| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
33,467 |
29,147 |
$5.77M |
| 99285 |
|
14,471 |
12,485 |
$5.47M |
| 99283 |
|
32,591 |
29,331 |
$3.18M |
| 74177 |
|
9,752 |
8,661 |
$1.74M |
| 85025 |
|
118,027 |
91,629 |
$1.71M |
| 80053 |
|
86,113 |
71,505 |
$1.71M |
| J7120 |
Ringers lactate infusion |
21,132 |
16,572 |
$821K |
| 96413 |
|
6,710 |
3,665 |
$816K |
| 84443 |
|
25,567 |
23,266 |
$781K |
| A9552 |
F18 fdg |
1,146 |
1,043 |
$744K |
| 88305 |
|
11,521 |
7,470 |
$726K |
| 96375 |
|
17,632 |
11,940 |
$712K |
| 96374 |
|
19,408 |
16,228 |
$709K |
| 80307 |
|
10,675 |
8,928 |
$654K |
| 80048 |
|
37,315 |
28,185 |
$653K |
| 99282 |
|
9,788 |
8,945 |
$650K |
| 71046 |
|
15,100 |
13,702 |
$648K |
| 78452 |
|
2,190 |
1,988 |
$642K |
| 96365 |
|
10,020 |
7,053 |
$611K |
| 87637 |
|
6,294 |
5,752 |
$607K |
| 93005 |
|
38,264 |
32,525 |
$583K |
| 72148 |
|
3,517 |
3,310 |
$580K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
16,258 |
14,063 |
$539K |
| 78815 |
|
1,131 |
1,028 |
$536K |
| 93306 |
|
3,987 |
3,688 |
$508K |
| J2405 |
Ondansetron hcl injection |
20,374 |
14,566 |
$489K |
| 87086 |
|
31,752 |
27,408 |
$461K |
| 71260 |
|
3,459 |
3,103 |
$457K |
| G0378 |
Hospital observation per hr |
9,647 |
3,346 |
$456K |
| 70450 |
|
7,195 |
6,405 |
$452K |
| 84484 |
|
21,895 |
16,415 |
$449K |
| 80061 |
|
16,442 |
15,617 |
$445K |
| 96361 |
|
10,321 |
7,857 |
$444K |
| 87631 |
|
2,759 |
2,392 |
$437K |
| G0480 |
Drug test def 1-7 classes |
5,696 |
4,760 |
$421K |
| J2250 |
Inj midazolam hydrochloride |
9,237 |
7,613 |
$421K |
| 45380 |
|
1,323 |
1,079 |
$417K |
| 81001 |
|
33,625 |
28,884 |
$414K |
| 82248 |
|
32,821 |
27,797 |
$395K |
| 43239 |
|
1,949 |
1,640 |
$385K |
| 11042 |
|
4,044 |
2,325 |
$385K |
| 93458 |
|
359 |
305 |
$382K |
| J1100 |
Dexamethasone sodium phos |
13,304 |
9,611 |
$379K |
| 99212 |
|
22,661 |
19,867 |
$373K |
| J9271 |
Inj pembrolizumab |
130 |
92 |
$373K |
| 82306 |
|
7,654 |
7,215 |
$362K |
| U0002 |
Covid-19 lab test non-cdc |
8,073 |
7,296 |
$359K |
| A9500 |
Tc99m sestamibi |
2,202 |
2,006 |
$342K |
| 83690 |
|
17,127 |
14,609 |
$319K |
| J0690 |
Cefazolin sodium injection |
6,634 |
4,548 |
$307K |
| 85610 |
|
22,820 |
17,511 |
$303K |
| 97110 |
|
10,072 |
3,321 |
$302K |
| 93017 |
|
2,447 |
2,228 |
$297K |
| 96372 |
|
12,199 |
8,090 |
$297K |
| 73721 |
|
1,173 |
1,048 |
$293K |
| 72141 |
|
1,522 |
1,454 |
$293K |
| 88342 |
|
3,794 |
2,990 |
$290K |
| J2785 |
Regadenoson injection |
1,855 |
1,669 |
$279K |
| 74176 |
|
2,820 |
2,552 |
$278K |
| 81025 |
|
8,441 |
7,206 |
$278K |
| 96376 |
|
5,588 |
3,112 |
$273K |
| 45385 |
|
559 |
445 |
$268K |
| 85027 |
|
14,556 |
12,386 |
$259K |
| 77067 |
|
2,148 |
2,037 |
$243K |
| 83735 |
|
17,411 |
10,734 |
$237K |
| 59025 |
|
2,851 |
2,072 |
$236K |
| J7060 |
5% dextrose/water |
5,969 |
3,049 |
$224K |
| 97113 |
|
1,475 |
381 |
$220K |
| 96360 |
|
3,956 |
3,385 |
$219K |
| U0004 |
Cov-19 test non-cdc hgh thru |
2,547 |
2,258 |
$215K |
| 71045 |
|
12,574 |
10,986 |
$214K |
| 64483 |
|
594 |
535 |
$213K |
| 83036 |
|
10,605 |
10,024 |
$207K |
| 73564 |
|
6,586 |
5,019 |
$198K |
| 72110 |
|
5,293 |
4,976 |
$198K |
| 71275 |
|
1,732 |
1,566 |
$193K |
| 70551 |
|
867 |
802 |
$188K |
| 76705 |
|
3,114 |
2,847 |
$183K |
| 87186 |
|
10,115 |
8,778 |
$181K |
| 97140 |
|
6,559 |
2,096 |
$177K |
| 72125 |
|
2,876 |
2,609 |
$176K |
| 41899 |
|
155 |
134 |
$169K |
| 77336 |
|
823 |
347 |
$167K |
| 70553 |
|
793 |
742 |
$164K |
| 83605 |
|
8,999 |
7,535 |
$163K |
| J1885 |
Ketorolac tromethamine inj |
8,862 |
7,156 |
$162K |
| 96366 |
|
4,453 |
2,547 |
$161K |
| 82607 |
|
5,850 |
5,494 |
$156K |
| 82803 |
|
6,322 |
5,229 |
$154K |
| 87077 |
|
9,185 |
8,057 |
$153K |
| 84703 |
|
6,887 |
5,969 |
$153K |
| 73221 |
|
552 |
508 |
$152K |
| 81003 |
|
9,457 |
8,490 |
$150K |
| 88304 |
|
1,403 |
1,084 |
$147K |
| 73130 |
|
4,240 |
3,255 |
$146K |
| 76770 |
|
2,282 |
2,064 |
$145K |
| 84100 |
|
12,346 |
7,687 |
$145K |
| 82728 |
|
7,155 |
6,473 |
$144K |
| 86140 |
|
14,193 |
12,602 |
$140K |
| 87591 |
|
2,053 |
1,851 |
$135K |
| 85651 |
|
11,775 |
10,695 |
$133K |
| J2710 |
Neostigmine methylslfte inj |
1,134 |
851 |
$131K |
| 73030 |
|
5,327 |
4,513 |
$131K |
| 36591 |
|
6,090 |
3,511 |
$128K |
| 87491 |
|
2,060 |
1,860 |
$126K |
| 76700 |
|
1,069 |
1,016 |
$125K |
| 96417 |
|
1,403 |
765 |
$124K |
| 83880 |
|
4,728 |
4,084 |
$119K |
| 73110 |
|
3,625 |
2,896 |
$119K |
| J3370 |
Vancomycin hcl injection |
2,480 |
1,318 |
$114K |
| 76830 |
|
1,056 |
959 |
$111K |
| 84702 |
|
3,039 |
2,321 |
$110K |
| 85730 |
|
6,031 |
5,213 |
$109K |
| 93971 |
|
1,984 |
1,791 |
$106K |
| 76536 |
|
1,221 |
1,165 |
$105K |
| 36415 |
|
24,667 |
20,543 |
$104K |
| J1644 |
Inj heparin sodium per 1000u |
4,272 |
2,244 |
$100K |
| 74018 |
|
3,527 |
3,153 |
$99K |
| 84439 |
|
5,037 |
4,690 |
$97K |
| 84466 |
|
5,589 |
5,137 |
$96K |
| J1459 |
Inj ivig privigen 500 mg |
62 |
51 |
$96K |
| 73610 |
|
3,715 |
3,134 |
$93K |
| J0131 |
Inj, acetaminophen (nos) |
1,955 |
1,475 |
$91K |
| 96415 |
|
1,812 |
1,141 |
$90K |
| 87040 |
|
3,745 |
2,470 |
$90K |
| 73630 |
|
3,876 |
3,310 |
$90K |
| 86850 |
|
5,543 |
4,689 |
$89K |
| 82805 |
|
1,536 |
1,287 |
$88K |
| G0463 |
Hospital outpt clinic visit |
43,963 |
33,778 |
$87K |
| 71250 |
|
1,716 |
1,584 |
$87K |
| J2270 |
Morphine sulfate injection |
4,772 |
3,349 |
$85K |
| C1769 |
Guide wire |
1,217 |
1,048 |
$81K |
| 83540 |
|
6,278 |
5,758 |
$80K |
| J2001 |
Lidocaine injection |
6,740 |
5,412 |
$78K |
| 74178 |
|
443 |
403 |
$76K |
| 64493 |
|
764 |
593 |
$76K |
| 97014 |
|
2,174 |
785 |
$73K |
| 77412 |
|
735 |
78 |
$72K |
| 82550 |
|
4,292 |
3,676 |
$72K |
| 73502 |
|
3,050 |
2,851 |
$71K |
| 82565 |
|
4,942 |
4,349 |
$71K |
| 86803 |
|
2,611 |
2,413 |
$70K |
| 76856 |
|
540 |
511 |
$68K |
| 82378 |
|
1,353 |
832 |
$67K |
| J1200 |
Diphenhydramine hcl injectio |
3,812 |
2,829 |
$66K |
| 87880 |
|
1,524 |
1,393 |
$66K |
| 86480 |
|
830 |
782 |
$65K |
| 80050 |
|
1,603 |
1,472 |
$65K |
| 87522 |
Neg quan hep c or qual rna |
807 |
759 |
$65K |
| 20610 |
|
4,979 |
3,341 |
$65K |
| 99218 |
|
248 |
93 |
$64K |
| 86901 |
|
5,555 |
4,702 |
$64K |
| 70498 |
|
643 |
594 |
$64K |
| 87081 |
|
2,754 |
2,560 |
$63K |
| 94640 |
|
3,701 |
1,905 |
$63K |
| 70486 |
|
570 |
539 |
$62K |
| 70496 |
|
618 |
570 |
$60K |
| 86900 |
|
5,559 |
4,707 |
$60K |
| 99211 |
|
5,152 |
4,648 |
$60K |
| J2550 |
Promethazine hcl injection |
958 |
670 |
$59K |
| 74019 |
|
1,374 |
1,231 |
$59K |
| 42820 |
|
48 |
45 |
$59K |
| 76642 |
|
845 |
764 |
$58K |
| 74022 |
|
858 |
768 |
$57K |
| J2370 |
Phenylephrine hcl injection |
2,243 |
1,794 |
$56K |
| 87070 |
|
3,169 |
2,656 |
$55K |
| J0875 |
Injection, dalbavancin |
18 |
12 |
$55K |
| 82784 |
|
2,254 |
1,610 |
$55K |
| 73562 |
|
2,212 |
1,636 |
$52K |
| 86038 |
|
1,740 |
1,611 |
$52K |
| 86235 |
|
800 |
712 |
$51K |
| 72146 |
|
266 |
256 |
$51K |
| 82570 |
|
3,996 |
3,730 |
$50K |
| 87502 |
|
697 |
608 |
$49K |
| J1650 |
Inj enoxaparin sodium |
4,300 |
1,875 |
$49K |
| 93880 |
|
502 |
459 |
$49K |
| 66982 |
|
85 |
63 |
$48K |
| 73522 |
|
1,881 |
1,797 |
$48K |
| 80076 |
|
2,152 |
1,954 |
$48K |
| 83516 |
|
1,668 |
1,229 |
$48K |
| 36430 |
|
213 |
151 |
$47K |
| 97161 |
|
984 |
890 |
$47K |
| 72131 |
|
496 |
450 |
$47K |
| 97162 |
|
1,072 |
993 |
$47K |
| 77063 |
|
1,529 |
1,464 |
$46K |
| 84153 |
|
1,942 |
1,763 |
$46K |
| 86300 |
|
1,787 |
1,290 |
$46K |
| 93970 |
|
484 |
438 |
$46K |
| 87340 |
|
2,012 |
1,849 |
$46K |
| C9803 |
Hopd covid-19 spec collect |
3,452 |
2,989 |
$46K |
| 83655 |
|
2,422 |
2,309 |
$45K |
| 72158 |
|
186 |
175 |
$45K |
| 88307 |
|
340 |
234 |
$45K |
| A9585 |
Gadobutrol injection |
192 |
158 |
$44K |
| J2930 |
Methylprednisolone injection |
2,636 |
2,191 |
$43K |
| 73620 |
|
1,492 |
1,061 |
$43K |
| 72170 |
|
1,339 |
1,262 |
$43K |
| 77066 |
Tomosynthesis, mammo |
332 |
294 |
$43K |
| 72050 |
|
948 |
880 |
$43K |
| C9290 |
Inj, bupivacaine liposome |
459 |
405 |
$43K |
| J2795 |
Ropivacaine hcl injection |
469 |
377 |
$43K |
| 96367 |
|
2,209 |
1,458 |
$42K |
| 76801 |
|
485 |
420 |
$42K |
| 73590 |
|
1,553 |
1,313 |
$42K |
| 86706 |
|
2,018 |
1,886 |
$41K |
| 85379 |
|
2,090 |
1,857 |
$41K |
| 82043 |
|
3,006 |
2,848 |
$40K |
| 0241U |
|
2,895 |
2,687 |
$40K |
| 64484 |
|
122 |
106 |
$40K |
| 62323 |
|
849 |
765 |
$40K |
| 82746 |
|
1,823 |
1,729 |
$39K |
| 96368 |
|
362 |
172 |
$39K |
| 96416 |
|
181 |
68 |
$38K |
| 70491 |
|
70 |
57 |
$37K |
| 45378 |
|
279 |
236 |
$37K |
| 84436 |
|
794 |
720 |
$37K |
| 96411 |
|
339 |
158 |
$36K |
| U0003 |
Cov-19 amp prb hgh thruput |
619 |
549 |
$36K |
| 83970 |
|
852 |
763 |
$36K |
| 87205 |
|
2,973 |
2,491 |
$36K |
| J3475 |
Inj magnesium sulfate |
2,459 |
1,494 |
$35K |
| 73080 |
|
1,200 |
1,028 |
$35K |
| J0330 |
Succinycholine chloride inj |
901 |
759 |
$34K |
| 73120 |
|
1,251 |
830 |
$34K |
| 90471 |
|
1,963 |
1,725 |
$34K |
| A9578 |
Inj multihance multipack |
2,225 |
2,037 |
$34K |
| 90715 |
|
953 |
869 |
$33K |
| 86704 |
|
1,154 |
1,073 |
$33K |
| 74183 |
|
64 |
59 |
$33K |
| 64635 |
|
394 |
303 |
$32K |
| 86160 |
|
734 |
671 |
$32K |
| 73560 |
|
884 |
778 |
$32K |
| 73090 |
|
1,012 |
839 |
$31K |
| 11045 |
|
36 |
26 |
$31K |
| 82140 |
|
1,755 |
1,448 |
$31K |
| 99281 |
|
797 |
752 |
$31K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
504 |
423 |
$31K |
| 72100 |
|
986 |
904 |
$30K |
| 85007 |
|
1,422 |
1,103 |
$30K |
| J0692 |
Cefepime hcl for injection |
1,541 |
837 |
$30K |
| M0243 |
Casirivi and imdevi inj |
79 |
74 |
$29K |
| 88185 |
|
285 |
261 |
$29K |
| 83615 |
|
1,260 |
980 |
$29K |
| 86255 |
|
996 |
911 |
$28K |
| 82977 |
|
797 |
713 |
$28K |
| G0475 |
Hiv combination assay |
986 |
923 |
$28K |
| 20611 |
|
1,448 |
1,122 |
$27K |
| 97597 |
|
900 |
561 |
$27K |
| J1030 |
Methylprednisolone 40 mg inj |
1,362 |
1,218 |
$26K |
| J8501 |
Oral aprepitant |
539 |
411 |
$26K |
| 87075 |
|
1,554 |
1,300 |
$25K |
| J2704 |
Inj, propofol, 10 mg |
14,141 |
10,312 |
$25K |
| M0245 |
Bamlan and etesev infusion |
72 |
62 |
$25K |
| 86200 |
|
1,013 |
927 |
$25K |
| 84460 |
|
1,080 |
906 |
$25K |
| 84156 |
|
1,453 |
1,251 |
$25K |
| 78264 |
|
113 |
106 |
$25K |
| J1580 |
Garamycin gentamicin inj |
922 |
772 |
$24K |
| 77065 |
Tomosynthesis, mammo |
264 |
224 |
$24K |
| 72052 |
|
377 |
359 |
$23K |
| 86431 |
|
1,259 |
1,166 |
$23K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
854 |
744 |
$23K |
| J2469 |
Palonosetron hcl |
1,261 |
768 |
$23K |
| J0702 |
Betamethasone acet&sod phosp |
3,007 |
2,670 |
$23K |
| 72195 |
|
67 |
65 |
$22K |
| 87633 |
|
88 |
87 |
$21K |
| 64721 |
|
64 |
52 |
$21K |
| 87389 |
|
709 |
670 |
$21K |
| 84481 |
|
568 |
538 |
$21K |
| A9541 |
Tc99m sulfur colloid |
158 |
146 |
$21K |
| 86376 |
|
587 |
544 |
$20K |
| G0279 |
Tomosynthesis, mammo |
264 |
233 |
$20K |
| 88341 |
|
334 |
235 |
$20K |
| 84550 |
|
1,720 |
1,478 |
$20K |
| P9016 |
Rbc leukocytes reduced |
142 |
107 |
$19K |
| 88300 |
|
217 |
167 |
$19K |
| 0099U |
|
23 |
17 |
$18K |
| 80164 |
|
745 |
662 |
$18K |
| 95810 |
|
12 |
12 |
$18K |
| J1335 |
Ertapenem injection |
149 |
91 |
$18K |
| 84520 |
|
1,010 |
800 |
$18K |
| 72072 |
|
494 |
465 |
$17K |
| 66984 |
|
103 |
80 |
$17K |
| 84450 |
|
882 |
721 |
$17K |
| J0696 |
Ceftriaxone sodium injection |
1,505 |
1,053 |
$17K |
| 84146 |
|
325 |
306 |
$17K |
| 78306 |
|
71 |
66 |
$17K |
| 76870 |
|
163 |
149 |
$17K |
| J2765 |
Metoclopramide hcl injection |
1,237 |
894 |
$16K |
| 99213 |
|
1,390 |
1,109 |
$16K |
| 86790 |
|
692 |
657 |
$16K |
| 83883 |
|
428 |
333 |
$15K |
| 86920 |
|
280 |
217 |
$15K |
| 94060 |
|
434 |
415 |
$15K |
| 87209 |
|
421 |
402 |
$15K |
| J3301 |
Triamcinolone acet inj nos |
5,323 |
4,386 |
$14K |
| 86618 |
|
716 |
476 |
$14K |
| 73600 |
|
314 |
288 |
$14K |
| 73060 |
|
437 |
368 |
$14K |
| 88142 |
|
642 |
572 |
$14K |
| 87426 |
|
365 |
330 |
$14K |
| 69436 |
|
47 |
38 |
$14K |
| J1756 |
Iron sucrose injection |
457 |
201 |
$13K |
| 84145 |
|
598 |
493 |
$13K |
| 87324 |
|
409 |
385 |
$13K |
| 86592 |
|
504 |
450 |
$13K |
| 73140 |
|
350 |
302 |
$13K |
| 12001 |
|
132 |
128 |
$12K |
| 93923 |
|
228 |
211 |
$12K |
| 76882 |
|
323 |
297 |
$12K |
| 99202 |
|
2,106 |
1,959 |
$12K |
| J2060 |
Lorazepam injection |
987 |
719 |
$12K |
| 87210 |
|
448 |
402 |
$12K |
| 87177 |
|
421 |
402 |
$12K |
| 82247 |
|
270 |
200 |
$12K |
| 82009 |
|
208 |
168 |
$11K |
| 72040 |
|
303 |
277 |
$11K |
| 87624 |
|
272 |
242 |
$11K |
| 73552 |
|
429 |
374 |
$11K |
| 84403 |
|
211 |
202 |
$10K |
| J2175 |
Meperidine hydrochl /100 mg |
407 |
295 |
$10K |
| 87635 |
|
172 |
121 |
$10K |
| J2920 |
Methylprednisolone injection |
187 |
101 |
$10K |
| 86703 |
|
213 |
176 |
$10K |
| 73100 |
|
168 |
155 |
$10K |
| 72084 |
|
223 |
209 |
$10K |
| A9537 |
Tc99m mebrofenin |
120 |
108 |
$9K |
| 97116 |
|
878 |
421 |
$9K |
| J0780 |
Prochlorperazine injection |
796 |
632 |
$9K |
| 73070 |
|
157 |
141 |
$9K |
| 62321 |
|
51 |
50 |
$9K |
| 78227 |
|
49 |
45 |
$9K |
| 93225 |
|
195 |
189 |
$9K |
| 84165 |
|
429 |
379 |
$9K |
| 77334 |
|
38 |
30 |
$9K |
| Q3014 |
Telehealth facility fee |
951 |
866 |
$9K |
| 43235 |
|
79 |
72 |
$8K |
| 93226 |
|
181 |
176 |
$8K |
| 96523 |
|
531 |
496 |
$8K |
| 88184 |
|
289 |
262 |
$8K |
| 82105 |
|
204 |
189 |
$8K |
| 86812 |
|
112 |
106 |
$8K |
| 72202 |
|
245 |
239 |
$7K |
| 77080 |
|
97 |
96 |
$7K |
| 74221 |
|
52 |
39 |
$7K |
| J0640 |
Leucovorin calcium injection |
109 |
37 |
$7K |
| 83010 |
|
92 |
80 |
$7K |
| 29580 |
|
63 |
27 |
$7K |
| G0299 |
Hhs/hospice of rn ea 15 min |
269 |
70 |
$7K |
| 82310 |
|
617 |
573 |
$6K |
| 87506 |
|
33 |
33 |
$6K |
| 97112 |
|
252 |
79 |
$6K |
| 87045 |
|
200 |
190 |
$6K |
| J1040 |
Methylprednisolone 80 mg inj |
483 |
463 |
$6K |
| G0123 |
Screen cerv/vag thin layer |
221 |
195 |
$6K |
| V2632 |
Post chmbr intraocular lens |
242 |
181 |
$6K |
| 73501 |
|
117 |
107 |
$6K |
| 12002 |
|
56 |
56 |
$6K |
| 86147 |
|
52 |
49 |
$6K |
| 87046 |
|
200 |
190 |
$6K |
| 82172 |
|
83 |
71 |
$6K |
| 86708 |
|
51 |
42 |
$6K |
| 82010 |
|
450 |
375 |
$5K |
| G8979 |
Mobility goal status |
202 |
175 |
$5K |
| 92134 |
|
559 |
499 |
$5K |
| G8978 |
Mobility current status |
190 |
168 |
$5K |
| J7324 |
Orthovisc inj per dose |
89 |
45 |
$5K |
| 36416 |
|
493 |
486 |
$5K |
| 10060 |
|
49 |
42 |
$5K |
| 29125 |
|
29 |
26 |
$5K |
| 88313 |
|
127 |
99 |
$5K |
| 67028 |
|
243 |
201 |
$5K |
| 87493 |
|
121 |
103 |
$5K |
| 80051 |
|
462 |
432 |
$5K |
| 71101 |
|
112 |
101 |
$5K |
| 82390 |
|
129 |
123 |
$5K |
| J2360 |
Orphenadrine injection |
533 |
454 |
$4K |
| 76819 |
|
19 |
12 |
$4K |
| A9561 |
Tc99m oxidronate |
122 |
110 |
$4K |
| 82947 |
|
309 |
291 |
$4K |
| 82103 |
|
104 |
98 |
$4K |
| 73000 |
|
105 |
84 |
$4K |
| 90686 |
|
244 |
225 |
$4K |
| 85046 |
|
234 |
212 |
$4K |
| 72074 |
|
111 |
107 |
$4K |
| 0202U |
|
51 |
46 |
$3K |
| 83993 |
|
111 |
109 |
$3K |
| 87147 |
|
165 |
154 |
$3K |
| 95165 |
|
106 |
103 |
$3K |
| 69210 |
|
166 |
160 |
$3K |
| J1815 |
Insulin injection |
1,351 |
381 |
$3K |
| J1453 |
Fosaprepitant injection |
132 |
83 |
$3K |
| 88173 |
|
25 |
24 |
$3K |
| 76805 |
|
18 |
14 |
$3K |
| 80179 |
|
133 |
118 |
$3K |
| 99214 |
|
222 |
200 |
$3K |
| 82150 |
|
47 |
43 |
$3K |
| 94729 |
|
220 |
209 |
$3K |
| C1755 |
Catheter, intraspinal |
2,529 |
2,070 |
$3K |
| 86334 |
|
74 |
65 |
$3K |
| 97035 |
|
51 |
12 |
$3K |
| J1170 |
Hydromorphone injection |
1,722 |
1,058 |
$3K |
| 77417 |
|
28 |
14 |
$3K |
| J9045 |
Carboplatin injection |
153 |
92 |
$3K |
| 87641 |
|
107 |
104 |
$3K |
| 93308 |
|
89 |
82 |
$2K |
| 84478 |
|
82 |
62 |
$2K |
| 81015 |
|
27 |
24 |
$2K |
| 80055 |
|
67 |
61 |
$2K |
| 82951 |
|
40 |
36 |
$2K |
| 77061 |
|
26 |
24 |
$2K |
| J0171 |
Adrenalin epinephrine inject |
166 |
139 |
$2K |
| 83521 |
|
229 |
196 |
$2K |
| 92567 |
|
448 |
421 |
$2K |
| 82952 |
|
40 |
36 |
$2K |
| 86665 |
|
44 |
28 |
$2K |
| 99203 |
|
194 |
176 |
$2K |
| 51798 |
|
1,465 |
1,207 |
$2K |
| 80069 |
|
845 |
599 |
$2K |
| 87481 |
|
12 |
12 |
$2K |
| 94726 |
|
160 |
152 |
$2K |
| 86308 |
|
84 |
76 |
$2K |
| 94660 |
|
52 |
25 |
$2K |
| J1940 |
Furosemide injection |
425 |
258 |
$2K |
| J3010 |
Fentanyl citrate injection |
6,264 |
5,036 |
$2K |
| 74021 |
|
76 |
66 |
$2K |
| J3490 |
Drugs unclassified injection |
10,670 |
3,316 |
$2K |
| 83001 |
|
30 |
28 |
$1K |
| 71271 |
|
34 |
26 |
$1K |
| 76816 |
|
14 |
13 |
$1K |
| 92557 |
|
129 |
120 |
$1K |
| J1439 |
Inj ferric carboxymaltos 1mg |
19 |
12 |
$1K |
| 81206 |
|
13 |
13 |
$1K |
| 87106 |
|
29 |
26 |
$1K |
| J1720 |
Hydrocortisone sodium succ i |
156 |
131 |
$1K |
| S0077 |
Injection, clindamycin phosp |
367 |
264 |
$1K |
| G0283 |
Elec stim other than wound |
339 |
157 |
$1K |
| 89051 |
|
41 |
26 |
$1K |
| 87801 |
|
12 |
12 |
$1K |
| 87338 |
|
46 |
44 |
$1K |
| 96377 |
|
19 |
12 |
$1K |
| 76942 |
|
152 |
102 |
$1K |
| 84132 |
|
103 |
97 |
$1K |
| 86762 |
|
18 |
12 |
$1K |
| 87651 |
|
45 |
44 |
$1K |
| 86664 |
|
29 |
28 |
$1K |
| G0379 |
Direct refer hospital observ |
41 |
31 |
$980.41 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
551 |
468 |
$926.26 |
| 97530 |
|
200 |
133 |
$864.48 |
| 12011 |
|
13 |
12 |
$842.00 |
| 75635 |
|
16 |
13 |
$811.14 |
| 76817 |
|
16 |
12 |
$785.00 |
| U0005 |
Infec agen detec ampli probe |
142 |
136 |
$755.79 |
| 87176 |
|
35 |
30 |
$684.69 |
| 92587 |
|
12 |
12 |
$659.85 |
| 86617 |
|
24 |
24 |
$645.63 |
| 86709 |
|
13 |
12 |
$631.87 |
| 87661 |
|
12 |
12 |
$624.47 |
| 88112 |
|
50 |
44 |
$609.04 |
| Q0162 |
Ondansetron oral |
730 |
549 |
$588.31 |
| 97535 |
|
300 |
195 |
$529.68 |
| 86364 |
|
57 |
51 |
$491.08 |
| 84480 |
|
16 |
15 |
$483.15 |
| 74230 |
|
12 |
12 |
$478.25 |
| 86341 |
|
15 |
12 |
$422.24 |
| G0260 |
Inj for sacroiliac jt anesth |
16 |
12 |
$409.64 |
| 51702 |
|
231 |
188 |
$388.46 |
| 87076 |
|
46 |
38 |
$384.63 |
| 72192 |
|
13 |
12 |
$378.12 |
| 74250 |
|
18 |
18 |
$373.42 |
| 87015 |
|
89 |
69 |
$372.54 |
| 87329 |
|
26 |
26 |
$360.97 |
| 86705 |
|
16 |
15 |
$358.45 |
| 74220 |
|
12 |
12 |
$339.78 |
| 84402 |
|
15 |
15 |
$335.74 |
| J7512 |
Prednisone ir or dr oral 1mg |
505 |
288 |
$280.18 |
| Q0163 |
Diphenhydramine hcl 50mg |
52 |
32 |
$279.65 |
| 74420 |
|
18 |
13 |
$259.38 |
| 83520 |
|
17 |
17 |
$245.13 |
| 90656 |
|
38 |
37 |
$239.04 |
| 84681 |
|
14 |
12 |
$235.41 |
| 92136 |
|
60 |
57 |
$231.28 |
| C1725 |
Cath, translumin non-laser |
15 |
13 |
$222.63 |
| 97016 |
|
27 |
12 |
$201.34 |
| J3480 |
Inj potassium chloride |
68 |
26 |
$178.10 |
| J2919 |
Inj, methylpred sod succ 5mg |
213 |
165 |
$152.48 |
| C1894 |
Intro/sheath, non-laser |
552 |
479 |
$144.48 |
| 94760 |
|
684 |
275 |
$143.30 |
| J3411 |
Thiamine hcl 100 mg |
40 |
31 |
$134.53 |
| 72070 |
|
14 |
13 |
$129.42 |
| 90653 |
|
26 |
26 |
$119.71 |
| 93242 |
|
37 |
36 |
$115.89 |
| G0008 |
Admin influenza virus vac |
14 |
14 |
$95.84 |
| J1010 |
Inj, methylpred acetate 1 mg |
32 |
30 |
$85.96 |
| J3260 |
Tobramycin sulfate injection |
15 |
13 |
$65.15 |
| 86780 |
|
12 |
12 |
$61.20 |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
263 |
243 |
$56.30 |
| 90694 |
|
17 |
15 |
$37.75 |
| G1010 |
Cdsm stanson |
1,335 |
1,004 |
$35.41 |
| 82077 |
|
286 |
241 |
$34.88 |
| J0744 |
Ciprofloxacin iv |
20 |
14 |
$31.40 |
| 85018 |
|
14 |
13 |
$26.58 |
| 82962 |
|
40 |
35 |
$14.75 |
| J3420 |
Vitamin b12 injection |
56 |
49 |
$13.89 |
| J0136 |
Inj, acetaminophen (b braun) |
104 |
85 |
$13.43 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
83 |
57 |
$8.06 |
| Q0177 |
Hydroxyzine pamoate 25mg |
44 |
25 |
$7.11 |
| J7609 |
Albuterol comp unit |
23 |
15 |
$6.00 |
| C1726 |
Cath, bal dil, non-vascular |
13 |
12 |
$5.17 |
| Q9960 |
Hocm 200-249mg/ml iodine,1ml |
290 |
263 |
$2.72 |
| C9113 |
Inj pantoprazole sodium, via |
104 |
36 |
$0.39 |
| C1760 |
Closure dev, vasc |
15 |
15 |
$0.00 |
| C9257 |
Bevacizumab injection |
16 |
12 |
$0.00 |
| C1887 |
Catheter, guiding |
19 |
12 |
$0.00 |
| A4649 |
Surgical supplies |
31 |
30 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
40 |
26 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
257 |
244 |
$0.00 |
| Q0240 |
Casirivi and imdevi 600 mg |
74 |
34 |
$0.00 |
| C1889 |
Implant/insert device, noc |
12 |
12 |
$0.00 |