| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
234,479 |
223,340 |
$56.35M |
| 99284 |
|
258,134 |
245,986 |
$46.50M |
| 99283 |
|
126,913 |
119,346 |
$17.15M |
| 74177 |
|
36,516 |
35,232 |
$10.93M |
| 87636 |
|
75,575 |
72,613 |
$9.38M |
| 90378 |
|
2,114 |
2,002 |
$7.00M |
| G0463 |
Hospital outpt clinic visit |
152,850 |
122,296 |
$6.99M |
| U0003 |
Cov-19 amp prb hgh thruput |
80,814 |
76,897 |
$6.67M |
| 93005 |
|
100,521 |
85,049 |
$5.93M |
| 70450 |
|
31,364 |
29,838 |
$5.00M |
| 43239 |
|
10,854 |
10,730 |
$4.52M |
| G0378 |
Hospital observation per hr |
8,967 |
8,414 |
$4.49M |
| D2930 |
|
24,723 |
4,681 |
$3.64M |
| 96374 |
|
92,938 |
85,461 |
$3.55M |
| 99214 |
|
28,026 |
26,731 |
$3.40M |
| 85025 |
|
398,618 |
355,715 |
$3.03M |
| 80307 |
|
62,538 |
57,276 |
$3.00M |
| 96375 |
|
61,066 |
52,234 |
$2.97M |
| 97110 |
|
63,910 |
28,168 |
$2.84M |
| 99213 |
|
35,996 |
33,384 |
$2.78M |
| 71046 |
|
55,444 |
52,571 |
$2.73M |
| 80048 |
|
251,918 |
224,597 |
$2.38M |
| 87491 |
|
67,995 |
65,949 |
$2.36M |
| 87591 |
|
68,009 |
65,963 |
$2.34M |
| 47562 |
|
805 |
791 |
$2.33M |
| 71275 |
|
7,775 |
7,558 |
$2.20M |
| 45380 |
|
4,658 |
4,604 |
$2.20M |
| 95810 |
|
2,736 |
2,708 |
$2.10M |
| 88305 |
|
45,837 |
34,259 |
$1.98M |
| 96365 |
|
19,728 |
16,148 |
$1.92M |
| 84443 |
|
125,867 |
122,002 |
$1.90M |
| 80053 |
|
186,402 |
170,852 |
$1.87M |
| 81513 |
|
13,812 |
13,466 |
$1.73M |
| 74176 |
|
8,410 |
8,131 |
$1.66M |
| 94640 |
|
13,611 |
10,880 |
$1.65M |
| 93976 |
|
11,308 |
10,831 |
$1.57M |
| J1561 |
Gamunex-c/gammaked |
931 |
365 |
$1.56M |
| 70553 |
|
3,681 |
3,608 |
$1.52M |
| 87631 |
|
11,451 |
11,199 |
$1.49M |
| 76705 |
|
15,544 |
15,055 |
$1.46M |
| D2934 |
|
10,173 |
2,752 |
$1.46M |
| 96361 |
|
41,339 |
36,457 |
$1.45M |
| 90791 |
|
12,624 |
11,620 |
$1.45M |
| 99203 |
|
13,696 |
13,058 |
$1.39M |
| 72125 |
|
7,372 |
7,173 |
$1.38M |
| 82306 |
|
49,534 |
48,758 |
$1.28M |
| 95811 |
|
1,838 |
1,811 |
$1.23M |
| 27447 |
|
207 |
204 |
$1.20M |
| 99282 |
|
12,191 |
11,686 |
$1.11M |
| U0005 |
Infec agen detec ampli probe |
46,023 |
44,192 |
$1.11M |
| 96372 |
|
43,167 |
34,095 |
$1.10M |
| 76856 |
|
11,401 |
11,168 |
$1.09M |
| 99204 |
|
6,187 |
6,045 |
$1.05M |
| 44970 |
|
346 |
339 |
$1.05M |
| 71045 |
|
23,027 |
21,779 |
$1.02M |
| 96360 |
|
13,657 |
12,293 |
$1.02M |
| 76830 |
|
10,670 |
10,450 |
$1.02M |
| 78815 |
|
1,407 |
1,387 |
$993K |
| 45385 |
|
2,216 |
2,199 |
$981K |
| 80076 |
|
102,192 |
94,939 |
$972K |
| 70551 |
|
3,508 |
3,459 |
$954K |
| 84484 |
|
62,864 |
50,967 |
$943K |
| 59025 |
|
8,866 |
6,966 |
$907K |
| 83036 |
|
106,429 |
104,259 |
$901K |
| G0480 |
Drug test def 1-7 classes |
9,396 |
8,944 |
$816K |
| 97140 |
|
28,021 |
14,017 |
$815K |
| D3310 |
|
6,660 |
1,767 |
$805K |
| 71260 |
|
3,747 |
3,673 |
$801K |
| 87651 |
|
23,161 |
22,515 |
$797K |
| 73562 |
|
10,559 |
9,730 |
$774K |
| 96413 |
|
5,927 |
4,305 |
$746K |
| 87637 |
|
5,144 |
5,117 |
$744K |
| 81514 |
|
3,922 |
3,859 |
$724K |
| 0241U |
|
5,301 |
5,189 |
$721K |
| 87481 |
|
16,796 |
16,174 |
$720K |
| D0220 |
|
3,158 |
3,132 |
$716K |
| 83690 |
|
72,991 |
67,525 |
$712K |
| 36415 |
|
145,533 |
135,122 |
$709K |
| 87086 |
|
92,689 |
86,607 |
$703K |
| D7140 |
|
4,684 |
1,672 |
$692K |
| 70496 |
|
2,454 |
2,400 |
$683K |
| 70498 |
|
2,561 |
2,506 |
$682K |
| D0230 |
|
4,603 |
3,102 |
$643K |
| D3220 |
|
4,620 |
1,478 |
$633K |
| 42820 |
|
352 |
351 |
$631K |
| 84439 |
|
74,590 |
72,840 |
$623K |
| 73610 |
|
7,888 |
7,506 |
$619K |
| 76700 |
|
7,114 |
7,050 |
$618K |
| 87389 |
|
26,534 |
26,089 |
$615K |
| 49083 |
|
1,828 |
962 |
$599K |
| D0272 |
|
4,324 |
4,286 |
$596K |
| 87633 |
|
1,529 |
1,496 |
$588K |
| 70486 |
|
3,202 |
3,135 |
$582K |
| 93306 |
|
2,817 |
2,737 |
$574K |
| 73030 |
|
8,201 |
7,561 |
$568K |
| D1120 |
|
3,934 |
3,891 |
$562K |
| 73130 |
|
9,605 |
8,856 |
$547K |
| 72148 |
|
2,306 |
2,273 |
$545K |
| 82075 |
|
27,870 |
23,389 |
$544K |
| 87661 |
|
15,165 |
14,779 |
$533K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
52,524 |
50,023 |
$527K |
| 82728 |
|
41,477 |
40,261 |
$525K |
| 87650 |
|
25,266 |
24,168 |
$508K |
| 58571 |
|
189 |
187 |
$507K |
| 81025 |
|
54,030 |
50,799 |
$507K |
| 80061 |
|
42,190 |
41,618 |
$503K |
| 52356 |
|
197 |
193 |
$498K |
| 84702 |
|
28,255 |
23,603 |
$479K |
| 64493 |
|
1,046 |
1,024 |
$466K |
| 87505 |
|
3,210 |
3,100 |
$463K |
| 45378 |
|
908 |
895 |
$463K |
| 70491 |
|
1,701 |
1,673 |
$462K |
| 85027 |
|
78,946 |
73,125 |
$459K |
| 87880 |
|
30,287 |
29,405 |
$454K |
| D0240 |
|
2,907 |
1,485 |
$447K |
| 76801 |
|
4,419 |
4,036 |
$442K |
| 73630 |
|
8,469 |
7,957 |
$437K |
| U0002 |
Covid-19 lab test non-cdc |
10,524 |
10,169 |
$435K |
| 96376 |
|
18,169 |
13,037 |
$434K |
| 88307 |
|
3,570 |
3,468 |
$433K |
| 86780 |
|
32,466 |
31,925 |
$432K |
| 72100 |
|
6,062 |
5,937 |
$426K |
| 99291 |
|
2,037 |
2,016 |
$416K |
| 86803 |
|
30,230 |
29,713 |
$405K |
| J1745 |
Infliximab not biosimil 10mg |
258 |
205 |
$401K |
| 74174 |
|
1,028 |
1,011 |
$397K |
| 93971 |
|
5,901 |
5,696 |
$390K |
| D2391 |
|
2,485 |
1,044 |
$387K |
| 76536 |
|
4,446 |
4,401 |
$380K |
| 73721 |
|
1,197 |
1,159 |
$364K |
| 64635 |
|
464 |
456 |
$362K |
| 69436 |
|
236 |
235 |
$359K |
| 80074 |
|
8,008 |
7,844 |
$359K |
| 76770 |
|
4,158 |
4,103 |
$353K |
| 87624 |
|
10,343 |
10,295 |
$328K |
| 73110 |
|
6,090 |
5,707 |
$324K |
| 88175 |
|
13,485 |
13,250 |
$324K |
| 99499 |
|
2,205 |
2,176 |
$323K |
| 87077 |
|
36,907 |
35,057 |
$322K |
| 81003 |
|
96,063 |
90,288 |
$321K |
| G0121 |
Colon ca scrn not hi rsk ind |
686 |
684 |
$316K |
| 97162 |
|
8,596 |
8,435 |
$313K |
| 97113 |
|
4,350 |
1,771 |
$309K |
| G0399 |
Home sleep test/type 3 porta |
1,760 |
1,749 |
$302K |
| 77385 |
|
886 |
84 |
$300K |
| 99281 |
|
5,170 |
4,990 |
$296K |
| 87653 |
|
8,506 |
8,370 |
$292K |
| 83880 |
|
12,409 |
11,717 |
$291K |
| 96366 |
|
6,778 |
4,564 |
$290K |
| 83605 |
|
20,163 |
17,981 |
$287K |
| D1206 |
|
3,151 |
3,113 |
$283K |
| 76870 |
|
3,014 |
2,911 |
$282K |
| 83550 |
|
33,810 |
32,905 |
$275K |
| 43235 |
|
610 |
603 |
$269K |
| 30140 |
|
181 |
178 |
$261K |
| 72141 |
|
1,001 |
989 |
$258K |
| 82607 |
|
20,002 |
19,619 |
$257K |
| 74018 |
|
4,621 |
4,421 |
$257K |
| 95782 |
|
299 |
298 |
$257K |
| 86480 |
|
4,367 |
4,277 |
$255K |
| 74183 |
|
603 |
599 |
$254K |
| 76817 |
|
3,771 |
3,456 |
$254K |
| D3330 |
|
2,193 |
831 |
$253K |
| 74178 |
|
1,054 |
1,045 |
$252K |
| 87186 |
|
28,704 |
27,340 |
$250K |
| 93970 |
|
2,400 |
2,341 |
$250K |
| 81001 |
|
57,769 |
54,058 |
$247K |
| 88342 |
|
5,347 |
5,191 |
$247K |
| 72158 |
|
575 |
564 |
$230K |
| 86235 |
|
2,993 |
2,913 |
$228K |
| 12001 |
|
2,456 |
2,411 |
$225K |
| J0585 |
Injection,onabotulinumtoxina |
807 |
426 |
$220K |
| 86850 |
|
23,295 |
22,030 |
$218K |
| 71250 |
|
1,781 |
1,753 |
$218K |
| 73080 |
|
3,880 |
3,681 |
$211K |
| 83540 |
|
34,526 |
33,589 |
$206K |
| 93010 |
|
34,721 |
31,493 |
$203K |
| 97530 |
|
5,945 |
4,480 |
$203K |
| 86923 |
|
1,400 |
1,169 |
$202K |
| J0561 |
Penicillin g benzathine inj |
1,767 |
1,729 |
$201K |
| 64636 |
|
816 |
451 |
$199K |
| 83970 |
|
5,831 |
5,595 |
$198K |
| 72040 |
|
2,712 |
2,663 |
$198K |
| 64490 |
|
449 |
440 |
$193K |
| 83516 |
|
8,954 |
7,905 |
$192K |
| J0897 |
Denosumab injection |
523 |
517 |
$191K |
| 87040 |
|
10,025 |
6,903 |
$190K |
| 84703 |
|
20,745 |
19,902 |
$189K |
| 87340 |
|
19,037 |
18,710 |
$189K |
| 36430 |
|
1,028 |
709 |
$188K |
| 47563 |
|
75 |
74 |
$185K |
| 95813 |
|
990 |
988 |
$185K |
| 72131 |
|
1,181 |
1,161 |
$184K |
| 87522 |
Neg quan hep c or qual rna |
4,406 |
4,226 |
$184K |
| 82746 |
|
14,377 |
14,122 |
$181K |
| 70487 |
|
591 |
584 |
$175K |
| 29125 |
|
1,607 |
1,567 |
$174K |
| 71101 |
|
2,444 |
2,378 |
$172K |
| 82962 |
|
35,118 |
21,138 |
$172K |
| 86140 |
|
38,515 |
37,111 |
$169K |
| 99222 |
|
1,204 |
1,176 |
$167K |
| 83735 |
|
25,971 |
21,164 |
$165K |
| 77301 |
|
252 |
245 |
$162K |
| 84403 |
|
6,520 |
6,295 |
$161K |
| 72070 |
|
2,226 |
2,177 |
$160K |
| 90471 |
|
7,155 |
6,964 |
$156K |
| 77386 |
|
430 |
49 |
$156K |
| 95819 |
|
1,055 |
1,043 |
$156K |
| 73502 |
|
4,184 |
3,976 |
$155K |
| 73090 |
|
2,714 |
2,554 |
$154K |
| 86762 |
|
10,907 |
10,741 |
$153K |
| Q5119 |
Inj ruxience, 10 mg |
73 |
50 |
$153K |
| 10005 |
|
266 |
260 |
$151K |
| 73590 |
|
2,917 |
2,738 |
$150K |
| 10060 |
|
1,849 |
1,793 |
$150K |
| 73221 |
|
521 |
500 |
$150K |
| J1750 |
Inj iron dextran |
624 |
562 |
$148K |
| 84112 |
|
1,856 |
1,530 |
$148K |
| 85379 |
|
12,897 |
12,511 |
$146K |
| 86038 |
|
12,767 |
12,516 |
$144K |
| 12011 |
|
1,444 |
1,431 |
$140K |
| 82805 |
|
3,335 |
2,946 |
$139K |
| 96367 |
|
3,434 |
2,559 |
$139K |
| 78264 |
|
601 |
597 |
$139K |
| 58661 |
|
51 |
51 |
$138K |
| 87902 |
|
537 |
516 |
$138K |
| J1439 |
Inj ferric carboxymaltos 1mg |
240 |
152 |
$138K |
| 85610 |
|
36,811 |
31,590 |
$138K |
| 74019 |
|
1,380 |
1,348 |
$136K |
| 87660 |
|
7,018 |
6,678 |
$136K |
| 82570 |
|
30,373 |
28,937 |
$136K |
| 87510 |
|
7,004 |
6,667 |
$136K |
| 87480 |
|
7,017 |
6,676 |
$135K |
| P9047 |
Albumin (human), 25%, 50ml |
832 |
405 |
$135K |
| 20610 |
|
1,819 |
1,608 |
$134K |
| 86787 |
|
10,578 |
10,445 |
$133K |
| J3490 |
Drugs unclassified injection |
129,865 |
41,206 |
$131K |
| 12002 |
|
1,487 |
1,458 |
$130K |
| 88185 |
|
548 |
499 |
$130K |
| 73700 |
|
769 |
750 |
$128K |
| 74022 |
|
1,479 |
1,454 |
$127K |
| 82784 |
|
12,866 |
12,442 |
$126K |
| M0243 |
Casirivi and imdevi inj |
321 |
320 |
$124K |
| 43249 |
|
353 |
349 |
$119K |
| 77336 |
|
1,532 |
682 |
$116K |
| 86900 |
|
25,383 |
23,860 |
$114K |
| D2330 |
|
933 |
531 |
$112K |
| 0225U |
|
288 |
280 |
$110K |
| 97112 |
|
2,232 |
1,258 |
$110K |
| 82043 |
|
22,023 |
21,549 |
$108K |
| 36000 |
|
17,718 |
17,025 |
$107K |
| 82077 |
|
9,431 |
8,697 |
$107K |
| 97163 |
|
1,892 |
1,863 |
$105K |
| 78227 |
|
397 |
391 |
$104K |
| 87632 |
|
470 |
444 |
$103K |
| 80047 |
|
9,375 |
9,021 |
$103K |
| 84153 |
|
6,434 |
6,267 |
$103K |
| 93017 |
|
830 |
802 |
$103K |
| D1351 |
|
888 |
310 |
$103K |
| 85652 |
|
33,452 |
32,347 |
$100K |
| 86160 |
|
4,754 |
4,286 |
$98K |
| 87798 |
|
2,275 |
2,250 |
$98K |
| 83001 |
|
5,188 |
5,121 |
$96K |
| D2331 |
|
823 |
443 |
$95K |
| 82670 |
|
3,323 |
3,285 |
$93K |
| 84270 |
|
4,398 |
4,260 |
$92K |
| 29581 |
|
1,304 |
567 |
$90K |
| 90715 |
|
5,997 |
5,881 |
$89K |
| 88341 |
|
747 |
719 |
$88K |
| 86901 |
|
25,308 |
23,801 |
$88K |
| 97597 |
|
1,300 |
904 |
$86K |
| 73701 |
|
302 |
294 |
$86K |
| 86376 |
|
5,973 |
5,889 |
$84K |
| 87502 |
|
1,087 |
1,064 |
$80K |
| 64494 |
|
1,033 |
1,016 |
$80K |
| 87635 |
|
2,181 |
2,125 |
$80K |
| 30520 |
|
78 |
76 |
$79K |
| D2392 |
|
685 |
355 |
$78K |
| J0248 |
Inj, remdesivir, 1 mg |
221 |
72 |
$78K |
| 97161 |
|
3,591 |
3,517 |
$77K |
| 87075 |
|
6,210 |
5,881 |
$77K |
| 76805 |
|
779 |
755 |
$77K |
| 88304 |
|
3,429 |
3,357 |
$76K |
| 64495 |
|
984 |
965 |
$75K |
| 87070 |
|
8,063 |
7,612 |
$75K |
| 94010 |
|
677 |
666 |
$74K |
| 84146 |
|
3,775 |
3,724 |
$74K |
| 86706 |
|
7,174 |
7,022 |
$73K |
| 86704 |
|
6,463 |
6,324 |
$73K |
| G0145 |
Scr c/v cyto,thinlayer,rescr |
3,411 |
3,380 |
$73K |
| 96415 |
|
1,617 |
1,268 |
$73K |
| 87081 |
|
11,846 |
11,700 |
$71K |
| 82378 |
|
4,427 |
3,596 |
$71K |
| 83002 |
|
3,811 |
3,762 |
$70K |
| 93797 |
|
2,041 |
362 |
$69K |
| 76775 |
|
854 |
842 |
$69K |
| 82565 |
|
14,243 |
13,340 |
$69K |
| 84425 |
|
3,488 |
3,463 |
$67K |
| 84481 |
|
4,066 |
3,974 |
$66K |
| 87338 |
|
4,808 |
4,751 |
$65K |
| 73140 |
|
1,209 |
1,157 |
$65K |
| 82274 |
|
4,505 |
4,447 |
$63K |
| 62323 |
|
175 |
172 |
$62K |
| 86147 |
|
1,152 |
1,072 |
$62K |
| 85730 |
|
10,774 |
10,247 |
$61K |
| Q3014 |
Telehealth facility fee |
3,924 |
3,686 |
$61K |
| 83655 |
|
4,683 |
4,658 |
$61K |
| 86200 |
|
4,811 |
4,719 |
$59K |
| J7120 |
Ringers lactate infusion |
43,587 |
35,638 |
$58K |
| 72156 |
|
131 |
131 |
$58K |
| 87801 |
|
944 |
921 |
$58K |
| 94375 |
|
910 |
890 |
$58K |
| 51702 |
|
1,468 |
1,345 |
$57K |
| 77300 |
|
326 |
311 |
$56K |
| 73522 |
|
1,015 |
995 |
$56K |
| 87529 |
|
1,531 |
1,505 |
$56K |
| 82550 |
|
9,152 |
8,507 |
$55K |
| 73060 |
|
1,097 |
1,052 |
$55K |
| 77014 |
|
1,878 |
188 |
$55K |
| 64721 |
|
56 |
56 |
$55K |
| 82248 |
|
11,060 |
8,350 |
$55K |
| C8929 |
Tte w or wo fol wcon,doppler |
110 |
108 |
$55K |
| P9016 |
Rbc leukocytes reduced |
299 |
253 |
$54K |
| 74240 |
|
619 |
618 |
$54K |
| 86258 |
|
4,966 |
4,921 |
$53K |
| 77338 |
|
261 |
249 |
$53K |
| 82024 |
|
1,404 |
1,378 |
$53K |
| 86146 |
|
1,019 |
960 |
$53K |
| 84305 |
|
1,901 |
1,853 |
$53K |
| 97166 |
|
1,555 |
1,530 |
$52K |
| M0245 |
Bamlan and etesev infusion |
107 |
107 |
$52K |
| 86431 |
|
9,803 |
9,601 |
$52K |
| 83615 |
|
9,050 |
7,841 |
$51K |
| 86364 |
|
4,948 |
4,916 |
$51K |
| 74230 |
|
676 |
670 |
$50K |
| 51701 |
|
626 |
607 |
$50K |
| 77334 |
|
181 |
139 |
$50K |
| 77427 |
|
421 |
181 |
$50K |
| 82951 |
|
3,802 |
3,785 |
$49K |
| 82247 |
|
9,496 |
6,926 |
$48K |
| 86800 |
|
3,132 |
3,090 |
$48K |
| 36561 |
|
42 |
42 |
$48K |
| 78452 |
|
183 |
176 |
$47K |
| D1510 |
|
416 |
296 |
$47K |
| J1885 |
Ketorolac tromethamine inj |
42,812 |
38,210 |
$47K |
| 92611 |
|
653 |
647 |
$46K |
| 86225 |
|
3,377 |
3,320 |
$46K |
| 83993 |
|
2,416 |
2,391 |
$46K |
| 36591 |
|
1,219 |
725 |
$46K |
| 82105 |
|
3,051 |
2,915 |
$45K |
| 82533 |
|
2,693 |
2,505 |
$45K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
962 |
946 |
$45K |
| 86870 |
|
253 |
228 |
$45K |
| 82803 |
|
1,780 |
1,720 |
$44K |
| 84100 |
|
9,687 |
7,303 |
$44K |
| J0696 |
Ceftriaxone sodium injection |
12,025 |
9,939 |
$44K |
| 29515 |
|
643 |
631 |
$43K |
| 84550 |
|
10,033 |
9,082 |
$43K |
| 72110 |
|
658 |
649 |
$43K |
| 70360 |
|
763 |
759 |
$43K |
| G0283 |
Elec stim other than wound |
2,920 |
1,712 |
$42K |
| 90837 |
|
983 |
695 |
$42K |
| 86003 |
|
599 |
593 |
$41K |
| 88173 |
|
707 |
529 |
$41K |
| 73552 |
|
948 |
900 |
$40K |
| 81002 |
|
13,584 |
12,843 |
$40K |
| 86696 |
|
2,066 |
2,054 |
$40K |
| D2332 |
|
339 |
195 |
$38K |
| 88313 |
|
413 |
407 |
$38K |
| 72197 |
|
82 |
82 |
$37K |
| 76882 |
|
420 |
412 |
$37K |
| 99221 |
|
353 |
350 |
$36K |
| 84520 |
|
9,353 |
8,970 |
$35K |
| 82140 |
|
2,837 |
2,543 |
$35K |
| 86708 |
|
2,881 |
2,831 |
$34K |
| 84132 |
|
7,962 |
7,247 |
$34K |
| 74181 |
|
118 |
113 |
$34K |
| 87205 |
|
8,076 |
7,662 |
$34K |
| 72170 |
|
536 |
523 |
$33K |
| 84460 |
|
6,457 |
5,765 |
$33K |
| 82977 |
|
4,620 |
4,469 |
$33K |
| 64491 |
|
446 |
437 |
$32K |
| 64492 |
|
438 |
428 |
$32K |
| 74220 |
|
449 |
448 |
$31K |
| 86300 |
|
1,349 |
1,185 |
$31K |
| A9577 |
Inj multihance |
5,553 |
5,394 |
$31K |
| J7040 |
Normal saline solution infus |
40,759 |
31,784 |
$31K |
| 84450 |
|
6,169 |
5,477 |
$31K |
| 77412 |
|
283 |
29 |
$31K |
| M0222 |
Bebtelovimab injection |
100 |
100 |
$31K |
| 84145 |
|
1,916 |
1,821 |
$30K |
| 80143 |
|
2,119 |
1,960 |
$30K |
| 72114 |
|
554 |
542 |
$29K |
| 52332 |
|
14 |
14 |
$29K |
| 82330 |
|
2,612 |
2,087 |
$29K |
| 84295 |
|
6,214 |
5,849 |
$29K |
| 80179 |
|
2,049 |
1,903 |
$29K |
| 88184 |
|
550 |
520 |
$29K |
| 84156 |
|
8,349 |
7,485 |
$28K |
| 82435 |
|
6,063 |
5,727 |
$28K |
| 83525 |
|
2,394 |
2,359 |
$28K |
| 82947 |
|
6,707 |
6,364 |
$28K |
| 87210 |
|
4,775 |
4,633 |
$28K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
1,424 |
880 |
$27K |
| 86255 |
|
1,482 |
1,376 |
$27K |
| 85060 |
|
1,233 |
1,202 |
$27K |
| C1769 |
Guide wire |
2,884 |
2,736 |
$27K |
| 94060 |
|
341 |
338 |
$27K |
| G0105 |
Colorectal scrn; hi risk ind |
59 |
59 |
$27K |
| 10022 |
|
88 |
88 |
$27K |
| 86695 |
|
2,030 |
2,019 |
$27K |
| 82731 |
|
389 |
370 |
$27K |
| 83498 |
|
963 |
956 |
$27K |
| 82950 |
|
5,525 |
5,466 |
$26K |
| 95812 |
|
161 |
159 |
$26K |
| 95816 |
|
203 |
198 |
$26K |
| 83521 |
|
1,178 |
996 |
$26K |
| J2560 |
Phenobarbital sodium inj |
1,460 |
1,077 |
$26K |
| J2469 |
Palonosetron hcl |
412 |
262 |
$26K |
| 97165 |
|
1,203 |
1,172 |
$26K |
| 97150 |
|
1,876 |
620 |
$25K |
| 83520 |
|
1,035 |
971 |
$25K |
| 84165 |
|
2,736 |
2,633 |
$25K |
| G0257 |
Unsched dialysis esrd pt hos |
118 |
42 |
$25K |
| 84144 |
|
1,196 |
1,154 |
$25K |
| 87581 |
|
707 |
700 |
$25K |
| 86039 |
|
2,312 |
2,263 |
$25K |
| 74420 |
|
191 |
184 |
$25K |
| 28285 |
|
36 |
13 |
$24K |
| 87799 |
|
631 |
566 |
$24K |
| Q0138 |
Ferumoxytol, non-esrd |
38 |
33 |
$24K |
| 51798 |
|
1,029 |
959 |
$24K |
| 87486 |
|
694 |
687 |
$24K |
| 97016 |
|
2,035 |
833 |
$24K |
| 97802 |
|
596 |
592 |
$24K |
| 99195 |
|
394 |
349 |
$24K |
| 84480 |
|
1,742 |
1,686 |
$23K |
| 86304 |
|
1,179 |
1,024 |
$23K |
| 86381 |
|
1,023 |
1,007 |
$23K |
| J2405 |
Ondansetron hcl injection |
43,513 |
36,920 |
$22K |
| 58563 |
|
12 |
12 |
$22K |
| 82040 |
|
4,501 |
3,906 |
$22K |
| J2270 |
Morphine sulfate injection |
19,407 |
14,897 |
$22K |
| A6250 |
Skin seal protect moisturizr |
3,719 |
2,118 |
$22K |
| 82103 |
|
1,654 |
1,627 |
$22K |
| 90834 |
|
612 |
506 |
$21K |
| 97116 |
|
1,518 |
1,142 |
$21K |
| 72128 |
|
137 |
134 |
$21K |
| 90792 |
|
156 |
144 |
$21K |
| 72157 |
|
45 |
42 |
$21K |
| 88312 |
|
282 |
273 |
$20K |
| 73120 |
|
317 |
252 |
$20K |
| 64633 |
|
60 |
59 |
$19K |
| 87449 |
|
1,883 |
1,820 |
$19K |
| 41899 |
|
165 |
165 |
$19K |
| 78262 |
|
60 |
60 |
$19K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
3,670 |
3,435 |
$18K |
| 99215 |
Prolong outpt/office vis |
162 |
160 |
$18K |
| 82390 |
|
1,735 |
1,707 |
$18K |
| 93458 |
|
23 |
19 |
$18K |
| 73564 |
|
423 |
337 |
$18K |
| 92610 |
|
419 |
404 |
$18K |
| 94625 |
|
573 |
99 |
$18K |
| 97167 |
|
227 |
226 |
$18K |
| 43244 |
|
42 |
39 |
$17K |
| 12013 |
|
203 |
201 |
$17K |
| 82627 |
|
784 |
778 |
$17K |
| 76857 |
|
285 |
284 |
$17K |
| 85018 |
|
5,721 |
4,984 |
$17K |
| J0690 |
Cefazolin sodium injection |
10,482 |
7,630 |
$17K |
| 58558 |
|
12 |
12 |
$17K |
| 82010 |
|
2,273 |
2,096 |
$16K |
| 64483 |
|
39 |
39 |
$16K |
| 99211 |
|
773 |
705 |
$16K |
| 84207 |
|
600 |
599 |
$16K |
| 86665 |
|
464 |
441 |
$16K |
| 83883 |
|
1,193 |
1,165 |
$16K |
| 85046 |
|
3,290 |
3,120 |
$16K |
| 91299 |
|
113 |
113 |
$16K |
| J1100 |
Dexamethasone sodium phos |
18,096 |
16,634 |
$15K |
| 72192 |
|
139 |
137 |
$15K |
| 84154 |
|
995 |
986 |
$15K |
| 99152 |
|
1,815 |
1,743 |
$15K |
| 88112 |
|
544 |
520 |
$14K |
| 73000 |
|
246 |
235 |
$14K |
| 84445 |
|
283 |
277 |
$14K |
| 92526 |
|
272 |
166 |
$14K |
| 76885 |
|
117 |
117 |
$13K |
| D2932 |
|
118 |
31 |
$13K |
| 82150 |
|
2,134 |
2,093 |
$13K |
| U0001 |
2019-ncov diagnostic p |
370 |
364 |
$13K |
| 47000 |
|
24 |
24 |
$13K |
| 86334 |
|
726 |
698 |
$13K |
| 73201 |
|
40 |
40 |
$13K |
| 83721 |
|
1,370 |
1,362 |
$13K |
| 90461 |
|
489 |
264 |
$13K |
| 72052 |
|
243 |
238 |
$13K |
| 85014 |
|
4,725 |
4,037 |
$13K |
| J3010 |
Fentanyl citrate injection |
26,319 |
20,331 |
$13K |
| 29130 |
|
265 |
264 |
$13K |
| 80164 |
|
967 |
908 |
$13K |
| 84432 |
|
831 |
818 |
$12K |
| 97535 |
|
643 |
536 |
$12K |
| 77072 |
|
120 |
119 |
$12K |
| 86015 |
|
1,202 |
1,193 |
$12K |
| 90460 |
|
432 |
428 |
$12K |
| 86256 |
|
1,042 |
1,030 |
$12K |
| 84681 |
|
578 |
561 |
$12K |
| 86694 |
|
799 |
788 |
$12K |
| Q5121 |
Inj. avsola, 10 mg |
630 |
405 |
$11K |
| 70481 |
|
40 |
39 |
$11K |
| 78306 |
|
59 |
59 |
$11K |
| J2704 |
Inj, propofol, 10 mg |
19,488 |
17,723 |
$11K |
| 90833 |
|
1,505 |
1,449 |
$11K |
| 92507 |
|
208 |
115 |
$11K |
| 72081 |
|
146 |
146 |
$11K |
| 94726 |
|
184 |
184 |
$11K |
| 82397 |
|
786 |
781 |
$11K |
| 99233 |
Prolong inpt eval add15 m |
126 |
81 |
$11K |
| D1208 |
|
83 |
82 |
$11K |
| 87634 |
|
168 |
167 |
$11K |
| 85613 |
|
1,035 |
1,020 |
$10K |
| 64634 |
|
62 |
58 |
$10K |
| 93296 |
|
882 |
865 |
$9K |
| G0239 |
Oth resp proc, group |
461 |
77 |
$9K |
| 86308 |
|
1,389 |
1,373 |
$9K |
| 80177 |
|
799 |
759 |
$9K |
| 64615 |
|
123 |
120 |
$9K |
| Q0091 |
Obtaining screen pap smear |
658 |
630 |
$9K |
| J1650 |
Inj enoxaparin sodium |
3,731 |
2,101 |
$9K |
| 96401 |
|
376 |
274 |
$9K |
| 82985 |
|
632 |
628 |
$9K |
| C1776 |
Joint device (implantable) |
543 |
537 |
$9K |
| 62270 |
|
44 |
40 |
$9K |
| J2785 |
Regadenoson injection |
126 |
122 |
$8K |
| 73560 |
|
235 |
223 |
$8K |
| D2390 |
|
77 |
26 |
$8K |
| 97035 |
|
689 |
441 |
$8K |
| J2360 |
Orphenadrine injection |
1,607 |
1,563 |
$8K |
| 87324 |
|
676 |
655 |
$8K |
| 10061 |
|
75 |
73 |
$8K |
| J3370 |
Vancomycin hcl injection |
1,266 |
830 |
$8K |
| 72146 |
|
30 |
29 |
$8K |
| 87328 |
|
608 |
584 |
$8K |
| 73200 |
|
47 |
46 |
$7K |
| J1790 |
Droperidol injection |
3,003 |
2,831 |
$7K |
| 94729 |
|
238 |
236 |
$7K |
| A6212 |
Foam drg <=16 sq in w/border |
659 |
482 |
$7K |
| C1725 |
Cath, translumin non-laser |
313 |
300 |
$7K |
| 90670 |
|
712 |
680 |
$7K |
| J1200 |
Diphenhydramine hcl injectio |
10,509 |
9,242 |
$7K |
| J0780 |
Prochlorperazine injection |
2,905 |
2,795 |
$7K |
| 86301 |
|
415 |
342 |
$7K |
| 77263 |
|
62 |
62 |
$7K |
| J2001 |
Lidocaine injection |
10,221 |
8,740 |
$7K |
| 94644 |
|
71 |
67 |
$7K |
| 72220 |
|
144 |
141 |
$7K |
| J2060 |
Lorazepam injection |
5,921 |
4,990 |
$7K |
| 90832 |
|
210 |
175 |
$7K |
| 89051 |
|
1,017 |
785 |
$6K |
| 52000 |
|
39 |
39 |
$6K |
| 86664 |
|
400 |
399 |
$6K |
| 80197 |
|
888 |
445 |
$6K |
| J7030 |
Normal saline solution infus |
4,926 |
4,697 |
$6K |
| 82653 |
|
308 |
307 |
$6K |
| J2250 |
Inj midazolam hydrochloride |
14,143 |
13,117 |
$6K |
| 74450 |
|
36 |
36 |
$5K |
| 86663 |
|
400 |
399 |
$5K |
| 90686 |
|
1,112 |
1,092 |
$5K |
| J3411 |
Thiamine hcl 100 mg |
1,721 |
1,099 |
$5K |
| 90732 |
|
218 |
207 |
$5K |
| 97760 |
|
129 |
115 |
$5K |
| 72193 |
|
13 |
13 |
$5K |
| C1894 |
Intro/sheath, non-laser |
784 |
763 |
$5K |
| J0295 |
Ampicillin sulbactam 1.5 gm |
1,358 |
674 |
$5K |
| J2930 |
Methylprednisolone injection |
2,401 |
2,023 |
$5K |
| M0247 |
Sotrovimab infusion |
15 |
15 |
$5K |
| 73100 |
|
101 |
89 |
$5K |
| 99231 |
|
98 |
80 |
$5K |
| 82525 |
|
413 |
404 |
$5K |
| J3480 |
Inj potassium chloride |
1,776 |
1,209 |
$5K |
| A6196 |
Alginate dressing <=16 sq in |
538 |
346 |
$5K |
| G0260 |
Inj for sacroiliac jt anesth |
13 |
13 |
$5K |
| 80178 |
|
640 |
591 |
$5K |
| 74241 |
|
59 |
59 |
$5K |
| G0481 |
Drug test def 8-14 classes |
69 |
69 |
$5K |
| J1815 |
Insulin injection |
5,691 |
2,624 |
$4K |
| A9500 |
Tc99m sestamibi |
312 |
300 |
$4K |
| 99153 |
Mod sedat endo service >5yrs |
1,165 |
1,133 |
$4K |
| 62321 |
|
13 |
12 |
$4K |
| 93303 |
|
13 |
12 |
$4K |
| 73620 |
|
106 |
93 |
$4K |
| 87506 |
|
18 |
18 |
$4K |
| 45381 |
|
13 |
13 |
$4K |
| J1644 |
Inj heparin sodium per 1000u |
4,387 |
2,291 |
$4K |
| 97012 |
|
298 |
166 |
$4K |
| J3475 |
Inj magnesium sulfate |
1,933 |
1,666 |
$4K |
| 82952 |
|
1,025 |
1,022 |
$4K |
| 75574 |
|
13 |
13 |
$4K |
| 76380 |
|
79 |
79 |
$4K |
| 96368 |
|
287 |
234 |
$4K |
| J7512 |
Prednisone ir or dr oral 1mg |
2,739 |
2,263 |
$4K |
| 87088 |
|
609 |
585 |
$4K |
| 93798 |
|
115 |
56 |
$4K |
| J2710 |
Neostigmine methylslfte inj |
2,289 |
2,212 |
$4K |
| C1781 |
Mesh (implantable) |
501 |
497 |
$4K |
| Q9957 |
Inj perflutren lip micros,ml |
311 |
306 |
$4K |
| J2506 |
Inj pegfilgrast ex bio 0.5mg |
17 |
12 |
$4K |
| 77470 |
|
13 |
13 |
$4K |
| 29105 |
|
56 |
55 |
$4K |
| J1170 |
Hydromorphone injection |
5,079 |
3,928 |
$4K |
| 96417 |
|
92 |
65 |
$3K |
| 64450 |
|
14 |
14 |
$3K |
| 76098 |
|
12 |
12 |
$3K |
| 88300 |
|
292 |
290 |
$3K |
| 86060 |
|
449 |
445 |
$3K |
| 76815 |
|
41 |
39 |
$3K |
| 85246 |
|
122 |
120 |
$3K |
| 69209 |
|
108 |
103 |
$3K |
| 83921 |
|
167 |
167 |
$3K |
| 86593 |
|
663 |
651 |
$3K |
| 85245 |
|
118 |
115 |
$3K |
| 84436 |
|
431 |
424 |
$3K |
| J2550 |
Promethazine hcl injection |
4,916 |
3,758 |
$3K |
| 97018 |
|
563 |
278 |
$3K |
| 85045 |
|
621 |
573 |
$3K |
| 73600 |
|
39 |
31 |
$3K |
| D3320 |
|
24 |
15 |
$3K |
| 94681 |
|
30 |
28 |
$3K |
| A9517 |
I131 iodide cap, rx |
12 |
12 |
$3K |
| T1017 |
Targeted case management |
12 |
12 |
$3K |
| J2765 |
Metoclopramide hcl injection |
4,300 |
3,979 |
$3K |
| 93990 |
|
74 |
72 |
$3K |
| 76080 |
|
18 |
12 |
$3K |
| 80069 |
|
418 |
340 |
$3K |
| 82310 |
|
532 |
511 |
$2K |
| G0103 |
Psa screening |
429 |
428 |
$2K |
| 82785 |
|
140 |
140 |
$2K |
| 87147 |
|
454 |
446 |
$2K |
| 87015 |
|
329 |
305 |
$2K |
| J0171 |
Adrenalin epinephrine inject |
245 |
231 |
$2K |
| 86036 |
|
229 |
228 |
$2K |
| 71111 |
|
25 |
25 |
$2K |
| 84134 |
|
146 |
145 |
$2K |
| G0008 |
Admin influenza virus vac |
1,768 |
1,713 |
$2K |
| 93325 |
|
354 |
322 |
$2K |
| J1630 |
Haloperidol injection |
2,058 |
1,900 |
$2K |
| 85390 |
|
123 |
118 |
$2K |
| 84238 |
|
49 |
43 |
$2K |
| 88302 |
|
92 |
91 |
$2K |
| J2543 |
Piperacillin/tazobactam |
833 |
408 |
$2K |
| 88344 |
|
14 |
13 |
$2K |
| J1642 |
Inj heparin sodium per 10 u |
2,437 |
1,113 |
$2K |
| 84155 |
|
586 |
571 |
$2K |
| 93880 |
|
40 |
39 |
$2K |
| 91320 |
|
194 |
194 |
$2K |
| 71100 |
|
40 |
40 |
$2K |
| 36416 |
|
782 |
702 |
$2K |
| 70480 |
|
13 |
13 |
$2K |
| C1726 |
Cath, bal dil, non-vascular |
377 |
371 |
$2K |
| J3301 |
Triamcinolone acet inj nos |
1,529 |
1,467 |
$2K |
| Q9969 |
Non-heu tc-99m add-on/dose |
1,262 |
1,223 |
$2K |
| 80175 |
|
144 |
140 |
$2K |
| 85240 |
|
83 |
83 |
$2K |
| A6253 |
Absorpt drg > 48 sq in w/o b |
1,454 |
792 |
$2K |
| 76942 |
|
258 |
252 |
$2K |
| J0330 |
Succinycholine chloride inj |
1,771 |
1,729 |
$2K |
| C1729 |
Cath, drainage |
2,054 |
1,300 |
$2K |
| 88311 |
|
285 |
258 |
$2K |
| 80185 |
|
117 |
97 |
$2K |
| 87209 |
|
97 |
95 |
$2K |
| C1751 |
Cath, inf, per/cent/midline |
54 |
51 |
$2K |
| 73660 |
|
36 |
36 |
$2K |
| J1953 |
Levetiracetam injection |
500 |
406 |
$2K |
| 95992 |
|
17 |
12 |
$1K |
| 82365 |
|
132 |
129 |
$1K |
| J8540 |
Oral dexamethasone |
709 |
612 |
$1K |
| S0028 |
Injection, famotidine, 20 mg |
1,049 |
945 |
$1K |
| 82668 |
|
84 |
83 |
$1K |
| 99232 |
|
18 |
12 |
$1K |
| J2359 |
Inj. olanzapine, 0.5mg |
82 |
71 |
$1K |
| J0500 |
Dicyclomine injection |
537 |
490 |
$1K |
| 64447 |
|
13 |
13 |
$1K |
| 81050 |
|
388 |
376 |
$1K |
| J0475 |
Baclofen 10 mg injection |
154 |
96 |
$1K |
| 76937 |
|
293 |
282 |
$1K |
| 99157 |
|
308 |
306 |
$1K |
| J3360 |
Diazepam injection |
134 |
122 |
$1K |
| 84157 |
|
239 |
216 |
$1K |
| 82157 |
|
41 |
41 |
$1K |
| 85384 |
|
124 |
123 |
$1K |
| 91065 |
|
12 |
12 |
$1K |
| J0360 |
Hydralazine hcl injection |
732 |
627 |
$1K |
| 80050 |
|
51 |
51 |
$1K |
| C2617 |
Stent, non-cor, tem w/o del |
342 |
332 |
$1K |
| 82375 |
|
67 |
64 |
$1K |
| 90656 |
|
243 |
243 |
$1K |
| Q0177 |
Hydroxyzine pamoate 25mg |
2,604 |
2,177 |
$990.96 |
| J1756 |
Iron sucrose injection |
201 |
105 |
$973.27 |
| 82652 |
|
29 |
29 |
$938.16 |
| 87102 |
|
119 |
117 |
$907.66 |
| 87177 |
|
96 |
94 |
$860.14 |
| 17250 |
|
165 |
122 |
$830.94 |
| 97168 |
|
15 |
15 |
$825.16 |
| 85347 |
|
81 |
53 |
$819.45 |
| 70160 |
|
12 |
12 |
$805.82 |
| 86341 |
|
27 |
24 |
$798.78 |
| 93320 |
|
75 |
69 |
$794.00 |
| 86765 |
|
61 |
55 |
$770.59 |
| J0735 |
Clonidine hydrochloride |
756 |
637 |
$760.04 |
| A6206 |
Contact layer <= 16 sq in |
110 |
60 |
$759.75 |
| 86735 |
|
58 |
53 |
$753.00 |
| 85130 |
|
67 |
65 |
$740.05 |
| J1040 |
Methylprednisolone 80 mg inj |
522 |
503 |
$738.50 |
| 72050 |
|
12 |
12 |
$736.50 |
| S9083 |
Urgent care center global |
53,854 |
51,092 |
$725.07 |
| C1887 |
Catheter, guiding |
191 |
183 |
$713.03 |
| 30901 |
|
13 |
12 |
$700.64 |
| J7060 |
5% dextrose/water |
822 |
601 |
$692.86 |
| 73070 |
|
13 |
12 |
$687.08 |
| 76010 |
|
13 |
13 |
$682.40 |
| J1940 |
Furosemide injection |
1,072 |
815 |
$664.41 |
| 87329 |
|
53 |
52 |
$654.24 |
| J2919 |
Inj, methylpred sod succ 5mg |
674 |
585 |
$652.02 |
| A6261 |
Wound filler gel/paste /oz |
406 |
267 |
$649.65 |
| 82088 |
|
15 |
14 |
$639.12 |
| G0009 |
Admin pneumococcal vaccine |
548 |
522 |
$637.11 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
1,450 |
1,277 |
$616.88 |
| 93926 |
|
12 |
12 |
$616.05 |
| 82945 |
|
125 |
116 |
$615.97 |
| J2370 |
Phenylephrine hcl injection |
2,127 |
1,861 |
$593.44 |
| J3489 |
Zoledronic acid 1mg |
37 |
37 |
$581.30 |
| J0131 |
Inj, acetaminophen (nos) |
92 |
92 |
$567.91 |
| 80321 |
|
381 |
369 |
$564.50 |
| J1836 |
Inj, metronidazole, 10 mg |
808 |
506 |
$559.01 |
| 84080 |
|
41 |
41 |
$558.68 |
| J2310 |
Inj naloxone hydrochloride |
61 |
52 |
$520.22 |
| 99212 |
|
12 |
12 |
$513.52 |
| 87641 |
|
12 |
12 |
$509.06 |
| A6211 |
Foam drg > 48 sq in w/o brdr |
14 |
12 |
$501.90 |
| A9537 |
Tc99m mebrofenin |
368 |
361 |
$487.09 |
| 83020 |
|
34 |
33 |
$486.75 |
| 86769 |
|
13 |
13 |
$479.43 |
| 84075 |
|
93 |
88 |
$468.95 |
| 84478 |
|
96 |
96 |
$464.13 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
828 |
802 |
$452.63 |
| G0452 |
Molecular pathology interpr |
33 |
30 |
$446.21 |
| 80361 |
|
930 |
911 |
$446.06 |
| 94760 |
|
47 |
37 |
$437.75 |
| 90480 |
|
194 |
194 |
$434.88 |
| J0744 |
Ciprofloxacin iv |
302 |
222 |
$425.74 |
| J2920 |
Methylprednisolone injection |
221 |
166 |
$417.25 |
| S9443 |
Lactation class |
125 |
106 |
$415.00 |
| 82104 |
|
26 |
25 |
$391.51 |
| 82085 |
|
40 |
38 |
$386.04 |
| J1817 |
Insulin for insulin pump use |
265 |
144 |
$384.52 |
| A6262 |
Wound filler dry form / gram |
448 |
319 |
$379.30 |
| 84466 |
|
28 |
28 |
$373.97 |
| 90785 |
|
238 |
225 |
$348.56 |
| 84244 |
|
15 |
15 |
$344.97 |
| J2795 |
Ropivacaine hcl injection |
902 |
719 |
$327.85 |
| A9552 |
F18 fdg |
1,221 |
1,207 |
$318.54 |
| 82657 |
|
16 |
16 |
$302.04 |
| 80325 |
|
141 |
141 |
$294.19 |
| A6260 |
Wound cleanser any type/size |
298 |
227 |
$278.24 |
| 93246 |
|
12 |
12 |
$277.97 |
| J7620 |
Albuterol ipratrop non-comp |
116 |
95 |
$275.81 |
| Q2038 |
Fluzone vacc, 3 yrs & >, im |
185 |
180 |
$272.65 |
| 93242 |
|
13 |
12 |
$272.61 |
| J7613 |
Albuterol non-comp unit |
57 |
50 |
$268.83 |
| 87176 |
|
89 |
84 |
$266.26 |
| 97039 |
|
20 |
13 |
$265.08 |
| 69210 |
|
12 |
12 |
$258.13 |
| 0141U |
|
121 |
120 |
$251.61 |
| A9541 |
Tc99m sulfur colloid |
559 |
553 |
$250.52 |
| 80365 |
|
935 |
916 |
$249.70 |
| 94761 |
|
74 |
74 |
$233.09 |
| 90651 |
|
29 |
29 |
$224.74 |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
32 |
26 |
$222.20 |
| 80356 |
|
952 |
933 |
$220.49 |
| J0137 |
Inj, acetaminophen (hikma) |
410 |
407 |
$213.12 |
| 82175 |
|
13 |
13 |
$211.57 |
| J0612 |
Inj, calcium gluconate, nos |
188 |
116 |
$211.39 |
| G8978 |
Mobility current status |
687 |
648 |
$197.63 |
| 84376 |
|
32 |
32 |
$188.76 |
| 83825 |
|
13 |
13 |
$188.58 |
| 83835 |
|
13 |
12 |
$164.94 |
| 80165 |
|
12 |
12 |
$162.10 |
| 99406 |
|
146 |
135 |
$155.34 |
| 84630 |
|
13 |
13 |
$153.56 |
| 89060 |
|
27 |
27 |
$144.24 |
| A9579 |
Gad-base mr contrast nos,1ml |
107 |
106 |
$141.38 |
| 86709 |
|
12 |
12 |
$141.20 |
| J7510 |
Prednisolone oral per 5 mg |
40 |
33 |
$139.16 |
| J1050 |
Medroxyprogesterone acetate |
157 |
155 |
$134.03 |
| 74300 |
|
29 |
28 |
$125.05 |
| C1758 |
Catheter, ureteral |
178 |
172 |
$121.35 |
| 82705 |
|
25 |
25 |
$121.09 |
| A4216 |
Sterile water/saline, 10 ml |
107 |
87 |
$120.63 |
| 87184 |
|
15 |
13 |
$105.12 |
| J3420 |
Vitamin b12 injection |
295 |
256 |
$104.91 |
| 89050 |
|
29 |
27 |
$104.42 |
| Q0162 |
Ondansetron oral |
82 |
81 |
$103.15 |
| 49424 |
|
18 |
12 |
$99.24 |
| Q2039 |
Influenza virus vaccine, nos |
220 |
218 |
$97.57 |
| 99151 |
|
39 |
39 |
$90.58 |
| 90756 |
|
18 |
18 |
$74.43 |
| Q0169 |
Promethazine hcl 12.5mg oral |
310 |
290 |
$74.14 |
| Q0144 |
Azithromycin dihydrate, oral |
33 |
30 |
$72.73 |
| 83930 |
|
12 |
12 |
$70.48 |
| 82465 |
|
17 |
17 |
$68.24 |
| Q2036 |
Flulaval vacc, 3 yrs & >, im |
152 |
140 |
$65.58 |
| G8979 |
Mobility goal status |
780 |
729 |
$63.50 |
| J2175 |
Meperidine hydrochl /100 mg |
293 |
284 |
$62.36 |
| J0736 |
Inj, clindamycin phosp 300mg |
34 |
32 |
$59.06 |
| J0610 |
Calcium glucon (fresenius) |
46 |
25 |
$56.55 |
| C1788 |
Port, indwelling, imp |
40 |
40 |
$51.23 |
| 0001A |
|
327 |
325 |
$50.39 |
| J0670 |
Inj mepivacaine hcl/10 ml |
83 |
82 |
$48.70 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
430 |
374 |
$47.19 |
| G8985 |
Carry goal status |
186 |
165 |
$46.68 |
| 81015 |
|
16 |
15 |
$44.77 |
| 90677 |
|
124 |
123 |
$41.05 |
| J7042 |
5% dextrose/normal saline |
64 |
51 |
$40.62 |
| 0124A |
|
45 |
36 |
$40.10 |
| J0456 |
Azithromycin |
56 |
45 |
$37.72 |
| 99155 |
|
15 |
15 |
$32.01 |
| J2805 |
Sincalide injection |
38 |
38 |
$30.53 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
339 |
335 |
$26.29 |
| 51610 |
|
24 |
24 |
$25.55 |
| A4452 |
Waterproof tape |
645 |
494 |
$18.66 |
| J2004 |
Inj, lidocaine w epinephrine |
129 |
129 |
$14.31 |
| A9503 |
Tc99m medronate |
73 |
73 |
$13.54 |
| C2625 |
Stent, non-cor, tem w/del sy |
14 |
13 |
$8.66 |
| 77001 |
|
118 |
116 |
$4.67 |
| 96377 |
|
17 |
13 |
$3.45 |
| 90662 |
|
104 |
103 |
$1.01 |
| G8997 |
Swallow goal status |
120 |
112 |
$0.01 |
| G8996 |
Swallow current status |
119 |
110 |
$0.01 |
| 90633 |
|
12 |
12 |
$0.00 |
| 0002A |
|
263 |
263 |
$0.00 |
| G8984 |
Carry current status |
112 |
104 |
$0.00 |
| 80346 |
|
52 |
52 |
$0.00 |
| 97799 |
|
20 |
13 |
$0.00 |
| A9153 |
Multi-vitamin nos |
19 |
14 |
$0.00 |
| 37253 |
|
15 |
14 |
$0.00 |
| C1760 |
Closure dev, vasc |
13 |
12 |
$0.00 |
| 75774 |
|
13 |
12 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
90 |
74 |
$0.00 |
| A4649 |
Surgical supplies |
47 |
26 |
$0.00 |
| D3230 |
|
466 |
118 |
$0.00 |
| 37252 |
|
15 |
14 |
$0.00 |
| G8982 |
Body pos goal status |
19 |
16 |
$0.00 |
| G8980 |
Mobility d/c status |
198 |
186 |
$0.00 |
| 0031A |
|
36 |
36 |
$0.00 |
| S2900 |
Robotic surgical system |
247 |
243 |
$0.00 |
| G8981 |
Body pos current status |
17 |
14 |
$0.00 |
| 90688 |
|
27 |
26 |
$0.00 |
| D3240 |
|
77 |
41 |
$0.00 |
| C1889 |
Implant/insert device, noc |
44 |
43 |
$0.00 |
| 0011A |
|
59 |
59 |
$0.00 |
| 0134A |
|
18 |
14 |
$0.00 |
| G8998 |
Swallow d/c status |
14 |
13 |
$0.00 |
| 0012A |
|
20 |
20 |
$0.00 |