| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpt clinic visit |
244,981 |
207,115 |
$11.51M |
| 99284 |
|
20,859 |
19,511 |
$3.85M |
| 99283 |
|
28,569 |
26,628 |
$3.43M |
| 99285 |
|
8,301 |
7,871 |
$3.19M |
| 96374 |
|
12,232 |
11,196 |
$1.18M |
| J0585 |
Injection,onabotulinumtoxina |
3,781 |
1,563 |
$872K |
| 74177 |
|
5,561 |
5,375 |
$818K |
| 97110 |
|
30,319 |
8,183 |
$799K |
| J2350 |
Injection, ocrelizumab, 1 mg |
48 |
48 |
$610K |
| 96365 |
|
6,547 |
5,164 |
$591K |
| U0004 |
Cov-19 test non-cdc hgh thru |
15,743 |
14,739 |
$539K |
| 70553 |
|
2,133 |
2,081 |
$513K |
| 20610 |
|
3,556 |
3,110 |
$471K |
| 43239 |
|
1,355 |
1,341 |
$451K |
| 99282 |
|
6,328 |
6,084 |
$422K |
| 96413 |
|
2,563 |
1,735 |
$353K |
| 96375 |
|
11,294 |
9,583 |
$346K |
| 87633 |
|
2,771 |
2,724 |
$315K |
| 71046 |
|
8,615 |
8,272 |
$312K |
| 45380 |
|
609 |
601 |
$294K |
| 90471 |
|
24,188 |
23,839 |
$245K |
| 93306 |
|
1,157 |
1,151 |
$234K |
| 74176 |
|
2,050 |
1,971 |
$213K |
| 70450 |
|
3,754 |
3,642 |
$212K |
| 77067 |
|
4,016 |
3,994 |
$190K |
| 99291 |
|
339 |
332 |
$186K |
| 76705 |
|
3,123 |
3,064 |
$182K |
| 76830 |
|
3,404 |
3,340 |
$182K |
| 76856 |
|
3,725 |
3,653 |
$178K |
| 97140 |
|
12,366 |
4,165 |
$177K |
| 90472 |
|
11,842 |
11,763 |
$174K |
| 64615 |
|
1,416 |
1,400 |
$172K |
| 71045 |
|
4,639 |
4,431 |
$168K |
| 80061 |
|
18,491 |
18,400 |
$160K |
| 87637 |
|
2,055 |
2,032 |
$149K |
| 96372 |
|
18,053 |
15,379 |
$144K |
| 72148 |
|
1,280 |
1,268 |
$138K |
| 72125 |
|
1,045 |
1,029 |
$135K |
| U0005 |
Infec agen detec ampli probe |
11,653 |
10,919 |
$126K |
| 76801 |
|
2,451 |
2,130 |
$125K |
| C9803 |
Hopd covid-19 spec collect |
8,761 |
8,193 |
$122K |
| 71275 |
|
1,362 |
1,324 |
$119K |
| 84443 |
|
23,996 |
23,407 |
$103K |
| 97162 |
|
2,072 |
2,047 |
$102K |
| 86008 |
|
931 |
876 |
$102K |
| G0378 |
Hospital observation per hr |
1,468 |
1,398 |
$96K |
| 45385 |
|
186 |
186 |
$94K |
| 80053 |
|
52,218 |
46,322 |
$88K |
| 82306 |
|
9,576 |
9,540 |
$84K |
| 85025 |
|
59,831 |
52,636 |
$79K |
| 47562 |
|
24 |
24 |
$78K |
| 87491 |
|
7,461 |
7,372 |
$77K |
| 96367 |
|
2,413 |
1,685 |
$74K |
| 96415 |
|
1,339 |
995 |
$73K |
| 97161 |
|
1,505 |
1,494 |
$72K |
| 87591 |
|
6,772 |
6,702 |
$71K |
| 80307 |
|
8,044 |
7,459 |
$69K |
| 87635 |
|
3,292 |
3,196 |
$67K |
| 93975 |
|
552 |
542 |
$66K |
| 90677 |
|
998 |
997 |
$65K |
| 96366 |
|
2,216 |
1,276 |
$65K |
| 76805 |
|
1,478 |
1,461 |
$65K |
| 64493 |
|
123 |
116 |
$64K |
| 90651 |
|
2,119 |
2,109 |
$63K |
| 94060 |
|
438 |
438 |
$62K |
| 59025 |
|
622 |
268 |
$60K |
| 96360 |
|
523 |
390 |
$57K |
| 90686 |
|
8,189 |
8,160 |
$57K |
| 73721 |
|
439 |
427 |
$55K |
| 76770 |
|
961 |
947 |
$55K |
| 36415 |
|
61,786 |
50,830 |
$54K |
| 76816 |
|
1,248 |
1,186 |
$53K |
| 96361 |
|
1,858 |
1,386 |
$53K |
| 17110 |
|
1,180 |
1,037 |
$53K |
| 76700 |
|
754 |
749 |
$50K |
| 87661 |
|
4,219 |
4,192 |
$49K |
| 76536 |
|
920 |
915 |
$45K |
| 77063 |
|
3,625 |
3,620 |
$44K |
| 93971 |
|
836 |
822 |
$43K |
| 71250 |
|
881 |
874 |
$42K |
| 83036 |
|
15,273 |
15,154 |
$41K |
| 73630 |
|
3,401 |
3,082 |
$39K |
| 87798 |
|
2,190 |
2,155 |
$39K |
| 97530 |
|
1,375 |
559 |
$38K |
| 71260 |
|
412 |
405 |
$38K |
| 90460 |
|
2,267 |
2,232 |
$35K |
| 76642 |
|
916 |
903 |
$33K |
| 88175 |
|
3,783 |
3,768 |
$33K |
| 87624 |
|
2,874 |
2,858 |
$32K |
| 97035 |
|
5,796 |
1,856 |
$30K |
| 72141 |
|
284 |
284 |
$30K |
| 99281 |
|
708 |
696 |
$29K |
| 93017 |
|
555 |
545 |
$28K |
| 88305 |
|
6,443 |
4,300 |
$28K |
| 71271 |
|
462 |
461 |
$26K |
| 73610 |
|
2,669 |
2,410 |
$25K |
| 73564 |
|
2,048 |
1,805 |
$25K |
| 73130 |
|
2,876 |
2,424 |
$24K |
| 76815 |
|
922 |
847 |
$24K |
| 82607 |
|
5,372 |
5,349 |
$22K |
| G0260 |
Inj for sacroiliac jt anesth |
70 |
70 |
$22K |
| 87086 |
|
14,565 |
13,570 |
$22K |
| 80055 |
|
1,165 |
1,162 |
$22K |
| 95806 |
|
266 |
266 |
$22K |
| 95117 |
|
1,975 |
901 |
$21K |
| 90474 |
|
3,487 |
3,483 |
$21K |
| 93005 |
|
13,534 |
12,269 |
$21K |
| 72156 |
|
191 |
188 |
$20K |
| 73110 |
|
2,043 |
1,803 |
$20K |
| 87389 |
|
2,506 |
2,499 |
$20K |
| 72110 |
|
1,117 |
1,108 |
$20K |
| 87502 |
|
2,753 |
2,152 |
$19K |
| 97112 |
|
955 |
461 |
$19K |
| 72100 |
|
957 |
939 |
$19K |
| 90670 |
|
5,238 |
5,217 |
$18K |
| 73030 |
|
2,813 |
2,605 |
$18K |
| 82728 |
|
4,351 |
4,281 |
$18K |
| 87651 |
|
3,862 |
3,804 |
$18K |
| 84439 |
|
6,455 |
6,366 |
$17K |
| 87088 |
|
11,453 |
10,755 |
$17K |
| 87581 |
|
1,573 |
1,540 |
$17K |
| 87486 |
|
1,573 |
1,540 |
$17K |
| 70551 |
|
95 |
95 |
$16K |
| J7298 |
Mirena, 52 mg |
24 |
24 |
$15K |
| 84702 |
|
4,729 |
3,763 |
$15K |
| 92557 |
|
1,245 |
1,242 |
$15K |
| 78452 |
|
37 |
37 |
$14K |
| 87653 |
|
1,085 |
1,083 |
$14K |
| 80048 |
|
9,930 |
8,773 |
$14K |
| 87070 |
|
5,754 |
5,629 |
$13K |
| 81025 |
|
14,058 |
13,102 |
$12K |
| G0103 |
Psa screening |
1,835 |
1,833 |
$12K |
| 90682 |
|
222 |
222 |
$12K |
| 83516 |
|
1,049 |
1,024 |
$12K |
| G0480 |
Drug test def 1-7 classes |
293 |
290 |
$11K |
| M0243 |
Casirivi and imdevi inj |
47 |
47 |
$11K |
| J7307 |
Etonogestrel implant system |
13 |
13 |
$11K |
| 73501 |
|
534 |
521 |
$11K |
| 83655 |
|
2,790 |
2,739 |
$11K |
| 86803 |
|
2,149 |
2,145 |
$11K |
| 84403 |
|
1,341 |
1,325 |
$10K |
| 80074 |
|
780 |
778 |
$10K |
| 77080 |
|
175 |
175 |
$10K |
| 77066 |
Tomosynthesis, mammo |
174 |
173 |
$10K |
| 83550 |
|
3,812 |
3,780 |
$10K |
| 73560 |
|
1,174 |
1,046 |
$9K |
| S4005 |
Interim labor facility globa |
78 |
63 |
$9K |
| 90621 |
|
356 |
355 |
$9K |
| G0279 |
Tomosynthesis, mammo |
738 |
736 |
$9K |
| 87505 |
|
209 |
206 |
$9K |
| 64405 |
|
55 |
54 |
$8K |
| 36591 |
|
362 |
144 |
$8K |
| 83880 |
|
2,775 |
2,592 |
$8K |
| 86787 |
|
1,372 |
1,331 |
$8K |
| 83540 |
|
4,203 |
4,155 |
$8K |
| 82746 |
|
1,790 |
1,784 |
$8K |
| 86038 |
|
2,233 |
2,221 |
$8K |
| 87186 |
|
4,116 |
3,988 |
$7K |
| 86900 |
|
2,516 |
2,341 |
$7K |
| G0008 |
Admin influenza virus vac |
1,124 |
1,117 |
$7K |
| 87077 |
|
4,384 |
4,251 |
$7K |
| 84402 |
|
913 |
906 |
$7K |
| 90734 |
|
1,132 |
1,124 |
$7K |
| 97535 |
|
257 |
122 |
$7K |
| 82652 |
|
614 |
611 |
$7K |
| 81002 |
|
8,053 |
7,837 |
$6K |
| 86140 |
|
5,948 |
5,428 |
$6K |
| 74018 |
|
471 |
443 |
$6K |
| 64483 |
|
12 |
12 |
$6K |
| 94640 |
|
4,288 |
2,837 |
$5K |
| 82784 |
|
1,174 |
1,166 |
$5K |
| 70486 |
|
138 |
138 |
$5K |
| 94799 |
|
2,937 |
2,732 |
$5K |
| 81003 |
|
21,060 |
19,322 |
$5K |
| 92567 |
|
2,343 |
2,334 |
$5K |
| 87634 |
|
285 |
284 |
$5K |
| 84146 |
|
808 |
795 |
$5K |
| G0009 |
Admin pneumococcal vaccine |
701 |
701 |
$5K |
| 85651 |
|
4,546 |
4,273 |
$5K |
| 82043 |
|
2,911 |
2,898 |
$5K |
| 97163 |
|
89 |
88 |
$4K |
| 90480 |
|
108 |
108 |
$4K |
| 73080 |
|
484 |
432 |
$4K |
| 83735 |
|
6,360 |
4,816 |
$4K |
| 82785 |
|
740 |
732 |
$4K |
| G0108 |
Diab manage trn per indiv |
77 |
66 |
$4K |
| 69210 |
|
350 |
339 |
$4K |
| 85610 |
|
6,620 |
5,273 |
$4K |
| 93970 |
|
39 |
39 |
$4K |
| 86480 |
|
206 |
204 |
$4K |
| 87480 |
|
997 |
988 |
$4K |
| 0012A |
|
122 |
121 |
$4K |
| 84550 |
|
2,628 |
2,557 |
$4K |
| 82670 |
|
398 |
397 |
$4K |
| 85027 |
|
3,758 |
3,126 |
$4K |
| M0245 |
Bamlan and etesev infusion |
14 |
14 |
$4K |
| 10060 |
|
41 |
39 |
$4K |
| 87660 |
|
944 |
937 |
$4K |
| 83001 |
|
644 |
644 |
$4K |
| 73221 |
|
25 |
25 |
$4K |
| 97165 |
|
79 |
75 |
$4K |
| 87510 |
|
956 |
947 |
$3K |
| 80076 |
|
2,063 |
1,955 |
$3K |
| 84166 |
|
669 |
640 |
$3K |
| 87081 |
|
1,566 |
1,554 |
$3K |
| 90716 |
|
1,368 |
1,364 |
$3K |
| 86481 |
|
97 |
97 |
$3K |
| 87636 |
|
43 |
43 |
$3K |
| 73562 |
|
1,116 |
1,061 |
$3K |
| 72050 |
|
132 |
132 |
$3K |
| 86255 |
|
700 |
698 |
$3K |
| 86780 |
|
582 |
578 |
$3K |
| 88304 |
|
959 |
895 |
$3K |
| 76882 |
|
64 |
63 |
$3K |
| 97014 |
|
307 |
139 |
$3K |
| 90732 |
|
45 |
43 |
$3K |
| 81001 |
|
10,479 |
9,609 |
$3K |
| 84112 |
|
80 |
68 |
$3K |
| 93226 |
|
91 |
83 |
$3K |
| 90688 |
|
299 |
297 |
$3K |
| 83690 |
|
9,259 |
8,522 |
$3K |
| 82570 |
|
1,509 |
1,505 |
$3K |
| G0010 |
Admin hepatitis b vaccine |
362 |
362 |
$2K |
| 73100 |
|
114 |
90 |
$2K |
| 73590 |
|
281 |
250 |
$2K |
| 70491 |
|
27 |
26 |
$2K |
| 0011A |
|
99 |
99 |
$2K |
| 82950 |
|
1,166 |
1,164 |
$2K |
| 86850 |
|
2,014 |
1,913 |
$2K |
| 95911 |
|
12 |
12 |
$2K |
| 29075 |
|
14 |
12 |
$2K |
| 83002 |
|
354 |
354 |
$2K |
| 95909 |
|
13 |
13 |
$2K |
| 85730 |
|
3,359 |
2,998 |
$2K |
| 82105 |
|
384 |
380 |
$2K |
| 86431 |
|
1,086 |
1,078 |
$2K |
| 97166 |
|
38 |
38 |
$2K |
| 82947 |
|
1,161 |
1,160 |
$2K |
| 85378 |
|
2,445 |
2,361 |
$2K |
| 77065 |
Tomosynthesis, mammo |
43 |
43 |
$2K |
| 87147 |
|
1,238 |
1,211 |
$2K |
| 82805 |
|
516 |
479 |
$2K |
| 73090 |
|
217 |
193 |
$2K |
| 85018 |
|
2,257 |
2,256 |
$2K |
| 25600 |
|
13 |
13 |
$2K |
| 36600 |
|
97 |
75 |
$2K |
| 85007 |
|
2,812 |
2,417 |
$2K |
| 82550 |
|
1,612 |
1,488 |
$1K |
| 93225 |
|
42 |
42 |
$1K |
| 90619 |
|
771 |
770 |
$1K |
| 0002A |
|
39 |
39 |
$1K |
| 82962 |
|
7,289 |
5,704 |
$1K |
| 87426 |
|
112 |
109 |
$1K |
| 83721 |
|
405 |
399 |
$1K |
| 99392 |
|
13 |
13 |
$1K |
| 80069 |
|
665 |
521 |
$1K |
| U0002 |
Covid-19 lab test non-cdc |
85 |
85 |
$1K |
| 83970 |
|
100 |
93 |
$1K |
| 83993 |
|
214 |
213 |
$1K |
| 82565 |
|
977 |
912 |
$1K |
| 84100 |
|
1,892 |
1,251 |
$1K |
| 82150 |
|
1,594 |
1,527 |
$1K |
| 87899 |
|
202 |
101 |
$1K |
| 90744 |
|
2,195 |
2,185 |
$1K |
| 20550 |
|
13 |
12 |
$1K |
| 99213 |
|
80 |
79 |
$1K |
| 94760 |
|
1,916 |
1,323 |
$1K |
| 70496 |
|
40 |
40 |
$1K |
| 74019 |
|
42 |
42 |
$971.98 |
| 90473 |
|
79 |
79 |
$968.36 |
| 73502 |
|
103 |
103 |
$952.89 |
| 84481 |
|
215 |
214 |
$921.05 |
| 76819 |
|
25 |
14 |
$917.77 |
| 86376 |
|
194 |
193 |
$911.13 |
| 99495 |
|
15 |
15 |
$896.47 |
| 99214 |
|
40 |
40 |
$884.63 |
| 0001A |
|
42 |
42 |
$880.90 |
| 99406 |
|
87 |
81 |
$874.12 |
| 58300 |
|
51 |
51 |
$873.15 |
| 91320 |
|
13 |
13 |
$849.85 |
| 76817 |
|
764 |
658 |
$839.57 |
| 87340 |
|
222 |
220 |
$746.39 |
| 94010 |
|
209 |
201 |
$697.97 |
| 86901 |
|
2,502 |
2,328 |
$670.17 |
| 87205 |
|
954 |
919 |
$633.47 |
| 72114 |
|
29 |
29 |
$584.61 |
| 82248 |
|
381 |
353 |
$546.00 |
| 89220 |
|
85 |
77 |
$532.77 |
| 82533 |
|
68 |
65 |
$516.54 |
| 84450 |
|
295 |
289 |
$473.34 |
| 87801 |
|
358 |
351 |
$468.46 |
| 0071A |
|
12 |
12 |
$450.36 |
| 86671 |
|
112 |
112 |
$443.76 |
| 73140 |
|
56 |
54 |
$441.89 |
| 90656 |
|
192 |
192 |
$431.52 |
| 71101 |
|
25 |
25 |
$430.30 |
| 82247 |
|
216 |
186 |
$428.18 |
| 84484 |
|
7,000 |
5,391 |
$416.25 |
| 83605 |
|
4,996 |
4,276 |
$403.28 |
| 92083 |
|
269 |
264 |
$397.48 |
| 76870 |
|
26 |
24 |
$361.80 |
| 87641 |
|
51 |
51 |
$348.90 |
| 87040 |
|
3,235 |
1,975 |
$346.01 |
| 72072 |
|
12 |
12 |
$324.20 |
| 94726 |
|
157 |
157 |
$312.54 |
| 96381 |
|
18 |
18 |
$295.02 |
| 86778 |
|
44 |
44 |
$276.99 |
| 11721 |
|
24 |
24 |
$254.61 |
| 82977 |
|
88 |
83 |
$231.77 |
| 87045 |
|
99 |
97 |
$230.87 |
| 29125 |
|
54 |
54 |
$228.30 |
| 84460 |
|
163 |
161 |
$226.50 |
| 83520 |
|
38 |
38 |
$224.80 |
| 84478 |
|
122 |
108 |
$213.12 |
| 87430 |
|
130 |
129 |
$210.33 |
| 83615 |
|
166 |
149 |
$207.76 |
| G0145 |
Scr c/v cyto,thinlayer,rescr |
13 |
13 |
$199.80 |
| 93270 |
|
12 |
12 |
$197.48 |
| 86141 |
|
81 |
80 |
$181.19 |
| 84703 |
|
394 |
385 |
$173.76 |
| 72070 |
|
12 |
12 |
$167.13 |
| 80164 |
|
28 |
27 |
$154.54 |
| G0123 |
Screen cerv/vag thin layer |
13 |
13 |
$150.36 |
| 72040 |
|
12 |
12 |
$144.99 |
| 88174 |
|
20 |
20 |
$144.85 |
| 87880 |
|
339 |
332 |
$130.68 |
| 86777 |
|
25 |
25 |
$121.93 |
| 87804 |
|
1,089 |
534 |
$117.88 |
| 86580 |
|
44 |
39 |
$117.84 |
| 90633 |
|
3,480 |
3,466 |
$113.00 |
| 12001 |
|
267 |
266 |
$107.29 |
| 86039 |
|
41 |
41 |
$101.71 |
| 90648 |
|
498 |
496 |
$97.00 |
| 86706 |
|
26 |
25 |
$94.11 |
| 84153 |
|
15 |
15 |
$90.89 |
| 73120 |
|
15 |
14 |
$84.29 |
| 82103 |
|
12 |
12 |
$84.03 |
| 84165 |
|
26 |
26 |
$82.00 |
| 85044 |
|
71 |
69 |
$80.66 |
| 70498 |
|
39 |
39 |
$79.37 |
| 82172 |
|
12 |
12 |
$75.07 |
| 86665 |
|
12 |
12 |
$71.82 |
| 82465 |
|
39 |
39 |
$71.51 |
| 95886 |
|
1,583 |
1,555 |
$65.60 |
| 86225 |
|
12 |
12 |
$63.47 |
| 90660 |
|
18 |
18 |
$57.74 |
| 90672 |
|
79 |
79 |
$53.80 |
| 87076 |
|
68 |
64 |
$50.34 |
| 87807 |
|
187 |
180 |
$43.85 |
| 90715 |
|
3,985 |
3,965 |
$40.62 |
| 83010 |
|
13 |
13 |
$37.87 |
| 87106 |
|
25 |
25 |
$37.75 |
| 84145 |
|
13 |
13 |
$35.96 |
| A9577 |
Inj multihance |
2,531 |
1,894 |
$34.71 |
| 87109 |
|
17 |
16 |
$33.78 |
| 87184 |
|
14 |
13 |
$33.36 |
| 86308 |
|
96 |
95 |
$33.11 |
| 86664 |
|
12 |
12 |
$30.27 |
| 86200 |
|
12 |
12 |
$28.31 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
4,931 |
4,749 |
$26.86 |
| 90658 |
|
14 |
14 |
$22.85 |
| 82044 |
|
29 |
29 |
$22.45 |
| 86592 |
|
14 |
14 |
$22.20 |
| P9612 |
Catheterize for urine spec |
12 |
12 |
$13.68 |
| 82140 |
|
12 |
12 |
$9.59 |
| J7030 |
Normal saline solution infus |
8,939 |
7,013 |
$7.20 |
| J1040 |
Methylprednisolone 80 mg inj |
336 |
332 |
$6.34 |
| 82010 |
|
26 |
25 |
$5.38 |
| J1030 |
Methylprednisolone 40 mg inj |
2,189 |
2,052 |
$5.11 |
| 84436 |
|
125 |
121 |
$5.03 |
| J2405 |
Ondansetron hcl injection |
12,142 |
9,688 |
$5.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
348 |
322 |
$4.50 |
| 36416 |
|
1,118 |
1,042 |
$4.32 |
| J1885 |
Ketorolac tromethamine inj |
15,932 |
12,318 |
$2.11 |
| J7120 |
Ringers lactate infusion |
6,927 |
4,970 |
$1.76 |
| J1170 |
Hydromorphone injection |
3,889 |
2,469 |
$0.31 |
| J2250 |
Inj midazolam hydrochloride |
5,346 |
4,417 |
$0.08 |
| 90698 |
|
4,138 |
4,121 |
$0.01 |
| J3420 |
Vitamin b12 injection |
618 |
532 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
8,342 |
6,818 |
$0.00 |
| 90697 |
|
1,013 |
1,013 |
$0.00 |
| 90696 |
|
1,472 |
1,466 |
$0.00 |
| J2360 |
Orphenadrine injection |
176 |
170 |
$0.00 |
| J7999 |
Compounded drug, noc |
333 |
294 |
$0.00 |
| J2060 |
Lorazepam injection |
1,378 |
1,058 |
$0.00 |
| J1630 |
Haloperidol injection |
931 |
824 |
$0.00 |
| A9579 |
Gad-base mr contrast nos,1ml |
832 |
790 |
$0.00 |
| J2765 |
Metoclopramide hcl injection |
2,152 |
1,944 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
5,875 |
4,755 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
223 |
209 |
$0.00 |
| J3490 |
Drugs unclassified injection |
3,345 |
2,537 |
$0.00 |
| 96376 |
|
2,516 |
1,757 |
$0.00 |
| J1010 |
Inj, methylpred acetate 1 mg |
143 |
137 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
7,040 |
5,261 |
$0.00 |
| J7050 |
Normal saline solution infus |
1,032 |
734 |
$0.00 |
| J0696 |
Ceftriaxone sodium injection |
2,565 |
1,904 |
$0.00 |
| C9290 |
Inj, bupivacaine liposome |
218 |
201 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
2,212 |
1,856 |
$0.00 |
| J2001 |
Lidocaine injection |
966 |
814 |
$0.00 |
| 90680 |
|
4,023 |
4,011 |
$0.00 |
| 64494 |
|
70 |
67 |
$0.00 |
| 95012 |
|
63 |
63 |
$0.00 |
| 84479 |
|
105 |
101 |
$0.00 |
| J1642 |
Inj heparin sodium per 10 u |
741 |
279 |
$0.00 |
| 91307 |
|
57 |
54 |
$0.00 |
| 90632 |
|
120 |
119 |
$0.00 |
| A4217 |
Sterile water/saline, 500 ml |
35 |
35 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
42 |
40 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
14 |
14 |
$0.00 |
| 99058 |
|
32 |
31 |
$0.00 |
| J3480 |
Inj potassium chloride |
61 |
43 |
$0.00 |
| A9500 |
Tc99m sestamibi |
24 |
24 |
$0.00 |
| 91318 |
|
15 |
15 |
$0.00 |
| 96110 |
|
19 |
19 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
16 |
13 |
$0.00 |
| 12002 |
|
14 |
12 |
$0.00 |
| C1769 |
Guide wire |
14 |
13 |
$0.00 |
| 94150 |
|
658 |
545 |
$0.00 |
| 90707 |
|
1,472 |
1,466 |
$0.00 |
| J1050 |
Medroxyprogesterone acetate |
2,355 |
2,339 |
$0.00 |
| 90710 |
|
1,556 |
1,549 |
$0.00 |
| J2930 |
Methylprednisolone injection |
2,304 |
1,933 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
31 |
25 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
912 |
609 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
3,430 |
2,950 |
$0.00 |
| J2270 |
Morphine sulfate injection |
3,574 |
2,664 |
$0.00 |
| J7040 |
Normal saline solution infus |
3,664 |
2,045 |
$0.00 |
| 90700 |
|
844 |
842 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
3,407 |
2,804 |
$0.00 |
| 90685 |
|
483 |
475 |
$0.00 |
| C1758 |
Catheter, ureteral |
55 |
55 |
$0.00 |
| J1650 |
Inj enoxaparin sodium |
136 |
72 |
$0.00 |
| 94729 |
|
247 |
247 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
67 |
56 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
167 |
155 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
289 |
270 |
$0.00 |
| J7510 |
Prednisolone oral per 5 mg |
38 |
38 |
$0.00 |
| 90687 |
|
16 |
15 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
278 |
186 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
19 |
14 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
188 |
157 |
$0.00 |
| J0702 |
Betamethasone acet&sod phosp |
42 |
39 |
$0.00 |
| A6402 |
Sterile gauze <= 16 sq in |
23 |
14 |
$0.00 |
| 69209 |
|
13 |
12 |
$0.00 |
| 87210 |
|
26 |
26 |
$0.00 |
| C1776 |
Joint device (implantable) |
12 |
12 |
$0.00 |
| 82731 |
|
15 |
14 |
$0.00 |
| 92133 |
|
72 |
70 |
$0.00 |
| 88302 |
|
14 |
13 |
$0.00 |
| G8427 |
Docrev cur meds by elig clin |
20 |
20 |
$0.00 |