |
|
190 |
168 |
$16K |
| 94729 |
|
592 |
545 |
$16K |
| 87040 |
|
3,250 |
1,642 |
$16K |
| 80050 |
|
2,116 |
1,731 |
$16K |
| 71045 |
|
14,446 |
12,745 |
$16K |
| 82746 |
|
2,875 |
2,664 |
$16K |
| 70486 |
|
382 |
360 |
$15K |
| 90471 |
|
2,836 |
2,519 |
$15K |
| 80076 |
|
4,176 |
3,585 |
$15K |
| 74178 |
|
42 |
41 |
$15K |
| 87428 |
|
612 |
599 |
$15K |
| 87147 |
|
6,123 |
5,547 |
$14K |
| 80055 |
|
571 |
544 |
$14K |
| 72114 |
|
436 |
425 |
$14K |
| 74183 |
|
42 |
40 |
$14K |
| 86704 |
|
1,980 |
1,847 |
$13K |
| 83970 |
|
827 |
731 |
$13K |
| 64493 |
|
12 |
12 |
$13K |
| 96375 |
|
22,591 |
17,236 |
$12K |
| 86038 |
|
1,875 |
1,706 |
$12K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
87 |
78 |
$12K |
| 36591 |
|
2,516 |
1,262 |
$12K |
| 82043 |
|
4,660 |
4,353 |
$12K |
| 87522 |
Neg quan hep c or qual rna |
416 |
390 |
$11K |
| 86706 |
|
2,443 |
2,259 |
$11K |
| 84480 |
|
1,386 |
1,296 |
$11K |
| 87088 |
|
4,043 |
3,670 |
$11K |
| 80143 |
|
1,991 |
1,835 |
$11K |
| 81003 |
|
12,378 |
10,974 |
$10K |
| 76870 |
|
116 |
108 |
$10K |
| 85610 |
|
9,098 |
6,993 |
$10K |
| 99281 |
|
76 |
54 |
$10K |
| C1769 |
Guide wire |
1,815 |
1,556 |
$10K |
| 87493 |
|
745 |
690 |
$10K |
| 73080 |
|
1,061 |
966 |
$10K |
| 71101 |
|
852 |
791 |
$10K |
| 93298 |
|
251 |
245 |
$10K |
| 86403 |
|
2,047 |
1,859 |
$9K |
| 29515 |
|
87 |
79 |
$9K |
| 84403 |
|
633 |
606 |
$9K |
| J2405 |
Ondansetron hcl injection |
29,850 |
21,768 |
$9K |
| 45378 |
|
26 |
24 |
$9K |
| 82784 |
|
1,657 |
1,374 |
$9K |
| G0480 |
Drug test def 1-7 classes |
780 |
614 |
$8K |
| 87070 |
|
2,680 |
2,149 |
$8K |
| 69209 |
|
80 |
79 |
$8K |
| J7030 |
Normal saline solution infus |
7,379 |
5,881 |
$8K |
| 80329 |
|
1,055 |
751 |
$8K |
| 86364 |
|
604 |
571 |
$8K |
| 86756 |
|
935 |
750 |
$8K |
| 73590 |
|
641 |
575 |
$7K |
| 86787 |
|
1,263 |
1,153 |
$7K |
| 80179 |
|
1,934 |
1,785 |
$7K |
| 86708 |
|
1,346 |
1,278 |
$7K |
| 83605 |
|
4,535 |
3,482 |
$7K |
| 87210 |
|
3,035 |
2,831 |
$7K |
| C9803 |
Hopd covid-19 spec collect |
437 |
411 |
$7K |
| C8929 |
Tte w or wo fol wcon,doppler |
37 |
25 |
$7K |
| J3010 |
Fentanyl citrate injection |
16,969 |
11,496 |
$7K |
| 94726 |
|
261 |
233 |
$7K |
| 95812 |
|
14 |
14 |
$6K |
| U0002 |
Covid-19 lab test non-cdc |
1,174 |
1,016 |
$6K |
| 82077 |
|
3,060 |
2,794 |
$6K |
| 83001 |
|
559 |
541 |
$6K |
| 84703 |
|
2,605 |
2,408 |
$6K |
| 84146 |
|
506 |
485 |
$6K |
| 88305 |
|
2,206 |
1,806 |
$6K |
| 86900 |
|
4,013 |
3,398 |
$5K |
| J1756 |
Iron sucrose injection |
404 |
185 |
$5K |
| 83516 |
|
774 |
680 |
$5K |
| J8597 |
Antiemetic drug oral nos |
2,862 |
2,240 |
$5K |
| 86762 |
|
596 |
574 |
$5K |
| 85730 |
|
4,021 |
3,460 |
$5K |
| 80320 |
|
1,277 |
1,072 |
$5K |
| 73090 |
|
572 |
512 |
$5K |
| 80164 |
|
768 |
612 |
$5K |
| 77062 |
|
106 |
103 |
$5K |
| 96376 |
|
9,107 |
6,415 |
$5K |
| 86235 |
|
254 |
189 |
$5K |
| 82803 |
|
2,194 |
1,777 |
$5K |
| 86850 |
|
3,057 |
2,609 |
$5K |
| 73562 |
|
167 |
129 |
$5K |
| 82565 |
|
4,589 |
4,117 |
$5K |
| E0431 |
Portable gaseous 02 |
719 |
452 |
$5K |
| 87205 |
|
2,672 |
2,140 |
$5K |
| J7120 |
Ringers lactate infusion |
2,753 |
2,259 |
$5K |
| 64494 |
|
12 |
12 |
$4K |
| 97167 |
|
25 |
24 |
$4K |
| 82950 |
|
928 |
894 |
$4K |
| 86901 |
|
4,066 |
3,419 |
$4K |
| 82570 |
|
1,704 |
1,382 |
$4K |
| 93299 |
|
212 |
184 |
$4K |
| 86431 |
|
1,091 |
1,023 |
$4K |
| 95910 |
|
67 |
65 |
$4K |
| 84550 |
|
941 |
852 |
$3K |
| 86200 |
|
429 |
409 |
$3K |
| 84100 |
|
4,424 |
2,993 |
$3K |
| 36430 |
|
15 |
12 |
$3K |
| 87449 |
|
784 |
722 |
$3K |
| 77002 |
|
42 |
41 |
$3K |
| 86709 |
|
654 |
621 |
$3K |
| 80047 |
|
603 |
511 |
$3K |
| 93225 |
|
79 |
78 |
$3K |
| 70498 |
|
110 |
105 |
$3K |
| 82550 |
|
1,374 |
1,130 |
$3K |
| 86618 |
|
276 |
208 |
$3K |
| 87427 |
|
590 |
556 |
$3K |
| 85014 |
|
1,409 |
1,177 |
$3K |
| 77336 |
|
34 |
13 |
$3K |
| 87905 |
|
449 |
422 |
$3K |
| G0108 |
Diab manage trn per indiv |
153 |
133 |
$3K |
| 83002 |
|
285 |
274 |
$3K |
| J1200 |
Diphenhydramine hcl injectio |
4,686 |
3,635 |
$3K |
| 83993 |
|
211 |
199 |
$3K |
| 97166 |
|
31 |
25 |
$2K |
| 84153 |
|
220 |
206 |
$2K |
| 83525 |
|
294 |
285 |
$2K |
| G0279 |
Tomosynthesis, mammo |
185 |
173 |
$2K |
| 73120 |
|
99 |
92 |
$2K |
| 72052 |
|
78 |
77 |
$2K |
| 97542 |
|
153 |
115 |
$2K |
| 87045 |
|
590 |
556 |
$2K |
| J1885 |
Ketorolac tromethamine inj |
21,302 |
18,192 |
$2K |
| 80178 |
|
328 |
266 |
$2K |
| 90686 |
|
175 |
156 |
$2K |
| J7050 |
Normal saline solution infus |
4,207 |
1,883 |
$2K |
| 93226 |
|
79 |
78 |
$2K |
| 97803 |
|
89 |
82 |
$2K |
| 84450 |
|
519 |
496 |
$2K |
| 84460 |
|
533 |
509 |
$2K |
| 86480 |
|
87 |
83 |
$2K |
| J2250 |
Inj midazolam hydrochloride |
7,105 |
5,539 |
$1K |
| 86160 |
|
267 |
218 |
$1K |
| 76882 |
|
15 |
14 |
$1K |
| E0570 |
Nebulizer with compression |
58 |
52 |
$1K |
| J0171 |
Adrenalin epinephrine inject |
2,571 |
2,216 |
$1K |
| J0131 |
Inj, acetaminophen (nos) |
2,604 |
2,194 |
$1K |
| 83615 |
|
925 |
705 |
$1K |
| P9016 |
Rbc leukocytes reduced |
16 |
13 |
$1K |
| J2550 |
Promethazine hcl injection |
3,645 |
2,905 |
$1K |
| 99234 |
|
158 |
63 |
$1K |
| J1100 |
Dexamethasone sodium phos |
10,840 |
8,484 |
$1K |
| 96368 |
|
76 |
52 |
$1K |
| 87808 |
|
350 |
336 |
$1K |
| 97802 |
|
66 |
61 |
$1K |
| 72070 |
|
42 |
42 |
$1K |
| 93356 |
|
741 |
696 |
$1K |
| J1650 |
Inj enoxaparin sodium |
2,716 |
1,353 |
$1K |
| 86308 |
|
332 |
320 |
$1K |
| 84478 |
|
292 |
271 |
$853.16 |
| 85018 |
|
469 |
349 |
$785.51 |
| 93242 |
|
12 |
12 |
$748.31 |
| 72050 |
|
42 |
39 |
$724.09 |
| 87529 |
|
12 |
12 |
$716.44 |
| 82670 |
|
50 |
49 |
$710.16 |
| 93280 |
|
40 |
39 |
$691.63 |
| 77061 |
|
12 |
12 |
$690.13 |
| 81002 |
|
514 |
479 |
$677.39 |
| 91322 |
|
14 |
12 |
$660.28 |
| J1170 |
Hydromorphone injection |
10,928 |
6,948 |
$653.27 |
| 86037 |
|
86 |
77 |
$648.62 |
| J0696 |
Ceftriaxone sodium injection |
4,741 |
3,726 |
$599.50 |
| 82977 |
|
144 |
136 |
$578.41 |
| J7060 |
5% dextrose/water |
764 |
341 |
$568.64 |
| 97535 |
|
38 |
27 |
$554.43 |
| 83721 |
|
69 |
66 |
$553.64 |
| 94762 |
|
15 |
15 |
$532.59 |
| 76376 |
|
941 |
879 |
$516.41 |
| 87480 |
|
40 |
38 |
$498.99 |
| 87660 |
|
40 |
38 |
$494.37 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
13,928 |
12,224 |
$487.77 |
| 76942 |
|
43 |
41 |
$474.83 |
| 84145 |
|
65 |
51 |
$467.45 |
| 87510 |
|
40 |
38 |
$466.67 |
| 86376 |
|
45 |
44 |
$463.29 |
| 82105 |
|
83 |
78 |
$441.99 |
| 72072 |
|
27 |
25 |
$424.88 |
| G0008 |
Admin influenza virus vac |
94 |
83 |
$423.09 |
| J0690 |
Cefazolin sodium injection |
5,670 |
3,947 |
$379.05 |
| 82150 |
|
89 |
77 |
$339.91 |
| 90656 |
|
18 |
18 |
$338.26 |
| 82951 |
|
25 |
24 |
$331.32 |
| 86677 |
|
25 |
25 |
$319.84 |
| 73523 |
|
12 |
12 |
$318.20 |
| 82010 |
|
868 |
707 |
$318.04 |
| 90480 |
|
13 |
12 |
$268.98 |
| 84520 |
|
320 |
248 |
$267.76 |
| J1644 |
Inj heparin sodium per 1000u |
3,787 |
1,667 |
$219.60 |
| 86039 |
|
41 |
39 |
$219.37 |
| A7035 |
Pos airway press headgear |
13 |
13 |
$218.04 |
| J1642 |
Inj heparin sodium per 10 u |
3,256 |
1,519 |
$214.33 |
| A9502 |
Tc99m tetrofosmin |
640 |
547 |
$212.08 |
| J2704 |
Inj, propofol, 10 mg |
17,447 |
11,589 |
$210.17 |
| J2270 |
Morphine sulfate injection |
3,987 |
2,846 |
$202.88 |
| J2060 |
Lorazepam injection |
2,455 |
1,776 |
$201.41 |
| A7038 |
Pos airway pressure filter |
100 |
66 |
$199.68 |
| 84481 |
|
18 |
18 |
$199.10 |
| 82365 |
|
62 |
54 |
$198.19 |
| J3301 |
Triamcinolone acet inj nos |
1,486 |
1,258 |
$196.13 |
| A0428 |
Bls |
166 |
143 |
$191.59 |
| J7040 |
Normal saline solution infus |
1,417 |
1,125 |
$190.74 |
| 73560 |
|
33 |
27 |
$190.59 |
| 84144 |
|
24 |
24 |
$189.61 |
| E0601 |
Cont airway pressure device |
16 |
12 |
$178.84 |
| J1030 |
Methylprednisolone 40 mg inj |
1,292 |
1,173 |
$175.06 |
| 86920 |
|
15 |
13 |
$172.00 |
| J2765 |
Metoclopramide hcl injection |
708 |
580 |
$161.68 |
| Q0177 |
Hydroxyzine pamoate 25mg |
355 |
302 |
$158.57 |
| A0425 |
Ground mileage |
351 |
288 |
$144.73 |
| 72170 |
|
31 |
25 |
$141.14 |
| 87075 |
|
71 |
64 |
$136.68 |
| 74022 |
|
116 |
93 |
$132.95 |
| A7037 |
Pos airway pressure tubing |
16 |
16 |
$131.67 |
| 84165 |
|
29 |
25 |
$120.30 |
| 73660 |
|
15 |
15 |
$118.40 |
| J0780 |
Prochlorperazine injection |
1,963 |
1,716 |
$108.63 |
| 82040 |
|
25 |
24 |
$106.43 |
| 82952 |
|
25 |
24 |
$104.24 |
| J1815 |
Insulin injection |
2,300 |
1,032 |
$96.24 |
| J2930 |
Methylprednisolone injection |
1,928 |
1,581 |
$95.74 |
| 82247 |
|
17 |
12 |
$92.90 |
| 73552 |
|
17 |
13 |
$86.70 |
| 86008 |
|
16 |
14 |
$84.18 |
| 0352U |
|
67 |
67 |
$83.35 |
| 86674 |
|
13 |
13 |
$72.28 |
| 82270 |
|
26 |
25 |
$53.84 |
| 89051 |
|
37 |
27 |
$53.55 |
| 86225 |
|
14 |
12 |
$51.33 |
| 82465 |
|
16 |
16 |
$46.89 |
| J0702 |
Betamethasone acet&sod phosp |
55 |
38 |
$43.62 |
| 80305 |
|
13 |
12 |
$37.80 |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
373 |
332 |
$36.80 |
| 73060 |
|
15 |
14 |
$31.96 |
| Q9969 |
Non-heu tc-99m add-on/dose |
1,104 |
1,038 |
$28.50 |
| J0744 |
Ciprofloxacin iv |
449 |
334 |
$25.90 |
| G8978 |
Mobility current status |
295 |
189 |
$22.17 |
| J3370 |
Vancomycin hcl injection |
440 |
273 |
$15.03 |
| J3475 |
Inj magnesium sulfate |
187 |
147 |
$13.71 |
| J2370 |
Phenylephrine hcl injection |
210 |
177 |
$11.30 |
| J1940 |
Furosemide injection |
132 |
79 |
$6.00 |
| 99152 |
|
33 |
27 |
$5.38 |
| J3480 |
Inj potassium chloride |
115 |
76 |
$5.37 |
| C1894 |
Intro/sheath, non-laser |
461 |
395 |
$3.31 |
| J1040 |
Methylprednisolone 80 mg inj |
17 |
16 |
$2.26 |
| Q0163 |
Diphenhydramine hcl 50mg |
78 |
65 |
$1.99 |
| J2710 |
Neostigmine methylslfte inj |
16 |
14 |
$0.46 |
| J2785 |
Regadenoson injection |
169 |
146 |
$0.22 |
| 99153 |
Mod sedat endo service >5yrs |
17 |
14 |
$0.00 |
| J1790 |
Droperidol injection |
416 |
340 |
$0.00 |
| V2632 |
Post chmbr intraocular lens |
345 |
310 |
$0.00 |
| J3490 |
Drugs unclassified injection |
3,142 |
1,059 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
15 |
12 |
$0.00 |
| G8980 |
Mobility d/c status |
92 |
59 |
$0.00 |
| 76815 |
|
14 |
13 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
113 |
49 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
140 |
121 |
$0.00 |
| J3360 |
Diazepam injection |
36 |
26 |
$0.00 |
| J1010 |
Inj, methylpred acetate 1 mg |
172 |
165 |
$0.00 |
| C2617 |
Stent, non-cor, tem w/o del |
51 |
38 |
$0.00 |
| 82945 |
|
17 |
12 |
$0.00 |
| 84157 |
|
17 |
12 |
$0.00 |
| G8988 |
Self care goal status |
47 |
31 |
$0.00 |
| G8987 |
Self care current status |
21 |
14 |
$0.00 |
| C1758 |
Catheter, ureteral |
439 |
396 |
$0.00 |
| A9577 |
Inj multihance |
825 |
741 |
$0.00 |
| P9604 |
One-way allow prorated trip |
395 |
267 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
224 |
185 |
$0.00 |
| A9537 |
Tc99m mebrofenin |
12 |
12 |
$0.00 |
| Q9950 |
Inj sulf hexa lipid microsph |
47 |
38 |
$0.00 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
709 |
662 |
$0.00 |
| J7510 |
Prednisolone oral per 5 mg |
49 |
42 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
1,358 |
1,272 |
$0.00 |
| Q9957 |
Inj perflutren lip micros,ml |
26 |
25 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
401 |
257 |
$0.00 |
| A9552 |
F18 fdg |
109 |
101 |
$0.00 |
| G8979 |
Mobility goal status |
433 |
249 |
$0.00 |
| C1729 |
Cath, drainage |
34 |
24 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
149 |
83 |
$0.00 |
| G8989 |
Self care d/c status |
20 |
13 |
$0.00 |