| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
40,482 |
39,776 |
$11.95M |
| 99283 |
|
68,766 |
67,757 |
$11.91M |
| G0378 |
Hospital observation per hr |
10,241 |
6,239 |
$7.54M |
| D2930 |
|
5,950 |
4,126 |
$6.78M |
| J1745 |
Infliximab not biosimil 10mg |
2,587 |
2,394 |
$5.79M |
| T1015 |
Clinic service |
32,360 |
18,625 |
$2.61M |
| J1569 |
Gammagard liquid injection |
1,116 |
827 |
$2.40M |
| 69436 |
|
3,180 |
3,155 |
$2.28M |
| 99285 |
|
9,237 |
8,895 |
$1.98M |
| 70551 |
|
2,934 |
2,848 |
$1.34M |
| 96413 |
|
3,863 |
3,514 |
$1.03M |
| V5261 |
Hearing aid, digit, bin, bte |
181 |
177 |
$970K |
| 92507 |
|
26,403 |
7,414 |
$875K |
| J0585 |
Injection,onabotulinumtoxina |
1,863 |
1,758 |
$816K |
| 93303 |
|
3,922 |
3,824 |
$762K |
| 70553 |
|
1,382 |
1,369 |
$712K |
| 93306 |
|
2,411 |
2,351 |
$680K |
| 95782 |
|
408 |
408 |
$642K |
| 99282 |
|
5,664 |
5,591 |
$632K |
| 85025 |
|
46,575 |
40,168 |
$533K |
| 43239 |
|
1,187 |
1,180 |
$494K |
| J3380 |
Inj vedolizumab iv 1 mg |
276 |
265 |
$422K |
| 42820 |
|
358 |
355 |
$404K |
| 84443 |
|
9,088 |
8,953 |
$395K |
| J1100 |
Dexamethasone sodium phos |
20,941 |
16,980 |
$381K |
| G0480 |
Drug test def 1-7 classes |
634 |
620 |
$375K |
| 93005 |
|
15,871 |
15,266 |
$330K |
| J2405 |
Ondansetron hcl injection |
26,892 |
22,109 |
$325K |
| 95810 |
|
543 |
541 |
$317K |
| 80048 |
|
11,296 |
9,050 |
$278K |
| 93320 |
|
3,863 |
3,751 |
$276K |
| 76770 |
|
2,663 |
2,615 |
$261K |
| 99281 |
|
4,100 |
4,034 |
$258K |
| U0003 |
Cov-19 amp prb hgh thruput |
13,070 |
12,939 |
$252K |
| D7140 |
|
3,734 |
2,909 |
$249K |
| 0241U |
|
12,043 |
11,947 |
$249K |
| J7030 |
Normal saline solution infus |
9,717 |
7,579 |
$245K |
| 64642 |
|
621 |
618 |
$215K |
| 80053 |
|
7,687 |
7,209 |
$201K |
| D2391 |
|
1,207 |
1,031 |
$197K |
| 71046 |
|
8,352 |
8,089 |
$197K |
| 96361 |
|
3,146 |
2,319 |
$190K |
| J3490 |
Drugs unclassified injection |
24,242 |
13,524 |
$187K |
| 73721 |
|
299 |
295 |
$186K |
| 92567 |
|
7,362 |
7,267 |
$186K |
| 82977 |
|
11,578 |
9,413 |
$183K |
| 82306 |
|
4,204 |
4,119 |
$181K |
| 94010 |
|
7,976 |
7,854 |
$179K |
| 72141 |
|
334 |
326 |
$174K |
| 84439 |
|
11,173 |
11,002 |
$174K |
| D2390 |
|
996 |
832 |
$173K |
| 80076 |
|
8,402 |
6,938 |
$169K |
| J7050 |
Normal saline solution infus |
15,544 |
10,542 |
$168K |
| 70543 |
|
177 |
177 |
$167K |
| V5264 |
Ear mold/insert |
2,070 |
1,155 |
$159K |
| 72148 |
|
399 |
390 |
$155K |
| J7042 |
5% dextrose/normal saline |
3,713 |
2,864 |
$154K |
| G0108 |
Diab manage trn per indiv |
2,997 |
2,968 |
$150K |
| 72082 |
|
1,804 |
1,787 |
$147K |
| 54161 |
|
132 |
132 |
$147K |
| 86832 |
|
601 |
563 |
$146K |
| 81229 |
|
247 |
244 |
$140K |
| 83735 |
|
10,639 |
7,407 |
$140K |
| 80061 |
|
4,804 |
4,721 |
$136K |
| 82784 |
|
3,592 |
3,456 |
$136K |
| 42830 |
|
175 |
174 |
$136K |
| 96365 |
|
1,099 |
955 |
$129K |
| 86003 |
|
1,214 |
1,191 |
$128K |
| 87799 |
|
1,441 |
850 |
$126K |
| 45380 |
|
306 |
300 |
$126K |
| J7040 |
Normal saline solution infus |
1,935 |
1,715 |
$124K |
| 86833 |
|
569 |
538 |
$123K |
| J1885 |
Ketorolac tromethamine inj |
19,266 |
16,818 |
$122K |
| 95812 |
|
1,198 |
1,186 |
$119K |
| 80050 |
|
1,312 |
1,304 |
$119K |
| 88230 |
|
340 |
321 |
$114K |
| 92587 |
|
1,721 |
1,698 |
$110K |
| 76885 |
|
510 |
503 |
$109K |
| 95816 |
|
3,237 |
3,220 |
$109K |
| J7120 |
Ringers lactate infusion |
31,855 |
26,833 |
$108K |
| S9470 |
Nutritional counseling, diet |
2,303 |
2,254 |
$106K |
| 36415 |
|
4,954 |
4,074 |
$105K |
| 96040 |
|
1,488 |
1,477 |
$104K |
| 72146 |
|
272 |
266 |
$100K |
| 93975 |
|
1,122 |
1,076 |
$96K |
| J0475 |
Baclofen 10 mg injection |
907 |
766 |
$96K |
| 77073 |
|
1,645 |
1,631 |
$96K |
| 76705 |
|
3,056 |
2,957 |
$95K |
| 96409 |
|
495 |
345 |
$89K |
| J0696 |
Ceftriaxone sodium injection |
1,300 |
1,126 |
$87K |
| 74018 |
|
2,854 |
2,658 |
$86K |
| D2392 |
|
303 |
280 |
$86K |
| 80197 |
|
2,766 |
1,670 |
$86K |
| 74177 |
|
346 |
344 |
$85K |
| 87491 |
|
2,185 |
2,142 |
$84K |
| V5160 |
Dispensing fee binaural |
200 |
196 |
$83K |
| 80069 |
|
2,873 |
2,302 |
$82K |
| 84460 |
|
6,405 |
5,772 |
$82K |
| 87497 |
|
719 |
443 |
$80K |
| 85652 |
|
11,462 |
10,883 |
$79K |
| 88305 |
|
1,922 |
1,870 |
$79K |
| 82728 |
|
4,005 |
3,788 |
$79K |
| 96415 |
|
1,048 |
947 |
$79K |
| 84100 |
|
6,880 |
5,015 |
$76K |
| 87591 |
|
2,154 |
2,113 |
$75K |
| 73610 |
|
2,179 |
2,055 |
$74K |
| 84450 |
|
5,999 |
5,379 |
$73K |
| 86140 |
|
9,328 |
8,734 |
$71K |
| 72081 |
|
1,461 |
1,449 |
$71K |
| 86360 |
|
650 |
638 |
$69K |
| 83036 |
|
5,517 |
5,446 |
$68K |
| 96374 |
|
6,451 |
6,196 |
$68K |
| J7611 |
Albuterol non-comp con |
1,581 |
1,371 |
$65K |
| J0171 |
Adrenalin epinephrine inject |
1,638 |
1,502 |
$65K |
| 69610 |
|
48 |
46 |
$63K |
| 96375 |
|
3,097 |
2,564 |
$62K |
| 73560 |
|
1,687 |
1,585 |
$61K |
| 54830 |
|
56 |
54 |
$59K |
| J3480 |
Inj potassium chloride |
1,280 |
843 |
$57K |
| 97162 |
|
441 |
437 |
$57K |
| 94664 |
|
1,970 |
1,933 |
$56K |
| J0295 |
Ampicillin sulbactam 1.5 gm |
853 |
533 |
$55K |
| G0008 |
Admin influenza virus vac |
508 |
498 |
$54K |
| 97166 |
|
441 |
438 |
$53K |
| 84403 |
|
883 |
872 |
$53K |
| 92557 |
|
731 |
721 |
$53K |
| 82565 |
|
4,500 |
4,314 |
$53K |
| 92611 |
|
542 |
539 |
$52K |
| 86480 |
|
392 |
386 |
$51K |
| 81243 |
|
274 |
271 |
$51K |
| 73630 |
|
2,183 |
2,098 |
$50K |
| 54640 |
|
163 |
161 |
$50K |
| 97110 |
|
878 |
339 |
$49K |
| 43193 |
|
49 |
49 |
$49K |
| A9577 |
Inj multihance |
2,711 |
2,667 |
$49K |
| 86618 |
|
904 |
895 |
$49K |
| 93325 |
|
1,652 |
1,578 |
$49K |
| 82962 |
|
8,481 |
7,961 |
$48K |
| 76700 |
|
434 |
430 |
$48K |
| 83970 |
|
567 |
558 |
$48K |
| 86359 |
|
650 |
638 |
$48K |
| 90674 |
|
1,012 |
995 |
$47K |
| 95700 |
|
762 |
748 |
$47K |
| 36430 |
|
400 |
335 |
$47K |
| 83655 |
|
2,192 |
2,171 |
$45K |
| 44970 |
|
26 |
26 |
$45K |
| 93226 |
|
511 |
499 |
$44K |
| 85045 |
|
4,193 |
3,621 |
$44K |
| 84305 |
|
813 |
808 |
$44K |
| 73564 |
|
752 |
737 |
$43K |
| J3010 |
Fentanyl citrate injection |
22,072 |
16,401 |
$41K |
| 82139 |
|
736 |
691 |
$40K |
| 87631 |
|
147 |
140 |
$40K |
| 86355 |
|
649 |
637 |
$40K |
| 86357 |
|
650 |
638 |
$40K |
| 73090 |
|
2,208 |
1,836 |
$40K |
| 70450 |
|
858 |
843 |
$40K |
| 88185 |
|
250 |
231 |
$39K |
| 84402 |
|
603 |
597 |
$38K |
| 73521 |
|
848 |
830 |
$38K |
| 82570 |
|
2,576 |
2,480 |
$37K |
| V5257 |
Hearing aid, digit, mon, bte |
12 |
12 |
$37K |
| 81001 |
|
13,309 |
12,884 |
$37K |
| 83540 |
|
2,653 |
2,603 |
$36K |
| 70544 |
|
128 |
126 |
$36K |
| 86923 |
|
424 |
370 |
$35K |
| 87661 |
|
721 |
710 |
$35K |
| J0131 |
Inj, acetaminophen (nos) |
16,519 |
12,204 |
$35K |
| D2330 |
|
764 |
700 |
$35K |
| 74230 |
|
535 |
532 |
$35K |
| 82607 |
|
1,830 |
1,825 |
$35K |
| 76775 |
|
298 |
294 |
$34K |
| 76536 |
|
364 |
357 |
$34K |
| 73590 |
|
1,244 |
1,118 |
$34K |
| 83615 |
|
2,340 |
1,876 |
$33K |
| 97165 |
|
243 |
242 |
$33K |
| 95713 |
|
528 |
482 |
$33K |
| 82024 |
|
400 |
394 |
$33K |
| A4606 |
Oxygen probe used w oximeter |
1,016 |
946 |
$32K |
| 77072 |
|
1,327 |
1,317 |
$32K |
| 82785 |
|
906 |
896 |
$32K |
| 84520 |
|
4,029 |
3,867 |
$32K |
| 73100 |
|
1,302 |
1,107 |
$31K |
| 85730 |
|
3,031 |
2,715 |
$31K |
| 82247 |
|
3,295 |
2,805 |
$31K |
| 92555 |
|
2,164 |
2,135 |
$31K |
| P9021 |
Red blood cells unit |
207 |
187 |
$31K |
| 83021 |
|
595 |
538 |
$30K |
| 83001 |
|
807 |
788 |
$30K |
| 92583 |
|
373 |
368 |
$30K |
| 88262 |
|
91 |
90 |
$29K |
| 83002 |
|
810 |
791 |
$29K |
| D1510 |
|
377 |
345 |
$29K |
| 82157 |
|
505 |
499 |
$28K |
| 86317 |
|
212 |
188 |
$28K |
| 84270 |
|
484 |
479 |
$27K |
| 84075 |
|
3,022 |
2,905 |
$27K |
| 74019 |
|
1,331 |
1,265 |
$27K |
| 76506 |
|
232 |
229 |
$27K |
| 74183 |
|
37 |
36 |
$26K |
| 87070 |
|
2,252 |
2,206 |
$26K |
| 85610 |
|
3,562 |
3,180 |
$26K |
| 71260 |
|
170 |
168 |
$26K |
| J0690 |
Cefazolin sodium injection |
5,258 |
4,028 |
$25K |
| 74240 |
|
286 |
285 |
$25K |
| 82627 |
|
536 |
531 |
$25K |
| 93225 |
|
543 |
527 |
$25K |
| 95990 |
|
213 |
198 |
$25K |
| 73070 |
|
1,071 |
938 |
$25K |
| 82550 |
|
1,882 |
1,808 |
$25K |
| 83498 |
|
511 |
500 |
$24K |
| J2250 |
Inj midazolam hydrochloride |
9,480 |
8,612 |
$24K |
| 82248 |
|
2,482 |
2,313 |
$24K |
| 96450 |
|
168 |
148 |
$24K |
| 72158 |
|
41 |
41 |
$24K |
| 97161 |
|
186 |
183 |
$24K |
| J0780 |
Prochlorperazine injection |
466 |
407 |
$24K |
| 85246 |
|
362 |
347 |
$24K |
| 84146 |
|
462 |
458 |
$23K |
| G0109 |
Diab manage trn ind/group |
249 |
245 |
$23K |
| 82670 |
|
482 |
466 |
$23K |
| J2001 |
Lidocaine injection |
731 |
378 |
$22K |
| 87086 |
|
3,512 |
3,383 |
$22K |
| 83880 |
|
460 |
436 |
$21K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
2,748 |
2,432 |
$21K |
| 92552 |
|
1,112 |
1,104 |
$21K |
| 96366 |
|
513 |
454 |
$21K |
| 82533 |
|
590 |
560 |
$20K |
| 83550 |
|
2,585 |
2,543 |
$20K |
| J1815 |
Insulin injection |
110 |
68 |
$20K |
| 76856 |
|
681 |
663 |
$20K |
| J1200 |
Diphenhydramine hcl injectio |
1,750 |
1,450 |
$19K |
| 97167 |
|
133 |
129 |
$19K |
| 85245 |
|
286 |
274 |
$19K |
| 84481 |
|
662 |
661 |
$18K |
| 95951 |
|
37 |
37 |
$18K |
| 85247 |
|
272 |
255 |
$18K |
| 82947 |
|
2,380 |
2,280 |
$17K |
| 85576 |
|
265 |
251 |
$17K |
| 83525 |
|
411 |
389 |
$17K |
| 31624 |
|
49 |
46 |
$17K |
| 87081 |
|
2,137 |
2,084 |
$17K |
| 86800 |
|
409 |
408 |
$17K |
| 93017 |
|
170 |
166 |
$17K |
| 82542 |
|
454 |
403 |
$17K |
| 76800 |
|
146 |
145 |
$17K |
| 72156 |
|
37 |
37 |
$16K |
| V5266 |
Battery for hearing device |
1,574 |
1,537 |
$16K |
| 83690 |
|
2,564 |
2,317 |
$16K |
| 93531 |
|
12 |
12 |
$16K |
| 71555 |
|
28 |
27 |
$16K |
| 83921 |
|
610 |
610 |
$16K |
| 88341 |
|
203 |
190 |
$15K |
| 82105 |
|
445 |
434 |
$15K |
| 88184 |
|
233 |
218 |
$15K |
| 84630 |
|
753 |
751 |
$15K |
| 86850 |
|
1,392 |
1,308 |
$15K |
| 92553 |
|
444 |
438 |
$15K |
| 72157 |
|
25 |
25 |
$14K |
| 82525 |
|
791 |
786 |
$14K |
| 94060 |
|
517 |
495 |
$14K |
| 72170 |
|
708 |
701 |
$14K |
| 31575 |
|
14 |
14 |
$14K |
| 49452 |
|
13 |
13 |
$14K |
| 88342 |
|
406 |
389 |
$14K |
| J2920 |
Methylprednisolone injection |
98 |
79 |
$14K |
| 93321 |
|
356 |
345 |
$13K |
| 82803 |
|
1,056 |
1,011 |
$13K |
| 77074 |
|
186 |
185 |
$13K |
| 87186 |
|
1,282 |
1,260 |
$13K |
| 87635 |
|
212 |
211 |
$13K |
| 86160 |
|
221 |
208 |
$13K |
| 73552 |
|
521 |
486 |
$13K |
| 83516 |
|
423 |
407 |
$13K |
| 73620 |
|
564 |
534 |
$12K |
| 82610 |
|
408 |
399 |
$12K |
| G0481 |
Drug test def 8-14 classes |
13 |
13 |
$12K |
| 84681 |
|
261 |
250 |
$12K |
| D3220 |
|
474 |
443 |
$12K |
| 96411 |
|
89 |
54 |
$12K |
| 86038 |
|
374 |
372 |
$12K |
| 76870 |
|
313 |
296 |
$12K |
| 92591 |
|
189 |
186 |
$12K |
| 70480 |
|
70 |
70 |
$12K |
| 31622 |
|
31 |
31 |
$11K |
| 69210 |
|
12 |
12 |
$11K |
| 86001 |
|
607 |
596 |
$11K |
| 73130 |
|
729 |
699 |
$11K |
| 80299 |
|
439 |
427 |
$11K |
| 97163 |
|
85 |
85 |
$11K |
| 86664 |
|
388 |
381 |
$11K |
| 94621 |
|
80 |
77 |
$11K |
| 71045 |
|
1,047 |
1,004 |
$11K |
| 73562 |
|
501 |
488 |
$11K |
| 82040 |
|
1,993 |
1,924 |
$11K |
| 88249 |
|
28 |
28 |
$11K |
| 64643 |
|
277 |
271 |
$10K |
| 51600 |
|
124 |
123 |
$10K |
| 94761 |
|
167 |
155 |
$10K |
| 83919 |
|
282 |
276 |
$10K |
| 72040 |
|
729 |
702 |
$10K |
| 84155 |
|
1,503 |
1,233 |
$10K |
| J2270 |
Morphine sulfate injection |
1,234 |
959 |
$10K |
| 87633 |
|
13 |
13 |
$10K |
| 73600 |
|
393 |
354 |
$10K |
| 92556 |
|
291 |
289 |
$10K |
| 86376 |
|
559 |
557 |
$9K |
| J7699 |
Inhalation solution for dme |
224 |
164 |
$9K |
| D2331 |
|
125 |
123 |
$9K |
| 85240 |
|
356 |
342 |
$9K |
| 86665 |
|
393 |
380 |
$9K |
| 86663 |
|
386 |
379 |
$9K |
| 73110 |
|
767 |
738 |
$9K |
| 77075 |
|
297 |
295 |
$9K |
| 84590 |
|
325 |
325 |
$9K |
| 73030 |
|
381 |
368 |
$9K |
| 80307 |
|
1,448 |
1,380 |
$9K |
| 80195 |
|
275 |
206 |
$9K |
| 82746 |
|
514 |
513 |
$8K |
| 82150 |
|
1,430 |
1,229 |
$8K |
| 93971 |
|
75 |
74 |
$8K |
| 92595 |
|
421 |
414 |
$8K |
| 87077 |
|
878 |
864 |
$8K |
| 80051 |
|
534 |
522 |
$8K |
| 86901 |
|
1,285 |
1,204 |
$8K |
| 86900 |
|
1,395 |
1,313 |
$8K |
| 70360 |
|
352 |
348 |
$8K |
| 70486 |
|
230 |
227 |
$8K |
| 86255 |
|
195 |
193 |
$8K |
| 96372 |
|
742 |
687 |
$7K |
| 84550 |
|
672 |
633 |
$7K |
| 83993 |
|
195 |
192 |
$7K |
| 85018 |
|
1,276 |
1,262 |
$7K |
| 93308 |
|
180 |
174 |
$7K |
| 80183 |
|
301 |
296 |
$7K |
| 74270 |
|
133 |
133 |
$7K |
| 73080 |
|
691 |
655 |
$7K |
| J2795 |
Ropivacaine hcl injection |
4,777 |
3,643 |
$7K |
| 82747 |
|
173 |
173 |
$7K |
| 73140 |
|
439 |
422 |
$7K |
| 84156 |
|
752 |
716 |
$7K |
| 84480 |
|
422 |
410 |
$7K |
| 82652 |
|
227 |
225 |
$7K |
| 73000 |
|
337 |
312 |
$7K |
| 84446 |
|
299 |
299 |
$6K |
| 74455 |
|
104 |
103 |
$6K |
| 84478 |
|
642 |
285 |
$6K |
| 82180 |
|
600 |
600 |
$6K |
| 92585 |
|
169 |
166 |
$6K |
| 87147 |
|
1,047 |
1,026 |
$6K |
| 93304 |
|
135 |
134 |
$6K |
| 86235 |
|
38 |
38 |
$6K |
| 86803 |
|
163 |
162 |
$6K |
| 73060 |
|
354 |
325 |
$6K |
| 86702 |
|
327 |
322 |
$6K |
| 72100 |
|
240 |
237 |
$5K |
| 86780 |
|
241 |
233 |
$5K |
| 86617 |
|
178 |
173 |
$5K |
| 86706 |
|
216 |
212 |
$5K |
| 86701 |
|
327 |
322 |
$5K |
| 87340 |
|
198 |
196 |
$5K |
| 76942 |
|
264 |
254 |
$5K |
| 82330 |
|
1,138 |
1,089 |
$5K |
| 80175 |
|
233 |
226 |
$5K |
| 81025 |
|
1,811 |
1,722 |
$5K |
| J7644 |
Ipratropium bromide non-comp |
1,710 |
1,597 |
$5K |
| J7510 |
Prednisolone oral per 5 mg |
171 |
98 |
$5K |
| J3475 |
Inj magnesium sulfate |
53 |
44 |
$5K |
| 82726 |
|
121 |
119 |
$5K |
| 85732 |
|
318 |
306 |
$5K |
| 80177 |
|
268 |
260 |
$5K |
| 95716 |
|
76 |
75 |
$5K |
| 87426 |
|
1,851 |
1,828 |
$5K |
| 88313 |
|
252 |
240 |
$4K |
| 84295 |
|
1,261 |
1,164 |
$4K |
| 83605 |
|
345 |
336 |
$4K |
| 94640 |
|
127 |
93 |
$4K |
| 87390 |
|
325 |
320 |
$4K |
| 82390 |
|
208 |
207 |
$4K |
| 76882 |
|
323 |
312 |
$4K |
| 71275 |
|
26 |
25 |
$4K |
| 73700 |
|
38 |
38 |
$4K |
| 85384 |
|
209 |
201 |
$4K |
| 96360 |
|
679 |
661 |
$4K |
| 82310 |
|
331 |
322 |
$4K |
| J1170 |
Hydromorphone injection |
2,564 |
1,850 |
$4K |
| 87040 |
|
506 |
476 |
$4K |
| 94760 |
|
598 |
567 |
$4K |
| 0001A |
|
127 |
125 |
$3K |
| 82085 |
|
187 |
181 |
$3K |
| 70491 |
|
25 |
25 |
$3K |
| 86060 |
|
358 |
357 |
$3K |
| J0694 |
Cefoxitin sodium injection |
171 |
93 |
$3K |
| 74220 |
|
85 |
82 |
$3K |
| P9058 |
Rbc, l/r, cmv-neg, irrad |
32 |
27 |
$3K |
| V5241 |
Dispensing fee, monaural |
12 |
12 |
$3K |
| 89051 |
|
314 |
286 |
$3K |
| 72070 |
|
175 |
173 |
$3K |
| 85027 |
|
237 |
229 |
$3K |
| 85660 |
|
270 |
243 |
$3K |
| S0119 |
Ondansetron 4 mg |
5,863 |
5,490 |
$3K |
| J9370 |
Vincristine sulfate 1 mg inj |
1,387 |
963 |
$3K |
| 77080 |
|
28 |
27 |
$3K |
| 86704 |
|
92 |
91 |
$3K |
| 80203 |
|
121 |
119 |
$3K |
| 92594 |
|
142 |
134 |
$3K |
| 82140 |
|
294 |
277 |
$2K |
| 85014 |
|
1,298 |
1,249 |
$2K |
| 82104 |
|
60 |
60 |
$2K |
| 87329 |
|
130 |
128 |
$2K |
| J1953 |
Levetiracetam injection |
61 |
52 |
$2K |
| 84132 |
|
1,134 |
1,073 |
$2K |
| 72125 |
|
115 |
115 |
$2K |
| 83018 |
|
39 |
38 |
$2K |
| 82373 |
|
130 |
126 |
$2K |
| 87102 |
|
153 |
139 |
$2K |
| 80164 |
|
71 |
66 |
$2K |
| 86769 |
|
114 |
112 |
$2K |
| 0071A |
|
58 |
58 |
$2K |
| 86902 |
|
75 |
63 |
$2K |
| Q9958 |
Hocm <=149 mg/ml iodine, 1ml |
239 |
229 |
$2K |
| 70250 |
|
95 |
87 |
$2K |
| 82340 |
|
108 |
106 |
$2K |
| 82945 |
|
258 |
235 |
$2K |
| 94644 |
|
436 |
426 |
$2K |
| 76937 |
|
168 |
160 |
$2K |
| 84157 |
|
256 |
233 |
$2K |
| 83930 |
|
285 |
277 |
$2K |
| 88108 |
|
338 |
313 |
$2K |
| 97530 |
|
41 |
24 |
$2K |
| 82465 |
|
306 |
306 |
$1K |
| 87804 |
|
1,792 |
1,790 |
$1K |
| 92626 |
|
25 |
25 |
$1K |
| U0001 |
2019-ncov diagnostic p |
17 |
16 |
$1K |
| 86592 |
|
250 |
245 |
$1K |
| 87807 |
|
1,788 |
1,786 |
$1K |
| 84484 |
|
374 |
343 |
$1K |
| S0080 |
Injection, pentamidine iseth |
15 |
13 |
$1K |
| 86644 |
|
41 |
41 |
$1K |
| 84703 |
|
114 |
110 |
$1K |
| 80074 |
|
13 |
13 |
$1K |
| 72020 |
|
96 |
94 |
$1K |
| 85540 |
|
59 |
59 |
$1K |
| 87045 |
|
138 |
136 |
$1K |
| 80180 |
|
31 |
30 |
$952.37 |
| 87046 |
|
139 |
137 |
$952.15 |
| 92579 |
|
13 |
13 |
$952.14 |
| 86708 |
|
24 |
24 |
$944.46 |
| 92588 |
|
12 |
12 |
$917.56 |
| 88307 |
|
94 |
87 |
$895.85 |
| 86977 |
|
26 |
25 |
$851.61 |
| 76857 |
|
28 |
28 |
$820.63 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
570 |
565 |
$808.67 |
| 85397 |
|
13 |
13 |
$778.41 |
| 82103 |
|
17 |
17 |
$766.29 |
| 84436 |
|
44 |
44 |
$736.74 |
| J2704 |
Inj, propofol, 10 mg |
8,052 |
6,243 |
$697.55 |
| J1756 |
Iron sucrose injection |
54 |
43 |
$650.40 |
| 89230 |
|
89 |
87 |
$635.23 |
| 86713 |
|
25 |
25 |
$611.77 |
| 85379 |
|
207 |
197 |
$596.30 |
| C9399 |
Unclassified drugs or biolog |
266 |
210 |
$593.56 |
| 85520 |
|
34 |
27 |
$562.90 |
| 99213 |
|
12 |
12 |
$562.23 |
| 84145 |
|
341 |
329 |
$554.58 |
| 83090 |
|
16 |
16 |
$528.97 |
| 86215 |
|
24 |
24 |
$522.07 |
| 0002A |
|
14 |
14 |
$480.00 |
| 88312 |
|
25 |
24 |
$478.82 |
| 83003 |
|
15 |
13 |
$464.26 |
| 86308 |
|
159 |
156 |
$392.08 |
| 83935 |
|
70 |
63 |
$388.21 |
| 88304 |
|
296 |
291 |
$388.19 |
| 84244 |
|
15 |
14 |
$383.52 |
| 84585 |
|
12 |
12 |
$329.92 |
| 87400 |
|
13 |
12 |
$292.33 |
| 87075 |
|
25 |
24 |
$290.18 |
| 73592 |
|
29 |
28 |
$275.31 |
| 83864 |
|
13 |
12 |
$267.30 |
| 82270 |
|
50 |
47 |
$220.27 |
| 83150 |
|
12 |
12 |
$206.19 |
| 82010 |
|
81 |
72 |
$201.20 |
| 87015 |
|
26 |
24 |
$191.24 |
| J1644 |
Inj heparin sodium per 1000u |
1,184 |
436 |
$170.40 |
| 99152 |
|
144 |
143 |
$152.93 |
| 87880 |
|
255 |
251 |
$132.53 |
| 86880 |
|
13 |
13 |
$122.92 |
| 99153 |
Mod sedat endo service >5yrs |
46 |
45 |
$98.44 |
| 85041 |
|
12 |
12 |
$80.17 |
| 99151 |
|
57 |
56 |
$69.04 |
| J7999 |
Compounded drug, noc |
10,547 |
8,560 |
$65.72 |
| 85048 |
|
219 |
217 |
$63.13 |
| J2370 |
Phenylephrine hcl injection |
130 |
101 |
$54.00 |
| 82948 |
|
866 |
843 |
$49.10 |
| J7060 |
5% dextrose/water |
380 |
297 |
$41.50 |
| J2710 |
Neostigmine methylslfte inj |
505 |
348 |
$38.72 |
| 94645 |
|
103 |
97 |
$36.36 |
| J2919 |
Inj, methylpred sod succ 5mg |
89 |
77 |
$27.95 |
| J9250 |
Methotrexate sodium inj |
113 |
102 |
$18.92 |
| 88300 |
|
674 |
662 |
$14.22 |
| 80329 |
|
135 |
132 |
$7.73 |
| J2060 |
Lorazepam injection |
61 |
43 |
$7.02 |
| S0020 |
Injection, bupivicaine hydro |
512 |
427 |
$5.46 |
| 91300 |
|
161 |
158 |
$1.08 |
| 91307 |
|
54 |
54 |
$0.42 |
| J0136 |
Inj, acetaminophen (b braun) |
275 |
263 |
$0.00 |
| J0137 |
Inj, acetaminophen (hikma) |
804 |
770 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
1,577 |
1,558 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
88 |
88 |
$0.00 |
| S0077 |
Injection, clindamycin phosp |
41 |
24 |
$0.00 |
| J9260 |
Inj methotrexate sodium 50mg |
46 |
36 |
$0.00 |
| 81002 |
|
71 |
70 |
$0.00 |
| 90715 |
|
37 |
30 |
$0.00 |
| 90675 |
|
39 |
14 |
$0.00 |
| L1830 |
Ko immob canvas long pre ots |
27 |
27 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
80 |
66 |
$0.00 |
| 90661 |
|
218 |
218 |
$0.00 |
| L4360 |
Pneumat walking boot pre cst |
55 |
54 |
$0.00 |
| Q5121 |
Inj. avsola, 10 mg |
1,733 |
1,512 |
$0.00 |
| A9573 |
Inj, gadopiclenol, 1 ml |
478 |
470 |
$0.00 |
| Q5104 |
Injection, renflexis |
66 |
65 |
$0.00 |
| J1626 |
Granisetron hcl injection |
128 |
63 |
$0.00 |
| J8540 |
Oral dexamethasone |
62 |
56 |
$0.00 |
| J7613 |
Albuterol non-comp unit |
28 |
28 |
$0.00 |
| J0173 |
Inj, epinephrine (belcher) |
25 |
25 |
$0.00 |
| 41899 |
|
25 |
25 |
$0.00 |
| J9312 |
Inj., rituximab, 10 mg |
16 |
13 |
$0.00 |