| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpt clinic visit |
259,221 |
198,635 |
$20.85M |
| J3357 |
Ustekinumab sub cu inj, 1 mg |
2,197 |
1,785 |
$17.13M |
| 99284 |
|
102,709 |
79,050 |
$14.47M |
| J2350 |
Injection, ocrelizumab, 1 mg |
691 |
541 |
$12.25M |
| 99285 |
|
32,930 |
24,787 |
$10.48M |
| 99283 |
|
79,293 |
62,712 |
$8.27M |
| 96372 |
|
28,751 |
19,292 |
$6.67M |
| J1459 |
Inj ivig privigen 500 mg |
6,326 |
1,314 |
$5.89M |
| J3241 |
Inj. teprotumumab-trbw 10 mg |
245 |
83 |
$4.97M |
| J0791 |
Inj crizanlizumab-tmca 5mg |
1,131 |
737 |
$4.43M |
| 97110 |
|
66,820 |
21,901 |
$4.08M |
| 96374 |
|
34,901 |
22,763 |
$4.00M |
| J1745 |
Infliximab not biosimil 10mg |
2,137 |
1,482 |
$3.60M |
| 64483 |
|
5,120 |
4,558 |
$3.57M |
| 96365 |
|
25,988 |
15,578 |
$2.91M |
| 96413 |
|
14,497 |
7,975 |
$2.76M |
| 27447 |
|
312 |
277 |
$2.63M |
| 93306 |
|
9,656 |
7,713 |
$2.37M |
| 43239 |
|
4,432 |
3,879 |
$1.89M |
| 96361 |
|
40,727 |
23,128 |
$1.82M |
| P9040 |
Rbc leukoreduced irradiated |
3,520 |
2,231 |
$1.64M |
| 74177 |
|
11,223 |
9,029 |
$1.61M |
| 70553 |
|
6,102 |
5,146 |
$1.60M |
| 45380 |
|
2,226 |
1,978 |
$1.59M |
| 27130 |
|
171 |
149 |
$1.55M |
| 41899 |
|
1,170 |
859 |
$1.36M |
| 99213 |
|
41,050 |
29,613 |
$1.31M |
| 96375 |
|
37,933 |
22,087 |
$1.30M |
| 96360 |
|
10,955 |
7,178 |
$1.24M |
| 45385 |
|
2,149 |
1,933 |
$1.23M |
| 62323 |
|
2,655 |
2,360 |
$1.22M |
| 71046 |
|
26,854 |
20,986 |
$1.22M |
| 99282 |
|
12,807 |
10,458 |
$1.13M |
| U0003 |
Cov-19 amp prb hgh thruput |
20,057 |
16,898 |
$1.13M |
| 36512 |
|
1,945 |
1,278 |
$1.12M |
| 95810 |
|
1,672 |
1,477 |
$1.12M |
| 99214 |
|
23,109 |
15,105 |
$1.11M |
| Q5104 |
Injection, renflexis |
708 |
479 |
$1.07M |
| J0897 |
Denosumab injection |
2,244 |
1,469 |
$981K |
| 78452 |
|
1,825 |
1,376 |
$963K |
| 93975 |
|
5,264 |
4,537 |
$947K |
| 70450 |
|
11,287 |
8,755 |
$905K |
| 29848 |
|
725 |
653 |
$806K |
| 86900 |
|
21,495 |
15,279 |
$805K |
| J9271 |
Inj pembrolizumab |
98 |
67 |
$754K |
| 87591 |
|
28,938 |
25,263 |
$727K |
| 87637 |
|
8,778 |
7,372 |
$723K |
| 87491 |
|
28,897 |
25,226 |
$723K |
| 72110 |
|
9,222 |
8,340 |
$712K |
| 77067 |
|
7,575 |
6,942 |
$694K |
| 62321 |
|
1,345 |
1,234 |
$667K |
| 97161 |
|
12,188 |
10,520 |
$621K |
| 72148 |
|
4,153 |
3,525 |
$593K |
| 81513 |
|
6,567 |
5,865 |
$588K |
| 45378 |
|
1,033 |
929 |
$572K |
| 78815 |
|
782 |
682 |
$562K |
| J0585 |
Injection,onabotulinumtoxina |
1,222 |
1,031 |
$557K |
| 84443 |
|
58,325 |
50,474 |
$555K |
| 76705 |
|
6,511 |
5,383 |
$546K |
| 90834 |
|
18,983 |
9,396 |
$512K |
| 76830 |
|
5,821 |
5,023 |
$501K |
| 74176 |
|
4,730 |
3,808 |
$500K |
| 76856 |
|
6,111 |
5,268 |
$488K |
| 96415 |
|
7,330 |
4,689 |
$487K |
| 71260 |
|
3,811 |
2,938 |
$479K |
| G0379 |
Direct refer hospital observ |
581 |
421 |
$465K |
| 20610 |
|
2,445 |
2,068 |
$459K |
| 11104 |
|
2,656 |
1,769 |
$453K |
| 73721 |
|
2,510 |
2,163 |
$453K |
| 11102 |
|
4,861 |
3,451 |
$452K |
| 87389 |
|
27,197 |
23,798 |
$445K |
| 94060 |
|
2,731 |
2,443 |
$444K |
| 59025 |
|
3,444 |
2,150 |
$444K |
| 70551 |
|
3,188 |
2,568 |
$430K |
| 72100 |
|
9,127 |
7,612 |
$429K |
| 82306 |
|
26,683 |
23,239 |
$424K |
| J9312 |
Inj., rituximab, 10 mg |
235 |
79 |
$418K |
| 72141 |
|
2,457 |
2,125 |
$417K |
| 96366 |
|
11,574 |
5,603 |
$394K |
| 82947 |
|
142,154 |
104,378 |
$389K |
| 73221 |
|
2,211 |
1,877 |
$377K |
| U0004 |
Cov-19 test non-cdc hgh thru |
5,476 |
4,448 |
$359K |
| 76536 |
|
5,680 |
4,859 |
$355K |
| U0005 |
Infec agen detec ampli probe |
19,493 |
16,351 |
$355K |
| 72050 |
|
4,148 |
3,768 |
$345K |
| 76700 |
|
2,787 |
2,423 |
$336K |
| 22612 |
|
47 |
38 |
$311K |
| C8929 |
Tte w or wo fol wcon,doppler |
958 |
806 |
$296K |
| 95911 |
|
848 |
709 |
$291K |
| 87661 |
|
11,125 |
10,005 |
$289K |
| J1439 |
Inj ferric carboxymaltos 1mg |
448 |
278 |
$285K |
| 96920 |
|
2,088 |
387 |
$280K |
| 96900 |
|
10,613 |
2,258 |
$278K |
| J1628 |
Inj., guselkumab, 1 mg |
47 |
37 |
$276K |
| 83036 |
|
46,478 |
40,939 |
$275K |
| 90792 |
|
4,037 |
2,525 |
$275K |
| J9310 |
Rituximab injection |
101 |
41 |
$262K |
| 71250 |
|
5,245 |
4,081 |
$258K |
| 36415 |
|
306,317 |
217,116 |
$253K |
| 85025 |
|
139,632 |
101,729 |
$252K |
| 83718 |
|
37,677 |
34,704 |
$247K |
| 71045 |
|
7,165 |
5,465 |
$237K |
| 87624 |
|
10,014 |
8,766 |
$236K |
| 36430 |
|
2,077 |
1,197 |
$235K |
| 82310 |
|
122,959 |
95,473 |
$232K |
| 86803 |
|
24,772 |
21,712 |
$231K |
| S9480 |
Intensive outpatient psychia |
2,524 |
389 |
$227K |
| 97162 |
|
4,841 |
4,131 |
$224K |
| 77065 |
Tomosynthesis, mammo |
2,388 |
1,911 |
$219K |
| 97140 |
|
35,138 |
11,793 |
$217K |
| 77080 |
|
3,496 |
3,108 |
$216K |
| 72040 |
|
4,713 |
3,991 |
$209K |
| 80307 |
|
18,860 |
12,992 |
$209K |
| 86480 |
|
8,403 |
7,272 |
$204K |
| 76770 |
|
2,982 |
2,513 |
$200K |
| 11100 |
|
1,142 |
859 |
$200K |
| C9803 |
Hopd covid-19 spec collect |
30,652 |
23,834 |
$197K |
| 71275 |
|
2,006 |
1,608 |
$193K |
| 76641 |
|
2,929 |
2,490 |
$193K |
| 97165 |
|
3,013 |
2,595 |
$191K |
| 17110 |
|
5,157 |
4,383 |
$190K |
| 93971 |
|
3,409 |
2,731 |
$190K |
| 11900 |
|
2,963 |
2,619 |
$182K |
| 93017 |
|
3,075 |
2,465 |
$174K |
| 97112 |
|
9,005 |
3,503 |
$168K |
| 74183 |
|
923 |
758 |
$168K |
| 85027 |
|
56,952 |
43,888 |
$166K |
| 97035 |
|
2,114 |
1,014 |
$164K |
| 87481 |
|
6,563 |
5,864 |
$160K |
| 72156 |
|
1,176 |
1,014 |
$160K |
| 76642 |
|
2,957 |
2,568 |
$152K |
| 64650 |
|
720 |
617 |
$152K |
| 95806 |
|
1,352 |
1,218 |
$151K |
| 70496 |
|
2,026 |
1,638 |
$146K |
| J2997 |
Alteplase recombinant |
1,387 |
879 |
$143K |
| 90853 |
|
15,476 |
3,774 |
$142K |
| 82607 |
|
16,372 |
14,308 |
$140K |
| 63047 |
|
79 |
66 |
$138K |
| 82728 |
|
21,606 |
17,929 |
$137K |
| 94010 |
|
3,919 |
3,190 |
$130K |
| 88305 |
|
18,870 |
13,697 |
$128K |
| 72197 |
|
504 |
410 |
$128K |
| 86003 |
|
1,936 |
1,490 |
$122K |
| 97530 |
|
14,686 |
6,306 |
$117K |
| 93970 |
|
1,101 |
872 |
$116K |
| 86780 |
|
11,268 |
9,764 |
$116K |
| 36593 |
|
937 |
615 |
$115K |
| 87536 |
|
2,835 |
2,441 |
$113K |
| 88142 |
|
9,597 |
8,633 |
$110K |
| 77066 |
Tomosynthesis, mammo |
1,144 |
1,008 |
$110K |
| J0129 |
Abatacept injection |
58 |
37 |
$110K |
| 77336 |
|
1,734 |
516 |
$104K |
| 64721 |
|
72 |
68 |
$102K |
| 99203 |
|
2,070 |
1,871 |
$101K |
| 58558 |
|
116 |
91 |
$101K |
| 95812 |
|
605 |
527 |
$100K |
| 86235 |
|
4,017 |
3,221 |
$98K |
| 87340 |
|
17,103 |
14,417 |
$98K |
| 29888 |
|
19 |
15 |
$98K |
| Q5106 |
Inj retacrit non-esrd use |
1,138 |
598 |
$96K |
| 72158 |
|
538 |
444 |
$95K |
| 77063 |
|
7,271 |
6,670 |
$94K |
| 17311 |
|
558 |
381 |
$90K |
| 87086 |
|
28,791 |
23,456 |
$90K |
| 97116 |
|
4,265 |
2,269 |
$89K |
| 88184 |
|
725 |
597 |
$87K |
| 26055 |
|
152 |
116 |
$86K |
| 83550 |
|
21,915 |
18,203 |
$86K |
| 95708 |
|
269 |
126 |
$84K |
| 70491 |
|
670 |
573 |
$84K |
| 99212 |
|
3,636 |
2,902 |
$82K |
| 74018 |
|
2,523 |
2,080 |
$82K |
| 72082 |
|
1,345 |
1,256 |
$81K |
| 96417 |
|
2,059 |
1,053 |
$81K |
| 83970 |
|
6,429 |
5,294 |
$79K |
| 73564 |
|
2,180 |
1,389 |
$76K |
| 84132 |
|
135,233 |
102,309 |
$76K |
| 70486 |
|
1,330 |
1,151 |
$73K |
| 84439 |
|
16,050 |
13,938 |
$72K |
| 73700 |
|
1,004 |
854 |
$72K |
| 17000 |
|
5,250 |
3,968 |
$70K |
| 84153 |
|
6,681 |
5,708 |
$69K |
| 83540 |
|
22,439 |
18,603 |
$65K |
| 72070 |
|
1,573 |
1,351 |
$65K |
| 90832 |
|
3,427 |
2,149 |
$63K |
| 86160 |
|
5,639 |
4,496 |
$62K |
| 10005 |
|
162 |
138 |
$62K |
| 87635 |
|
2,176 |
1,681 |
$62K |
| 84403 |
|
3,815 |
3,291 |
$61K |
| 96367 |
|
2,830 |
1,733 |
$61K |
| 86706 |
|
10,389 |
9,081 |
$59K |
| 93005 |
|
44,452 |
33,417 |
$59K |
| 82784 |
|
8,265 |
6,491 |
$58K |
| 95811 |
|
96 |
81 |
$57K |
| 82570 |
|
23,865 |
17,832 |
$56K |
| 72125 |
|
4,081 |
3,256 |
$54K |
| J0741 |
Inj, cabote rilpivir 2mg 3mg |
14 |
12 |
$54K |
| 64493 |
|
58 |
51 |
$53K |
| 82670 |
|
2,911 |
2,489 |
$53K |
| 84702 |
|
10,231 |
8,000 |
$53K |
| 88342 |
|
4,049 |
3,138 |
$52K |
| 95910 |
|
238 |
219 |
$52K |
| 73130 |
|
4,627 |
2,946 |
$51K |
| 87510 |
|
3,192 |
2,828 |
$49K |
| 87480 |
|
3,192 |
2,828 |
$49K |
| 86762 |
|
5,322 |
4,180 |
$49K |
| 86147 |
|
1,284 |
1,080 |
$48K |
| 83516 |
|
6,907 |
5,039 |
$48K |
| 87660 |
|
3,143 |
2,780 |
$48K |
| 86038 |
|
7,591 |
6,361 |
$48K |
| 71271 |
|
629 |
557 |
$48K |
| 86360 |
|
2,387 |
2,013 |
$47K |
| 72131 |
|
873 |
753 |
$45K |
| 82105 |
|
3,647 |
3,258 |
$44K |
| 29827 |
|
14 |
13 |
$43K |
| 87798 |
|
1,363 |
1,113 |
$42K |
| 95909 |
|
221 |
185 |
$42K |
| J0517 |
Inj., benralizumab, 1 mg |
19 |
13 |
$42K |
| 10060 |
|
315 |
259 |
$41K |
| 86140 |
|
17,238 |
14,329 |
$41K |
| 95700 |
|
481 |
411 |
$41K |
| 77091 |
|
1,137 |
1,052 |
$41K |
| 73030 |
|
3,975 |
3,153 |
$40K |
| 82043 |
|
13,507 |
11,685 |
$40K |
| 84270 |
|
3,181 |
2,740 |
$40K |
| 82746 |
|
4,952 |
4,426 |
$39K |
| 76882 |
|
985 |
820 |
$39K |
| 66984 |
|
90 |
58 |
$39K |
| 77386 |
|
135 |
12 |
$38K |
| 84146 |
|
3,144 |
2,779 |
$36K |
| 90837 |
|
1,085 |
518 |
$36K |
| 99202 |
|
944 |
860 |
$36K |
| 82465 |
|
39,854 |
36,707 |
$36K |
| 83001 |
|
3,016 |
2,678 |
$36K |
| 86592 |
|
10,624 |
9,019 |
$34K |
| 82040 |
|
91,473 |
72,911 |
$34K |
| 87653 |
|
1,311 |
1,175 |
$34K |
| 88307 |
|
1,737 |
1,261 |
$34K |
| 86787 |
|
3,934 |
3,072 |
$33K |
| 87522 |
Neg quan hep c or qual rna |
1,198 |
1,072 |
$33K |
| 88175 |
|
2,861 |
2,557 |
$32K |
| 88304 |
|
4,034 |
3,277 |
$32K |
| 86704 |
|
5,577 |
4,888 |
$31K |
| 81001 |
|
17,587 |
14,850 |
$30K |
| P9016 |
Rbc leukocytes reduced |
163 |
106 |
$30K |
| 86225 |
|
4,194 |
3,498 |
$30K |
| 83735 |
|
42,257 |
25,184 |
$30K |
| 87077 |
|
11,636 |
9,056 |
$30K |
| 95912 |
|
84 |
68 |
$30K |
| 51729 |
|
91 |
78 |
$30K |
| 87426 |
|
1,198 |
1,071 |
$29K |
| 84402 |
|
1,932 |
1,669 |
$29K |
| J2426 |
Inj, invega sustenna, 1 mg |
26 |
12 |
$29K |
| 73630 |
|
5,268 |
3,619 |
$29K |
| 95800 |
|
239 |
229 |
$29K |
| 83020 |
|
6,247 |
4,640 |
$28K |
| 76801 |
|
317 |
276 |
$28K |
| J0885 |
Epoetin alfa, non-esrd |
537 |
273 |
$28K |
| 93976 |
|
334 |
293 |
$26K |
| 73502 |
|
2,399 |
1,974 |
$26K |
| 82533 |
|
4,979 |
3,562 |
$25K |
| 78306 |
|
137 |
103 |
$25K |
| 84165 |
|
6,561 |
5,210 |
$25K |
| 85652 |
|
20,914 |
17,041 |
$25K |
| 83002 |
|
2,161 |
1,880 |
$25K |
| 86618 |
|
3,387 |
2,571 |
$25K |
| 82274 |
|
2,066 |
1,963 |
$25K |
| 87186 |
|
9,403 |
7,288 |
$24K |
| 93225 |
|
485 |
406 |
$24K |
| J2357 |
Omalizumab injection |
26 |
12 |
$24K |
| 82565 |
|
165,196 |
123,970 |
$23K |
| 43235 |
|
49 |
40 |
$23K |
| 86146 |
|
883 |
756 |
$23K |
| 90686 |
|
1,954 |
1,711 |
$23K |
| 95819 |
|
165 |
129 |
$23K |
| 86800 |
|
3,474 |
2,875 |
$22K |
| 72146 |
|
163 |
155 |
$22K |
| 97016 |
|
557 |
169 |
$22K |
| 74220 |
|
219 |
191 |
$22K |
| 86141 |
|
4,252 |
3,529 |
$22K |
| 82747 |
|
2,379 |
1,995 |
$21K |
| G0480 |
Drug test def 1-7 classes |
2,617 |
1,815 |
$21K |
| 86376 |
|
2,963 |
2,508 |
$20K |
| 86334 |
|
3,369 |
2,645 |
$20K |
| 99215 |
Prolong outpt/office vis |
241 |
171 |
$20K |
| 85610 |
|
22,656 |
13,796 |
$20K |
| 86039 |
|
3,500 |
2,838 |
$20K |
| 84481 |
|
1,997 |
1,716 |
$19K |
| 80061 |
|
8,034 |
5,929 |
$19K |
| 20680 |
|
28 |
24 |
$19K |
| 83655 |
|
1,819 |
1,713 |
$19K |
| 90833 |
|
942 |
444 |
$18K |
| 82247 |
|
77,425 |
61,956 |
$18K |
| 82088 |
|
1,454 |
1,167 |
$17K |
| 82024 |
|
1,907 |
1,630 |
$17K |
| 83880 |
|
7,260 |
5,575 |
$17K |
| 73110 |
|
1,789 |
1,451 |
$17K |
| 86850 |
|
19,839 |
14,850 |
$17K |
| 87338 |
|
1,481 |
1,385 |
$17K |
| 77334 |
|
75 |
41 |
$16K |
| 82627 |
|
1,246 |
1,119 |
$16K |
| 93296 |
|
1,131 |
921 |
$16K |
| 94726 |
|
393 |
353 |
$15K |
| 86200 |
|
2,631 |
2,185 |
$15K |
| 84480 |
|
2,500 |
2,160 |
$15K |
| 76857 |
|
277 |
234 |
$15K |
| 88112 |
|
1,145 |
904 |
$15K |
| 86705 |
|
3,100 |
2,614 |
$15K |
| 73610 |
|
3,095 |
2,481 |
$15K |
| 81003 |
|
48,541 |
39,205 |
$15K |
| 80053 |
|
20,942 |
13,284 |
$14K |
| 86359 |
|
2,388 |
2,014 |
$14K |
| 82652 |
|
644 |
543 |
$14K |
| 76000 |
|
99 |
83 |
$14K |
| 84154 |
|
1,167 |
1,023 |
$14K |
| 84425 |
|
1,129 |
1,001 |
$14K |
| 86430 |
|
4,823 |
3,980 |
$14K |
| 74178 |
|
67 |
61 |
$13K |
| 82785 |
|
1,628 |
1,302 |
$13K |
| 87070 |
|
7,707 |
6,169 |
$12K |
| 76981 |
|
1,340 |
1,192 |
$12K |
| 90677 |
|
108 |
97 |
$12K |
| 70546 |
|
27 |
24 |
$12K |
| 83520 |
|
2,206 |
1,783 |
$12K |
| 83690 |
|
19,281 |
15,382 |
$12K |
| 82523 |
|
1,843 |
1,499 |
$12K |
| 82950 |
|
2,957 |
2,696 |
$12K |
| 84156 |
|
8,812 |
6,713 |
$11K |
| 73562 |
|
683 |
455 |
$11K |
| 86708 |
|
1,423 |
1,296 |
$11K |
| J2469 |
Palonosetron hcl |
2,085 |
937 |
$11K |
| 74019 |
|
477 |
404 |
$11K |
| 86765 |
|
1,151 |
963 |
$11K |
| 72170 |
|
1,273 |
1,089 |
$11K |
| 11042 |
|
45 |
28 |
$10K |
| 82550 |
|
10,057 |
8,115 |
$10K |
| 70498 |
|
1,509 |
1,196 |
$10K |
| 84080 |
|
2,034 |
1,666 |
$10K |
| 86162 |
|
1,008 |
829 |
$10K |
| 73200 |
|
151 |
123 |
$10K |
| 84244 |
|
1,373 |
1,171 |
$10K |
| 80048 |
|
23,323 |
14,368 |
$10K |
| J0185 |
Inj., aprepitant, 1 mg |
64 |
38 |
$10K |
| 85730 |
|
5,213 |
4,050 |
$9K |
| 96401 |
|
495 |
225 |
$9K |
| 92611 |
|
83 |
77 |
$9K |
| 86617 |
|
1,100 |
482 |
$9K |
| 86735 |
|
955 |
806 |
$9K |
| 86256 |
|
1,336 |
1,119 |
$9K |
| 81420 |
|
25 |
19 |
$9K |
| 96910 |
|
330 |
87 |
$9K |
| 84295 |
|
134,804 |
102,279 |
$9K |
| 77062 |
|
749 |
669 |
$9K |
| 64415 |
|
79 |
69 |
$9K |
| 83883 |
|
952 |
697 |
$8K |
| 86304 |
|
1,985 |
1,445 |
$8K |
| 87529 |
|
245 |
227 |
$8K |
| 72157 |
|
52 |
43 |
$8K |
| 84166 |
|
1,258 |
945 |
$8K |
| 77061 |
|
713 |
610 |
$8K |
| G2066 |
Inter devc remote 30d |
797 |
679 |
$8K |
| 86902 |
|
5,677 |
1,976 |
$8K |
| 13132 |
|
115 |
79 |
$8K |
| 83525 |
|
914 |
797 |
$8K |
| 51702 |
|
1,165 |
866 |
$7K |
| 87081 |
|
2,828 |
2,530 |
$7K |
| J0136 |
Inj, acetaminophen (b braun) |
4,485 |
3,793 |
$7K |
| 97535 |
|
243 |
191 |
$7K |
| 70544 |
|
14 |
13 |
$7K |
| 51798 |
|
2,051 |
1,250 |
$7K |
| 85018 |
|
8,050 |
6,099 |
$7K |
| 85014 |
|
8,822 |
6,373 |
$7K |
| 84450 |
|
96,113 |
77,916 |
$7K |
| 76815 |
|
668 |
530 |
$7K |
| 51784 |
|
101 |
88 |
$7K |
| 74230 |
|
83 |
77 |
$7K |
| 12032 |
|
102 |
74 |
$7K |
| 96133 |
|
111 |
69 |
$7K |
| 87625 |
|
289 |
261 |
$7K |
| G0260 |
Inj for sacroiliac jt anesth |
23 |
12 |
$6K |
| 98968 |
|
122 |
96 |
$6K |
| 86255 |
|
1,003 |
772 |
$6K |
| 10022 |
|
18 |
12 |
$6K |
| 85613 |
|
1,265 |
1,053 |
$6K |
| 29823 |
|
16 |
13 |
$6K |
| 94660 |
|
151 |
94 |
$6K |
| 99443 |
|
579 |
275 |
$6K |
| 94640 |
|
4,979 |
3,339 |
$6K |
| 83921 |
|
669 |
573 |
$6K |
| 99204 |
|
78 |
69 |
$6K |
| 62328 |
|
14 |
12 |
$6K |
| 84478 |
|
39,936 |
36,762 |
$6K |
| 36591 |
|
1,663 |
711 |
$5K |
| 84207 |
|
368 |
312 |
$5K |
| 89230 |
|
116 |
107 |
$5K |
| 83835 |
|
868 |
727 |
$5K |
| 93308 |
|
49 |
37 |
$5K |
| 82340 |
|
2,193 |
1,794 |
$5K |
| 86694 |
|
446 |
409 |
$5K |
| 87205 |
|
5,966 |
4,477 |
$5K |
| 84432 |
|
1,051 |
885 |
$5K |
| 86335 |
|
456 |
364 |
$5K |
| 73560 |
|
3,855 |
3,058 |
$5K |
| 73080 |
|
833 |
687 |
$5K |
| 84445 |
|
200 |
182 |
$4K |
| 78264 |
|
18 |
15 |
$4K |
| 87631 |
|
1,035 |
840 |
$4K |
| 86364 |
|
503 |
374 |
$4K |
| 93270 |
|
486 |
384 |
$4K |
| 81025 |
|
22,640 |
19,103 |
$4K |
| 96411 |
|
107 |
43 |
$4K |
| 80164 |
|
696 |
558 |
$4K |
| 87147 |
|
1,943 |
1,718 |
$4K |
| 84144 |
|
221 |
157 |
$4K |
| J7298 |
Mirena, 52 mg |
18 |
12 |
$4K |
| 82150 |
|
977 |
829 |
$4K |
| 82248 |
|
42,031 |
31,452 |
$3K |
| 87804 |
|
7,222 |
4,271 |
$3K |
| 85007 |
|
8,841 |
5,551 |
$3K |
| 99442 |
|
278 |
136 |
$3K |
| 86880 |
|
131 |
114 |
$3K |
| 93786 |
|
55 |
42 |
$3K |
| 73590 |
|
798 |
623 |
$3K |
| 84300 |
|
1,706 |
1,326 |
$3K |
| 83721 |
|
2,219 |
1,966 |
$3K |
| 95924 |
|
17 |
12 |
$3K |
| 95816 |
|
16 |
14 |
$3K |
| 86757 |
|
238 |
206 |
$3K |
| 81015 |
|
26,396 |
21,550 |
$3K |
| 93297 |
|
267 |
236 |
$3K |
| 82103 |
|
399 |
345 |
$3K |
| 82378 |
|
1,627 |
1,187 |
$3K |
| 81050 |
|
1,698 |
1,475 |
$3K |
| 98967 |
|
57 |
46 |
$3K |
| 11721 |
|
180 |
127 |
$3K |
| 95249 |
|
90 |
63 |
$3K |
| 82390 |
|
371 |
331 |
$2K |
| 85045 |
|
9,098 |
4,778 |
$2K |
| 88173 |
|
1,003 |
800 |
$2K |
| 90694 |
|
478 |
382 |
$2K |
| 87641 |
|
109 |
97 |
$2K |
| 64642 |
|
18 |
13 |
$2K |
| 87640 |
|
122 |
112 |
$2K |
| 97163 |
|
40 |
40 |
$2K |
| 96116 |
|
50 |
40 |
$2K |
| 80051 |
|
4,270 |
2,505 |
$2K |
| 82164 |
|
323 |
261 |
$2K |
| 76604 |
|
550 |
438 |
$2K |
| 82330 |
|
5,991 |
3,773 |
$2K |
| 93280 |
|
262 |
227 |
$2K |
| 85379 |
|
3,897 |
3,179 |
$2K |
| 84155 |
|
76,857 |
60,856 |
$2K |
| 87075 |
|
2,158 |
1,520 |
$2K |
| 87469 |
|
175 |
169 |
$2K |
| 87015 |
|
1,381 |
1,124 |
$2K |
| 96132 |
|
52 |
41 |
$2K |
| 80177 |
|
262 |
240 |
$2K |
| 87468 |
|
171 |
166 |
$2K |
| 84460 |
|
98,187 |
79,384 |
$2K |
| 87484 |
|
171 |
166 |
$2K |
| 93298 |
|
191 |
169 |
$2K |
| 73521 |
|
53 |
48 |
$2K |
| 86696 |
|
114 |
107 |
$2K |
| G0297 |
Ldct for lung ca screen |
27 |
27 |
$2K |
| 80076 |
|
2,538 |
1,653 |
$2K |
| 74181 |
|
15 |
13 |
$2K |
| 83615 |
|
16,714 |
9,434 |
$2K |
| 87046 |
|
365 |
315 |
$2K |
| 11301 |
|
55 |
43 |
$2K |
| 82977 |
|
3,067 |
2,712 |
$2K |
| 99281 |
|
29 |
26 |
$2K |
| 84550 |
|
6,037 |
4,745 |
$2K |
| 97166 |
|
45 |
38 |
$2K |
| 84540 |
|
840 |
632 |
$2K |
| 87045 |
|
365 |
315 |
$2K |
| 86258 |
|
171 |
87 |
$1K |
| 82525 |
|
293 |
254 |
$1K |
| 87517 |
|
66 |
64 |
$1K |
| 87449 |
|
367 |
307 |
$1K |
| 93285 |
|
54 |
52 |
$1K |
| 86769 |
|
41 |
35 |
$1K |
| 70480 |
|
13 |
12 |
$1K |
| 84520 |
|
151,581 |
114,756 |
$1K |
| 83498 |
|
76 |
66 |
$1K |
| 93923 |
|
16 |
13 |
$1K |
| 88312 |
|
2,344 |
1,704 |
$1K |
| 83993 |
|
103 |
91 |
$1K |
| 90662 |
|
178 |
131 |
$1K |
| 84484 |
|
20,812 |
14,979 |
$1K |
| 77073 |
|
16 |
16 |
$1K |
| 87324 |
|
296 |
247 |
$1K |
| 93880 |
|
19 |
12 |
$1K |
| 73140 |
|
354 |
320 |
$1K |
| 86695 |
|
114 |
107 |
$1K |
| 86666 |
|
121 |
100 |
$1K |
| 84075 |
|
79,478 |
63,863 |
$1K |
| 76775 |
|
387 |
289 |
$1K |
| 90732 |
|
29 |
28 |
$1K |
| 96137 |
|
19 |
13 |
$1K |
| 72202 |
|
27 |
26 |
$1K |
| 87209 |
|
149 |
125 |
$1K |
| 84305 |
|
175 |
145 |
$992.67 |
| 99441 |
|
185 |
87 |
$971.36 |
| 82085 |
|
250 |
209 |
$937.62 |
| 93299 |
|
44 |
38 |
$877.52 |
| 92610 |
|
14 |
12 |
$843.60 |
| 87040 |
|
3,452 |
1,744 |
$835.98 |
| 85660 |
|
5,362 |
2,067 |
$792.13 |
| G0279 |
Tomosynthesis, mammo |
146 |
114 |
$791.36 |
| 82962 |
|
23,528 |
8,631 |
$763.88 |
| 96136 |
|
49 |
39 |
$761.07 |
| 87177 |
|
149 |
125 |
$723.17 |
| G0378 |
Hospital observation per hr |
12,249 |
5,724 |
$711.36 |
| 87116 |
|
583 |
438 |
$702.68 |
| 87880 |
|
7,358 |
6,363 |
$701.86 |
| 84436 |
|
238 |
204 |
$695.36 |
| 64447 |
|
78 |
70 |
$665.29 |
| 83519 |
|
47 |
42 |
$641.25 |
| 80069 |
|
1,001 |
753 |
$632.67 |
| 83605 |
|
8,013 |
5,742 |
$591.12 |
| 76870 |
|
140 |
131 |
$574.04 |
| 87807 |
|
324 |
289 |
$571.01 |
| 87207 |
|
431 |
375 |
$554.98 |
| 84100 |
|
25,361 |
14,986 |
$554.03 |
| 86709 |
|
111 |
103 |
$546.29 |
| 96523 |
|
37 |
25 |
$535.91 |
| 96402 |
|
52 |
38 |
$534.26 |
| 87252 |
|
36 |
26 |
$527.66 |
| 82232 |
|
258 |
195 |
$523.62 |
| 82374 |
|
132,241 |
100,487 |
$510.91 |
| 87102 |
|
600 |
435 |
$499.95 |
| 86753 |
|
39 |
26 |
$489.75 |
| 84630 |
|
118 |
107 |
$489.15 |
| 86923 |
|
4,318 |
1,648 |
$488.29 |
| 82951 |
|
51 |
44 |
$479.31 |
| 94727 |
|
4,581 |
3,865 |
$431.64 |
| G0008 |
Admin influenza virus vac |
980 |
729 |
$424.20 |
| 82438 |
|
128 |
119 |
$412.23 |
| 82010 |
|
1,244 |
945 |
$408.38 |
| 90471 |
|
4,385 |
3,739 |
$406.44 |
| 86308 |
|
521 |
458 |
$397.06 |
| 84446 |
|
49 |
39 |
$395.09 |
| 84133 |
|
266 |
196 |
$388.83 |
| 82435 |
|
132,555 |
100,659 |
$382.62 |
| 88302 |
|
43 |
39 |
$368.64 |
| 86036 |
|
72 |
56 |
$358.87 |
| 73060 |
|
19 |
14 |
$358.24 |
| S0028 |
Injection, famotidine, 20 mg |
858 |
427 |
$352.00 |
| J1097 |
Phenylep ketorolac opth soln |
74 |
52 |
$337.05 |
| 87502 |
|
64 |
56 |
$325.04 |
| 74455 |
|
47 |
37 |
$301.73 |
| 86901 |
|
21,499 |
15,284 |
$287.29 |
| 84681 |
|
26 |
25 |
$281.53 |
| 97164 |
|
40 |
36 |
$277.86 |
| 94618 |
|
13 |
12 |
$257.29 |
| 76377 |
|
791 |
590 |
$239.02 |
| 71101 |
|
34 |
28 |
$233.08 |
| 83010 |
|
124 |
101 |
$214.92 |
| 82140 |
|
95 |
63 |
$209.90 |
| 11901 |
|
12 |
12 |
$186.17 |
| 82239 |
|
13 |
12 |
$179.96 |
| J0131 |
Inj, acetaminophen (nos) |
13,727 |
10,769 |
$179.61 |
| 82803 |
|
1,485 |
1,089 |
$171.59 |
| 86677 |
|
17 |
14 |
$170.45 |
| 87206 |
|
594 |
432 |
$167.56 |
| 86645 |
|
18 |
14 |
$160.90 |
| 85049 |
|
106 |
71 |
$160.82 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
5,049 |
4,336 |
$160.73 |
| 82530 |
|
13 |
12 |
$159.60 |
| 95012 |
|
178 |
172 |
$159.42 |
| 82575 |
|
30 |
24 |
$153.34 |
| 86644 |
|
19 |
14 |
$151.25 |
| 87107 |
|
20 |
12 |
$147.90 |
| 82952 |
|
45 |
39 |
$130.90 |
| 86431 |
|
57 |
54 |
$126.60 |
| 89051 |
|
124 |
104 |
$124.32 |
| 51701 |
|
187 |
139 |
$122.89 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
27,349 |
19,718 |
$122.69 |
| 76817 |
|
131 |
104 |
$105.77 |
| G0108 |
Diab manage trn per indiv |
592 |
471 |
$102.00 |
| 90715 |
|
1,020 |
877 |
$101.37 |
| 82787 |
|
12 |
12 |
$93.29 |
| 73090 |
|
45 |
38 |
$89.56 |
| 85240 |
|
18 |
12 |
$85.50 |
| 85705 |
|
14 |
13 |
$84.35 |
| 84560 |
|
37 |
30 |
$80.37 |
| 96376 |
|
13,988 |
5,791 |
$77.16 |
| 80178 |
|
51 |
36 |
$74.93 |
| 85008 |
|
2,968 |
2,287 |
$72.84 |
| G0001 |
|
477 |
335 |
$69.81 |
| 82553 |
|
44 |
26 |
$66.12 |
| J2272 |
Inj, morphine (fresenius) |
585 |
382 |
$65.62 |
| J1836 |
Inj, metronidazole, 10 mg |
705 |
338 |
$64.01 |
| 82985 |
|
12 |
12 |
$58.81 |
| 82308 |
|
15 |
13 |
$51.16 |
| J7120 |
Ringers lactate infusion |
31,387 |
23,512 |
$47.72 |
| 86593 |
|
13 |
12 |
$46.20 |
| 82610 |
|
14 |
12 |
$38.94 |
| 94729 |
|
5,384 |
4,563 |
$38.72 |
| 73501 |
|
14 |
12 |
$36.70 |
| 84105 |
|
17 |
12 |
$34.58 |
| J0736 |
Inj, clindamycin phosp 300mg |
209 |
154 |
$25.30 |
| J1650 |
Inj enoxaparin sodium |
4,925 |
1,820 |
$24.10 |
| 87181 |
|
71 |
55 |
$23.49 |
| J7030 |
Normal saline solution infus |
26,701 |
16,888 |
$22.89 |
| 85048 |
|
14 |
13 |
$21.78 |
| 84145 |
|
2,521 |
1,916 |
$21.77 |
| 86300 |
|
38 |
25 |
$19.87 |
| J1885 |
Ketorolac tromethamine inj |
28,997 |
17,895 |
$19.69 |
| 83935 |
|
18 |
12 |
$19.53 |
| 83930 |
|
30 |
26 |
$18.93 |
| J2704 |
Inj, propofol, 10 mg |
33,816 |
25,690 |
$18.85 |
| J3490 |
Drugs unclassified injection |
390,026 |
91,775 |
$15.52 |
| J2598 |
Inj, vasopressin, 1 unit |
23 |
12 |
$15.44 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
2,360 |
2,048 |
$15.41 |
| 88313 |
|
239 |
154 |
$13.44 |
| J0687 |
Inj cefazolin (wg crit care) |
227 |
138 |
$11.72 |
| J2405 |
Ondansetron hcl injection |
38,318 |
27,043 |
$9.93 |
| Q0162 |
Ondansetron oral |
6,605 |
4,325 |
$7.05 |
| A9270 |
Non-covered item or service |
10,605 |
4,475 |
$7.00 |
| J2250 |
Inj midazolam hydrochloride |
19,312 |
15,515 |
$6.65 |
| J2765 |
Metoclopramide hcl injection |
4,789 |
3,592 |
$6.63 |
| J0134 |
Inj acetaminophen -fresenius |
419 |
350 |
$6.28 |
| J3010 |
Fentanyl citrate injection |
28,327 |
20,685 |
$5.58 |
| J7050 |
Normal saline solution infus |
9,216 |
4,733 |
$5.10 |
| 90656 |
|
45 |
43 |
$4.45 |
| J2370 |
Phenylephrine hcl injection |
6,114 |
4,214 |
$3.18 |
| J0696 |
Ceftriaxone sodium injection |
4,159 |
2,375 |
$2.94 |
| G8979 |
Mobility goal status |
987 |
683 |
$2.86 |
| J2060 |
Lorazepam injection |
1,916 |
1,314 |
$2.83 |
| J1170 |
Hydromorphone injection |
20,185 |
8,886 |
$2.76 |
| J7512 |
Prednisone ir or dr oral 1mg |
3,104 |
1,961 |
$2.75 |
| G8978 |
Mobility current status |
972 |
674 |
$2.62 |
| J1630 |
Haloperidol injection |
3,365 |
2,670 |
$2.01 |
| J7620 |
Albuterol ipratrop non-comp |
1,485 |
950 |
$1.98 |
| J1200 |
Diphenhydramine hcl injectio |
7,480 |
4,410 |
$1.98 |
| J2270 |
Morphine sulfate injection |
4,968 |
3,467 |
$1.94 |
| A9585 |
Gadobutrol injection |
12,448 |
10,078 |
$1.87 |
| J1100 |
Dexamethasone sodium phos |
25,106 |
14,918 |
$1.63 |
| J1920 |
Inj, labetalol hcl, 5mg |
460 |
315 |
$1.60 |
| J2550 |
Promethazine hcl injection |
1,715 |
1,188 |
$1.05 |
| G8980 |
Mobility d/c status |
409 |
287 |
$0.96 |
| J1644 |
Inj heparin sodium per 1000u |
13,014 |
4,505 |
$0.95 |
| J2919 |
Inj, methylpred sod succ 5mg |
420 |
272 |
$0.82 |
| J2001 |
Lidocaine injection |
21,619 |
15,506 |
$0.71 |
| Q0163 |
Diphenhydramine hcl 50mg |
16,070 |
7,527 |
$0.50 |
| J3475 |
Inj magnesium sulfate |
5,212 |
2,675 |
$0.24 |
| G8985 |
Carry goal status |
23 |
13 |
$0.07 |
| G8997 |
Swallow goal status |
20 |
13 |
$0.06 |
| G8984 |
Carry current status |
22 |
12 |
$0.06 |
| G8998 |
Swallow d/c status |
19 |
13 |
$0.05 |
| G8988 |
Self care goal status |
17 |
12 |
$0.05 |
| G8996 |
Swallow current status |
19 |
13 |
$0.05 |
| J3590 |
Unclassified biologics |
814 |
645 |
$0.00 |
| C1769 |
Guide wire |
3,941 |
2,903 |
$0.00 |
| J1815 |
Insulin injection |
5,767 |
1,804 |
$0.00 |
| J1720 |
Hydrocortisone sodium succ i |
8,025 |
4,706 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
18,278 |
12,134 |
$0.00 |
| 94760 |
|
6,820 |
5,571 |
$0.00 |
| J7042 |
5% dextrose/normal saline |
6,613 |
2,149 |
$0.00 |
| A9503 |
Tc99m medronate |
272 |
210 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
1,022 |
726 |
$0.00 |
| J7613 |
Albuterol non-comp unit |
503 |
353 |
$0.00 |
| J1790 |
Droperidol injection |
501 |
365 |
$0.00 |
| J3420 |
Vitamin b12 injection |
602 |
350 |
$0.00 |
| J2785 |
Regadenoson injection |
869 |
658 |
$0.00 |
| J1940 |
Furosemide injection |
1,161 |
577 |
$0.00 |
| J8540 |
Oral dexamethasone |
1,924 |
767 |
$0.00 |
| C1725 |
Cath, translumin non-laser |
354 |
217 |
$0.00 |
| 82945 |
|
177 |
143 |
$0.00 |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
1,836 |
1,438 |
$0.00 |
| J1642 |
Inj heparin sodium per 10 u |
11,764 |
3,872 |
$0.00 |
| 88185 |
|
685 |
569 |
$0.00 |
| J1040 |
Methylprednisolone 80 mg inj |
1,396 |
1,226 |
$0.00 |
| J7060 |
5% dextrose/water |
732 |
307 |
$0.00 |
| G0328 |
Fecal blood scrn immunoassay |
311 |
293 |
$0.00 |
| J2920 |
Methylprednisolone injection |
454 |
288 |
$0.00 |
| 88341 |
|
2,161 |
1,581 |
$0.00 |
| 95886 |
|
2,889 |
2,542 |
$0.00 |
| J3480 |
Inj potassium chloride |
1,293 |
643 |
$0.00 |
| 84157 |
|
200 |
160 |
$0.00 |
| 96368 |
|
648 |
388 |
$0.00 |
| J1010 |
Inj, methylpred acetate 1 mg |
215 |
203 |
$0.00 |
| 95885 |
|
563 |
483 |
$0.00 |
| A9698 |
Non-rad contrast materialnoc |
491 |
452 |
$0.00 |
| J1094 |
Inj dexamethasone acetate |
2,341 |
1,622 |
$0.00 |
| A9500 |
Tc99m sestamibi |
2,106 |
1,461 |
$0.00 |
| C9359 |
Implnt,bon void filler-putty |
1,243 |
1,047 |
$0.00 |
| 99402 |
|
734 |
588 |
$0.00 |
| 51600 |
|
77 |
62 |
$0.00 |
| 94761 |
|
821 |
693 |
$0.00 |
| J0360 |
Hydralazine hcl injection |
113 |
76 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
2,997 |
1,134 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
154 |
80 |
$0.00 |
| G0499 |
Hepb screen high risk indiv |
201 |
177 |
$0.00 |
| V2632 |
Post chmbr intraocular lens |
103 |
67 |
$0.00 |
| J1030 |
Methylprednisolone 40 mg inj |
704 |
569 |
$0.00 |
| 51797 |
|
69 |
62 |
$0.00 |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
230 |
183 |
$0.00 |
| J9045 |
Carboplatin injection |
70 |
38 |
$0.00 |
| Q3014 |
Telehealth facility fee |
769 |
619 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
1,104 |
980 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
1,635 |
1,205 |
$0.00 |
| 17312 |
|
108 |
71 |
$0.00 |
| 29826 |
|
25 |
25 |
$0.00 |
| 88311 |
|
90 |
66 |
$0.00 |
| 22614 |
|
66 |
51 |
$0.00 |
| 82810 |
|
26 |
13 |
$0.00 |
| 22842 |
|
48 |
38 |
$0.00 |
| 64450 |
|
16 |
15 |
$0.00 |
| J9267 |
Paclitaxel injection |
87 |
38 |
$0.00 |
| 11302 |
|
22 |
13 |
$0.00 |
| 73552 |
|
16 |
12 |
$0.00 |
| C2617 |
Stent, non-cor, tem w/o del |
15 |
12 |
$0.00 |
| Q4114 |
Integra flowable wound matri |
13 |
12 |
$0.00 |
| 12001 |
|
12 |
12 |
$0.00 |
| A4648 |
Implantable tissue marker |
14 |
13 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
46 |
12 |
$0.00 |
| C1776 |
Joint device (implantable) |
1,794 |
1,580 |
$0.00 |
| J2930 |
Methylprednisolone injection |
3,760 |
2,216 |
$0.00 |
| J1756 |
Iron sucrose injection |
2,913 |
1,347 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
11,922 |
8,451 |
$0.00 |
| Q9957 |
Inj perflutren lip micros,ml |
1,556 |
1,205 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
2,152 |
1,595 |
$0.00 |
| A4649 |
Surgical supplies |
237 |
201 |
$0.00 |
| 17003 |
|
3,495 |
2,597 |
$0.00 |
| 86922 |
|
2,320 |
782 |
$0.00 |
| 76942 |
|
204 |
161 |
$0.00 |
| 77002 |
|
1,861 |
1,595 |
$0.00 |
| A9552 |
F18 fdg |
882 |
741 |
$0.00 |
| J3370 |
Vancomycin hcl injection |
3,199 |
1,991 |
$0.00 |
| 11101 |
|
286 |
215 |
$0.00 |
| C1887 |
Catheter, guiding |
1,334 |
939 |
$0.00 |
| J7040 |
Normal saline solution infus |
7,804 |
4,413 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
14,203 |
12,136 |
$0.00 |
| 93226 |
|
485 |
406 |
$0.00 |
| J1956 |
Levofloxacin injection |
19 |
12 |
$0.00 |
| 11103 |
|
929 |
707 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
96 |
85 |
$0.00 |
| G1004 |
Cdsm ndsc |
4,543 |
2,867 |
$0.00 |
| 99152 |
|
1,481 |
1,076 |
$0.00 |
| J3489 |
Zoledronic acid 1mg |
499 |
405 |
$0.00 |
| 99401 |
|
108 |
96 |
$0.00 |
| 85347 |
|
129 |
63 |
$0.00 |
| 88360 |
|
98 |
78 |
$0.00 |
| 95874 |
|
36 |
26 |
$0.00 |
| S0077 |
Injection, clindamycin phosp |
513 |
329 |
$0.00 |
| 20936 |
|
124 |
100 |
$0.00 |
| J0780 |
Prochlorperazine injection |
174 |
121 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
2,801 |
2,060 |
$0.00 |
| 99001 |
|
1,210 |
1,006 |
$0.00 |
| 77003 |
|
431 |
322 |
$0.00 |
| J2916 |
Na ferric gluconate complex |
292 |
144 |
$0.00 |
| C1758 |
Catheter, ureteral |
49 |
40 |
$0.00 |
| C1729 |
Cath, drainage |
59 |
40 |
$0.00 |
| 51741 |
|
73 |
64 |
$0.00 |
| 90653 |
|
133 |
127 |
$0.00 |
| 90472 |
|
27 |
24 |
$0.00 |
| J0689 |
Inj cefazolin sodium, baxter |
238 |
100 |
$0.00 |
| J0688 |
Inj cefazolin sodium, hikma |
212 |
180 |
$0.00 |
| 93356 |
|
58 |
49 |
$0.00 |
| Q9958 |
Hocm <=149 mg/ml iodine, 1ml |
61 |
52 |
$0.00 |
| 20930 |
|
140 |
119 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
233 |
119 |
$0.00 |
| Q0177 |
Hydroxyzine pamoate 25mg |
345 |
218 |
$0.00 |
| Q0144 |
Azithromycin dihydrate, oral |
20 |
13 |
$0.00 |
| G2211 |
Complex e/m visit add on |
488 |
396 |
$0.00 |
| 22853 |
|
16 |
16 |
$0.00 |
| A9541 |
Tc99m sulfur colloid |
20 |
17 |
$0.00 |
| 82042 |
|
13 |
12 |
$0.00 |
| J2274 |
Inj morphine pf epid ithc |
268 |
184 |
$0.00 |
| 98960 |
|
22 |
22 |
$0.00 |
| 95923 |
|
17 |
12 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
129 |
123 |
$0.00 |
| A6402 |
Sterile gauze <= 16 sq in |
15 |
12 |
$0.00 |
| C1762 |
Conn tiss, human(inc fascia) |
13 |
12 |
$0.00 |
| 36600 |
|
15 |
12 |
$0.00 |
| 11105 |
|
44 |
25 |
$0.00 |