| Code | Description | Claims | Beneficiaries | Total Paid |
| 0450 |
|
38,443 |
33,913 |
$1.85M |
| 74174 |
|
8,574 |
7,707 |
$540K |
| 99205 |
Prolong outpt/office vis |
4,610 |
4,216 |
$430K |
| G9008 |
Mccd,phys coor-care ovrsght |
9,115 |
5,992 |
$222K |
| 70450 |
|
6,224 |
5,633 |
$210K |
| 93005 |
|
37,681 |
32,013 |
$210K |
| 99199 |
|
3,924 |
3,539 |
$199K |
| 0510 |
|
11,240 |
10,048 |
$197K |
| 0241U |
|
5,608 |
5,028 |
$183K |
| 99285 |
|
16,186 |
15,284 |
$155K |
| 99215 |
Prolong outpt/office vis |
6,800 |
6,272 |
$150K |
| 80048 |
|
40,835 |
33,760 |
$150K |
| 99284 |
|
19,695 |
18,487 |
$132K |
| 85025 |
|
37,533 |
31,360 |
$126K |
| J9271 |
Inj pembrolizumab |
768 |
545 |
$114K |
| 99283 |
|
20,634 |
19,793 |
$108K |
| 76705 |
|
5,349 |
4,780 |
$107K |
| G0463 |
Hospital outpt clinic visit |
1,993 |
1,726 |
$99K |
| Q5103 |
Injection, inflectra |
824 |
729 |
$86K |
| 0760 |
|
3,183 |
2,680 |
$80K |
| U0003 |
Cov-19 amp prb hgh thruput |
2,642 |
2,407 |
$75K |
| 71046 |
|
15,717 |
14,289 |
$67K |
| 87491 |
|
5,854 |
5,342 |
$67K |
| 71045 |
|
19,612 |
16,198 |
$66K |
| 87591 |
|
5,754 |
5,305 |
$66K |
| 59025 |
|
7,846 |
3,240 |
$64K |
| 71275 |
|
1,548 |
1,437 |
$60K |
| 99221 |
|
2,025 |
1,799 |
$56K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
5,251 |
4,925 |
$56K |
| 80076 |
|
11,647 |
10,479 |
$56K |
| 93971 |
|
2,810 |
2,506 |
$55K |
| 76856 |
|
2,408 |
2,192 |
$54K |
| 84484 |
|
6,607 |
5,973 |
$53K |
| 72125 |
|
961 |
885 |
$52K |
| 74176 |
|
1,811 |
1,629 |
$52K |
| 71260 |
|
1,442 |
1,383 |
$49K |
| 70553 |
|
460 |
420 |
$47K |
| 99281 |
|
6,517 |
6,303 |
$42K |
| 83880 |
|
2,107 |
1,965 |
$40K |
| J1815 |
Insulin injection |
1,083 |
348 |
$38K |
| 0111 |
|
234 |
100 |
$37K |
| J1569 |
Gammagard liquid injection |
2,008 |
993 |
$36K |
| 83690 |
|
6,644 |
6,143 |
$34K |
| 0202U |
|
882 |
793 |
$34K |
| 86780 |
|
4,034 |
3,730 |
$33K |
| 87635 |
|
2,205 |
2,031 |
$29K |
| 87086 |
|
8,212 |
7,320 |
$29K |
| 93306 |
|
3,602 |
3,286 |
$28K |
| J1885 |
Ketorolac tromethamine inj |
14,754 |
12,950 |
$27K |
| J7030 |
Normal saline solution infus |
20,534 |
15,159 |
$27K |
| 90792 |
|
562 |
513 |
$27K |
| 70551 |
|
349 |
328 |
$27K |
| 76827 |
|
2,027 |
1,867 |
$26K |
| 76830 |
|
1,060 |
951 |
$25K |
| J7040 |
Normal saline solution infus |
11,918 |
7,738 |
$25K |
| U0005 |
Infec agen detec ampli probe |
10,238 |
8,909 |
$24K |
| 88305 |
|
10,526 |
9,891 |
$23K |
| 94640 |
|
4,111 |
2,975 |
$23K |
| U0002 |
Covid-19 lab test non-cdc |
749 |
665 |
$22K |
| J2001 |
Lidocaine injection |
4,263 |
3,900 |
$22K |
| 86480 |
|
3,631 |
3,377 |
$22K |
| 73564 |
|
3,426 |
3,082 |
$22K |
| 73610 |
|
3,771 |
3,312 |
$21K |
| 81001 |
|
15,685 |
14,190 |
$21K |
| 76801 |
|
1,125 |
921 |
$21K |
| 73630 |
|
5,794 |
5,078 |
$20K |
| 76815 |
|
763 |
641 |
$20K |
| 80053 |
|
16,473 |
13,938 |
$20K |
| J2405 |
Ondansetron hcl injection |
24,583 |
17,248 |
$19K |
| J2270 |
Morphine sulfate injection |
6,536 |
5,192 |
$19K |
| 81025 |
|
6,757 |
6,245 |
$19K |
| 71250 |
|
573 |
549 |
$19K |
| 87522 |
Neg quan hep c or qual rna |
3,439 |
3,288 |
$19K |
| S5551 |
Insulin most rapid 5 u |
5,021 |
1,505 |
$18K |
| 73130 |
|
4,233 |
3,585 |
$18K |
| 73110 |
|
3,589 |
2,947 |
$18K |
| J9306 |
Injection, pertuzumab, 1 mg |
93 |
61 |
$18K |
| 0250 |
|
24,388 |
19,747 |
$17K |
| 0516 |
|
598 |
574 |
$17K |
| 93970 |
|
843 |
775 |
$17K |
| 88342 |
|
2,380 |
2,243 |
$17K |
| 73030 |
|
3,250 |
2,889 |
$17K |
| 83605 |
|
2,083 |
1,867 |
$16K |
| J2560 |
Phenobarbital sodium inj |
297 |
242 |
$15K |
| Q5116 |
Inj., trazimera, 10 mg |
390 |
262 |
$15K |
| 86141 |
|
3,930 |
3,720 |
$14K |
| 72100 |
|
2,060 |
1,865 |
$14K |
| 83036 |
|
16,070 |
15,118 |
$13K |
| 84702 |
|
2,088 |
1,558 |
$13K |
| 85610 |
|
18,920 |
12,746 |
$13K |
| J0696 |
Ceftriaxone sodium injection |
6,932 |
4,665 |
$13K |
| Q5118 |
Inj., zirabev, 10 mg |
331 |
219 |
$13K |
| 99282 |
|
10,938 |
10,477 |
$13K |
| 86703 |
|
4,095 |
3,925 |
$12K |
| 76770 |
|
886 |
830 |
$12K |
| 90715 |
|
1,012 |
891 |
$12K |
| 94760 |
|
4,696 |
2,814 |
$11K |
| 87507 |
|
108 |
102 |
$11K |
| 83735 |
|
8,764 |
5,927 |
$11K |
| 76642 |
|
812 |
717 |
$11K |
| 99391 |
|
4,379 |
3,830 |
$10K |
| 87624 |
|
1,911 |
1,708 |
$10K |
| 90677 |
|
2,405 |
1,959 |
$10K |
| 76870 |
|
636 |
569 |
$10K |
| 87661 |
|
1,238 |
1,098 |
$10K |
| J7120 |
Ringers lactate infusion |
16,064 |
13,905 |
$10K |
| 86850 |
|
3,347 |
2,767 |
$10K |
| 73590 |
|
1,387 |
1,205 |
$9K |
| 76700 |
|
581 |
549 |
$9K |
| 80305 |
|
3,045 |
2,854 |
$9K |
| 81220 |
|
157 |
142 |
$9K |
| P9016 |
Rbc leukocytes reduced |
277 |
197 |
$9K |
| 87633 |
|
33 |
32 |
$9K |
| 70498 |
|
167 |
154 |
$9K |
| 80061 |
|
10,760 |
10,350 |
$9K |
| 85027 |
|
8,935 |
7,160 |
$9K |
| 73080 |
|
1,237 |
1,091 |
$9K |
| 70491 |
|
196 |
181 |
$9K |
| 84443 |
|
2,729 |
2,607 |
$9K |
| 86901 |
|
3,907 |
3,203 |
$9K |
| 90651 |
|
1,168 |
1,008 |
$9K |
| 80422 |
|
877 |
661 |
$8K |
| 87186 |
|
2,053 |
1,888 |
$8K |
| G9012 |
Other specified case mgmt |
66 |
39 |
$8K |
| 67028 |
|
166 |
158 |
$8K |
| 73562 |
|
1,252 |
1,129 |
$8K |
| 86900 |
|
3,694 |
3,010 |
$7K |
| 87040 |
|
762 |
650 |
$7K |
| 99232 |
|
197 |
44 |
$7K |
| 76512 |
|
475 |
398 |
$7K |
| 92134 |
|
4,753 |
4,431 |
$6K |
| 82306 |
|
4,065 |
3,939 |
$6K |
| J2704 |
Inj, propofol, 10 mg |
4,972 |
4,780 |
$6K |
| 70486 |
|
111 |
101 |
$6K |
| 73700 |
|
138 |
120 |
$6K |
| J1170 |
Hydromorphone injection |
5,509 |
3,975 |
$6K |
| 85730 |
|
2,499 |
2,117 |
$6K |
| J1050 |
Medroxyprogesterone acetate |
1,661 |
1,495 |
$6K |
| 73502 |
|
616 |
539 |
$6K |
| 99213 |
|
106,403 |
92,001 |
$6K |
| 77066 |
Tomosynthesis, mammo |
229 |
218 |
$6K |
| 77067 |
|
1,953 |
1,897 |
$5K |
| 97110 |
|
22,545 |
12,927 |
$5K |
| J1100 |
Dexamethasone sodium phos |
12,324 |
8,236 |
$5K |
| J9217 |
Leuprolide acetate suspnsion |
872 |
802 |
$5K |
| 36415 |
|
210,764 |
149,849 |
$5K |
| 76857 |
|
470 |
435 |
$5K |
| 70496 |
|
55 |
50 |
$5K |
| J2795 |
Ropivacaine hcl injection |
110 |
110 |
$5K |
| J0780 |
Prochlorperazine injection |
1,940 |
1,712 |
$5K |
| 87340 |
|
2,097 |
1,993 |
$5K |
| 86592 |
|
2,347 |
2,140 |
$5K |
| 73090 |
|
581 |
536 |
$5K |
| 86593 |
|
1,414 |
1,258 |
$5K |
| 76811 |
|
109 |
91 |
$5K |
| 73140 |
|
1,170 |
997 |
$5K |
| 99381 |
|
493 |
422 |
$4K |
| 87070 |
|
1,842 |
1,611 |
$4K |
| 99231 |
|
444 |
331 |
$4K |
| J2505 |
Injection, pegfilgrastim 6mg |
21 |
13 |
$4K |
| 74177 |
|
83 |
81 |
$4K |
| 90723 |
|
1,131 |
948 |
$4K |
| 84100 |
|
3,685 |
2,841 |
$4K |
| 81003 |
|
4,108 |
3,780 |
$4K |
| 87088 |
|
3,446 |
3,142 |
$4K |
| J1200 |
Diphenhydramine hcl injectio |
6,563 |
4,849 |
$4K |
| 88142 |
|
4,390 |
3,947 |
$4K |
| Q3014 |
Telehealth facility fee |
621 |
546 |
$4K |
| Q0162 |
Ondansetron oral |
6,973 |
5,253 |
$4K |
| 51798 |
|
692 |
622 |
$4K |
| 83970 |
|
1,032 |
988 |
$4K |
| 92250 |
|
2,672 |
2,309 |
$4K |
| 86765 |
|
672 |
594 |
$4K |
| J0129 |
Abatacept injection |
1,023 |
851 |
$4K |
| 76536 |
|
491 |
451 |
$4K |
| 82728 |
|
2,632 |
2,537 |
$3K |
| 84439 |
|
1,714 |
1,612 |
$3K |
| 90750 |
|
1,649 |
1,300 |
$3K |
| 77065 |
Tomosynthesis, mammo |
282 |
257 |
$3K |
| 86762 |
|
472 |
422 |
$3K |
| 92557 |
|
2,927 |
2,807 |
$3K |
| J3475 |
Inj magnesium sulfate |
4,182 |
2,386 |
$3K |
| 96110 |
|
2,680 |
2,319 |
$3K |
| 78452 |
|
173 |
160 |
$3K |
| 72148 |
|
54 |
52 |
$3K |
| J7050 |
Normal saline solution infus |
17,306 |
10,937 |
$3K |
| 74018 |
|
1,024 |
848 |
$3K |
| 81000 |
|
8,990 |
6,540 |
$3K |
| 92012 |
|
1,262 |
1,163 |
$3K |
| J2060 |
Lorazepam injection |
3,051 |
2,235 |
$3K |
| 73620 |
|
465 |
419 |
$3K |
| 99243 |
|
1,867 |
1,833 |
$3K |
| 99392 |
|
7,395 |
6,468 |
$3K |
| 97164 |
|
4,407 |
3,231 |
$3K |
| P9040 |
Rbc leukoreduced irradiated |
180 |
112 |
$3K |
| 82550 |
|
887 |
848 |
$2K |
| 95806 |
|
1,468 |
1,431 |
$2K |
| 76817 |
|
72 |
66 |
$2K |
| 82962 |
|
7,200 |
5,182 |
$2K |
| 73120 |
|
393 |
352 |
$2K |
| 96413 |
|
1,178 |
804 |
$2K |
| 90935 |
|
278 |
148 |
$2K |
| 82607 |
|
2,039 |
1,986 |
$2K |
| 90471 |
|
19,085 |
15,840 |
$2K |
| 45378 |
|
126 |
124 |
$2K |
| J1644 |
Inj heparin sodium per 1000u |
6,598 |
2,376 |
$2K |
| G0279 |
Tomosynthesis, mammo |
326 |
311 |
$2K |
| 82746 |
|
1,385 |
1,344 |
$2K |
| 96365 |
|
518 |
406 |
$2K |
| 76881 |
|
223 |
204 |
$2K |
| 86787 |
|
364 |
321 |
$2K |
| 83550 |
|
2,432 |
2,357 |
$2K |
| 96372 |
|
503 |
420 |
$2K |
| 92133 |
|
1,887 |
1,801 |
$2K |
| 87798 |
|
34 |
33 |
$2K |
| 43239 |
|
617 |
597 |
$2K |
| 72040 |
|
486 |
424 |
$2K |
| 81243 |
|
119 |
110 |
$2K |
| 87536 |
|
172 |
166 |
$2K |
| 58100 |
|
678 |
603 |
$2K |
| 83540 |
|
2,478 |
2,401 |
$2K |
| 93303 |
|
323 |
311 |
$2K |
| 90670 |
|
436 |
344 |
$2K |
| 86706 |
|
1,539 |
1,504 |
$2K |
| G9920 |
Scrning perf and negative |
3,261 |
3,010 |
$2K |
| 85652 |
|
2,896 |
2,768 |
$2K |
| 99395 |
|
1,749 |
1,560 |
$2K |
| J7297 |
Liletta, 52 mg |
43 |
39 |
$2K |
| J1750 |
Inj iron dextran |
65 |
56 |
$2K |
| 97140 |
|
1,482 |
1,025 |
$2K |
| J1642 |
Inj heparin sodium per 10 u |
1,732 |
979 |
$2K |
| 97161 |
|
9,603 |
8,743 |
$2K |
| J1950 |
Leuprolide acetate /3.75 mg |
16 |
14 |
$2K |
| J3370 |
Vancomycin hcl injection |
1,259 |
700 |
$2K |
| 99393 |
|
3,273 |
2,953 |
$2K |
| 92014 |
|
1,335 |
1,275 |
$1K |
| 87581 |
|
111 |
105 |
$1K |
| 99442 |
|
47,202 |
42,325 |
$1K |
| 87210 |
|
1,626 |
1,500 |
$1K |
| J2765 |
Metoclopramide hcl injection |
1,943 |
1,604 |
$1K |
| 80074 |
|
151 |
147 |
$1K |
| 99244 |
|
1,262 |
1,222 |
$1K |
| 86705 |
|
930 |
909 |
$1K |
| 82570 |
|
2,645 |
2,424 |
$1K |
| 92004 |
|
1,040 |
961 |
$1K |
| 99394 |
|
2,148 |
1,942 |
$1K |
| J3010 |
Fentanyl citrate injection |
9,324 |
8,725 |
$1K |
| 99024 |
|
483 |
439 |
$1K |
| 85378 |
|
259 |
254 |
$1K |
| 99203 |
|
13,320 |
12,738 |
$1K |
| J2250 |
Inj midazolam hydrochloride |
4,839 |
4,617 |
$1K |
| 83021 |
|
150 |
130 |
$1K |
| 82043 |
|
4,228 |
4,049 |
$1K |
| 97010 |
|
15,094 |
7,962 |
$1K |
| J1630 |
Haloperidol injection |
1,690 |
1,209 |
$1K |
| 93247 |
|
1,244 |
1,139 |
$1K |
| 86923 |
|
1,399 |
855 |
$1K |
| 86160 |
|
401 |
387 |
$1K |
| 82274 |
|
7,850 |
6,821 |
$1K |
| 94729 |
|
783 |
758 |
$1K |
| 99385 |
|
748 |
683 |
$1K |
| 86039 |
|
404 |
388 |
$1K |
| 27502 |
|
13 |
12 |
$1K |
| 95811 |
|
372 |
370 |
$1K |
| 76775 |
|
74 |
66 |
$1K |
| 87205 |
|
708 |
594 |
$1K |
| 94010 |
|
1,689 |
1,634 |
$1K |
| 90686 |
|
4,279 |
3,493 |
$997.50 |
| 99204 |
|
8,925 |
8,419 |
$987.49 |
| 87081 |
|
677 |
611 |
$971.35 |
| 99441 |
|
22,097 |
19,561 |
$960.60 |
| J0690 |
Cefazolin sodium injection |
4,439 |
3,934 |
$959.50 |
| 73060 |
|
171 |
150 |
$949.94 |
| 99238 |
|
26 |
25 |
$948.96 |
| 85007 |
|
892 |
681 |
$944.96 |
| 88307 |
|
337 |
328 |
$944.40 |
| 99443 |
|
37,471 |
33,902 |
$942.08 |
| J1940 |
Furosemide injection |
1,934 |
889 |
$933.84 |
| 93017 |
|
560 |
526 |
$914.94 |
| 82540 |
|
4,232 |
4,039 |
$913.00 |
| 92082 |
|
281 |
266 |
$908.07 |
| 99202 |
|
3,470 |
3,430 |
$904.12 |
| 90707 |
|
527 |
430 |
$891.54 |
| 88187 |
|
393 |
368 |
$867.49 |
| 90648 |
|
1,456 |
1,208 |
$833.09 |
| 90472 |
|
1,575 |
1,464 |
$821.94 |
| 82565 |
|
5,083 |
4,545 |
$810.63 |
| 88312 |
|
395 |
393 |
$807.51 |
| 90716 |
|
528 |
434 |
$804.35 |
| J2785 |
Regadenoson injection |
157 |
148 |
$776.00 |
| J2930 |
Methylprednisolone injection |
984 |
764 |
$750.20 |
| 76942 |
|
355 |
324 |
$744.78 |
| 86753 |
|
139 |
122 |
$743.69 |
| 82105 |
|
236 |
216 |
$739.37 |
| 80307 |
|
19 |
18 |
$727.60 |
| 84703 |
|
393 |
279 |
$725.34 |
| 83615 |
|
765 |
619 |
$719.53 |
| 90674 |
|
369 |
306 |
$716.75 |
| 99383 |
|
237 |
216 |
$700.44 |
| 96375 |
|
159 |
104 |
$661.55 |
| J7611 |
Albuterol non-comp con |
1,397 |
1,105 |
$652.82 |
| J3489 |
Zoledronic acid 1mg |
1,417 |
1,230 |
$640.03 |
| 87150 |
|
195 |
166 |
$638.45 |
| 76499 |
|
51 |
49 |
$634.98 |
| S0164 |
Injection pantroprazole |
767 |
321 |
$618.62 |
| 92227 |
|
2,447 |
2,086 |
$612.78 |
| J9070 |
Cyclophosphamide 100 mg inj |
87 |
63 |
$609.47 |
| 78014 |
|
171 |
151 |
$605.62 |
| 85008 |
|
665 |
643 |
$603.23 |
| 51702 |
|
42 |
36 |
$573.86 |
| 99214 |
|
45,371 |
40,543 |
$573.57 |
| 88173 |
|
400 |
372 |
$548.25 |
| 87338 |
|
1,698 |
1,484 |
$539.97 |
| 97162 |
|
2,219 |
2,050 |
$532.08 |
| S0020 |
Injection, bupivicaine hydro |
355 |
329 |
$517.76 |
| 84153 |
|
457 |
410 |
$513.79 |
| J8540 |
Oral dexamethasone |
1,990 |
910 |
$486.61 |
| 45380 |
|
186 |
184 |
$473.68 |
| J3490 |
Drugs unclassified injection |
512 |
490 |
$464.98 |
| 73000 |
|
132 |
109 |
$439.54 |
| J3480 |
Inj potassium chloride |
1,213 |
663 |
$437.13 |
| J7060 |
5% dextrose/water |
1,531 |
964 |
$413.56 |
| 84550 |
|
601 |
520 |
$408.79 |
| 87880 |
|
181 |
174 |
$402.89 |
| 88304 |
|
1,289 |
1,272 |
$399.17 |
| 97530 |
|
2,136 |
1,299 |
$396.20 |
| 74170 |
|
13 |
13 |
$377.33 |
| 99245 |
|
261 |
242 |
$376.98 |
| 99212 |
|
32,749 |
29,782 |
$376.51 |
| 88141 |
|
486 |
448 |
$371.38 |
| 84403 |
|
153 |
142 |
$367.40 |
| Q0163 |
Diphenhydramine hcl 50mg |
11,600 |
7,702 |
$366.61 |
| 73503 |
|
30 |
27 |
$363.76 |
| 73600 |
|
52 |
42 |
$349.48 |
| S5550 |
Insulin rapid 5 u |
671 |
457 |
$319.89 |
| 87102 |
|
98 |
93 |
$296.25 |
| J2916 |
Na ferric gluconate complex |
438 |
219 |
$292.40 |
| 92235 |
|
51 |
47 |
$287.51 |
| 73660 |
|
60 |
52 |
$284.73 |
| 73560 |
|
52 |
46 |
$282.34 |
| J1650 |
Inj enoxaparin sodium |
4,415 |
1,207 |
$282.32 |
| 0401 |
|
30 |
30 |
$278.44 |
| 45385 |
|
218 |
213 |
$275.04 |
| 96417 |
|
29 |
25 |
$270.14 |
| 94726 |
|
216 |
209 |
$267.58 |
| 84146 |
|
71 |
69 |
$266.68 |
| 96366 |
|
59 |
39 |
$264.94 |
| 85014 |
|
973 |
955 |
$262.19 |
| 85018 |
|
979 |
961 |
$261.93 |
| 82784 |
|
388 |
350 |
$260.01 |
| 87481 |
|
17 |
16 |
$257.94 |
| 90734 |
|
655 |
563 |
$255.33 |
| 90746 |
|
140 |
109 |
$251.46 |
| 0124A |
|
251 |
203 |
$238.80 |
| 92025 |
|
147 |
135 |
$226.41 |
| J2370 |
Phenylephrine hcl injection |
985 |
952 |
$222.16 |
| 97166 |
|
917 |
831 |
$220.64 |
| J7613 |
Albuterol non-comp unit |
1,950 |
1,641 |
$208.45 |
| 82378 |
|
32 |
25 |
$206.78 |
| J2710 |
Neostigmine methylslfte inj |
1,350 |
1,316 |
$206.60 |
| 82040 |
|
332 |
316 |
$205.81 |
| J7512 |
Prednisone ir or dr oral 1mg |
1,760 |
1,143 |
$205.64 |
| 75989 |
|
12 |
12 |
$203.83 |
| 90633 |
|
952 |
789 |
$203.76 |
| J9267 |
Paclitaxel injection |
1,185 |
532 |
$198.12 |
| J9263 |
Oxaliplatin |
538 |
344 |
$197.88 |
| 93926 |
|
211 |
180 |
$192.88 |
| 99211 |
|
96,286 |
64,029 |
$187.09 |
| 85044 |
|
227 |
194 |
$170.64 |
| 97116 |
|
514 |
425 |
$170.49 |
| 96415 |
|
28 |
24 |
$170.21 |
| 81002 |
|
327 |
266 |
$170.19 |
| 76519 |
|
42 |
37 |
$165.81 |
| J0330 |
Succinycholine chloride inj |
780 |
764 |
$163.94 |
| 0300 |
|
3,781 |
3,651 |
$161.96 |
| 90739 |
|
557 |
472 |
$160.00 |
| 92550 |
|
152 |
150 |
$157.95 |
| 86431 |
|
145 |
138 |
$154.31 |
| 87184 |
|
49 |
44 |
$152.35 |
| J9045 |
Carboplatin injection |
1,019 |
689 |
$151.69 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
151 |
138 |
$143.39 |
| 97168 |
|
914 |
659 |
$139.75 |
| 84481 |
|
42 |
41 |
$138.35 |
| 99382 |
|
113 |
94 |
$134.52 |
| 86635 |
|
69 |
66 |
$132.56 |
| 99201 |
|
731 |
726 |
$125.07 |
| 86235 |
|
41 |
40 |
$124.03 |
| J2272 |
Inj, morphine (fresenius) |
16 |
15 |
$114.76 |
| J9060 |
Cisplatin 10 mg injection |
30 |
13 |
$110.50 |
| 72170 |
|
13 |
12 |
$110.11 |
| 86225 |
|
83 |
81 |
$107.95 |
| J9035 |
Bevacizumab injection |
251 |
246 |
$106.00 |
| 94618 |
|
317 |
306 |
$100.80 |
| 88112 |
|
156 |
137 |
$98.69 |
| 82248 |
|
89 |
87 |
$93.60 |
| 85041 |
|
103 |
101 |
$92.52 |
| 74183 |
|
27 |
26 |
$86.82 |
| 92504 |
|
609 |
509 |
$86.56 |
| 83521 |
|
73 |
64 |
$83.73 |
| 84155 |
|
519 |
463 |
$80.88 |
| 90700 |
|
429 |
360 |
$80.72 |
| J7644 |
Ipratropium bromide non-comp |
1,416 |
1,153 |
$80.42 |
| 77080 |
|
220 |
217 |
$78.78 |
| 88175 |
|
140 |
126 |
$74.90 |
| 76376 |
|
852 |
817 |
$74.67 |
| 92083 |
|
185 |
177 |
$74.24 |
| 84450 |
|
138 |
133 |
$71.68 |
| J9190 |
Fluorouracil injection |
198 |
100 |
$70.68 |
| 88313 |
|
17 |
17 |
$70.18 |
| 76825 |
|
25 |
25 |
$69.42 |
| 99234 |
|
19 |
16 |
$68.20 |
| P9047 |
Albumin (human), 25%, 50ml |
84 |
30 |
$68.00 |
| 76000 |
|
218 |
212 |
$63.32 |
| 92015 |
|
157 |
147 |
$62.47 |
| J1453 |
Fosaprepitant injection |
1,543 |
910 |
$62.39 |
| 94660 |
|
36 |
12 |
$58.52 |
| 99242 |
|
28 |
28 |
$58.03 |
| J0456 |
Azithromycin |
70 |
39 |
$57.56 |
| 97018 |
|
1,308 |
748 |
$57.49 |
| J7042 |
5% dextrose/normal saline |
18 |
12 |
$53.70 |
| 0636 |
|
5,993 |
5,532 |
$49.16 |
| J0640 |
Leucovorin calcium injection |
161 |
87 |
$48.51 |
| 84460 |
|
127 |
125 |
$48.06 |
| 83921 |
|
50 |
48 |
$43.79 |
| 98968 |
|
2,021 |
1,862 |
$42.49 |
| 51736 |
|
24 |
24 |
$42.19 |
| 97165 |
|
303 |
288 |
$41.16 |
| 83001 |
|
12 |
12 |
$39.70 |
| 97760 |
|
294 |
237 |
$38.02 |
| 99241 |
|
36 |
36 |
$34.76 |
| J2543 |
Piperacillin/tazobactam |
60 |
41 |
$34.44 |
| 90656 |
|
1,737 |
1,530 |
$33.14 |
| A9152 |
Single vitamin nos |
399 |
317 |
$26.76 |
| J3301 |
Triamcinolone acet inj nos |
80 |
76 |
$25.81 |
| 83721 |
|
56 |
53 |
$20.80 |
| Q0144 |
Azithromycin dihydrate, oral |
32 |
25 |
$20.17 |
| 92567 |
|
270 |
251 |
$19.80 |
| 98966 |
|
1,025 |
985 |
$19.72 |
| J1720 |
Hydrocortisone sodium succ i |
26 |
12 |
$19.00 |
| S5553 |
Insulin long acting 5 u |
296 |
93 |
$16.77 |
| 85060 |
|
26 |
24 |
$12.63 |
| J7642 |
Glycopyrrolate comp con |
1,435 |
1,399 |
$9.69 |
| 90696 |
|
365 |
310 |
$8.91 |
| 90710 |
|
379 |
323 |
$8.91 |
| J7620 |
Albuterol ipratrop non-comp |
391 |
189 |
$8.78 |
| 88300 |
|
184 |
183 |
$7.32 |
| 82247 |
|
23 |
12 |
$4.97 |
| J0612 |
Inj, calcium gluconate, nos |
15 |
15 |
$4.51 |
| S0028 |
Injection, famotidine, 20 mg |
457 |
312 |
$2.83 |
| S0030 |
Injection, metronidazole |
365 |
188 |
$1.98 |
| 0771 |
|
5,657 |
5,245 |
$0.00 |
| 20610 |
|
149 |
112 |
$0.00 |
| 3079F |
|
2,009 |
1,936 |
$0.00 |
| 99384 |
|
126 |
114 |
$0.00 |
| 0100 |
|
9,485 |
1,912 |
$0.00 |
| 91307 |
|
460 |
395 |
$0.00 |
| 1220F |
|
465 |
454 |
$0.00 |
| 3052F |
|
811 |
647 |
$0.00 |
| 96161 |
|
1,731 |
1,432 |
$0.00 |
| 3074F |
|
17,781 |
14,687 |
$0.00 |
| 31231 |
|
105 |
103 |
$0.00 |
| 3075F |
|
4,214 |
3,625 |
$0.00 |
| 92507 |
|
42 |
26 |
$0.00 |
| 80320 |
|
52 |
51 |
$0.00 |
| 98967 |
|
2,622 |
2,319 |
$0.00 |
| 0110 |
|
903 |
408 |
$0.00 |
| 90694 |
|
62 |
47 |
$0.00 |
| T1014 |
Telehealth transmit, per min |
446 |
379 |
$0.00 |
| 81015 |
|
428 |
351 |
$0.00 |
| 99386 |
|
398 |
389 |
$0.00 |
| J2357 |
Omalizumab injection |
409 |
226 |
$0.00 |
| 0074A |
|
28 |
23 |
$0.00 |
| 59414 |
|
198 |
197 |
$0.00 |
| J9312 |
Inj., rituximab, 10 mg |
45 |
27 |
$0.00 |
| 91317 |
|
37 |
34 |
$0.00 |
| 0206 |
|
47 |
15 |
$0.00 |
| 91305 |
|
83 |
81 |
$0.00 |
| 93294 |
|
13 |
13 |
$0.00 |
| 3080F |
|
654 |
635 |
$0.00 |
| 99412 |
|
104 |
60 |
$0.00 |
| 92551 |
|
26 |
26 |
$0.00 |
| 1111F |
|
12,388 |
10,173 |
$0.00 |
| 59410 |
|
42 |
42 |
$0.00 |
| 3044F |
|
6,245 |
5,263 |
$0.00 |
| 86335 |
|
13 |
12 |
$0.00 |
| 36410 |
|
75 |
73 |
$0.00 |
| 2001F |
|
13 |
13 |
$0.00 |
| 52000 |
|
14 |
12 |
$0.00 |
| J0610 |
Calcium glucon (fresenius) |
19 |
13 |
$0.00 |
| 99464 |
|
15 |
15 |
$0.00 |
| 91315 |
|
100 |
92 |
$0.00 |
| 80502 |
|
20 |
20 |
$0.00 |
| 99465 |
|
15 |
15 |
$0.00 |
| 92587 |
|
17 |
17 |
$0.00 |
| J9299 |
Injection, nivolumab |
37 |
25 |
$0.00 |
| 80329 |
|
24 |
24 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |
| J0461 |
Atropine sulfate injection |
26 |
15 |
$0.00 |
| 77062 |
|
1,461 |
1,430 |
$0.00 |
| 31575 |
|
413 |
393 |
$0.00 |
| J2590 |
Oxytocin injection |
133 |
117 |
$0.00 |
| 95810 |
|
113 |
105 |
$0.00 |
| 36600 |
|
674 |
580 |
$0.00 |
| J9000 |
Doxorubicin hcl injection |
17 |
13 |
$0.00 |
| 91300 |
|
2,064 |
1,609 |
$0.00 |
| 98960 |
|
4,374 |
3,117 |
$0.00 |
| 99397 |
|
27 |
26 |
$0.00 |
| 97602 |
|
608 |
264 |
$0.00 |
| 99396 |
|
1,442 |
1,338 |
$0.00 |
| 96160 |
|
532 |
438 |
$0.00 |
| 3051F |
|
1,398 |
1,120 |
$0.00 |
| 0424 |
|
100 |
96 |
$0.00 |
| 3078F |
|
14,111 |
12,817 |
$0.00 |
| J9355 |
Inj trastuzumab excl biosimi |
260 |
170 |
$0.00 |
| 0120 |
|
2,102 |
709 |
$0.00 |
| 93041 |
|
520 |
320 |
$0.00 |
| 91312 |
|
600 |
517 |
$0.00 |
| 83655 |
|
87 |
87 |
$0.00 |
| J9171 |
Docetaxel injection |
15 |
12 |
$0.00 |
| 3077F |
|
3,383 |
2,900 |
$0.00 |
| 90653 |
|
325 |
273 |
$0.00 |
| J0694 |
Cefoxitin sodium injection |
12 |
12 |
$0.00 |
| 3046F |
|
1,332 |
1,095 |
$0.00 |
| 93882 |
|
24 |
19 |
$0.00 |
| 0731 |
|
123 |
123 |
$0.00 |
| 86334 |
|
39 |
36 |
$0.00 |
| 86922 |
|
17 |
13 |
$0.00 |
| 87502 |
|
114 |
98 |
$0.00 |
| 90473 |
|
40 |
37 |
$0.00 |
| J9206 |
Irinotecan injection |
25 |
14 |
$0.00 |
| 93880 |
|
28 |
26 |
$0.00 |
| 92555 |
|
31 |
27 |
$0.00 |
| 0200 |
|
46 |
13 |
$0.00 |
| 93978 |
|
12 |
12 |
$0.00 |
| 84145 |
|
19 |
13 |
$0.00 |
| 91308 |
|
23 |
21 |
$0.00 |
| 90661 |
|
243 |
203 |
$0.00 |
| 99173 |
|
12 |
12 |
$0.00 |
| C9257 |
Bevacizumab injection |
30 |
28 |
$0.00 |
| J9201 |
In gemcitabine hcl nos 200mg |
48 |
25 |
$0.00 |