| Code | Description | Claims | Beneficiaries | Total Paid |
| 99283 |
|
117,839 |
106,164 |
$34.16M |
| 99284 |
|
19,299 |
18,035 |
$6.70M |
| 74177 |
|
17,434 |
16,678 |
$3.55M |
| 99291 |
|
4,945 |
4,790 |
$3.19M |
| 99282 |
|
14,439 |
13,798 |
$2.65M |
| G0378 |
Hospital observation per hr |
8,222 |
5,232 |
$2.56M |
| 0450 |
|
43,676 |
39,596 |
$1.97M |
| 78815 |
|
1,344 |
1,336 |
$1.32M |
| 70450 |
|
17,903 |
17,043 |
$1.30M |
| 74176 |
|
7,877 |
7,557 |
$891K |
| 86900 |
|
22,734 |
20,561 |
$886K |
| 70553 |
|
3,577 |
3,450 |
$841K |
| 71046 |
|
24,732 |
23,615 |
$831K |
| 86885 |
|
15,204 |
14,154 |
$715K |
| 78452 |
|
1,450 |
1,387 |
$615K |
| 71045 |
|
21,213 |
19,709 |
$601K |
| 85025 |
|
175,085 |
147,634 |
$590K |
| 80051 |
|
183,945 |
152,546 |
$572K |
| 70551 |
|
4,044 |
3,926 |
$566K |
| 87636 |
|
26,351 |
25,565 |
$562K |
| 76856 |
|
8,912 |
8,550 |
$516K |
| 73721 |
|
3,530 |
3,233 |
$499K |
| 76830 |
|
7,876 |
7,580 |
$466K |
| 82565 |
|
202,888 |
169,112 |
$464K |
| 76705 |
|
8,756 |
8,379 |
$462K |
| 99499 |
|
4,581 |
4,100 |
$456K |
| 74183 |
|
1,701 |
1,663 |
$436K |
| 72148 |
|
3,540 |
3,412 |
$435K |
| 84702 |
|
57,003 |
47,925 |
$410K |
| 93017 |
|
1,120 |
1,116 |
$390K |
| 71275 |
|
2,145 |
2,123 |
$359K |
| 71260 |
|
3,398 |
3,292 |
$348K |
| 87591 |
|
17,796 |
16,435 |
$345K |
| 87491 |
|
17,769 |
16,414 |
$345K |
| 93970 |
|
1,922 |
1,875 |
$334K |
| 96374 |
|
23,354 |
21,142 |
$326K |
| Z7502 |
|
9,369 |
9,067 |
$317K |
| 99281 |
|
5,310 |
4,858 |
$303K |
| 76801 |
|
5,516 |
4,458 |
$301K |
| 93971 |
|
3,616 |
3,376 |
$298K |
| 84460 |
|
112,534 |
97,822 |
$293K |
| 86901 |
|
22,749 |
20,571 |
$278K |
| 84443 |
|
31,039 |
28,508 |
$270K |
| 87505 |
|
3,594 |
3,528 |
$270K |
| 80307 |
|
12,077 |
10,195 |
$266K |
| 83880 |
|
24,544 |
22,600 |
$253K |
| 76817 |
|
4,709 |
3,798 |
$253K |
| 72141 |
|
1,975 |
1,902 |
$242K |
| 84520 |
|
153,325 |
128,856 |
$233K |
| 76805 |
|
2,884 |
2,884 |
$233K |
| 82247 |
|
94,520 |
80,995 |
$224K |
| 73221 |
|
1,519 |
1,394 |
$220K |
| 84075 |
|
87,986 |
76,852 |
$215K |
| 70486 |
|
2,413 |
2,328 |
$209K |
| 84450 |
|
81,847 |
71,626 |
$204K |
| 81220 |
|
1,691 |
1,629 |
$199K |
| 76816 |
|
2,850 |
2,724 |
$198K |
| 82947 |
|
129,199 |
114,451 |
$197K |
| 77067 |
|
2,934 |
2,934 |
$195K |
| 96375 |
|
16,870 |
15,338 |
$182K |
| 72125 |
|
1,967 |
1,912 |
$180K |
| 70491 |
|
1,372 |
1,337 |
$175K |
| 82306 |
|
11,966 |
10,979 |
$167K |
| 83036 |
|
33,887 |
31,599 |
$166K |
| 86923 |
|
1,724 |
1,545 |
$164K |
| 73630 |
|
4,563 |
4,287 |
$161K |
| 83690 |
|
51,912 |
47,983 |
$160K |
| 93458 |
|
56 |
56 |
$154K |
| 85027 |
|
54,171 |
46,610 |
$154K |
| 72197 |
|
459 |
459 |
$152K |
| 70496 |
|
795 |
786 |
$152K |
| 84484 |
|
47,617 |
32,485 |
$144K |
| 73562 |
|
4,413 |
4,054 |
$142K |
| 81003 |
|
123,476 |
113,284 |
$135K |
| 74178 |
|
433 |
433 |
$133K |
| 73610 |
|
3,825 |
3,565 |
$133K |
| 80061 |
|
18,618 |
17,299 |
$133K |
| 71250 |
|
1,617 |
1,573 |
$131K |
| 87389 |
|
8,646 |
8,202 |
$128K |
| 83970 |
|
7,902 |
7,327 |
$126K |
| 87633 |
|
2,873 |
2,857 |
$124K |
| 76770 |
|
2,448 |
2,388 |
$124K |
| 86141 |
|
15,918 |
14,979 |
$120K |
| 73030 |
|
3,562 |
3,319 |
$117K |
| A9585 |
Gadobutrol injection |
4,774 |
4,573 |
$116K |
| 70498 |
|
656 |
653 |
$115K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
22,990 |
21,748 |
$114K |
| 73130 |
|
3,486 |
3,196 |
$113K |
| 72100 |
|
2,202 |
2,158 |
$107K |
| J0131 |
Inj, acetaminophen (nos) |
7,518 |
7,128 |
$102K |
| 86780 |
|
11,081 |
10,610 |
$101K |
| 76641 |
|
1,185 |
1,181 |
$99K |
| 85610 |
|
61,681 |
48,916 |
$97K |
| A9552 |
F18 fdg |
537 |
532 |
$97K |
| 76870 |
|
1,702 |
1,624 |
$95K |
| 96365 |
|
5,383 |
4,994 |
$93K |
| 81513 |
|
1,401 |
1,396 |
$93K |
| 82310 |
|
35,535 |
30,742 |
$90K |
| 82728 |
|
13,066 |
12,204 |
$90K |
| 73110 |
|
2,657 |
2,441 |
$89K |
| 74018 |
|
2,290 |
2,174 |
$87K |
| 72146 |
|
594 |
578 |
$86K |
| 88305 |
|
4,848 |
3,418 |
$82K |
| 83735 |
|
27,971 |
22,870 |
$82K |
| 72158 |
|
234 |
233 |
$78K |
| 93005 |
|
8,008 |
7,694 |
$77K |
| 93306 |
|
688 |
687 |
$76K |
| 74022 |
|
1,569 |
1,500 |
$74K |
| 77066 |
Tomosynthesis, mammo |
684 |
684 |
$74K |
| J7030 |
Normal saline solution infus |
39,454 |
33,470 |
$73K |
| 87088 |
|
24,608 |
23,433 |
$72K |
| 0637 |
|
132,213 |
51,177 |
$68K |
| 87040 |
|
22,497 |
11,653 |
$68K |
| 70544 |
|
324 |
315 |
$68K |
| 96372 |
|
10,024 |
9,442 |
$68K |
| 74170 |
|
303 |
301 |
$67K |
| 86803 |
|
6,917 |
6,687 |
$66K |
| 73502 |
|
2,011 |
1,879 |
$66K |
| 76536 |
|
1,127 |
1,102 |
$62K |
| 82570 |
|
18,524 |
16,393 |
$61K |
| A9500 |
Tc99m sestamibi |
982 |
732 |
$56K |
| 87340 |
|
9,546 |
9,106 |
$56K |
| U0003 |
Cov-19 amp prb hgh thruput |
2,490 |
2,416 |
$54K |
| 83605 |
|
15,404 |
12,120 |
$54K |
| 80076 |
|
8,522 |
7,849 |
$53K |
| 73080 |
|
1,569 |
1,448 |
$53K |
| 82607 |
|
6,656 |
6,225 |
$49K |
| 76815 |
|
740 |
695 |
$49K |
| 73590 |
|
1,456 |
1,329 |
$47K |
| 83550 |
|
11,527 |
10,772 |
$47K |
| 73140 |
|
1,508 |
1,384 |
$46K |
| 74174 |
|
122 |
122 |
$46K |
| 73090 |
|
1,500 |
1,358 |
$45K |
| 86762 |
|
4,557 |
4,350 |
$45K |
| 87481 |
|
1,471 |
1,466 |
$45K |
| 93990 |
|
509 |
509 |
$45K |
| 87661 |
|
1,401 |
1,395 |
$44K |
| 82248 |
|
15,202 |
12,895 |
$44K |
| 90686 |
|
4,987 |
4,968 |
$43K |
| 72131 |
|
470 |
465 |
$43K |
| 86480 |
|
1,171 |
1,133 |
$43K |
| 66984 |
|
693 |
621 |
$43K |
| 74181 |
|
211 |
204 |
$40K |
| 86787 |
|
4,647 |
4,437 |
$39K |
| 83520 |
|
5,429 |
2,917 |
$39K |
| 82040 |
|
19,979 |
17,902 |
$39K |
| 84156 |
|
17,198 |
15,377 |
$39K |
| P9021 |
Red blood cells unit |
993 |
821 |
$38K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
2,921 |
2,586 |
$38K |
| 96361 |
|
3,879 |
3,767 |
$36K |
| 83540 |
|
11,771 |
10,993 |
$35K |
| 77065 |
Tomosynthesis, mammo |
402 |
400 |
$33K |
| 96360 |
|
2,053 |
2,015 |
$33K |
| 87210 |
|
13,960 |
12,764 |
$33K |
| 76380 |
|
862 |
830 |
$33K |
| 86880 |
|
1,109 |
1,079 |
$32K |
| 84439 |
|
5,964 |
5,351 |
$32K |
| 85379 |
|
7,163 |
6,897 |
$32K |
| 73564 |
|
439 |
421 |
$32K |
| 82746 |
|
4,327 |
4,110 |
$32K |
| 83021 |
|
2,659 |
2,536 |
$31K |
| 80306 |
|
3,663 |
3,467 |
$31K |
| 82077 |
|
6,076 |
5,342 |
$31K |
| 87449 |
|
5,429 |
4,182 |
$31K |
| J2785 |
Regadenoson injection |
319 |
318 |
$30K |
| 83615 |
|
8,967 |
8,085 |
$30K |
| 82950 |
|
9,680 |
9,383 |
$29K |
| 84100 |
|
17,508 |
15,004 |
$29K |
| 72040 |
|
795 |
773 |
$29K |
| 85730 |
|
9,860 |
8,840 |
$28K |
| 93880 |
|
206 |
204 |
$27K |
| 73700 |
|
259 |
239 |
$27K |
| 87497 |
|
1,011 |
869 |
$27K |
| 99285 |
|
156 |
147 |
$26K |
| J7120 |
Ringers lactate infusion |
6,391 |
5,656 |
$26K |
| J1885 |
Ketorolac tromethamine inj |
18,073 |
15,021 |
$26K |
| A9609 |
F18 fdg, 15 millicuries |
296 |
296 |
$25K |
| 70547 |
|
96 |
96 |
$25K |
| 90674 |
|
1,117 |
1,110 |
$25K |
| 82378 |
|
2,253 |
1,737 |
$24K |
| 78306 |
|
141 |
141 |
$24K |
| 84403 |
|
1,571 |
1,464 |
$24K |
| 82105 |
|
2,614 |
2,521 |
$24K |
| 85652 |
|
17,515 |
15,941 |
$23K |
| 82043 |
|
9,051 |
8,604 |
$23K |
| 82951 |
|
2,595 |
2,505 |
$23K |
| 84146 |
|
1,718 |
1,611 |
$23K |
| 86665 |
|
2,020 |
990 |
$22K |
| 87324 |
|
3,665 |
3,554 |
$22K |
| 74019 |
|
339 |
337 |
$22K |
| 76881 |
|
309 |
305 |
$22K |
| 73552 |
|
610 |
581 |
$22K |
| 86870 |
|
108 |
87 |
$22K |
| 86300 |
|
2,169 |
1,856 |
$22K |
| 94640 |
|
880 |
598 |
$22K |
| 71101 |
|
355 |
344 |
$21K |
| 86225 |
|
2,585 |
2,420 |
$21K |
| J2405 |
Ondansetron hcl injection |
22,077 |
19,753 |
$21K |
| J2270 |
Morphine sulfate injection |
11,338 |
9,733 |
$21K |
| 73060 |
|
617 |
561 |
$21K |
| 72157 |
|
53 |
53 |
$21K |
| 99199 |
|
510 |
477 |
$21K |
| 73100 |
|
447 |
362 |
$20K |
| 80179 |
|
4,267 |
3,996 |
$20K |
| 83001 |
|
1,450 |
1,352 |
$20K |
| 87624 |
|
1,114 |
1,063 |
$19K |
| 83993 |
|
1,177 |
1,170 |
$19K |
| 0250 |
|
14,045 |
10,256 |
$18K |
| 82784 |
|
2,037 |
1,846 |
$18K |
| J0696 |
Ceftriaxone sodium injection |
11,109 |
9,492 |
$18K |
| 76700 |
|
456 |
420 |
$17K |
| 90656 |
|
1,321 |
1,316 |
$17K |
| 72050 |
|
251 |
249 |
$17K |
| 82670 |
|
748 |
661 |
$17K |
| 72156 |
|
40 |
40 |
$17K |
| 49083 |
|
120 |
51 |
$17K |
| 77080 |
|
606 |
602 |
$16K |
| 72070 |
|
239 |
237 |
$16K |
| 87637 |
|
1,248 |
1,233 |
$16K |
| 78830 |
|
12 |
12 |
$15K |
| 86704 |
|
2,460 |
2,380 |
$15K |
| 84134 |
|
2,066 |
1,786 |
$15K |
| 0710 |
|
2,534 |
2,518 |
$15K |
| 72170 |
|
440 |
419 |
$15K |
| 86038 |
|
2,264 |
2,160 |
$14K |
| 96366 |
|
640 |
621 |
$14K |
| 84165 |
|
3,035 |
2,754 |
$14K |
| 96367 |
|
943 |
888 |
$14K |
| 84153 |
|
1,978 |
1,837 |
$14K |
| 82550 |
|
4,408 |
3,917 |
$14K |
| 84550 |
|
6,579 |
6,181 |
$14K |
| 80197 |
|
1,958 |
1,689 |
$14K |
| 80359 |
|
1,279 |
1,204 |
$13K |
| 70543 |
|
43 |
43 |
$13K |
| 72081 |
|
281 |
277 |
$13K |
| 83721 |
|
2,547 |
2,323 |
$13K |
| 73660 |
|
293 |
283 |
$13K |
| 86304 |
|
980 |
810 |
$13K |
| 86160 |
|
1,214 |
1,105 |
$12K |
| 86317 |
|
1,620 |
1,551 |
$12K |
| 80324 |
|
1,294 |
1,216 |
$12K |
| 81015 |
|
5,078 |
4,903 |
$11K |
| 82330 |
|
2,633 |
2,329 |
$11K |
| 0258 |
|
5,030 |
4,355 |
$11K |
| 47562 |
|
109 |
93 |
$10K |
| 87081 |
|
4,647 |
4,550 |
$10K |
| 73560 |
|
289 |
261 |
$10K |
| 80164 |
|
1,408 |
1,278 |
$10K |
| 82805 |
|
489 |
458 |
$10K |
| J3490 |
Drugs unclassified injection |
7,678 |
6,173 |
$10K |
| 83002 |
|
714 |
661 |
$9K |
| 86664 |
|
1,013 |
990 |
$9K |
| 87522 |
Neg quan hep c or qual rna |
327 |
321 |
$9K |
| J1100 |
Dexamethasone sodium phos |
6,869 |
6,051 |
$9K |
| 20610 |
|
24 |
24 |
$9K |
| J1815 |
Insulin injection |
5,709 |
3,098 |
$9K |
| 87205 |
|
4,461 |
3,961 |
$9K |
| 97161 |
|
1,039 |
1,024 |
$9K |
| 73523 |
|
125 |
125 |
$8K |
| 73070 |
|
178 |
160 |
$8K |
| J1170 |
Hydromorphone injection |
3,430 |
2,770 |
$8K |
| 85046 |
|
2,852 |
2,574 |
$8K |
| 82962 |
|
4,305 |
3,151 |
$8K |
| 87186 |
|
2,934 |
2,863 |
$8K |
| 82627 |
|
410 |
398 |
$8K |
| 82140 |
|
1,369 |
1,218 |
$8K |
| 90715 |
|
314 |
310 |
$8K |
| 86364 |
|
653 |
651 |
$8K |
| 82952 |
|
2,563 |
2,478 |
$7K |
| 72128 |
|
64 |
63 |
$7K |
| 87502 |
|
486 |
480 |
$7K |
| 86334 |
|
780 |
731 |
$7K |
| 99292 |
|
117 |
117 |
$7K |
| J3010 |
Fentanyl citrate injection |
3,445 |
3,283 |
$7K |
| 77073 |
|
81 |
79 |
$7K |
| J2060 |
Lorazepam injection |
4,381 |
3,628 |
$7K |
| 86301 |
|
474 |
349 |
$7K |
| 88342 |
|
319 |
318 |
$6K |
| 83718 |
|
1,324 |
1,226 |
$6K |
| 88341 |
|
194 |
193 |
$6K |
| J0690 |
Cefazolin sodium injection |
1,842 |
1,691 |
$6K |
| 82977 |
|
1,105 |
1,039 |
$6K |
| 77072 |
|
75 |
75 |
$6K |
| J2272 |
Inj, morphine (fresenius) |
3,872 |
3,373 |
$6K |
| 82150 |
|
1,919 |
1,774 |
$6K |
| 87635 |
|
341 |
326 |
$6K |
| 73522 |
|
81 |
81 |
$6K |
| J2765 |
Metoclopramide hcl injection |
4,784 |
4,424 |
$6K |
| 84132 |
|
3,369 |
2,894 |
$5K |
| 44970 |
|
63 |
54 |
$5K |
| J2930 |
Methylprednisolone injection |
2,219 |
2,043 |
$5K |
| 83655 |
|
2,046 |
1,427 |
$5K |
| J1200 |
Diphenhydramine hcl injectio |
5,651 |
5,031 |
$5K |
| J1953 |
Levetiracetam injection |
586 |
516 |
$5K |
| 74240 |
|
36 |
36 |
$4K |
| G0008 |
Admin influenza virus vac |
3,879 |
3,855 |
$4K |
| J3475 |
Inj magnesium sulfate |
2,698 |
2,544 |
$4K |
| 86308 |
|
1,298 |
1,242 |
$4K |
| 82465 |
|
1,627 |
1,521 |
$4K |
| 84155 |
|
2,050 |
1,914 |
$4K |
| J1644 |
Inj heparin sodium per 1000u |
4,266 |
2,318 |
$4K |
| A0429 |
Bls-emergency |
241 |
126 |
$4K |
| 86765 |
|
381 |
381 |
$4K |
| 86146 |
|
55 |
54 |
$4K |
| 86431 |
|
1,109 |
1,025 |
$4K |
| 0370 |
|
3,089 |
3,062 |
$4K |
| 90662 |
|
484 |
483 |
$3K |
| 87070 |
|
1,207 |
1,119 |
$3K |
| 86147 |
|
70 |
69 |
$3K |
| C1894 |
Intro/sheath, non-laser |
12 |
12 |
$3K |
| 87804 |
|
851 |
419 |
$3K |
| 82705 |
|
670 |
665 |
$3K |
| 82390 |
|
374 |
372 |
$3K |
| 80202 |
|
335 |
152 |
$3K |
| 85014 |
|
5,055 |
4,046 |
$3K |
| 12001 |
|
258 |
256 |
$3K |
| 73200 |
|
28 |
28 |
$3K |
| 86677 |
|
1,334 |
1,145 |
$3K |
| 97165 |
|
197 |
196 |
$3K |
| 73718 |
|
16 |
15 |
$3K |
| 90688 |
|
227 |
226 |
$3K |
| 84425 |
|
152 |
152 |
$3K |
| J2274 |
Inj morphine pf epid ithc |
165 |
134 |
$3K |
| 80321 |
|
61 |
57 |
$3K |
| 70360 |
|
59 |
59 |
$3K |
| G0480 |
Drug test def 1-7 classes |
39 |
38 |
$2K |
| 85018 |
|
2,448 |
2,145 |
$2K |
| 72082 |
|
25 |
25 |
$2K |
| 85613 |
|
278 |
276 |
$2K |
| 90471 |
|
1,434 |
1,433 |
$2K |
| 82272 |
|
951 |
924 |
$2K |
| 86708 |
|
278 |
269 |
$2K |
| 84295 |
|
1,145 |
901 |
$2K |
| J0360 |
Hydralazine hcl injection |
1,389 |
1,227 |
$2K |
| 97116 |
|
686 |
586 |
$2K |
| J0134 |
Inj acetaminophen -fresenius |
215 |
207 |
$2K |
| 99238 |
|
141 |
140 |
$2K |
| 86256 |
|
147 |
146 |
$2K |
| J1940 |
Furosemide injection |
2,588 |
1,737 |
$2K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
418 |
327 |
$2K |
| J2550 |
Promethazine hcl injection |
1,228 |
1,020 |
$2K |
| G0257 |
Unsched dialysis esrd pt hos |
79 |
71 |
$2K |
| 83010 |
|
186 |
182 |
$2K |
| 89051 |
|
636 |
487 |
$2K |
| 86709 |
|
263 |
240 |
$2K |
| 29125 |
|
162 |
160 |
$2K |
| Q0144 |
Azithromycin dihydrate, oral |
282 |
257 |
$2K |
| 72220 |
|
39 |
39 |
$2K |
| 97162 |
|
272 |
267 |
$2K |
| J2919 |
Inj, methylpred sod succ 5mg |
722 |
530 |
$2K |
| J1650 |
Inj enoxaparin sodium |
1,280 |
824 |
$2K |
| 84145 |
|
370 |
360 |
$2K |
| 85246 |
|
102 |
95 |
$2K |
| 70355 |
|
26 |
26 |
$1K |
| 97530 |
|
490 |
380 |
$1K |
| C1725 |
Cath, translumin non-laser |
12 |
12 |
$1K |
| 80178 |
|
502 |
445 |
$1K |
| 87631 |
|
142 |
141 |
$1K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
292 |
291 |
$1K |
| 74220 |
|
13 |
13 |
$1K |
| 87149 |
|
360 |
353 |
$1K |
| J0780 |
Prochlorperazine injection |
981 |
952 |
$1K |
| 82533 |
|
95 |
92 |
$1K |
| J2001 |
Lidocaine injection |
1,298 |
1,257 |
$1K |
| 82653 |
|
53 |
53 |
$1K |
| 88304 |
|
558 |
481 |
$1K |
| 84480 |
|
152 |
126 |
$1K |
| J1630 |
Haloperidol injection |
686 |
574 |
$1K |
| 73120 |
|
15 |
15 |
$1K |
| 12011 |
|
97 |
96 |
$1K |
| J1836 |
Inj, metronidazole, 10 mg |
353 |
266 |
$1K |
| 82103 |
|
92 |
91 |
$1K |
| J3371 |
Inj, vancomycin hcl (mylan) |
130 |
94 |
$974.46 |
| 85240 |
|
60 |
57 |
$971.00 |
| 86140 |
|
2,601 |
2,003 |
$960.33 |
| P9047 |
Albumin (human), 25%, 50ml |
28 |
25 |
$953.74 |
| 84270 |
|
42 |
42 |
$923.00 |
| 72110 |
|
14 |
14 |
$915.00 |
| 84478 |
|
177 |
125 |
$822.47 |
| 76010 |
|
14 |
12 |
$776.43 |
| 85384 |
|
94 |
88 |
$769.46 |
| A9503 |
Tc99m medronate |
89 |
88 |
$752.27 |
| J2470 |
Inj pantoprazole sodium 40mg |
325 |
266 |
$715.14 |
| 86769 |
|
59 |
59 |
$684.45 |
| J0456 |
Azithromycin |
1,109 |
866 |
$660.17 |
| 73000 |
|
13 |
13 |
$660.00 |
| 86635 |
|
56 |
28 |
$652.40 |
| 90935 |
|
34 |
24 |
$651.14 |
| 83930 |
|
201 |
185 |
$635.98 |
| J3480 |
Inj potassium chloride |
1,901 |
1,386 |
$634.58 |
| 85520 |
|
72 |
37 |
$625.71 |
| J2250 |
Inj midazolam hydrochloride |
1,080 |
1,047 |
$614.10 |
| J7060 |
5% dextrose/water |
488 |
406 |
$613.24 |
| 90749 |
|
751 |
750 |
$568.44 |
| 0255 |
|
119 |
115 |
$558.39 |
| J7512 |
Prednisone ir or dr oral 1mg |
1,339 |
1,180 |
$547.75 |
| 83935 |
|
137 |
133 |
$522.68 |
| 80162 |
|
92 |
81 |
$512.05 |
| 80185 |
|
94 |
77 |
$502.47 |
| 72080 |
|
14 |
14 |
$498.17 |
| 82274 |
|
116 |
84 |
$481.00 |
| 86235 |
|
39 |
38 |
$458.00 |
| J3370 |
Vancomycin hcl injection |
239 |
173 |
$433.74 |
| 86696 |
|
27 |
27 |
$424.12 |
| S0119 |
Ondansetron 4 mg |
761 |
746 |
$424.06 |
| 88312 |
|
12 |
12 |
$405.00 |
| 92610 |
|
13 |
13 |
$404.73 |
| J7042 |
5% dextrose/normal saline |
254 |
207 |
$372.95 |
| 29515 |
|
54 |
53 |
$354.83 |
| 80048 |
|
40 |
40 |
$339.00 |
| 86003 |
|
228 |
129 |
$330.70 |
| 87807 |
|
74 |
72 |
$319.27 |
| 86695 |
|
27 |
27 |
$299.95 |
| J2543 |
Piperacillin/tazobactam |
370 |
308 |
$295.12 |
| 87184 |
|
55 |
53 |
$293.75 |
| J3360 |
Diazepam injection |
67 |
61 |
$277.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
141 |
115 |
$263.97 |
| 82232 |
|
28 |
26 |
$242.18 |
| 86360 |
|
229 |
147 |
$240.97 |
| J0136 |
Inj, acetaminophen (b braun) |
43 |
42 |
$238.61 |
| 85045 |
|
115 |
109 |
$222.76 |
| 82374 |
|
63 |
63 |
$219.41 |
| 83986 |
|
66 |
65 |
$219.25 |
| 84157 |
|
89 |
80 |
$216.13 |
| 83525 |
|
17 |
17 |
$202.00 |
| J1756 |
Iron sucrose injection |
14 |
12 |
$196.20 |
| 10060 |
|
39 |
39 |
$195.88 |
| 86359 |
|
229 |
147 |
$194.98 |
| J2704 |
Inj, propofol, 10 mg |
163 |
128 |
$174.34 |
| C9113 |
Inj pantoprazole sodium, via |
836 |
620 |
$143.17 |
| 82435 |
|
58 |
54 |
$142.00 |
| Z7512 |
|
13 |
13 |
$130.65 |
| 69436 |
|
27 |
27 |
$126.95 |
| 80320 |
|
519 |
418 |
$120.60 |
| V2632 |
Post chmbr intraocular lens |
294 |
289 |
$120.01 |
| J3411 |
Thiamine hcl 100 mg |
101 |
81 |
$110.21 |
| 86735 |
|
13 |
13 |
$104.73 |
| 82945 |
|
142 |
131 |
$101.16 |
| 80329 |
|
626 |
290 |
$95.70 |
| S0164 |
Injection pantroprazole |
15 |
12 |
$86.27 |
| J1920 |
Inj, labetalol hcl, 5mg |
168 |
135 |
$78.62 |
| 87185 |
|
51 |
51 |
$76.73 |
| J7510 |
Prednisolone oral per 5 mg |
465 |
457 |
$76.06 |
| J0612 |
Inj, calcium gluconate, nos |
59 |
55 |
$73.99 |
| 77002 |
|
115 |
115 |
$66.51 |
| 87045 |
|
40 |
32 |
$65.33 |
| 80156 |
|
13 |
13 |
$64.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
190 |
150 |
$59.03 |
| 88307 |
|
266 |
223 |
$50.28 |
| J1580 |
Garamycin gentamicin inj |
32 |
30 |
$49.60 |
| 87255 |
|
13 |
13 |
$40.00 |
| 82340 |
|
14 |
14 |
$36.00 |
| 87046 |
|
33 |
29 |
$34.72 |
| J2795 |
Ropivacaine hcl injection |
165 |
156 |
$33.76 |
| J0737 |
Inj, clindamycin (baxter) |
12 |
12 |
$32.40 |
| 97535 |
|
30 |
28 |
$15.34 |
| J0171 |
Adrenalin epinephrine inject |
269 |
261 |
$6.00 |
| J2280 |
Inj, moxifloxacin 100 mg |
284 |
279 |
$1.63 |
| C1769 |
Guide wire |
60 |
58 |
$0.28 |
| 0272 |
|
239 |
238 |
$0.00 |
| 3051F |
|
92 |
90 |
$0.00 |
| 87338 |
|
70 |
56 |
$0.00 |
| 3046F |
|
155 |
153 |
$0.00 |
| G0297 |
Ldct for lung ca screen |
69 |
58 |
$0.00 |
| 3078F |
|
59 |
56 |
$0.00 |
| C1758 |
Catheter, ureteral |
26 |
26 |
$0.00 |
| 54161 |
|
26 |
26 |
$0.00 |
| 76376 |
|
44 |
43 |
$0.00 |
| C1729 |
Cath, drainage |
12 |
12 |
$0.00 |
| C1765 |
Adhesion barrier |
13 |
13 |
$0.00 |
| 84590 |
|
29 |
16 |
$0.00 |
| 85670 |
|
13 |
13 |
$0.00 |
| 97110 |
|
23 |
14 |
$0.00 |
| J0744 |
Ciprofloxacin iv |
14 |
12 |
$0.00 |
| C1751 |
Cath, inf, per/cent/midline |
13 |
13 |
$0.00 |
| 3044F |
|
2,060 |
2,051 |
$0.00 |
| G0299 |
Hhs/hospice of rn ea 15 min |
123 |
16 |
$0.00 |
| C2617 |
Stent, non-cor, tem w/o del |
14 |
12 |
$0.00 |
| G0300 |
Hhs/hospice of lpn ea 15 min |
186 |
14 |
$0.00 |
| 42820 |
|
24 |
12 |
$0.00 |
| 29881 |
|
12 |
12 |
$0.00 |
| 87536 |
|
137 |
81 |
$0.00 |
| 84540 |
|
12 |
12 |
$0.00 |
| 3074F |
|
51 |
48 |
$0.00 |
| 86376 |
|
20 |
12 |
$0.00 |
| 3052F |
|
53 |
53 |
$0.00 |
| 88108 |
|
15 |
13 |
$0.00 |
| G0155 |
Hhcp-svs of csw,ea 15 min |
123 |
12 |
$0.00 |
| J8540 |
Oral dexamethasone |
14 |
14 |
$0.00 |