| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90791 |
|
5,832 |
4,682 |
$7.80M |
| 99214 |
|
21,765 |
20,262 |
$3.68M |
| 99213 |
|
14,935 |
14,332 |
$2.80M |
| 99283 |
|
12,224 |
11,459 |
$2.67M |
| 99284 |
|
13,946 |
12,929 |
$2.64M |
| 97110 |
|
14,816 |
7,665 |
$1.82M |
| U0003 |
Cov-19 amp prb hgh thruput |
20,332 |
19,418 |
$1.71M |
| 99215 |
Prolong outpt/office vis |
9,308 |
8,414 |
$1.66M |
| 96415 |
|
1,726 |
1,481 |
$1.48M |
| 96413 |
|
5,735 |
3,925 |
$1.24M |
| 99282 |
|
5,543 |
5,245 |
$1.23M |
| S9485 |
Crisis intervention mental h |
576 |
527 |
$1.09M |
| H0020 |
Alcohol and/or drug services |
37,608 |
2,935 |
$1.07M |
| 96361 |
|
3,013 |
2,563 |
$1.01M |
| 96365 |
|
4,242 |
3,498 |
$1.00M |
| Q5103 |
Injection, inflectra |
691 |
657 |
$963K |
| 43239 |
|
1,114 |
1,103 |
$887K |
| 90834 |
|
6,624 |
4,570 |
$871K |
| 93306 |
|
2,523 |
2,506 |
$850K |
| 70450 |
|
2,223 |
2,166 |
$813K |
| 80053 |
|
38,853 |
33,300 |
$799K |
| 99285 |
|
3,912 |
3,756 |
$732K |
| 70553 |
|
1,725 |
1,709 |
$666K |
| G0378 |
Hospital observation per hr |
3,756 |
2,892 |
$654K |
| 87631 |
|
4,989 |
4,911 |
$623K |
| 74177 |
|
2,117 |
2,091 |
$588K |
| 69436 |
|
301 |
301 |
$564K |
| 99212 |
|
2,863 |
2,784 |
$544K |
| 87491 |
|
13,399 |
13,111 |
$508K |
| 93303 |
|
1,135 |
1,121 |
$478K |
| D2930 |
|
441 |
434 |
$461K |
| J0585 |
Injection,onabotulinumtoxina |
455 |
450 |
$456K |
| 87591 |
|
13,334 |
13,046 |
$454K |
| 97161 |
|
2,694 |
2,664 |
$451K |
| 80048 |
|
17,328 |
15,371 |
$437K |
| 99281 |
|
1,837 |
1,674 |
$401K |
| 90832 |
|
3,952 |
2,984 |
$399K |
| H0040 |
Assert comm tx pgm per diem |
230 |
229 |
$397K |
| 82306 |
|
7,966 |
7,916 |
$376K |
| D9223 |
|
573 |
573 |
$374K |
| 96366 |
|
1,349 |
1,046 |
$372K |
| 88305 |
|
8,097 |
5,830 |
$357K |
| 90837 |
|
2,595 |
1,753 |
$332K |
| 76770 |
|
1,618 |
1,599 |
$332K |
| U0005 |
Infec agen detec ampli probe |
12,899 |
12,400 |
$319K |
| 59025 |
|
1,041 |
585 |
$301K |
| 92567 |
|
2,340 |
2,333 |
$252K |
| 83036 |
|
17,665 |
17,529 |
$247K |
| 96360 |
|
892 |
753 |
$244K |
| 87661 |
|
7,808 |
7,702 |
$243K |
| 86850 |
|
5,869 |
4,724 |
$239K |
| 84443 |
|
19,350 |
18,970 |
$229K |
| 76856 |
|
363 |
353 |
$225K |
| 95812 |
|
518 |
516 |
$224K |
| 80307 |
|
10,028 |
6,954 |
$221K |
| 71260 |
|
1,084 |
1,073 |
$208K |
| 87624 |
|
4,960 |
4,956 |
$207K |
| 97530 |
|
1,973 |
1,202 |
$194K |
| 97162 |
|
936 |
924 |
$190K |
| 87536 |
|
1,392 |
1,377 |
$190K |
| D9222 |
|
556 |
556 |
$189K |
| 92134 |
|
1,433 |
1,377 |
$189K |
| 87389 |
|
7,521 |
7,476 |
$186K |
| 86901 |
|
6,048 |
4,902 |
$164K |
| 80061 |
|
16,806 |
16,728 |
$161K |
| 80051 |
|
4,364 |
3,921 |
$156K |
| 92557 |
|
1,364 |
1,357 |
$156K |
| 41899 |
|
86 |
86 |
$152K |
| 99205 |
Prolong outpt/office vis |
774 |
766 |
$149K |
| 80076 |
|
7,808 |
7,294 |
$145K |
| 76705 |
|
2,293 |
2,191 |
$140K |
| 85025 |
|
48,096 |
41,197 |
$140K |
| 86780 |
|
7,627 |
7,560 |
$135K |
| 36415 |
|
41,941 |
35,507 |
$131K |
| 93320 |
|
1,607 |
1,575 |
$124K |
| 86900 |
|
6,036 |
4,894 |
$121K |
| G0145 |
Scr c/v cyto,thinlayer,rescr |
6,148 |
6,143 |
$120K |
| 94010 |
|
676 |
668 |
$112K |
| 84439 |
|
9,676 |
9,434 |
$111K |
| 94060 |
|
332 |
331 |
$111K |
| 93325 |
|
1,938 |
1,868 |
$109K |
| 87635 |
|
2,641 |
2,553 |
$106K |
| 86803 |
|
7,802 |
7,755 |
$105K |
| 82728 |
|
6,601 |
6,321 |
$103K |
| 96372 |
|
5,610 |
4,447 |
$102K |
| 87086 |
|
11,532 |
10,904 |
$101K |
| 83880 |
|
2,037 |
1,771 |
$99K |
| 99204 |
|
475 |
475 |
$96K |
| 92133 |
|
569 |
565 |
$94K |
| 97803 |
|
1,677 |
1,619 |
$94K |
| 86480 |
|
1,124 |
1,113 |
$88K |
| 95810 |
|
105 |
105 |
$87K |
| H0035 |
Mh partial hosp tx under 24h |
519 |
78 |
$84K |
| 87522 |
Neg quan hep c or qual rna |
1,253 |
1,226 |
$84K |
| 82607 |
|
5,044 |
5,012 |
$83K |
| 92579 |
|
752 |
748 |
$81K |
| 84403 |
|
2,504 |
2,461 |
$81K |
| 93975 |
|
249 |
223 |
$80K |
| 87340 |
|
5,524 |
5,482 |
$76K |
| 86360 |
|
1,494 |
1,473 |
$75K |
| 83970 |
|
1,169 |
1,141 |
$74K |
| 87480 |
|
4,517 |
4,432 |
$73K |
| Q9956 |
Inj octafluoropropane mic,ml |
1,438 |
760 |
$73K |
| 87510 |
|
4,517 |
4,432 |
$73K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
9,446 |
5,312 |
$72K |
| 42820 |
|
38 |
38 |
$71K |
| 95886 |
|
455 |
452 |
$69K |
| 76816 |
|
1,698 |
1,319 |
$67K |
| 93017 |
|
350 |
345 |
$66K |
| 82670 |
|
1,547 |
1,530 |
$65K |
| 45380 |
|
70 |
68 |
$64K |
| 88342 |
|
1,154 |
1,072 |
$62K |
| 90847 |
|
305 |
196 |
$61K |
| 87660 |
|
4,656 |
4,551 |
$61K |
| 97140 |
|
1,574 |
859 |
$57K |
| 83655 |
|
2,851 |
2,833 |
$56K |
| 73721 |
|
131 |
129 |
$54K |
| 86359 |
|
1,510 |
1,488 |
$53K |
| 87081 |
|
8,903 |
8,739 |
$52K |
| 97010 |
|
1,987 |
1,093 |
$52K |
| 76882 |
|
369 |
367 |
$51K |
| 85610 |
|
8,648 |
6,735 |
$50K |
| 86706 |
|
3,811 |
3,783 |
$49K |
| 85027 |
|
14,456 |
12,334 |
$46K |
| 88185 |
|
419 |
197 |
$45K |
| 74176 |
|
143 |
139 |
$45K |
| 86704 |
|
3,566 |
3,537 |
$45K |
| J1459 |
Inj ivig privigen 500 mg |
13 |
12 |
$43K |
| 95951 |
|
164 |
82 |
$41K |
| 86762 |
|
1,859 |
1,855 |
$39K |
| J7120 |
Ringers lactate infusion |
11,946 |
11,387 |
$39K |
| 83540 |
|
6,233 |
6,085 |
$39K |
| H2011 |
Crisis interven svc, 15 min |
511 |
296 |
$38K |
| 88341 |
|
670 |
416 |
$37K |
| 82570 |
|
5,242 |
5,031 |
$36K |
| 84702 |
|
2,628 |
2,149 |
$35K |
| G0480 |
Drug test def 1-7 classes |
1,894 |
1,773 |
$35K |
| J1745 |
Infliximab not biosimil 10mg |
12 |
12 |
$35K |
| D1120 |
|
444 |
444 |
$33K |
| 70551 |
|
91 |
91 |
$33K |
| 99232 |
|
522 |
261 |
$32K |
| 97165 |
|
223 |
221 |
$32K |
| 71275 |
|
75 |
74 |
$31K |
| 83735 |
|
8,455 |
5,636 |
$30K |
| 87186 |
|
3,536 |
3,417 |
$30K |
| 86708 |
|
2,204 |
2,201 |
$30K |
| 86140 |
|
7,165 |
6,466 |
$29K |
| 84146 |
|
989 |
976 |
$29K |
| 76830 |
|
734 |
730 |
$29K |
| J2704 |
Inj, propofol, 10 mg |
9,487 |
9,342 |
$29K |
| 82746 |
|
1,811 |
1,794 |
$28K |
| 95720 |
|
209 |
104 |
$28K |
| 97802 |
|
591 |
589 |
$28K |
| D3220 |
|
98 |
98 |
$27K |
| 93971 |
|
404 |
371 |
$27K |
| A9576 |
Inj prohance multipack |
1,240 |
1,211 |
$27K |
| 82784 |
|
2,258 |
2,083 |
$26K |
| 97112 |
|
360 |
207 |
$26K |
| 83001 |
|
970 |
963 |
$26K |
| 81001 |
|
8,217 |
7,708 |
$26K |
| 83550 |
|
3,969 |
3,866 |
$25K |
| 82043 |
|
3,355 |
3,332 |
$25K |
| A9573 |
Inj, gadopiclenol, 1 ml |
505 |
296 |
$24K |
| 97164 |
|
224 |
221 |
$23K |
| 71046 |
|
6,178 |
5,936 |
$23K |
| 80069 |
|
1,516 |
1,347 |
$23K |
| 84466 |
|
1,699 |
1,673 |
$23K |
| J0131 |
Inj, acetaminophen (nos) |
1,485 |
1,467 |
$23K |
| 12001 |
|
39 |
39 |
$22K |
| J1170 |
Hydromorphone injection |
3,390 |
2,884 |
$21K |
| 87070 |
|
2,591 |
2,524 |
$21K |
| 99291 |
|
102 |
37 |
$20K |
| 93005 |
|
7,679 |
6,853 |
$20K |
| 92083 |
|
167 |
166 |
$20K |
| 80197 |
|
1,978 |
992 |
$20K |
| 96367 |
|
160 |
118 |
$20K |
| 72148 |
|
54 |
54 |
$20K |
| 84402 |
|
833 |
829 |
$19K |
| A9585 |
Gadobutrol injection |
626 |
621 |
$18K |
| G0103 |
Psa screening |
1,339 |
1,335 |
$17K |
| 93976 |
|
105 |
103 |
$17K |
| A9579 |
Gad-base mr contrast nos,1ml |
816 |
799 |
$17K |
| 76000 |
|
149 |
145 |
$17K |
| 90715 |
|
529 |
526 |
$16K |
| 92556 |
|
246 |
246 |
$16K |
| 88112 |
|
260 |
248 |
$16K |
| 92552 |
|
107 |
107 |
$16K |
| 86355 |
|
375 |
367 |
$16K |
| 59841 |
|
14 |
14 |
$15K |
| 74183 |
|
32 |
30 |
$15K |
| 84100 |
|
5,200 |
3,410 |
$15K |
| J2469 |
Palonosetron hcl |
824 |
512 |
$14K |
| 83002 |
|
520 |
516 |
$13K |
| 85652 |
|
6,283 |
5,871 |
$13K |
| 86038 |
|
1,722 |
1,712 |
$12K |
| 92507 |
|
76 |
55 |
$12K |
| 70486 |
|
106 |
105 |
$12K |
| 82565 |
|
8,266 |
7,591 |
$12K |
| 76811 |
|
180 |
176 |
$12K |
| 82805 |
|
551 |
513 |
$12K |
| 73610 |
|
1,814 |
1,707 |
$12K |
| 83690 |
|
8,703 |
7,966 |
$12K |
| 99223 |
Prolong inpt eval add15 m |
72 |
72 |
$11K |
| 83615 |
|
3,654 |
2,422 |
$11K |
| 73630 |
|
1,786 |
1,724 |
$11K |
| 85730 |
|
2,404 |
2,352 |
$11K |
| 88304 |
|
278 |
247 |
$11K |
| 84460 |
|
2,932 |
2,869 |
$11K |
| J0690 |
Cefazolin sodium injection |
3,827 |
3,428 |
$10K |
| 78815 |
|
12 |
12 |
$10K |
| 71250 |
|
97 |
95 |
$10K |
| 82105 |
|
1,165 |
1,119 |
$10K |
| 86357 |
|
364 |
356 |
$10K |
| J0330 |
Succinycholine chloride inj |
966 |
893 |
$10K |
| 0071A |
|
161 |
158 |
$10K |
| J3010 |
Fentanyl citrate injection |
9,027 |
8,815 |
$10K |
| G0124 |
Screen c/v thin layer by md |
697 |
697 |
$9K |
| 84156 |
|
2,087 |
1,853 |
$9K |
| 90853 |
|
186 |
77 |
$9K |
| 0001A |
|
243 |
240 |
$9K |
| 12002 |
|
14 |
14 |
$9K |
| 86787 |
|
933 |
927 |
$9K |
| 88307 |
|
90 |
77 |
$9K |
| 99222 |
|
85 |
85 |
$9K |
| 92250 |
|
126 |
121 |
$9K |
| 82248 |
|
2,984 |
2,756 |
$9K |
| 81025 |
|
1,898 |
1,844 |
$8K |
| 73030 |
|
1,094 |
1,068 |
$8K |
| 76536 |
|
287 |
285 |
$8K |
| 86765 |
|
428 |
426 |
$8K |
| 99233 |
Prolong inpt eval add15 m |
112 |
43 |
$8K |
| 87102 |
|
959 |
947 |
$8K |
| 84450 |
|
1,328 |
1,304 |
$8K |
| 82950 |
|
995 |
994 |
$8K |
| 0002A |
|
126 |
126 |
$8K |
| 70498 |
|
56 |
55 |
$8K |
| 82150 |
|
8,229 |
7,555 |
$8K |
| 86481 |
|
106 |
105 |
$7K |
| 87529 |
|
88 |
88 |
$7K |
| 86618 |
|
339 |
338 |
$7K |
| 0012A |
|
136 |
136 |
$7K |
| J2270 |
Morphine sulfate injection |
1,608 |
1,494 |
$7K |
| 85380 |
|
390 |
387 |
$7K |
| 86364 |
|
710 |
685 |
$7K |
| 0124A |
|
112 |
112 |
$7K |
| J1100 |
Dexamethasone sodium phos |
8,727 |
8,154 |
$6K |
| J1885 |
Ketorolac tromethamine inj |
8,162 |
7,373 |
$6K |
| 82550 |
|
1,621 |
1,494 |
$6K |
| 88184 |
|
253 |
235 |
$6K |
| 87651 |
|
107 |
107 |
$6K |
| D7140 |
|
12 |
12 |
$6K |
| 85007 |
|
4,909 |
3,551 |
$6K |
| 87205 |
|
1,968 |
1,912 |
$6K |
| 95885 |
|
55 |
55 |
$6K |
| 99203 |
|
27 |
26 |
$6K |
| 90686 |
|
438 |
437 |
$6K |
| 85014 |
|
2,037 |
1,973 |
$6K |
| 74018 |
|
1,400 |
1,350 |
$6K |
| 72125 |
|
91 |
91 |
$6K |
| 73130 |
|
1,300 |
1,215 |
$6K |
| 82977 |
|
912 |
819 |
$6K |
| 72082 |
|
329 |
328 |
$5K |
| 93296 |
|
34 |
34 |
$5K |
| 86376 |
|
254 |
252 |
$5K |
| 88321 |
|
105 |
101 |
$5K |
| 72100 |
|
720 |
718 |
$5K |
| 99231 |
|
159 |
73 |
$5K |
| J8540 |
Oral dexamethasone |
1,363 |
777 |
$5K |
| 86430 |
|
757 |
756 |
$5K |
| 82247 |
|
2,689 |
2,531 |
$5K |
| 73562 |
|
812 |
801 |
$5K |
| 84550 |
|
1,084 |
900 |
$5K |
| 0011A |
|
155 |
155 |
$5K |
| J2405 |
Ondansetron hcl injection |
12,256 |
11,154 |
$5K |
| 87497 |
|
104 |
51 |
$5K |
| 81003 |
|
3,674 |
3,569 |
$5K |
| J1756 |
Iron sucrose injection |
121 |
72 |
$5K |
| 74230 |
|
12 |
12 |
$5K |
| 72156 |
|
12 |
12 |
$4K |
| 84480 |
|
653 |
620 |
$4K |
| 73560 |
|
696 |
655 |
$4K |
| J2930 |
Methylprednisolone injection |
574 |
481 |
$4K |
| D1208 |
|
64 |
64 |
$4K |
| 86923 |
|
102 |
48 |
$4K |
| 82040 |
|
2,481 |
2,401 |
$4K |
| J7060 |
5% dextrose/water |
1,595 |
1,078 |
$4K |
| 82533 |
|
222 |
195 |
$4K |
| 93299 |
|
24 |
24 |
$4K |
| 83020 |
|
260 |
187 |
$4K |
| 99221 |
|
40 |
40 |
$4K |
| 0072A |
|
63 |
63 |
$4K |
| 82947 |
|
7,439 |
6,568 |
$4K |
| J2250 |
Inj midazolam hydrochloride |
8,350 |
8,124 |
$4K |
| 86735 |
|
326 |
325 |
$4K |
| 74178 |
|
29 |
29 |
$3K |
| 0004A |
|
58 |
58 |
$3K |
| Q9969 |
Non-heu tc-99m add-on/dose |
80 |
79 |
$3K |
| 93225 |
|
13 |
13 |
$3K |
| G0328 |
Fecal blood scrn immunoassay |
281 |
281 |
$3K |
| 94640 |
|
1,906 |
1,731 |
$3K |
| P9604 |
One-way allow prorated trip |
304 |
143 |
$3K |
| 88189 |
|
68 |
67 |
$3K |
| 88142 |
|
114 |
114 |
$3K |
| 73110 |
|
562 |
527 |
$3K |
| 76817 |
|
63 |
53 |
$3K |
| 82785 |
|
193 |
193 |
$3K |
| 73502 |
|
449 |
437 |
$3K |
| 86160 |
|
197 |
102 |
$3K |
| 84075 |
|
1,863 |
1,822 |
$3K |
| 84165 |
|
382 |
300 |
$3K |
| 86800 |
|
132 |
132 |
$3K |
| 99443 |
|
24 |
20 |
$2K |
| 82310 |
|
2,257 |
2,169 |
$2K |
| 87338 |
|
205 |
205 |
$2K |
| 73590 |
|
463 |
419 |
$2K |
| 72170 |
|
278 |
276 |
$2K |
| 76700 |
|
12 |
12 |
$2K |
| 96402 |
|
28 |
26 |
$2K |
| J0780 |
Prochlorperazine injection |
535 |
502 |
$2K |
| 95909 |
|
27 |
27 |
$2K |
| 84155 |
|
2,350 |
2,269 |
$2K |
| J0171 |
Adrenalin epinephrine inject |
342 |
324 |
$2K |
| 84520 |
|
6,718 |
6,062 |
$2K |
| J1200 |
Diphenhydramine hcl injectio |
2,218 |
1,699 |
$2K |
| 84481 |
|
158 |
157 |
$2K |
| J1644 |
Inj heparin sodium per 1000u |
1,281 |
1,102 |
$2K |
| 97166 |
|
12 |
12 |
$2K |
| 92611 |
|
12 |
12 |
$2K |
| 94729 |
|
65 |
65 |
$2K |
| 87040 |
|
1,822 |
1,253 |
$2K |
| J7042 |
5% dextrose/normal saline |
857 |
736 |
$2K |
| 31575 |
|
13 |
12 |
$2K |
| J2550 |
Promethazine hcl injection |
737 |
643 |
$2K |
| 86696 |
|
121 |
120 |
$2K |
| J2274 |
Inj morphine pf epid ithc |
166 |
165 |
$2K |
| J1720 |
Hydrocortisone sodium succ i |
96 |
74 |
$2K |
| 85045 |
|
935 |
823 |
$2K |
| 84295 |
|
2,599 |
2,490 |
$2K |
| J1650 |
Inj enoxaparin sodium |
536 |
308 |
$2K |
| 71045 |
|
1,505 |
1,448 |
$2K |
| J1630 |
Haloperidol injection |
1,327 |
1,296 |
$2K |
| U0002 |
Covid-19 lab test non-cdc |
43 |
42 |
$2K |
| J2272 |
Inj, morphine (fresenius) |
198 |
180 |
$2K |
| 88313 |
|
168 |
126 |
$2K |
| D1351 |
|
12 |
12 |
$2K |
| 76805 |
|
26 |
26 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
768 |
667 |
$2K |
| Q9950 |
Inj sulf hexa lipid microsph |
25 |
13 |
$1K |
| 86235 |
|
52 |
52 |
$1K |
| 86077 |
|
28 |
13 |
$1K |
| J2370 |
Phenylephrine hcl injection |
820 |
808 |
$1K |
| 73140 |
|
290 |
261 |
$1K |
| 93226 |
|
13 |
13 |
$1K |
| 87641 |
|
49 |
48 |
$1K |
| 84703 |
|
2,811 |
2,689 |
$1K |
| G0399 |
Home sleep test/type 3 porta |
13 |
13 |
$1K |
| 82435 |
|
2,291 |
2,211 |
$1K |
| 82374 |
|
2,089 |
2,019 |
$1K |
| J3475 |
Inj magnesium sulfate |
313 |
224 |
$1K |
| 86008 |
|
40 |
25 |
$1K |
| 93922 |
|
39 |
28 |
$1K |
| 85060 |
|
87 |
84 |
$1K |
| 88319 |
|
22 |
12 |
$1K |
| 83993 |
|
67 |
67 |
$1K |
| 86665 |
|
49 |
49 |
$1K |
| 73090 |
|
310 |
252 |
$1K |
| 87088 |
|
99 |
96 |
$1K |
| J1642 |
Inj heparin sodium per 10 u |
3,567 |
1,831 |
$1K |
| 87158 |
|
1,791 |
1,759 |
$1K |
| 73564 |
|
66 |
65 |
$1K |
| 0031A |
|
17 |
17 |
$1K |
| 84132 |
|
864 |
825 |
$997.35 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
637 |
632 |
$991.22 |
| 85384 |
|
268 |
252 |
$935.29 |
| 76801 |
|
12 |
12 |
$928.05 |
| 87206 |
|
168 |
165 |
$921.77 |
| 73070 |
|
141 |
110 |
$866.76 |
| 73100 |
|
135 |
110 |
$851.19 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
348 |
179 |
$840.44 |
| 0054A |
|
14 |
14 |
$840.00 |
| 85097 |
|
12 |
12 |
$815.20 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
367 |
365 |
$805.31 |
| 88312 |
|
17 |
13 |
$788.37 |
| 86592 |
|
178 |
172 |
$751.08 |
| 83605 |
|
1,453 |
1,350 |
$705.59 |
| 73080 |
|
115 |
108 |
$704.62 |
| S9484 |
Crisis intervention per hour |
17 |
13 |
$655.41 |
| J2919 |
Inj, methylpred sod succ 5mg |
108 |
93 |
$627.59 |
| 86769 |
|
12 |
12 |
$568.80 |
| 86225 |
|
77 |
77 |
$568.71 |
| 84153 |
|
27 |
27 |
$551.80 |
| 0241U |
|
3,064 |
3,000 |
$539.28 |
| G0008 |
Admin influenza virus vac |
32 |
32 |
$521.04 |
| 84134 |
|
64 |
56 |
$514.51 |
| 85018 |
|
219 |
211 |
$489.50 |
| 82378 |
|
44 |
37 |
$485.83 |
| J1030 |
Methylprednisolone 40 mg inj |
51 |
51 |
$471.08 |
| 87535 |
|
12 |
12 |
$440.62 |
| V5266 |
Battery for hearing device |
39 |
39 |
$435.60 |
| 95911 |
|
12 |
12 |
$435.42 |
| 87811 |
|
212 |
211 |
$434.49 |
| 86709 |
|
28 |
28 |
$427.50 |
| Q0163 |
Diphenhydramine hcl 50mg |
1,577 |
1,274 |
$418.19 |
| 73552 |
|
87 |
81 |
$417.49 |
| 87184 |
|
26 |
26 |
$401.42 |
| 84484 |
|
3,827 |
2,018 |
$401.16 |
| 97035 |
|
18 |
12 |
$352.44 |
| 83521 |
|
42 |
14 |
$320.70 |
| 82330 |
|
224 |
213 |
$314.03 |
| 86304 |
|
12 |
12 |
$312.20 |
| J7620 |
Albuterol ipratrop non-comp |
1,074 |
910 |
$310.90 |
| 87324 |
|
44 |
41 |
$282.00 |
| 82390 |
|
25 |
25 |
$255.15 |
| 83525 |
|
13 |
13 |
$205.80 |
| G0123 |
Screen cerv/vag thin layer |
12 |
12 |
$198.24 |
| 86308 |
|
50 |
49 |
$196.53 |
| Q0164 |
Prochlorperazine maleate 5mg |
367 |
208 |
$196.22 |
| 87449 |
|
31 |
30 |
$195.00 |
| 86301 |
|
13 |
12 |
$187.32 |
| Q0162 |
Ondansetron oral |
2,649 |
2,454 |
$176.70 |
| 87015 |
|
27 |
27 |
$170.54 |
| 87880 |
|
1,594 |
1,572 |
$167.27 |
| J7613 |
Albuterol non-comp unit |
909 |
828 |
$151.77 |
| 87116 |
|
13 |
13 |
$141.93 |
| 72040 |
|
15 |
14 |
$136.40 |
| J1815 |
Insulin injection |
92 |
41 |
$133.71 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
122 |
122 |
$125.88 |
| J2710 |
Neostigmine methylslfte inj |
13 |
13 |
$117.81 |
| 87075 |
|
28 |
27 |
$113.68 |
| 96374 |
|
4,756 |
4,303 |
$90.34 |
| 83721 |
|
220 |
218 |
$80.70 |
| 72070 |
|
13 |
13 |
$68.20 |
| J2060 |
Lorazepam injection |
70 |
67 |
$55.68 |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
14 |
14 |
$55.10 |
| J7644 |
Ipratropium bromide non-comp |
134 |
128 |
$51.97 |
| 96375 |
|
5,702 |
4,332 |
$50.22 |
| J7512 |
Prednisone ir or dr oral 1mg |
91 |
78 |
$48.40 |
| J7611 |
Albuterol non-comp con |
33 |
29 |
$38.64 |
| 81002 |
|
1,383 |
1,347 |
$36.20 |
| 80143 |
|
989 |
927 |
$25.44 |
| 85390 |
|
399 |
371 |
$20.15 |
| J2470 |
Inj pantoprazole sodium 40mg |
12 |
12 |
$15.60 |
| J2765 |
Metoclopramide hcl injection |
16 |
14 |
$14.98 |
| 80179 |
|
975 |
915 |
$12.72 |
| 88300 |
|
474 |
402 |
$8.84 |
| 90471 |
|
1,023 |
1,016 |
$7.50 |
| 99153 |
Mod sedat endo service >5yrs |
1,475 |
1,437 |
$0.00 |
| C1769 |
Guide wire |
1,046 |
1,024 |
$0.00 |
| 96376 |
|
1,367 |
970 |
$0.00 |
| 82077 |
|
534 |
508 |
$0.00 |
| 95012 |
|
91 |
90 |
$0.00 |
| 96127 |
|
13 |
13 |
$0.00 |
| 99152 |
|
2,320 |
2,253 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
567 |
556 |
$0.00 |
| G2212 |
Prolong outpt/office vis |
115 |
110 |
$0.00 |
| 96417 |
|
87 |
50 |
$0.00 |
| 85347 |
|
38 |
38 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
263 |
258 |
$0.00 |
| 87804 |
|
99 |
99 |
$0.00 |
| C1729 |
Cath, drainage |
13 |
13 |
$0.00 |
| T1040 |
Comm bh clinic svc per diem |
26 |
24 |
$0.00 |
| 95800 |
|
12 |
12 |
$0.00 |