| Code | Description | Claims | Beneficiaries | Total Paid |
| 99212 |
|
89,559 |
84,009 |
$10.45M |
| 96361 |
|
18,430 |
15,611 |
$5.69M |
| 99284 |
|
34,853 |
31,250 |
$4.80M |
| 99283 |
|
37,942 |
35,438 |
$4.53M |
| 99211 |
|
37,002 |
33,421 |
$4.51M |
| 99285 |
|
16,591 |
14,678 |
$2.51M |
| H0015 |
Alcohol and/or drug services |
8,756 |
828 |
$1.44M |
| 99282 |
|
9,593 |
9,138 |
$1.17M |
| 70450 |
|
4,480 |
3,944 |
$1.17M |
| 74177 |
|
4,200 |
3,566 |
$1.14M |
| 99213 |
|
7,363 |
6,882 |
$853K |
| 96360 |
|
3,150 |
2,638 |
$710K |
| 97110 |
|
8,346 |
2,553 |
$641K |
| U0003 |
Cov-19 amp prb hgh thruput |
2,930 |
2,831 |
$632K |
| 62323 |
|
1,444 |
1,340 |
$499K |
| 80053 |
|
29,446 |
25,173 |
$496K |
| 74176 |
|
1,660 |
1,420 |
$482K |
| 96365 |
|
3,241 |
2,343 |
$466K |
| 64493 |
|
735 |
673 |
$393K |
| 99281 |
|
3,057 |
2,844 |
$392K |
| 92507 |
|
4,536 |
1,555 |
$390K |
| 87491 |
|
9,936 |
9,078 |
$388K |
| G0378 |
Hospital observation per hr |
6,189 |
2,264 |
$371K |
| 80048 |
|
45,987 |
39,790 |
$359K |
| 27096 |
|
1,401 |
1,249 |
$356K |
| 43239 |
|
876 |
801 |
$341K |
| 71275 |
|
1,212 |
1,040 |
$338K |
| 94640 |
|
2,802 |
1,860 |
$315K |
| 81513 |
|
1,797 |
1,569 |
$279K |
| 93306 |
|
1,059 |
987 |
$258K |
| 87591 |
|
9,836 |
8,988 |
$249K |
| 96366 |
|
1,174 |
670 |
$240K |
| 96413 |
|
1,906 |
1,116 |
$230K |
| 97530 |
|
2,705 |
1,028 |
$220K |
| 78452 |
|
515 |
460 |
$218K |
| 76805 |
|
1,291 |
1,207 |
$201K |
| 45380 |
|
391 |
340 |
$186K |
| 83036 |
|
11,817 |
11,005 |
$183K |
| 84443 |
|
9,892 |
8,997 |
$180K |
| 80307 |
|
11,619 |
10,324 |
$169K |
| 83655 |
|
4,932 |
4,675 |
$159K |
| 76816 |
|
992 |
887 |
$159K |
| 85025 |
|
60,101 |
50,605 |
$157K |
| 76801 |
|
1,039 |
941 |
$156K |
| 87661 |
|
5,728 |
5,186 |
$152K |
| 80061 |
|
9,396 |
8,817 |
$152K |
| 87086 |
|
14,331 |
12,512 |
$143K |
| 20552 |
|
2,033 |
1,881 |
$135K |
| 76830 |
|
1,182 |
1,066 |
$127K |
| 81220 |
|
381 |
300 |
$121K |
| 36415 |
|
57,528 |
49,508 |
$117K |
| 64494 |
|
933 |
673 |
$112K |
| 88142 |
|
5,051 |
4,697 |
$107K |
| 71260 |
|
532 |
461 |
$95K |
| 64635 |
|
215 |
210 |
$94K |
| 73721 |
|
403 |
369 |
$93K |
| 88305 |
|
5,044 |
4,487 |
$93K |
| 76705 |
|
1,071 |
969 |
$92K |
| 77063 |
|
1,974 |
1,788 |
$91K |
| 94060 |
|
635 |
576 |
$90K |
| 71046 |
|
10,738 |
9,899 |
$90K |
| 82306 |
|
4,025 |
3,690 |
$88K |
| 97161 |
|
1,187 |
1,085 |
$87K |
| 76815 |
|
547 |
472 |
$84K |
| 97112 |
|
1,352 |
594 |
$82K |
| 81420 |
|
621 |
528 |
$82K |
| 76817 |
|
691 |
548 |
$81K |
| 71271 |
|
411 |
389 |
$81K |
| 87481 |
|
1,767 |
1,547 |
$80K |
| 12001 |
|
459 |
399 |
$79K |
| G0472 |
Hep c screen high risk/other |
2,151 |
1,907 |
$75K |
| 84439 |
|
3,057 |
2,768 |
$71K |
| 0241U |
|
565 |
474 |
$70K |
| 76856 |
|
350 |
329 |
$70K |
| G0475 |
Hiv combination assay |
3,083 |
2,734 |
$70K |
| 66984 |
|
141 |
106 |
$69K |
| 70496 |
|
276 |
239 |
$67K |
| 76642 |
|
490 |
452 |
$64K |
| 95810 |
|
109 |
104 |
$60K |
| 96367 |
|
730 |
464 |
$60K |
| 93971 |
|
738 |
671 |
$59K |
| 93017 |
|
666 |
602 |
$59K |
| 87081 |
|
17,805 |
16,754 |
$55K |
| 80076 |
|
12,332 |
10,820 |
$54K |
| 97162 |
|
707 |
638 |
$54K |
| 82607 |
|
2,714 |
2,485 |
$53K |
| 64490 |
|
126 |
120 |
$52K |
| 84702 |
|
2,394 |
1,746 |
$52K |
| 72148 |
|
300 |
283 |
$49K |
| 86592 |
|
1,558 |
1,434 |
$49K |
| 70551 |
|
285 |
258 |
$49K |
| 80055 |
|
1,697 |
1,515 |
$49K |
| 85027 |
|
11,660 |
10,291 |
$48K |
| 10060 |
|
276 |
236 |
$47K |
| 76536 |
|
427 |
407 |
$47K |
| 87653 |
|
1,093 |
1,014 |
$47K |
| 82728 |
|
2,575 |
2,321 |
$46K |
| 90792 |
|
176 |
153 |
$46K |
| 87077 |
|
6,169 |
5,399 |
$45K |
| 70553 |
|
160 |
149 |
$41K |
| 86850 |
|
1,682 |
1,327 |
$40K |
| 93005 |
|
20,562 |
18,169 |
$39K |
| 94726 |
|
558 |
503 |
$38K |
| 72131 |
|
596 |
521 |
$38K |
| 86140 |
|
2,139 |
1,881 |
$37K |
| 94729 |
|
543 |
490 |
$36K |
| 83970 |
|
1,260 |
1,165 |
$35K |
| 97140 |
|
1,041 |
466 |
$34K |
| 45385 |
|
66 |
52 |
$33K |
| 72100 |
|
869 |
790 |
$33K |
| 96415 |
|
120 |
91 |
$32K |
| 97165 |
|
523 |
469 |
$31K |
| 20553 |
|
360 |
325 |
$30K |
| 80069 |
|
1,809 |
1,666 |
$30K |
| 93970 |
|
239 |
215 |
$30K |
| 81001 |
|
38,829 |
34,864 |
$29K |
| 71250 |
|
379 |
351 |
$29K |
| 45378 |
|
42 |
39 |
$28K |
| 96374 |
|
24,733 |
21,174 |
$28K |
| 72125 |
|
1,282 |
1,125 |
$28K |
| 73130 |
|
1,639 |
1,465 |
$28K |
| 74018 |
|
903 |
805 |
$28K |
| 77067 |
|
1,975 |
1,788 |
$28K |
| 97010 |
|
801 |
341 |
$27K |
| 83735 |
|
9,794 |
8,089 |
$26K |
| 73630 |
|
1,855 |
1,674 |
$24K |
| 83721 |
|
1,714 |
1,603 |
$24K |
| 85014 |
|
2,576 |
2,339 |
$24K |
| H0012 |
Alcohol and/or drug services |
78 |
25 |
$23K |
| 70486 |
|
351 |
310 |
$23K |
| 86900 |
|
1,809 |
1,439 |
$22K |
| 87480 |
|
1,290 |
1,139 |
$22K |
| 82950 |
|
1,684 |
1,573 |
$22K |
| 87635 |
|
3,502 |
3,100 |
$21K |
| 73560 |
|
1,624 |
1,424 |
$20K |
| 64491 |
|
137 |
120 |
$19K |
| 12011 |
|
98 |
88 |
$19K |
| 84484 |
|
9,332 |
6,328 |
$19K |
| 86039 |
|
705 |
632 |
$19K |
| 76775 |
|
227 |
212 |
$19K |
| 72040 |
|
426 |
384 |
$19K |
| 78815 |
|
27 |
26 |
$18K |
| G0463 |
Hospital outpt clinic visit |
1,268 |
1,154 |
$18K |
| 76000 |
|
153 |
141 |
$17K |
| 87510 |
|
1,289 |
1,138 |
$17K |
| 87428 |
|
31,814 |
29,730 |
$17K |
| 99214 |
|
208 |
194 |
$16K |
| 84460 |
|
1,661 |
1,543 |
$16K |
| 87186 |
|
3,427 |
2,976 |
$16K |
| 82043 |
|
2,058 |
1,926 |
$16K |
| 73030 |
|
1,114 |
990 |
$15K |
| 87340 |
|
726 |
669 |
$15K |
| 96372 |
|
6,867 |
5,045 |
$14K |
| 82570 |
|
1,620 |
1,463 |
$14K |
| 85652 |
|
2,887 |
2,549 |
$14K |
| 70491 |
|
56 |
52 |
$14K |
| 73110 |
|
1,002 |
881 |
$14K |
| 73610 |
|
1,466 |
1,258 |
$14K |
| 87070 |
|
1,194 |
1,047 |
$14K |
| 84481 |
|
853 |
791 |
$14K |
| 70498 |
|
275 |
241 |
$13K |
| 97116 |
|
421 |
213 |
$13K |
| 95811 |
|
27 |
26 |
$13K |
| 84466 |
|
1,449 |
1,314 |
$13K |
| 81161 |
|
109 |
87 |
$13K |
| 85018 |
|
2,619 |
2,377 |
$12K |
| 87522 |
Neg quan hep c or qual rna |
332 |
275 |
$12K |
| 90715 |
|
769 |
665 |
$12K |
| 76857 |
|
456 |
412 |
$12K |
| 64495 |
|
58 |
40 |
$11K |
| 82746 |
|
1,454 |
1,326 |
$11K |
| 80305 |
|
4,637 |
3,907 |
$11K |
| 84153 |
|
706 |
649 |
$11K |
| 80074 |
|
540 |
449 |
$11K |
| 80326 |
|
691 |
683 |
$11K |
| 29581 |
|
121 |
46 |
$11K |
| 83615 |
|
2,289 |
1,853 |
$10K |
| 11102 |
|
28 |
26 |
$10K |
| 83001 |
|
398 |
345 |
$10K |
| 73502 |
|
595 |
538 |
$10K |
| 97802 |
|
109 |
101 |
$10K |
| 84146 |
|
411 |
367 |
$10K |
| 83880 |
|
2,181 |
1,818 |
$10K |
| 71045 |
|
5,838 |
5,046 |
$10K |
| J1756 |
Iron sucrose injection |
390 |
109 |
$10K |
| 12002 |
|
54 |
53 |
$10K |
| 93976 |
|
53 |
44 |
$9K |
| 88342 |
|
633 |
563 |
$9K |
| G0480 |
Drug test def 1-7 classes |
546 |
455 |
$9K |
| 82248 |
|
2,572 |
2,339 |
$9K |
| 86901 |
|
1,809 |
1,439 |
$9K |
| 84403 |
|
420 |
380 |
$9K |
| 81200 |
|
109 |
87 |
$9K |
| 88112 |
|
228 |
205 |
$9K |
| 81329 |
|
379 |
300 |
$8K |
| 88307 |
|
62 |
52 |
$8K |
| 86803 |
|
157 |
150 |
$7K |
| 81255 |
|
109 |
87 |
$7K |
| 86431 |
|
470 |
435 |
$7K |
| 81251 |
|
109 |
87 |
$7K |
| 81290 |
|
109 |
87 |
$7K |
| 93270 |
|
40 |
39 |
$7K |
| 80346 |
|
983 |
972 |
$7K |
| 81330 |
|
109 |
87 |
$7K |
| 0352U |
|
481 |
462 |
$7K |
| 87633 |
|
33 |
32 |
$7K |
| 96375 |
|
17,137 |
14,174 |
$7K |
| 73080 |
|
513 |
471 |
$7K |
| 81209 |
|
109 |
87 |
$7K |
| 82784 |
|
445 |
386 |
$7K |
| 86235 |
|
368 |
318 |
$7K |
| 87389 |
|
263 |
253 |
$6K |
| 80361 |
|
979 |
968 |
$6K |
| 81260 |
|
109 |
87 |
$6K |
| 96376 |
|
2,679 |
1,503 |
$6K |
| 81242 |
|
109 |
87 |
$6K |
| 83690 |
|
10,993 |
9,540 |
$6K |
| 80365 |
|
931 |
920 |
$6K |
| G0481 |
Drug test def 8-14 classes |
109 |
95 |
$6K |
| 83550 |
|
536 |
496 |
$6K |
| 97803 |
|
106 |
96 |
$6K |
| 81361 |
|
109 |
87 |
$6K |
| 80355 |
|
652 |
645 |
$6K |
| 86364 |
|
268 |
232 |
$6K |
| 80370 |
|
684 |
676 |
$6K |
| 80334 |
|
521 |
515 |
$6K |
| 80338 |
|
521 |
515 |
$6K |
| 80331 |
|
521 |
515 |
$6K |
| 80337 |
|
521 |
515 |
$6K |
| 85610 |
|
3,667 |
2,745 |
$6K |
| 86480 |
|
124 |
114 |
$6K |
| 80354 |
|
573 |
566 |
$5K |
| 80353 |
|
549 |
543 |
$5K |
| 36430 |
|
37 |
26 |
$5K |
| 82105 |
|
275 |
260 |
$5K |
| 86200 |
|
369 |
342 |
$5K |
| 80372 |
|
521 |
515 |
$5K |
| 80344 |
|
521 |
515 |
$5K |
| 80366 |
|
521 |
515 |
$5K |
| 80377 |
|
521 |
515 |
$5K |
| 80373 |
|
521 |
515 |
$5K |
| 80357 |
|
521 |
515 |
$5K |
| 80367 |
|
521 |
515 |
$5K |
| 80368 |
|
521 |
515 |
$5K |
| 80341 |
|
521 |
515 |
$5K |
| 88304 |
|
617 |
517 |
$5K |
| G0476 |
Hpv combo assay ca screen |
95 |
94 |
$5K |
| 84550 |
|
908 |
784 |
$5K |
| 80364 |
|
844 |
835 |
$5K |
| 80360 |
|
521 |
515 |
$5K |
| 80348 |
|
521 |
515 |
$5K |
| 80359 |
|
521 |
515 |
$5K |
| 80358 |
|
521 |
515 |
$5K |
| 80371 |
|
521 |
515 |
$5K |
| 93880 |
|
55 |
53 |
$5K |
| 84156 |
|
1,083 |
944 |
$5K |
| 95816 |
|
29 |
28 |
$5K |
| 64636 |
|
298 |
210 |
$5K |
| 97163 |
|
67 |
58 |
$5K |
| 82077 |
|
3,952 |
3,276 |
$5K |
| 82670 |
|
147 |
128 |
$4K |
| 87426 |
|
3,507 |
3,401 |
$4K |
| 88341 |
|
75 |
64 |
$4K |
| 87205 |
|
1,053 |
920 |
$4K |
| 73590 |
|
390 |
335 |
$4K |
| 77062 |
|
141 |
128 |
$4K |
| 86255 |
|
252 |
216 |
$4K |
| 72128 |
|
202 |
176 |
$4K |
| 87804 |
|
9,706 |
9,140 |
$4K |
| 73221 |
|
31 |
28 |
$4K |
| 87660 |
|
573 |
478 |
$4K |
| 69209 |
|
27 |
25 |
$4K |
| 73700 |
|
27 |
25 |
$4K |
| J3490 |
Drugs unclassified injection |
2,799 |
2,372 |
$4K |
| 81003 |
|
8,832 |
8,301 |
$4K |
| 82565 |
|
429 |
365 |
$4K |
| 11042 |
|
30 |
26 |
$4K |
| 80143 |
|
3,896 |
3,251 |
$4K |
| 77065 |
Tomosynthesis, mammo |
242 |
205 |
$4K |
| 72072 |
|
125 |
112 |
$4K |
| 82157 |
|
96 |
76 |
$4K |
| 90471 |
|
919 |
761 |
$4K |
| 87624 |
|
123 |
115 |
$4K |
| 84436 |
|
189 |
169 |
$4K |
| 86258 |
|
103 |
86 |
$3K |
| 84100 |
|
649 |
505 |
$3K |
| 86762 |
|
230 |
222 |
$3K |
| 29125 |
|
112 |
90 |
$3K |
| 73090 |
|
300 |
262 |
$3K |
| 92526 |
|
39 |
12 |
$3K |
| 82550 |
|
556 |
451 |
$3K |
| J0897 |
Denosumab injection |
12 |
12 |
$3K |
| 84450 |
|
354 |
313 |
$3K |
| 86160 |
|
220 |
193 |
$3K |
| 84145 |
|
1,227 |
964 |
$3K |
| 82677 |
|
74 |
74 |
$3K |
| P9016 |
Rbc leukocytes reduced |
18 |
14 |
$3K |
| 87147 |
|
611 |
545 |
$3K |
| 87880 |
|
17,863 |
16,759 |
$3K |
| 81025 |
|
16,094 |
14,281 |
$3K |
| 93922 |
|
24 |
24 |
$2K |
| 86376 |
|
98 |
87 |
$2K |
| 17000 |
|
26 |
26 |
$2K |
| 80164 |
|
124 |
119 |
$2K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
446 |
384 |
$2K |
| 20610 |
|
16 |
13 |
$2K |
| 85055 |
|
113 |
102 |
$2K |
| M0243 |
Casirivi and imdevi inj |
15 |
14 |
$2K |
| 82977 |
|
268 |
210 |
$2K |
| 85379 |
|
3,394 |
2,903 |
$2K |
| 83630 |
|
152 |
131 |
$2K |
| G0483 |
Drug test def 22+ classes |
132 |
119 |
$2K |
| J7030 |
Normal saline solution infus |
28,003 |
23,869 |
$2K |
| 83540 |
|
214 |
192 |
$2K |
| 86308 |
|
347 |
301 |
$2K |
| 99215 |
Prolong outpt/office vis |
30 |
29 |
$2K |
| 80179 |
|
3,857 |
3,220 |
$2K |
| 76770 |
|
13 |
12 |
$2K |
| Q0138 |
Ferumoxytol, non-esrd |
34 |
24 |
$2K |
| 92523 |
|
23 |
20 |
$2K |
| 76882 |
|
32 |
27 |
$2K |
| 94618 |
|
41 |
41 |
$2K |
| 81243 |
|
109 |
87 |
$2K |
| J0131 |
Inj, acetaminophen (nos) |
168 |
127 |
$2K |
| 71101 |
|
229 |
210 |
$2K |
| 86787 |
|
45 |
40 |
$2K |
| 87046 |
|
99 |
87 |
$2K |
| 86618 |
|
202 |
132 |
$2K |
| 76819 |
|
21 |
12 |
$2K |
| 77066 |
Tomosynthesis, mammo |
158 |
142 |
$2K |
| 86706 |
|
76 |
66 |
$2K |
| 83605 |
|
2,250 |
1,755 |
$1K |
| 85730 |
|
826 |
676 |
$1K |
| 86812 |
|
102 |
90 |
$1K |
| J1170 |
Hydromorphone injection |
3,166 |
2,101 |
$1K |
| 80051 |
|
32 |
24 |
$1K |
| 81257 |
|
17 |
16 |
$1K |
| 87641 |
|
69 |
52 |
$1K |
| J2790 |
Rho d immune globulin inj |
15 |
14 |
$989.38 |
| 82247 |
|
95 |
63 |
$988.02 |
| 84703 |
|
345 |
297 |
$980.25 |
| 82947 |
|
92 |
82 |
$967.90 |
| 73140 |
|
227 |
199 |
$943.99 |
| 77080 |
|
15 |
15 |
$889.80 |
| 87427 |
|
95 |
83 |
$874.27 |
| 76870 |
|
53 |
44 |
$847.69 |
| 77061 |
|
43 |
38 |
$829.91 |
| 84112 |
|
25 |
25 |
$797.06 |
| J1650 |
Inj enoxaparin sodium |
1,715 |
675 |
$788.60 |
| 80081 |
|
34 |
34 |
$754.42 |
| J7120 |
Ringers lactate infusion |
6,991 |
5,980 |
$737.89 |
| 84132 |
|
185 |
133 |
$736.62 |
| 82803 |
|
1,788 |
1,409 |
$720.53 |
| 82040 |
|
57 |
50 |
$713.56 |
| 87529 |
|
32 |
25 |
$694.44 |
| 86920 |
|
16 |
14 |
$678.90 |
| 87040 |
|
640 |
440 |
$668.69 |
| 86696 |
|
34 |
28 |
$668.19 |
| J2272 |
Inj, morphine (fresenius) |
1,355 |
1,064 |
$616.03 |
| 87493 |
|
41 |
40 |
$602.82 |
| 84300 |
|
145 |
130 |
$601.47 |
| J0134 |
Inj acetaminophen -fresenius |
2,076 |
1,566 |
$551.92 |
| 29105 |
|
12 |
12 |
$518.25 |
| 84165 |
|
80 |
71 |
$508.07 |
| 82140 |
|
37 |
26 |
$460.08 |
| 87507 |
|
15 |
15 |
$454.15 |
| J1885 |
Ketorolac tromethamine inj |
8,539 |
6,338 |
$452.96 |
| 73522 |
|
14 |
13 |
$449.51 |
| 86800 |
|
28 |
24 |
$432.82 |
| J1040 |
Methylprednisolone 80 mg inj |
3,473 |
3,107 |
$429.33 |
| J2704 |
Inj, propofol, 10 mg |
10,371 |
6,248 |
$386.93 |
| 86694 |
|
20 |
16 |
$385.41 |
| 83993 |
|
28 |
26 |
$374.33 |
| 00813 |
|
145 |
127 |
$366.02 |
| J7050 |
Normal saline solution infus |
5,196 |
2,940 |
$355.21 |
| 84155 |
|
45 |
36 |
$351.56 |
| 86336 |
|
62 |
62 |
$341.72 |
| J2405 |
Ondansetron hcl injection |
14,573 |
11,486 |
$335.42 |
| J1642 |
Inj heparin sodium per 10 u |
1,744 |
905 |
$306.84 |
| J2930 |
Methylprednisolone injection |
507 |
352 |
$300.33 |
| 83727 |
|
17 |
12 |
$299.45 |
| 82951 |
|
13 |
13 |
$274.51 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
627 |
571 |
$271.39 |
| 80178 |
|
14 |
14 |
$264.27 |
| 87899 |
|
97 |
85 |
$235.37 |
| 86695 |
|
19 |
15 |
$231.21 |
| 84520 |
|
31 |
23 |
$229.92 |
| 73552 |
|
15 |
12 |
$227.47 |
| 84270 |
|
13 |
12 |
$222.41 |
| 85045 |
|
131 |
99 |
$222.33 |
| 82310 |
|
26 |
19 |
$220.34 |
| 73060 |
|
27 |
24 |
$217.48 |
| D0120 |
|
12 |
12 |
$215.16 |
| J0330 |
Succinycholine chloride inj |
949 |
619 |
$212.04 |
| 96368 |
|
32 |
24 |
$211.94 |
| J7620 |
Albuterol ipratrop non-comp |
2,445 |
1,657 |
$196.48 |
| D1208 |
|
12 |
12 |
$189.00 |
| 84075 |
|
31 |
22 |
$182.11 |
| 87338 |
|
12 |
12 |
$181.15 |
| 82952 |
|
13 |
13 |
$177.73 |
| J1010 |
Inj, methylpred acetate 1 mg |
521 |
378 |
$174.61 |
| J3010 |
Fentanyl citrate injection |
3,359 |
2,796 |
$170.79 |
| 84425 |
|
16 |
12 |
$161.89 |
| J2919 |
Inj, methylpred sod succ 5mg |
312 |
190 |
$136.95 |
| J0690 |
Cefazolin sodium injection |
1,631 |
1,175 |
$132.38 |
| J0696 |
Ceftriaxone sodium injection |
1,544 |
1,041 |
$122.99 |
| 72170 |
|
26 |
24 |
$112.11 |
| J2360 |
Orphenadrine injection |
356 |
283 |
$111.93 |
| J1100 |
Dexamethasone sodium phos |
4,553 |
3,340 |
$98.75 |
| J3475 |
Inj magnesium sulfate |
1,115 |
803 |
$96.03 |
| J1200 |
Diphenhydramine hcl injectio |
2,536 |
2,019 |
$95.59 |
| J0780 |
Prochlorperazine injection |
598 |
495 |
$77.83 |
| 87486 |
|
33 |
32 |
$77.60 |
| J2060 |
Lorazepam injection |
756 |
571 |
$71.94 |
| 82150 |
|
232 |
222 |
$68.41 |
| J2765 |
Metoclopramide hcl injection |
1,675 |
1,315 |
$57.38 |
| J2470 |
Inj pantoprazole sodium 40mg |
110 |
76 |
$51.61 |
| J1644 |
Inj heparin sodium per 1000u |
572 |
230 |
$50.95 |
| J1030 |
Methylprednisolone 40 mg inj |
2,325 |
2,081 |
$47.71 |
| J7512 |
Prednisone ir or dr oral 1mg |
1,031 |
751 |
$44.62 |
| 87581 |
|
33 |
32 |
$38.80 |
| J0688 |
Inj cefazolin sodium, hikma |
35 |
27 |
$30.65 |
| J1940 |
Furosemide injection |
396 |
195 |
$28.81 |
| J1630 |
Haloperidol injection |
455 |
332 |
$26.44 |
| J7040 |
Normal saline solution infus |
1,183 |
898 |
$25.64 |
| J3411 |
Thiamine hcl 100 mg |
86 |
55 |
$23.22 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,736 |
1,237 |
$21.94 |
| J3480 |
Inj potassium chloride |
421 |
262 |
$19.71 |
| J0136 |
Inj, acetaminophen (b braun) |
19 |
17 |
$18.60 |
| J3420 |
Vitamin b12 injection |
45 |
39 |
$18.43 |
| J0360 |
Hydralazine hcl injection |
64 |
48 |
$17.22 |
| 82962 |
|
380 |
344 |
$14.95 |
| J2250 |
Inj midazolam hydrochloride |
3,999 |
3,232 |
$13.43 |
| J2270 |
Morphine sulfate injection |
106 |
86 |
$12.88 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
9,577 |
8,327 |
$12.00 |
| J0737 |
Inj, clindamycin (baxter) |
45 |
38 |
$11.38 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
51 |
12 |
$9.40 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
3,707 |
3,334 |
$6.44 |
| 83986 |
|
14 |
14 |
$6.39 |
| J0171 |
Adrenalin epinephrine inject |
720 |
510 |
$4.17 |
| J7510 |
Prednisolone oral per 5 mg |
83 |
71 |
$3.81 |
| J7613 |
Albuterol non-comp unit |
644 |
488 |
$3.31 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
403 |
284 |
$2.75 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
242 |
226 |
$2.34 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
211 |
146 |
$2.32 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
656 |
273 |
$0.62 |
| 88302 |
|
18 |
12 |
$0.00 |
| 01810 |
|
38 |
27 |
$0.00 |
| 77002 |
|
925 |
814 |
$0.00 |
| A9552 |
F18 fdg |
27 |
26 |
$0.00 |
| G1004 |
Cdsm ndsc |
591 |
479 |
$0.00 |
| 15853 |
|
42 |
37 |
$0.00 |
| J1953 |
Levetiracetam injection |
21 |
12 |
$0.00 |
| 00731 |
|
204 |
172 |
$0.00 |
| 00812 |
|
71 |
59 |
$0.00 |
| 86328 |
|
112 |
107 |
$0.00 |
| J1956 |
Levofloxacin injection |
157 |
126 |
$0.00 |
| J3370 |
Vancomycin hcl injection |
55 |
27 |
$0.00 |
| 87798 |
|
18 |
18 |
$0.00 |
| 82010 |
|
68 |
56 |
$0.00 |
| Q0163 |
Diphenhydramine hcl 50mg |
55 |
37 |
$0.00 |
| 00170 |
|
48 |
42 |
$0.00 |
| 00910 |
|
15 |
15 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
38 |
38 |
$0.00 |
| 00840 |
|
55 |
26 |
$0.00 |
| C1758 |
Catheter, ureteral |
15 |
12 |
$0.00 |
| A9500 |
Tc99m sestamibi |
541 |
474 |
$0.00 |
| C1769 |
Guide wire |
160 |
129 |
$0.00 |
| J2785 |
Regadenoson injection |
441 |
395 |
$0.00 |
| J1815 |
Insulin injection |
15 |
13 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
138 |
108 |
$0.00 |
| J7644 |
Ipratropium bromide non-comp |
13 |
12 |
$0.00 |
| A9270 |
Non-covered item or service |
146 |
53 |
$0.00 |
| 00142 |
|
37 |
25 |
$0.00 |
| U0002 |
Covid-19 lab test non-cdc |
30 |
28 |
$0.00 |
| C2627 |
Cath, suprapubic/cystoscopic |
134 |
110 |
$0.00 |
| J1920 |
Inj, labetalol hcl, 5mg |
90 |
42 |
$0.00 |
| 87807 |
|
13 |
12 |
$0.00 |