| Code | Description | Claims | Beneficiaries | Total Paid |
| 99285 |
|
16,609 |
14,111 |
$5.96M |
| 99284 |
|
39,201 |
33,826 |
$5.61M |
| 99283 |
|
43,968 |
38,989 |
$3.67M |
| 80053 |
|
81,820 |
66,823 |
$1.11M |
| 80307 |
|
19,687 |
15,380 |
$1.06M |
| 85025 |
|
91,185 |
72,529 |
$1.05M |
| 74177 |
|
5,942 |
5,181 |
$934K |
| 99282 |
|
15,943 |
14,593 |
$751K |
| 97110 |
|
20,074 |
5,922 |
$706K |
| 96413 |
|
4,788 |
2,448 |
$665K |
| U0004 |
Cov-19 test non-cdc hgh thru |
8,264 |
7,485 |
$558K |
| 74176 |
|
6,250 |
5,619 |
$472K |
| 87637 |
|
4,641 |
4,247 |
$470K |
| 96374 |
|
18,362 |
15,080 |
$436K |
| 96372 |
|
14,847 |
10,095 |
$358K |
| 84443 |
|
21,049 |
18,964 |
$348K |
| 96365 |
|
7,244 |
5,069 |
$334K |
| 93306 |
|
2,982 |
2,731 |
$326K |
| 36415 |
|
33,762 |
26,915 |
$300K |
| 87651 |
|
8,228 |
7,655 |
$285K |
| 93005 |
|
29,994 |
25,409 |
$282K |
| 99212 |
|
15,951 |
14,517 |
$278K |
| 88305 |
|
4,124 |
3,707 |
$275K |
| 96375 |
|
16,531 |
12,065 |
$271K |
| 92507 |
|
5,129 |
2,019 |
$258K |
| J2405 |
Ondansetron hcl injection |
11,701 |
8,653 |
$256K |
| 70450 |
|
4,556 |
4,071 |
$250K |
| 87631 |
|
2,508 |
2,297 |
$247K |
| 84484 |
|
18,922 |
14,936 |
$247K |
| 97530 |
|
5,562 |
2,132 |
$242K |
| G0378 |
Hospital observation per hr |
4,693 |
1,781 |
$240K |
| 71045 |
|
12,820 |
11,101 |
$234K |
| G0463 |
Hospital outpt clinic visit |
7,116 |
5,936 |
$230K |
| 81001 |
|
22,409 |
19,198 |
$223K |
| J1100 |
Dexamethasone sodium phos |
12,202 |
9,417 |
$217K |
| 83735 |
|
7,808 |
5,443 |
$181K |
| 71275 |
|
1,623 |
1,409 |
$176K |
| 78452 |
|
573 |
502 |
$167K |
| 87633 |
|
1,033 |
945 |
$166K |
| 83690 |
|
15,325 |
13,142 |
$163K |
| 41899 |
|
143 |
132 |
$163K |
| 71046 |
|
7,246 |
6,684 |
$162K |
| 77067 |
|
2,306 |
2,175 |
$161K |
| J2250 |
Inj midazolam hydrochloride |
4,937 |
4,265 |
$153K |
| 87591 |
|
5,108 |
4,579 |
$153K |
| 87491 |
|
5,104 |
4,576 |
$153K |
| 97140 |
|
6,887 |
2,474 |
$150K |
| G0480 |
Drug test def 1-7 classes |
1,549 |
1,138 |
$149K |
| U0002 |
Covid-19 lab test non-cdc |
3,694 |
3,277 |
$148K |
| 81025 |
|
10,620 |
9,139 |
$144K |
| J7060 |
5% dextrose/water |
2,032 |
620 |
$139K |
| 76705 |
|
2,613 |
2,385 |
$138K |
| 0202U |
|
4,646 |
4,261 |
$135K |
| 72148 |
|
936 |
891 |
$135K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
11,347 |
9,765 |
$133K |
| 80061 |
|
8,295 |
7,871 |
$129K |
| 43239 |
|
669 |
613 |
$128K |
| 76830 |
|
1,708 |
1,555 |
$124K |
| J0131 |
Inj, acetaminophen (nos) |
3,679 |
3,113 |
$120K |
| 87086 |
|
10,053 |
8,866 |
$119K |
| 96376 |
|
3,706 |
2,057 |
$119K |
| J1885 |
Ketorolac tromethamine inj |
10,484 |
8,548 |
$117K |
| 45380 |
|
340 |
311 |
$113K |
| 96366 |
|
2,177 |
1,270 |
$109K |
| 81003 |
|
11,966 |
10,554 |
$106K |
| 93971 |
|
1,704 |
1,573 |
$103K |
| 71250 |
|
2,114 |
1,942 |
$101K |
| 87661 |
|
3,346 |
2,996 |
$98K |
| 84702 |
|
6,615 |
5,394 |
$97K |
| J0690 |
Cefazolin sodium injection |
1,873 |
1,413 |
$96K |
| 73721 |
|
580 |
538 |
$95K |
| 70553 |
|
512 |
459 |
$93K |
| 80048 |
|
7,651 |
6,198 |
$93K |
| 72125 |
|
1,522 |
1,359 |
$93K |
| 85610 |
|
7,971 |
6,545 |
$93K |
| 96367 |
|
2,811 |
1,577 |
$93K |
| 0099U |
|
538 |
485 |
$92K |
| 82306 |
|
3,442 |
3,282 |
$86K |
| 97162 |
|
1,859 |
1,761 |
$85K |
| 70551 |
|
752 |
675 |
$82K |
| 96361 |
|
4,878 |
3,758 |
$81K |
| 86140 |
|
6,266 |
5,463 |
$78K |
| 76641 |
|
1,335 |
1,182 |
$78K |
| 87522 |
Neg quan hep c or qual rna |
1,562 |
1,461 |
$77K |
| J1642 |
Inj heparin sodium per 10 u |
6,320 |
3,464 |
$76K |
| 83036 |
|
6,825 |
6,445 |
$75K |
| 78815 |
|
209 |
194 |
$74K |
| J2785 |
Regadenoson injection |
462 |
394 |
$74K |
| A9500 |
Tc99m sestamibi |
618 |
540 |
$69K |
| 90471 |
|
3,646 |
3,325 |
$69K |
| 85027 |
|
3,982 |
3,280 |
$69K |
| 72131 |
|
1,025 |
940 |
$67K |
| 76856 |
|
1,050 |
969 |
$66K |
| 87507 |
|
257 |
239 |
$66K |
| 71260 |
|
736 |
622 |
$65K |
| 96415 |
|
895 |
585 |
$64K |
| 88304 |
|
947 |
834 |
$64K |
| 94640 |
|
4,631 |
3,154 |
$64K |
| 82607 |
|
3,442 |
3,254 |
$64K |
| 86850 |
|
4,693 |
4,036 |
$63K |
| 95811 |
|
107 |
98 |
$62K |
| 93017 |
|
715 |
630 |
$62K |
| 76801 |
|
1,102 |
917 |
$61K |
| 80050 |
|
1,563 |
1,460 |
$61K |
| 97161 |
|
1,140 |
1,065 |
$60K |
| J2270 |
Morphine sulfate injection |
1,672 |
1,254 |
$60K |
| 83880 |
|
2,932 |
2,543 |
$59K |
| 72141 |
|
319 |
308 |
$58K |
| 87653 |
|
1,731 |
1,621 |
$58K |
| 84439 |
|
3,670 |
3,375 |
$57K |
| 90837 |
|
601 |
392 |
$57K |
| 82728 |
|
3,602 |
3,343 |
$56K |
| 80074 |
|
1,298 |
1,229 |
$55K |
| 77063 |
|
2,003 |
1,885 |
$55K |
| 83605 |
|
3,416 |
2,728 |
$55K |
| 86901 |
|
4,908 |
4,132 |
$54K |
| 86900 |
|
4,902 |
4,133 |
$52K |
| 87040 |
|
2,763 |
1,822 |
$52K |
| 87502 |
|
834 |
754 |
$51K |
| 64483 |
|
195 |
170 |
$51K |
| 11042 |
|
430 |
286 |
$50K |
| 99211 |
|
3,211 |
2,939 |
$50K |
| 87186 |
|
3,909 |
3,530 |
$49K |
| 70486 |
|
608 |
577 |
$48K |
| 93975 |
|
427 |
394 |
$47K |
| 85730 |
|
4,098 |
3,470 |
$45K |
| 93970 |
|
459 |
422 |
$43K |
| 87340 |
|
2,185 |
2,031 |
$42K |
| 86803 |
|
2,247 |
2,111 |
$42K |
| 85007 |
|
2,231 |
1,734 |
$42K |
| U0005 |
Infec agen detec ampli probe |
2,266 |
2,114 |
$40K |
| 87798 |
|
515 |
465 |
$40K |
| 64493 |
|
187 |
153 |
$40K |
| 87486 |
|
482 |
436 |
$40K |
| 76700 |
|
461 |
436 |
$39K |
| 87581 |
|
481 |
435 |
$39K |
| 97112 |
|
1,336 |
557 |
$39K |
| 93303 |
|
232 |
227 |
$38K |
| 96360 |
|
1,634 |
1,373 |
$38K |
| 84466 |
|
3,038 |
2,820 |
$37K |
| 76536 |
|
561 |
525 |
$37K |
| 59025 |
|
1,776 |
1,025 |
$36K |
| 97113 |
|
995 |
338 |
$36K |
| 87389 |
|
1,578 |
1,461 |
$35K |
| 88312 |
|
515 |
475 |
$35K |
| 0097U |
|
431 |
395 |
$34K |
| 86780 |
|
2,310 |
2,166 |
$34K |
| 99281 |
|
1,624 |
1,504 |
$34K |
| 87624 |
|
1,087 |
909 |
$33K |
| 87070 |
|
2,100 |
1,838 |
$33K |
| 76817 |
|
773 |
655 |
$32K |
| J0330 |
Succinycholine chloride inj |
856 |
730 |
$32K |
| 99392 |
|
701 |
660 |
$31K |
| 82565 |
|
1,427 |
1,191 |
$30K |
| 73630 |
|
1,318 |
1,163 |
$30K |
| 84703 |
|
1,236 |
1,113 |
$30K |
| 85651 |
|
2,748 |
2,494 |
$29K |
| 94060 |
|
629 |
604 |
$29K |
| 10060 |
|
402 |
360 |
$29K |
| J0780 |
Prochlorperazine injection |
3,092 |
2,524 |
$29K |
| 82746 |
|
1,529 |
1,446 |
$27K |
| 87077 |
|
2,355 |
2,129 |
$27K |
| 76775 |
|
497 |
473 |
$27K |
| 73130 |
|
1,039 |
887 |
$27K |
| 72110 |
|
939 |
903 |
$27K |
| 82550 |
|
1,932 |
1,564 |
$26K |
| 73564 |
|
1,006 |
880 |
$26K |
| A9576 |
Inj prohance multipack |
1,100 |
976 |
$26K |
| 96523 |
|
1,413 |
1,145 |
$26K |
| 85379 |
|
1,709 |
1,527 |
$26K |
| 83540 |
|
3,184 |
2,959 |
$26K |
| J1200 |
Diphenhydramine hcl injectio |
4,603 |
3,410 |
$25K |
| 86706 |
|
1,045 |
978 |
$25K |
| 73610 |
|
1,047 |
934 |
$24K |
| 88142 |
|
1,391 |
1,203 |
$24K |
| 96417 |
|
355 |
185 |
$24K |
| 84145 |
|
1,366 |
1,138 |
$24K |
| C9803 |
Hopd covid-19 spec collect |
2,761 |
2,151 |
$23K |
| J0696 |
Ceftriaxone sodium injection |
2,230 |
1,599 |
$23K |
| 86618 |
|
1,085 |
669 |
$23K |
| 84112 |
|
282 |
234 |
$22K |
| 81513 |
|
192 |
176 |
$22K |
| 74018 |
|
1,020 |
933 |
$22K |
| 97014 |
|
1,471 |
577 |
$22K |
| 90715 |
|
617 |
577 |
$22K |
| 90472 |
|
1,314 |
1,222 |
$21K |
| 0241U |
|
1,697 |
1,458 |
$21K |
| 87210 |
|
1,431 |
1,071 |
$21K |
| 84100 |
|
1,868 |
1,368 |
$21K |
| J1745 |
Infliximab not biosimil 10mg |
13 |
12 |
$21K |
| 73030 |
|
1,179 |
1,065 |
$21K |
| J1756 |
Iron sucrose injection |
678 |
241 |
$21K |
| J2060 |
Lorazepam injection |
1,788 |
1,209 |
$21K |
| 99291 |
|
178 |
152 |
$20K |
| 88307 |
|
239 |
181 |
$20K |
| J1439 |
Inj ferric carboxymaltos 1mg |
41 |
27 |
$20K |
| 83516 |
|
757 |
616 |
$20K |
| J2001 |
Lidocaine injection |
3,123 |
2,677 |
$20K |
| 77066 |
Tomosynthesis, mammo |
301 |
288 |
$20K |
| 82570 |
|
1,977 |
1,787 |
$20K |
| 93271 |
|
247 |
229 |
$19K |
| 12001 |
|
230 |
217 |
$19K |
| 86255 |
|
619 |
580 |
$18K |
| J1644 |
Inj heparin sodium per 1000u |
2,017 |
966 |
$18K |
| 87088 |
|
1,128 |
1,030 |
$18K |
| Q9957 |
Inj perflutren lip micros,ml |
223 |
185 |
$18K |
| 93925 |
|
162 |
160 |
$17K |
| 95806 |
|
297 |
287 |
$17K |
| 87641 |
|
639 |
595 |
$17K |
| 94729 |
|
410 |
389 |
$16K |
| 87205 |
|
1,492 |
1,269 |
$16K |
| 86038 |
|
864 |
833 |
$16K |
| 93320 |
|
233 |
228 |
$16K |
| G0475 |
Hiv combination assay |
1,444 |
1,371 |
$16K |
| 76770 |
|
393 |
373 |
$16K |
| J1650 |
Inj enoxaparin sodium |
1,563 |
641 |
$16K |
| J2765 |
Metoclopramide hcl injection |
942 |
786 |
$15K |
| Q3014 |
Telehealth facility fee |
698 |
581 |
$15K |
| 99393 |
|
303 |
294 |
$15K |
| J2550 |
Promethazine hcl injection |
842 |
670 |
$14K |
| 93325 |
|
245 |
240 |
$14K |
| 84550 |
|
1,124 |
940 |
$14K |
| 73110 |
|
460 |
414 |
$14K |
| 82150 |
|
295 |
275 |
$14K |
| J3475 |
Inj magnesium sulfate |
1,759 |
1,320 |
$14K |
| 99391 |
|
362 |
334 |
$14K |
| 99213 |
|
1,016 |
943 |
$14K |
| 92557 |
|
654 |
623 |
$13K |
| 86762 |
|
723 |
657 |
$13K |
| 80076 |
|
1,111 |
1,042 |
$13K |
| 84153 |
|
487 |
461 |
$13K |
| 86308 |
|
801 |
717 |
$12K |
| 94726 |
|
377 |
356 |
$12K |
| 93978 |
|
114 |
112 |
$12K |
| 82784 |
|
562 |
396 |
$12K |
| 86431 |
|
636 |
611 |
$12K |
| 73502 |
|
551 |
505 |
$12K |
| 96411 |
|
231 |
135 |
$12K |
| 87147 |
|
922 |
840 |
$12K |
| 83615 |
|
911 |
719 |
$12K |
| 81329 |
|
83 |
77 |
$12K |
| 76819 |
|
91 |
63 |
$12K |
| C1769 |
Guide wire |
578 |
499 |
$11K |
| 20610 |
|
128 |
116 |
$11K |
| 84156 |
|
1,029 |
834 |
$11K |
| 82043 |
|
1,099 |
1,059 |
$11K |
| 87481 |
|
391 |
322 |
$11K |
| 83970 |
|
395 |
374 |
$11K |
| 12011 |
|
154 |
142 |
$11K |
| U0003 |
Cov-19 amp prb hgh thruput |
184 |
168 |
$11K |
| 87081 |
|
912 |
884 |
$11K |
| 90791 |
|
101 |
94 |
$10K |
| 45378 |
|
106 |
89 |
$10K |
| 82803 |
|
381 |
300 |
$10K |
| 81596 |
|
128 |
122 |
$10K |
| J2790 |
Rho d immune globulin inj |
141 |
133 |
$10K |
| 87902 |
|
74 |
72 |
$10K |
| J2930 |
Methylprednisolone injection |
1,010 |
823 |
$10K |
| 93976 |
|
116 |
104 |
$10K |
| 77002 |
|
190 |
167 |
$10K |
| 81220 |
|
115 |
103 |
$9K |
| 76870 |
|
164 |
147 |
$9K |
| 84403 |
|
371 |
345 |
$9K |
| 29125 |
|
92 |
81 |
$9K |
| 82248 |
|
1,044 |
896 |
$9K |
| 70491 |
|
164 |
131 |
$9K |
| 82977 |
|
386 |
352 |
$9K |
| 86704 |
|
363 |
354 |
$9K |
| J2704 |
Inj, propofol, 10 mg |
3,973 |
3,394 |
$8K |
| 73221 |
|
105 |
95 |
$8K |
| 90671 |
|
470 |
432 |
$8K |
| 86480 |
|
150 |
145 |
$8K |
| 86003 |
|
88 |
81 |
$8K |
| 82950 |
|
895 |
846 |
$8K |
| 84520 |
|
1,158 |
966 |
$8K |
| 82140 |
|
238 |
201 |
$7K |
| 83883 |
|
250 |
232 |
$7K |
| 86790 |
|
250 |
241 |
$7K |
| 84146 |
|
330 |
302 |
$7K |
| 97116 |
|
490 |
219 |
$7K |
| 92567 |
|
1,167 |
1,106 |
$7K |
| 80069 |
|
591 |
511 |
$7K |
| 72100 |
|
218 |
198 |
$6K |
| 86376 |
|
342 |
327 |
$6K |
| 82172 |
|
216 |
200 |
$6K |
| 83010 |
|
219 |
203 |
$6K |
| J1453 |
Fosaprepitant injection |
125 |
55 |
$6K |
| J3301 |
Triamcinolone acet inj nos |
788 |
679 |
$6K |
| J2710 |
Neostigmine methylslfte inj |
206 |
150 |
$6K |
| 82247 |
|
545 |
358 |
$6K |
| J1630 |
Haloperidol injection |
343 |
274 |
$6K |
| 87635 |
|
123 |
107 |
$6K |
| 45385 |
|
14 |
14 |
$6K |
| 93798 |
|
715 |
130 |
$5K |
| 82272 |
|
268 |
243 |
$5K |
| 73140 |
|
180 |
168 |
$5K |
| P9612 |
Catheterize for urine spec |
154 |
141 |
$5K |
| 86787 |
|
389 |
361 |
$5K |
| J2469 |
Palonosetron hcl |
256 |
131 |
$5K |
| 95813 |
|
25 |
25 |
$5K |
| 84460 |
|
370 |
289 |
$5K |
| 96110 |
|
573 |
533 |
$5K |
| G0279 |
Tomosynthesis, mammo |
255 |
244 |
$5K |
| 92587 |
|
132 |
121 |
$5K |
| 82010 |
|
599 |
468 |
$5K |
| 72040 |
|
184 |
174 |
$5K |
| 99202 |
|
667 |
649 |
$4K |
| 83655 |
|
229 |
216 |
$4K |
| 92551 |
|
589 |
565 |
$4K |
| 73560 |
|
209 |
176 |
$4K |
| 88185 |
|
49 |
45 |
$4K |
| 86200 |
|
83 |
81 |
$4K |
| 36600 |
|
98 |
77 |
$4K |
| A9552 |
F18 fdg |
246 |
224 |
$4K |
| J2370 |
Phenylephrine hcl injection |
57 |
44 |
$4K |
| 76805 |
|
25 |
24 |
$4K |
| 71271 |
|
72 |
71 |
$4K |
| 73562 |
|
307 |
224 |
$4K |
| 93270 |
|
246 |
228 |
$3K |
| 81015 |
|
584 |
538 |
$3K |
| 95800 |
|
136 |
133 |
$3K |
| 27096 |
|
12 |
12 |
$3K |
| G0260 |
Inj for sacroiliac jt anesth |
92 |
90 |
$3K |
| 82105 |
|
99 |
94 |
$3K |
| 97164 |
|
84 |
78 |
$3K |
| 93923 |
|
55 |
51 |
$3K |
| 93225 |
|
54 |
52 |
$3K |
| 83001 |
|
142 |
135 |
$3K |
| 90686 |
|
220 |
176 |
$3K |
| C1729 |
Cath, drainage |
60 |
26 |
$2K |
| 70496 |
|
58 |
49 |
$2K |
| 72072 |
|
103 |
96 |
$2K |
| 90832 |
|
36 |
36 |
$2K |
| 59430 |
|
27 |
26 |
$2K |
| 93226 |
|
54 |
52 |
$2K |
| G0108 |
Diab manage trn per indiv |
34 |
24 |
$2K |
| 49083 |
|
33 |
13 |
$2K |
| 84165 |
|
124 |
120 |
$2K |
| 74178 |
|
13 |
13 |
$2K |
| 94664 |
|
116 |
108 |
$2K |
| 90723 |
|
253 |
237 |
$2K |
| 97165 |
|
45 |
42 |
$2K |
| 76816 |
|
41 |
41 |
$2K |
| 51798 |
|
413 |
382 |
$2K |
| 82103 |
|
28 |
26 |
$2K |
| 90833 |
|
45 |
38 |
$2K |
| Q0162 |
Ondansetron oral |
2,050 |
1,401 |
$2K |
| 73100 |
|
16 |
14 |
$2K |
| 97166 |
|
56 |
53 |
$2K |
| 92579 |
|
48 |
45 |
$2K |
| J1170 |
Hydromorphone injection |
1,286 |
874 |
$2K |
| J3360 |
Diazepam injection |
126 |
105 |
$2K |
| 80179 |
|
98 |
85 |
$2K |
| 88184 |
|
49 |
45 |
$1K |
| 86160 |
|
39 |
37 |
$1K |
| J0171 |
Adrenalin epinephrine inject |
128 |
104 |
$1K |
| 73090 |
|
60 |
55 |
$1K |
| 86920 |
|
31 |
26 |
$1K |
| 90792 |
|
16 |
13 |
$1K |
| G0481 |
Drug test def 8-14 classes |
13 |
12 |
$1K |
| C1894 |
Intro/sheath, non-laser |
95 |
89 |
$1K |
| 84450 |
|
196 |
140 |
$1K |
| 83002 |
|
56 |
52 |
$1K |
| 83520 |
|
52 |
50 |
$1K |
| 90656 |
|
243 |
231 |
$1K |
| J2543 |
Piperacillin/tazobactam |
147 |
87 |
$1K |
| 87529 |
|
22 |
13 |
$1K |
| 72202 |
|
40 |
40 |
$1K |
| J3490 |
Drugs unclassified injection |
6,116 |
2,915 |
$1K |
| 73080 |
|
56 |
53 |
$1K |
| 72052 |
|
30 |
29 |
$1K |
| 90474 |
|
141 |
136 |
$1K |
| 72050 |
|
38 |
38 |
$1K |
| 74183 |
|
14 |
14 |
$965.23 |
| 86592 |
|
37 |
30 |
$962.09 |
| 74221 |
|
38 |
25 |
$955.43 |
| 90636 |
|
13 |
12 |
$929.83 |
| 90746 |
|
31 |
28 |
$926.58 |
| J7512 |
Prednisone ir or dr oral 1mg |
1,450 |
1,115 |
$917.29 |
| 73590 |
|
56 |
51 |
$915.12 |
| 80164 |
|
62 |
56 |
$912.98 |
| J2780 |
Ranitidine hydrochloride inj |
29 |
24 |
$880.36 |
| 80055 |
|
25 |
25 |
$877.03 |
| 84402 |
|
26 |
26 |
$807.94 |
| 80143 |
|
58 |
52 |
$803.81 |
| 80051 |
|
65 |
37 |
$803.78 |
| 99395 |
|
13 |
13 |
$775.77 |
| 73700 |
|
12 |
12 |
$758.84 |
| 99394 |
|
13 |
13 |
$751.20 |
| 87804 |
|
26 |
21 |
$745.10 |
| 72114 |
|
33 |
29 |
$716.20 |
| J3010 |
Fentanyl citrate injection |
2,217 |
1,981 |
$714.26 |
| 76882 |
|
43 |
38 |
$695.42 |
| 82947 |
|
72 |
67 |
$695.32 |
| 82525 |
|
27 |
24 |
$693.84 |
| 90658 |
|
32 |
29 |
$657.19 |
| 86769 |
|
18 |
17 |
$638.57 |
| 84075 |
|
82 |
50 |
$633.44 |
| 90710 |
|
16 |
15 |
$628.72 |
| 76811 |
|
13 |
13 |
$601.13 |
| 82390 |
|
25 |
25 |
$599.04 |
| 97035 |
|
25 |
12 |
$587.50 |
| 99203 |
|
91 |
88 |
$533.97 |
| C1725 |
Cath, translumin non-laser |
12 |
12 |
$530.39 |
| J3370 |
Vancomycin hcl injection |
61 |
39 |
$513.03 |
| 85018 |
|
151 |
121 |
$511.33 |
| 36592 |
|
16 |
14 |
$480.00 |
| 72081 |
|
18 |
17 |
$476.97 |
| 86677 |
|
17 |
16 |
$458.98 |
| 83021 |
|
27 |
26 |
$450.22 |
| 73070 |
|
13 |
12 |
$425.74 |
| 83020 |
|
27 |
26 |
$416.27 |
| 87807 |
|
15 |
13 |
$400.83 |
| G0010 |
Admin hepatitis b vaccine |
14 |
12 |
$394.54 |
| 73620 |
|
39 |
28 |
$347.54 |
| 90680 |
|
85 |
83 |
$301.65 |
| 73600 |
|
140 |
24 |
$240.90 |
| J3105 |
Terbutaline sulfate inj |
89 |
69 |
$237.57 |
| 77080 |
|
13 |
13 |
$231.04 |
| J1940 |
Furosemide injection |
34 |
29 |
$218.07 |
| 80178 |
|
12 |
12 |
$207.92 |
| 80306 |
|
29 |
25 |
$196.94 |
| J0134 |
Inj acetaminophen -fresenius |
258 |
229 |
$164.48 |
| 88342 |
|
30 |
26 |
$161.98 |
| 94010 |
|
14 |
13 |
$145.32 |
| 90648 |
|
423 |
396 |
$125.80 |
| 82962 |
|
75 |
72 |
$123.89 |
| 96127 |
|
44 |
42 |
$118.80 |
| 70498 |
|
16 |
13 |
$117.06 |
| G8979 |
Mobility goal status |
28 |
28 |
$113.14 |
| A9585 |
Gadobutrol injection |
58 |
56 |
$109.02 |
| 86705 |
|
25 |
25 |
$108.76 |
| Q0163 |
Diphenhydramine hcl 50mg |
15 |
12 |
$85.79 |
| 85652 |
|
48 |
41 |
$64.35 |
| 36416 |
|
118 |
115 |
$60.80 |
| J2919 |
Inj, methylpred sod succ 5mg |
101 |
69 |
$53.24 |
| G1010 |
Cdsm stanson |
788 |
675 |
$36.67 |
| J3480 |
Inj potassium chloride |
47 |
26 |
$29.95 |
| 99173 |
|
13 |
12 |
$28.22 |
| 99459 |
|
66 |
61 |
$25.00 |
| J1790 |
Droperidol injection |
102 |
92 |
$14.11 |
| 99001 |
|
43 |
39 |
$11.40 |
| Q0177 |
Hydroxyzine pamoate 25mg |
129 |
94 |
$11.14 |
| J0137 |
Inj, acetaminophen (hikma) |
70 |
51 |
$7.98 |
| C1751 |
Cath, inf, per/cent/midline |
56 |
47 |
$3.96 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
40 |
29 |
$1.35 |
| J1815 |
Insulin injection |
33 |
26 |
$0.56 |
| J0136 |
Inj, acetaminophen (b braun) |
62 |
54 |
$0.00 |
| 90633 |
|
38 |
38 |
$0.00 |
| 90653 |
|
21 |
21 |
$0.00 |
| G8978 |
Mobility current status |
13 |
13 |
$0.00 |
| 99172 |
|
109 |
109 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
39 |
35 |
$0.00 |
| V2632 |
Post chmbr intraocular lens |
13 |
12 |
$0.00 |