| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96361 |
|
56,926 |
46,857 |
$16.64M |
| G0463 |
Hospital outpt clinic visit |
171,116 |
124,189 |
$12.35M |
| 99283 |
|
104,261 |
95,574 |
$11.54M |
| 99285 |
|
119,538 |
107,180 |
$10.05M |
| 99284 |
|
83,656 |
76,987 |
$7.65M |
| J9271 |
Inj pembrolizumab |
1,644 |
1,180 |
$6.99M |
| 74177 |
|
32,722 |
31,020 |
$5.72M |
| J2350 |
Injection, ocrelizumab, 1 mg |
455 |
409 |
$5.02M |
| 77412 |
|
7,217 |
813 |
$3.33M |
| 96365 |
|
27,245 |
20,702 |
$2.75M |
| 70450 |
|
19,622 |
18,484 |
$2.66M |
| 96366 |
|
11,156 |
7,934 |
$2.66M |
| 99282 |
|
23,934 |
21,136 |
$2.57M |
| J2323 |
Natalizumab injection |
1,615 |
1,437 |
$2.38M |
| 96360 |
|
20,107 |
15,951 |
$2.23M |
| 77386 |
|
5,805 |
507 |
$2.07M |
| 59025 |
|
11,165 |
8,203 |
$1.74M |
| 80053 |
|
339,690 |
292,141 |
$1.66M |
| 96413 |
|
21,520 |
11,341 |
$1.60M |
| 80307 |
|
62,496 |
48,457 |
$1.52M |
| 87635 |
|
47,565 |
45,639 |
$1.46M |
| J9263 |
Oxaliplatin |
1,906 |
716 |
$1.44M |
| 42820 |
|
762 |
759 |
$1.39M |
| U0003 |
Cov-19 amp prb hgh thruput |
15,311 |
14,820 |
$1.34M |
| 87591 |
|
98,097 |
94,466 |
$1.32M |
| 96415 |
|
6,814 |
4,801 |
$1.21M |
| 36415 |
|
439,423 |
381,538 |
$1.15M |
| 74176 |
|
6,484 |
6,240 |
$1.14M |
| J9035 |
Bevacizumab injection |
728 |
356 |
$1.06M |
| 71275 |
|
7,086 |
6,784 |
$1.04M |
| 76816 |
|
21,388 |
17,695 |
$988K |
| 87491 |
|
98,111 |
94,481 |
$940K |
| 85025 |
|
385,163 |
324,022 |
$887K |
| 70553 |
|
3,997 |
3,933 |
$860K |
| 84443 |
|
88,835 |
86,210 |
$835K |
| 70496 |
|
4,680 |
4,552 |
$803K |
| 76811 |
|
13,189 |
13,051 |
$799K |
| 76830 |
|
8,932 |
8,693 |
$769K |
| Q5115 |
Inj truxima 10 mg |
264 |
135 |
$762K |
| 69436 |
|
734 |
733 |
$711K |
| 76705 |
|
9,071 |
8,724 |
$689K |
| 87086 |
|
157,039 |
147,633 |
$625K |
| 80061 |
|
92,747 |
91,535 |
$603K |
| J2505 |
Injection, pegfilgrastim 6mg |
373 |
251 |
$597K |
| 76856 |
|
10,489 |
10,199 |
$596K |
| 10060 |
|
3,366 |
3,221 |
$590K |
| 93971 |
|
6,148 |
5,893 |
$537K |
| 76801 |
|
10,382 |
9,353 |
$532K |
| 87070 |
|
97,382 |
94,080 |
$525K |
| J0585 |
Injection,onabotulinumtoxina |
2,215 |
1,817 |
$507K |
| 78815 |
|
968 |
945 |
$504K |
| 47562 |
|
222 |
215 |
$487K |
| 76819 |
|
9,322 |
6,771 |
$472K |
| 58661 |
|
172 |
171 |
$457K |
| 83036 |
|
88,059 |
86,763 |
$449K |
| 42830 |
|
250 |
246 |
$429K |
| 99281 |
|
4,337 |
4,004 |
$403K |
| J1569 |
Gammagard liquid injection |
446 |
169 |
$384K |
| J2469 |
Palonosetron hcl |
6,169 |
3,411 |
$379K |
| 12001 |
|
2,155 |
2,109 |
$376K |
| 95813 |
|
1,330 |
1,312 |
$368K |
| P9016 |
Rbc leukocytes reduced |
1,566 |
1,267 |
$362K |
| 88175 |
|
23,851 |
23,538 |
$354K |
| 64615 |
|
1,543 |
1,478 |
$354K |
| 96416 |
|
1,549 |
839 |
$353K |
| 70491 |
|
2,628 |
2,535 |
$347K |
| 80048 |
|
65,681 |
56,742 |
$334K |
| 93970 |
|
3,232 |
3,107 |
$301K |
| 71046 |
|
43,628 |
41,149 |
$293K |
| 82728 |
|
42,662 |
40,753 |
$286K |
| 82306 |
|
40,957 |
40,211 |
$279K |
| 84484 |
|
65,561 |
48,606 |
$279K |
| 96367 |
|
5,190 |
3,710 |
$276K |
| 77336 |
|
4,861 |
2,123 |
$265K |
| 86780 |
|
29,108 |
28,661 |
$259K |
| 70551 |
|
1,651 |
1,621 |
$257K |
| 80050 |
|
32,236 |
31,817 |
$250K |
| 93306 |
|
841 |
830 |
$244K |
| 29581 |
|
1,872 |
619 |
$242K |
| J9312 |
Inj., rituximab, 10 mg |
105 |
67 |
$242K |
| G0378 |
Hospital observation per hr |
17,954 |
8,900 |
$241K |
| 76805 |
|
3,489 |
3,452 |
$237K |
| 95800 |
|
1,162 |
1,148 |
$237K |
| 64405 |
|
1,186 |
1,130 |
$231K |
| 83880 |
|
27,392 |
25,040 |
$230K |
| 96374 |
|
97,439 |
82,275 |
$230K |
| 36430 |
|
3,059 |
2,008 |
$230K |
| 87389 |
|
49,988 |
49,220 |
$229K |
| 58571 |
|
76 |
74 |
$225K |
| J1950 |
Leuprolide acetate /3.75 mg |
379 |
335 |
$224K |
| J1453 |
Fosaprepitant injection |
2,149 |
1,361 |
$218K |
| 87186 |
|
46,585 |
44,372 |
$216K |
| 76770 |
|
2,443 |
2,399 |
$214K |
| 87505 |
|
4,984 |
4,891 |
$202K |
| 87205 |
|
78,221 |
74,815 |
$202K |
| 84702 |
|
35,174 |
27,069 |
$200K |
| 87801 |
|
18,375 |
17,700 |
$198K |
| 76817 |
|
7,135 |
6,279 |
$196K |
| 43239 |
|
638 |
618 |
$188K |
| 86803 |
|
37,827 |
37,184 |
$186K |
| 87808 |
|
44,576 |
43,333 |
$185K |
| 82607 |
|
27,028 |
26,015 |
$184K |
| 88305 |
|
15,048 |
12,606 |
$181K |
| 73721 |
|
1,153 |
1,118 |
$177K |
| 12002 |
|
1,079 |
1,064 |
$174K |
| J0897 |
Denosumab injection |
1,624 |
1,392 |
$170K |
| 99291 |
|
1,450 |
1,395 |
$168K |
| 84439 |
|
28,449 |
27,291 |
$168K |
| 73630 |
|
12,208 |
11,045 |
$167K |
| 83970 |
|
8,662 |
8,270 |
$166K |
| 64400 |
|
596 |
556 |
$165K |
| 76815 |
|
3,763 |
3,463 |
$161K |
| 12011 |
|
999 |
976 |
$160K |
| 76536 |
|
1,929 |
1,912 |
$159K |
| 87529 |
|
8,888 |
7,546 |
$158K |
| 72148 |
|
1,342 |
1,326 |
$157K |
| 49083 |
|
492 |
251 |
$152K |
| 76870 |
|
1,959 |
1,853 |
$152K |
| 83605 |
|
28,573 |
25,292 |
$151K |
| 86003 |
|
21,361 |
11,017 |
$150K |
| 87661 |
|
17,318 |
16,895 |
$149K |
| 95810 |
|
369 |
366 |
$148K |
| 87624 |
|
11,292 |
11,180 |
$147K |
| 83550 |
|
37,472 |
35,732 |
$146K |
| 87481 |
|
17,720 |
16,883 |
$145K |
| 77334 |
|
1,483 |
1,110 |
$143K |
| 72125 |
|
8,164 |
7,834 |
$142K |
| 82570 |
|
33,068 |
29,489 |
$141K |
| 86140 |
|
37,326 |
34,518 |
$140K |
| 87633 |
|
1,598 |
1,574 |
$140K |
| 70498 |
|
4,932 |
4,802 |
$139K |
| 95806 |
|
267 |
265 |
$139K |
| Q0138 |
Ferumoxytol, non-esrd |
882 |
583 |
$134K |
| 71260 |
|
5,811 |
5,660 |
$133K |
| 86480 |
|
7,373 |
7,275 |
$132K |
| J1756 |
Iron sucrose injection |
7,187 |
3,231 |
$128K |
| 71250 |
|
2,679 |
2,628 |
$128K |
| 64450 |
|
489 |
451 |
$128K |
| 93005 |
|
90,588 |
71,755 |
$126K |
| 87400 |
|
12,454 |
6,248 |
$126K |
| J0185 |
Inj., aprepitant, 1 mg |
1,599 |
941 |
$124K |
| 76937 |
|
3,573 |
3,203 |
$122K |
| 96523 |
|
3,432 |
2,670 |
$122K |
| 87040 |
|
18,698 |
10,450 |
$121K |
| 70487 |
|
747 |
730 |
$120K |
| 36561 |
|
111 |
107 |
$118K |
| 86235 |
|
12,921 |
7,322 |
$115K |
| 85027 |
|
30,579 |
28,166 |
$115K |
| 84403 |
|
9,776 |
9,491 |
$114K |
| 83540 |
|
39,386 |
37,599 |
$114K |
| 96372 |
|
40,737 |
30,363 |
$112K |
| 70486 |
|
3,785 |
3,689 |
$111K |
| 58670 |
|
45 |
45 |
$108K |
| 73610 |
|
8,705 |
7,964 |
$100K |
| 29125 |
|
880 |
839 |
$100K |
| 77301 |
|
223 |
202 |
$96K |
| 82784 |
|
13,063 |
11,167 |
$96K |
| 82785 |
|
7,938 |
7,826 |
$96K |
| 80055 |
|
16,222 |
16,010 |
$95K |
| 77295 |
|
248 |
220 |
$92K |
| 72100 |
|
7,054 |
6,886 |
$91K |
| G0108 |
Diab manage trn per indiv |
2,816 |
2,363 |
$90K |
| 87149 |
|
15,594 |
15,058 |
$88K |
| 94640 |
|
11,839 |
10,622 |
$87K |
| 90715 |
|
4,909 |
4,813 |
$87K |
| 74018 |
|
3,742 |
3,535 |
$86K |
| 83735 |
|
40,498 |
30,066 |
$84K |
| J9217 |
Leuprolide acetate suspnsion |
397 |
382 |
$81K |
| 82746 |
|
18,229 |
17,459 |
$80K |
| 76820 |
|
2,945 |
1,509 |
$79K |
| Q5103 |
Injection, inflectra |
154 |
132 |
$78K |
| 82247 |
|
13,011 |
9,822 |
$78K |
| 81229 |
|
324 |
321 |
$78K |
| 84146 |
|
6,726 |
6,560 |
$78K |
| 82670 |
|
5,392 |
5,222 |
$77K |
| 77300 |
|
1,481 |
1,277 |
$77K |
| 96375 |
|
78,742 |
60,539 |
$77K |
| 87077 |
|
27,254 |
25,946 |
$75K |
| 73562 |
|
6,614 |
6,067 |
$75K |
| 87510 |
|
5,770 |
5,521 |
$75K |
| 85652 |
|
30,949 |
29,021 |
$74K |
| 87340 |
|
19,531 |
19,154 |
$74K |
| 86376 |
|
6,353 |
6,264 |
$72K |
| 81001 |
|
88,526 |
81,006 |
$72K |
| 76700 |
|
785 |
778 |
$70K |
| 83001 |
|
7,633 |
7,521 |
$69K |
| 99214 |
|
869 |
844 |
$69K |
| 72156 |
|
930 |
914 |
$68K |
| 36592 |
|
70,134 |
62,161 |
$68K |
| 72197 |
|
297 |
293 |
$68K |
| 83655 |
|
4,888 |
4,842 |
$68K |
| 85379 |
|
15,632 |
14,945 |
$67K |
| 87522 |
Neg quan hep c or qual rna |
3,904 |
3,801 |
$66K |
| 86706 |
|
16,468 |
16,153 |
$65K |
| 73030 |
|
7,564 |
7,009 |
$65K |
| 77290 |
|
230 |
218 |
$65K |
| 86665 |
|
6,513 |
3,632 |
$64K |
| 86039 |
|
11,476 |
11,211 |
$63K |
| 80076 |
|
13,584 |
10,968 |
$62K |
| 86481 |
|
3,356 |
3,305 |
$61K |
| 52356 |
|
44 |
41 |
$61K |
| 87798 |
|
5,439 |
5,322 |
$60K |
| 72193 |
|
310 |
301 |
$60K |
| 86704 |
|
12,710 |
12,465 |
$60K |
| 77067 |
|
1,166 |
1,155 |
$58K |
| 82950 |
|
16,842 |
16,683 |
$58K |
| 82105 |
|
5,532 |
5,390 |
$57K |
| 58662 |
|
27 |
27 |
$56K |
| 87660 |
|
5,770 |
5,521 |
$56K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
2,758 |
2,496 |
$56K |
| 73130 |
|
6,953 |
6,371 |
$56K |
| 84703 |
|
49,989 |
45,735 |
$54K |
| J0881 |
Darbepoetin alfa, non-esrd |
657 |
435 |
$53K |
| 95811 |
|
156 |
155 |
$53K |
| 72141 |
|
573 |
562 |
$53K |
| 74175 |
|
319 |
312 |
$51K |
| 86695 |
|
5,731 |
5,640 |
$51K |
| 74174 |
|
296 |
285 |
$51K |
| 97803 |
|
1,294 |
1,126 |
$51K |
| 73110 |
|
5,251 |
4,777 |
$50K |
| 83013 |
|
2,579 |
2,550 |
$50K |
| Q5107 |
Inj mvasi 10 mg |
115 |
51 |
$49K |
| 83690 |
|
50,391 |
45,404 |
$48K |
| 44970 |
|
13 |
12 |
$47K |
| 76813 |
|
1,246 |
1,212 |
$47K |
| Q3014 |
Telehealth facility fee |
2,201 |
2,075 |
$46K |
| 80074 |
|
5,645 |
5,550 |
$46K |
| 86696 |
|
6,770 |
6,672 |
$46K |
| 83002 |
|
4,995 |
4,921 |
$46K |
| 84156 |
|
16,489 |
14,627 |
$45K |
| 81003 |
|
65,982 |
61,920 |
$45K |
| 73502 |
|
4,505 |
4,287 |
$44K |
| J9310 |
Rituximab injection |
19 |
12 |
$44K |
| 87081 |
|
15,239 |
15,053 |
$44K |
| 80143 |
|
12,410 |
11,135 |
$44K |
| 83993 |
|
3,370 |
3,328 |
$44K |
| 87636 |
|
18,848 |
18,094 |
$43K |
| 86256 |
|
6,267 |
5,718 |
$43K |
| 82677 |
|
2,070 |
2,041 |
$43K |
| 82043 |
|
18,025 |
17,703 |
$43K |
| 95913 |
|
296 |
290 |
$42K |
| 72131 |
|
1,559 |
1,522 |
$42K |
| 86800 |
|
3,604 |
3,536 |
$42K |
| 87631 |
|
1,508 |
1,482 |
$41K |
| G0480 |
Drug test def 1-7 classes |
3,338 |
2,661 |
$41K |
| 97597 |
|
811 |
547 |
$41K |
| 86364 |
|
5,419 |
5,349 |
$41K |
| 84153 |
|
6,354 |
6,100 |
$40K |
| 83520 |
|
5,929 |
4,842 |
$39K |
| J2357 |
Omalizumab injection |
80 |
61 |
$39K |
| 87480 |
|
5,770 |
5,521 |
$39K |
| 87637 |
|
9,689 |
9,350 |
$39K |
| 67311 |
|
13 |
13 |
$39K |
| 71045 |
|
32,816 |
30,174 |
$38K |
| 82248 |
|
9,073 |
6,728 |
$37K |
| 0001A |
|
1,179 |
1,172 |
$37K |
| 73560 |
|
4,432 |
4,023 |
$37K |
| 36591 |
|
8,350 |
5,010 |
$36K |
| 84481 |
|
6,630 |
6,469 |
$36K |
| E0604 |
Hosp grade elec breast pump |
1,154 |
528 |
$36K |
| 88307 |
|
2,064 |
1,834 |
$35K |
| 84550 |
|
23,540 |
19,200 |
$35K |
| 81220 |
|
609 |
604 |
$35K |
| 83516 |
|
5,617 |
3,628 |
$35K |
| 82330 |
|
9,325 |
8,696 |
$34K |
| 82533 |
|
4,513 |
3,610 |
$34K |
| 0002A |
|
857 |
856 |
$34K |
| 84145 |
|
3,502 |
3,320 |
$33K |
| 80164 |
|
3,832 |
3,592 |
$33K |
| 77338 |
|
292 |
240 |
$32K |
| 92507 |
|
898 |
435 |
$32K |
| 96368 |
|
3,008 |
1,921 |
$32K |
| J1447 |
Inj tbo filgrastim 1 microg |
188 |
60 |
$32K |
| 84270 |
|
3,226 |
3,169 |
$32K |
| 73140 |
|
2,755 |
2,640 |
$31K |
| 97802 |
|
487 |
478 |
$31K |
| 10061 |
|
213 |
204 |
$31K |
| 86787 |
|
5,763 |
4,539 |
$31K |
| 84144 |
|
2,864 |
2,725 |
$30K |
| 72040 |
|
1,845 |
1,816 |
$30K |
| 72158 |
|
222 |
218 |
$29K |
| 85610 |
|
50,407 |
36,221 |
$28K |
| 96417 |
|
5,458 |
3,433 |
$28K |
| 74183 |
|
146 |
146 |
$28K |
| 64721 |
|
52 |
50 |
$28K |
| 83883 |
|
3,395 |
1,840 |
$28K |
| J1439 |
Inj ferric carboxymaltos 1mg |
730 |
459 |
$27K |
| 86762 |
|
4,086 |
3,558 |
$27K |
| 82951 |
|
3,304 |
3,277 |
$27K |
| 73221 |
|
186 |
183 |
$27K |
| 83615 |
|
20,264 |
14,481 |
$27K |
| 83525 |
|
2,928 |
2,831 |
$26K |
| 82550 |
|
14,400 |
13,032 |
$26K |
| 99152 |
|
4,810 |
4,591 |
$26K |
| 73701 |
|
161 |
156 |
$26K |
| J9202 |
Goserelin acetate implant |
110 |
101 |
$26K |
| 86160 |
|
6,669 |
4,654 |
$25K |
| 95886 |
|
1,218 |
1,201 |
$25K |
| J3490 |
Drugs unclassified injection |
1,099 |
972 |
$25K |
| 99153 |
Mod sedat endo service >5yrs |
4,065 |
3,870 |
$25K |
| J0561 |
Penicillin g benzathine inj |
611 |
590 |
$24K |
| 97162 |
|
736 |
714 |
$24K |
| 86431 |
|
5,718 |
5,661 |
$24K |
| J2704 |
Inj, propofol, 10 mg |
24,777 |
23,202 |
$24K |
| 99213 |
|
386 |
369 |
$24K |
| 58558 |
|
25 |
24 |
$24K |
| 84100 |
|
12,970 |
9,676 |
$24K |
| 80178 |
|
2,845 |
2,628 |
$24K |
| 87430 |
|
8,687 |
8,449 |
$24K |
| 85014 |
|
7,129 |
6,324 |
$23K |
| 73080 |
|
1,911 |
1,819 |
$23K |
| 84165 |
|
6,020 |
5,499 |
$23K |
| 87209 |
|
3,216 |
3,147 |
$23K |
| 97161 |
|
690 |
666 |
$22K |
| 86334 |
|
3,809 |
3,492 |
$22K |
| 80179 |
|
12,360 |
11,115 |
$22K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
56,829 |
52,836 |
$22K |
| 73590 |
|
3,693 |
3,391 |
$22K |
| 87493 |
|
2,729 |
2,669 |
$22K |
| 80177 |
|
2,438 |
2,321 |
$22K |
| 80069 |
|
3,320 |
3,071 |
$22K |
| J9201 |
In gemcitabine hcl nos 200mg |
136 |
38 |
$21K |
| 86225 |
|
4,497 |
4,421 |
$21K |
| D2393 |
|
12 |
12 |
$20K |
| 87338 |
|
2,955 |
2,932 |
$20K |
| 86200 |
|
3,888 |
3,853 |
$20K |
| 86850 |
|
10,981 |
9,791 |
$20K |
| 82627 |
|
2,039 |
2,004 |
$19K |
| D2930 |
|
22 |
22 |
$19K |
| 80197 |
|
2,046 |
1,665 |
$19K |
| 88342 |
|
2,270 |
2,050 |
$19K |
| 76642 |
|
205 |
184 |
$19K |
| 73700 |
|
264 |
259 |
$19K |
| 64483 |
|
48 |
48 |
$18K |
| 84480 |
|
2,689 |
2,607 |
$18K |
| 82378 |
|
4,793 |
3,677 |
$18K |
| 86304 |
|
2,057 |
1,800 |
$18K |
| 83020 |
|
2,162 |
2,046 |
$18K |
| 86812 |
|
1,461 |
1,443 |
$18K |
| 86147 |
|
2,064 |
1,372 |
$18K |
| 84410 |
|
998 |
974 |
$18K |
| A4649 |
Surgical supplies |
7,391 |
6,672 |
$18K |
| 86308 |
|
3,967 |
3,917 |
$17K |
| 71101 |
|
2,578 |
2,495 |
$17K |
| 73090 |
|
2,265 |
2,103 |
$17K |
| 86708 |
|
2,848 |
2,813 |
$17K |
| 73120 |
|
655 |
492 |
$17K |
| J3489 |
Zoledronic acid 1mg |
1,152 |
1,080 |
$17K |
| 71271 |
|
189 |
182 |
$17K |
| J9206 |
Irinotecan injection |
170 |
52 |
$17K |
| 69209 |
|
180 |
175 |
$16K |
| 72157 |
|
240 |
236 |
$16K |
| A9552 |
F18 fdg |
1,065 |
1,034 |
$16K |
| 86923 |
|
2,108 |
1,368 |
$16K |
| 87641 |
|
1,019 |
983 |
$15K |
| 72072 |
|
825 |
810 |
$15K |
| 86900 |
|
11,963 |
10,701 |
$15K |
| 97140 |
|
524 |
165 |
$15K |
| 86008 |
|
2,114 |
1,943 |
$15K |
| 82565 |
|
7,703 |
7,307 |
$15K |
| 81025 |
|
23,083 |
22,043 |
$14K |
| 86301 |
|
1,534 |
1,109 |
$14K |
| 84134 |
|
1,817 |
1,123 |
$14K |
| Q5102 |
Inj., infliximab biosimilar |
16 |
13 |
$14K |
| 87177 |
|
3,218 |
3,149 |
$14K |
| 73552 |
|
1,622 |
1,512 |
$14K |
| 85730 |
|
13,816 |
12,992 |
$14K |
| J9070 |
Cyclophosphamide 100 mg inj |
176 |
88 |
$14K |
| 80175 |
|
1,675 |
1,618 |
$14K |
| 86677 |
|
1,225 |
1,216 |
$14K |
| 86870 |
|
1,383 |
1,010 |
$13K |
| 75574 |
|
70 |
69 |
$13K |
| 84445 |
|
623 |
613 |
$13K |
| 88304 |
|
3,323 |
3,100 |
$13K |
| 84432 |
|
919 |
796 |
$13K |
| 85018 |
|
6,221 |
5,449 |
$13K |
| 95812 |
|
45 |
45 |
$13K |
| 83014 |
|
2,576 |
2,547 |
$13K |
| 88185 |
|
516 |
447 |
$13K |
| 87634 |
|
556 |
548 |
$13K |
| 82232 |
|
1,269 |
1,052 |
$13K |
| J2270 |
Morphine sulfate injection |
29,802 |
24,560 |
$13K |
| 84425 |
|
2,294 |
2,266 |
$12K |
| 78306 |
|
66 |
63 |
$12K |
| 99195 |
|
369 |
320 |
$12K |
| 82274 |
|
2,767 |
2,746 |
$12K |
| 87517 |
|
808 |
694 |
$12K |
| 83721 |
|
2,358 |
2,337 |
$12K |
| 85651 |
|
4,040 |
3,762 |
$12K |
| 78452 |
|
39 |
39 |
$12K |
| 90471 |
|
6,722 |
6,477 |
$12K |
| 82952 |
|
3,230 |
3,062 |
$12K |
| 70544 |
|
149 |
144 |
$12K |
| 82977 |
|
6,869 |
6,481 |
$12K |
| 11042 |
|
104 |
66 |
$11K |
| 73660 |
|
949 |
913 |
$11K |
| 86146 |
|
1,417 |
1,055 |
$11K |
| 82947 |
|
7,739 |
7,495 |
$11K |
| 96376 |
|
20,597 |
15,185 |
$11K |
| 84305 |
|
870 |
861 |
$11K |
| 83498 |
|
907 |
890 |
$11K |
| 97166 |
|
341 |
331 |
$11K |
| 84450 |
|
7,797 |
7,507 |
$11K |
| 84163 |
|
977 |
951 |
$11K |
| 86300 |
|
1,494 |
1,184 |
$11K |
| 86756 |
|
3,082 |
2,956 |
$10K |
| 0012A |
|
270 |
269 |
$10K |
| 20610 |
|
54 |
53 |
$10K |
| 82150 |
|
6,415 |
6,188 |
$10K |
| 87184 |
|
3,789 |
3,725 |
$10K |
| J1885 |
Ketorolac tromethamine inj |
49,205 |
44,427 |
$10K |
| 97530 |
|
439 |
285 |
$10K |
| 77001 |
|
302 |
293 |
$10K |
| 29515 |
|
175 |
165 |
$10K |
| 86901 |
|
13,027 |
11,618 |
$9K |
| 86336 |
|
2,109 |
2,079 |
$9K |
| 86694 |
|
745 |
660 |
$9K |
| 84460 |
|
8,093 |
7,799 |
$9K |
| 87046 |
|
1,688 |
1,659 |
$9K |
| J2405 |
Ondansetron hcl injection |
72,758 |
58,725 |
$9K |
| 0011A |
|
328 |
325 |
$9K |
| 87328 |
|
1,783 |
1,761 |
$9K |
| 36416 |
|
31,618 |
26,609 |
$9K |
| 87210 |
|
1,976 |
1,881 |
$9K |
| 82542 |
|
1,019 |
996 |
$9K |
| 72128 |
|
566 |
555 |
$8K |
| 72170 |
|
1,964 |
1,879 |
$8K |
| 82040 |
|
6,417 |
6,192 |
$8K |
| 90686 |
|
713 |
696 |
$7K |
| 74178 |
|
51 |
50 |
$7K |
| 80203 |
|
933 |
900 |
$7K |
| 87536 |
|
117 |
110 |
$7K |
| 81015 |
|
2,885 |
2,795 |
$7K |
| 84166 |
|
974 |
892 |
$7K |
| 88341 |
|
1,268 |
1,068 |
$7K |
| 85045 |
|
3,909 |
3,483 |
$7K |
| 82465 |
|
3,119 |
3,035 |
$7K |
| 36590 |
|
12 |
12 |
$7K |
| 45380 |
|
27 |
27 |
$7K |
| 97165 |
|
182 |
181 |
$7K |
| 97110 |
|
257 |
102 |
$7K |
| 72070 |
|
1,012 |
989 |
$7K |
| 96402 |
|
2,301 |
2,050 |
$7K |
| 81050 |
|
3,005 |
2,321 |
$6K |
| 43235 |
|
12 |
12 |
$6K |
| 81241 |
|
278 |
274 |
$6K |
| C8929 |
Tte w or wo fol wcon,doppler |
222 |
218 |
$6K |
| 77387 |
|
2,375 |
281 |
$6K |
| 82239 |
|
686 |
601 |
$6K |
| A9585 |
Gadobutrol injection |
2,342 |
2,280 |
$6K |
| 93798 |
|
1,042 |
331 |
$6K |
| 93017 |
|
62 |
62 |
$6K |
| 95911 |
|
39 |
38 |
$6K |
| 87593 |
|
72 |
47 |
$6K |
| 82962 |
|
16,893 |
9,692 |
$6K |
| 62323 |
|
12 |
12 |
$6K |
| 87625 |
|
734 |
726 |
$6K |
| 84155 |
|
6,118 |
5,854 |
$6K |
| 83521 |
|
1,743 |
1,438 |
$6K |
| 84681 |
|
658 |
648 |
$6K |
| 86880 |
|
2,086 |
1,873 |
$6K |
| 84478 |
|
1,915 |
1,515 |
$6K |
| 82652 |
|
442 |
441 |
$6K |
| 82103 |
|
688 |
677 |
$6K |
| 36569 |
|
14 |
14 |
$6K |
| 82390 |
|
865 |
852 |
$6K |
| 20553 |
|
67 |
57 |
$6K |
| 85613 |
|
1,116 |
1,011 |
$5K |
| 87329 |
|
1,755 |
1,735 |
$5K |
| 96040 |
|
680 |
655 |
$5K |
| 88112 |
|
667 |
630 |
$5K |
| 86920 |
|
914 |
486 |
$5K |
| 82140 |
|
1,271 |
1,179 |
$5K |
| 82310 |
|
2,796 |
2,661 |
$5K |
| 87632 |
|
48 |
48 |
$5K |
| 16020 |
|
41 |
38 |
$5K |
| 77470 |
|
29 |
26 |
$5K |
| 86735 |
|
1,301 |
1,220 |
$5K |
| 87420 |
|
342 |
335 |
$5K |
| 82024 |
|
648 |
501 |
$5K |
| J1170 |
Hydromorphone injection |
18,363 |
14,509 |
$5K |
| C1769 |
Guide wire |
5,001 |
4,580 |
$5K |
| U0002 |
Covid-19 lab test non-cdc |
535 |
507 |
$5K |
| 85240 |
|
1,087 |
1,045 |
$5K |
| 83010 |
|
787 |
655 |
$5K |
| 73070 |
|
1,451 |
1,345 |
$5K |
| 86765 |
|
1,240 |
1,209 |
$5K |
| 83090 |
|
355 |
347 |
$5K |
| 77280 |
|
29 |
24 |
$5K |
| 51798 |
|
1,274 |
1,097 |
$4K |
| 73060 |
|
872 |
814 |
$4K |
| 86592 |
|
1,538 |
1,509 |
$4K |
| J0696 |
Ceftriaxone sodium injection |
22,712 |
18,583 |
$4K |
| 90674 |
|
369 |
357 |
$4K |
| 77332 |
|
78 |
67 |
$4K |
| 96401 |
|
1,438 |
671 |
$4K |
| 0031A |
|
111 |
109 |
$4K |
| 86769 |
|
776 |
768 |
$4K |
| 82731 |
|
192 |
186 |
$4K |
| G0103 |
Psa screening |
828 |
817 |
$4K |
| D7140 |
|
12 |
12 |
$4K |
| 82525 |
|
386 |
379 |
$4K |
| 74022 |
|
399 |
388 |
$4K |
| C1887 |
Catheter, guiding |
1,891 |
1,674 |
$4K |
| 80159 |
|
506 |
383 |
$4K |
| 80183 |
|
376 |
366 |
$4K |
| 73564 |
|
174 |
141 |
$4K |
| 94010 |
|
211 |
204 |
$4K |
| 59020 |
|
40 |
36 |
$4K |
| 84630 |
|
433 |
425 |
$4K |
| 99215 |
Prolong outpt/office vis |
61 |
57 |
$4K |
| 72050 |
|
131 |
130 |
$3K |
| J1642 |
Inj heparin sodium per 10 u |
34,834 |
14,924 |
$3K |
| J1100 |
Dexamethasone sodium phos |
37,423 |
29,594 |
$3K |
| 96411 |
|
3,170 |
1,988 |
$3K |
| J0640 |
Leucovorin calcium injection |
4,369 |
1,448 |
$3K |
| 82668 |
|
561 |
545 |
$3K |
| 10005 |
|
13 |
13 |
$3K |
| 87902 |
|
161 |
159 |
$3K |
| D2392 |
|
12 |
12 |
$3K |
| 88173 |
|
250 |
205 |
$3K |
| 88360 |
|
202 |
174 |
$3K |
| 86360 |
|
234 |
227 |
$3K |
| 81240 |
|
256 |
252 |
$3K |
| 77063 |
|
1,166 |
1,155 |
$3K |
| 77080 |
|
60 |
58 |
$3K |
| C1894 |
Intro/sheath, non-laser |
4,663 |
3,806 |
$3K |
| 76942 |
|
41 |
38 |
$3K |
| 88184 |
|
483 |
449 |
$3K |
| 80051 |
|
4,075 |
3,894 |
$3K |
| 83021 |
|
673 |
590 |
$3K |
| J2765 |
Metoclopramide hcl injection |
15,471 |
13,902 |
$3K |
| 85007 |
|
2,751 |
1,946 |
$3K |
| J3010 |
Fentanyl citrate injection |
26,672 |
24,160 |
$3K |
| 82077 |
|
14,929 |
12,562 |
$3K |
| G0145 |
Scr c/v cyto,thinlayer,rescr |
173 |
172 |
$3K |
| 77066 |
Tomosynthesis, mammo |
87 |
87 |
$3K |
| 81596 |
|
98 |
96 |
$3K |
| J2930 |
Methylprednisolone injection |
8,312 |
6,859 |
$3K |
| 81243 |
|
72 |
72 |
$3K |
| 82270 |
|
2,093 |
2,019 |
$2K |
| C1760 |
Closure dev, vasc |
1,652 |
1,609 |
$2K |
| 82010 |
|
3,780 |
3,351 |
$2K |
| 10160 |
|
25 |
24 |
$2K |
| 99203 |
|
30 |
30 |
$2K |
| J1200 |
Diphenhydramine hcl injectio |
22,294 |
17,139 |
$2K |
| 86036 |
|
473 |
465 |
$2K |
| 86141 |
|
411 |
401 |
$2K |
| J2060 |
Lorazepam injection |
7,362 |
6,269 |
$2K |
| 84520 |
|
4,632 |
4,381 |
$2K |
| 82553 |
|
247 |
231 |
$2K |
| J9267 |
Paclitaxel injection |
2,668 |
1,018 |
$2K |
| 82681 |
|
223 |
220 |
$2K |
| 86778 |
|
206 |
199 |
$2K |
| 86341 |
|
260 |
257 |
$2K |
| 86593 |
|
844 |
826 |
$2K |
| 87075 |
|
690 |
625 |
$2K |
| 99204 |
|
15 |
15 |
$2K |
| 84466 |
|
396 |
388 |
$2K |
| J0690 |
Cefazolin sodium injection |
15,074 |
12,708 |
$2K |
| J8540 |
Oral dexamethasone |
5,268 |
4,082 |
$2K |
| 84132 |
|
1,484 |
1,402 |
$2K |
| 91065 |
|
86 |
86 |
$2K |
| J0500 |
Dicyclomine injection |
1,070 |
1,020 |
$2K |
| 92567 |
|
212 |
208 |
$2K |
| J7120 |
Ringers lactate infusion |
28,015 |
24,121 |
$2K |
| 92610 |
|
54 |
52 |
$1K |
| J9190 |
Fluorouracil injection |
6,226 |
1,604 |
$1K |
| J2250 |
Inj midazolam hydrochloride |
16,960 |
16,125 |
$1K |
| 80299 |
|
263 |
253 |
$1K |
| 84436 |
|
189 |
188 |
$1K |
| 87045 |
|
241 |
234 |
$1K |
| 87101 |
|
242 |
240 |
$1K |
| 87102 |
|
535 |
502 |
$1K |
| 84075 |
|
4,282 |
4,096 |
$1K |
| 70549 |
|
15 |
14 |
$1K |
| 86645 |
|
126 |
124 |
$1K |
| 83718 |
|
115 |
114 |
$1K |
| J2997 |
Alteplase recombinant |
34 |
28 |
$1K |
| P9040 |
Rbc leukoreduced irradiated |
41 |
25 |
$1K |
| 86777 |
|
208 |
199 |
$1K |
| 73000 |
|
109 |
103 |
$1K |
| 99151 |
|
15 |
13 |
$1K |
| 85048 |
|
179 |
174 |
$1K |
| 80185 |
|
120 |
108 |
$1K |
| 74019 |
|
26 |
24 |
$1K |
| 41800 |
|
14 |
14 |
$1K |
| C1781 |
Mesh (implantable) |
260 |
253 |
$1K |
| 77333 |
|
14 |
13 |
$1K |
| 76857 |
|
29 |
29 |
$1K |
| D3220 |
|
17 |
17 |
$1K |
| 93797 |
|
307 |
79 |
$1K |
| 86644 |
|
116 |
113 |
$1K |
| 85390 |
|
490 |
478 |
$988.99 |
| 84590 |
|
162 |
161 |
$987.33 |
| 89055 |
|
602 |
594 |
$934.46 |
| 87427 |
|
237 |
233 |
$921.93 |
| 77002 |
|
12 |
12 |
$892.80 |
| 70360 |
|
92 |
87 |
$881.19 |
| 87449 |
|
153 |
150 |
$881.00 |
| 85246 |
|
170 |
167 |
$869.53 |
| 82805 |
|
1,551 |
1,402 |
$869.09 |
| 72220 |
|
101 |
96 |
$852.62 |
| J3370 |
Vancomycin hcl injection |
4,633 |
2,540 |
$842.70 |
| 85245 |
|
124 |
118 |
$833.12 |
| 86359 |
|
207 |
201 |
$825.37 |
| 93923 |
|
12 |
12 |
$804.78 |
| J1940 |
Furosemide injection |
2,958 |
2,184 |
$803.83 |
| 96409 |
|
72 |
36 |
$772.20 |
| C1776 |
Joint device (implantable) |
54 |
51 |
$756.43 |
| 87220 |
|
239 |
238 |
$749.41 |
| 87880 |
|
6,624 |
6,388 |
$745.90 |
| 51702 |
|
191 |
163 |
$716.48 |
| G0498 |
Chemo extend iv infus w/pump |
1,172 |
659 |
$710.35 |
| 85306 |
|
159 |
151 |
$700.02 |
| A9579 |
Gad-base mr contrast nos,1ml |
3,623 |
3,511 |
$694.49 |
| 82365 |
|
164 |
149 |
$681.66 |
| M0220 |
Tixagev and cilgav inj |
73 |
72 |
$666.62 |
| J0780 |
Prochlorperazine injection |
3,292 |
3,049 |
$656.90 |
| 84235 |
|
29 |
28 |
$650.38 |
| 84181 |
|
94 |
90 |
$630.74 |
| 84402 |
|
50 |
50 |
$629.50 |
| J9045 |
Carboplatin injection |
1,796 |
1,089 |
$606.14 |
| 90714 |
|
32 |
31 |
$587.83 |
| 80156 |
|
59 |
57 |
$584.30 |
| G2215 |
Home supply nasal naloxone |
56 |
51 |
$576.47 |
| 92582 |
|
13 |
13 |
$568.10 |
| 0225U |
|
989 |
979 |
$550.26 |
| J2310 |
Inj naloxone hydrochloride |
50 |
38 |
$548.02 |
| 92524 |
|
13 |
12 |
$541.09 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
1,417 |
1,358 |
$534.37 |
| 77065 |
Tomosynthesis, mammo |
17 |
17 |
$511.98 |
| J2710 |
Neostigmine methylslfte inj |
6,686 |
6,038 |
$509.24 |
| C2617 |
Stent, non-cor, tem w/o del |
170 |
161 |
$502.23 |
| 76802 |
|
14 |
12 |
$490.37 |
| J7060 |
5% dextrose/water |
9,487 |
2,949 |
$489.69 |
| J1630 |
Haloperidol injection |
3,496 |
3,029 |
$477.40 |
| J3480 |
Inj potassium chloride |
3,972 |
2,493 |
$469.27 |
| 85303 |
|
138 |
132 |
$469.06 |
| A9577 |
Inj multihance |
1,168 |
1,151 |
$458.92 |
| 95250 |
|
13 |
13 |
$453.55 |
| 76812 |
|
13 |
12 |
$446.60 |
| 84446 |
|
64 |
63 |
$435.64 |
| 85384 |
|
440 |
395 |
$422.72 |
| J1650 |
Inj enoxaparin sodium |
6,619 |
3,722 |
$421.06 |
| C1729 |
Cath, drainage |
2,490 |
1,497 |
$420.94 |
| 87804 |
|
253 |
226 |
$417.32 |
| 86618 |
|
55 |
54 |
$409.81 |
| 89051 |
|
918 |
743 |
$401.14 |
| 73600 |
|
16 |
12 |
$370.90 |
| J3360 |
Diazepam injection |
1,229 |
1,162 |
$370.50 |
| 88300 |
|
28 |
28 |
$362.63 |
| 82626 |
|
29 |
29 |
$358.03 |
| 74220 |
|
12 |
12 |
$356.15 |
| J0702 |
Betamethasone acet&sod phosp |
599 |
447 |
$349.90 |
| C9113 |
Inj pantoprazole sodium, via |
902 |
579 |
$340.78 |
| 82164 |
|
46 |
41 |
$330.64 |
| J1815 |
Insulin injection |
6,261 |
3,674 |
$328.05 |
| 92555 |
|
24 |
24 |
$326.92 |
| 36593 |
|
12 |
12 |
$324.77 |
| 86352 |
|
12 |
12 |
$324.27 |
| 73521 |
|
12 |
12 |
$320.84 |
| 81270 |
|
15 |
15 |
$319.80 |
| J3420 |
Vitamin b12 injection |
1,879 |
1,388 |
$314.51 |
| J1644 |
Inj heparin sodium per 1000u |
9,819 |
5,505 |
$306.92 |
| 82672 |
|
25 |
24 |
$303.65 |
| 97760 |
|
18 |
12 |
$299.70 |
| J1790 |
Droperidol injection |
1,587 |
1,431 |
$282.62 |
| 76380 |
|
12 |
12 |
$280.04 |
| 80202 |
|
27 |
12 |
$271.42 |
| C1751 |
Cath, inf, per/cent/midline |
382 |
367 |
$267.80 |
| A9502 |
Tc99m tetrofosmin |
26 |
26 |
$266.31 |
| 84112 |
|
183 |
171 |
$257.71 |
| 85300 |
|
100 |
99 |
$251.37 |
| 89125 |
|
78 |
77 |
$250.85 |
| 0003A |
|
12 |
12 |
$243.20 |
| 84207 |
|
49 |
48 |
$235.69 |
| 72192 |
|
12 |
12 |
$235.01 |
| C1725 |
Cath, translumin non-laser |
126 |
109 |
$234.71 |
| 88142 |
|
14 |
14 |
$231.78 |
| 80305 |
|
1,614 |
1,539 |
$218.64 |
| 84244 |
|
24 |
24 |
$214.70 |
| J2543 |
Piperacillin/tazobactam |
359 |
220 |
$205.25 |
| 87116 |
|
15 |
12 |
$195.14 |
| 87140 |
|
15 |
14 |
$192.30 |
| 83519 |
|
36 |
25 |
$188.78 |
| 80162 |
|
17 |
14 |
$184.48 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
749 |
535 |
$179.12 |
| 81256 |
|
15 |
15 |
$177.96 |
| J3475 |
Inj magnesium sulfate |
4,323 |
3,068 |
$171.80 |
| J0330 |
Succinycholine chloride inj |
2,297 |
2,235 |
$164.28 |
| C9399 |
Unclassified drugs or biolog |
286 |
183 |
$162.80 |
| J0171 |
Adrenalin epinephrine inject |
2,014 |
1,885 |
$162.71 |
| 82803 |
|
3,492 |
3,011 |
$160.86 |
| J2550 |
Promethazine hcl injection |
920 |
832 |
$132.64 |
| 85660 |
|
78 |
54 |
$124.50 |
| 90656 |
|
13 |
12 |
$117.80 |
| 82085 |
|
37 |
36 |
$111.82 |
| J0461 |
Atropine sulfate injection |
588 |
345 |
$109.30 |
| A9503 |
Tc99m medronate |
128 |
122 |
$104.52 |
| J2370 |
Phenylephrine hcl injection |
2,715 |
2,409 |
$101.43 |
| A9541 |
Tc99m sulfur colloid |
65 |
62 |
$100.14 |
| 86335 |
|
27 |
26 |
$99.70 |
| 87341 |
|
24 |
24 |
$88.89 |
| 92587 |
|
13 |
12 |
$82.56 |
| C9463 |
Injection, aprepitant |
194 |
103 |
$79.01 |
| J2795 |
Ropivacaine hcl injection |
601 |
592 |
$71.11 |
| 85347 |
|
560 |
375 |
$69.83 |
| J7512 |
Prednisone ir or dr oral 1mg |
6,101 |
5,337 |
$69.45 |
| J2175 |
Meperidine hydrochl /100 mg |
538 |
523 |
$67.61 |
| 87110 |
|
15 |
14 |
$66.20 |
| J3411 |
Thiamine hcl 100 mg |
805 |
605 |
$62.03 |
| 85307 |
|
13 |
12 |
$61.26 |
| 99173 |
|
31 |
31 |
$58.00 |
| 86922 |
|
23 |
12 |
$57.30 |
| C1758 |
Catheter, ureteral |
547 |
487 |
$53.05 |
| 87425 |
|
13 |
13 |
$52.43 |
| 88302 |
|
110 |
102 |
$52.39 |
| C2625 |
Stent, non-cor, tem w/del sy |
220 |
211 |
$51.63 |
| 87015 |
|
15 |
12 |
$41.81 |
| 84300 |
|
12 |
12 |
$40.11 |
| 87206 |
|
16 |
13 |
$35.53 |
| 90662 |
|
114 |
109 |
$31.52 |
| G0472 |
Hep c screen high risk/other |
620 |
618 |
$30.47 |
| J1956 |
Levofloxacin injection |
757 |
696 |
$28.32 |
| A4314 |
Cath w/drainage 2-way latex |
1,715 |
1,628 |
$28.10 |
| 86162 |
|
14 |
13 |
$26.88 |
| J0360 |
Hydralazine hcl injection |
1,291 |
1,156 |
$22.91 |
| 87088 |
|
422 |
402 |
$13.36 |
| 83930 |
|
14 |
12 |
$13.29 |
| 90694 |
|
26 |
25 |
$13.08 |
| J2916 |
Na ferric gluconate complex |
14 |
12 |
$11.61 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
2,148 |
2,061 |
$10.02 |
| J1920 |
Inj, labetalol hcl, 5mg |
302 |
281 |
$6.44 |
| J0456 |
Azithromycin |
303 |
265 |
$5.12 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
529 |
495 |
$4.63 |
| J1836 |
Inj, metronidazole, 10 mg |
533 |
351 |
$3.56 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
910 |
883 |
$3.16 |
| 87905 |
|
252 |
244 |
$2.28 |
| J2470 |
Inj pantoprazole sodium 40mg |
119 |
88 |
$2.20 |
| J2920 |
Methylprednisolone injection |
20 |
12 |
$1.88 |
| J2919 |
Inj, methylpred sod succ 5mg |
1,024 |
846 |
$1.01 |
| A4351 |
Straight tip urine catheter |
706 |
694 |
$0.82 |
| S2900 |
Robotic surgical system |
120 |
116 |
$0.76 |
| Q9969 |
Non-heu tc-99m add-on/dose |
531 |
500 |
$0.46 |
| 84157 |
|
12 |
12 |
$0.44 |
| J3301 |
Triamcinolone acet inj nos |
234 |
223 |
$0.29 |
| Q0220 |
Tixagev and cilgav, 300mg |
83 |
74 |
$0.28 |
| P9604 |
One-way allow prorated trip |
766 |
550 |
$0.00 |
| J9060 |
Cisplatin 10 mg injection |
176 |
76 |
$0.00 |
| J0689 |
Inj cefazolin sodium, baxter |
20 |
15 |
$0.00 |
| G1004 |
Cdsm ndsc |
25,496 |
21,171 |
$0.00 |
| J2720 |
Inj protamine sulfate/10 mg |
37 |
37 |
$0.00 |
| G0500 |
Mod sedat endo service >5yrs |
51 |
46 |
$0.00 |
| J1953 |
Levetiracetam injection |
124 |
95 |
$0.00 |
| A4358 |
Urinary leg or abdomen bag |
67 |
54 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
437 |
336 |
$0.00 |
| D1120 |
|
34 |
34 |
$0.00 |
| 77062 |
|
85 |
85 |
$0.00 |
| J0134 |
Inj acetaminophen -fresenius |
168 |
166 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
125 |
123 |
$0.00 |
| J0737 |
Inj, clindamycin (baxter) |
134 |
125 |
$0.00 |
| C1788 |
Port, indwelling, imp |
151 |
142 |
$0.00 |
| J3473 |
Hyaluronidase recombinant |
12 |
12 |
$0.00 |
| 91300 |
|
1,837 |
1,693 |
$0.00 |
| A9537 |
Tc99m mebrofenin |
12 |
12 |
$0.00 |
| J0688 |
Inj cefazolin sodium, hikma |
12 |
12 |
$0.00 |
| J3371 |
Inj, vancomycin hcl (mylan) |
41 |
23 |
$0.00 |
| D0220 |
|
18 |
18 |
$0.00 |
| G0008 |
Admin influenza virus vac |
169 |
156 |
$0.00 |
| A4338 |
Indwelling catheter latex |
230 |
205 |
$0.00 |
| C1726 |
Cath, bal dil, non-vascular |
122 |
113 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
693 |
658 |
$0.00 |
| J0173 |
Inj, epinephrine (belcher) |
239 |
227 |
$0.00 |
| J2305 |
Inj, nitroglycerin, 5 mg |
25 |
24 |
$0.00 |
| J9181 |
Etoposide injection |
56 |
12 |
$0.00 |
| 91301 |
|
578 |
558 |
$0.00 |
| D0230 |
|
18 |
18 |
$0.00 |
| J7999 |
Compounded drug, noc |
13 |
13 |
$0.00 |
| G0475 |
Hiv combination assay |
20 |
16 |
$0.00 |
| 96521 |
|
65 |
47 |
$0.00 |
| A9500 |
Tc99m sestamibi |
27 |
26 |
$0.00 |
| J7620 |
Albuterol ipratrop non-comp |
76 |
53 |
$0.00 |
| J2560 |
Phenobarbital sodium inj |
34 |
25 |
$0.00 |
| J2785 |
Regadenoson injection |
25 |
25 |
$0.00 |
| C1766 |
Intro/sheath,strble,non-peel |
13 |
13 |
$0.00 |
| C1732 |
Cath, ep, diag/abl, 3d/vect |
32 |
27 |
$0.00 |
| J1720 |
Hydrocortisone sodium succ i |
17 |
12 |
$0.00 |
| D1208 |
|
20 |
20 |
$0.00 |
| 81511 |
|
12 |
12 |
$0.00 |
| A4590 |
Special casting material |
12 |
12 |
$0.00 |
| J1030 |
Methylprednisolone 40 mg inj |
13 |
12 |
$0.00 |