| Code | Description | Claims | Beneficiaries | Total Paid |
| 99283 |
|
97,300 |
91,048 |
$39.48M |
| 99284 |
|
73,525 |
68,075 |
$28.32M |
| G0463 |
Hospital outpt clinic visit |
538,951 |
466,835 |
$14.39M |
| 99285 |
|
27,300 |
24,975 |
$8.13M |
| U0003 |
Cov-19 amp prb hgh thruput |
78,509 |
69,340 |
$7.18M |
| J3490 |
Drugs unclassified injection |
130,700 |
63,476 |
$7.11M |
| 80053 |
|
133,421 |
113,726 |
$5.05M |
| J1642 |
Inj heparin sodium per 10 u |
8,522 |
3,968 |
$4.81M |
| 96365 |
|
3,662 |
2,144 |
$4.15M |
| 87491 |
|
115,011 |
103,035 |
$3.52M |
| 87591 |
|
114,059 |
102,105 |
$2.92M |
| 96413 |
|
7,994 |
4,469 |
$2.47M |
| 87636 |
|
15,488 |
14,506 |
$2.41M |
| 36415 |
|
73,058 |
63,075 |
$2.10M |
| 99282 |
|
15,533 |
14,847 |
$1.66M |
| J0690 |
Cefazolin sodium injection |
2,531 |
1,837 |
$1.47M |
| J8499 |
Oral prescrip drug non chemo |
55,219 |
17,601 |
$1.30M |
| J0585 |
Injection,onabotulinumtoxina |
2,630 |
2,142 |
$1.27M |
| U0005 |
Infec agen detec ampli probe |
47,997 |
41,259 |
$1.26M |
| 87389 |
|
52,050 |
46,223 |
$1.20M |
| 93005 |
|
22,714 |
20,386 |
$1.19M |
| 85025 |
|
145,465 |
117,562 |
$1.12M |
| 76816 |
|
12,943 |
11,026 |
$1.01M |
| G0378 |
Hospital observation per hr |
8,288 |
5,586 |
$950K |
| 36591 |
|
2,732 |
1,503 |
$936K |
| 80048 |
|
27,731 |
23,724 |
$852K |
| 71046 |
|
16,496 |
15,411 |
$817K |
| J1745 |
Infliximab not biosimil 10mg |
174 |
157 |
$785K |
| P9016 |
Rbc leukocytes reduced |
1,799 |
1,532 |
$746K |
| 87086 |
|
47,807 |
43,625 |
$743K |
| 87070 |
|
46,220 |
44,150 |
$732K |
| 96374 |
|
25,148 |
22,183 |
$692K |
| 59025 |
|
5,238 |
4,000 |
$670K |
| 36512 |
|
1,412 |
1,192 |
$669K |
| 80061 |
|
36,998 |
34,078 |
$668K |
| 84443 |
|
42,859 |
39,985 |
$631K |
| J2270 |
Morphine sulfate injection |
2,347 |
1,863 |
$620K |
| 76811 |
|
4,658 |
3,915 |
$599K |
| J2250 |
Inj midazolam hydrochloride |
3,857 |
3,241 |
$574K |
| 86592 |
|
53,214 |
47,224 |
$569K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
3,472 |
2,971 |
$528K |
| Q3014 |
Telehealth facility fee |
22,507 |
20,861 |
$519K |
| 99199 |
|
52,574 |
45,267 |
$505K |
| 87633 |
|
2,716 |
2,575 |
$497K |
| 83020 |
|
11,743 |
9,516 |
$484K |
| 76819 |
|
5,722 |
4,481 |
$481K |
| 64643 |
|
1,729 |
1,609 |
$471K |
| 96367 |
|
416 |
220 |
$469K |
| 64642 |
|
2,340 |
2,194 |
$466K |
| 96361 |
|
4,479 |
3,317 |
$456K |
| 85027 |
|
57,011 |
50,139 |
$404K |
| 87635 |
|
7,983 |
3,746 |
$393K |
| 87801 |
|
5,988 |
5,280 |
$382K |
| 90471 |
|
24,667 |
22,696 |
$378K |
| 87081 |
|
30,809 |
29,673 |
$374K |
| 82306 |
|
11,763 |
10,964 |
$364K |
| 83036 |
|
32,482 |
29,217 |
$344K |
| 82962 |
|
11,477 |
9,091 |
$336K |
| 88175 |
|
15,582 |
14,055 |
$336K |
| S0028 |
Injection, famotidine, 20 mg |
550 |
399 |
$328K |
| 88305 |
|
3,155 |
2,967 |
$315K |
| 80069 |
|
8,711 |
6,173 |
$309K |
| 82728 |
|
18,726 |
17,029 |
$307K |
| 54161 |
|
326 |
279 |
$298K |
| 80307 |
|
4,366 |
3,829 |
$296K |
| 84439 |
|
24,794 |
23,313 |
$285K |
| 81025 |
|
19,520 |
17,541 |
$272K |
| 96360 |
|
951 |
840 |
$269K |
| 86923 |
|
880 |
697 |
$245K |
| 95700 |
|
196 |
185 |
$241K |
| J8597 |
Antiemetic drug oral nos |
5,160 |
4,596 |
$237K |
| 86850 |
|
18,727 |
16,107 |
$234K |
| J1644 |
Inj heparin sodium per 1000u |
1,614 |
940 |
$227K |
| 87486 |
|
2,735 |
2,590 |
$224K |
| 76805 |
|
2,047 |
1,797 |
$220K |
| 95714 |
|
173 |
157 |
$215K |
| 74177 |
|
1,212 |
1,085 |
$211K |
| S0020 |
Injection, bupivicaine hydro |
3,330 |
2,970 |
$210K |
| 11042 |
|
3,377 |
1,704 |
$201K |
| 81003 |
|
24,757 |
22,097 |
$197K |
| 86360 |
|
3,734 |
3,487 |
$195K |
| 86803 |
|
12,947 |
11,386 |
$181K |
| 94010 |
|
1,733 |
1,658 |
$170K |
| 87480 |
|
5,157 |
4,582 |
$165K |
| 86359 |
|
3,732 |
3,487 |
$157K |
| 87661 |
|
7,661 |
6,809 |
$152K |
| 96375 |
|
15,472 |
11,328 |
$149K |
| 87340 |
|
18,045 |
16,068 |
$143K |
| C9803 |
Hopd covid-19 spec collect |
11,959 |
10,833 |
$143K |
| 99177 |
|
2,411 |
2,260 |
$142K |
| J2405 |
Ondansetron hcl injection |
16,642 |
13,231 |
$142K |
| 96372 |
|
15,868 |
13,034 |
$141K |
| 87536 |
|
3,874 |
3,605 |
$141K |
| J1050 |
Medroxyprogesterone acetate |
6,917 |
6,578 |
$137K |
| J2997 |
Alteplase recombinant |
1,493 |
738 |
$136K |
| 87624 |
|
3,721 |
3,532 |
$131K |
| 86920 |
|
315 |
281 |
$128K |
| J1100 |
Dexamethasone sodium phos |
6,195 |
4,417 |
$123K |
| J1170 |
Hydromorphone injection |
1,740 |
1,227 |
$122K |
| 0001A |
|
2,494 |
2,318 |
$120K |
| 0002A |
|
2,306 |
2,156 |
$120K |
| 83021 |
|
2,051 |
1,723 |
$120K |
| 82950 |
|
6,794 |
6,374 |
$118K |
| 70553 |
|
243 |
223 |
$117K |
| 87660 |
|
5,176 |
4,601 |
$117K |
| 43239 |
|
193 |
177 |
$115K |
| 70450 |
|
1,090 |
944 |
$113K |
| 86762 |
|
9,659 |
8,623 |
$110K |
| 87510 |
|
5,169 |
4,594 |
$99K |
| 82570 |
|
4,368 |
3,803 |
$95K |
| 82607 |
|
6,816 |
6,352 |
$94K |
| 76817 |
|
1,077 |
827 |
$92K |
| 76801 |
|
972 |
850 |
$88K |
| J0696 |
Ceftriaxone sodium injection |
573 |
417 |
$85K |
| 86787 |
|
5,753 |
5,036 |
$83K |
| 87581 |
|
2,735 |
2,590 |
$79K |
| J8540 |
Oral dexamethasone |
808 |
710 |
$79K |
| 81220 |
|
182 |
170 |
$77K |
| 90999 |
|
910 |
51 |
$76K |
| 86140 |
|
11,325 |
10,075 |
$75K |
| 91200 |
|
357 |
336 |
$73K |
| 76856 |
|
393 |
348 |
$73K |
| 84484 |
|
8,543 |
7,440 |
$71K |
| 80076 |
|
2,545 |
2,206 |
$70K |
| 80047 |
|
3,115 |
2,748 |
$69K |
| 81001 |
|
16,358 |
14,840 |
$69K |
| Q0162 |
Ondansetron oral |
1,943 |
1,802 |
$68K |
| 36430 |
|
430 |
376 |
$68K |
| 54300 |
|
98 |
95 |
$68K |
| 86780 |
|
3,091 |
2,908 |
$64K |
| 76770 |
|
324 |
308 |
$62K |
| 85045 |
|
14,878 |
13,150 |
$60K |
| A9270 |
Non-covered item or service |
5,956 |
1,965 |
$59K |
| 84702 |
|
3,286 |
2,471 |
$55K |
| J3010 |
Fentanyl citrate injection |
11,132 |
9,785 |
$55K |
| 76705 |
|
1,063 |
966 |
$52K |
| 82330 |
|
2,349 |
1,903 |
$51K |
| 82105 |
|
2,298 |
2,135 |
$51K |
| 36593 |
|
769 |
511 |
$50K |
| C1887 |
Catheter, guiding |
78 |
53 |
$50K |
| 85007 |
|
3,776 |
2,849 |
$49K |
| 95951 |
|
60 |
43 |
$48K |
| 90677 |
|
922 |
695 |
$48K |
| 81420 |
|
85 |
68 |
$46K |
| 87077 |
|
2,199 |
2,057 |
$46K |
| 82784 |
|
3,549 |
2,459 |
$45K |
| 83690 |
|
8,878 |
7,962 |
$45K |
| 43762 |
|
290 |
269 |
$43K |
| 84466 |
|
7,033 |
6,513 |
$43K |
| 86900 |
|
15,819 |
13,368 |
$40K |
| J2710 |
Neostigmine methylslfte inj |
485 |
420 |
$40K |
| 71045 |
|
1,564 |
1,375 |
$39K |
| 11045 |
|
92 |
50 |
$39K |
| 74018 |
|
768 |
660 |
$38K |
| 86901 |
|
15,912 |
13,449 |
$37K |
| 14040 |
|
68 |
65 |
$36K |
| 81002 |
|
9,396 |
8,553 |
$35K |
| 76815 |
|
480 |
360 |
$33K |
| 82565 |
|
1,447 |
1,298 |
$33K |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,683 |
1,126 |
$32K |
| 90715 |
|
2,193 |
2,094 |
$32K |
| 83540 |
|
7,791 |
7,217 |
$31K |
| 41899 |
|
17 |
12 |
$30K |
| 94640 |
|
1,902 |
1,276 |
$30K |
| 83615 |
|
7,046 |
5,505 |
$30K |
| 87535 |
|
876 |
803 |
$29K |
| J1885 |
Ketorolac tromethamine inj |
10,196 |
8,572 |
$29K |
| 0031A |
|
607 |
590 |
$29K |
| 90837 |
|
2,162 |
1,194 |
$28K |
| 96409 |
|
244 |
178 |
$28K |
| J2704 |
Inj, propofol, 10 mg |
11,949 |
10,349 |
$27K |
| 90686 |
|
18,907 |
17,150 |
$27K |
| 97597 |
|
924 |
548 |
$26K |
| 80050 |
|
825 |
801 |
$26K |
| 87798 |
|
2,144 |
1,883 |
$26K |
| 76820 |
|
346 |
240 |
$25K |
| 80197 |
|
3,023 |
1,916 |
$25K |
| 20610 |
|
215 |
197 |
$24K |
| 83735 |
|
10,472 |
6,937 |
$24K |
| 85610 |
|
9,117 |
6,114 |
$23K |
| J2323 |
Natalizumab injection |
12 |
12 |
$22K |
| 99395 |
|
699 |
628 |
$21K |
| 97803 |
|
2,060 |
1,821 |
$21K |
| 87637 |
|
104 |
104 |
$21K |
| G0480 |
Drug test def 1-7 classes |
831 |
724 |
$21K |
| 97140 |
|
298 |
120 |
$20K |
| 97802 |
|
691 |
573 |
$19K |
| 49591 |
|
12 |
12 |
$19K |
| 83880 |
|
1,517 |
1,229 |
$18K |
| 0012A |
|
378 |
366 |
$17K |
| 85018 |
|
4,962 |
4,416 |
$16K |
| J3301 |
Triamcinolone acet inj nos |
1,554 |
1,448 |
$15K |
| 86003 |
|
109 |
108 |
$15K |
| 82610 |
|
987 |
897 |
$15K |
| 83970 |
|
957 |
786 |
$15K |
| 90460 |
|
1,766 |
1,365 |
$15K |
| C1894 |
Intro/sheath, non-laser |
102 |
80 |
$15K |
| 86902 |
|
2,429 |
2,095 |
$15K |
| G0379 |
Direct refer hospital observ |
156 |
150 |
$14K |
| 86480 |
|
309 |
276 |
$14K |
| 88342 |
|
146 |
128 |
$14K |
| 90678 |
|
112 |
104 |
$14K |
| 85660 |
|
2,467 |
2,128 |
$14K |
| J9370 |
Vincristine sulfate 1 mg inj |
187 |
138 |
$14K |
| 82977 |
|
2,321 |
2,066 |
$13K |
| 87538 |
|
372 |
341 |
$13K |
| 0011A |
|
413 |
404 |
$13K |
| 82803 |
|
676 |
588 |
$12K |
| 87147 |
|
4,049 |
3,881 |
$12K |
| 83516 |
|
1,007 |
924 |
$12K |
| 82248 |
|
2,242 |
2,010 |
$11K |
| 96127 |
|
1,920 |
1,721 |
$11K |
| 85652 |
|
5,923 |
5,399 |
$11K |
| 0071A |
|
199 |
187 |
$11K |
| 86038 |
|
826 |
791 |
$11K |
| 90472 |
|
541 |
473 |
$10K |
| 82746 |
|
1,374 |
1,295 |
$10K |
| J0330 |
Succinycholine chloride inj |
85 |
65 |
$10K |
| Q4081 |
Epoetin alfa, 100 units esrd |
241 |
12 |
$10K |
| 82550 |
|
767 |
634 |
$10K |
| 82043 |
|
1,303 |
1,261 |
$10K |
| 87205 |
|
2,604 |
2,408 |
$10K |
| 87186 |
|
3,531 |
3,321 |
$10K |
| 90656 |
|
721 |
671 |
$9K |
| 84146 |
|
341 |
285 |
$9K |
| C1769 |
Guide wire |
211 |
182 |
$9K |
| C1750 |
Cath, hemodialysis,long-term |
29 |
24 |
$9K |
| 87210 |
|
1,979 |
1,801 |
$8K |
| 83605 |
|
2,163 |
1,818 |
$8K |
| 84100 |
|
3,261 |
2,013 |
$8K |
| 84450 |
|
2,241 |
2,012 |
$8K |
| J1200 |
Diphenhydramine hcl injectio |
2,082 |
1,135 |
$8K |
| 83655 |
|
476 |
367 |
$8K |
| G0472 |
Hep c screen high risk/other |
499 |
461 |
$7K |
| 82670 |
|
163 |
152 |
$7K |
| 87880 |
|
441 |
423 |
$7K |
| 82150 |
|
647 |
526 |
$7K |
| 80074 |
|
96 |
93 |
$7K |
| 0072A |
|
112 |
110 |
$7K |
| 64483 |
|
21 |
12 |
$6K |
| 87522 |
Neg quan hep c or qual rna |
230 |
211 |
$6K |
| 87502 |
|
81 |
80 |
$6K |
| 84305 |
|
366 |
353 |
$6K |
| 0124A |
|
145 |
127 |
$6K |
| 0004A |
|
114 |
102 |
$6K |
| 82075 |
|
851 |
727 |
$6K |
| J1630 |
Haloperidol injection |
41 |
28 |
$6K |
| 96366 |
|
449 |
236 |
$5K |
| 84153 |
|
547 |
471 |
$5K |
| 83001 |
|
348 |
338 |
$5K |
| 96380 |
|
350 |
331 |
$4K |
| 87040 |
|
733 |
667 |
$4K |
| G0481 |
Drug test def 8-14 classes |
32 |
27 |
$4K |
| 87430 |
|
230 |
223 |
$4K |
| J7999 |
Compounded drug, noc |
100 |
73 |
$4K |
| J2060 |
Lorazepam injection |
68 |
24 |
$4K |
| 84460 |
|
2,351 |
2,109 |
$4K |
| 94060 |
|
15 |
15 |
$4K |
| J1453 |
Fosaprepitant injection |
43 |
24 |
$3K |
| 82951 |
|
216 |
200 |
$3K |
| 99281 |
|
52 |
52 |
$3K |
| 11982 |
|
12 |
12 |
$3K |
| J7298 |
Mirena, 52 mg |
13 |
13 |
$3K |
| 84156 |
|
2,261 |
1,854 |
$3K |
| 86364 |
|
819 |
783 |
$3K |
| 93299 |
|
253 |
243 |
$3K |
| 93886 |
|
12 |
12 |
$3K |
| 87799 |
|
521 |
304 |
$3K |
| A9585 |
Gadobutrol injection |
73 |
68 |
$3K |
| 82103 |
|
142 |
135 |
$3K |
| 82104 |
|
127 |
120 |
$3K |
| 80055 |
|
121 |
118 |
$3K |
| 90620 |
|
75 |
71 |
$3K |
| 96415 |
|
338 |
235 |
$2K |
| 84403 |
|
254 |
243 |
$2K |
| 86160 |
|
72 |
67 |
$2K |
| 82677 |
|
117 |
113 |
$2K |
| 82947 |
|
415 |
371 |
$2K |
| 80081 |
|
16 |
16 |
$2K |
| 97110 |
|
69 |
27 |
$2K |
| J1756 |
Iron sucrose injection |
34 |
13 |
$2K |
| 87641 |
|
53 |
50 |
$2K |
| 0052A |
|
35 |
33 |
$2K |
| 83993 |
|
68 |
66 |
$2K |
| 85014 |
|
2,265 |
1,938 |
$2K |
| 51798 |
|
174 |
155 |
$2K |
| 84154 |
|
155 |
129 |
$2K |
| 97167 |
|
14 |
14 |
$2K |
| 0054A |
|
29 |
29 |
$2K |
| C1726 |
Cath, bal dil, non-vascular |
14 |
12 |
$2K |
| 72125 |
|
16 |
13 |
$2K |
| 74230 |
|
12 |
12 |
$2K |
| 86336 |
|
117 |
113 |
$2K |
| 99391 |
|
82 |
52 |
$2K |
| 86258 |
|
36 |
32 |
$1K |
| 96376 |
|
1,078 |
694 |
$1K |
| 86334 |
|
97 |
88 |
$1K |
| 87808 |
|
136 |
133 |
$1K |
| 99392 |
|
68 |
51 |
$1K |
| 83521 |
|
115 |
100 |
$1K |
| 0352U |
|
34 |
34 |
$1K |
| 58301 |
|
13 |
13 |
$1K |
| 86317 |
|
39 |
35 |
$1K |
| 90480 |
|
63 |
53 |
$1K |
| 86231 |
|
36 |
32 |
$1K |
| 73552 |
|
28 |
26 |
$1K |
| 86704 |
|
100 |
94 |
$1K |
| J2272 |
Inj, morphine (fresenius) |
383 |
301 |
$1K |
| 86376 |
|
65 |
62 |
$1K |
| 91322 |
|
45 |
41 |
$1K |
| 99381 |
|
36 |
25 |
$999.73 |
| 58300 |
|
13 |
13 |
$998.09 |
| 92611 |
|
13 |
13 |
$949.16 |
| 82390 |
|
57 |
51 |
$926.30 |
| 84165 |
|
141 |
130 |
$908.10 |
| 84481 |
|
65 |
62 |
$899.31 |
| 93306 |
|
29 |
28 |
$895.88 |
| 96156 |
|
15 |
14 |
$881.20 |
| 64415 |
|
13 |
13 |
$862.34 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
164 |
146 |
$857.34 |
| 11981 |
|
14 |
14 |
$852.39 |
| 83550 |
|
227 |
206 |
$806.94 |
| 84425 |
|
27 |
26 |
$800.12 |
| 72081 |
|
16 |
16 |
$799.87 |
| 85730 |
|
929 |
734 |
$774.81 |
| 97161 |
|
17 |
16 |
$771.30 |
| 86696 |
|
47 |
42 |
$757.28 |
| 83520 |
|
53 |
53 |
$743.65 |
| 87088 |
|
1,132 |
1,069 |
$740.52 |
| 85240 |
|
29 |
29 |
$736.23 |
| 87497 |
|
318 |
156 |
$718.72 |
| 93297 |
|
99 |
94 |
$703.57 |
| 85347 |
|
69 |
51 |
$697.64 |
| 83002 |
|
44 |
40 |
$692.73 |
| 82533 |
|
28 |
24 |
$668.67 |
| 72170 |
|
13 |
13 |
$656.89 |
| 88184 |
|
13 |
12 |
$648.42 |
| 83718 |
|
47 |
46 |
$622.38 |
| 73630 |
|
14 |
12 |
$610.09 |
| 82627 |
|
15 |
12 |
$597.99 |
| A9552 |
F18 fdg |
12 |
12 |
$584.13 |
| 76942 |
|
13 |
13 |
$570.60 |
| 84163 |
|
67 |
64 |
$567.15 |
| 86706 |
|
220 |
192 |
$557.49 |
| 86769 |
|
16 |
15 |
$551.47 |
| 86225 |
|
27 |
25 |
$549.18 |
| 87276 |
|
39 |
39 |
$542.64 |
| 99396 |
|
14 |
12 |
$519.22 |
| 87275 |
|
37 |
37 |
$514.08 |
| 82952 |
|
123 |
117 |
$509.92 |
| 84590 |
|
25 |
25 |
$482.25 |
| J1040 |
Methylprednisolone 80 mg inj |
139 |
125 |
$463.42 |
| 84478 |
|
47 |
46 |
$436.89 |
| J0612 |
Inj, calcium gluconate, nos |
30 |
26 |
$431.47 |
| 82465 |
|
77 |
77 |
$430.57 |
| 86664 |
|
39 |
36 |
$428.65 |
| 83631 |
|
15 |
14 |
$426.08 |
| 86695 |
|
31 |
26 |
$419.04 |
| C1780 |
Lens, intraocular (new tech) |
14 |
14 |
$418.59 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
165 |
146 |
$413.48 |
| A6197 |
Alginate drsg >16 <=48 sq in |
145 |
63 |
$413.39 |
| 86431 |
|
106 |
100 |
$395.72 |
| 84550 |
|
388 |
308 |
$380.57 |
| J0670 |
Inj mepivacaine hcl/10 ml |
419 |
348 |
$373.86 |
| 94761 |
|
62 |
60 |
$373.03 |
| 84446 |
|
13 |
13 |
$328.63 |
| 96110 |
|
152 |
106 |
$324.48 |
| 84402 |
|
15 |
13 |
$317.20 |
| J1030 |
Methylprednisolone 40 mg inj |
92 |
84 |
$297.33 |
| 82397 |
|
13 |
12 |
$295.47 |
| 87206 |
|
109 |
103 |
$237.12 |
| 96161 |
|
144 |
104 |
$233.82 |
| J7307 |
Etonogestrel implant system |
16 |
16 |
$230.80 |
| 82525 |
|
12 |
12 |
$228.54 |
| 84630 |
|
12 |
12 |
$209.76 |
| 86702 |
|
16 |
12 |
$208.89 |
| 82247 |
|
34 |
31 |
$195.34 |
| 86255 |
|
37 |
37 |
$195.13 |
| 82378 |
|
17 |
13 |
$189.12 |
| J0688 |
Inj cefazolin sodium, hikma |
69 |
61 |
$187.59 |
| J3420 |
Vitamin b12 injection |
93 |
80 |
$175.28 |
| 88307 |
|
12 |
12 |
$168.75 |
| J2001 |
Lidocaine injection |
320 |
286 |
$168.70 |
| 86701 |
|
16 |
12 |
$157.73 |
| 86663 |
|
26 |
24 |
$147.06 |
| 87046 |
|
13 |
13 |
$141.00 |
| 87045 |
|
13 |
13 |
$141.00 |
| 84480 |
|
15 |
15 |
$140.56 |
| A6456 |
Zinc paste band w >=3"<5"/yd |
34 |
12 |
$138.53 |
| 83883 |
|
57 |
24 |
$135.52 |
| 88304 |
|
13 |
12 |
$132.42 |
| 82985 |
|
14 |
14 |
$131.93 |
| 81015 |
|
14 |
14 |
$126.26 |
| 90732 |
|
12 |
12 |
$122.30 |
| 86015 |
|
13 |
13 |
$96.97 |
| J2765 |
Metoclopramide hcl injection |
28 |
25 |
$83.08 |
| 86593 |
|
15 |
12 |
$82.58 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
69 |
56 |
$82.48 |
| 82140 |
|
15 |
12 |
$72.88 |
| G0008 |
Admin influenza virus vac |
242 |
188 |
$68.87 |
| 82272 |
|
14 |
13 |
$66.25 |
| 82042 |
|
15 |
15 |
$48.98 |
| 82270 |
|
13 |
13 |
$48.60 |
| J2550 |
Promethazine hcl injection |
18 |
13 |
$47.51 |
| J0171 |
Adrenalin epinephrine inject |
14 |
14 |
$39.88 |
| 71260 |
|
45 |
43 |
$35.59 |
| 96160 |
|
14 |
13 |
$30.85 |
| 82805 |
|
16 |
12 |
$24.00 |
| 91307 |
|
177 |
170 |
$15.35 |
| 83068 |
|
29 |
25 |
$14.90 |
| 90662 |
|
46 |
41 |
$14.58 |
| 99173 |
|
71 |
56 |
$12.55 |
| 92551 |
|
62 |
47 |
$11.50 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
91 |
60 |
$0.00 |
| 91301 |
|
790 |
766 |
$0.00 |
| 90680 |
|
13 |
13 |
$0.00 |
| 90474 |
|
13 |
13 |
$0.00 |
| 90723 |
|
33 |
27 |
$0.00 |
| 90647 |
|
24 |
17 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
26 |
25 |
$0.00 |
| 91303 |
|
586 |
569 |
$0.00 |
| A0428 |
Bls |
40 |
20 |
$0.00 |
| A0426 |
Als 1 |
26 |
16 |
$0.00 |
| 71275 |
|
14 |
12 |
$0.00 |
| 86705 |
|
14 |
14 |
$0.00 |
| 91300 |
|
3,687 |
3,441 |
$0.00 |
| 76937 |
|
40 |
37 |
$0.00 |
| G0479 |
Drug test presump not opt |
20 |
19 |
$0.00 |
| 81329 |
|
54 |
53 |
$0.00 |
| A0425 |
Ground mileage |
147 |
80 |
$0.00 |
| 90648 |
|
17 |
17 |
$0.00 |
| 90685 |
|
15 |
15 |
$0.00 |
| 91312 |
|
150 |
132 |
$0.00 |
| 90670 |
|
76 |
61 |
$0.00 |
| 86665 |
|
13 |
12 |
$0.00 |
| 86008 |
|
12 |
12 |
$0.00 |
| 90750 |
|
14 |
12 |
$0.00 |
| 96417 |
|
20 |
12 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
16 |
12 |
$0.00 |
| 90710 |
|
15 |
12 |
$0.00 |
| 93975 |
|
13 |
12 |
$0.00 |