| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
21,914 |
19,070 |
$42.76M |
| 99283 |
|
100,630 |
89,393 |
$23.73M |
| 99284 |
|
52,550 |
45,752 |
$22.14M |
| J1745 |
Infliximab not biosimil 10mg |
7,571 |
6,359 |
$15.13M |
| 42820 |
|
2,838 |
2,685 |
$14.46M |
| 99282 |
|
83,765 |
75,034 |
$11.37M |
| 97110 |
|
92,916 |
33,336 |
$6.89M |
| J3380 |
Inj vedolizumab iv 1 mg |
1,586 |
1,088 |
$6.87M |
| 95810 |
|
5,598 |
5,332 |
$5.41M |
| G0379 |
Direct refer hospital observ |
2,065 |
1,835 |
$4.45M |
| 92507 |
|
46,693 |
24,284 |
$4.29M |
| 97530 |
|
84,103 |
32,222 |
$4.18M |
| 42830 |
|
1,492 |
1,421 |
$4.02M |
| 69436 |
|
3,896 |
3,683 |
$3.48M |
| 96413 |
|
9,727 |
7,743 |
$3.03M |
| 93303 |
|
6,320 |
5,719 |
$2.88M |
| 93306 |
|
5,876 |
5,419 |
$2.85M |
| 95782 |
|
2,810 |
2,719 |
$2.81M |
| 43239 |
|
4,422 |
4,079 |
$2.77M |
| 87636 |
|
19,435 |
16,747 |
$2.40M |
| 44970 |
|
443 |
405 |
$2.20M |
| 96365 |
|
12,244 |
9,624 |
$2.18M |
| 93304 |
|
3,814 |
3,327 |
$1.93M |
| 92587 |
|
7,081 |
6,727 |
$1.92M |
| 76705 |
|
14,778 |
12,557 |
$1.91M |
| G0330 |
Facility svs dental rehab |
1,361 |
1,238 |
$1.90M |
| G0463 |
Hospital outpt clinic visit |
14,701 |
12,235 |
$1.71M |
| 96374 |
|
11,898 |
10,048 |
$1.70M |
| 71046 |
|
24,198 |
21,051 |
$1.68M |
| 92523 |
|
7,034 |
6,649 |
$1.67M |
| J1569 |
Gammagard liquid injection |
731 |
446 |
$1.66M |
| 92579 |
|
12,995 |
12,327 |
$1.50M |
| 54161 |
|
1,082 |
1,014 |
$1.47M |
| 70553 |
|
3,443 |
3,177 |
$1.44M |
| 76770 |
|
12,824 |
11,837 |
$1.39M |
| 93975 |
|
7,268 |
6,193 |
$1.39M |
| 96360 |
|
8,211 |
7,238 |
$1.21M |
| 41899 |
|
4,836 |
4,313 |
$1.20M |
| 94010 |
|
8,829 |
8,234 |
$1.15M |
| 45380 |
|
1,179 |
1,048 |
$1.10M |
| 92552 |
|
8,854 |
8,228 |
$858K |
| 99281 |
|
10,811 |
9,938 |
$831K |
| 92610 |
|
3,795 |
3,510 |
$823K |
| 70551 |
|
3,643 |
3,062 |
$787K |
| 92526 |
|
8,054 |
5,428 |
$727K |
| 96361 |
|
16,322 |
11,779 |
$723K |
| 92582 |
|
5,529 |
5,220 |
$719K |
| 97161 |
|
9,475 |
8,795 |
$694K |
| 94060 |
|
2,495 |
2,338 |
$686K |
| 97162 |
|
9,394 |
8,551 |
$669K |
| 36430 |
|
2,038 |
1,287 |
$647K |
| 93005 |
|
34,431 |
30,501 |
$633K |
| 97112 |
|
13,078 |
6,937 |
$596K |
| 95812 |
|
2,228 |
2,078 |
$586K |
| 95716 |
|
626 |
555 |
$559K |
| 97165 |
|
6,457 |
5,966 |
$552K |
| U0004 |
Cov-19 test non-cdc hgh thru |
7,909 |
6,808 |
$522K |
| 76700 |
|
4,378 |
4,042 |
$521K |
| 96415 |
|
7,538 |
6,605 |
$516K |
| 49452 |
|
952 |
542 |
$494K |
| 96375 |
|
11,739 |
8,799 |
$439K |
| 73100 |
|
5,527 |
4,028 |
$425K |
| 72170 |
|
4,421 |
4,068 |
$423K |
| 70450 |
|
3,934 |
3,435 |
$417K |
| 92553 |
|
3,085 |
2,864 |
$408K |
| 73610 |
|
8,485 |
7,016 |
$383K |
| 72197 |
|
518 |
480 |
$380K |
| 96366 |
|
4,562 |
3,095 |
$373K |
| 95819 |
|
1,430 |
1,329 |
$371K |
| 73721 |
|
1,587 |
1,435 |
$361K |
| 77072 |
|
3,614 |
3,359 |
$354K |
| 96409 |
|
1,616 |
1,033 |
$348K |
| 93308 |
|
1,589 |
1,425 |
$347K |
| 92611 |
|
1,524 |
1,413 |
$345K |
| U0003 |
Cov-19 amp prb hgh thruput |
4,471 |
3,933 |
$345K |
| C9399 |
Unclassified drugs or biolog |
6,313 |
3,678 |
$340K |
| 95951 |
|
424 |
353 |
$338K |
| 76825 |
|
641 |
601 |
$327K |
| 73564 |
|
4,946 |
4,418 |
$279K |
| 95700 |
|
1,479 |
1,370 |
$275K |
| 72081 |
|
4,464 |
4,160 |
$269K |
| 92652 |
|
1,158 |
1,036 |
$268K |
| J0585 |
Injection,onabotulinumtoxina |
489 |
239 |
$260K |
| 73090 |
|
5,098 |
3,624 |
$249K |
| 74240 |
|
1,724 |
1,591 |
$232K |
| 24538 |
|
46 |
37 |
$231K |
| 97166 |
|
2,765 |
2,519 |
$230K |
| 74230 |
|
1,575 |
1,442 |
$227K |
| V5090 |
Hearing aid dispensing fee |
443 |
370 |
$223K |
| 73070 |
|
2,848 |
2,218 |
$216K |
| 73140 |
|
4,857 |
4,090 |
$215K |
| 73630 |
|
5,968 |
4,913 |
$214K |
| 87635 |
|
4,827 |
4,380 |
$213K |
| 72082 |
|
2,038 |
1,879 |
$212K |
| 92585 |
|
891 |
812 |
$202K |
| 76856 |
|
4,723 |
4,095 |
$202K |
| 73590 |
|
4,599 |
3,516 |
$197K |
| 76536 |
|
2,930 |
2,671 |
$193K |
| 73080 |
|
4,111 |
3,196 |
$191K |
| 76885 |
|
2,419 |
2,262 |
$186K |
| 31526 |
|
110 |
109 |
$179K |
| 73560 |
|
3,506 |
2,829 |
$177K |
| 54640 |
|
67 |
64 |
$170K |
| 76506 |
|
1,686 |
1,560 |
$169K |
| 76881 |
|
1,527 |
1,306 |
$153K |
| 0202U |
|
452 |
419 |
$148K |
| 95714 |
|
307 |
289 |
$142K |
| 71045 |
|
2,611 |
2,189 |
$140K |
| 73110 |
|
3,659 |
3,023 |
$140K |
| 86900 |
|
4,343 |
3,035 |
$138K |
| 77073 |
|
1,541 |
1,445 |
$136K |
| 74018 |
|
3,844 |
3,366 |
$131K |
| 92508 |
|
1,851 |
680 |
$121K |
| 75561 |
|
218 |
183 |
$113K |
| P9016 |
Rbc leukocytes reduced |
307 |
258 |
$111K |
| 95816 |
|
454 |
430 |
$111K |
| 73130 |
|
3,501 |
2,917 |
$109K |
| 97116 |
|
2,163 |
1,218 |
$107K |
| 25605 |
|
113 |
69 |
$107K |
| 97113 |
|
1,636 |
575 |
$106K |
| 96372 |
|
5,075 |
3,591 |
$105K |
| 96367 |
|
2,009 |
1,496 |
$99K |
| 74177 |
|
731 |
659 |
$94K |
| 96450 |
|
313 |
255 |
$94K |
| 83036 |
|
10,834 |
10,001 |
$81K |
| 72100 |
|
1,371 |
1,241 |
$78K |
| 74183 |
|
544 |
499 |
$77K |
| 76870 |
|
2,916 |
2,450 |
$77K |
| 73521 |
|
1,681 |
1,518 |
$75K |
| 73030 |
|
1,954 |
1,692 |
$75K |
| 94640 |
|
13,297 |
10,829 |
$74K |
| 72141 |
|
238 |
206 |
$73K |
| 73552 |
|
1,982 |
1,674 |
$71K |
| V5264 |
Ear mold/insert |
1,679 |
1,497 |
$71K |
| 97140 |
|
21,939 |
7,780 |
$69K |
| 73000 |
|
1,387 |
1,237 |
$68K |
| 93017 |
|
302 |
275 |
$67K |
| 73562 |
|
1,144 |
951 |
$61K |
| 85025 |
|
39,151 |
29,816 |
$58K |
| 74019 |
|
9,989 |
8,725 |
$58K |
| 92522 |
|
242 |
234 |
$57K |
| 92557 |
|
485 |
442 |
$56K |
| 82947 |
|
16,229 |
13,888 |
$51K |
| 72148 |
|
500 |
454 |
$49K |
| V5261 |
Hearing aid, digit, bin, bte |
71 |
62 |
$48K |
| 97533 |
|
688 |
342 |
$45K |
| 10060 |
|
261 |
229 |
$45K |
| 0001A |
|
1,188 |
1,087 |
$42K |
| 92555 |
|
16,926 |
15,832 |
$40K |
| 0002A |
|
1,051 |
999 |
$39K |
| 71260 |
|
208 |
192 |
$39K |
| 97542 |
|
595 |
548 |
$38K |
| 20680 |
|
14 |
14 |
$37K |
| U0002 |
Covid-19 lab test non-cdc |
798 |
718 |
$35K |
| 85246 |
|
1,461 |
1,161 |
$34K |
| 94667 |
|
704 |
670 |
$33K |
| 92567 |
|
24,694 |
23,206 |
$32K |
| 51784 |
|
368 |
246 |
$29K |
| 82728 |
|
3,954 |
3,484 |
$29K |
| 73060 |
|
788 |
618 |
$28K |
| 95811 |
|
28 |
27 |
$28K |
| 90375 |
|
19 |
12 |
$27K |
| G0378 |
Hospital observation per hr |
16,695 |
13,479 |
$27K |
| 76800 |
|
251 |
244 |
$26K |
| 67311 |
|
13 |
13 |
$26K |
| 97535 |
|
5,132 |
2,673 |
$23K |
| 92651 |
|
113 |
106 |
$23K |
| 80053 |
|
10,294 |
8,046 |
$23K |
| L4350 |
Ankle control ortho pre ots |
608 |
520 |
$22K |
| 73660 |
|
618 |
528 |
$20K |
| 70360 |
|
627 |
574 |
$20K |
| 87631 |
|
5,427 |
5,025 |
$19K |
| 24640 |
|
84 |
79 |
$19K |
| 77077 |
|
222 |
212 |
$19K |
| 73620 |
|
620 |
420 |
$18K |
| 76000 |
|
602 |
385 |
$18K |
| 71250 |
|
171 |
164 |
$18K |
| 87491 |
|
1,953 |
1,744 |
$17K |
| 87591 |
|
1,957 |
1,747 |
$17K |
| 86902 |
|
101 |
88 |
$16K |
| 95813 |
|
54 |
54 |
$14K |
| 82962 |
|
16,421 |
13,576 |
$14K |
| 29105 |
|
89 |
82 |
$13K |
| 83550 |
|
2,394 |
2,140 |
$13K |
| 85240 |
|
1,145 |
1,027 |
$13K |
| 76641 |
|
193 |
133 |
$13K |
| 97014 |
|
290 |
166 |
$12K |
| 76857 |
|
144 |
115 |
$11K |
| 74455 |
|
46 |
43 |
$11K |
| 92593 |
|
663 |
601 |
$10K |
| 83540 |
|
2,469 |
2,203 |
$10K |
| 74210 |
|
41 |
41 |
$9K |
| 85045 |
|
5,202 |
4,285 |
$9K |
| 74220 |
|
55 |
51 |
$7K |
| 86923 |
|
882 |
692 |
$7K |
| 95953 |
|
12 |
12 |
$7K |
| L1830 |
Ko immob canvas long pre ots |
134 |
122 |
$6K |
| 72156 |
|
26 |
25 |
$6K |
| 94664 |
|
48 |
48 |
$6K |
| 72040 |
|
252 |
220 |
$5K |
| 85730 |
|
6,119 |
5,264 |
$5K |
| 84443 |
|
2,352 |
2,044 |
$5K |
| V5257 |
Hearing aid, digit, mon, bte |
18 |
14 |
$5K |
| 0071A |
|
121 |
118 |
$5K |
| 72070 |
|
128 |
119 |
$5K |
| J3490 |
Drugs unclassified injection |
284,454 |
110,332 |
$4K |
| 0072A |
|
102 |
102 |
$4K |
| 64615 |
|
13 |
13 |
$4K |
| 83021 |
|
463 |
397 |
$4K |
| 73600 |
|
68 |
49 |
$4K |
| 70491 |
|
12 |
12 |
$4K |
| 82784 |
|
958 |
767 |
$4K |
| J0134 |
Inj acetaminophen -fresenius |
11,305 |
5,523 |
$4K |
| 90675 |
|
14 |
12 |
$4K |
| 72157 |
|
40 |
38 |
$4K |
| 82306 |
|
422 |
375 |
$4K |
| 92586 |
|
27 |
26 |
$4K |
| 85610 |
|
6,353 |
5,410 |
$3K |
| 96411 |
|
39 |
25 |
$3K |
| 93325 |
|
13,215 |
11,704 |
$3K |
| 74712 |
|
13 |
13 |
$3K |
| 85250 |
|
275 |
263 |
$3K |
| 77080 |
|
41 |
28 |
$3K |
| 83735 |
|
7,062 |
5,258 |
$3K |
| 94726 |
|
28 |
27 |
$3K |
| 76826 |
|
12 |
12 |
$3K |
| 85384 |
|
590 |
530 |
$3K |
| 88305 |
|
7,854 |
5,848 |
$3K |
| 12001 |
|
1,337 |
1,269 |
$3K |
| 72158 |
|
41 |
41 |
$2K |
| 76010 |
|
1,171 |
1,076 |
$2K |
| 92591 |
|
76 |
67 |
$2K |
| 12011 |
|
2,114 |
1,999 |
$2K |
| 0012A |
|
142 |
87 |
$2K |
| 72146 |
|
44 |
36 |
$2K |
| 85027 |
|
2,378 |
2,093 |
$2K |
| J2704 |
Inj, propofol, 10 mg |
28,268 |
24,329 |
$2K |
| 83615 |
|
2,466 |
2,098 |
$2K |
| 92602 |
|
14 |
13 |
$2K |
| 72125 |
|
76 |
63 |
$2K |
| 76820 |
|
1,130 |
1,025 |
$2K |
| 94644 |
|
1,337 |
1,036 |
$2K |
| 81003 |
|
27,398 |
20,185 |
$2K |
| 90471 |
|
1,163 |
1,029 |
$2K |
| 14040 |
|
52 |
49 |
$2K |
| 86780 |
|
155 |
145 |
$2K |
| 36415 |
|
1,207 |
1,054 |
$2K |
| 77074 |
|
13 |
13 |
$2K |
| J0131 |
Inj, acetaminophen (nos) |
8,927 |
4,496 |
$2K |
| 84439 |
|
1,767 |
1,526 |
$2K |
| 80307 |
|
6,342 |
5,471 |
$1K |
| 92556 |
|
1,434 |
1,339 |
$1K |
| 86140 |
|
14,308 |
11,748 |
$1K |
| 88342 |
|
1,448 |
1,278 |
$1K |
| 72083 |
|
12 |
12 |
$1K |
| 84100 |
|
7,132 |
5,290 |
$1K |
| 85652 |
|
5,727 |
4,812 |
$1K |
| 81025 |
|
17,527 |
15,226 |
$1K |
| 80047 |
|
803 |
516 |
$1K |
| 73700 |
|
16 |
12 |
$1K |
| 70486 |
|
13 |
13 |
$1K |
| 97163 |
|
15 |
14 |
$1K |
| 97167 |
|
14 |
12 |
$1K |
| 76604 |
|
42 |
41 |
$1K |
| 85007 |
|
852 |
749 |
$1K |
| 82330 |
|
11,459 |
9,709 |
$1K |
| 87502 |
|
4,944 |
4,686 |
$1K |
| 85270 |
|
70 |
67 |
$974.70 |
| 76821 |
|
1,136 |
1,031 |
$967.53 |
| 0111A |
|
59 |
25 |
$920.00 |
| 95012 |
|
1,052 |
963 |
$899.41 |
| 97032 |
|
14 |
12 |
$882.00 |
| 80048 |
|
4,226 |
3,556 |
$864.61 |
| J7030 |
Normal saline solution infus |
22,092 |
15,003 |
$859.17 |
| 82248 |
|
2,601 |
2,064 |
$849.33 |
| J2272 |
Inj, morphine (fresenius) |
1,501 |
1,385 |
$781.01 |
| 90686 |
|
201 |
188 |
$761.20 |
| 80076 |
|
5,057 |
4,253 |
$743.22 |
| J1100 |
Dexamethasone sodium phos |
41,548 |
35,048 |
$731.94 |
| J7050 |
Normal saline solution infus |
37,085 |
22,411 |
$703.01 |
| 86665 |
|
380 |
350 |
$690.71 |
| J2405 |
Ondansetron hcl injection |
41,061 |
26,837 |
$689.92 |
| 82565 |
|
16,483 |
13,999 |
$672.73 |
| L3908 |
Who cock-up nonmolde pre ots |
40 |
30 |
$640.15 |
| J1642 |
Inj heparin sodium per 10 u |
1,558 |
1,146 |
$639.64 |
| J1885 |
Ketorolac tromethamine inj |
37,697 |
19,687 |
$556.19 |
| J2250 |
Inj midazolam hydrochloride |
7,269 |
6,198 |
$537.91 |
| J0690 |
Cefazolin sodium injection |
9,023 |
5,375 |
$532.05 |
| 85014 |
|
1,922 |
1,620 |
$481.11 |
| 0112A |
|
27 |
13 |
$480.00 |
| 76376 |
|
844 |
726 |
$380.86 |
| 82977 |
|
5,683 |
4,865 |
$377.83 |
| 85041 |
|
264 |
226 |
$365.75 |
| 87077 |
|
2,726 |
2,390 |
$363.89 |
| 76827 |
|
641 |
601 |
$363.03 |
| 82803 |
|
2,840 |
2,363 |
$361.29 |
| 87086 |
|
10,835 |
9,672 |
$356.48 |
| 83880 |
|
836 |
698 |
$330.09 |
| 92592 |
|
31 |
30 |
$323.64 |
| 85018 |
|
314 |
273 |
$323.18 |
| J2270 |
Morphine sulfate injection |
15,906 |
12,843 |
$307.11 |
| 82247 |
|
1,568 |
1,347 |
$301.54 |
| 86664 |
|
343 |
322 |
$290.42 |
| 86850 |
|
4,321 |
3,016 |
$280.37 |
| 84145 |
|
2,163 |
1,856 |
$274.88 |
| 80061 |
|
25 |
25 |
$274.15 |
| J7120 |
Ringers lactate infusion |
17,873 |
16,369 |
$264.16 |
| J3010 |
Fentanyl citrate injection |
18,525 |
16,665 |
$261.08 |
| 86663 |
|
274 |
259 |
$249.08 |
| 84702 |
|
275 |
240 |
$236.07 |
| 87651 |
|
1,081 |
1,030 |
$231.76 |
| 82010 |
|
64 |
49 |
$230.10 |
| 83690 |
|
4,610 |
3,966 |
$221.48 |
| 87070 |
|
2,446 |
2,160 |
$208.48 |
| L3670 |
So acro/clav can web pre ots |
13 |
12 |
$197.16 |
| 87186 |
|
2,060 |
1,827 |
$194.55 |
| J7699 |
Inhalation solution for dme |
746 |
640 |
$192.20 |
| 82435 |
|
15,780 |
13,520 |
$184.82 |
| 83605 |
|
856 |
699 |
$183.15 |
| G0480 |
Drug test def 1-7 classes |
2,104 |
1,744 |
$179.07 |
| 85230 |
|
13 |
12 |
$171.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
938 |
663 |
$157.40 |
| 87040 |
|
3,689 |
3,163 |
$156.92 |
| J1170 |
Hydromorphone injection |
3,147 |
2,165 |
$153.52 |
| J1200 |
Diphenhydramine hcl injectio |
2,817 |
2,001 |
$153.52 |
| J3535 |
Metered dose inhaler drug |
10,643 |
9,709 |
$143.32 |
| 82150 |
|
2,040 |
1,767 |
$141.11 |
| Q0162 |
Ondansetron oral |
27,190 |
24,058 |
$131.84 |
| 84520 |
|
15,856 |
13,574 |
$130.25 |
| 84295 |
|
16,270 |
13,898 |
$126.61 |
| 86901 |
|
4,326 |
3,021 |
$125.91 |
| 82374 |
|
15,680 |
13,450 |
$124.93 |
| 82570 |
|
52 |
42 |
$113.62 |
| J1720 |
Hydrocortisone sodium succ i |
191 |
122 |
$110.64 |
| 87880 |
|
7,187 |
6,607 |
$110.42 |
| 87205 |
|
2,419 |
2,132 |
$106.06 |
| 84132 |
|
16,294 |
13,927 |
$105.55 |
| 86038 |
|
34 |
26 |
$103.86 |
| 88304 |
|
1,942 |
1,792 |
$102.19 |
| 87081 |
|
5,507 |
5,041 |
$96.68 |
| A9585 |
Gadobutrol injection |
12,159 |
5,909 |
$83.24 |
| 82550 |
|
1,312 |
1,126 |
$80.22 |
| 87328 |
|
510 |
485 |
$80.15 |
| 82105 |
|
12 |
12 |
$80.10 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
2,199 |
2,012 |
$75.00 |
| 86364 |
|
86 |
68 |
$66.12 |
| J7644 |
Ipratropium bromide non-comp |
9,242 |
8,115 |
$58.32 |
| 84450 |
|
2,107 |
1,841 |
$56.20 |
| 86618 |
|
351 |
274 |
$48.81 |
| 85379 |
|
80 |
70 |
$48.60 |
| J7611 |
Albuterol non-comp con |
12,588 |
9,916 |
$42.75 |
| 82040 |
|
830 |
739 |
$41.95 |
| 76828 |
|
12 |
12 |
$40.26 |
| 36416 |
|
11,637 |
10,193 |
$35.49 |
| 29125 |
|
266 |
243 |
$32.27 |
| 84460 |
|
2,068 |
1,813 |
$25.55 |
| 81001 |
|
4,556 |
4,212 |
$23.71 |
| J1836 |
Inj, metronidazole, 10 mg |
150 |
93 |
$23.40 |
| 84484 |
|
923 |
763 |
$22.00 |
| 90472 |
|
12 |
12 |
$22.00 |
| 87184 |
|
376 |
321 |
$19.78 |
| 87340 |
|
70 |
69 |
$19.74 |
| 84550 |
|
304 |
266 |
$17.84 |
| 87075 |
|
167 |
154 |
$16.99 |
| 80069 |
|
28 |
24 |
$16.60 |
| J3480 |
Inj potassium chloride |
8,252 |
5,500 |
$15.01 |
| J8499 |
Oral prescrip drug non chemo |
18,558 |
4,118 |
$14.19 |
| 82140 |
|
12 |
12 |
$13.92 |
| 86706 |
|
48 |
47 |
$10.26 |
| 89050 |
|
99 |
88 |
$8.47 |
| A4606 |
Oxygen probe used w oximeter |
3,793 |
3,222 |
$5.00 |
| 86308 |
|
143 |
129 |
$4.94 |
| Q0163 |
Diphenhydramine hcl 50mg |
9,292 |
6,875 |
$4.19 |
| J7040 |
Normal saline solution infus |
10,667 |
8,293 |
$4.09 |
| 84075 |
|
955 |
836 |
$1.44 |
| J0696 |
Ceftriaxone sodium injection |
4,711 |
3,288 |
$0.18 |
| A4217 |
Sterile water/saline, 500 ml |
1,251 |
845 |
$0.00 |
| L8699 |
Prosthetic implant nos |
3,167 |
2,988 |
$0.00 |
| 96376 |
|
2,887 |
1,859 |
$0.00 |
| 93320 |
|
6,457 |
5,832 |
$0.00 |
| 90656 |
|
26 |
26 |
$0.00 |
| J1815 |
Insulin injection |
982 |
159 |
$0.00 |
| J7042 |
5% dextrose/normal saline |
598 |
441 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
582 |
555 |
$0.00 |
| 94760 |
|
319 |
291 |
$0.00 |
| J9250 |
Methotrexate sodium inj |
125 |
102 |
$0.00 |
| C1769 |
Guide wire |
872 |
586 |
$0.00 |
| J2001 |
Lidocaine injection |
4,678 |
3,342 |
$0.00 |
| J7626 |
Budesonide non-comp unit |
143 |
72 |
$0.00 |
| J2920 |
Methylprednisolone injection |
876 |
789 |
$0.00 |
| J2060 |
Lorazepam injection |
383 |
211 |
$0.00 |
| J7799 |
Non-inhalation drug for dme |
552 |
343 |
$0.00 |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
565 |
328 |
$0.00 |
| 91307 |
|
226 |
185 |
$0.00 |
| J2765 |
Metoclopramide hcl injection |
566 |
449 |
$0.00 |
| 96111 |
|
290 |
264 |
$0.00 |
| 86803 |
|
125 |
117 |
$0.00 |
| 51798 |
|
78 |
53 |
$0.00 |
| 96112 |
|
315 |
299 |
$0.00 |
| 12002 |
|
72 |
71 |
$0.00 |
| 12013 |
|
26 |
13 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
94 |
75 |
$0.00 |
| 99156 |
|
61 |
44 |
$0.00 |
| 82553 |
|
142 |
118 |
$0.00 |
| 76377 |
|
344 |
318 |
$0.00 |
| J7060 |
5% dextrose/water |
150 |
117 |
$0.00 |
| A9150 |
Misc/exper non-prescript dru |
11,694 |
8,912 |
$0.00 |
| 85660 |
|
37 |
25 |
$0.00 |
| J7613 |
Albuterol non-comp unit |
186 |
149 |
$0.00 |
| 82533 |
|
17 |
17 |
$0.00 |
| B4088 |
Gastro/jejuno tube, low-pro |
159 |
93 |
$0.00 |
| 82077 |
|
139 |
123 |
$0.00 |
| 87046 |
|
71 |
66 |
$0.00 |
| 81015 |
|
64 |
63 |
$0.00 |
| 94200 |
|
39 |
37 |
$0.00 |
| 51600 |
|
32 |
29 |
$0.00 |
| 86920 |
|
21 |
16 |
$0.00 |
| 84703 |
|
13 |
13 |
$0.00 |
| 91301 |
|
154 |
96 |
$0.00 |
| J0461 |
Atropine sulfate injection |
40 |
25 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
57 |
52 |
$0.00 |
| J7070 |
D5w infusion |
224 |
154 |
$0.00 |
| 51741 |
|
137 |
84 |
$0.00 |
| 98960 |
|
748 |
714 |
$0.00 |
| 93321 |
|
5,310 |
4,688 |
$0.00 |
| 94645 |
|
277 |
221 |
$0.00 |
| 91311 |
|
86 |
25 |
$0.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
307 |
103 |
$0.00 |
| 96113 |
|
377 |
339 |
$0.00 |
| J7510 |
Prednisolone oral per 5 mg |
441 |
329 |
$0.00 |
| J2930 |
Methylprednisolone injection |
1,378 |
1,102 |
$0.00 |
| J2274 |
Inj morphine pf epid ithc |
477 |
453 |
$0.00 |
| 80143 |
|
205 |
175 |
$0.00 |
| 75565 |
|
240 |
192 |
$0.00 |
| 76937 |
|
88 |
71 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
1,394 |
854 |
$0.00 |
| J9370 |
Vincristine sulfate 1 mg inj |
1,587 |
841 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
5,887 |
3,493 |
$0.00 |
| J7676 |
Pentamidine comp unit dose |
356 |
313 |
$0.00 |
| J0780 |
Prochlorperazine injection |
290 |
253 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
382 |
258 |
$0.00 |
| 92595 |
|
155 |
132 |
$0.00 |
| J7610 |
Albuterol comp con |
866 |
773 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
169 |
87 |
$0.00 |
| 91300 |
|
2,239 |
1,835 |
$0.00 |
| 88313 |
|
33 |
28 |
$0.00 |
| L8612 |
Aqueous shunt prosthesis |
114 |
107 |
$0.00 |
| 82375 |
|
15 |
15 |
$0.00 |
| 80179 |
|
181 |
155 |
$0.00 |
| 51701 |
|
79 |
74 |
$0.00 |
| 94729 |
|
12 |
12 |
$0.00 |
| 81002 |
|
170 |
155 |
$0.00 |
| C8909 |
Mra w/cont, chest |
26 |
25 |
$0.00 |
| Q9961 |
Hocm 250-299mg/ml iodine,1ml |
136 |
97 |
$0.00 |
| S0080 |
Injection, pentamidine iseth |
16 |
12 |
$0.00 |
| 87427 |
|
57 |
53 |
$0.00 |
| J0688 |
Inj cefazolin sodium, hikma |
28 |
20 |
$0.00 |
| 76882 |
|
12 |
12 |
$0.00 |
| 87045 |
|
57 |
53 |
$0.00 |
| 92594 |
|
13 |
12 |
$0.00 |
| 87798 |
|
13 |
13 |
$0.00 |
| A6250 |
Skin seal protect moisturizr |
77 |
74 |
$0.00 |
| J0136 |
Inj, acetaminophen (b braun) |
2,947 |
1,456 |
$0.00 |
| 86705 |
|
13 |
13 |
$0.00 |
| 69200 |
|
12 |
12 |
$0.00 |
| A4565 |
Slings |
26 |
17 |
$0.00 |