| Code | Description | Claims | Beneficiaries | Total Paid |
| 99283 |
|
81,708 |
76,735 |
$9.34M |
| 99284 |
|
72,558 |
65,133 |
$8.75M |
| G0463 |
Hospital outpt clinic visit |
81,939 |
71,497 |
$6.58M |
| 99285 |
|
44,229 |
38,019 |
$5.96M |
| 70450 |
|
20,282 |
17,909 |
$4.99M |
| 74177 |
|
11,545 |
9,999 |
$2.88M |
| 96361 |
|
5,684 |
4,122 |
$1.81M |
| 99282 |
|
20,119 |
19,160 |
$1.80M |
| 80053 |
|
142,769 |
121,515 |
$1.72M |
| 71275 |
|
3,498 |
2,976 |
$929K |
| 74176 |
|
3,649 |
3,123 |
$923K |
| G0378 |
Hospital observation per hr |
10,873 |
4,332 |
$727K |
| U0003 |
Cov-19 amp prb hgh thruput |
5,643 |
3,664 |
$614K |
| 84443 |
|
29,505 |
27,179 |
$581K |
| 96366 |
|
2,231 |
1,354 |
$578K |
| 78452 |
|
1,406 |
1,210 |
$549K |
| 93306 |
|
2,256 |
2,007 |
$535K |
| 96365 |
|
4,051 |
2,846 |
$523K |
| 92507 |
|
7,403 |
2,642 |
$522K |
| 11042 |
|
4,547 |
2,011 |
$469K |
| 85025 |
|
143,745 |
119,337 |
$464K |
| 97530 |
|
7,955 |
2,656 |
$444K |
| 96413 |
|
4,022 |
2,207 |
$359K |
| 80061 |
|
29,132 |
27,101 |
$358K |
| 99212 |
|
3,932 |
3,741 |
$342K |
| 94640 |
|
2,724 |
1,453 |
$298K |
| 97110 |
|
4,993 |
1,399 |
$292K |
| 80307 |
|
20,906 |
17,421 |
$268K |
| 82306 |
|
12,182 |
11,013 |
$257K |
| 43239 |
|
558 |
444 |
$210K |
| 83036 |
|
18,145 |
16,692 |
$188K |
| 80048 |
|
26,244 |
20,373 |
$188K |
| 83605 |
|
38,124 |
30,964 |
$185K |
| H2020 |
Ther behav svc, per diem |
1,279 |
233 |
$182K |
| 36415 |
|
127,953 |
103,466 |
$171K |
| 70496 |
|
652 |
565 |
$169K |
| 96360 |
|
1,760 |
1,398 |
$167K |
| 87636 |
|
10,184 |
8,628 |
$167K |
| 70491 |
|
556 |
465 |
$165K |
| 0202U |
|
1,343 |
1,172 |
$164K |
| 84484 |
|
47,595 |
34,892 |
$158K |
| 93017 |
|
1,811 |
1,580 |
$151K |
| 76705 |
|
1,633 |
1,404 |
$143K |
| 76856 |
|
830 |
727 |
$143K |
| 87635 |
|
12,738 |
7,945 |
$142K |
| 84439 |
|
8,954 |
8,219 |
$141K |
| 11045 |
|
377 |
156 |
$134K |
| 76642 |
|
1,079 |
966 |
$129K |
| 77067 |
|
2,934 |
2,692 |
$128K |
| 85027 |
|
21,017 |
18,039 |
$128K |
| 71046 |
|
18,133 |
16,587 |
$123K |
| 93458 |
|
150 |
118 |
$123K |
| 93005 |
|
54,635 |
46,493 |
$120K |
| S9472 |
Cardiac rehabilitation progr |
1,442 |
200 |
$117K |
| 80320 |
|
8,688 |
7,193 |
$109K |
| 87801 |
|
2,186 |
1,981 |
$108K |
| 93798 |
|
1,809 |
285 |
$108K |
| 71045 |
|
29,423 |
25,720 |
$104K |
| 72131 |
|
1,782 |
1,540 |
$97K |
| 71250 |
|
1,323 |
1,185 |
$96K |
| 70553 |
|
451 |
392 |
$93K |
| 93970 |
|
654 |
572 |
$92K |
| 87491 |
|
4,977 |
4,478 |
$91K |
| 77334 |
|
264 |
204 |
$90K |
| 99392 |
|
925 |
895 |
$86K |
| 97161 |
|
1,831 |
1,577 |
$86K |
| 99213 |
|
954 |
830 |
$83K |
| 12001 |
|
532 |
469 |
$81K |
| 93971 |
|
1,347 |
1,172 |
$79K |
| 72125 |
|
7,435 |
6,546 |
$78K |
| 99391 |
|
913 |
841 |
$78K |
| 82607 |
|
5,198 |
4,585 |
$77K |
| 87591 |
|
4,934 |
4,441 |
$73K |
| 86900 |
|
3,832 |
3,104 |
$67K |
| 96374 |
|
47,675 |
40,948 |
$65K |
| 82728 |
|
3,380 |
2,999 |
$62K |
| 72148 |
|
460 |
413 |
$62K |
| 71271 |
|
466 |
431 |
$62K |
| 87086 |
|
6,781 |
5,934 |
$61K |
| 95911 |
|
246 |
219 |
$59K |
| 99281 |
|
484 |
409 |
$59K |
| 77336 |
|
695 |
326 |
$57K |
| 86803 |
|
2,525 |
2,238 |
$57K |
| 10060 |
|
335 |
269 |
$54K |
| G0382 |
Lev 3 hosp type b ed visit |
644 |
636 |
$54K |
| 93975 |
|
625 |
489 |
$53K |
| 45380 |
|
123 |
95 |
$53K |
| 97165 |
|
1,135 |
960 |
$52K |
| 70551 |
|
367 |
332 |
$52K |
| 71260 |
|
1,233 |
1,069 |
$50K |
| 41899 |
|
102 |
70 |
$50K |
| 95886 |
|
856 |
771 |
$49K |
| 87502 |
|
4,846 |
4,483 |
$47K |
| 76830 |
|
872 |
752 |
$46K |
| 94060 |
|
548 |
485 |
$46K |
| 88305 |
|
2,803 |
2,110 |
$45K |
| 86850 |
|
3,540 |
2,894 |
$45K |
| 76536 |
|
473 |
435 |
$45K |
| 87624 |
|
1,270 |
1,197 |
$44K |
| 87088 |
|
7,463 |
6,616 |
$42K |
| 86140 |
|
4,707 |
3,547 |
$42K |
| 96372 |
|
36,507 |
29,839 |
$42K |
| 81001 |
|
51,729 |
46,138 |
$42K |
| 99393 |
|
440 |
433 |
$42K |
| 96367 |
|
738 |
507 |
$40K |
| 76770 |
|
281 |
249 |
$40K |
| 83880 |
|
9,533 |
7,528 |
$39K |
| 97140 |
|
1,516 |
449 |
$39K |
| 73700 |
|
357 |
304 |
$38K |
| 90853 |
|
1,599 |
228 |
$36K |
| 83540 |
|
3,524 |
3,081 |
$36K |
| 87389 |
|
1,871 |
1,650 |
$36K |
| 83735 |
|
13,749 |
10,614 |
$35K |
| A0426 |
Als 1 |
763 |
621 |
$35K |
| 70498 |
|
591 |
520 |
$34K |
| 87081 |
|
1,834 |
1,732 |
$33K |
| 86038 |
|
1,362 |
1,187 |
$32K |
| 77063 |
|
2,907 |
2,683 |
$32K |
| 88142 |
|
1,755 |
1,692 |
$32K |
| 95913 |
|
127 |
106 |
$31K |
| 86703 |
|
1,123 |
1,006 |
$30K |
| 97014 |
|
1,044 |
354 |
$29K |
| 82746 |
|
4,017 |
3,563 |
$29K |
| 84153 |
|
1,583 |
1,444 |
$29K |
| 96375 |
|
29,811 |
24,129 |
$29K |
| 90714 |
|
1,909 |
1,581 |
$28K |
| 87070 |
|
2,546 |
2,012 |
$28K |
| A0428 |
Bls |
516 |
455 |
$27K |
| 94729 |
|
404 |
368 |
$27K |
| 83550 |
|
3,080 |
2,712 |
$26K |
| 72128 |
|
721 |
633 |
$26K |
| 70486 |
|
989 |
841 |
$26K |
| 12002 |
|
170 |
142 |
$26K |
| 88175 |
|
1,591 |
1,522 |
$25K |
| 82570 |
|
2,950 |
2,668 |
$25K |
| 93308 |
|
144 |
126 |
$25K |
| 97112 |
|
710 |
239 |
$25K |
| 77066 |
Tomosynthesis, mammo |
711 |
640 |
$25K |
| 74174 |
|
111 |
93 |
$24K |
| 72100 |
|
1,443 |
1,280 |
$24K |
| 86592 |
|
1,509 |
1,330 |
$24K |
| 45385 |
|
49 |
37 |
$24K |
| 83970 |
|
1,000 |
884 |
$24K |
| 83516 |
|
902 |
553 |
$23K |
| 74018 |
|
773 |
662 |
$23K |
| 83690 |
|
26,608 |
23,198 |
$23K |
| J0897 |
Denosumab injection |
25 |
12 |
$23K |
| P9016 |
Rbc leukocytes reduced |
81 |
41 |
$22K |
| 73130 |
|
2,398 |
2,033 |
$22K |
| 85610 |
|
8,790 |
6,916 |
$22K |
| 82805 |
|
697 |
575 |
$21K |
| 96415 |
|
212 |
117 |
$21K |
| 73030 |
|
2,341 |
1,954 |
$21K |
| G0480 |
Drug test def 1-7 classes |
1,386 |
1,046 |
$21K |
| 93880 |
|
318 |
285 |
$20K |
| 77065 |
Tomosynthesis, mammo |
611 |
498 |
$20K |
| 73630 |
|
2,571 |
2,223 |
$20K |
| 73502 |
|
1,530 |
1,274 |
$19K |
| 73562 |
|
1,674 |
1,463 |
$19K |
| 84702 |
|
1,872 |
1,469 |
$19K |
| 94726 |
|
297 |
276 |
$19K |
| 87077 |
|
2,521 |
2,082 |
$19K |
| 72141 |
|
135 |
120 |
$19K |
| 80076 |
|
1,644 |
1,386 |
$19K |
| 87340 |
|
1,105 |
957 |
$19K |
| 12011 |
|
128 |
112 |
$19K |
| 73610 |
|
3,244 |
2,698 |
$18K |
| 97535 |
|
824 |
508 |
$18K |
| 74178 |
|
65 |
58 |
$17K |
| 80346 |
|
894 |
860 |
$17K |
| A0425 |
Ground mileage |
1,476 |
1,233 |
$17K |
| 80074 |
|
874 |
763 |
$17K |
| 90677 |
|
71 |
62 |
$17K |
| 84403 |
|
809 |
725 |
$17K |
| 90686 |
|
1,130 |
1,051 |
$17K |
| 93923 |
|
238 |
220 |
$16K |
| 72040 |
|
532 |
479 |
$16K |
| 73560 |
|
1,507 |
1,274 |
$16K |
| 84550 |
|
2,214 |
2,003 |
$15K |
| C8929 |
Tte w or wo fol wcon,doppler |
59 |
56 |
$15K |
| 86901 |
|
3,792 |
3,104 |
$15K |
| 86039 |
|
885 |
788 |
$15K |
| 20610 |
|
97 |
68 |
$14K |
| 80143 |
|
8,775 |
7,301 |
$14K |
| 86787 |
|
580 |
504 |
$14K |
| 86431 |
|
818 |
728 |
$14K |
| 85652 |
|
2,985 |
2,336 |
$14K |
| 87522 |
Neg quan hep c or qual rna |
390 |
323 |
$13K |
| 82077 |
|
5,231 |
4,138 |
$13K |
| 81003 |
|
9,459 |
8,566 |
$13K |
| 84146 |
|
619 |
549 |
$12K |
| 80164 |
|
1,370 |
1,104 |
$12K |
| 77300 |
|
62 |
51 |
$12K |
| 83001 |
|
590 |
532 |
$12K |
| 87210 |
|
1,620 |
1,419 |
$11K |
| 96376 |
|
3,547 |
1,978 |
$11K |
| 86403 |
|
683 |
558 |
$11K |
| 86762 |
|
550 |
481 |
$11K |
| 84630 |
|
709 |
657 |
$11K |
| 85378 |
|
3,143 |
2,748 |
$11K |
| 80364 |
|
976 |
943 |
$11K |
| 82962 |
|
8,622 |
4,285 |
$10K |
| 88112 |
|
411 |
326 |
$10K |
| 99394 |
|
109 |
105 |
$10K |
| G0279 |
Tomosynthesis, mammo |
1,090 |
975 |
$10K |
| 36591 |
|
424 |
242 |
$10K |
| 85651 |
|
1,838 |
1,375 |
$10K |
| 90832 |
|
123 |
83 |
$10K |
| 88304 |
|
585 |
480 |
$10K |
| 73590 |
|
1,395 |
1,144 |
$9K |
| 82043 |
|
1,674 |
1,565 |
$9K |
| 84100 |
|
2,740 |
1,999 |
$9K |
| 86317 |
|
513 |
457 |
$9K |
| 82525 |
|
459 |
424 |
$9K |
| 49083 |
|
23 |
12 |
$9K |
| 90471 |
|
3,090 |
2,570 |
$9K |
| 82550 |
|
3,655 |
2,722 |
$9K |
| 84481 |
|
666 |
605 |
$9K |
| 84425 |
|
768 |
718 |
$9K |
| C8908 |
Mri w/o fol w/cont, breast, |
28 |
26 |
$9K |
| 84270 |
|
477 |
423 |
$8K |
| 73110 |
|
1,428 |
1,170 |
$8K |
| J0500 |
Dicyclomine injection |
602 |
472 |
$8K |
| 82044 |
|
986 |
896 |
$8K |
| 86481 |
|
234 |
208 |
$8K |
| 82784 |
|
843 |
525 |
$8K |
| 87651 |
|
2,633 |
2,425 |
$8K |
| 81002 |
|
7,297 |
2,849 |
$8K |
| J2469 |
Palonosetron hcl |
544 |
296 |
$8K |
| 80179 |
|
8,757 |
7,292 |
$7K |
| 76817 |
|
408 |
331 |
$7K |
| 36430 |
|
92 |
55 |
$7K |
| 82670 |
|
278 |
242 |
$7K |
| 86376 |
|
400 |
339 |
$7K |
| 87186 |
|
1,180 |
859 |
$7K |
| 82248 |
|
2,025 |
1,733 |
$7K |
| 83002 |
|
426 |
375 |
$7K |
| 86003 |
|
340 |
199 |
$7K |
| 84134 |
|
591 |
538 |
$7K |
| 82533 |
|
401 |
323 |
$7K |
| 72110 |
|
206 |
198 |
$7K |
| 73552 |
|
896 |
738 |
$7K |
| 87040 |
|
3,764 |
1,672 |
$7K |
| 64415 |
|
38 |
27 |
$6K |
| 84703 |
|
6,425 |
5,211 |
$6K |
| 90715 |
|
429 |
367 |
$6K |
| 86706 |
|
277 |
245 |
$6K |
| 78815 |
|
15 |
12 |
$6K |
| 92523 |
|
101 |
95 |
$6K |
| 86704 |
|
323 |
283 |
$6K |
| 87205 |
|
1,872 |
1,320 |
$6K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
515 |
384 |
$6K |
| 88307 |
|
101 |
85 |
$5K |
| 86200 |
|
315 |
275 |
$5K |
| 84520 |
|
741 |
650 |
$5K |
| 84480 |
|
413 |
373 |
$5K |
| U0005 |
Infec agen detec ampli probe |
2,918 |
1,764 |
$5K |
| 84590 |
|
425 |
395 |
$5K |
| 83695 |
|
400 |
393 |
$5K |
| 82140 |
|
823 |
615 |
$5K |
| G0008 |
Admin influenza virus vac |
1,282 |
1,179 |
$5K |
| 82105 |
|
378 |
312 |
$4K |
| 81025 |
|
10,456 |
9,574 |
$4K |
| 73564 |
|
484 |
423 |
$4K |
| 76641 |
|
33 |
27 |
$4K |
| 84156 |
|
820 |
740 |
$4K |
| 86255 |
|
182 |
129 |
$4K |
| 95912 |
|
13 |
12 |
$4K |
| 90791 |
|
32 |
29 |
$4K |
| 76981 |
|
48 |
41 |
$4K |
| 73080 |
|
544 |
469 |
$4K |
| 82565 |
|
861 |
750 |
$4K |
| 84436 |
|
1,091 |
918 |
$4K |
| 82947 |
|
1,061 |
726 |
$4K |
| 72120 |
|
106 |
92 |
$4K |
| U0002 |
Covid-19 lab test non-cdc |
542 |
500 |
$4K |
| 86618 |
|
239 |
183 |
$4K |
| 93922 |
|
57 |
54 |
$4K |
| 97597 |
|
30 |
24 |
$4K |
| 86235 |
|
197 |
130 |
$4K |
| 92526 |
|
83 |
55 |
$4K |
| 85730 |
|
2,786 |
2,286 |
$4K |
| 73521 |
|
218 |
198 |
$3K |
| 76870 |
|
82 |
66 |
$3K |
| J3490 |
Drugs unclassified injection |
133 |
61 |
$3K |
| 90935 |
|
20 |
12 |
$3K |
| 72050 |
|
93 |
82 |
$3K |
| 87880 |
|
5,428 |
5,036 |
$3K |
| 72170 |
|
898 |
784 |
$3K |
| M0243 |
Casirivi and imdevi inj |
20 |
17 |
$3K |
| J1050 |
Medroxyprogesterone acetate |
34 |
24 |
$3K |
| 86225 |
|
175 |
149 |
$3K |
| 86923 |
|
118 |
57 |
$3K |
| J1642 |
Inj heparin sodium per 10 u |
5,754 |
2,479 |
$3K |
| 73090 |
|
637 |
540 |
$3K |
| 77080 |
|
47 |
43 |
$3K |
| 88342 |
|
610 |
501 |
$3K |
| 73070 |
|
350 |
305 |
$3K |
| J1953 |
Levetiracetam injection |
683 |
459 |
$3K |
| 83615 |
|
440 |
338 |
$3K |
| 85379 |
|
3,017 |
2,633 |
$3K |
| 94250 |
|
32 |
14 |
$3K |
| 83520 |
|
85 |
67 |
$2K |
| 87075 |
|
684 |
491 |
$2K |
| 95910 |
|
15 |
13 |
$2K |
| 83655 |
|
115 |
113 |
$2K |
| 97022 |
|
36 |
13 |
$2K |
| 99203 |
|
63 |
59 |
$2K |
| 80349 |
|
186 |
178 |
$2K |
| 74183 |
|
13 |
13 |
$2K |
| 82785 |
|
158 |
134 |
$2K |
| J1650 |
Inj enoxaparin sodium |
3,490 |
1,562 |
$2K |
| 95816 |
|
12 |
12 |
$2K |
| 72072 |
|
121 |
114 |
$2K |
| 76801 |
|
64 |
51 |
$2K |
| 73060 |
|
396 |
347 |
$2K |
| 73221 |
|
14 |
12 |
$2K |
| 80178 |
|
193 |
166 |
$2K |
| 86308 |
|
535 |
442 |
$2K |
| 87147 |
|
150 |
126 |
$2K |
| 97129 |
|
59 |
27 |
$2K |
| 94010 |
|
202 |
180 |
$2K |
| 90648 |
|
209 |
200 |
$2K |
| 95117 |
|
84 |
49 |
$2K |
| 84165 |
|
205 |
175 |
$2K |
| 81005 |
|
302 |
295 |
$2K |
| 71101 |
|
218 |
185 |
$2K |
| 96368 |
|
268 |
173 |
$2K |
| 84145 |
|
530 |
425 |
$2K |
| 73721 |
|
13 |
13 |
$2K |
| S9445 |
Pt education noc individ |
28 |
27 |
$2K |
| 81170 |
|
14 |
13 |
$1K |
| 78306 |
|
15 |
12 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
30,511 |
26,642 |
$1K |
| 85014 |
|
485 |
340 |
$1K |
| 88185 |
|
21 |
12 |
$1K |
| 86256 |
|
74 |
57 |
$1K |
| 82150 |
|
1,419 |
1,214 |
$1K |
| 82977 |
|
176 |
161 |
$1K |
| 82950 |
|
94 |
86 |
$1K |
| 86160 |
|
97 |
73 |
$1K |
| 86800 |
|
81 |
66 |
$1K |
| J0696 |
Ceftriaxone sodium injection |
5,040 |
3,809 |
$1K |
| 94664 |
|
940 |
760 |
$1K |
| G0123 |
Screen cerv/vag thin layer |
88 |
65 |
$1K |
| 81206 |
|
12 |
12 |
$1K |
| 82627 |
|
55 |
50 |
$1K |
| J3486 |
Ziprasidone mesylate |
100 |
70 |
$1K |
| 99214 |
|
14 |
12 |
$1K |
| J2270 |
Morphine sulfate injection |
3,090 |
2,165 |
$1K |
| 90670 |
|
223 |
211 |
$1K |
| 99202 |
|
14 |
13 |
$1K |
| 84132 |
|
842 |
673 |
$1K |
| 80177 |
|
111 |
88 |
$965.49 |
| 87449 |
|
150 |
109 |
$928.78 |
| 80202 |
|
45 |
16 |
$887.58 |
| 86334 |
|
61 |
50 |
$880.65 |
| 80353 |
|
75 |
70 |
$852.16 |
| 82951 |
|
32 |
27 |
$833.64 |
| 72070 |
|
18 |
15 |
$827.33 |
| 93325 |
|
15 |
13 |
$820.57 |
| 82378 |
|
122 |
79 |
$809.40 |
| J1644 |
Inj heparin sodium per 1000u |
2,252 |
977 |
$808.70 |
| 87045 |
|
68 |
56 |
$786.46 |
| 74022 |
|
73 |
60 |
$777.55 |
| 87634 |
|
754 |
666 |
$761.33 |
| 00170 |
|
424 |
270 |
$746.38 |
| 82103 |
|
57 |
51 |
$724.85 |
| 82553 |
|
69 |
58 |
$699.22 |
| J2543 |
Piperacillin/tazobactam |
368 |
141 |
$683.74 |
| 84155 |
|
127 |
115 |
$681.81 |
| 80373 |
|
59 |
59 |
$667.81 |
| 85018 |
|
366 |
252 |
$665.52 |
| 97130 |
|
41 |
14 |
$662.32 |
| 80323 |
|
40 |
36 |
$659.75 |
| 90633 |
|
75 |
70 |
$653.80 |
| 80162 |
|
40 |
37 |
$624.53 |
| 84478 |
|
128 |
110 |
$619.72 |
| 82465 |
|
69 |
62 |
$616.36 |
| J2272 |
Inj, morphine (fresenius) |
543 |
427 |
$615.37 |
| J0360 |
Hydralazine hcl injection |
665 |
459 |
$595.07 |
| J1170 |
Hydromorphone injection |
989 |
655 |
$565.16 |
| 84466 |
|
74 |
60 |
$550.98 |
| 82010 |
|
693 |
558 |
$549.40 |
| 80050 |
|
312 |
271 |
$542.39 |
| 84460 |
|
68 |
61 |
$533.82 |
| J1453 |
Fosaprepitant injection |
45 |
25 |
$532.50 |
| 88184 |
|
12 |
12 |
$528.95 |
| 86735 |
|
18 |
18 |
$528.21 |
| 85045 |
|
138 |
105 |
$521.54 |
| 80347 |
|
32 |
29 |
$514.35 |
| J7030 |
Normal saline solution infus |
1,312 |
1,102 |
$512.73 |
| 76775 |
|
13 |
12 |
$508.48 |
| G0009 |
Admin pneumococcal vaccine |
271 |
240 |
$504.68 |
| 86880 |
|
29 |
24 |
$503.28 |
| J2360 |
Orphenadrine injection |
1,757 |
1,434 |
$498.72 |
| 90723 |
|
129 |
126 |
$483.30 |
| C1894 |
Intro/sheath, non-laser |
873 |
690 |
$474.13 |
| G0296 |
Visit to determ ldct elig |
15 |
14 |
$467.21 |
| 86765 |
|
21 |
19 |
$433.81 |
| J1200 |
Diphenhydramine hcl injectio |
5,201 |
4,095 |
$423.30 |
| 82330 |
|
35 |
30 |
$418.24 |
| J2310 |
Inj naloxone hydrochloride |
34 |
12 |
$394.59 |
| J2405 |
Ondansetron hcl injection |
17,321 |
13,846 |
$390.94 |
| 87046 |
|
66 |
56 |
$387.43 |
| J2704 |
Inj, propofol, 10 mg |
7,868 |
4,225 |
$372.79 |
| 00731 |
|
336 |
275 |
$372.09 |
| J3010 |
Fentanyl citrate injection |
7,581 |
5,429 |
$371.03 |
| 00813 |
|
145 |
109 |
$359.26 |
| 00811 |
|
31 |
24 |
$359.26 |
| J3475 |
Inj magnesium sulfate |
1,017 |
731 |
$347.77 |
| J0690 |
Cefazolin sodium injection |
3,215 |
1,738 |
$338.84 |
| 73120 |
|
13 |
12 |
$335.32 |
| 90681 |
|
37 |
32 |
$311.60 |
| 87427 |
|
53 |
43 |
$310.20 |
| J2060 |
Lorazepam injection |
1,817 |
1,353 |
$296.72 |
| 83525 |
|
18 |
13 |
$295.02 |
| C1769 |
Guide wire |
963 |
753 |
$289.58 |
| J3370 |
Vancomycin hcl injection |
1,041 |
551 |
$258.57 |
| 80051 |
|
53 |
43 |
$257.04 |
| J0780 |
Prochlorperazine injection |
1,158 |
911 |
$256.28 |
| J2930 |
Methylprednisolone injection |
1,146 |
804 |
$248.66 |
| J2765 |
Metoclopramide hcl injection |
2,160 |
1,779 |
$246.85 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
23,221 |
20,172 |
$244.66 |
| 82652 |
|
14 |
12 |
$242.19 |
| J1100 |
Dexamethasone sodium phos |
7,586 |
5,352 |
$230.52 |
| 87426 |
|
16 |
13 |
$227.67 |
| J0574 |
Bupren/nal 6.1 to 10mg bupre |
22 |
12 |
$224.94 |
| 80175 |
|
20 |
18 |
$224.91 |
| 87807 |
|
105 |
95 |
$224.28 |
| 83020 |
|
14 |
12 |
$212.93 |
| J1790 |
Droperidol injection |
600 |
449 |
$192.05 |
| 82800 |
|
602 |
496 |
$188.68 |
| 90460 |
|
138 |
135 |
$164.32 |
| 88341 |
|
30 |
25 |
$160.28 |
| 88173 |
|
36 |
24 |
$154.43 |
| J3410 |
Hydroxyzine hcl injection |
44 |
40 |
$145.46 |
| A9579 |
Gad-base mr contrast nos,1ml |
699 |
610 |
$140.44 |
| J1456 |
Inj, fosaprepitant (teva) |
18 |
12 |
$133.56 |
| 73620 |
|
14 |
13 |
$132.71 |
| 90694 |
|
22 |
20 |
$132.64 |
| 80176 |
|
12 |
12 |
$128.52 |
| 96417 |
|
204 |
130 |
$121.95 |
| V5266 |
Battery for hearing device |
15 |
14 |
$112.36 |
| J2919 |
Inj, methylpred sod succ 5mg |
661 |
490 |
$112.26 |
| 80198 |
|
23 |
12 |
$98.58 |
| J3250 |
Trimethobenzamide hcl inj |
25 |
14 |
$91.24 |
| J3301 |
Triamcinolone acet inj nos |
244 |
188 |
$88.72 |
| 93797 |
|
15 |
12 |
$82.45 |
| J2250 |
Inj midazolam hydrochloride |
4,374 |
3,237 |
$79.13 |
| J2795 |
Ropivacaine hcl injection |
493 |
274 |
$76.91 |
| 29125 |
|
157 |
141 |
$66.07 |
| 89051 |
|
73 |
51 |
$63.67 |
| 90472 |
|
350 |
347 |
$61.62 |
| J1940 |
Furosemide injection |
568 |
394 |
$59.76 |
| 81015 |
|
18 |
15 |
$58.80 |
| 86694 |
|
16 |
14 |
$54.02 |
| 85384 |
|
49 |
38 |
$39.77 |
| J1720 |
Hydrocortisone sodium succ i |
48 |
37 |
$37.20 |
| J2470 |
Inj pantoprazole sodium 40mg |
255 |
199 |
$36.90 |
| 80305 |
|
26 |
12 |
$35.53 |
| J1630 |
Haloperidol injection |
134 |
83 |
$33.50 |
| J7605 |
Arformoterol non-comp unit |
134 |
96 |
$24.99 |
| J7050 |
Normal saline solution infus |
637 |
412 |
$23.74 |
| Q9957 |
Inj perflutren lip micros,ml |
213 |
186 |
$23.40 |
| 80145 |
|
21 |
16 |
$21.42 |
| 84300 |
|
14 |
12 |
$18.82 |
| J1921 |
Inj labetalol hcl hikma, 5mg |
101 |
85 |
$18.21 |
| J3480 |
Inj potassium chloride |
641 |
376 |
$17.99 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
571 |
444 |
$17.69 |
| J3360 |
Diazepam injection |
15 |
14 |
$17.60 |
| J2920 |
Methylprednisolone injection |
16 |
12 |
$17.35 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
618 |
493 |
$15.43 |
| 83037 |
|
122 |
115 |
$15.04 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
127 |
79 |
$9.93 |
| J3411 |
Thiamine hcl 100 mg |
26 |
12 |
$8.49 |
| J1939 |
Inj, bumetanide, 0.5 mg |
57 |
40 |
$8.22 |
| J2001 |
Lidocaine injection |
2,306 |
1,667 |
$4.81 |
| Q0162 |
Ondansetron oral |
106 |
96 |
$4.78 |
| J1920 |
Inj, labetalol hcl, 5mg |
176 |
107 |
$4.58 |
| J1836 |
Inj, metronidazole, 10 mg |
61 |
29 |
$4.28 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
285 |
256 |
$3.88 |
| Q0243 |
Casirivimab and imdevimab |
32 |
29 |
$0.27 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
196 |
188 |
$0.25 |
| Q0244 |
Casirivi and imdevi 1200 mg |
17 |
17 |
$0.15 |
| A9503 |
Tc99m medronate |
15 |
12 |
$0.00 |
| 85576 |
|
17 |
13 |
$0.00 |
| A9500 |
Tc99m sestamibi |
973 |
832 |
$0.00 |
| C1889 |
Implant/insert device, noc |
52 |
42 |
$0.00 |
| G0103 |
Psa screening |
183 |
173 |
$0.00 |
| G0283 |
Elec stim other than wound |
51 |
15 |
$0.00 |
| C1725 |
Cath, translumin non-laser |
95 |
66 |
$0.00 |
| J2785 |
Regadenoson injection |
1,128 |
970 |
$0.00 |
| A4648 |
Implantable tissue marker |
222 |
168 |
$0.00 |
| J2305 |
Inj, nitroglycerin, 5 mg |
19 |
18 |
$0.00 |
| C9399 |
Unclassified drugs or biolog |
72 |
59 |
$0.00 |
| A9585 |
Gadobutrol injection |
29 |
27 |
$0.00 |
| 95012 |
|
18 |
14 |
$0.00 |
| 96411 |
|
18 |
13 |
$0.00 |
| 00790 |
|
25 |
13 |
$0.00 |
| A9502 |
Tc99m tetrofosmin |
434 |
380 |
$0.00 |
| 85347 |
|
175 |
118 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
14 |
14 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
76 |
56 |
$0.00 |
| 00812 |
|
61 |
57 |
$0.00 |
| A9577 |
Inj multihance |
127 |
109 |
$0.00 |
| C1729 |
Cath, drainage |
76 |
42 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
15 |
12 |
$0.00 |
| 00400 |
|
34 |
26 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
66 |
52 |
$0.00 |
| G0330 |
Facility svs dental rehab |
14 |
12 |
$0.00 |
| J2550 |
Promethazine hcl injection |
15 |
14 |
$0.00 |