| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
90,496 |
82,793 |
$10.97M |
| 99284 |
|
59,009 |
52,386 |
$8.01M |
| 96361 |
|
18,947 |
15,177 |
$5.88M |
| 0241U |
|
15,663 |
13,552 |
$2.08M |
| 99211 |
|
11,200 |
7,949 |
$1.50M |
| 99213 |
|
11,852 |
8,967 |
$1.45M |
| 74177 |
|
5,833 |
4,611 |
$1.39M |
| 70450 |
|
5,295 |
4,300 |
$1.13M |
| 99285 |
|
9,351 |
7,382 |
$1.11M |
| 80053 |
|
40,708 |
37,546 |
$891K |
| 59025 |
|
4,336 |
2,911 |
$702K |
| 87491 |
|
17,076 |
15,438 |
$647K |
| 84443 |
|
28,588 |
26,562 |
$645K |
| 96365 |
|
4,216 |
3,178 |
$586K |
| 74176 |
|
2,152 |
1,733 |
$584K |
| U0003 |
Cov-19 amp prb hgh thruput |
2,635 |
2,483 |
$539K |
| 95810 |
|
744 |
702 |
$535K |
| 99282 |
|
4,968 |
4,463 |
$534K |
| 97110 |
|
7,150 |
2,280 |
$503K |
| G0378 |
Hospital observation per hr |
7,054 |
2,710 |
$461K |
| 94640 |
|
4,124 |
2,621 |
$460K |
| 11042 |
|
4,617 |
1,979 |
$458K |
| 80061 |
|
28,713 |
26,795 |
$431K |
| 58661 |
|
280 |
169 |
$420K |
| 85025 |
|
109,679 |
94,989 |
$392K |
| 93306 |
|
1,691 |
1,485 |
$387K |
| 71275 |
|
1,547 |
1,279 |
$377K |
| 99212 |
|
2,860 |
2,424 |
$362K |
| 87591 |
|
17,004 |
15,369 |
$349K |
| 87651 |
|
6,872 |
6,215 |
$342K |
| 96360 |
|
1,935 |
1,600 |
$339K |
| 83036 |
|
24,488 |
22,707 |
$330K |
| 43239 |
|
980 |
847 |
$324K |
| 80048 |
|
72,145 |
59,919 |
$323K |
| 82306 |
|
11,081 |
10,352 |
$301K |
| 87624 |
|
8,641 |
8,098 |
$295K |
| 76816 |
|
2,013 |
1,722 |
$291K |
| 87086 |
|
28,351 |
24,821 |
$269K |
| 78815 |
|
401 |
352 |
$264K |
| 88175 |
|
14,627 |
13,834 |
$263K |
| 95811 |
|
371 |
349 |
$261K |
| J7307 |
Etonogestrel implant system |
224 |
211 |
$251K |
| 96366 |
|
1,024 |
627 |
$229K |
| 71260 |
|
1,025 |
901 |
$228K |
| G0472 |
Hep c screen high risk/other |
6,975 |
6,409 |
$212K |
| 82607 |
|
8,231 |
7,676 |
$188K |
| 45380 |
|
405 |
314 |
$184K |
| 70496 |
|
1,069 |
842 |
$181K |
| 80307 |
|
9,640 |
8,515 |
$179K |
| 85027 |
|
19,215 |
16,919 |
$179K |
| 86850 |
|
8,596 |
7,615 |
$176K |
| 45385 |
|
312 |
255 |
$174K |
| 36415 |
|
138,300 |
114,070 |
$173K |
| 70553 |
|
630 |
549 |
$171K |
| 76856 |
|
952 |
828 |
$164K |
| G0481 |
Drug test def 8-14 classes |
2,406 |
2,222 |
$157K |
| 87389 |
|
9,227 |
8,562 |
$154K |
| 78452 |
|
438 |
373 |
$146K |
| 76811 |
|
848 |
759 |
$130K |
| 76642 |
|
931 |
841 |
$116K |
| 88305 |
|
6,545 |
5,234 |
$114K |
| 87070 |
|
9,086 |
8,006 |
$112K |
| 87661 |
|
4,775 |
4,370 |
$111K |
| 80047 |
|
6,503 |
5,994 |
$108K |
| 77063 |
|
2,169 |
1,980 |
$108K |
| 80076 |
|
26,452 |
21,991 |
$106K |
| 82728 |
|
5,520 |
5,085 |
$106K |
| 84439 |
|
5,601 |
5,163 |
$97K |
| 72148 |
|
668 |
604 |
$96K |
| 86762 |
|
4,136 |
3,846 |
$96K |
| 76805 |
|
622 |
558 |
$95K |
| 76818 |
|
796 |
367 |
$93K |
| 69436 |
|
59 |
53 |
$93K |
| G0463 |
Hospital outpt clinic visit |
1,185 |
905 |
$91K |
| 76705 |
|
858 |
762 |
$86K |
| 71046 |
|
7,119 |
6,414 |
$85K |
| 99291 |
|
757 |
576 |
$82K |
| 71250 |
|
762 |
694 |
$82K |
| 86780 |
|
5,422 |
4,794 |
$81K |
| 83540 |
|
7,402 |
6,826 |
$81K |
| 12001 |
|
539 |
444 |
$79K |
| 81514 |
|
907 |
730 |
$75K |
| 86900 |
|
8,716 |
7,672 |
$75K |
| 84702 |
|
3,907 |
2,607 |
$70K |
| 87077 |
|
7,116 |
5,812 |
$70K |
| 70551 |
|
551 |
448 |
$70K |
| 82570 |
|
6,804 |
6,141 |
$68K |
| 11045 |
|
202 |
94 |
$68K |
| 93017 |
|
783 |
681 |
$66K |
| 10060 |
|
425 |
356 |
$66K |
| 83550 |
|
6,483 |
5,978 |
$63K |
| 97140 |
|
2,474 |
943 |
$61K |
| 84153 |
|
2,695 |
2,471 |
$60K |
| 87653 |
|
1,825 |
1,653 |
$59K |
| 93971 |
|
775 |
702 |
$57K |
| 77067 |
|
2,711 |
2,465 |
$55K |
| 71045 |
|
20,142 |
17,416 |
$53K |
| 84484 |
|
15,759 |
12,361 |
$52K |
| 97112 |
|
1,567 |
587 |
$50K |
| 11043 |
|
332 |
188 |
$48K |
| 87205 |
|
5,876 |
5,279 |
$48K |
| 72141 |
|
295 |
259 |
$45K |
| 94060 |
|
404 |
353 |
$45K |
| 87340 |
|
2,818 |
2,513 |
$44K |
| 88307 |
|
571 |
408 |
$44K |
| 76817 |
|
706 |
558 |
$43K |
| 97162 |
|
941 |
795 |
$43K |
| 76536 |
|
380 |
358 |
$41K |
| 86481 |
|
1,010 |
951 |
$40K |
| 82043 |
|
4,958 |
4,603 |
$40K |
| 86901 |
|
8,717 |
7,672 |
$40K |
| 93005 |
|
29,818 |
25,577 |
$40K |
| U0005 |
Infec agen detec ampli probe |
1,383 |
1,265 |
$39K |
| 70491 |
|
144 |
127 |
$39K |
| 86140 |
|
4,534 |
3,815 |
$39K |
| 47562 |
|
20 |
12 |
$36K |
| 87186 |
|
5,216 |
4,353 |
$35K |
| 83970 |
|
1,051 |
959 |
$35K |
| 81001 |
|
34,736 |
30,186 |
$35K |
| 76815 |
|
857 |
604 |
$35K |
| 83001 |
|
1,213 |
1,114 |
$35K |
| 82746 |
|
3,030 |
2,780 |
$34K |
| 87481 |
|
1,584 |
1,270 |
$34K |
| 99395 |
|
258 |
240 |
$33K |
| 76830 |
|
880 |
764 |
$32K |
| 71271 |
|
203 |
190 |
$32K |
| 72100 |
|
1,776 |
1,488 |
$32K |
| 97530 |
|
1,034 |
608 |
$32K |
| 70498 |
|
1,047 |
820 |
$30K |
| 82950 |
|
3,386 |
3,189 |
$30K |
| 83735 |
|
8,604 |
6,560 |
$30K |
| 87801 |
|
1,358 |
1,269 |
$29K |
| 96374 |
|
35,023 |
29,675 |
$27K |
| 72125 |
|
1,477 |
1,224 |
$25K |
| 87522 |
Neg quan hep c or qual rna |
744 |
673 |
$25K |
| 93458 |
|
17 |
13 |
$25K |
| 87635 |
|
2,415 |
2,353 |
$24K |
| 90715 |
|
1,739 |
1,457 |
$24K |
| 76801 |
|
159 |
146 |
$24K |
| 84144 |
|
876 |
713 |
$24K |
| 97163 |
|
758 |
601 |
$23K |
| 87625 |
|
1,084 |
1,012 |
$23K |
| 94727 |
|
447 |
392 |
$23K |
| C9803 |
Hopd covid-19 spec collect |
498 |
480 |
$22K |
| C9290 |
Inj, bupivacaine liposome |
323 |
226 |
$22K |
| 93970 |
|
163 |
132 |
$22K |
| 96367 |
|
569 |
397 |
$22K |
| 76775 |
|
218 |
195 |
$22K |
| 70486 |
|
323 |
266 |
$21K |
| 76700 |
|
115 |
101 |
$21K |
| 80320 |
|
2,299 |
1,748 |
$21K |
| 86038 |
|
1,134 |
1,030 |
$21K |
| 74018 |
|
886 |
739 |
$21K |
| 84146 |
|
1,002 |
915 |
$20K |
| 58563 |
|
18 |
13 |
$20K |
| 96375 |
|
25,638 |
20,290 |
$20K |
| 94729 |
|
445 |
390 |
$19K |
| 82565 |
|
2,976 |
2,453 |
$19K |
| 12011 |
|
132 |
114 |
$19K |
| 73560 |
|
1,644 |
1,284 |
$19K |
| 84403 |
|
1,066 |
989 |
$19K |
| 12002 |
|
139 |
115 |
$18K |
| 80069 |
|
1,329 |
975 |
$18K |
| 88341 |
|
400 |
279 |
$18K |
| 77062 |
|
458 |
415 |
$18K |
| 81025 |
|
30,073 |
25,758 |
$18K |
| 85610 |
|
6,316 |
4,956 |
$17K |
| 97167 |
|
555 |
427 |
$17K |
| 77080 |
|
239 |
218 |
$17K |
| 84481 |
|
588 |
517 |
$17K |
| 72040 |
|
898 |
751 |
$16K |
| 96372 |
|
10,610 |
7,103 |
$16K |
| 80074 |
|
756 |
693 |
$15K |
| 73630 |
|
1,914 |
1,573 |
$15K |
| 83525 |
|
599 |
546 |
$15K |
| S5161 |
Emer rspns sys serv permonth |
486 |
480 |
$15K |
| 85652 |
|
3,047 |
2,590 |
$15K |
| 97113 |
|
158 |
48 |
$15K |
| 88342 |
|
911 |
719 |
$15K |
| 87088 |
|
1,932 |
1,670 |
$15K |
| 73030 |
|
1,392 |
1,152 |
$15K |
| 96376 |
|
4,497 |
2,115 |
$15K |
| 93976 |
|
143 |
114 |
$15K |
| 86695 |
|
848 |
778 |
$15K |
| 84550 |
|
2,614 |
2,180 |
$14K |
| 84100 |
|
2,326 |
1,885 |
$14K |
| 83880 |
|
3,389 |
2,687 |
$14K |
| 73721 |
|
76 |
67 |
$14K |
| 29580 |
|
106 |
43 |
$14K |
| 97014 |
|
398 |
118 |
$13K |
| 83516 |
|
703 |
488 |
$13K |
| 99214 |
|
359 |
299 |
$13K |
| 86696 |
|
848 |
778 |
$13K |
| 87255 |
|
263 |
247 |
$13K |
| 86431 |
|
922 |
840 |
$12K |
| G0480 |
Drug test def 1-7 classes |
1,135 |
1,031 |
$12K |
| 83690 |
|
18,469 |
15,214 |
$12K |
| 86706 |
|
660 |
590 |
$12K |
| 82951 |
|
509 |
476 |
$12K |
| 73610 |
|
1,560 |
1,314 |
$12K |
| J3490 |
Drugs unclassified injection |
2,818 |
1,670 |
$11K |
| 82962 |
|
8,029 |
4,739 |
$11K |
| 93880 |
|
165 |
149 |
$11K |
| 73130 |
|
1,249 |
1,032 |
$11K |
| 82670 |
|
676 |
618 |
$11K |
| 84402 |
|
607 |
577 |
$11K |
| 77065 |
Tomosynthesis, mammo |
509 |
432 |
$11K |
| 58558 |
|
13 |
12 |
$11K |
| 82550 |
|
1,539 |
1,244 |
$11K |
| 83002 |
|
629 |
581 |
$11K |
| 84270 |
|
566 |
524 |
$11K |
| 86200 |
|
604 |
548 |
$10K |
| 83020 |
|
455 |
412 |
$10K |
| 84156 |
|
2,082 |
1,727 |
$10K |
| 88304 |
|
981 |
716 |
$10K |
| 97116 |
|
960 |
337 |
$10K |
| 74183 |
|
43 |
39 |
$10K |
| 87493 |
|
326 |
267 |
$10K |
| 81002 |
|
12,709 |
9,055 |
$9K |
| 83615 |
|
1,868 |
1,463 |
$9K |
| 84460 |
|
1,913 |
1,541 |
$9K |
| 87510 |
|
294 |
289 |
$9K |
| 84450 |
|
1,823 |
1,468 |
$8K |
| 86704 |
|
409 |
368 |
$8K |
| 82627 |
|
278 |
252 |
$8K |
| 82247 |
|
1,586 |
1,245 |
$8K |
| 95816 |
|
46 |
36 |
$8K |
| 76820 |
|
124 |
68 |
$8K |
| 62323 |
|
19 |
18 |
$8K |
| 73502 |
|
879 |
738 |
$8K |
| 73110 |
|
904 |
738 |
$7K |
| 82784 |
|
587 |
501 |
$7K |
| 87109 |
|
353 |
334 |
$7K |
| 93226 |
|
70 |
67 |
$7K |
| 86235 |
|
514 |
317 |
$7K |
| 72131 |
|
107 |
83 |
$7K |
| 77066 |
Tomosynthesis, mammo |
529 |
483 |
$7K |
| 82952 |
|
503 |
471 |
$7K |
| 93325 |
|
141 |
129 |
$7K |
| 72070 |
|
399 |
340 |
$7K |
| 73562 |
|
580 |
464 |
$7K |
| 86364 |
|
310 |
290 |
$6K |
| 00840 |
|
818 |
534 |
$6K |
| 64483 |
|
17 |
12 |
$6K |
| 77061 |
|
171 |
156 |
$6K |
| 82533 |
|
296 |
257 |
$6K |
| 82525 |
|
272 |
257 |
$6K |
| 86694 |
|
324 |
225 |
$6K |
| 86376 |
|
274 |
240 |
$6K |
| 85730 |
|
4,042 |
3,227 |
$6K |
| 84425 |
|
381 |
365 |
$6K |
| 86225 |
|
326 |
303 |
$5K |
| J2800 |
Methocarbamol injection |
1,950 |
1,308 |
$5K |
| 87480 |
|
294 |
289 |
$5K |
| 84520 |
|
1,355 |
1,069 |
$5K |
| 85045 |
|
1,015 |
914 |
$5K |
| 97166 |
|
97 |
81 |
$5K |
| 87660 |
|
321 |
316 |
$5K |
| 82105 |
|
171 |
164 |
$5K |
| 83722 |
|
384 |
351 |
$4K |
| 83605 |
|
4,172 |
3,145 |
$4K |
| 81003 |
|
6,947 |
5,869 |
$4K |
| 73070 |
|
593 |
489 |
$4K |
| 86161 |
|
217 |
199 |
$4K |
| 86787 |
|
185 |
172 |
$4K |
| 87902 |
|
26 |
24 |
$4K |
| 87536 |
|
70 |
63 |
$4K |
| 93225 |
|
39 |
37 |
$4K |
| 86039 |
|
136 |
127 |
$4K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
11,650 |
9,429 |
$4K |
| 83520 |
|
137 |
125 |
$4K |
| 86361 |
|
55 |
48 |
$3K |
| 90686 |
|
154 |
138 |
$3K |
| 93242 |
|
51 |
50 |
$3K |
| 87045 |
|
200 |
162 |
$3K |
| 58300 |
|
32 |
25 |
$3K |
| 00790 |
|
87 |
51 |
$3K |
| 86160 |
|
216 |
195 |
$3K |
| 73140 |
|
468 |
385 |
$3K |
| 71100 |
|
452 |
378 |
$3K |
| 73120 |
|
28 |
24 |
$3K |
| 85379 |
|
2,126 |
1,777 |
$3K |
| 82947 |
|
354 |
327 |
$3K |
| 73590 |
|
385 |
312 |
$3K |
| 82664 |
|
99 |
87 |
$3K |
| 84630 |
|
246 |
237 |
$3K |
| 86765 |
|
88 |
79 |
$3K |
| 74019 |
|
328 |
268 |
$3K |
| 84165 |
|
185 |
171 |
$3K |
| 87102 |
|
570 |
493 |
$3K |
| 74174 |
|
24 |
24 |
$3K |
| 87040 |
|
2,090 |
1,364 |
$3K |
| 75574 |
|
12 |
12 |
$3K |
| 84590 |
|
205 |
195 |
$2K |
| J2704 |
Inj, propofol, 10 mg |
9,906 |
6,614 |
$2K |
| 86708 |
|
113 |
90 |
$2K |
| 99281 |
|
20 |
14 |
$2K |
| 87046 |
|
242 |
162 |
$2K |
| Q0111 |
Wet mounts/ w preparations |
2,485 |
2,226 |
$2K |
| 93925 |
|
25 |
24 |
$2K |
| 84145 |
|
809 |
598 |
$2K |
| 97161 |
|
97 |
88 |
$2K |
| 86664 |
|
93 |
67 |
$2K |
| 73620 |
|
38 |
25 |
$2K |
| 82150 |
|
478 |
413 |
$2K |
| J0500 |
Dicyclomine injection |
100 |
50 |
$2K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
1,444 |
1,254 |
$2K |
| J2272 |
Inj, morphine (fresenius) |
3,157 |
2,244 |
$2K |
| 82803 |
|
1,739 |
1,347 |
$2K |
| 29125 |
|
480 |
410 |
$2K |
| 86735 |
|
77 |
68 |
$2K |
| 86308 |
|
228 |
198 |
$2K |
| 29515 |
|
655 |
567 |
$2K |
| 87075 |
|
625 |
514 |
$2K |
| 80356 |
|
151 |
151 |
$2K |
| J7030 |
Normal saline solution infus |
9,473 |
6,597 |
$1K |
| 87430 |
|
2,911 |
2,450 |
$1K |
| 82140 |
|
326 |
247 |
$1K |
| 90471 |
|
1,671 |
1,414 |
$1K |
| 84445 |
|
44 |
40 |
$1K |
| 80361 |
|
151 |
151 |
$1K |
| 80365 |
|
151 |
151 |
$1K |
| 73090 |
|
283 |
231 |
$1K |
| 86665 |
|
94 |
67 |
$1K |
| 87328 |
|
96 |
82 |
$1K |
| 84681 |
|
81 |
69 |
$1K |
| J1650 |
Inj enoxaparin sodium |
2,123 |
790 |
$1K |
| 97535 |
|
67 |
27 |
$1K |
| 87210 |
|
1,617 |
1,332 |
$1K |
| 86800 |
|
73 |
55 |
$1K |
| 85014 |
|
605 |
399 |
$1K |
| 87015 |
|
469 |
386 |
$1K |
| 86803 |
|
82 |
82 |
$1K |
| 82248 |
|
131 |
123 |
$1K |
| 87804 |
|
1,533 |
1,449 |
$1K |
| J2405 |
Ondansetron hcl injection |
21,035 |
16,057 |
$1K |
| 87329 |
|
79 |
69 |
$1K |
| 88312 |
|
27 |
24 |
$986.63 |
| 87798 |
|
39 |
38 |
$956.43 |
| C9113 |
Inj pantoprazole sodium, via |
836 |
444 |
$894.16 |
| 82985 |
|
71 |
62 |
$779.70 |
| J1885 |
Ketorolac tromethamine inj |
12,476 |
9,488 |
$744.45 |
| J0131 |
Inj, acetaminophen (nos) |
118 |
73 |
$700.57 |
| 86341 |
|
16 |
12 |
$667.59 |
| J1170 |
Hydromorphone injection |
2,825 |
1,799 |
$644.78 |
| A9552 |
F18 fdg |
422 |
375 |
$640.12 |
| J7120 |
Ringers lactate infusion |
6,265 |
4,504 |
$624.75 |
| 83498 |
|
38 |
38 |
$621.22 |
| 90656 |
|
76 |
76 |
$601.71 |
| J3370 |
Vancomycin hcl injection |
739 |
453 |
$551.96 |
| 87116 |
|
372 |
314 |
$551.56 |
| 82010 |
|
587 |
438 |
$513.14 |
| 87206 |
|
372 |
314 |
$492.76 |
| J1644 |
Inj heparin sodium per 1000u |
2,459 |
1,246 |
$453.20 |
| C1889 |
Implant/insert device, noc |
183 |
167 |
$446.07 |
| 80349 |
|
39 |
38 |
$439.93 |
| 84132 |
|
79 |
69 |
$432.71 |
| 80143 |
|
373 |
286 |
$418.67 |
| 88173 |
|
30 |
24 |
$398.03 |
| 84480 |
|
30 |
29 |
$388.43 |
| J3010 |
Fentanyl citrate injection |
6,257 |
4,515 |
$384.31 |
| 85018 |
|
185 |
104 |
$377.11 |
| 76870 |
|
13 |
13 |
$363.90 |
| J0696 |
Ceftriaxone sodium injection |
2,371 |
1,580 |
$360.48 |
| J2550 |
Promethazine hcl injection |
1,996 |
1,343 |
$344.10 |
| J1815 |
Insulin injection |
715 |
302 |
$337.87 |
| J0702 |
Betamethasone acet&sod phosp |
28 |
26 |
$312.11 |
| 86870 |
|
19 |
12 |
$297.92 |
| 80164 |
|
33 |
27 |
$288.05 |
| 82330 |
|
19 |
13 |
$281.86 |
| 80329 |
|
315 |
249 |
$273.88 |
| 82977 |
|
28 |
27 |
$268.68 |
| J2360 |
Orphenadrine injection |
1,070 |
837 |
$260.99 |
| 85347 |
|
391 |
260 |
$247.81 |
| J0690 |
Cefazolin sodium injection |
2,711 |
1,834 |
$246.99 |
| 00952 |
|
60 |
51 |
$246.57 |
| 86304 |
|
13 |
12 |
$232.26 |
| J3475 |
Inj magnesium sulfate |
740 |
526 |
$224.55 |
| J2543 |
Piperacillin/tazobactam |
152 |
54 |
$221.33 |
| J0780 |
Prochlorperazine injection |
1,084 |
780 |
$215.10 |
| J2270 |
Morphine sulfate injection |
978 |
678 |
$213.86 |
| 29540 |
|
69 |
50 |
$207.72 |
| 88302 |
|
277 |
163 |
$199.49 |
| 86255 |
|
16 |
15 |
$193.22 |
| 73060 |
|
17 |
15 |
$182.53 |
| 86698 |
|
15 |
14 |
$182.32 |
| J1100 |
Dexamethasone sodium phos |
5,758 |
4,079 |
$181.57 |
| G0008 |
Admin influenza virus vac |
210 |
199 |
$167.80 |
| 88112 |
|
14 |
13 |
$162.54 |
| C1729 |
Cath, drainage |
120 |
65 |
$148.32 |
| J3411 |
Thiamine hcl 100 mg |
267 |
138 |
$143.60 |
| J2765 |
Metoclopramide hcl injection |
1,376 |
934 |
$142.60 |
| 82270 |
|
162 |
119 |
$138.12 |
| 88720 |
|
46 |
40 |
$135.63 |
| 89051 |
|
82 |
59 |
$124.23 |
| J2930 |
Methylprednisolone injection |
758 |
538 |
$106.09 |
| J1200 |
Diphenhydramine hcl injectio |
3,384 |
2,498 |
$98.34 |
| 82310 |
|
13 |
13 |
$90.43 |
| J0330 |
Succinycholine chloride inj |
828 |
603 |
$88.40 |
| J1953 |
Levetiracetam injection |
29 |
25 |
$88.11 |
| Q9957 |
Inj perflutren lip micros,ml |
379 |
306 |
$87.64 |
| J3480 |
Inj potassium chloride |
637 |
377 |
$84.89 |
| J0360 |
Hydralazine hcl injection |
193 |
140 |
$84.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
88 |
38 |
$81.11 |
| J3301 |
Triamcinolone acet inj nos |
653 |
552 |
$78.39 |
| J7050 |
Normal saline solution infus |
1,163 |
761 |
$75.29 |
| 84703 |
|
14 |
12 |
$68.84 |
| J7121 |
5% dextrose in lac ringers |
343 |
236 |
$63.82 |
| J1642 |
Inj heparin sodium per 10 u |
442 |
301 |
$54.84 |
| J2250 |
Inj midazolam hydrochloride |
5,117 |
3,724 |
$53.00 |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
409 |
352 |
$52.93 |
| J1790 |
Droperidol injection |
1,219 |
841 |
$49.09 |
| J2919 |
Inj, methylpred sod succ 5mg |
293 |
235 |
$41.90 |
| Q0114 |
Fern test |
105 |
84 |
$37.34 |
| J7040 |
Normal saline solution infus |
822 |
619 |
$37.02 |
| J2471 |
Inj pantoprazole(hikma) 40mg |
53 |
39 |
$36.41 |
| J1940 |
Furosemide injection |
207 |
123 |
$28.91 |
| J2060 |
Lorazepam injection |
709 |
463 |
$26.23 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
267 |
197 |
$23.41 |
| 93321 |
|
13 |
12 |
$21.66 |
| J0134 |
Inj acetaminophen -fresenius |
83 |
74 |
$19.15 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
367 |
326 |
$15.80 |
| J2720 |
Inj protamine sulfate/10 mg |
16 |
14 |
$15.05 |
| J3360 |
Diazepam injection |
142 |
90 |
$13.33 |
| J1630 |
Haloperidol injection |
106 |
64 |
$5.02 |
| J2470 |
Inj pantoprazole sodium 40mg |
17 |
14 |
$3.66 |
| J2004 |
Inj, lidocaine w epinephrine |
76 |
72 |
$1.48 |
| C1894 |
Intro/sheath, non-laser |
451 |
326 |
$0.00 |
| G1004 |
Cdsm ndsc |
1,106 |
620 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
218 |
136 |
$0.00 |
| A9502 |
Tc99m tetrofosmin |
446 |
379 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
673 |
476 |
$0.00 |
| J0688 |
Inj cefazolin sodium, hikma |
31 |
24 |
$0.00 |
| J0689 |
Inj cefazolin sodium, baxter |
21 |
20 |
$0.00 |
| 43450 |
|
63 |
61 |
$0.00 |
| C1887 |
Catheter, guiding |
309 |
224 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
21 |
12 |
$0.00 |
| C1751 |
Cath, inf, per/cent/midline |
12 |
12 |
$0.00 |
| 29240 |
|
20 |
14 |
$0.00 |
| C1788 |
Port, indwelling, imp |
20 |
12 |
$0.00 |
| 00170 |
|
13 |
13 |
$0.00 |
| 94760 |
|
1,129 |
738 |
$0.00 |
| C1769 |
Guide wire |
548 |
403 |
$0.00 |
| 00126 |
|
26 |
26 |
$0.00 |
| J2785 |
Regadenoson injection |
372 |
315 |
$0.00 |
| A4648 |
Implantable tissue marker |
28 |
24 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
24 |
12 |
$0.00 |
| 94761 |
|
203 |
89 |
$0.00 |
| 77001 |
|
65 |
40 |
$0.00 |
| J1836 |
Inj, metronidazole, 10 mg |
16 |
12 |
$0.00 |
| C2617 |
Stent, non-cor, tem w/o del |
17 |
13 |
$0.00 |
| C1725 |
Cath, translumin non-laser |
21 |
12 |
$0.00 |