| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
|
165,352 |
143,334 |
$20.60M |
| 80053 |
|
131,381 |
118,318 |
$4.28M |
| 99214 |
|
94,215 |
87,382 |
$4.11M |
| 99199 |
|
58,929 |
48,307 |
$3.00M |
| G9012 |
Other specified case mgmt |
24,667 |
9,288 |
$2.71M |
| 99213 |
|
67,862 |
61,957 |
$2.10M |
| 97110 |
|
71,793 |
16,707 |
$1.72M |
| 74177 |
|
17,280 |
16,784 |
$1.63M |
| 87428 |
|
33,482 |
31,779 |
$1.45M |
| 87502 |
|
29,545 |
28,425 |
$1.41M |
| 80048 |
|
26,970 |
22,504 |
$1.26M |
| 93306 |
|
9,627 |
9,328 |
$984K |
| 70450 |
|
14,459 |
14,019 |
$895K |
| 0160 |
|
14,289 |
11,268 |
$850K |
| 93005 |
|
68,099 |
60,384 |
$778K |
| 85025 |
|
156,354 |
134,825 |
$773K |
| 71046 |
|
48,351 |
45,907 |
$767K |
| 97139 |
|
42,519 |
6,893 |
$738K |
| U0002 |
Covid-19 lab test non-cdc |
24,962 |
23,513 |
$732K |
| H0043 |
Supported housing, per diem |
5,355 |
1,657 |
$649K |
| 97750 |
|
14,068 |
9,381 |
$642K |
| 76700 |
|
14,862 |
14,482 |
$625K |
| 97010 |
|
13,987 |
3,898 |
$594K |
| 0760 |
|
18,017 |
15,379 |
$593K |
| 96372 |
|
47,881 |
43,442 |
$559K |
| 80307 |
|
17,939 |
15,757 |
$558K |
| 78815 |
|
724 |
695 |
$509K |
| 93303 |
|
3,889 |
3,863 |
$501K |
| 95811 |
|
2,585 |
2,560 |
$492K |
| J3490 |
Drugs unclassified injection |
12,646 |
10,555 |
$468K |
| 84443 |
|
25,228 |
24,561 |
$458K |
| 70551 |
|
1,852 |
1,827 |
$428K |
| 93325 |
|
4,403 |
4,365 |
$423K |
| C9803 |
Hopd covid-19 spec collect |
31,117 |
29,201 |
$415K |
| 77067 |
|
5,533 |
5,485 |
$407K |
| 70553 |
|
899 |
879 |
$405K |
| 72148 |
|
1,409 |
1,396 |
$381K |
| 99212 |
|
13,440 |
12,369 |
$377K |
| 96360 |
|
13,820 |
13,186 |
$366K |
| 0360 |
|
2,684 |
1,580 |
$366K |
| 96365 |
|
12,037 |
10,169 |
$360K |
| 87661 |
|
14,233 |
13,434 |
$332K |
| 71260 |
|
3,944 |
3,885 |
$325K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
25,453 |
24,537 |
$324K |
| 71275 |
|
3,861 |
3,767 |
$312K |
| 99215 |
Prolong outpt/office vis |
5,887 |
5,697 |
$308K |
| 72125 |
|
4,662 |
4,579 |
$302K |
| 87426 |
|
18,139 |
16,054 |
$300K |
| 80061 |
|
22,642 |
22,324 |
$298K |
| 76856 |
|
8,596 |
8,334 |
$297K |
| 87591 |
|
11,137 |
10,848 |
$294K |
| 78452 |
|
1,634 |
1,583 |
$290K |
| 99203 |
|
6,397 |
6,223 |
$288K |
| 84484 |
|
43,849 |
37,592 |
$287K |
| 96374 |
|
16,045 |
14,775 |
$287K |
| 87491 |
|
11,132 |
10,849 |
$282K |
| 87634 |
|
7,868 |
7,592 |
$265K |
| 71045 |
|
22,481 |
21,395 |
$263K |
| 87880 |
|
26,621 |
25,820 |
$254K |
| 83036 |
|
22,247 |
21,885 |
$254K |
| J2785 |
Regadenoson injection |
1,928 |
1,832 |
$254K |
| 96361 |
|
18,791 |
16,677 |
$252K |
| 36415 |
|
68,083 |
56,088 |
$244K |
| 82306 |
|
11,993 |
11,854 |
$241K |
| 93320 |
|
3,878 |
3,852 |
$235K |
| 76815 |
|
5,936 |
3,961 |
$217K |
| 95810 |
|
1,138 |
1,127 |
$208K |
| 76705 |
|
6,244 |
6,065 |
$195K |
| 99285 |
|
2,502 |
2,315 |
$195K |
| 81001 |
|
63,194 |
59,041 |
$194K |
| G0463 |
Hospital outpt clinic visit |
13,431 |
12,089 |
$193K |
| 82803 |
|
20,903 |
19,212 |
$193K |
| Z7502 |
|
5,069 |
4,970 |
$192K |
| 0270 |
|
3,802 |
3,406 |
$189K |
| 76770 |
|
4,135 |
3,998 |
$183K |
| 76801 |
|
6,322 |
5,531 |
$183K |
| J1815 |
Insulin injection |
2,765 |
1,790 |
$172K |
| 76805 |
|
2,812 |
2,739 |
$172K |
| 0720 |
|
3,527 |
2,587 |
$167K |
| 76830 |
|
4,858 |
4,762 |
$166K |
| 87798 |
|
5,407 |
5,311 |
$166K |
| 99284 |
|
2,184 |
2,058 |
$164K |
| Q9957 |
Inj perflutren lip micros,ml |
1,510 |
1,483 |
$163K |
| 70496 |
|
1,680 |
1,651 |
$160K |
| 82330 |
|
19,817 |
18,326 |
$159K |
| 87481 |
|
5,233 |
4,905 |
$158K |
| G9008 |
Mccd,phys coor-care ovrsght |
1,343 |
965 |
$157K |
| 81025 |
|
18,338 |
17,208 |
$155K |
| 97799 |
|
9,621 |
1,697 |
$154K |
| A9577 |
Inj multihance |
1,964 |
1,913 |
$151K |
| 83605 |
|
24,948 |
22,407 |
$150K |
| 73130 |
|
6,981 |
6,672 |
$148K |
| 93971 |
|
3,171 |
3,064 |
$147K |
| 83880 |
|
11,733 |
10,953 |
$145K |
| 0761 |
|
4,081 |
3,412 |
$141K |
| 97165 |
|
3,485 |
2,938 |
$140K |
| 73630 |
|
6,640 |
6,411 |
$137K |
| 73610 |
|
5,883 |
5,699 |
$136K |
| 83690 |
|
38,030 |
35,141 |
$133K |
| 96375 |
|
10,099 |
9,248 |
$133K |
| 81220 |
|
814 |
813 |
$131K |
| 93970 |
|
1,404 |
1,374 |
$130K |
| 99204 |
|
2,513 |
2,479 |
$129K |
| 83735 |
|
25,475 |
20,666 |
$129K |
| 76641 |
|
2,393 |
2,329 |
$128K |
| 93017 |
|
3,530 |
3,394 |
$123K |
| 80074 |
|
2,788 |
2,762 |
$123K |
| 73030 |
|
5,652 |
5,355 |
$122K |
| 87086 |
|
25,425 |
24,196 |
$120K |
| 94640 |
|
10,008 |
8,652 |
$120K |
| 80076 |
|
5,077 |
4,706 |
$118K |
| 99283 |
|
1,748 |
1,516 |
$117K |
| 72141 |
|
556 |
552 |
$115K |
| 70498 |
|
1,985 |
1,947 |
$114K |
| 82947 |
|
31,918 |
25,780 |
$113K |
| 74176 |
|
1,785 |
1,762 |
$107K |
| 77063 |
|
5,517 |
5,480 |
$106K |
| 72110 |
|
2,449 |
2,419 |
$102K |
| 86850 |
|
15,023 |
14,496 |
$102K |
| 96366 |
|
4,931 |
3,822 |
$100K |
| 87389 |
|
6,331 |
6,271 |
$99K |
| 84439 |
|
13,089 |
12,762 |
$94K |
| A9500 |
Tc99m sestamibi |
1,169 |
1,111 |
$93K |
| 92507 |
|
3,897 |
1,642 |
$92K |
| 82375 |
|
11,343 |
10,518 |
$91K |
| 86480 |
|
1,810 |
1,791 |
$90K |
| 70486 |
|
1,220 |
1,196 |
$90K |
| 96379 |
|
4,310 |
3,336 |
$89K |
| 59025 |
|
8,320 |
3,259 |
$84K |
| 73110 |
|
4,438 |
4,266 |
$83K |
| G0378 |
Hospital observation per hr |
1,246 |
1,093 |
$83K |
| 97140 |
|
8,712 |
2,896 |
$82K |
| J1885 |
Ketorolac tromethamine inj |
31,647 |
29,185 |
$82K |
| 99221 |
|
2,325 |
2,217 |
$81K |
| 73562 |
|
4,522 |
4,406 |
$78K |
| 93308 |
|
2,031 |
2,003 |
$77K |
| 76817 |
|
2,719 |
2,430 |
$75K |
| 84702 |
|
11,902 |
10,504 |
$75K |
| 84703 |
|
24,081 |
22,814 |
$74K |
| 86803 |
|
3,619 |
3,586 |
$73K |
| J0561 |
Penicillin g benzathine inj |
496 |
408 |
$71K |
| 73564 |
|
2,579 |
2,490 |
$70K |
| 0683 |
|
473 |
473 |
$70K |
| 82607 |
|
7,295 |
7,197 |
$69K |
| 73502 |
|
2,058 |
1,986 |
$68K |
| 90715 |
|
4,737 |
4,631 |
$68K |
| 74018 |
|
4,245 |
4,147 |
$67K |
| A9552 |
F18 fdg |
397 |
381 |
$64K |
| 73080 |
|
2,742 |
2,669 |
$61K |
| 83789 |
|
4,710 |
4,525 |
$60K |
| 76819 |
|
2,207 |
1,397 |
$60K |
| 93458 |
|
107 |
100 |
$58K |
| U0003 |
Cov-19 amp prb hgh thruput |
1,668 |
1,588 |
$58K |
| 87081 |
|
10,283 |
10,033 |
$58K |
| 85610 |
|
19,893 |
18,269 |
$57K |
| 83050 |
|
11,299 |
10,481 |
$57K |
| 72100 |
|
2,065 |
2,038 |
$56K |
| 87040 |
|
5,867 |
5,380 |
$55K |
| A9502 |
Tc99m tetrofosmin |
436 |
433 |
$55K |
| 73590 |
|
3,347 |
3,207 |
$52K |
| 84999 |
|
2,535 |
2,222 |
$51K |
| J0696 |
Ceftriaxone sodium injection |
12,438 |
11,185 |
$51K |
| 83721 |
|
14,816 |
14,630 |
$51K |
| 87635 |
|
2,660 |
2,500 |
$49K |
| 90999 |
|
520 |
52 |
$48K |
| 87430 |
|
2,823 |
2,774 |
$47K |
| 97803 |
|
1,494 |
1,200 |
$47K |
| 97161 |
|
1,474 |
1,138 |
$46K |
| J3010 |
Fentanyl citrate injection |
10,672 |
9,668 |
$46K |
| 73721 |
|
175 |
163 |
$45K |
| 76870 |
|
1,441 |
1,390 |
$45K |
| 94729 |
|
1,393 |
1,370 |
$44K |
| 86900 |
|
18,762 |
17,913 |
$43K |
| 86901 |
|
18,766 |
17,911 |
$42K |
| 73090 |
|
2,758 |
2,657 |
$42K |
| 94726 |
|
1,423 |
1,393 |
$41K |
| Q3014 |
Telehealth facility fee |
2,282 |
1,987 |
$41K |
| 94060 |
|
1,562 |
1,535 |
$41K |
| 90471 |
|
8,824 |
8,415 |
$40K |
| 77066 |
Tomosynthesis, mammo |
448 |
440 |
$40K |
| 99202 |
|
1,342 |
1,295 |
$39K |
| 81003 |
|
13,677 |
12,242 |
$39K |
| 86140 |
|
8,774 |
8,355 |
$38K |
| 84132 |
|
19,010 |
17,358 |
$37K |
| 82948 |
|
7,607 |
6,005 |
$37K |
| 76604 |
|
1,450 |
1,441 |
$36K |
| 83970 |
|
1,126 |
1,099 |
$35K |
| J1100 |
Dexamethasone sodium phos |
10,360 |
9,971 |
$34K |
| 84100 |
|
10,640 |
9,416 |
$33K |
| 84295 |
|
18,619 |
17,092 |
$33K |
| 72170 |
|
3,430 |
3,392 |
$33K |
| J2704 |
Inj, propofol, 10 mg |
2,899 |
2,779 |
$32K |
| 84550 |
|
8,015 |
7,515 |
$32K |
| J2405 |
Ondansetron hcl injection |
10,607 |
9,570 |
$32K |
| 85379 |
|
6,118 |
5,891 |
$32K |
| 93880 |
|
345 |
331 |
$32K |
| 85730 |
|
8,117 |
7,807 |
$31K |
| 70491 |
|
401 |
390 |
$31K |
| 87653 |
|
1,285 |
1,264 |
$31K |
| 97802 |
|
408 |
398 |
$31K |
| 76536 |
|
630 |
624 |
$31K |
| 72050 |
|
895 |
888 |
$31K |
| 77065 |
Tomosynthesis, mammo |
450 |
447 |
$30K |
| 72040 |
|
1,096 |
1,073 |
$30K |
| 82728 |
|
3,162 |
3,052 |
$29K |
| 0710 |
|
1,030 |
959 |
$29K |
| 47562 |
|
182 |
181 |
$29K |
| 87186 |
|
8,152 |
7,852 |
$29K |
| 82435 |
|
17,684 |
16,348 |
$29K |
| 97530 |
|
3,107 |
1,497 |
$29K |
| 84480 |
|
2,289 |
2,253 |
$29K |
| 86003 |
|
316 |
294 |
$29K |
| 74019 |
|
1,751 |
1,723 |
$29K |
| J1650 |
Inj enoxaparin sodium |
4,110 |
2,166 |
$28K |
| 82550 |
|
5,218 |
4,655 |
$27K |
| 12001 |
|
1,641 |
1,598 |
$26K |
| G0279 |
Tomosynthesis, mammo |
1,314 |
1,297 |
$25K |
| 87801 |
|
2,026 |
1,926 |
$25K |
| 73140 |
|
1,811 |
1,773 |
$25K |
| 82746 |
|
1,916 |
1,867 |
$25K |
| 83540 |
|
4,725 |
4,621 |
$24K |
| Q0144 |
Azithromycin dihydrate, oral |
401 |
361 |
$24K |
| 87340 |
|
1,807 |
1,778 |
$23K |
| 86592 |
|
6,651 |
6,568 |
$23K |
| 77336 |
|
895 |
369 |
$22K |
| 84145 |
|
1,784 |
1,727 |
$22K |
| J2001 |
Lidocaine injection |
10,420 |
9,995 |
$22K |
| J1644 |
Inj heparin sodium per 1000u |
3,301 |
1,814 |
$22K |
| 82043 |
|
3,119 |
3,063 |
$21K |
| 0300 |
|
420 |
367 |
$21K |
| 83520 |
|
1,821 |
1,781 |
$20K |
| G9793 |
Pt on daily asa/antiplat |
2,054 |
1,907 |
$20K |
| J2250 |
Inj midazolam hydrochloride |
5,176 |
4,960 |
$20K |
| G2066 |
Inter devc remote 30d |
1,092 |
1,064 |
$19K |
| 73552 |
|
1,312 |
1,206 |
$19K |
| 85576 |
|
415 |
384 |
$19K |
| J0131 |
Inj, acetaminophen (nos) |
334 |
317 |
$19K |
| 85014 |
|
18,787 |
17,264 |
$18K |
| 83550 |
|
3,486 |
3,431 |
$18K |
| 96367 |
|
1,132 |
1,086 |
$18K |
| J3475 |
Inj magnesium sulfate |
2,584 |
2,165 |
$18K |
| 93296 |
|
639 |
631 |
$18K |
| 70360 |
|
1,025 |
1,008 |
$18K |
| 85651 |
|
7,640 |
7,273 |
$18K |
| 77412 |
|
558 |
52 |
$17K |
| 81002 |
|
9,458 |
8,851 |
$17K |
| 97112 |
|
2,580 |
953 |
$17K |
| J1790 |
Droperidol injection |
2,111 |
1,935 |
$17K |
| 12011 |
|
843 |
817 |
$16K |
| 86376 |
|
1,315 |
1,278 |
$15K |
| 12002 |
|
850 |
822 |
$15K |
| 99281 |
|
1,411 |
1,235 |
$15K |
| 73060 |
|
1,226 |
1,142 |
$15K |
| J1756 |
Iron sucrose injection |
177 |
67 |
$15K |
| 86762 |
|
1,083 |
1,048 |
$15K |
| J1200 |
Diphenhydramine hcl injectio |
6,802 |
6,165 |
$14K |
| 97018 |
|
299 |
91 |
$14K |
| 82010 |
|
2,987 |
2,812 |
$14K |
| 87070 |
|
2,467 |
2,377 |
$14K |
| J2765 |
Metoclopramide hcl injection |
6,380 |
5,883 |
$14K |
| 29125 |
|
1,121 |
1,053 |
$14K |
| 82140 |
|
2,143 |
1,988 |
$14K |
| 84153 |
|
820 |
810 |
$14K |
| 71250 |
|
158 |
158 |
$14K |
| 87088 |
|
4,799 |
4,654 |
$14K |
| 86635 |
|
888 |
846 |
$14K |
| 80069 |
|
1,556 |
1,520 |
$13K |
| J2270 |
Morphine sulfate injection |
4,075 |
3,439 |
$13K |
| S0020 |
Injection, bupivicaine hydro |
1,204 |
1,137 |
$13K |
| P9016 |
Rbc leukocytes reduced |
411 |
366 |
$13K |
| 90686 |
|
2,277 |
2,214 |
$13K |
| 86038 |
|
1,171 |
1,152 |
$12K |
| 84466 |
|
1,219 |
1,180 |
$12K |
| 97116 |
|
1,589 |
844 |
$12K |
| 73221 |
|
45 |
43 |
$11K |
| 85027 |
|
1,988 |
1,595 |
$11K |
| 99401 |
|
862 |
611 |
$11K |
| J0690 |
Cefazolin sodium injection |
1,882 |
1,717 |
$11K |
| 80164 |
|
872 |
762 |
$11K |
| 93225 |
|
423 |
416 |
$11K |
| 85018 |
|
10,880 |
10,006 |
$11K |
| 96376 |
|
2,582 |
2,383 |
$11K |
| 82248 |
|
2,609 |
2,464 |
$11K |
| 82274 |
|
708 |
702 |
$10K |
| 95816 |
|
330 |
316 |
$10K |
| 96368 |
|
715 |
706 |
$10K |
| T2041 |
Support broker waiver/15 min |
53 |
24 |
$10K |
| 93000 |
|
443 |
440 |
$10K |
| 80050 |
|
752 |
730 |
$10K |
| 71101 |
|
370 |
366 |
$10K |
| J2930 |
Methylprednisolone injection |
1,770 |
1,606 |
$9K |
| 84403 |
|
455 |
414 |
$9K |
| 82950 |
|
1,653 |
1,643 |
$9K |
| 93226 |
|
236 |
230 |
$9K |
| 82570 |
|
1,915 |
1,761 |
$9K |
| 99205 |
Prolong outpt/office vis |
152 |
147 |
$9K |
| Z9725 |
|
197 |
196 |
$8K |
| 93010 |
|
1,210 |
1,152 |
$8K |
| 29515 |
|
679 |
645 |
$8K |
| 10060 |
|
465 |
437 |
$8K |
| 87205 |
|
2,837 |
2,736 |
$8K |
| T1999 |
Noc retail items andsupplies |
484 |
426 |
$8K |
| J2060 |
Lorazepam injection |
3,661 |
3,207 |
$7K |
| G0108 |
Diab manage trn per indiv |
99 |
98 |
$7K |
| 72070 |
|
364 |
359 |
$7K |
| J3370 |
Vancomycin hcl injection |
958 |
802 |
$7K |
| 87210 |
|
2,411 |
2,337 |
$7K |
| 95782 |
|
14 |
14 |
$7K |
| J1953 |
Levetiracetam injection |
807 |
711 |
$7K |
| 74178 |
|
38 |
38 |
$7K |
| 0762 |
|
988 |
908 |
$7K |
| 93356 |
|
417 |
404 |
$6K |
| 74022 |
|
265 |
264 |
$6K |
| 36455 |
|
334 |
286 |
$6K |
| 87505 |
|
56 |
55 |
$6K |
| 93925 |
|
114 |
113 |
$6K |
| 86403 |
|
583 |
568 |
$6K |
| 90837 |
|
67 |
51 |
$6K |
| 72158 |
|
13 |
12 |
$6K |
| 93242 |
|
509 |
507 |
$6K |
| 87807 |
|
871 |
865 |
$6K |
| 77334 |
|
52 |
38 |
$6K |
| 77280 |
|
163 |
130 |
$6K |
| H1001 |
Antepartum management |
196 |
124 |
$6K |
| J1170 |
Hydromorphone injection |
1,126 |
919 |
$6K |
| 84436 |
|
2,993 |
2,938 |
$6K |
| 73560 |
|
438 |
422 |
$5K |
| 87220 |
|
1,502 |
1,458 |
$5K |
| 73620 |
|
209 |
201 |
$5K |
| 3074F |
|
303 |
301 |
$5K |
| 86431 |
|
909 |
902 |
$5K |
| G8419 |
Calc bmi out nrm param nof/u |
869 |
835 |
$5K |
| 76775 |
|
166 |
162 |
$5K |
| 78451 |
|
73 |
72 |
$5K |
| 97597 |
|
182 |
105 |
$5K |
| J0360 |
Hydralazine hcl injection |
634 |
489 |
$5K |
| 26145 |
|
45 |
40 |
$4K |
| 93246 |
|
305 |
305 |
$4K |
| 84146 |
|
257 |
254 |
$4K |
| 87631 |
|
128 |
126 |
$4K |
| 87338 |
|
445 |
438 |
$4K |
| 83001 |
|
189 |
188 |
$4K |
| 78227 |
|
18 |
15 |
$4K |
| 76882 |
|
192 |
190 |
$4K |
| 73120 |
|
122 |
119 |
$4K |
| 0301 |
|
442 |
384 |
$4K |
| 85384 |
|
651 |
600 |
$4K |
| 29530 |
|
546 |
529 |
$4K |
| 87045 |
|
602 |
589 |
$4K |
| 90677 |
|
12 |
12 |
$4K |
| 84479 |
|
755 |
744 |
$4K |
| 72131 |
|
61 |
61 |
$4K |
| 90658 |
|
217 |
217 |
$3K |
| J0171 |
Adrenalin epinephrine inject |
197 |
185 |
$3K |
| 99244 |
|
79 |
78 |
$3K |
| J0137 |
Inj, acetaminophen (hikma) |
195 |
186 |
$3K |
| 83615 |
|
720 |
630 |
$3K |
| 99243 |
|
156 |
155 |
$3K |
| 3077F |
|
124 |
122 |
$3K |
| 85045 |
|
904 |
870 |
$3K |
| 92551 |
|
199 |
199 |
$3K |
| Z6406 |
|
244 |
173 |
$3K |
| 83516 |
|
268 |
261 |
$3K |
| 29240 |
|
749 |
736 |
$3K |
| 36430 |
|
126 |
120 |
$3K |
| Q4081 |
Epoetin alfa, 100 units esrd |
123 |
13 |
$3K |
| 72072 |
|
120 |
119 |
$3K |
| 29581 |
|
398 |
74 |
$3K |
| 84481 |
|
381 |
377 |
$3K |
| 93297 |
|
125 |
119 |
$3K |
| 93016 |
|
243 |
243 |
$3K |
| 84155 |
|
921 |
903 |
$3K |
| 84520 |
|
530 |
391 |
$3K |
| J2550 |
Promethazine hcl injection |
1,165 |
1,035 |
$3K |
| 82784 |
|
314 |
286 |
$3K |
| 77080 |
|
92 |
92 |
$2K |
| 3079F |
|
239 |
237 |
$2K |
| 51798 |
|
149 |
142 |
$2K |
| G8420 |
Calc bmi norm parameters |
408 |
386 |
$2K |
| 82553 |
|
160 |
112 |
$2K |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
388 |
376 |
$2K |
| 67042 |
|
13 |
12 |
$2K |
| 87581 |
|
129 |
127 |
$2K |
| 73000 |
|
92 |
90 |
$2K |
| J3105 |
Terbutaline sulfate inj |
247 |
214 |
$2K |
| U0005 |
Infec agen detec ampli probe |
239 |
228 |
$2K |
| 87046 |
|
570 |
555 |
$2K |
| 87486 |
|
129 |
127 |
$2K |
| 0510 |
|
1,572 |
1,505 |
$2K |
| 82565 |
|
441 |
428 |
$2K |
| 87804 |
|
384 |
379 |
$2K |
| 76000 |
|
82 |
77 |
$2K |
| 71020 |
|
338 |
200 |
$2K |
| 29130 |
|
401 |
386 |
$2K |
| 99223 |
Prolong inpt eval add15 m |
49 |
49 |
$2K |
| 97535 |
|
213 |
125 |
$2K |
| 87899 |
|
212 |
211 |
$2K |
| 82310 |
|
385 |
361 |
$2K |
| 86677 |
|
160 |
159 |
$2K |
| 85390 |
|
413 |
383 |
$2K |
| 86787 |
|
154 |
152 |
$2K |
| 84156 |
|
809 |
747 |
$2K |
| J1630 |
Haloperidol injection |
1,321 |
1,167 |
$2K |
| 86308 |
|
327 |
327 |
$2K |
| 97166 |
|
312 |
309 |
$2K |
| 90791 |
|
13 |
13 |
$2K |
| 69209 |
|
246 |
244 |
$2K |
| J2272 |
Inj, morphine (fresenius) |
203 |
190 |
$2K |
| 86703 |
|
117 |
116 |
$2K |
| 99282 |
|
12 |
12 |
$2K |
| J2919 |
Inj, methylpred sod succ 5mg |
187 |
165 |
$2K |
| 99218 |
|
288 |
239 |
$1K |
| 99393 |
|
58 |
58 |
$1K |
| 84157 |
|
690 |
650 |
$1K |
| 0324 |
|
505 |
498 |
$1K |
| J3372 |
Inj, vancomycin hcl (xellia) |
99 |
92 |
$1K |
| J3260 |
Tobramycin sulfate injection |
81 |
76 |
$1K |
| 97016 |
|
470 |
116 |
$1K |
| 74174 |
|
12 |
12 |
$1K |
| Q9969 |
Non-heu tc-99m add-on/dose |
383 |
382 |
$1K |
| 73070 |
|
124 |
114 |
$1K |
| 82272 |
|
166 |
162 |
$1K |
| 86800 |
|
137 |
134 |
$1K |
| 92610 |
|
29 |
29 |
$1K |
| 51702 |
|
89 |
82 |
$1K |
| J3360 |
Diazepam injection |
97 |
93 |
$1K |
| 85347 |
|
430 |
400 |
$1K |
| 73600 |
|
46 |
45 |
$1K |
| 82530 |
|
81 |
80 |
$1K |
| 71100 |
|
57 |
56 |
$1K |
| 74220 |
|
59 |
58 |
$1K |
| 90732 |
|
13 |
13 |
$1K |
| 84402 |
|
95 |
95 |
$1K |
| 99394 |
|
29 |
29 |
$1K |
| 82610 |
|
117 |
113 |
$1K |
| J2560 |
Phenobarbital sodium inj |
15 |
13 |
$1K |
| 90746 |
|
13 |
13 |
$1K |
| J0702 |
Betamethasone acet&sod phosp |
23 |
13 |
$1K |
| 82810 |
|
164 |
151 |
$1K |
| 80081 |
|
12 |
12 |
$1K |
| 0370 |
|
357 |
351 |
$994.76 |
| 87449 |
|
104 |
102 |
$991.79 |
| 95819 |
|
38 |
38 |
$981.37 |
| 76376 |
|
303 |
300 |
$979.85 |
| 82378 |
|
122 |
113 |
$964.40 |
| 84460 |
|
218 |
213 |
$914.81 |
| J0689 |
Inj cefazolin sodium, baxter |
131 |
107 |
$903.14 |
| 49083 |
|
15 |
12 |
$887.32 |
| 73660 |
|
91 |
89 |
$871.16 |
| 84134 |
|
84 |
83 |
$870.17 |
| 93350 |
|
18 |
16 |
$860.09 |
| 84450 |
|
206 |
202 |
$848.48 |
| 29105 |
|
84 |
78 |
$834.58 |
| 86769 |
|
26 |
25 |
$820.13 |
| 85008 |
|
997 |
916 |
$819.12 |
| 83002 |
|
36 |
36 |
$791.35 |
| 64721 |
|
12 |
12 |
$759.00 |
| 87184 |
|
227 |
222 |
$730.46 |
| 76999 |
|
25 |
25 |
$704.74 |
| 86920 |
|
21 |
12 |
$691.53 |
| J3301 |
Triamcinolone acet inj nos |
104 |
97 |
$689.00 |
| 51701 |
|
174 |
153 |
$684.14 |
| 80178 |
|
105 |
95 |
$674.69 |
| 85007 |
|
885 |
834 |
$641.79 |
| 82785 |
|
40 |
40 |
$615.97 |
| 90688 |
|
74 |
74 |
$576.38 |
| 90472 |
|
58 |
58 |
$536.35 |
| 73521 |
|
25 |
25 |
$534.39 |
| 82977 |
|
72 |
72 |
$531.92 |
| 3075F |
|
28 |
28 |
$531.45 |
| 82105 |
|
14 |
14 |
$520.69 |
| 70487 |
|
13 |
12 |
$504.28 |
| 82040 |
|
148 |
135 |
$502.04 |
| 99231 |
|
45 |
45 |
$492.12 |
| 72220 |
|
27 |
27 |
$477.82 |
| 90675 |
|
24 |
13 |
$477.16 |
| J1940 |
Furosemide injection |
128 |
99 |
$472.87 |
| 29260 |
|
281 |
274 |
$451.30 |
| 82945 |
|
176 |
171 |
$446.37 |
| Z7500 |
|
13 |
12 |
$443.30 |
| 82731 |
|
14 |
13 |
$440.50 |
| 80329 |
|
93 |
84 |
$439.86 |
| 92558 |
|
15 |
14 |
$435.56 |
| 84075 |
|
119 |
118 |
$435.52 |
| 84270 |
|
27 |
27 |
$435.22 |
| 82575 |
|
52 |
52 |
$399.22 |
| J7512 |
Prednisone ir or dr oral 1mg |
2,116 |
1,926 |
$387.39 |
| 82652 |
|
40 |
39 |
$378.98 |
| 83037 |
|
287 |
281 |
$375.47 |
| 86171 |
|
30 |
30 |
$370.24 |
| A9537 |
Tc99m mebrofenin |
16 |
14 |
$366.94 |
| 82247 |
|
72 |
51 |
$365.44 |
| 86331 |
|
30 |
30 |
$346.25 |
| 99232 |
|
19 |
12 |
$340.20 |
| Z7610 |
|
26 |
26 |
$321.87 |
| 73100 |
|
12 |
12 |
$320.99 |
| Z6404 |
|
12 |
12 |
$289.56 |
| 81050 |
|
149 |
148 |
$252.26 |
| J3420 |
Vitamin b12 injection |
150 |
144 |
$241.50 |
| 93321 |
|
13 |
12 |
$233.06 |
| 83993 |
|
12 |
12 |
$228.44 |
| 71010 |
|
88 |
36 |
$224.77 |
| 86200 |
|
34 |
29 |
$219.31 |
| S0164 |
Injection pantroprazole |
16 |
14 |
$194.38 |
| J8540 |
Oral dexamethasone |
189 |
165 |
$189.86 |
| 86706 |
|
12 |
12 |
$169.20 |
| J1642 |
Inj heparin sodium per 10 u |
53 |
36 |
$167.54 |
| 94760 |
|
19 |
19 |
$138.30 |
| J0456 |
Azithromycin |
44 |
43 |
$133.38 |
| 84165 |
|
25 |
24 |
$131.04 |
| 0305 |
|
319 |
289 |
$129.71 |
| 3080F |
|
12 |
12 |
$115.48 |
| J3486 |
Ziprasidone mesylate |
16 |
13 |
$113.65 |
| 86256 |
|
13 |
13 |
$103.90 |
| 29540 |
|
131 |
131 |
$97.44 |
| 0320 |
|
32 |
31 |
$96.67 |
| 0730 |
|
12 |
12 |
$89.51 |
| 87075 |
|
16 |
16 |
$88.38 |
| 82374 |
|
68 |
67 |
$79.33 |
| 99000 |
|
143 |
137 |
$73.28 |
| 96413 |
|
33 |
25 |
$72.68 |
| 99173 |
|
152 |
143 |
$64.64 |
| 90651 |
|
13 |
13 |
$61.65 |
| 83930 |
|
12 |
12 |
$57.92 |
| J2310 |
Inj naloxone hydrochloride |
16 |
16 |
$54.84 |
| 87077 |
|
27 |
26 |
$53.66 |
| 86880 |
|
13 |
13 |
$47.87 |
| 93018 |
|
14 |
14 |
$45.15 |
| 0636 |
|
38 |
27 |
$39.60 |
| 86300 |
|
13 |
12 |
$35.76 |
| G9724 |
Pt w/doc use anticoag mst yr |
31 |
29 |
$24.04 |
| 36000 |
|
16 |
12 |
$21.80 |
| G8483 |
Flu imm no admin doc rea |
47 |
44 |
$17.71 |
| S0077 |
Injection, clindamycin phosp |
13 |
13 |
$16.12 |
| G8482 |
Flu immunize order/admin |
309 |
285 |
$14.13 |
| A4657 |
Syringe w/wo needle |
580 |
69 |
$0.03 |
| S9088 |
Services provided in urgent |
80 |
76 |
$0.00 |
| 97014 |
|
92 |
28 |
$0.00 |
| 99291 |
|
18 |
15 |
$0.00 |
| G8986 |
Carry d/c status |
13 |
13 |
$0.00 |
| G0008 |
Admin influenza virus vac |
15 |
15 |
$0.00 |
| A4649 |
Surgical supplies |
206 |
191 |
$0.00 |
| G8984 |
Carry current status |
60 |
59 |
$0.00 |
| G8985 |
Carry goal status |
142 |
130 |
$0.00 |
| 0940 |
|
40 |
40 |
$0.00 |
| 0370R |
|
12 |
12 |
$0.00 |