| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
45,653 |
39,865 |
$9.65M |
| 99284 |
|
29,340 |
26,091 |
$5.42M |
| 99283 |
|
32,896 |
29,693 |
$5.37M |
| 96361 |
|
19,217 |
15,172 |
$4.65M |
| 41899 |
|
3,066 |
2,822 |
$4.06M |
| 74177 |
|
8,897 |
8,303 |
$2.44M |
| G0378 |
Hospital observation per hr |
12,322 |
9,868 |
$1.78M |
| 70450 |
|
9,457 |
8,628 |
$1.55M |
| 97110 |
|
20,776 |
6,595 |
$1.39M |
| 43239 |
|
2,229 |
2,144 |
$1.10M |
| 74176 |
|
3,925 |
3,659 |
$999K |
| 96365 |
|
6,010 |
4,306 |
$894K |
| 78452 |
|
1,350 |
1,247 |
$879K |
| 96360 |
|
5,552 |
5,102 |
$854K |
| 96374 |
|
28,753 |
24,533 |
$837K |
| 97530 |
|
14,303 |
5,412 |
$778K |
| 71275 |
|
3,317 |
3,083 |
$778K |
| 99282 |
|
5,189 |
4,826 |
$757K |
| 92507 |
|
9,689 |
2,968 |
$743K |
| 0241U |
|
10,449 |
9,850 |
$721K |
| 80307 |
|
15,480 |
13,184 |
$705K |
| 36415 |
|
93,863 |
68,587 |
$705K |
| 93306 |
|
2,281 |
2,148 |
$696K |
| 45385 |
|
1,249 |
1,209 |
$692K |
| 45380 |
|
1,055 |
1,024 |
$650K |
| 97112 |
|
9,181 |
3,469 |
$606K |
| 45378 |
|
842 |
806 |
$599K |
| 49083 |
|
1,232 |
460 |
$585K |
| 76816 |
|
7,891 |
7,317 |
$569K |
| 96366 |
|
2,803 |
1,762 |
$553K |
| A4216 |
Sterile water/saline, 10 ml |
3,084 |
2,089 |
$544K |
| 70551 |
|
2,132 |
2,019 |
$509K |
| 76819 |
|
5,473 |
3,155 |
$493K |
| 11042 |
|
2,311 |
1,359 |
$453K |
| 76811 |
|
4,287 |
4,105 |
$436K |
| 97161 |
|
4,468 |
4,138 |
$433K |
| 43235 |
|
929 |
871 |
$423K |
| 59025 |
|
2,253 |
1,438 |
$405K |
| 71046 |
|
23,411 |
21,259 |
$361K |
| 76817 |
|
6,121 |
5,487 |
$352K |
| 85025 |
|
89,060 |
67,545 |
$331K |
| 76705 |
|
3,569 |
3,353 |
$326K |
| G0463 |
Hospital outpt clinic visit |
3,530 |
2,509 |
$319K |
| 80053 |
|
50,558 |
42,143 |
$315K |
| 70553 |
|
963 |
906 |
$303K |
| 99291 |
|
1,118 |
1,030 |
$277K |
| 72148 |
|
1,391 |
1,335 |
$255K |
| 93005 |
|
35,997 |
30,284 |
$241K |
| 80048 |
|
33,269 |
25,498 |
$224K |
| 76770 |
|
1,936 |
1,811 |
$223K |
| 93971 |
|
2,432 |
2,218 |
$215K |
| 95810 |
|
309 |
298 |
$204K |
| J2704 |
Inj, propofol, 10 mg |
15,767 |
13,789 |
$201K |
| J3010 |
Fentanyl citrate injection |
15,555 |
11,976 |
$200K |
| 96372 |
|
14,070 |
8,150 |
$195K |
| 78815 |
|
262 |
252 |
$190K |
| G0330 |
Facility svs dental rehab |
105 |
103 |
$189K |
| 29581 |
|
1,318 |
525 |
$188K |
| 76700 |
|
1,596 |
1,527 |
$185K |
| 77067 |
|
3,071 |
3,014 |
$183K |
| 96375 |
|
19,100 |
15,161 |
$181K |
| S9480 |
Intensive outpatient psychia |
775 |
82 |
$181K |
| 96376 |
|
11,849 |
6,669 |
$179K |
| G0480 |
Drug test def 1-7 classes |
8,396 |
7,129 |
$176K |
| 93325 |
|
1,135 |
1,063 |
$171K |
| 97140 |
|
4,518 |
1,865 |
$170K |
| 88305 |
|
6,247 |
5,241 |
$152K |
| J1100 |
Dexamethasone sodium phos |
10,202 |
9,152 |
$148K |
| 76801 |
|
3,359 |
3,090 |
$147K |
| 80047 |
|
14,734 |
12,915 |
$141K |
| 76856 |
|
1,783 |
1,701 |
$137K |
| 77386 |
|
414 |
37 |
$135K |
| 76830 |
|
1,279 |
1,223 |
$132K |
| J3490 |
Drugs unclassified injection |
23,913 |
11,855 |
$128K |
| 76641 |
|
1,136 |
983 |
$126K |
| 71250 |
|
1,887 |
1,782 |
$126K |
| 84443 |
|
13,115 |
12,252 |
$126K |
| 93017 |
|
1,529 |
1,418 |
$122K |
| P9047 |
Albumin (human), 25%, 50ml |
291 |
105 |
$119K |
| 94640 |
|
2,168 |
1,322 |
$118K |
| 97165 |
|
1,738 |
1,592 |
$115K |
| 76813 |
|
1,205 |
1,171 |
$110K |
| 77336 |
|
1,386 |
604 |
$109K |
| 69436 |
|
94 |
92 |
$109K |
| 77412 |
|
278 |
26 |
$99K |
| 71260 |
|
1,662 |
1,563 |
$99K |
| 93970 |
|
839 |
811 |
$95K |
| 83880 |
|
6,786 |
5,903 |
$93K |
| 82948 |
|
17,609 |
7,472 |
$90K |
| 84484 |
|
23,147 |
16,449 |
$89K |
| 80061 |
|
8,734 |
8,285 |
$89K |
| 86901 |
|
4,831 |
4,306 |
$89K |
| 82306 |
|
4,295 |
4,077 |
$89K |
| C1769 |
Guide wire |
3,376 |
2,972 |
$84K |
| 81001 |
|
28,402 |
25,169 |
$76K |
| 72125 |
|
2,664 |
2,463 |
$74K |
| 97602 |
|
657 |
531 |
$72K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
14,288 |
12,880 |
$71K |
| 97116 |
|
2,260 |
997 |
$69K |
| J0131 |
Inj, acetaminophen (nos) |
6,408 |
5,929 |
$67K |
| 93925 |
|
756 |
712 |
$67K |
| 76820 |
|
1,389 |
608 |
$66K |
| 83036 |
|
8,931 |
8,477 |
$63K |
| 73610 |
|
2,822 |
2,519 |
$62K |
| 97162 |
|
639 |
603 |
$60K |
| 85610 |
|
15,000 |
11,387 |
$55K |
| 76815 |
|
1,302 |
1,101 |
$54K |
| 87086 |
|
13,056 |
11,713 |
$54K |
| 73502 |
|
2,248 |
1,954 |
$54K |
| G0108 |
Diab manage trn per indiv |
1,142 |
917 |
$53K |
| 74018 |
|
2,381 |
2,178 |
$53K |
| C1894 |
Intro/sheath, non-laser |
2,541 |
2,290 |
$53K |
| 73564 |
|
2,867 |
2,528 |
$52K |
| 73630 |
|
2,214 |
2,005 |
$51K |
| 72110 |
|
1,106 |
1,059 |
$51K |
| 87420 |
|
2,613 |
2,428 |
$51K |
| 71045 |
|
10,817 |
9,504 |
$49K |
| 73030 |
|
2,482 |
2,245 |
$48K |
| 76642 |
|
480 |
444 |
$48K |
| 87880 |
|
4,155 |
3,952 |
$47K |
| 12001 |
|
194 |
184 |
$45K |
| 85379 |
|
5,685 |
5,081 |
$44K |
| 77066 |
Tomosynthesis, mammo |
750 |
717 |
$44K |
| 76805 |
|
748 |
717 |
$44K |
| C1887 |
Catheter, guiding |
106 |
99 |
$44K |
| U0002 |
Covid-19 lab test non-cdc |
5,451 |
5,017 |
$43K |
| 72100 |
|
2,496 |
2,343 |
$43K |
| 97535 |
|
1,254 |
824 |
$43K |
| 87040 |
|
3,621 |
2,895 |
$42K |
| 76536 |
|
398 |
388 |
$42K |
| 83690 |
|
11,023 |
9,635 |
$41K |
| 52356 |
|
13 |
13 |
$41K |
| 80076 |
|
6,304 |
5,641 |
$40K |
| 87804 |
|
8,117 |
3,721 |
$40K |
| J2250 |
Inj midazolam hydrochloride |
8,042 |
7,307 |
$38K |
| 87070 |
|
3,569 |
2,913 |
$36K |
| 76825 |
|
451 |
423 |
$36K |
| 73130 |
|
1,626 |
1,436 |
$36K |
| 72141 |
|
221 |
212 |
$34K |
| 84703 |
|
11,752 |
10,713 |
$34K |
| 76818 |
|
298 |
187 |
$32K |
| 74019 |
|
987 |
926 |
$32K |
| 70496 |
|
151 |
136 |
$30K |
| 87591 |
|
2,204 |
2,065 |
$30K |
| 84702 |
|
5,390 |
4,630 |
$30K |
| J7050 |
Normal saline solution infus |
8,013 |
3,314 |
$30K |
| 77063 |
|
1,831 |
1,798 |
$30K |
| J2405 |
Ondansetron hcl injection |
11,269 |
9,729 |
$29K |
| 84112 |
|
1,010 |
874 |
$29K |
| 82947 |
|
5,547 |
2,069 |
$28K |
| 71271 |
|
261 |
251 |
$28K |
| J1885 |
Ketorolac tromethamine inj |
12,057 |
9,967 |
$28K |
| 83735 |
|
11,147 |
7,590 |
$27K |
| A9500 |
Tc99m sestamibi |
1,372 |
1,240 |
$27K |
| 87502 |
|
1,289 |
1,212 |
$27K |
| 97597 |
|
821 |
538 |
$26K |
| 83970 |
|
1,095 |
1,008 |
$26K |
| 90853 |
|
172 |
41 |
$26K |
| 92609 |
|
568 |
212 |
$25K |
| 87491 |
|
2,201 |
2,057 |
$25K |
| 73110 |
|
1,125 |
1,029 |
$25K |
| 97113 |
|
405 |
113 |
$24K |
| 87634 |
|
1,062 |
998 |
$24K |
| J2270 |
Morphine sulfate injection |
5,260 |
4,050 |
$24K |
| J0690 |
Cefazolin sodium injection |
5,732 |
4,235 |
$23K |
| 88341 |
|
627 |
435 |
$23K |
| 66984 |
|
15 |
12 |
$23K |
| 85027 |
|
3,684 |
3,186 |
$22K |
| J0330 |
Succinycholine chloride inj |
895 |
785 |
$22K |
| J1644 |
Inj heparin sodium per 1000u |
5,534 |
2,838 |
$22K |
| 77334 |
|
90 |
71 |
$22K |
| 82607 |
|
3,079 |
2,881 |
$21K |
| J1815 |
Insulin injection |
1,466 |
652 |
$21K |
| J1650 |
Inj enoxaparin sodium |
5,586 |
2,764 |
$21K |
| J7620 |
Albuterol ipratrop non-comp |
2,677 |
1,846 |
$21K |
| 86140 |
|
6,036 |
5,318 |
$21K |
| 70491 |
|
109 |
106 |
$20K |
| S0020 |
Injection, bupivicaine hydro |
1,521 |
1,394 |
$20K |
| 81025 |
|
3,260 |
3,022 |
$20K |
| 72040 |
|
820 |
785 |
$20K |
| A9552 |
F18 fdg |
320 |
306 |
$20K |
| 93880 |
|
240 |
221 |
$19K |
| J0696 |
Ceftriaxone sodium injection |
5,931 |
4,032 |
$19K |
| 86618 |
|
1,452 |
1,368 |
$19K |
| 76827 |
|
465 |
435 |
$19K |
| U0003 |
Cov-19 amp prb hgh thruput |
871 |
814 |
$19K |
| 88342 |
|
1,343 |
1,186 |
$19K |
| 97163 |
|
201 |
180 |
$18K |
| 77065 |
Tomosynthesis, mammo |
371 |
338 |
$18K |
| 85652 |
|
4,734 |
4,321 |
$17K |
| 87077 |
|
2,991 |
2,598 |
$17K |
| 81003 |
|
5,479 |
5,127 |
$17K |
| G0279 |
Tomosynthesis, mammo |
1,129 |
1,084 |
$17K |
| 84439 |
|
3,330 |
3,164 |
$17K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
243 |
223 |
$16K |
| 73590 |
|
901 |
797 |
$16K |
| 85730 |
|
5,268 |
4,610 |
$16K |
| 82746 |
|
2,512 |
2,352 |
$15K |
| 76870 |
|
159 |
153 |
$15K |
| 12011 |
|
52 |
50 |
$14K |
| 93458 |
|
12 |
12 |
$14K |
| J1170 |
Hydromorphone injection |
6,591 |
4,579 |
$14K |
| 82728 |
|
2,262 |
1,951 |
$14K |
| 82565 |
|
1,913 |
1,723 |
$14K |
| 86850 |
|
4,181 |
3,711 |
$13K |
| 94060 |
|
324 |
318 |
$13K |
| 88304 |
|
971 |
916 |
$13K |
| 82803 |
|
2,050 |
1,464 |
$13K |
| A4217 |
Sterile water/saline, 500 ml |
1,007 |
598 |
$13K |
| 84466 |
|
2,254 |
2,136 |
$13K |
| 94660 |
|
51 |
25 |
$12K |
| 87081 |
|
5,111 |
4,772 |
$12K |
| 86900 |
|
4,831 |
4,306 |
$11K |
| 83605 |
|
3,781 |
3,149 |
$11K |
| 80074 |
|
352 |
324 |
$11K |
| 84550 |
|
2,251 |
1,812 |
$11K |
| 73721 |
|
58 |
55 |
$11K |
| 93922 |
|
263 |
237 |
$11K |
| 93660 |
|
71 |
68 |
$10K |
| 94726 |
|
176 |
171 |
$10K |
| 86803 |
|
1,172 |
1,128 |
$10K |
| 80143 |
|
2,477 |
2,209 |
$10K |
| 94729 |
|
203 |
198 |
$10K |
| 87186 |
|
4,806 |
4,150 |
$10K |
| 87301 |
|
2,505 |
2,333 |
$10K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
2,001 |
1,878 |
$10K |
| 70498 |
|
181 |
169 |
$10K |
| 93010 |
|
1,849 |
1,382 |
$9K |
| 97166 |
|
109 |
106 |
$9K |
| 87205 |
|
3,100 |
2,583 |
$9K |
| 84100 |
|
4,621 |
3,075 |
$8K |
| 10061 |
|
58 |
54 |
$8K |
| 83540 |
|
2,375 |
2,244 |
$8K |
| 87046 |
|
661 |
518 |
$7K |
| 82570 |
|
2,745 |
2,335 |
$7K |
| 87389 |
|
1,419 |
1,344 |
$7K |
| C8929 |
Tte w or wo fol wcon,doppler |
27 |
24 |
$7K |
| M0243 |
Casirivi and imdevi inj |
24 |
24 |
$7K |
| J3535 |
Metered dose inhaler drug |
897 |
782 |
$7K |
| 93351 |
|
16 |
14 |
$7K |
| 10005 |
|
12 |
12 |
$7K |
| 76821 |
|
124 |
66 |
$6K |
| 82550 |
|
2,522 |
2,161 |
$6K |
| S0119 |
Ondansetron 4 mg |
2,247 |
1,991 |
$6K |
| 70486 |
|
172 |
164 |
$6K |
| G0379 |
Direct refer hospital observ |
264 |
225 |
$6K |
| 87045 |
|
530 |
506 |
$6K |
| 90471 |
|
971 |
800 |
$6K |
| 84145 |
|
673 |
551 |
$6K |
| 97012 |
|
190 |
77 |
$6K |
| 12002 |
|
26 |
26 |
$6K |
| J1200 |
Diphenhydramine hcl injectio |
3,100 |
2,665 |
$6K |
| 95806 |
|
39 |
38 |
$6K |
| 88307 |
|
124 |
120 |
$5K |
| 73090 |
|
385 |
345 |
$5K |
| 97167 |
|
77 |
70 |
$5K |
| 73080 |
|
318 |
303 |
$5K |
| 73140 |
|
261 |
238 |
$5K |
| 80179 |
|
2,278 |
2,031 |
$5K |
| J7512 |
Prednisone ir or dr oral 1mg |
2,285 |
1,893 |
$5K |
| J2785 |
Regadenoson injection |
228 |
217 |
$5K |
| 72131 |
|
80 |
77 |
$4K |
| 92610 |
|
42 |
40 |
$4K |
| J8540 |
Oral dexamethasone |
666 |
601 |
$4K |
| 87340 |
|
867 |
824 |
$4K |
| 43249 |
|
12 |
12 |
$4K |
| J2550 |
Promethazine hcl injection |
470 |
363 |
$4K |
| M0247 |
Sotrovimab infusion |
15 |
14 |
$4K |
| J2060 |
Lorazepam injection |
1,894 |
1,539 |
$4K |
| 76937 |
|
244 |
226 |
$4K |
| 92523 |
|
30 |
26 |
$4K |
| 85018 |
|
1,582 |
1,064 |
$4K |
| 80069 |
|
929 |
613 |
$4K |
| 87210 |
|
804 |
760 |
$4K |
| 74183 |
|
12 |
12 |
$4K |
| 84156 |
|
2,224 |
1,821 |
$4K |
| 85014 |
|
2,391 |
1,321 |
$4K |
| 86592 |
|
577 |
532 |
$3K |
| 93976 |
|
41 |
39 |
$3K |
| 73552 |
|
122 |
110 |
$3K |
| 95886 |
|
61 |
56 |
$3K |
| J2765 |
Metoclopramide hcl injection |
1,715 |
1,463 |
$3K |
| 87088 |
|
1,270 |
1,152 |
$3K |
| 93000 |
|
703 |
594 |
$3K |
| 36600 |
|
363 |
305 |
$3K |
| 85007 |
|
887 |
828 |
$2K |
| 36430 |
|
31 |
26 |
$2K |
| 29125 |
|
71 |
69 |
$2K |
| 77300 |
|
44 |
41 |
$2K |
| 87400 |
|
282 |
132 |
$2K |
| A9585 |
Gadobutrol injection |
194 |
167 |
$2K |
| 86706 |
|
369 |
357 |
$2K |
| 36416 |
|
465 |
357 |
$2K |
| 84132 |
|
665 |
359 |
$2K |
| 82075 |
|
513 |
462 |
$2K |
| 87635 |
|
304 |
274 |
$2K |
| J7613 |
Albuterol non-comp unit |
818 |
656 |
$2K |
| 86038 |
|
321 |
300 |
$2K |
| 88360 |
|
44 |
38 |
$2K |
| 72050 |
|
36 |
35 |
$2K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
833 |
752 |
$2K |
| J7510 |
Prednisolone oral per 5 mg |
485 |
452 |
$2K |
| 77080 |
|
25 |
24 |
$2K |
| 90715 |
|
81 |
78 |
$2K |
| 87493 |
|
111 |
108 |
$2K |
| 75625 |
|
12 |
12 |
$2K |
| 73560 |
|
43 |
39 |
$1K |
| 43450 |
|
59 |
55 |
$1K |
| 90714 |
|
67 |
67 |
$1K |
| 86920 |
|
178 |
123 |
$1K |
| 82043 |
|
554 |
529 |
$1K |
| J3370 |
Vancomycin hcl injection |
1,441 |
761 |
$1K |
| 82140 |
|
226 |
179 |
$1K |
| 83655 |
|
69 |
69 |
$1K |
| J2543 |
Piperacillin/tazobactam |
1,342 |
448 |
$1K |
| J3475 |
Inj magnesium sulfate |
962 |
790 |
$968.13 |
| 86430 |
|
193 |
175 |
$934.74 |
| J2920 |
Methylprednisolone injection |
886 |
552 |
$867.48 |
| 80081 |
|
13 |
13 |
$789.97 |
| 93226 |
|
15 |
14 |
$734.41 |
| J2560 |
Phenobarbital sodium inj |
79 |
55 |
$688.50 |
| J2001 |
Lidocaine injection |
37 |
24 |
$667.83 |
| 84436 |
|
156 |
152 |
$665.84 |
| 82248 |
|
262 |
223 |
$663.57 |
| 87522 |
Neg quan hep c or qual rna |
31 |
30 |
$635.77 |
| 71101 |
|
74 |
62 |
$556.28 |
| 87798 |
|
14 |
14 |
$555.16 |
| 74022 |
|
46 |
43 |
$545.19 |
| J0780 |
Prochlorperazine injection |
2,428 |
2,080 |
$529.59 |
| 82010 |
|
458 |
387 |
$486.88 |
| 94664 |
|
91 |
77 |
$469.24 |
| 83615 |
|
224 |
142 |
$464.00 |
| C1726 |
Cath, bal dil, non-vascular |
182 |
169 |
$407.38 |
| J1630 |
Haloperidol injection |
710 |
571 |
$398.35 |
| 82330 |
|
129 |
73 |
$364.51 |
| J1642 |
Inj heparin sodium per 10 u |
369 |
215 |
$359.97 |
| 99152 |
|
485 |
454 |
$359.88 |
| 93225 |
|
15 |
14 |
$356.81 |
| 80164 |
|
62 |
49 |
$343.61 |
| 72072 |
|
12 |
12 |
$334.23 |
| J2930 |
Methylprednisolone injection |
203 |
180 |
$324.33 |
| 82150 |
|
163 |
149 |
$316.67 |
| J1940 |
Furosemide injection |
850 |
561 |
$308.40 |
| 70360 |
|
16 |
16 |
$273.21 |
| C1751 |
Cath, inf, per/cent/midline |
458 |
399 |
$271.39 |
| 72070 |
|
14 |
13 |
$269.62 |
| 73620 |
|
12 |
12 |
$237.26 |
| 82784 |
|
56 |
50 |
$226.88 |
| 82950 |
|
44 |
43 |
$224.81 |
| 01999 |
|
99 |
64 |
$221.10 |
| C1776 |
Joint device (implantable) |
12 |
12 |
$209.56 |
| 87661 |
|
25 |
24 |
$207.37 |
| 87425 |
|
13 |
13 |
$181.78 |
| 84403 |
|
13 |
13 |
$176.71 |
| 93320 |
|
13 |
13 |
$164.14 |
| 86308 |
|
162 |
155 |
$156.53 |
| 87428 |
|
14 |
14 |
$128.78 |
| 87147 |
|
167 |
154 |
$120.10 |
| 88173 |
|
14 |
12 |
$120.06 |
| 86160 |
|
29 |
15 |
$114.98 |
| 82247 |
|
16 |
13 |
$112.31 |
| J1756 |
Iron sucrose injection |
98 |
41 |
$98.66 |
| 89051 |
|
146 |
91 |
$96.90 |
| 86664 |
|
12 |
12 |
$95.54 |
| C1725 |
Cath, translumin non-laser |
481 |
426 |
$93.62 |
| 86364 |
|
14 |
13 |
$92.46 |
| J3480 |
Inj potassium chloride |
206 |
125 |
$84.46 |
| G8978 |
Mobility current status |
220 |
165 |
$84.19 |
| 73060 |
|
12 |
12 |
$77.40 |
| 99153 |
Mod sedat endo service >5yrs |
146 |
139 |
$73.24 |
| 85347 |
|
42 |
29 |
$70.08 |
| 84295 |
|
44 |
28 |
$68.99 |
| J1643 |
Inj heparin, pfizer, 1000u |
141 |
130 |
$67.99 |
| J2919 |
Inj, methylpred sod succ 5mg |
262 |
190 |
$65.10 |
| 86787 |
|
14 |
12 |
$62.03 |
| 87260 |
|
21 |
18 |
$51.06 |
| J1790 |
Droperidol injection |
476 |
434 |
$49.52 |
| J0171 |
Adrenalin epinephrine inject |
466 |
397 |
$32.99 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
105 |
25 |
$30.17 |
| J7999 |
Compounded drug, noc |
846 |
705 |
$28.01 |
| 82365 |
|
27 |
25 |
$25.51 |
| 86665 |
|
24 |
12 |
$13.10 |
| 87015 |
|
16 |
12 |
$12.32 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
842 |
753 |
$10.39 |
| J2795 |
Ropivacaine hcl injection |
171 |
143 |
$5.87 |
| J0360 |
Hydralazine hcl injection |
33 |
25 |
$4.48 |
| J2370 |
Phenylephrine hcl injection |
483 |
390 |
$4.03 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
171 |
127 |
$3.06 |
| C9113 |
Inj pantoprazole sodium, via |
148 |
78 |
$2.87 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
297 |
279 |
$1.76 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
96 |
90 |
$0.26 |
| S0028 |
Injection, famotidine, 20 mg |
278 |
195 |
$0.04 |
| G8979 |
Mobility goal status |
278 |
199 |
$0.00 |
| Q9957 |
Inj perflutren lip micros,ml |
32 |
29 |
$0.00 |
| J3371 |
Inj, vancomycin hcl (mylan) |
68 |
43 |
$0.00 |
| G1004 |
Cdsm ndsc |
1,533 |
1,191 |
$0.00 |
| J0735 |
Clonidine hydrochloride |
12 |
12 |
$0.00 |
| C1758 |
Catheter, ureteral |
40 |
37 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
118 |
117 |
$0.00 |
| 29515 |
|
12 |
12 |
$0.00 |
| J2272 |
Inj, morphine (fresenius) |
13 |
13 |
$0.00 |
| C2617 |
Stent, non-cor, tem w/o del |
68 |
64 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
52 |
28 |
$0.00 |
| 81000 |
|
20 |
18 |
$0.00 |
| V2632 |
Post chmbr intraocular lens |
37 |
25 |
$0.00 |
| 77001 |
|
16 |
14 |
$0.00 |
| A9152 |
Single vitamin nos |
42 |
25 |
$0.00 |