| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
|
70,169 |
62,514 |
$8.78M |
| 99283 |
|
75,140 |
69,312 |
$8.62M |
| 99285 |
|
35,760 |
30,628 |
$4.84M |
| G0463 |
Hospital outpt clinic visit |
48,092 |
35,481 |
$3.88M |
| 97110 |
|
34,388 |
8,048 |
$2.47M |
| 70450 |
|
8,383 |
6,672 |
$2.09M |
| 99282 |
|
18,168 |
16,497 |
$1.86M |
| 74177 |
|
5,647 |
4,262 |
$1.29M |
| 96361 |
|
2,921 |
1,817 |
$937K |
| 96365 |
|
4,805 |
2,175 |
$935K |
| 80053 |
|
72,083 |
56,687 |
$779K |
| J9271 |
Inj pembrolizumab |
96 |
50 |
$680K |
| G0378 |
Hospital observation per hr |
8,172 |
3,107 |
$678K |
| 93306 |
|
2,667 |
2,119 |
$663K |
| 0202U |
|
4,010 |
3,174 |
$643K |
| 0241U |
|
6,128 |
4,870 |
$622K |
| 74176 |
|
2,098 |
1,575 |
$584K |
| 87491 |
|
13,897 |
11,918 |
$553K |
| 94640 |
|
3,590 |
2,575 |
$482K |
| 93458 |
|
377 |
262 |
$440K |
| 80048 |
|
48,518 |
38,628 |
$431K |
| 96366 |
|
1,597 |
758 |
$426K |
| 85025 |
|
132,940 |
104,146 |
$421K |
| 11042 |
|
4,099 |
1,893 |
$420K |
| 96367 |
|
2,769 |
1,183 |
$410K |
| 58661 |
|
265 |
118 |
$392K |
| 78452 |
|
901 |
686 |
$391K |
| 71275 |
|
1,334 |
1,014 |
$373K |
| 74160 |
|
1,111 |
819 |
$340K |
| 76856 |
|
1,935 |
1,538 |
$332K |
| 87591 |
|
13,762 |
11,788 |
$308K |
| 84443 |
|
16,653 |
14,199 |
$282K |
| 96413 |
|
4,539 |
2,045 |
$281K |
| 95810 |
|
440 |
364 |
$273K |
| 70553 |
|
967 |
810 |
$251K |
| 71260 |
|
1,543 |
1,275 |
$245K |
| 59025 |
|
1,384 |
900 |
$236K |
| 86592 |
|
8,088 |
7,112 |
$224K |
| 36415 |
|
170,975 |
131,223 |
$220K |
| 97140 |
|
8,110 |
2,452 |
$215K |
| 93976 |
|
1,516 |
1,134 |
$208K |
| 80061 |
|
14,746 |
12,943 |
$196K |
| 87086 |
|
17,352 |
13,735 |
$196K |
| 70491 |
|
661 |
473 |
$185K |
| J0897 |
Denosumab injection |
102 |
51 |
$184K |
| 86703 |
|
6,956 |
6,168 |
$172K |
| 96360 |
|
851 |
510 |
$162K |
| U0003 |
Cov-19 amp prb hgh thruput |
1,324 |
1,262 |
$155K |
| 62323 |
|
346 |
248 |
$151K |
| 76700 |
|
895 |
749 |
$139K |
| 86850 |
|
7,134 |
5,450 |
$139K |
| 97161 |
|
2,607 |
2,184 |
$133K |
| 82306 |
|
6,713 |
5,936 |
$130K |
| 71046 |
|
8,797 |
7,478 |
$130K |
| 86900 |
|
6,972 |
5,299 |
$128K |
| U0004 |
Cov-19 test non-cdc hgh thru |
911 |
836 |
$124K |
| 83036 |
|
9,764 |
8,504 |
$118K |
| 76705 |
|
1,259 |
983 |
$118K |
| 76805 |
|
1,531 |
1,352 |
$116K |
| 76642 |
|
1,081 |
918 |
$116K |
| 78815 |
|
222 |
173 |
$115K |
| 95811 |
|
195 |
160 |
$115K |
| 70496 |
|
439 |
319 |
$111K |
| 93798 |
|
1,898 |
256 |
$110K |
| 77063 |
|
2,455 |
2,072 |
$106K |
| 76770 |
|
735 |
612 |
$103K |
| 71271 |
|
650 |
558 |
$101K |
| 88305 |
|
3,941 |
2,882 |
$98K |
| 99291 |
|
747 |
509 |
$98K |
| 77336 |
|
767 |
277 |
$98K |
| 12001 |
|
624 |
533 |
$97K |
| 93017 |
|
1,055 |
827 |
$96K |
| 87081 |
|
4,000 |
3,550 |
$95K |
| 95886 |
|
411 |
222 |
$95K |
| C8929 |
Tte w or wo fol wcon,doppler |
561 |
494 |
$93K |
| 86803 |
|
4,953 |
4,334 |
$93K |
| 84484 |
|
23,004 |
18,288 |
$91K |
| 88175 |
|
4,967 |
4,406 |
$88K |
| 93971 |
|
1,192 |
953 |
$88K |
| 87340 |
|
4,706 |
4,123 |
$86K |
| 87624 |
|
2,743 |
2,322 |
$84K |
| 97162 |
|
1,761 |
1,463 |
$83K |
| 93005 |
|
43,111 |
36,330 |
$81K |
| 70551 |
|
502 |
376 |
$81K |
| 84439 |
|
4,233 |
3,586 |
$78K |
| 72148 |
|
441 |
375 |
$75K |
| 76801 |
|
1,464 |
1,101 |
$73K |
| 80307 |
|
4,558 |
3,510 |
$72K |
| 76817 |
|
2,271 |
1,825 |
$71K |
| 76536 |
|
728 |
635 |
$71K |
| 97035 |
|
1,338 |
436 |
$69K |
| 71250 |
|
738 |
645 |
$67K |
| 71045 |
|
23,943 |
20,218 |
$65K |
| 82607 |
|
3,779 |
3,202 |
$65K |
| 93970 |
|
522 |
415 |
$64K |
| 12011 |
|
431 |
359 |
$63K |
| 76937 |
|
4,267 |
2,757 |
$62K |
| 82728 |
|
4,562 |
3,779 |
$62K |
| 88307 |
|
688 |
382 |
$61K |
| 87480 |
|
5,059 |
4,070 |
$60K |
| 87660 |
|
5,066 |
4,077 |
$59K |
| 87653 |
|
2,049 |
1,661 |
$58K |
| 97165 |
|
922 |
713 |
$58K |
| 70498 |
|
602 |
442 |
$57K |
| 93975 |
|
427 |
342 |
$57K |
| 10060 |
|
354 |
287 |
$54K |
| 47562 |
|
25 |
14 |
$54K |
| 77386 |
|
152 |
12 |
$54K |
| 87633 |
|
406 |
390 |
$52K |
| 97113 |
|
825 |
201 |
$51K |
| 73562 |
|
2,115 |
1,562 |
$50K |
| J1756 |
Iron sucrose injection |
1,386 |
518 |
$48K |
| 11045 |
|
231 |
144 |
$47K |
| 86787 |
|
2,710 |
2,424 |
$47K |
| 12002 |
|
315 |
264 |
$47K |
| 96374 |
|
42,073 |
33,914 |
$47K |
| 86762 |
|
2,697 |
2,406 |
$46K |
| 76830 |
|
1,703 |
1,358 |
$46K |
| 87077 |
|
3,823 |
3,079 |
$45K |
| 97530 |
|
1,554 |
676 |
$45K |
| J3490 |
Drugs unclassified injection |
5,252 |
2,951 |
$43K |
| 94060 |
|
319 |
265 |
$43K |
| 52000 |
|
86 |
70 |
$42K |
| 73721 |
|
184 |
141 |
$41K |
| 80320 |
|
4,188 |
3,083 |
$41K |
| U0005 |
Infec agen detec ampli probe |
1,513 |
1,433 |
$41K |
| 84702 |
|
2,629 |
1,615 |
$40K |
| 97014 |
|
1,207 |
382 |
$40K |
| 72125 |
|
2,349 |
1,846 |
$38K |
| 73630 |
|
2,287 |
1,794 |
$38K |
| 73030 |
|
1,635 |
1,267 |
$36K |
| 87510 |
|
5,055 |
4,069 |
$36K |
| 83540 |
|
4,573 |
3,807 |
$36K |
| 76816 |
|
822 |
701 |
$35K |
| 96372 |
|
12,289 |
6,754 |
$35K |
| 81001 |
|
14,739 |
11,751 |
$34K |
| 82947 |
|
2,547 |
2,226 |
$34K |
| 72100 |
|
1,242 |
999 |
$33K |
| 83735 |
|
9,949 |
6,153 |
$30K |
| 82570 |
|
3,618 |
2,942 |
$30K |
| 97535 |
|
806 |
474 |
$28K |
| 73130 |
|
1,692 |
1,274 |
$28K |
| 77067 |
|
2,462 |
2,079 |
$27K |
| 76000 |
|
290 |
143 |
$27K |
| 73610 |
|
1,722 |
1,336 |
$27K |
| 77334 |
|
72 |
44 |
$27K |
| 70486 |
|
718 |
596 |
$27K |
| 83615 |
|
6,868 |
4,712 |
$26K |
| 94726 |
|
348 |
290 |
$26K |
| 94729 |
|
377 |
314 |
$26K |
| 74018 |
|
1,105 |
870 |
$25K |
| 80076 |
|
2,704 |
2,142 |
$24K |
| 97166 |
|
418 |
326 |
$24K |
| 86140 |
|
1,901 |
1,459 |
$24K |
| 83880 |
|
4,390 |
3,350 |
$23K |
| 86038 |
|
928 |
778 |
$23K |
| 81003 |
|
17,289 |
13,537 |
$22K |
| 77080 |
|
362 |
317 |
$22K |
| 77066 |
Tomosynthesis, mammo |
654 |
551 |
$22K |
| 76819 |
|
526 |
296 |
$22K |
| P9016 |
Rbc leukocytes reduced |
137 |
89 |
$21K |
| 97112 |
|
727 |
346 |
$21K |
| 72110 |
|
499 |
438 |
$21K |
| 84153 |
|
1,528 |
1,323 |
$20K |
| 83550 |
|
3,346 |
2,735 |
$20K |
| 99281 |
|
147 |
131 |
$19K |
| 97163 |
|
493 |
350 |
$19K |
| 11043 |
|
51 |
29 |
$19K |
| 93880 |
|
272 |
216 |
$19K |
| 77301 |
|
32 |
26 |
$18K |
| 90715 |
|
1,373 |
1,115 |
$18K |
| 72131 |
|
235 |
185 |
$18K |
| 73110 |
|
1,104 |
872 |
$18K |
| 85027 |
|
1,592 |
1,408 |
$17K |
| 73502 |
|
627 |
489 |
$17K |
| 72050 |
|
329 |
284 |
$17K |
| 96375 |
|
24,276 |
17,439 |
$17K |
| 87186 |
|
2,811 |
2,287 |
$16K |
| 87522 |
Neg quan hep c or qual rna |
474 |
417 |
$16K |
| 87651 |
|
3,632 |
2,833 |
$16K |
| 88341 |
|
239 |
145 |
$15K |
| 77065 |
Tomosynthesis, mammo |
429 |
347 |
$15K |
| 84481 |
|
1,503 |
1,227 |
$14K |
| 76811 |
|
327 |
310 |
$14K |
| J1453 |
Fosaprepitant injection |
952 |
414 |
$14K |
| 43239 |
|
30 |
12 |
$14K |
| 77300 |
|
35 |
28 |
$13K |
| 84146 |
|
581 |
507 |
$12K |
| 82043 |
|
2,021 |
1,780 |
$12K |
| 49083 |
|
33 |
12 |
$12K |
| 87070 |
|
1,299 |
1,040 |
$12K |
| 83970 |
|
540 |
475 |
$11K |
| 84436 |
|
681 |
573 |
$11K |
| 97116 |
|
352 |
151 |
$11K |
| 85610 |
|
8,234 |
4,697 |
$11K |
| 85652 |
|
2,620 |
1,906 |
$11K |
| 86706 |
|
670 |
584 |
$11K |
| 83690 |
|
11,323 |
8,966 |
$11K |
| 83516 |
|
422 |
356 |
$11K |
| J2469 |
Palonosetron hcl |
1,925 |
757 |
$11K |
| 84403 |
|
653 |
578 |
$10K |
| J7030 |
Normal saline solution infus |
39,610 |
31,476 |
$10K |
| 82951 |
|
440 |
367 |
$10K |
| 87536 |
|
293 |
256 |
$10K |
| 82746 |
|
1,480 |
1,220 |
$10K |
| G0279 |
Tomosynthesis, mammo |
867 |
734 |
$10K |
| 82670 |
|
401 |
343 |
$10K |
| 36430 |
|
71 |
42 |
$9K |
| 83001 |
|
480 |
418 |
$8K |
| 87502 |
|
1,060 |
848 |
$8K |
| 86901 |
|
2,856 |
2,127 |
$8K |
| 86480 |
|
230 |
201 |
$8K |
| 80069 |
|
583 |
504 |
$8K |
| 87661 |
|
384 |
332 |
$8K |
| 86431 |
|
524 |
456 |
$8K |
| 71100 |
|
383 |
285 |
$8K |
| 97167 |
|
111 |
88 |
$7K |
| 83655 |
|
303 |
263 |
$7K |
| 88342 |
|
647 |
475 |
$7K |
| 73503 |
|
488 |
361 |
$7K |
| 73080 |
|
574 |
459 |
$7K |
| 86359 |
|
196 |
165 |
$7K |
| 80074 |
|
654 |
508 |
$7K |
| 82550 |
|
2,065 |
1,456 |
$7K |
| 86704 |
|
500 |
434 |
$6K |
| 82565 |
|
928 |
739 |
$6K |
| 29580 |
|
64 |
24 |
$6K |
| 80329 |
|
3,596 |
2,635 |
$6K |
| 82784 |
|
529 |
440 |
$6K |
| 87493 |
|
210 |
158 |
$6K |
| 84156 |
|
1,607 |
1,175 |
$6K |
| 87205 |
|
1,384 |
1,098 |
$6K |
| 77338 |
|
31 |
25 |
$6K |
| 82952 |
|
381 |
315 |
$6K |
| 85007 |
|
1,544 |
1,130 |
$5K |
| J2791 |
Rhophylac injection |
79 |
45 |
$5K |
| 73590 |
|
555 |
432 |
$5K |
| 84480 |
|
485 |
406 |
$5K |
| 82533 |
|
665 |
410 |
$5K |
| J0131 |
Inj, acetaminophen (nos) |
475 |
226 |
$5K |
| J1815 |
Insulin injection |
1,130 |
491 |
$5K |
| 72170 |
|
685 |
539 |
$5K |
| 88142 |
|
372 |
358 |
$5K |
| 83020 |
|
216 |
174 |
$5K |
| 73560 |
|
380 |
271 |
$5K |
| 20553 |
|
27 |
15 |
$5K |
| 81025 |
|
20,372 |
16,810 |
$5K |
| 72070 |
|
212 |
175 |
$4K |
| 97164 |
|
140 |
99 |
$4K |
| 74183 |
|
14 |
12 |
$4K |
| 84550 |
|
630 |
539 |
$4K |
| 76870 |
|
347 |
272 |
$4K |
| 76981 |
|
43 |
39 |
$4K |
| 87040 |
|
2,134 |
1,473 |
$4K |
| 86360 |
|
196 |
165 |
$4K |
| 84100 |
|
1,182 |
676 |
$4K |
| 84450 |
|
488 |
415 |
$4K |
| 85379 |
|
3,026 |
2,252 |
$4K |
| 86355 |
|
196 |
165 |
$3K |
| 86357 |
|
196 |
165 |
$3K |
| 86880 |
|
245 |
167 |
$3K |
| J2272 |
Inj, morphine (fresenius) |
3,627 |
2,331 |
$3K |
| 99213 |
|
64 |
40 |
$3K |
| 86304 |
|
296 |
195 |
$3K |
| 74022 |
|
107 |
93 |
$3K |
| 72141 |
|
32 |
27 |
$3K |
| 96368 |
|
444 |
183 |
$3K |
| 82150 |
|
501 |
388 |
$3K |
| 87635 |
|
209 |
163 |
$3K |
| 78227 |
|
15 |
14 |
$3K |
| 93356 |
|
152 |
128 |
$3K |
| 87507 |
|
33 |
27 |
$3K |
| 72158 |
|
12 |
12 |
$3K |
| J7120 |
Ringers lactate infusion |
7,087 |
4,300 |
$3K |
| 96110 |
|
12 |
12 |
$3K |
| 51702 |
|
321 |
248 |
$3K |
| 93923 |
|
39 |
31 |
$3K |
| 83002 |
|
201 |
174 |
$3K |
| 83605 |
|
2,117 |
1,532 |
$3K |
| 87529 |
|
84 |
66 |
$3K |
| 80164 |
|
228 |
194 |
$3K |
| 87210 |
|
3,464 |
1,166 |
$3K |
| 84460 |
|
522 |
441 |
$3K |
| 93325 |
|
22 |
12 |
$3K |
| 85014 |
|
699 |
507 |
$3K |
| 82977 |
|
396 |
225 |
$2K |
| 85730 |
|
2,393 |
1,708 |
$2K |
| 82105 |
|
210 |
165 |
$2K |
| 82247 |
|
180 |
108 |
$2K |
| 81002 |
|
7,218 |
6,516 |
$2K |
| 82140 |
|
400 |
280 |
$2K |
| J3486 |
Ziprasidone mesylate |
119 |
82 |
$2K |
| 73140 |
|
310 |
265 |
$2K |
| 73700 |
|
24 |
14 |
$2K |
| 86920 |
|
154 |
95 |
$2K |
| 85018 |
|
770 |
556 |
$2K |
| 84165 |
|
332 |
246 |
$2K |
| 99214 |
|
18 |
13 |
$2K |
| 82378 |
|
706 |
422 |
$2K |
| 88304 |
|
777 |
477 |
$2K |
| 73090 |
|
339 |
284 |
$2K |
| 77370 |
|
17 |
12 |
$2K |
| 36591 |
|
116 |
84 |
$2K |
| J1170 |
Hydromorphone injection |
4,144 |
2,308 |
$2K |
| 86147 |
|
55 |
25 |
$2K |
| 86708 |
|
139 |
116 |
$2K |
| 89060 |
|
1,810 |
1,139 |
$2K |
| 94664 |
|
126 |
84 |
$2K |
| J1644 |
Inj heparin sodium per 1000u |
3,497 |
1,602 |
$2K |
| 87798 |
|
362 |
332 |
$1K |
| 83525 |
|
76 |
68 |
$1K |
| 80047 |
|
1,819 |
1,134 |
$1K |
| J0694 |
Cefoxitin sodium injection |
145 |
78 |
$1K |
| 87581 |
|
278 |
266 |
$1K |
| 96376 |
|
1,684 |
1,120 |
$1K |
| J1650 |
Inj enoxaparin sodium |
1,424 |
495 |
$1K |
| 86255 |
|
105 |
88 |
$1K |
| J0702 |
Betamethasone acet&sod phosp |
45 |
17 |
$1K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
13,707 |
10,314 |
$1K |
| C9113 |
Inj pantoprazole sodium, via |
554 |
244 |
$1K |
| J2543 |
Piperacillin/tazobactam |
575 |
248 |
$1K |
| J0696 |
Ceftriaxone sodium injection |
2,962 |
1,726 |
$1K |
| 85597 |
|
15 |
13 |
$1K |
| 86800 |
|
83 |
73 |
$1K |
| 84144 |
|
52 |
40 |
$1K |
| J3475 |
Inj magnesium sulfate |
1,886 |
826 |
$1K |
| 82330 |
|
126 |
89 |
$1K |
| 82627 |
|
33 |
24 |
$1K |
| 84402 |
|
77 |
72 |
$1K |
| 80202 |
|
42 |
12 |
$1K |
| 76857 |
|
12 |
12 |
$1K |
| 87088 |
|
144 |
111 |
$1K |
| 84703 |
|
416 |
346 |
$942.18 |
| 87486 |
|
278 |
266 |
$941.88 |
| J1885 |
Ketorolac tromethamine inj |
12,201 |
8,676 |
$931.46 |
| 86039 |
|
62 |
46 |
$922.32 |
| J3370 |
Vancomycin hcl injection |
819 |
356 |
$906.91 |
| 86709 |
|
62 |
47 |
$879.23 |
| 82962 |
|
2,069 |
1,459 |
$869.52 |
| 00840 |
|
933 |
507 |
$869.44 |
| 84132 |
|
226 |
137 |
$866.05 |
| 86665 |
|
46 |
40 |
$864.83 |
| 82803 |
|
532 |
359 |
$830.60 |
| 88112 |
|
48 |
39 |
$814.02 |
| 51798 |
|
697 |
618 |
$812.92 |
| 87389 |
|
66 |
59 |
$803.45 |
| 72040 |
|
18 |
16 |
$741.43 |
| J2270 |
Morphine sulfate injection |
2,122 |
1,480 |
$725.48 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
328 |
127 |
$722.49 |
| 73060 |
|
84 |
70 |
$716.43 |
| J2405 |
Ondansetron hcl injection |
23,976 |
17,246 |
$703.72 |
| 87075 |
|
273 |
187 |
$661.20 |
| 83986 |
|
1,889 |
1,196 |
$635.81 |
| 86301 |
|
96 |
49 |
$605.27 |
| 85384 |
|
441 |
311 |
$599.98 |
| 36416 |
|
627 |
482 |
$599.17 |
| 86003 |
|
16 |
12 |
$585.20 |
| 86146 |
|
34 |
25 |
$555.29 |
| J0690 |
Cefazolin sodium injection |
2,996 |
1,808 |
$483.81 |
| 86300 |
|
156 |
104 |
$472.43 |
| 85049 |
|
452 |
323 |
$461.09 |
| J2930 |
Methylprednisolone injection |
858 |
503 |
$445.15 |
| J2360 |
Orphenadrine injection |
710 |
502 |
$437.54 |
| 82800 |
|
331 |
219 |
$435.77 |
| 80347 |
|
76 |
73 |
$429.96 |
| J0360 |
Hydralazine hcl injection |
536 |
345 |
$424.09 |
| 87015 |
|
35 |
25 |
$423.07 |
| 90686 |
|
26 |
13 |
$418.58 |
| 82677 |
|
12 |
12 |
$390.84 |
| 51701 |
|
64 |
53 |
$388.20 |
| G0008 |
Admin influenza virus vac |
27 |
16 |
$386.22 |
| 86308 |
|
54 |
40 |
$385.93 |
| J1953 |
Levetiracetam injection |
96 |
52 |
$383.05 |
| 84630 |
|
38 |
36 |
$381.46 |
| J1100 |
Dexamethasone sodium phos |
9,110 |
5,130 |
$377.20 |
| 90471 |
|
588 |
499 |
$376.01 |
| 73552 |
|
54 |
38 |
$375.25 |
| 96523 |
|
14 |
12 |
$373.02 |
| 86870 |
|
22 |
12 |
$372.70 |
| J2765 |
Metoclopramide hcl injection |
2,136 |
1,344 |
$334.44 |
| 29125 |
|
257 |
224 |
$310.01 |
| 84445 |
|
15 |
12 |
$298.42 |
| J7070 |
D5w infusion |
1,626 |
842 |
$292.65 |
| J0137 |
Inj, acetaminophen (hikma) |
825 |
514 |
$290.50 |
| J0780 |
Prochlorperazine injection |
864 |
539 |
$279.42 |
| 82010 |
|
414 |
284 |
$278.51 |
| 86644 |
|
15 |
12 |
$264.21 |
| J0153 |
Adenosine inj 1mg |
18 |
12 |
$263.54 |
| J2704 |
Inj, propofol, 10 mg |
5,687 |
3,776 |
$262.07 |
| 85046 |
|
140 |
110 |
$261.10 |
| J1200 |
Diphenhydramine hcl injectio |
3,953 |
2,234 |
$253.91 |
| J3010 |
Fentanyl citrate injection |
7,681 |
5,140 |
$248.40 |
| 87427 |
|
35 |
25 |
$240.61 |
| 36600 |
|
115 |
77 |
$239.17 |
| J2060 |
Lorazepam injection |
1,506 |
953 |
$235.65 |
| 82103 |
|
15 |
12 |
$235.21 |
| 82652 |
|
31 |
29 |
$233.18 |
| 87045 |
|
35 |
25 |
$232.55 |
| 87046 |
|
35 |
25 |
$225.25 |
| 86645 |
|
15 |
12 |
$218.14 |
| 00400 |
|
391 |
230 |
$212.66 |
| 96402 |
|
13 |
12 |
$196.94 |
| G0480 |
Drug test def 1-7 classes |
675 |
534 |
$191.03 |
| 93321 |
|
22 |
12 |
$190.97 |
| J7040 |
Normal saline solution infus |
2,413 |
1,454 |
$184.43 |
| 86200 |
|
15 |
12 |
$183.36 |
| J7050 |
Normal saline solution infus |
4,794 |
2,160 |
$176.47 |
| 85613 |
|
15 |
13 |
$171.76 |
| 83921 |
|
21 |
13 |
$170.87 |
| 86376 |
|
15 |
12 |
$170.52 |
| 86364 |
|
12 |
12 |
$158.36 |
| 87449 |
|
40 |
25 |
$148.25 |
| 80178 |
|
16 |
12 |
$145.42 |
| J2250 |
Inj midazolam hydrochloride |
7,091 |
4,688 |
$142.65 |
| 86141 |
|
13 |
12 |
$140.73 |
| 87641 |
|
14 |
12 |
$124.98 |
| 83883 |
|
39 |
28 |
$108.88 |
| J3301 |
Triamcinolone acet inj nos |
1,199 |
914 |
$102.69 |
| 71101 |
|
15 |
12 |
$99.18 |
| 29515 |
|
164 |
128 |
$93.94 |
| 86334 |
|
21 |
12 |
$90.03 |
| J0171 |
Adrenalin epinephrine inject |
168 |
112 |
$88.78 |
| 86738 |
|
16 |
12 |
$85.80 |
| 83721 |
|
12 |
12 |
$82.05 |
| 86618 |
|
16 |
15 |
$77.60 |
| 84466 |
|
13 |
12 |
$77.27 |
| 96417 |
|
748 |
378 |
$62.58 |
| J1630 |
Haloperidol injection |
755 |
492 |
$59.04 |
| 84134 |
|
12 |
12 |
$53.26 |
| 87276 |
|
12 |
12 |
$45.86 |
| 84520 |
|
22 |
13 |
$43.05 |
| G0123 |
Screen cerv/vag thin layer |
17 |
14 |
$38.87 |
| J3480 |
Inj potassium chloride |
414 |
230 |
$35.47 |
| J3420 |
Vitamin b12 injection |
71 |
52 |
$35.40 |
| J0330 |
Succinycholine chloride inj |
316 |
208 |
$34.01 |
| Q9969 |
Non-heu tc-99m add-on/dose |
530 |
425 |
$23.60 |
| 87275 |
|
12 |
12 |
$22.92 |
| 29130 |
|
39 |
25 |
$22.50 |
| 83521 |
|
13 |
12 |
$21.86 |
| J1642 |
Inj heparin sodium per 10 u |
650 |
525 |
$17.85 |
| A9270 |
Non-covered item or service |
968 |
647 |
$17.30 |
| J1940 |
Furosemide injection |
107 |
67 |
$17.16 |
| J7512 |
Prednisone ir or dr oral 1mg |
1,362 |
856 |
$15.86 |
| J8540 |
Oral dexamethasone |
632 |
393 |
$12.14 |
| J2919 |
Inj, methylpred sod succ 5mg |
361 |
281 |
$10.05 |
| G0432 |
Eia hiv-1/hiv-2 screen |
33 |
29 |
$7.82 |
| J8597 |
Antiemetic drug oral nos |
361 |
213 |
$6.64 |
| J2550 |
Promethazine hcl injection |
45 |
42 |
$1.86 |
| J1920 |
Inj, labetalol hcl, 5mg |
12 |
12 |
$0.36 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
518 |
415 |
$0.06 |
| C1894 |
Intro/sheath, non-laser |
1,097 |
766 |
$0.00 |
| Q9957 |
Inj perflutren lip micros,ml |
789 |
629 |
$0.00 |
| A9577 |
Inj multihance |
1,952 |
1,602 |
$0.00 |
| A9552 |
F18 fdg |
205 |
165 |
$0.00 |
| C1887 |
Catheter, guiding |
803 |
559 |
$0.00 |
| 01992 |
|
75 |
42 |
$0.00 |
| 00731 |
|
19 |
12 |
$0.00 |
| 76376 |
|
139 |
130 |
$0.00 |
| C1760 |
Closure dev, vasc |
79 |
54 |
$0.00 |
| 76942 |
|
64 |
44 |
$0.00 |
| 88302 |
|
286 |
138 |
$0.00 |
| C1729 |
Cath, drainage |
418 |
201 |
$0.00 |
| 87880 |
|
61 |
61 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
47 |
30 |
$0.00 |
| C1788 |
Port, indwelling, imp |
64 |
43 |
$0.00 |
| C1874 |
Stent, coated/cov w/del sys |
24 |
16 |
$0.00 |
| 01810 |
|
15 |
15 |
$0.00 |
| 00532 |
|
25 |
14 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
32 |
31 |
$0.00 |
| 88360 |
|
13 |
12 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
31 |
24 |
$0.00 |
| 86336 |
|
13 |
13 |
$0.00 |
| A9537 |
Tc99m mebrofenin |
15 |
14 |
$0.00 |
| J2785 |
Regadenoson injection |
605 |
461 |
$0.00 |
| C1769 |
Guide wire |
1,517 |
1,036 |
$0.00 |
| 00952 |
|
55 |
27 |
$0.00 |
| A9500 |
Tc99m sestamibi |
937 |
717 |
$0.00 |
| 00790 |
|
134 |
63 |
$0.00 |
| C1781 |
Mesh (implantable) |
25 |
14 |
$0.00 |
| C1725 |
Cath, translumin non-laser |
110 |
83 |
$0.00 |
| J9045 |
Carboplatin injection |
110 |
65 |
$0.00 |
| A9503 |
Tc99m medronate |
20 |
13 |
$0.00 |
| J9267 |
Paclitaxel injection |
51 |
24 |
$0.00 |
| 87807 |
|
12 |
12 |
$0.00 |
| 96411 |
|
16 |
12 |
$0.00 |
| A4648 |
Implantable tissue marker |
33 |
24 |
$0.00 |