| Code | Description | Claims | Beneficiaries | Total Paid |
| 99285 |
|
23,805 |
22,686 |
$13.98M |
| 99284 |
|
20,785 |
19,847 |
$7.43M |
| 99283 |
|
21,777 |
20,873 |
$5.37M |
| 99214 |
|
34,298 |
32,646 |
$3.35M |
| D0999 |
|
28,367 |
22,922 |
$3.12M |
| 90999 |
|
18,482 |
1,607 |
$2.93M |
| 74177 |
|
6,395 |
6,247 |
$2.76M |
| G0463 |
Hospital outpt clinic visit |
28,704 |
23,712 |
$2.42M |
| 99213 |
|
27,849 |
26,341 |
$2.01M |
| 96374 |
|
11,531 |
10,658 |
$1.59M |
| 96365 |
|
7,456 |
6,139 |
$1.29M |
| 96361 |
|
12,716 |
11,017 |
$1.13M |
| 70450 |
|
5,215 |
5,047 |
$1.10M |
| 43239 |
|
1,519 |
1,507 |
$1.01M |
| 74176 |
|
2,587 |
2,537 |
$880K |
| 97110 |
|
14,373 |
4,491 |
$796K |
| 99282 |
|
5,162 |
5,009 |
$787K |
| 87635 |
|
15,468 |
14,865 |
$767K |
| 0223U |
|
4,471 |
4,405 |
$695K |
| 0241U |
|
5,654 |
5,587 |
$664K |
| 96375 |
|
10,974 |
9,148 |
$663K |
| 96360 |
|
3,651 |
3,499 |
$662K |
| 96413 |
|
2,326 |
1,543 |
$648K |
| 71046 |
|
8,313 |
8,146 |
$629K |
| 90791 |
|
4,630 |
4,333 |
$592K |
| 71045 |
|
9,766 |
9,457 |
$587K |
| 77067 |
|
4,513 |
4,511 |
$500K |
| 80053 |
|
52,565 |
47,019 |
$499K |
| U0003 |
Cov-19 amp prb hgh thruput |
6,885 |
6,169 |
$499K |
| 76705 |
|
3,560 |
3,518 |
$467K |
| 99203 |
|
4,490 |
4,489 |
$443K |
| 90834 |
|
3,973 |
3,017 |
$419K |
| 71275 |
|
1,323 |
1,308 |
$378K |
| 76856 |
|
2,236 |
2,212 |
$377K |
| 93306 |
|
1,133 |
1,126 |
$352K |
| 41899 |
|
204 |
204 |
$351K |
| 99232 |
|
6,706 |
2,135 |
$338K |
| 76830 |
|
2,497 |
2,461 |
$325K |
| 99281 |
|
4,200 |
4,050 |
$321K |
| 90837 |
|
2,470 |
1,680 |
$305K |
| 76816 |
|
3,296 |
3,080 |
$274K |
| G0378 |
Hospital observation per hr |
2,348 |
2,112 |
$258K |
| 45380 |
|
282 |
281 |
$255K |
| D7140 |
|
2,891 |
2,469 |
$249K |
| 76642 |
|
2,431 |
2,416 |
$246K |
| 76805 |
|
1,933 |
1,927 |
$236K |
| 76770 |
|
1,446 |
1,432 |
$236K |
| 90792 |
|
1,781 |
1,534 |
$222K |
| 76801 |
|
1,871 |
1,829 |
$214K |
| 96366 |
|
1,742 |
1,294 |
$214K |
| 86900 |
|
7,167 |
6,725 |
$213K |
| 80307 |
|
8,123 |
7,490 |
$212K |
| 93005 |
|
16,711 |
15,624 |
$210K |
| 90832 |
|
1,960 |
1,707 |
$207K |
| 76819 |
|
2,154 |
1,371 |
$207K |
| 88305 |
|
4,154 |
4,092 |
$206K |
| 71250 |
|
1,069 |
1,063 |
$196K |
| 87502 |
|
4,702 |
4,629 |
$193K |
| 36415 |
|
74,134 |
57,981 |
$188K |
| 77066 |
Tomosynthesis, mammo |
1,578 |
1,569 |
$187K |
| J0882 |
Darbepoetin alfa, esrd use |
4,236 |
1,264 |
$179K |
| 93971 |
|
1,352 |
1,320 |
$177K |
| 85025 |
|
54,881 |
48,448 |
$176K |
| 87491 |
|
7,305 |
7,203 |
$173K |
| 71271 |
|
818 |
817 |
$169K |
| 87591 |
|
7,321 |
7,218 |
$168K |
| 97161 |
|
1,999 |
1,979 |
$165K |
| 71260 |
|
838 |
832 |
$161K |
| 99231 |
|
5,382 |
1,883 |
$158K |
| 96372 |
|
12,271 |
9,042 |
$155K |
| 76536 |
|
1,384 |
1,376 |
$153K |
| C9803 |
Hopd covid-19 spec collect |
7,478 |
7,157 |
$149K |
| 99393 |
|
1,509 |
1,505 |
$148K |
| 77065 |
Tomosynthesis, mammo |
1,509 |
1,440 |
$147K |
| 70498 |
|
476 |
470 |
$141K |
| 72125 |
|
1,023 |
1,009 |
$139K |
| 99204 |
|
881 |
881 |
$133K |
| 92507 |
|
1,884 |
568 |
$132K |
| 73610 |
|
2,420 |
2,221 |
$132K |
| 93970 |
|
487 |
485 |
$132K |
| 82306 |
|
5,414 |
5,392 |
$125K |
| 99392 |
|
1,210 |
1,208 |
$117K |
| 84443 |
|
9,138 |
9,016 |
$116K |
| 76815 |
|
1,977 |
1,817 |
$115K |
| 76700 |
|
680 |
678 |
$114K |
| 87661 |
|
4,341 |
4,263 |
$107K |
| 99394 |
|
1,006 |
1,005 |
$107K |
| 42820 |
|
19 |
19 |
$101K |
| 80061 |
|
8,082 |
8,044 |
$99K |
| 83880 |
|
4,340 |
4,172 |
$99K |
| 76818 |
|
870 |
435 |
$99K |
| 99291 |
|
493 |
183 |
$95K |
| 94060 |
|
1,426 |
1,423 |
$92K |
| 73630 |
|
1,882 |
1,811 |
$91K |
| 73562 |
|
1,366 |
1,340 |
$90K |
| 78815 |
|
70 |
70 |
$89K |
| 99238 |
|
1,401 |
1,369 |
$85K |
| 97597 |
|
504 |
229 |
$84K |
| 88342 |
|
1,802 |
1,776 |
$84K |
| 81513 |
|
3,430 |
3,365 |
$83K |
| 73030 |
|
1,713 |
1,659 |
$81K |
| 77063 |
|
4,202 |
4,200 |
$80K |
| 87636 |
|
562 |
525 |
$79K |
| 96367 |
|
1,027 |
809 |
$76K |
| 87651 |
|
4,468 |
4,393 |
$73K |
| G0108 |
Diab manage trn per indiv |
1,332 |
1,228 |
$72K |
| 97530 |
|
1,079 |
526 |
$71K |
| 99396 |
|
560 |
535 |
$68K |
| 99391 |
|
716 |
658 |
$64K |
| 97140 |
|
1,779 |
671 |
$64K |
| 70491 |
|
197 |
195 |
$62K |
| 72110 |
|
609 |
609 |
$62K |
| 76817 |
|
1,246 |
1,072 |
$62K |
| 73130 |
|
1,477 |
1,421 |
$61K |
| 73564 |
|
1,335 |
1,321 |
$61K |
| 73110 |
|
1,185 |
1,110 |
$60K |
| 74018 |
|
1,739 |
1,692 |
$59K |
| 87624 |
|
1,872 |
1,870 |
$58K |
| 83036 |
|
6,743 |
6,696 |
$58K |
| 01967 |
|
95 |
95 |
$57K |
| 72131 |
|
301 |
300 |
$57K |
| 97162 |
|
658 |
653 |
$57K |
| 86850 |
|
6,441 |
6,043 |
$57K |
| 70486 |
|
250 |
250 |
$56K |
| C1769 |
Guide wire |
1,045 |
999 |
$55K |
| 87088 |
|
15,095 |
14,251 |
$54K |
| 90471 |
|
8,916 |
8,837 |
$54K |
| 99222 |
|
526 |
519 |
$53K |
| 96376 |
|
2,827 |
1,868 |
$53K |
| 76641 |
|
332 |
332 |
$52K |
| 88142 |
|
2,766 |
2,764 |
$52K |
| 99443 |
|
452 |
370 |
$51K |
| 80048 |
|
7,032 |
6,415 |
$49K |
| 87389 |
|
3,399 |
3,386 |
$49K |
| G0279 |
Tomosynthesis, mammo |
2,211 |
2,202 |
$47K |
| 87481 |
|
1,924 |
1,893 |
$44K |
| 58661 |
|
12 |
12 |
$43K |
| 84702 |
|
8,325 |
7,428 |
$42K |
| 99395 |
|
361 |
349 |
$42K |
| 94640 |
|
3,800 |
3,064 |
$41K |
| 87798 |
|
619 |
616 |
$40K |
| 84484 |
|
10,221 |
9,041 |
$40K |
| 96415 |
|
244 |
187 |
$40K |
| 87801 |
|
711 |
704 |
$40K |
| 82728 |
|
3,661 |
3,589 |
$40K |
| 0002A |
|
1,100 |
1,097 |
$37K |
| 70496 |
|
419 |
415 |
$37K |
| J1439 |
Inj ferric carboxymaltos 1mg |
45 |
31 |
$37K |
| 99223 |
Prolong inpt eval add15 m |
273 |
263 |
$36K |
| 59050 |
|
551 |
462 |
$35K |
| 72100 |
|
504 |
497 |
$35K |
| 0001A |
|
1,219 |
1,214 |
$34K |
| 73100 |
|
500 |
392 |
$33K |
| G0480 |
Drug test def 1-7 classes |
2,121 |
2,009 |
$33K |
| 87653 |
|
1,270 |
1,261 |
$31K |
| 83735 |
|
13,491 |
11,872 |
$31K |
| 77080 |
|
258 |
257 |
$30K |
| 86480 |
|
594 |
591 |
$30K |
| 73080 |
|
547 |
491 |
$30K |
| 90686 |
|
2,774 |
2,770 |
$29K |
| 86901 |
|
7,160 |
6,718 |
$29K |
| 97166 |
|
369 |
367 |
$29K |
| 83550 |
|
3,580 |
3,487 |
$28K |
| 82607 |
|
2,337 |
2,316 |
$28K |
| 86803 |
|
3,287 |
3,263 |
$28K |
| 87471 |
|
853 |
836 |
$27K |
| 87660 |
|
2,302 |
2,259 |
$25K |
| 73590 |
|
572 |
532 |
$25K |
| 99239 |
|
418 |
414 |
$25K |
| 81001 |
|
16,868 |
16,027 |
$24K |
| 83655 |
|
2,729 |
2,714 |
$24K |
| J3490 |
Drugs unclassified injection |
250 |
249 |
$24K |
| 73502 |
|
451 |
450 |
$24K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
9,397 |
9,109 |
$24K |
| 83605 |
|
5,934 |
5,556 |
$23K |
| 87510 |
|
2,135 |
2,095 |
$22K |
| 87480 |
|
2,145 |
2,104 |
$22K |
| 88304 |
|
735 |
735 |
$22K |
| 96110 |
|
1,775 |
1,774 |
$22K |
| 59025 |
|
156 |
131 |
$22K |
| 85027 |
|
5,062 |
4,841 |
$22K |
| 84439 |
|
2,876 |
2,856 |
$22K |
| 73140 |
|
406 |
377 |
$22K |
| 83540 |
|
3,942 |
3,864 |
$22K |
| 73090 |
|
429 |
365 |
$22K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
26 |
26 |
$21K |
| 76870 |
|
225 |
222 |
$21K |
| 94726 |
|
1,047 |
1,043 |
$21K |
| 83690 |
|
11,737 |
11,110 |
$20K |
| 0003A |
|
498 |
498 |
$19K |
| 84703 |
|
7,855 |
7,612 |
$19K |
| 99212 |
|
445 |
428 |
$19K |
| 00731 |
|
161 |
159 |
$18K |
| U0002 |
Covid-19 lab test non-cdc |
347 |
277 |
$18K |
| 69436 |
|
14 |
14 |
$18K |
| 12001 |
|
184 |
184 |
$17K |
| 87186 |
|
3,660 |
3,469 |
$17K |
| 99221 |
|
208 |
203 |
$17K |
| 87340 |
|
2,432 |
2,389 |
$17K |
| 93880 |
|
93 |
93 |
$16K |
| 94729 |
|
1,005 |
1,001 |
$16K |
| 81220 |
|
28 |
28 |
$16K |
| 87040 |
|
4,789 |
3,062 |
$15K |
| 85610 |
|
8,019 |
7,562 |
$15K |
| 81511 |
|
142 |
140 |
$14K |
| 99442 |
|
204 |
185 |
$14K |
| 83970 |
|
728 |
706 |
$14K |
| 87536 |
|
174 |
174 |
$14K |
| 00170 |
|
139 |
139 |
$14K |
| 98968 |
|
438 |
318 |
$14K |
| 87077 |
|
3,277 |
3,090 |
$13K |
| 0012A |
|
408 |
408 |
$13K |
| 92557 |
|
146 |
146 |
$13K |
| 82746 |
|
1,125 |
1,116 |
$13K |
| 86592 |
|
2,978 |
2,958 |
$13K |
| 0011A |
|
578 |
577 |
$13K |
| 72081 |
|
173 |
173 |
$13K |
| 81003 |
|
11,615 |
11,077 |
$12K |
| 90715 |
|
976 |
974 |
$12K |
| 90472 |
|
1,729 |
1,725 |
$12K |
| 92523 |
|
66 |
61 |
$12K |
| 87631 |
|
518 |
512 |
$11K |
| 86140 |
|
5,246 |
4,819 |
$11K |
| P9016 |
Rbc leukocytes reduced |
48 |
40 |
$11K |
| 82962 |
|
7,228 |
5,683 |
$11K |
| 99152 |
|
346 |
339 |
$10K |
| J1756 |
Iron sucrose injection |
769 |
396 |
$10K |
| 85730 |
|
4,440 |
4,277 |
$10K |
| 97112 |
|
231 |
125 |
$10K |
| 82077 |
|
2,339 |
2,194 |
$10K |
| 01961 |
|
42 |
42 |
$9K |
| 93925 |
|
55 |
55 |
$9K |
| 87507 |
|
28 |
28 |
$9K |
| 97150 |
|
513 |
275 |
$9K |
| 86618 |
|
397 |
397 |
$9K |
| 87070 |
|
1,811 |
1,746 |
$9K |
| 0013A |
|
220 |
220 |
$9K |
| 87880 |
|
541 |
531 |
$8K |
| 93010 |
|
1,159 |
1,095 |
$8K |
| 84403 |
|
356 |
354 |
$8K |
| C1894 |
Intro/sheath, non-laser |
164 |
159 |
$8K |
| G0103 |
Psa screening |
484 |
483 |
$7K |
| 86360 |
|
171 |
170 |
$7K |
| 72050 |
|
123 |
123 |
$7K |
| 82570 |
|
2,001 |
1,880 |
$7K |
| 86762 |
|
1,286 |
1,277 |
$7K |
| 86003 |
|
60 |
58 |
$7K |
| 83021 |
|
861 |
858 |
$7K |
| 12011 |
|
71 |
70 |
$7K |
| 88313 |
|
246 |
245 |
$6K |
| 99233 |
Prolong inpt eval add15 m |
69 |
24 |
$6K |
| 36430 |
|
15 |
14 |
$6K |
| 84480 |
|
517 |
515 |
$6K |
| 86787 |
|
1,177 |
1,172 |
$6K |
| 82043 |
|
1,225 |
1,218 |
$6K |
| 94760 |
|
2,530 |
1,821 |
$6K |
| 83615 |
|
1,559 |
1,380 |
$6K |
| 97165 |
|
96 |
95 |
$6K |
| 85018 |
|
5,973 |
2,466 |
$6K |
| 86617 |
|
187 |
187 |
$6K |
| 88341 |
|
110 |
107 |
$6K |
| J2704 |
Inj, propofol, 10 mg |
6,549 |
6,425 |
$5K |
| G0399 |
Home sleep test/type 3 porta |
70 |
69 |
$5K |
| 72040 |
|
109 |
107 |
$5K |
| A9552 |
F18 fdg |
76 |
76 |
$5K |
| 82105 |
|
460 |
458 |
$5K |
| 73560 |
|
92 |
90 |
$5K |
| 95819 |
|
27 |
27 |
$5K |
| 86359 |
|
171 |
170 |
$5K |
| 85379 |
|
1,627 |
1,608 |
$5K |
| 86706 |
|
504 |
494 |
$5K |
| 92550 |
|
184 |
182 |
$5K |
| 84550 |
|
2,381 |
2,243 |
$5K |
| 87503 |
|
286 |
285 |
$5K |
| 99153 |
Mod sedat endo service >5yrs |
197 |
186 |
$5K |
| 12002 |
|
60 |
59 |
$5K |
| 82950 |
|
1,042 |
1,040 |
$5K |
| 83020 |
|
834 |
829 |
$5K |
| 88173 |
|
119 |
118 |
$5K |
| C1887 |
Catheter, guiding |
130 |
128 |
$5K |
| 80143 |
|
516 |
477 |
$4K |
| 88307 |
|
53 |
52 |
$4K |
| 80179 |
|
510 |
472 |
$4K |
| C9290 |
Inj, bupivacaine liposome |
51 |
51 |
$4K |
| 83001 |
|
252 |
252 |
$4K |
| T1013 |
Sign lang/oral interpreter |
400 |
373 |
$4K |
| 25600 |
|
12 |
12 |
$4K |
| 82784 |
|
271 |
267 |
$4K |
| 96417 |
|
76 |
50 |
$4K |
| 92567 |
|
540 |
539 |
$4K |
| 84270 |
|
207 |
207 |
$4K |
| 81025 |
|
653 |
642 |
$4K |
| 87205 |
|
1,504 |
1,446 |
$4K |
| D2930 |
|
62 |
32 |
$4K |
| 88112 |
|
99 |
97 |
$4K |
| 82670 |
|
148 |
148 |
$4K |
| 84402 |
|
167 |
167 |
$4K |
| 86038 |
|
382 |
380 |
$4K |
| J2469 |
Palonosetron hcl |
548 |
301 |
$4K |
| 85652 |
|
2,132 |
1,995 |
$4K |
| 83002 |
|
210 |
210 |
$3K |
| 82652 |
|
95 |
95 |
$3K |
| 87522 |
Neg quan hep c or qual rna |
82 |
81 |
$3K |
| 99215 |
Prolong outpt/office vis |
24 |
24 |
$3K |
| 82803 |
|
379 |
354 |
$3K |
| 84146 |
|
195 |
192 |
$3K |
| 0053A |
|
83 |
83 |
$3K |
| 76937 |
|
42 |
40 |
$3K |
| 86376 |
|
224 |
224 |
$3K |
| G0297 |
Ldct for lung ca screen |
12 |
12 |
$3K |
| J0690 |
Cefazolin sodium injection |
2,293 |
2,050 |
$3K |
| J3010 |
Fentanyl citrate injection |
5,388 |
5,184 |
$3K |
| 90656 |
|
530 |
529 |
$3K |
| 80047 |
|
652 |
644 |
$3K |
| 96160 |
|
775 |
721 |
$3K |
| 84153 |
|
167 |
164 |
$2K |
| 0099U |
|
77 |
76 |
$2K |
| 10060 |
|
13 |
13 |
$2K |
| 86704 |
|
216 |
216 |
$2K |
| 84100 |
|
2,259 |
2,115 |
$2K |
| 82248 |
|
507 |
423 |
$2K |
| J1885 |
Ketorolac tromethamine inj |
9,268 |
8,737 |
$2K |
| 0031A |
|
57 |
57 |
$2K |
| 80076 |
|
311 |
308 |
$2K |
| 97167 |
|
25 |
24 |
$2K |
| 90677 |
|
300 |
300 |
$2K |
| 86703 |
|
141 |
141 |
$2K |
| 84520 |
|
2,877 |
1,581 |
$2K |
| J2930 |
Methylprednisolone injection |
600 |
410 |
$2K |
| 86709 |
|
249 |
249 |
$2K |
| 86765 |
|
187 |
187 |
$2K |
| J1100 |
Dexamethasone sodium phos |
7,229 |
6,476 |
$2K |
| 96368 |
|
114 |
88 |
$2K |
| 97803 |
|
95 |
95 |
$2K |
| 82550 |
|
644 |
604 |
$2K |
| J2270 |
Morphine sulfate injection |
3,668 |
3,188 |
$2K |
| 86705 |
|
234 |
232 |
$2K |
| 83516 |
|
106 |
104 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
1,807 |
1,504 |
$1K |
| 87086 |
|
549 |
535 |
$1K |
| 86430 |
|
271 |
271 |
$1K |
| 82945 |
|
107 |
107 |
$1K |
| A4657 |
Syringe w/wo needle |
10,928 |
1,418 |
$1K |
| 29125 |
|
26 |
26 |
$1K |
| 86780 |
|
108 |
108 |
$1K |
| 95810 |
|
12 |
12 |
$1K |
| 97802 |
|
73 |
73 |
$1K |
| C1889 |
Implant/insert device, noc |
422 |
416 |
$1K |
| 73000 |
|
16 |
14 |
$1K |
| 86364 |
|
118 |
118 |
$1K |
| 87338 |
|
100 |
99 |
$1K |
| 84156 |
|
690 |
579 |
$1K |
| 72170 |
|
42 |
42 |
$1K |
| 86735 |
|
126 |
126 |
$1K |
| 99381 |
|
12 |
12 |
$1K |
| C1819 |
Tissue localization-excision |
154 |
154 |
$1K |
| 92579 |
|
12 |
12 |
$1K |
| D1110 |
|
5,891 |
5,889 |
$1K |
| 73070 |
|
14 |
12 |
$1K |
| 86308 |
|
311 |
310 |
$1K |
| 98967 |
|
43 |
39 |
$1K |
| J2405 |
Ondansetron hcl injection |
11,455 |
10,378 |
$946.22 |
| 82040 |
|
271 |
269 |
$904.70 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
422 |
417 |
$897.22 |
| 84145 |
|
301 |
289 |
$874.54 |
| J1644 |
Inj heparin sodium per 1000u |
6,823 |
1,434 |
$873.03 |
| 99202 |
|
12 |
12 |
$854.96 |
| 87426 |
|
27 |
26 |
$839.09 |
| 82247 |
|
190 |
121 |
$817.81 |
| 84436 |
|
137 |
137 |
$805.45 |
| 11719 |
|
28 |
28 |
$800.00 |
| 82150 |
|
135 |
134 |
$790.39 |
| C1788 |
Port, indwelling, imp |
12 |
12 |
$768.51 |
| J1642 |
Inj heparin sodium per 10 u |
1,480 |
905 |
$748.34 |
| 71101 |
|
29 |
29 |
$737.32 |
| J0330 |
Succinycholine chloride inj |
636 |
635 |
$734.25 |
| G2211 |
Complex e/m visit add on |
82 |
79 |
$706.47 |
| J2543 |
Piperacillin/tazobactam |
413 |
302 |
$704.18 |
| 73552 |
|
15 |
15 |
$693.98 |
| J1720 |
Hydrocortisone sodium succ i |
78 |
71 |
$686.73 |
| 92610 |
|
13 |
13 |
$680.42 |
| 99441 |
|
27 |
26 |
$675.69 |
| J3370 |
Vancomycin hcl injection |
530 |
295 |
$649.61 |
| 90460 |
|
70 |
69 |
$640.60 |
| 82948 |
|
552 |
372 |
$608.44 |
| 87430 |
|
181 |
181 |
$606.79 |
| 0052A |
|
15 |
15 |
$578.86 |
| 87899 |
|
143 |
143 |
$569.62 |
| 84481 |
|
41 |
41 |
$568.28 |
| J3475 |
Inj magnesium sulfate |
1,116 |
841 |
$568.18 |
| J2250 |
Inj midazolam hydrochloride |
4,486 |
4,393 |
$552.62 |
| D0120 |
|
8,499 |
8,492 |
$551.00 |
| 96127 |
|
151 |
146 |
$538.39 |
| J1200 |
Diphenhydramine hcl injectio |
2,562 |
2,215 |
$537.35 |
| 90474 |
|
90 |
90 |
$535.50 |
| 87800 |
|
14 |
13 |
$524.76 |
| 97116 |
|
31 |
28 |
$522.58 |
| 0034A |
|
13 |
13 |
$510.48 |
| 0051A |
|
13 |
13 |
$501.88 |
| 94010 |
|
19 |
17 |
$499.87 |
| 82951 |
|
40 |
40 |
$488.26 |
| 99078 |
|
16 |
13 |
$480.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
268 |
217 |
$453.93 |
| J1650 |
Inj enoxaparin sodium |
624 |
306 |
$435.34 |
| 96130 |
|
13 |
13 |
$428.68 |
| 87517 |
|
12 |
12 |
$427.28 |
| 87469 |
|
13 |
13 |
$423.53 |
| 86769 |
|
14 |
13 |
$421.30 |
| G0499 |
Hepb screen high risk indiv |
94 |
62 |
$415.43 |
| J2765 |
Metoclopramide hcl injection |
2,098 |
1,949 |
$409.44 |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
65 |
61 |
$407.24 |
| 90480 |
|
46 |
46 |
$405.75 |
| 87420 |
|
104 |
104 |
$396.90 |
| 81015 |
|
380 |
379 |
$384.02 |
| 97535 |
|
17 |
13 |
$373.01 |
| J1170 |
Hydromorphone injection |
862 |
703 |
$370.54 |
| D0140 |
|
4,856 |
4,703 |
$362.11 |
| J0702 |
Betamethasone acet&sod phosp |
138 |
88 |
$355.98 |
| A4649 |
Surgical supplies |
63 |
60 |
$310.92 |
| 73060 |
|
13 |
13 |
$304.93 |
| 87484 |
|
13 |
13 |
$299.60 |
| 87468 |
|
13 |
13 |
$299.60 |
| 87478 |
|
13 |
13 |
$299.60 |
| D0274 |
|
3,631 |
3,621 |
$290.00 |
| 82627 |
|
12 |
12 |
$279.05 |
| C9113 |
Inj pantoprazole sodium, via |
873 |
593 |
$276.10 |
| 88302 |
|
12 |
12 |
$271.46 |
| D2330 |
|
406 |
349 |
$262.50 |
| 99211 |
|
12 |
12 |
$255.46 |
| D0220 |
|
4,652 |
4,499 |
$253.31 |
| J0171 |
Adrenalin epinephrine inject |
14 |
14 |
$250.16 |
| J7050 |
Normal saline solution infus |
573 |
426 |
$248.62 |
| 90662 |
|
126 |
125 |
$247.62 |
| 86696 |
|
17 |
17 |
$225.22 |
| 85045 |
|
76 |
73 |
$216.80 |
| J2060 |
Lorazepam injection |
1,072 |
940 |
$210.46 |
| D0330 |
|
2,745 |
2,743 |
$200.00 |
| 82747 |
|
12 |
12 |
$192.31 |
| J2360 |
Orphenadrine injection |
118 |
117 |
$187.68 |
| 93000 |
|
13 |
12 |
$182.38 |
| C1758 |
Catheter, ureteral |
13 |
13 |
$180.19 |
| 81002 |
|
44 |
40 |
$178.98 |
| 92555 |
|
13 |
13 |
$177.18 |
| 86923 |
|
46 |
39 |
$172.49 |
| J3411 |
Thiamine hcl 100 mg |
45 |
27 |
$170.59 |
| D2392 |
|
2,692 |
2,394 |
$168.00 |
| 86695 |
|
17 |
17 |
$161.23 |
| G0008 |
Admin influenza virus vac |
240 |
237 |
$160.99 |
| 80320 |
|
41 |
38 |
$153.58 |
| 86225 |
|
12 |
12 |
$139.52 |
| D0150 |
|
1,599 |
1,599 |
$120.00 |
| D0230 |
|
2,798 |
2,740 |
$119.00 |
| 36410 |
|
15 |
15 |
$115.68 |
| 83695 |
|
13 |
13 |
$113.82 |
| 82947 |
|
29 |
28 |
$113.69 |
| J0780 |
Prochlorperazine injection |
127 |
120 |
$113.29 |
| 92700 |
|
20 |
20 |
$102.95 |
| 82952 |
|
28 |
28 |
$95.20 |
| D2331 |
|
45 |
41 |
$87.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
127 |
114 |
$82.23 |
| J1630 |
Haloperidol injection |
320 |
287 |
$75.41 |
| J0461 |
Atropine sulfate injection |
36 |
26 |
$72.74 |
| 90473 |
|
14 |
14 |
$70.00 |
| 82009 |
|
74 |
65 |
$68.42 |
| 99173 |
|
1,781 |
1,780 |
$65.42 |
| J7030 |
Normal saline solution infus |
1,828 |
1,704 |
$61.14 |
| 82565 |
|
12 |
12 |
$61.11 |
| J1953 |
Levetiracetam injection |
50 |
40 |
$57.63 |
| Q0162 |
Ondansetron oral |
116 |
115 |
$53.88 |
| J3480 |
Inj potassium chloride |
99 |
61 |
$52.97 |
| Q3014 |
Telehealth facility fee |
60 |
30 |
$51.71 |
| J7512 |
Prednisone ir or dr oral 1mg |
582 |
505 |
$50.12 |
| 84132 |
|
28 |
25 |
$45.22 |
| J3420 |
Vitamin b12 injection |
80 |
67 |
$44.56 |
| 83721 |
|
12 |
12 |
$34.06 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
18 |
17 |
$24.80 |
| J2470 |
Inj pantoprazole sodium 40mg |
60 |
40 |
$24.18 |
| 90785 |
|
18 |
14 |
$23.79 |
| J1815 |
Insulin injection |
318 |
163 |
$19.32 |
| D0272 |
|
1,783 |
1,777 |
$17.00 |
| J0360 |
Hydralazine hcl injection |
59 |
52 |
$11.16 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
25 |
25 |
$10.86 |
| J8540 |
Oral dexamethasone |
52 |
44 |
$10.54 |
| J1790 |
Droperidol injection |
14 |
14 |
$9.29 |
| 99001 |
|
13 |
13 |
$6.27 |
| J7510 |
Prednisolone oral per 5 mg |
76 |
76 |
$6.00 |
| J1050 |
Medroxyprogesterone acetate |
56 |
56 |
$2.58 |
| J0692 |
Cefepime hcl for injection |
36 |
26 |
$2.09 |
| G1004 |
Cdsm ndsc |
1,947 |
1,829 |
$0.33 |
| J7060 |
5% dextrose/water |
39 |
26 |
$0.18 |
| 90619 |
|
66 |
66 |
$0.11 |
| D2393 |
|
204 |
193 |
$0.00 |
| D1208 |
|
3,946 |
3,943 |
$0.00 |
| 90651 |
|
54 |
54 |
$0.00 |
| D1206 |
|
1,044 |
1,043 |
$0.00 |
| D1330 |
|
1,019 |
1,018 |
$0.00 |
| 90680 |
|
63 |
63 |
$0.00 |
| 90697 |
|
79 |
79 |
$0.00 |
| 96131 |
|
13 |
13 |
$0.00 |
| A4338 |
Indwelling catheter latex |
13 |
13 |
$0.00 |
| D1120 |
|
3,718 |
3,714 |
$0.00 |
| D2391 |
|
3,269 |
2,846 |
$0.00 |
| D0270 |
|
333 |
329 |
$0.00 |
| 90734 |
|
27 |
26 |
$0.00 |
| 91320 |
|
25 |
25 |
$0.00 |
| 85007 |
|
12 |
12 |
$0.00 |
| C1751 |
Cath, inf, per/cent/midline |
14 |
14 |
$0.00 |