| Code | Description | Claims | Beneficiaries | Total Paid |
| 36415 |
|
39,840 |
35,108 |
$7.39M |
| 97110 |
|
61,026 |
20,186 |
$4.31M |
| 81025 |
|
16,078 |
15,455 |
$3.88M |
| 99283 |
|
50,115 |
46,981 |
$3.74M |
| 80048 |
|
25,475 |
22,198 |
$3.16M |
| 96374 |
|
10,353 |
9,570 |
$2.86M |
| 80053 |
|
29,762 |
26,738 |
$2.61M |
| 99282 |
|
13,927 |
13,108 |
$2.14M |
| 70553 |
|
1,779 |
1,764 |
$2.12M |
| 96372 |
|
12,898 |
9,906 |
$1.92M |
| 99212 |
|
26,132 |
23,221 |
$1.84M |
| G0463 |
Hospital outpt clinic visit |
28,801 |
23,717 |
$1.73M |
| 81003 |
|
17,051 |
12,702 |
$1.68M |
| 96361 |
|
12,823 |
9,161 |
$1.67M |
| C9803 |
Hopd covid-19 spec collect |
9,021 |
8,754 |
$1.39M |
| 0241U |
|
9,366 |
9,189 |
$1.21M |
| 93306 |
|
3,897 |
3,863 |
$1.17M |
| 70551 |
|
1,737 |
1,709 |
$1.14M |
| 96365 |
|
7,486 |
5,300 |
$943K |
| 88305 |
|
4,044 |
3,995 |
$936K |
| 95810 |
|
1,843 |
1,839 |
$933K |
| 99211 |
|
10,053 |
9,335 |
$897K |
| 86850 |
|
6,213 |
5,545 |
$884K |
| 99284 |
|
23,840 |
22,632 |
$796K |
| 88304 |
|
2,254 |
2,245 |
$789K |
| 71046 |
|
15,733 |
15,300 |
$708K |
| 99213 |
|
15,077 |
12,619 |
$694K |
| 87491 |
|
15,757 |
15,319 |
$645K |
| 96360 |
|
4,824 |
4,610 |
$619K |
| 92507 |
|
8,269 |
2,953 |
$616K |
| 97530 |
|
10,885 |
4,015 |
$587K |
| 84156 |
|
1,622 |
1,444 |
$577K |
| 97161 |
|
8,176 |
8,040 |
$570K |
| 81001 |
|
22,650 |
21,398 |
$465K |
| 87086 |
|
13,265 |
12,768 |
$436K |
| 99281 |
|
2,499 |
2,310 |
$403K |
| 99391 |
|
3,925 |
3,915 |
$390K |
| 99285 |
|
14,815 |
13,908 |
$374K |
| 95782 |
|
378 |
378 |
$355K |
| 80069 |
|
4,022 |
2,962 |
$346K |
| 70450 |
|
4,694 |
4,540 |
$319K |
| 87480 |
|
3,054 |
2,998 |
$299K |
| 54360 |
|
680 |
680 |
$288K |
| 84702 |
|
4,226 |
3,757 |
$282K |
| 85027 |
|
10,842 |
9,897 |
$281K |
| 74018 |
|
4,756 |
4,448 |
$270K |
| 78452 |
|
417 |
416 |
$269K |
| 76770 |
|
1,753 |
1,739 |
$269K |
| 87081 |
|
5,948 |
5,894 |
$269K |
| 87804 |
|
1,827 |
1,768 |
$268K |
| 82306 |
|
6,091 |
6,039 |
$268K |
| 99214 |
|
5,011 |
4,523 |
$263K |
| 87070 |
|
1,728 |
1,671 |
$262K |
| 85025 |
|
49,974 |
42,637 |
$252K |
| 99392 |
|
4,378 |
4,368 |
$250K |
| 87481 |
|
602 |
599 |
$248K |
| 80307 |
|
5,635 |
5,323 |
$248K |
| 92551 |
|
3,266 |
3,261 |
$246K |
| 87210 |
|
3,379 |
3,267 |
$242K |
| 96366 |
|
3,026 |
1,927 |
$227K |
| 76830 |
|
1,310 |
1,288 |
$217K |
| 76705 |
|
3,044 |
2,964 |
$205K |
| U0003 |
Cov-19 amp prb hgh thruput |
9,004 |
8,729 |
$196K |
| 95700 |
|
606 |
595 |
$191K |
| 76700 |
|
885 |
879 |
$190K |
| 86900 |
|
6,832 |
6,111 |
$185K |
| 99393 |
|
3,988 |
3,980 |
$178K |
| D2930 |
|
299 |
299 |
$177K |
| 96375 |
|
7,032 |
5,853 |
$171K |
| 87077 |
|
4,556 |
4,427 |
$169K |
| 82657 |
|
216 |
216 |
$168K |
| 69436 |
|
696 |
683 |
$161K |
| 87651 |
|
2,380 |
2,357 |
$161K |
| 99394 |
|
3,264 |
3,258 |
$161K |
| 93005 |
|
14,869 |
12,859 |
$158K |
| 73130 |
|
1,693 |
1,558 |
$158K |
| 80061 |
|
9,358 |
9,283 |
$156K |
| 76816 |
|
1,793 |
1,425 |
$155K |
| 36416 |
|
1,205 |
1,182 |
$154K |
| G0378 |
Hospital observation per hr |
12,650 |
9,461 |
$153K |
| 71045 |
|
6,712 |
6,292 |
$151K |
| 85018 |
|
2,986 |
2,797 |
$151K |
| 83655 |
|
2,042 |
2,012 |
$133K |
| 74177 |
|
2,830 |
2,784 |
$131K |
| 93010 |
|
23,776 |
20,780 |
$130K |
| 42820 |
|
1,221 |
1,216 |
$123K |
| 93971 |
|
352 |
344 |
$118K |
| 85347 |
|
440 |
373 |
$118K |
| 77063 |
|
894 |
894 |
$117K |
| 73721 |
|
116 |
114 |
$113K |
| 83036 |
|
9,403 |
9,298 |
$102K |
| 73630 |
|
1,698 |
1,574 |
$101K |
| 86780 |
|
7,668 |
7,576 |
$97K |
| 73560 |
|
1,681 |
1,539 |
$91K |
| 87389 |
|
8,765 |
8,678 |
$87K |
| 93017 |
|
989 |
987 |
$86K |
| 73030 |
|
1,106 |
1,040 |
$84K |
| 96376 |
|
4,382 |
2,905 |
$84K |
| 99202 |
|
1,443 |
1,437 |
$82K |
| 73610 |
|
1,073 |
1,012 |
$81K |
| 82565 |
|
423 |
413 |
$80K |
| 77067 |
|
2,412 |
2,412 |
$79K |
| 93922 |
|
156 |
155 |
$78K |
| 87880 |
|
1,972 |
1,949 |
$77K |
| 76937 |
|
1,187 |
1,089 |
$77K |
| 87624 |
|
1,546 |
1,538 |
$72K |
| 97165 |
|
1,323 |
1,306 |
$72K |
| 12011 |
|
295 |
294 |
$69K |
| 94640 |
|
5,725 |
4,620 |
$69K |
| 87635 |
|
2,249 |
2,209 |
$67K |
| 76856 |
|
1,145 |
1,126 |
$64K |
| 95806 |
|
297 |
296 |
$63K |
| 71260 |
|
549 |
544 |
$58K |
| 73110 |
|
719 |
659 |
$58K |
| 72100 |
|
1,044 |
1,029 |
$57K |
| 95811 |
|
151 |
151 |
$53K |
| 54161 |
|
356 |
356 |
$51K |
| J7120 |
Ringers lactate infusion |
23,023 |
21,420 |
$48K |
| 72040 |
|
564 |
554 |
$48K |
| 88300 |
|
122 |
122 |
$48K |
| 85610 |
|
6,742 |
5,004 |
$45K |
| 87637 |
|
510 |
505 |
$45K |
| 76811 |
|
236 |
236 |
$44K |
| 73090 |
|
415 |
384 |
$44K |
| 95951 |
|
211 |
93 |
$43K |
| 43239 |
|
1,629 |
1,617 |
$42K |
| 82043 |
|
2,423 |
2,407 |
$41K |
| 86140 |
|
5,091 |
4,564 |
$40K |
| U0005 |
Infec agen detec ampli probe |
1,505 |
1,468 |
$38K |
| 87502 |
|
397 |
396 |
$38K |
| 71275 |
|
759 |
741 |
$37K |
| 95957 |
|
423 |
203 |
$35K |
| 72125 |
|
1,140 |
1,118 |
$35K |
| 80074 |
|
1,162 |
1,152 |
$34K |
| 87428 |
|
275 |
269 |
$33K |
| 71250 |
|
84 |
82 |
$33K |
| 84703 |
|
598 |
587 |
$33K |
| 97140 |
|
3,409 |
1,664 |
$32K |
| 72148 |
|
79 |
79 |
$32K |
| 97535 |
|
1,025 |
811 |
$32K |
| 74019 |
|
753 |
741 |
$31K |
| 84443 |
|
9,444 |
9,281 |
$30K |
| 95813 |
|
109 |
107 |
$30K |
| 80076 |
|
1,936 |
1,882 |
$29K |
| 83735 |
|
13,091 |
10,606 |
$29K |
| 86902 |
|
945 |
776 |
$28K |
| 92523 |
|
353 |
352 |
$28K |
| J3490 |
Drugs unclassified injection |
6,990 |
5,167 |
$27K |
| 0202U |
|
177 |
175 |
$25K |
| 92526 |
|
391 |
201 |
$25K |
| 73590 |
|
420 |
381 |
$25K |
| 93888 |
|
141 |
141 |
$24K |
| 76536 |
|
189 |
186 |
$24K |
| 82728 |
|
3,260 |
3,095 |
$24K |
| 12001 |
|
122 |
122 |
$24K |
| 82950 |
|
2,668 |
2,651 |
$24K |
| 59025 |
|
714 |
473 |
$24K |
| 97162 |
|
510 |
501 |
$23K |
| 84439 |
|
2,570 |
2,537 |
$23K |
| 76642 |
|
300 |
293 |
$21K |
| 76805 |
|
141 |
140 |
$20K |
| 41899 |
|
421 |
415 |
$19K |
| 94760 |
|
1,306 |
830 |
$18K |
| 70496 |
|
80 |
78 |
$18K |
| 84145 |
|
2,263 |
1,865 |
$18K |
| 76886 |
|
102 |
97 |
$18K |
| 84484 |
|
7,057 |
5,299 |
$18K |
| J7030 |
Normal saline solution infus |
5,472 |
4,806 |
$17K |
| 73502 |
|
334 |
310 |
$17K |
| 76815 |
|
379 |
355 |
$17K |
| 76376 |
|
42 |
42 |
$17K |
| 93880 |
|
56 |
54 |
$17K |
| 76000 |
|
423 |
410 |
$17K |
| 99215 |
Prolong outpt/office vis |
646 |
561 |
$16K |
| 85014 |
|
653 |
611 |
$16K |
| 76801 |
|
650 |
596 |
$16K |
| C8929 |
Tte w or wo fol wcon,doppler |
85 |
84 |
$16K |
| 85660 |
|
755 |
639 |
$16K |
| 87807 |
|
284 |
282 |
$15K |
| P9016 |
Rbc leukocytes reduced |
1,075 |
896 |
$15K |
| 82330 |
|
415 |
398 |
$15K |
| 42830 |
|
53 |
53 |
$15K |
| A4649 |
Surgical supplies |
175 |
157 |
$15K |
| 88142 |
|
1,494 |
1,489 |
$15K |
| 87631 |
|
1,230 |
1,216 |
$14K |
| 82570 |
|
4,014 |
3,807 |
$14K |
| 99203 |
|
163 |
163 |
$14K |
| 76818 |
|
444 |
258 |
$14K |
| 99174 |
|
200 |
198 |
$14K |
| 74230 |
|
49 |
49 |
$14K |
| 76870 |
|
66 |
64 |
$13K |
| 77072 |
|
374 |
374 |
$13K |
| 93923 |
|
39 |
37 |
$13K |
| 72141 |
|
12 |
12 |
$12K |
| 90686 |
|
6,389 |
6,373 |
$12K |
| 93970 |
|
40 |
40 |
$12K |
| J1100 |
Dexamethasone sodium phos |
13,027 |
12,367 |
$12K |
| J3010 |
Fentanyl citrate injection |
14,868 |
13,814 |
$11K |
| J2270 |
Morphine sulfate injection |
3,866 |
3,212 |
$11K |
| J2704 |
Inj, propofol, 10 mg |
2,223 |
2,043 |
$11K |
| J2405 |
Ondansetron hcl injection |
16,135 |
14,614 |
$11K |
| 82550 |
|
1,575 |
1,318 |
$11K |
| 0002A |
|
288 |
288 |
$10K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
4,533 |
4,104 |
$10K |
| 76885 |
|
64 |
64 |
$10K |
| 73070 |
|
59 |
55 |
$10K |
| 83020 |
|
3,372 |
3,135 |
$9K |
| 83001 |
|
321 |
320 |
$9K |
| S5010 |
5% dextrose and 0.45% saline |
1,452 |
865 |
$8K |
| S9445 |
Pt education noc individ |
66 |
60 |
$8K |
| 82105 |
|
418 |
415 |
$8K |
| 10060 |
|
38 |
37 |
$8K |
| 70360 |
|
69 |
69 |
$8K |
| 93976 |
|
1,601 |
1,530 |
$8K |
| 76817 |
|
781 |
704 |
$8K |
| 0072A |
|
220 |
219 |
$8K |
| 97112 |
|
387 |
165 |
$7K |
| G0145 |
Scr c/v cyto,thinlayer,rescr |
650 |
641 |
$7K |
| 84146 |
|
293 |
290 |
$7K |
| 87426 |
|
70 |
65 |
$7K |
| 86361 |
|
487 |
481 |
$7K |
| 86706 |
|
393 |
387 |
$6K |
| 99204 |
|
76 |
76 |
$6K |
| 82272 |
|
132 |
131 |
$6K |
| 90715 |
|
3,602 |
3,572 |
$6K |
| 90460 |
|
12,335 |
12,267 |
$6K |
| 87661 |
|
10,698 |
10,422 |
$6K |
| 96367 |
|
174 |
158 |
$6K |
| J1815 |
Insulin injection |
574 |
267 |
$6K |
| 82805 |
|
381 |
347 |
$6K |
| 82607 |
|
1,316 |
1,305 |
$6K |
| 69209 |
|
52 |
51 |
$5K |
| 86901 |
|
6,842 |
6,115 |
$5K |
| J7040 |
Normal saline solution infus |
3,517 |
2,872 |
$5K |
| S0315 |
Disease management program |
146 |
146 |
$5K |
| 82962 |
|
131 |
112 |
$5K |
| 80177 |
|
171 |
156 |
$5K |
| 87040 |
|
2,020 |
1,799 |
$5K |
| 83037 |
|
96 |
96 |
$5K |
| 76819 |
|
541 |
288 |
$5K |
| 86038 |
|
414 |
406 |
$5K |
| 70250 |
|
12 |
12 |
$5K |
| 86592 |
|
342 |
340 |
$5K |
| 85045 |
|
8,179 |
7,061 |
$5K |
| 87205 |
|
1,713 |
1,663 |
$5K |
| J1885 |
Ketorolac tromethamine inj |
8,075 |
7,237 |
$5K |
| 99188 |
|
1,187 |
1,186 |
$5K |
| 73552 |
|
71 |
67 |
$4K |
| 74176 |
|
39 |
37 |
$4K |
| 82040 |
|
43 |
43 |
$4K |
| 43762 |
|
27 |
24 |
$4K |
| 73080 |
|
28 |
27 |
$4K |
| 85651 |
|
88 |
80 |
$4K |
| 83540 |
|
2,409 |
2,362 |
$4K |
| 11981 |
|
24 |
24 |
$4K |
| 94664 |
|
1,482 |
1,066 |
$4K |
| U0002 |
Covid-19 lab test non-cdc |
61 |
59 |
$4K |
| 90647 |
|
2,372 |
2,372 |
$3K |
| J0696 |
Ceftriaxone sodium injection |
3,638 |
2,924 |
$3K |
| 99173 |
|
867 |
865 |
$3K |
| 83880 |
|
2,356 |
2,103 |
$3K |
| 92610 |
|
105 |
102 |
$3K |
| 86695 |
|
42 |
39 |
$3K |
| 84132 |
|
368 |
341 |
$3K |
| 84466 |
|
1,887 |
1,849 |
$3K |
| 82670 |
|
83 |
83 |
$3K |
| J2060 |
Lorazepam injection |
982 |
778 |
$3K |
| 85379 |
|
513 |
505 |
$3K |
| J1650 |
Inj enoxaparin sodium |
470 |
185 |
$3K |
| 74022 |
|
89 |
89 |
$3K |
| 84134 |
|
561 |
541 |
$3K |
| 86803 |
|
4,388 |
4,352 |
$3K |
| 0001A |
|
366 |
365 |
$3K |
| 87591 |
|
15,442 |
15,019 |
$3K |
| 90656 |
|
499 |
499 |
$3K |
| 90670 |
|
2,905 |
2,904 |
$3K |
| A9585 |
Gadobutrol injection |
1,203 |
1,164 |
$3K |
| 99205 |
Prolong outpt/office vis |
116 |
115 |
$2K |
| G0123 |
Screen cerv/vag thin layer |
85 |
85 |
$2K |
| A9500 |
Tc99m sestamibi |
272 |
272 |
$2K |
| 97116 |
|
436 |
211 |
$2K |
| 87486 |
|
25 |
25 |
$2K |
| 0071A |
|
315 |
315 |
$2K |
| 90677 |
|
736 |
736 |
$2K |
| J1642 |
Inj heparin sodium per 10 u |
1,217 |
639 |
$2K |
| 72170 |
|
55 |
54 |
$2K |
| 84425 |
|
737 |
727 |
$2K |
| 97113 |
|
30 |
13 |
$2K |
| 76377 |
|
17 |
17 |
$2K |
| J1050 |
Medroxyprogesterone acetate |
4,038 |
4,021 |
$2K |
| 97597 |
|
73 |
54 |
$2K |
| 99291 |
|
105 |
104 |
$2K |
| J3475 |
Inj magnesium sulfate |
753 |
633 |
$2K |
| 93297 |
|
12 |
12 |
$2K |
| 86480 |
|
275 |
273 |
$2K |
| 73060 |
|
12 |
12 |
$2K |
| 85730 |
|
3,246 |
2,966 |
$2K |
| 90633 |
|
2,627 |
2,625 |
$2K |
| J2550 |
Promethazine hcl injection |
640 |
477 |
$2K |
| 80081 |
|
66 |
66 |
$2K |
| 74240 |
|
12 |
12 |
$2K |
| 83690 |
|
5,970 |
5,648 |
$2K |
| J1170 |
Hydromorphone injection |
3,866 |
2,325 |
$2K |
| J7042 |
5% dextrose/normal saline |
451 |
313 |
$1K |
| 0082A |
|
47 |
47 |
$1K |
| 83516 |
|
341 |
338 |
$1K |
| 85384 |
|
194 |
172 |
$1K |
| 70498 |
|
76 |
76 |
$1K |
| 90471 |
|
5,018 |
4,937 |
$1K |
| 87536 |
|
553 |
544 |
$1K |
| Q3014 |
Telehealth facility fee |
29 |
29 |
$1K |
| 74220 |
|
12 |
12 |
$1K |
| Q9957 |
Inj perflutren lip micros,ml |
160 |
157 |
$1K |
| 82077 |
|
490 |
475 |
$993.30 |
| J7050 |
Normal saline solution infus |
1,889 |
1,550 |
$956.15 |
| J3480 |
Inj potassium chloride |
737 |
537 |
$954.64 |
| J1200 |
Diphenhydramine hcl injectio |
1,544 |
1,242 |
$931.89 |
| 90651 |
|
1,180 |
1,179 |
$931.48 |
| 84100 |
|
2,299 |
1,750 |
$912.22 |
| 84481 |
|
432 |
432 |
$869.80 |
| 91320 |
|
188 |
188 |
$853.81 |
| 87660 |
|
2,979 |
2,928 |
$820.08 |
| 86580 |
|
52 |
49 |
$813.70 |
| 90472 |
|
218 |
214 |
$812.26 |
| 87340 |
|
3,963 |
3,910 |
$742.28 |
| 83605 |
|
1,229 |
1,104 |
$714.91 |
| 0004A |
|
128 |
128 |
$710.34 |
| 86308 |
|
14 |
14 |
$697.91 |
| 92522 |
|
12 |
12 |
$684.77 |
| G0257 |
Unsched dialysis esrd pt hos |
235 |
88 |
$672.81 |
| 82784 |
|
597 |
584 |
$660.39 |
| 94644 |
|
745 |
706 |
$634.69 |
| J2250 |
Inj midazolam hydrochloride |
6,111 |
5,986 |
$613.57 |
| 0124A |
|
274 |
274 |
$604.46 |
| 87522 |
Neg quan hep c or qual rna |
126 |
125 |
$581.64 |
| J1644 |
Inj heparin sodium per 1000u |
1,353 |
875 |
$559.27 |
| 80143 |
|
70 |
68 |
$551.50 |
| 58300 |
|
12 |
12 |
$550.82 |
| G1004 |
Cdsm ndsc |
333 |
264 |
$531.58 |
| 86364 |
|
134 |
133 |
$516.25 |
| J0360 |
Hydralazine hcl injection |
30 |
28 |
$498.75 |
| 99383 |
|
12 |
12 |
$482.90 |
| 86920 |
|
1,211 |
1,017 |
$482.59 |
| 86696 |
|
58 |
53 |
$448.45 |
| 86704 |
|
136 |
134 |
$402.18 |
| 83615 |
|
1,116 |
815 |
$378.63 |
| 90707 |
|
564 |
564 |
$367.90 |
| 0054A |
|
134 |
134 |
$360.66 |
| 85652 |
|
2,996 |
2,785 |
$339.84 |
| G8978 |
Mobility current status |
22 |
18 |
$337.66 |
| 87075 |
|
132 |
131 |
$336.68 |
| 36430 |
|
1,114 |
901 |
$336.53 |
| 87186 |
|
3,177 |
3,096 |
$319.66 |
| J0690 |
Cefazolin sodium injection |
4,475 |
3,922 |
$317.94 |
| 86762 |
|
1,587 |
1,571 |
$310.80 |
| 82627 |
|
12 |
12 |
$289.77 |
| 90620 |
|
512 |
511 |
$288.88 |
| 99152 |
|
258 |
252 |
$265.67 |
| 82553 |
|
35 |
27 |
$262.80 |
| 0081A |
|
105 |
105 |
$261.45 |
| 86923 |
|
165 |
142 |
$259.47 |
| 90696 |
|
437 |
437 |
$258.04 |
| 84550 |
|
220 |
213 |
$254.32 |
| 88342 |
|
198 |
192 |
$234.30 |
| 82746 |
|
734 |
731 |
$222.39 |
| J2795 |
Ropivacaine hcl injection |
2,304 |
2,273 |
$221.51 |
| 90700 |
|
478 |
478 |
$184.11 |
| 86003 |
|
43 |
41 |
$182.45 |
| J0330 |
Succinycholine chloride inj |
1,360 |
1,332 |
$171.30 |
| 0052A |
|
14 |
14 |
$166.10 |
| 90723 |
|
2,423 |
2,423 |
$156.00 |
| 29125 |
|
12 |
12 |
$140.22 |
| 36591 |
|
184 |
148 |
$135.60 |
| 84403 |
|
231 |
230 |
$133.50 |
| 90746 |
|
29 |
29 |
$119.81 |
| 89051 |
|
72 |
69 |
$111.51 |
| 80323 |
|
164 |
163 |
$94.94 |
| 0154A |
|
43 |
43 |
$81.66 |
| J0171 |
Adrenalin epinephrine inject |
67 |
65 |
$79.73 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
776 |
549 |
$74.02 |
| 90710 |
|
610 |
610 |
$55.07 |
| 90682 |
|
62 |
61 |
$51.55 |
| 86235 |
|
106 |
97 |
$51.16 |
| J0780 |
Prochlorperazine injection |
276 |
263 |
$46.12 |
| 82951 |
|
12 |
12 |
$43.76 |
| J2272 |
Inj, morphine (fresenius) |
361 |
324 |
$41.74 |
| 90734 |
|
1,660 |
1,625 |
$39.64 |
| H0002 |
Alcohol and/or drug screenin |
16 |
16 |
$37.60 |
| 90681 |
|
1,318 |
1,318 |
$36.00 |
| 86255 |
|
156 |
146 |
$35.71 |
| 86787 |
|
76 |
75 |
$32.14 |
| 82785 |
|
19 |
19 |
$18.68 |
| 84450 |
|
152 |
152 |
$17.87 |
| J2765 |
Metoclopramide hcl injection |
15 |
13 |
$17.62 |
| 86317 |
|
35 |
35 |
$13.67 |
| 82947 |
|
45 |
45 |
$13.19 |
| J2274 |
Inj morphine pf epid ithc |
152 |
132 |
$11.49 |
| A9270 |
Non-covered item or service |
1,192 |
618 |
$7.98 |
| 36410 |
|
155 |
144 |
$4.30 |
| 84460 |
|
152 |
152 |
$2.71 |
| G0480 |
Drug test def 1-7 classes |
124 |
124 |
$0.00 |
| J0280 |
Aminophyllin 250 mg inj |
129 |
129 |
$0.00 |
| 87510 |
|
3,041 |
2,985 |
$0.00 |
| 90716 |
|
549 |
549 |
$0.00 |
| 90732 |
|
54 |
51 |
$0.00 |
| 90480 |
|
338 |
337 |
$0.00 |
| 45380 |
|
243 |
242 |
$0.00 |
| S0020 |
Injection, bupivicaine hydro |
1,420 |
1,414 |
$0.00 |
| G0472 |
Hep c screen high risk/other |
77 |
75 |
$0.00 |
| 88307 |
|
26 |
26 |
$0.00 |
| G0008 |
Admin influenza virus vac |
161 |
158 |
$0.00 |
| 95716 |
|
204 |
168 |
$0.00 |
| 86921 |
|
138 |
114 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
54 |
52 |
$0.00 |
| J2785 |
Regadenoson injection |
317 |
316 |
$0.00 |
| 83002 |
|
184 |
183 |
$0.00 |
| 86160 |
|
297 |
279 |
$0.00 |
| J1940 |
Furosemide injection |
158 |
117 |
$0.00 |
| 70491 |
|
13 |
13 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
150 |
143 |
$0.00 |
| J1630 |
Haloperidol injection |
66 |
54 |
$0.00 |
| C1725 |
Cath, translumin non-laser |
41 |
37 |
$0.00 |
| J7298 |
Mirena, 52 mg |
12 |
12 |
$0.00 |
| 84436 |
|
37 |
37 |
$0.00 |
| 81050 |
|
12 |
12 |
$0.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
145 |
100 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
56 |
54 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
251 |
221 |
$0.00 |
| 93458 |
|
56 |
55 |
$0.00 |
| C1769 |
Guide wire |
300 |
287 |
$0.00 |
| Q9969 |
Non-heu tc-99m add-on/dose |
74 |
74 |
$0.00 |
| 31231 |
|
13 |
13 |
$0.00 |
| 86376 |
|
88 |
86 |
$0.00 |
| G0379 |
Direct refer hospital observ |
76 |
76 |
$0.00 |
| 87581 |
|
25 |
25 |
$0.00 |
| 0051A |
|
14 |
14 |
$0.00 |
| 86225 |
|
44 |
42 |
$0.00 |
| 88341 |
|
14 |
14 |
$0.00 |
| 90935 |
|
23 |
12 |
$0.00 |
| 0011A |
|
12 |
12 |
$0.00 |
| 87799 |
|
612 |
607 |
$0.00 |
| 90649 |
|
722 |
722 |
$0.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
39 |
26 |
$0.00 |
| 86922 |
|
138 |
114 |
$0.00 |
| 90461 |
|
2,778 |
2,775 |
$0.00 |
| 90685 |
|
612 |
612 |
$0.00 |
| 95714 |
|
209 |
152 |
$0.00 |
| 99395 |
|
26 |
26 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
220 |
212 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
610 |
606 |
$0.00 |
| 93325 |
|
16 |
16 |
$0.00 |
| J2930 |
Methylprednisolone injection |
139 |
129 |
$0.00 |
| 87512 |
|
602 |
599 |
$0.00 |
| C1887 |
Catheter, guiding |
46 |
43 |
$0.00 |
| 92611 |
|
13 |
13 |
$0.00 |
| S0077 |
Injection, clindamycin phosp |
98 |
81 |
$0.00 |
| 80179 |
|
40 |
40 |
$0.00 |
| 84295 |
|
24 |
24 |
$0.00 |
| 87798 |
|
26 |
26 |
$0.00 |
| 93750 |
|
49 |
43 |
$0.00 |
| 86200 |
|
49 |
49 |
$0.00 |
| J3370 |
Vancomycin hcl injection |
56 |
42 |
$0.00 |
| 90473 |
|
12 |
12 |
$0.00 |
| 14040 |
|
12 |
12 |
$0.00 |
| J1953 |
Levetiracetam injection |
29 |
24 |
$0.00 |
| J1598 |
Inj glycopyrrolate fres kabi |
66 |
66 |
$0.00 |
| 82977 |
|
14 |
14 |
$0.00 |
| 86431 |
|
159 |
159 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
248 |
248 |
$0.00 |
| 83970 |
|
34 |
34 |
$0.00 |
| 82610 |
|
12 |
12 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
21 |
12 |
$0.00 |
| 90662 |
|
20 |
18 |
$0.00 |
| 94645 |
|
41 |
41 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
16 |
16 |
$0.00 |
| 87633 |
|
25 |
25 |
$0.00 |
| 87641 |
|
13 |
13 |
$0.00 |
| J2916 |
Na ferric gluconate complex |
45 |
16 |
$0.00 |
| G8979 |
Mobility goal status |
22 |
18 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
39 |
34 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
15 |
14 |
$0.00 |
| 76857 |
|
12 |
12 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
13 |
13 |
$0.00 |
| 82248 |
|
13 |
13 |
$0.00 |
| 84590 |
|
14 |
14 |
$0.00 |
| 88175 |
|
25 |
25 |
$0.00 |