| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
41,128 |
38,741 |
$7.14M |
| 99283 |
|
38,016 |
35,044 |
$6.71M |
| J1745 |
Infliximab not biosimil 10mg |
1,344 |
1,296 |
$4.21M |
| 99285 |
|
23,684 |
22,101 |
$3.86M |
| 43239 |
|
3,702 |
3,670 |
$2.73M |
| 70450 |
|
7,868 |
7,596 |
$2.63M |
| 90834 |
|
19,210 |
8,440 |
$2.45M |
| 96415 |
|
3,177 |
2,933 |
$2.33M |
| 76700 |
|
4,002 |
3,983 |
$2.21M |
| 76856 |
|
3,864 |
3,788 |
$2.10M |
| G0378 |
Hospital observation per hr |
6,672 |
6,511 |
$1.95M |
| J3490 |
Drugs unclassified injection |
4,351 |
3,851 |
$1.92M |
| U0004 |
Cov-19 test non-cdc hgh thru |
16,739 |
16,255 |
$1.87M |
| 80053 |
|
59,230 |
53,394 |
$1.71M |
| 99282 |
|
8,916 |
8,521 |
$1.57M |
| 45380 |
|
1,744 |
1,731 |
$1.48M |
| C1713 |
Anchor/screw bn/bn,tis/bn |
1,342 |
1,288 |
$1.45M |
| 74177 |
|
4,865 |
4,783 |
$1.33M |
| 96365 |
|
7,753 |
4,955 |
$1.18M |
| 99213 |
|
9,781 |
6,458 |
$1.16M |
| 70553 |
|
2,157 |
2,148 |
$1.09M |
| 97110 |
|
10,964 |
3,721 |
$847K |
| 96366 |
|
3,306 |
1,869 |
$781K |
| 59025 |
|
3,026 |
2,360 |
$746K |
| 76770 |
|
1,993 |
1,960 |
$711K |
| 93306 |
|
2,180 |
2,128 |
$674K |
| 36430 |
|
1,872 |
1,307 |
$674K |
| 88305 |
|
9,659 |
9,146 |
$640K |
| 87633 |
|
6,812 |
6,707 |
$604K |
| 71275 |
|
1,614 |
1,593 |
$581K |
| 70496 |
|
1,708 |
1,689 |
$554K |
| 99214 |
|
4,292 |
3,200 |
$550K |
| 70551 |
|
1,136 |
1,128 |
$518K |
| 86900 |
|
12,455 |
11,393 |
$515K |
| 12011 |
|
991 |
976 |
$496K |
| P9016 |
Rbc leukocytes reduced |
877 |
784 |
$490K |
| 93308 |
|
1,605 |
1,571 |
$459K |
| 80307 |
|
8,063 |
7,215 |
$411K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
14,147 |
11,495 |
$397K |
| 93975 |
|
649 |
634 |
$395K |
| 87536 |
|
2,613 |
2,555 |
$389K |
| 12001 |
|
732 |
726 |
$377K |
| 86901 |
|
12,735 |
11,650 |
$374K |
| 87491 |
|
8,511 |
8,285 |
$367K |
| 87591 |
|
8,493 |
8,270 |
$340K |
| 99281 |
|
1,941 |
1,837 |
$339K |
| 97140 |
|
5,946 |
2,542 |
$338K |
| 97112 |
|
6,219 |
2,323 |
$333K |
| 45378 |
|
338 |
331 |
$326K |
| 86850 |
|
12,300 |
11,474 |
$321K |
| 96361 |
|
996 |
923 |
$320K |
| 87798 |
|
8,224 |
7,174 |
$313K |
| 82306 |
|
5,592 |
5,550 |
$311K |
| 90836 |
|
5,460 |
3,129 |
$305K |
| 96413 |
|
4,348 |
3,907 |
$296K |
| 90832 |
|
2,107 |
1,541 |
$283K |
| 87486 |
|
6,847 |
6,742 |
$280K |
| 74176 |
|
866 |
846 |
$274K |
| 45385 |
|
300 |
298 |
$259K |
| 43235 |
|
287 |
285 |
$251K |
| 76705 |
|
4,619 |
4,511 |
$243K |
| 86360 |
|
2,539 |
2,515 |
$211K |
| 87581 |
|
6,880 |
6,772 |
$204K |
| 88342 |
|
2,898 |
2,850 |
$204K |
| 92526 |
|
1,415 |
561 |
$199K |
| 80048 |
|
7,838 |
6,782 |
$191K |
| 97161 |
|
1,216 |
1,206 |
$156K |
| 12002 |
|
290 |
286 |
$156K |
| 93970 |
|
223 |
217 |
$156K |
| 87661 |
|
4,271 |
4,155 |
$154K |
| 70498 |
|
1,494 |
1,481 |
$153K |
| 84443 |
|
13,121 |
12,873 |
$152K |
| 71260 |
|
1,726 |
1,713 |
$147K |
| 88185 |
|
548 |
507 |
$145K |
| 96372 |
|
6,655 |
5,153 |
$141K |
| 36415 |
|
38,355 |
34,614 |
$138K |
| J1561 |
Gamunex-c/gammaked |
46 |
24 |
$127K |
| 83880 |
|
3,019 |
2,904 |
$126K |
| 85025 |
|
64,752 |
55,857 |
$119K |
| 87624 |
|
2,369 |
2,361 |
$117K |
| 90792 |
|
512 |
511 |
$107K |
| 87635 |
|
3,990 |
3,690 |
$107K |
| 84439 |
|
9,296 |
9,123 |
$106K |
| P9040 |
Rbc leukoreduced irradiated |
174 |
105 |
$106K |
| 87389 |
|
5,925 |
5,860 |
$104K |
| 97162 |
|
694 |
692 |
$103K |
| 86359 |
|
2,537 |
2,514 |
$103K |
| 96360 |
|
575 |
512 |
$102K |
| 36592 |
|
2,999 |
2,797 |
$100K |
| 70486 |
|
1,012 |
1,000 |
$98K |
| 87631 |
|
875 |
832 |
$97K |
| 90715 |
|
1,980 |
1,969 |
$96K |
| 76815 |
|
644 |
608 |
$94K |
| 86480 |
|
1,027 |
1,021 |
$94K |
| 90833 |
|
2,763 |
2,360 |
$92K |
| 95816 |
|
1,652 |
1,628 |
$89K |
| 88307 |
|
863 |
829 |
$89K |
| J2270 |
Morphine sulfate injection |
4,415 |
3,630 |
$88K |
| 93976 |
|
492 |
485 |
$86K |
| 80061 |
|
7,070 |
6,982 |
$79K |
| 82728 |
|
4,159 |
4,039 |
$78K |
| 83036 |
|
6,003 |
5,929 |
$78K |
| Q5104 |
Injection, renflexis |
124 |
73 |
$77K |
| 88304 |
|
1,957 |
1,946 |
$76K |
| G0463 |
Hospital outpt clinic visit |
5,052 |
2,727 |
$75K |
| 99215 |
Prolong outpt/office vis |
584 |
558 |
$73K |
| 83970 |
|
986 |
958 |
$71K |
| 51701 |
|
166 |
164 |
$69K |
| 88175 |
|
1,389 |
1,387 |
$68K |
| 87086 |
|
11,232 |
10,727 |
$68K |
| 87077 |
|
5,948 |
5,604 |
$66K |
| 88142 |
|
1,870 |
1,867 |
$66K |
| J3380 |
Inj vedolizumab iv 1 mg |
14 |
12 |
$63K |
| 74230 |
|
358 |
358 |
$63K |
| 88341 |
|
930 |
896 |
$62K |
| 82784 |
|
2,854 |
2,686 |
$59K |
| 76830 |
|
1,989 |
1,944 |
$59K |
| 84403 |
|
1,236 |
1,204 |
$58K |
| 93971 |
|
627 |
615 |
$55K |
| 72125 |
|
2,233 |
2,194 |
$52K |
| 82607 |
|
2,690 |
2,672 |
$52K |
| 86803 |
|
4,852 |
4,807 |
$49K |
| 86923 |
|
1,648 |
1,240 |
$49K |
| 69436 |
|
26 |
26 |
$47K |
| 95700 |
|
408 |
403 |
$46K |
| 99233 |
Prolong inpt eval add15 m |
501 |
165 |
$45K |
| 44970 |
|
15 |
14 |
$44K |
| 81025 |
|
10,047 |
9,719 |
$44K |
| 99291 |
|
231 |
190 |
$43K |
| 71046 |
|
13,242 |
12,739 |
$42K |
| 82805 |
|
2,171 |
2,064 |
$41K |
| 76801 |
|
263 |
252 |
$38K |
| 92611 |
|
351 |
351 |
$37K |
| 87801 |
|
720 |
718 |
$35K |
| 82803 |
|
1,213 |
1,179 |
$35K |
| 99232 |
|
557 |
199 |
$34K |
| 99204 |
|
240 |
239 |
$34K |
| 83520 |
|
1,854 |
1,815 |
$32K |
| A0225 |
Neonatal emergency transport |
53 |
53 |
$32K |
| 99223 |
Prolong inpt eval add15 m |
184 |
162 |
$32K |
| 70491 |
|
89 |
89 |
$31K |
| 10060 |
|
81 |
80 |
$31K |
| 76536 |
|
894 |
889 |
$31K |
| 82570 |
|
4,230 |
4,008 |
$30K |
| 87340 |
|
2,357 |
2,342 |
$29K |
| 86334 |
|
797 |
756 |
$27K |
| 76885 |
|
822 |
799 |
$27K |
| J1885 |
Ketorolac tromethamine inj |
12,112 |
10,441 |
$27K |
| 85027 |
|
8,218 |
7,550 |
$26K |
| 76000 |
|
82 |
81 |
$25K |
| 83001 |
|
731 |
724 |
$25K |
| 88112 |
|
417 |
405 |
$25K |
| 86376 |
|
964 |
956 |
$25K |
| 86140 |
|
8,437 |
8,045 |
$23K |
| 80069 |
|
1,299 |
1,045 |
$23K |
| 93005 |
|
25,541 |
21,545 |
$23K |
| 94640 |
|
2,931 |
2,208 |
$23K |
| 95819 |
|
368 |
361 |
$23K |
| 97530 |
|
510 |
289 |
$22K |
| 87070 |
|
2,922 |
2,851 |
$22K |
| 96374 |
|
19,177 |
18,083 |
$22K |
| 94010 |
|
1,195 |
1,169 |
$22K |
| 71250 |
|
165 |
164 |
$21K |
| 83002 |
|
638 |
631 |
$21K |
| 83550 |
|
2,933 |
2,878 |
$21K |
| 85610 |
|
6,870 |
6,440 |
$21K |
| 82043 |
|
2,356 |
2,324 |
$20K |
| 76881 |
|
311 |
295 |
$20K |
| 84146 |
|
581 |
573 |
$20K |
| 83655 |
|
859 |
852 |
$19K |
| 85730 |
|
5,594 |
5,329 |
$19K |
| 87088 |
|
3,129 |
3,022 |
$19K |
| 99212 |
|
175 |
163 |
$19K |
| 83690 |
|
10,514 |
10,025 |
$19K |
| 86592 |
|
4,452 |
4,414 |
$19K |
| J1170 |
Hydromorphone injection |
4,041 |
3,658 |
$18K |
| 82533 |
|
635 |
612 |
$18K |
| 87186 |
|
2,485 |
2,383 |
$18K |
| 84165 |
|
1,421 |
1,346 |
$18K |
| 88184 |
|
528 |
502 |
$17K |
| 84702 |
|
4,965 |
4,523 |
$17K |
| 86800 |
|
712 |
706 |
$17K |
| 83735 |
|
9,282 |
8,068 |
$16K |
| 86706 |
|
1,119 |
1,109 |
$16K |
| 82670 |
|
317 |
311 |
$16K |
| 81001 |
|
13,551 |
13,005 |
$16K |
| 82746 |
|
941 |
935 |
$16K |
| 77336 |
|
25 |
12 |
$15K |
| J1650 |
Inj enoxaparin sodium |
934 |
613 |
$15K |
| 86920 |
|
399 |
376 |
$15K |
| 83921 |
|
414 |
412 |
$15K |
| 86618 |
|
1,430 |
1,421 |
$15K |
| 86704 |
|
950 |
943 |
$14K |
| 87081 |
|
3,356 |
3,184 |
$14K |
| 80076 |
|
910 |
828 |
$14K |
| 86762 |
|
914 |
907 |
$13K |
| 84153 |
|
412 |
410 |
$12K |
| J0696 |
Ceftriaxone sodium injection |
2,202 |
2,018 |
$12K |
| 86003 |
|
225 |
202 |
$12K |
| 99404 |
|
88 |
87 |
$12K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
1,740 |
1,723 |
$11K |
| 82565 |
|
8,406 |
7,994 |
$11K |
| 84484 |
|
9,241 |
7,796 |
$11K |
| 82310 |
|
7,351 |
6,956 |
$11K |
| 84100 |
|
7,443 |
6,450 |
$11K |
| 87481 |
|
237 |
177 |
$10K |
| 77072 |
|
646 |
646 |
$10K |
| 85652 |
|
7,201 |
6,912 |
$10K |
| 93325 |
|
207 |
203 |
$10K |
| 78815 |
|
12 |
12 |
$10K |
| 93010 |
|
1,283 |
833 |
$9K |
| 81513 |
|
197 |
192 |
$9K |
| 84480 |
|
969 |
954 |
$9K |
| 80197 |
|
710 |
482 |
$9K |
| 86039 |
|
1,056 |
1,054 |
$9K |
| C1889 |
Implant/insert device, noc |
13 |
13 |
$9K |
| J1815 |
Insulin injection |
1,521 |
869 |
$9K |
| M0243 |
Casirivi and imdevi inj |
19 |
16 |
$8K |
| 84156 |
|
1,994 |
1,799 |
$8K |
| J8499 |
Oral prescrip drug non chemo |
1,823 |
1,300 |
$8K |
| 36416 |
|
1,816 |
1,190 |
$8K |
| 86902 |
|
237 |
199 |
$8K |
| 97166 |
|
49 |
49 |
$8K |
| 82962 |
|
9,451 |
7,227 |
$7K |
| 74018 |
|
1,591 |
1,513 |
$7K |
| J3010 |
Fentanyl citrate injection |
11,616 |
11,268 |
$7K |
| 86147 |
|
179 |
166 |
$7K |
| 95714 |
|
17 |
12 |
$7K |
| 90791 |
|
38 |
37 |
$7K |
| 86160 |
|
248 |
224 |
$7K |
| G0379 |
Direct refer hospital observ |
31 |
31 |
$7K |
| 97165 |
|
69 |
69 |
$7K |
| 83021 |
|
208 |
203 |
$6K |
| 83516 |
|
537 |
501 |
$6K |
| C1894 |
Intro/sheath, non-laser |
562 |
543 |
$6K |
| 90471 |
|
2,000 |
1,977 |
$6K |
| J1100 |
Dexamethasone sodium phos |
8,227 |
7,896 |
$6K |
| 84520 |
|
8,213 |
7,348 |
$6K |
| 86769 |
|
144 |
142 |
$6K |
| 99203 |
|
67 |
67 |
$6K |
| 96375 |
|
15,163 |
12,479 |
$6K |
| 87483 |
|
27 |
27 |
$6K |
| 75561 |
|
12 |
12 |
$6K |
| J0780 |
Prochlorperazine injection |
821 |
778 |
$6K |
| 76604 |
|
118 |
115 |
$6K |
| 71045 |
|
4,130 |
3,909 |
$6K |
| 0240U |
|
2,394 |
2,333 |
$6K |
| J2543 |
Piperacillin/tazobactam |
325 |
209 |
$5K |
| 97163 |
|
24 |
24 |
$5K |
| 84311 |
|
516 |
515 |
$5K |
| A9541 |
Tc99m sulfur colloid |
29 |
29 |
$5K |
| 87205 |
|
3,412 |
3,307 |
$5K |
| 76937 |
|
26 |
26 |
$5K |
| 72141 |
|
13 |
13 |
$5K |
| 87468 |
|
122 |
119 |
$5K |
| 90460 |
|
186 |
173 |
$5K |
| 94729 |
|
312 |
308 |
$5K |
| 82550 |
|
4,126 |
3,943 |
$5K |
| U0002 |
Covid-19 lab test non-cdc |
106 |
104 |
$5K |
| 81003 |
|
5,811 |
5,593 |
$5K |
| 94060 |
|
126 |
125 |
$5K |
| 99205 |
Prolong outpt/office vis |
24 |
24 |
$4K |
| 72148 |
|
14 |
14 |
$4K |
| 84305 |
|
138 |
138 |
$4K |
| 85007 |
|
2,274 |
1,946 |
$4K |
| 87184 |
|
410 |
385 |
$4K |
| 83615 |
|
1,339 |
1,203 |
$4K |
| 85612 |
|
769 |
496 |
$4K |
| 88173 |
|
96 |
94 |
$4K |
| 70360 |
|
533 |
530 |
$4K |
| 87522 |
Neg quan hep c or qual rna |
56 |
56 |
$4K |
| 88312 |
|
118 |
104 |
$4K |
| 95708 |
|
95 |
94 |
$4K |
| 82627 |
|
97 |
97 |
$4K |
| 82947 |
|
8,147 |
7,807 |
$4K |
| 82040 |
|
6,930 |
6,684 |
$4K |
| 73130 |
|
1,990 |
1,842 |
$4K |
| 84155 |
|
7,083 |
6,857 |
$4K |
| 84295 |
|
8,544 |
8,124 |
$4K |
| 82150 |
|
1,244 |
1,220 |
$4K |
| 82374 |
|
7,833 |
7,509 |
$4K |
| 93351 |
|
12 |
12 |
$4K |
| 86708 |
|
210 |
210 |
$4K |
| 93017 |
|
26 |
26 |
$4K |
| 84075 |
|
6,843 |
6,630 |
$3K |
| 82435 |
|
7,326 |
7,009 |
$3K |
| 82950 |
|
400 |
395 |
$3K |
| 87510 |
|
1,266 |
1,247 |
$3K |
| 86880 |
|
179 |
171 |
$3K |
| 87480 |
|
1,191 |
1,174 |
$3K |
| 87484 |
|
121 |
119 |
$3K |
| J3370 |
Vancomycin hcl injection |
720 |
599 |
$3K |
| 87469 |
|
89 |
88 |
$3K |
| 87502 |
|
109 |
109 |
$3K |
| 86787 |
|
211 |
210 |
$3K |
| 77001 |
|
13 |
13 |
$3K |
| 82785 |
|
144 |
144 |
$3K |
| 90837 |
|
22 |
13 |
$3K |
| 85046 |
|
1,736 |
1,509 |
$3K |
| 73562 |
|
1,464 |
1,380 |
$3K |
| 83020 |
|
136 |
135 |
$3K |
| 76377 |
|
299 |
294 |
$3K |
| C1781 |
Mesh (implantable) |
12 |
12 |
$3K |
| 96376 |
|
6,131 |
4,421 |
$3K |
| 87660 |
|
1,253 |
1,236 |
$3K |
| A9585 |
Gadobutrol injection |
985 |
972 |
$2K |
| 86146 |
|
66 |
64 |
$2K |
| 85246 |
|
129 |
124 |
$2K |
| 86431 |
|
304 |
303 |
$2K |
| 99392 |
|
25 |
25 |
$2K |
| 87040 |
|
2,066 |
1,849 |
$2K |
| 72170 |
|
1,050 |
1,025 |
$2K |
| 86922 |
|
108 |
81 |
$2K |
| J2250 |
Inj midazolam hydrochloride |
11,045 |
10,651 |
$2K |
| 80051 |
|
127 |
84 |
$2K |
| 99391 |
|
25 |
25 |
$2K |
| 87507 |
|
12 |
12 |
$2K |
| J0690 |
Cefazolin sodium injection |
6,031 |
5,353 |
$2K |
| 72100 |
|
529 |
525 |
$2K |
| 87503 |
|
110 |
110 |
$2K |
| J2765 |
Metoclopramide hcl injection |
1,504 |
1,338 |
$2K |
| M0240 |
Casiri and imdev repeat |
32 |
32 |
$2K |
| 84681 |
|
63 |
63 |
$2K |
| 86225 |
|
240 |
239 |
$2K |
| 73630 |
|
1,363 |
1,298 |
$2K |
| 88313 |
|
203 |
199 |
$2K |
| 76506 |
|
60 |
59 |
$2K |
| 92610 |
|
14 |
14 |
$2K |
| 82330 |
|
1,172 |
1,131 |
$2K |
| 97116 |
|
26 |
13 |
$2K |
| 83605 |
|
7,149 |
6,674 |
$2K |
| 73030 |
|
1,207 |
1,146 |
$2K |
| 82248 |
|
290 |
270 |
$2K |
| 90838 |
|
14 |
13 |
$2K |
| 82977 |
|
213 |
199 |
$2K |
| 74019 |
|
276 |
265 |
$1K |
| 87075 |
|
313 |
311 |
$1K |
| Q9957 |
Inj perflutren lip micros,ml |
117 |
117 |
$1K |
| 73090 |
|
1,465 |
1,332 |
$1K |
| 73110 |
|
1,096 |
1,043 |
$1K |
| 92557 |
|
50 |
50 |
$1K |
| 82375 |
|
2,108 |
2,002 |
$1K |
| 86870 |
|
30 |
29 |
$1K |
| 84436 |
|
2,637 |
2,600 |
$1K |
| J2405 |
Ondansetron hcl injection |
15,235 |
13,736 |
$1K |
| 85240 |
|
78 |
74 |
$1K |
| 73552 |
|
561 |
542 |
$1K |
| 85397 |
|
64 |
63 |
$1K |
| 78264 |
|
12 |
12 |
$1K |
| 73610 |
|
1,462 |
1,378 |
$1K |
| 73590 |
|
1,363 |
1,277 |
$1K |
| 76817 |
|
16 |
15 |
$1K |
| 85379 |
|
1,256 |
1,241 |
$1K |
| 94664 |
|
306 |
306 |
$1K |
| J1644 |
Inj heparin sodium per 1000u |
1,108 |
603 |
$1K |
| 87625 |
|
163 |
163 |
$1K |
| 92567 |
|
116 |
116 |
$1K |
| J2060 |
Lorazepam injection |
1,483 |
1,346 |
$1K |
| J2704 |
Inj, propofol, 10 mg |
10,282 |
10,095 |
$1K |
| 97010 |
|
51 |
25 |
$1K |
| 99401 |
|
24 |
24 |
$1K |
| 87102 |
|
178 |
178 |
$1K |
| J3475 |
Inj magnesium sulfate |
205 |
190 |
$1K |
| J1200 |
Diphenhydramine hcl injectio |
4,735 |
4,020 |
$1K |
| J0171 |
Adrenalin epinephrine inject |
901 |
885 |
$991.26 |
| 85245 |
|
50 |
50 |
$969.42 |
| 89051 |
|
497 |
460 |
$967.15 |
| J0131 |
Inj, acetaminophen (nos) |
1,157 |
1,117 |
$951.77 |
| 82105 |
|
87 |
86 |
$948.75 |
| J3535 |
Metered dose inhaler drug |
439 |
413 |
$914.44 |
| 72040 |
|
194 |
188 |
$913.25 |
| 86235 |
|
31 |
31 |
$884.12 |
| 84703 |
|
2,741 |
2,678 |
$879.10 |
| 87497 |
|
17 |
12 |
$857.44 |
| 85384 |
|
295 |
247 |
$854.50 |
| 96110 |
|
93 |
92 |
$849.36 |
| 95886 |
|
39 |
39 |
$833.39 |
| Q0162 |
Ondansetron oral |
4,811 |
4,573 |
$785.51 |
| 80164 |
|
78 |
75 |
$768.26 |
| 76870 |
|
100 |
94 |
$748.56 |
| 76816 |
|
13 |
13 |
$673.00 |
| 96367 |
|
13 |
12 |
$660.24 |
| 87521 |
Neg quan hep c or qual rna |
13 |
12 |
$656.68 |
| 73080 |
|
541 |
513 |
$649.08 |
| 74220 |
|
38 |
38 |
$629.28 |
| 88311 |
|
163 |
163 |
$621.98 |
| 85014 |
|
1,525 |
1,471 |
$613.66 |
| 84550 |
|
116 |
108 |
$599.00 |
| 87427 |
|
39 |
38 |
$599.00 |
| 86364 |
|
56 |
54 |
$566.47 |
| 80320 |
|
5,615 |
5,190 |
$551.07 |
| 73070 |
|
386 |
332 |
$548.03 |
| 85670 |
|
61 |
61 |
$528.95 |
| 83050 |
|
2,087 |
1,976 |
$518.72 |
| 90686 |
|
80 |
80 |
$512.91 |
| 84630 |
|
39 |
39 |
$500.95 |
| C1769 |
Guide wire |
2,917 |
2,706 |
$496.09 |
| J7030 |
Normal saline solution infus |
1,845 |
1,668 |
$483.42 |
| 82164 |
|
40 |
40 |
$481.80 |
| J7050 |
Normal saline solution infus |
4,913 |
4,030 |
$480.73 |
| 86705 |
|
30 |
30 |
$477.40 |
| 80339 |
|
994 |
949 |
$462.06 |
| 51600 |
|
12 |
12 |
$455.87 |
| 99153 |
Mod sedat endo service >5yrs |
1,973 |
1,920 |
$441.31 |
| J7120 |
Ringers lactate infusion |
431 |
398 |
$426.30 |
| 82247 |
|
595 |
554 |
$424.45 |
| 81002 |
|
1,295 |
1,281 |
$422.12 |
| 86255 |
|
41 |
41 |
$420.66 |
| 99152 |
|
2,587 |
2,508 |
$412.35 |
| C1725 |
Cath, translumin non-laser |
53 |
52 |
$400.02 |
| 88300 |
|
422 |
414 |
$392.58 |
| 73502 |
|
164 |
148 |
$364.50 |
| 82657 |
|
848 |
847 |
$332.55 |
| 84145 |
|
1,192 |
1,166 |
$319.27 |
| 87880 |
|
1,587 |
1,571 |
$310.59 |
| 87206 |
|
55 |
51 |
$279.92 |
| 73120 |
|
39 |
36 |
$276.89 |
| 86765 |
|
12 |
12 |
$270.48 |
| 84460 |
|
488 |
472 |
$253.95 |
| 87015 |
|
156 |
152 |
$243.35 |
| 94726 |
|
13 |
13 |
$241.21 |
| 84132 |
|
1,447 |
1,394 |
$232.33 |
| 88302 |
|
14 |
14 |
$230.92 |
| 73560 |
|
68 |
54 |
$226.53 |
| 87046 |
|
39 |
38 |
$221.25 |
| 82042 |
|
27 |
27 |
$219.82 |
| 87045 |
|
39 |
38 |
$203.75 |
| J1953 |
Levetiracetam injection |
191 |
180 |
$189.91 |
| 80203 |
|
12 |
12 |
$177.28 |
| 95885 |
|
13 |
12 |
$176.30 |
| V5266 |
Battery for hearing device |
12 |
12 |
$158.40 |
| 73060 |
|
416 |
399 |
$134.12 |
| 81015 |
|
42 |
40 |
$121.23 |
| J7999 |
Compounded drug, noc |
666 |
657 |
$119.27 |
| J0137 |
Inj, acetaminophen (hikma) |
130 |
117 |
$113.45 |
| J2272 |
Inj, morphine (fresenius) |
1,223 |
983 |
$97.16 |
| 76010 |
|
42 |
40 |
$84.54 |
| 85018 |
|
51 |
50 |
$81.81 |
| 86617 |
|
13 |
13 |
$77.45 |
| 82010 |
|
305 |
275 |
$58.33 |
| J8540 |
Oral dexamethasone |
2,276 |
2,109 |
$57.00 |
| Q0144 |
Azithromycin dihydrate, oral |
311 |
307 |
$54.50 |
| 86308 |
|
143 |
143 |
$52.38 |
| 73100 |
|
132 |
118 |
$43.44 |
| 82553 |
|
102 |
91 |
$40.25 |
| 72080 |
|
13 |
12 |
$30.00 |
| 82272 |
|
28 |
28 |
$16.92 |
| 73140 |
|
14 |
13 |
$15.00 |
| J0330 |
Succinycholine chloride inj |
58 |
55 |
$13.58 |
| 92551 |
|
12 |
12 |
$11.24 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,169 |
849 |
$9.00 |
| J2001 |
Lidocaine injection |
475 |
406 |
$7.67 |
| J2370 |
Phenylephrine hcl injection |
70 |
69 |
$6.16 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
274 |
273 |
$5.41 |
| J2710 |
Neostigmine methylslfte inj |
528 |
522 |
$4.53 |
| J2919 |
Inj, methylpred sod succ 5mg |
252 |
223 |
$4.10 |
| J2920 |
Methylprednisolone injection |
24 |
23 |
$2.84 |
| J1642 |
Inj heparin sodium per 10 u |
242 |
179 |
$2.64 |
| J7040 |
Normal saline solution infus |
166 |
159 |
$1.30 |
| J7620 |
Albuterol ipratrop non-comp |
785 |
656 |
$0.95 |
| J7613 |
Albuterol non-comp unit |
428 |
403 |
$0.61 |
| Q0163 |
Diphenhydramine hcl 50mg |
588 |
517 |
$0.08 |
| Q0240 |
Casirivi and imdevi 600 mg |
32 |
32 |
$0.07 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
99 |
99 |
$0.06 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
89 |
82 |
$0.03 |
| G1004 |
Cdsm ndsc |
1,752 |
1,702 |
$0.03 |
| J2930 |
Methylprednisolone injection |
74 |
61 |
$0.00 |
| J2550 |
Promethazine hcl injection |
82 |
66 |
$0.00 |
| C1729 |
Cath, drainage |
160 |
147 |
$0.00 |
| Q0177 |
Hydroxyzine pamoate 25mg |
167 |
115 |
$0.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
74 |
54 |
$0.00 |
| 4250F |
|
64 |
63 |
$0.00 |
| J0670 |
Inj mepivacaine hcl/10 ml |
13 |
13 |
$0.00 |
| 99157 |
|
31 |
30 |
$0.00 |
| C1887 |
Catheter, guiding |
39 |
39 |
$0.00 |
| C1760 |
Closure dev, vasc |
64 |
61 |
$0.00 |
| 90461 |
|
12 |
12 |
$0.00 |
| J2359 |
Inj. olanzapine, 0.5mg |
21 |
16 |
$0.00 |
| 3078F |
|
57 |
55 |
$0.00 |
| 1159F |
|
89 |
87 |
$0.00 |
| 96127 |
|
96 |
96 |
$0.00 |
| 80329 |
|
563 |
511 |
$0.00 |
| J1790 |
Droperidol injection |
128 |
112 |
$0.00 |
| C9399 |
Unclassified drugs or biolog |
72 |
71 |
$0.00 |
| J7042 |
5% dextrose/normal saline |
96 |
85 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
211 |
202 |
$0.00 |
| J1630 |
Haloperidol injection |
12 |
12 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
85 |
75 |
$0.00 |
| S2900 |
Robotic surgical system |
102 |
101 |
$0.00 |
| C1726 |
Cath, bal dil, non-vascular |
56 |
54 |
$0.00 |
| 2000F |
|
72 |
70 |
$0.00 |
| 99156 |
|
12 |
12 |
$0.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
72 |
49 |
$0.00 |
| J1720 |
Hydrocortisone sodium succ i |
19 |
13 |
$0.00 |
| C1727 |
Cath, bal tis dis, non-vas |
15 |
15 |
$0.00 |
| 3008F |
|
71 |
70 |
$0.00 |
| 3079F |
|
14 |
14 |
$0.00 |
| 1000F |
|
22 |
22 |
$0.00 |
| 1036F |
|
17 |
17 |
$0.00 |
| 3074F |
|
58 |
56 |
$0.00 |