| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
46,966 |
35,780 |
$12.04M |
| 99283 |
|
56,769 |
46,657 |
$10.43M |
| 96374 |
|
29,251 |
22,331 |
$3.67M |
| 99285 |
|
7,622 |
6,054 |
$3.57M |
| 97010 |
|
41,716 |
10,248 |
$2.58M |
| G0463 |
Hospital outpt clinic visit |
30,131 |
19,587 |
$2.05M |
| 97110 |
|
74,207 |
17,340 |
$1.84M |
| 74177 |
|
9,970 |
8,166 |
$1.73M |
| 99291 |
|
2,819 |
2,241 |
$1.57M |
| 43239 |
|
2,513 |
2,244 |
$1.20M |
| 96361 |
|
24,781 |
17,387 |
$1.02M |
| U0003 |
Cov-19 amp prb hgh thruput |
17,309 |
14,420 |
$999K |
| 99282 |
|
8,856 |
7,785 |
$995K |
| S9480 |
Intensive outpatient psychia |
9,140 |
1,595 |
$945K |
| 96365 |
|
8,848 |
6,052 |
$904K |
| 59025 |
|
8,783 |
2,328 |
$892K |
| 96360 |
|
7,070 |
5,551 |
$811K |
| 96375 |
|
21,783 |
15,522 |
$792K |
| 78452 |
|
1,645 |
1,398 |
$722K |
| 71046 |
|
12,527 |
10,536 |
$659K |
| 93306 |
|
2,615 |
2,291 |
$619K |
| 74176 |
|
4,655 |
3,726 |
$598K |
| 96413 |
|
3,113 |
1,562 |
$582K |
| 71045 |
|
12,358 |
9,919 |
$568K |
| 93975 |
|
2,781 |
2,362 |
$532K |
| 99213 |
|
13,216 |
10,677 |
$498K |
| 77067 |
|
4,295 |
4,105 |
$470K |
| 95810 |
|
651 |
597 |
$466K |
| 70450 |
|
9,220 |
7,345 |
$456K |
| 97161 |
|
7,211 |
6,440 |
$407K |
| 90853 |
|
33,608 |
12,582 |
$407K |
| 72125 |
|
3,323 |
2,665 |
$372K |
| 90832 |
|
11,235 |
6,359 |
$354K |
| 87591 |
|
12,253 |
11,047 |
$333K |
| 87491 |
|
12,250 |
11,045 |
$332K |
| 97597 |
|
4,033 |
1,935 |
$319K |
| 90791 |
|
3,121 |
2,702 |
$300K |
| 76705 |
|
3,839 |
3,262 |
$299K |
| 86900 |
|
8,555 |
6,114 |
$296K |
| 71260 |
|
2,146 |
1,809 |
$290K |
| 45385 |
|
468 |
427 |
$263K |
| U0005 |
Infec agen detec ampli probe |
14,026 |
11,808 |
$257K |
| 84443 |
|
26,419 |
22,890 |
$252K |
| C8929 |
Tte w or wo fol wcon,doppler |
899 |
791 |
$244K |
| 97035 |
|
9,605 |
2,993 |
$242K |
| 71275 |
|
2,296 |
1,872 |
$231K |
| 70551 |
|
1,780 |
1,532 |
$228K |
| 76801 |
|
2,559 |
1,844 |
$220K |
| 76856 |
|
2,454 |
2,167 |
$219K |
| 80053 |
|
71,601 |
55,715 |
$212K |
| H0015 |
Alcohol and/or drug services |
1,749 |
351 |
$211K |
| 82306 |
|
11,076 |
9,710 |
$211K |
| 94060 |
|
1,464 |
1,339 |
$207K |
| 80061 |
|
23,396 |
20,763 |
$201K |
| 45380 |
|
304 |
271 |
$201K |
| 76830 |
|
1,933 |
1,722 |
$188K |
| 72148 |
|
1,189 |
1,038 |
$182K |
| 90834 |
|
3,961 |
2,152 |
$171K |
| 87635 |
|
5,442 |
4,566 |
$170K |
| 97140 |
|
58,478 |
14,122 |
$169K |
| 73721 |
|
906 |
805 |
$163K |
| 76641 |
|
1,955 |
1,782 |
$162K |
| 85025 |
|
102,258 |
75,857 |
$161K |
| 91065 |
|
1,442 |
854 |
$151K |
| 93971 |
|
2,528 |
2,107 |
$147K |
| 87633 |
|
2,470 |
2,164 |
$129K |
| 87624 |
|
4,597 |
4,310 |
$125K |
| Q0138 |
Ferumoxytol, non-esrd |
830 |
456 |
$121K |
| 62323 |
|
281 |
255 |
$121K |
| 11042 |
|
819 |
390 |
$117K |
| 83036 |
|
19,757 |
17,416 |
$115K |
| 76775 |
|
2,467 |
2,092 |
$106K |
| 36415 |
|
142,807 |
100,978 |
$101K |
| 76816 |
|
1,184 |
973 |
$99K |
| 80307 |
|
11,339 |
9,086 |
$98K |
| 88142 |
|
7,582 |
7,090 |
$98K |
| 99281 |
|
1,765 |
1,495 |
$96K |
| 88305 |
|
8,512 |
7,185 |
$95K |
| 97162 |
|
3,443 |
2,786 |
$94K |
| 71250 |
|
1,747 |
1,492 |
$91K |
| 76805 |
|
837 |
729 |
$84K |
| 82607 |
|
11,269 |
9,623 |
$84K |
| 96366 |
|
3,689 |
2,066 |
$82K |
| C9803 |
Hopd covid-19 spec collect |
15,240 |
12,716 |
$78K |
| 87800 |
|
2,268 |
2,068 |
$77K |
| 93017 |
|
2,271 |
1,944 |
$76K |
| 97602 |
|
1,098 |
580 |
$73K |
| 94010 |
|
1,197 |
1,049 |
$67K |
| 10060 |
|
496 |
411 |
$67K |
| 77063 |
|
4,288 |
4,100 |
$63K |
| 96367 |
|
1,796 |
1,126 |
$62K |
| 88342 |
|
3,609 |
3,116 |
$61K |
| 82728 |
|
9,816 |
8,325 |
$60K |
| 20610 |
|
434 |
345 |
$57K |
| 71271 |
|
645 |
603 |
$57K |
| 97014 |
|
6,434 |
1,742 |
$55K |
| 86780 |
|
5,437 |
4,669 |
$54K |
| J1439 |
Inj ferric carboxymaltos 1mg |
166 |
93 |
$54K |
| 96372 |
|
11,081 |
7,803 |
$53K |
| 95811 |
|
80 |
71 |
$52K |
| 87086 |
|
28,848 |
22,555 |
$50K |
| 80048 |
|
40,515 |
28,723 |
$50K |
| 76536 |
|
611 |
550 |
$44K |
| 84439 |
|
7,660 |
6,698 |
$43K |
| 82746 |
|
6,855 |
5,779 |
$41K |
| 86703 |
|
7,220 |
6,176 |
$41K |
| 93970 |
|
359 |
294 |
$40K |
| 83550 |
|
9,778 |
8,302 |
$38K |
| 99214 |
|
2,598 |
1,921 |
$38K |
| 83970 |
|
1,570 |
1,363 |
$38K |
| 86803 |
|
6,016 |
5,139 |
$37K |
| 95819 |
|
271 |
231 |
$36K |
| 93798 |
|
732 |
107 |
$36K |
| 97012 |
|
881 |
286 |
$35K |
| U0002 |
Covid-19 lab test non-cdc |
1,014 |
907 |
$33K |
| G0480 |
Drug test def 1-7 classes |
7,722 |
6,195 |
$32K |
| 86235 |
|
714 |
586 |
$32K |
| 97113 |
|
594 |
160 |
$32K |
| 73221 |
|
181 |
164 |
$32K |
| 66984 |
|
60 |
43 |
$31K |
| 85027 |
|
11,912 |
8,969 |
$30K |
| 83540 |
|
10,028 |
8,517 |
$29K |
| 70553 |
|
100 |
81 |
$27K |
| 93005 |
|
28,399 |
20,947 |
$27K |
| 72100 |
|
2,104 |
1,790 |
$25K |
| 73030 |
|
2,680 |
2,235 |
$25K |
| 70496 |
|
164 |
137 |
$25K |
| 97112 |
|
2,343 |
697 |
$24K |
| 86696 |
|
1,408 |
1,133 |
$23K |
| 73130 |
|
2,302 |
1,983 |
$22K |
| 86480 |
|
505 |
433 |
$22K |
| 86141 |
|
3,914 |
3,326 |
$22K |
| 84425 |
|
1,381 |
1,220 |
$21K |
| 97116 |
|
1,739 |
997 |
$21K |
| 97165 |
|
367 |
315 |
$21K |
| 98968 |
|
449 |
239 |
$21K |
| 84702 |
|
5,534 |
4,005 |
$20K |
| 72110 |
|
313 |
284 |
$19K |
| 72141 |
|
108 |
95 |
$19K |
| 74018 |
|
1,579 |
1,302 |
$18K |
| 87653 |
|
689 |
603 |
$17K |
| 73630 |
|
2,891 |
2,462 |
$17K |
| 0012A |
|
540 |
490 |
$17K |
| 98967 |
|
360 |
229 |
$17K |
| 86038 |
|
2,862 |
2,396 |
$17K |
| 0011A |
|
707 |
547 |
$17K |
| 82105 |
|
1,485 |
1,292 |
$17K |
| 97530 |
|
2,044 |
979 |
$16K |
| 73502 |
|
1,635 |
1,389 |
$16K |
| 73560 |
|
693 |
589 |
$16K |
| 84153 |
|
1,712 |
1,494 |
$16K |
| 86695 |
|
1,377 |
1,106 |
$15K |
| H0035 |
Mh partial hosp tx under 24h |
123 |
12 |
$15K |
| 49083 |
|
24 |
12 |
$14K |
| 76642 |
|
274 |
254 |
$14K |
| 77065 |
Tomosynthesis, mammo |
167 |
145 |
$14K |
| 87081 |
|
5,590 |
4,709 |
$14K |
| 87340 |
|
3,659 |
3,097 |
$14K |
| 86706 |
|
2,776 |
2,274 |
$14K |
| 87186 |
|
6,060 |
5,003 |
$13K |
| 87077 |
|
5,913 |
4,868 |
$13K |
| 73610 |
|
2,658 |
2,268 |
$12K |
| 81003 |
|
32,343 |
25,792 |
$12K |
| 64493 |
|
16 |
13 |
$11K |
| 82570 |
|
3,854 |
3,310 |
$11K |
| 82784 |
|
2,505 |
2,075 |
$11K |
| 73700 |
|
170 |
136 |
$11K |
| 86334 |
|
2,102 |
1,646 |
$10K |
| 29515 |
|
89 |
80 |
$10K |
| 82043 |
|
3,144 |
2,771 |
$10K |
| 70491 |
|
58 |
53 |
$10K |
| 78815 |
|
12 |
12 |
$10K |
| 88304 |
|
719 |
602 |
$10K |
| 84403 |
|
585 |
511 |
$10K |
| 73110 |
|
1,648 |
1,410 |
$10K |
| 87147 |
|
5,279 |
4,543 |
$10K |
| 83880 |
|
3,761 |
2,922 |
$10K |
| M0243 |
Casirivi and imdevi inj |
29 |
26 |
$9K |
| 86618 |
|
1,492 |
1,278 |
$9K |
| 93880 |
|
131 |
107 |
$9K |
| 83735 |
|
18,063 |
11,600 |
$9K |
| 76817 |
|
450 |
360 |
$9K |
| 85610 |
|
13,535 |
9,564 |
$9K |
| 83516 |
|
1,044 |
840 |
$8K |
| 90471 |
|
2,830 |
2,256 |
$8K |
| 86200 |
|
976 |
845 |
$8K |
| 0001A |
|
268 |
224 |
$8K |
| 0002A |
|
242 |
217 |
$8K |
| 86762 |
|
2,424 |
1,947 |
$8K |
| 85652 |
|
6,873 |
5,754 |
$8K |
| 80076 |
|
7,949 |
6,325 |
$8K |
| 86704 |
|
1,664 |
1,405 |
$7K |
| 81001 |
|
17,670 |
13,228 |
$7K |
| 73564 |
|
2,540 |
2,165 |
$7K |
| 82550 |
|
3,867 |
3,120 |
$7K |
| 76811 |
|
29 |
27 |
$7K |
| Q3014 |
Telehealth facility fee |
841 |
480 |
$6K |
| 87467 |
|
1,365 |
1,178 |
$6K |
| 86140 |
|
2,785 |
2,257 |
$6K |
| 83615 |
|
8,767 |
6,220 |
$6K |
| G0103 |
Psa screening |
509 |
475 |
$6K |
| G0260 |
Inj for sacroiliac jt anesth |
20 |
12 |
$6K |
| 86787 |
|
2,000 |
1,596 |
$6K |
| 82950 |
|
1,466 |
1,289 |
$6K |
| 99442 |
|
482 |
406 |
$5K |
| 84590 |
|
672 |
591 |
$5K |
| 87088 |
|
2,882 |
2,411 |
$5K |
| 86431 |
|
1,984 |
1,664 |
$5K |
| 84165 |
|
2,007 |
1,625 |
$5K |
| 97018 |
|
76 |
26 |
$5K |
| 87070 |
|
1,574 |
1,287 |
$4K |
| 84480 |
|
444 |
407 |
$4K |
| 87205 |
|
2,538 |
2,049 |
$4K |
| 83690 |
|
25,190 |
19,170 |
$4K |
| 85730 |
|
5,282 |
4,029 |
$4K |
| 64450 |
|
38 |
38 |
$3K |
| 80050 |
|
232 |
174 |
$3K |
| 83001 |
|
240 |
217 |
$3K |
| 29581 |
|
44 |
12 |
$3K |
| 73080 |
|
524 |
468 |
$3K |
| 86708 |
|
395 |
359 |
$3K |
| 86753 |
|
571 |
482 |
$3K |
| 71101 |
|
502 |
427 |
$3K |
| 82565 |
|
1,961 |
1,644 |
$3K |
| 82040 |
|
1,001 |
887 |
$3K |
| 72070 |
|
115 |
102 |
$3K |
| 96415 |
|
52 |
39 |
$3K |
| 0031A |
|
80 |
76 |
$3K |
| 97535 |
|
296 |
244 |
$3K |
| 96417 |
|
44 |
24 |
$3K |
| M0222 |
Bebtelovimab injection |
17 |
13 |
$2K |
| 84146 |
|
167 |
150 |
$2K |
| 74241 |
|
15 |
14 |
$2K |
| 94664 |
|
71 |
67 |
$2K |
| 73140 |
|
637 |
539 |
$2K |
| 83519 |
|
136 |
81 |
$2K |
| J2272 |
Inj, morphine (fresenius) |
2,420 |
1,653 |
$2K |
| 84100 |
|
10,829 |
6,495 |
$2K |
| Q9969 |
Non-heu tc-99m add-on/dose |
337 |
304 |
$2K |
| 82247 |
|
1,532 |
1,142 |
$2K |
| 84550 |
|
1,491 |
1,218 |
$2K |
| 74240 |
|
13 |
12 |
$2K |
| 85045 |
|
2,574 |
2,115 |
$2K |
| 84436 |
|
459 |
401 |
$2K |
| 82652 |
|
59 |
54 |
$2K |
| 83525 |
|
190 |
171 |
$2K |
| 76700 |
|
29 |
26 |
$2K |
| G0297 |
Ldct for lung ca screen |
27 |
26 |
$2K |
| 84450 |
|
2,705 |
2,316 |
$2K |
| 86225 |
|
210 |
172 |
$2K |
| 87651 |
|
1,093 |
970 |
$1K |
| 77066 |
Tomosynthesis, mammo |
16 |
12 |
$1K |
| 85379 |
|
5,073 |
4,218 |
$1K |
| G0378 |
Hospital observation per hr |
4,229 |
3,238 |
$1K |
| 87502 |
|
1,874 |
1,662 |
$1K |
| 83021 |
|
721 |
599 |
$1K |
| 84703 |
|
2,602 |
2,158 |
$1K |
| 83655 |
|
117 |
112 |
$1K |
| 84145 |
|
3,627 |
2,699 |
$1K |
| J3490 |
Drugs unclassified injection |
133,993 |
43,742 |
$1K |
| 87102 |
|
150 |
140 |
$1K |
| 84484 |
|
21,997 |
11,913 |
$1K |
| 70498 |
|
200 |
172 |
$1K |
| 84481 |
|
85 |
79 |
$1K |
| 87506 |
|
13 |
12 |
$1K |
| 94726 |
|
426 |
400 |
$993.62 |
| 83883 |
|
670 |
524 |
$976.61 |
| 84155 |
|
2,018 |
1,634 |
$971.29 |
| 84479 |
|
258 |
223 |
$946.64 |
| 82248 |
|
2,369 |
1,719 |
$836.23 |
| 96523 |
|
39 |
25 |
$828.73 |
| 84270 |
|
51 |
44 |
$788.88 |
| 83013 |
|
12 |
12 |
$771.84 |
| 86160 |
|
61 |
43 |
$745.55 |
| J2469 |
Palonosetron hcl |
349 |
179 |
$722.06 |
| 87040 |
|
3,383 |
2,249 |
$701.25 |
| 84075 |
|
2,019 |
1,716 |
$665.10 |
| 82803 |
|
2,782 |
1,834 |
$631.88 |
| 87493 |
|
39 |
28 |
$590.24 |
| 86666 |
|
117 |
80 |
$544.32 |
| 87804 |
|
7,972 |
3,471 |
$533.25 |
| 82310 |
|
730 |
622 |
$528.58 |
| 85014 |
|
1,727 |
1,332 |
$475.51 |
| 86592 |
|
153 |
132 |
$459.91 |
| 80164 |
|
93 |
78 |
$437.36 |
| 86152 |
|
18 |
12 |
$424.68 |
| 99204 |
|
170 |
145 |
$410.60 |
| 83521 |
|
341 |
253 |
$370.80 |
| 12001 |
|
473 |
415 |
$369.64 |
| 87634 |
|
473 |
422 |
$356.79 |
| 84134 |
|
31 |
25 |
$348.00 |
| 84156 |
|
213 |
173 |
$334.88 |
| 72040 |
|
99 |
79 |
$322.34 |
| 82951 |
|
27 |
25 |
$319.54 |
| 90792 |
|
20 |
12 |
$312.64 |
| 88307 |
|
147 |
128 |
$311.74 |
| 86735 |
|
39 |
29 |
$286.58 |
| 86765 |
|
39 |
29 |
$283.13 |
| 86376 |
|
24 |
24 |
$275.77 |
| 94640 |
|
677 |
504 |
$270.64 |
| 82948 |
|
16,591 |
7,526 |
$264.46 |
| 82150 |
|
100 |
83 |
$260.10 |
| 12002 |
|
211 |
184 |
$258.50 |
| 84460 |
|
2,699 |
2,317 |
$255.90 |
| G8978 |
Mobility current status |
888 |
723 |
$246.91 |
| 85018 |
|
970 |
776 |
$246.34 |
| 70486 |
|
16 |
14 |
$245.22 |
| 99443 |
|
13 |
13 |
$229.56 |
| 86709 |
|
33 |
24 |
$215.00 |
| 82785 |
|
13 |
13 |
$204.49 |
| 87449 |
|
47 |
41 |
$199.59 |
| 73590 |
|
76 |
56 |
$197.17 |
| 29125 |
|
349 |
308 |
$192.22 |
| 90715 |
|
2,154 |
1,801 |
$189.23 |
| 85041 |
|
652 |
543 |
$176.00 |
| 81015 |
|
86 |
72 |
$171.10 |
| 83605 |
|
8,917 |
6,035 |
$161.96 |
| 84132 |
|
173 |
133 |
$143.56 |
| 87324 |
|
32 |
28 |
$142.60 |
| 87880 |
|
2,415 |
2,131 |
$141.73 |
| 84144 |
|
27 |
25 |
$139.44 |
| 96376 |
|
6,226 |
3,819 |
$131.70 |
| 84520 |
|
1,107 |
912 |
$129.23 |
| J7613 |
Albuterol non-comp unit |
430 |
374 |
$117.98 |
| J2785 |
Regadenoson injection |
1,085 |
920 |
$115.37 |
| 82140 |
|
84 |
68 |
$113.85 |
| 82533 |
|
15 |
12 |
$99.00 |
| 82232 |
|
130 |
105 |
$92.70 |
| 83014 |
|
12 |
12 |
$90.12 |
| 88313 |
|
3,009 |
2,654 |
$86.61 |
| 83721 |
|
16 |
14 |
$81.99 |
| 86850 |
|
7,483 |
5,831 |
$79.64 |
| 82330 |
|
82 |
64 |
$69.60 |
| 95251 |
|
359 |
245 |
$62.75 |
| 82977 |
|
33 |
26 |
$61.40 |
| 82553 |
|
306 |
207 |
$52.90 |
| J1644 |
Inj heparin sodium per 1000u |
3,782 |
1,425 |
$41.27 |
| J0689 |
Inj cefazolin sodium, baxter |
121 |
85 |
$39.92 |
| 90686 |
|
21 |
17 |
$38.06 |
| J2060 |
Lorazepam injection |
4,866 |
3,440 |
$30.93 |
| 86308 |
|
29 |
24 |
$29.64 |
| 94727 |
|
2,281 |
2,031 |
$28.02 |
| J0134 |
Inj acetaminophen -fresenius |
299 |
216 |
$25.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,308 |
1,162 |
$14.52 |
| A9270 |
Non-covered item or service |
15,913 |
8,501 |
$13.51 |
| 87807 |
|
121 |
114 |
$11.45 |
| J2405 |
Ondansetron hcl injection |
22,182 |
15,591 |
$10.17 |
| 80051 |
|
23 |
14 |
$9.43 |
| J2270 |
Morphine sulfate injection |
8,198 |
5,390 |
$9.41 |
| J7620 |
Albuterol ipratrop non-comp |
2,337 |
1,756 |
$7.37 |
| J1885 |
Ketorolac tromethamine inj |
15,819 |
12,030 |
$5.33 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
17,664 |
14,287 |
$5.07 |
| J0696 |
Ceftriaxone sodium injection |
3,946 |
2,480 |
$4.80 |
| 84295 |
|
51 |
39 |
$4.59 |
| 82009 |
|
182 |
140 |
$4.31 |
| 82962 |
|
813 |
551 |
$4.29 |
| G8979 |
Mobility goal status |
1,025 |
814 |
$4.09 |
| J2765 |
Metoclopramide hcl injection |
4,505 |
3,409 |
$2.40 |
| J1630 |
Haloperidol injection |
2,026 |
1,577 |
$1.95 |
| J0690 |
Cefazolin sodium injection |
6,518 |
4,429 |
$1.94 |
| G0283 |
Elec stim other than wound |
66 |
25 |
$1.87 |
| J1100 |
Dexamethasone sodium phos |
6,594 |
5,480 |
$1.81 |
| J1170 |
Hydromorphone injection |
5,694 |
3,448 |
$1.00 |
| G8980 |
Mobility d/c status |
103 |
88 |
$0.27 |
| G8988 |
Self care goal status |
62 |
52 |
$0.17 |
| G8987 |
Self care current status |
45 |
38 |
$0.14 |
| J1200 |
Diphenhydramine hcl injectio |
3,991 |
3,008 |
$0.08 |
| J2930 |
Methylprednisolone injection |
2,187 |
1,644 |
$0.00 |
| 76813 |
|
975 |
668 |
$0.00 |
| C1776 |
Joint device (implantable) |
45 |
31 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
1,396 |
1,097 |
$0.00 |
| 94729 |
|
2,703 |
2,428 |
$0.00 |
| J2550 |
Promethazine hcl injection |
286 |
212 |
$0.00 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
1,690 |
1,349 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
988 |
685 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
1,388 |
1,162 |
$0.00 |
| Q0163 |
Diphenhydramine hcl 50mg |
1,401 |
1,007 |
$0.00 |
| 77002 |
|
88 |
84 |
$0.00 |
| G1004 |
Cdsm ndsc |
687 |
540 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
850 |
726 |
$0.00 |
| J0780 |
Prochlorperazine injection |
586 |
446 |
$0.00 |
| 76942 |
|
312 |
269 |
$0.00 |
| Q9957 |
Inj perflutren lip micros,ml |
743 |
645 |
$0.00 |
| J3370 |
Vancomycin hcl injection |
122 |
81 |
$0.00 |
| 93356 |
|
710 |
640 |
$0.00 |
| A9552 |
F18 fdg |
12 |
12 |
$0.00 |
| C1887 |
Catheter, guiding |
234 |
77 |
$0.00 |
| 12011 |
|
45 |
38 |
$0.00 |
| 91300 |
|
494 |
446 |
$0.00 |
| J1650 |
Inj enoxaparin sodium |
712 |
329 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
337 |
227 |
$0.00 |
| J1453 |
Fosaprepitant injection |
41 |
24 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
168 |
111 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
412 |
227 |
$0.00 |
| C1874 |
Stent, coated/cov w/del sys |
16 |
13 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
15 |
13 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
2,424 |
2,005 |
$0.00 |
| C1769 |
Guide wire |
149 |
90 |
$0.00 |
| J1040 |
Methylprednisolone 80 mg inj |
431 |
382 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
8,350 |
5,738 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
5,777 |
4,342 |
$0.00 |
| J7999 |
Compounded drug, noc |
32 |
27 |
$0.00 |
| A9500 |
Tc99m sestamibi |
1,733 |
1,478 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
384 |
348 |
$0.00 |
| J1642 |
Inj heparin sodium per 10 u |
1,827 |
975 |
$0.00 |
| J3420 |
Vitamin b12 injection |
806 |
565 |
$0.00 |
| 88341 |
|
503 |
419 |
$0.00 |
| J1030 |
Methylprednisolone 40 mg inj |
335 |
288 |
$0.00 |
| J2471 |
Inj pantoprazole(hikma) 40mg |
47 |
30 |
$0.00 |
| 96368 |
|
68 |
44 |
$0.00 |
| G0471 |
Ven blood coll snf/hha |
1,109 |
538 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
535 |
455 |
$0.00 |
| J7609 |
Albuterol comp unit |
225 |
182 |
$0.00 |
| 91303 |
|
66 |
63 |
$0.00 |
| C1889 |
Implant/insert device, noc |
298 |
267 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
126 |
40 |
$0.00 |
| J3480 |
Inj potassium chloride |
72 |
48 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
193 |
149 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
175 |
139 |
$0.00 |
| 91301 |
|
1,142 |
1,008 |
$0.00 |
| J7512 |
Prednisone ir or dr oral 1mg |
128 |
108 |
$0.00 |
| 82435 |
|
51 |
38 |
$0.00 |
| J2001 |
Lidocaine injection |
122 |
110 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
202 |
113 |
$0.00 |
| 86880 |
|
77 |
65 |
$0.00 |
| 64494 |
|
16 |
13 |
$0.00 |
| 76870 |
|
18 |
13 |
$0.00 |
| J1010 |
Inj, methylpred acetate 1 mg |
28 |
26 |
$0.00 |
| 64415 |
|
14 |
12 |
$0.00 |
| G0108 |
Diab manage trn per indiv |
14 |
12 |
$0.00 |