| Code | Description | Claims | Beneficiaries | Total Paid |
| G0463 |
Hospital outpt clinic visit |
203,024 |
159,663 |
$19.02M |
| 99283 |
|
27,954 |
26,362 |
$3.22M |
| 99213 |
|
22,300 |
19,947 |
$2.46M |
| 96361 |
|
8,844 |
6,114 |
$2.25M |
| 99284 |
|
23,948 |
21,816 |
$1.93M |
| 99214 |
|
10,504 |
9,351 |
$1.09M |
| 59025 |
|
7,284 |
4,254 |
$910K |
| 99282 |
|
6,836 |
6,580 |
$856K |
| 74177 |
|
4,719 |
4,465 |
$713K |
| 43239 |
|
3,052 |
2,752 |
$695K |
| 45380 |
|
2,208 |
2,000 |
$679K |
| 90471 |
|
44,630 |
40,439 |
$620K |
| 99285 |
|
8,542 |
7,812 |
$613K |
| 96365 |
|
7,043 |
4,131 |
$555K |
| 96360 |
|
4,279 |
2,728 |
$501K |
| 70450 |
|
3,972 |
3,684 |
$481K |
| 93306 |
|
2,206 |
2,103 |
$449K |
| 96366 |
|
1,873 |
1,196 |
$353K |
| 92507 |
|
8,113 |
2,905 |
$337K |
| U0003 |
Cov-19 amp prb hgh thruput |
4,575 |
4,234 |
$292K |
| 45385 |
|
1,264 |
1,107 |
$288K |
| 74176 |
|
1,712 |
1,617 |
$253K |
| 97110 |
|
9,640 |
4,308 |
$235K |
| 99212 |
|
2,176 |
2,027 |
$224K |
| 90472 |
|
25,261 |
22,857 |
$208K |
| 76705 |
|
2,806 |
2,699 |
$208K |
| 76856 |
|
2,756 |
2,692 |
$205K |
| 76815 |
|
3,863 |
3,521 |
$193K |
| 87635 |
|
2,851 |
2,664 |
$183K |
| 80053 |
|
41,692 |
32,599 |
$174K |
| 76805 |
|
2,765 |
2,633 |
$171K |
| 80307 |
|
5,713 |
5,203 |
$158K |
| 76801 |
|
2,980 |
2,711 |
$153K |
| 76700 |
|
1,615 |
1,590 |
$151K |
| 97530 |
|
5,222 |
3,325 |
$148K |
| 17110 |
|
596 |
558 |
$131K |
| 97140 |
|
6,182 |
2,944 |
$129K |
| 76830 |
|
2,379 |
2,323 |
$127K |
| 99203 |
|
1,113 |
1,098 |
$109K |
| 96413 |
|
1,933 |
982 |
$106K |
| 76819 |
|
2,650 |
1,549 |
$90K |
| 45378 |
|
273 |
251 |
$88K |
| 97161 |
|
1,693 |
1,645 |
$83K |
| 99204 |
|
788 |
771 |
$77K |
| 92523 |
|
604 |
591 |
$76K |
| 76817 |
|
1,857 |
1,630 |
$67K |
| 76642 |
|
869 |
805 |
$67K |
| 71046 |
|
5,016 |
4,722 |
$65K |
| 95810 |
|
156 |
153 |
$65K |
| 11042 |
|
445 |
217 |
$63K |
| G0378 |
Hospital observation per hr |
2,520 |
2,229 |
$63K |
| 76770 |
|
734 |
710 |
$61K |
| 71275 |
|
449 |
431 |
$59K |
| 77067 |
|
2,320 |
2,282 |
$56K |
| 90686 |
|
12,477 |
11,645 |
$53K |
| C9803 |
Hopd covid-19 spec collect |
4,821 |
4,475 |
$53K |
| 76811 |
|
914 |
897 |
$52K |
| 90715 |
|
5,417 |
4,877 |
$51K |
| 85025 |
|
44,556 |
35,009 |
$46K |
| 76536 |
|
572 |
565 |
$46K |
| 77063 |
|
2,318 |
2,280 |
$44K |
| 36415 |
|
43,077 |
33,911 |
$44K |
| 73630 |
|
2,455 |
2,061 |
$42K |
| 90651 |
|
3,977 |
3,639 |
$40K |
| 99211 |
|
410 |
264 |
$40K |
| 99215 |
Prolong outpt/office vis |
386 |
352 |
$39K |
| 97162 |
|
1,038 |
995 |
$39K |
| 84443 |
|
7,788 |
7,380 |
$38K |
| 93971 |
|
542 |
502 |
$38K |
| 90670 |
|
10,193 |
9,329 |
$35K |
| 69209 |
|
936 |
874 |
$31K |
| 93005 |
|
15,605 |
13,283 |
$29K |
| 97803 |
|
1,136 |
852 |
$27K |
| 12001 |
|
142 |
137 |
$26K |
| 71260 |
|
1,007 |
956 |
$26K |
| 96367 |
|
1,127 |
755 |
$26K |
| 72110 |
|
983 |
954 |
$24K |
| 96372 |
|
10,263 |
8,012 |
$24K |
| 84484 |
|
7,967 |
6,095 |
$24K |
| 94640 |
|
3,146 |
2,509 |
$22K |
| 72148 |
|
184 |
180 |
$22K |
| 73610 |
|
1,705 |
1,558 |
$21K |
| 11043 |
|
147 |
81 |
$20K |
| 70553 |
|
95 |
93 |
$20K |
| 73562 |
|
1,639 |
1,411 |
$20K |
| 73030 |
|
1,572 |
1,394 |
$19K |
| G0108 |
Diab manage trn per indiv |
692 |
608 |
$19K |
| 29125 |
|
99 |
96 |
$19K |
| 87040 |
|
3,934 |
2,090 |
$19K |
| 90648 |
|
4,769 |
4,438 |
$18K |
| 87641 |
|
1,942 |
1,774 |
$18K |
| 74018 |
|
1,714 |
1,641 |
$17K |
| 99202 |
|
168 |
168 |
$16K |
| 87502 |
|
1,669 |
1,598 |
$16K |
| 80061 |
|
4,505 |
4,311 |
$16K |
| 80048 |
|
3,209 |
2,846 |
$15K |
| J2469 |
Palonosetron hcl |
264 |
124 |
$15K |
| 76816 |
|
228 |
223 |
$15K |
| 97802 |
|
284 |
277 |
$14K |
| 58300 |
|
141 |
132 |
$14K |
| 94729 |
|
526 |
510 |
$13K |
| 87651 |
|
1,764 |
1,716 |
$13K |
| 83880 |
|
3,705 |
3,374 |
$13K |
| 96415 |
|
91 |
49 |
$12K |
| 94060 |
|
637 |
613 |
$12K |
| 84145 |
|
1,557 |
1,417 |
$12K |
| 87591 |
|
1,149 |
1,097 |
$11K |
| 11056 |
|
136 |
125 |
$10K |
| 83036 |
|
7,091 |
6,499 |
$10K |
| J1453 |
Fosaprepitant injection |
175 |
81 |
$10K |
| 36591 |
|
1,995 |
1,101 |
$10K |
| 10060 |
|
45 |
43 |
$10K |
| 85379 |
|
1,928 |
1,810 |
$9K |
| 82728 |
|
1,578 |
1,495 |
$9K |
| 71045 |
|
10,326 |
9,323 |
$9K |
| 11750 |
|
27 |
15 |
$9K |
| 87420 |
|
2,777 |
2,631 |
$9K |
| 83735 |
|
12,180 |
8,855 |
$8K |
| 85027 |
|
3,922 |
3,408 |
$8K |
| 72125 |
|
641 |
604 |
$8K |
| 97166 |
|
153 |
149 |
$8K |
| 82553 |
|
1,222 |
898 |
$8K |
| 83605 |
|
2,464 |
2,076 |
$8K |
| 96374 |
|
13,892 |
10,682 |
$8K |
| 94726 |
|
498 |
482 |
$8K |
| 99291 |
|
239 |
218 |
$8K |
| 90460 |
|
1,258 |
1,095 |
$7K |
| 87491 |
|
1,165 |
1,113 |
$7K |
| 77072 |
|
145 |
144 |
$7K |
| 72040 |
|
339 |
329 |
$7K |
| 82247 |
|
1,524 |
1,035 |
$7K |
| 97165 |
|
107 |
106 |
$6K |
| 73110 |
|
499 |
461 |
$6K |
| 90734 |
|
1,731 |
1,644 |
$6K |
| 72100 |
|
566 |
554 |
$6K |
| 87631 |
|
323 |
312 |
$6K |
| 92526 |
|
125 |
65 |
$6K |
| 84436 |
|
1,410 |
1,347 |
$5K |
| G0480 |
Drug test def 1-7 classes |
1,206 |
1,086 |
$5K |
| 82570 |
|
1,626 |
1,536 |
$5K |
| 73130 |
|
690 |
633 |
$5K |
| 12011 |
|
26 |
26 |
$5K |
| 83550 |
|
1,420 |
1,348 |
$5K |
| 86140 |
|
4,337 |
3,544 |
$5K |
| 82607 |
|
597 |
578 |
$4K |
| 73502 |
|
420 |
375 |
$4K |
| 96368 |
|
468 |
273 |
$4K |
| 11721 |
|
316 |
293 |
$4K |
| 81003 |
|
12,217 |
10,962 |
$4K |
| 97112 |
|
256 |
144 |
$4K |
| 83615 |
|
4,238 |
2,170 |
$4K |
| 83540 |
|
1,458 |
1,389 |
$4K |
| 84112 |
|
664 |
598 |
$4K |
| 87086 |
|
4,826 |
4,498 |
$4K |
| 88305 |
|
4,826 |
4,489 |
$4K |
| 83520 |
|
522 |
495 |
$4K |
| 86850 |
|
2,656 |
2,447 |
$4K |
| 84702 |
|
2,443 |
2,125 |
$4K |
| 97605 |
|
44 |
12 |
$4K |
| 84439 |
|
505 |
489 |
$4K |
| 78815 |
|
14 |
12 |
$4K |
| 86900 |
|
3,944 |
3,640 |
$4K |
| 83498 |
|
491 |
465 |
$3K |
| 97124 |
|
237 |
115 |
$3K |
| 73560 |
|
165 |
128 |
$3K |
| 82017 |
|
488 |
462 |
$3K |
| 81025 |
|
10,121 |
9,486 |
$3K |
| 81001 |
|
13,007 |
11,757 |
$3K |
| J9190 |
Fluorouracil injection |
57 |
25 |
$3K |
| 99205 |
Prolong outpt/office vis |
27 |
27 |
$3K |
| 85652 |
|
4,015 |
3,306 |
$3K |
| 20610 |
|
26 |
26 |
$3K |
| 85610 |
|
8,932 |
7,949 |
$3K |
| 84479 |
|
631 |
610 |
$2K |
| 82306 |
|
994 |
964 |
$2K |
| 82139 |
|
508 |
481 |
$2K |
| 82775 |
|
484 |
458 |
$2K |
| 82261 |
|
484 |
458 |
$2K |
| 92558 |
|
47 |
43 |
$2K |
| 80306 |
|
3,057 |
2,927 |
$2K |
| 77066 |
Tomosynthesis, mammo |
98 |
96 |
$2K |
| 90674 |
|
204 |
172 |
$2K |
| 82746 |
|
493 |
473 |
$2K |
| 82043 |
|
1,177 |
1,140 |
$2K |
| 86901 |
|
4,341 |
3,643 |
$2K |
| 86780 |
|
546 |
520 |
$2K |
| 83690 |
|
10,823 |
9,746 |
$2K |
| 71250 |
|
87 |
80 |
$2K |
| 87340 |
|
530 |
512 |
$2K |
| 87389 |
|
681 |
647 |
$2K |
| 84030 |
|
484 |
458 |
$2K |
| 90461 |
|
819 |
679 |
$2K |
| 0072A |
|
43 |
43 |
$2K |
| 70551 |
|
12 |
12 |
$2K |
| Q0138 |
Ferumoxytol, non-esrd |
20 |
14 |
$2K |
| 84703 |
|
1,392 |
1,326 |
$2K |
| 87804 |
|
8,816 |
8,376 |
$2K |
| 90656 |
|
793 |
790 |
$2K |
| 73564 |
|
49 |
42 |
$2K |
| 85007 |
|
1,894 |
1,525 |
$2K |
| 96375 |
|
11,268 |
8,032 |
$2K |
| 86762 |
|
332 |
315 |
$2K |
| 90707 |
|
2,008 |
1,859 |
$2K |
| 92521 |
|
23 |
23 |
$1K |
| 73590 |
|
114 |
104 |
$1K |
| 90671 |
|
3,551 |
3,242 |
$1K |
| 84450 |
|
736 |
716 |
$1K |
| 82947 |
|
2,641 |
1,750 |
$1K |
| 77065 |
Tomosynthesis, mammo |
60 |
54 |
$1K |
| 93017 |
|
12 |
12 |
$1K |
| 92524 |
|
26 |
26 |
$1K |
| 97597 |
|
48 |
26 |
$1K |
| 86710 |
|
2,300 |
2,179 |
$1K |
| 84460 |
|
781 |
756 |
$1K |
| 69210 |
|
13 |
13 |
$1K |
| 93970 |
|
13 |
13 |
$1K |
| 73140 |
|
86 |
80 |
$1K |
| 82550 |
|
2,965 |
2,272 |
$987.81 |
| 85730 |
|
7,962 |
7,118 |
$987.31 |
| 82962 |
|
3,588 |
2,034 |
$984.98 |
| 86803 |
|
249 |
241 |
$980.13 |
| 76870 |
|
13 |
12 |
$969.64 |
| 0012A |
|
31 |
29 |
$920.27 |
| 0071A |
|
22 |
22 |
$881.20 |
| 81002 |
|
4,061 |
3,673 |
$846.23 |
| 87880 |
|
7,955 |
7,656 |
$832.86 |
| 70486 |
|
37 |
37 |
$808.52 |
| 90832 |
|
483 |
368 |
$792.62 |
| 82150 |
|
3,558 |
3,321 |
$716.06 |
| 99392 |
|
473 |
386 |
$705.91 |
| 97014 |
|
83 |
33 |
$684.06 |
| 90756 |
|
80 |
75 |
$658.31 |
| 86003 |
|
99 |
96 |
$651.25 |
| 93010 |
|
124 |
104 |
$634.89 |
| 82105 |
|
84 |
82 |
$599.90 |
| 92522 |
|
13 |
13 |
$587.19 |
| 99391 |
|
629 |
525 |
$582.31 |
| 82248 |
|
192 |
142 |
$568.20 |
| 87637 |
|
1,063 |
1,026 |
$555.11 |
| 74022 |
|
288 |
280 |
$542.86 |
| 90473 |
|
40 |
40 |
$518.00 |
| 84100 |
|
1,444 |
1,219 |
$513.76 |
| 92610 |
|
12 |
12 |
$508.94 |
| 83655 |
|
51 |
51 |
$508.09 |
| 97032 |
|
94 |
55 |
$504.60 |
| 84550 |
|
516 |
433 |
$491.33 |
| 99381 |
|
45 |
39 |
$485.00 |
| 90688 |
|
98 |
89 |
$478.20 |
| 85018 |
|
115 |
110 |
$477.75 |
| 0011A |
|
17 |
17 |
$468.70 |
| J1885 |
Ketorolac tromethamine inj |
2,937 |
2,675 |
$449.40 |
| 84153 |
|
83 |
79 |
$432.16 |
| 90660 |
|
57 |
57 |
$403.95 |
| 88304 |
|
348 |
329 |
$395.55 |
| 97535 |
|
17 |
12 |
$379.06 |
| 77002 |
|
17 |
12 |
$368.93 |
| 87661 |
|
54 |
54 |
$351.02 |
| 80076 |
|
52 |
50 |
$340.52 |
| 86695 |
|
62 |
58 |
$331.16 |
| 96376 |
|
2,688 |
2,012 |
$296.66 |
| 90620 |
|
149 |
141 |
$284.17 |
| 86317 |
|
29 |
26 |
$283.46 |
| 90685 |
|
30 |
19 |
$279.84 |
| 90732 |
|
51 |
44 |
$268.00 |
| 73090 |
|
20 |
12 |
$267.33 |
| 88342 |
|
812 |
744 |
$263.90 |
| 84481 |
|
61 |
61 |
$256.75 |
| 87088 |
|
955 |
820 |
$237.29 |
| 86160 |
|
53 |
47 |
$229.68 |
| 86696 |
|
62 |
58 |
$224.43 |
| 87186 |
|
1,147 |
1,078 |
$216.53 |
| 90680 |
|
8,780 |
8,033 |
$206.84 |
| 87070 |
|
524 |
476 |
$193.64 |
| 90694 |
|
398 |
355 |
$190.99 |
| 87205 |
|
334 |
296 |
$183.06 |
| 87807 |
|
1,572 |
1,495 |
$182.29 |
| 94760 |
|
2,028 |
1,637 |
$180.48 |
| 72072 |
|
13 |
12 |
$171.90 |
| J2405 |
Ondansetron hcl injection |
6,985 |
5,328 |
$163.31 |
| 82785 |
|
16 |
14 |
$160.54 |
| 90632 |
|
35 |
32 |
$148.82 |
| 94664 |
|
435 |
350 |
$148.53 |
| 83516 |
|
37 |
30 |
$139.70 |
| 83001 |
|
26 |
25 |
$123.64 |
| G0008 |
Admin influenza virus vac |
1,112 |
878 |
$121.89 |
| 80074 |
|
16 |
14 |
$119.75 |
| 73080 |
|
14 |
13 |
$118.17 |
| 86480 |
|
15 |
14 |
$117.70 |
| 87430 |
|
619 |
611 |
$112.98 |
| 86704 |
|
17 |
14 |
$112.78 |
| 76000 |
|
106 |
104 |
$98.67 |
| 86255 |
|
13 |
12 |
$93.86 |
| 90723 |
|
2,052 |
1,936 |
$87.75 |
| 84156 |
|
45 |
38 |
$87.25 |
| 82378 |
|
41 |
25 |
$85.41 |
| 90698 |
|
4,855 |
4,460 |
$83.80 |
| 87081 |
|
579 |
571 |
$82.82 |
| 86038 |
|
14 |
13 |
$78.96 |
| 36416 |
|
219 |
175 |
$78.82 |
| 73600 |
|
17 |
12 |
$75.56 |
| U0005 |
Infec agen detec ampli probe |
3,029 |
2,793 |
$75.00 |
| 80050 |
|
30 |
27 |
$64.57 |
| 99000 |
|
176 |
166 |
$62.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
7,166 |
6,664 |
$58.51 |
| 87077 |
|
447 |
368 |
$58.46 |
| J7120 |
Ringers lactate infusion |
2,581 |
2,179 |
$54.75 |
| 84403 |
|
12 |
12 |
$49.73 |
| 86769 |
|
34 |
30 |
$48.38 |
| J2704 |
Inj, propofol, 10 mg |
7,935 |
7,110 |
$47.97 |
| 74019 |
|
13 |
12 |
$42.38 |
| 82784 |
|
12 |
12 |
$40.72 |
| J1100 |
Dexamethasone sodium phos |
4,574 |
3,155 |
$40.46 |
| 90672 |
|
165 |
162 |
$39.79 |
| G0009 |
Admin pneumococcal vaccine |
88 |
70 |
$37.41 |
| 88312 |
|
142 |
138 |
$35.86 |
| 86765 |
|
13 |
12 |
$33.61 |
| 90710 |
|
4,667 |
4,360 |
$33.52 |
| 90474 |
|
1,046 |
968 |
$30.00 |
| 85008 |
|
1,630 |
1,350 |
$29.37 |
| J7030 |
Normal saline solution infus |
7,055 |
5,531 |
$29.24 |
| 86920 |
|
59 |
51 |
$27.81 |
| 82565 |
|
84 |
78 |
$27.61 |
| 82010 |
|
88 |
79 |
$27.25 |
| 82272 |
|
43 |
37 |
$23.12 |
| J3301 |
Triamcinolone acet inj nos |
333 |
281 |
$22.81 |
| 82948 |
|
79 |
72 |
$20.42 |
| J2710 |
Neostigmine methylslfte inj |
640 |
592 |
$18.06 |
| J2270 |
Morphine sulfate injection |
772 |
669 |
$14.50 |
| 88313 |
|
62 |
58 |
$13.84 |
| J2930 |
Methylprednisolone injection |
626 |
520 |
$12.71 |
| 91301 |
|
70 |
68 |
$11.76 |
| J1170 |
Hydromorphone injection |
4,157 |
3,356 |
$10.91 |
| Q0162 |
Ondansetron oral |
819 |
797 |
$10.84 |
| A9585 |
Gadobutrol injection |
151 |
147 |
$7.51 |
| J3010 |
Fentanyl citrate injection |
3,256 |
2,907 |
$6.33 |
| J2550 |
Promethazine hcl injection |
1,244 |
1,025 |
$6.24 |
| J0690 |
Cefazolin sodium injection |
1,251 |
1,114 |
$4.20 |
| J0696 |
Ceftriaxone sodium injection |
1,371 |
1,172 |
$4.16 |
| 82800 |
|
55 |
49 |
$3.70 |
| J7040 |
Normal saline solution infus |
1,140 |
1,007 |
$1.36 |
| J1644 |
Inj heparin sodium per 1000u |
577 |
328 |
$1.03 |
| 82805 |
|
65 |
56 |
$0.96 |
| J2060 |
Lorazepam injection |
1,407 |
1,237 |
$0.78 |
| J7050 |
Normal saline solution infus |
3,198 |
1,785 |
$0.64 |
| 36600 |
|
65 |
55 |
$0.12 |
| J7613 |
Albuterol non-comp unit |
626 |
583 |
$0.12 |
| 90700 |
|
2,871 |
2,669 |
$0.00 |
| 90633 |
|
6,809 |
6,298 |
$0.00 |
| A4216 |
Sterile water/saline, 10 ml |
611 |
371 |
$0.00 |
| 90621 |
|
14 |
14 |
$0.00 |
| J1650 |
Inj enoxaparin sodium |
556 |
421 |
$0.00 |
| C1776 |
Joint device (implantable) |
415 |
388 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
386 |
361 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
952 |
731 |
$0.00 |
| 90380 |
|
32 |
31 |
$0.00 |
| A9577 |
Inj multihance |
495 |
475 |
$0.00 |
| J0640 |
Leucovorin calcium injection |
57 |
25 |
$0.00 |
| 99394 |
|
47 |
42 |
$0.00 |
| 99173 |
|
16 |
15 |
$0.00 |
| 90649 |
|
100 |
80 |
$0.00 |
| 96417 |
|
68 |
36 |
$0.00 |
| 99393 |
|
235 |
204 |
$0.00 |
| S0164 |
Injection pantroprazole |
45 |
40 |
$0.00 |
| S0028 |
Injection, famotidine, 20 mg |
190 |
121 |
$0.00 |
| A4315 |
Cath w/drainage 2-way silcne |
25 |
25 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
124 |
101 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
599 |
452 |
$0.00 |
| J0694 |
Cefoxitin sodium injection |
118 |
100 |
$0.00 |
| 90653 |
|
61 |
54 |
$0.00 |
| 77062 |
|
13 |
12 |
$0.00 |
| 51702 |
|
43 |
40 |
$0.00 |
| 98926 |
|
13 |
12 |
$0.00 |
| 0502F |
|
661 |
494 |
$0.00 |
| 94690 |
|
28 |
25 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
19 |
12 |
$0.00 |
| 90662 |
|
97 |
56 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
52 |
46 |
$0.00 |
| A9552 |
F18 fdg |
15 |
13 |
$0.00 |
| J2001 |
Lidocaine injection |
626 |
571 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
1,451 |
1,293 |
$0.00 |
| 90744 |
|
1,436 |
1,346 |
$0.00 |
| 90696 |
|
3,143 |
2,973 |
$0.00 |
| 90716 |
|
2,114 |
1,951 |
$0.00 |
| J1642 |
Inj heparin sodium per 10 u |
7,088 |
1,707 |
$0.00 |
| 90697 |
|
3,926 |
3,569 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
291 |
178 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
240 |
214 |
$0.00 |
| 99024 |
|
247 |
215 |
$0.00 |
| 99406 |
|
126 |
107 |
$0.00 |
| 82803 |
|
54 |
52 |
$0.00 |
| 90619 |
|
1,181 |
1,017 |
$0.00 |
| J3410 |
Hydroxyzine hcl injection |
99 |
95 |
$0.00 |
| J7620 |
Albuterol ipratrop non-comp |
138 |
126 |
$0.00 |
| J7060 |
5% dextrose/water |
511 |
222 |
$0.00 |
| J1030 |
Methylprednisolone 40 mg inj |
61 |
46 |
$0.00 |
| 80329 |
|
743 |
688 |
$0.00 |
| J3480 |
Inj potassium chloride |
110 |
80 |
$0.00 |
| 51798 |
|
78 |
76 |
$0.00 |
| J3360 |
Diazepam injection |
45 |
40 |
$0.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
185 |
167 |
$0.00 |
| 90381 |
|
29 |
25 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
31 |
29 |
$0.00 |
| J1815 |
Insulin injection |
69 |
51 |
$0.00 |
| 82330 |
|
15 |
12 |
$0.00 |
| C1769 |
Guide wire |
48 |
41 |
$0.00 |
| J2765 |
Metoclopramide hcl injection |
87 |
79 |
$0.00 |
| J3420 |
Vitamin b12 injection |
36 |
29 |
$0.00 |
| J1940 |
Furosemide injection |
15 |
13 |
$0.00 |
| C1781 |
Mesh (implantable) |
13 |
13 |
$0.00 |
| J0561 |
Penicillin g benzathine inj |
14 |
13 |
$0.00 |