| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
68,052 |
62,632 |
$45.54M |
| 99283 |
|
171,540 |
166,661 |
$28.60M |
| 99284 |
|
74,520 |
71,913 |
$26.48M |
| G0378 |
Hospital observation per hr |
17,137 |
8,515 |
$6.08M |
| J1569 |
Gammagard liquid injection |
2,159 |
1,692 |
$5.39M |
| J1745 |
Infliximab not biosimil 10mg |
1,625 |
1,417 |
$5.20M |
| 70551 |
|
4,453 |
4,203 |
$4.22M |
| 70553 |
|
2,123 |
1,995 |
$3.78M |
| 43239 |
|
2,094 |
1,963 |
$3.08M |
| 99213 |
|
30,168 |
25,513 |
$2.89M |
| 95810 |
|
1,754 |
1,706 |
$2.87M |
| 96413 |
|
8,086 |
5,344 |
$2.80M |
| P9016 |
Rbc leukocytes reduced |
2,678 |
2,268 |
$2.67M |
| 95782 |
|
1,415 |
1,365 |
$2.37M |
| 42820 |
|
1,386 |
1,334 |
$2.22M |
| 99282 |
|
23,225 |
22,080 |
$1.96M |
| 93325 |
|
9,808 |
8,544 |
$1.79M |
| J0585 |
Injection,onabotulinumtoxina |
1,703 |
1,431 |
$1.74M |
| J9312 |
Inj., rituximab, 10 mg |
255 |
188 |
$1.63M |
| 92611 |
|
4,130 |
3,926 |
$1.63M |
| 74230 |
|
4,109 |
3,949 |
$1.61M |
| 71046 |
|
23,640 |
22,038 |
$1.58M |
| 74183 |
|
948 |
883 |
$1.56M |
| 70543 |
|
816 |
767 |
$1.49M |
| 96365 |
|
14,986 |
11,720 |
$1.42M |
| 70450 |
|
4,163 |
3,809 |
$1.35M |
| 94776 |
|
3,412 |
3,258 |
$1.32M |
| 93975 |
|
2,777 |
2,553 |
$1.27M |
| 69436 |
|
1,795 |
1,720 |
$1.24M |
| 37241 |
|
367 |
338 |
$1.17M |
| 76825 |
|
1,528 |
1,423 |
$1.17M |
| 36430 |
|
2,753 |
2,143 |
$1.16M |
| 93321 |
|
6,096 |
5,358 |
$1.05M |
| J3490 |
Drugs unclassified injection |
59,471 |
35,983 |
$971K |
| J0586 |
Abobotulinumtoxina |
1,071 |
835 |
$922K |
| 87633 |
|
8,309 |
7,854 |
$894K |
| 72197 |
|
523 |
486 |
$887K |
| 99214 |
|
7,426 |
6,782 |
$867K |
| 96450 |
|
1,540 |
1,196 |
$864K |
| 96361 |
|
12,609 |
10,662 |
$839K |
| 85025 |
|
101,039 |
76,981 |
$833K |
| 80053 |
|
72,999 |
57,208 |
$829K |
| 76770 |
|
3,025 |
2,865 |
$827K |
| 74177 |
|
591 |
535 |
$795K |
| 96360 |
|
10,852 |
10,137 |
$783K |
| 96366 |
|
5,768 |
3,952 |
$756K |
| 76705 |
|
5,865 |
5,223 |
$734K |
| 88305 |
|
4,957 |
4,467 |
$723K |
| 74019 |
|
9,123 |
8,500 |
$720K |
| 93005 |
|
10,032 |
9,046 |
$661K |
| 71555 |
|
512 |
487 |
$646K |
| 86920 |
|
2,879 |
2,383 |
$643K |
| 96409 |
|
3,564 |
2,508 |
$642K |
| 94640 |
|
17,309 |
10,758 |
$641K |
| 93308 |
|
3,487 |
2,922 |
$638K |
| J1561 |
Gamunex-c/gammaked |
234 |
128 |
$628K |
| 71260 |
|
670 |
621 |
$621K |
| 93304 |
|
2,934 |
2,507 |
$616K |
| 75565 |
|
896 |
849 |
$575K |
| 76700 |
|
2,010 |
1,846 |
$572K |
| 96415 |
|
1,819 |
1,298 |
$550K |
| 64642 |
|
2,485 |
2,343 |
$544K |
| 93306 |
|
695 |
609 |
$517K |
| 76827 |
|
1,545 |
1,436 |
$497K |
| 99291 |
|
521 |
466 |
$493K |
| 93303 |
|
1,232 |
1,019 |
$461K |
| 54161 |
|
403 |
385 |
$450K |
| 86833 |
|
4,714 |
3,854 |
$444K |
| 75573 |
|
212 |
208 |
$442K |
| 99215 |
Prolong outpt/office vis |
2,882 |
2,583 |
$432K |
| D0230 |
|
829 |
756 |
$430K |
| 74240 |
|
981 |
946 |
$423K |
| D9420 |
|
184 |
169 |
$419K |
| 87799 |
|
16,000 |
8,468 |
$407K |
| 86832 |
|
4,708 |
3,852 |
$400K |
| 87497 |
|
8,681 |
5,707 |
$388K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
724 |
666 |
$373K |
| J2704 |
Inj, propofol, 10 mg |
31,554 |
27,744 |
$369K |
| Q5103 |
Injection, inflectra |
82 |
81 |
$365K |
| 75561 |
|
267 |
253 |
$356K |
| 94775 |
|
2,818 |
2,688 |
$347K |
| 96375 |
|
7,237 |
5,918 |
$344K |
| 51701 |
|
5,441 |
5,197 |
$340K |
| 82306 |
|
11,387 |
10,354 |
$336K |
| 96374 |
|
8,781 |
7,937 |
$333K |
| 99203 |
|
2,116 |
2,026 |
$315K |
| 93320 |
|
1,679 |
1,396 |
$313K |
| 76536 |
|
1,410 |
1,332 |
$303K |
| 99212 |
|
3,761 |
3,497 |
$302K |
| 74018 |
|
6,051 |
4,953 |
$299K |
| 88185 |
|
1,239 |
942 |
$296K |
| J3262 |
Tocilizumab injection |
171 |
101 |
$296K |
| 70486 |
|
461 |
419 |
$292K |
| 49465 |
|
1,120 |
948 |
$278K |
| 96367 |
|
2,129 |
1,727 |
$277K |
| 31622 |
|
577 |
517 |
$269K |
| 95819 |
|
513 |
467 |
$267K |
| 80197 |
|
16,582 |
9,834 |
$267K |
| 95812 |
|
515 |
490 |
$257K |
| 64643 |
|
2,502 |
2,317 |
$251K |
| 93886 |
|
401 |
386 |
$245K |
| D0220 |
|
835 |
762 |
$244K |
| 86828 |
|
4,899 |
3,987 |
$238K |
| 76856 |
|
1,499 |
1,382 |
$235K |
| 71045 |
|
7,456 |
5,849 |
$227K |
| J9310 |
Rituximab injection |
50 |
27 |
$209K |
| 92018 |
|
400 |
369 |
$206K |
| 94668 |
|
2,043 |
971 |
$204K |
| 76942 |
|
1,135 |
1,011 |
$204K |
| 87086 |
|
22,462 |
20,980 |
$198K |
| 96411 |
|
980 |
508 |
$196K |
| 87637 |
|
4,303 |
4,202 |
$195K |
| 31526 |
|
155 |
145 |
$184K |
| 80307 |
|
6,680 |
5,894 |
$177K |
| 87798 |
|
3,953 |
3,727 |
$173K |
| 72170 |
|
2,472 |
2,319 |
$172K |
| 82728 |
|
11,631 |
9,810 |
$172K |
| D1351 |
|
362 |
350 |
$169K |
| 83970 |
|
4,298 |
3,775 |
$167K |
| 88307 |
|
1,318 |
1,157 |
$166K |
| 72040 |
|
1,920 |
1,788 |
$159K |
| 54640 |
|
119 |
112 |
$154K |
| 83880 |
|
4,338 |
3,700 |
$153K |
| 92585 |
|
234 |
212 |
$152K |
| 93296 |
|
1,271 |
1,234 |
$152K |
| 93531 |
|
83 |
77 |
$144K |
| 93505 |
|
132 |
122 |
$143K |
| D7140 |
|
284 |
265 |
$142K |
| 76870 |
|
845 |
784 |
$142K |
| 87581 |
|
8,299 |
7,853 |
$139K |
| 87486 |
|
8,281 |
7,840 |
$139K |
| 87636 |
|
832 |
832 |
$138K |
| U0003 |
Cov-19 amp prb hgh thruput |
2,957 |
2,870 |
$130K |
| 87040 |
|
12,457 |
11,574 |
$130K |
| 92250 |
|
565 |
477 |
$130K |
| 96372 |
|
3,206 |
2,773 |
$127K |
| 70544 |
|
263 |
230 |
$126K |
| J9070 |
Cyclophosphamide 100 mg inj |
352 |
204 |
$125K |
| J2930 |
Methylprednisolone injection |
3,991 |
2,253 |
$125K |
| 73610 |
|
2,724 |
2,587 |
$123K |
| 73630 |
|
2,540 |
2,399 |
$123K |
| 73590 |
|
2,164 |
2,024 |
$120K |
| 43762 |
|
805 |
716 |
$120K |
| 84443 |
|
6,811 |
6,274 |
$119K |
| P9011 |
Blood split unit |
384 |
313 |
$119K |
| 83735 |
|
13,042 |
8,406 |
$117K |
| 36512 |
|
64 |
51 |
$115K |
| 76886 |
|
367 |
329 |
$112K |
| 86850 |
|
7,513 |
6,128 |
$109K |
| 86360 |
|
2,516 |
2,203 |
$108K |
| U0002 |
Covid-19 lab test non-cdc |
2,716 |
2,471 |
$107K |
| D0272 |
|
529 |
483 |
$107K |
| APT15 |
|
9,611 |
7,082 |
$106K |
| 88342 |
|
2,296 |
1,971 |
$106K |
| 87651 |
|
10,455 |
10,187 |
$105K |
| 73090 |
|
2,602 |
2,383 |
$103K |
| 86922 |
|
1,214 |
964 |
$102K |
| D1120 |
|
997 |
924 |
$101K |
| 83690 |
|
7,453 |
6,858 |
$98K |
| 87507 |
|
777 |
638 |
$96K |
| 93017 |
|
128 |
118 |
$95K |
| 76881 |
|
660 |
616 |
$94K |
| 12011 |
|
1,434 |
1,372 |
$94K |
| 82784 |
|
6,094 |
5,136 |
$93K |
| 86140 |
|
19,323 |
16,881 |
$92K |
| 97162 |
|
807 |
620 |
$92K |
| 85045 |
|
20,836 |
16,745 |
$91K |
| 42830 |
|
82 |
73 |
$91K |
| Q5121 |
Inj. avsola, 10 mg |
46 |
43 |
$90K |
| 85246 |
|
3,269 |
2,798 |
$89K |
| 80069 |
|
10,854 |
7,161 |
$89K |
| 70360 |
|
1,012 |
974 |
$89K |
| 78816 |
|
26 |
26 |
$87K |
| 73552 |
|
1,065 |
969 |
$85K |
| J7120 |
Ringers lactate infusion |
30,890 |
28,165 |
$85K |
| 94644 |
|
4,114 |
3,860 |
$85K |
| P9040 |
Rbc leukoreduced irradiated |
190 |
140 |
$83K |
| 93568 |
|
108 |
100 |
$82K |
| 75557 |
|
93 |
82 |
$80K |
| 73130 |
|
1,642 |
1,544 |
$78K |
| 88184 |
|
1,292 |
969 |
$77K |
| 92587 |
|
952 |
869 |
$77K |
| 73070 |
|
1,610 |
1,435 |
$75K |
| 49452 |
|
73 |
65 |
$75K |
| 93458 |
|
27 |
25 |
$74K |
| 94660 |
|
169 |
104 |
$72K |
| 90471 |
|
5,721 |
5,175 |
$71K |
| 70480 |
|
68 |
67 |
$71K |
| 74181 |
|
115 |
95 |
$70K |
| 73560 |
|
823 |
765 |
$70K |
| 88341 |
|
543 |
463 |
$69K |
| 80048 |
|
9,919 |
8,894 |
$69K |
| 72100 |
|
879 |
825 |
$69K |
| 88313 |
|
981 |
867 |
$67K |
| 99202 |
|
534 |
484 |
$67K |
| 12001 |
|
742 |
716 |
$67K |
| 86359 |
|
3,009 |
2,225 |
$65K |
| 87077 |
|
6,864 |
6,369 |
$65K |
| 86357 |
|
2,519 |
2,203 |
$65K |
| 86901 |
|
8,301 |
6,713 |
$64K |
| 73562 |
|
1,289 |
1,204 |
$63K |
| 86160 |
|
2,384 |
1,939 |
$62K |
| 82570 |
|
11,614 |
8,932 |
$61K |
| J7030 |
Normal saline solution infus |
22,175 |
17,993 |
$61K |
| 92652 |
|
96 |
83 |
$61K |
| 86355 |
|
2,514 |
2,201 |
$60K |
| D0240 |
|
126 |
119 |
$59K |
| 76885 |
|
187 |
174 |
$57K |
| 92019 |
|
196 |
165 |
$57K |
| 82977 |
|
9,896 |
7,581 |
$55K |
| 85730 |
|
8,315 |
7,255 |
$55K |
| 92567 |
|
1,004 |
903 |
$55K |
| 87186 |
|
5,738 |
5,325 |
$55K |
| 86902 |
|
2,898 |
2,380 |
$54K |
| 85027 |
|
7,805 |
6,849 |
$53K |
| 94642 |
|
758 |
692 |
$52K |
| 81001 |
|
19,932 |
17,411 |
$51K |
| 71250 |
|
64 |
63 |
$51K |
| 77080 |
|
156 |
143 |
$51K |
| 85576 |
|
661 |
568 |
$51K |
| 83550 |
|
5,310 |
4,793 |
$50K |
| 84439 |
|
5,102 |
4,693 |
$49K |
| 94621 |
|
46 |
38 |
$48K |
| 72148 |
|
57 |
55 |
$48K |
| 73110 |
|
1,028 |
988 |
$46K |
| 82803 |
|
7,188 |
6,328 |
$45K |
| D2930 |
|
93 |
83 |
$45K |
| J9370 |
Vincristine sulfate 1 mg inj |
3,640 |
2,501 |
$45K |
| 85610 |
|
9,583 |
7,911 |
$45K |
| 82330 |
|
8,618 |
7,252 |
$45K |
| 20680 |
|
26 |
25 |
$44K |
| 88304 |
|
1,244 |
1,140 |
$44K |
| 77072 |
|
344 |
325 |
$43K |
| 87502 |
|
1,793 |
1,570 |
$42K |
| 85240 |
|
1,870 |
1,683 |
$42K |
| 45380 |
|
12 |
12 |
$42K |
| 83540 |
|
5,721 |
5,135 |
$41K |
| 70250 |
|
357 |
335 |
$41K |
| 83036 |
|
4,729 |
4,251 |
$41K |
| 86003 |
|
356 |
332 |
$41K |
| 80061 |
|
5,121 |
4,517 |
$41K |
| 86356 |
|
625 |
564 |
$41K |
| J2997 |
Alteplase recombinant |
115 |
84 |
$40K |
| 75820 |
|
231 |
202 |
$40K |
| J1100 |
Dexamethasone sodium phos |
19,185 |
16,863 |
$39K |
| APT16 |
|
3,078 |
2,335 |
$39K |
| 80195 |
|
2,732 |
1,861 |
$38K |
| 86665 |
|
944 |
850 |
$37K |
| 87070 |
|
4,571 |
4,178 |
$37K |
| 43760 |
|
271 |
240 |
$36K |
| 72081 |
|
278 |
270 |
$36K |
| 87389 |
|
2,275 |
2,116 |
$36K |
| J3010 |
Fentanyl citrate injection |
31,351 |
28,032 |
$36K |
| 85652 |
|
12,226 |
10,495 |
$35K |
| 81003 |
|
20,967 |
18,729 |
$34K |
| 83020 |
|
6,669 |
5,167 |
$34K |
| 01922 |
|
102 |
100 |
$33K |
| 80158 |
|
1,317 |
452 |
$33K |
| 81025 |
|
7,293 |
6,684 |
$33K |
| 81268 |
|
364 |
308 |
$33K |
| 84156 |
|
8,781 |
6,343 |
$33K |
| J0131 |
Inj, acetaminophen (nos) |
568 |
525 |
$33K |
| 85245 |
|
1,148 |
1,030 |
$32K |
| 94726 |
|
314 |
283 |
$32K |
| 99211 |
|
634 |
508 |
$32K |
| 93597 |
|
40 |
24 |
$31K |
| 86480 |
|
440 |
385 |
$31K |
| 83520 |
|
785 |
662 |
$31K |
| 94680 |
|
344 |
328 |
$31K |
| 86900 |
|
8,300 |
6,713 |
$30K |
| 73030 |
|
485 |
447 |
$30K |
| J2270 |
Morphine sulfate injection |
7,315 |
5,992 |
$30K |
| 85660 |
|
3,551 |
2,369 |
$29K |
| 93280 |
|
90 |
86 |
$29K |
| 24538 |
|
13 |
12 |
$29K |
| 85999 |
|
1,209 |
1,097 |
$29K |
| J0330 |
Succinycholine chloride inj |
1,034 |
922 |
$28K |
| 76937 |
|
579 |
443 |
$28K |
| 87635 |
|
839 |
792 |
$28K |
| 87491 |
|
2,202 |
1,958 |
$27K |
| P9045 |
Albumin (human), 5%, 250 ml |
107 |
51 |
$27K |
| 73140 |
|
712 |
668 |
$26K |
| 99204 |
|
149 |
147 |
$26K |
| J7050 |
Normal saline solution infus |
7,357 |
5,592 |
$26K |
| D7111 |
|
130 |
120 |
$26K |
| 85384 |
|
2,662 |
2,174 |
$25K |
| J1885 |
Ketorolac tromethamine inj |
21,325 |
17,593 |
$25K |
| 73721 |
|
26 |
25 |
$25K |
| 49585 |
|
16 |
15 |
$25K |
| 77075 |
|
84 |
78 |
$24K |
| 94667 |
|
1,063 |
786 |
$24K |
| 86256 |
|
1,646 |
1,343 |
$24K |
| 31624 |
|
26 |
26 |
$24K |
| 82248 |
|
4,555 |
3,548 |
$24K |
| 44970 |
|
13 |
12 |
$24K |
| 85397 |
|
774 |
717 |
$23K |
| 87591 |
|
2,123 |
1,956 |
$23K |
| J0690 |
Cefazolin sodium injection |
9,894 |
7,642 |
$22K |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,312 |
1,239 |
$22K |
| D7240 |
|
12 |
12 |
$21K |
| S0020 |
Injection, bupivicaine hydro |
8,137 |
7,433 |
$21K |
| 76010 |
|
348 |
329 |
$21K |
| 82105 |
|
870 |
781 |
$21K |
| 94060 |
|
178 |
165 |
$21K |
| 84100 |
|
9,127 |
6,616 |
$20K |
| 86664 |
|
1,165 |
1,052 |
$20K |
| 49446 |
|
14 |
14 |
$19K |
| 88240 |
|
691 |
576 |
$19K |
| J1170 |
Hydromorphone injection |
6,911 |
6,167 |
$19K |
| 86235 |
|
149 |
128 |
$19K |
| 73060 |
|
290 |
274 |
$18K |
| 87880 |
|
3,576 |
3,293 |
$18K |
| 99460 |
|
183 |
183 |
$18K |
| 72141 |
|
25 |
24 |
$17K |
| 87340 |
|
1,903 |
1,676 |
$17K |
| 96376 |
|
663 |
577 |
$17K |
| 36590 |
|
17 |
15 |
$16K |
| 83615 |
|
5,071 |
3,833 |
$16K |
| 90686 |
|
4,146 |
3,703 |
$16K |
| 84703 |
|
3,348 |
3,051 |
$16K |
| 72070 |
|
210 |
197 |
$16K |
| 85379 |
|
1,520 |
1,278 |
$15K |
| 93567 |
|
27 |
25 |
$15K |
| 85520 |
|
994 |
753 |
$15K |
| 94664 |
|
2,206 |
2,116 |
$14K |
| J0610 |
Calcium glucon (fresenius) |
1,236 |
646 |
$14K |
| 83516 |
|
910 |
801 |
$14K |
| 12002 |
|
110 |
102 |
$14K |
| 95716 |
|
16 |
13 |
$14K |
| 86663 |
|
927 |
850 |
$13K |
| J2405 |
Ondansetron hcl injection |
26,618 |
23,474 |
$13K |
| 87081 |
|
3,280 |
2,996 |
$13K |
| 10060 |
|
102 |
99 |
$13K |
| 74455 |
|
39 |
38 |
$13K |
| 86039 |
|
872 |
798 |
$12K |
| 51600 |
|
43 |
41 |
$12K |
| APT04 |
|
1,082 |
904 |
$12K |
| P9037 |
Plate pheres leukoredu irrad |
26 |
15 |
$12K |
| 94645 |
|
645 |
599 |
$12K |
| 88108 |
|
417 |
345 |
$12K |
| 82043 |
|
1,685 |
1,535 |
$12K |
| 86706 |
|
1,397 |
1,288 |
$11K |
| J1756 |
Iron sucrose injection |
328 |
186 |
$11K |
| A9552 |
F18 fdg |
43 |
38 |
$11K |
| 82550 |
|
3,071 |
2,578 |
$11K |
| 87205 |
|
4,203 |
3,833 |
$11K |
| J2710 |
Neostigmine methylslfte inj |
3,084 |
2,521 |
$11K |
| 93971 |
|
57 |
51 |
$11K |
| 82785 |
|
513 |
482 |
$10K |
| 72146 |
|
12 |
12 |
$10K |
| 86645 |
|
388 |
317 |
$10K |
| 86644 |
|
482 |
363 |
$10K |
| 88348 |
|
58 |
50 |
$10K |
| APT17 |
|
770 |
628 |
$10K |
| 82810 |
|
2,168 |
1,775 |
$9K |
| 97161 |
|
143 |
114 |
$9K |
| J0696 |
Ceftriaxone sodium injection |
3,637 |
2,722 |
$9K |
| 88344 |
|
118 |
111 |
$9K |
| J9260 |
Inj methotrexate sodium 50mg |
1,838 |
1,136 |
$9K |
| 82150 |
|
1,562 |
1,394 |
$8K |
| 80143 |
|
1,119 |
1,043 |
$8K |
| 88188 |
|
148 |
113 |
$8K |
| 70491 |
|
12 |
12 |
$8K |
| 60000 |
|
37 |
15 |
$8K |
| 87661 |
|
780 |
751 |
$8K |
| 80179 |
|
1,075 |
1,012 |
$8K |
| 80180 |
|
1,573 |
1,095 |
$8K |
| 86803 |
|
480 |
404 |
$8K |
| 84630 |
|
634 |
600 |
$8K |
| 86147 |
|
113 |
90 |
$8K |
| J0171 |
Adrenalin epinephrine inject |
1,530 |
1,355 |
$7K |
| 83002 |
|
322 |
301 |
$7K |
| 82247 |
|
1,921 |
1,489 |
$7K |
| 84305 |
|
225 |
211 |
$7K |
| D1206 |
|
160 |
151 |
$7K |
| 76506 |
|
27 |
27 |
$7K |
| 82525 |
|
488 |
457 |
$7K |
| 86146 |
|
116 |
89 |
$7K |
| 84999 |
|
14 |
12 |
$7K |
| 83718 |
|
660 |
633 |
$7K |
| 90732 |
|
72 |
67 |
$7K |
| 86592 |
|
1,814 |
1,629 |
$7K |
| J1644 |
Inj heparin sodium per 1000u |
5,165 |
3,286 |
$7K |
| 25600 |
|
55 |
53 |
$7K |
| 89051 |
|
2,628 |
2,121 |
$7K |
| 86376 |
|
338 |
307 |
$6K |
| 82533 |
|
174 |
152 |
$6K |
| 84403 |
|
195 |
186 |
$6K |
| 87075 |
|
649 |
583 |
$6K |
| 82085 |
|
532 |
408 |
$6K |
| 25605 |
|
26 |
25 |
$6K |
| D2391 |
|
41 |
39 |
$6K |
| 85670 |
|
892 |
812 |
$6K |
| J2919 |
Inj, methylpred sod succ 5mg |
294 |
235 |
$6K |
| 29105 |
|
132 |
120 |
$6K |
| 85014 |
|
6,733 |
5,965 |
$6K |
| 86317 |
|
155 |
102 |
$6K |
| 84446 |
|
376 |
354 |
$6K |
| 82077 |
|
879 |
833 |
$6K |
| J2250 |
Inj midazolam hydrochloride |
6,023 |
5,458 |
$6K |
| J7042 |
5% dextrose/normal saline |
913 |
685 |
$6K |
| 80164 |
|
461 |
418 |
$5K |
| J0290 |
Ampicillin 500 mg inj |
1,536 |
1,090 |
$5K |
| J0780 |
Prochlorperazine injection |
969 |
824 |
$5K |
| 94729 |
|
58 |
53 |
$5K |
| S0077 |
Injection, clindamycin phosp |
1,606 |
873 |
$5K |
| 83921 |
|
260 |
249 |
$5K |
| 92610 |
|
42 |
38 |
$5K |
| 83001 |
|
221 |
208 |
$5K |
| J1815 |
Insulin injection |
207 |
181 |
$5K |
| 82610 |
|
354 |
269 |
$5K |
| 95816 |
|
14 |
12 |
$5K |
| 69210 |
|
19 |
18 |
$5K |
| 25565 |
|
17 |
17 |
$5K |
| 94375 |
|
126 |
107 |
$5K |
| 82670 |
|
146 |
139 |
$5K |
| 86800 |
|
234 |
201 |
$5K |
| 82820 |
|
778 |
628 |
$5K |
| 82340 |
|
645 |
612 |
$5K |
| 94799 |
|
468 |
426 |
$5K |
| 82542 |
|
487 |
435 |
$4K |
| 10061 |
|
27 |
25 |
$4K |
| 85018 |
|
3,103 |
2,133 |
$4K |
| 82948 |
|
3,681 |
2,300 |
$4K |
| 92579 |
|
37 |
37 |
$4K |
| 93225 |
|
14 |
12 |
$4K |
| 84550 |
|
1,137 |
934 |
$4K |
| 84295 |
|
5,674 |
5,087 |
$4K |
| 88346 |
|
93 |
87 |
$4K |
| J7040 |
Normal saline solution infus |
2,130 |
1,727 |
$4K |
| 88311 |
|
197 |
168 |
$4K |
| 87529 |
|
89 |
84 |
$4K |
| 80076 |
|
445 |
397 |
$4K |
| 90472 |
|
298 |
276 |
$3K |
| 82103 |
|
185 |
181 |
$3K |
| 84484 |
|
369 |
313 |
$3K |
| 73000 |
|
76 |
75 |
$3K |
| 73080 |
|
51 |
49 |
$3K |
| 84132 |
|
5,668 |
5,129 |
$3K |
| 82947 |
|
6,778 |
6,061 |
$3K |
| J0561 |
Penicillin g benzathine inj |
73 |
72 |
$3K |
| 83090 |
|
190 |
183 |
$3K |
| J3475 |
Inj magnesium sulfate |
811 |
712 |
$3K |
| 86364 |
|
102 |
102 |
$3K |
| S5553 |
Insulin long acting 5 u |
266 |
234 |
$3K |
| 82607 |
|
164 |
156 |
$3K |
| S5551 |
Insulin most rapid 5 u |
318 |
282 |
$3K |
| 62270 |
|
15 |
13 |
$3K |
| J2780 |
Ranitidine hydrochloride inj |
127 |
83 |
$3K |
| 82104 |
|
138 |
136 |
$3K |
| 80074 |
|
58 |
54 |
$3K |
| APT18 |
|
225 |
197 |
$3K |
| 29125 |
|
90 |
86 |
$3K |
| 95700 |
|
32 |
30 |
$3K |
| 83050 |
|
729 |
631 |
$3K |
| 88312 |
|
63 |
56 |
$3K |
| 83498 |
|
72 |
65 |
$3K |
| 87206 |
|
359 |
307 |
$3K |
| 84480 |
|
150 |
140 |
$3K |
| 84590 |
|
210 |
207 |
$3K |
| J1200 |
Diphenhydramine hcl injectio |
2,879 |
2,164 |
$3K |
| J7999 |
Compounded drug, noc |
2,291 |
1,985 |
$2K |
| 90734 |
|
45 |
41 |
$2K |
| 82310 |
|
1,380 |
1,146 |
$2K |
| 99238 |
|
31 |
31 |
$2K |
| 82397 |
|
114 |
106 |
$2K |
| 87102 |
|
254 |
221 |
$2K |
| 69200 |
|
16 |
13 |
$2K |
| 84255 |
|
73 |
68 |
$2K |
| 82390 |
|
128 |
124 |
$2K |
| APT09 |
|
202 |
156 |
$2K |
| 87116 |
|
54 |
50 |
$2K |
| J0295 |
Ampicillin sulbactam 1.5 gm |
298 |
154 |
$2K |
| 87015 |
|
328 |
303 |
$2K |
| J2795 |
Ropivacaine hcl injection |
98 |
89 |
$2K |
| 86880 |
|
255 |
212 |
$2K |
| 97530 |
|
79 |
44 |
$2K |
| 29505 |
|
66 |
60 |
$2K |
| 84145 |
|
156 |
139 |
$2K |
| 82375 |
|
707 |
631 |
$2K |
| 85347 |
|
1,371 |
1,217 |
$2K |
| 70355 |
|
15 |
13 |
$2K |
| 31720 |
|
32 |
26 |
$2K |
| 81379 |
|
14 |
12 |
$2K |
| J2370 |
Phenylephrine hcl injection |
609 |
533 |
$2K |
| D2392 |
|
12 |
12 |
$2K |
| 76932 |
|
15 |
13 |
$2K |
| 87522 |
Neg quan hep c or qual rna |
33 |
28 |
$2K |
| J7060 |
5% dextrose/water |
534 |
308 |
$1K |
| 72072 |
|
25 |
24 |
$1K |
| J3360 |
Diazepam injection |
89 |
67 |
$1K |
| 82565 |
|
332 |
293 |
$1K |
| 90715 |
|
78 |
71 |
$1K |
| J2060 |
Lorazepam injection |
438 |
303 |
$1K |
| 86341 |
|
27 |
27 |
$1K |
| 85613 |
|
112 |
89 |
$1K |
| G0463 |
Hospital outpt clinic visit |
1,107 |
803 |
$1K |
| 84146 |
|
47 |
40 |
$1K |
| 90656 |
|
414 |
399 |
$1K |
| 85732 |
|
76 |
70 |
$1K |
| 83883 |
|
81 |
79 |
$1K |
| 82652 |
|
26 |
24 |
$1K |
| J0613 |
Calcium glucon (wg critical) |
33 |
25 |
$1K |
| 84402 |
|
31 |
27 |
$1K |
| 85044 |
|
225 |
192 |
$1K |
| 99051 |
|
57 |
54 |
$1K |
| APT02 |
|
130 |
114 |
$872.89 |
| 82024 |
|
18 |
16 |
$872.50 |
| 85335 |
|
51 |
49 |
$868.02 |
| 82746 |
|
45 |
44 |
$859.49 |
| 16020 |
|
16 |
15 |
$832.36 |
| 82270 |
|
295 |
261 |
$807.63 |
| 73660 |
|
15 |
14 |
$806.87 |
| 84075 |
|
213 |
204 |
$797.83 |
| J2920 |
Methylprednisolone injection |
186 |
156 |
$767.27 |
| 90620 |
|
17 |
14 |
$759.58 |
| 24640 |
|
14 |
13 |
$741.96 |
| 86431 |
|
102 |
91 |
$719.73 |
| 84520 |
|
215 |
188 |
$712.60 |
| J9255 |
Inj, methotrexate (accord) |
154 |
123 |
$705.27 |
| 86696 |
|
17 |
13 |
$695.47 |
| 87045 |
|
39 |
38 |
$684.88 |
| 87517 |
|
13 |
12 |
$658.80 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
190 |
182 |
$658.73 |
| 87804 |
|
58 |
29 |
$651.12 |
| 83605 |
|
52 |
48 |
$642.67 |
| S0030 |
Injection, metronidazole |
52 |
27 |
$629.28 |
| 84244 |
|
21 |
18 |
$610.67 |
| 86695 |
|
17 |
13 |
$606.39 |
| 86769 |
|
14 |
14 |
$590.44 |
| J9040 |
Bleomycin sulfate injection |
28 |
26 |
$563.90 |
| 93041 |
|
30 |
30 |
$536.10 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
213 |
204 |
$528.48 |
| J2272 |
Inj, morphine (fresenius) |
109 |
101 |
$494.66 |
| 82657 |
|
48 |
38 |
$481.79 |
| 80183 |
|
29 |
26 |
$478.07 |
| 83789 |
|
59 |
56 |
$458.72 |
| 86812 |
|
14 |
13 |
$450.37 |
| J1956 |
Levofloxacin injection |
63 |
51 |
$447.58 |
| 80299 |
|
49 |
47 |
$444.22 |
| 87811 |
|
12 |
12 |
$434.48 |
| 0071A |
|
55 |
45 |
$425.03 |
| 84478 |
|
175 |
134 |
$419.81 |
| J2543 |
Piperacillin/tazobactam |
90 |
63 |
$389.38 |
| 85250 |
|
16 |
13 |
$388.16 |
| 86308 |
|
115 |
111 |
$376.74 |
| 0124A |
|
20 |
18 |
$320.88 |
| APT11 |
|
31 |
27 |
$315.12 |
| 87147 |
|
178 |
160 |
$313.10 |
| 86200 |
|
16 |
15 |
$264.31 |
| S0080 |
Injection, pentamidine iseth |
43 |
40 |
$243.56 |
| 81015 |
|
71 |
56 |
$242.25 |
| 84466 |
|
15 |
12 |
$229.74 |
| J1953 |
Levetiracetam injection |
53 |
50 |
$228.08 |
| 80339 |
|
14 |
14 |
$211.35 |
| 82140 |
|
20 |
13 |
$208.60 |
| 80187 |
|
17 |
12 |
$201.58 |
| 90685 |
|
99 |
90 |
$183.51 |
| J0694 |
Cefoxitin sodium injection |
28 |
14 |
$182.32 |
| J3489 |
Zoledronic acid 1mg |
14 |
14 |
$173.76 |
| J1720 |
Hydrocortisone sodium succ i |
18 |
12 |
$171.52 |
| S5571 |
Insulin dispos pen 3 ml |
12 |
12 |
$171.40 |
| 87046 |
|
39 |
38 |
$170.78 |
| S0164 |
Injection pantroprazole |
21 |
12 |
$162.69 |
| 82139 |
|
30 |
25 |
$153.30 |
| 84436 |
|
30 |
30 |
$148.14 |
| 0054A |
|
12 |
12 |
$108.70 |
| 86704 |
|
15 |
12 |
$99.37 |
| S0028 |
Injection, famotidine, 20 mg |
15 |
13 |
$96.81 |
| J2550 |
Promethazine hcl injection |
57 |
49 |
$90.07 |
| 84030 |
|
14 |
12 |
$90.04 |
| J3480 |
Inj potassium chloride |
65 |
38 |
$89.50 |
| 0003A |
|
16 |
14 |
$89.50 |
| 96523 |
|
15 |
14 |
$78.47 |
| J7070 |
D5w infusion |
23 |
12 |
$72.75 |
| J1940 |
Furosemide injection |
38 |
27 |
$61.54 |
| 84300 |
|
14 |
13 |
$60.69 |
| 82945 |
|
12 |
12 |
$53.26 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
13 |
12 |
$13.56 |
| S0119 |
Ondansetron 4 mg |
16 |
16 |
$4.80 |
| 94760 |
|
1,363 |
741 |
$1.48 |
| D1208 |
|
116 |
106 |
$0.00 |
| 81382 |
|
14 |
12 |
$0.00 |
| 99053 |
|
790 |
778 |
$0.00 |