| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
|
28,306 |
22,933 |
$8.06M |
| 99283 |
|
35,357 |
29,880 |
$7.16M |
| 97110 |
|
59,471 |
17,823 |
$4.94M |
| 74177 |
|
7,750 |
6,612 |
$3.80M |
| G0378 |
Hospital observation per hr |
6,951 |
5,330 |
$3.70M |
| 99285 |
|
6,701 |
5,081 |
$2.34M |
| 92507 |
|
29,914 |
9,465 |
$2.02M |
| 43239 |
|
5,922 |
4,241 |
$2.02M |
| 74176 |
|
3,920 |
3,412 |
$1.76M |
| 70450 |
|
7,148 |
5,870 |
$1.70M |
| 97530 |
|
25,363 |
9,305 |
$1.53M |
| 96365 |
|
12,831 |
6,495 |
$1.49M |
| 96361 |
|
14,734 |
8,322 |
$1.48M |
| 96375 |
|
20,863 |
13,978 |
$1.12M |
| 45380 |
|
3,062 |
2,583 |
$1.07M |
| 41899 |
|
718 |
680 |
$1.06M |
| C1713 |
Anchor/screw bn/bn,tis/bn |
879 |
731 |
$1.06M |
| 80053 |
|
105,000 |
64,530 |
$1.03M |
| 96374 |
|
29,277 |
17,135 |
$948K |
| 95810 |
|
969 |
823 |
$839K |
| 93005 |
|
21,164 |
16,075 |
$790K |
| 96372 |
|
18,760 |
8,227 |
$785K |
| 93306 |
|
1,362 |
1,198 |
$673K |
| 78452 |
|
789 |
524 |
$672K |
| 36415 |
|
146,636 |
74,562 |
$633K |
| 96413 |
|
2,116 |
762 |
$608K |
| 0202U |
|
2,318 |
2,141 |
$606K |
| 96376 |
|
8,693 |
4,384 |
$591K |
| 96366 |
|
4,348 |
2,031 |
$589K |
| 85025 |
|
84,444 |
61,761 |
$589K |
| 11042 |
|
4,034 |
1,642 |
$580K |
| 71275 |
|
1,813 |
1,536 |
$552K |
| 87636 |
|
7,334 |
5,999 |
$535K |
| 80307 |
|
10,543 |
8,323 |
$535K |
| 87635 |
|
11,983 |
11,084 |
$532K |
| 99282 |
|
4,224 |
3,763 |
$525K |
| 73721 |
|
1,414 |
1,284 |
$520K |
| 71260 |
|
2,547 |
1,609 |
$506K |
| 72148 |
|
1,539 |
1,407 |
$493K |
| 71045 |
|
13,730 |
11,163 |
$484K |
| 72125 |
|
1,837 |
1,621 |
$465K |
| 96360 |
|
3,964 |
2,784 |
$461K |
| 82306 |
|
20,523 |
17,657 |
$453K |
| 80050 |
|
10,517 |
9,580 |
$422K |
| 59025 |
|
3,621 |
2,453 |
$413K |
| 76705 |
|
3,468 |
3,125 |
$365K |
| 84443 |
|
25,961 |
23,977 |
$365K |
| 87491 |
|
11,264 |
10,256 |
$356K |
| 45378 |
|
687 |
636 |
$342K |
| 83880 |
|
9,756 |
8,105 |
$339K |
| 87591 |
|
11,078 |
10,214 |
$337K |
| 97140 |
|
7,373 |
3,496 |
$325K |
| 97162 |
|
6,992 |
5,317 |
$292K |
| 71046 |
|
7,813 |
6,633 |
$291K |
| 87661 |
|
10,294 |
9,494 |
$291K |
| 80061 |
|
23,532 |
20,963 |
$280K |
| 93971 |
|
1,262 |
1,117 |
$265K |
| 93017 |
|
857 |
789 |
$255K |
| U0003 |
Cov-19 amp prb hgh thruput |
3,544 |
3,272 |
$249K |
| G0481 |
Drug test def 8-14 classes |
3,119 |
2,056 |
$245K |
| 86003 |
|
3,443 |
2,987 |
$242K |
| 83036 |
|
30,019 |
27,390 |
$233K |
| 88305 |
|
4,302 |
2,532 |
$231K |
| 82607 |
|
19,671 |
16,068 |
$226K |
| C1769 |
Guide wire |
2,584 |
1,915 |
$226K |
| 74022 |
|
1,544 |
1,420 |
$215K |
| 43248 |
|
739 |
593 |
$206K |
| 84484 |
|
18,145 |
10,762 |
$205K |
| 96367 |
|
2,739 |
1,256 |
$199K |
| 69436 |
|
268 |
238 |
$187K |
| 80081 |
|
2,413 |
2,190 |
$187K |
| 71250 |
|
1,285 |
1,031 |
$186K |
| 75574 |
|
600 |
495 |
$186K |
| 97161 |
|
3,675 |
3,221 |
$184K |
| 87480 |
|
8,710 |
7,456 |
$182K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
15,760 |
12,275 |
$180K |
| G0463 |
Hospital outpt clinic visit |
10,657 |
7,757 |
$170K |
| 72131 |
|
697 |
595 |
$170K |
| 42820 |
|
135 |
131 |
$170K |
| 80306 |
|
11,084 |
9,642 |
$163K |
| 45385 |
|
432 |
356 |
$163K |
| 73630 |
|
1,501 |
1,298 |
$155K |
| C1889 |
Implant/insert device, noc |
1,423 |
1,067 |
$154K |
| 70553 |
|
417 |
325 |
$148K |
| 87510 |
|
8,239 |
7,341 |
$146K |
| A9500 |
Tc99m sestamibi |
649 |
459 |
$143K |
| 84439 |
|
17,596 |
16,058 |
$143K |
| 73221 |
|
416 |
373 |
$142K |
| 0352U |
|
1,233 |
1,104 |
$138K |
| 73564 |
|
1,161 |
921 |
$134K |
| 80048 |
|
17,698 |
11,052 |
$128K |
| G0283 |
Elec stim other than wound |
5,371 |
1,735 |
$126K |
| 87086 |
|
16,621 |
14,557 |
$125K |
| 74018 |
|
1,647 |
1,365 |
$122K |
| G0480 |
Drug test def 1-7 classes |
1,539 |
1,263 |
$121K |
| 94640 |
|
3,692 |
3,032 |
$120K |
| 73610 |
|
1,174 |
988 |
$115K |
| 87660 |
|
6,228 |
5,536 |
$112K |
| 76775 |
|
533 |
482 |
$108K |
| 82728 |
|
9,611 |
8,367 |
$107K |
| 76817 |
|
945 |
817 |
$106K |
| 86803 |
|
8,683 |
8,081 |
$105K |
| 83690 |
|
16,266 |
13,629 |
$103K |
| 73130 |
|
1,006 |
907 |
$102K |
| 93458 |
|
51 |
36 |
$99K |
| 83735 |
|
16,347 |
11,679 |
$99K |
| 84702 |
|
6,921 |
5,100 |
$98K |
| 80074 |
|
2,504 |
1,945 |
$95K |
| 92526 |
|
1,513 |
663 |
$94K |
| 87653 |
|
2,833 |
2,561 |
$89K |
| U0004 |
Cov-19 test non-cdc hgh thru |
1,369 |
1,227 |
$89K |
| 72100 |
|
1,113 |
914 |
$88K |
| 76830 |
|
895 |
800 |
$88K |
| 73030 |
|
1,094 |
847 |
$87K |
| 81001 |
|
25,347 |
20,269 |
$83K |
| 84466 |
|
7,711 |
7,261 |
$80K |
| 97535 |
|
2,967 |
1,788 |
$79K |
| C1894 |
Intro/sheath, non-laser |
1,326 |
1,077 |
$79K |
| 76536 |
|
697 |
659 |
$79K |
| 97112 |
|
1,968 |
1,184 |
$79K |
| 82746 |
|
6,365 |
5,977 |
$76K |
| 99211 |
|
3,932 |
3,269 |
$74K |
| 87804 |
|
2,426 |
2,203 |
$74K |
| 87522 |
Neg quan hep c or qual rna |
1,891 |
1,694 |
$73K |
| 83540 |
|
12,464 |
11,686 |
$69K |
| 93976 |
|
471 |
417 |
$68K |
| J2704 |
Inj, propofol, 10 mg |
15,763 |
13,871 |
$67K |
| 95800 |
|
391 |
381 |
$66K |
| 84403 |
|
2,871 |
2,596 |
$65K |
| 70486 |
|
278 |
253 |
$64K |
| J1756 |
Iron sucrose injection |
1,264 |
457 |
$64K |
| C9803 |
Hopd covid-19 spec collect |
8,063 |
6,501 |
$62K |
| 78226 |
|
175 |
138 |
$62K |
| 85027 |
|
10,724 |
9,123 |
$62K |
| 87081 |
|
7,719 |
7,066 |
$61K |
| 0099U |
|
302 |
247 |
$60K |
| J2785 |
Regadenoson injection |
170 |
157 |
$59K |
| 84703 |
|
7,529 |
6,730 |
$56K |
| 87040 |
|
5,714 |
3,207 |
$56K |
| 93975 |
|
202 |
188 |
$56K |
| 82962 |
|
15,185 |
5,236 |
$55K |
| 76700 |
|
454 |
407 |
$52K |
| 83605 |
|
5,346 |
3,894 |
$51K |
| 85610 |
|
10,325 |
7,937 |
$48K |
| J1170 |
Hydromorphone injection |
8,955 |
5,271 |
$47K |
| 81025 |
|
7,644 |
6,780 |
$45K |
| 0100U |
|
76 |
70 |
$45K |
| 87880 |
|
2,797 |
2,589 |
$44K |
| 47562 |
|
13 |
12 |
$43K |
| 80055 |
|
958 |
852 |
$43K |
| 92523 |
|
497 |
395 |
$43K |
| 82077 |
|
3,027 |
2,561 |
$41K |
| 84402 |
|
1,876 |
1,721 |
$41K |
| 83516 |
|
2,093 |
1,313 |
$40K |
| 82043 |
|
8,014 |
6,400 |
$40K |
| 85379 |
|
4,262 |
3,778 |
$40K |
| G0432 |
Eia hiv-1/hiv-2 screen |
2,918 |
2,245 |
$39K |
| 81003 |
|
17,658 |
14,680 |
$38K |
| 86850 |
|
4,813 |
3,716 |
$38K |
| 73110 |
|
346 |
307 |
$37K |
| 82670 |
|
1,261 |
1,145 |
$36K |
| 87624 |
|
1,245 |
1,086 |
$34K |
| J3010 |
Fentanyl citrate injection |
10,419 |
8,867 |
$34K |
| 93970 |
|
149 |
130 |
$34K |
| 80143 |
|
1,730 |
1,474 |
$34K |
| 87507 |
|
118 |
104 |
$33K |
| 84481 |
|
2,187 |
2,050 |
$33K |
| 83001 |
|
1,950 |
1,823 |
$33K |
| 90715 |
|
917 |
828 |
$33K |
| 97116 |
|
1,966 |
984 |
$33K |
| J0330 |
Succinycholine chloride inj |
2,272 |
1,924 |
$32K |
| J1644 |
Inj heparin sodium per 1000u |
3,818 |
1,349 |
$32K |
| G0123 |
Screen cerv/vag thin layer |
1,750 |
1,526 |
$32K |
| A9576 |
Inj prohance multipack |
414 |
387 |
$31K |
| 82550 |
|
4,706 |
3,921 |
$30K |
| 70551 |
|
129 |
106 |
$29K |
| 82570 |
|
6,708 |
5,950 |
$29K |
| 73562 |
|
337 |
250 |
$29K |
| 87186 |
|
3,642 |
3,139 |
$28K |
| 72128 |
|
123 |
111 |
$28K |
| 87389 |
|
1,471 |
1,380 |
$28K |
| G0103 |
Psa screening |
3,500 |
1,970 |
$27K |
| 0002A |
|
1,080 |
1,051 |
$27K |
| 73090 |
|
264 |
230 |
$26K |
| J2710 |
Neostigmine methylslfte inj |
2,026 |
1,694 |
$26K |
| 80179 |
|
1,692 |
1,454 |
$26K |
| 86038 |
|
2,348 |
2,145 |
$25K |
| 84146 |
|
1,461 |
1,354 |
$25K |
| 71271 |
|
350 |
322 |
$25K |
| A9579 |
Gad-base mr contrast nos,1ml |
645 |
587 |
$25K |
| J2405 |
Ondansetron hcl injection |
23,304 |
17,511 |
$24K |
| 83002 |
|
1,527 |
1,429 |
$24K |
| 82105 |
|
1,733 |
1,362 |
$24K |
| 97166 |
|
754 |
607 |
$24K |
| 72141 |
|
70 |
65 |
$23K |
| 87902 |
|
99 |
86 |
$23K |
| J2270 |
Morphine sulfate injection |
9,139 |
5,739 |
$23K |
| 85730 |
|
3,989 |
3,208 |
$23K |
| 97533 |
|
864 |
387 |
$23K |
| 0001A |
|
1,165 |
1,092 |
$23K |
| 36591 |
|
818 |
374 |
$23K |
| J1885 |
Ketorolac tromethamine inj |
11,461 |
9,374 |
$22K |
| 83550 |
|
2,577 |
2,448 |
$22K |
| Q0138 |
Ferumoxytol, non-esrd |
22 |
12 |
$22K |
| 74019 |
|
259 |
227 |
$22K |
| 94760 |
|
3,160 |
1,465 |
$21K |
| C1760 |
Closure dev, vasc |
92 |
82 |
$21K |
| 88304 |
|
868 |
684 |
$21K |
| 73590 |
|
245 |
194 |
$21K |
| 58661 |
|
16 |
14 |
$21K |
| 86140 |
|
4,641 |
3,934 |
$21K |
| M0243 |
Casirivi and imdevi inj |
90 |
81 |
$20K |
| 83970 |
|
668 |
568 |
$20K |
| 84480 |
|
1,512 |
1,395 |
$19K |
| 82785 |
|
1,094 |
933 |
$19K |
| 86900 |
|
5,460 |
4,037 |
$19K |
| 86757 |
|
588 |
436 |
$18K |
| 83883 |
|
1,487 |
973 |
$18K |
| 12001 |
|
168 |
155 |
$18K |
| 90471 |
|
1,103 |
974 |
$18K |
| 82172 |
|
1,151 |
861 |
$17K |
| 87077 |
|
2,405 |
1,969 |
$17K |
| 70498 |
|
88 |
74 |
$17K |
| 82948 |
|
2,674 |
1,202 |
$17K |
| 83655 |
|
1,524 |
1,450 |
$17K |
| 87070 |
|
2,553 |
1,782 |
$17K |
| 83525 |
|
1,630 |
1,505 |
$17K |
| 88342 |
|
376 |
317 |
$16K |
| 86901 |
|
5,025 |
3,978 |
$16K |
| 87633 |
|
64 |
48 |
$16K |
| 86008 |
|
1,499 |
1,334 |
$15K |
| 82803 |
|
872 |
651 |
$15K |
| 87641 |
|
527 |
466 |
$15K |
| J1650 |
Inj enoxaparin sodium |
3,654 |
1,553 |
$15K |
| 82150 |
|
2,284 |
2,029 |
$15K |
| 78227 |
|
31 |
25 |
$15K |
| J2930 |
Methylprednisolone injection |
1,962 |
1,429 |
$14K |
| 70496 |
|
59 |
49 |
$14K |
| 82950 |
|
2,988 |
2,788 |
$13K |
| 84145 |
|
641 |
487 |
$13K |
| 0003M |
|
180 |
78 |
$13K |
| 86235 |
|
122 |
107 |
$13K |
| J2469 |
Palonosetron hcl |
194 |
89 |
$13K |
| 87147 |
|
1,609 |
1,165 |
$13K |
| J0696 |
Ceftriaxone sodium injection |
4,751 |
3,094 |
$12K |
| 82627 |
|
484 |
434 |
$12K |
| 96368 |
|
106 |
68 |
$12K |
| 81596 |
|
157 |
133 |
$12K |
| 84100 |
|
2,836 |
1,748 |
$11K |
| A9537 |
Tc99m mebrofenin |
128 |
122 |
$11K |
| 86592 |
|
1,978 |
1,796 |
$11K |
| J1100 |
Dexamethasone sodium phos |
9,019 |
7,318 |
$11K |
| 84156 |
|
3,383 |
2,879 |
$11K |
| 86618 |
|
518 |
464 |
$11K |
| 94060 |
|
150 |
80 |
$11K |
| 87340 |
|
1,289 |
1,136 |
$11K |
| 86376 |
|
854 |
812 |
$11K |
| 87807 |
|
697 |
656 |
$10K |
| 76819 |
|
111 |
68 |
$10K |
| J0897 |
Denosumab injection |
16 |
14 |
$10K |
| J3490 |
Drugs unclassified injection |
115 |
97 |
$10K |
| 86696 |
|
537 |
412 |
$9K |
| 82784 |
|
886 |
747 |
$9K |
| 84144 |
|
510 |
465 |
$9K |
| 83010 |
|
883 |
802 |
$9K |
| 97113 |
|
86 |
39 |
$9K |
| 78264 |
|
14 |
12 |
$9K |
| 36600 |
|
409 |
324 |
$9K |
| 80069 |
|
1,194 |
808 |
$9K |
| 88300 |
|
549 |
510 |
$8K |
| M0245 |
Bamlan and etesev infusion |
40 |
36 |
$8K |
| 73502 |
|
143 |
106 |
$8K |
| 87502 |
|
110 |
105 |
$8K |
| 82533 |
|
372 |
270 |
$8K |
| 86364 |
|
666 |
624 |
$8K |
| J3475 |
Inj magnesium sulfate |
1,266 |
783 |
$8K |
| J2250 |
Inj midazolam hydrochloride |
9,316 |
8,000 |
$7K |
| 97035 |
|
213 |
81 |
$7K |
| 88142 |
|
351 |
329 |
$7K |
| 82977 |
|
1,187 |
1,080 |
$7K |
| 86695 |
|
489 |
398 |
$7K |
| J2272 |
Inj, morphine (fresenius) |
1,725 |
1,118 |
$6K |
| 87205 |
|
1,688 |
1,423 |
$6K |
| G8978 |
Mobility current status |
893 |
235 |
$6K |
| 86258 |
|
484 |
455 |
$6K |
| 84550 |
|
1,464 |
1,320 |
$6K |
| C1887 |
Catheter, guiding |
66 |
54 |
$6K |
| 80076 |
|
785 |
683 |
$6K |
| 86666 |
|
145 |
139 |
$6K |
| 82247 |
|
1,240 |
974 |
$6K |
| J3370 |
Vancomycin hcl injection |
418 |
211 |
$5K |
| J0690 |
Cefazolin sodium injection |
1,915 |
1,389 |
$5K |
| 82553 |
|
510 |
415 |
$5K |
| 87631 |
|
41 |
31 |
$5K |
| 0097U |
|
30 |
30 |
$5K |
| J0780 |
Prochlorperazine injection |
980 |
800 |
$5K |
| 82565 |
|
414 |
361 |
$5K |
| 76870 |
|
47 |
41 |
$5K |
| J2543 |
Piperacillin/tazobactam |
477 |
227 |
$5K |
| 85652 |
|
1,812 |
1,644 |
$5K |
| A9552 |
F18 fdg |
15 |
12 |
$4K |
| J0171 |
Adrenalin epinephrine inject |
395 |
243 |
$4K |
| 73700 |
|
12 |
12 |
$4K |
| 85014 |
|
2,140 |
1,730 |
$4K |
| J0360 |
Hydralazine hcl injection |
544 |
406 |
$4K |
| 73080 |
|
43 |
37 |
$4K |
| 85651 |
|
1,067 |
920 |
$4K |
| 97597 |
|
23 |
14 |
$4K |
| 82140 |
|
383 |
290 |
$4K |
| J2550 |
Promethazine hcl injection |
2,115 |
1,276 |
$4K |
| 85018 |
|
1,888 |
1,552 |
$4K |
| 99212 |
|
81 |
67 |
$4K |
| 82024 |
|
102 |
68 |
$4K |
| 86431 |
|
633 |
595 |
$4K |
| J1200 |
Diphenhydramine hcl injectio |
3,553 |
2,685 |
$4K |
| Q9969 |
Non-heu tc-99m add-on/dose |
2,044 |
1,654 |
$3K |
| 94727 |
|
64 |
56 |
$3K |
| 76770 |
|
30 |
29 |
$3K |
| J2060 |
Lorazepam injection |
2,039 |
1,416 |
$3K |
| J2765 |
Metoclopramide hcl injection |
2,024 |
1,581 |
$3K |
| 92610 |
|
43 |
38 |
$3K |
| 84478 |
|
656 |
605 |
$3K |
| 80164 |
|
314 |
235 |
$3K |
| 84153 |
|
213 |
182 |
$3K |
| 87088 |
|
396 |
365 |
$3K |
| 83721 |
|
408 |
342 |
$3K |
| 83615 |
|
530 |
441 |
$3K |
| 12002 |
|
35 |
27 |
$3K |
| C1751 |
Cath, inf, per/cent/midline |
13 |
12 |
$3K |
| A4648 |
Implantable tissue marker |
28 |
25 |
$3K |
| 87798 |
|
100 |
84 |
$3K |
| 87581 |
|
90 |
74 |
$2K |
| 82951 |
|
248 |
230 |
$2K |
| P9612 |
Catheterize for urine spec |
716 |
475 |
$2K |
| J2360 |
Orphenadrine injection |
517 |
475 |
$2K |
| 84132 |
|
583 |
290 |
$2K |
| 82248 |
|
445 |
336 |
$2K |
| 84436 |
|
386 |
338 |
$2K |
| 94729 |
|
45 |
43 |
$2K |
| 93325 |
|
14 |
13 |
$2K |
| 82677 |
|
76 |
72 |
$2K |
| 29580 |
|
23 |
12 |
$2K |
| 86762 |
|
171 |
151 |
$2K |
| 96523 |
|
125 |
65 |
$2K |
| J2370 |
Phenylephrine hcl injection |
827 |
698 |
$2K |
| J1642 |
Inj heparin sodium per 10 u |
2,916 |
1,391 |
$2K |
| 82465 |
|
580 |
494 |
$2K |
| 97165 |
|
81 |
39 |
$2K |
| 86225 |
|
143 |
133 |
$2K |
| 71101 |
|
12 |
12 |
$2K |
| 82947 |
|
647 |
559 |
$2K |
| J2795 |
Ropivacaine hcl injection |
415 |
346 |
$2K |
| J2805 |
Sincalide injection |
12 |
12 |
$2K |
| 76816 |
|
21 |
21 |
$2K |
| 84520 |
|
278 |
254 |
$2K |
| 81513 |
|
16 |
12 |
$2K |
| 76801 |
|
12 |
12 |
$2K |
| 97163 |
|
33 |
31 |
$1K |
| J1956 |
Levofloxacin injection |
555 |
341 |
$1K |
| 83527 |
|
130 |
123 |
$1K |
| J3480 |
Inj potassium chloride |
167 |
76 |
$1K |
| 86336 |
|
81 |
73 |
$1K |
| 88307 |
|
21 |
12 |
$1K |
| J2919 |
Inj, methylpred sod succ 5mg |
150 |
107 |
$1K |
| 81050 |
|
355 |
297 |
$1K |
| 84445 |
|
30 |
29 |
$1K |
| G0297 |
Ldct for lung ca screen |
25 |
24 |
$1K |
| 72040 |
|
25 |
12 |
$1K |
| 86769 |
|
44 |
37 |
$1K |
| 76856 |
|
12 |
12 |
$1K |
| 84460 |
|
281 |
251 |
$1K |
| 86706 |
|
114 |
101 |
$1K |
| 94664 |
|
40 |
25 |
$1K |
| 84681 |
|
45 |
42 |
$978.79 |
| 87486 |
|
41 |
31 |
$964.15 |
| 76937 |
|
14 |
13 |
$960.23 |
| 97602 |
|
24 |
16 |
$941.26 |
| 76942 |
|
18 |
14 |
$902.96 |
| 84450 |
|
230 |
212 |
$857.62 |
| 82009 |
|
213 |
184 |
$819.83 |
| 86381 |
|
53 |
51 |
$814.40 |
| 97164 |
|
27 |
25 |
$793.80 |
| 86480 |
|
12 |
12 |
$792.26 |
| 99213 |
|
16 |
12 |
$772.84 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
104 |
71 |
$717.07 |
| G0008 |
Admin influenza virus vac |
71 |
46 |
$692.16 |
| 86015 |
|
68 |
66 |
$633.35 |
| 82805 |
|
18 |
13 |
$633.32 |
| 82952 |
|
218 |
200 |
$628.61 |
| 82672 |
|
16 |
16 |
$560.77 |
| L3020 |
Foot longitud/metatarsal sup |
17 |
15 |
$534.50 |
| J2175 |
Meperidine hydrochl /100 mg |
149 |
128 |
$527.77 |
| 86704 |
|
43 |
37 |
$514.53 |
| G0379 |
Direct refer hospital observ |
29 |
26 |
$506.14 |
| 85007 |
|
193 |
164 |
$498.04 |
| 99152 |
|
13 |
13 |
$495.53 |
| 86677 |
|
13 |
12 |
$488.65 |
| 88302 |
|
20 |
13 |
$466.44 |
| 90674 |
|
29 |
22 |
$462.20 |
| 84270 |
|
27 |
25 |
$453.19 |
| 90661 |
|
17 |
12 |
$441.42 |
| L8613 |
Ossicular implant |
14 |
14 |
$433.78 |
| 86308 |
|
70 |
64 |
$428.48 |
| 36416 |
|
127 |
94 |
$408.96 |
| 86231 |
|
47 |
44 |
$398.97 |
| 86665 |
|
17 |
14 |
$397.10 |
| A9541 |
Tc99m sulfur colloid |
13 |
12 |
$391.49 |
| 81015 |
|
128 |
109 |
$373.02 |
| 82390 |
|
40 |
38 |
$365.16 |
| 87484 |
|
15 |
15 |
$350.90 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
17 |
13 |
$346.61 |
| 97168 |
|
27 |
24 |
$339.06 |
| 87481 |
|
17 |
14 |
$326.04 |
| 87468 |
|
14 |
14 |
$315.81 |
| 82103 |
|
26 |
24 |
$309.12 |
| 80171 |
|
22 |
19 |
$304.67 |
| G8979 |
Mobility goal status |
203 |
137 |
$301.41 |
| J1040 |
Methylprednisolone 80 mg inj |
17 |
13 |
$267.41 |
| 86787 |
|
25 |
24 |
$259.53 |
| 97750 |
|
16 |
13 |
$259.42 |
| 86430 |
|
47 |
40 |
$249.92 |
| 90686 |
|
37 |
18 |
$247.95 |
| J2470 |
Inj pantoprazole sodium 40mg |
47 |
33 |
$221.30 |
| 86800 |
|
13 |
12 |
$217.21 |
| 83021 |
|
15 |
13 |
$190.60 |
| J2471 |
Inj pantoprazole(hikma) 40mg |
53 |
43 |
$179.51 |
| 82375 |
|
25 |
14 |
$168.59 |
| 80162 |
|
18 |
13 |
$165.55 |
| 86664 |
|
13 |
12 |
$161.40 |
| J1920 |
Inj, labetalol hcl, 5mg |
19 |
12 |
$143.92 |
| J1940 |
Furosemide injection |
77 |
38 |
$142.53 |
| J3411 |
Thiamine hcl 100 mg |
16 |
12 |
$119.13 |
| J0595 |
Butorphanol tartrate 1 mg |
17 |
12 |
$116.52 |
| J1597 |
Inj glycopyrrolate, glyrx-pf |
38 |
38 |
$113.84 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
44 |
36 |
$110.61 |
| 84479 |
|
12 |
12 |
$88.88 |
| 83050 |
|
18 |
13 |
$72.76 |
| J3301 |
Triamcinolone acet inj nos |
14 |
13 |
$62.00 |
| 85660 |
|
15 |
13 |
$52.03 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
39 |
33 |
$16.58 |
| G8987 |
Self care current status |
18 |
13 |
$0.00 |
| G8988 |
Self care goal status |
18 |
13 |
$0.00 |