| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
44,154 |
41,427 |
$8.86M |
| G0463 |
Hospital outpt clinic visit |
126,518 |
107,141 |
$7.75M |
| 99285 |
|
20,983 |
19,370 |
$6.77M |
| 99283 |
|
54,401 |
48,666 |
$6.55M |
| G0378 |
Hospital observation per hr |
8,405 |
7,797 |
$3.59M |
| 27447 |
|
524 |
520 |
$3.36M |
| 36512 |
|
4,332 |
3,751 |
$2.01M |
| 36556 |
|
1,951 |
1,720 |
$1.95M |
| 43239 |
|
5,249 |
5,202 |
$1.91M |
| 45385 |
|
3,941 |
3,894 |
$1.91M |
| 96374 |
|
22,731 |
20,761 |
$1.62M |
| P9016 |
Rbc leukocytes reduced |
5,136 |
4,482 |
$1.49M |
| 27130 |
|
204 |
204 |
$1.42M |
| 59025 |
|
17,362 |
11,284 |
$1.36M |
| 93458 |
|
879 |
869 |
$1.25M |
| 66984 |
|
1,209 |
1,171 |
$1.09M |
| 45380 |
|
1,827 |
1,807 |
$941K |
| 76811 |
|
7,350 |
7,346 |
$858K |
| 76816 |
|
15,724 |
14,824 |
$841K |
| G0121 |
Colon ca scrn not hi rsk ind |
1,993 |
1,980 |
$806K |
| C1776 |
Joint device (implantable) |
1,254 |
1,242 |
$803K |
| 58558 |
|
542 |
538 |
$665K |
| 74177 |
|
4,127 |
4,048 |
$626K |
| 70553 |
|
3,102 |
3,082 |
$590K |
| 99282 |
|
7,263 |
6,285 |
$587K |
| 71046 |
|
17,080 |
16,438 |
$514K |
| 93306 |
|
2,529 |
2,495 |
$466K |
| 76801 |
|
8,705 |
8,184 |
$453K |
| 96365 |
|
6,824 |
5,979 |
$441K |
| 96375 |
|
19,124 |
16,351 |
$429K |
| 43235 |
|
1,215 |
1,180 |
$428K |
| 45378 |
|
1,123 |
1,114 |
$409K |
| 72148 |
|
3,839 |
3,817 |
$406K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
2,756 |
2,633 |
$406K |
| 58661 |
|
143 |
143 |
$371K |
| 72141 |
|
2,292 |
2,286 |
$364K |
| 76830 |
|
6,289 |
6,246 |
$354K |
| U0003 |
Cov-19 amp prb hgh thruput |
8,829 |
8,535 |
$352K |
| 76856 |
|
6,455 |
6,413 |
$340K |
| 78452 |
|
618 |
613 |
$334K |
| 95910 |
|
2,455 |
2,307 |
$334K |
| 73721 |
|
2,180 |
2,082 |
$295K |
| 76805 |
|
4,879 |
4,873 |
$295K |
| 87491 |
|
26,806 |
26,104 |
$284K |
| 94060 |
|
2,076 |
2,068 |
$281K |
| 87591 |
|
26,795 |
26,099 |
$277K |
| 71045 |
|
9,219 |
8,678 |
$270K |
| 72156 |
|
657 |
647 |
$245K |
| C8928 |
Tte w or w/o fol w/con,stres |
774 |
764 |
$244K |
| 70450 |
|
3,826 |
3,749 |
$243K |
| 95911 |
|
942 |
915 |
$231K |
| 87637 |
|
3,825 |
3,692 |
$225K |
| 99281 |
|
3,864 |
3,566 |
$224K |
| 76819 |
|
3,635 |
2,032 |
$221K |
| 86900 |
|
31,391 |
29,607 |
$210K |
| C8929 |
Tte w or wo fol wcon,doppler |
944 |
927 |
$202K |
| 58300 |
|
942 |
901 |
$198K |
| 74176 |
|
1,873 |
1,843 |
$197K |
| 99218 |
|
688 |
362 |
$190K |
| 96372 |
|
20,811 |
18,229 |
$182K |
| 94726 |
|
3,376 |
3,363 |
$176K |
| 71260 |
|
2,461 |
2,426 |
$175K |
| 80061 |
|
2,150 |
2,059 |
$166K |
| 73221 |
|
979 |
945 |
$144K |
| 74178 |
|
761 |
755 |
$141K |
| 93970 |
|
1,418 |
1,403 |
$139K |
| J7298 |
Mirena, 52 mg |
299 |
281 |
$128K |
| 70551 |
|
909 |
906 |
$128K |
| 86902 |
|
2,228 |
1,968 |
$124K |
| 99395 |
|
2,019 |
1,999 |
$118K |
| 87661 |
|
22,062 |
21,560 |
$116K |
| 86780 |
|
16,109 |
15,746 |
$114K |
| 76705 |
|
2,231 |
2,215 |
$113K |
| 76770 |
|
1,736 |
1,726 |
$102K |
| 80048 |
|
48,421 |
38,215 |
$102K |
| 76700 |
|
1,508 |
1,503 |
$96K |
| 97162 |
|
1,875 |
1,839 |
$90K |
| J2250 |
Inj midazolam hydrochloride |
13,980 |
13,760 |
$89K |
| 97166 |
|
1,996 |
1,960 |
$88K |
| 76536 |
|
1,642 |
1,632 |
$87K |
| 93971 |
|
1,604 |
1,587 |
$87K |
| 71250 |
|
1,434 |
1,418 |
$83K |
| 96361 |
|
2,538 |
2,055 |
$83K |
| U0002 |
Covid-19 lab test non-cdc |
3,478 |
3,329 |
$79K |
| G0123 |
Screen cerv/vag thin layer |
6,826 |
6,785 |
$76K |
| 76815 |
|
3,694 |
2,873 |
$73K |
| 95816 |
|
518 |
506 |
$72K |
| 86923 |
|
2,972 |
2,661 |
$67K |
| 37225 |
|
12 |
12 |
$63K |
| 86870 |
|
1,004 |
905 |
$62K |
| 95819 |
|
496 |
491 |
$58K |
| 77080 |
|
970 |
967 |
$57K |
| 71271 |
|
996 |
996 |
$55K |
| 76825 |
|
227 |
227 |
$55K |
| 93975 |
|
545 |
539 |
$54K |
| 73700 |
|
859 |
858 |
$52K |
| J7307 |
Etonogestrel implant system |
127 |
124 |
$51K |
| 87389 |
|
11,641 |
11,505 |
$51K |
| 95908 |
|
394 |
388 |
$50K |
| 76813 |
|
1,253 |
1,251 |
$49K |
| 80053 |
|
19,502 |
18,172 |
$47K |
| 72100 |
|
1,752 |
1,742 |
$44K |
| 87625 |
|
3,542 |
3,522 |
$43K |
| 99396 |
|
720 |
717 |
$41K |
| C1725 |
Cath, translumin non-laser |
319 |
304 |
$41K |
| 72110 |
|
1,012 |
1,004 |
$40K |
| 73560 |
|
1,523 |
1,356 |
$40K |
| 85027 |
|
49,577 |
41,940 |
$40K |
| G0108 |
Diab manage trn per indiv |
585 |
584 |
$38K |
| 90471 |
|
4,557 |
4,486 |
$38K |
| 93922 |
|
987 |
975 |
$38K |
| 83735 |
|
35,958 |
29,563 |
$37K |
| 70486 |
|
627 |
624 |
$36K |
| 72125 |
|
762 |
758 |
$35K |
| 67113 |
|
13 |
13 |
$35K |
| 70491 |
|
299 |
298 |
$34K |
| 82306 |
|
4,612 |
4,573 |
$32K |
| 93005 |
|
20,897 |
18,921 |
$32K |
| C1874 |
Stent, coated/cov w/del sys |
13 |
13 |
$32K |
| 36430 |
|
235 |
226 |
$31K |
| 73130 |
|
2,711 |
2,209 |
$30K |
| 11981 |
|
141 |
137 |
$30K |
| J1100 |
Dexamethasone sodium phos |
9,997 |
9,569 |
$30K |
| 10060 |
|
303 |
299 |
$30K |
| 87635 |
|
1,403 |
1,381 |
$30K |
| G0379 |
Direct refer hospital observ |
68 |
68 |
$30K |
| 93017 |
|
2,022 |
1,997 |
$29K |
| 76817 |
|
11,993 |
11,220 |
$29K |
| 86850 |
|
31,079 |
29,293 |
$29K |
| 72158 |
|
186 |
181 |
$29K |
| 86922 |
|
2,272 |
2,006 |
$27K |
| 73030 |
|
2,555 |
2,282 |
$27K |
| 73562 |
|
1,962 |
1,467 |
$26K |
| 81025 |
|
26,511 |
25,457 |
$25K |
| 86829 |
|
824 |
488 |
$23K |
| 81401 |
|
520 |
510 |
$22K |
| 75716 |
|
44 |
43 |
$22K |
| 81220 |
|
513 |
504 |
$22K |
| 82951 |
|
2,971 |
2,950 |
$22K |
| 88305 |
|
13,321 |
13,099 |
$22K |
| 80307 |
|
4,917 |
4,719 |
$20K |
| 94640 |
|
3,720 |
3,320 |
$20K |
| 85025 |
|
34,163 |
29,837 |
$19K |
| 87086 |
|
13,894 |
13,386 |
$19K |
| 82728 |
|
5,691 |
5,151 |
$19K |
| 58670 |
|
17 |
12 |
$18K |
| 84443 |
|
4,604 |
4,497 |
$18K |
| 72170 |
|
717 |
714 |
$17K |
| 81003 |
|
19,218 |
18,164 |
$17K |
| J2704 |
Inj, propofol, 10 mg |
25,600 |
24,996 |
$17K |
| 96360 |
|
188 |
185 |
$17K |
| 84484 |
|
13,816 |
11,996 |
$16K |
| 87480 |
|
2,976 |
2,954 |
$16K |
| 84702 |
|
9,850 |
8,661 |
$15K |
| 93454 |
|
12 |
12 |
$15K |
| Q3014 |
Telehealth facility fee |
1,070 |
1,061 |
$15K |
| 82962 |
|
10,249 |
9,124 |
$15K |
| 97530 |
|
4,635 |
1,976 |
$15K |
| 86762 |
|
6,379 |
6,300 |
$14K |
| 77001 |
|
2,031 |
1,790 |
$14K |
| 72146 |
|
103 |
103 |
$14K |
| 73564 |
|
1,787 |
1,537 |
$14K |
| 87510 |
|
2,852 |
2,831 |
$14K |
| 72131 |
|
315 |
313 |
$14K |
| 57454 |
|
110 |
102 |
$13K |
| 87340 |
|
10,360 |
10,145 |
$13K |
| 0012A |
|
379 |
379 |
$13K |
| S0028 |
Injection, famotidine, 20 mg |
3,282 |
2,987 |
$13K |
| J1200 |
Diphenhydramine hcl injectio |
14,982 |
12,870 |
$13K |
| 83036 |
|
4,482 |
4,415 |
$13K |
| G0109 |
Diab manage trn ind/group |
376 |
305 |
$12K |
| Q9957 |
Inj perflutren lip micros,ml |
2,145 |
2,094 |
$12K |
| 86901 |
|
31,116 |
29,334 |
$12K |
| 94618 |
|
865 |
855 |
$12K |
| 73502 |
|
1,250 |
1,202 |
$12K |
| 86833 |
|
98 |
97 |
$12K |
| 86832 |
|
98 |
97 |
$12K |
| 95708 |
|
73 |
40 |
$12K |
| 76881 |
|
174 |
173 |
$11K |
| 94010 |
|
1,599 |
1,593 |
$11K |
| 81002 |
|
17,267 |
13,589 |
$11K |
| 96366 |
|
322 |
261 |
$10K |
| 83021 |
|
4,782 |
3,707 |
$10K |
| 87660 |
|
2,040 |
2,027 |
$10K |
| 86803 |
|
2,519 |
2,510 |
$10K |
| 11976 |
|
28 |
26 |
$10K |
| 0011A |
|
425 |
425 |
$10K |
| 76937 |
|
2,253 |
2,008 |
$10K |
| J7300 |
Intra copp contra (paragard) |
28 |
28 |
$10K |
| 72050 |
|
234 |
231 |
$10K |
| J7030 |
Normal saline solution infus |
32,735 |
28,694 |
$9K |
| 72040 |
|
410 |
407 |
$9K |
| 82330 |
|
4,444 |
3,725 |
$9K |
| 87467 |
|
2,669 |
2,621 |
$9K |
| 95700 |
|
67 |
67 |
$9K |
| 91200 |
|
132 |
132 |
$9K |
| 64447 |
|
214 |
211 |
$9K |
| 66982 |
|
12 |
12 |
$8K |
| 73630 |
|
2,001 |
1,833 |
$8K |
| 58301 |
|
42 |
42 |
$8K |
| Q2037 |
Fluvirin vacc, 3 yrs & >, im |
481 |
476 |
$8K |
| 29881 |
|
13 |
12 |
$8K |
| 87077 |
|
5,655 |
5,260 |
$8K |
| C1887 |
Catheter, guiding |
2,144 |
2,096 |
$8K |
| 99153 |
Mod sedat endo service >5yrs |
1,675 |
1,639 |
$8K |
| 81001 |
|
23,850 |
22,630 |
$8K |
| 88307 |
|
786 |
767 |
$8K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
11,722 |
11,162 |
$7K |
| 93880 |
|
89 |
88 |
$7K |
| J7120 |
Ringers lactate infusion |
21,102 |
19,309 |
$7K |
| 87081 |
|
5,033 |
4,958 |
$7K |
| 82607 |
|
1,915 |
1,889 |
$7K |
| 70496 |
|
54 |
54 |
$7K |
| 0002A |
|
183 |
183 |
$7K |
| 73610 |
|
1,414 |
1,318 |
$6K |
| 83880 |
|
3,665 |
3,479 |
$6K |
| 0001A |
|
198 |
198 |
$6K |
| 97161 |
|
51 |
51 |
$6K |
| 73110 |
|
725 |
658 |
$6K |
| 99152 |
|
1,881 |
1,843 |
$6K |
| 82565 |
|
5,122 |
5,050 |
$6K |
| 90686 |
|
367 |
366 |
$6K |
| J1720 |
Hydrocortisone sodium succ i |
3,301 |
2,800 |
$6K |
| A9270 |
Non-covered item or service |
84,670 |
56,932 |
$5K |
| 93325 |
|
1,332 |
1,304 |
$5K |
| 76870 |
|
169 |
169 |
$5K |
| 83690 |
|
10,052 |
9,312 |
$5K |
| J1050 |
Medroxyprogesterone acetate |
4,106 |
4,055 |
$5K |
| 87799 |
|
374 |
299 |
$5K |
| J1750 |
Inj iron dextran |
24 |
24 |
$5K |
| 85610 |
|
12,578 |
11,651 |
$5K |
| 90674 |
|
286 |
276 |
$5K |
| J3475 |
Inj magnesium sulfate |
3,045 |
2,709 |
$5K |
| 99407 |
|
82 |
75 |
$5K |
| 97116 |
|
2,455 |
1,714 |
$5K |
| 85384 |
|
1,089 |
878 |
$5K |
| A9502 |
Tc99m tetrofosmin |
551 |
546 |
$4K |
| G0297 |
Ldct for lung ca screen |
120 |
119 |
$4K |
| 85730 |
|
11,998 |
11,179 |
$4K |
| 87522 |
Neg quan hep c or qual rna |
366 |
366 |
$4K |
| 87040 |
|
1,799 |
1,650 |
$4K |
| 76820 |
|
3,779 |
2,125 |
$4K |
| 93308 |
|
67 |
63 |
$4K |
| 82248 |
|
4,621 |
4,342 |
$4K |
| 86787 |
|
1,425 |
1,282 |
$3K |
| 97535 |
|
1,922 |
1,446 |
$3K |
| 95886 |
|
4,543 |
4,258 |
$3K |
| J0690 |
Cefazolin sodium injection |
8,075 |
6,721 |
$3K |
| 83605 |
|
2,922 |
2,636 |
$3K |
| 82105 |
|
893 |
885 |
$3K |
| 84100 |
|
4,032 |
2,988 |
$3K |
| J0330 |
Succinycholine chloride inj |
3,877 |
3,817 |
$3K |
| J1644 |
Inj heparin sodium per 1000u |
12,023 |
7,427 |
$3K |
| 80197 |
|
641 |
466 |
$3K |
| 84460 |
|
7,727 |
7,332 |
$3K |
| 94729 |
|
3,324 |
3,312 |
$3K |
| 84450 |
|
7,728 |
7,324 |
$3K |
| J1170 |
Hydromorphone injection |
10,970 |
8,606 |
$3K |
| 93320 |
|
857 |
844 |
$3K |
| 84425 |
|
438 |
436 |
$3K |
| 84439 |
|
1,013 |
981 |
$3K |
| 72197 |
|
13 |
13 |
$2K |
| 84703 |
|
4,964 |
4,830 |
$2K |
| 72070 |
|
104 |
104 |
$2K |
| 83540 |
|
1,666 |
1,608 |
$2K |
| 80177 |
|
891 |
886 |
$2K |
| 82570 |
|
3,094 |
2,836 |
$2K |
| 97110 |
|
1,628 |
1,122 |
$2K |
| 73120 |
|
74 |
52 |
$2K |
| J0610 |
Calcium glucon (fresenius) |
1,887 |
1,575 |
$2K |
| G0008 |
Admin influenza virus vac |
339 |
337 |
$2K |
| 88312 |
|
1,757 |
1,741 |
$2K |
| 84132 |
|
5,674 |
5,340 |
$2K |
| 84075 |
|
5,693 |
5,422 |
$2K |
| A4649 |
Surgical supplies |
267 |
195 |
$2K |
| 87070 |
|
1,542 |
1,487 |
$2K |
| S0077 |
Injection, clindamycin phosp |
328 |
279 |
$2K |
| 86140 |
|
1,580 |
1,515 |
$2K |
| 88304 |
|
1,674 |
1,638 |
$2K |
| A9579 |
Gad-base mr contrast nos,1ml |
509 |
499 |
$2K |
| 87502 |
|
783 |
766 |
$2K |
| 88342 |
|
497 |
485 |
$2K |
| J2270 |
Morphine sulfate injection |
10,364 |
8,919 |
$2K |
| 86703 |
|
2,096 |
2,026 |
$2K |
| 83921 |
|
333 |
333 |
$2K |
| 86235 |
|
276 |
263 |
$1K |
| 86038 |
|
552 |
545 |
$1K |
| 85014 |
|
4,787 |
4,501 |
$1K |
| 74018 |
|
144 |
136 |
$1K |
| 74022 |
|
519 |
509 |
$1K |
| 87631 |
|
1,217 |
1,190 |
$1K |
| J7040 |
Normal saline solution infus |
3,224 |
2,810 |
$1K |
| 84295 |
|
4,237 |
4,023 |
$1K |
| 80051 |
|
723 |
694 |
$1K |
| 74021 |
|
183 |
177 |
$1K |
| 84156 |
|
2,740 |
2,547 |
$1K |
| 82247 |
|
5,040 |
4,761 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
18,451 |
15,704 |
$1K |
| 80074 |
|
149 |
148 |
$1K |
| 85379 |
|
2,598 |
2,546 |
$1K |
| J0696 |
Ceftriaxone sodium injection |
5,756 |
4,953 |
$1K |
| 84146 |
|
154 |
152 |
$1K |
| V2632 |
Post chmbr intraocular lens |
1,223 |
1,185 |
$1K |
| 83615 |
|
1,813 |
1,689 |
$974.57 |
| 76821 |
|
1,964 |
1,092 |
$971.95 |
| J7050 |
Normal saline solution infus |
2,456 |
2,199 |
$958.15 |
| 64415 |
|
93 |
92 |
$951.27 |
| 83970 |
|
113 |
108 |
$941.43 |
| 82542 |
|
4,086 |
3,307 |
$924.76 |
| 82150 |
|
1,355 |
1,280 |
$916.11 |
| J0780 |
Prochlorperazine injection |
2,035 |
1,901 |
$905.37 |
| J2405 |
Ondansetron hcl injection |
22,178 |
19,612 |
$892.61 |
| J3370 |
Vancomycin hcl injection |
3,026 |
2,466 |
$820.61 |
| 99202 |
|
222 |
222 |
$802.90 |
| J2785 |
Regadenoson injection |
56 |
56 |
$802.05 |
| J3415 |
Pyridoxine hcl 100 mg |
1,064 |
900 |
$788.44 |
| 74019 |
|
155 |
154 |
$764.78 |
| 83090 |
|
209 |
203 |
$711.06 |
| 82803 |
|
312 |
271 |
$678.92 |
| 82550 |
|
597 |
564 |
$677.65 |
| 87341 |
|
235 |
233 |
$666.87 |
| 88341 |
|
31 |
27 |
$639.20 |
| 87102 |
|
377 |
373 |
$638.75 |
| 86360 |
|
40 |
40 |
$631.53 |
| J7070 |
D5w infusion |
482 |
404 |
$630.93 |
| 82784 |
|
190 |
114 |
$620.79 |
| 80076 |
|
341 |
339 |
$579.64 |
| 96367 |
|
25 |
24 |
$548.89 |
| 99385 |
|
12 |
12 |
$522.46 |
| C1894 |
Intro/sheath, non-laser |
4,832 |
4,474 |
$507.81 |
| 88302 |
|
344 |
336 |
$507.32 |
| 86359 |
|
40 |
40 |
$506.58 |
| 87205 |
|
1,234 |
1,185 |
$493.88 |
| 73590 |
|
117 |
111 |
$479.63 |
| J0171 |
Adrenalin epinephrine inject |
1,066 |
1,045 |
$465.05 |
| 90715 |
|
3,629 |
3,616 |
$452.45 |
| J3480 |
Inj potassium chloride |
873 |
663 |
$452.31 |
| 84550 |
|
433 |
425 |
$434.09 |
| 85652 |
|
1,197 |
1,148 |
$425.54 |
| 36415 |
|
2,471 |
2,191 |
$412.92 |
| 82746 |
|
136 |
135 |
$382.08 |
| 85018 |
|
522 |
444 |
$366.47 |
| 87804 |
|
559 |
395 |
$357.96 |
| J7121 |
5% dextrose in lac ringers |
967 |
894 |
$349.15 |
| J2765 |
Metoclopramide hcl injection |
4,263 |
3,557 |
$325.29 |
| 86357 |
|
27 |
27 |
$318.78 |
| 86355 |
|
27 |
27 |
$318.78 |
| 84466 |
|
102 |
102 |
$317.05 |
| C1760 |
Closure dev, vasc |
276 |
263 |
$271.35 |
| S0020 |
Injection, bupivicaine hydro |
3,349 |
3,257 |
$266.63 |
| 70498 |
|
13 |
13 |
$258.48 |
| 73080 |
|
44 |
41 |
$258.14 |
| 87075 |
|
117 |
112 |
$245.73 |
| 83516 |
|
53 |
27 |
$239.56 |
| 86334 |
|
37 |
37 |
$239.19 |
| C9399 |
Unclassified drugs or biolog |
82 |
79 |
$237.16 |
| 85046 |
|
214 |
176 |
$235.23 |
| 86706 |
|
120 |
117 |
$225.06 |
| 85347 |
|
438 |
417 |
$219.59 |
| 83550 |
|
195 |
184 |
$213.50 |
| 83001 |
|
25 |
25 |
$211.47 |
| G0480 |
Drug test def 1-7 classes |
13 |
13 |
$206.85 |
| 80235 |
|
51 |
51 |
$201.05 |
| J0692 |
Cefepime hcl for injection |
76 |
52 |
$197.92 |
| 76376 |
|
203 |
198 |
$180.16 |
| 86255 |
|
34 |
31 |
$172.47 |
| J0461 |
Atropine sulfate injection |
687 |
677 |
$157.84 |
| 83020 |
|
81 |
73 |
$153.55 |
| 84207 |
|
76 |
76 |
$152.22 |
| J2920 |
Methylprednisolone injection |
149 |
83 |
$145.49 |
| 88313 |
|
385 |
372 |
$132.56 |
| 82652 |
|
26 |
26 |
$117.24 |
| C1752 |
Cath,hemodialysis,short-term |
1,913 |
1,685 |
$111.60 |
| J1650 |
Inj enoxaparin sodium |
382 |
216 |
$109.62 |
| J2710 |
Neostigmine methylslfte inj |
2,513 |
2,487 |
$103.80 |
| 82040 |
|
478 |
454 |
$101.44 |
| 83655 |
|
27 |
27 |
$88.27 |
| 93321 |
|
40 |
38 |
$84.96 |
| 90472 |
|
12 |
12 |
$82.00 |
| 86592 |
|
29 |
28 |
$78.49 |
| J7060 |
5% dextrose/water |
38 |
32 |
$74.10 |
| J0613 |
Calcium glucon (wg critical) |
28 |
26 |
$73.66 |
| 84155 |
|
103 |
100 |
$70.58 |
| 87807 |
|
109 |
105 |
$69.72 |
| J1940 |
Furosemide injection |
426 |
218 |
$64.75 |
| J0360 |
Hydralazine hcl injection |
458 |
420 |
$62.89 |
| 82785 |
|
12 |
12 |
$62.29 |
| A9576 |
Inj prohance multipack |
3,059 |
2,955 |
$60.00 |
| J1250 |
Inj dobutamine hcl/250 mg |
143 |
142 |
$58.50 |
| 82677 |
|
70 |
70 |
$55.24 |
| 86704 |
|
13 |
13 |
$55.11 |
| J3301 |
Triamcinolone acet inj nos |
140 |
137 |
$53.38 |
| J2930 |
Methylprednisolone injection |
126 |
102 |
$52.21 |
| 87880 |
|
257 |
252 |
$49.25 |
| A9585 |
Gadobutrol injection |
1,001 |
953 |
$48.90 |
| J0611 |
Calcium glucon (wg critical) |
16 |
16 |
$41.84 |
| J1630 |
Haloperidol injection |
533 |
466 |
$40.81 |
| J1580 |
Garamycin gentamicin inj |
343 |
310 |
$39.66 |
| 96376 |
|
5,301 |
3,666 |
$39.02 |
| 86141 |
|
13 |
13 |
$38.63 |
| 80183 |
|
12 |
12 |
$36.00 |
| 76942 |
|
33 |
26 |
$35.84 |
| 86336 |
|
83 |
83 |
$35.59 |
| 82107 |
|
14 |
14 |
$35.56 |
| J7042 |
5% dextrose/normal saline |
183 |
166 |
$35.40 |
| 82465 |
|
13 |
13 |
$32.35 |
| 82810 |
|
13 |
13 |
$32.34 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,167 |
1,144 |
$31.21 |
| 82010 |
|
138 |
126 |
$28.31 |
| J0702 |
Betamethasone acet&sod phosp |
90 |
53 |
$27.38 |
| 80175 |
|
13 |
13 |
$24.51 |
| 87206 |
|
38 |
38 |
$23.88 |
| 82164 |
|
14 |
14 |
$18.38 |
| J2060 |
Lorazepam injection |
384 |
328 |
$15.03 |
| J3010 |
Fentanyl citrate injection |
13,158 |
12,925 |
$14.94 |
| 86039 |
|
12 |
12 |
$14.50 |
| J2795 |
Ropivacaine hcl injection |
1,086 |
1,081 |
$14.28 |
| 84520 |
|
28 |
26 |
$11.68 |
| J7512 |
Prednisone ir or dr oral 1mg |
344 |
207 |
$10.29 |
| J1815 |
Insulin injection |
104 |
96 |
$2.75 |
| J1805 |
Inj, esmolol hcl, 10mg |
12 |
12 |
$1.47 |
| J1920 |
Inj, labetalol hcl, 5mg |
168 |
165 |
$1.12 |
| C9113 |
Inj pantoprazole sodium, via |
1,480 |
906 |
$0.00 |
| 76827 |
|
187 |
187 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
671 |
669 |
$0.00 |
| C1729 |
Cath, drainage |
210 |
201 |
$0.00 |
| C1782 |
Morcellator |
303 |
302 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
33 |
33 |
$0.00 |
| 20985 |
|
40 |
40 |
$0.00 |
| V2630 |
Anter chamber intraocul lens |
39 |
38 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
248 |
214 |
$0.00 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
479 |
463 |
$0.00 |
| 64999 |
|
13 |
13 |
$0.00 |
| 97537 |
|
67 |
41 |
$0.00 |
| 87634 |
|
13 |
13 |
$0.00 |
| A4565 |
Slings |
16 |
15 |
$0.00 |
| C1769 |
Guide wire |
5,009 |
4,662 |
$0.00 |
| S2900 |
Robotic surgical system |
320 |
314 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
795 |
790 |
$0.00 |
| J3411 |
Thiamine hcl 100 mg |
14 |
12 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
568 |
561 |
$0.00 |
| J2791 |
Rhophylac injection |
73 |
70 |
$0.00 |
| C1781 |
Mesh (implantable) |
118 |
116 |
$0.00 |
| 86225 |
|
14 |
13 |
$0.00 |
| 94660 |
|
33 |
13 |
$0.00 |
| 85660 |
|
24 |
24 |
$0.00 |
| C1753 |
Cath, intravas ultrasound |
12 |
12 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
25 |
18 |
$0.00 |