| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
|
23,087 |
19,418 |
$2.92M |
| 99213 |
|
68,903 |
51,625 |
$2.23M |
| 99212 |
|
38,935 |
32,741 |
$1.47M |
| 99285 |
|
6,608 |
5,234 |
$1.43M |
| 80053 |
|
56,391 |
44,143 |
$1.26M |
| 99283 |
|
14,617 |
13,109 |
$1.19M |
| 74177 |
|
4,036 |
3,282 |
$1.08M |
| 85025 |
|
67,088 |
51,247 |
$1.00M |
| 80307 |
|
12,084 |
8,742 |
$896K |
| 92507 |
|
12,808 |
4,561 |
$744K |
| 70450 |
|
5,260 |
4,333 |
$663K |
| 74176 |
|
2,478 |
2,030 |
$607K |
| 36415 |
|
61,215 |
45,762 |
$585K |
| 93306 |
|
4,685 |
3,972 |
$575K |
| 97110 |
|
9,941 |
3,516 |
$566K |
| 96365 |
|
6,063 |
4,052 |
$494K |
| 99214 |
|
11,584 |
8,705 |
$458K |
| 84443 |
|
18,238 |
15,585 |
$452K |
| U0003 |
Cov-19 amp prb hgh thruput |
5,588 |
4,818 |
$446K |
| 96361 |
|
6,196 |
4,405 |
$443K |
| 93005 |
|
20,800 |
16,421 |
$415K |
| 88305 |
|
8,193 |
6,742 |
$392K |
| G0378 |
Hospital observation per hr |
4,915 |
1,989 |
$378K |
| 96413 |
|
3,696 |
1,929 |
$367K |
| 80061 |
|
13,312 |
11,971 |
$343K |
| 81001 |
|
23,062 |
18,830 |
$338K |
| 71046 |
|
8,926 |
7,581 |
$334K |
| 96374 |
|
11,452 |
8,994 |
$329K |
| 90460 |
|
10,707 |
9,476 |
$328K |
| 80048 |
|
13,545 |
9,973 |
$324K |
| G0480 |
Drug test def 1-7 classes |
2,378 |
1,886 |
$321K |
| 97530 |
|
7,247 |
2,642 |
$318K |
| 99211 |
|
9,262 |
8,070 |
$308K |
| 71275 |
|
1,455 |
1,140 |
$305K |
| 99392 |
|
5,796 |
4,662 |
$271K |
| 99391 |
|
6,303 |
4,878 |
$261K |
| 87491 |
|
6,924 |
6,121 |
$252K |
| 77067 |
|
1,893 |
1,756 |
$251K |
| 96366 |
|
2,901 |
1,546 |
$250K |
| 87591 |
|
6,964 |
6,162 |
$242K |
| 78452 |
|
1,482 |
1,260 |
$241K |
| 88175 |
|
5,432 |
4,586 |
$233K |
| 84484 |
|
10,916 |
7,949 |
$228K |
| 76830 |
|
1,576 |
1,395 |
$222K |
| 96375 |
|
10,501 |
7,160 |
$222K |
| 96367 |
|
3,936 |
1,623 |
$220K |
| 59025 |
|
3,286 |
1,653 |
$218K |
| J2704 |
Inj, propofol, 10 mg |
8,412 |
6,368 |
$215K |
| G0463 |
Hospital outpt clinic visit |
15,124 |
11,235 |
$215K |
| J3010 |
Fentanyl citrate injection |
6,433 |
4,525 |
$210K |
| 87088 |
|
7,333 |
6,052 |
$201K |
| 96372 |
|
10,010 |
6,664 |
$199K |
| 72125 |
|
1,964 |
1,608 |
$195K |
| 70553 |
|
691 |
628 |
$195K |
| 85610 |
|
9,329 |
6,729 |
$195K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
6,080 |
4,800 |
$186K |
| 76856 |
|
1,063 |
963 |
$182K |
| J2250 |
Inj midazolam hydrochloride |
5,040 |
3,568 |
$182K |
| J2405 |
Ondansetron hcl injection |
10,770 |
7,282 |
$179K |
| 85730 |
|
5,211 |
4,082 |
$174K |
| G0383 |
Lev 4 hosp type b ed visit |
1,821 |
1,547 |
$170K |
| G0382 |
Lev 3 hosp type b ed visit |
2,423 |
2,114 |
$168K |
| 83036 |
|
10,105 |
9,105 |
$165K |
| 96110 |
|
8,690 |
8,302 |
$165K |
| 76805 |
|
744 |
690 |
$163K |
| 83690 |
|
8,622 |
6,833 |
$162K |
| 81025 |
|
4,585 |
3,510 |
$162K |
| 87502 |
|
2,841 |
2,454 |
$157K |
| 71045 |
|
10,452 |
8,416 |
$151K |
| A9577 |
Inj multihance |
532 |
482 |
$148K |
| J2270 |
Morphine sulfate injection |
3,964 |
2,346 |
$141K |
| 82306 |
|
5,406 |
4,945 |
$141K |
| 43239 |
|
744 |
594 |
$139K |
| 76705 |
|
1,759 |
1,497 |
$135K |
| 87637 |
|
3,269 |
2,753 |
$134K |
| 99393 |
|
2,963 |
2,429 |
$129K |
| 80074 |
|
1,500 |
1,235 |
$124K |
| J1100 |
Dexamethasone sodium phos |
6,609 |
4,400 |
$123K |
| 82962 |
|
6,425 |
2,922 |
$123K |
| 96376 |
|
3,786 |
1,776 |
$123K |
| 76816 |
|
1,633 |
1,354 |
$122K |
| 94640 |
|
3,691 |
1,828 |
$118K |
| 97161 |
|
2,787 |
2,366 |
$112K |
| J2785 |
Regadenoson injection |
1,170 |
983 |
$107K |
| 84702 |
|
3,008 |
2,197 |
$105K |
| 83735 |
|
11,341 |
8,194 |
$103K |
| 82150 |
|
3,079 |
2,423 |
$100K |
| 92557 |
|
2,104 |
1,872 |
$95K |
| 96360 |
|
1,956 |
1,406 |
$95K |
| 87040 |
|
4,105 |
2,853 |
$95K |
| 84439 |
|
4,255 |
3,626 |
$93K |
| 84703 |
|
3,743 |
3,076 |
$86K |
| 73564 |
|
1,880 |
1,508 |
$86K |
| 82550 |
|
2,074 |
1,543 |
$82K |
| 71260 |
|
598 |
507 |
$82K |
| 74018 |
|
1,795 |
1,489 |
$81K |
| 82553 |
|
1,043 |
737 |
$80K |
| J1644 |
Inj heparin sodium per 1000u |
1,698 |
718 |
$79K |
| 86850 |
|
4,901 |
3,958 |
$76K |
| 87071 |
|
1,347 |
1,194 |
$73K |
| 97010 |
|
3,721 |
1,085 |
$71K |
| 73630 |
|
2,092 |
1,687 |
$71K |
| 99282 |
|
1,155 |
1,014 |
$69K |
| 86703 |
|
1,257 |
1,056 |
$69K |
| 92567 |
|
3,706 |
3,364 |
$68K |
| 87624 |
|
1,948 |
1,666 |
$68K |
| 86900 |
|
5,348 |
4,244 |
$67K |
| J1885 |
Ketorolac tromethamine inj |
7,344 |
5,366 |
$66K |
| 82565 |
|
2,209 |
1,884 |
$65K |
| 90471 |
|
6,200 |
5,195 |
$65K |
| 76642 |
|
897 |
799 |
$65K |
| 72110 |
|
1,147 |
1,008 |
$65K |
| 83880 |
|
2,569 |
2,066 |
$64K |
| J1170 |
Hydromorphone injection |
3,864 |
1,983 |
$63K |
| 77063 |
|
1,722 |
1,602 |
$61K |
| C9803 |
Hopd covid-19 spec collect |
6,003 |
5,155 |
$61K |
| 92551 |
|
6,037 |
5,559 |
$60K |
| 93000 |
|
6,415 |
5,459 |
$60K |
| 86803 |
|
2,823 |
2,471 |
$60K |
| 72148 |
|
275 |
249 |
$59K |
| 85027 |
|
8,518 |
6,514 |
$58K |
| 86901 |
|
2,788 |
2,244 |
$58K |
| A4649 |
Surgical supplies |
241 |
178 |
$57K |
| 73610 |
|
1,477 |
1,209 |
$57K |
| 87651 |
|
2,867 |
2,475 |
$56K |
| 87070 |
|
2,836 |
2,394 |
$56K |
| 87522 |
Neg quan hep c or qual rna |
736 |
613 |
$55K |
| A9500 |
Tc99m sestamibi |
1,502 |
1,268 |
$55K |
| 82607 |
|
2,982 |
2,651 |
$55K |
| 99395 |
|
921 |
815 |
$53K |
| 93925 |
|
253 |
220 |
$52K |
| 81003 |
|
5,076 |
4,275 |
$52K |
| 87186 |
|
3,308 |
2,769 |
$51K |
| 93880 |
|
727 |
609 |
$50K |
| 87634 |
|
753 |
628 |
$49K |
| 78815 |
|
182 |
162 |
$48K |
| 87077 |
|
1,876 |
1,587 |
$47K |
| 86592 |
|
2,005 |
1,751 |
$47K |
| 71250 |
|
579 |
519 |
$46K |
| 87633 |
|
421 |
377 |
$45K |
| 99394 |
|
998 |
849 |
$45K |
| J0131 |
Inj, acetaminophen (nos) |
2,560 |
1,827 |
$44K |
| 77065 |
Tomosynthesis, mammo |
687 |
586 |
$44K |
| J0690 |
Cefazolin sodium injection |
761 |
361 |
$43K |
| 99202 |
|
1,360 |
1,257 |
$43K |
| 90715 |
|
1,627 |
1,344 |
$41K |
| 97035 |
|
670 |
218 |
$40K |
| 83605 |
|
3,933 |
2,885 |
$40K |
| 82746 |
|
1,633 |
1,444 |
$40K |
| 85652 |
|
2,878 |
2,471 |
$39K |
| 73130 |
|
909 |
727 |
$39K |
| 20610 |
|
664 |
479 |
$38K |
| 82043 |
|
2,830 |
2,559 |
$37K |
| 94760 |
|
1,277 |
784 |
$37K |
| 86762 |
|
1,477 |
1,271 |
$37K |
| U0002 |
Covid-19 lab test non-cdc |
1,153 |
978 |
$36K |
| 99203 |
|
884 |
709 |
$36K |
| 73030 |
|
1,434 |
1,146 |
$36K |
| 86140 |
|
2,530 |
2,072 |
$36K |
| 87340 |
|
1,925 |
1,682 |
$36K |
| 80050 |
|
1,190 |
1,110 |
$35K |
| 88342 |
|
1,323 |
1,034 |
$35K |
| 93017 |
|
684 |
581 |
$35K |
| J3490 |
Drugs unclassified injection |
2,797 |
1,017 |
$34K |
| 87430 |
|
1,064 |
850 |
$34K |
| 93971 |
|
475 |
402 |
$34K |
| 70486 |
|
224 |
188 |
$34K |
| 90472 |
|
3,273 |
2,713 |
$34K |
| 95886 |
|
456 |
400 |
$34K |
| 93015 |
|
880 |
749 |
$33K |
| J0185 |
Inj., aprepitant, 1 mg |
40 |
12 |
$33K |
| 83615 |
|
2,033 |
1,501 |
$32K |
| 93010 |
|
6,921 |
5,295 |
$32K |
| 97803 |
|
964 |
895 |
$31K |
| 73110 |
|
754 |
596 |
$30K |
| 93970 |
|
347 |
287 |
$29K |
| 88304 |
|
616 |
438 |
$29K |
| 97165 |
|
1,062 |
879 |
$29K |
| 84146 |
|
605 |
520 |
$28K |
| C1769 |
Guide wire |
532 |
385 |
$28K |
| 84550 |
|
1,975 |
1,478 |
$28K |
| 94762 |
|
314 |
134 |
$28K |
| 82728 |
|
2,103 |
1,825 |
$28K |
| 82105 |
|
921 |
828 |
$28K |
| 73502 |
|
846 |
724 |
$27K |
| 36591 |
|
1,546 |
932 |
$27K |
| 85379 |
|
1,329 |
1,099 |
$27K |
| 87389 |
|
1,205 |
1,080 |
$27K |
| 90670 |
|
2,558 |
2,323 |
$26K |
| 80076 |
|
1,139 |
985 |
$26K |
| 82570 |
|
1,992 |
1,627 |
$26K |
| 82950 |
|
1,341 |
1,141 |
$26K |
| 84153 |
|
957 |
857 |
$26K |
| J1200 |
Diphenhydramine hcl injectio |
2,293 |
1,427 |
$25K |
| 99232 |
|
2,678 |
624 |
$25K |
| 96150 |
|
328 |
78 |
$25K |
| Q9969 |
Non-heu tc-99m add-on/dose |
535 |
401 |
$25K |
| G0384 |
Lev 5 hosp type b ed visit |
212 |
197 |
$24K |
| 87205 |
|
1,707 |
1,361 |
$24K |
| 83540 |
|
2,445 |
2,113 |
$24K |
| 96415 |
|
176 |
100 |
$23K |
| G0381 |
Lev 2 hosp type b ed visit |
427 |
374 |
$23K |
| 73721 |
|
70 |
63 |
$22K |
| 76536 |
|
185 |
166 |
$22K |
| J1741 |
Ibuprofen injection |
319 |
165 |
$22K |
| 95911 |
|
13 |
12 |
$22K |
| 84156 |
|
1,009 |
700 |
$21K |
| 76801 |
|
286 |
230 |
$20K |
| 45385 |
|
101 |
77 |
$18K |
| 87880 |
|
1,790 |
1,669 |
$18K |
| J2930 |
Methylprednisolone injection |
1,253 |
878 |
$18K |
| 90686 |
|
3,374 |
2,991 |
$17K |
| 00170 |
|
74 |
56 |
$17K |
| 77066 |
Tomosynthesis, mammo |
172 |
153 |
$17K |
| 77336 |
|
203 |
67 |
$17K |
| 87400 |
|
919 |
750 |
$16K |
| 87086 |
|
4,698 |
3,845 |
$16K |
| 83001 |
|
336 |
293 |
$16K |
| 84460 |
|
1,271 |
1,094 |
$15K |
| 90837 |
|
181 |
135 |
$15K |
| 83550 |
|
827 |
757 |
$15K |
| 99396 |
|
343 |
320 |
$15K |
| 86038 |
|
591 |
522 |
$15K |
| 0241U |
|
572 |
529 |
$15K |
| A9552 |
F18 fdg |
195 |
168 |
$13K |
| J0696 |
Ceftriaxone sodium injection |
2,046 |
1,190 |
$13K |
| 85018 |
|
1,585 |
1,306 |
$13K |
| 99281 |
|
290 |
254 |
$12K |
| 76817 |
|
335 |
256 |
$12K |
| C1894 |
Intro/sheath, non-laser |
361 |
277 |
$12K |
| 00731 |
|
313 |
257 |
$12K |
| 87081 |
|
1,421 |
1,276 |
$12K |
| 81220 |
|
13 |
12 |
$12K |
| 84450 |
|
1,008 |
859 |
$11K |
| 97140 |
|
688 |
210 |
$11K |
| 83655 |
|
760 |
647 |
$11K |
| 94729 |
|
488 |
419 |
$11K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
139 |
87 |
$11K |
| 92523 |
|
126 |
122 |
$11K |
| 42820 |
|
12 |
12 |
$10K |
| 97116 |
|
962 |
402 |
$10K |
| 84403 |
|
411 |
352 |
$10K |
| C1819 |
Tissue localization-excision |
56 |
30 |
$10K |
| 76770 |
|
194 |
171 |
$9K |
| 93975 |
|
88 |
81 |
$9K |
| 86618 |
|
542 |
496 |
$9K |
| 82805 |
|
144 |
114 |
$9K |
| 94726 |
|
376 |
339 |
$8K |
| J1626 |
Granisetron hcl injection |
281 |
161 |
$8K |
| 99204 |
|
145 |
133 |
$8K |
| 87804 |
|
627 |
557 |
$8K |
| 76811 |
|
116 |
91 |
$8K |
| 11721 |
|
843 |
732 |
$8K |
| 95811 |
|
28 |
25 |
$8K |
| 84481 |
|
629 |
550 |
$7K |
| 73560 |
|
400 |
320 |
$7K |
| 87661 |
|
481 |
432 |
$7K |
| 76819 |
|
172 |
68 |
$7K |
| 97014 |
|
155 |
41 |
$7K |
| 96156 |
|
248 |
179 |
$7K |
| P9016 |
Rbc leukocytes reduced |
87 |
53 |
$7K |
| 83002 |
|
149 |
130 |
$6K |
| 82977 |
|
361 |
284 |
$6K |
| 76775 |
|
58 |
49 |
$6K |
| G0475 |
Hiv combination assay |
974 |
836 |
$6K |
| 73590 |
|
220 |
178 |
$6K |
| 72100 |
|
141 |
129 |
$6K |
| 87481 |
|
170 |
121 |
$6K |
| 96127 |
|
196 |
166 |
$6K |
| 90834 |
|
93 |
51 |
$5K |
| 80143 |
|
628 |
512 |
$5K |
| 90648 |
|
3,102 |
2,722 |
$5K |
| 80179 |
|
626 |
514 |
$5K |
| 99222 |
|
284 |
229 |
$5K |
| 72131 |
|
189 |
152 |
$5K |
| 84100 |
|
1,523 |
1,050 |
$5K |
| 85014 |
|
236 |
173 |
$5K |
| 85007 |
|
2,723 |
2,046 |
$5K |
| J1050 |
Medroxyprogesterone acetate |
65 |
53 |
$5K |
| 82784 |
|
479 |
342 |
$5K |
| 82248 |
|
945 |
791 |
$5K |
| 87799 |
|
68 |
57 |
$5K |
| 99441 |
|
419 |
394 |
$4K |
| 88307 |
|
46 |
41 |
$4K |
| 94060 |
|
124 |
105 |
$4K |
| 86780 |
|
891 |
784 |
$4K |
| 87075 |
|
318 |
236 |
$4K |
| J7120 |
Ringers lactate infusion |
2,938 |
2,331 |
$4K |
| 73562 |
|
19 |
14 |
$4K |
| J1650 |
Inj enoxaparin sodium |
979 |
384 |
$4K |
| 95810 |
|
14 |
12 |
$4K |
| 84436 |
|
161 |
143 |
$4K |
| 77061 |
|
224 |
211 |
$4K |
| 86706 |
|
465 |
415 |
$3K |
| 94010 |
|
124 |
110 |
$3K |
| 92587 |
|
96 |
92 |
$3K |
| 90723 |
|
1,873 |
1,597 |
$3K |
| 81243 |
|
14 |
13 |
$3K |
| 77417 |
|
25 |
13 |
$3K |
| 81329 |
|
14 |
13 |
$3K |
| 90651 |
|
117 |
95 |
$3K |
| 87641 |
|
140 |
110 |
$3K |
| 81513 |
|
46 |
44 |
$3K |
| J1756 |
Iron sucrose injection |
125 |
52 |
$3K |
| J1040 |
Methylprednisolone 80 mg inj |
77 |
65 |
$3K |
| 87798 |
|
34 |
32 |
$3K |
| 74022 |
|
58 |
52 |
$3K |
| 51798 |
|
428 |
338 |
$3K |
| J2765 |
Metoclopramide hcl injection |
785 |
597 |
$2K |
| 82947 |
|
326 |
274 |
$2K |
| G2023 |
Specimen collect covid-19 |
154 |
127 |
$2K |
| 80164 |
|
51 |
39 |
$2K |
| 99173 |
|
1,521 |
1,407 |
$2K |
| 87147 |
|
902 |
740 |
$2K |
| 95957 |
|
43 |
40 |
$2K |
| 73080 |
|
82 |
68 |
$2K |
| 90671 |
|
177 |
122 |
$2K |
| 83520 |
|
37 |
29 |
$2K |
| 45378 |
|
15 |
12 |
$2K |
| 90633 |
|
567 |
515 |
$2K |
| 83516 |
|
27 |
26 |
$2K |
| 70491 |
|
13 |
12 |
$2K |
| 86769 |
|
32 |
27 |
$2K |
| 87426 |
|
79 |
73 |
$2K |
| 71271 |
|
25 |
25 |
$2K |
| G0008 |
Admin influenza virus vac |
885 |
794 |
$2K |
| 97535 |
|
234 |
126 |
$2K |
| 87512 |
|
33 |
30 |
$2K |
| J2469 |
Palonosetron hcl |
406 |
204 |
$2K |
| 82040 |
|
526 |
425 |
$2K |
| Q0091 |
Obtaining screen pap smear |
188 |
180 |
$2K |
| 94618 |
|
52 |
44 |
$2K |
| 93246 |
|
48 |
43 |
$2K |
| 52281 |
|
16 |
14 |
$1K |
| 36430 |
|
41 |
26 |
$1K |
| 87015 |
|
60 |
36 |
$1K |
| 96417 |
|
171 |
103 |
$1K |
| 51728 |
|
13 |
12 |
$1K |
| 97113 |
|
45 |
12 |
$1K |
| 72141 |
|
23 |
13 |
$1K |
| 97802 |
|
28 |
27 |
$1K |
| 90680 |
|
1,418 |
1,233 |
$1K |
| 80069 |
|
151 |
95 |
$1K |
| 90656 |
|
338 |
331 |
$1K |
| 96368 |
|
30 |
13 |
$1K |
| 82803 |
|
255 |
200 |
$1K |
| 83883 |
|
17 |
12 |
$1K |
| 93242 |
|
29 |
25 |
$1K |
| J2360 |
Orphenadrine injection |
82 |
63 |
$1K |
| 72072 |
|
12 |
12 |
$1K |
| 86364 |
|
92 |
84 |
$1K |
| 87420 |
|
134 |
123 |
$959.79 |
| 99218 |
|
109 |
88 |
$879.00 |
| 86704 |
|
182 |
166 |
$878.37 |
| J2060 |
Lorazepam injection |
465 |
318 |
$807.60 |
| 93325 |
|
35 |
27 |
$743.93 |
| 99219 |
|
31 |
24 |
$741.97 |
| 90734 |
|
103 |
86 |
$718.30 |
| 81002 |
|
464 |
326 |
$694.85 |
| 51797 |
|
13 |
12 |
$688.85 |
| 86430 |
|
16 |
13 |
$685.11 |
| 84402 |
|
32 |
27 |
$667.86 |
| J1030 |
Methylprednisolone 40 mg inj |
610 |
452 |
$643.24 |
| 99215 |
Prolong outpt/office vis |
19 |
15 |
$583.53 |
| J3370 |
Vancomycin hcl injection |
491 |
184 |
$576.67 |
| 99385 |
|
12 |
12 |
$536.40 |
| 96402 |
|
26 |
25 |
$516.65 |
| 99381 |
|
14 |
14 |
$490.51 |
| 94664 |
|
140 |
55 |
$486.70 |
| 77062 |
|
32 |
31 |
$481.30 |
| Q3014 |
Telehealth facility fee |
76 |
64 |
$472.46 |
| 82077 |
|
969 |
752 |
$458.78 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
297 |
274 |
$455.78 |
| 76813 |
|
12 |
12 |
$453.26 |
| 77080 |
|
13 |
13 |
$439.11 |
| 97112 |
|
30 |
12 |
$435.53 |
| 99221 |
|
35 |
32 |
$387.76 |
| 92610 |
|
17 |
13 |
$372.86 |
| J1453 |
Fosaprepitant injection |
45 |
25 |
$363.87 |
| 80329 |
|
193 |
144 |
$363.37 |
| 90474 |
|
275 |
251 |
$310.63 |
| 86920 |
|
57 |
44 |
$295.98 |
| J2543 |
Piperacillin/tazobactam |
156 |
67 |
$278.29 |
| 86778 |
|
56 |
53 |
$275.55 |
| 96523 |
|
30 |
25 |
$245.67 |
| A9576 |
Inj prohance multipack |
489 |
415 |
$241.54 |
| 80320 |
|
441 |
320 |
$229.06 |
| 87807 |
|
21 |
21 |
$224.84 |
| J2919 |
Inj, methylpred sod succ 5mg |
259 |
182 |
$210.04 |
| 86431 |
|
53 |
52 |
$205.61 |
| 82140 |
|
39 |
30 |
$200.62 |
| 83521 |
|
47 |
40 |
$200.31 |
| 72040 |
|
14 |
13 |
$198.61 |
| 99442 |
|
12 |
12 |
$194.38 |
| 80055 |
|
17 |
13 |
$194.08 |
| 90696 |
|
27 |
18 |
$193.80 |
| J0136 |
Inj, acetaminophen (b braun) |
458 |
344 |
$192.86 |
| 85045 |
|
156 |
132 |
$189.73 |
| 82397 |
|
15 |
15 |
$186.95 |
| 90707 |
|
53 |
40 |
$183.20 |
| J1010 |
Inj, methylpred acetate 1 mg |
237 |
217 |
$166.77 |
| G0283 |
Elec stim other than wound |
323 |
93 |
$159.91 |
| 84163 |
|
12 |
12 |
$156.34 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
462 |
364 |
$156.00 |
| 90716 |
|
39 |
30 |
$136.70 |
| 73552 |
|
12 |
12 |
$135.49 |
| G0009 |
Admin pneumococcal vaccine |
484 |
406 |
$134.31 |
| 72050 |
|
17 |
13 |
$132.93 |
| 82009 |
|
16 |
12 |
$125.10 |
| 99308 |
|
107 |
86 |
$120.82 |
| 74230 |
|
20 |
14 |
$119.16 |
| C9113 |
Inj pantoprazole sodium, via |
146 |
71 |
$105.00 |
| J3475 |
Inj magnesium sulfate |
465 |
286 |
$104.94 |
| 84165 |
|
47 |
40 |
$100.27 |
| 86308 |
|
36 |
27 |
$94.78 |
| 90700 |
|
17 |
13 |
$86.45 |
| 90620 |
|
23 |
13 |
$81.90 |
| 90710 |
|
39 |
30 |
$76.90 |
| 90658 |
|
14 |
12 |
$72.74 |
| 51741 |
|
13 |
12 |
$65.66 |
| 82247 |
|
18 |
12 |
$64.41 |
| 87210 |
|
85 |
59 |
$57.98 |
| 92611 |
|
17 |
13 |
$57.86 |
| 73090 |
|
29 |
24 |
$46.26 |
| 84520 |
|
46 |
37 |
$45.93 |
| 90473 |
|
22 |
15 |
$41.63 |
| J1815 |
Insulin injection |
32 |
14 |
$40.35 |
| J2370 |
Phenylephrine hcl injection |
355 |
242 |
$35.61 |
| 73060 |
|
16 |
13 |
$33.14 |
| 80349 |
|
26 |
15 |
$31.68 |
| 84145 |
|
21 |
12 |
$30.02 |
| 90694 |
|
30 |
28 |
$29.17 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
133 |
77 |
$25.57 |
| J3420 |
Vitamin b12 injection |
73 |
53 |
$24.87 |
| J1940 |
Furosemide injection |
134 |
62 |
$20.96 |
| 86923 |
|
18 |
12 |
$19.30 |
| 96380 |
|
14 |
14 |
$16.69 |
| J0360 |
Hydralazine hcl injection |
15 |
12 |
$11.12 |
| G1010 |
Cdsm stanson |
481 |
283 |
$8.94 |
| Q2039 |
Influenza virus vaccine, nos |
14 |
14 |
$8.11 |
| G0103 |
Psa screening |
97 |
82 |
$6.24 |
| J0330 |
Succinycholine chloride inj |
176 |
116 |
$5.45 |
| J0134 |
Inj acetaminophen -fresenius |
16 |
16 |
$5.15 |
| J1643 |
Inj heparin, pfizer, 1000u |
41 |
38 |
$4.34 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
42 |
12 |
$4.34 |
| J3480 |
Inj potassium chloride |
24 |
12 |
$3.63 |
| C1751 |
Cath, inf, per/cent/midline |
69 |
53 |
$2.93 |
| Q0162 |
Ondansetron oral |
617 |
320 |
$2.40 |
| J7512 |
Prednisone ir or dr oral 1mg |
51 |
13 |
$1.00 |
| Q0177 |
Hydroxyzine pamoate 25mg |
71 |
51 |
$0.14 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
169 |
157 |
$0.04 |
| A4648 |
Implantable tissue marker |
73 |
50 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
18 |
14 |
$0.00 |
| 3074F |
|
13 |
12 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
73 |
53 |
$0.00 |
| 93356 |
|
13 |
12 |
$0.00 |
| 76376 |
|
46 |
42 |
$0.00 |
| 90461 |
|
49 |
33 |
$0.00 |
| 3078F |
|
13 |
13 |
$0.00 |
| C1887 |
Catheter, guiding |
18 |
15 |
$0.00 |
| 00811 |
|
12 |
12 |
$0.00 |
| J0780 |
Prochlorperazine injection |
17 |
14 |
$0.00 |