| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
|
88,362 |
85,681 |
$19.31M |
| 99283 |
|
63,777 |
61,651 |
$11.83M |
| T1015 |
Clinic service |
137,815 |
74,615 |
$6.79M |
| G0378 |
Hospital observation per hr |
4,100 |
3,271 |
$4.70M |
| 99285 |
|
24,613 |
23,770 |
$4.66M |
| U0003 |
Cov-19 amp prb hgh thruput |
13,253 |
12,756 |
$770K |
| J9271 |
Inj pembrolizumab |
586 |
462 |
$735K |
| 74177 |
|
4,362 |
4,223 |
$563K |
| 99212 |
|
10,079 |
9,773 |
$481K |
| 80053 |
|
67,037 |
63,002 |
$451K |
| 77067 |
|
4,525 |
4,428 |
$446K |
| 70553 |
|
1,406 |
1,385 |
$378K |
| X0621 |
|
1,433 |
1,193 |
$353K |
| 96413 |
|
3,258 |
2,234 |
$351K |
| 93306 |
|
3,351 |
3,296 |
$316K |
| J1745 |
Infliximab not biosimil 10mg |
527 |
497 |
$287K |
| J3380 |
Inj vedolizumab iv 1 mg |
130 |
119 |
$284K |
| 95810 |
|
778 |
756 |
$273K |
| 95782 |
|
303 |
293 |
$267K |
| 78815 |
|
258 |
251 |
$264K |
| 97161 |
|
3,478 |
3,427 |
$236K |
| 87637 |
|
4,724 |
4,601 |
$229K |
| 97110 |
|
4,180 |
1,409 |
$228K |
| 85025 |
|
64,635 |
59,929 |
$215K |
| 93005 |
|
31,847 |
30,206 |
$211K |
| 70551 |
|
696 |
683 |
$194K |
| 80061 |
|
12,430 |
12,215 |
$188K |
| 99211 |
|
5,759 |
5,558 |
$178K |
| 87536 |
|
1,619 |
1,584 |
$177K |
| 73721 |
|
572 |
545 |
$173K |
| 71046 |
|
10,270 |
9,874 |
$170K |
| 72148 |
|
868 |
844 |
$168K |
| 96361 |
|
3,215 |
2,472 |
$163K |
| 72141 |
|
540 |
534 |
$149K |
| 74183 |
|
343 |
340 |
$149K |
| 96365 |
|
3,974 |
2,891 |
$144K |
| 82306 |
|
3,542 |
3,473 |
$140K |
| 97162 |
|
2,218 |
2,160 |
$136K |
| 96375 |
|
5,489 |
4,053 |
$135K |
| 72197 |
|
282 |
278 |
$133K |
| 450 |
Pov group 1 hd 301-450 lbs |
144 |
78 |
$133K |
| 96374 |
|
4,910 |
4,200 |
$132K |
| 73221 |
|
421 |
404 |
$120K |
| J2323 |
Natalizumab injection |
148 |
138 |
$118K |
| 84443 |
|
4,861 |
4,740 |
$116K |
| 77063 |
|
4,465 |
4,368 |
$115K |
| 71260 |
|
1,997 |
1,950 |
$112K |
| 80050 |
|
3,163 |
3,058 |
$108K |
| 43239 |
|
583 |
570 |
$107K |
| 95806 |
|
1,207 |
1,187 |
$106K |
| 76770 |
|
1,655 |
1,625 |
$103K |
| 70450 |
|
2,428 |
2,352 |
$102K |
| 99214 |
|
1,767 |
1,697 |
$101K |
| 76536 |
|
1,734 |
1,697 |
$99K |
| 76705 |
|
2,751 |
2,684 |
$98K |
| 76811 |
|
795 |
782 |
$95K |
| 87636 |
|
1,380 |
1,369 |
$90K |
| 76642 |
|
1,774 |
1,602 |
$89K |
| 36415 |
|
11,008 |
8,689 |
$81K |
| 76816 |
|
1,524 |
1,365 |
$79K |
| G0480 |
Drug test def 1-7 classes |
2,667 |
2,397 |
$78K |
| 78452 |
|
484 |
472 |
$76K |
| 77066 |
Tomosynthesis, mammo |
751 |
734 |
$76K |
| 74178 |
|
313 |
306 |
$73K |
| 97530 |
|
1,332 |
557 |
$71K |
| 64615 |
|
502 |
494 |
$69K |
| 87631 |
|
1,079 |
1,044 |
$69K |
| 95700 |
|
306 |
289 |
$64K |
| 77065 |
Tomosynthesis, mammo |
762 |
711 |
$63K |
| 77386 |
|
231 |
25 |
$63K |
| 93971 |
|
1,088 |
1,051 |
$62K |
| 76830 |
|
1,509 |
1,452 |
$60K |
| 71250 |
|
847 |
831 |
$59K |
| 87389 |
|
1,861 |
1,822 |
$58K |
| 76856 |
|
1,644 |
1,586 |
$58K |
| 62323 |
|
442 |
438 |
$57K |
| 83036 |
|
8,151 |
8,007 |
$57K |
| 72158 |
|
221 |
216 |
$57K |
| 74176 |
|
950 |
928 |
$54K |
| 84703 |
|
9,938 |
9,334 |
$52K |
| 76700 |
|
827 |
815 |
$51K |
| 93975 |
|
696 |
671 |
$50K |
| J1750 |
Inj iron dextran |
2,797 |
2,079 |
$48K |
| 97165 |
|
732 |
729 |
$46K |
| 93296 |
|
3,293 |
3,265 |
$46K |
| 86803 |
|
2,156 |
2,119 |
$45K |
| 99282 |
|
443 |
427 |
$45K |
| 84484 |
|
10,412 |
9,439 |
$45K |
| 80081 |
|
494 |
487 |
$45K |
| 99215 |
Prolong outpt/office vis |
570 |
545 |
$44K |
| J0897 |
Denosumab injection |
86 |
79 |
$43K |
| 96372 |
|
2,780 |
2,192 |
$43K |
| D1110 |
|
1,273 |
1,265 |
$43K |
| 80307 |
|
697 |
673 |
$42K |
| J0185 |
Inj., aprepitant, 1 mg |
873 |
619 |
$42K |
| 76813 |
|
644 |
635 |
$42K |
| D7140 |
|
610 |
310 |
$41K |
| J2785 |
Regadenoson injection |
1,137 |
1,100 |
$40K |
| 81003 |
|
22,742 |
21,643 |
$40K |
| 93970 |
|
426 |
405 |
$39K |
| 93226 |
|
894 |
874 |
$38K |
| 93017 |
|
897 |
874 |
$36K |
| 93976 |
|
461 |
451 |
$36K |
| 96417 |
|
561 |
336 |
$35K |
| 95708 |
|
267 |
211 |
$35K |
| 77080 |
|
584 |
573 |
$35K |
| 76775 |
|
742 |
728 |
$35K |
| 92507 |
|
937 |
345 |
$34K |
| 16020 |
|
1,349 |
1,173 |
$34K |
| 72156 |
|
129 |
126 |
$34K |
| 97166 |
|
564 |
546 |
$33K |
| 97164 |
|
791 |
772 |
$33K |
| 96040 |
|
678 |
665 |
$32K |
| 74018 |
|
1,626 |
1,568 |
$32K |
| J0585 |
Injection,onabotulinumtoxina |
667 |
538 |
$32K |
| G0463 |
Hospital outpt clinic visit |
2,049 |
1,794 |
$32K |
| 86480 |
|
420 |
409 |
$31K |
| 36430 |
|
187 |
162 |
$30K |
| 76805 |
|
507 |
499 |
$30K |
| 99213 |
|
758 |
721 |
$30K |
| 86780 |
|
1,763 |
1,721 |
$30K |
| 73564 |
|
1,437 |
1,319 |
$29K |
| 87880 |
|
2,739 |
2,657 |
$29K |
| 96360 |
|
1,042 |
791 |
$28K |
| 76885 |
|
256 |
253 |
$28K |
| 96415 |
|
747 |
600 |
$28K |
| 85027 |
|
3,743 |
3,610 |
$27K |
| 70544 |
|
124 |
123 |
$27K |
| 83690 |
|
8,131 |
7,682 |
$27K |
| 80048 |
|
3,421 |
3,207 |
$27K |
| 64493 |
|
141 |
131 |
$26K |
| 92579 |
|
439 |
428 |
$26K |
| 76818 |
|
367 |
254 |
$26K |
| 77412 |
|
581 |
65 |
$26K |
| 77336 |
|
627 |
299 |
$26K |
| 72110 |
|
1,144 |
1,135 |
$26K |
| 84702 |
|
2,105 |
1,791 |
$25K |
| 97140 |
|
1,041 |
382 |
$25K |
| 92587 |
|
722 |
706 |
$25K |
| 76817 |
|
362 |
303 |
$25K |
| 94729 |
|
694 |
680 |
$23K |
| A9500 |
Tc99m sestamibi |
241 |
234 |
$23K |
| 70486 |
|
349 |
343 |
$23K |
| 76821 |
|
353 |
157 |
$23K |
| J1756 |
Iron sucrose injection |
3,976 |
1,780 |
$23K |
| D0120 |
|
1,144 |
1,136 |
$23K |
| 87491 |
|
1,088 |
1,064 |
$22K |
| 82728 |
|
1,807 |
1,760 |
$22K |
| 92523 |
|
259 |
257 |
$22K |
| 66984 |
|
34 |
26 |
$22K |
| 96411 |
|
307 |
217 |
$22K |
| 87591 |
|
1,096 |
1,070 |
$21K |
| 12001 |
|
180 |
177 |
$21K |
| 82570 |
|
3,082 |
2,991 |
$21K |
| 76870 |
|
456 |
446 |
$20K |
| 72125 |
|
566 |
555 |
$19K |
| 97163 |
|
302 |
292 |
$19K |
| 78264 |
|
193 |
188 |
$19K |
| 93225 |
|
955 |
934 |
$18K |
| 95886 |
|
403 |
384 |
$18K |
| 82043 |
|
2,467 |
2,413 |
$18K |
| 93350 |
|
382 |
368 |
$18K |
| A9585 |
Gadobutrol injection |
1,212 |
705 |
$18K |
| 86360 |
|
275 |
268 |
$18K |
| 10005 |
|
131 |
130 |
$18K |
| 84466 |
|
1,003 |
983 |
$18K |
| 64483 |
|
98 |
96 |
$17K |
| 83970 |
|
390 |
381 |
$16K |
| 86003 |
|
95 |
94 |
$16K |
| 77334 |
|
228 |
206 |
$16K |
| 94726 |
|
490 |
479 |
$16K |
| J2469 |
Palonosetron hcl |
2,635 |
1,654 |
$16K |
| 87086 |
|
2,762 |
2,663 |
$16K |
| 80074 |
|
289 |
282 |
$16K |
| 73610 |
|
1,004 |
969 |
$16K |
| 97597 |
|
775 |
589 |
$16K |
| G2066 |
Inter devc remote 30d |
603 |
600 |
$15K |
| 83880 |
|
1,187 |
1,139 |
$15K |
| 85610 |
|
5,315 |
4,542 |
$15K |
| 93923 |
|
274 |
269 |
$15K |
| 86706 |
|
1,022 |
1,009 |
$15K |
| 73030 |
|
1,037 |
993 |
$15K |
| 72050 |
|
515 |
509 |
$14K |
| 73630 |
|
1,391 |
1,293 |
$14K |
| 70491 |
|
211 |
211 |
$14K |
| 72082 |
|
282 |
277 |
$14K |
| 97112 |
|
475 |
226 |
$14K |
| 86359 |
|
275 |
268 |
$14K |
| 77062 |
|
539 |
526 |
$14K |
| M0243 |
Casirivi and imdevi inj |
38 |
37 |
$13K |
| 92567 |
|
890 |
872 |
$13K |
| 92557 |
|
377 |
373 |
$13K |
| 95954 |
|
411 |
310 |
$13K |
| 82784 |
|
562 |
549 |
$12K |
| 87522 |
Neg quan hep c or qual rna |
304 |
294 |
$12K |
| 73502 |
|
630 |
609 |
$12K |
| 76819 |
|
176 |
122 |
$12K |
| 87800 |
|
623 |
603 |
$11K |
| 73130 |
|
1,054 |
934 |
$11K |
| 82947 |
|
6,425 |
5,785 |
$11K |
| 96366 |
|
697 |
456 |
$11K |
| 82607 |
|
813 |
794 |
$11K |
| 86850 |
|
1,918 |
1,707 |
$11K |
| 93880 |
|
129 |
124 |
$11K |
| 71045 |
|
3,088 |
2,948 |
$11K |
| 72146 |
|
56 |
56 |
$11K |
| J7030 |
Normal saline solution infus |
31,855 |
25,569 |
$11K |
| C9803 |
Hopd covid-19 spec collect |
1,049 |
1,022 |
$11K |
| 83735 |
|
2,890 |
2,625 |
$10K |
| 87635 |
|
471 |
441 |
$10K |
| 95819 |
|
416 |
408 |
$10K |
| 92611 |
|
266 |
259 |
$10K |
| 84403 |
|
338 |
328 |
$10K |
| 83540 |
|
1,131 |
1,105 |
$10K |
| 80076 |
|
1,014 |
1,004 |
$10K |
| 96401 |
|
307 |
180 |
$10K |
| 76820 |
|
327 |
144 |
$10K |
| 80305 |
|
1,795 |
1,671 |
$9K |
| 84439 |
|
1,138 |
1,110 |
$9K |
| 45385 |
|
39 |
39 |
$9K |
| 49083 |
|
30 |
12 |
$9K |
| 96416 |
|
58 |
38 |
$9K |
| 73110 |
|
649 |
625 |
$9K |
| G0297 |
Ldct for lung ca screen |
104 |
104 |
$9K |
| 81001 |
|
4,997 |
4,780 |
$9K |
| 91200 |
|
305 |
301 |
$8K |
| 84480 |
|
939 |
933 |
$8K |
| 86038 |
|
532 |
522 |
$8K |
| J7120 |
Ringers lactate infusion |
22,234 |
19,419 |
$8K |
| 86704 |
|
455 |
447 |
$8K |
| 84436 |
|
747 |
744 |
$8K |
| 87340 |
|
460 |
447 |
$8K |
| 96409 |
|
87 |
58 |
$7K |
| 83605 |
|
2,139 |
1,983 |
$7K |
| 17108 |
|
75 |
73 |
$7K |
| 86618 |
|
348 |
343 |
$7K |
| 72100 |
|
332 |
327 |
$7K |
| 74230 |
|
286 |
279 |
$7K |
| 88172 |
|
134 |
132 |
$7K |
| 84153 |
|
279 |
270 |
$7K |
| 70480 |
|
56 |
54 |
$7K |
| 78227 |
|
26 |
26 |
$7K |
| 74240 |
|
149 |
148 |
$7K |
| 10060 |
|
107 |
102 |
$7K |
| 84146 |
|
235 |
234 |
$6K |
| 86708 |
|
405 |
399 |
$6K |
| 96523 |
|
323 |
256 |
$6K |
| G0008 |
Admin influenza virus vac |
793 |
786 |
$6K |
| 86900 |
|
1,996 |
1,782 |
$6K |
| 12011 |
|
66 |
65 |
$6K |
| 77387 |
|
92 |
12 |
$6K |
| D0274 |
|
214 |
214 |
$6K |
| 74221 |
|
103 |
100 |
$6K |
| 82105 |
|
272 |
258 |
$6K |
| 85379 |
|
1,316 |
1,279 |
$6K |
| J9395 |
Injection, fulvestrant |
12 |
12 |
$6K |
| 77300 |
|
150 |
142 |
$6K |
| 86901 |
|
1,980 |
1,766 |
$6K |
| 93798 |
|
209 |
41 |
$5K |
| 86235 |
|
283 |
279 |
$5K |
| 72131 |
|
89 |
88 |
$5K |
| 84460 |
|
587 |
577 |
$5K |
| 95910 |
|
75 |
74 |
$5K |
| J2405 |
Ondansetron hcl injection |
19,874 |
16,014 |
$5K |
| 90686 |
|
696 |
690 |
$5K |
| 70360 |
|
407 |
403 |
$5K |
| 85730 |
|
860 |
837 |
$5K |
| 59025 |
|
368 |
309 |
$5K |
| 71271 |
|
52 |
49 |
$5K |
| 82746 |
|
367 |
360 |
$5K |
| 83655 |
|
391 |
379 |
$5K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
4,364 |
2,825 |
$5K |
| 96376 |
|
742 |
568 |
$5K |
| 73590 |
|
359 |
338 |
$5K |
| A9579 |
Gad-base mr contrast nos,1ml |
928 |
544 |
$5K |
| J2704 |
Inj, propofol, 10 mg |
10,553 |
5,746 |
$4K |
| 73220 |
|
13 |
12 |
$4K |
| 84270 |
|
150 |
149 |
$4K |
| 82950 |
|
584 |
572 |
$4K |
| 86225 |
|
296 |
287 |
$4K |
| 94640 |
|
189 |
171 |
$4K |
| 82962 |
|
2,677 |
2,337 |
$4K |
| 88185 |
|
14 |
13 |
$4K |
| 83001 |
|
224 |
216 |
$4K |
| 78306 |
|
82 |
82 |
$4K |
| 76882 |
|
505 |
451 |
$4K |
| 76827 |
|
82 |
82 |
$4K |
| 88173 |
|
137 |
135 |
$4K |
| 86200 |
|
275 |
271 |
$4K |
| 83021 |
|
175 |
162 |
$4K |
| 64400 |
|
30 |
28 |
$4K |
| 85652 |
|
1,466 |
1,413 |
$4K |
| 45378 |
|
13 |
13 |
$4K |
| 74022 |
|
234 |
229 |
$4K |
| 76641 |
|
62 |
44 |
$4K |
| D0220 |
|
512 |
501 |
$4K |
| 94010 |
|
437 |
428 |
$4K |
| 86160 |
|
112 |
104 |
$4K |
| 80197 |
|
303 |
236 |
$4K |
| 72040 |
|
214 |
209 |
$4K |
| 72072 |
|
181 |
178 |
$4K |
| 90715 |
|
1,075 |
1,009 |
$4K |
| 81025 |
|
2,331 |
2,191 |
$4K |
| 86140 |
|
1,340 |
1,292 |
$4K |
| 96402 |
|
138 |
132 |
$3K |
| 72070 |
|
151 |
147 |
$3K |
| 73080 |
|
360 |
344 |
$3K |
| 73523 |
|
105 |
102 |
$3K |
| J3010 |
Fentanyl citrate injection |
9,739 |
8,351 |
$3K |
| 94727 |
|
161 |
158 |
$3K |
| 88305 |
|
1,282 |
1,246 |
$3K |
| 94060 |
|
291 |
286 |
$3K |
| 87186 |
|
654 |
638 |
$3K |
| J1885 |
Ketorolac tromethamine inj |
28,793 |
23,702 |
$3K |
| 73560 |
|
223 |
194 |
$3K |
| D0140 |
|
260 |
256 |
$3K |
| 97168 |
|
70 |
68 |
$3K |
| 76825 |
|
123 |
116 |
$3K |
| 86431 |
|
372 |
366 |
$3K |
| 77049 |
|
12 |
12 |
$3K |
| 72157 |
|
12 |
12 |
$3K |
| 88313 |
|
58 |
57 |
$3K |
| 95885 |
|
73 |
64 |
$3K |
| 73140 |
|
367 |
360 |
$3K |
| 83525 |
|
217 |
217 |
$3K |
| J2930 |
Methylprednisolone injection |
2,201 |
1,736 |
$3K |
| 87077 |
|
645 |
627 |
$3K |
| 62321 |
|
16 |
16 |
$3K |
| 82550 |
|
556 |
532 |
$3K |
| 84165 |
|
196 |
187 |
$3K |
| 80164 |
|
238 |
209 |
$3K |
| 84156 |
|
624 |
586 |
$3K |
| 71101 |
|
180 |
175 |
$3K |
| J3301 |
Triamcinolone acet inj nos |
1,915 |
1,886 |
$2K |
| 73552 |
|
163 |
149 |
$2K |
| 97167 |
|
41 |
41 |
$2K |
| J1100 |
Dexamethasone sodium phos |
9,520 |
7,317 |
$2K |
| 99202 |
|
80 |
79 |
$2K |
| 77061 |
|
88 |
88 |
$2K |
| D0330 |
|
70 |
70 |
$2K |
| 83002 |
|
128 |
124 |
$2K |
| 74246 |
|
55 |
55 |
$2K |
| 92522 |
|
41 |
41 |
$2K |
| 84550 |
|
343 |
324 |
$2K |
| 70496 |
|
17 |
17 |
$2K |
| 77072 |
|
164 |
159 |
$2K |
| G2023 |
Specimen collect covid-19 |
161 |
159 |
$2K |
| D0150 |
|
94 |
94 |
$2K |
| 73700 |
|
27 |
27 |
$2K |
| 84100 |
|
570 |
502 |
$2K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
12,059 |
10,014 |
$2K |
| D0210 |
|
46 |
46 |
$2K |
| 84630 |
|
128 |
126 |
$2K |
| 87040 |
|
227 |
219 |
$2K |
| 92593 |
|
107 |
105 |
$2K |
| 92083 |
|
44 |
44 |
$2K |
| 88342 |
|
229 |
228 |
$2K |
| 95816 |
|
147 |
146 |
$2K |
| 74019 |
|
130 |
126 |
$2K |
| 85045 |
|
351 |
327 |
$2K |
| 73090 |
|
202 |
192 |
$2K |
| S0028 |
Injection, famotidine, 20 mg |
3,527 |
2,858 |
$2K |
| 83520 |
|
196 |
189 |
$2K |
| X0592 |
|
92 |
85 |
$2K |
| 82803 |
|
163 |
150 |
$2K |
| 87653 |
|
41 |
41 |
$2K |
| 84590 |
|
109 |
107 |
$2K |
| D2391 |
|
29 |
24 |
$2K |
| A9270 |
Non-covered item or service |
29,172 |
10,733 |
$1K |
| 0202U |
|
174 |
170 |
$1K |
| 45380 |
|
13 |
13 |
$1K |
| 86039 |
|
95 |
95 |
$1K |
| 84425 |
|
177 |
170 |
$1K |
| 86255 |
|
43 |
42 |
$1K |
| 64405 |
|
13 |
13 |
$1K |
| 83615 |
|
213 |
198 |
$1K |
| 82670 |
|
54 |
50 |
$1K |
| 82533 |
|
95 |
92 |
$1K |
| 99153 |
Mod sedat endo service >5yrs |
203 |
194 |
$1K |
| 86800 |
|
64 |
63 |
$1K |
| 82330 |
|
324 |
304 |
$1K |
| 12002 |
|
14 |
14 |
$1K |
| 90471 |
|
259 |
244 |
$1K |
| 64494 |
|
64 |
56 |
$1K |
| J9045 |
Carboplatin injection |
109 |
75 |
$1K |
| 77280 |
|
31 |
26 |
$1K |
| 72220 |
|
62 |
60 |
$1K |
| D1206 |
|
68 |
66 |
$1K |
| 70498 |
|
13 |
13 |
$999.12 |
| 92133 |
|
85 |
85 |
$981.34 |
| D0230 |
|
73 |
70 |
$975.50 |
| J2270 |
Morphine sulfate injection |
4,631 |
3,581 |
$975.12 |
| J9190 |
Fluorouracil injection |
534 |
202 |
$952.83 |
| J2370 |
Phenylephrine hcl injection |
376 |
349 |
$929.30 |
| 84132 |
|
340 |
270 |
$926.84 |
| 99152 |
|
235 |
226 |
$918.24 |
| 86617 |
|
48 |
48 |
$889.76 |
| J0640 |
Leucovorin calcium injection |
341 |
199 |
$888.67 |
| 83516 |
|
71 |
68 |
$887.06 |
| J1170 |
Hydromorphone injection |
2,319 |
1,253 |
$873.76 |
| 73562 |
|
48 |
39 |
$858.43 |
| 86695 |
|
40 |
40 |
$858.30 |
| D2392 |
|
13 |
13 |
$836.20 |
| 76506 |
|
13 |
13 |
$827.97 |
| 73660 |
|
117 |
115 |
$815.49 |
| 82977 |
|
78 |
74 |
$780.48 |
| 94761 |
|
164 |
161 |
$775.98 |
| 73060 |
|
99 |
95 |
$746.08 |
| 82248 |
|
96 |
96 |
$723.36 |
| 86696 |
|
28 |
28 |
$714.93 |
| 27096 |
|
12 |
12 |
$695.82 |
| 29125 |
|
61 |
60 |
$682.99 |
| J1200 |
Diphenhydramine hcl injectio |
7,987 |
6,077 |
$677.41 |
| 94375 |
|
34 |
34 |
$666.31 |
| 80177 |
|
63 |
62 |
$656.10 |
| 86376 |
|
76 |
75 |
$647.69 |
| J0780 |
Prochlorperazine injection |
2,058 |
1,765 |
$646.45 |
| 83498 |
|
27 |
27 |
$631.94 |
| 82785 |
|
30 |
30 |
$600.68 |
| 82627 |
|
24 |
24 |
$593.48 |
| J7040 |
Normal saline solution infus |
3,987 |
3,177 |
$578.81 |
| 86592 |
|
132 |
130 |
$572.18 |
| 96368 |
|
50 |
28 |
$554.55 |
| 86923 |
|
32 |
29 |
$553.58 |
| 76604 |
|
26 |
26 |
$541.58 |
| J2800 |
Methocarbamol injection |
1,599 |
1,476 |
$530.71 |
| Q3014 |
Telehealth facility fee |
185 |
140 |
$526.74 |
| 82805 |
|
41 |
41 |
$511.43 |
| 51798 |
|
161 |
148 |
$488.06 |
| 82810 |
|
113 |
104 |
$478.41 |
| 96367 |
|
59 |
54 |
$466.51 |
| J0171 |
Adrenalin epinephrine inject |
677 |
480 |
$451.78 |
| G0009 |
Admin pneumococcal vaccine |
44 |
44 |
$426.71 |
| 85007 |
|
96 |
93 |
$418.89 |
| 87517 |
|
13 |
13 |
$416.74 |
| 76942 |
|
12 |
12 |
$415.57 |
| 97010 |
|
17 |
12 |
$412.76 |
| J3480 |
Inj potassium chloride |
1,529 |
797 |
$408.55 |
| 88184 |
|
14 |
13 |
$403.89 |
| A9541 |
Tc99m sulfur colloid |
14 |
14 |
$373.40 |
| 93308 |
|
29 |
29 |
$362.15 |
| 90732 |
|
12 |
12 |
$360.63 |
| 86665 |
|
16 |
16 |
$344.75 |
| 86762 |
|
14 |
13 |
$334.11 |
| 80178 |
|
75 |
70 |
$333.81 |
| J2710 |
Neostigmine methylslfte inj |
394 |
326 |
$329.76 |
| 93922 |
|
13 |
13 |
$323.46 |
| 87070 |
|
147 |
140 |
$316.12 |
| J2795 |
Ropivacaine hcl injection |
1,066 |
978 |
$312.03 |
| 84481 |
|
13 |
13 |
$302.67 |
| 84295 |
|
224 |
209 |
$294.10 |
| J2920 |
Methylprednisolone injection |
786 |
627 |
$288.58 |
| J7050 |
Normal saline solution infus |
3,970 |
2,823 |
$283.25 |
| 82435 |
|
151 |
141 |
$273.73 |
| 82150 |
|
63 |
62 |
$269.26 |
| J3475 |
Inj magnesium sulfate |
678 |
440 |
$258.73 |
| J2765 |
Metoclopramide hcl injection |
4,350 |
3,838 |
$258.17 |
| 85018 |
|
142 |
123 |
$243.66 |
| J3411 |
Thiamine hcl 100 mg |
640 |
411 |
$238.36 |
| 86664 |
|
14 |
14 |
$236.88 |
| 82378 |
|
13 |
13 |
$232.33 |
| 86308 |
|
46 |
41 |
$222.69 |
| J2060 |
Lorazepam injection |
2,922 |
2,306 |
$219.02 |
| C1769 |
Guide wire |
109 |
107 |
$215.55 |
| 73120 |
|
17 |
12 |
$207.87 |
| 72202 |
|
12 |
12 |
$207.82 |
| 86663 |
|
14 |
14 |
$203.16 |
| 87205 |
|
144 |
137 |
$200.39 |
| 82951 |
|
14 |
12 |
$199.19 |
| 86705 |
|
13 |
13 |
$193.21 |
| J0696 |
Ceftriaxone sodium injection |
1,909 |
1,672 |
$166.87 |
| J3370 |
Vancomycin hcl injection |
705 |
560 |
$161.19 |
| J0690 |
Cefazolin sodium injection |
2,383 |
1,844 |
$157.43 |
| J1644 |
Inj heparin sodium per 1000u |
2,597 |
1,354 |
$152.72 |
| 85014 |
|
105 |
86 |
$151.85 |
| J1815 |
Insulin injection |
2,201 |
941 |
$150.42 |
| C9113 |
Inj pantoprazole sodium, via |
474 |
403 |
$147.70 |
| J2250 |
Inj midazolam hydrochloride |
4,545 |
3,675 |
$137.85 |
| 87088 |
|
25 |
25 |
$133.78 |
| 99201 |
|
19 |
18 |
$123.72 |
| 92592 |
|
12 |
12 |
$112.85 |
| 64450 |
|
15 |
15 |
$86.91 |
| 91320 |
|
82 |
81 |
$84.76 |
| 82565 |
|
12 |
12 |
$77.31 |
| J7512 |
Prednisone ir or dr oral 1mg |
2,715 |
2,240 |
$73.78 |
| 82140 |
|
14 |
14 |
$65.93 |
| 82010 |
|
36 |
36 |
$64.47 |
| 82375 |
|
24 |
24 |
$57.94 |
| J1630 |
Haloperidol injection |
277 |
203 |
$54.60 |
| 84155 |
|
12 |
12 |
$52.06 |
| J7060 |
5% dextrose/water |
676 |
424 |
$51.06 |
| 87147 |
|
12 |
12 |
$48.00 |
| J7042 |
5% dextrose/normal saline |
654 |
453 |
$39.99 |
| J7510 |
Prednisolone oral per 5 mg |
1,104 |
912 |
$39.23 |
| J7620 |
Albuterol ipratrop non-comp |
1,480 |
1,115 |
$33.01 |
| 88307 |
|
39 |
37 |
$31.63 |
| J3360 |
Diazepam injection |
170 |
106 |
$31.58 |
| J1790 |
Droperidol injection |
679 |
582 |
$31.20 |
| J1940 |
Furosemide injection |
250 |
187 |
$28.63 |
| 88304 |
|
31 |
30 |
$24.87 |
| 87075 |
|
13 |
12 |
$21.50 |
| J0330 |
Succinycholine chloride inj |
26 |
14 |
$15.19 |
| 82009 |
|
17 |
16 |
$10.54 |
| J1650 |
Inj enoxaparin sodium |
203 |
145 |
$6.46 |
| Q9957 |
Inj perflutren lip micros,ml |
499 |
493 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
474 |
362 |
$0.00 |
| J2272 |
Inj, morphine (fresenius) |
427 |
395 |
$0.00 |
| J1453 |
Fosaprepitant injection |
117 |
89 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
734 |
537 |
$0.00 |
| J0134 |
Inj acetaminophen -fresenius |
63 |
61 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
101 |
50 |
$0.00 |
| J0136 |
Inj, acetaminophen (b braun) |
251 |
241 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
842 |
659 |
$0.00 |
| J3489 |
Zoledronic acid 1mg |
13 |
12 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
54 |
49 |
$0.00 |
| S0030 |
Injection, metronidazole |
28 |
16 |
$0.00 |
| J0701 |
Inj. cefepime hcl (baxter) |
30 |
26 |
$0.00 |
| J1953 |
Levetiracetam injection |
17 |
12 |
$0.00 |
| J0137 |
Inj, acetaminophen (hikma) |
88 |
79 |
$0.00 |
| 90687 |
|
15 |
14 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
19 |
13 |
$0.00 |
| J3032 |
Inj. eptinezumab-jjmr 1 mg |
13 |
13 |
$0.00 |
| 90375 |
|
12 |
12 |
$0.00 |
| J3420 |
Vitamin b12 injection |
101 |
74 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
41 |
41 |
$0.00 |
| 90480 |
|
86 |
86 |
$0.00 |
| J7613 |
Albuterol non-comp unit |
1,058 |
973 |
$0.00 |
| J0129 |
Abatacept injection |
218 |
196 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
121 |
112 |
$0.00 |
| 88341 |
|
12 |
12 |
$0.00 |
| 90656 |
|
51 |
51 |
$0.00 |
| J1836 |
Inj, metronidazole, 10 mg |
70 |
58 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
125 |
102 |
$0.00 |
| V2788 |
Presbyopia-correct function |
29 |
24 |
$0.00 |
| J3490 |
Drugs unclassified injection |
15 |
13 |
$0.00 |
| J1642 |
Inj heparin sodium per 10 u |
30 |
13 |
$0.00 |
| J2560 |
Phenobarbital sodium inj |
13 |
12 |
$0.00 |
| J7644 |
Ipratropium bromide non-comp |
24 |
20 |
$0.00 |