| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
127,384 |
109,168 |
$11.41M |
| 99284 |
|
86,359 |
71,178 |
$7.91M |
| 99285 |
|
52,123 |
40,908 |
$6.06M |
| 96361 |
|
28,148 |
22,547 |
$5.86M |
| 92507 |
|
27,856 |
9,272 |
$4.50M |
| 99282 |
|
39,528 |
35,202 |
$3.77M |
| 97530 |
|
32,511 |
10,626 |
$3.05M |
| 87635 |
|
17,545 |
13,570 |
$2.72M |
| 96360 |
|
10,871 |
8,951 |
$1.95M |
| 93303 |
|
4,353 |
3,810 |
$1.92M |
| 0241U |
|
31,181 |
26,075 |
$1.88M |
| 96365 |
|
8,765 |
6,805 |
$1.87M |
| 93304 |
|
3,504 |
3,279 |
$1.87M |
| 42820 |
|
1,959 |
1,673 |
$1.61M |
| 80053 |
|
52,309 |
39,429 |
$1.21M |
| 69436 |
|
2,828 |
2,504 |
$1.13M |
| 96374 |
|
35,929 |
28,371 |
$1.04M |
| 96413 |
|
4,479 |
2,077 |
$1.04M |
| 80048 |
|
51,648 |
36,489 |
$998K |
| 54161 |
|
1,339 |
1,099 |
$983K |
| 87631 |
|
10,818 |
9,805 |
$907K |
| 42830 |
|
858 |
735 |
$832K |
| 74177 |
|
11,050 |
9,111 |
$806K |
| G0378 |
Hospital observation per hr |
19,914 |
8,800 |
$730K |
| 70450 |
|
15,434 |
12,220 |
$710K |
| U0003 |
Cov-19 amp prb hgh thruput |
8,592 |
7,710 |
$696K |
| 94640 |
|
19,611 |
11,518 |
$557K |
| 97110 |
|
5,518 |
2,243 |
$551K |
| 70551 |
|
3,657 |
3,136 |
$531K |
| 41899 |
|
559 |
453 |
$519K |
| 71046 |
|
25,647 |
21,894 |
$486K |
| 99291 |
|
3,042 |
2,473 |
$471K |
| 96367 |
|
2,417 |
1,261 |
$468K |
| 70553 |
|
2,336 |
1,917 |
$446K |
| 87081 |
|
13,674 |
12,140 |
$437K |
| 95810 |
|
947 |
859 |
$424K |
| 81025 |
|
37,925 |
30,578 |
$398K |
| 43239 |
|
1,507 |
1,272 |
$342K |
| 92526 |
|
4,431 |
1,975 |
$339K |
| 97161 |
|
2,822 |
2,393 |
$337K |
| 44970 |
|
68 |
57 |
$336K |
| 99281 |
|
4,359 |
3,706 |
$329K |
| 76705 |
|
7,729 |
6,524 |
$318K |
| 87088 |
|
25,610 |
21,255 |
$306K |
| 93308 |
|
1,017 |
914 |
$285K |
| 0202U |
|
3,541 |
2,902 |
$269K |
| 95782 |
|
467 |
447 |
$256K |
| 36415 |
|
29,191 |
19,389 |
$243K |
| 12011 |
|
1,692 |
1,552 |
$241K |
| 76770 |
|
2,402 |
2,127 |
$241K |
| 93306 |
|
3,795 |
2,796 |
$240K |
| 87430 |
|
19,509 |
17,358 |
$218K |
| 71275 |
|
5,309 |
4,336 |
$214K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
500 |
405 |
$207K |
| 92523 |
|
1,383 |
1,275 |
$203K |
| 76856 |
|
5,763 |
4,924 |
$186K |
| 93005 |
|
44,885 |
34,092 |
$179K |
| 82962 |
|
9,975 |
6,467 |
$178K |
| 99217 |
|
3,580 |
3,163 |
$177K |
| 73721 |
|
766 |
697 |
$173K |
| 78452 |
|
1,321 |
994 |
$171K |
| 85025 |
|
98,062 |
70,366 |
$168K |
| 96375 |
|
24,237 |
17,872 |
$168K |
| L8613 |
Ossicular implant |
1,853 |
1,742 |
$165K |
| C9803 |
Hopd covid-19 spec collect |
24,652 |
21,722 |
$160K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
17,548 |
14,063 |
$159K |
| 11042 |
|
2,437 |
1,000 |
$158K |
| 81002 |
|
5,135 |
4,505 |
$152K |
| 12001 |
|
1,537 |
1,389 |
$150K |
| 90715 |
|
1,975 |
1,680 |
$150K |
| 10060 |
|
1,329 |
1,141 |
$148K |
| J2505 |
Injection, pegfilgrastim 6mg |
168 |
111 |
$145K |
| 74176 |
|
4,002 |
3,230 |
$131K |
| J0696 |
Ceftriaxone sodium injection |
10,072 |
7,665 |
$129K |
| 81001 |
|
49,580 |
40,152 |
$126K |
| 97162 |
|
952 |
803 |
$126K |
| 71045 |
|
31,591 |
24,792 |
$125K |
| P9016 |
Rbc leukocytes reduced |
1,014 |
760 |
$123K |
| 73610 |
|
3,409 |
2,901 |
$123K |
| 73130 |
|
3,121 |
2,596 |
$120K |
| 59025 |
|
2,712 |
2,058 |
$115K |
| 80305 |
|
12,816 |
10,303 |
$114K |
| 92610 |
|
986 |
826 |
$110K |
| 74019 |
|
3,876 |
3,449 |
$105K |
| 73630 |
|
4,315 |
3,648 |
$104K |
| J2001 |
Lidocaine injection |
10,277 |
8,370 |
$98K |
| 95700 |
|
902 |
798 |
$98K |
| J1642 |
Inj heparin sodium per 10 u |
6,631 |
3,231 |
$97K |
| 74018 |
|
4,542 |
3,733 |
$95K |
| 74240 |
|
562 |
526 |
$94K |
| 69210 |
|
1,271 |
1,201 |
$93K |
| 96372 |
|
12,765 |
10,372 |
$93K |
| 93976 |
|
5,705 |
4,797 |
$92K |
| 86850 |
|
2,811 |
2,229 |
$90K |
| 88305 |
|
3,425 |
2,813 |
$89K |
| 97166 |
|
612 |
563 |
$86K |
| 76700 |
|
1,070 |
919 |
$85K |
| 72141 |
|
790 |
677 |
$84K |
| 99205 |
Prolong outpt/office vis |
1,864 |
1,324 |
$83K |
| 96366 |
|
2,632 |
1,953 |
$83K |
| 73090 |
|
2,057 |
1,629 |
$82K |
| 96415 |
|
500 |
233 |
$80K |
| 97597 |
|
2,186 |
938 |
$80K |
| 87147 |
|
1,577 |
1,446 |
$79K |
| 84702 |
|
4,549 |
3,368 |
$76K |
| 97165 |
|
858 |
734 |
$73K |
| 69610 |
|
64 |
57 |
$73K |
| 95951 |
|
313 |
254 |
$71K |
| 93321 |
|
3,540 |
3,268 |
$71K |
| 87077 |
|
6,133 |
4,978 |
$70K |
| 24640 |
|
148 |
145 |
$70K |
| 90471 |
|
2,051 |
1,619 |
$68K |
| 73560 |
|
1,883 |
1,562 |
$67K |
| 87040 |
|
9,826 |
6,381 |
$65K |
| 76815 |
|
6,835 |
5,183 |
$61K |
| G0463 |
Hospital outpt clinic visit |
3,335 |
2,323 |
$60K |
| 70496 |
|
1,666 |
1,323 |
$60K |
| 01922 |
|
1,472 |
1,337 |
$60K |
| 93975 |
|
622 |
467 |
$57K |
| 99224 |
|
1,439 |
882 |
$57K |
| 10061 |
|
548 |
486 |
$55K |
| 87070 |
|
4,026 |
3,361 |
$54K |
| 73110 |
|
1,785 |
1,518 |
$53K |
| 76536 |
|
833 |
700 |
$53K |
| 93017 |
|
1,789 |
1,370 |
$53K |
| 73080 |
|
1,404 |
1,195 |
$52K |
| 81003 |
|
13,445 |
11,069 |
$50K |
| 73030 |
|
2,889 |
2,282 |
$48K |
| 93971 |
|
3,348 |
2,633 |
$48K |
| 74022 |
|
2,974 |
2,523 |
$48K |
| 87210 |
|
8,912 |
7,453 |
$48K |
| 76830 |
|
3,916 |
3,331 |
$47K |
| 87045 |
|
1,253 |
1,102 |
$46K |
| 74230 |
|
455 |
398 |
$46K |
| 70491 |
|
942 |
789 |
$46K |
| 80329 |
|
2,353 |
1,161 |
$45K |
| 76642 |
|
1,114 |
854 |
$44K |
| 71260 |
|
1,247 |
967 |
$44K |
| J2405 |
Ondansetron hcl injection |
30,924 |
23,727 |
$43K |
| 85007 |
|
9,353 |
6,930 |
$42K |
| 73590 |
|
1,795 |
1,487 |
$40K |
| 12002 |
|
455 |
421 |
$40K |
| 73140 |
|
888 |
783 |
$40K |
| 89051 |
|
484 |
399 |
$39K |
| J1100 |
Dexamethasone sodium phos |
14,467 |
11,135 |
$39K |
| 67311 |
|
29 |
26 |
$38K |
| J3010 |
Fentanyl citrate injection |
10,169 |
7,866 |
$37K |
| 72125 |
|
3,058 |
2,338 |
$36K |
| 73564 |
|
2,389 |
1,871 |
$36K |
| J1644 |
Inj heparin sodium per 1000u |
5,285 |
2,413 |
$35K |
| 99218 |
|
3,498 |
3,053 |
$34K |
| 80076 |
|
22,341 |
17,578 |
$33K |
| 84484 |
|
30,364 |
18,093 |
$33K |
| 70486 |
|
1,032 |
869 |
$31K |
| 93325 |
|
8,839 |
7,933 |
$29K |
| 72148 |
|
897 |
746 |
$29K |
| 76870 |
|
657 |
565 |
$29K |
| A9579 |
Gad-base mr contrast nos,1ml |
2,243 |
1,708 |
$28K |
| J2250 |
Inj midazolam hydrochloride |
4,887 |
3,943 |
$27K |
| 82728 |
|
3,697 |
3,023 |
$26K |
| 83690 |
|
24,124 |
19,002 |
$25K |
| 94770 |
|
55 |
48 |
$24K |
| 86901 |
|
6,905 |
5,409 |
$23K |
| 29125 |
|
1,310 |
1,154 |
$23K |
| 85610 |
|
18,612 |
13,615 |
$23K |
| 93970 |
|
1,790 |
1,444 |
$23K |
| 73060 |
|
471 |
396 |
$23K |
| 86140 |
|
8,087 |
6,552 |
$22K |
| 97140 |
|
1,136 |
489 |
$22K |
| J1885 |
Ketorolac tromethamine inj |
21,062 |
16,631 |
$22K |
| 74174 |
|
191 |
151 |
$21K |
| 80307 |
|
733 |
446 |
$21K |
| 84443 |
|
11,422 |
9,028 |
$21K |
| 76817 |
|
4,370 |
3,234 |
$20K |
| J2270 |
Morphine sulfate injection |
14,368 |
10,055 |
$20K |
| 76881 |
|
264 |
208 |
$20K |
| 72040 |
|
710 |
600 |
$20K |
| 87801 |
|
7,754 |
6,534 |
$19K |
| 96409 |
|
249 |
177 |
$19K |
| 97755 |
|
86 |
77 |
$19K |
| 73502 |
|
1,751 |
1,404 |
$18K |
| 97116 |
|
260 |
184 |
$18K |
| 76010 |
|
264 |
238 |
$18K |
| J7510 |
Prednisolone oral per 5 mg |
2,087 |
1,741 |
$18K |
| 76885 |
|
93 |
91 |
$17K |
| 88307 |
|
105 |
91 |
$16K |
| 83735 |
|
16,557 |
11,981 |
$16K |
| 80061 |
|
5,624 |
4,460 |
$16K |
| 71250 |
|
1,107 |
829 |
$16K |
| 85730 |
|
13,884 |
10,595 |
$15K |
| 84703 |
|
1,524 |
1,250 |
$15K |
| 82330 |
|
618 |
475 |
$15K |
| 36592 |
|
826 |
649 |
$15K |
| 84439 |
|
4,029 |
3,159 |
$14K |
| 73552 |
|
790 |
638 |
$14K |
| 72100 |
|
1,684 |
1,400 |
$14K |
| 72146 |
|
275 |
256 |
$14K |
| 82274 |
|
277 |
241 |
$13K |
| 83880 |
|
8,488 |
6,168 |
$13K |
| 87637 |
|
258 |
196 |
$13K |
| J2469 |
Palonosetron hcl |
504 |
270 |
$13K |
| 87633 |
|
378 |
243 |
$13K |
| 36430 |
|
1,173 |
830 |
$13K |
| 77080 |
|
203 |
165 |
$12K |
| 92611 |
|
256 |
225 |
$12K |
| 45380 |
|
108 |
89 |
$12K |
| 95713 |
|
66 |
60 |
$12K |
| 95715 |
|
46 |
41 |
$12K |
| 84704 |
|
2,949 |
2,201 |
$12K |
| J1200 |
Diphenhydramine hcl injectio |
6,873 |
4,924 |
$12K |
| 82565 |
|
3,579 |
2,707 |
$11K |
| 72110 |
|
1,463 |
1,174 |
$11K |
| 82550 |
|
7,633 |
5,731 |
$11K |
| 70360 |
|
598 |
545 |
$11K |
| 86923 |
|
929 |
734 |
$11K |
| 85027 |
|
10,359 |
7,660 |
$11K |
| 96402 |
|
82 |
66 |
$10K |
| 87150 |
|
653 |
425 |
$10K |
| 97542 |
|
84 |
70 |
$10K |
| 88341 |
|
147 |
117 |
$10K |
| J3490 |
Drugs unclassified injection |
776 |
597 |
$10K |
| 74455 |
|
26 |
26 |
$10K |
| 82306 |
|
2,484 |
1,923 |
$10K |
| 71101 |
|
334 |
284 |
$10K |
| J2704 |
Inj, propofol, 10 mg |
12,419 |
10,474 |
$9K |
| Q0162 |
Ondansetron oral |
6,995 |
5,994 |
$9K |
| 96417 |
|
901 |
493 |
$9K |
| 83605 |
|
8,112 |
5,892 |
$9K |
| 54300 |
|
12 |
12 |
$9K |
| J0690 |
Cefazolin sodium injection |
4,851 |
3,923 |
$9K |
| 25605 |
|
16 |
16 |
$8K |
| 93225 |
|
340 |
299 |
$8K |
| 96376 |
|
4,275 |
3,316 |
$8K |
| 42821 |
|
30 |
27 |
$8K |
| 99203 |
|
257 |
227 |
$8K |
| 93226 |
|
332 |
298 |
$8K |
| 31622 |
|
12 |
12 |
$8K |
| 82150 |
|
5,828 |
4,746 |
$8K |
| 83020 |
|
1,727 |
1,492 |
$8K |
| G0480 |
Drug test def 1-7 classes |
905 |
666 |
$8K |
| 86308 |
|
929 |
808 |
$8K |
| 70498 |
|
1,346 |
1,065 |
$7K |
| C1769 |
Guide wire |
603 |
374 |
$7K |
| 87205 |
|
3,930 |
3,089 |
$7K |
| 84145 |
|
2,528 |
1,993 |
$7K |
| 80069 |
|
222 |
143 |
$7K |
| 69200 |
|
26 |
26 |
$7K |
| 87641 |
|
1,396 |
1,063 |
$7K |
| 29405 |
|
28 |
12 |
$7K |
| 29515 |
|
382 |
347 |
$7K |
| 73521 |
|
123 |
120 |
$6K |
| 92587 |
|
517 |
238 |
$6K |
| 99234 |
|
558 |
483 |
$6K |
| 72131 |
|
719 |
561 |
$6K |
| J2550 |
Promethazine hcl injection |
4,558 |
3,183 |
$6K |
| 88304 |
|
727 |
614 |
$6K |
| 70543 |
|
25 |
25 |
$6K |
| 0042T |
|
255 |
212 |
$6K |
| 83036 |
|
3,887 |
3,088 |
$6K |
| 90686 |
|
379 |
280 |
$6K |
| J1453 |
Fosaprepitant injection |
127 |
75 |
$6K |
| 72072 |
|
437 |
369 |
$6K |
| 73620 |
|
238 |
206 |
$5K |
| 85014 |
|
2,220 |
1,586 |
$5K |
| 73100 |
|
194 |
156 |
$5K |
| 84112 |
|
74 |
66 |
$5K |
| 87186 |
|
6,222 |
5,159 |
$5K |
| Q0144 |
Azithromycin dihydrate, oral |
407 |
321 |
$5K |
| 99201 |
|
198 |
166 |
$5K |
| 72050 |
|
206 |
178 |
$5K |
| J0330 |
Succinycholine chloride inj |
765 |
633 |
$5K |
| 86900 |
|
3,304 |
2,453 |
$5K |
| J1650 |
Inj enoxaparin sodium |
4,238 |
1,867 |
$5K |
| 85379 |
|
5,625 |
4,641 |
$5K |
| 85046 |
|
4,702 |
3,748 |
$4K |
| 82553 |
|
2,176 |
1,559 |
$4K |
| 82247 |
|
177 |
115 |
$4K |
| 85652 |
|
8,268 |
6,685 |
$4K |
| J3370 |
Vancomycin hcl injection |
1,421 |
886 |
$4K |
| 97164 |
|
15 |
13 |
$4K |
| 77066 |
Tomosynthesis, mammo |
183 |
136 |
$4K |
| 99202 |
|
117 |
103 |
$4K |
| 93320 |
|
3,496 |
3,166 |
$4K |
| J2060 |
Lorazepam injection |
2,577 |
1,929 |
$4K |
| 99213 |
|
25 |
18 |
$4K |
| 00170 |
|
3,134 |
2,669 |
$4K |
| 37799 |
|
122 |
83 |
$4K |
| 73660 |
|
45 |
40 |
$3K |
| 82803 |
|
2,631 |
1,929 |
$3K |
| 84100 |
|
5,734 |
4,084 |
$3K |
| 80047 |
|
273 |
221 |
$3K |
| 77067 |
|
560 |
469 |
$3K |
| C1894 |
Intro/sheath, non-laser |
202 |
136 |
$3K |
| 95812 |
|
13 |
13 |
$3K |
| P9603 |
One-way allow prorated miles |
5,404 |
1,875 |
$3K |
| 87486 |
|
774 |
708 |
$3K |
| 82607 |
|
2,801 |
2,123 |
$3K |
| 97598 |
|
36 |
12 |
$3K |
| 97535 |
|
151 |
108 |
$3K |
| 77065 |
Tomosynthesis, mammo |
267 |
187 |
$3K |
| 73000 |
|
54 |
50 |
$3K |
| 54360 |
|
22 |
14 |
$3K |
| 72082 |
|
49 |
41 |
$3K |
| 82784 |
|
388 |
313 |
$3K |
| 73700 |
|
68 |
54 |
$3K |
| 77063 |
|
350 |
294 |
$3K |
| 78815 |
|
26 |
24 |
$3K |
| 00635 |
|
12 |
12 |
$3K |
| 76000 |
|
12 |
12 |
$3K |
| 43762 |
|
32 |
25 |
$3K |
| 87491 |
|
2,152 |
1,792 |
$2K |
| 97750 |
|
17 |
12 |
$2K |
| 92522 |
|
12 |
12 |
$2K |
| 73120 |
|
16 |
13 |
$2K |
| 83615 |
|
2,133 |
1,699 |
$2K |
| J1170 |
Hydromorphone injection |
1,092 |
826 |
$2K |
| M0243 |
Casirivi and imdevi inj |
16 |
13 |
$2K |
| 00300 |
|
473 |
413 |
$2K |
| 29105 |
|
164 |
151 |
$2K |
| G8978 |
Mobility current status |
127 |
91 |
$2K |
| J2543 |
Piperacillin/tazobactam |
604 |
355 |
$2K |
| A9502 |
Tc99m tetrofosmin |
1,127 |
846 |
$2K |
| J0171 |
Adrenalin epinephrine inject |
1,805 |
1,557 |
$2K |
| 77062 |
|
30 |
25 |
$2K |
| 73070 |
|
86 |
67 |
$2K |
| G8979 |
Mobility goal status |
155 |
118 |
$2K |
| 84132 |
|
1,143 |
878 |
$2K |
| 72070 |
|
53 |
48 |
$2K |
| J0360 |
Hydralazine hcl injection |
656 |
447 |
$1K |
| J2930 |
Methylprednisolone injection |
2,843 |
2,194 |
$1K |
| 82140 |
|
509 |
380 |
$1K |
| 82947 |
|
1,297 |
946 |
$1K |
| J7512 |
Prednisone ir or dr oral 1mg |
3,426 |
2,470 |
$1K |
| G1004 |
Cdsm ndsc |
443 |
260 |
$1K |
| 73562 |
|
71 |
66 |
$1K |
| J0780 |
Prochlorperazine injection |
1,734 |
1,414 |
$1K |
| 00920 |
|
1,767 |
1,460 |
$1K |
| J0561 |
Penicillin g benzathine inj |
1,057 |
915 |
$1K |
| 83540 |
|
2,369 |
1,906 |
$1K |
| 76999 |
|
14 |
14 |
$1K |
| J2785 |
Regadenoson injection |
583 |
437 |
$1K |
| 90937 |
|
32 |
13 |
$1K |
| 80320 |
|
2,733 |
2,264 |
$995.50 |
| 96523 |
|
112 |
91 |
$975.53 |
| 77075 |
|
14 |
13 |
$955.66 |
| 80051 |
|
1,112 |
806 |
$948.88 |
| C9113 |
Inj pantoprazole sodium, via |
1,649 |
1,140 |
$911.40 |
| 12013 |
|
16 |
16 |
$857.84 |
| J1815 |
Insulin injection |
796 |
344 |
$822.88 |
| 90674 |
|
124 |
99 |
$810.98 |
| 96368 |
|
240 |
152 |
$784.96 |
| 99499 |
|
158 |
154 |
$743.61 |
| 36600 |
|
555 |
433 |
$740.48 |
| 86902 |
|
30 |
24 |
$716.06 |
| 85018 |
|
1,257 |
828 |
$697.78 |
| 73600 |
|
13 |
13 |
$690.16 |
| 96411 |
|
76 |
48 |
$687.87 |
| 00731 |
|
1,267 |
1,055 |
$657.25 |
| 84466 |
|
2,295 |
1,826 |
$649.27 |
| 82270 |
|
104 |
83 |
$643.14 |
| 82746 |
|
1,358 |
1,071 |
$633.21 |
| 72158 |
|
13 |
12 |
$622.96 |
| 99152 |
|
97 |
87 |
$615.55 |
| 82248 |
|
1,916 |
1,396 |
$603.02 |
| J2765 |
Metoclopramide hcl injection |
1,952 |
1,515 |
$591.97 |
| A9577 |
Inj multihance |
156 |
126 |
$585.17 |
| J3475 |
Inj magnesium sulfate |
1,444 |
1,101 |
$583.90 |
| 82378 |
|
119 |
82 |
$582.29 |
| 82310 |
|
1,113 |
809 |
$557.41 |
| 82374 |
|
300 |
233 |
$535.76 |
| 82570 |
|
1,408 |
1,026 |
$510.60 |
| 36591 |
|
15 |
12 |
$510.15 |
| 0012A |
|
268 |
228 |
$504.29 |
| Q0163 |
Diphenhydramine hcl 50mg |
162 |
123 |
$496.91 |
| S0164 |
Injection pantroprazole |
852 |
593 |
$488.23 |
| 87798 |
|
804 |
734 |
$485.20 |
| 0011A |
|
237 |
202 |
$457.40 |
| 84520 |
|
1,293 |
937 |
$445.02 |
| L1830 |
Ko immob canvas long pre ots |
14 |
12 |
$444.81 |
| 00126 |
|
1,524 |
1,397 |
$433.51 |
| 84550 |
|
1,268 |
964 |
$431.46 |
| J8540 |
Oral dexamethasone |
1,580 |
1,288 |
$417.72 |
| 51600 |
|
26 |
26 |
$415.47 |
| G0279 |
Tomosynthesis, mammo |
52 |
42 |
$402.88 |
| J7030 |
Normal saline solution infus |
84 |
57 |
$398.77 |
| 00120 |
|
98 |
91 |
$323.03 |
| J1953 |
Levetiracetam injection |
377 |
282 |
$307.09 |
| J7611 |
Albuterol non-comp con |
716 |
480 |
$292.27 |
| J1630 |
Haloperidol injection |
380 |
287 |
$263.83 |
| A6257 |
Transparent film <= 16 sq in |
347 |
213 |
$260.30 |
| C1751 |
Cath, inf, per/cent/midline |
161 |
121 |
$260.30 |
| J2360 |
Orphenadrine injection |
173 |
149 |
$260.12 |
| 88342 |
|
607 |
489 |
$256.63 |
| J0692 |
Cefepime hcl for injection |
706 |
509 |
$256.22 |
| 83970 |
|
213 |
163 |
$245.94 |
| 87176 |
|
60 |
49 |
$219.79 |
| 84295 |
|
460 |
355 |
$219.08 |
| 51701 |
|
433 |
385 |
$194.65 |
| 76937 |
|
71 |
49 |
$189.91 |
| 84134 |
|
22 |
15 |
$185.99 |
| 86141 |
|
173 |
135 |
$161.61 |
| 87015 |
|
36 |
27 |
$142.46 |
| 81513 |
|
33 |
28 |
$123.54 |
| 86592 |
|
58 |
48 |
$119.20 |
| 87529 |
|
28 |
25 |
$118.89 |
| L4350 |
Ankle control ortho pre ots |
36 |
28 |
$107.59 |
| 94729 |
|
19 |
14 |
$100.94 |
| 93880 |
|
32 |
25 |
$98.16 |
| 0001A |
|
85 |
77 |
$96.94 |
| 84480 |
|
48 |
38 |
$86.40 |
| 72170 |
|
32 |
25 |
$80.90 |
| 87591 |
|
2,150 |
1,792 |
$76.80 |
| 84156 |
|
434 |
333 |
$71.23 |
| A6258 |
Transparent film >16<=48 in |
106 |
64 |
$64.25 |
| 82043 |
|
353 |
297 |
$60.80 |
| 94060 |
|
37 |
25 |
$59.16 |
| J0461 |
Atropine sulfate injection |
420 |
366 |
$48.38 |
| S0028 |
Injection, famotidine, 20 mg |
138 |
87 |
$42.57 |
| J1817 |
Insulin for insulin pump use |
18 |
12 |
$38.23 |
| 93041 |
|
30 |
28 |
$31.24 |
| J2272 |
Inj, morphine (fresenius) |
139 |
103 |
$26.85 |
| 80299 |
|
46 |
40 |
$22.75 |
| 00400 |
|
153 |
133 |
$20.33 |
| 82533 |
|
65 |
51 |
$17.98 |
| 84153 |
|
17 |
13 |
$15.21 |
| 86300 |
|
13 |
12 |
$10.88 |
| 84157 |
|
28 |
25 |
$9.61 |
| 85384 |
|
30 |
28 |
$6.89 |
| 86780 |
|
52 |
42 |
$3.36 |
| J7644 |
Ipratropium bromide non-comp |
18 |
15 |
$1.58 |
| 99292 |
|
154 |
142 |
$0.00 |
| J2920 |
Methylprednisolone injection |
556 |
416 |
$0.00 |
| J1940 |
Furosemide injection |
474 |
294 |
$0.00 |
| 82077 |
|
180 |
146 |
$0.00 |
| 01400 |
|
13 |
12 |
$0.00 |
| 00160 |
|
81 |
74 |
$0.00 |
| J7613 |
Albuterol non-comp unit |
328 |
219 |
$0.00 |
| J3480 |
Inj potassium chloride |
364 |
252 |
$0.00 |
| J7620 |
Albuterol ipratrop non-comp |
1,114 |
818 |
$0.00 |
| 87581 |
|
765 |
696 |
$0.00 |
| 96377 |
|
43 |
27 |
$0.00 |
| 00813 |
|
97 |
81 |
$0.00 |
| 86769 |
|
38 |
36 |
$0.00 |
| 87661 |
|
15 |
13 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
22 |
15 |
$0.00 |
| J3535 |
Metered dose inhaler drug |
397 |
209 |
$0.00 |
| 00320 |
|
16 |
12 |
$0.00 |
| 88108 |
|
12 |
12 |
$0.00 |
| S5553 |
Insulin long acting 5 u |
58 |
30 |
$0.00 |
| G0008 |
Admin influenza virus vac |
35 |
35 |
$0.00 |
| A6222 |
Gauze <=16 in no w/sal w/o b |
32 |
24 |
$0.00 |
| J1790 |
Droperidol injection |
19 |
18 |
$0.00 |
| 86945 |
|
27 |
24 |
$0.00 |
| 82945 |
|
16 |
13 |
$0.00 |
| 3008F |
|
12 |
12 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
18 |
13 |
$0.00 |
| 83519 |
|
14 |
13 |
$0.00 |
| 84075 |
|
30 |
22 |
$0.00 |
| 82040 |
|
19 |
13 |
$0.00 |
| 82657 |
|
15 |
12 |
$0.00 |
| C1763 |
Conn tiss, non-human |
12 |
12 |
$0.00 |
| J1956 |
Levofloxacin injection |
15 |
12 |
$0.00 |
| J9370 |
Vincristine sulfate 1 mg inj |
276 |
165 |
$0.00 |
| 00840 |
|
561 |
454 |
$0.00 |
| 82010 |
|
339 |
272 |
$0.00 |
| J1756 |
Iron sucrose injection |
35 |
12 |
$0.00 |
| 00140 |
|
73 |
70 |
$0.00 |
| 90460 |
|
14 |
14 |
$0.00 |
| 80179 |
|
140 |
115 |
$0.00 |
| 80143 |
|
140 |
115 |
$0.00 |
| J7120 |
Ringers lactate infusion |
84 |
71 |
$0.00 |
| Q9962 |
Hocm 300-349mg/ml iodine,1ml |
12 |
12 |
$0.00 |
| Q0169 |
Promethazine hcl 12.5mg oral |
35 |
26 |
$0.00 |
| 84155 |
|
29 |
21 |
$0.00 |
| A9552 |
F18 fdg |
16 |
12 |
$0.00 |
| 84146 |
|
12 |
12 |
$0.00 |
| 00124 |
|
12 |
12 |
$0.00 |
| 84481 |
|
15 |
13 |
$0.00 |
| 84460 |
|
30 |
23 |
$0.00 |
| 0002A |
|
58 |
53 |
$0.00 |
| 84450 |
|
25 |
20 |
$0.00 |
| 87481 |
|
15 |
13 |
$0.00 |