| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0123 |
|
3,159 |
3,050 |
$21.92M |
| 0450 |
|
216,286 |
200,698 |
$11.84M |
| Z7500 |
|
256,280 |
235,390 |
$8.67M |
| 70553 |
|
8,140 |
7,563 |
$6.79M |
| Z6020 |
|
19,924 |
1,756 |
$5.16M |
| 0636 |
|
7,816 |
7,249 |
$3.67M |
| 70551 |
|
7,479 |
7,108 |
$3.09M |
| Z4300 |
|
29,438 |
25,786 |
$3.03M |
| 95782 |
|
2,968 |
2,930 |
$2.53M |
| U0003 |
Cov-19 amp prb hgh thruput |
25,421 |
24,113 |
$1.96M |
| 99281 |
|
26,961 |
22,965 |
$1.69M |
| P9016 |
Rbc leukocytes reduced |
3,013 |
2,384 |
$1.60M |
| 0360 |
|
9,861 |
7,093 |
$1.57M |
| 0515 |
|
125,695 |
115,013 |
$1.42M |
| Z4307 |
|
37,497 |
34,254 |
$1.42M |
| Z7610 |
|
103,200 |
66,616 |
$1.25M |
| 99199 |
|
34,808 |
32,010 |
$1.24M |
| 80053 |
|
103,996 |
83,612 |
$1.24M |
| Z4308 |
|
17,572 |
17,333 |
$1.17M |
| 93306 |
|
5,739 |
5,638 |
$1.12M |
| Z4301 |
|
30,596 |
28,480 |
$1.11M |
| 87633 |
|
3,403 |
3,355 |
$1.10M |
| 87799 |
|
16,428 |
10,533 |
$1.10M |
| Z4303 |
|
25,075 |
19,757 |
$1.09M |
| 95810 |
|
4,453 |
4,400 |
$1.08M |
| J0490 |
Belimumab injection |
617 |
439 |
$1.08M |
| J0131 |
Inj, acetaminophen (nos) |
3,910 |
3,819 |
$1.03M |
| Z4304 |
|
13,337 |
13,179 |
$1.03M |
| 93975 |
|
5,654 |
5,451 |
$962K |
| 72148 |
|
1,893 |
1,762 |
$942K |
| 93303 |
|
5,449 |
5,399 |
$929K |
| Z7502 |
|
24,659 |
24,520 |
$911K |
| 72141 |
|
1,684 |
1,549 |
$884K |
| 93325 |
|
6,910 |
6,821 |
$874K |
| 96374 |
|
12,984 |
9,833 |
$835K |
| J3490 |
Drugs unclassified injection |
57,117 |
42,410 |
$813K |
| 72146 |
|
1,521 |
1,391 |
$807K |
| 96365 |
|
9,166 |
6,974 |
$785K |
| 0270 |
|
74,206 |
64,376 |
$784K |
| Z4311 |
|
52,562 |
46,382 |
$748K |
| 87497 |
|
15,050 |
9,663 |
$718K |
| 76770 |
|
9,217 |
9,153 |
$694K |
| 71046 |
|
20,823 |
20,016 |
$669K |
| 72156 |
|
645 |
540 |
$634K |
| Z4310 |
|
44,290 |
37,650 |
$607K |
| 85025 |
|
74,434 |
64,178 |
$599K |
| 97799 |
|
17,694 |
6,777 |
$597K |
| 0760 |
|
26,240 |
24,177 |
$570K |
| Z7506 |
|
4,245 |
3,776 |
$567K |
| 70450 |
|
3,634 |
3,535 |
$545K |
| X4303 |
|
7,855 |
2,822 |
$502K |
| 72158 |
|
506 |
403 |
$499K |
| 71260 |
|
1,845 |
1,703 |
$494K |
| 82306 |
|
22,169 |
21,870 |
$483K |
| J1439 |
Inj ferric carboxymaltos 1mg |
237 |
201 |
$477K |
| 72157 |
|
479 |
410 |
$455K |
| Q3014 |
Telehealth facility fee |
20,403 |
19,877 |
$449K |
| 93320 |
|
5,497 |
5,448 |
$443K |
| 97139 |
|
14,213 |
4,751 |
$439K |
| 99283 |
|
2,627 |
2,502 |
$414K |
| 99231 |
|
12,073 |
11,214 |
$412K |
| X4500 |
|
4,327 |
4,029 |
$406K |
| 93005 |
|
16,264 |
15,809 |
$382K |
| 96360 |
|
5,193 |
5,032 |
$369K |
| 87635 |
|
9,354 |
8,955 |
$358K |
| Z5406 |
|
18,184 |
12,085 |
$345K |
| G0463 |
Hospital outpt clinic visit |
6,633 |
6,156 |
$343K |
| 76705 |
|
6,131 |
5,904 |
$327K |
| 70543 |
|
1,105 |
834 |
$320K |
| 83036 |
|
25,614 |
25,033 |
$314K |
| J1745 |
Infliximab not biosimil 10mg |
201 |
173 |
$311K |
| 94729 |
|
6,313 |
6,221 |
$304K |
| 72142 |
|
431 |
402 |
$300K |
| X3908 |
|
8,901 |
3,534 |
$294K |
| 0761 |
|
11,653 |
11,113 |
$289K |
| 92587 |
|
6,637 |
6,551 |
$283K |
| 94726 |
|
6,370 |
6,267 |
$279K |
| 94640 |
|
10,596 |
10,096 |
$272K |
| 84443 |
|
15,864 |
15,630 |
$272K |
| 74183 |
|
840 |
737 |
$263K |
| 99213 |
|
814 |
768 |
$260K |
| 87798 |
|
7,411 |
7,169 |
$254K |
| 76700 |
|
3,246 |
3,193 |
$249K |
| 80197 |
|
16,382 |
10,081 |
$249K |
| J2704 |
Inj, propofol, 10 mg |
13,072 |
11,838 |
$246K |
| J2997 |
Alteplase recombinant |
2,848 |
344 |
$244K |
| 96450 |
|
873 |
792 |
$236K |
| 96375 |
|
7,162 |
4,375 |
$231K |
| 72149 |
|
340 |
311 |
$230K |
| 72147 |
|
339 |
310 |
$230K |
| 72197 |
|
758 |
643 |
$229K |
| 0710 |
|
9,054 |
8,819 |
$227K |
| 95812 |
|
5,203 |
5,139 |
$220K |
| X4530 |
|
4,606 |
4,588 |
$217K |
| 94642 |
|
1,240 |
1,214 |
$217K |
| J1569 |
Gammagard liquid injection |
157 |
80 |
$204K |
| Z4312 |
|
15,854 |
15,446 |
$202K |
| 74019 |
|
6,673 |
6,413 |
$200K |
| 85027 |
|
29,212 |
24,192 |
$198K |
| 99234 |
|
2,746 |
2,504 |
$192K |
| T1014 |
Telehealth transmit, per min |
29,513 |
27,075 |
$183K |
| J1459 |
Inj ivig privigen 500 mg |
153 |
78 |
$180K |
| X4110 |
|
5,967 |
2,912 |
$179K |
| 74177 |
|
700 |
692 |
$178K |
| X3920 |
|
3,463 |
3,398 |
$172K |
| 83735 |
|
23,319 |
15,728 |
$172K |
| 92582 |
|
4,362 |
4,318 |
$168K |
| 86945 |
|
3,049 |
2,412 |
$160K |
| 97802 |
|
3,266 |
3,156 |
$160K |
| 87086 |
|
19,368 |
18,048 |
$158K |
| 84439 |
|
16,152 |
15,853 |
$150K |
| X3910 |
|
7,884 |
3,197 |
$149K |
| J2405 |
Ondansetron hcl injection |
12,793 |
11,424 |
$145K |
| 84100 |
|
26,696 |
17,920 |
$142K |
| 0127 |
|
14 |
13 |
$142K |
| 83970 |
|
3,070 |
2,919 |
$139K |
| 92567 |
|
5,184 |
5,161 |
$136K |
| X4301 |
|
1,335 |
1,334 |
$125K |
| 76536 |
|
1,947 |
1,903 |
$125K |
| 86140 |
|
21,318 |
20,481 |
$123K |
| Q4081 |
Epoetin alfa, 100 units esrd |
18,062 |
1,369 |
$123K |
| 86480 |
|
2,459 |
2,442 |
$123K |
| 82728 |
|
9,522 |
8,512 |
$122K |
| Z7512 |
|
4,604 |
4,300 |
$120K |
| 97750 |
|
2,920 |
2,164 |
$118K |
| X4100 |
|
2,391 |
2,377 |
$118K |
| 96409 |
|
4,515 |
3,344 |
$117K |
| 87505 |
|
868 |
844 |
$112K |
| X3922 |
|
2,319 |
2,285 |
$107K |
| J1644 |
Inj heparin sodium per 1000u |
19,897 |
1,695 |
$106K |
| 92579 |
|
4,232 |
4,193 |
$106K |
| 72080 |
|
3,950 |
3,881 |
$105K |
| 85007 |
|
27,390 |
22,527 |
$101K |
| 99000 |
|
25,041 |
23,544 |
$100K |
| 71250 |
|
402 |
378 |
$98K |
| J1642 |
Inj heparin sodium per 10 u |
15,683 |
7,444 |
$98K |
| 82977 |
|
12,900 |
10,016 |
$96K |
| 0250 |
|
11,765 |
10,649 |
$96K |
| 86352 |
|
1,104 |
1,093 |
$95K |
| 94010 |
|
6,118 |
6,033 |
$95K |
| Q5103 |
Injection, inflectra |
165 |
160 |
$95K |
| J3010 |
Fentanyl citrate injection |
5,428 |
5,199 |
$91K |
| 96361 |
|
3,948 |
3,677 |
$90K |
| 84703 |
|
12,722 |
11,125 |
$87K |
| 69210 |
|
6,460 |
6,227 |
$87K |
| X4112 |
|
4,568 |
2,331 |
$87K |
| Z5999 |
|
93 |
84 |
$86K |
| J9370 |
Vincristine sulfate 1 mg inj |
6,979 |
4,288 |
$85K |
| 97165 |
|
2,134 |
1,361 |
$85K |
| 0259 |
|
16,370 |
13,894 |
$84K |
| 80061 |
|
6,653 |
6,544 |
$83K |
| 73610 |
|
3,162 |
3,002 |
$83K |
| 87650 |
|
5,249 |
5,120 |
$81K |
| 73080 |
|
2,558 |
2,277 |
$80K |
| X4102 |
|
1,666 |
1,649 |
$80K |
| 74455 |
|
1,190 |
1,181 |
$79K |
| 41899 |
|
131 |
128 |
$77K |
| 72170 |
|
3,673 |
3,613 |
$77K |
| J2270 |
Morphine sulfate injection |
3,475 |
3,069 |
$77K |
| Z4302 |
|
5,347 |
5,314 |
$76K |
| 96372 |
|
3,999 |
3,678 |
$76K |
| 85045 |
|
18,298 |
15,899 |
$76K |
| 81003 |
|
30,233 |
28,814 |
$76K |
| 99284 |
|
5,108 |
4,874 |
$75K |
| G0390 |
Trauma respons w/hosp criti |
70 |
67 |
$75K |
| 99221 |
|
1,786 |
1,696 |
$75K |
| X3926 |
|
2,455 |
1,060 |
$74K |
| 83550 |
|
10,207 |
9,249 |
$74K |
| 96366 |
|
1,577 |
1,406 |
$73K |
| 86360 |
|
1,369 |
1,069 |
$72K |
| J2501 |
Paricalcitol |
16,367 |
1,345 |
$71K |
| 88305 |
|
1,597 |
1,559 |
$71K |
| 73090 |
|
3,382 |
2,800 |
$69K |
| 75561 |
|
237 |
198 |
$68K |
| 99203 |
|
1,503 |
1,461 |
$68K |
| 87077 |
|
7,976 |
7,580 |
$68K |
| 86353 |
|
181 |
168 |
$67K |
| 87040 |
|
3,099 |
2,885 |
$64K |
| 83519 |
|
3,485 |
3,417 |
$64K |
| 70486 |
|
422 |
422 |
$63K |
| 86923 |
|
1,742 |
1,433 |
$63K |
| 84305 |
|
3,749 |
3,733 |
$63K |
| J0696 |
Ceftriaxone sodium injection |
2,483 |
2,223 |
$63K |
| 88185 |
|
215 |
203 |
$63K |
| 86356 |
|
2,022 |
1,500 |
$62K |
| 87631 |
|
932 |
895 |
$61K |
| 97803 |
|
1,399 |
1,310 |
$61K |
| 82784 |
|
6,560 |
4,116 |
$60K |
| J0690 |
Cefazolin sodium injection |
2,340 |
2,163 |
$59K |
| 97110 |
|
1,710 |
684 |
$59K |
| 92557 |
|
1,168 |
1,028 |
$59K |
| 87426 |
|
1,683 |
1,638 |
$59K |
| J2916 |
Na ferric gluconate complex |
3,982 |
662 |
$57K |
| 73590 |
|
2,639 |
2,297 |
$57K |
| 92555 |
|
4,359 |
4,318 |
$55K |
| J3380 |
Inj vedolizumab iv 1 mg |
47 |
12 |
$55K |
| 92250 |
|
760 |
736 |
$54K |
| 74018 |
|
2,724 |
2,586 |
$54K |
| 86359 |
|
1,267 |
1,046 |
$54K |
| 73630 |
|
2,133 |
2,048 |
$54K |
| 85652 |
|
18,433 |
17,777 |
$53K |
| 86922 |
|
1,130 |
910 |
$53K |
| J1100 |
Dexamethasone sodium phos |
4,240 |
3,880 |
$53K |
| 87880 |
|
5,778 |
5,542 |
$52K |
| 0203 |
|
12 |
12 |
$52K |
| Z5918 |
|
2,354 |
2,352 |
$51K |
| 73130 |
|
1,583 |
1,532 |
$51K |
| J1885 |
Ketorolac tromethamine inj |
3,851 |
3,608 |
$50K |
| 86850 |
|
5,548 |
4,358 |
$50K |
| 86160 |
|
2,212 |
2,102 |
$49K |
| 83020 |
|
3,197 |
2,921 |
$48K |
| 86355 |
|
1,752 |
1,363 |
$47K |
| 82803 |
|
3,157 |
3,044 |
$47K |
| 73562 |
|
1,724 |
1,683 |
$47K |
| J2710 |
Neostigmine methylslfte inj |
1,103 |
1,061 |
$47K |
| 82330 |
|
3,351 |
3,202 |
$46K |
| J2250 |
Inj midazolam hydrochloride |
3,069 |
2,959 |
$45K |
| A4649 |
Surgical supplies |
1,652 |
1,318 |
$44K |
| J3262 |
Tocilizumab injection |
173 |
56 |
$44K |
| T1024 |
Team evaluation & management |
1,752 |
1,582 |
$44K |
| 86905 |
|
2,003 |
1,646 |
$43K |
| 96040 |
|
837 |
834 |
$43K |
| 94060 |
|
1,558 |
1,535 |
$42K |
| G0378 |
Hospital observation per hr |
2,013 |
1,928 |
$42K |
| 81001 |
|
11,980 |
9,324 |
$41K |
| 80048 |
|
4,668 |
4,358 |
$41K |
| 82670 |
|
2,458 |
2,418 |
$40K |
| 82570 |
|
6,773 |
5,902 |
$40K |
| 87491 |
|
1,621 |
1,456 |
$39K |
| 77074 |
|
1,285 |
1,252 |
$39K |
| 81229 |
|
178 |
178 |
$39K |
| 12011 |
|
534 |
515 |
$38K |
| V5010 |
Assessment for hearing aid |
501 |
501 |
$37K |
| 86357 |
|
1,341 |
1,023 |
$37K |
| 84403 |
|
3,407 |
3,362 |
$37K |
| 0370 |
|
1,667 |
1,634 |
$36K |
| 92588 |
|
500 |
492 |
$36K |
| 84630 |
|
3,530 |
3,524 |
$35K |
| 92507 |
|
785 |
309 |
$35K |
| 99070 |
|
3,561 |
2,690 |
$35K |
| 87186 |
|
4,363 |
4,185 |
$34K |
| 99282 |
|
757 |
722 |
$34K |
| 80299 |
|
1,719 |
1,605 |
$33K |
| 84156 |
|
11,106 |
8,812 |
$32K |
| 80306 |
|
1,638 |
1,585 |
$31K |
| 83615 |
|
5,167 |
4,914 |
$31K |
| J9260 |
Inj methotrexate sodium 50mg |
3,856 |
2,759 |
$31K |
| 99285 |
|
57 |
48 |
$30K |
| 74160 |
|
113 |
111 |
$30K |
| 71555 |
|
90 |
64 |
$30K |
| 83880 |
|
1,235 |
1,153 |
$30K |
| 87533 |
|
629 |
332 |
$30K |
| 73110 |
|
1,118 |
1,083 |
$29K |
| 97010 |
|
429 |
212 |
$29K |
| 86003 |
|
443 |
439 |
$29K |
| P9035 |
Platelet pheres leukoreduced |
40 |
29 |
$28K |
| 82947 |
|
6,098 |
5,798 |
$27K |
| 83690 |
|
4,058 |
3,917 |
$27K |
| 75565 |
|
676 |
509 |
$27K |
| 70310 |
|
3,455 |
3,385 |
$26K |
| 84255 |
|
1,520 |
1,520 |
$26K |
| 36593 |
|
746 |
209 |
$26K |
| 73100 |
|
1,464 |
1,254 |
$26K |
| 86317 |
|
506 |
503 |
$26K |
| 86900 |
|
5,609 |
4,382 |
$25K |
| 95811 |
|
76 |
76 |
$25K |
| 74181 |
|
40 |
40 |
$25K |
| 85610 |
|
5,987 |
5,631 |
$25K |
| 86920 |
|
663 |
527 |
$24K |
| 82610 |
|
1,533 |
1,419 |
$24K |
| Z5932 |
|
509 |
508 |
$24K |
| 73521 |
|
669 |
644 |
$24K |
| 86225 |
|
1,555 |
1,496 |
$24K |
| 93296 |
|
504 |
496 |
$24K |
| 84445 |
|
557 |
554 |
$24K |
| 82397 |
|
1,167 |
1,134 |
$24K |
| J0585 |
Injection,onabotulinumtoxina |
14 |
14 |
$23K |
| 82652 |
|
1,301 |
1,291 |
$23K |
| 73070 |
|
1,502 |
1,228 |
$23K |
| 85730 |
|
3,750 |
3,513 |
$23K |
| 86769 |
|
557 |
532 |
$22K |
| 86901 |
|
5,607 |
4,389 |
$22K |
| S0020 |
Injection, bupivicaine hydro |
2,470 |
2,361 |
$22K |
| 90686 |
|
1,103 |
1,079 |
$21K |
| J2001 |
Lidocaine injection |
2,807 |
2,720 |
$21K |
| 82043 |
|
3,170 |
2,922 |
$20K |
| G0480 |
Drug test def 1-7 classes |
279 |
270 |
$20K |
| 83516 |
|
1,505 |
1,416 |
$20K |
| 95004 |
|
425 |
418 |
$20K |
| 82542 |
|
784 |
764 |
$20K |
| 80180 |
|
1,296 |
1,179 |
$20K |
| 73140 |
|
1,330 |
1,243 |
$19K |
| 87070 |
|
2,471 |
2,405 |
$19K |
| 71045 |
|
830 |
812 |
$19K |
| 86833 |
|
2,242 |
2,115 |
$18K |
| 83002 |
|
2,511 |
2,489 |
$18K |
| 88104 |
|
2,345 |
2,070 |
$18K |
| 72040 |
|
570 |
551 |
$17K |
| 72100 |
|
581 |
567 |
$17K |
| 82157 |
|
775 |
764 |
$17K |
| 84244 |
|
698 |
685 |
$17K |
| 86832 |
|
2,039 |
1,920 |
$17K |
| 84425 |
|
567 |
562 |
$17K |
| 92060 |
|
1,962 |
1,946 |
$16K |
| 84446 |
|
828 |
823 |
$16K |
| 76881 |
|
238 |
235 |
$16K |
| 81015 |
|
5,765 |
5,553 |
$16K |
| Z4314 |
|
588 |
573 |
$16K |
| 73552 |
|
549 |
508 |
$16K |
| 72081 |
|
698 |
696 |
$16K |
| 83001 |
|
2,098 |
1,973 |
$16K |
| 84590 |
|
975 |
970 |
$15K |
| Z5920 |
|
694 |
693 |
$15K |
| 0002A |
|
403 |
402 |
$15K |
| 92570 |
|
800 |
758 |
$14K |
| 0272 |
|
4,226 |
4,001 |
$14K |
| X4540 |
|
438 |
437 |
$14K |
| 29125 |
|
1,139 |
1,102 |
$14K |
| 83520 |
|
751 |
723 |
$14K |
| J7120 |
Ringers lactate infusion |
1,961 |
1,623 |
$14K |
| 0001A |
|
383 |
382 |
$13K |
| 83498 |
|
939 |
919 |
$13K |
| 87590 |
|
1,083 |
1,060 |
$13K |
| 90471 |
|
3,130 |
3,089 |
$12K |
| 43239 |
|
171 |
163 |
$12K |
| 72082 |
|
357 |
357 |
$12K |
| 93356 |
|
253 |
249 |
$12K |
| 93225 |
|
263 |
261 |
$12K |
| 73000 |
|
467 |
442 |
$11K |
| 86706 |
|
946 |
920 |
$11K |
| A0429 |
Bls-emergency |
404 |
261 |
$11K |
| 0420 |
|
409 |
136 |
$11K |
| 80195 |
|
1,138 |
788 |
$11K |
| 84478 |
|
1,626 |
1,492 |
$10K |
| 12001 |
|
162 |
151 |
$10K |
| 82105 |
|
656 |
637 |
$10K |
| 84295 |
|
2,695 |
2,598 |
$10K |
| 84207 |
|
637 |
630 |
$10K |
| 84132 |
|
2,671 |
2,581 |
$10K |
| 96413 |
|
192 |
94 |
$9K |
| 88184 |
|
215 |
203 |
$9K |
| 82010 |
|
784 |
781 |
$9K |
| 87651 |
|
440 |
412 |
$9K |
| 99212 |
|
626 |
590 |
$9K |
| 82657 |
|
117 |
117 |
$9K |
| 92556 |
|
680 |
678 |
$9K |
| 70360 |
|
559 |
546 |
$9K |
| 84484 |
|
822 |
756 |
$9K |
| 84402 |
|
689 |
686 |
$9K |
| J1170 |
Hydromorphone injection |
350 |
253 |
$8K |
| 96411 |
|
280 |
164 |
$8K |
| 82024 |
|
682 |
666 |
$8K |
| S0302 |
Completed epsdt |
422 |
271 |
$8K |
| 92700 |
|
250 |
248 |
$8K |
| J1200 |
Diphenhydramine hcl injectio |
1,183 |
1,000 |
$8K |
| 82550 |
|
1,341 |
1,245 |
$8K |
| 85014 |
|
3,611 |
3,502 |
$8K |
| 90658 |
|
851 |
827 |
$8K |
| 82785 |
|
635 |
631 |
$8K |
| 95974 |
|
29 |
27 |
$7K |
| 97116 |
|
277 |
173 |
$7K |
| 0301 |
|
2,272 |
2,184 |
$7K |
| 70355 |
|
867 |
850 |
$7K |
| 76776 |
|
83 |
82 |
$7K |
| 90656 |
|
417 |
416 |
$7K |
| 84146 |
|
722 |
707 |
$7K |
| 92550 |
|
550 |
535 |
$7K |
| 73060 |
|
290 |
260 |
$7K |
| 87340 |
|
570 |
551 |
$7K |
| 88304 |
|
749 |
731 |
$7K |
| 82533 |
|
310 |
303 |
$7K |
| 92134 |
|
613 |
606 |
$6K |
| 86341 |
|
318 |
315 |
$6K |
| 77080 |
|
222 |
172 |
$6K |
| 82525 |
|
579 |
576 |
$6K |
| A9552 |
F18 fdg |
12 |
12 |
$6K |
| 73560 |
|
224 |
209 |
$6K |
| Z7510 |
|
92 |
87 |
$5K |
| 76856 |
|
74 |
73 |
$5K |
| 73620 |
|
277 |
265 |
$5K |
| 82379 |
|
281 |
280 |
$5K |
| 87389 |
|
330 |
322 |
$5K |
| 80201 |
|
301 |
301 |
$5K |
| 95012 |
|
187 |
187 |
$5K |
| 92133 |
|
420 |
420 |
$5K |
| 92522 |
|
92 |
89 |
$5K |
| 87205 |
|
1,251 |
1,209 |
$5K |
| 74230 |
|
198 |
197 |
$5K |
| 84520 |
|
911 |
797 |
$5K |
| 77072 |
|
437 |
437 |
$4K |
| 99202 |
|
267 |
265 |
$4K |
| Z7504 |
|
92 |
81 |
$4K |
| 0251 |
|
1,342 |
1,269 |
$4K |
| 82139 |
|
213 |
203 |
$4K |
| 73030 |
|
138 |
134 |
$4K |
| 87081 |
|
658 |
647 |
$4K |
| 85347 |
|
605 |
508 |
$4K |
| X4522 |
|
13 |
13 |
$4K |
| 81479 |
|
12 |
12 |
$4K |
| J0780 |
Prochlorperazine injection |
254 |
247 |
$4K |
| 86803 |
|
225 |
221 |
$4K |
| 93016 |
|
87 |
87 |
$4K |
| 72070 |
|
116 |
116 |
$3K |
| 86704 |
|
249 |
242 |
$3K |
| 77334 |
|
18 |
12 |
$3K |
| 83051 |
|
381 |
378 |
$3K |
| 81243 |
|
61 |
61 |
$3K |
| 70491 |
|
13 |
13 |
$3K |
| 96415 |
|
79 |
37 |
$3K |
| 0700 |
|
153 |
124 |
$3K |
| 89051 |
|
1,816 |
1,602 |
$3K |
| Z4309 |
|
123 |
120 |
$3K |
| 97140 |
|
167 |
116 |
$3K |
| 93886 |
|
12 |
12 |
$3K |
| 76825 |
|
41 |
39 |
$3K |
| 76010 |
|
126 |
119 |
$3K |
| 84550 |
|
784 |
729 |
$3K |
| 82248 |
|
550 |
473 |
$3K |
| 43760 |
|
68 |
59 |
$3K |
| 86765 |
|
143 |
129 |
$3K |
| 76827 |
|
54 |
50 |
$3K |
| 93976 |
|
14 |
14 |
$3K |
| 84681 |
|
137 |
136 |
$3K |
| 70480 |
|
12 |
12 |
$3K |
| 96112 |
|
16 |
16 |
$3K |
| 84702 |
|
163 |
120 |
$3K |
| 85379 |
|
265 |
236 |
$2K |
| 54640 |
|
39 |
37 |
$2K |
| 86592 |
|
172 |
171 |
$2K |
| 76885 |
|
29 |
29 |
$2K |
| 77336 |
|
47 |
24 |
$2K |
| 97161 |
|
58 |
40 |
$2K |
| J9070 |
Cyclophosphamide 100 mg inj |
36 |
12 |
$2K |
| 51701 |
|
45 |
41 |
$2K |
| 84432 |
|
91 |
83 |
$2K |
| 76512 |
|
56 |
56 |
$2K |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
643 |
632 |
$2K |
| 92504 |
|
175 |
173 |
$2K |
| 87252 |
|
27 |
27 |
$2K |
| 54161 |
|
52 |
52 |
$2K |
| 99499 |
|
35 |
31 |
$2K |
| 31575 |
|
52 |
50 |
$2K |
| 82746 |
|
300 |
299 |
$2K |
| 85246 |
|
111 |
110 |
$2K |
| 83789 |
|
75 |
73 |
$2K |
| J2185 |
Meropenem |
29 |
26 |
$2K |
| 71020 |
|
67 |
39 |
$2K |
| 80164 |
|
112 |
112 |
$2K |
| J7611 |
Albuterol non-comp con |
1,368 |
1,227 |
$2K |
| 85384 |
|
193 |
176 |
$2K |
| 84480 |
|
106 |
106 |
$2K |
| 00000 |
|
66 |
64 |
$2K |
| 31231 |
|
108 |
108 |
$2K |
| 86787 |
|
117 |
116 |
$2K |
| 86645 |
|
116 |
112 |
$2K |
| 85240 |
|
107 |
106 |
$2K |
| 80354 |
|
269 |
265 |
$2K |
| 0324 |
|
1,106 |
1,069 |
$2K |
| 86999 |
|
118 |
93 |
$2K |
| 86615 |
|
41 |
41 |
$2K |
| 82634 |
|
52 |
52 |
$1K |
| 0471 |
|
65 |
39 |
$1K |
| Z5930 |
|
39 |
39 |
$1K |
| 84143 |
|
45 |
45 |
$1K |
| 94761 |
|
76 |
66 |
$1K |
| 82633 |
|
27 |
27 |
$1K |
| 85245 |
|
74 |
74 |
$1K |
| 80158 |
|
57 |
27 |
$1K |
| 95970 |
|
28 |
28 |
$1K |
| 82390 |
|
94 |
94 |
$1K |
| J2920 |
Methylprednisolone injection |
125 |
114 |
$1K |
| 94760 |
|
340 |
333 |
$1K |
| 83993 |
|
76 |
76 |
$1K |
| 49452 |
|
25 |
25 |
$1K |
| 86644 |
|
99 |
97 |
$990.00 |
| 30300 |
|
12 |
12 |
$946.68 |
| 94681 |
|
12 |
12 |
$924.03 |
| 86376 |
|
93 |
93 |
$923.72 |
| 82607 |
|
166 |
166 |
$910.15 |
| 87529 |
|
14 |
13 |
$907.36 |
| 29105 |
|
24 |
24 |
$888.46 |
| 0424 |
|
49 |
39 |
$884.46 |
| 0306 |
|
3,292 |
3,181 |
$877.27 |
| 84436 |
|
112 |
111 |
$873.31 |
| 83655 |
|
109 |
109 |
$872.00 |
| 91200 |
|
55 |
55 |
$855.62 |
| 73721 |
|
14 |
13 |
$850.00 |
| 99211 |
|
204 |
195 |
$832.09 |
| 86774 |
|
49 |
48 |
$821.73 |
| 0410 |
|
1,238 |
1,194 |
$809.89 |
| 97112 |
|
70 |
45 |
$807.50 |
| 86665 |
|
26 |
26 |
$800.16 |
| J3475 |
Inj magnesium sulfate |
48 |
45 |
$783.83 |
| 87075 |
|
174 |
156 |
$776.58 |
| 93041 |
|
95 |
90 |
$770.65 |
| 91065 |
|
116 |
69 |
$765.76 |
| 86308 |
|
140 |
138 |
$760.14 |
| 82626 |
|
42 |
41 |
$756.00 |
| 97810 |
|
176 |
104 |
$729.42 |
| 89050 |
|
527 |
469 |
$703.86 |
| 99366 |
|
65 |
51 |
$696.31 |
| 99215 |
Prolong outpt/office vis |
23 |
22 |
$693.71 |
| 86039 |
|
88 |
88 |
$686.13 |
| 94645 |
|
37 |
37 |
$682.16 |
| 86762 |
|
57 |
51 |
$678.23 |
| 86255 |
|
24 |
24 |
$671.31 |
| 86337 |
|
66 |
66 |
$660.00 |
| 86735 |
|
52 |
51 |
$640.83 |
| A0422 |
Ambulance 02 life sustaining |
45 |
39 |
$631.39 |
| 87449 |
|
46 |
34 |
$631.20 |
| 87801 |
|
15 |
15 |
$628.20 |
| 96900 |
|
61 |
14 |
$620.70 |
| 99244 |
|
34 |
28 |
$620.01 |
| 64642 |
|
41 |
41 |
$615.00 |
| 87305 |
|
68 |
53 |
$585.12 |
| 76140 |
|
34 |
34 |
$583.18 |
| 69436 |
|
14 |
14 |
$577.75 |
| J7040 |
Normal saline solution infus |
67 |
64 |
$574.03 |
| 87116 |
|
40 |
40 |
$563.76 |
| 36415 |
|
499 |
457 |
$554.91 |
| 29280 |
|
46 |
44 |
$549.70 |
| 82310 |
|
75 |
71 |
$547.50 |
| 76000 |
|
30 |
30 |
$547.39 |
| 85247 |
|
29 |
29 |
$543.63 |
| 82725 |
|
27 |
27 |
$509.22 |
| J1626 |
Granisetron hcl injection |
145 |
77 |
$501.23 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
63 |
62 |
$494.67 |
| 92626 |
|
21 |
21 |
$464.24 |
| 99072 |
|
1,901 |
1,359 |
$445.50 |
| 93280 |
|
15 |
15 |
$436.95 |
| 10060 |
|
26 |
25 |
$436.81 |
| 80230 |
|
14 |
14 |
$432.04 |
| J0688 |
Inj cefazolin sodium, hikma |
16 |
16 |
$431.20 |
| 64643 |
|
25 |
25 |
$375.00 |
| 80177 |
|
28 |
28 |
$366.24 |
| 86708 |
|
25 |
25 |
$351.00 |
| 86800 |
|
24 |
24 |
$350.26 |
| 82523 |
|
13 |
12 |
$333.96 |
| 82085 |
|
29 |
28 |
$333.00 |
| 83919 |
|
14 |
14 |
$326.34 |
| 95874 |
|
40 |
40 |
$319.20 |
| 82140 |
|
19 |
15 |
$313.69 |
| 84144 |
|
26 |
26 |
$312.00 |
| T1001 |
Nursing assessment/evaluatn |
28 |
26 |
$304.62 |
| 84479 |
|
40 |
40 |
$295.43 |
| 0434 |
|
28 |
24 |
$288.79 |
| 86364 |
|
27 |
27 |
$276.84 |
| 0310 |
|
516 |
512 |
$258.30 |
| 97164 |
|
12 |
12 |
$254.45 |
| 0300 |
|
2,346 |
2,260 |
$251.84 |
| 73120 |
|
16 |
14 |
$246.73 |
| J1071 |
Inj testosterone cypionate |
102 |
47 |
$239.90 |
| 0320 |
|
831 |
795 |
$237.47 |
| 92083 |
|
27 |
27 |
$231.29 |
| 92132 |
|
15 |
14 |
$219.57 |
| 29130 |
|
26 |
25 |
$215.93 |
| 84585 |
|
12 |
12 |
$210.84 |
| J9000 |
Doxorubicin hcl injection |
18 |
12 |
$204.18 |
| 11900 |
|
29 |
28 |
$184.02 |
| 99214 |
|
20 |
20 |
$179.33 |
| 0305 |
|
1,978 |
1,909 |
$178.80 |
| 73600 |
|
12 |
12 |
$169.06 |
| 82747 |
|
28 |
28 |
$168.00 |
| 80329 |
|
81 |
80 |
$167.60 |
| 86709 |
|
13 |
13 |
$165.88 |
| 80076 |
|
28 |
26 |
$162.04 |
| J7050 |
Normal saline solution infus |
33 |
25 |
$159.98 |
| 0637 |
|
43 |
40 |
$159.41 |
| 51798 |
|
16 |
12 |
$158.18 |
| 83150 |
|
12 |
12 |
$156.96 |
| 29515 |
|
29 |
29 |
$135.66 |
| 51741 |
|
16 |
12 |
$131.27 |
| 92583 |
|
208 |
208 |
$116.74 |
| 87045 |
|
12 |
12 |
$104.74 |
| 87184 |
|
15 |
15 |
$104.39 |
| 83525 |
|
12 |
12 |
$91.20 |
| J9100 |
Cytarabine hcl 100 mg inj |
31 |
26 |
$88.11 |
| Q0162 |
Ondansetron oral |
27 |
26 |
$87.74 |
| 84481 |
|
12 |
12 |
$81.60 |
| J0171 |
Adrenalin epinephrine inject |
14 |
12 |
$72.66 |
| 0271 |
|
856 |
844 |
$48.12 |
| 84460 |
|
12 |
12 |
$46.78 |
| 87046 |
|
12 |
12 |
$43.65 |
| 70300 |
|
26 |
26 |
$43.57 |
| 82565 |
|
13 |
13 |
$40.05 |
| 99001 |
|
52 |
47 |
$36.63 |
| 87181 |
|
12 |
12 |
$35.89 |
| 97014 |
|
364 |
200 |
$27.86 |
| 85018 |
|
63 |
54 |
$23.56 |
| 0307 |
|
830 |
798 |
$9.16 |
| 0302 |
|
1,307 |
1,265 |
$5.97 |
| 0730 |
|
191 |
187 |
$0.00 |
| 0402 |
|
638 |
621 |
$0.00 |
| 0483 |
|
15 |
15 |
$0.00 |
| 0351 |
|
43 |
42 |
$0.00 |
| 0412 |
|
27 |
27 |
$0.00 |
| 0309 |
|
42 |
37 |
$0.00 |
| 0352 |
|
71 |
67 |
$0.00 |
| 0740 |
|
15 |
15 |
$0.00 |
| 0440 |
|
13 |
12 |
$0.00 |
| Q4051 |
Splint supplies misc |
48 |
28 |
$0.00 |
| 0771 |
|
22 |
21 |
$0.00 |