| Code | Description | Claims | Beneficiaries | Total Paid |
| G0463 |
Hospital outpt clinic visit |
598,678 |
534,843 |
$54.87M |
| 99285 |
|
3,520 |
3,075 |
$4.78M |
| 99283 |
|
19,609 |
18,643 |
$2.60M |
| 70553 |
|
4,334 |
4,128 |
$1.58M |
| 99284 |
|
7,268 |
6,801 |
$1.34M |
| 90471 |
|
25,691 |
24,744 |
$1.19M |
| J3380 |
Inj vedolizumab iv 1 mg |
613 |
455 |
$1.17M |
| 93306 |
|
2,761 |
2,506 |
$1.02M |
| 76811 |
|
4,590 |
4,189 |
$794K |
| 87635 |
|
16,337 |
14,916 |
$788K |
| 93303 |
|
2,036 |
1,856 |
$712K |
| 67028 |
|
2,926 |
2,651 |
$648K |
| J1745 |
Infliximab not biosimil 10mg |
527 |
407 |
$630K |
| 95810 |
|
872 |
848 |
$623K |
| J2426 |
Inj, invega sustenna, 1 mg |
1,159 |
1,003 |
$567K |
| 92587 |
|
2,966 |
2,527 |
$566K |
| 69436 |
|
666 |
570 |
$504K |
| 41899 |
|
438 |
282 |
$503K |
| 90853 |
|
10,350 |
2,896 |
$457K |
| 71260 |
|
1,255 |
1,177 |
$424K |
| 96365 |
|
2,815 |
2,173 |
$420K |
| 87636 |
|
2,940 |
2,820 |
$398K |
| 90834 |
|
4,213 |
2,593 |
$394K |
| 94060 |
|
2,264 |
2,141 |
$380K |
| J1439 |
Inj ferric carboxymaltos 1mg |
974 |
780 |
$377K |
| 77067 |
|
4,447 |
4,201 |
$363K |
| 76770 |
|
4,449 |
4,171 |
$358K |
| 90935 |
|
4,323 |
325 |
$346K |
| 92523 |
|
2,680 |
2,151 |
$338K |
| 92014 |
|
3,177 |
3,062 |
$329K |
| 59025 |
|
2,556 |
1,888 |
$329K |
| 99392 |
|
4,155 |
3,959 |
$315K |
| 82947 |
|
9,900 |
8,972 |
$304K |
| 76705 |
|
4,073 |
3,858 |
$302K |
| 99391 |
|
4,210 |
3,941 |
$293K |
| 90791 |
|
1,863 |
1,734 |
$268K |
| 20611 |
|
1,401 |
1,324 |
$266K |
| 96112 |
|
2,407 |
2,067 |
$262K |
| 90870 |
|
2,413 |
1,320 |
$261K |
| 95782 |
|
347 |
336 |
$251K |
| 70551 |
|
1,091 |
1,012 |
$250K |
| 95004 |
|
1,089 |
1,002 |
$237K |
| 96413 |
|
970 |
820 |
$223K |
| 76816 |
|
5,741 |
4,698 |
$214K |
| 90686 |
|
12,328 |
11,975 |
$209K |
| 29450 |
|
1,480 |
743 |
$203K |
| 16020 |
|
1,368 |
1,177 |
$196K |
| 71046 |
|
4,044 |
3,759 |
$192K |
| 96372 |
|
5,940 |
4,872 |
$189K |
| 95813 |
|
803 |
773 |
$180K |
| 74177 |
|
2,804 |
2,636 |
$175K |
| 99282 |
|
1,912 |
1,867 |
$171K |
| 31231 |
|
1,435 |
1,367 |
$165K |
| 42820 |
|
42 |
40 |
$163K |
| C9803 |
Hopd covid-19 spec collect |
9,754 |
8,543 |
$157K |
| 87637 |
|
1,763 |
1,630 |
$156K |
| 77063 |
|
3,968 |
3,747 |
$155K |
| H0035 |
Mh partial hosp tx under 24h |
1,093 |
254 |
$147K |
| 31575 |
|
1,069 |
1,021 |
$132K |
| 90670 |
|
1,931 |
1,885 |
$123K |
| G0480 |
Drug test def 1-7 classes |
4,975 |
3,951 |
$120K |
| 93005 |
|
22,008 |
19,883 |
$119K |
| 91065 |
|
1,132 |
904 |
$116K |
| 80307 |
|
5,696 |
4,329 |
$115K |
| 99393 |
|
1,391 |
1,376 |
$110K |
| 77386 |
|
312 |
70 |
$108K |
| 74183 |
|
455 |
428 |
$104K |
| 95800 |
|
1,044 |
996 |
$104K |
| 96127 |
|
6,364 |
5,523 |
$97K |
| G0378 |
Hospital observation per hr |
3,672 |
2,736 |
$96K |
| 92610 |
|
1,441 |
1,201 |
$93K |
| 96374 |
|
1,016 |
942 |
$93K |
| 92004 |
|
981 |
950 |
$91K |
| 96101 |
|
952 |
813 |
$88K |
| 77080 |
|
1,315 |
1,257 |
$77K |
| 92557 |
|
2,544 |
2,388 |
$77K |
| 36415 |
|
132,888 |
117,060 |
$72K |
| A9585 |
Gadobutrol injection |
9,253 |
8,601 |
$70K |
| G0008 |
Admin influenza virus vac |
2,259 |
2,149 |
$69K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
6,353 |
5,632 |
$68K |
| 78815 |
|
85 |
77 |
$67K |
| 96110 |
|
1,110 |
880 |
$66K |
| J0585 |
Injection,onabotulinumtoxina |
128 |
119 |
$66K |
| 81229 |
|
58 |
56 |
$59K |
| 90837 |
|
567 |
363 |
$57K |
| 76830 |
|
670 |
622 |
$54K |
| 80061 |
|
4,540 |
4,291 |
$51K |
| 99394 |
|
578 |
564 |
$50K |
| 94010 |
|
5,061 |
4,709 |
$43K |
| 95811 |
|
89 |
81 |
$43K |
| 84443 |
|
14,151 |
13,077 |
$42K |
| 92012 |
|
378 |
367 |
$39K |
| 96111 |
|
335 |
332 |
$39K |
| 11721 |
|
1,854 |
1,797 |
$39K |
| 90792 |
|
357 |
349 |
$38K |
| 97165 |
|
792 |
599 |
$34K |
| 43239 |
|
77 |
61 |
$34K |
| 20610 |
|
208 |
191 |
$34K |
| H0015 |
Alcohol and/or drug services |
490 |
146 |
$32K |
| 92507 |
|
569 |
184 |
$29K |
| 85025 |
|
54,718 |
47,082 |
$29K |
| M0243 |
Casirivi and imdevi inj |
75 |
71 |
$29K |
| 72082 |
|
2,622 |
2,340 |
$28K |
| 93296 |
|
1,289 |
1,229 |
$27K |
| 71250 |
|
390 |
377 |
$27K |
| 87633 |
|
185 |
183 |
$27K |
| 97161 |
|
510 |
425 |
$27K |
| 96130 |
|
749 |
684 |
$26K |
| 93226 |
|
365 |
326 |
$23K |
| 97803 |
|
1,961 |
1,800 |
$22K |
| M0245 |
Bamlan and etesev infusion |
59 |
55 |
$22K |
| 76642 |
|
507 |
474 |
$22K |
| 90697 |
|
524 |
518 |
$21K |
| 80053 |
|
14,423 |
12,333 |
$21K |
| 91320 |
|
213 |
210 |
$20K |
| 0241U |
|
650 |
571 |
$19K |
| G0279 |
Tomosynthesis, mammo |
580 |
534 |
$19K |
| 97110 |
|
521 |
334 |
$19K |
| J0178 |
Aflibercept injection |
37 |
37 |
$18K |
| 76536 |
|
575 |
547 |
$18K |
| 0001A |
|
478 |
464 |
$18K |
| J0475 |
Baclofen 10 mg injection |
112 |
81 |
$18K |
| 83036 |
|
14,804 |
13,998 |
$17K |
| 96415 |
|
319 |
284 |
$17K |
| 92604 |
|
175 |
163 |
$17K |
| J0882 |
Darbepoetin alfa, esrd use |
551 |
183 |
$16K |
| 0002A |
|
458 |
427 |
$15K |
| 97166 |
|
264 |
233 |
$15K |
| 73721 |
|
84 |
82 |
$14K |
| J1756 |
Iron sucrose injection |
556 |
297 |
$14K |
| 90480 |
|
385 |
377 |
$13K |
| 90723 |
|
479 |
457 |
$13K |
| 95812 |
|
75 |
68 |
$13K |
| 84439 |
|
5,979 |
5,556 |
$12K |
| 93271 |
|
163 |
159 |
$12K |
| 97167 |
|
211 |
184 |
$11K |
| 76825 |
|
27 |
24 |
$11K |
| 77072 |
|
1,118 |
1,043 |
$11K |
| 82728 |
|
4,449 |
4,144 |
$11K |
| 86900 |
|
795 |
713 |
$10K |
| 76801 |
|
110 |
102 |
$10K |
| 93975 |
|
75 |
71 |
$10K |
| 74230 |
|
122 |
105 |
$9K |
| 82565 |
|
17,038 |
15,306 |
$9K |
| 95970 |
|
458 |
426 |
$9K |
| 76817 |
|
304 |
270 |
$9K |
| 81479 |
|
203 |
173 |
$9K |
| 73030 |
|
1,828 |
1,629 |
$9K |
| 87536 |
|
574 |
544 |
$9K |
| 96409 |
|
48 |
37 |
$9K |
| 92522 |
|
131 |
113 |
$9K |
| 77066 |
Tomosynthesis, mammo |
99 |
91 |
$9K |
| 76881 |
|
91 |
78 |
$8K |
| 92611 |
|
126 |
113 |
$8K |
| 87491 |
|
694 |
612 |
$8K |
| 92134 |
|
7,087 |
6,472 |
$8K |
| 95165 |
|
271 |
268 |
$8K |
| 97162 |
|
154 |
125 |
$8K |
| 64642 |
|
16 |
16 |
$8K |
| 76815 |
|
786 |
598 |
$8K |
| 92083 |
|
1,522 |
1,469 |
$8K |
| 70450 |
|
96 |
90 |
$7K |
| 90688 |
|
643 |
606 |
$7K |
| 84520 |
|
13,291 |
10,837 |
$7K |
| 0072A |
|
250 |
245 |
$7K |
| 87661 |
|
319 |
303 |
$7K |
| 97802 |
|
371 |
345 |
$7K |
| 87591 |
|
649 |
572 |
$7K |
| 75561 |
|
12 |
12 |
$7K |
| 76882 |
|
129 |
104 |
$6K |
| 64483 |
|
12 |
12 |
$6K |
| 73630 |
|
1,194 |
1,042 |
$6K |
| 96136 |
|
698 |
645 |
$6K |
| 77336 |
|
70 |
39 |
$6K |
| 96137 |
|
776 |
630 |
$6K |
| U0004 |
Cov-19 test non-cdc hgh thru |
162 |
126 |
$6K |
| 97530 |
|
125 |
99 |
$6K |
| 80048 |
|
4,010 |
3,637 |
$6K |
| 17110 |
|
134 |
133 |
$6K |
| 87081 |
|
860 |
839 |
$5K |
| 86780 |
|
371 |
348 |
$5K |
| 94726 |
|
332 |
317 |
$5K |
| 84295 |
|
8,892 |
7,990 |
$5K |
| 90651 |
|
87 |
84 |
$5K |
| 84132 |
|
8,272 |
7,418 |
$5K |
| 83880 |
|
611 |
564 |
$5K |
| 82374 |
|
8,602 |
7,744 |
$5K |
| 80051 |
|
1,430 |
1,354 |
$5K |
| 84403 |
|
1,002 |
957 |
$5K |
| 82435 |
|
8,550 |
7,702 |
$5K |
| 90656 |
|
1,413 |
1,389 |
$5K |
| 90677 |
|
321 |
319 |
$5K |
| 85027 |
|
8,707 |
7,856 |
$4K |
| 82670 |
|
825 |
794 |
$4K |
| 0071A |
|
189 |
188 |
$4K |
| 84460 |
|
7,324 |
6,720 |
$4K |
| 73564 |
|
572 |
518 |
$4K |
| 82310 |
|
7,846 |
7,037 |
$4K |
| 69210 |
|
328 |
301 |
$4K |
| J0330 |
Succinycholine chloride inj |
2,336 |
1,286 |
$4K |
| J2704 |
Inj, propofol, 10 mg |
7,218 |
5,422 |
$4K |
| 96375 |
|
170 |
130 |
$4K |
| 84466 |
|
3,014 |
2,801 |
$4K |
| 0124A |
|
131 |
123 |
$4K |
| 72141 |
|
30 |
27 |
$4K |
| 82977 |
|
3,003 |
2,698 |
$4K |
| 84450 |
|
6,472 |
5,934 |
$4K |
| 99395 |
|
44 |
43 |
$4K |
| 87651 |
|
1,127 |
1,069 |
$4K |
| J2250 |
Inj midazolam hydrochloride |
1,034 |
878 |
$3K |
| 82306 |
|
1,094 |
1,027 |
$3K |
| 29075 |
|
15 |
12 |
$3K |
| 73610 |
|
651 |
591 |
$3K |
| 82570 |
|
2,623 |
2,357 |
$3K |
| 83520 |
|
777 |
736 |
$3K |
| 73502 |
|
540 |
505 |
$3K |
| 96138 |
|
69 |
56 |
$3K |
| 82040 |
|
5,502 |
4,968 |
$3K |
| C9257 |
Bevacizumab injection |
497 |
451 |
$3K |
| 74018 |
|
389 |
364 |
$3K |
| 81001 |
|
7,266 |
6,612 |
$3K |
| 90832 |
|
182 |
152 |
$3K |
| 82248 |
|
2,021 |
1,825 |
$3K |
| 96360 |
|
13 |
12 |
$3K |
| 82465 |
|
420 |
406 |
$3K |
| 83735 |
|
1,607 |
1,205 |
$2K |
| 93225 |
|
91 |
79 |
$2K |
| 87389 |
|
278 |
254 |
$2K |
| 96116 |
|
16 |
16 |
$2K |
| G0108 |
Diab manage trn per indiv |
415 |
383 |
$2K |
| 85610 |
|
2,692 |
2,490 |
$2K |
| J3301 |
Triamcinolone acet inj nos |
1,938 |
1,845 |
$2K |
| 83718 |
|
420 |
406 |
$2K |
| 72170 |
|
266 |
248 |
$2K |
| 97140 |
|
97 |
64 |
$2K |
| 95983 |
|
85 |
75 |
$2K |
| Q3014 |
Telehealth facility fee |
729 |
542 |
$2K |
| 88142 |
|
419 |
388 |
$2K |
| 83540 |
|
2,980 |
2,769 |
$2K |
| 92582 |
|
26 |
24 |
$2K |
| 83970 |
|
612 |
561 |
$2K |
| 93297 |
|
95 |
90 |
$2K |
| 76885 |
|
54 |
50 |
$2K |
| 84478 |
|
420 |
406 |
$2K |
| 90619 |
|
55 |
55 |
$2K |
| 82105 |
|
1,299 |
1,197 |
$2K |
| 72100 |
|
193 |
187 |
$2K |
| 73110 |
|
417 |
369 |
$2K |
| 0054A |
|
56 |
54 |
$2K |
| 84075 |
|
3,823 |
3,411 |
$2K |
| 80197 |
|
601 |
356 |
$2K |
| 92567 |
|
4,474 |
4,075 |
$2K |
| 84100 |
|
2,119 |
1,879 |
$2K |
| 82247 |
|
3,562 |
3,141 |
$2K |
| 92250 |
|
39 |
35 |
$2K |
| 87480 |
|
95 |
89 |
$1K |
| 86803 |
|
332 |
304 |
$1K |
| 0004A |
|
65 |
64 |
$1K |
| U0002 |
Covid-19 lab test non-cdc |
69 |
54 |
$1K |
| 97799 |
|
83 |
48 |
$1K |
| 86480 |
|
36 |
36 |
$1K |
| 85045 |
|
3,681 |
3,317 |
$1K |
| 88305 |
|
614 |
557 |
$1K |
| 82607 |
|
838 |
806 |
$1K |
| 87502 |
|
100 |
99 |
$1K |
| 94640 |
|
322 |
299 |
$1K |
| 84156 |
|
1,700 |
1,573 |
$1K |
| J3010 |
Fentanyl citrate injection |
2,407 |
2,082 |
$1K |
| 36591 |
|
501 |
309 |
$1K |
| 87510 |
|
95 |
89 |
$1K |
| 73590 |
|
526 |
400 |
$1K |
| 73521 |
|
112 |
108 |
$1K |
| 84155 |
|
3,203 |
2,857 |
$1K |
| 73562 |
|
382 |
338 |
$1K |
| 84703 |
|
202 |
177 |
$1K |
| 90685 |
|
308 |
297 |
$1K |
| 72148 |
|
15 |
15 |
$1K |
| 77065 |
Tomosynthesis, mammo |
16 |
14 |
$1K |
| 80069 |
|
621 |
528 |
$1K |
| J1100 |
Dexamethasone sodium phos |
2,520 |
1,893 |
$1K |
| 99152 |
|
405 |
361 |
$993.21 |
| 96131 |
|
35 |
34 |
$973.57 |
| 73560 |
|
176 |
158 |
$967.60 |
| 92607 |
|
12 |
12 |
$893.70 |
| J0131 |
Inj, acetaminophen (nos) |
180 |
155 |
$879.98 |
| 82043 |
|
985 |
913 |
$876.06 |
| 82784 |
|
469 |
431 |
$744.01 |
| 90734 |
|
16 |
14 |
$743.60 |
| 99281 |
|
23 |
19 |
$743.25 |
| 81243 |
|
14 |
13 |
$708.79 |
| 0154A |
|
28 |
28 |
$682.21 |
| 86140 |
|
2,108 |
1,985 |
$669.19 |
| J0690 |
Cefazolin sodium injection |
654 |
416 |
$647.16 |
| 0082A |
|
26 |
26 |
$640.00 |
| 92593 |
|
53 |
50 |
$624.82 |
| J2795 |
Ropivacaine hcl injection |
1,179 |
1,099 |
$562.96 |
| 87086 |
|
720 |
622 |
$562.91 |
| G1004 |
Cdsm ndsc |
135 |
92 |
$544.29 |
| 70250 |
|
57 |
50 |
$541.34 |
| 83655 |
|
161 |
148 |
$524.40 |
| 86361 |
|
139 |
136 |
$522.18 |
| 0081A |
|
19 |
19 |
$480.00 |
| 36592 |
|
19 |
14 |
$457.20 |
| 85651 |
|
1,368 |
1,307 |
$443.22 |
| 92595 |
|
38 |
36 |
$435.31 |
| 87077 |
|
271 |
246 |
$431.41 |
| 90680 |
|
703 |
682 |
$420.19 |
| 73130 |
|
105 |
86 |
$419.83 |
| 90671 |
|
17 |
17 |
$419.72 |
| 87799 |
|
20 |
14 |
$408.63 |
| 93325 |
|
3,489 |
3,152 |
$404.14 |
| 0052A |
|
13 |
13 |
$400.96 |
| 82379 |
|
101 |
92 |
$394.83 |
| 86850 |
|
1,978 |
1,792 |
$385.86 |
| 86706 |
|
210 |
180 |
$382.84 |
| 0112A |
|
18 |
18 |
$360.00 |
| 80076 |
|
434 |
405 |
$349.77 |
| G2066 |
Inter devc remote 30d |
16 |
16 |
$345.53 |
| 87340 |
|
248 |
217 |
$331.42 |
| 81003 |
|
2,635 |
2,179 |
$326.77 |
| 86704 |
|
123 |
107 |
$321.15 |
| G0009 |
Admin pneumococcal vaccine |
12 |
12 |
$317.56 |
| J3490 |
Drugs unclassified injection |
864 |
478 |
$305.97 |
| 92592 |
|
38 |
24 |
$295.86 |
| 91200 |
|
12 |
12 |
$284.71 |
| 86160 |
|
98 |
96 |
$275.70 |
| 94618 |
|
18 |
17 |
$275.06 |
| 83020 |
|
150 |
141 |
$251.31 |
| 95976 |
|
14 |
14 |
$246.33 |
| 92555 |
|
488 |
403 |
$238.72 |
| 86255 |
|
137 |
126 |
$227.96 |
| 92133 |
|
378 |
362 |
$224.75 |
| 82274 |
|
12 |
12 |
$223.92 |
| 93320 |
|
1,983 |
1,807 |
$211.75 |
| 0111A |
|
12 |
12 |
$200.00 |
| 83615 |
|
569 |
491 |
$195.06 |
| 87186 |
|
50 |
47 |
$192.88 |
| 84702 |
|
36 |
27 |
$187.64 |
| 83516 |
|
113 |
103 |
$186.65 |
| 73070 |
|
72 |
66 |
$180.55 |
| J2405 |
Ondansetron hcl injection |
2,058 |
1,659 |
$176.80 |
| 87497 |
|
19 |
14 |
$163.61 |
| 82610 |
|
307 |
288 |
$160.29 |
| 93922 |
|
14 |
14 |
$144.51 |
| 87102 |
|
285 |
269 |
$141.17 |
| 92579 |
|
13 |
12 |
$139.92 |
| 87653 |
|
34 |
34 |
$136.04 |
| 83690 |
|
250 |
233 |
$135.23 |
| 76514 |
|
172 |
161 |
$133.42 |
| 81050 |
|
357 |
322 |
$119.45 |
| 87070 |
|
391 |
353 |
$119.13 |
| J0689 |
Inj cefazolin sodium, baxter |
21 |
13 |
$118.83 |
| 86038 |
|
127 |
115 |
$115.18 |
| 90648 |
|
1,080 |
1,037 |
$112.60 |
| 83605 |
|
279 |
241 |
$101.81 |
| 87522 |
Neg quan hep c or qual rna |
17 |
15 |
$100.48 |
| 76820 |
|
198 |
158 |
$99.23 |
| J1885 |
Ketorolac tromethamine inj |
540 |
422 |
$90.33 |
| 86364 |
|
31 |
31 |
$88.26 |
| 72040 |
|
13 |
12 |
$82.32 |
| 82785 |
|
280 |
236 |
$82.17 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
52 |
51 |
$80.86 |
| 62322 |
|
126 |
104 |
$78.99 |
| 86235 |
|
13 |
13 |
$77.56 |
| 82103 |
|
132 |
120 |
$70.29 |
| 82533 |
|
28 |
24 |
$68.48 |
| 51798 |
|
37 |
37 |
$64.70 |
| 85018 |
|
127 |
126 |
$64.45 |
| 73552 |
|
30 |
26 |
$59.39 |
| 92025 |
|
13 |
12 |
$56.58 |
| 84484 |
|
287 |
236 |
$48.36 |
| 82390 |
|
74 |
64 |
$45.94 |
| 86334 |
|
78 |
69 |
$45.69 |
| 94729 |
|
2,472 |
2,332 |
$44.02 |
| C1769 |
Guide wire |
829 |
694 |
$43.85 |
| 84153 |
|
14 |
14 |
$43.14 |
| 87210 |
|
92 |
77 |
$33.18 |
| J9370 |
Vincristine sulfate 1 mg inj |
17 |
13 |
$32.71 |
| 86003 |
|
141 |
110 |
$29.86 |
| 82140 |
|
60 |
55 |
$28.24 |
| 86762 |
|
33 |
33 |
$27.88 |
| 83883 |
|
80 |
70 |
$27.83 |
| 96158 |
|
129 |
117 |
$26.51 |
| 85014 |
|
69 |
68 |
$25.20 |
| 86787 |
|
18 |
18 |
$25.08 |
| 84165 |
|
78 |
69 |
$21.96 |
| J2274 |
Inj morphine pf epid ithc |
27 |
24 |
$20.96 |
| 86301 |
|
421 |
277 |
$20.17 |
| 82378 |
|
618 |
409 |
$18.37 |
| 81025 |
|
28 |
27 |
$16.36 |
| 86708 |
|
34 |
27 |
$15.09 |
| 82397 |
|
14 |
14 |
$13.68 |
| 85652 |
|
44 |
44 |
$12.90 |
| J0171 |
Adrenalin epinephrine inject |
14 |
12 |
$12.44 |
| J1170 |
Hydromorphone injection |
19 |
12 |
$11.48 |
| 73140 |
|
13 |
12 |
$11.07 |
| 90715 |
|
270 |
249 |
$8.76 |
| L8613 |
Ossicular implant |
478 |
448 |
$7.95 |
| 90472 |
|
9,965 |
9,571 |
$7.55 |
| 82010 |
|
16 |
12 |
$7.30 |
| 86800 |
|
12 |
12 |
$5.15 |
| 85730 |
|
50 |
50 |
$3.61 |
| G0176 |
Opps/php/iop; activity thrpy |
156 |
53 |
$3.08 |
| 86901 |
|
795 |
713 |
$2.99 |
| J2270 |
Morphine sulfate injection |
90 |
78 |
$2.35 |
| J2930 |
Methylprednisolone injection |
46 |
37 |
$2.21 |
| J1644 |
Inj heparin sodium per 1000u |
464 |
37 |
$0.15 |
| J1805 |
Inj, esmolol hcl, 10mg |
16 |
13 |
$0.09 |
| 91307 |
|
58 |
58 |
$0.02 |
| 86580 |
|
15 |
15 |
$0.00 |
| 83930 |
|
1,945 |
1,675 |
$0.00 |
| 88300 |
|
109 |
105 |
$0.00 |
| 95885 |
|
129 |
123 |
$0.00 |
| 90474 |
|
129 |
127 |
$0.00 |
| 95012 |
|
34 |
30 |
$0.00 |
| 94250 |
|
75 |
70 |
$0.00 |
| 36416 |
|
510 |
486 |
$0.00 |
| Q9969 |
Non-heu tc-99m add-on/dose |
225 |
217 |
$0.00 |
| G0379 |
Direct refer hospital observ |
33 |
32 |
$0.00 |
| C1726 |
Cath, bal dil, non-vascular |
13 |
13 |
$0.00 |
| 82962 |
|
15 |
14 |
$0.00 |
| 96161 |
|
28 |
26 |
$0.00 |
| 96139 |
|
93 |
45 |
$0.00 |
| 94762 |
|
138 |
73 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
63 |
48 |
$0.00 |
| 95886 |
|
51 |
49 |
$0.00 |
| 92499 |
|
39 |
38 |
$0.00 |
| 91305 |
|
42 |
41 |
$0.00 |
| V2632 |
Post chmbr intraocular lens |
28 |
24 |
$0.00 |
| 84134 |
|
13 |
12 |
$0.00 |
| J1270 |
Injection, doxercalciferol |
337 |
48 |
$0.00 |
| 83002 |
|
15 |
14 |
$0.00 |
| 87205 |
|
15 |
13 |
$0.00 |
| 91300 |
|
34 |
34 |
$0.00 |
| 96113 |
|
604 |
498 |
$0.00 |
| 85046 |
|
377 |
332 |
$0.00 |
| 0115U |
|
82 |
82 |
$0.00 |
| 96159 |
|
53 |
49 |
$0.00 |
| 94799 |
|
74 |
67 |
$0.00 |
| 95874 |
|
93 |
77 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
82 |
54 |
$0.00 |
| 87641 |
|
13 |
13 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
30 |
26 |
$0.00 |
| 84305 |
|
18 |
18 |
$0.00 |
| 90633 |
|
221 |
208 |
$0.00 |
| 76827 |
|
27 |
24 |
$0.00 |
| A9541 |
Tc99m sulfur colloid |
12 |
12 |
$0.00 |
| A9552 |
F18 fdg |
88 |
79 |
$0.00 |
| C1729 |
Cath, drainage |
12 |
12 |
$0.00 |
| 81002 |
|
31 |
25 |
$0.00 |
| 90785 |
|
42 |
26 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
19 |
12 |
$0.00 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
18 |
15 |
$0.00 |
| 84481 |
|
13 |
12 |
$0.00 |
| 64643 |
|
28 |
26 |
$0.00 |