| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
|
573,206 |
521,812 |
$61.84M |
| 99283 |
|
140,047 |
130,395 |
$20.13M |
| 99212 |
|
163,466 |
155,859 |
$17.42M |
| 99214 |
|
141,939 |
127,299 |
$14.91M |
| 69436 |
|
9,913 |
8,472 |
$11.19M |
| 96127 |
|
94,705 |
89,836 |
$11.01M |
| 96110 |
|
43,712 |
41,484 |
$10.90M |
| 90834 |
|
64,613 |
35,367 |
$8.15M |
| 97530 |
|
102,911 |
39,797 |
$7.32M |
| 99282 |
|
46,542 |
43,723 |
$6.26M |
| 99284 |
|
35,219 |
31,941 |
$6.06M |
| 99392 |
|
50,097 |
47,820 |
$5.97M |
| 90791 |
|
22,350 |
19,273 |
$5.89M |
| 92507 |
|
76,417 |
34,633 |
$5.88M |
| 42820 |
|
5,082 |
4,333 |
$5.69M |
| 97110 |
|
62,883 |
28,379 |
$5.67M |
| 99391 |
|
47,517 |
44,436 |
$5.41M |
| 99393 |
|
45,667 |
43,800 |
$5.39M |
| 99215 |
Prolong outpt/office vis |
51,303 |
45,976 |
$5.36M |
| H2020 |
Ther behav svc, per diem |
28,622 |
4,178 |
$4.27M |
| 90837 |
|
31,201 |
17,526 |
$4.26M |
| S0201 |
Partial hospitalization serv |
5,861 |
1,140 |
$3.52M |
| 99219 |
|
9,681 |
4,845 |
$3.45M |
| 99285 |
|
13,276 |
11,486 |
$3.40M |
| G0378 |
Hospital observation per hr |
22,080 |
9,803 |
$3.20M |
| 99401 |
|
14,397 |
13,524 |
$2.87M |
| H2019 |
Ther behav svc, per 15 min |
21,597 |
10,273 |
$2.80M |
| D2930 |
|
4,792 |
3,612 |
$2.71M |
| 70551 |
|
6,073 |
5,399 |
$2.70M |
| J1569 |
Gammagard liquid injection |
1,228 |
603 |
$2.69M |
| 99394 |
|
22,356 |
20,952 |
$2.64M |
| 90847 |
|
12,216 |
8,089 |
$2.63M |
| 93325 |
|
15,050 |
13,293 |
$2.56M |
| 41899 |
|
3,855 |
3,581 |
$2.51M |
| 92551 |
|
29,768 |
28,181 |
$2.32M |
| 70553 |
|
3,535 |
3,160 |
$2.25M |
| 94640 |
|
15,228 |
11,437 |
$2.21M |
| 93306 |
|
3,184 |
2,895 |
$2.15M |
| 43239 |
|
4,592 |
3,904 |
$2.14M |
| 99211 |
|
25,260 |
23,413 |
$2.13M |
| 90832 |
|
25,173 |
15,496 |
$2.07M |
| D7140 |
|
4,003 |
3,141 |
$1.98M |
| 96361 |
|
6,100 |
4,933 |
$1.93M |
| C9803 |
Hopd covid-19 spec collect |
48,501 |
45,275 |
$1.90M |
| 90846 |
|
8,545 |
6,806 |
$1.78M |
| 70450 |
|
4,302 |
3,808 |
$1.66M |
| U0002 |
Covid-19 lab test non-cdc |
98,180 |
91,100 |
$1.61M |
| H0036 |
Comm psy face-face per 15min |
22,515 |
9,668 |
$1.55M |
| D1351 |
|
2,590 |
1,949 |
$1.54M |
| 95810 |
|
1,578 |
1,454 |
$1.48M |
| J0585 |
Injection,onabotulinumtoxina |
1,722 |
1,447 |
$1.45M |
| 96365 |
|
9,449 |
6,546 |
$1.44M |
| 42830 |
|
1,373 |
1,118 |
$1.41M |
| 88305 |
|
11,076 |
5,573 |
$1.37M |
| 87502 |
|
39,262 |
35,327 |
$1.31M |
| 01922 |
|
5,820 |
4,653 |
$1.30M |
| J1745 |
Infliximab not biosimil 10mg |
888 |
695 |
$1.30M |
| 93303 |
|
3,426 |
2,952 |
$1.29M |
| 31624 |
|
1,766 |
1,473 |
$1.29M |
| 95004 |
|
3,433 |
3,269 |
$1.23M |
| 95782 |
|
1,159 |
1,058 |
$1.19M |
| Q5103 |
Injection, inflectra |
974 |
753 |
$1.18M |
| 97803 |
|
12,468 |
11,460 |
$1.13M |
| 97161 |
|
10,782 |
9,992 |
$1.11M |
| 76770 |
|
5,809 |
5,238 |
$1.10M |
| 96130 |
|
4,008 |
3,640 |
$1.03M |
| 99402 |
|
5,011 |
4,734 |
$1.00M |
| 92523 |
|
9,711 |
8,889 |
$966K |
| 93308 |
|
2,983 |
2,509 |
$886K |
| 92587 |
|
9,154 |
8,457 |
$881K |
| A0434 |
Specialty care transport |
6,226 |
5,091 |
$853K |
| J3535 |
Metered dose inhaler drug |
11,678 |
8,659 |
$839K |
| 96360 |
|
4,244 |
3,560 |
$837K |
| 76705 |
|
7,444 |
6,569 |
$817K |
| 96413 |
|
4,789 |
3,449 |
$809K |
| 95715 |
|
1,047 |
857 |
$763K |
| 44970 |
|
243 |
208 |
$748K |
| 97112 |
|
32,282 |
14,853 |
$738K |
| A0428 |
Bls |
7,255 |
6,423 |
$723K |
| J3490 |
Drugs unclassified injection |
151,600 |
97,784 |
$707K |
| 83655 |
|
41,011 |
38,419 |
$699K |
| 93005 |
|
33,639 |
30,447 |
$666K |
| 96366 |
|
2,872 |
1,980 |
$629K |
| 97150 |
|
19,073 |
5,109 |
$628K |
| 87799 |
|
5,492 |
2,827 |
$618K |
| 36415 |
|
167,877 |
142,520 |
$599K |
| 85025 |
|
86,703 |
67,518 |
$579K |
| 31622 |
|
738 |
604 |
$573K |
| 87651 |
|
47,507 |
42,804 |
$571K |
| 96415 |
|
1,398 |
1,051 |
$565K |
| 97802 |
|
6,198 |
5,736 |
$565K |
| 74177 |
|
1,126 |
1,000 |
$556K |
| 00170 |
|
17,777 |
16,079 |
$553K |
| 93304 |
|
1,646 |
1,356 |
$527K |
| 82306 |
|
27,431 |
24,454 |
$521K |
| 97165 |
|
5,519 |
4,991 |
$510K |
| 71046 |
|
21,758 |
19,011 |
$508K |
| 29075 |
|
3,245 |
2,932 |
$503K |
| 97166 |
|
4,451 |
4,051 |
$496K |
| 92508 |
|
12,955 |
4,941 |
$477K |
| 67311 |
|
209 |
160 |
$468K |
| 80053 |
|
32,797 |
27,037 |
$467K |
| 45380 |
|
907 |
773 |
$465K |
| 90792 |
|
1,693 |
1,543 |
$462K |
| 12011 |
|
2,086 |
1,832 |
$455K |
| 29065 |
|
2,996 |
2,559 |
$454K |
| A0425 |
Ground mileage |
15,534 |
13,150 |
$452K |
| D2330 |
|
775 |
654 |
$444K |
| 31526 |
|
1,704 |
1,400 |
$434K |
| 96156 |
|
1,603 |
1,461 |
$430K |
| 54163 |
|
351 |
297 |
$426K |
| 42821 |
|
296 |
260 |
$414K |
| 97755 |
|
4,425 |
3,753 |
$407K |
| 64643 |
|
824 |
746 |
$401K |
| 96161 |
|
9,896 |
9,772 |
$399K |
| 92579 |
|
4,566 |
4,229 |
$398K |
| 74183 |
|
819 |
713 |
$387K |
| 95816 |
|
1,915 |
1,716 |
$379K |
| 97750 |
|
6,427 |
5,839 |
$346K |
| 96136 |
|
2,313 |
2,005 |
$341K |
| 54161 |
|
274 |
228 |
$337K |
| 94010 |
|
9,415 |
8,545 |
$333K |
| 72197 |
|
602 |
509 |
$327K |
| 87497 |
|
2,722 |
1,664 |
$322K |
| 86832 |
|
1,567 |
1,149 |
$320K |
| 97162 |
|
3,366 |
3,111 |
$314K |
| 92567 |
|
18,328 |
17,087 |
$313K |
| 74018 |
|
9,592 |
7,620 |
$313K |
| 92526 |
|
4,983 |
2,766 |
$305K |
| 76700 |
|
1,536 |
1,390 |
$303K |
| 0202U |
|
1,147 |
1,064 |
$303K |
| 92652 |
|
2,443 |
2,146 |
$297K |
| 80076 |
|
26,203 |
20,537 |
$296K |
| 80048 |
|
19,931 |
15,042 |
$291K |
| 76820 |
|
2,646 |
1,644 |
$290K |
| 81229 |
|
1,182 |
917 |
$288K |
| 84443 |
|
27,469 |
24,664 |
$287K |
| 90686 |
|
34,017 |
31,681 |
$285K |
| 72148 |
|
867 |
774 |
$285K |
| 12001 |
|
1,269 |
1,127 |
$282K |
| 92609 |
|
3,761 |
1,944 |
$280K |
| 93320 |
|
3,258 |
2,896 |
$276K |
| 73721 |
|
778 |
713 |
$272K |
| D2391 |
|
825 |
700 |
$267K |
| 93321 |
|
5,063 |
4,430 |
$265K |
| 87635 |
|
6,487 |
6,010 |
$265K |
| J1050 |
Medroxyprogesterone acetate |
2,934 |
2,689 |
$264K |
| 74181 |
|
748 |
657 |
$263K |
| 97164 |
|
2,666 |
2,430 |
$262K |
| 29405 |
|
1,549 |
1,385 |
$259K |
| 80061 |
|
27,547 |
25,075 |
$258K |
| 99457 |
|
2,294 |
2,106 |
$257K |
| 17110 |
|
1,165 |
1,057 |
$256K |
| 90853 |
|
3,958 |
1,481 |
$255K |
| 86833 |
|
1,554 |
1,130 |
$255K |
| 96367 |
|
2,199 |
1,594 |
$249K |
| 80069 |
|
18,879 |
13,778 |
$248K |
| 20680 |
|
151 |
115 |
$245K |
| 93976 |
|
1,466 |
1,297 |
$243K |
| 76856 |
|
1,121 |
1,004 |
$243K |
| 82728 |
|
21,725 |
19,080 |
$240K |
| 87491 |
|
20,825 |
18,619 |
$236K |
| 87633 |
|
972 |
833 |
$235K |
| 87591 |
|
20,824 |
18,618 |
$235K |
| 90471 |
|
72,880 |
65,499 |
$235K |
| 97168 |
|
2,372 |
2,190 |
$234K |
| 92610 |
|
2,841 |
2,604 |
$231K |
| 88313 |
|
2,623 |
2,201 |
$230K |
| J0131 |
Inj, acetaminophen (nos) |
13,467 |
12,094 |
$226K |
| 78816 |
|
143 |
125 |
$216K |
| 96112 |
|
933 |
812 |
$206K |
| 90670 |
|
21,772 |
20,418 |
$203K |
| 92555 |
|
4,931 |
4,546 |
$196K |
| 72141 |
|
568 |
515 |
$192K |
| 92582 |
|
2,640 |
2,434 |
$190K |
| 88185 |
|
1,566 |
1,271 |
$190K |
| 97167 |
|
1,396 |
1,298 |
$187K |
| 83735 |
|
22,442 |
14,157 |
$184K |
| 83036 |
|
36,197 |
33,067 |
$181K |
| 80197 |
|
5,767 |
3,153 |
$179K |
| 96138 |
|
926 |
830 |
$173K |
| 76827 |
|
1,785 |
1,233 |
$172K |
| J7999 |
Compounded drug, noc |
30,584 |
18,255 |
$170K |
| D3220 |
|
333 |
307 |
$169K |
| 74230 |
|
1,192 |
995 |
$167K |
| 76825 |
|
1,375 |
1,045 |
$167K |
| 87505 |
|
1,244 |
1,072 |
$164K |
| 00731 |
|
2,924 |
2,575 |
$162K |
| 00126 |
|
6,258 |
5,754 |
$161K |
| 88184 |
|
2,590 |
2,094 |
$161K |
| A0426 |
Als 1 |
1,491 |
1,295 |
$157K |
| 84439 |
|
11,721 |
10,417 |
$153K |
| 95951 |
|
279 |
215 |
$152K |
| 43762 |
|
927 |
800 |
$151K |
| J2997 |
Alteplase recombinant |
587 |
104 |
$149K |
| 49452 |
|
549 |
443 |
$144K |
| 73100 |
|
6,116 |
4,907 |
$144K |
| 92557 |
|
1,303 |
1,209 |
$144K |
| 90651 |
|
11,853 |
10,747 |
$143K |
| 82977 |
|
25,904 |
22,247 |
$139K |
| 71260 |
|
425 |
371 |
$139K |
| 76536 |
|
1,097 |
976 |
$138K |
| 87086 |
|
23,058 |
20,238 |
$138K |
| 83525 |
|
7,961 |
7,305 |
$137K |
| 90698 |
|
21,440 |
19,918 |
$137K |
| 82610 |
|
6,903 |
5,565 |
$137K |
| 99395 |
|
1,047 |
948 |
$132K |
| 87798 |
|
2,298 |
1,789 |
$132K |
| 90633 |
|
16,021 |
15,042 |
$131K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
5,297 |
4,742 |
$128K |
| 97113 |
|
1,195 |
595 |
$127K |
| 99155 |
|
860 |
735 |
$127K |
| 96375 |
|
6,434 |
4,850 |
$126K |
| 73090 |
|
4,486 |
3,256 |
$125K |
| 95700 |
|
1,081 |
973 |
$125K |
| 70544 |
|
462 |
396 |
$124K |
| 00920 |
|
2,065 |
1,882 |
$123K |
| 86140 |
|
17,358 |
14,775 |
$122K |
| 84100 |
|
21,978 |
14,564 |
$120K |
| J7307 |
Etonogestrel implant system |
108 |
101 |
$119K |
| Q0162 |
Ondansetron oral |
17,461 |
15,168 |
$118K |
| 92611 |
|
1,022 |
929 |
$117K |
| 81479 |
|
3,266 |
2,503 |
$116K |
| 95819 |
|
492 |
442 |
$115K |
| 96202 |
|
1,205 |
346 |
$115K |
| 72146 |
|
471 |
426 |
$113K |
| 97763 |
|
1,850 |
1,356 |
$110K |
| 74019 |
|
3,674 |
3,265 |
$109K |
| 72082 |
|
3,007 |
2,758 |
$108K |
| 82784 |
|
10,923 |
9,074 |
$107K |
| 94621 |
|
521 |
483 |
$107K |
| 74712 |
|
296 |
246 |
$104K |
| 53450 |
|
58 |
52 |
$103K |
| 51784 |
|
589 |
520 |
$101K |
| P9040 |
Rbc leukoreduced irradiated |
411 |
263 |
$101K |
| 86850 |
|
4,823 |
3,743 |
$101K |
| 80050 |
|
1,931 |
1,723 |
$97K |
| 96374 |
|
6,263 |
5,117 |
$97K |
| 64642 |
|
889 |
780 |
$97K |
| 82803 |
|
5,118 |
3,768 |
$96K |
| 87650 |
|
6,627 |
6,169 |
$96K |
| 83970 |
|
3,246 |
2,449 |
$95K |
| D2331 |
|
223 |
183 |
$95K |
| 90674 |
|
9,516 |
8,329 |
$95K |
| 00520 |
|
1,369 |
1,177 |
$94K |
| 73521 |
|
3,323 |
2,968 |
$94K |
| 76886 |
|
684 |
604 |
$94K |
| J7298 |
Mirena, 52 mg |
73 |
71 |
$94K |
| 96116 |
|
333 |
309 |
$93K |
| 95811 |
|
103 |
95 |
$93K |
| 97535 |
|
1,891 |
1,069 |
$93K |
| 92133 |
|
1,664 |
1,463 |
$92K |
| 96132 |
|
320 |
273 |
$92K |
| 97760 |
|
1,274 |
1,155 |
$92K |
| D0150 |
|
5,330 |
4,610 |
$91K |
| 0001A |
|
2,970 |
2,621 |
$90K |
| 83520 |
|
3,892 |
3,335 |
$88K |
| J2704 |
Inj, propofol, 10 mg |
37,468 |
30,180 |
$87K |
| Q3014 |
Telehealth facility fee |
4,210 |
4,111 |
$87K |
| 88307 |
|
643 |
535 |
$86K |
| 73630 |
|
4,484 |
3,920 |
$86K |
| 71250 |
|
359 |
328 |
$86K |
| 81025 |
|
26,954 |
23,495 |
$85K |
| 86900 |
|
5,886 |
4,421 |
$85K |
| 0002A |
|
2,516 |
2,333 |
$85K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
5,888 |
4,822 |
$84K |
| 96158 |
|
1,119 |
893 |
$84K |
| 99291 |
|
479 |
407 |
$83K |
| 0071A |
|
2,254 |
2,167 |
$83K |
| 83516 |
|
6,868 |
6,091 |
$83K |
| J3380 |
Inj vedolizumab iv 1 mg |
17 |
13 |
$82K |
| 86003 |
|
3,352 |
3,034 |
$82K |
| 97016 |
|
1,894 |
754 |
$82K |
| 96125 |
|
327 |
304 |
$81K |
| 99157 |
|
695 |
586 |
$81K |
| 29345 |
|
473 |
413 |
$80K |
| 90681 |
|
10,082 |
9,196 |
$79K |
| 86780 |
|
9,424 |
8,406 |
$79K |
| D2390 |
|
200 |
150 |
$78K |
| 70486 |
|
433 |
377 |
$78K |
| 73070 |
|
3,725 |
2,891 |
$77K |
| 83540 |
|
11,941 |
10,514 |
$77K |
| D2392 |
|
444 |
400 |
$77K |
| J3262 |
Tocilizumab injection |
48 |
24 |
$76K |
| 77075 |
|
552 |
443 |
$76K |
| 92250 |
|
1,971 |
1,744 |
$75K |
| 92553 |
|
805 |
715 |
$75K |
| D1120 |
|
6,217 |
5,543 |
$75K |
| 24640 |
|
269 |
227 |
$75K |
| 82247 |
|
6,231 |
4,616 |
$74K |
| 76881 |
|
640 |
561 |
$74K |
| 0072A |
|
1,959 |
1,938 |
$74K |
| 90839 |
|
426 |
359 |
$74K |
| 96040 |
|
2,120 |
1,942 |
$74K |
| 74240 |
|
467 |
428 |
$73K |
| 73590 |
|
3,492 |
2,931 |
$73K |
| 12002 |
|
302 |
271 |
$72K |
| 85027 |
|
26,351 |
24,241 |
$71K |
| 76870 |
|
1,014 |
904 |
$70K |
| 90710 |
|
6,882 |
6,311 |
$69K |
| 83550 |
|
10,583 |
9,387 |
$68K |
| 90744 |
|
11,116 |
10,273 |
$68K |
| 93975 |
|
327 |
257 |
$68K |
| 71045 |
|
2,997 |
2,516 |
$68K |
| 99454 |
|
609 |
541 |
$68K |
| 90619 |
|
7,022 |
6,043 |
$67K |
| 73610 |
|
4,083 |
3,551 |
$67K |
| 24538 |
|
13 |
13 |
$66K |
| 74270 |
|
389 |
334 |
$66K |
| 95117 |
|
1,878 |
954 |
$66K |
| 00813 |
|
938 |
804 |
$65K |
| C1769 |
Guide wire |
1,944 |
1,595 |
$65K |
| 88346 |
|
688 |
597 |
$65K |
| 00300 |
|
964 |
831 |
$64K |
| 90480 |
|
1,906 |
1,720 |
$64K |
| 91200 |
|
610 |
539 |
$63K |
| 87661 |
|
5,220 |
4,492 |
$63K |
| 85610 |
|
9,532 |
7,404 |
$63K |
| 97140 |
|
1,500 |
748 |
$62K |
| 70360 |
|
3,136 |
2,827 |
$61K |
| 90677 |
|
5,515 |
5,022 |
$60K |
| 90716 |
|
6,145 |
5,646 |
$60K |
| 36591 |
|
2,251 |
1,256 |
$59K |
| 87077 |
|
6,941 |
6,122 |
$59K |
| 75557 |
|
168 |
155 |
$59K |
| 90715 |
|
6,544 |
5,880 |
$59K |
| 96167 |
|
765 |
675 |
$59K |
| J8499 |
Oral prescrip drug non chemo |
8,522 |
4,878 |
$58K |
| 51798 |
|
1,056 |
950 |
$58K |
| 77080 |
|
776 |
656 |
$57K |
| 92556 |
|
1,143 |
1,047 |
$57K |
| 88342 |
|
1,578 |
1,328 |
$57K |
| 74455 |
|
369 |
333 |
$57K |
| 82947 |
|
12,963 |
11,653 |
$56K |
| 82607 |
|
4,014 |
3,631 |
$55K |
| 72081 |
|
1,885 |
1,699 |
$55K |
| 82248 |
|
8,503 |
6,428 |
$55K |
| 84403 |
|
4,085 |
3,576 |
$54K |
| 96131 |
|
3,709 |
3,412 |
$54K |
| 90707 |
|
6,263 |
5,754 |
$54K |
| 73140 |
|
3,212 |
2,667 |
$53K |
| 81513 |
|
314 |
252 |
$53K |
| 10060 |
|
255 |
222 |
$53K |
| 73560 |
|
2,932 |
2,557 |
$53K |
| 88341 |
|
449 |
347 |
$52K |
| G0463 |
Hospital outpt clinic visit |
2,640 |
1,246 |
$52K |
| 90685 |
|
6,744 |
6,278 |
$50K |
| 11900 |
|
246 |
225 |
$50K |
| 90648 |
|
8,971 |
8,338 |
$50K |
| 82330 |
|
4,796 |
3,502 |
$49K |
| 81003 |
|
23,956 |
20,263 |
$49K |
| 86481 |
|
2,994 |
2,625 |
$49K |
| 99281 |
|
447 |
434 |
$48K |
| 92083 |
|
534 |
475 |
$48K |
| 96372 |
|
4,657 |
3,667 |
$48K |
| 81001 |
|
21,495 |
18,881 |
$47K |
| 82542 |
|
3,891 |
3,490 |
$47K |
| 84450 |
|
13,992 |
12,720 |
$47K |
| 84460 |
|
13,817 |
12,562 |
$46K |
| 77072 |
|
1,521 |
1,359 |
$46K |
| 86901 |
|
5,810 |
4,378 |
$45K |
| 87389 |
|
8,763 |
7,879 |
$45K |
| 87070 |
|
5,925 |
5,144 |
$44K |
| J0561 |
Penicillin g benzathine inj |
218 |
171 |
$44K |
| G0108 |
Diab manage trn per indiv |
818 |
635 |
$43K |
| 00320 |
|
622 |
521 |
$43K |
| 88312 |
|
864 |
711 |
$43K |
| J1100 |
Dexamethasone sodium phos |
50,072 |
40,771 |
$43K |
| 36596 |
|
83 |
72 |
$42K |
| 72170 |
|
1,791 |
1,584 |
$42K |
| 85730 |
|
6,068 |
5,028 |
$41K |
| 82570 |
|
8,148 |
6,641 |
$41K |
| 92552 |
|
1,981 |
1,805 |
$41K |
| 88304 |
|
1,107 |
967 |
$41K |
| 0124A |
|
1,126 |
841 |
$41K |
| 83605 |
|
3,369 |
2,434 |
$41K |
| 73130 |
|
2,171 |
1,886 |
$41K |
| 85652 |
|
15,717 |
13,606 |
$41K |
| 94060 |
|
770 |
678 |
$40K |
| 90661 |
|
4,843 |
4,798 |
$40K |
| 96450 |
|
119 |
92 |
$40K |
| 96137 |
|
2,286 |
1,995 |
$40K |
| 92504 |
|
299 |
271 |
$39K |
| J3010 |
Fentanyl citrate injection |
53,913 |
43,038 |
$38K |
| 86923 |
|
1,064 |
698 |
$38K |
| 88108 |
|
1,746 |
1,489 |
$37K |
| 97542 |
|
370 |
339 |
$37K |
| 90723 |
|
4,794 |
4,448 |
$36K |
| 83993 |
|
1,857 |
1,650 |
$36K |
| 90734 |
|
3,113 |
3,057 |
$35K |
| 85240 |
|
1,783 |
1,538 |
$35K |
| 54640 |
|
21 |
16 |
$35K |
| 88300 |
|
5,372 |
4,822 |
$35K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
419 |
381 |
$34K |
| 94799 |
|
3,161 |
2,564 |
$34K |
| 82785 |
|
2,636 |
2,381 |
$34K |
| Q9958 |
Hocm <=149 mg/ml iodine, 1ml |
959 |
857 |
$33K |
| 82670 |
|
2,453 |
2,135 |
$33K |
| 72100 |
|
1,539 |
1,358 |
$33K |
| 69210 |
|
546 |
470 |
$33K |
| 90696 |
|
6,448 |
5,917 |
$32K |
| 29125 |
|
854 |
755 |
$32K |
| 00840 |
|
490 |
406 |
$32K |
| 87186 |
|
5,409 |
4,780 |
$32K |
| J2405 |
Ondansetron hcl injection |
43,693 |
37,145 |
$32K |
| D1110 |
|
313 |
277 |
$31K |
| 70491 |
|
76 |
63 |
$31K |
| 87641 |
|
1,076 |
976 |
$31K |
| 77073 |
|
1,220 |
1,093 |
$31K |
| 99221 |
|
55 |
46 |
$31K |
| 86355 |
|
1,338 |
1,165 |
$31K |
| 86706 |
|
5,716 |
5,097 |
$31K |
| 90700 |
|
4,367 |
4,054 |
$31K |
| 90472 |
|
35,339 |
31,844 |
$31K |
| 99458 |
|
542 |
475 |
$30K |
| 76506 |
|
215 |
178 |
$30K |
| 72070 |
|
1,427 |
1,264 |
$30K |
| 92522 |
|
322 |
297 |
$30K |
| 01920 |
|
230 |
188 |
$30K |
| 88271 |
|
383 |
270 |
$30K |
| 97014 |
|
882 |
445 |
$30K |
| 72040 |
|
1,784 |
1,591 |
$30K |
| 76821 |
|
264 |
176 |
$30K |
| 92015 |
|
2,377 |
2,220 |
$30K |
| 87205 |
|
7,962 |
6,938 |
$29K |
| 25565 |
|
96 |
74 |
$29K |
| 83880 |
|
1,247 |
1,002 |
$29K |
| 99244 |
|
241 |
229 |
$29K |
| 84145 |
|
2,097 |
1,793 |
$29K |
| 87040 |
|
4,464 |
3,786 |
$28K |
| 86803 |
|
5,680 |
5,113 |
$28K |
| 99243 |
|
389 |
328 |
$28K |
| 82550 |
|
4,259 |
3,661 |
$28K |
| 87400 |
|
982 |
928 |
$27K |
| 86360 |
|
1,266 |
1,095 |
$27K |
| 86359 |
|
1,339 |
1,166 |
$27K |
| 0154A |
|
718 |
579 |
$27K |
| 82105 |
|
1,351 |
1,154 |
$27K |
| 97163 |
|
223 |
204 |
$27K |
| 82962 |
|
4,803 |
2,856 |
$27K |
| 86480 |
|
1,309 |
1,240 |
$26K |
| 86357 |
|
1,341 |
1,167 |
$26K |
| 83690 |
|
6,656 |
5,764 |
$26K |
| 00140 |
|
529 |
446 |
$26K |
| 84305 |
|
1,539 |
1,366 |
$26K |
| 92134 |
|
460 |
405 |
$26K |
| 93788 |
|
293 |
252 |
$25K |
| C1894 |
Intro/sheath, non-laser |
773 |
651 |
$25K |
| 0081A |
|
704 |
579 |
$25K |
| 00120 |
|
225 |
205 |
$25K |
| 73552 |
|
1,567 |
1,318 |
$25K |
| 85046 |
|
8,262 |
6,709 |
$25K |
| 87496 |
|
486 |
315 |
$25K |
| 82746 |
|
2,795 |
2,557 |
$24K |
| 83020 |
|
2,396 |
1,974 |
$24K |
| 87340 |
|
5,496 |
4,929 |
$24K |
| 86038 |
|
1,672 |
1,476 |
$24K |
| J7120 |
Ringers lactate infusion |
6,231 |
4,684 |
$24K |
| 87102 |
|
2,821 |
2,442 |
$24K |
| 87634 |
|
2,187 |
1,924 |
$23K |
| 00400 |
|
492 |
438 |
$23K |
| 81406 |
|
322 |
281 |
$23K |
| 87486 |
|
954 |
822 |
$23K |
| 83519 |
|
1,522 |
1,338 |
$23K |
| 81405 |
|
357 |
308 |
$22K |
| 86665 |
|
1,751 |
1,478 |
$21K |
| 81415 |
|
29 |
28 |
$21K |
| 85245 |
|
1,063 |
941 |
$21K |
| 85246 |
|
1,288 |
1,142 |
$21K |
| 86704 |
|
4,668 |
4,183 |
$21K |
| 92607 |
|
223 |
194 |
$21K |
| 82533 |
|
828 |
673 |
$21K |
| 92018 |
|
18 |
12 |
$21K |
| 78264 |
|
64 |
60 |
$20K |
| 49500 |
|
12 |
12 |
$20K |
| J2001 |
Lidocaine injection |
6,135 |
4,919 |
$20K |
| 85014 |
|
4,348 |
3,634 |
$20K |
| 84146 |
|
1,444 |
1,258 |
$20K |
| 91320 |
|
763 |
669 |
$20K |
| 94726 |
|
358 |
331 |
$20K |
| 95076 |
|
47 |
41 |
$20K |
| 87581 |
|
956 |
824 |
$20K |
| 95115 |
|
559 |
241 |
$20K |
| 00160 |
|
258 |
237 |
$20K |
| 51701 |
|
916 |
785 |
$19K |
| J1750 |
Inj iron dextran |
103 |
90 |
$19K |
| 36592 |
|
1,355 |
710 |
$19K |
| 72142 |
|
96 |
87 |
$19K |
| 94618 |
|
187 |
155 |
$19K |
| 90680 |
|
2,169 |
2,059 |
$19K |
| 70480 |
|
77 |
73 |
$19K |
| 88275 |
|
319 |
221 |
$19K |
| 73030 |
|
1,141 |
1,009 |
$19K |
| 70250 |
|
629 |
533 |
$19K |
| 54150 |
|
14 |
12 |
$18K |
| 83002 |
|
1,069 |
953 |
$18K |
| 84156 |
|
4,986 |
3,816 |
$18K |
| 85247 |
|
1,115 |
993 |
$18K |
| 86849 |
|
457 |
409 |
$18K |
| 80299 |
|
798 |
531 |
$18K |
| 90675 |
|
53 |
14 |
$18K |
| 93505 |
|
17 |
13 |
$17K |
| 87801 |
|
1,525 |
1,348 |
$17K |
| 83001 |
|
1,556 |
1,378 |
$17K |
| 92585 |
|
46 |
42 |
$17K |
| 86160 |
|
1,482 |
1,148 |
$17K |
| J3590 |
Unclassified biologics |
190 |
162 |
$16K |
| 86376 |
|
1,334 |
1,185 |
$16K |
| 81403 |
|
113 |
89 |
$16K |
| D2335 |
|
17 |
17 |
$16K |
| J2515 |
Pentobarbital sodium inj |
430 |
361 |
$16K |
| 87493 |
|
430 |
393 |
$16K |
| D0272 |
|
1,951 |
1,683 |
$16K |
| 73564 |
|
861 |
761 |
$16K |
| 86664 |
|
1,577 |
1,370 |
$16K |
| J2795 |
Ropivacaine hcl injection |
6,167 |
5,426 |
$16K |
| 76811 |
|
101 |
82 |
$15K |
| 71555 |
|
36 |
31 |
$15K |
| 80164 |
|
1,033 |
908 |
$15K |
| 87808 |
|
4,776 |
4,212 |
$15K |
| 0082A |
|
405 |
383 |
$15K |
| 51600 |
|
199 |
170 |
$15K |
| 90732 |
|
414 |
335 |
$14K |
| 99403 |
|
52 |
48 |
$14K |
| 99238 |
|
49 |
47 |
$14K |
| L3060 |
Foot arch supp longitud/meta |
724 |
675 |
$14K |
| 93000 |
|
732 |
678 |
$14K |
| 87529 |
|
785 |
677 |
$14K |
| 90717 |
|
95 |
92 |
$14K |
| D7111 |
|
28 |
26 |
$14K |
| 81244 |
|
328 |
253 |
$14K |
| 73000 |
|
943 |
819 |
$14K |
| 83615 |
|
2,392 |
1,609 |
$13K |
| 95957 |
|
135 |
112 |
$13K |
| 94770 |
|
185 |
172 |
$13K |
| 73060 |
|
905 |
765 |
$13K |
| 84590 |
|
1,344 |
1,200 |
$13K |
| 51727 |
|
42 |
40 |
$13K |
| 93226 |
|
195 |
180 |
$13K |
| 87071 |
|
1,679 |
1,442 |
$13K |
| 73660 |
|
734 |
639 |
$13K |
| 84252 |
|
1,481 |
1,354 |
$13K |
| 80320 |
|
496 |
428 |
$13K |
| 96101 |
|
91 |
89 |
$13K |
| 84270 |
|
1,081 |
925 |
$13K |
| 92524 |
|
187 |
167 |
$13K |
| 0051A |
|
368 |
327 |
$13K |
| 93971 |
|
134 |
116 |
$12K |
| 88237 |
|
113 |
82 |
$12K |
| 76010 |
|
810 |
710 |
$12K |
| 81382 |
|
48 |
24 |
$12K |
| J0690 |
Cefazolin sodium injection |
4,898 |
3,595 |
$12K |
| J1756 |
Iron sucrose injection |
368 |
204 |
$12K |
| D0240 |
|
1,420 |
1,199 |
$12K |
| 88188 |
|
346 |
287 |
$12K |
| 75561 |
|
13 |
12 |
$12K |
| 80169 |
|
610 |
386 |
$12K |
| 84295 |
|
3,938 |
3,186 |
$12K |
| 84155 |
|
1,918 |
1,520 |
$12K |
| 82948 |
|
971 |
763 |
$12K |
| 76642 |
|
103 |
86 |
$11K |
| 36430 |
|
84 |
52 |
$11K |
| P9016 |
Rbc leukocytes reduced |
37 |
27 |
$11K |
| 76857 |
|
98 |
84 |
$11K |
| 93296 |
|
306 |
273 |
$11K |
| P9037 |
Plate pheres leukoredu irrad |
20 |
12 |
$11K |
| 84446 |
|
1,194 |
1,071 |
$11K |
| 92583 |
|
339 |
307 |
$11K |
| 81243 |
|
330 |
255 |
$10K |
| 82379 |
|
869 |
798 |
$10K |
| 95199 |
|
747 |
658 |
$10K |
| 84075 |
|
2,045 |
1,619 |
$10K |
| 84132 |
|
4,020 |
3,187 |
$10K |
| J1815 |
Insulin injection |
707 |
321 |
$10K |
| 81265 |
|
50 |
37 |
$10K |
| 69200 |
|
332 |
274 |
$10K |
| 82627 |
|
701 |
593 |
$10K |
| 87536 |
|
441 |
354 |
$10K |
| 87177 |
|
474 |
396 |
$10K |
| 99204 |
|
106 |
90 |
$10K |
| 92228 |
|
120 |
116 |
$10K |
| 87265 |
|
958 |
821 |
$10K |
| J7030 |
Normal saline solution infus |
1,837 |
1,113 |
$10K |
| C1726 |
Cath, bal dil, non-vascular |
201 |
149 |
$10K |
| J0134 |
Inj acetaminophen -fresenius |
3,527 |
3,256 |
$10K |
| J2270 |
Morphine sulfate injection |
5,677 |
5,100 |
$10K |
| D1206 |
|
623 |
608 |
$10K |
| J1885 |
Ketorolac tromethamine inj |
10,925 |
9,030 |
$10K |
| 86317 |
|
382 |
332 |
$10K |
| 93225 |
|
195 |
180 |
$10K |
| 00940 |
|
40 |
38 |
$10K |
| 81259 |
|
46 |
38 |
$10K |
| 85384 |
|
1,811 |
1,414 |
$9K |
| 76800 |
|
62 |
61 |
$9K |
| 86308 |
|
1,184 |
1,048 |
$9K |
| 73562 |
|
612 |
532 |
$9K |
| 99156 |
|
621 |
512 |
$9K |
| 76499 |
|
238 |
213 |
$9K |
| 73620 |
|
592 |
499 |
$9K |
| 88230 |
|
87 |
66 |
$9K |
| 73110 |
|
378 |
335 |
$9K |
| 92550 |
|
73 |
65 |
$9K |
| 0052A |
|
226 |
222 |
$8K |
| C1887 |
Catheter, guiding |
435 |
371 |
$8K |
| 12013 |
|
43 |
39 |
$8K |
| 84703 |
|
2,133 |
1,893 |
$8K |
| 85018 |
|
2,517 |
2,229 |
$8K |
| 90380 |
|
615 |
435 |
$8K |
| 72147 |
|
39 |
37 |
$8K |
| 0173A |
|
221 |
159 |
$8K |
| 31575 |
|
28 |
27 |
$8K |
| 88187 |
|
500 |
430 |
$8K |
| 82310 |
|
1,422 |
1,097 |
$8K |
| G0480 |
Drug test def 1-7 classes |
111 |
85 |
$8K |
| 81226 |
|
76 |
70 |
$8K |
| 93017 |
|
57 |
57 |
$8K |
| D7240 |
|
12 |
12 |
$7K |
| 58300 |
|
55 |
55 |
$7K |
| 87522 |
Neg quan hep c or qual rna |
298 |
284 |
$7K |
| 90849 |
|
41 |
14 |
$7K |
| 96113 |
|
593 |
504 |
$7K |
| 90381 |
|
783 |
565 |
$7K |
| 81225 |
|
89 |
83 |
$7K |
| J1644 |
Inj heparin sodium per 1000u |
4,339 |
861 |
$7K |
| 86141 |
|
670 |
565 |
$7K |
| 84466 |
|
921 |
789 |
$7K |
| J2250 |
Inj midazolam hydrochloride |
10,514 |
9,247 |
$7K |
| 86644 |
|
208 |
153 |
$7K |
| 80230 |
|
532 |
454 |
$7K |
| 83498 |
|
694 |
592 |
$7K |
| 91319 |
|
634 |
581 |
$7K |
| J2710 |
Neostigmine methylslfte inj |
855 |
779 |
$6K |
| J0696 |
Ceftriaxone sodium injection |
4,087 |
2,872 |
$6K |
| 82525 |
|
631 |
556 |
$6K |
| 82043 |
|
1,939 |
1,721 |
$6K |
| 82397 |
|
871 |
736 |
$6K |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
157 |
133 |
$6K |
| 96111 |
|
45 |
42 |
$6K |
| 80306 |
|
887 |
775 |
$6K |
| 80195 |
|
331 |
248 |
$6K |
| 86800 |
|
656 |
595 |
$6K |
| 87481 |
|
313 |
251 |
$6K |
| 82272 |
|
609 |
502 |
$6K |
| 84480 |
|
568 |
474 |
$6K |
| 87209 |
|
474 |
396 |
$6K |
| 0073A |
|
163 |
155 |
$6K |
| 86353 |
|
49 |
37 |
$6K |
| 84630 |
|
791 |
691 |
$6K |
| 84484 |
|
739 |
619 |
$6K |
| 73600 |
|
311 |
267 |
$6K |
| 0003A |
|
156 |
156 |
$6K |
| 85250 |
|
407 |
336 |
$6K |
| 82436 |
|
602 |
463 |
$6K |
| J1642 |
Inj heparin sodium per 10 u |
3,501 |
1,854 |
$6K |
| 91318 |
|
554 |
514 |
$6K |
| 72125 |
|
44 |
37 |
$5K |
| D0120 |
|
291 |
280 |
$5K |
| 92612 |
|
28 |
26 |
$5K |
| 84300 |
|
925 |
723 |
$5K |
| 73080 |
|
119 |
105 |
$5K |
| 90691 |
|
369 |
361 |
$5K |
| 82747 |
|
749 |
666 |
$5K |
| 82465 |
|
2,134 |
1,935 |
$5K |
| 83992 |
|
512 |
412 |
$5K |
| 76830 |
|
48 |
37 |
$5K |
| 84478 |
|
1,386 |
1,066 |
$5K |
| 86225 |
|
586 |
474 |
$5K |
| A9573 |
Inj, gadopiclenol, 1 ml |
434 |
425 |
$5K |
| 74220 |
|
61 |
56 |
$5K |
| 0053A |
|
136 |
136 |
$5K |
| 83021 |
|
247 |
202 |
$5K |
| 76376 |
|
95 |
87 |
$5K |
| 84238 |
|
254 |
198 |
$5K |
| 82040 |
|
1,145 |
998 |
$5K |
| 86255 |
|
411 |
341 |
$4K |
| 76942 |
|
132 |
102 |
$4K |
| 92060 |
|
76 |
69 |
$4K |
| S9443 |
Lactation class |
4,231 |
3,231 |
$4K |
| 82378 |
|
237 |
204 |
$4K |
| 00635 |
|
142 |
104 |
$4K |
| 82150 |
|
959 |
824 |
$4K |
| 82390 |
|
564 |
493 |
$4K |
| 96900 |
|
162 |
29 |
$4K |
| 86337 |
|
320 |
282 |
$4K |
| 96401 |
|
59 |
49 |
$4K |
| 86341 |
|
389 |
341 |
$4K |
| 82103 |
|
382 |
323 |
$4K |
| 87269 |
|
277 |
246 |
$4K |
| 86235 |
|
316 |
276 |
$4K |
| 84255 |
|
319 |
279 |
$4K |
| 85045 |
|
1,130 |
938 |
$4K |
| 80183 |
|
392 |
341 |
$4K |
| 93786 |
|
211 |
196 |
$4K |
| 43760 |
|
12 |
12 |
$4K |
| 80329 |
|
1,016 |
820 |
$4K |
| 90474 |
|
7,787 |
6,989 |
$4K |
| 84702 |
|
270 |
230 |
$3K |
| 84436 |
|
458 |
400 |
$3K |
| 84133 |
|
628 |
489 |
$3K |
| 71100 |
|
78 |
65 |
$3K |
| 87272 |
|
278 |
247 |
$3K |
| 17250 |
|
17 |
12 |
$3K |
| 84550 |
|
954 |
788 |
$3K |
| 87088 |
|
791 |
698 |
$3K |
| 0174A |
|
87 |
62 |
$3K |
| 29450 |
|
26 |
14 |
$3K |
| 86677 |
|
220 |
198 |
$3K |
| G2023 |
Specimen collect covid-19 |
229 |
197 |
$3K |
| 82140 |
|
262 |
226 |
$3K |
| 70496 |
|
15 |
12 |
$3K |
| J1170 |
Hydromorphone injection |
1,063 |
882 |
$3K |
| 96376 |
|
336 |
226 |
$3K |
| 93886 |
|
12 |
12 |
$3K |
| 82657 |
|
250 |
217 |
$3K |
| J0171 |
Adrenalin epinephrine inject |
1,134 |
954 |
$3K |
| J0295 |
Ampicillin sulbactam 1.5 gm |
879 |
241 |
$3K |
| 85347 |
|
758 |
558 |
$3K |
| J7613 |
Albuterol non-comp unit |
5,189 |
3,750 |
$3K |
| 86703 |
|
1,031 |
875 |
$3K |
| 73700 |
|
13 |
12 |
$3K |
| 83010 |
|
164 |
111 |
$3K |
| J1610 |
Glucagon hydrochloride/1 mg |
16 |
12 |
$3K |
| 96203 |
|
914 |
266 |
$3K |
| 82565 |
|
419 |
369 |
$2K |
| 86787 |
|
186 |
158 |
$2K |
| 84681 |
|
303 |
251 |
$2K |
| 80201 |
|
289 |
256 |
$2K |
| 80177 |
|
198 |
178 |
$2K |
| 92626 |
|
29 |
29 |
$2K |
| 80323 |
|
588 |
484 |
$2K |
| 30901 |
|
13 |
12 |
$2K |
| 87880 |
|
463 |
451 |
$2K |
| D2332 |
|
15 |
15 |
$2K |
| 75565 |
|
34 |
30 |
$2K |
| 01830 |
|
34 |
27 |
$2K |
| 95714 |
|
23 |
16 |
$2K |
| 93356 |
|
77 |
75 |
$2K |
| 89051 |
|
488 |
417 |
$2K |
| 82010 |
|
221 |
190 |
$2K |
| 84425 |
|
197 |
179 |
$2K |
| 82104 |
|
270 |
226 |
$2K |
| 76816 |
|
41 |
24 |
$2K |
| 85230 |
|
136 |
106 |
$2K |
| 86431 |
|
231 |
205 |
$2K |
| 00790 |
|
14 |
13 |
$2K |
| 87101 |
|
583 |
484 |
$2K |
| 81470 |
|
14 |
12 |
$2K |
| 86769 |
|
43 |
39 |
$2K |
| 95712 |
|
29 |
26 |
$2K |
| 96139 |
|
939 |
838 |
$2K |
| 86902 |
|
81 |
51 |
$2K |
| J1720 |
Hydrocortisone sodium succ i |
455 |
297 |
$2K |
| 85270 |
|
172 |
150 |
$2K |
| 90713 |
|
235 |
197 |
$2K |
| 80325 |
|
554 |
450 |
$2K |
| J2930 |
Methylprednisolone injection |
974 |
652 |
$2K |
| 29105 |
|
49 |
36 |
$2K |
| 84134 |
|
167 |
153 |
$2K |
| 85397 |
|
109 |
101 |
$2K |
| 95012 |
|
221 |
203 |
$2K |
| J7060 |
5% dextrose/water |
195 |
128 |
$2K |
| J0780 |
Prochlorperazine injection |
1,132 |
983 |
$2K |
| 86645 |
|
97 |
82 |
$2K |
| 85379 |
|
290 |
235 |
$2K |
| 96102 |
|
12 |
12 |
$2K |
| 76817 |
|
25 |
12 |
$2K |
| 82139 |
|
138 |
109 |
$2K |
| 83921 |
|
147 |
124 |
$1K |
| 84520 |
|
539 |
430 |
$1K |
| 80353 |
|
520 |
422 |
$1K |
| 80348 |
|
509 |
413 |
$1K |
| 82805 |
|
15 |
12 |
$1K |
| 85576 |
|
40 |
37 |
$1K |
| 84210 |
|
151 |
118 |
$1K |
| 0083A |
|
35 |
34 |
$1K |
| J3475 |
Inj magnesium sulfate |
217 |
151 |
$1K |
| 83935 |
|
274 |
230 |
$1K |
| 87106 |
|
281 |
251 |
$1K |
| 87075 |
|
340 |
290 |
$1K |
| 77081 |
|
31 |
28 |
$1K |
| 99203 |
|
13 |
13 |
$1K |
| 73120 |
|
50 |
40 |
$1K |
| 86015 |
|
125 |
111 |
$1K |
| 94729 |
|
28 |
26 |
$1K |
| J0330 |
Succinycholine chloride inj |
113 |
107 |
$1K |
| 01480 |
|
28 |
24 |
$998.43 |
| J7611 |
Albuterol non-comp con |
2,667 |
1,968 |
$984.83 |
| 36416 |
|
1,218 |
1,022 |
$981.18 |
| 88104 |
|
63 |
51 |
$949.85 |
| 86880 |
|
74 |
64 |
$941.91 |
| 80158 |
|
80 |
37 |
$937.72 |
| 96160 |
|
31 |
31 |
$914.50 |
| 80345 |
|
121 |
101 |
$880.90 |
| 80307 |
|
14 |
12 |
$869.31 |
| 80346 |
|
223 |
189 |
$862.66 |
| J3301 |
Triamcinolone acet inj nos |
585 |
501 |
$855.50 |
| 82540 |
|
94 |
84 |
$854.02 |
| 76981 |
|
12 |
12 |
$852.43 |
| 84165 |
|
60 |
58 |
$843.76 |
| S9485 |
Crisis intervention mental h |
32 |
29 |
$818.94 |
| 94680 |
|
31 |
31 |
$817.88 |
| 87181 |
|
74 |
63 |
$797.50 |
| 92604 |
|
28 |
26 |
$789.94 |
| 86592 |
|
116 |
102 |
$771.00 |
| 92014 |
|
12 |
12 |
$768.47 |
| 0012A |
|
26 |
26 |
$751.34 |
| 76937 |
|
18 |
16 |
$744.19 |
| 73565 |
|
12 |
12 |
$704.96 |
| 80178 |
|
30 |
25 |
$703.40 |
| 99453 |
|
18 |
15 |
$699.24 |
| 01400 |
|
25 |
25 |
$689.38 |
| 86618 |
|
71 |
60 |
$671.63 |
| J9370 |
Vincristine sulfate 1 mg inj |
341 |
183 |
$656.66 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,316 |
1,165 |
$644.99 |
| J2919 |
Inj, methylpred sod succ 5mg |
387 |
299 |
$618.20 |
| J8540 |
Oral dexamethasone |
2,473 |
1,152 |
$605.84 |
| 51741 |
|
25 |
25 |
$575.13 |
| 76882 |
|
26 |
24 |
$565.42 |
| 96381 |
|
928 |
768 |
$564.36 |
| 30300 |
|
61 |
57 |
$547.12 |
| 80358 |
|
121 |
101 |
$527.92 |
| 01730 |
|
14 |
14 |
$499.84 |
| 87210 |
|
381 |
336 |
$499.02 |
| 00930 |
|
19 |
14 |
$489.72 |
| 80369 |
|
121 |
101 |
$484.94 |
| 83090 |
|
93 |
72 |
$482.44 |
| 86828 |
|
14 |
12 |
$475.92 |
| 72149 |
|
16 |
14 |
$469.66 |
| 88348 |
|
15 |
12 |
$451.65 |
| 0151A |
|
13 |
12 |
$441.54 |
| 80364 |
|
149 |
126 |
$437.93 |
| 86708 |
|
60 |
50 |
$431.88 |
| 86705 |
|
15 |
12 |
$419.81 |
| 80175 |
|
34 |
30 |
$419.07 |
| J1836 |
Inj, metronidazole, 10 mg |
230 |
152 |
$416.92 |
| 0011A |
|
63 |
29 |
$411.64 |
| 69209 |
|
247 |
210 |
$409.84 |
| J7644 |
Ipratropium bromide non-comp |
2,251 |
1,805 |
$408.91 |
| 86735 |
|
36 |
30 |
$400.04 |
| 88311 |
|
52 |
51 |
$393.31 |
| J3360 |
Diazepam injection |
152 |
130 |
$388.10 |
| 96121 |
|
45 |
44 |
$366.00 |
| L4361 |
Pneuma/vac walk boot pre ots |
12 |
12 |
$354.63 |
| 86765 |
|
35 |
29 |
$335.65 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
157 |
137 |
$327.32 |
| 83695 |
|
24 |
24 |
$327.18 |
| J7510 |
Prednisolone oral per 5 mg |
919 |
719 |
$320.44 |
| 95165 |
|
12 |
12 |
$311.79 |
| D0140 |
|
12 |
12 |
$311.64 |
| 96133 |
|
65 |
56 |
$305.80 |
| J1200 |
Diphenhydramine hcl injectio |
1,085 |
664 |
$282.86 |
| 00830 |
|
29 |
26 |
$282.28 |
| 80145 |
|
18 |
14 |
$281.35 |
| 95873 |
|
35 |
32 |
$278.95 |
| 83721 |
|
47 |
41 |
$276.54 |
| 82653 |
|
15 |
13 |
$272.04 |
| 82180 |
|
34 |
33 |
$261.61 |
| 83883 |
|
29 |
29 |
$249.94 |
| 76377 |
|
14 |
13 |
$210.68 |
| J0136 |
Inj, acetaminophen (b braun) |
145 |
133 |
$205.95 |
| J0736 |
Inj, clindamycin phosp 300mg |
84 |
57 |
$196.52 |
| 86762 |
|
16 |
13 |
$193.85 |
| 92608 |
|
67 |
59 |
$187.99 |
| 80203 |
|
26 |
26 |
$185.65 |
| 83919 |
|
13 |
12 |
$178.95 |
| 84207 |
|
18 |
13 |
$145.60 |
| 82085 |
|
50 |
42 |
$145.06 |
| J3420 |
Vitamin b12 injection |
21 |
13 |
$120.84 |
| 82945 |
|
15 |
12 |
$117.14 |
| 82017 |
|
15 |
12 |
$115.16 |
| J7507 |
Tacrolimus imme rel oral 1mg |
50 |
14 |
$104.75 |
| 84220 |
|
12 |
12 |
$103.85 |
| 80361 |
|
47 |
38 |
$99.57 |
| 88738 |
|
16 |
15 |
$98.28 |
| 70210 |
|
27 |
26 |
$85.81 |
| J1597 |
Inj glycopyrrolate, glyrx-pf |
96 |
93 |
$85.31 |
| 80356 |
|
47 |
38 |
$84.92 |
| 80373 |
|
47 |
38 |
$84.92 |
| 80360 |
|
47 |
38 |
$84.92 |
| Q0163 |
Diphenhydramine hcl 50mg |
683 |
541 |
$81.83 |
| 87339 |
|
38 |
27 |
$81.60 |
| 80365 |
|
47 |
38 |
$59.08 |
| 85999 |
|
55 |
52 |
$58.63 |
| 80363 |
|
27 |
25 |
$55.13 |
| 80357 |
|
47 |
38 |
$54.95 |
| 80341 |
|
47 |
38 |
$54.95 |
| 80371 |
|
47 |
38 |
$54.95 |
| 80359 |
|
47 |
38 |
$54.95 |
| 80368 |
|
47 |
38 |
$54.95 |
| 80355 |
|
47 |
38 |
$54.95 |
| 80334 |
|
47 |
38 |
$54.95 |
| 80344 |
|
47 |
38 |
$54.95 |
| 80372 |
|
47 |
38 |
$54.95 |
| 80337 |
|
47 |
38 |
$54.95 |
| 80366 |
|
47 |
38 |
$54.95 |
| 80338 |
|
47 |
38 |
$54.95 |
| J0834 |
Inj., cosyntropin, 0.25 mg |
17 |
16 |
$54.11 |
| 93568 |
|
23 |
14 |
$53.09 |
| 85300 |
|
14 |
12 |
$52.23 |
| 80347 |
|
27 |
25 |
$50.35 |
| 91300 |
|
4,974 |
4,291 |
$44.07 |
| 91307 |
|
4,529 |
4,269 |
$43.73 |
| J9250 |
Methotrexate sodium inj |
129 |
81 |
$41.90 |
| J7512 |
Prednisone ir or dr oral 1mg |
356 |
209 |
$41.83 |
| 85670 |
|
13 |
12 |
$34.28 |
| 80370 |
|
27 |
25 |
$32.24 |
| J1940 |
Furosemide injection |
25 |
13 |
$13.51 |
| 91308 |
|
1,230 |
1,038 |
$11.40 |
| 91305 |
|
1,054 |
947 |
$9.55 |
| 91312 |
|
1,066 |
802 |
$8.52 |
| 91315 |
|
739 |
599 |
$6.78 |
| J3480 |
Inj potassium chloride |
16 |
12 |
$6.24 |
| 91317 |
|
252 |
177 |
$2.35 |
| J2060 |
Lorazepam injection |
13 |
13 |
$0.71 |
| 91301 |
|
83 |
49 |
$0.39 |
| 96168 |
|
282 |
232 |
$0.00 |
| 87081 |
|
13 |
12 |
$0.00 |
| 96159 |
|
385 |
278 |
$0.00 |