| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
219,205 |
210,319 |
$27.81M |
| G0463 |
Hospital outpt clinic visit |
456,204 |
408,601 |
$25.84M |
| 99285 |
|
39,805 |
38,508 |
$16.99M |
| 42820 |
|
4,376 |
4,354 |
$11.61M |
| 99284 |
|
52,315 |
51,143 |
$11.51M |
| G0378 |
Hospital observation per hr |
20,848 |
20,269 |
$10.12M |
| 41899 |
|
3,666 |
3,649 |
$4.05M |
| Q5103 |
Injection, inflectra |
2,571 |
2,443 |
$2.83M |
| 93306 |
|
10,570 |
10,279 |
$2.76M |
| 93303 |
|
8,581 |
8,306 |
$2.15M |
| 97530 |
|
43,105 |
11,697 |
$1.92M |
| 99282 |
|
22,054 |
21,847 |
$1.90M |
| 99281 |
|
31,815 |
31,289 |
$1.83M |
| 69436 |
|
3,723 |
3,695 |
$1.73M |
| 95810 |
|
3,415 |
3,405 |
$1.73M |
| 70553 |
|
4,293 |
4,267 |
$1.69M |
| 92507 |
|
39,810 |
10,505 |
$1.61M |
| 43239 |
|
4,035 |
4,013 |
$1.56M |
| 87637 |
|
25,367 |
24,769 |
$1.55M |
| 99391 |
|
24,189 |
23,636 |
$1.49M |
| 99392 |
|
22,201 |
22,107 |
$1.37M |
| 70551 |
|
7,822 |
7,775 |
$1.29M |
| 42830 |
|
877 |
871 |
$1.24M |
| 92587 |
|
8,546 |
8,480 |
$1.21M |
| 54161 |
|
1,742 |
1,736 |
$1.15M |
| 95782 |
|
2,293 |
2,281 |
$1.13M |
| P9016 |
Rbc leukocytes reduced |
6,824 |
5,679 |
$1.11M |
| J0585 |
Injection,onabotulinumtoxina |
1,282 |
1,261 |
$1.11M |
| G0379 |
Direct refer hospital observ |
1,890 |
1,877 |
$1.11M |
| 96374 |
|
14,564 |
13,910 |
$914K |
| 76770 |
|
11,688 |
11,623 |
$912K |
| 97110 |
|
28,204 |
8,442 |
$911K |
| 36455 |
|
4,449 |
3,849 |
$908K |
| 96365 |
|
9,355 |
7,152 |
$901K |
| 71046 |
|
28,464 |
27,836 |
$878K |
| 96413 |
|
5,172 |
3,982 |
$851K |
| 99393 |
|
13,287 |
13,246 |
$801K |
| 36430 |
|
3,882 |
2,936 |
$796K |
| 67311 |
|
701 |
687 |
$765K |
| U0003 |
Cov-19 amp prb hgh thruput |
17,525 |
17,090 |
$738K |
| 95716 |
|
1,253 |
1,240 |
$675K |
| 70543 |
|
623 |
615 |
$669K |
| 95951 |
|
1,539 |
1,505 |
$667K |
| J1561 |
Gamunex-c/gammaked |
552 |
459 |
$637K |
| 76705 |
|
12,065 |
11,751 |
$633K |
| 96360 |
|
7,512 |
7,405 |
$601K |
| 90472 |
|
34,114 |
33,947 |
$565K |
| 96361 |
|
14,668 |
11,718 |
$519K |
| J7050 |
Normal saline solution infus |
11,846 |
9,704 |
$518K |
| 95816 |
|
3,982 |
3,971 |
$509K |
| 54640 |
|
327 |
326 |
$498K |
| 92523 |
|
4,419 |
4,364 |
$490K |
| 95715 |
|
1,654 |
1,626 |
$462K |
| 76825 |
|
1,579 |
1,514 |
$456K |
| 93975 |
|
4,688 |
4,609 |
$437K |
| 64642 |
|
871 |
852 |
$418K |
| 95700 |
|
3,635 |
3,613 |
$418K |
| 90471 |
|
41,283 |
40,833 |
$413K |
| 36591 |
|
2,188 |
1,522 |
$411K |
| J1200 |
Diphenhydramine hcl injectio |
3,607 |
2,830 |
$409K |
| 92526 |
|
8,736 |
2,816 |
$396K |
| 96409 |
|
3,297 |
1,790 |
$392K |
| 67312 |
|
212 |
212 |
$380K |
| 99394 |
|
6,471 |
6,423 |
$354K |
| Q5104 |
Injection, renflexis |
404 |
371 |
$350K |
| 45380 |
|
703 |
700 |
$337K |
| 31575 |
|
2,462 |
2,448 |
$316K |
| J7040 |
Normal saline solution infus |
15,615 |
14,672 |
$314K |
| 29075 |
|
1,753 |
1,692 |
$313K |
| 72197 |
|
372 |
369 |
$312K |
| 76700 |
|
4,328 |
4,295 |
$281K |
| 70450 |
|
5,177 |
5,118 |
$269K |
| 99381 |
|
4,007 |
3,980 |
$255K |
| 95004 |
|
6,742 |
6,674 |
$254K |
| 97116 |
|
9,105 |
3,208 |
$251K |
| 87635 |
|
9,845 |
9,688 |
$239K |
| 16020 |
|
4,113 |
2,759 |
$229K |
| 44970 |
|
84 |
82 |
$228K |
| 97760 |
|
4,692 |
2,319 |
$219K |
| 90670 |
|
16,095 |
14,656 |
$214K |
| 96375 |
|
10,488 |
7,810 |
$210K |
| 78815 |
|
315 |
312 |
$209K |
| J1459 |
Inj ivig privigen 500 mg |
324 |
129 |
$201K |
| 99218 |
|
393 |
290 |
$198K |
| 54150 |
|
175 |
174 |
$193K |
| 29065 |
|
1,046 |
990 |
$192K |
| 72141 |
|
542 |
540 |
$189K |
| 85025 |
|
114,950 |
100,548 |
$187K |
| 54360 |
|
111 |
111 |
$186K |
| 49500 |
|
105 |
105 |
$184K |
| 82306 |
|
20,378 |
20,169 |
$180K |
| V5264 |
Ear mold/insert |
4,301 |
2,718 |
$171K |
| 97163 |
|
3,320 |
3,301 |
$168K |
| 42821 |
|
104 |
104 |
$162K |
| 71045 |
|
5,756 |
5,576 |
$161K |
| 72156 |
|
81 |
81 |
$157K |
| J1745 |
Infliximab not biosimil 10mg |
86 |
80 |
$148K |
| 54163 |
|
145 |
143 |
$144K |
| 70486 |
|
1,720 |
1,713 |
$139K |
| 97112 |
|
4,035 |
1,717 |
$139K |
| 96415 |
|
3,622 |
3,166 |
$137K |
| 92551 |
|
19,156 |
19,107 |
$130K |
| 96366 |
|
3,141 |
2,187 |
$128K |
| 82728 |
|
25,695 |
23,776 |
$117K |
| 94640 |
|
24,871 |
22,871 |
$107K |
| 97167 |
|
2,057 |
2,047 |
$106K |
| 29515 |
|
1,438 |
1,388 |
$92K |
| 92588 |
|
882 |
857 |
$92K |
| 87491 |
|
9,822 |
9,605 |
$91K |
| 74183 |
|
559 |
554 |
$90K |
| 90378 |
|
68 |
65 |
$89K |
| 96372 |
|
6,500 |
5,637 |
$86K |
| 90651 |
|
3,425 |
3,041 |
$85K |
| 73721 |
|
642 |
615 |
$84K |
| 80053 |
|
34,810 |
33,532 |
$84K |
| 86902 |
|
4,294 |
3,720 |
$84K |
| 83655 |
|
13,640 |
13,550 |
$83K |
| 80048 |
|
34,964 |
29,732 |
$79K |
| 36416 |
|
15,578 |
15,107 |
$77K |
| 87591 |
|
9,798 |
9,589 |
$76K |
| 87631 |
|
17,917 |
17,625 |
$76K |
| 84443 |
|
18,082 |
17,800 |
$76K |
| 94010 |
|
9,993 |
9,866 |
$75K |
| 20680 |
|
52 |
50 |
$72K |
| 76856 |
|
3,220 |
3,167 |
$71K |
| 76536 |
|
3,070 |
3,016 |
$71K |
| 69210 |
|
2,782 |
2,754 |
$70K |
| 96450 |
|
501 |
386 |
$70K |
| J2930 |
Methylprednisolone injection |
1,314 |
1,040 |
$68K |
| 17110 |
|
74 |
73 |
$67K |
| P9011 |
Blood split unit |
948 |
879 |
$67K |
| 95117 |
|
3,219 |
1,766 |
$66K |
| 29105 |
|
1,008 |
973 |
$64K |
| 25605 |
|
71 |
71 |
$64K |
| J1756 |
Iron sucrose injection |
777 |
563 |
$63K |
| 83735 |
|
28,615 |
22,071 |
$61K |
| 88184 |
|
708 |
673 |
$61K |
| 51784 |
|
881 |
876 |
$60K |
| 90474 |
|
10,396 |
10,361 |
$59K |
| 92585 |
|
671 |
635 |
$59K |
| J1100 |
Dexamethasone sodium phos |
33,005 |
32,032 |
$58K |
| 92579 |
|
8,943 |
8,898 |
$58K |
| 86900 |
|
15,670 |
12,915 |
$58K |
| 80061 |
|
6,023 |
5,961 |
$55K |
| 74455 |
|
467 |
456 |
$54K |
| U0002 |
Covid-19 lab test non-cdc |
2,445 |
2,391 |
$52K |
| 85046 |
|
41,717 |
31,848 |
$52K |
| 81003 |
|
32,746 |
31,598 |
$52K |
| G0008 |
Admin influenza virus vac |
6,292 |
6,256 |
$50K |
| 92626 |
|
1,737 |
1,692 |
$50K |
| 83036 |
|
13,520 |
13,431 |
$50K |
| 92557 |
|
5,187 |
5,163 |
$49K |
| 81025 |
|
23,720 |
22,813 |
$48K |
| 84460 |
|
38,216 |
32,293 |
$47K |
| 93005 |
|
29,064 |
27,481 |
$47K |
| 84450 |
|
38,181 |
32,259 |
$46K |
| 90620 |
|
1,960 |
1,779 |
$44K |
| 74018 |
|
12,042 |
11,714 |
$43K |
| 10060 |
|
513 |
508 |
$41K |
| 84439 |
|
16,900 |
16,540 |
$41K |
| 92552 |
|
7,882 |
7,862 |
$39K |
| 97162 |
|
807 |
805 |
$39K |
| 51600 |
|
422 |
412 |
$38K |
| 93886 |
|
305 |
302 |
$38K |
| 92586 |
|
547 |
540 |
$38K |
| 82947 |
|
4,507 |
4,356 |
$37K |
| 77072 |
|
2,270 |
2,261 |
$37K |
| 90686 |
|
15,247 |
14,202 |
$37K |
| 97161 |
|
910 |
889 |
$36K |
| 82784 |
|
17,472 |
11,115 |
$36K |
| 72082 |
|
5,427 |
5,383 |
$36K |
| 96367 |
|
1,123 |
976 |
$35K |
| 29405 |
|
171 |
164 |
$35K |
| 86832 |
|
723 |
691 |
$34K |
| 82465 |
|
7,140 |
7,109 |
$34K |
| 86833 |
|
721 |
689 |
$34K |
| 36415 |
|
64,696 |
61,837 |
$34K |
| 86140 |
|
29,111 |
27,535 |
$34K |
| 92018 |
|
36 |
35 |
$33K |
| 87389 |
|
5,023 |
5,001 |
$33K |
| A9270 |
Non-covered item or service |
181,407 |
146,914 |
$33K |
| 72148 |
|
733 |
730 |
$33K |
| 12011 |
|
2,735 |
2,718 |
$32K |
| 87799 |
|
3,569 |
2,099 |
$32K |
| Q3014 |
Telehealth facility fee |
2,338 |
2,229 |
$32K |
| 76506 |
|
992 |
982 |
$32K |
| G0009 |
Admin pneumococcal vaccine |
4,193 |
4,170 |
$32K |
| 92595 |
|
1,069 |
1,066 |
$31K |
| 86780 |
|
4,258 |
4,234 |
$31K |
| J2405 |
Ondansetron hcl injection |
37,752 |
34,532 |
$31K |
| 83970 |
|
3,118 |
3,058 |
$30K |
| 97166 |
|
593 |
586 |
$30K |
| 80307 |
|
10,842 |
10,341 |
$29K |
| 83718 |
|
6,496 |
6,482 |
$28K |
| 90716 |
|
4,172 |
3,849 |
$28K |
| 96411 |
|
774 |
475 |
$27K |
| 80051 |
|
24,667 |
23,555 |
$27K |
| 51741 |
|
506 |
505 |
$27K |
| 51798 |
|
4,634 |
4,470 |
$27K |
| 69200 |
|
841 |
819 |
$27K |
| 43762 |
|
220 |
206 |
$25K |
| 82565 |
|
23,266 |
21,661 |
$25K |
| 83550 |
|
11,163 |
10,495 |
$25K |
| 92567 |
|
31,499 |
31,109 |
$24K |
| 67808 |
|
24 |
24 |
$24K |
| 86850 |
|
15,296 |
12,538 |
$24K |
| J0475 |
Baclofen 10 mg injection |
49 |
48 |
$23K |
| 82805 |
|
14,677 |
14,261 |
$23K |
| 83021 |
|
6,081 |
5,550 |
$23K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
1,748 |
1,692 |
$22K |
| 82248 |
|
21,455 |
16,288 |
$22K |
| 82247 |
|
20,471 |
15,432 |
$22K |
| 83615 |
|
19,389 |
15,332 |
$22K |
| 90734 |
|
4,042 |
3,293 |
$22K |
| J2919 |
Inj, methylpred sod succ 5mg |
37 |
26 |
$22K |
| 73560 |
|
2,570 |
2,137 |
$21K |
| 84520 |
|
23,014 |
21,324 |
$20K |
| 92582 |
|
2,863 |
2,860 |
$20K |
| J0690 |
Cefazolin sodium injection |
7,289 |
6,509 |
$20K |
| 83540 |
|
11,786 |
11,070 |
$20K |
| 70260 |
|
2,873 |
2,866 |
$19K |
| C1887 |
Catheter, guiding |
284 |
272 |
$19K |
| 87496 |
|
2,445 |
1,848 |
$19K |
| 87651 |
|
20,594 |
20,374 |
$19K |
| 84100 |
|
26,363 |
21,141 |
$19K |
| 76882 |
|
1,454 |
1,416 |
$19K |
| 92524 |
|
384 |
379 |
$19K |
| 73521 |
|
2,816 |
2,794 |
$18K |
| 82570 |
|
15,332 |
14,108 |
$18K |
| J1720 |
Hydrocortisone sodium succ i |
957 |
748 |
$18K |
| 85027 |
|
6,302 |
6,213 |
$18K |
| 84075 |
|
17,847 |
13,691 |
$18K |
| 92652 |
|
191 |
186 |
$17K |
| 86923 |
|
3,773 |
3,202 |
$17K |
| J0131 |
Inj, acetaminophen (nos) |
5,103 |
5,006 |
$17K |
| 94060 |
|
138 |
135 |
$16K |
| 83516 |
|
6,987 |
6,093 |
$16K |
| 86880 |
|
11,952 |
7,805 |
$16K |
| 74021 |
|
6,821 |
6,701 |
$15K |
| 87086 |
|
21,742 |
21,382 |
$15K |
| 24640 |
|
167 |
165 |
$15K |
| 87536 |
|
353 |
331 |
$15K |
| 92610 |
|
331 |
327 |
$15K |
| 80069 |
|
2,629 |
1,939 |
$14K |
| 85652 |
|
15,767 |
15,069 |
$14K |
| 73130 |
|
5,083 |
4,572 |
$14K |
| 86360 |
|
1,249 |
1,213 |
$14K |
| 92019 |
|
15 |
15 |
$14K |
| 86803 |
|
2,352 |
2,324 |
$14K |
| 73630 |
|
6,630 |
5,886 |
$14K |
| 99395 |
|
324 |
319 |
$13K |
| 73610 |
|
6,516 |
5,779 |
$13K |
| 12001 |
|
1,922 |
1,910 |
$13K |
| 76870 |
|
2,004 |
1,965 |
$13K |
| 81001 |
|
31,721 |
30,464 |
$13K |
| 95713 |
|
44 |
44 |
$12K |
| 62369 |
|
50 |
50 |
$12K |
| 93226 |
|
417 |
414 |
$12K |
| 76857 |
|
2,476 |
2,471 |
$12K |
| 86359 |
|
1,285 |
1,247 |
$12K |
| 84550 |
|
12,661 |
10,231 |
$12K |
| 92591 |
|
222 |
221 |
$11K |
| 73110 |
|
6,145 |
5,234 |
$11K |
| 83690 |
|
9,747 |
9,540 |
$11K |
| 83001 |
|
2,268 |
2,238 |
$11K |
| 83002 |
|
2,278 |
2,247 |
$11K |
| 74240 |
|
124 |
124 |
$11K |
| 90656 |
|
143 |
118 |
$11K |
| S0077 |
Injection, clindamycin phosp |
1,876 |
1,232 |
$10K |
| J1642 |
Inj heparin sodium per 10 u |
4,495 |
3,386 |
$10K |
| 74241 |
|
107 |
107 |
$10K |
| 87661 |
|
3,245 |
3,180 |
$10K |
| 0202U |
|
862 |
846 |
$10K |
| 80074 |
|
1,994 |
1,978 |
$10K |
| 93017 |
|
308 |
301 |
$10K |
| 84156 |
|
12,341 |
11,260 |
$10K |
| 73564 |
|
3,260 |
2,955 |
$10K |
| 87040 |
|
7,599 |
7,408 |
$10K |
| 82977 |
|
5,985 |
5,592 |
$10K |
| 80076 |
|
4,644 |
4,282 |
$9K |
| 80197 |
|
3,270 |
2,302 |
$9K |
| 72170 |
|
3,210 |
3,150 |
$9K |
| 73590 |
|
5,194 |
4,334 |
$9K |
| 85244 |
|
1,966 |
1,910 |
$9K |
| 85240 |
|
2,029 |
1,820 |
$9K |
| J7070 |
D5w infusion |
3,598 |
3,213 |
$9K |
| 73090 |
|
7,283 |
5,435 |
$9K |
| J7030 |
Normal saline solution infus |
17,209 |
13,942 |
$9K |
| 82962 |
|
13,052 |
12,003 |
$9K |
| 86870 |
|
101 |
81 |
$9K |
| 86357 |
|
1,055 |
1,024 |
$9K |
| 82043 |
|
6,462 |
6,145 |
$9K |
| 86355 |
|
1,056 |
1,023 |
$9K |
| 85576 |
|
1,089 |
598 |
$9K |
| 82040 |
|
12,864 |
10,946 |
$9K |
| 64643 |
|
726 |
694 |
$8K |
| 86235 |
|
1,863 |
1,557 |
$8K |
| 83605 |
|
15,084 |
14,596 |
$8K |
| 88305 |
|
5,818 |
5,774 |
$8K |
| 86038 |
|
2,954 |
2,919 |
$8K |
| 84703 |
|
6,613 |
5,938 |
$8K |
| 70360 |
|
1,994 |
1,969 |
$8K |
| 29345 |
|
55 |
46 |
$8K |
| J1050 |
Medroxyprogesterone acetate |
787 |
775 |
$8K |
| 31622 |
|
101 |
100 |
$8K |
| 85245 |
|
1,373 |
1,338 |
$8K |
| 82670 |
|
1,109 |
1,088 |
$8K |
| 86901 |
|
15,659 |
12,905 |
$8K |
| 93271 |
|
129 |
129 |
$8K |
| 86922 |
|
2,862 |
2,364 |
$8K |
| 93325 |
|
8,639 |
8,319 |
$7K |
| 73080 |
|
6,133 |
4,890 |
$7K |
| 70250 |
|
1,550 |
1,495 |
$7K |
| 82550 |
|
3,995 |
3,755 |
$7K |
| J2270 |
Morphine sulfate injection |
19,613 |
18,524 |
$7K |
| 82330 |
|
15,346 |
14,872 |
$7K |
| 84403 |
|
1,158 |
1,140 |
$7K |
| 87502 |
|
5,826 |
5,790 |
$7K |
| 86665 |
|
3,140 |
1,686 |
$7K |
| 85610 |
|
8,882 |
8,199 |
$7K |
| 86706 |
|
2,555 |
2,527 |
$7K |
| 86376 |
|
2,169 |
2,157 |
$7K |
| 85730 |
|
8,418 |
7,786 |
$7K |
| J7042 |
5% dextrose/normal saline |
15,509 |
13,101 |
$7K |
| 86480 |
|
450 |
441 |
$7K |
| 87077 |
|
5,711 |
5,359 |
$6K |
| 82533 |
|
1,473 |
1,420 |
$6K |
| 87081 |
|
5,182 |
5,121 |
$6K |
| 86341 |
|
1,120 |
722 |
$6K |
| 77073 |
|
1,998 |
1,982 |
$6K |
| 73140 |
|
3,957 |
3,510 |
$6K |
| 95714 |
|
162 |
162 |
$6K |
| 72146 |
|
210 |
210 |
$6K |
| 82310 |
|
6,399 |
6,114 |
$6K |
| 76885 |
|
137 |
137 |
$6K |
| 73552 |
|
2,676 |
2,351 |
$6K |
| 83880 |
|
1,028 |
911 |
$5K |
| 87804 |
|
10,130 |
5,107 |
$5K |
| 72040 |
|
2,428 |
2,370 |
$5K |
| 76827 |
|
1,519 |
1,453 |
$5K |
| 82627 |
|
902 |
897 |
$5K |
| 74019 |
|
1,186 |
1,151 |
$5K |
| 86225 |
|
1,893 |
1,713 |
$5K |
| 86003 |
|
3,194 |
1,780 |
$5K |
| 83013 |
|
251 |
251 |
$5K |
| 82607 |
|
1,324 |
1,285 |
$5K |
| 72100 |
|
1,031 |
1,019 |
$5K |
| 82131 |
|
1,040 |
1,010 |
$5K |
| J7120 |
Ringers lactate infusion |
30,129 |
29,380 |
$5K |
| 49452 |
|
16 |
14 |
$5K |
| 93320 |
|
8,407 |
8,107 |
$5K |
| 83020 |
|
1,943 |
1,681 |
$5K |
| 82785 |
|
1,443 |
1,415 |
$5K |
| 71260 |
|
72 |
72 |
$5K |
| 86800 |
|
1,593 |
1,587 |
$5K |
| 82150 |
|
4,160 |
4,071 |
$5K |
| 73030 |
|
1,890 |
1,738 |
$5K |
| 99383 |
|
67 |
67 |
$5K |
| 74177 |
|
39 |
39 |
$5K |
| 85384 |
|
1,997 |
1,865 |
$5K |
| 83993 |
|
615 |
606 |
$5K |
| 86364 |
|
1,582 |
1,577 |
$5K |
| 29705 |
|
44 |
42 |
$4K |
| 86769 |
|
259 |
256 |
$4K |
| 72158 |
|
78 |
78 |
$4K |
| 72125 |
|
190 |
189 |
$4K |
| J2704 |
Inj, propofol, 10 mg |
32,012 |
31,140 |
$4K |
| 84145 |
|
709 |
681 |
$4K |
| 94664 |
|
1,987 |
1,982 |
$4K |
| 87633 |
|
558 |
550 |
$4K |
| 29505 |
|
53 |
51 |
$4K |
| 84305 |
|
1,943 |
1,934 |
$4K |
| J0171 |
Adrenalin epinephrine inject |
371 |
365 |
$4K |
| 92522 |
|
78 |
78 |
$4K |
| 95712 |
|
24 |
24 |
$4K |
| 92556 |
|
8,622 |
8,604 |
$4K |
| 86664 |
|
1,727 |
1,670 |
$4K |
| 86905 |
|
199 |
198 |
$3K |
| 84402 |
|
439 |
438 |
$3K |
| 87880 |
|
5,802 |
5,718 |
$3K |
| 86663 |
|
1,729 |
1,672 |
$3K |
| 73060 |
|
1,604 |
1,408 |
$3K |
| 73000 |
|
1,147 |
1,079 |
$3K |
| 86039 |
|
1,053 |
1,035 |
$3K |
| 87070 |
|
3,107 |
3,010 |
$3K |
| 83520 |
|
1,643 |
1,539 |
$3K |
| S0080 |
Injection, pentamidine iseth |
834 |
785 |
$3K |
| 92555 |
|
8,748 |
8,712 |
$3K |
| 88342 |
|
1,052 |
1,029 |
$3K |
| 73562 |
|
1,157 |
1,058 |
$3K |
| P9040 |
Rbc leukoreduced irradiated |
15 |
12 |
$3K |
| 12002 |
|
366 |
366 |
$2K |
| 72157 |
|
40 |
40 |
$2K |
| 73120 |
|
794 |
711 |
$2K |
| 84478 |
|
767 |
707 |
$2K |
| 84484 |
|
2,281 |
2,189 |
$2K |
| 86147 |
|
522 |
397 |
$2K |
| J0561 |
Penicillin g benzathine inj |
46 |
45 |
$2K |
| 29125 |
|
2,200 |
2,155 |
$2K |
| 30901 |
|
14 |
14 |
$2K |
| 92594 |
|
150 |
150 |
$2K |
| G0480 |
Drug test def 1-7 classes |
136 |
136 |
$2K |
| 82340 |
|
1,805 |
1,760 |
$2K |
| 83037 |
|
1,146 |
1,138 |
$2K |
| 82274 |
|
500 |
475 |
$2K |
| 72070 |
|
220 |
219 |
$2K |
| C1769 |
Guide wire |
1,530 |
1,470 |
$2K |
| 94375 |
|
27 |
26 |
$2K |
| 88300 |
|
3,876 |
3,848 |
$2K |
| 85732 |
|
1,145 |
598 |
$2K |
| 95813 |
|
13 |
13 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
6,962 |
5,757 |
$2K |
| 94660 |
|
321 |
206 |
$2K |
| 86431 |
|
1,119 |
1,113 |
$2K |
| 83525 |
|
619 |
607 |
$2K |
| 87467 |
|
407 |
401 |
$2K |
| 77076 |
|
407 |
406 |
$2K |
| 84155 |
|
1,883 |
1,684 |
$2K |
| 87340 |
|
724 |
713 |
$2K |
| 84134 |
|
897 |
870 |
$2K |
| J1644 |
Inj heparin sodium per 1000u |
3,128 |
1,224 |
$2K |
| 95822 |
|
12 |
12 |
$2K |
| 82652 |
|
358 |
354 |
$1K |
| 87807 |
|
3,123 |
3,044 |
$1K |
| 83930 |
|
919 |
822 |
$1K |
| 88185 |
|
348 |
329 |
$1K |
| 83498 |
|
421 |
417 |
$1K |
| 84146 |
|
236 |
235 |
$1K |
| 83921 |
|
364 |
339 |
$1K |
| 85250 |
|
227 |
224 |
$1K |
| 97165 |
|
29 |
29 |
$1K |
| 86337 |
|
194 |
192 |
$1K |
| 82803 |
|
789 |
739 |
$1K |
| 86317 |
|
336 |
222 |
$1K |
| 11900 |
|
13 |
13 |
$1K |
| 73620 |
|
678 |
583 |
$1K |
| 87046 |
|
907 |
883 |
$999.12 |
| 72081 |
|
806 |
797 |
$983.73 |
| 82746 |
|
246 |
242 |
$949.17 |
| 87045 |
|
887 |
869 |
$946.63 |
| 87205 |
|
2,233 |
2,169 |
$898.02 |
| 85379 |
|
780 |
724 |
$897.74 |
| 30300 |
|
55 |
52 |
$872.00 |
| 80230 |
|
91 |
81 |
$845.22 |
| 70480 |
|
12 |
12 |
$822.02 |
| 84702 |
|
318 |
309 |
$798.35 |
| 88312 |
|
437 |
437 |
$787.59 |
| 92650 |
|
485 |
485 |
$786.60 |
| 86255 |
|
282 |
273 |
$764.25 |
| 76642 |
|
40 |
38 |
$756.82 |
| 82105 |
|
162 |
159 |
$748.38 |
| 73100 |
|
580 |
452 |
$738.60 |
| 99152 |
|
322 |
320 |
$714.04 |
| J0290 |
Ampicillin 500 mg inj |
798 |
605 |
$640.36 |
| 86709 |
|
213 |
210 |
$619.53 |
| J2997 |
Alteplase recombinant |
13 |
12 |
$586.41 |
| J1953 |
Levetiracetam injection |
276 |
250 |
$570.47 |
| 82010 |
|
818 |
696 |
$569.61 |
| 99156 |
|
243 |
241 |
$562.93 |
| 88304 |
|
1,979 |
1,958 |
$559.91 |
| 93243 |
|
39 |
39 |
$553.28 |
| 0001A |
|
25 |
21 |
$542.56 |
| J1885 |
Ketorolac tromethamine inj |
17,565 |
16,676 |
$537.77 |
| 90473 |
|
144 |
144 |
$529.11 |
| 85247 |
|
78 |
78 |
$528.60 |
| 83090 |
|
125 |
123 |
$527.25 |
| 73070 |
|
496 |
432 |
$524.06 |
| 82024 |
|
256 |
252 |
$514.04 |
| 62322 |
|
242 |
174 |
$498.79 |
| 80164 |
|
98 |
96 |
$496.87 |
| 96376 |
|
2,269 |
1,775 |
$488.00 |
| 84466 |
|
100 |
96 |
$486.68 |
| 82747 |
|
122 |
119 |
$480.40 |
| 82379 |
|
147 |
144 |
$471.33 |
| G0109 |
Diab manage trn ind/group |
12 |
12 |
$459.17 |
| 84481 |
|
155 |
151 |
$438.35 |
| 80165 |
|
25 |
25 |
$435.42 |
| 89230 |
|
25 |
25 |
$412.85 |
| 82542 |
|
1,616 |
1,541 |
$412.50 |
| 93225 |
|
51 |
51 |
$402.27 |
| 80195 |
|
81 |
51 |
$401.79 |
| 90732 |
|
13 |
13 |
$400.41 |
| 99211 |
|
543 |
529 |
$377.56 |
| 82139 |
|
68 |
68 |
$350.85 |
| 90680 |
|
10,321 |
9,453 |
$348.78 |
| 82985 |
|
211 |
207 |
$343.51 |
| 89050 |
|
601 |
535 |
$338.57 |
| 80177 |
|
117 |
116 |
$320.58 |
| 99155 |
|
133 |
133 |
$306.58 |
| S5010 |
5% dextrose and 0.45% saline |
1,568 |
1,244 |
$305.36 |
| 87480 |
|
65 |
65 |
$288.69 |
| 87510 |
|
65 |
65 |
$288.69 |
| 86308 |
|
826 |
819 |
$288.61 |
| 86704 |
|
86 |
85 |
$287.36 |
| 84202 |
|
70 |
69 |
$285.12 |
| 99151 |
|
123 |
122 |
$275.12 |
| 82610 |
|
1,513 |
1,498 |
$270.00 |
| 84480 |
|
98 |
93 |
$261.84 |
| 82017 |
|
112 |
107 |
$255.22 |
| J0780 |
Prochlorperazine injection |
1,101 |
1,012 |
$252.07 |
| J9370 |
Vincristine sulfate 1 mg inj |
2,043 |
1,304 |
$247.82 |
| 87493 |
|
56 |
55 |
$245.22 |
| V5011 |
Hearing aid fitting/checking |
902 |
900 |
$222.22 |
| 73600 |
|
42 |
29 |
$222.09 |
| S0020 |
Injection, bupivicaine hydro |
3,955 |
3,913 |
$219.31 |
| 90744 |
|
56 |
51 |
$216.42 |
| 87209 |
|
134 |
129 |
$208.57 |
| 85014 |
|
684 |
635 |
$199.03 |
| 86787 |
|
54 |
50 |
$189.49 |
| 84132 |
|
687 |
608 |
$180.45 |
| 84295 |
|
650 |
579 |
$170.22 |
| 87660 |
|
37 |
37 |
$164.77 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
428 |
274 |
$160.69 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,411 |
1,394 |
$146.85 |
| 82140 |
|
93 |
87 |
$132.66 |
| 88341 |
|
69 |
67 |
$129.46 |
| S0028 |
Injection, famotidine, 20 mg |
1,597 |
1,257 |
$128.49 |
| 86644 |
|
120 |
114 |
$123.40 |
| J3475 |
Inj magnesium sulfate |
2,602 |
2,449 |
$122.75 |
| 84681 |
|
147 |
144 |
$120.90 |
| 94680 |
|
135 |
129 |
$119.32 |
| 87338 |
|
16 |
16 |
$111.15 |
| 86200 |
|
68 |
68 |
$104.57 |
| 90633 |
|
8,265 |
7,708 |
$104.00 |
| A9552 |
F18 fdg |
427 |
423 |
$103.88 |
| 87177 |
|
134 |
129 |
$103.27 |
| 86146 |
|
25 |
24 |
$102.81 |
| 86701 |
|
196 |
195 |
$101.70 |
| J2916 |
Na ferric gluconate complex |
134 |
80 |
$92.88 |
| A9585 |
Gadobutrol injection |
1,128 |
1,090 |
$90.12 |
| 90647 |
|
10,611 |
9,838 |
$89.82 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
1,176 |
1,121 |
$89.79 |
| 84436 |
|
149 |
148 |
$87.62 |
| 73502 |
|
39 |
39 |
$86.98 |
| 90715 |
|
2,476 |
2,144 |
$85.97 |
| P9041 |
Albumin (human),5%, 50ml |
12 |
12 |
$75.39 |
| 85520 |
|
15 |
15 |
$71.78 |
| 88262 |
|
12 |
12 |
$70.91 |
| 94200 |
|
91 |
91 |
$69.66 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,860 |
1,833 |
$65.83 |
| 90723 |
|
10,688 |
10,049 |
$64.51 |
| 87529 |
|
99 |
55 |
$60.03 |
| 82157 |
|
27 |
27 |
$56.16 |
| 99157 |
|
28 |
28 |
$55.49 |
| 88275 |
|
12 |
12 |
$52.43 |
| 86765 |
|
42 |
39 |
$50.88 |
| 82438 |
|
38 |
37 |
$49.92 |
| 88271 |
|
12 |
12 |
$48.75 |
| 92558 |
|
266 |
264 |
$48.24 |
| 77075 |
|
12 |
12 |
$47.04 |
| 86645 |
|
82 |
80 |
$46.19 |
| J3301 |
Triamcinolone acet inj nos |
97 |
97 |
$44.78 |
| 90700 |
|
3,857 |
3,613 |
$44.52 |
| 83010 |
|
32 |
27 |
$40.88 |
| 73660 |
|
42 |
38 |
$40.35 |
| 90707 |
|
4,000 |
3,699 |
$38.85 |
| J0736 |
Inj, clindamycin phosp 300mg |
80 |
54 |
$38.20 |
| 82180 |
|
14 |
14 |
$37.67 |
| J3010 |
Fentanyl citrate injection |
24,118 |
23,673 |
$35.79 |
| Q9968 |
Visualization adjunct |
85 |
82 |
$33.21 |
| 99202 |
|
24 |
24 |
$31.86 |
| Q0162 |
Ondansetron oral |
3,305 |
3,240 |
$28.72 |
| J2060 |
Lorazepam injection |
384 |
255 |
$28.59 |
| 99213 |
|
18 |
18 |
$24.60 |
| J2710 |
Neostigmine methylslfte inj |
4,946 |
4,856 |
$24.22 |
| 84244 |
|
12 |
12 |
$22.93 |
| 84157 |
|
28 |
26 |
$19.26 |
| 76376 |
|
346 |
346 |
$18.65 |
| 88280 |
|
12 |
12 |
$17.14 |
| 90696 |
|
3,258 |
2,970 |
$15.05 |
| 82390 |
|
12 |
12 |
$14.24 |
| J2250 |
Inj midazolam hydrochloride |
8,928 |
8,797 |
$13.29 |
| 99214 |
|
15 |
15 |
$10.80 |
| 82945 |
|
28 |
26 |
$8.92 |
| 82085 |
|
25 |
25 |
$4.00 |
| J9260 |
Inj methotrexate sodium 50mg |
738 |
394 |
$1.88 |
| 85018 |
|
14 |
14 |
$1.31 |
| S0030 |
Injection, metronidazole |
14 |
12 |
$1.27 |
| J1580 |
Garamycin gentamicin inj |
13 |
12 |
$0.72 |
| 85396 |
|
227 |
223 |
$0.00 |
| 90710 |
|
76 |
74 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
323 |
322 |
$0.00 |
| A9576 |
Inj prohance multipack |
3,511 |
3,393 |
$0.00 |
| 82272 |
|
12 |
12 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
150 |
117 |
$0.00 |
| J0692 |
Cefepime hcl for injection |
30 |
12 |
$0.00 |
| 94799 |
|
52 |
35 |
$0.00 |
| J1240 |
Dimenhydrinate injection |
141 |
140 |
$0.00 |
| 51701 |
|
58 |
58 |
$0.00 |
| 90713 |
|
95 |
81 |
$0.00 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
1,047 |
994 |
$0.00 |
| 87798 |
|
22 |
12 |
$0.00 |
| 82397 |
|
19 |
17 |
$0.00 |
| Q9958 |
Hocm <=149 mg/ml iodine, 1ml |
58 |
58 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
75 |
75 |
$0.00 |
| 88313 |
|
30 |
25 |
$0.00 |
| A4565 |
Slings |
14 |
14 |
$0.00 |
| 76377 |
|
146 |
145 |
$0.00 |
| C1766 |
Intro/sheath,strble,non-peel |
689 |
612 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
207 |
206 |
$0.00 |
| 94760 |
|
308 |
302 |
$0.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
77 |
65 |
$0.00 |
| 87181 |
|
38 |
27 |
$0.00 |
| J7060 |
5% dextrose/water |
14 |
12 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
448 |
445 |
$0.00 |
| 86258 |
|
20 |
12 |
$0.00 |
| 86353 |
|
12 |
12 |
$0.00 |
| 88307 |
|
28 |
28 |
$0.00 |
| 87425 |
|
21 |
20 |
$0.00 |
| A9579 |
Gad-base mr contrast nos,1ml |
49 |
49 |
$0.00 |
| 29130 |
|
13 |
12 |
$0.00 |
| J1170 |
Hydromorphone injection |
13 |
13 |
$0.00 |