| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
120,446 |
111,338 |
$14.20M |
| 96361 |
|
43,194 |
33,452 |
$13.48M |
| 99284 |
|
88,967 |
81,513 |
$12.46M |
| G0463 |
Hospital outpt clinic visit |
105,481 |
85,470 |
$10.14M |
| J9271 |
Inj pembrolizumab |
1,338 |
864 |
$9.31M |
| 99285 |
|
38,908 |
34,333 |
$5.76M |
| 70450 |
|
13,780 |
12,045 |
$3.62M |
| 96365 |
|
17,260 |
10,461 |
$2.50M |
| 74177 |
|
10,580 |
9,135 |
$2.47M |
| 74176 |
|
7,680 |
6,538 |
$1.99M |
| 97110 |
|
22,582 |
7,745 |
$1.77M |
| 96413 |
|
11,734 |
5,877 |
$1.70M |
| 96366 |
|
7,287 |
3,725 |
$1.63M |
| 96360 |
|
6,117 |
4,759 |
$1.30M |
| 99282 |
|
10,192 |
9,453 |
$1.16M |
| G0378 |
Hospital observation per hr |
14,834 |
7,985 |
$1.11M |
| 43239 |
|
2,153 |
1,940 |
$884K |
| J9299 |
Injection, nivolumab |
200 |
105 |
$882K |
| 94640 |
|
6,120 |
4,936 |
$794K |
| 58662 |
|
423 |
363 |
$742K |
| 80048 |
|
118,217 |
99,910 |
$734K |
| 80053 |
|
62,363 |
46,681 |
$699K |
| 71275 |
|
2,444 |
2,063 |
$645K |
| C9803 |
Hopd covid-19 spec collect |
17,121 |
15,466 |
$622K |
| 58661 |
|
267 |
173 |
$593K |
| 99281 |
|
4,680 |
4,130 |
$592K |
| 96415 |
|
2,316 |
1,193 |
$585K |
| U0003 |
Cov-19 amp prb hgh thruput |
3,229 |
3,139 |
$550K |
| J1439 |
Inj ferric carboxymaltos 1mg |
827 |
478 |
$539K |
| 47562 |
|
247 |
177 |
$498K |
| 93356 |
|
1,956 |
1,782 |
$483K |
| 11042 |
|
3,541 |
2,408 |
$478K |
| J0897 |
Denosumab injection |
448 |
370 |
$469K |
| 59025 |
|
3,042 |
2,133 |
$465K |
| 87502 |
|
26,255 |
23,504 |
$437K |
| 76830 |
|
3,590 |
3,242 |
$344K |
| 85025 |
|
194,304 |
155,754 |
$330K |
| 62323 |
|
878 |
821 |
$308K |
| 71260 |
|
2,064 |
1,790 |
$306K |
| J2506 |
Inj pegfilgrast ex bio 0.5mg |
464 |
282 |
$295K |
| 97140 |
|
11,592 |
4,495 |
$261K |
| 76705 |
|
2,578 |
2,279 |
$244K |
| 87529 |
|
26,198 |
13,967 |
$241K |
| 80307 |
|
17,935 |
15,184 |
$232K |
| 45385 |
|
391 |
353 |
$230K |
| 45380 |
|
467 |
422 |
$225K |
| 71046 |
|
13,725 |
12,655 |
$220K |
| 84443 |
|
17,974 |
15,537 |
$217K |
| 36415 |
|
94,161 |
69,732 |
$216K |
| 77063 |
|
4,530 |
4,256 |
$215K |
| 70496 |
|
875 |
766 |
$208K |
| 84484 |
|
53,073 |
33,100 |
$195K |
| 70553 |
|
789 |
740 |
$188K |
| 70491 |
|
660 |
551 |
$184K |
| 71250 |
|
2,103 |
1,863 |
$177K |
| Q0222 |
Bebtelovimab 175 mg |
366 |
207 |
$174K |
| 93970 |
|
1,209 |
1,082 |
$167K |
| 87491 |
|
15,555 |
14,186 |
$164K |
| 73721 |
|
772 |
720 |
$163K |
| 72148 |
|
1,005 |
948 |
$157K |
| 58563 |
|
188 |
136 |
$154K |
| 76817 |
|
2,230 |
1,793 |
$153K |
| 76536 |
|
1,356 |
1,280 |
$152K |
| 76642 |
|
1,133 |
1,076 |
$147K |
| 78452 |
|
430 |
374 |
$144K |
| 93971 |
|
1,887 |
1,679 |
$140K |
| 76700 |
|
718 |
679 |
$137K |
| 99291 |
|
1,124 |
938 |
$129K |
| 93306 |
|
2,442 |
2,213 |
$129K |
| 72131 |
|
2,208 |
1,869 |
$128K |
| 80076 |
|
44,188 |
38,761 |
$121K |
| 87591 |
|
15,551 |
14,186 |
$121K |
| 12001 |
|
804 |
710 |
$121K |
| 87661 |
|
15,424 |
14,077 |
$118K |
| 93005 |
|
60,362 |
51,172 |
$117K |
| 97162 |
|
2,707 |
2,399 |
$116K |
| J1756 |
Iron sucrose injection |
6,475 |
2,359 |
$112K |
| 70551 |
|
718 |
631 |
$111K |
| 71045 |
|
39,620 |
35,019 |
$107K |
| 76856 |
|
608 |
553 |
$106K |
| 10060 |
|
668 |
599 |
$106K |
| 80061 |
|
8,346 |
7,652 |
$105K |
| 87651 |
|
11,455 |
10,173 |
$104K |
| 0202U |
|
670 |
601 |
$96K |
| 72141 |
|
569 |
544 |
$95K |
| 72125 |
|
5,285 |
4,551 |
$93K |
| 82306 |
|
4,287 |
3,839 |
$93K |
| J0561 |
Penicillin g benzathine inj |
377 |
304 |
$92K |
| 73221 |
|
451 |
428 |
$92K |
| 71271 |
|
560 |
538 |
$91K |
| 95810 |
|
135 |
135 |
$90K |
| P9016 |
Rbc leukocytes reduced |
539 |
352 |
$89K |
| 72100 |
|
1,792 |
1,658 |
$86K |
| 73630 |
|
3,861 |
3,373 |
$86K |
| 95811 |
|
109 |
103 |
$86K |
| J9173 |
Inj., durvalumab, 10 mg |
38 |
12 |
$83K |
| 82728 |
|
8,540 |
7,525 |
$82K |
| 96372 |
|
55,053 |
42,778 |
$80K |
| 97161 |
|
1,769 |
1,549 |
$77K |
| M0222 |
Bebtelovimab injection |
367 |
208 |
$75K |
| 96416 |
|
829 |
427 |
$75K |
| 96374 |
|
59,687 |
51,521 |
$74K |
| 36430 |
|
698 |
438 |
$72K |
| 74018 |
|
1,743 |
1,467 |
$72K |
| 86850 |
|
3,497 |
2,838 |
$71K |
| 82607 |
|
5,520 |
4,806 |
$71K |
| 96367 |
|
4,604 |
2,787 |
$70K |
| 12002 |
|
453 |
404 |
$68K |
| 97165 |
|
1,151 |
988 |
$67K |
| Q5114 |
Inj ogivri 10 mg |
40 |
26 |
$67K |
| 73030 |
|
3,226 |
2,727 |
$67K |
| 73562 |
|
2,523 |
2,140 |
$66K |
| 29581 |
|
527 |
206 |
$65K |
| 74183 |
|
265 |
238 |
$65K |
| 73700 |
|
613 |
531 |
$64K |
| 83036 |
|
6,711 |
5,997 |
$64K |
| 77067 |
|
5,220 |
4,945 |
$63K |
| 97530 |
|
2,444 |
1,563 |
$63K |
| 76775 |
|
602 |
556 |
$62K |
| 93017 |
|
692 |
625 |
$57K |
| 86780 |
|
2,851 |
2,614 |
$57K |
| J3490 |
Drugs unclassified injection |
12,088 |
7,691 |
$56K |
| 84439 |
|
4,182 |
3,608 |
$54K |
| 86900 |
|
4,178 |
3,358 |
$52K |
| Q5118 |
Inj., zirabev, 10 mg |
86 |
39 |
$52K |
| 97166 |
|
1,162 |
959 |
$51K |
| 74178 |
|
192 |
181 |
$51K |
| J9217 |
Leuprolide acetate suspnsion |
181 |
159 |
$51K |
| 72040 |
|
899 |
859 |
$51K |
| J1050 |
Medroxyprogesterone acetate |
641 |
548 |
$49K |
| 83540 |
|
8,395 |
7,392 |
$48K |
| 12011 |
|
326 |
281 |
$48K |
| 87086 |
|
9,451 |
8,300 |
$48K |
| 73130 |
|
3,080 |
2,654 |
$47K |
| 93880 |
|
587 |
552 |
$45K |
| 76870 |
|
513 |
461 |
$45K |
| 88307 |
|
610 |
430 |
$44K |
| 90471 |
|
3,033 |
2,307 |
$44K |
| U0005 |
Infec agen detec ampli probe |
2,516 |
2,451 |
$43K |
| 73610 |
|
2,729 |
2,392 |
$43K |
| 97112 |
|
1,425 |
844 |
$43K |
| 99211 |
|
319 |
295 |
$42K |
| 90715 |
|
2,642 |
2,110 |
$41K |
| 81001 |
|
62,109 |
55,682 |
$40K |
| 72110 |
|
767 |
699 |
$40K |
| 85027 |
|
9,501 |
7,096 |
$40K |
| 70486 |
|
1,404 |
1,193 |
$38K |
| 83550 |
|
8,144 |
7,195 |
$37K |
| 76882 |
|
373 |
349 |
$37K |
| 73502 |
|
1,752 |
1,517 |
$35K |
| 76770 |
|
238 |
224 |
$33K |
| 80069 |
|
4,502 |
2,545 |
$32K |
| 87389 |
|
2,121 |
1,969 |
$32K |
| 75635 |
|
132 |
124 |
$32K |
| 96375 |
|
49,031 |
36,372 |
$32K |
| Q5107 |
Inj mvasi 10 mg |
30 |
13 |
$32K |
| 30520 |
|
22 |
17 |
$31K |
| U0002 |
Covid-19 lab test non-cdc |
28,121 |
24,679 |
$31K |
| P9045 |
Albumin (human), 5%, 250 ml |
193 |
151 |
$30K |
| 36591 |
|
10,930 |
5,393 |
$29K |
| 86803 |
|
1,208 |
1,096 |
$28K |
| 93923 |
|
318 |
290 |
$27K |
| 81025 |
|
37,968 |
34,260 |
$27K |
| 72132 |
|
787 |
650 |
$27K |
| 77080 |
|
445 |
418 |
$27K |
| 72128 |
|
1,110 |
960 |
$27K |
| 83605 |
|
6,939 |
5,101 |
$26K |
| 87511 |
|
1,011 |
984 |
$26K |
| 73110 |
|
1,679 |
1,469 |
$25K |
| 83880 |
|
5,024 |
4,043 |
$25K |
| 74174 |
|
176 |
158 |
$24K |
| 94727 |
|
397 |
361 |
$24K |
| 94060 |
|
176 |
159 |
$24K |
| 87070 |
|
4,673 |
4,256 |
$23K |
| 94729 |
|
411 |
375 |
$23K |
| 44970 |
|
12 |
12 |
$23K |
| 87624 |
|
1,062 |
1,018 |
$23K |
| 87210 |
|
6,517 |
5,828 |
$23K |
| 77066 |
Tomosynthesis, mammo |
623 |
579 |
$22K |
| 82746 |
|
4,816 |
4,174 |
$22K |
| 97535 |
|
971 |
481 |
$22K |
| 85610 |
|
7,902 |
5,866 |
$22K |
| 81220 |
|
224 |
218 |
$22K |
| 96523 |
|
596 |
386 |
$22K |
| J0640 |
Leucovorin calcium injection |
1,787 |
444 |
$21K |
| J1453 |
Fosaprepitant injection |
1,515 |
814 |
$21K |
| 87480 |
|
3,051 |
2,741 |
$20K |
| 76815 |
|
698 |
611 |
$20K |
| 73200 |
|
160 |
138 |
$20K |
| 83735 |
|
11,804 |
7,479 |
$20K |
| 88175 |
|
1,554 |
1,499 |
$20K |
| 11045 |
|
59 |
40 |
$19K |
| 97014 |
|
492 |
200 |
$19K |
| 72072 |
|
457 |
413 |
$19K |
| 84702 |
|
2,937 |
2,309 |
$19K |
| 84153 |
|
1,335 |
1,177 |
$18K |
| J0500 |
Dicyclomine injection |
1,292 |
998 |
$17K |
| 73560 |
|
1,618 |
1,339 |
$17K |
| 77065 |
Tomosynthesis, mammo |
464 |
438 |
$17K |
| 80074 |
|
1,069 |
947 |
$16K |
| 97116 |
|
699 |
427 |
$16K |
| 93922 |
|
254 |
230 |
$16K |
| 96368 |
|
2,038 |
1,087 |
$16K |
| 76801 |
|
253 |
228 |
$15K |
| 73564 |
|
360 |
306 |
$15K |
| 87798 |
|
1,044 |
1,015 |
$15K |
| 83021 |
|
737 |
662 |
$14K |
| 73080 |
|
951 |
829 |
$14K |
| 64400 |
|
50 |
38 |
$14K |
| 86140 |
|
1,541 |
1,255 |
$14K |
| 72197 |
|
61 |
53 |
$14K |
| 83690 |
|
36,973 |
32,441 |
$14K |
| 83970 |
|
658 |
542 |
$14K |
| 70498 |
|
857 |
749 |
$13K |
| 86762 |
|
903 |
832 |
$13K |
| 73620 |
|
261 |
219 |
$13K |
| 93308 |
|
52 |
50 |
$13K |
| 92610 |
|
491 |
386 |
$12K |
| 97597 |
|
300 |
199 |
$12K |
| 92523 |
|
317 |
239 |
$12K |
| 73590 |
|
1,041 |
886 |
$12K |
| 84403 |
|
729 |
668 |
$12K |
| 87660 |
|
3,050 |
2,740 |
$12K |
| 86901 |
|
4,180 |
3,358 |
$12K |
| 96376 |
|
7,519 |
4,011 |
$12K |
| 64721 |
|
27 |
24 |
$11K |
| 87510 |
|
3,051 |
2,741 |
$11K |
| 87880 |
|
3,071 |
2,952 |
$11K |
| 97035 |
|
133 |
77 |
$11K |
| 73140 |
|
714 |
662 |
$11K |
| 87340 |
|
898 |
843 |
$11K |
| G0279 |
Tomosynthesis, mammo |
992 |
934 |
$11K |
| G0257 |
Unsched dialysis esrd pt hos |
69 |
29 |
$11K |
| J2310 |
Inj naloxone hydrochloride |
626 |
398 |
$10K |
| 80320 |
|
846 |
707 |
$10K |
| 85007 |
|
4,216 |
2,869 |
$10K |
| 86923 |
|
609 |
348 |
$10K |
| 82947 |
|
982 |
808 |
$10K |
| 72050 |
|
169 |
142 |
$10K |
| 85378 |
|
6,060 |
5,229 |
$10K |
| 87077 |
|
3,784 |
2,979 |
$9K |
| 82043 |
|
1,205 |
1,106 |
$9K |
| J2469 |
Palonosetron hcl |
2,087 |
1,111 |
$8K |
| 49083 |
|
19 |
12 |
$8K |
| 86431 |
|
497 |
444 |
$8K |
| 81003 |
|
15,202 |
13,259 |
$8K |
| 86334 |
|
700 |
590 |
$8K |
| 96402 |
|
778 |
643 |
$8K |
| 84436 |
|
418 |
382 |
$8K |
| 85651 |
|
3,678 |
3,170 |
$8K |
| 84146 |
|
381 |
338 |
$7K |
| 64447 |
|
37 |
37 |
$7K |
| 94010 |
|
47 |
44 |
$7K |
| 43235 |
|
13 |
13 |
$7K |
| 84481 |
|
566 |
511 |
$7K |
| 87522 |
Neg quan hep c or qual rna |
223 |
202 |
$7K |
| 92133 |
|
152 |
140 |
$7K |
| 72129 |
|
684 |
569 |
$7K |
| 92134 |
|
274 |
259 |
$7K |
| 82550 |
|
2,226 |
1,725 |
$7K |
| 83516 |
|
445 |
231 |
$7K |
| 82575 |
|
923 |
762 |
$7K |
| 82248 |
|
1,137 |
830 |
$6K |
| J9045 |
Carboplatin injection |
861 |
440 |
$6K |
| 88341 |
|
117 |
57 |
$6K |
| 82784 |
|
902 |
569 |
$6K |
| 87635 |
|
133 |
123 |
$6K |
| 84100 |
|
2,271 |
1,331 |
$6K |
| 82533 |
|
435 |
286 |
$6K |
| 93225 |
|
47 |
42 |
$6K |
| 72070 |
|
101 |
94 |
$6K |
| 77049 |
|
14 |
14 |
$6K |
| 43249 |
|
32 |
32 |
$6K |
| 78264 |
|
30 |
25 |
$5K |
| 73090 |
|
781 |
673 |
$5K |
| 87186 |
|
2,814 |
2,246 |
$5K |
| 86039 |
|
220 |
198 |
$5K |
| 82525 |
|
439 |
380 |
$5K |
| 83001 |
|
289 |
256 |
$5K |
| 97113 |
|
79 |
26 |
$5K |
| 82950 |
|
389 |
358 |
$5K |
| 92083 |
|
139 |
130 |
$5K |
| J2543 |
Piperacillin/tazobactam |
1,851 |
766 |
$5K |
| 86038 |
|
413 |
369 |
$5K |
| 84112 |
|
88 |
66 |
$5K |
| 71101 |
|
540 |
485 |
$5K |
| 83521 |
|
782 |
410 |
$4K |
| 01999 |
|
1,559 |
1,344 |
$4K |
| 85014 |
|
810 |
556 |
$4K |
| 87633 |
|
94 |
83 |
$4K |
| 86592 |
|
378 |
366 |
$4K |
| 29125 |
|
1,161 |
1,052 |
$4K |
| 36600 |
|
3,061 |
2,210 |
$4K |
| 87040 |
|
4,396 |
1,969 |
$4K |
| 64488 |
|
27 |
24 |
$4K |
| J3489 |
Zoledronic acid 1mg |
350 |
262 |
$4K |
| 85660 |
|
785 |
677 |
$4K |
| 83527 |
|
163 |
146 |
$4K |
| 83615 |
|
2,368 |
1,923 |
$4K |
| 90686 |
|
215 |
184 |
$4K |
| 73718 |
|
17 |
13 |
$4K |
| 84425 |
|
396 |
344 |
$4K |
| 84156 |
|
1,025 |
851 |
$4K |
| 72158 |
|
24 |
24 |
$4K |
| 36592 |
|
263 |
153 |
$4K |
| 84165 |
|
752 |
662 |
$4K |
| 70487 |
|
15 |
13 |
$4K |
| 84402 |
|
187 |
183 |
$4K |
| 73060 |
|
441 |
360 |
$4K |
| 86141 |
|
954 |
859 |
$3K |
| 88305 |
|
5,495 |
4,044 |
$3K |
| Q0138 |
Ferumoxytol, non-esrd |
59 |
41 |
$3K |
| 86304 |
|
421 |
321 |
$3K |
| J1650 |
Inj enoxaparin sodium |
5,202 |
2,241 |
$3K |
| 84550 |
|
651 |
564 |
$3K |
| 84590 |
|
413 |
355 |
$3K |
| 86300 |
|
904 |
689 |
$3K |
| 73552 |
|
474 |
404 |
$3K |
| 87154 |
|
20 |
12 |
$3K |
| 93226 |
|
43 |
42 |
$3K |
| 76881 |
|
32 |
25 |
$3K |
| 86376 |
|
159 |
144 |
$3K |
| 82105 |
|
232 |
189 |
$3K |
| J1953 |
Levetiracetam injection |
444 |
280 |
$3K |
| 85018 |
|
1,069 |
764 |
$3K |
| J1642 |
Inj heparin sodium per 10 u |
9,037 |
4,126 |
$3K |
| 80164 |
|
312 |
253 |
$3K |
| 58300 |
|
44 |
42 |
$3K |
| 86480 |
|
69 |
63 |
$2K |
| 73600 |
|
103 |
88 |
$2K |
| 84703 |
|
1,648 |
1,471 |
$2K |
| 82378 |
|
1,182 |
870 |
$2K |
| 86147 |
|
130 |
78 |
$2K |
| 84630 |
|
296 |
242 |
$2K |
| 73120 |
|
99 |
82 |
$2K |
| 96401 |
|
214 |
65 |
$2K |
| J2800 |
Methocarbamol injection |
696 |
538 |
$2K |
| 82803 |
|
2,680 |
2,044 |
$2K |
| 30140 |
|
21 |
16 |
$2K |
| 72080 |
|
46 |
44 |
$2K |
| 73522 |
|
47 |
40 |
$2K |
| 72170 |
|
275 |
234 |
$2K |
| 84450 |
|
392 |
299 |
$2K |
| 94660 |
|
58 |
27 |
$2K |
| 87081 |
|
567 |
510 |
$2K |
| 82140 |
|
797 |
626 |
$2K |
| 87634 |
|
850 |
758 |
$2K |
| J1170 |
Hydromorphone injection |
5,827 |
3,727 |
$2K |
| 72082 |
|
19 |
14 |
$2K |
| 85730 |
|
2,894 |
2,409 |
$2K |
| 87507 |
|
18 |
13 |
$2K |
| 84145 |
|
2,505 |
2,049 |
$2K |
| 86235 |
|
137 |
67 |
$2K |
| 85045 |
|
1,423 |
1,235 |
$2K |
| 84132 |
|
1,543 |
1,085 |
$2K |
| 84460 |
|
409 |
313 |
$2K |
| J8501 |
Oral aprepitant |
165 |
110 |
$2K |
| 82670 |
|
91 |
82 |
$2K |
| 83002 |
|
120 |
105 |
$2K |
| 87205 |
|
1,418 |
1,110 |
$2K |
| J1885 |
Ketorolac tromethamine inj |
53,453 |
41,082 |
$2K |
| 86308 |
|
427 |
356 |
$2K |
| 72156 |
|
12 |
12 |
$2K |
| 86703 |
|
134 |
129 |
$2K |
| 86706 |
|
106 |
87 |
$2K |
| 84480 |
|
105 |
97 |
$1K |
| 86800 |
|
110 |
100 |
$1K |
| 82330 |
|
752 |
537 |
$1K |
| 97760 |
|
21 |
17 |
$1K |
| G0008 |
Admin influenza virus vac |
307 |
251 |
$1K |
| 00840 |
|
1,075 |
856 |
$1K |
| J3420 |
Vitamin b12 injection |
2,044 |
1,407 |
$1K |
| 96411 |
|
1,011 |
527 |
$1K |
| J2270 |
Morphine sulfate injection |
6,390 |
4,798 |
$1K |
| 93925 |
|
12 |
12 |
$1K |
| 82565 |
|
198 |
173 |
$1K |
| 86003 |
|
51 |
25 |
$1K |
| 97010 |
|
23 |
12 |
$1K |
| J9263 |
Oxaliplatin |
408 |
104 |
$1K |
| 82040 |
|
181 |
125 |
$1K |
| 74246 |
|
12 |
12 |
$1K |
| 82977 |
|
269 |
199 |
$1K |
| 86255 |
|
52 |
44 |
$1K |
| 86200 |
|
64 |
59 |
$1K |
| 82570 |
|
143 |
140 |
$1K |
| J1200 |
Diphenhydramine hcl injectio |
7,956 |
5,191 |
$1K |
| J1644 |
Inj heparin sodium per 1000u |
7,139 |
3,058 |
$1K |
| J0696 |
Ceftriaxone sodium injection |
5,903 |
4,496 |
$1K |
| 82247 |
|
215 |
157 |
$1K |
| 83010 |
|
286 |
226 |
$1K |
| J7999 |
Compounded drug, noc |
596 |
458 |
$1K |
| 83721 |
|
90 |
72 |
$1K |
| J9171 |
Docetaxel injection |
22 |
13 |
$1K |
| J9060 |
Cisplatin 10 mg injection |
77 |
27 |
$924.57 |
| 73501 |
|
56 |
42 |
$887.09 |
| 86225 |
|
76 |
70 |
$859.62 |
| 88342 |
|
2,216 |
1,861 |
$858.07 |
| 97163 |
|
12 |
12 |
$847.54 |
| 85576 |
|
33 |
25 |
$812.23 |
| 72220 |
|
13 |
12 |
$798.11 |
| 29130 |
|
205 |
183 |
$786.51 |
| 73660 |
|
57 |
56 |
$754.24 |
| 71100 |
|
12 |
12 |
$742.81 |
| 01400 |
|
146 |
114 |
$734.76 |
| 82150 |
|
221 |
189 |
$722.48 |
| 73070 |
|
65 |
59 |
$681.58 |
| 96377 |
|
464 |
285 |
$671.68 |
| 73100 |
|
40 |
38 |
$653.82 |
| 76819 |
|
19 |
13 |
$614.56 |
| J1100 |
Dexamethasone sodium phos |
16,215 |
11,331 |
$581.58 |
| J3475 |
Inj magnesium sulfate |
3,109 |
1,696 |
$569.53 |
| 72120 |
|
14 |
14 |
$567.35 |
| 87486 |
|
19 |
18 |
$557.84 |
| J2550 |
Promethazine hcl injection |
3,530 |
2,329 |
$553.32 |
| J2405 |
Ondansetron hcl injection |
37,327 |
29,117 |
$550.39 |
| 87324 |
|
83 |
69 |
$540.02 |
| J2919 |
Inj, methylpred sod succ 5mg |
937 |
706 |
$535.46 |
| 99195 |
|
30 |
26 |
$488.26 |
| J3473 |
Hyaluronidase recombinant |
17 |
14 |
$475.62 |
| 72052 |
|
13 |
12 |
$434.16 |
| J3010 |
Fentanyl citrate injection |
17,005 |
12,940 |
$410.93 |
| 85049 |
|
450 |
321 |
$410.68 |
| J2360 |
Orphenadrine injection |
993 |
811 |
$401.68 |
| 82010 |
|
1,229 |
980 |
$399.70 |
| J2930 |
Methylprednisolone injection |
1,885 |
1,352 |
$385.73 |
| 80177 |
|
28 |
25 |
$374.90 |
| 87449 |
|
72 |
58 |
$369.35 |
| 00731 |
|
515 |
454 |
$362.21 |
| J0360 |
Hydralazine hcl injection |
883 |
626 |
$356.94 |
| 86146 |
|
58 |
40 |
$349.24 |
| 83655 |
|
12 |
12 |
$340.70 |
| 87075 |
|
639 |
482 |
$323.72 |
| 87581 |
|
19 |
18 |
$317.39 |
| J3370 |
Vancomycin hcl injection |
1,466 |
873 |
$315.19 |
| 90656 |
|
48 |
45 |
$294.17 |
| J0171 |
Adrenalin epinephrine inject |
814 |
415 |
$291.62 |
| 90662 |
|
87 |
61 |
$287.06 |
| C1894 |
Intro/sheath, non-laser |
618 |
491 |
$286.00 |
| C1769 |
Guide wire |
822 |
662 |
$285.00 |
| J0780 |
Prochlorperazine injection |
1,452 |
1,088 |
$264.06 |
| J3411 |
Thiamine hcl 100 mg |
1,079 |
422 |
$260.72 |
| J2920 |
Methylprednisolone injection |
290 |
143 |
$256.89 |
| J1380 |
Estradiol valerate 10 mg inj |
15 |
12 |
$245.49 |
| J2704 |
Inj, propofol, 10 mg |
4,591 |
3,794 |
$233.31 |
| 88304 |
|
1,378 |
1,074 |
$204.99 |
| J1805 |
Inj, esmolol hcl, 10mg |
332 |
273 |
$190.37 |
| J1030 |
Methylprednisolone 40 mg inj |
1,847 |
1,576 |
$189.35 |
| 86704 |
|
27 |
24 |
$185.32 |
| 86301 |
|
32 |
27 |
$167.14 |
| 81015 |
|
137 |
128 |
$165.03 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
1,028 |
863 |
$143.97 |
| J2250 |
Inj midazolam hydrochloride |
11,761 |
9,752 |
$140.00 |
| 82024 |
|
16 |
15 |
$129.60 |
| J1940 |
Furosemide injection |
1,419 |
744 |
$128.58 |
| J1790 |
Droperidol injection |
1,723 |
1,369 |
$128.11 |
| J0690 |
Cefazolin sodium injection |
2,974 |
2,163 |
$125.25 |
| J0737 |
Inj, clindamycin (baxter) |
240 |
200 |
$119.63 |
| C1887 |
Catheter, guiding |
365 |
287 |
$117.00 |
| J2060 |
Lorazepam injection |
1,650 |
1,173 |
$109.92 |
| 29515 |
|
29 |
27 |
$102.95 |
| 84155 |
|
47 |
36 |
$95.31 |
| 84075 |
|
34 |
27 |
$94.41 |
| J3301 |
Triamcinolone acet inj nos |
286 |
232 |
$93.37 |
| J3480 |
Inj potassium chloride |
2,241 |
1,105 |
$93.22 |
| J9190 |
Fluorouracil injection |
1,617 |
466 |
$92.22 |
| J2471 |
Inj pantoprazole(hikma) 40mg |
187 |
156 |
$87.86 |
| J3360 |
Diazepam injection |
393 |
228 |
$80.87 |
| J1040 |
Methylprednisolone 80 mg inj |
144 |
137 |
$78.65 |
| 94667 |
|
14 |
12 |
$76.04 |
| J9267 |
Paclitaxel injection |
873 |
364 |
$75.13 |
| J2795 |
Ropivacaine hcl injection |
2,296 |
1,907 |
$68.06 |
| G1004 |
Cdsm ndsc |
279 |
179 |
$67.62 |
| 88302 |
|
439 |
206 |
$66.10 |
| 85520 |
|
92 |
41 |
$62.68 |
| J2765 |
Metoclopramide hcl injection |
1,446 |
1,102 |
$55.85 |
| J0613 |
Calcium glucon (wg critical) |
88 |
67 |
$47.61 |
| J1020 |
Methylprednisolone 20 mg inj |
137 |
123 |
$46.96 |
| J1626 |
Granisetron hcl injection |
598 |
190 |
$44.19 |
| J1010 |
Inj, methylpred acetate 1 mg |
248 |
215 |
$40.15 |
| 96417 |
|
2,096 |
1,142 |
$39.48 |
| 99152 |
|
231 |
167 |
$37.75 |
| J2370 |
Phenylephrine hcl injection |
718 |
485 |
$36.00 |
| J1630 |
Haloperidol injection |
487 |
377 |
$36.00 |
| J0330 |
Succinycholine chloride inj |
1,557 |
1,229 |
$28.69 |
| 85347 |
|
140 |
63 |
$28.56 |
| 84295 |
|
201 |
146 |
$27.04 |
| J0689 |
Inj cefazolin sodium, baxter |
1,276 |
1,167 |
$27.03 |
| J0592 |
Buprenorphine hydrochloride |
404 |
323 |
$25.87 |
| J2175 |
Meperidine hydrochl /100 mg |
453 |
385 |
$22.53 |
| J2916 |
Na ferric gluconate complex |
201 |
109 |
$22.47 |
| 82375 |
|
69 |
60 |
$21.87 |
| 87147 |
|
12 |
12 |
$18.56 |
| J1920 |
Inj, labetalol hcl, 5mg |
327 |
267 |
$17.74 |
| 82810 |
|
53 |
45 |
$15.59 |
| J3410 |
Hydroxyzine hcl injection |
81 |
58 |
$13.90 |
| J8540 |
Oral dexamethasone |
22 |
13 |
$13.21 |
| 83050 |
|
69 |
60 |
$11.51 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
1,932 |
1,428 |
$10.55 |
| J7512 |
Prednisone ir or dr oral 1mg |
278 |
258 |
$9.51 |
| Q0177 |
Hydroxyzine pamoate 25mg |
1,066 |
768 |
$9.49 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
417 |
277 |
$7.68 |
| J0456 |
Azithromycin |
298 |
170 |
$6.89 |
| 94761 |
|
1,187 |
773 |
$6.22 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
867 |
604 |
$4.84 |
| J2470 |
Inj pantoprazole sodium 40mg |
80 |
67 |
$2.46 |
| J2305 |
Inj, nitroglycerin, 5 mg |
12 |
12 |
$1.49 |
| 88311 |
|
515 |
362 |
$1.25 |
| J0461 |
Atropine sulfate injection |
162 |
66 |
$0.76 |
| C1776 |
Joint device (implantable) |
321 |
273 |
$0.00 |
| 01810 |
|
199 |
169 |
$0.00 |
| C1729 |
Cath, drainage |
172 |
146 |
$0.00 |
| C1751 |
Cath, inf, per/cent/midline |
157 |
139 |
$0.00 |
| 92015 |
|
144 |
129 |
$0.00 |
| 15853 |
|
81 |
80 |
$0.00 |
| 00300 |
|
255 |
201 |
$0.00 |
| J0692 |
Cefepime hcl for injection |
136 |
54 |
$0.00 |
| 00940 |
|
15 |
13 |
$0.00 |
| 00811 |
|
318 |
287 |
$0.00 |
| C1760 |
Closure dev, vasc |
43 |
28 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
31 |
27 |
$0.00 |
| 01830 |
|
193 |
157 |
$0.00 |
| G0500 |
Mod sedat endo service >5yrs |
47 |
42 |
$0.00 |
| C1780 |
Lens, intraocular (new tech) |
28 |
25 |
$0.00 |
| A9541 |
Tc99m sulfur colloid |
35 |
28 |
$0.00 |
| 51702 |
|
45 |
39 |
$0.00 |
| A9537 |
Tc99m mebrofenin |
17 |
14 |
$0.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
113 |
42 |
$0.00 |
| J0744 |
Ciprofloxacin iv |
21 |
12 |
$0.00 |
| A9500 |
Tc99m sestamibi |
433 |
376 |
$0.00 |
| C1889 |
Implant/insert device, noc |
508 |
413 |
$0.00 |
| 00813 |
|
359 |
311 |
$0.00 |
| C1781 |
Mesh (implantable) |
123 |
95 |
$0.00 |
| J2785 |
Regadenoson injection |
240 |
191 |
$0.00 |
| 00160 |
|
41 |
33 |
$0.00 |
| C1726 |
Cath, bal dil, non-vascular |
93 |
91 |
$0.00 |
| 00790 |
|
257 |
187 |
$0.00 |
| 94760 |
|
375 |
308 |
$0.00 |
| 00952 |
|
243 |
194 |
$0.00 |
| J0610 |
Calcium glucon (fresenius) |
49 |
25 |
$0.00 |
| 76377 |
|
41 |
38 |
$0.00 |
| J1720 |
Hydrocortisone sodium succ i |
17 |
13 |
$0.00 |
| J1836 |
Inj, metronidazole, 10 mg |
73 |
44 |
$0.00 |
| 01480 |
|
13 |
12 |
$0.00 |
| C9290 |
Inj, bupivacaine liposome |
12 |
12 |
$0.00 |