| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
|
43,793 |
39,980 |
$12.86M |
| J2350 |
Injection, ocrelizumab, 1 mg |
550 |
437 |
$9.11M |
| 99283 |
|
21,740 |
20,427 |
$6.39M |
| J2323 |
Natalizumab injection |
1,318 |
1,158 |
$5.83M |
| 97110 |
|
90,089 |
20,266 |
$3.92M |
| G0378 |
Hospital observation per hr |
8,752 |
7,448 |
$3.64M |
| 99285 |
|
17,906 |
16,081 |
$3.43M |
| 93306 |
|
7,966 |
7,439 |
$3.04M |
| 43239 |
|
3,345 |
3,211 |
$2.59M |
| 96413 |
|
9,710 |
6,331 |
$2.21M |
| 97140 |
|
57,771 |
14,184 |
$2.20M |
| 95810 |
|
1,590 |
1,518 |
$1.88M |
| 76641 |
|
12,287 |
11,826 |
$1.72M |
| 74177 |
|
8,240 |
7,573 |
$1.55M |
| 96365 |
|
14,428 |
9,740 |
$1.54M |
| 93458 |
|
1,449 |
1,229 |
$1.49M |
| 77067 |
|
13,612 |
13,186 |
$1.43M |
| 93017 |
|
6,242 |
5,712 |
$1.37M |
| 76811 |
|
4,837 |
4,764 |
$1.24M |
| 78452 |
|
4,363 |
3,912 |
$1.13M |
| 92507 |
|
21,452 |
5,855 |
$1.08M |
| 70553 |
|
2,217 |
2,024 |
$1.02M |
| 76819 |
|
7,134 |
3,901 |
$955K |
| 78815 |
|
920 |
818 |
$947K |
| 76816 |
|
7,158 |
6,520 |
$824K |
| 96361 |
|
16,583 |
12,999 |
$808K |
| U0003 |
Cov-19 amp prb hgh thruput |
14,451 |
12,778 |
$732K |
| 80053 |
|
79,511 |
62,707 |
$690K |
| G0463 |
Hospital outpt clinic visit |
28,613 |
20,708 |
$682K |
| J0897 |
Denosumab injection |
889 |
802 |
$663K |
| 96375 |
|
16,851 |
13,180 |
$660K |
| 93970 |
|
2,612 |
2,403 |
$658K |
| 0202U |
|
8,542 |
7,955 |
$657K |
| 99282 |
|
3,827 |
3,636 |
$649K |
| 96417 |
|
2,773 |
1,589 |
$643K |
| 19083 |
|
816 |
755 |
$613K |
| 96415 |
|
3,100 |
2,270 |
$610K |
| 85025 |
|
77,313 |
60,648 |
$587K |
| OP272 |
|
39,997 |
35,694 |
$552K |
| 76856 |
|
5,589 |
5,306 |
$543K |
| 70551 |
|
2,239 |
2,106 |
$532K |
| 97535 |
|
15,716 |
6,522 |
$518K |
| Q5111 |
Injection, udenyca 0.5 mg |
184 |
119 |
$475K |
| 76813 |
|
3,038 |
3,006 |
$460K |
| 76830 |
|
4,000 |
3,882 |
$451K |
| 97530 |
|
10,677 |
4,320 |
$439K |
| 76801 |
|
4,825 |
4,490 |
$435K |
| 70450 |
|
7,468 |
6,681 |
$429K |
| 74176 |
|
4,033 |
3,633 |
$426K |
| OP259 |
|
66,487 |
52,250 |
$413K |
| 45380 |
|
602 |
596 |
$392K |
| 99281 |
|
2,609 |
2,424 |
$379K |
| 96372 |
|
19,511 |
15,967 |
$373K |
| 93005 |
|
35,139 |
29,224 |
$363K |
| 71260 |
|
2,234 |
2,010 |
$360K |
| 97112 |
|
11,930 |
4,284 |
$355K |
| 77063 |
|
11,340 |
10,933 |
$334K |
| 77066 |
Tomosynthesis, mammo |
2,714 |
2,631 |
$333K |
| 88305 |
|
13,364 |
8,205 |
$324K |
| 77080 |
|
3,907 |
3,784 |
$322K |
| 77065 |
Tomosynthesis, mammo |
3,559 |
3,424 |
$310K |
| 96360 |
|
4,494 |
4,059 |
$304K |
| 94060 |
|
2,258 |
2,128 |
$304K |
| 36415 |
|
94,893 |
69,439 |
$289K |
| 71250 |
|
2,753 |
2,471 |
$289K |
| 93971 |
|
1,866 |
1,715 |
$278K |
| 0001A |
|
9,051 |
9,021 |
$264K |
| 58558 |
|
271 |
253 |
$256K |
| 97010 |
|
26,799 |
7,865 |
$252K |
| 96374 |
|
16,069 |
14,240 |
$251K |
| 76817 |
|
2,651 |
2,311 |
$243K |
| 87633 |
|
3,181 |
3,069 |
$242K |
| 97014 |
|
11,981 |
3,235 |
$238K |
| 76642 |
|
2,314 |
2,193 |
$236K |
| 0002A |
|
7,508 |
7,487 |
$234K |
| 71046 |
|
15,143 |
14,081 |
$233K |
| 76536 |
|
2,059 |
1,946 |
$231K |
| 87635 |
|
4,684 |
4,432 |
$227K |
| 97161 |
|
5,496 |
5,022 |
$226K |
| A9500 |
Tc99m sestamibi |
6,434 |
3,697 |
$226K |
| 71275 |
|
1,659 |
1,534 |
$222K |
| 59025 |
|
1,283 |
1,119 |
$214K |
| 96376 |
|
4,463 |
3,703 |
$207K |
| 93880 |
|
1,367 |
1,229 |
$207K |
| J9355 |
Inj trastuzumab excl biosimi |
102 |
61 |
$199K |
| 76700 |
|
2,531 |
2,397 |
$193K |
| J2505 |
Injection, pegfilgrastim 6mg |
68 |
52 |
$193K |
| Q0138 |
Ferumoxytol, non-esrd |
337 |
211 |
$185K |
| 76775 |
|
2,049 |
1,925 |
$165K |
| 97162 |
|
3,797 |
3,506 |
$160K |
| 96367 |
|
2,996 |
2,216 |
$148K |
| 47562 |
|
121 |
120 |
$148K |
| 76820 |
|
1,163 |
661 |
$147K |
| 96366 |
|
3,007 |
2,125 |
$145K |
| 84443 |
|
13,426 |
12,199 |
$143K |
| 72148 |
|
765 |
739 |
$137K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
466 |
374 |
$135K |
| 71045 |
|
16,580 |
14,698 |
$132K |
| 76805 |
|
1,092 |
1,078 |
$128K |
| 72197 |
|
264 |
250 |
$126K |
| G0108 |
Diab manage trn per indiv |
2,125 |
1,876 |
$118K |
| 77336 |
|
1,437 |
572 |
$117K |
| J2785 |
Regadenoson injection |
1,876 |
1,603 |
$117K |
| 82962 |
|
25,876 |
12,582 |
$110K |
| 80061 |
|
16,366 |
14,909 |
$110K |
| C1769 |
Guide wire |
5,075 |
3,722 |
$106K |
| 76705 |
|
2,349 |
2,240 |
$105K |
| U0002 |
Covid-19 lab test non-cdc |
8,956 |
8,034 |
$103K |
| 82306 |
|
6,435 |
6,212 |
$101K |
| J9312 |
Inj., rituximab, 10 mg |
19 |
13 |
$99K |
| 96523 |
|
1,935 |
1,330 |
$99K |
| 86900 |
|
9,019 |
7,220 |
$99K |
| 74183 |
|
267 |
249 |
$93K |
| 95811 |
|
71 |
66 |
$91K |
| 82378 |
|
6,287 |
4,824 |
$86K |
| 86850 |
|
12,131 |
9,993 |
$86K |
| 74178 |
|
248 |
235 |
$85K |
| C1887 |
Catheter, guiding |
3,490 |
2,594 |
$85K |
| 78999 |
|
1,477 |
1,285 |
$83K |
| 93976 |
|
886 |
850 |
$81K |
| 0223U |
|
1,122 |
1,019 |
$80K |
| 85027 |
|
22,042 |
18,113 |
$79K |
| 80048 |
|
13,742 |
10,944 |
$77K |
| 93270 |
|
3,042 |
1,589 |
$76K |
| 80307 |
|
3,158 |
2,891 |
$76K |
| 76815 |
|
932 |
841 |
$75K |
| C8929 |
Tte w or wo fol wcon,doppler |
528 |
420 |
$75K |
| 72100 |
|
2,919 |
2,722 |
$73K |
| C1725 |
Cath, translumin non-laser |
1,414 |
1,138 |
$72K |
| 97165 |
|
1,649 |
1,525 |
$71K |
| G0480 |
Drug test def 1-7 classes |
4,361 |
3,275 |
$71K |
| 94729 |
|
1,486 |
1,406 |
$69K |
| 97116 |
|
4,832 |
2,379 |
$69K |
| C1894 |
Intro/sheath, non-laser |
2,638 |
2,161 |
$68K |
| 82728 |
|
8,180 |
7,298 |
$66K |
| 11042 |
|
1,624 |
667 |
$65K |
| 77334 |
|
314 |
167 |
$65K |
| 88342 |
|
4,747 |
4,024 |
$62K |
| 94640 |
|
7,458 |
5,086 |
$62K |
| 84484 |
|
17,654 |
13,276 |
$61K |
| 73560 |
|
2,351 |
2,103 |
$60K |
| 96411 |
|
383 |
222 |
$59K |
| 83880 |
|
7,033 |
5,884 |
$57K |
| 87086 |
|
21,176 |
19,195 |
$57K |
| 93798 |
|
1,276 |
176 |
$56K |
| 85610 |
|
23,696 |
19,723 |
$56K |
| 82607 |
|
5,944 |
5,508 |
$56K |
| Q5117 |
Inj., kanjinti, 10 mg |
131 |
51 |
$56K |
| 73130 |
|
2,017 |
1,878 |
$55K |
| 73610 |
|
2,309 |
2,123 |
$54K |
| 83735 |
|
18,392 |
13,998 |
$54K |
| 73630 |
|
2,399 |
2,234 |
$54K |
| J9310 |
Rituximab injection |
18 |
14 |
$53K |
| 93923 |
|
349 |
328 |
$51K |
| 96402 |
|
1,031 |
881 |
$51K |
| 81001 |
|
21,838 |
19,916 |
$49K |
| 83036 |
|
10,887 |
10,160 |
$49K |
| Q0162 |
Ondansetron oral |
2,832 |
1,322 |
$49K |
| 73030 |
|
2,531 |
2,272 |
$48K |
| J1756 |
Iron sucrose injection |
1,203 |
460 |
$47K |
| OP254 |
|
10,479 |
9,023 |
$46K |
| G0379 |
Direct refer hospital observ |
816 |
695 |
$46K |
| 97164 |
|
1,012 |
975 |
$46K |
| 93041 |
|
3,511 |
3,384 |
$44K |
| 96401 |
|
921 |
426 |
$44K |
| 72050 |
|
780 |
741 |
$43K |
| 77412 |
|
344 |
37 |
$43K |
| 10005 |
|
95 |
77 |
$43K |
| 19081 |
|
58 |
42 |
$43K |
| 92523 |
|
657 |
611 |
$42K |
| 95806 |
|
53 |
52 |
$41K |
| M0243 |
Casirivi and imdevi inj |
182 |
177 |
$41K |
| C9290 |
Inj, bupivacaine liposome |
1,055 |
962 |
$40K |
| 0004A |
|
1,343 |
1,332 |
$40K |
| 94727 |
|
1,375 |
1,299 |
$40K |
| 88307 |
|
1,117 |
895 |
$40K |
| 84703 |
|
23,227 |
21,043 |
$39K |
| 85730 |
|
14,696 |
12,914 |
$39K |
| 84439 |
|
7,356 |
6,784 |
$39K |
| 81002 |
|
9,108 |
6,841 |
$38K |
| 75574 |
|
167 |
140 |
$38K |
| 87798 |
|
3,697 |
3,382 |
$37K |
| J2930 |
Methylprednisolone injection |
2,828 |
2,377 |
$36K |
| 88304 |
|
2,107 |
1,924 |
$35K |
| 73721 |
|
144 |
141 |
$35K |
| 29515 |
|
838 |
820 |
$34K |
| 84153 |
|
2,690 |
2,334 |
$34K |
| 87581 |
|
3,508 |
3,373 |
$33K |
| 86901 |
|
9,014 |
7,213 |
$32K |
| 72141 |
|
168 |
157 |
$32K |
| 95957 |
|
133 |
117 |
$32K |
| 87040 |
|
9,401 |
6,442 |
$32K |
| 73110 |
|
1,307 |
1,152 |
$31K |
| 87486 |
|
2,954 |
2,853 |
$31K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
4,765 |
3,523 |
$30K |
| J9395 |
Injection, fulvestrant |
29 |
26 |
$29K |
| 73564 |
|
1,274 |
1,177 |
$29K |
| 85652 |
|
8,352 |
7,647 |
$29K |
| 82746 |
|
4,118 |
3,817 |
$28K |
| 77062 |
|
1,202 |
1,189 |
$27K |
| 83550 |
|
6,530 |
5,848 |
$27K |
| 0031A |
|
861 |
861 |
$27K |
| 10022 |
|
45 |
43 |
$26K |
| 74018 |
|
1,560 |
1,487 |
$26K |
| J0131 |
Inj, acetaminophen (nos) |
5,818 |
4,928 |
$25K |
| 86300 |
|
3,410 |
2,768 |
$25K |
| C1874 |
Stent, coated/cov w/del sys |
37 |
32 |
$25K |
| A9552 |
F18 fdg |
751 |
626 |
$24K |
| 83615 |
|
3,772 |
3,100 |
$24K |
| 83690 |
|
13,396 |
11,974 |
$24K |
| J2405 |
Ondansetron hcl injection |
15,723 |
12,514 |
$23K |
| 87491 |
|
1,371 |
1,339 |
$23K |
| 83605 |
|
7,177 |
5,875 |
$22K |
| 97035 |
|
1,324 |
437 |
$22K |
| 81003 |
|
13,904 |
12,802 |
$22K |
| 93325 |
|
124 |
118 |
$22K |
| 73502 |
|
1,314 |
1,187 |
$22K |
| 83540 |
|
6,652 |
5,951 |
$21K |
| 87077 |
|
4,839 |
4,256 |
$21K |
| 85007 |
|
7,043 |
5,715 |
$20K |
| 29125 |
|
470 |
456 |
$20K |
| C2615 |
Sealant, pulmonary, liquid |
803 |
725 |
$20K |
| 72125 |
|
520 |
447 |
$20K |
| 84480 |
|
2,774 |
2,724 |
$20K |
| J9217 |
Leuprolide acetate suspnsion |
72 |
64 |
$20K |
| 87591 |
|
1,374 |
1,341 |
$19K |
| 87186 |
|
3,690 |
3,193 |
$19K |
| 97163 |
|
506 |
465 |
$17K |
| 69436 |
|
15 |
15 |
$16K |
| A9579 |
Gad-base mr contrast nos,1ml |
4,421 |
3,648 |
$16K |
| C9600 |
Perc drug-el cor stent sing |
15 |
12 |
$16K |
| A4649 |
Surgical supplies |
2,872 |
2,689 |
$16K |
| 87804 |
|
3,011 |
1,905 |
$15K |
| 30802 |
|
26 |
26 |
$15K |
| 97018 |
|
2,048 |
562 |
$15K |
| 84702 |
|
2,724 |
2,342 |
$15K |
| 90471 |
|
1,596 |
1,468 |
$15K |
| 76825 |
|
62 |
59 |
$14K |
| 94761 |
|
678 |
623 |
$14K |
| 82553 |
|
3,512 |
2,687 |
$14K |
| J0881 |
Darbepoetin alfa, non-esrd |
87 |
75 |
$13K |
| 82784 |
|
1,784 |
1,039 |
$13K |
| 87389 |
|
623 |
615 |
$13K |
| 85379 |
|
4,916 |
4,493 |
$12K |
| 87880 |
|
3,879 |
3,760 |
$12K |
| 86140 |
|
6,282 |
5,703 |
$12K |
| 86301 |
|
431 |
337 |
$11K |
| 88341 |
|
712 |
313 |
$11K |
| 76827 |
|
61 |
60 |
$11K |
| 29505 |
|
311 |
304 |
$11K |
| 0072A |
|
307 |
305 |
$10K |
| 90714 |
|
1,394 |
1,329 |
$10K |
| 88173 |
|
213 |
188 |
$10K |
| C1729 |
Cath, drainage |
1,995 |
1,616 |
$10K |
| 82150 |
|
3,756 |
3,546 |
$10K |
| 0071A |
|
305 |
302 |
$9K |
| 86769 |
|
394 |
387 |
$9K |
| J1200 |
Diphenhydramine hcl injectio |
3,634 |
3,106 |
$9K |
| 76821 |
|
63 |
61 |
$9K |
| 93350 |
|
13 |
13 |
$9K |
| J0185 |
Inj., aprepitant, 1 mg |
36 |
24 |
$8K |
| 87071 |
|
3,137 |
2,954 |
$8K |
| 12001 |
|
146 |
139 |
$8K |
| J3420 |
Vitamin b12 injection |
1,857 |
1,271 |
$8K |
| 36591 |
|
1,612 |
676 |
$8K |
| 73080 |
|
328 |
293 |
$8K |
| 77061 |
|
539 |
524 |
$7K |
| 95819 |
|
41 |
40 |
$7K |
| 86038 |
|
1,419 |
1,343 |
$7K |
| C1781 |
Mesh (implantable) |
57 |
52 |
$7K |
| 84550 |
|
2,387 |
1,936 |
$7K |
| 70486 |
|
101 |
89 |
$7K |
| G0481 |
Drug test def 8-14 classes |
347 |
312 |
$7K |
| 82248 |
|
1,007 |
924 |
$7K |
| 74019 |
|
301 |
291 |
$7K |
| 96416 |
|
19 |
12 |
$7K |
| P9016 |
Rbc leukocytes reduced |
114 |
76 |
$6K |
| 97533 |
|
184 |
78 |
$6K |
| 86304 |
|
604 |
432 |
$6K |
| 88360 |
|
235 |
102 |
$6K |
| 86039 |
|
659 |
647 |
$6K |
| J8540 |
Oral dexamethasone |
1,289 |
606 |
$6K |
| E1637 |
Hemostats for dialysis, each |
1,296 |
1,032 |
$5K |
| 0064A |
|
198 |
195 |
$5K |
| 84145 |
|
1,068 |
942 |
$5K |
| 84403 |
|
460 |
413 |
$5K |
| 0124A |
|
250 |
218 |
$5K |
| 82043 |
|
2,301 |
2,256 |
$5K |
| 73590 |
|
273 |
243 |
$5K |
| M0245 |
Bamlan and etesev infusion |
19 |
19 |
$5K |
| 76942 |
|
69 |
68 |
$5K |
| 84100 |
|
2,945 |
2,140 |
$5K |
| 86334 |
|
663 |
600 |
$5K |
| 80299 |
|
838 |
768 |
$5K |
| 82550 |
|
2,559 |
2,307 |
$4K |
| 77290 |
|
13 |
13 |
$4K |
| 86235 |
|
484 |
313 |
$4K |
| G0279 |
Tomosynthesis, mammo |
302 |
271 |
$4K |
| 96368 |
|
190 |
153 |
$4K |
| 76870 |
|
38 |
38 |
$4K |
| 82565 |
|
1,015 |
917 |
$4K |
| 85045 |
|
1,378 |
1,143 |
$4K |
| 73221 |
|
15 |
15 |
$4K |
| J2704 |
Inj, propofol, 10 mg |
5,115 |
4,690 |
$4K |
| G0283 |
Elec stim other than wound |
301 |
81 |
$4K |
| 77280 |
|
27 |
26 |
$3K |
| J1100 |
Dexamethasone sodium phos |
7,381 |
6,454 |
$3K |
| 86430 |
|
1,046 |
1,008 |
$3K |
| 96521 |
|
27 |
16 |
$3K |
| 84520 |
|
805 |
731 |
$3K |
| 87205 |
|
1,385 |
1,195 |
$3K |
| 99213 |
|
101 |
66 |
$3K |
| 95861 |
|
15 |
12 |
$3K |
| C1760 |
Closure dev, vasc |
196 |
141 |
$3K |
| 36430 |
|
33 |
26 |
$3K |
| C1889 |
Implant/insert device, noc |
329 |
235 |
$3K |
| 78306 |
|
39 |
29 |
$3K |
| G8979 |
Mobility goal status |
321 |
296 |
$3K |
| G8978 |
Mobility current status |
301 |
282 |
$2K |
| 70491 |
|
14 |
14 |
$2K |
| 71101 |
|
67 |
65 |
$2K |
| 72072 |
|
136 |
126 |
$2K |
| 82985 |
|
859 |
841 |
$2K |
| 87340 |
|
381 |
338 |
$2K |
| 86225 |
|
539 |
520 |
$2K |
| 87081 |
|
1,023 |
978 |
$2K |
| 84165 |
|
708 |
661 |
$2K |
| 82803 |
|
260 |
242 |
$2K |
| J2916 |
Na ferric gluconate complex |
74 |
26 |
$2K |
| 82009 |
|
121 |
95 |
$2K |
| J3010 |
Fentanyl citrate injection |
3,370 |
3,061 |
$2K |
| J9190 |
Fluorouracil injection |
123 |
39 |
$1K |
| 84154 |
|
160 |
159 |
$1K |
| 10060 |
|
16 |
13 |
$1K |
| 86706 |
|
263 |
238 |
$1K |
| 83090 |
|
103 |
102 |
$1K |
| 86920 |
|
62 |
41 |
$1K |
| 12011 |
|
12 |
12 |
$1K |
| 95813 |
|
15 |
14 |
$1K |
| M0247 |
Sotrovimab infusion |
16 |
15 |
$1K |
| 84156 |
|
331 |
289 |
$1K |
| 83921 |
|
190 |
185 |
$1K |
| 29130 |
|
27 |
27 |
$1K |
| 83883 |
|
405 |
214 |
$1K |
| 86592 |
|
386 |
386 |
$1K |
| 80076 |
|
338 |
286 |
$1K |
| 86803 |
|
112 |
102 |
$1K |
| J0640 |
Leucovorin calcium injection |
44 |
14 |
$1K |
| 70490 |
|
19 |
13 |
$1K |
| 97168 |
|
25 |
24 |
$999.14 |
| 36600 |
|
192 |
165 |
$989.64 |
| 73090 |
|
58 |
51 |
$929.84 |
| 0134A |
|
59 |
50 |
$900.31 |
| 0012A |
|
44 |
44 |
$867.15 |
| 0011A |
|
55 |
55 |
$836.73 |
| 73140 |
|
83 |
78 |
$832.56 |
| P9604 |
One-way allow prorated trip |
1,074 |
882 |
$800.63 |
| 82272 |
|
207 |
206 |
$762.79 |
| 87420 |
|
146 |
146 |
$703.35 |
| 84402 |
|
57 |
57 |
$697.78 |
| 86308 |
|
632 |
617 |
$637.26 |
| 0003A |
|
18 |
18 |
$592.88 |
| 77001 |
|
13 |
13 |
$588.78 |
| J2919 |
Inj, methylpred sod succ 5mg |
351 |
229 |
$586.09 |
| OP270 |
|
599 |
592 |
$582.23 |
| 82164 |
|
114 |
113 |
$581.48 |
| 88302 |
|
40 |
37 |
$556.86 |
| 92610 |
|
29 |
26 |
$549.27 |
| 86787 |
|
48 |
41 |
$532.63 |
| 86360 |
|
34 |
28 |
$510.59 |
| 72170 |
|
38 |
37 |
$497.17 |
| 83516 |
|
123 |
100 |
$464.63 |
| 72131 |
|
13 |
12 |
$408.89 |
| 86357 |
|
33 |
27 |
$384.50 |
| 36416 |
|
532 |
212 |
$382.67 |
| 86355 |
|
33 |
27 |
$379.86 |
| 86800 |
|
55 |
50 |
$366.56 |
| 86359 |
|
33 |
27 |
$366.34 |
| 0241U |
|
25 |
25 |
$362.60 |
| 84132 |
|
572 |
452 |
$360.69 |
| OP278 |
|
27 |
16 |
$356.69 |
| 88112 |
|
27 |
26 |
$356.05 |
| Q9969 |
Non-heu tc-99m add-on/dose |
3,319 |
1,260 |
$349.07 |
| 84481 |
|
44 |
40 |
$333.57 |
| 88172 |
|
37 |
24 |
$325.71 |
| 86063 |
|
100 |
100 |
$248.11 |
| 86762 |
|
43 |
43 |
$239.31 |
| 88142 |
|
13 |
13 |
$234.00 |
| 90686 |
|
83 |
78 |
$233.35 |
| 93356 |
|
20 |
12 |
$207.45 |
| 83020 |
|
51 |
50 |
$205.38 |
| 82085 |
|
101 |
99 |
$189.04 |
| 83520 |
|
54 |
51 |
$187.39 |
| 86704 |
|
43 |
37 |
$182.76 |
| 86376 |
|
12 |
12 |
$179.83 |
| 84270 |
|
27 |
27 |
$155.24 |
| 84436 |
|
103 |
100 |
$130.33 |
| M0201 |
Pne flu hepb cov home admin |
75 |
66 |
$112.27 |
| A9503 |
Tc99m medronate |
43 |
29 |
$94.21 |
| 82105 |
|
12 |
12 |
$77.92 |
| 82668 |
|
12 |
12 |
$70.77 |
| 87070 |
|
15 |
13 |
$61.66 |
| 82950 |
|
12 |
12 |
$49.09 |
| 80178 |
|
13 |
12 |
$43.26 |
| J2920 |
Methylprednisolone injection |
33 |
25 |
$38.48 |
| J9045 |
Carboplatin injection |
17 |
12 |
$24.83 |
| 0077U |
|
15 |
14 |
$20.23 |
| J2274 |
Inj morphine pf epid ithc |
12 |
12 |
$14.15 |
| 82570 |
|
17 |
14 |
$9.18 |
| A4628 |
Oropharyngeal suction cath |
12 |
12 |
$3.00 |
| C1758 |
Catheter, ureteral |
19 |
19 |
$3.00 |