| Code | Description | Claims | Beneficiaries | Total Paid |
| 99283 |
|
112,485 |
100,739 |
$16.19M |
| 0450 |
|
86,519 |
76,827 |
$3.95M |
| 74177 |
|
13,974 |
13,464 |
$2.52M |
| 87636 |
|
26,272 |
25,334 |
$2.15M |
| 99284 |
|
7,301 |
6,867 |
$2.10M |
| G0378 |
Hospital observation per hr |
6,192 |
3,710 |
$1.70M |
| 70450 |
|
16,095 |
15,410 |
$1.52M |
| 99291 |
|
4,492 |
4,333 |
$1.33M |
| 99282 |
|
7,336 |
6,963 |
$1.29M |
| 80051 |
|
165,918 |
140,663 |
$1.00M |
| 85025 |
|
141,261 |
121,846 |
$999K |
| 74176 |
|
7,690 |
7,452 |
$728K |
| 96374 |
|
22,562 |
20,483 |
$689K |
| 82565 |
|
182,514 |
155,839 |
$675K |
| 80307 |
|
15,599 |
13,156 |
$589K |
| 71046 |
|
21,488 |
20,708 |
$560K |
| 76856 |
|
9,655 |
9,248 |
$539K |
| 84702 |
|
37,960 |
33,749 |
$539K |
| 76830 |
|
8,805 |
8,433 |
$494K |
| 87591 |
|
17,820 |
16,297 |
$471K |
| 87491 |
|
17,806 |
16,286 |
$471K |
| 87633 |
|
2,782 |
2,738 |
$470K |
| 84520 |
|
132,347 |
113,075 |
$469K |
| 70551 |
|
2,676 |
2,587 |
$454K |
| 82947 |
|
122,550 |
109,100 |
$448K |
| 84460 |
|
107,519 |
96,797 |
$439K |
| 86900 |
|
15,357 |
14,195 |
$437K |
| 84484 |
|
41,440 |
30,010 |
$418K |
| 71045 |
|
24,931 |
23,324 |
$416K |
| 96375 |
|
15,874 |
14,494 |
$387K |
| 76705 |
|
7,683 |
7,382 |
$367K |
| 84075 |
|
76,510 |
68,851 |
$354K |
| 82247 |
|
81,611 |
72,345 |
$351K |
| 84443 |
|
40,375 |
38,084 |
$342K |
| 83690 |
|
48,925 |
45,185 |
$339K |
| 86885 |
|
9,723 |
9,207 |
$331K |
| 78815 |
|
458 |
454 |
$312K |
| 84450 |
|
65,958 |
59,695 |
$311K |
| 72125 |
|
2,034 |
1,978 |
$286K |
| 93971 |
|
2,780 |
2,591 |
$273K |
| 71275 |
|
1,967 |
1,934 |
$271K |
| 83036 |
|
54,399 |
51,635 |
$257K |
| 83880 |
|
15,026 |
14,132 |
$246K |
| 73630 |
|
7,458 |
7,016 |
$232K |
| 76805 |
|
3,504 |
3,378 |
$228K |
| 80061 |
|
33,140 |
31,542 |
$226K |
| 87040 |
|
21,453 |
10,972 |
$223K |
| 71260 |
|
1,932 |
1,897 |
$218K |
| J0131 |
Inj, acetaminophen (nos) |
12,151 |
11,340 |
$216K |
| 96365 |
|
5,121 |
4,816 |
$198K |
| 93005 |
|
11,472 |
10,814 |
$196K |
| 72148 |
|
1,446 |
1,407 |
$195K |
| 70553 |
|
807 |
792 |
$194K |
| 87505 |
|
2,626 |
2,573 |
$181K |
| 76801 |
|
3,455 |
3,120 |
$181K |
| 85027 |
|
60,605 |
54,567 |
$178K |
| 77067 |
|
2,600 |
2,600 |
$177K |
| U0003 |
Cov-19 amp prb hgh thruput |
2,630 |
2,556 |
$175K |
| 70486 |
|
1,648 |
1,597 |
$167K |
| 86901 |
|
15,375 |
14,209 |
$165K |
| 82306 |
|
11,990 |
11,297 |
$162K |
| 81003 |
|
84,611 |
78,335 |
$161K |
| 82077 |
|
7,723 |
6,667 |
$160K |
| 83605 |
|
14,140 |
10,838 |
$159K |
| 87389 |
|
10,652 |
10,175 |
$155K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
20,874 |
19,896 |
$152K |
| 73610 |
|
4,821 |
4,560 |
$145K |
| 73562 |
|
4,690 |
4,396 |
$138K |
| 81513 |
|
2,072 |
2,039 |
$136K |
| 71250 |
|
1,609 |
1,588 |
$136K |
| 73721 |
|
885 |
854 |
$133K |
| 87088 |
|
29,630 |
28,026 |
$132K |
| 72100 |
|
3,062 |
3,014 |
$128K |
| 73030 |
|
4,351 |
4,032 |
$126K |
| 73130 |
|
4,112 |
3,857 |
$121K |
| 86780 |
|
14,104 |
13,545 |
$121K |
| 93970 |
|
723 |
715 |
$118K |
| 83735 |
|
25,312 |
21,672 |
$117K |
| 96372 |
|
7,796 |
7,363 |
$115K |
| 80179 |
|
4,914 |
4,583 |
$114K |
| 72141 |
|
762 |
751 |
$113K |
| 90686 |
|
7,871 |
7,785 |
$112K |
| 99499 |
|
1,040 |
955 |
$111K |
| 76817 |
|
2,058 |
1,893 |
$107K |
| 76770 |
|
2,193 |
2,121 |
$101K |
| 82310 |
|
30,768 |
27,907 |
$99K |
| J7030 |
Normal saline solution infus |
45,942 |
38,118 |
$99K |
| 87637 |
|
1,427 |
1,408 |
$94K |
| 96361 |
|
5,004 |
4,847 |
$94K |
| 86803 |
|
10,098 |
9,765 |
$93K |
| 86923 |
|
694 |
642 |
$90K |
| 74018 |
|
2,742 |
2,618 |
$87K |
| 76536 |
|
1,810 |
1,758 |
$87K |
| 76816 |
|
1,235 |
1,177 |
$85K |
| 85610 |
|
38,121 |
31,217 |
$84K |
| 73110 |
|
2,937 |
2,778 |
$83K |
| 76870 |
|
1,500 |
1,449 |
$82K |
| 82248 |
|
16,218 |
15,271 |
$77K |
| 78452 |
|
212 |
211 |
$77K |
| 82728 |
|
10,891 |
10,261 |
$74K |
| 76700 |
|
1,556 |
1,495 |
$73K |
| 96360 |
|
2,158 |
2,112 |
$72K |
| 86141 |
|
9,665 |
9,181 |
$71K |
| 70491 |
|
456 |
451 |
$68K |
| 87340 |
|
10,586 |
10,159 |
$66K |
| 87481 |
|
2,155 |
2,120 |
$65K |
| 70496 |
|
498 |
492 |
$64K |
| 83970 |
|
5,143 |
4,835 |
$63K |
| P9021 |
Red blood cells unit |
663 |
553 |
$63K |
| 87661 |
|
2,073 |
2,040 |
$62K |
| 88305 |
|
4,010 |
2,790 |
$61K |
| 86480 |
|
1,601 |
1,576 |
$60K |
| 76881 |
|
851 |
838 |
$57K |
| 74022 |
|
1,388 |
1,342 |
$56K |
| 73080 |
|
1,936 |
1,813 |
$56K |
| 82607 |
|
7,448 |
7,152 |
$55K |
| 73502 |
|
1,928 |
1,832 |
$54K |
| 76815 |
|
854 |
817 |
$51K |
| 80306 |
|
4,369 |
4,158 |
$48K |
| 85379 |
|
5,367 |
5,167 |
$48K |
| 86003 |
|
1,704 |
1,383 |
$47K |
| 77080 |
|
2,276 |
2,255 |
$44K |
| 73590 |
|
1,708 |
1,592 |
$43K |
| 72040 |
|
1,349 |
1,320 |
$42K |
| 83550 |
|
10,852 |
10,219 |
$42K |
| 87502 |
|
984 |
970 |
$41K |
| 84439 |
|
8,304 |
7,767 |
$40K |
| 93306 |
|
632 |
626 |
$38K |
| 73140 |
|
1,491 |
1,405 |
$38K |
| 73090 |
|
1,710 |
1,573 |
$37K |
| 70498 |
|
420 |
417 |
$37K |
| 84403 |
|
2,515 |
2,413 |
$37K |
| 82805 |
|
944 |
860 |
$33K |
| 72131 |
|
322 |
314 |
$31K |
| 86762 |
|
3,464 |
3,314 |
$31K |
| 85730 |
|
6,935 |
6,192 |
$31K |
| 83540 |
|
11,095 |
10,431 |
$31K |
| 94640 |
|
1,499 |
1,114 |
$30K |
| 82746 |
|
4,221 |
4,092 |
$29K |
| 86787 |
|
3,580 |
3,426 |
$29K |
| 96366 |
|
849 |
820 |
$29K |
| 82570 |
|
10,689 |
9,454 |
$29K |
| J2270 |
Morphine sulfate injection |
11,003 |
9,415 |
$29K |
| 82550 |
|
4,441 |
3,984 |
$28K |
| 74174 |
|
134 |
132 |
$27K |
| A9585 |
Gadobutrol injection |
1,038 |
1,001 |
$27K |
| 82043 |
|
11,917 |
11,542 |
$27K |
| 96367 |
|
773 |
737 |
$27K |
| 80076 |
|
4,412 |
4,185 |
$27K |
| 84146 |
|
2,105 |
2,003 |
$27K |
| 84100 |
|
13,529 |
11,809 |
$27K |
| 87635 |
|
712 |
679 |
$26K |
| 87081 |
|
4,538 |
4,414 |
$26K |
| 76641 |
|
342 |
334 |
$26K |
| 87186 |
|
2,981 |
2,926 |
$25K |
| 87210 |
|
8,417 |
7,768 |
$25K |
| 83001 |
|
2,046 |
1,951 |
$25K |
| 83655 |
|
5,137 |
4,547 |
$25K |
| A9552 |
F18 fdg |
307 |
303 |
$24K |
| J3490 |
Drugs unclassified injection |
6,590 |
5,323 |
$24K |
| 82040 |
|
11,580 |
10,715 |
$24K |
| 93017 |
|
187 |
183 |
$23K |
| J0696 |
Ceftriaxone sodium injection |
12,850 |
10,961 |
$22K |
| 0637 |
|
63,912 |
19,912 |
$21K |
| 87449 |
|
3,344 |
2,637 |
$20K |
| 83520 |
|
3,424 |
2,109 |
$20K |
| 86317 |
|
2,289 |
2,202 |
$19K |
| 71101 |
|
378 |
371 |
$19K |
| 90674 |
|
764 |
730 |
$18K |
| J7120 |
Ringers lactate infusion |
5,230 |
4,632 |
$18K |
| 84156 |
|
9,736 |
8,695 |
$18K |
| 88173 |
|
408 |
406 |
$18K |
| 77066 |
Tomosynthesis, mammo |
173 |
173 |
$18K |
| 82950 |
|
6,259 |
6,044 |
$18K |
| 83615 |
|
5,024 |
4,523 |
$18K |
| 82670 |
|
852 |
822 |
$18K |
| 82105 |
|
2,114 |
2,047 |
$17K |
| Z7502 |
|
690 |
665 |
$17K |
| J1885 |
Ketorolac tromethamine inj |
21,364 |
17,987 |
$17K |
| 81220 |
|
266 |
260 |
$17K |
| 72070 |
|
307 |
307 |
$17K |
| 87536 |
|
525 |
470 |
$16K |
| 73700 |
|
167 |
160 |
$16K |
| 85652 |
|
10,647 |
9,866 |
$16K |
| 86665 |
|
1,569 |
738 |
$16K |
| 99238 |
|
1,078 |
1,067 |
$16K |
| 82951 |
|
1,851 |
1,783 |
$16K |
| 84153 |
|
2,705 |
2,574 |
$16K |
| 74220 |
|
189 |
189 |
$15K |
| 87804 |
|
2,400 |
1,164 |
$15K |
| 0710 |
|
1,055 |
1,042 |
$15K |
| 73060 |
|
676 |
650 |
$15K |
| 83002 |
|
1,140 |
1,106 |
$14K |
| 73560 |
|
692 |
630 |
$14K |
| 83021 |
|
1,551 |
1,470 |
$14K |
| 88342 |
|
338 |
331 |
$14K |
| 86704 |
|
2,121 |
2,038 |
$14K |
| 72081 |
|
402 |
371 |
$13K |
| 73564 |
|
212 |
205 |
$13K |
| 72050 |
|
201 |
201 |
$13K |
| 74178 |
|
58 |
58 |
$13K |
| 83721 |
|
2,467 |
2,309 |
$13K |
| 73552 |
|
603 |
575 |
$13K |
| 87205 |
|
3,960 |
3,322 |
$13K |
| 87497 |
|
524 |
452 |
$12K |
| 12001 |
|
1,002 |
982 |
$12K |
| 74170 |
|
86 |
85 |
$12K |
| 86765 |
|
1,324 |
1,293 |
$12K |
| 84132 |
|
5,411 |
4,853 |
$12K |
| 86038 |
|
1,939 |
1,857 |
$12K |
| J1170 |
Hydromorphone injection |
4,411 |
3,463 |
$12K |
| 90715 |
|
416 |
394 |
$12K |
| J1815 |
Insulin injection |
5,791 |
2,844 |
$12K |
| 73660 |
|
358 |
347 |
$11K |
| 82140 |
|
978 |
872 |
$11K |
| 84480 |
|
1,670 |
1,586 |
$11K |
| 87324 |
|
1,944 |
1,907 |
$11K |
| J2930 |
Methylprednisolone injection |
2,879 |
2,597 |
$11K |
| 87624 |
|
488 |
480 |
$11K |
| 82784 |
|
1,523 |
1,415 |
$11K |
| 82962 |
|
3,007 |
2,118 |
$11K |
| 83993 |
|
702 |
699 |
$10K |
| 87631 |
|
315 |
314 |
$10K |
| 90791 |
|
259 |
252 |
$10K |
| 82627 |
|
587 |
566 |
$10K |
| J2405 |
Ondansetron hcl injection |
24,673 |
22,003 |
$10K |
| J2272 |
Inj, morphine (fresenius) |
1,521 |
1,346 |
$9K |
| J1953 |
Levetiracetam injection |
1,347 |
1,144 |
$9K |
| 84550 |
|
4,461 |
4,159 |
$9K |
| 83718 |
|
2,212 |
2,075 |
$9K |
| 80164 |
|
851 |
766 |
$8K |
| 73221 |
|
66 |
64 |
$8K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
914 |
744 |
$8K |
| 86225 |
|
980 |
945 |
$8K |
| 97161 |
|
658 |
637 |
$8K |
| 93880 |
|
70 |
69 |
$8K |
| J1100 |
Dexamethasone sodium phos |
6,801 |
6,245 |
$8K |
| 74240 |
|
66 |
65 |
$7K |
| 84134 |
|
1,308 |
1,214 |
$7K |
| A9500 |
Tc99m sestamibi |
155 |
154 |
$7K |
| 99281 |
|
68 |
68 |
$7K |
| 80197 |
|
1,343 |
1,113 |
$7K |
| 86664 |
|
786 |
738 |
$7K |
| 84295 |
|
2,842 |
2,647 |
$7K |
| A9609 |
F18 fdg, 15 millicuries |
135 |
134 |
$7K |
| 82465 |
|
2,930 |
2,746 |
$6K |
| 77072 |
|
68 |
68 |
$6K |
| Q0144 |
Azithromycin dihydrate, oral |
1,249 |
1,145 |
$6K |
| 73100 |
|
185 |
172 |
$6K |
| 72146 |
|
38 |
38 |
$6K |
| 86364 |
|
556 |
545 |
$6K |
| 73522 |
|
107 |
106 |
$6K |
| J0690 |
Cefazolin sodium injection |
1,796 |
1,639 |
$6K |
| S0164 |
Injection pantroprazole |
681 |
535 |
$6K |
| 72170 |
|
250 |
245 |
$5K |
| 88341 |
|
122 |
121 |
$5K |
| 84165 |
|
1,494 |
1,434 |
$5K |
| 74183 |
|
27 |
27 |
$5K |
| 82952 |
|
1,836 |
1,768 |
$5K |
| 74181 |
|
25 |
25 |
$5K |
| 80321 |
|
120 |
111 |
$5K |
| 81015 |
|
2,153 |
2,092 |
$5K |
| 84270 |
|
254 |
253 |
$5K |
| G0008 |
Admin influenza virus vac |
2,439 |
2,423 |
$5K |
| 87070 |
|
741 |
665 |
$5K |
| J3475 |
Inj magnesium sulfate |
2,644 |
2,397 |
$4K |
| J2060 |
Lorazepam injection |
5,207 |
4,368 |
$4K |
| 90656 |
|
522 |
522 |
$4K |
| 12011 |
|
255 |
243 |
$4K |
| J2765 |
Metoclopramide hcl injection |
4,894 |
4,481 |
$4K |
| 0258 |
|
1,552 |
1,411 |
$4K |
| 10060 |
|
284 |
277 |
$4K |
| 83525 |
|
403 |
403 |
$4K |
| 86431 |
|
1,157 |
1,090 |
$4K |
| J1200 |
Diphenhydramine hcl injectio |
5,344 |
4,875 |
$4K |
| J3370 |
Vancomycin hcl injection |
532 |
406 |
$4K |
| 82533 |
|
328 |
317 |
$4K |
| J2543 |
Piperacillin/tazobactam |
1,165 |
948 |
$4K |
| 86360 |
|
374 |
306 |
$4K |
| 76380 |
|
72 |
72 |
$3K |
| 86769 |
|
202 |
202 |
$3K |
| A0429 |
Bls-emergency |
740 |
459 |
$3K |
| 66984 |
|
282 |
264 |
$3K |
| J0780 |
Prochlorperazine injection |
1,381 |
1,333 |
$3K |
| 85046 |
|
1,138 |
1,034 |
$3K |
| 82150 |
|
894 |
831 |
$3K |
| 90662 |
|
346 |
344 |
$3K |
| 70544 |
|
13 |
12 |
$3K |
| 84155 |
|
1,095 |
1,040 |
$3K |
| 29125 |
|
518 |
499 |
$3K |
| 86709 |
|
370 |
367 |
$3K |
| J0360 |
Hydralazine hcl injection |
945 |
820 |
$3K |
| J3010 |
Fentanyl citrate injection |
3,002 |
2,810 |
$3K |
| 0250 |
|
8,054 |
4,742 |
$3K |
| 86359 |
|
374 |
306 |
$3K |
| 87149 |
|
312 |
304 |
$3K |
| 82977 |
|
497 |
482 |
$3K |
| 86308 |
|
700 |
664 |
$3K |
| 86735 |
|
396 |
372 |
$3K |
| 90471 |
|
1,374 |
1,368 |
$2K |
| 85014 |
|
2,788 |
2,567 |
$2K |
| J0561 |
Penicillin g benzathine inj |
12 |
12 |
$2K |
| 81329 |
|
24 |
24 |
$2K |
| 86300 |
|
215 |
202 |
$2K |
| 0255 |
|
466 |
279 |
$2K |
| J1650 |
Inj enoxaparin sodium |
2,134 |
1,196 |
$2K |
| 82378 |
|
223 |
214 |
$2K |
| J1644 |
Inj heparin sodium per 1000u |
3,026 |
1,463 |
$2K |
| J2785 |
Regadenoson injection |
28 |
28 |
$2K |
| 85018 |
|
1,736 |
1,661 |
$2K |
| 90688 |
|
169 |
169 |
$2K |
| J3480 |
Inj potassium chloride |
2,479 |
1,726 |
$2K |
| 74019 |
|
108 |
105 |
$2K |
| J0456 |
Azithromycin |
1,476 |
1,132 |
$2K |
| 29515 |
|
364 |
355 |
$2K |
| J7060 |
5% dextrose/water |
954 |
700 |
$2K |
| 86677 |
|
882 |
775 |
$2K |
| 80359 |
|
31 |
28 |
$2K |
| 86870 |
|
14 |
13 |
$2K |
| 84478 |
|
412 |
368 |
$2K |
| 80324 |
|
32 |
29 |
$2K |
| 99199 |
|
140 |
137 |
$2K |
| 82272 |
|
496 |
492 |
$1K |
| 86696 |
|
117 |
107 |
$1K |
| 77065 |
Tomosynthesis, mammo |
17 |
16 |
$1K |
| J1940 |
Furosemide injection |
2,483 |
1,587 |
$1K |
| J1630 |
Haloperidol injection |
1,291 |
1,084 |
$1K |
| 70360 |
|
52 |
51 |
$1K |
| 86301 |
|
123 |
118 |
$1K |
| 84145 |
|
127 |
123 |
$1K |
| J2250 |
Inj midazolam hydrochloride |
1,178 |
1,134 |
$1K |
| 87807 |
|
251 |
248 |
$1K |
| 86140 |
|
1,476 |
1,155 |
$1K |
| 86160 |
|
192 |
164 |
$1K |
| 86635 |
|
157 |
79 |
$1K |
| 82390 |
|
170 |
169 |
$1K |
| 86708 |
|
158 |
158 |
$1K |
| 73120 |
|
40 |
39 |
$1K |
| 85045 |
|
440 |
414 |
$1K |
| 72082 |
|
12 |
12 |
$1K |
| 90935 |
|
33 |
25 |
$1K |
| 86695 |
|
117 |
107 |
$1K |
| J3371 |
Inj, vancomycin hcl (mylan) |
108 |
77 |
$1K |
| 12002 |
|
100 |
95 |
$1K |
| 82330 |
|
146 |
143 |
$978.40 |
| 82677 |
|
39 |
39 |
$963.00 |
| 87522 |
Neg quan hep c or qual rna |
87 |
86 |
$962.52 |
| 88312 |
|
65 |
65 |
$929.41 |
| 84425 |
|
76 |
68 |
$911.00 |
| 88304 |
|
313 |
291 |
$899.84 |
| J3411 |
Thiamine hcl 100 mg |
445 |
370 |
$886.75 |
| 99217 |
|
145 |
145 |
$842.70 |
| J2919 |
Inj, methylpred sod succ 5mg |
473 |
313 |
$836.06 |
| 86880 |
|
62 |
61 |
$825.43 |
| 89051 |
|
182 |
133 |
$808.50 |
| S0119 |
Ondansetron 4 mg |
1,550 |
1,502 |
$770.56 |
| 83930 |
|
208 |
197 |
$713.98 |
| 86256 |
|
52 |
52 |
$662.62 |
| J2550 |
Promethazine hcl injection |
313 |
289 |
$638.73 |
| 82103 |
|
66 |
66 |
$619.06 |
| 86336 |
|
39 |
39 |
$580.00 |
| 86376 |
|
171 |
171 |
$559.35 |
| J7512 |
Prednisone ir or dr oral 1mg |
1,592 |
1,359 |
$551.02 |
| 84163 |
|
88 |
76 |
$542.86 |
| 86334 |
|
67 |
65 |
$539.74 |
| 80178 |
|
165 |
155 |
$518.52 |
| 73070 |
|
16 |
14 |
$499.42 |
| 92610 |
|
70 |
66 |
$483.79 |
| 80185 |
|
45 |
39 |
$441.29 |
| 87426 |
|
51 |
50 |
$422.55 |
| 72072 |
|
14 |
14 |
$382.56 |
| J7510 |
Prednisolone oral per 5 mg |
487 |
472 |
$320.07 |
| J1836 |
Inj, metronidazole, 10 mg |
517 |
321 |
$307.47 |
| 83935 |
|
110 |
106 |
$299.90 |
| 85246 |
|
13 |
13 |
$275.00 |
| 85245 |
|
13 |
13 |
$255.00 |
| J7042 |
5% dextrose/normal saline |
159 |
112 |
$227.81 |
| 82024 |
|
14 |
13 |
$212.66 |
| J2001 |
Lidocaine injection |
866 |
843 |
$210.62 |
| J2470 |
Inj pantoprazole sodium 40mg |
146 |
90 |
$207.96 |
| 82705 |
|
52 |
52 |
$204.00 |
| C9113 |
Inj pantoprazole sodium, via |
232 |
168 |
$202.52 |
| 86304 |
|
12 |
12 |
$169.00 |
| S0077 |
Injection, clindamycin phosp |
43 |
40 |
$159.43 |
| 0370 |
|
1,104 |
1,086 |
$146.17 |
| 85384 |
|
25 |
14 |
$140.04 |
| G0480 |
Drug test def 1-7 classes |
120 |
118 |
$127.90 |
| J0737 |
Inj, clindamycin (baxter) |
34 |
28 |
$122.45 |
| 85613 |
|
27 |
25 |
$115.00 |
| C1769 |
Guide wire |
161 |
156 |
$106.95 |
| J3360 |
Diazepam injection |
13 |
13 |
$104.64 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
53 |
42 |
$98.92 |
| 29130 |
|
14 |
14 |
$78.00 |
| 87185 |
|
53 |
52 |
$64.41 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
114 |
68 |
$40.05 |
| J0744 |
Ciprofloxacin iv |
29 |
26 |
$38.22 |
| J1920 |
Inj, labetalol hcl, 5mg |
84 |
62 |
$34.36 |
| J2920 |
Methylprednisolone injection |
52 |
28 |
$30.36 |
| J0610 |
Calcium glucon (fresenius) |
18 |
18 |
$24.78 |
| J2175 |
Meperidine hydrochl /100 mg |
12 |
12 |
$23.60 |
| 90749 |
|
26 |
26 |
$23.17 |
| J8540 |
Oral dexamethasone |
19 |
13 |
$20.64 |
| 87045 |
|
31 |
15 |
$17.80 |
| 82945 |
|
12 |
12 |
$13.16 |
| 88307 |
|
31 |
29 |
$12.57 |
| 87046 |
|
33 |
16 |
$7.83 |
| J0171 |
Adrenalin epinephrine inject |
14 |
12 |
$7.47 |
| 3052F |
|
265 |
262 |
$0.01 |
| 3046F |
|
450 |
443 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
25 |
25 |
$0.00 |
| 3051F |
|
424 |
416 |
$0.00 |
| 0272 |
|
257 |
256 |
$0.00 |
| 87338 |
|
13 |
13 |
$0.00 |
| 3078F |
|
182 |
180 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
17 |
17 |
$0.00 |
| 82274 |
|
13 |
13 |
$0.00 |
| 0320 |
|
16 |
13 |
$0.00 |
| J2280 |
Inj, moxifloxacin 100 mg |
122 |
118 |
$0.00 |
| V2632 |
Post chmbr intraocular lens |
139 |
134 |
$0.00 |
| 3044F |
|
3,813 |
3,798 |
$0.00 |
| 3074F |
|
184 |
182 |
$0.00 |
| 0306 |
|
22 |
12 |
$0.00 |
| 90839 |
|
13 |
12 |
$0.00 |
| 80320 |
|
27 |
27 |
$0.00 |
| 0301 |
|
119 |
18 |
$0.00 |
| 80156 |
|
17 |
12 |
$0.00 |
| 99285 |
|
12 |
12 |
$0.00 |
| 0305 |
|
17 |
15 |
$0.00 |