| Code | Description | Claims | Beneficiaries | Total Paid |
| 99212 |
|
41,245 |
36,264 |
$6.22M |
| 99283 |
|
27,650 |
25,665 |
$4.37M |
| 99213 |
|
24,906 |
22,828 |
$3.70M |
| 99284 |
|
20,990 |
19,899 |
$3.38M |
| 99214 |
|
18,474 |
15,296 |
$2.66M |
| 99285 |
|
13,350 |
12,839 |
$2.06M |
| 93458 |
|
1,072 |
1,067 |
$1.90M |
| 99282 |
|
7,467 |
7,083 |
$1.17M |
| 76856 |
|
2,729 |
2,630 |
$1.06M |
| 99281 |
|
4,610 |
3,814 |
$830K |
| J9271 |
Inj pembrolizumab |
95 |
76 |
$807K |
| 70450 |
|
2,686 |
2,621 |
$749K |
| 43239 |
|
1,008 |
1,005 |
$700K |
| 99215 |
Prolong outpt/office vis |
4,385 |
3,567 |
$661K |
| 97110 |
|
8,271 |
2,879 |
$616K |
| 93975 |
|
1,152 |
1,145 |
$501K |
| 45380 |
|
734 |
730 |
$501K |
| 45378 |
|
578 |
575 |
$486K |
| 74177 |
|
1,998 |
1,970 |
$474K |
| 80048 |
|
29,400 |
27,219 |
$457K |
| 96361 |
|
1,685 |
1,446 |
$440K |
| 96365 |
|
2,075 |
1,400 |
$433K |
| 80053 |
|
26,657 |
24,278 |
$407K |
| 96415 |
|
804 |
640 |
$404K |
| 86850 |
|
12,513 |
11,741 |
$391K |
| 87635 |
|
12,275 |
11,865 |
$366K |
| 93306 |
|
1,966 |
1,956 |
$355K |
| 86901 |
|
13,060 |
11,787 |
$351K |
| 80076 |
|
15,041 |
14,259 |
$349K |
| 82306 |
|
11,964 |
11,892 |
$339K |
| 76818 |
|
4,462 |
2,018 |
$315K |
| 87491 |
|
12,653 |
12,441 |
$308K |
| 96110 |
|
1,815 |
1,801 |
$298K |
| 76805 |
|
4,071 |
3,186 |
$282K |
| 96413 |
|
2,258 |
1,454 |
$258K |
| 87591 |
|
12,648 |
12,436 |
$256K |
| 77336 |
|
578 |
262 |
$249K |
| 92551 |
|
2,997 |
2,984 |
$234K |
| 86900 |
|
13,131 |
11,821 |
$231K |
| 97112 |
|
2,667 |
1,168 |
$218K |
| 99391 |
|
1,382 |
1,351 |
$208K |
| 99392 |
|
1,299 |
1,290 |
$200K |
| 74176 |
|
732 |
727 |
$189K |
| 88305 |
|
4,112 |
3,907 |
$188K |
| 80061 |
|
14,853 |
14,760 |
$187K |
| 54150 |
|
165 |
165 |
$187K |
| 87661 |
|
5,822 |
5,768 |
$186K |
| 76811 |
|
2,120 |
2,111 |
$179K |
| 87633 |
|
2,622 |
2,589 |
$174K |
| 88175 |
|
5,951 |
5,942 |
$173K |
| 45385 |
|
279 |
276 |
$170K |
| 97140 |
|
5,405 |
2,080 |
$167K |
| 93976 |
|
354 |
354 |
$166K |
| 97161 |
|
1,286 |
1,280 |
$152K |
| 99211 |
|
7,111 |
6,527 |
$148K |
| 76700 |
|
471 |
469 |
$144K |
| C9600 |
Perc drug-el cor stent sing |
41 |
40 |
$129K |
| 99205 |
Prolong outpt/office vis |
851 |
845 |
$125K |
| 87624 |
|
4,579 |
4,568 |
$123K |
| P9016 |
Rbc leukocytes reduced |
246 |
202 |
$116K |
| 76817 |
|
1,949 |
1,625 |
$115K |
| 77067 |
|
1,360 |
1,357 |
$115K |
| 90686 |
|
6,227 |
6,197 |
$115K |
| J2323 |
Natalizumab injection |
25 |
25 |
$115K |
| 83880 |
|
3,950 |
3,821 |
$114K |
| 36415 |
|
18,774 |
15,774 |
$104K |
| 10060 |
|
292 |
284 |
$104K |
| 99393 |
|
657 |
657 |
$103K |
| 87486 |
|
2,634 |
2,600 |
$100K |
| 96374 |
|
9,943 |
9,357 |
$99K |
| 70551 |
|
261 |
260 |
$99K |
| 96360 |
|
480 |
466 |
$98K |
| 76816 |
|
1,990 |
1,607 |
$97K |
| 12001 |
|
204 |
202 |
$97K |
| 96161 |
|
1,937 |
1,928 |
$94K |
| 86480 |
|
1,778 |
1,769 |
$94K |
| 76801 |
|
1,106 |
1,054 |
$93K |
| 83036 |
|
14,287 |
14,168 |
$92K |
| 88342 |
|
1,661 |
1,573 |
$91K |
| 76770 |
|
378 |
377 |
$88K |
| 70553 |
|
204 |
200 |
$86K |
| 84443 |
|
16,660 |
16,311 |
$85K |
| 78452 |
|
244 |
244 |
$83K |
| 10E0XZZ |
|
124 |
16 |
$81K |
| 70460 |
|
262 |
252 |
$78K |
| 96372 |
|
6,173 |
5,381 |
$77K |
| 76830 |
|
2,305 |
2,216 |
$75K |
| 85025 |
|
51,779 |
47,343 |
$74K |
| 86701 |
|
7,207 |
7,184 |
$73K |
| 12011 |
|
158 |
157 |
$72K |
| 86780 |
|
7,334 |
7,292 |
$69K |
| 99202 |
|
423 |
422 |
$68K |
| 71260 |
|
334 |
331 |
$66K |
| 77386 |
|
378 |
32 |
$63K |
| 94060 |
|
368 |
368 |
$62K |
| 96366 |
|
283 |
210 |
$62K |
| 76819 |
|
1,257 |
1,207 |
$61K |
| 93017 |
|
982 |
977 |
$60K |
| 83655 |
|
3,972 |
3,957 |
$59K |
| 99394 |
|
367 |
367 |
$58K |
| 93970 |
|
165 |
164 |
$57K |
| 71275 |
|
185 |
181 |
$56K |
| 87536 |
|
786 |
774 |
$55K |
| 76820 |
|
1,508 |
754 |
$55K |
| 90670 |
|
4,852 |
4,834 |
$54K |
| 90715 |
|
2,465 |
2,441 |
$54K |
| 36430 |
|
121 |
95 |
$54K |
| 87798 |
|
2,634 |
2,598 |
$51K |
| 87581 |
|
2,634 |
2,600 |
$51K |
| 76705 |
|
515 |
502 |
$50K |
| 77300 |
|
139 |
138 |
$50K |
| J3490 |
Drugs unclassified injection |
228 |
184 |
$48K |
| 96375 |
|
6,518 |
5,507 |
$46K |
| 99395 |
|
300 |
299 |
$45K |
| 76815 |
|
1,005 |
753 |
$45K |
| 93303 |
|
543 |
522 |
$44K |
| 86769 |
|
1,267 |
1,259 |
$43K |
| 88304 |
|
991 |
976 |
$42K |
| G0463 |
Hospital outpt clinic visit |
3,388 |
2,650 |
$41K |
| 87088 |
|
9,955 |
9,531 |
$40K |
| 71046 |
|
10,165 |
9,898 |
$38K |
| 77334 |
|
102 |
90 |
$37K |
| 82607 |
|
4,329 |
4,291 |
$37K |
| 87340 |
|
5,617 |
5,596 |
$36K |
| 73721 |
|
85 |
82 |
$35K |
| 93005 |
|
22,982 |
20,852 |
$35K |
| 76813 |
|
675 |
673 |
$35K |
| 93320 |
|
539 |
520 |
$35K |
| 99396 |
|
229 |
228 |
$34K |
| 82728 |
|
4,207 |
4,066 |
$34K |
| 90680 |
|
3,210 |
3,198 |
$33K |
| 88307 |
|
349 |
328 |
$32K |
| 99385 |
|
211 |
210 |
$32K |
| 82803 |
|
1,131 |
965 |
$31K |
| 96367 |
|
268 |
200 |
$31K |
| 90698 |
|
3,147 |
3,139 |
$31K |
| 96127 |
|
1,162 |
1,160 |
$30K |
| 36416 |
|
1,401 |
1,346 |
$30K |
| 99203 |
|
207 |
207 |
$30K |
| 93351 |
|
76 |
75 |
$30K |
| 80050 |
|
224 |
223 |
$30K |
| 77412 |
|
98 |
12 |
$29K |
| 85610 |
|
12,330 |
11,496 |
$27K |
| 86762 |
|
2,429 |
2,419 |
$26K |
| 86803 |
|
3,424 |
3,411 |
$24K |
| G0480 |
Drug test def 1-7 classes |
740 |
720 |
$24K |
| 83020 |
|
2,186 |
2,161 |
$23K |
| 90633 |
|
2,220 |
2,213 |
$23K |
| 76536 |
|
338 |
336 |
$22K |
| 93350 |
|
207 |
207 |
$22K |
| 99173 |
|
1,710 |
1,703 |
$21K |
| 86706 |
|
3,307 |
3,298 |
$21K |
| 84153 |
|
1,241 |
1,225 |
$20K |
| J0185 |
Inj., aprepitant, 1 mg |
185 |
122 |
$20K |
| 29125 |
|
80 |
79 |
$20K |
| 87636 |
|
882 |
864 |
$20K |
| 86360 |
|
551 |
541 |
$20K |
| 70486 |
|
318 |
314 |
$20K |
| 84439 |
|
3,934 |
3,803 |
$19K |
| 99386 |
|
129 |
129 |
$19K |
| 85730 |
|
8,913 |
8,531 |
$19K |
| 80307 |
|
470 |
464 |
$18K |
| 86003 |
|
232 |
222 |
$18K |
| 92507 |
|
125 |
42 |
$18K |
| 93325 |
|
736 |
703 |
$18K |
| 72148 |
|
46 |
46 |
$18K |
| 86787 |
|
2,721 |
2,709 |
$17K |
| 88142 |
|
659 |
658 |
$17K |
| 83970 |
|
439 |
431 |
$16K |
| 84702 |
|
3,558 |
3,051 |
$16K |
| 76000 |
|
186 |
185 |
$15K |
| 80055 |
|
126 |
126 |
$15K |
| 87637 |
|
644 |
637 |
$15K |
| 72125 |
|
879 |
852 |
$15K |
| 90651 |
|
966 |
964 |
$15K |
| 90723 |
|
1,390 |
1,387 |
$13K |
| 90648 |
|
1,373 |
1,369 |
$13K |
| J7050 |
Normal saline solution infus |
1,292 |
768 |
$13K |
| 86704 |
|
2,486 |
2,482 |
$13K |
| 71045 |
|
2,600 |
2,489 |
$13K |
| 90744 |
|
1,173 |
1,169 |
$12K |
| 82746 |
|
1,774 |
1,767 |
$12K |
| 85027 |
|
6,373 |
5,913 |
$12K |
| 96417 |
|
473 |
336 |
$12K |
| 90716 |
|
1,131 |
1,130 |
$12K |
| 90707 |
|
1,128 |
1,127 |
$11K |
| 83540 |
|
3,110 |
3,078 |
$11K |
| 77063 |
|
662 |
659 |
$11K |
| 80047 |
|
472 |
441 |
$10K |
| 88360 |
|
119 |
119 |
$9K |
| 95813 |
|
38 |
37 |
$9K |
| 77080 |
|
104 |
104 |
$9K |
| 88341 |
|
229 |
155 |
$9K |
| 90734 |
|
766 |
765 |
$9K |
| 81025 |
|
3,294 |
3,241 |
$9K |
| 87081 |
|
2,306 |
2,294 |
$9K |
| 94729 |
|
369 |
369 |
$9K |
| 90710 |
|
739 |
736 |
$8K |
| 76827 |
|
251 |
246 |
$8K |
| 81001 |
|
11,771 |
11,327 |
$8K |
| 87070 |
|
3,518 |
3,439 |
$8K |
| 90621 |
|
367 |
367 |
$8K |
| 84481 |
|
1,138 |
1,108 |
$8K |
| 90696 |
|
707 |
704 |
$7K |
| J2469 |
Palonosetron hcl |
687 |
436 |
$7K |
| J1439 |
Inj ferric carboxymaltos 1mg |
17 |
13 |
$7K |
| 83001 |
|
595 |
588 |
$6K |
| 76825 |
|
171 |
168 |
$6K |
| 81220 |
|
17 |
17 |
$6K |
| 82043 |
|
1,869 |
1,861 |
$6K |
| 20610 |
|
25 |
25 |
$6K |
| 82947 |
|
2,872 |
2,853 |
$6K |
| 86140 |
|
3,642 |
3,547 |
$6K |
| 82948 |
|
1,370 |
1,146 |
$6K |
| 84146 |
|
511 |
499 |
$6K |
| 83516 |
|
285 |
267 |
$6K |
| 71250 |
|
26 |
26 |
$6K |
| 88112 |
|
153 |
151 |
$6K |
| 86708 |
|
665 |
661 |
$5K |
| 96376 |
|
877 |
819 |
$5K |
| 12002 |
|
12 |
12 |
$5K |
| 90471 |
|
2,685 |
2,613 |
$5K |
| 86255 |
|
1,024 |
1,012 |
$5K |
| 86160 |
|
387 |
368 |
$5K |
| 81003 |
|
3,805 |
3,726 |
$5K |
| 72141 |
|
14 |
14 |
$5K |
| 83525 |
|
638 |
632 |
$5K |
| 86376 |
|
515 |
512 |
$5K |
| 84154 |
|
241 |
239 |
$4K |
| 76642 |
|
67 |
67 |
$4K |
| J1756 |
Iron sucrose injection |
87 |
39 |
$4K |
| 94727 |
|
339 |
339 |
$4K |
| 97535 |
|
74 |
60 |
$4K |
| 99381 |
|
26 |
26 |
$4K |
| 84402 |
|
248 |
245 |
$4K |
| 93296 |
|
57 |
57 |
$4K |
| 76821 |
|
127 |
102 |
$4K |
| 83735 |
|
5,698 |
5,009 |
$4K |
| 73564 |
|
1,252 |
1,217 |
$3K |
| 86695 |
|
148 |
147 |
$3K |
| 92134 |
|
29 |
29 |
$3K |
| 83002 |
|
367 |
363 |
$3K |
| 96040 |
|
90 |
90 |
$3K |
| 87186 |
|
1,204 |
1,178 |
$3K |
| 72100 |
|
610 |
610 |
$3K |
| 76641 |
|
45 |
45 |
$3K |
| 83690 |
|
7,140 |
6,776 |
$3K |
| 90619 |
|
41 |
41 |
$3K |
| 86355 |
|
76 |
74 |
$3K |
| 73562 |
|
509 |
490 |
$3K |
| 87389 |
|
862 |
855 |
$3K |
| 84550 |
|
1,177 |
1,105 |
$2K |
| 84484 |
|
7,780 |
6,710 |
$2K |
| 99291 |
|
14 |
14 |
$2K |
| 94640 |
|
2,519 |
1,959 |
$2K |
| 86334 |
|
182 |
177 |
$2K |
| 83615 |
|
1,409 |
1,304 |
$2K |
| 73030 |
|
1,004 |
969 |
$2K |
| 97162 |
|
13 |
12 |
$2K |
| 97802 |
|
41 |
41 |
$2K |
| J9267 |
Paclitaxel injection |
129 |
68 |
$2K |
| 73630 |
|
1,358 |
1,331 |
$2K |
| 86304 |
|
463 |
414 |
$2K |
| C1769 |
Guide wire |
933 |
921 |
$2K |
| 86235 |
|
241 |
237 |
$2K |
| 93923 |
|
12 |
12 |
$2K |
| 99429 |
|
127 |
122 |
$2K |
| 85045 |
|
1,713 |
1,589 |
$2K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
100 |
100 |
$2K |
| 90697 |
|
30 |
26 |
$2K |
| 84460 |
|
350 |
343 |
$2K |
| 86430 |
|
477 |
475 |
$2K |
| 84165 |
|
338 |
327 |
$2K |
| 84450 |
|
350 |
343 |
$2K |
| 82550 |
|
990 |
973 |
$2K |
| 84134 |
|
244 |
243 |
$2K |
| U0001 |
2019-ncov diagnostic p |
508 |
461 |
$2K |
| 85652 |
|
2,028 |
1,987 |
$2K |
| 84681 |
|
92 |
92 |
$2K |
| 87086 |
|
1,611 |
1,568 |
$2K |
| 84100 |
|
2,848 |
2,605 |
$1K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,892 |
1,835 |
$1K |
| 83605 |
|
3,235 |
2,969 |
$1K |
| 94726 |
|
13 |
13 |
$1K |
| 72170 |
|
1,202 |
1,162 |
$1K |
| 82677 |
|
151 |
149 |
$1K |
| 82378 |
|
279 |
250 |
$1K |
| 86359 |
|
77 |
75 |
$1K |
| 86357 |
|
76 |
74 |
$1K |
| 82785 |
|
111 |
111 |
$1K |
| 73610 |
|
1,213 |
1,174 |
$1K |
| 85378 |
|
761 |
747 |
$1K |
| 84403 |
|
67 |
66 |
$1K |
| 96411 |
|
40 |
24 |
$1K |
| 90685 |
|
66 |
65 |
$1K |
| 86800 |
|
122 |
113 |
$1K |
| 81329 |
|
20 |
20 |
$1K |
| J9045 |
Carboplatin injection |
105 |
74 |
$1K |
| 74022 |
|
1,091 |
1,073 |
$1K |
| 81002 |
|
596 |
545 |
$1K |
| 82784 |
|
216 |
208 |
$1K |
| C1887 |
Catheter, guiding |
344 |
338 |
$1K |
| A9502 |
Tc99m tetrofosmin |
101 |
98 |
$992.79 |
| 73502 |
|
502 |
486 |
$962.40 |
| 73130 |
|
943 |
915 |
$959.75 |
| J8540 |
Oral dexamethasone |
743 |
387 |
$946.09 |
| 96402 |
|
25 |
25 |
$914.69 |
| 90681 |
|
80 |
80 |
$871.12 |
| 86592 |
|
839 |
826 |
$869.42 |
| 93291 |
|
12 |
12 |
$862.34 |
| J7030 |
Normal saline solution infus |
8,781 |
8,162 |
$832.88 |
| 85384 |
|
574 |
499 |
$806.40 |
| 73110 |
|
758 |
717 |
$793.75 |
| 97116 |
|
22 |
16 |
$793.61 |
| G0439 |
Ppps, subseq visit |
21 |
21 |
$783.99 |
| Q3014 |
Telehealth facility fee |
93 |
88 |
$777.51 |
| 86870 |
|
27 |
27 |
$728.86 |
| 90460 |
|
168 |
164 |
$721.32 |
| 86920 |
|
29 |
26 |
$717.87 |
| 82565 |
|
1,164 |
1,154 |
$691.45 |
| 73080 |
|
456 |
428 |
$684.09 |
| 83520 |
|
12 |
12 |
$655.50 |
| 76377 |
|
47 |
47 |
$648.27 |
| 82150 |
|
371 |
368 |
$646.48 |
| J2704 |
Inj, propofol, 10 mg |
5,094 |
4,578 |
$619.90 |
| 96368 |
|
18 |
12 |
$614.60 |
| 94375 |
|
80 |
80 |
$598.66 |
| 81243 |
|
21 |
20 |
$583.99 |
| 82105 |
|
162 |
159 |
$583.05 |
| 92250 |
|
12 |
12 |
$569.07 |
| 85651 |
|
446 |
437 |
$550.54 |
| 83883 |
|
148 |
137 |
$527.06 |
| 87502 |
|
15 |
15 |
$516.19 |
| 84520 |
|
1,132 |
1,122 |
$513.55 |
| 82951 |
|
178 |
175 |
$500.81 |
| 86765 |
|
215 |
208 |
$490.20 |
| 82164 |
|
13 |
13 |
$487.70 |
| J7120 |
Ringers lactate infusion |
700 |
657 |
$477.22 |
| J0696 |
Ceftriaxone sodium injection |
318 |
291 |
$457.66 |
| 85018 |
|
1,065 |
1,064 |
$457.09 |
| 82627 |
|
44 |
42 |
$455.49 |
| 84445 |
|
13 |
12 |
$439.29 |
| 84436 |
|
118 |
116 |
$433.20 |
| 88173 |
|
12 |
12 |
$427.61 |
| 82533 |
|
56 |
52 |
$426.90 |
| 87040 |
|
726 |
615 |
$415.55 |
| 82962 |
|
2,703 |
2,174 |
$408.05 |
| 82248 |
|
126 |
124 |
$406.04 |
| 72052 |
|
28 |
28 |
$405.23 |
| 82570 |
|
460 |
451 |
$400.57 |
| C1894 |
Intro/sheath, non-laser |
177 |
175 |
$395.13 |
| J7060 |
5% dextrose/water |
498 |
348 |
$362.16 |
| 80320 |
|
283 |
275 |
$336.77 |
| 82330 |
|
1,045 |
1,035 |
$325.56 |
| 88300 |
|
141 |
137 |
$322.80 |
| 84132 |
|
1,096 |
1,085 |
$310.54 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
74 |
72 |
$302.95 |
| J1642 |
Inj heparin sodium per 10 u |
392 |
257 |
$286.38 |
| 84155 |
|
106 |
101 |
$280.52 |
| 73590 |
|
362 |
348 |
$279.05 |
| 73560 |
|
191 |
188 |
$267.88 |
| 86880 |
|
14 |
14 |
$252.71 |
| J1100 |
Dexamethasone sodium phos |
4,459 |
4,301 |
$244.92 |
| 80329 |
|
146 |
143 |
$233.78 |
| 84295 |
|
1,058 |
1,048 |
$223.85 |
| 85660 |
|
43 |
39 |
$220.62 |
| J1885 |
Ketorolac tromethamine inj |
8,594 |
8,085 |
$220.55 |
| 86317 |
|
190 |
189 |
$212.53 |
| 82435 |
|
1,029 |
1,019 |
$205.92 |
| 87625 |
|
34 |
34 |
$203.85 |
| 85014 |
|
1,429 |
1,407 |
$192.07 |
| 74019 |
|
288 |
281 |
$189.81 |
| J0690 |
Cefazolin sodium injection |
1,884 |
1,845 |
$167.82 |
| 85379 |
|
257 |
246 |
$159.08 |
| J7040 |
Normal saline solution infus |
1,097 |
988 |
$155.41 |
| 82652 |
|
13 |
12 |
$137.56 |
| 87147 |
|
218 |
188 |
$135.65 |
| 85347 |
|
144 |
116 |
$128.82 |
| J7642 |
Glycopyrrolate comp con |
1,531 |
1,522 |
$124.61 |
| 73521 |
|
68 |
68 |
$119.63 |
| 82553 |
|
770 |
729 |
$112.41 |
| 84156 |
|
115 |
109 |
$100.89 |
| J7644 |
Ipratropium bromide non-comp |
600 |
454 |
$93.72 |
| 93971 |
|
16 |
14 |
$93.00 |
| J2405 |
Ondansetron hcl injection |
4,940 |
4,634 |
$91.29 |
| 73090 |
|
181 |
158 |
$89.78 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
43 |
42 |
$85.88 |
| 74018 |
|
48 |
48 |
$79.05 |
| 72082 |
|
36 |
36 |
$75.62 |
| 87181 |
|
174 |
173 |
$73.06 |
| 87045 |
|
24 |
24 |
$70.91 |
| 84166 |
|
12 |
12 |
$69.63 |
| 88720 |
|
404 |
340 |
$67.08 |
| J3010 |
Fentanyl citrate injection |
2,149 |
1,960 |
$66.69 |
| 87205 |
|
160 |
144 |
$65.70 |
| 86301 |
|
16 |
14 |
$63.89 |
| 80179 |
|
170 |
167 |
$63.82 |
| J1644 |
Inj heparin sodium per 1000u |
744 |
524 |
$61.48 |
| J2370 |
Phenylephrine hcl injection |
89 |
89 |
$61.41 |
| 72040 |
|
12 |
12 |
$61.05 |
| 87338 |
|
14 |
13 |
$57.81 |
| C9399 |
Unclassified drugs or biolog |
888 |
807 |
$57.55 |
| J2270 |
Morphine sulfate injection |
451 |
360 |
$56.64 |
| 82232 |
|
13 |
12 |
$50.71 |
| J2710 |
Neostigmine methylslfte inj |
485 |
483 |
$48.54 |
| 83010 |
|
14 |
14 |
$42.47 |
| J2250 |
Inj midazolam hydrochloride |
4,165 |
4,032 |
$40.62 |
| 82977 |
|
13 |
13 |
$36.75 |
| J1200 |
Diphenhydramine hcl injectio |
957 |
753 |
$27.80 |
| 82247 |
|
15 |
12 |
$25.15 |
| J1630 |
Haloperidol injection |
301 |
238 |
$21.23 |
| J1170 |
Hydromorphone injection |
126 |
102 |
$19.82 |
| C1758 |
Catheter, ureteral |
77 |
77 |
$18.58 |
| J2001 |
Lidocaine injection |
668 |
652 |
$16.04 |
| J2765 |
Metoclopramide hcl injection |
305 |
297 |
$12.52 |
| 86431 |
|
13 |
13 |
$10.71 |
| 90472 |
|
24 |
24 |
$9.18 |
| 73140 |
|
55 |
53 |
$7.88 |
| 82950 |
|
15 |
15 |
$7.02 |
| J2060 |
Lorazepam injection |
542 |
488 |
$6.86 |
| Q0162 |
Ondansetron oral |
1,046 |
924 |
$6.23 |
| J1650 |
Inj enoxaparin sodium |
193 |
141 |
$4.74 |
| J7613 |
Albuterol non-comp unit |
921 |
731 |
$2.45 |
| J3475 |
Inj magnesium sulfate |
15 |
12 |
$1.52 |
| J7512 |
Prednisone ir or dr oral 1mg |
117 |
109 |
$1.05 |
| Q0163 |
Diphenhydramine hcl 50mg |
482 |
387 |
$0.45 |
| J7042 |
5% dextrose/normal saline |
27 |
26 |
$0.16 |
| J0131 |
Inj, acetaminophen (nos) |
236 |
235 |
$0.00 |
| S0109 |
Methadone oral 5mg |
13 |
12 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
13 |
13 |
$0.00 |
| C2617 |
Stent, non-cor, tem w/o del |
13 |
13 |
$0.00 |
| 90461 |
|
14 |
14 |
$0.00 |
| 99080 |
|
6,695 |
1,667 |
$0.00 |
| 82010 |
|
12 |
12 |
$0.00 |
| 76857 |
|
13 |
13 |
$0.00 |
| 84145 |
|
12 |
12 |
$0.00 |