| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
91,802 |
89,981 |
$54.84M |
| 99284 |
|
65,227 |
63,963 |
$38.37M |
| 99285 |
|
59,805 |
58,424 |
$35.56M |
| G0378 |
Hospital observation per hr |
24,078 |
12,250 |
$20.99M |
| J1745 |
Infliximab not biosimil 10mg |
6,192 |
5,670 |
$16.02M |
| J1561 |
Gamunex-c/gammaked |
3,279 |
2,815 |
$10.23M |
| 90837 |
|
34,156 |
1,852 |
$7.94M |
| 93306 |
|
4,806 |
4,561 |
$3.77M |
| 69436 |
|
2,560 |
2,254 |
$3.63M |
| 93303 |
|
5,795 |
5,488 |
$3.58M |
| 70553 |
|
3,540 |
3,000 |
$3.54M |
| 43239 |
|
2,043 |
1,630 |
$3.51M |
| J3490 |
Drugs unclassified injection |
48,848 |
25,985 |
$3.21M |
| 70551 |
|
3,558 |
2,970 |
$2.46M |
| 93005 |
|
35,666 |
33,851 |
$2.35M |
| 93325 |
|
17,366 |
16,204 |
$2.34M |
| 99282 |
|
9,202 |
9,065 |
$2.28M |
| 42820 |
|
989 |
878 |
$2.15M |
| 96413 |
|
6,698 |
4,745 |
$2.09M |
| 87635 |
|
66,712 |
60,727 |
$2.06M |
| 41899 |
|
704 |
630 |
$2.00M |
| 85025 |
|
60,671 |
45,364 |
$1.58M |
| 36430 |
|
2,639 |
1,786 |
$1.48M |
| 76770 |
|
6,128 |
5,838 |
$1.41M |
| 80053 |
|
46,273 |
36,241 |
$1.40M |
| 93304 |
|
4,262 |
4,023 |
$1.20M |
| 95782 |
|
761 |
752 |
$1.17M |
| 36512 |
|
389 |
322 |
$1.17M |
| P9040 |
Rbc leukoreduced irradiated |
1,655 |
1,334 |
$1.04M |
| 94010 |
|
6,394 |
6,101 |
$1.02M |
| 96365 |
|
4,546 |
3,647 |
$1.00M |
| 93308 |
|
2,840 |
2,628 |
$1000K |
| OP370 |
|
8,546 |
7,648 |
$978K |
| 97530 |
|
10,922 |
4,734 |
$924K |
| 95810 |
|
1,038 |
1,026 |
$921K |
| 54161 |
|
268 |
238 |
$881K |
| S9470 |
Nutritional counseling, diet |
19,352 |
18,072 |
$787K |
| OP710 |
|
8,563 |
7,698 |
$734K |
| T1015 |
Clinic service |
25,807 |
9,657 |
$728K |
| 93320 |
|
5,546 |
5,303 |
$726K |
| 97110 |
|
10,296 |
4,511 |
$720K |
| 96366 |
|
2,587 |
2,046 |
$711K |
| 99281 |
|
3,067 |
3,017 |
$702K |
| A4649 |
Surgical supplies |
4,540 |
3,770 |
$697K |
| J1885 |
Ketorolac tromethamine inj |
15,018 |
12,810 |
$688K |
| 82306 |
|
12,727 |
11,947 |
$686K |
| 86850 |
|
7,294 |
5,315 |
$629K |
| J0131 |
Inj, acetaminophen (nos) |
5,573 |
4,977 |
$603K |
| J8499 |
Oral prescrip drug non chemo |
89,077 |
38,493 |
$595K |
| 93225 |
|
2,335 |
2,245 |
$572K |
| 93321 |
|
6,961 |
6,520 |
$568K |
| 64642 |
|
203 |
196 |
$555K |
| 85027 |
|
17,243 |
16,428 |
$543K |
| 92523 |
|
3,091 |
3,008 |
$540K |
| 92567 |
|
15,538 |
15,072 |
$520K |
| 92507 |
|
4,824 |
1,975 |
$514K |
| 92587 |
|
9,809 |
9,525 |
$511K |
| 70543 |
|
503 |
409 |
$489K |
| 83655 |
|
10,196 |
10,048 |
$488K |
| J3535 |
Metered dose inhaler drug |
12,135 |
9,970 |
$481K |
| 76825 |
|
1,252 |
1,111 |
$466K |
| 86356 |
|
1,602 |
1,143 |
$455K |
| 97162 |
|
5,463 |
5,283 |
$453K |
| J1100 |
Dexamethasone sodium phos |
13,953 |
11,995 |
$450K |
| 95816 |
|
3,281 |
3,199 |
$446K |
| 86900 |
|
7,269 |
5,324 |
$445K |
| 84443 |
|
11,290 |
10,684 |
$444K |
| 67311 |
|
156 |
132 |
$432K |
| 82728 |
|
9,737 |
8,565 |
$417K |
| 92552 |
|
9,254 |
9,039 |
$406K |
| 49452 |
|
129 |
122 |
$380K |
| 71046 |
|
7,333 |
6,606 |
$368K |
| 72148 |
|
539 |
482 |
$365K |
| 84100 |
|
21,903 |
14,807 |
$361K |
| 85045 |
|
12,608 |
11,004 |
$357K |
| 74183 |
|
315 |
269 |
$353K |
| 82784 |
|
7,335 |
6,715 |
$351K |
| 80061 |
|
10,944 |
10,530 |
$344K |
| 87591 |
|
4,542 |
4,390 |
$343K |
| 87491 |
|
4,540 |
4,388 |
$343K |
| 81229 |
|
657 |
644 |
$337K |
| 83020 |
|
4,378 |
3,899 |
$328K |
| 72082 |
|
2,549 |
2,452 |
$325K |
| 83735 |
|
18,926 |
12,461 |
$320K |
| 97166 |
|
3,165 |
3,032 |
$319K |
| 76705 |
|
2,583 |
2,420 |
$316K |
| 86902 |
|
1,241 |
898 |
$315K |
| 96361 |
|
2,382 |
1,721 |
$309K |
| 92610 |
|
3,856 |
3,628 |
$300K |
| 83036 |
|
13,116 |
12,685 |
$291K |
| 86832 |
|
1,649 |
1,316 |
$288K |
| 80048 |
|
10,024 |
7,960 |
$285K |
| 86833 |
|
1,642 |
1,311 |
$282K |
| 73721 |
|
294 |
271 |
$279K |
| 76820 |
|
3,616 |
2,018 |
$276K |
| 72197 |
|
276 |
267 |
$273K |
| 75561 |
|
273 |
230 |
$271K |
| 86140 |
|
10,943 |
9,571 |
$270K |
| 84466 |
|
7,106 |
6,589 |
$266K |
| 95700 |
|
739 |
683 |
$262K |
| 87798 |
|
2,141 |
1,726 |
$260K |
| J2405 |
Ondansetron hcl injection |
36,109 |
28,688 |
$258K |
| 93886 |
|
297 |
293 |
$252K |
| 96374 |
|
3,376 |
2,992 |
$251K |
| 76827 |
|
1,248 |
1,109 |
$240K |
| 88305 |
|
3,761 |
2,874 |
$238K |
| 80197 |
|
5,351 |
3,135 |
$232K |
| 86901 |
|
7,280 |
5,341 |
$228K |
| 76700 |
|
854 |
805 |
$216K |
| 87637 |
|
4,704 |
4,481 |
$204K |
| 72141 |
|
317 |
295 |
$203K |
| 96409 |
|
1,275 |
807 |
$202K |
| 81415 |
|
116 |
113 |
$195K |
| 87799 |
|
2,903 |
2,007 |
$194K |
| 94640 |
|
5,724 |
3,888 |
$190K |
| J2704 |
Inj, propofol, 10 mg |
26,026 |
22,542 |
$180K |
| 70450 |
|
977 |
905 |
$178K |
| 86923 |
|
4,046 |
2,636 |
$177K |
| 97163 |
|
1,147 |
1,113 |
$170K |
| 97164 |
|
2,062 |
1,990 |
$169K |
| 85652 |
|
8,411 |
7,714 |
$168K |
| 92555 |
|
10,164 |
9,898 |
$164K |
| 83970 |
|
3,578 |
3,141 |
$161K |
| 86360 |
|
1,393 |
1,220 |
$160K |
| 86255 |
|
2,954 |
2,902 |
$160K |
| 83880 |
|
3,077 |
2,510 |
$159K |
| 82977 |
|
7,889 |
6,514 |
$158K |
| 96375 |
|
4,463 |
2,837 |
$156K |
| 83540 |
|
7,140 |
6,627 |
$156K |
| 72146 |
|
227 |
200 |
$154K |
| 97803 |
|
1,751 |
1,627 |
$151K |
| 77072 |
|
2,308 |
2,206 |
$150K |
| 93975 |
|
309 |
296 |
$149K |
| 97112 |
|
2,534 |
1,124 |
$148K |
| 84439 |
|
4,427 |
4,150 |
$148K |
| 81479 |
|
537 |
490 |
$148K |
| 83516 |
|
3,047 |
2,856 |
$139K |
| 87497 |
|
2,195 |
1,506 |
$138K |
| 76816 |
|
612 |
480 |
$136K |
| 69210 |
|
67 |
61 |
$135K |
| 73610 |
|
1,450 |
1,312 |
$133K |
| 74018 |
|
2,716 |
2,463 |
$128K |
| 70544 |
|
162 |
146 |
$126K |
| 42830 |
|
55 |
53 |
$123K |
| 72081 |
|
1,391 |
1,338 |
$119K |
| 97168 |
|
1,772 |
1,698 |
$118K |
| 81003 |
|
14,434 |
12,899 |
$117K |
| 73630 |
|
1,439 |
1,247 |
$116K |
| 87661 |
|
2,372 |
2,337 |
$114K |
| 85610 |
|
5,697 |
4,721 |
$108K |
| 29075 |
|
686 |
650 |
$105K |
| 84703 |
|
6,498 |
5,707 |
$105K |
| 82610 |
|
3,370 |
2,904 |
$104K |
| 45380 |
|
93 |
80 |
$103K |
| 86355 |
|
1,507 |
1,357 |
$101K |
| 76821 |
|
548 |
282 |
$101K |
| 83615 |
|
2,713 |
2,123 |
$100K |
| P9011 |
Blood split unit |
283 |
232 |
$100K |
| 90686 |
|
1,563 |
1,488 |
$99K |
| J0690 |
Cefazolin sodium injection |
3,712 |
2,504 |
$99K |
| A4550 |
Surgical trays |
8,409 |
7,843 |
$98K |
| 76886 |
|
382 |
360 |
$97K |
| 96415 |
|
654 |
540 |
$94K |
| 86359 |
|
1,430 |
1,239 |
$94K |
| 72170 |
|
1,304 |
1,246 |
$94K |
| 73590 |
|
1,224 |
1,018 |
$94K |
| 73090 |
|
1,276 |
1,058 |
$94K |
| 92553 |
|
2,307 |
2,254 |
$92K |
| 87389 |
|
1,956 |
1,937 |
$91K |
| 86317 |
|
674 |
621 |
$87K |
| 73521 |
|
1,146 |
1,088 |
$86K |
| 74240 |
|
416 |
410 |
$86K |
| J2250 |
Inj midazolam hydrochloride |
7,103 |
6,184 |
$85K |
| 85730 |
|
3,526 |
3,007 |
$85K |
| G0108 |
Diab manage trn per indiv |
1,986 |
1,863 |
$85K |
| 73100 |
|
801 |
658 |
$83K |
| 82248 |
|
3,838 |
2,993 |
$82K |
| 80076 |
|
3,316 |
2,800 |
$82K |
| 86592 |
|
1,932 |
1,905 |
$82K |
| 95708 |
|
310 |
267 |
$80K |
| 94621 |
|
207 |
197 |
$79K |
| 94060 |
|
472 |
461 |
$79K |
| 73070 |
|
1,109 |
940 |
$78K |
| 83520 |
|
1,533 |
1,381 |
$78K |
| 84305 |
|
1,743 |
1,664 |
$76K |
| 97165 |
|
1,149 |
1,122 |
$75K |
| J2001 |
Lidocaine injection |
6,081 |
5,341 |
$74K |
| 76811 |
|
290 |
267 |
$74K |
| 20680 |
|
28 |
26 |
$73K |
| 70360 |
|
933 |
897 |
$71K |
| 29065 |
|
338 |
323 |
$69K |
| 84460 |
|
1,648 |
1,612 |
$68K |
| 76000 |
|
1,037 |
970 |
$67K |
| 78264 |
|
164 |
160 |
$66K |
| 72156 |
|
72 |
69 |
$65K |
| 82947 |
|
4,983 |
3,736 |
$65K |
| 51701 |
|
384 |
376 |
$64K |
| J2270 |
Morphine sulfate injection |
11,358 |
9,726 |
$64K |
| 76856 |
|
355 |
352 |
$63K |
| 86357 |
|
845 |
764 |
$62K |
| 84450 |
|
1,518 |
1,492 |
$61K |
| 96450 |
|
101 |
84 |
$61K |
| 97161 |
|
1,095 |
1,052 |
$60K |
| 73110 |
|
532 |
492 |
$60K |
| 73140 |
|
671 |
629 |
$59K |
| L4386 |
Non-pneum walk boot pre cst |
1,219 |
1,175 |
$59K |
| 76536 |
|
302 |
297 |
$59K |
| 97802 |
|
523 |
503 |
$59K |
| 73560 |
|
816 |
685 |
$58K |
| 84436 |
|
3,002 |
2,888 |
$57K |
| 31622 |
|
30 |
29 |
$56K |
| 87502 |
|
541 |
532 |
$55K |
| 92652 |
|
208 |
193 |
$54K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
106 |
101 |
$54K |
| 84403 |
|
825 |
796 |
$54K |
| 87081 |
|
4,528 |
4,284 |
$54K |
| J1644 |
Inj heparin sodium per 1000u |
5,539 |
1,364 |
$53K |
| 82139 |
|
1,251 |
1,030 |
$51K |
| J0585 |
Injection,onabotulinumtoxina |
286 |
278 |
$51K |
| 83498 |
|
333 |
330 |
$51K |
| 81001 |
|
3,675 |
3,237 |
$51K |
| 87186 |
|
2,275 |
2,029 |
$50K |
| J1200 |
Diphenhydramine hcl injectio |
1,971 |
1,327 |
$50K |
| J3010 |
Fentanyl citrate injection |
12,845 |
11,689 |
$49K |
| 87086 |
|
3,482 |
3,204 |
$48K |
| 93976 |
|
219 |
216 |
$48K |
| 82570 |
|
2,701 |
2,383 |
$48K |
| 97167 |
|
435 |
427 |
$47K |
| 92557 |
|
808 |
785 |
$46K |
| 77073 |
|
445 |
438 |
$46K |
| 97150 |
|
1,477 |
629 |
$44K |
| 82010 |
|
2,834 |
2,266 |
$44K |
| 87340 |
|
641 |
623 |
$44K |
| 73130 |
|
616 |
535 |
$43K |
| 97116 |
|
1,158 |
619 |
$43K |
| 76870 |
|
255 |
251 |
$43K |
| 80050 |
|
195 |
193 |
$42K |
| 87070 |
|
2,864 |
2,658 |
$42K |
| 81243 |
|
347 |
344 |
$42K |
| 73564 |
|
299 |
264 |
$42K |
| 87536 |
|
479 |
461 |
$41K |
| 86803 |
|
748 |
729 |
$41K |
| 83002 |
|
995 |
968 |
$41K |
| 96360 |
|
341 |
301 |
$40K |
| 83001 |
|
900 |
881 |
$39K |
| 81416 |
|
38 |
38 |
$39K |
| 97535 |
|
753 |
404 |
$38K |
| 74230 |
|
318 |
296 |
$37K |
| OP272 |
|
4,271 |
4,044 |
$37K |
| 86480 |
|
753 |
737 |
$36K |
| 96372 |
|
290 |
262 |
$36K |
| 82550 |
|
2,227 |
1,856 |
$36K |
| 82785 |
|
765 |
721 |
$34K |
| 69610 |
|
22 |
14 |
$34K |
| 51600 |
|
14 |
12 |
$34K |
| 96367 |
|
376 |
281 |
$34K |
| J9370 |
Vincristine sulfate 1 mg inj |
2,672 |
1,587 |
$34K |
| 82670 |
|
485 |
467 |
$33K |
| 83690 |
|
2,271 |
2,063 |
$33K |
| A9150 |
Misc/exper non-prescript dru |
4,091 |
2,631 |
$32K |
| 92604 |
|
315 |
310 |
$32K |
| 92524 |
|
502 |
498 |
$32K |
| 75565 |
|
229 |
228 |
$32K |
| 99157 |
|
116 |
100 |
$32K |
| 85018 |
|
1,834 |
1,307 |
$31K |
| 84630 |
|
1,043 |
978 |
$31K |
| 85246 |
|
388 |
367 |
$31K |
| 82542 |
|
543 |
483 |
$31K |
| 76800 |
|
123 |
121 |
$31K |
| 72157 |
|
37 |
37 |
$31K |
| 84146 |
|
542 |
532 |
$30K |
| 87077 |
|
3,402 |
2,735 |
$30K |
| 87040 |
|
1,455 |
1,211 |
$30K |
| 92556 |
|
1,064 |
1,037 |
$30K |
| 80230 |
|
333 |
327 |
$30K |
| 64644 |
|
15 |
14 |
$29K |
| J0696 |
Ceftriaxone sodium injection |
1,836 |
1,599 |
$29K |
| 90471 |
|
1,231 |
1,141 |
$29K |
| 86706 |
|
522 |
512 |
$28K |
| 92593 |
|
964 |
941 |
$28K |
| 83921 |
|
519 |
493 |
$28K |
| 92602 |
|
281 |
264 |
$28K |
| 82607 |
|
950 |
891 |
$28K |
| 36591 |
|
952 |
610 |
$28K |
| 80195 |
|
851 |
616 |
$27K |
| 81268 |
|
51 |
30 |
$27K |
| 74019 |
|
840 |
768 |
$27K |
| 82330 |
|
1,278 |
831 |
$27K |
| 96411 |
|
315 |
189 |
$26K |
| J7030 |
Normal saline solution infus |
2,601 |
1,858 |
$26K |
| S0119 |
Ondansetron 4 mg |
6,714 |
6,054 |
$25K |
| OP270 |
|
1,917 |
1,522 |
$25K |
| J2515 |
Pentobarbital sodium inj |
1,000 |
965 |
$25K |
| 85240 |
|
391 |
370 |
$25K |
| 82803 |
|
1,350 |
963 |
$24K |
| 83525 |
|
397 |
386 |
$24K |
| 76819 |
|
102 |
50 |
$24K |
| 71250 |
|
77 |
73 |
$24K |
| 54640 |
|
12 |
12 |
$24K |
| 86361 |
|
238 |
237 |
$23K |
| 86003 |
|
549 |
446 |
$23K |
| 85245 |
|
369 |
349 |
$23K |
| 94799 |
|
422 |
335 |
$22K |
| 94729 |
|
182 |
176 |
$22K |
| 82379 |
|
319 |
286 |
$21K |
| 82948 |
|
3,964 |
2,512 |
$21K |
| 72158 |
|
28 |
24 |
$21K |
| 84479 |
|
1,640 |
1,582 |
$21K |
| 29425 |
|
291 |
257 |
$21K |
| 87631 |
|
119 |
115 |
$21K |
| A4651 |
Calibrated microcap tube |
2,498 |
2,314 |
$21K |
| 76377 |
|
191 |
180 |
$20K |
| 74181 |
|
41 |
39 |
$20K |
| 86704 |
|
359 |
350 |
$20K |
| 84446 |
|
457 |
432 |
$19K |
| J2710 |
Neostigmine methylslfte inj |
2,346 |
2,138 |
$19K |
| 0002A |
|
1,246 |
1,245 |
$19K |
| 88313 |
|
436 |
331 |
$19K |
| 92651 |
|
92 |
89 |
$18K |
| 82017 |
|
269 |
247 |
$18K |
| 84295 |
|
1,206 |
829 |
$18K |
| 89051 |
|
720 |
597 |
$17K |
| 99214 |
|
188 |
183 |
$17K |
| 87205 |
|
1,616 |
1,478 |
$17K |
| 87102 |
|
1,002 |
984 |
$16K |
| 82105 |
|
284 |
266 |
$16K |
| 82150 |
|
876 |
804 |
$16K |
| 82627 |
|
324 |
323 |
$16K |
| 86160 |
|
174 |
172 |
$16K |
| 86774 |
|
348 |
336 |
$16K |
| J8540 |
Oral dexamethasone |
10,943 |
9,937 |
$16K |
| 80307 |
|
403 |
371 |
$16K |
| 64643 |
|
12 |
12 |
$16K |
| 72100 |
|
135 |
132 |
$16K |
| 73000 |
|
174 |
166 |
$15K |
| 86665 |
|
190 |
185 |
$15K |
| 71045 |
|
689 |
619 |
$15K |
| 83993 |
|
209 |
200 |
$15K |
| C1769 |
Guide wire |
752 |
708 |
$15K |
| 86945 |
|
289 |
243 |
$15K |
| 84134 |
|
726 |
607 |
$15K |
| 92591 |
|
203 |
200 |
$15K |
| 82157 |
|
228 |
227 |
$14K |
| 84132 |
|
1,148 |
784 |
$14K |
| 82043 |
|
303 |
296 |
$14K |
| 73552 |
|
343 |
302 |
$14K |
| 86038 |
|
327 |
320 |
$14K |
| 73080 |
|
114 |
105 |
$14K |
| 86364 |
|
403 |
351 |
$13K |
| 93226 |
|
96 |
89 |
$13K |
| 83519 |
|
377 |
376 |
$13K |
| 0001A |
|
1,306 |
1,306 |
$13K |
| 72040 |
|
146 |
143 |
$13K |
| 83605 |
|
409 |
372 |
$13K |
| 84550 |
|
836 |
542 |
$12K |
| 86231 |
|
382 |
334 |
$12K |
| 92585 |
|
68 |
67 |
$11K |
| S0020 |
Injection, bupivicaine hydro |
2,815 |
2,618 |
$11K |
| 84156 |
|
920 |
772 |
$11K |
| 84402 |
|
100 |
99 |
$11K |
| 82533 |
|
338 |
315 |
$11K |
| 86235 |
|
57 |
53 |
$10K |
| 93296 |
|
39 |
38 |
$10K |
| 12001 |
|
31 |
29 |
$10K |
| 84590 |
|
360 |
334 |
$10K |
| 85384 |
|
180 |
160 |
$10K |
| 80069 |
|
41 |
39 |
$10K |
| 86922 |
|
187 |
126 |
$10K |
| 86225 |
|
167 |
163 |
$10K |
| J1439 |
Inj ferric carboxymaltos 1mg |
124 |
112 |
$10K |
| 86376 |
|
390 |
384 |
$9K |
| 99155 |
|
100 |
93 |
$9K |
| 88342 |
|
166 |
145 |
$9K |
| 77080 |
|
153 |
146 |
$9K |
| 87430 |
|
1,436 |
1,389 |
$9K |
| 92607 |
|
96 |
93 |
$8K |
| 87634 |
|
111 |
107 |
$8K |
| 73060 |
|
120 |
109 |
$8K |
| 95079 |
|
33 |
29 |
$8K |
| 86708 |
|
153 |
151 |
$8K |
| 81267 |
|
46 |
42 |
$8K |
| 84480 |
|
193 |
190 |
$8K |
| 84210 |
|
142 |
139 |
$8K |
| 73030 |
|
85 |
79 |
$7K |
| 88304 |
|
134 |
124 |
$7K |
| 86664 |
|
189 |
184 |
$7K |
| 86663 |
|
189 |
184 |
$7K |
| 86787 |
|
166 |
163 |
$7K |
| L3908 |
Who cock-up nonmolde pre ots |
552 |
536 |
$7K |
| 87529 |
|
124 |
121 |
$7K |
| 86618 |
|
75 |
73 |
$7K |
| 85379 |
|
130 |
111 |
$7K |
| 76506 |
|
29 |
28 |
$6K |
| 95076 |
|
52 |
44 |
$6K |
| 76815 |
|
43 |
25 |
$6K |
| 89230 |
|
78 |
77 |
$6K |
| 92592 |
|
280 |
276 |
$6K |
| J2930 |
Methylprednisolone injection |
1,044 |
809 |
$6K |
| 70486 |
|
30 |
29 |
$6K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
855 |
790 |
$6K |
| 77074 |
|
30 |
28 |
$6K |
| A6532 |
Compress stking bk40-50 surg |
238 |
229 |
$6K |
| 82746 |
|
125 |
122 |
$6K |
| 99204 |
|
43 |
43 |
$6K |
| 74712 |
|
13 |
13 |
$6K |
| 82140 |
|
139 |
127 |
$5K |
| 86648 |
|
106 |
101 |
$5K |
| 86880 |
|
75 |
59 |
$5K |
| 73620 |
|
54 |
38 |
$4K |
| 82040 |
|
139 |
136 |
$4K |
| 87501 |
|
58 |
55 |
$4K |
| 12011 |
|
62 |
62 |
$4K |
| 88185 |
|
72 |
50 |
$4K |
| 82390 |
|
170 |
165 |
$4K |
| A9541 |
Tc99m sulfur colloid |
155 |
150 |
$4K |
| 76882 |
|
197 |
191 |
$4K |
| 82657 |
|
32 |
26 |
$4K |
| 71260 |
|
15 |
14 |
$4K |
| J2795 |
Ropivacaine hcl injection |
1,994 |
1,856 |
$4K |
| 94726 |
|
42 |
40 |
$4K |
| 82960 |
|
168 |
165 |
$4K |
| 80164 |
|
89 |
86 |
$4K |
| 83918 |
|
78 |
74 |
$4K |
| J0136 |
Inj, acetaminophen (b braun) |
1,382 |
1,170 |
$4K |
| 86039 |
|
59 |
54 |
$4K |
| 84270 |
|
117 |
116 |
$4K |
| 73562 |
|
31 |
24 |
$4K |
| 84520 |
|
127 |
109 |
$3K |
| 87581 |
|
241 |
235 |
$3K |
| 87147 |
|
491 |
458 |
$3K |
| 82525 |
|
98 |
93 |
$3K |
| 74241 |
|
39 |
29 |
$3K |
| 82985 |
|
101 |
98 |
$3K |
| 88312 |
|
30 |
27 |
$3K |
| 82340 |
|
150 |
143 |
$3K |
| 88307 |
|
28 |
25 |
$3K |
| 88341 |
|
20 |
13 |
$3K |
| 88184 |
|
89 |
63 |
$3K |
| 90656 |
|
249 |
233 |
$3K |
| 78999 |
|
12 |
12 |
$3K |
| 85014 |
|
206 |
203 |
$3K |
| 87177 |
|
70 |
61 |
$3K |
| 85055 |
|
79 |
65 |
$3K |
| 85520 |
|
48 |
38 |
$3K |
| 92586 |
|
50 |
45 |
$3K |
| 87209 |
|
70 |
61 |
$3K |
| J7611 |
Albuterol non-comp con |
560 |
410 |
$3K |
| 82810 |
|
88 |
52 |
$2K |
| A4215 |
Sterile needle |
689 |
617 |
$2K |
| 86800 |
|
207 |
201 |
$2K |
| 87107 |
|
193 |
184 |
$2K |
| 83789 |
|
43 |
38 |
$2K |
| 84702 |
|
58 |
55 |
$2K |
| 86644 |
|
48 |
48 |
$2K |
| 87181 |
|
68 |
65 |
$2K |
| 82024 |
|
206 |
196 |
$2K |
| 86682 |
|
139 |
136 |
$2K |
| 86008 |
|
93 |
58 |
$2K |
| 88311 |
|
31 |
29 |
$2K |
| 73660 |
|
15 |
15 |
$2K |
| 87329 |
|
28 |
28 |
$2K |
| 87522 |
Neg quan hep c or qual rna |
15 |
14 |
$2K |
| 87328 |
|
28 |
28 |
$2K |
| 92608 |
|
28 |
27 |
$2K |
| 82308 |
|
17 |
17 |
$1K |
| 82310 |
|
53 |
41 |
$1K |
| 84478 |
|
71 |
63 |
$1K |
| 82180 |
|
26 |
26 |
$1K |
| 87338 |
|
39 |
39 |
$1K |
| C1894 |
Intro/sheath, non-laser |
70 |
52 |
$1K |
| B4036 |
Enteral feed sup kit grav by |
237 |
206 |
$1K |
| 86985 |
|
30 |
27 |
$1K |
| S0080 |
Injection, pentamidine iseth |
15 |
13 |
$1K |
| 84484 |
|
47 |
41 |
$1K |
| 94770 |
|
64 |
63 |
$1K |
| J9250 |
Methotrexate sodium inj |
418 |
284 |
$1K |
| 99203 |
|
12 |
12 |
$1K |
| 81002 |
|
142 |
108 |
$1K |
| A4212 |
Non coring needle or stylet |
86 |
37 |
$1K |
| 84255 |
|
14 |
12 |
$1K |
| 86353 |
|
14 |
13 |
$1K |
| 85347 |
|
80 |
50 |
$1K |
| 96376 |
|
110 |
102 |
$910.31 |
| 88108 |
|
25 |
24 |
$678.52 |
| 82438 |
|
24 |
24 |
$667.98 |
| 85097 |
|
14 |
12 |
$625.26 |
| 86256 |
|
14 |
12 |
$595.26 |
| 94644 |
|
237 |
224 |
$570.48 |
| J7644 |
Ipratropium bromide non-comp |
3,203 |
3,057 |
$525.02 |
| 82652 |
|
25 |
25 |
$511.89 |
| 82247 |
|
15 |
12 |
$468.43 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,154 |
1,094 |
$440.46 |
| 92590 |
|
17 |
17 |
$436.78 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
1,067 |
1,031 |
$432.45 |
| J2919 |
Inj, methylpred sod succ 5mg |
315 |
237 |
$414.85 |
| 82085 |
|
13 |
13 |
$400.67 |
| J3475 |
Inj magnesium sulfate |
398 |
389 |
$398.00 |
| A9152 |
Single vitamin nos |
31 |
14 |
$392.52 |
| C1726 |
Cath, bal dil, non-vascular |
12 |
12 |
$301.65 |
| 85013 |
|
89 |
55 |
$288.21 |
| 82103 |
|
26 |
26 |
$275.58 |
| 82951 |
|
12 |
12 |
$269.24 |
| L1830 |
Ko immob canvas long pre ots |
13 |
12 |
$204.80 |
| A4216 |
Sterile water/saline, 10 ml |
80 |
70 |
$170.04 |
| 90472 |
|
12 |
12 |
$128.96 |
| S0028 |
Injection, famotidine, 20 mg |
36 |
28 |
$117.08 |
| J0330 |
Succinycholine chloride inj |
61 |
51 |
$99.13 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
216 |
208 |
$93.61 |
| 86308 |
|
40 |
39 |
$71.11 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
29 |
24 |
$41.58 |
| J0171 |
Adrenalin epinephrine inject |
428 |
417 |
$24.83 |
| J2765 |
Metoclopramide hcl injection |
769 |
683 |
$22.38 |
| J7040 |
Normal saline solution infus |
104 |
104 |
$0.00 |
| J7699 |
Inhalation solution for dme |
603 |
571 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
69 |
62 |
$0.00 |
| J2300 |
Inj nalbuphine hydrochloride |
32 |
26 |
$0.00 |
| J7120 |
Ringers lactate infusion |
570 |
562 |
$0.00 |
| J9260 |
Inj methotrexate sodium 50mg |
93 |
57 |
$0.00 |
| J0735 |
Clonidine hydrochloride |
115 |
115 |
$0.00 |
| J7510 |
Prednisolone oral per 5 mg |
235 |
181 |
$0.00 |
| J3380 |
Inj vedolizumab iv 1 mg |
118 |
117 |
$0.00 |
| J0736 |
Inj, clindamycin phosp 300mg |
16 |
12 |
$0.00 |
| S0077 |
Injection, clindamycin phosp |
24 |
12 |
$0.00 |
| J0791 |
Inj crizanlizumab-tmca 5mg |
13 |
12 |
$0.00 |
| Q0144 |
Azithromycin dihydrate, oral |
21 |
21 |
$0.00 |
| 94645 |
|
29 |
25 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
13 |
13 |
$0.00 |
| J1756 |
Iron sucrose injection |
34 |
25 |
$0.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
237 |
102 |
$0.00 |
| J1170 |
Hydromorphone injection |
629 |
508 |
$0.00 |
| J7613 |
Albuterol non-comp unit |
41 |
32 |
$0.00 |
| J1720 |
Hydrocortisone sodium succ i |
41 |
39 |
$0.00 |
| J2060 |
Lorazepam injection |
222 |
163 |
$0.00 |
| A4217 |
Sterile water/saline, 500 ml |
14 |
13 |
$0.00 |
| J1836 |
Inj, metronidazole, 10 mg |
108 |
67 |
$0.00 |
| J0586 |
Abobotulinumtoxina |
174 |
173 |
$0.00 |
| J2920 |
Methylprednisolone injection |
45 |
42 |
$0.00 |
| J3480 |
Inj potassium chloride |
32 |
25 |
$0.00 |
| J1940 |
Furosemide injection |
16 |
16 |
$0.00 |
| J9312 |
Inj., rituximab, 10 mg |
15 |
12 |
$0.00 |