| Code | Description | Claims | Beneficiaries | Total Paid |
| 90791 |
|
24,153 |
21,147 |
$16.18M |
| G0378 |
Hospital observation per hr |
7,767 |
3,282 |
$9.19M |
| G0463 |
Hospital outpt clinic visit |
86,746 |
73,270 |
$9.14M |
| 99284 |
|
28,774 |
25,976 |
$5.54M |
| 90834 |
|
37,598 |
23,142 |
$4.83M |
| 90832 |
|
49,649 |
32,331 |
$4.62M |
| S9485 |
Crisis intervention mental h |
3,985 |
3,731 |
$4.56M |
| 99283 |
|
22,768 |
20,295 |
$3.85M |
| 99285 |
|
15,520 |
14,320 |
$3.47M |
| 99213 |
|
36,139 |
32,749 |
$3.39M |
| 99214 |
|
36,848 |
33,939 |
$3.32M |
| 97110 |
|
21,522 |
7,013 |
$2.89M |
| U0004 |
Cov-19 test non-cdc hgh thru |
37,751 |
23,010 |
$2.87M |
| H0005 |
Alcohol and/or drug services |
39,392 |
8,864 |
$2.78M |
| 90999 |
|
12,566 |
1,235 |
$2.24M |
| 70450 |
|
7,338 |
7,059 |
$1.59M |
| 96361 |
|
11,623 |
7,974 |
$1.59M |
| 99282 |
|
6,572 |
6,122 |
$894K |
| 80053 |
|
53,090 |
44,801 |
$855K |
| G0390 |
Trauma respons w/hosp criti |
438 |
435 |
$746K |
| 36415 |
|
128,606 |
66,510 |
$735K |
| 87636 |
|
7,747 |
6,747 |
$706K |
| H0001 |
Alcohol and/or drug assess |
4,608 |
2,991 |
$702K |
| 80307 |
|
23,327 |
20,828 |
$675K |
| Q5105 |
Inj retacrit esrd on dialysi |
12,454 |
1,234 |
$590K |
| 43239 |
|
841 |
838 |
$554K |
| 99212 |
|
5,186 |
4,873 |
$472K |
| U0005 |
Infec agen detec ampli probe |
19,670 |
11,672 |
$470K |
| 90853 |
|
6,838 |
2,301 |
$453K |
| 74177 |
|
2,226 |
2,180 |
$430K |
| 90935 |
|
747 |
83 |
$422K |
| 97116 |
|
2,843 |
1,244 |
$402K |
| 71275 |
|
2,102 |
2,081 |
$387K |
| 97112 |
|
3,078 |
855 |
$365K |
| H2010 |
Comprehensive med svc 15 min |
5,621 |
4,818 |
$340K |
| 93306 |
|
3,093 |
3,055 |
$338K |
| 96365 |
|
3,566 |
3,016 |
$332K |
| 96360 |
|
3,151 |
2,983 |
$301K |
| 97161 |
|
2,964 |
2,940 |
$289K |
| 97530 |
|
4,003 |
1,730 |
$281K |
| 87491 |
|
10,575 |
7,676 |
$263K |
| 80048 |
|
16,098 |
14,329 |
$220K |
| 74176 |
|
1,433 |
1,408 |
$212K |
| 96372 |
|
16,047 |
11,789 |
$207K |
| 12001 |
|
632 |
630 |
$201K |
| 11042 |
|
367 |
248 |
$195K |
| D0120 |
|
4,738 |
1,836 |
$192K |
| 70486 |
|
2,314 |
2,284 |
$180K |
| H0038 |
Self-help/peer svc per 15min |
3,670 |
1,904 |
$176K |
| 72125 |
|
3,764 |
3,699 |
$171K |
| 96366 |
|
1,880 |
1,419 |
$170K |
| T1017 |
Targeted case management |
7,453 |
1,703 |
$170K |
| 96374 |
|
16,794 |
13,188 |
$169K |
| 99396 |
|
1,723 |
1,722 |
$163K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
957 |
950 |
$161K |
| 80061 |
|
11,529 |
11,449 |
$159K |
| 45380 |
|
246 |
246 |
$157K |
| 36416 |
|
9,247 |
7,071 |
$156K |
| 72131 |
|
1,664 |
1,652 |
$149K |
| HZ2ZZZZ |
|
321 |
41 |
$148K |
| 87591 |
|
7,448 |
7,301 |
$145K |
| H0004 |
Alcohol and/or drug services |
2,542 |
1,985 |
$144K |
| 20610 |
|
713 |
682 |
$140K |
| 72128 |
|
1,433 |
1,422 |
$137K |
| 64721 |
|
116 |
114 |
$134K |
| 88342 |
|
170 |
165 |
$132K |
| D7140 |
|
2,054 |
933 |
$131K |
| 92507 |
|
1,814 |
409 |
$127K |
| 87902 |
|
660 |
630 |
$126K |
| 85025 |
|
52,613 |
43,852 |
$125K |
| 76000 |
|
1,090 |
1,088 |
$123K |
| 82306 |
|
5,284 |
5,249 |
$122K |
| D0140 |
|
3,264 |
1,888 |
$120K |
| 86480 |
|
2,122 |
2,094 |
$118K |
| 70498 |
|
694 |
684 |
$118K |
| 90715 |
|
4,439 |
4,424 |
$115K |
| 93005 |
|
19,232 |
17,589 |
$114K |
| 93010 |
|
14,856 |
13,417 |
$113K |
| 83880 |
|
2,646 |
2,481 |
$113K |
| 73610 |
|
3,431 |
3,111 |
$109K |
| 82803 |
|
5,067 |
4,584 |
$109K |
| 99204 |
|
968 |
963 |
$105K |
| 99281 |
|
772 |
738 |
$105K |
| D1110 |
|
2,299 |
1,087 |
$104K |
| 97162 |
|
1,096 |
1,078 |
$103K |
| 12002 |
|
333 |
333 |
$100K |
| 87536 |
|
2,028 |
1,874 |
$100K |
| 86850 |
|
4,569 |
4,451 |
$98K |
| 99211 |
|
5,502 |
5,345 |
$96K |
| 87635 |
|
2,233 |
1,712 |
$94K |
| 71045 |
|
8,379 |
7,918 |
$93K |
| 86900 |
|
4,945 |
4,462 |
$93K |
| 70487 |
|
373 |
365 |
$92K |
| 88305 |
|
2,608 |
2,517 |
$86K |
| 71046 |
|
7,517 |
7,379 |
$84K |
| 86901 |
|
4,847 |
4,458 |
$83K |
| 87661 |
|
4,775 |
4,714 |
$82K |
| 99395 |
|
866 |
866 |
$80K |
| 78452 |
|
469 |
469 |
$75K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
6,406 |
6,151 |
$75K |
| 0002A |
|
2,119 |
2,101 |
$74K |
| 87799 |
|
516 |
452 |
$72K |
| 0001A |
|
2,275 |
2,245 |
$72K |
| 99203 |
|
402 |
400 |
$71K |
| 72148 |
|
251 |
251 |
$71K |
| 93975 |
|
298 |
294 |
$70K |
| 97166 |
|
597 |
588 |
$70K |
| 90686 |
|
3,413 |
3,403 |
$69K |
| 87522 |
Neg quan hep c or qual rna |
2,270 |
2,235 |
$66K |
| 73630 |
|
3,039 |
2,903 |
$61K |
| 99406 |
|
2,558 |
2,507 |
$60K |
| 84443 |
|
9,902 |
9,740 |
$58K |
| H0035 |
Mh partial hosp tx under 24h |
394 |
70 |
$55K |
| 87497 |
|
751 |
637 |
$54K |
| 83970 |
|
1,910 |
1,755 |
$53K |
| 92557 |
|
2,079 |
607 |
$53K |
| 76705 |
|
1,617 |
1,605 |
$51K |
| 0202U |
|
758 |
748 |
$50K |
| H0050 |
Alcohol/drug service 15 min |
1,680 |
1,533 |
$49K |
| Q4081 |
Epoetin alfa, 100 units esrd |
3,885 |
372 |
$48K |
| 76856 |
|
175 |
172 |
$47K |
| 97140 |
|
2,375 |
894 |
$47K |
| H2011 |
Crisis interven svc, 15 min |
168 |
163 |
$47K |
| 83036 |
|
10,909 |
10,790 |
$46K |
| 73562 |
|
645 |
637 |
$45K |
| J2916 |
Na ferric gluconate complex |
3,046 |
772 |
$42K |
| D0330 |
|
1,069 |
803 |
$42K |
| D0150 |
|
1,306 |
514 |
$42K |
| C9803 |
Hopd covid-19 spec collect |
8,810 |
7,603 |
$42K |
| 94060 |
|
1,137 |
867 |
$41K |
| 99291 |
|
367 |
363 |
$41K |
| 99232 |
|
1,536 |
583 |
$41K |
| 80047 |
|
2,931 |
2,911 |
$41K |
| 84484 |
|
8,766 |
7,800 |
$40K |
| 96112 |
|
106 |
103 |
$39K |
| 94729 |
|
778 |
776 |
$39K |
| A9500 |
Tc99m sestamibi |
473 |
473 |
$38K |
| 80069 |
|
3,500 |
2,069 |
$35K |
| 70491 |
|
324 |
320 |
$35K |
| 10060 |
|
185 |
181 |
$34K |
| 80197 |
|
1,945 |
1,044 |
$34K |
| 73502 |
|
1,577 |
1,533 |
$34K |
| 94640 |
|
1,452 |
1,087 |
$34K |
| 97127 |
|
528 |
114 |
$34K |
| 86359 |
|
1,315 |
1,296 |
$34K |
| 73564 |
|
2,656 |
2,584 |
$34K |
| 93017 |
|
920 |
912 |
$33K |
| 74174 |
|
1,221 |
1,213 |
$32K |
| 83735 |
|
13,400 |
9,999 |
$31K |
| 81025 |
|
9,862 |
9,462 |
$31K |
| 85610 |
|
11,962 |
10,665 |
$29K |
| 87389 |
|
5,376 |
5,322 |
$28K |
| G0008 |
Admin influenza virus vac |
2,246 |
2,238 |
$28K |
| 90675 |
|
200 |
81 |
$27K |
| 97165 |
|
491 |
485 |
$26K |
| 82728 |
|
3,376 |
3,318 |
$26K |
| 87340 |
|
7,321 |
7,197 |
$26K |
| 82962 |
|
7,790 |
5,441 |
$25K |
| 0031A |
|
644 |
644 |
$24K |
| 90460 |
|
2,093 |
2,004 |
$24K |
| 80074 |
|
1,457 |
1,455 |
$23K |
| 90837 |
|
661 |
397 |
$23K |
| 81001 |
|
16,711 |
15,079 |
$23K |
| 73700 |
|
167 |
167 |
$22K |
| 86361 |
|
1,281 |
1,275 |
$21K |
| 87086 |
|
4,153 |
3,475 |
$21K |
| J2785 |
Regadenoson injection |
122 |
122 |
$21K |
| 90471 |
|
6,016 |
5,567 |
$21K |
| 80076 |
|
1,755 |
1,726 |
$20K |
| 82570 |
|
5,978 |
4,933 |
$20K |
| G0121 |
Colon ca scrn not hi rsk ind |
25 |
25 |
$20K |
| 12011 |
|
76 |
76 |
$19K |
| 99408 |
|
536 |
500 |
$19K |
| 99222 |
|
380 |
336 |
$18K |
| 84100 |
|
7,097 |
5,033 |
$18K |
| 86706 |
|
3,258 |
3,235 |
$18K |
| 71250 |
|
339 |
338 |
$18K |
| 0003A |
|
448 |
439 |
$17K |
| 84439 |
|
4,004 |
3,962 |
$17K |
| 97535 |
|
506 |
317 |
$17K |
| 45378 |
|
26 |
26 |
$17K |
| 82607 |
|
3,046 |
3,016 |
$17K |
| 76770 |
|
126 |
126 |
$16K |
| 86780 |
|
4,046 |
4,019 |
$15K |
| 72110 |
|
1,335 |
1,322 |
$15K |
| 86803 |
|
7,519 |
7,427 |
$15K |
| 20680 |
|
13 |
13 |
$15K |
| 83550 |
|
3,725 |
3,640 |
$14K |
| 83615 |
|
2,789 |
1,703 |
$14K |
| 86704 |
|
5,087 |
5,022 |
$14K |
| 86141 |
|
3,959 |
3,848 |
$14K |
| 96413 |
|
212 |
125 |
$14K |
| 86708 |
|
1,427 |
1,424 |
$13K |
| 0124A |
|
270 |
262 |
$13K |
| 90677 |
|
287 |
287 |
$13K |
| 86376 |
|
108 |
107 |
$13K |
| 82043 |
|
3,208 |
3,172 |
$13K |
| 73030 |
|
2,562 |
2,471 |
$12K |
| 96375 |
|
10,109 |
7,505 |
$12K |
| Q3014 |
Telehealth facility fee |
809 |
788 |
$12K |
| A9585 |
Gadobutrol injection |
263 |
260 |
$12K |
| 73200 |
|
97 |
97 |
$12K |
| 83540 |
|
3,707 |
3,619 |
$11K |
| 94726 |
|
579 |
579 |
$11K |
| 84702 |
|
3,783 |
3,674 |
$11K |
| 97130 |
|
166 |
59 |
$11K |
| J1756 |
Iron sucrose injection |
185 |
84 |
$11K |
| 84153 |
|
1,417 |
1,404 |
$10K |
| 99238 |
|
423 |
402 |
$10K |
| 86039 |
|
231 |
229 |
$10K |
| 0054A |
|
273 |
268 |
$10K |
| 70496 |
|
55 |
55 |
$10K |
| 71271 |
|
195 |
195 |
$9K |
| 70551 |
|
39 |
39 |
$9K |
| D2392 |
|
109 |
91 |
$9K |
| 76700 |
|
128 |
128 |
$9K |
| 99442 |
|
265 |
259 |
$9K |
| 85730 |
|
5,301 |
5,158 |
$9K |
| 62323 |
|
13 |
13 |
$9K |
| D0220 |
|
576 |
546 |
$8K |
| 85014 |
|
4,962 |
3,685 |
$8K |
| 87088 |
|
930 |
823 |
$8K |
| 99091 |
|
168 |
162 |
$8K |
| 43235 |
|
12 |
12 |
$8K |
| 91300 |
|
1,879 |
1,460 |
$8K |
| 91200 |
|
783 |
762 |
$8K |
| 90670 |
|
260 |
259 |
$8K |
| 73130 |
|
3,012 |
2,867 |
$8K |
| 84156 |
|
2,919 |
1,922 |
$7K |
| 90732 |
|
124 |
124 |
$7K |
| 87631 |
|
183 |
181 |
$7K |
| 82746 |
|
1,491 |
1,478 |
$7K |
| 76536 |
|
244 |
244 |
$7K |
| 71260 |
|
49 |
49 |
$7K |
| 0004A |
|
179 |
177 |
$7K |
| 96376 |
|
4,698 |
3,028 |
$7K |
| 84550 |
|
2,209 |
1,574 |
$6K |
| 97129 |
|
100 |
44 |
$6K |
| 73110 |
|
1,817 |
1,713 |
$6K |
| D0274 |
|
218 |
210 |
$6K |
| 88312 |
|
249 |
248 |
$6K |
| 82977 |
|
316 |
315 |
$6K |
| 88304 |
|
118 |
118 |
$6K |
| G0009 |
Admin pneumococcal vaccine |
458 |
457 |
$6K |
| 0012A |
|
242 |
242 |
$6K |
| 0052A |
|
143 |
140 |
$6K |
| 82105 |
|
1,398 |
1,391 |
$5K |
| 94760 |
|
1,473 |
1,392 |
$5K |
| H0002 |
Alcohol and/or drug screenin |
28 |
28 |
$5K |
| 82248 |
|
851 |
521 |
$5K |
| G0396 |
Alcohol/subs interv 15-30mn |
66 |
64 |
$5K |
| 90656 |
|
321 |
321 |
$5K |
| 70553 |
|
25 |
25 |
$5K |
| 73590 |
|
2,017 |
1,851 |
$5K |
| 31579 |
|
14 |
13 |
$4K |
| 86235 |
|
744 |
741 |
$4K |
| 86481 |
|
219 |
216 |
$4K |
| 90651 |
|
111 |
111 |
$4K |
| 87798 |
|
172 |
171 |
$4K |
| 76830 |
|
152 |
152 |
$4K |
| 84132 |
|
1,388 |
1,304 |
$4K |
| 99215 |
Prolong outpt/office vis |
35 |
34 |
$4K |
| 95819 |
|
91 |
91 |
$4K |
| 72170 |
|
1,004 |
987 |
$4K |
| 85651 |
|
4,184 |
4,059 |
$4K |
| 90734 |
|
206 |
206 |
$4K |
| 99495 |
|
99 |
98 |
$3K |
| 73080 |
|
1,177 |
1,110 |
$3K |
| 0011A |
|
242 |
242 |
$3K |
| 99221 |
|
138 |
130 |
$3K |
| 86769 |
|
146 |
143 |
$3K |
| 87517 |
|
92 |
90 |
$3K |
| 99496 |
|
57 |
55 |
$3K |
| 0051A |
|
73 |
72 |
$3K |
| 88112 |
|
54 |
54 |
$3K |
| 0064A |
|
66 |
66 |
$3K |
| 93990 |
|
60 |
54 |
$2K |
| 99394 |
|
28 |
28 |
$2K |
| 87077 |
|
914 |
885 |
$2K |
| 83690 |
|
6,704 |
6,199 |
$2K |
| 94010 |
|
137 |
114 |
$2K |
| 87186 |
|
1,116 |
1,078 |
$2K |
| 86580 |
|
466 |
450 |
$2K |
| 90633 |
|
128 |
128 |
$2K |
| 90882 |
|
19 |
12 |
$2K |
| 85027 |
|
1,772 |
1,586 |
$2K |
| 73552 |
|
755 |
729 |
$2K |
| 90472 |
|
456 |
453 |
$2K |
| 86762 |
|
382 |
378 |
$2K |
| 31575 |
|
39 |
39 |
$2K |
| 86765 |
|
410 |
391 |
$2K |
| 83605 |
|
5,108 |
4,685 |
$2K |
| 86160 |
|
183 |
179 |
$2K |
| 97760 |
|
42 |
38 |
$1K |
| 90833 |
|
28 |
28 |
$1K |
| 90480 |
|
95 |
95 |
$1K |
| 99202 |
|
13 |
13 |
$1K |
| 11721 |
|
50 |
39 |
$1K |
| 85007 |
|
1,514 |
1,340 |
$1K |
| 82150 |
|
1,767 |
1,664 |
$1K |
| 73090 |
|
1,181 |
1,128 |
$1K |
| J1644 |
Inj heparin sodium per 1000u |
9,745 |
1,719 |
$1K |
| 73060 |
|
534 |
506 |
$1K |
| 72050 |
|
102 |
101 |
$1K |
| 86147 |
|
64 |
63 |
$1K |
| J1630 |
Haloperidol injection |
570 |
537 |
$1K |
| 86920 |
|
49 |
44 |
$1K |
| 73560 |
|
172 |
160 |
$1K |
| D2391 |
|
16 |
13 |
$996.47 |
| 87040 |
|
1,129 |
1,058 |
$959.16 |
| 72100 |
|
114 |
114 |
$918.60 |
| C1769 |
Guide wire |
120 |
106 |
$902.41 |
| 73140 |
|
74 |
70 |
$890.18 |
| 86735 |
|
253 |
249 |
$782.18 |
| 86431 |
|
346 |
345 |
$775.19 |
| 96367 |
|
52 |
36 |
$716.59 |
| J2359 |
Inj. olanzapine, 0.5mg |
72 |
55 |
$714.66 |
| 86832 |
|
18 |
17 |
$710.10 |
| 88307 |
|
13 |
13 |
$703.20 |
| 83883 |
|
180 |
179 |
$683.09 |
| 73523 |
|
37 |
37 |
$664.59 |
| 85379 |
|
857 |
850 |
$656.96 |
| 87071 |
|
950 |
910 |
$656.07 |
| 83010 |
|
194 |
194 |
$650.47 |
| 95886 |
|
48 |
45 |
$638.38 |
| 82550 |
|
995 |
921 |
$633.12 |
| 82172 |
|
155 |
155 |
$623.79 |
| 91322 |
|
59 |
59 |
$608.37 |
| 84520 |
|
2,080 |
1,397 |
$599.95 |
| 90746 |
|
15 |
13 |
$562.75 |
| 36430 |
|
12 |
12 |
$545.30 |
| G2023 |
Specimen collect covid-19 |
205 |
122 |
$509.35 |
| J1170 |
Hydromorphone injection |
4,848 |
4,039 |
$495.52 |
| 84134 |
|
535 |
526 |
$458.00 |
| 99252 |
|
12 |
12 |
$446.98 |
| C9290 |
Inj, bupivacaine liposome |
388 |
387 |
$425.60 |
| 86830 |
|
31 |
30 |
$391.19 |
| 84481 |
|
43 |
43 |
$386.29 |
| 84460 |
|
436 |
433 |
$376.84 |
| 87147 |
|
414 |
402 |
$375.84 |
| 86833 |
|
18 |
17 |
$366.02 |
| J1100 |
Dexamethasone sodium phos |
3,382 |
3,018 |
$336.31 |
| 87070 |
|
256 |
254 |
$329.29 |
| 86225 |
|
85 |
85 |
$329.07 |
| J1885 |
Ketorolac tromethamine inj |
5,821 |
5,429 |
$307.53 |
| J1650 |
Inj enoxaparin sodium |
827 |
407 |
$295.17 |
| J0690 |
Cefazolin sodium injection |
3,350 |
3,057 |
$286.51 |
| J2405 |
Ondansetron hcl injection |
9,204 |
6,904 |
$284.71 |
| 91301 |
|
200 |
161 |
$279.84 |
| 86256 |
|
54 |
53 |
$268.20 |
| 76775 |
|
12 |
12 |
$252.00 |
| 84480 |
|
54 |
52 |
$248.68 |
| J3301 |
Triamcinolone acet inj nos |
352 |
344 |
$241.37 |
| J2250 |
Inj midazolam hydrochloride |
6,292 |
6,064 |
$215.87 |
| 87338 |
|
24 |
24 |
$204.30 |
| 82108 |
|
193 |
185 |
$200.30 |
| 82247 |
|
169 |
169 |
$186.79 |
| J1200 |
Diphenhydramine hcl injectio |
3,604 |
1,548 |
$179.12 |
| 90710 |
|
12 |
12 |
$175.70 |
| 81003 |
|
922 |
910 |
$172.68 |
| 82784 |
|
15 |
15 |
$169.35 |
| 85018 |
|
1,478 |
1,091 |
$165.47 |
| 90698 |
|
13 |
13 |
$160.65 |
| 82310 |
|
302 |
284 |
$154.67 |
| 72052 |
|
14 |
13 |
$151.50 |
| 80320 |
|
998 |
990 |
$150.90 |
| 86696 |
|
50 |
50 |
$150.15 |
| J2704 |
Inj, propofol, 10 mg |
3,475 |
3,391 |
$149.32 |
| 90662 |
|
16 |
16 |
$142.92 |
| J0330 |
Succinycholine chloride inj |
387 |
381 |
$136.74 |
| J2270 |
Morphine sulfate injection |
2,986 |
2,751 |
$131.74 |
| S0166 |
Inj olanzapine 2.5mg |
392 |
358 |
$129.91 |
| 84165 |
|
27 |
26 |
$128.11 |
| 97804 |
|
12 |
12 |
$121.66 |
| 73600 |
|
41 |
37 |
$119.18 |
| 85045 |
|
108 |
107 |
$117.53 |
| J3010 |
Fentanyl citrate injection |
5,184 |
5,081 |
$114.67 |
| 86787 |
|
37 |
37 |
$105.02 |
| J0696 |
Ceftriaxone sodium injection |
1,880 |
1,727 |
$101.83 |
| 84681 |
|
12 |
12 |
$96.29 |
| 86831 |
|
14 |
13 |
$92.36 |
| J3475 |
Inj magnesium sulfate |
491 |
401 |
$87.91 |
| 86200 |
|
39 |
39 |
$84.72 |
| 86828 |
|
14 |
13 |
$82.96 |
| 84466 |
|
13 |
13 |
$77.21 |
| 83921 |
|
25 |
24 |
$74.65 |
| J1040 |
Methylprednisolone 80 mg inj |
28 |
28 |
$73.20 |
| 84075 |
|
319 |
313 |
$67.29 |
| 70355 |
|
16 |
16 |
$55.15 |
| C1894 |
Intro/sheath, non-laser |
58 |
53 |
$54.25 |
| 71101 |
|
49 |
49 |
$52.00 |
| J2060 |
Lorazepam injection |
832 |
745 |
$51.10 |
| 82010 |
|
502 |
454 |
$45.71 |
| J3370 |
Vancomycin hcl injection |
200 |
120 |
$44.79 |
| 86258 |
|
13 |
13 |
$42.06 |
| 74018 |
|
40 |
39 |
$41.52 |
| 88313 |
|
12 |
12 |
$39.92 |
| 81002 |
|
51 |
51 |
$38.24 |
| 86644 |
|
12 |
12 |
$32.65 |
| 87808 |
|
1,195 |
1,183 |
$30.31 |
| 73620 |
|
16 |
12 |
$30.30 |
| 87450 |
|
42 |
40 |
$28.67 |
| 84450 |
|
27 |
27 |
$27.75 |
| 87880 |
|
67 |
65 |
$23.50 |
| 86381 |
|
12 |
12 |
$21.12 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
559 |
548 |
$21.00 |
| J1010 |
Inj, methylpred acetate 1 mg |
52 |
49 |
$19.20 |
| 84560 |
|
27 |
27 |
$17.82 |
| 82565 |
|
32 |
32 |
$16.68 |
| 86592 |
|
13 |
13 |
$16.35 |
| 82542 |
|
25 |
25 |
$14.69 |
| J2919 |
Inj, methylpred sod succ 5mg |
14 |
14 |
$12.78 |
| 84436 |
|
12 |
12 |
$11.43 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
68 |
61 |
$10.60 |
| 82947 |
|
27 |
27 |
$10.31 |
| J1030 |
Methylprednisolone 40 mg inj |
15 |
14 |
$9.69 |
| 99454 |
|
14 |
12 |
$7.11 |
| 86695 |
|
12 |
12 |
$5.76 |
| S0028 |
Injection, famotidine, 20 mg |
278 |
262 |
$5.58 |
| 82270 |
|
12 |
12 |
$5.30 |
| J2710 |
Neostigmine methylslfte inj |
90 |
90 |
$4.40 |
| 82374 |
|
60 |
38 |
$4.08 |
| 87205 |
|
242 |
236 |
$4.04 |
| J2001 |
Lidocaine injection |
352 |
352 |
$1.80 |
| J2765 |
Metoclopramide hcl injection |
213 |
199 |
$1.54 |
| Q0162 |
Ondansetron oral |
173 |
168 |
$0.56 |
| 91305 |
|
221 |
212 |
$0.01 |
| 3288F |
|
1,911 |
1,820 |
$0.00 |
| 99080 |
|
3,615 |
3,526 |
$0.00 |
| 3078F |
|
582 |
566 |
$0.00 |
| 1160F |
|
941 |
895 |
$0.00 |
| 91312 |
|
121 |
121 |
$0.00 |
| J0780 |
Prochlorperazine injection |
38 |
37 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
128 |
84 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
87 |
73 |
$0.00 |
| 99499 |
|
158 |
155 |
$0.00 |
| 87811 |
|
12 |
12 |
$0.00 |
| J2930 |
Methylprednisolone injection |
14 |
12 |
$0.00 |
| 84295 |
|
13 |
13 |
$0.00 |
| J1953 |
Levetiracetam injection |
13 |
12 |
$0.00 |
| 1101F |
|
1,377 |
1,317 |
$0.00 |
| 3074F |
|
1,306 |
1,254 |
$0.00 |
| 3079F |
|
203 |
200 |
$0.00 |
| 3044F |
|
32 |
29 |
$0.00 |
| J7999 |
Compounded drug, noc |
68 |
68 |
$0.00 |
| 91303 |
|
133 |
133 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
73 |
71 |
$0.00 |
| J3411 |
Thiamine hcl 100 mg |
18 |
13 |
$0.00 |
| 90375 |
|
12 |
12 |
$0.00 |
| 3008F |
|
14 |
14 |
$0.00 |
| G0010 |
Admin hepatitis b vaccine |
12 |
12 |
$0.00 |
| 76377 |
|
12 |
12 |
$0.00 |
| 82435 |
|
13 |
13 |
$0.00 |