| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
47,093 |
43,957 |
$15.19M |
| 99284 |
|
73,316 |
68,228 |
$12.06M |
| 99283 |
|
62,747 |
58,992 |
$7.94M |
| G0463 |
Hospital outpt clinic visit |
105,933 |
97,139 |
$5.46M |
| G0378 |
Hospital observation per hr |
16,279 |
14,518 |
$4.27M |
| 96374 |
|
51,773 |
47,401 |
$4.17M |
| 96361 |
|
30,972 |
26,353 |
$1.20M |
| 93306 |
|
6,587 |
6,495 |
$1.10M |
| 99282 |
|
11,302 |
9,883 |
$951K |
| 80061 |
|
2,791 |
2,715 |
$911K |
| 71046 |
|
26,386 |
25,458 |
$779K |
| 78452 |
|
1,910 |
1,886 |
$772K |
| 70450 |
|
11,456 |
11,125 |
$768K |
| 96360 |
|
7,931 |
7,655 |
$755K |
| 74177 |
|
7,178 |
7,042 |
$710K |
| 99291 |
|
1,517 |
1,490 |
$699K |
| 77067 |
|
12,632 |
12,589 |
$599K |
| 11042 |
|
3,462 |
1,692 |
$560K |
| 96372 |
|
32,250 |
27,600 |
$531K |
| U0002 |
Covid-19 lab test non-cdc |
21,646 |
20,805 |
$510K |
| 71045 |
|
15,462 |
14,823 |
$483K |
| 20610 |
|
3,263 |
3,083 |
$483K |
| 97110 |
|
19,151 |
5,073 |
$472K |
| 93458 |
|
329 |
323 |
$471K |
| 82947 |
|
24,999 |
16,376 |
$456K |
| 76830 |
|
7,883 |
7,701 |
$395K |
| 74176 |
|
5,135 |
5,046 |
$395K |
| 96375 |
|
24,760 |
20,635 |
$393K |
| 43239 |
|
1,222 |
1,209 |
$388K |
| 76856 |
|
8,363 |
8,175 |
$375K |
| 99281 |
|
6,063 |
5,355 |
$367K |
| 71260 |
|
3,107 |
3,038 |
$305K |
| 96365 |
|
4,887 |
4,628 |
$275K |
| 70553 |
|
1,532 |
1,516 |
$270K |
| 80048 |
|
62,283 |
52,248 |
$268K |
| 99396 |
|
9,160 |
9,085 |
$252K |
| 76705 |
|
4,372 |
4,122 |
$197K |
| 45378 |
|
467 |
466 |
$185K |
| 62323 |
|
580 |
565 |
$183K |
| 99395 |
|
6,279 |
6,208 |
$173K |
| 72148 |
|
2,159 |
2,144 |
$171K |
| 76801 |
|
3,295 |
3,132 |
$156K |
| 87624 |
|
9,297 |
8,697 |
$148K |
| 93975 |
|
1,553 |
1,515 |
$146K |
| 72141 |
|
1,210 |
1,207 |
$145K |
| 45380 |
|
330 |
329 |
$144K |
| 73721 |
|
1,179 |
1,136 |
$143K |
| 93971 |
|
3,411 |
3,313 |
$142K |
| 77063 |
|
11,193 |
11,171 |
$139K |
| 93970 |
|
1,729 |
1,706 |
$138K |
| 90471 |
|
10,411 |
10,166 |
$135K |
| 97140 |
|
10,050 |
3,178 |
$133K |
| 76700 |
|
1,875 |
1,860 |
$117K |
| 71275 |
|
1,929 |
1,901 |
$116K |
| 97530 |
|
5,940 |
2,684 |
$111K |
| 70496 |
|
1,578 |
1,539 |
$108K |
| 76642 |
|
3,144 |
2,818 |
$103K |
| 76770 |
|
2,069 |
2,043 |
$102K |
| 76536 |
|
2,181 |
2,162 |
$100K |
| 97161 |
|
1,985 |
1,914 |
$97K |
| 93005 |
|
35,873 |
33,422 |
$96K |
| 10060 |
|
1,031 |
1,007 |
$95K |
| Q3014 |
Telehealth facility fee |
5,765 |
5,507 |
$90K |
| 93017 |
|
2,907 |
2,869 |
$87K |
| U0003 |
Cov-19 amp prb hgh thruput |
3,099 |
3,013 |
$87K |
| 87635 |
|
2,797 |
2,725 |
$76K |
| 88305 |
|
8,888 |
8,625 |
$73K |
| 93351 |
|
935 |
915 |
$73K |
| 97112 |
|
3,287 |
1,313 |
$71K |
| 58558 |
|
54 |
53 |
$70K |
| 97162 |
|
1,532 |
1,505 |
$67K |
| 99392 |
|
1,377 |
1,353 |
$66K |
| 87491 |
|
10,156 |
9,952 |
$65K |
| 59025 |
|
874 |
570 |
$63K |
| 87591 |
|
10,159 |
9,954 |
$61K |
| 99391 |
|
1,281 |
1,187 |
$59K |
| G0145 |
Scr c/v cyto,thinlayer,rescr |
5,404 |
5,258 |
$57K |
| 71250 |
|
1,344 |
1,332 |
$56K |
| 73564 |
|
6,100 |
5,796 |
$55K |
| 72131 |
|
1,770 |
1,747 |
$54K |
| 90686 |
|
2,754 |
2,690 |
$53K |
| 70486 |
|
2,058 |
2,037 |
$53K |
| 70551 |
|
631 |
619 |
$52K |
| 88175 |
|
2,903 |
2,894 |
$52K |
| 96366 |
|
2,910 |
2,229 |
$50K |
| 76811 |
|
400 |
400 |
$49K |
| 20611 |
|
317 |
302 |
$48K |
| 72125 |
|
5,240 |
5,135 |
$48K |
| 36430 |
|
477 |
376 |
$47K |
| 77065 |
Tomosynthesis, mammo |
1,045 |
952 |
$44K |
| 73502 |
|
2,940 |
2,830 |
$41K |
| 76816 |
|
902 |
787 |
$39K |
| 72110 |
|
1,262 |
1,246 |
$38K |
| 77066 |
Tomosynthesis, mammo |
652 |
646 |
$37K |
| 99385 |
|
1,323 |
1,309 |
$36K |
| 78815 |
|
49 |
49 |
$36K |
| 99394 |
|
1,486 |
1,465 |
$35K |
| 73030 |
|
5,285 |
5,012 |
$35K |
| 99393 |
|
1,529 |
1,517 |
$34K |
| 71271 |
|
663 |
663 |
$34K |
| 12001 |
|
1,249 |
1,227 |
$33K |
| 80053 |
|
30,410 |
25,533 |
$32K |
| 99495 |
|
555 |
536 |
$30K |
| 77080 |
|
570 |
568 |
$29K |
| 73562 |
|
2,344 |
1,914 |
$28K |
| 72100 |
|
2,187 |
2,164 |
$27K |
| 90460 |
|
2,175 |
2,111 |
$27K |
| P9016 |
Rbc leukocytes reduced |
374 |
291 |
$26K |
| 45385 |
|
54 |
54 |
$26K |
| 73221 |
|
194 |
187 |
$26K |
| 86900 |
|
11,297 |
10,702 |
$25K |
| 73610 |
|
4,047 |
3,860 |
$25K |
| 73630 |
|
4,736 |
4,567 |
$25K |
| 74178 |
|
209 |
207 |
$24K |
| 70491 |
|
264 |
263 |
$23K |
| 97165 |
|
657 |
640 |
$23K |
| 88304 |
|
2,223 |
2,176 |
$22K |
| 86780 |
|
568 |
553 |
$20K |
| 88307 |
|
483 |
463 |
$19K |
| 74018 |
|
2,631 |
2,506 |
$19K |
| U0005 |
Infec agen detec ampli probe |
2,026 |
1,974 |
$18K |
| 73130 |
|
3,841 |
3,760 |
$18K |
| 76815 |
|
4,450 |
3,918 |
$18K |
| 88342 |
|
1,211 |
1,174 |
$17K |
| 90674 |
|
594 |
588 |
$17K |
| 74019 |
|
1,978 |
1,942 |
$17K |
| 90670 |
|
258 |
247 |
$16K |
| 29125 |
|
692 |
673 |
$16K |
| 96160 |
|
1,476 |
1,364 |
$15K |
| 73110 |
|
2,462 |
2,328 |
$15K |
| 93350 |
|
51 |
51 |
$14K |
| 90472 |
|
1,091 |
981 |
$14K |
| 93880 |
|
218 |
213 |
$13K |
| 90656 |
|
752 |
729 |
$12K |
| 12011 |
|
424 |
418 |
$12K |
| 76805 |
|
223 |
223 |
$12K |
| 90651 |
|
227 |
226 |
$12K |
| 99406 |
|
830 |
771 |
$11K |
| M0243 |
Casirivi and imdevi inj |
43 |
43 |
$11K |
| G0108 |
Diab manage trn per indiv |
163 |
145 |
$11K |
| 99386 |
|
405 |
400 |
$11K |
| 90732 |
|
99 |
96 |
$10K |
| G0279 |
Tomosynthesis, mammo |
864 |
858 |
$10K |
| 19083 |
|
12 |
12 |
$8K |
| 73700 |
|
170 |
168 |
$8K |
| 94640 |
|
11,154 |
7,801 |
$8K |
| 97116 |
|
1,608 |
1,025 |
$7K |
| 83036 |
|
7,010 |
6,805 |
$7K |
| 72197 |
|
27 |
27 |
$7K |
| Q0091 |
Obtaining screen pap smear |
620 |
590 |
$7K |
| 76881 |
|
126 |
116 |
$7K |
| 64415 |
|
82 |
80 |
$7K |
| 72040 |
|
708 |
704 |
$6K |
| 76817 |
|
3,549 |
3,360 |
$6K |
| 12002 |
|
257 |
253 |
$6K |
| 70498 |
|
1,428 |
1,392 |
$6K |
| 29515 |
|
67 |
64 |
$6K |
| 0003A |
|
160 |
159 |
$6K |
| 73590 |
|
1,619 |
1,554 |
$5K |
| A9270 |
Non-covered item or service |
176,817 |
72,665 |
$5K |
| 80051 |
|
4,812 |
4,485 |
$5K |
| 64447 |
|
160 |
157 |
$5K |
| 73080 |
|
1,032 |
1,010 |
$5K |
| 90688 |
|
291 |
289 |
$5K |
| 76000 |
|
658 |
638 |
$5K |
| 72050 |
|
133 |
132 |
$5K |
| 72170 |
|
1,609 |
1,586 |
$4K |
| 86920 |
|
422 |
384 |
$4K |
| 94010 |
|
167 |
158 |
$4K |
| 90756 |
|
170 |
168 |
$4K |
| 90661 |
|
247 |
247 |
$4K |
| 73560 |
|
622 |
597 |
$4K |
| 73140 |
|
694 |
681 |
$4K |
| 0001A |
|
114 |
114 |
$4K |
| 97035 |
|
688 |
232 |
$4K |
| 92507 |
|
89 |
37 |
$4K |
| 71101 |
|
522 |
514 |
$4K |
| 93308 |
|
66 |
61 |
$4K |
| 83037 |
|
849 |
829 |
$3K |
| 99496 |
|
56 |
55 |
$3K |
| 85025 |
|
85,422 |
69,848 |
$3K |
| G8978 |
Mobility current status |
366 |
325 |
$3K |
| 81025 |
|
23,343 |
22,274 |
$3K |
| 0002A |
|
85 |
85 |
$3K |
| Q0112 |
Potassium hydroxide preps |
680 |
654 |
$3K |
| 36415 |
|
3,034 |
2,913 |
$3K |
| 97163 |
|
66 |
63 |
$3K |
| 80307 |
|
17,171 |
14,718 |
$3K |
| G0297 |
Ldct for lung ca screen |
66 |
66 |
$3K |
| 90677 |
|
14 |
14 |
$3K |
| 90461 |
|
771 |
747 |
$2K |
| 82565 |
|
5,167 |
4,757 |
$2K |
| 93976 |
|
69 |
67 |
$2K |
| 85610 |
|
15,995 |
14,019 |
$2K |
| 87502 |
|
16,737 |
16,389 |
$2K |
| 73090 |
|
826 |
800 |
$2K |
| 84484 |
|
26,366 |
23,091 |
$2K |
| 93225 |
|
37 |
36 |
$2K |
| 85379 |
|
6,019 |
5,884 |
$2K |
| 72128 |
|
95 |
95 |
$2K |
| 73070 |
|
207 |
189 |
$2K |
| 74022 |
|
6,262 |
6,081 |
$2K |
| 76882 |
|
56 |
54 |
$2K |
| 77091 |
|
57 |
57 |
$2K |
| 97012 |
|
343 |
90 |
$2K |
| 88341 |
|
297 |
291 |
$2K |
| 76818 |
|
35 |
12 |
$2K |
| 0012A |
|
47 |
47 |
$2K |
| 95867 |
|
739 |
723 |
$2K |
| G0008 |
Admin influenza virus vac |
455 |
436 |
$2K |
| 96376 |
|
9,726 |
6,483 |
$2K |
| J1815 |
Insulin injection |
7,507 |
3,365 |
$2K |
| 81002 |
|
7,196 |
6,324 |
$1K |
| 82962 |
|
3,810 |
2,413 |
$1K |
| 0011A |
|
51 |
51 |
$1K |
| G0123 |
Screen cerv/vag thin layer |
166 |
162 |
$1K |
| 83050 |
|
125 |
116 |
$1K |
| 86850 |
|
9,152 |
8,666 |
$1K |
| 97535 |
|
519 |
406 |
$1K |
| 88112 |
|
74 |
72 |
$1K |
| 84443 |
|
4,442 |
4,299 |
$1K |
| 0124A |
|
42 |
41 |
$1K |
| 76820 |
|
443 |
147 |
$1K |
| 87661 |
|
8,987 |
8,805 |
$1K |
| 70470 |
|
12 |
12 |
$1K |
| 85027 |
|
18,577 |
15,481 |
$1K |
| 97014 |
|
138 |
39 |
$1K |
| 84702 |
|
8,789 |
7,948 |
$1K |
| 90662 |
|
74 |
74 |
$992.33 |
| 97166 |
|
24 |
24 |
$881.40 |
| 0013A |
|
23 |
23 |
$870.55 |
| 87880 |
|
4,046 |
3,971 |
$860.75 |
| 83880 |
|
5,597 |
5,321 |
$858.16 |
| 85730 |
|
12,447 |
11,091 |
$839.75 |
| 88142 |
|
56 |
56 |
$815.07 |
| 36416 |
|
3,376 |
3,195 |
$810.07 |
| 86580 |
|
154 |
138 |
$791.91 |
| 87801 |
|
3,683 |
3,625 |
$752.24 |
| 73552 |
|
162 |
160 |
$713.53 |
| 73060 |
|
128 |
116 |
$654.28 |
| 86901 |
|
11,282 |
10,688 |
$576.31 |
| 83735 |
|
29,093 |
23,410 |
$532.37 |
| 82247 |
|
1,750 |
1,663 |
$492.77 |
| 73600 |
|
44 |
42 |
$489.85 |
| 72070 |
|
24 |
24 |
$482.28 |
| 82948 |
|
117 |
113 |
$480.74 |
| 88311 |
|
163 |
155 |
$472.90 |
| J2359 |
Inj. olanzapine, 0.5mg |
44 |
27 |
$469.16 |
| 81003 |
|
28,413 |
26,990 |
$465.96 |
| 95937 |
|
347 |
342 |
$408.02 |
| 99493 |
|
12 |
12 |
$404.62 |
| J2785 |
Regadenoson injection |
1,013 |
1,000 |
$400.00 |
| 87070 |
|
5,056 |
4,916 |
$345.46 |
| 73620 |
|
91 |
90 |
$339.09 |
| 73000 |
|
15 |
14 |
$338.31 |
| 93325 |
|
625 |
622 |
$330.00 |
| 90715 |
|
968 |
939 |
$314.03 |
| 82248 |
|
2,106 |
1,929 |
$295.45 |
| 87086 |
|
8,914 |
8,540 |
$284.96 |
| 70360 |
|
219 |
212 |
$280.57 |
| 93270 |
|
26 |
25 |
$274.26 |
| 87651 |
|
3,242 |
3,203 |
$269.94 |
| 84520 |
|
3,747 |
3,492 |
$263.12 |
| A9500 |
Tc99m sestamibi |
1,748 |
1,722 |
$250.00 |
| 86140 |
|
2,883 |
2,642 |
$237.67 |
| G2066 |
Inter devc remote 30d |
13 |
13 |
$234.36 |
| 81001 |
|
23,988 |
22,545 |
$230.55 |
| J2704 |
Inj, propofol, 10 mg |
13,904 |
13,353 |
$226.45 |
| J1644 |
Inj heparin sodium per 1000u |
10,713 |
5,835 |
$220.25 |
| J1885 |
Ketorolac tromethamine inj |
39,745 |
34,647 |
$211.43 |
| J2272 |
Inj, morphine (fresenius) |
943 |
698 |
$209.83 |
| 82728 |
|
1,495 |
1,388 |
$207.95 |
| 84703 |
|
1,109 |
1,067 |
$205.12 |
| 73100 |
|
28 |
26 |
$193.77 |
| 86592 |
|
105 |
99 |
$188.57 |
| 87040 |
|
3,992 |
3,757 |
$157.42 |
| 84450 |
|
2,872 |
2,667 |
$155.72 |
| J3301 |
Triamcinolone acet inj nos |
3,106 |
2,975 |
$154.92 |
| 84460 |
|
2,788 |
2,598 |
$150.19 |
| 87186 |
|
2,321 |
2,248 |
$149.59 |
| 85651 |
|
1,760 |
1,667 |
$147.47 |
| 83615 |
|
2,129 |
1,878 |
$146.65 |
| 90658 |
|
12 |
12 |
$139.86 |
| 73120 |
|
39 |
39 |
$130.10 |
| 93010 |
|
28 |
26 |
$128.25 |
| 83605 |
|
5,811 |
5,236 |
$126.79 |
| 83690 |
|
20,559 |
18,773 |
$121.41 |
| 87077 |
|
2,005 |
1,954 |
$120.67 |
| 98928 |
|
14 |
14 |
$119.68 |
| J7512 |
Prednisone ir or dr oral 1mg |
4,505 |
3,510 |
$118.66 |
| J7030 |
Normal saline solution infus |
46,249 |
37,416 |
$107.84 |
| 93320 |
|
265 |
263 |
$106.00 |
| J2405 |
Ondansetron hcl injection |
31,074 |
26,812 |
$98.75 |
| 84439 |
|
469 |
453 |
$98.20 |
| 80076 |
|
5,846 |
5,638 |
$95.64 |
| 84100 |
|
8,089 |
5,639 |
$94.87 |
| 94761 |
|
1,126 |
1,058 |
$86.00 |
| 87088 |
|
2,696 |
2,629 |
$83.62 |
| 82570 |
|
835 |
705 |
$83.08 |
| Q2035 |
Afluria vacc, 3 yrs & >, im |
15 |
12 |
$81.59 |
| J1030 |
Methylprednisolone 40 mg inj |
159 |
153 |
$78.65 |
| 94799 |
|
199 |
181 |
$69.39 |
| 87205 |
|
1,479 |
1,398 |
$69.38 |
| 82607 |
|
302 |
289 |
$68.98 |
| 82805 |
|
125 |
116 |
$65.22 |
| 76870 |
|
334 |
331 |
$65.05 |
| 94760 |
|
1,784 |
1,587 |
$64.00 |
| 84145 |
|
801 |
765 |
$58.52 |
| J2270 |
Morphine sulfate injection |
13,594 |
10,496 |
$54.29 |
| 84156 |
|
711 |
589 |
$51.85 |
| J2765 |
Metoclopramide hcl injection |
8,767 |
7,730 |
$39.17 |
| 99213 |
|
19 |
19 |
$38.77 |
| 82550 |
|
2,323 |
2,022 |
$38.34 |
| 82150 |
|
2,817 |
2,717 |
$37.51 |
| 84550 |
|
523 |
467 |
$35.25 |
| 85045 |
|
460 |
324 |
$34.63 |
| 96127 |
|
15 |
15 |
$33.64 |
| J2360 |
Orphenadrine injection |
1,711 |
1,550 |
$27.55 |
| 83550 |
|
176 |
168 |
$26.57 |
| 94664 |
|
250 |
238 |
$24.68 |
| 86308 |
|
580 |
575 |
$24.52 |
| J0696 |
Ceftriaxone sodium injection |
10,993 |
9,665 |
$22.44 |
| J3420 |
Vitamin b12 injection |
416 |
370 |
$22.11 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
622 |
601 |
$22.08 |
| J7120 |
Ringers lactate infusion |
5,158 |
4,141 |
$20.85 |
| J1170 |
Hydromorphone injection |
8,167 |
5,281 |
$18.78 |
| 82746 |
|
39 |
38 |
$16.40 |
| J1200 |
Diphenhydramine hcl injectio |
17,066 |
14,664 |
$16.28 |
| 84075 |
|
1,364 |
1,318 |
$16.06 |
| 81015 |
|
2,687 |
2,588 |
$14.64 |
| 83986 |
|
145 |
141 |
$14.00 |
| C1894 |
Intro/sheath, non-laser |
2,256 |
2,154 |
$12.37 |
| 81000 |
|
106 |
97 |
$12.27 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
15,902 |
15,290 |
$12.00 |
| J7040 |
Normal saline solution infus |
7,506 |
6,910 |
$11.56 |
| 82010 |
|
826 |
746 |
$11.23 |
| 82375 |
|
124 |
116 |
$10.20 |
| J1836 |
Inj, metronidazole, 10 mg |
152 |
95 |
$9.86 |
| J0780 |
Prochlorperazine injection |
1,837 |
1,618 |
$9.53 |
| J2930 |
Methylprednisolone injection |
5,812 |
4,980 |
$7.62 |
| 90633 |
|
68 |
67 |
$7.00 |
| 82310 |
|
77 |
67 |
$6.48 |
| 85384 |
|
122 |
108 |
$5.23 |
| J1100 |
Dexamethasone sodium phos |
12,105 |
11,224 |
$5.10 |
| J3010 |
Fentanyl citrate injection |
14,302 |
13,242 |
$4.11 |
| 87081 |
|
28 |
28 |
$3.63 |
| J1650 |
Inj enoxaparin sodium |
4,168 |
2,310 |
$3.47 |
| J3490 |
Drugs unclassified injection |
13,749 |
10,806 |
$3.05 |
| 87210 |
|
26 |
25 |
$2.96 |
| J1920 |
Inj, labetalol hcl, 5mg |
189 |
171 |
$1.55 |
| J2250 |
Inj midazolam hydrochloride |
13,809 |
13,166 |
$1.55 |
| J3475 |
Inj magnesium sulfate |
2,643 |
2,213 |
$0.43 |
| J2800 |
Methocarbamol injection |
677 |
657 |
$0.00 |
| C1887 |
Catheter, guiding |
673 |
655 |
$0.00 |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
69 |
37 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
1,406 |
1,352 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
2,264 |
2,167 |
$0.00 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
1,459 |
1,429 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
1,361 |
1,323 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
774 |
515 |
$0.00 |
| J7510 |
Prednisolone oral per 5 mg |
641 |
611 |
$0.00 |
| 87075 |
|
63 |
62 |
$0.00 |
| A9552 |
F18 fdg |
25 |
25 |
$0.00 |
| 90700 |
|
26 |
25 |
$0.00 |
| 76942 |
|
1,291 |
1,253 |
$0.00 |
| C1776 |
Joint device (implantable) |
149 |
126 |
$0.00 |
| 90734 |
|
44 |
44 |
$0.00 |
| 99053 |
|
71 |
68 |
$0.00 |
| 91312 |
|
42 |
41 |
$0.00 |
| 87633 |
|
85 |
81 |
$0.00 |
| G8979 |
Mobility goal status |
331 |
296 |
$0.00 |
| 85347 |
|
200 |
152 |
$0.00 |
| 80164 |
|
198 |
183 |
$0.00 |
| J3370 |
Vancomycin hcl injection |
275 |
156 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
194 |
121 |
$0.00 |
| 91300 |
|
423 |
400 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
456 |
451 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
268 |
192 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
40 |
40 |
$0.00 |
| 90714 |
|
27 |
24 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
101 |
62 |
$0.00 |
| J1050 |
Medroxyprogesterone acetate |
40 |
39 |
$0.00 |
| J1245 |
Dipyridamole injection |
99 |
84 |
$0.00 |
| J1953 |
Levetiracetam injection |
101 |
87 |
$0.00 |
| A6457 |
Tubular dressing |
68 |
38 |
$0.00 |
| 84295 |
|
13 |
12 |
$0.00 |
| 80074 |
|
16 |
14 |
$0.00 |
| 82374 |
|
13 |
12 |
$0.00 |
| 76377 |
|
559 |
546 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
8,960 |
7,538 |
$0.00 |
| 99214 |
|
29 |
29 |
$0.00 |
| J2060 |
Lorazepam injection |
9,825 |
6,569 |
$0.00 |
| J0360 |
Hydralazine hcl injection |
1,330 |
1,158 |
$0.00 |
| J7060 |
5% dextrose/water |
1,520 |
1,422 |
$0.00 |
| J0500 |
Dicyclomine injection |
2,983 |
2,758 |
$0.00 |
| 95940 |
|
876 |
857 |
$0.00 |
| J7042 |
5% dextrose/normal saline |
618 |
469 |
$0.00 |
| J7050 |
Normal saline solution infus |
2,631 |
2,246 |
$0.00 |
| J7121 |
5% dextrose in lac ringers |
1,411 |
1,183 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
2,310 |
2,171 |
$0.00 |
| A9585 |
Gadobutrol injection |
1,028 |
995 |
$0.00 |
| J3480 |
Inj potassium chloride |
1,456 |
1,166 |
$0.00 |
| J1630 |
Haloperidol injection |
2,699 |
1,865 |
$0.00 |
| J3230 |
Chlorpromazine hcl injection |
47 |
40 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
3,229 |
3,112 |
$0.00 |
| G0283 |
Elec stim other than wound |
941 |
303 |
$0.00 |
| C1769 |
Guide wire |
2,906 |
2,744 |
$0.00 |
| A6197 |
Alginate drsg >16 <=48 sq in |
4,622 |
1,883 |
$0.00 |
| J1940 |
Furosemide injection |
832 |
538 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
656 |
635 |
$0.00 |
| J8540 |
Oral dexamethasone |
392 |
378 |
$0.00 |
| J3411 |
Thiamine hcl 100 mg |
196 |
146 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
165 |
161 |
$0.00 |
| 87340 |
|
38 |
38 |
$0.00 |
| J2920 |
Methylprednisolone injection |
202 |
125 |
$0.00 |
| A6022 |
Collagen drsg>16<=48 sq in |
1,002 |
490 |
$0.00 |
| G8987 |
Self care current status |
88 |
83 |
$0.00 |
| 84132 |
|
13 |
13 |
$0.00 |
| 85018 |
|
13 |
12 |
$0.00 |
| C1889 |
Implant/insert device, noc |
30 |
30 |
$0.00 |
| C1725 |
Cath, translumin non-laser |
44 |
40 |
$0.00 |
| J3360 |
Diazepam injection |
343 |
261 |
$0.00 |
| J1010 |
Inj, methylpred acetate 1 mg |
40 |
40 |
$0.00 |
| 91301 |
|
155 |
152 |
$0.00 |
| 82435 |
|
13 |
12 |
$0.00 |
| 94644 |
|
87 |
83 |
$0.00 |
| A4648 |
Implantable tissue marker |
37 |
37 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
139 |
135 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
100 |
70 |
$0.00 |
| J1790 |
Droperidol injection |
34 |
30 |
$0.00 |
| C1781 |
Mesh (implantable) |
13 |
13 |
$0.00 |
| 90647 |
|
78 |
74 |
$0.00 |
| G8988 |
Self care goal status |
45 |
43 |
$0.00 |
| J0456 |
Azithromycin |
31 |
26 |
$0.00 |
| 90723 |
|
32 |
29 |
$0.00 |
| 73503 |
|
29 |
27 |
$0.00 |