| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
17,997 |
15,243 |
$6.40M |
| 99284 |
|
31,077 |
26,849 |
$5.24M |
| 99283 |
|
29,766 |
26,377 |
$3.12M |
| 74177 |
|
7,389 |
6,520 |
$2.00M |
| 80053 |
|
83,523 |
67,418 |
$1.46M |
| 41899 |
|
1,039 |
819 |
$1.40M |
| 85025 |
|
83,208 |
63,575 |
$1.19M |
| 87633 |
|
4,472 |
4,138 |
$996K |
| 78452 |
|
2,377 |
2,143 |
$854K |
| 70450 |
|
8,922 |
7,902 |
$852K |
| 96365 |
|
14,440 |
9,601 |
$788K |
| 96375 |
|
19,605 |
14,277 |
$715K |
| 93306 |
|
4,812 |
4,444 |
$697K |
| 96374 |
|
18,483 |
15,291 |
$674K |
| 74176 |
|
3,284 |
2,910 |
$639K |
| 93005 |
|
38,298 |
30,856 |
$622K |
| 99282 |
|
8,237 |
7,313 |
$574K |
| 80307 |
|
11,081 |
9,239 |
$532K |
| G0378 |
Hospital observation per hr |
11,422 |
4,134 |
$521K |
| 71275 |
|
1,955 |
1,740 |
$519K |
| 84484 |
|
23,967 |
16,554 |
$480K |
| 84443 |
|
19,916 |
18,325 |
$472K |
| G0480 |
Drug test def 1-7 classes |
5,582 |
4,754 |
$463K |
| 71046 |
|
14,869 |
13,524 |
$449K |
| 0099U |
|
1,033 |
886 |
$435K |
| 96376 |
|
6,530 |
3,449 |
$432K |
| 81001 |
|
29,017 |
24,636 |
$427K |
| 85027 |
|
24,713 |
20,423 |
$419K |
| J2405 |
Ondansetron hcl injection |
18,069 |
13,604 |
$419K |
| 71260 |
|
2,322 |
2,127 |
$415K |
| 81025 |
|
13,437 |
11,314 |
$404K |
| 96413 |
|
4,123 |
2,344 |
$391K |
| 71045 |
|
19,213 |
16,343 |
$385K |
| A9500 |
Tc99m sestamibi |
2,405 |
2,172 |
$375K |
| 96372 |
|
13,503 |
8,627 |
$365K |
| J7120 |
Ringers lactate infusion |
10,475 |
8,592 |
$357K |
| 88305 |
|
6,193 |
5,503 |
$334K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
11,930 |
10,339 |
$332K |
| 93017 |
|
2,981 |
2,710 |
$330K |
| 87086 |
|
19,405 |
16,845 |
$326K |
| U0002 |
Covid-19 lab test non-cdc |
7,117 |
6,619 |
$318K |
| 77067 |
|
3,533 |
3,270 |
$305K |
| U0004 |
Cov-19 test non-cdc hgh thru |
4,159 |
3,859 |
$300K |
| 11042 |
|
3,321 |
1,785 |
$300K |
| 87491 |
|
5,625 |
5,075 |
$293K |
| 87591 |
|
5,608 |
5,061 |
$287K |
| 70553 |
|
747 |
690 |
$281K |
| 80048 |
|
18,448 |
14,110 |
$274K |
| 96361 |
|
7,541 |
5,806 |
$269K |
| J1100 |
Dexamethasone sodium phos |
7,710 |
5,780 |
$269K |
| 36415 |
|
50,041 |
37,224 |
$266K |
| 99212 |
|
14,449 |
13,081 |
$264K |
| 83735 |
|
18,135 |
10,930 |
$259K |
| J0131 |
Inj, acetaminophen (nos) |
6,150 |
5,051 |
$255K |
| 80061 |
|
13,036 |
12,333 |
$251K |
| 83690 |
|
13,371 |
11,370 |
$251K |
| J2250 |
Inj midazolam hydrochloride |
8,108 |
6,933 |
$243K |
| 64493 |
|
180 |
107 |
$241K |
| 87637 |
|
2,796 |
2,511 |
$239K |
| G0463 |
Hospital outpt clinic visit |
16,697 |
13,236 |
$236K |
| J1885 |
Ketorolac tromethamine inj |
9,329 |
7,250 |
$235K |
| 94640 |
|
6,798 |
3,831 |
$232K |
| 85610 |
|
22,145 |
18,290 |
$230K |
| 72125 |
|
2,954 |
2,679 |
$230K |
| 76705 |
|
2,678 |
2,438 |
$222K |
| J2785 |
Regadenoson injection |
1,561 |
1,392 |
$202K |
| 85730 |
|
18,326 |
15,450 |
$201K |
| 81003 |
|
15,826 |
14,226 |
$188K |
| 72148 |
|
522 |
495 |
$171K |
| 74178 |
|
423 |
402 |
$167K |
| 87522 |
Neg quan hep c or qual rna |
2,418 |
2,257 |
$163K |
| 82150 |
|
3,308 |
2,786 |
$162K |
| 99211 |
|
10,217 |
9,109 |
$162K |
| 96366 |
|
5,048 |
2,751 |
$158K |
| 83880 |
|
4,665 |
4,042 |
$155K |
| 93880 |
|
2,536 |
2,385 |
$153K |
| 87040 |
|
7,416 |
4,691 |
$152K |
| 82306 |
|
5,133 |
4,842 |
$150K |
| 74018 |
|
4,479 |
3,925 |
$142K |
| 71250 |
|
1,537 |
1,459 |
$141K |
| 80305 |
|
3,731 |
3,225 |
$136K |
| 87631 |
|
818 |
728 |
$134K |
| 96367 |
|
3,484 |
2,245 |
$133K |
| 87186 |
|
8,158 |
7,165 |
$131K |
| 72110 |
|
2,717 |
2,554 |
$130K |
| 83605 |
|
7,795 |
6,217 |
$129K |
| 80074 |
|
2,419 |
2,238 |
$129K |
| 86850 |
|
5,835 |
5,089 |
$125K |
| 88142 |
|
4,078 |
3,716 |
$125K |
| 84439 |
|
5,820 |
5,432 |
$125K |
| 83721 |
|
7,009 |
6,176 |
$123K |
| 83036 |
|
10,302 |
9,651 |
$123K |
| 78815 |
|
279 |
256 |
$122K |
| J0696 |
Ceftriaxone sodium injection |
5,385 |
3,443 |
$121K |
| 84702 |
|
4,259 |
3,392 |
$121K |
| J2270 |
Morphine sulfate injection |
6,196 |
4,192 |
$120K |
| 85007 |
|
4,504 |
3,340 |
$115K |
| 86900 |
|
5,604 |
4,879 |
$110K |
| 76536 |
|
1,176 |
1,122 |
$108K |
| 0202U |
|
2,959 |
2,686 |
$108K |
| 86140 |
|
9,113 |
7,545 |
$105K |
| 87070 |
|
6,601 |
5,892 |
$100K |
| 86901 |
|
5,596 |
4,873 |
$99K |
| 93971 |
|
1,742 |
1,590 |
$97K |
| 87088 |
|
6,102 |
5,439 |
$95K |
| 76770 |
|
1,087 |
1,011 |
$94K |
| 70486 |
|
643 |
612 |
$91K |
| 95810 |
|
137 |
121 |
$88K |
| A9552 |
F18 fdg |
270 |
244 |
$87K |
| J2175 |
Meperidine hydrochl /100 mg |
836 |
634 |
$84K |
| 72141 |
|
140 |
134 |
$84K |
| 82803 |
|
3,023 |
2,322 |
$84K |
| 96360 |
|
1,752 |
1,540 |
$81K |
| 93970 |
|
888 |
814 |
$81K |
| 86803 |
|
3,517 |
3,308 |
$77K |
| 72050 |
|
1,216 |
1,150 |
$76K |
| 88304 |
|
762 |
666 |
$74K |
| 82607 |
|
3,855 |
3,606 |
$74K |
| 73630 |
|
2,778 |
2,397 |
$73K |
| 76642 |
|
1,343 |
1,132 |
$73K |
| 82565 |
|
3,538 |
2,335 |
$70K |
| 36600 |
|
2,550 |
2,024 |
$70K |
| 85379 |
|
2,885 |
2,524 |
$69K |
| 73030 |
|
2,565 |
2,251 |
$68K |
| 43239 |
|
421 |
375 |
$64K |
| 74022 |
|
833 |
749 |
$64K |
| 87798 |
|
678 |
612 |
$64K |
| 64494 |
|
118 |
74 |
$64K |
| 73130 |
|
1,791 |
1,544 |
$63K |
| 87486 |
|
664 |
598 |
$63K |
| 87581 |
|
662 |
596 |
$63K |
| 62323 |
|
237 |
210 |
$63K |
| 85651 |
|
5,493 |
4,683 |
$62K |
| 84145 |
|
2,229 |
1,848 |
$59K |
| 77063 |
|
2,440 |
2,303 |
$58K |
| 84520 |
|
2,421 |
1,545 |
$56K |
| 73721 |
|
261 |
240 |
$56K |
| 99213 |
|
4,706 |
3,975 |
$56K |
| 73610 |
|
1,676 |
1,500 |
$55K |
| 78227 |
|
187 |
183 |
$55K |
| 84100 |
|
5,256 |
3,322 |
$55K |
| A9537 |
Tc99m mebrofenin |
446 |
393 |
$54K |
| 82728 |
|
3,793 |
3,517 |
$53K |
| 87624 |
|
718 |
641 |
$52K |
| 87077 |
|
3,168 |
2,758 |
$52K |
| J0690 |
Cefazolin sodium injection |
1,598 |
1,128 |
$52K |
| J1650 |
Inj enoxaparin sodium |
4,559 |
2,004 |
$51K |
| 80051 |
|
1,275 |
712 |
$51K |
| 94060 |
|
1,928 |
1,833 |
$51K |
| 86756 |
|
655 |
582 |
$50K |
| 85018 |
|
2,592 |
2,274 |
$49K |
| 87902 |
|
223 |
197 |
$48K |
| 84481 |
|
1,410 |
1,336 |
$48K |
| 84460 |
|
1,727 |
1,065 |
$48K |
| 70491 |
|
130 |
115 |
$48K |
| 97161 |
|
2,013 |
1,715 |
$47K |
| 87276 |
|
1,099 |
957 |
$46K |
| 84450 |
|
1,607 |
973 |
$46K |
| 87275 |
|
1,101 |
959 |
$46K |
| 82247 |
|
2,555 |
1,330 |
$45K |
| 82248 |
|
5,305 |
4,398 |
$45K |
| 94726 |
|
1,787 |
1,702 |
$45K |
| 87340 |
|
2,740 |
2,558 |
$44K |
| 88342 |
|
1,032 |
925 |
$44K |
| J1644 |
Inj heparin sodium per 1000u |
3,867 |
1,540 |
$43K |
| 93458 |
|
14 |
12 |
$43K |
| 70551 |
|
93 |
85 |
$42K |
| 76856 |
|
378 |
351 |
$42K |
| 94729 |
|
1,993 |
1,892 |
$41K |
| J2930 |
Methylprednisolone injection |
2,189 |
1,810 |
$39K |
| 87075 |
|
2,519 |
2,170 |
$39K |
| 84075 |
|
1,355 |
754 |
$39K |
| 90471 |
|
2,835 |
2,553 |
$39K |
| 76830 |
|
430 |
389 |
$38K |
| 73562 |
|
1,105 |
901 |
$38K |
| 86592 |
|
3,831 |
3,564 |
$37K |
| 83655 |
|
1,663 |
1,585 |
$37K |
| 73564 |
|
970 |
854 |
$37K |
| 78226 |
|
189 |
167 |
$36K |
| A9578 |
Inj multihance multipack |
1,323 |
1,212 |
$36K |
| 73110 |
|
878 |
799 |
$36K |
| J2765 |
Metoclopramide hcl injection |
2,304 |
1,705 |
$36K |
| 87880 |
|
1,279 |
1,186 |
$35K |
| 90715 |
|
1,060 |
969 |
$34K |
| 87205 |
|
3,530 |
3,094 |
$34K |
| 74420 |
|
185 |
145 |
$32K |
| 99281 |
|
639 |
587 |
$32K |
| 72100 |
|
784 |
730 |
$31K |
| 87081 |
|
1,560 |
1,439 |
$31K |
| 97165 |
|
1,355 |
1,171 |
$31K |
| 36000 |
|
354 |
334 |
$30K |
| 83970 |
|
1,037 |
975 |
$30K |
| 72131 |
|
212 |
197 |
$29K |
| 87389 |
|
1,745 |
1,654 |
$29K |
| 87147 |
|
1,315 |
1,193 |
$28K |
| J3475 |
Inj magnesium sulfate |
2,103 |
1,481 |
$28K |
| 83540 |
|
3,519 |
3,282 |
$28K |
| 80050 |
|
695 |
657 |
$27K |
| 73560 |
|
892 |
739 |
$27K |
| 82746 |
|
1,473 |
1,376 |
$27K |
| G0475 |
Hiv combination assay |
1,986 |
1,862 |
$25K |
| 82043 |
|
2,964 |
2,808 |
$25K |
| 72040 |
|
531 |
502 |
$25K |
| 82553 |
|
620 |
562 |
$25K |
| J1200 |
Diphenhydramine hcl injectio |
2,101 |
1,586 |
$25K |
| G0108 |
Diab manage trn per indiv |
325 |
300 |
$24K |
| 82570 |
|
3,347 |
3,107 |
$24K |
| C9803 |
Hopd covid-19 spec collect |
1,627 |
1,405 |
$24K |
| 76700 |
|
306 |
295 |
$24K |
| 84153 |
|
1,142 |
1,085 |
$24K |
| 86762 |
|
1,122 |
1,056 |
$24K |
| U0005 |
Infec agen detec ampli probe |
1,111 |
1,056 |
$23K |
| J2060 |
Lorazepam injection |
1,451 |
1,096 |
$23K |
| 86038 |
|
984 |
927 |
$23K |
| 83516 |
|
995 |
706 |
$23K |
| 73502 |
|
1,101 |
1,042 |
$22K |
| 88720 |
|
3,426 |
1,975 |
$22K |
| 77065 |
Tomosynthesis, mammo |
384 |
358 |
$22K |
| 84403 |
|
506 |
475 |
$22K |
| 97602 |
|
350 |
231 |
$21K |
| 84436 |
|
466 |
434 |
$21K |
| 59025 |
|
266 |
221 |
$21K |
| J2370 |
Phenylephrine hcl injection |
84 |
71 |
$20K |
| 72072 |
|
395 |
376 |
$19K |
| 86003 |
|
59 |
39 |
$19K |
| J2360 |
Orphenadrine injection |
415 |
369 |
$18K |
| 81596 |
|
247 |
227 |
$18K |
| 99202 |
|
1,482 |
1,442 |
$18K |
| 99214 |
|
856 |
754 |
$17K |
| 86480 |
|
213 |
202 |
$17K |
| Q9957 |
Inj perflutren lip micros,ml |
340 |
298 |
$17K |
| 93296 |
|
1,472 |
1,375 |
$16K |
| 86677 |
|
482 |
456 |
$16K |
| 12001 |
|
234 |
224 |
$16K |
| 84146 |
|
442 |
406 |
$16K |
| 74246 |
|
281 |
260 |
$16K |
| J3370 |
Vancomycin hcl injection |
1,517 |
687 |
$15K |
| 86703 |
|
480 |
438 |
$15K |
| 84112 |
|
174 |
147 |
$14K |
| 82550 |
|
1,359 |
976 |
$14K |
| 73080 |
|
455 |
419 |
$14K |
| 73590 |
|
399 |
340 |
$13K |
| 45380 |
|
46 |
44 |
$13K |
| 84132 |
|
224 |
173 |
$13K |
| J2805 |
Sincalide injection |
184 |
181 |
$13K |
| 73221 |
|
27 |
24 |
$13K |
| 86706 |
|
680 |
607 |
$13K |
| 94618 |
|
410 |
380 |
$13K |
| 84550 |
|
1,938 |
1,711 |
$12K |
| 88185 |
|
142 |
127 |
$12K |
| 82950 |
|
971 |
913 |
$12K |
| 84402 |
|
191 |
181 |
$12K |
| 70498 |
|
413 |
370 |
$12K |
| 96523 |
|
407 |
281 |
$12K |
| 70496 |
|
287 |
257 |
$11K |
| 84466 |
|
2,066 |
1,933 |
$11K |
| J0702 |
Betamethasone acet&sod phosp |
345 |
185 |
$11K |
| 86431 |
|
714 |
676 |
$11K |
| 82947 |
|
951 |
872 |
$11K |
| 86200 |
|
392 |
363 |
$10K |
| 82962 |
|
7,546 |
3,695 |
$10K |
| 80076 |
|
659 |
574 |
$10K |
| 96415 |
|
353 |
239 |
$10K |
| 83525 |
|
432 |
400 |
$9K |
| J1956 |
Levofloxacin injection |
16 |
12 |
$9K |
| 95819 |
|
45 |
43 |
$9K |
| Q9961 |
Hocm 250-299mg/ml iodine,1ml |
185 |
157 |
$9K |
| Q0163 |
Diphenhydramine hcl 50mg |
54 |
38 |
$9K |
| 84156 |
|
1,408 |
1,271 |
$9K |
| G0379 |
Direct refer hospital observ |
86 |
73 |
$9K |
| 86696 |
|
359 |
341 |
$9K |
| U0003 |
Cov-19 amp prb hgh thruput |
134 |
131 |
$9K |
| 97597 |
|
152 |
91 |
$9K |
| J7060 |
5% dextrose/water |
272 |
109 |
$9K |
| 86376 |
|
163 |
158 |
$8K |
| J2704 |
Inj, propofol, 10 mg |
6,348 |
5,682 |
$8K |
| 82010 |
|
247 |
194 |
$7K |
| 86790 |
|
595 |
542 |
$7K |
| 77336 |
|
178 |
70 |
$7K |
| 76870 |
|
82 |
77 |
$7K |
| 86695 |
|
359 |
341 |
$7K |
| J1030 |
Methylprednisolone 40 mg inj |
775 |
663 |
$7K |
| J2469 |
Palonosetron hcl |
216 |
125 |
$6K |
| 87661 |
|
193 |
175 |
$6K |
| 93924 |
|
69 |
67 |
$6K |
| 86308 |
|
58 |
55 |
$6K |
| 72170 |
|
390 |
355 |
$6K |
| 86255 |
|
225 |
206 |
$6K |
| 80143 |
|
603 |
536 |
$6K |
| 96417 |
|
145 |
102 |
$6K |
| 96368 |
|
165 |
111 |
$6K |
| 86704 |
|
187 |
184 |
$6K |
| 97116 |
|
645 |
362 |
$6K |
| 64635 |
|
43 |
31 |
$6K |
| 76815 |
|
102 |
92 |
$6K |
| 93325 |
|
119 |
107 |
$6K |
| 78306 |
|
26 |
25 |
$6K |
| 73120 |
|
216 |
141 |
$6K |
| 88184 |
|
141 |
127 |
$6K |
| 99391 |
|
165 |
146 |
$6K |
| 76817 |
|
73 |
58 |
$5K |
| M0243 |
Casirivi and imdevi inj |
12 |
12 |
$5K |
| 99392 |
|
132 |
125 |
$5K |
| 73090 |
|
181 |
164 |
$5K |
| 90686 |
|
356 |
334 |
$5K |
| 87324 |
|
191 |
173 |
$5K |
| 94664 |
|
113 |
93 |
$5K |
| 10060 |
|
81 |
70 |
$5K |
| 0241U |
|
1,303 |
1,197 |
$5K |
| 80055 |
|
136 |
128 |
$5K |
| 82785 |
|
60 |
57 |
$5K |
| Q3014 |
Telehealth facility fee |
540 |
508 |
$5K |
| 82310 |
|
391 |
270 |
$5K |
| 83615 |
|
848 |
685 |
$5K |
| 87427 |
|
193 |
174 |
$5K |
| 93923 |
|
159 |
153 |
$4K |
| 87045 |
|
230 |
211 |
$4K |
| 74230 |
|
89 |
82 |
$4K |
| 90472 |
|
235 |
211 |
$4K |
| 92611 |
|
87 |
82 |
$4K |
| 87635 |
|
60 |
41 |
$4K |
| 87046 |
|
230 |
211 |
$4K |
| 88307 |
|
33 |
32 |
$4K |
| J0694 |
Cefoxitin sodium injection |
25 |
16 |
$4K |
| 97530 |
|
617 |
268 |
$4K |
| 83001 |
|
137 |
123 |
$3K |
| J2790 |
Rho d immune globulin inj |
25 |
25 |
$3K |
| 45385 |
|
29 |
26 |
$3K |
| 93308 |
|
96 |
90 |
$3K |
| 73552 |
|
91 |
80 |
$3K |
| 76882 |
|
33 |
29 |
$3K |
| 86235 |
|
74 |
58 |
$3K |
| J0692 |
Cefepime hcl for injection |
504 |
273 |
$3K |
| A9561 |
Tc99m oxidronate |
41 |
39 |
$3K |
| J0744 |
Ciprofloxacin iv |
89 |
55 |
$3K |
| 82140 |
|
214 |
182 |
$3K |
| J1815 |
Insulin injection |
645 |
461 |
$3K |
| 86618 |
|
180 |
97 |
$3K |
| 87210 |
|
58 |
51 |
$3K |
| 99393 |
|
74 |
73 |
$3K |
| 71101 |
|
109 |
105 |
$2K |
| J3105 |
Terbutaline sulfate inj |
49 |
40 |
$2K |
| 58563 |
|
14 |
13 |
$2K |
| 74240 |
|
52 |
51 |
$2K |
| 64451 |
|
17 |
15 |
$2K |
| 86694 |
|
26 |
25 |
$2K |
| Q0162 |
Ondansetron oral |
1,568 |
1,091 |
$2K |
| 82533 |
|
83 |
70 |
$2K |
| 86780 |
|
239 |
214 |
$2K |
| 94010 |
|
62 |
59 |
$2K |
| 80069 |
|
206 |
187 |
$2K |
| 86905 |
|
28 |
26 |
$2K |
| 99396 |
|
40 |
40 |
$2K |
| 95806 |
|
53 |
52 |
$2K |
| 87209 |
|
49 |
47 |
$2K |
| 74019 |
|
131 |
129 |
$2K |
| 81513 |
|
16 |
14 |
$2K |
| 73522 |
|
32 |
31 |
$2K |
| 99495 |
|
186 |
176 |
$2K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
543 |
472 |
$2K |
| 45378 |
|
30 |
29 |
$1K |
| 87804 |
|
136 |
125 |
$1K |
| 96110 |
|
130 |
130 |
$1K |
| J3411 |
Thiamine hcl 100 mg |
18 |
15 |
$1K |
| 76816 |
|
12 |
12 |
$1K |
| 93242 |
|
95 |
84 |
$1K |
| 29125 |
|
15 |
13 |
$1K |
| 87811 |
|
49 |
47 |
$1K |
| 77334 |
|
24 |
14 |
$1K |
| 93320 |
|
12 |
12 |
$1K |
| 81220 |
|
45 |
40 |
$1K |
| 99204 |
|
53 |
50 |
$1K |
| 83002 |
|
77 |
63 |
$1K |
| 86709 |
|
36 |
35 |
$1K |
| 82977 |
|
41 |
33 |
$1K |
| 93280 |
|
132 |
117 |
$1K |
| 87177 |
|
49 |
47 |
$1K |
| J0780 |
Prochlorperazine injection |
92 |
72 |
$1K |
| 77300 |
|
14 |
12 |
$1K |
| 93299 |
|
61 |
56 |
$1K |
| 83013 |
|
17 |
16 |
$1K |
| 73620 |
|
44 |
41 |
$984.33 |
| 85576 |
|
33 |
30 |
$952.19 |
| 80081 |
|
14 |
14 |
$943.18 |
| 86708 |
|
28 |
27 |
$926.70 |
| 85045 |
|
62 |
56 |
$914.50 |
| 82105 |
|
98 |
95 |
$910.05 |
| 99203 |
|
50 |
49 |
$897.91 |
| 87481 |
|
30 |
26 |
$894.16 |
| 85046 |
|
245 |
220 |
$847.97 |
| 86160 |
|
47 |
43 |
$784.15 |
| 36569 |
|
16 |
12 |
$784.00 |
| 93922 |
|
44 |
41 |
$764.01 |
| 86364 |
|
103 |
94 |
$746.07 |
| J3490 |
Drugs unclassified injection |
8,341 |
2,672 |
$729.80 |
| 99395 |
|
17 |
17 |
$715.12 |
| 36416 |
|
451 |
238 |
$663.42 |
| 90656 |
|
193 |
188 |
$617.59 |
| 12002 |
|
13 |
12 |
$602.50 |
| J1170 |
Hydromorphone injection |
744 |
564 |
$601.09 |
| 80164 |
|
45 |
41 |
$583.53 |
| 87641 |
|
25 |
24 |
$583.51 |
| 86800 |
|
15 |
13 |
$560.31 |
| 11721 |
|
177 |
174 |
$548.67 |
| J3010 |
Fentanyl citrate injection |
2,831 |
2,407 |
$530.83 |
| J2920 |
Methylprednisolone injection |
55 |
30 |
$515.75 |
| 73060 |
|
42 |
41 |
$495.59 |
| 82365 |
|
16 |
14 |
$482.82 |
| 77061 |
|
159 |
152 |
$465.97 |
| 77080 |
|
26 |
25 |
$451.57 |
| J0701 |
Inj. cefepime hcl (baxter) |
67 |
42 |
$441.81 |
| 88300 |
|
13 |
12 |
$433.18 |
| 81511 |
|
18 |
14 |
$403.39 |
| 72202 |
|
26 |
24 |
$400.42 |
| 64636 |
|
20 |
12 |
$395.88 |
| 84479 |
|
40 |
39 |
$370.69 |
| 71271 |
|
14 |
13 |
$367.74 |
| 93799 |
|
100 |
88 |
$354.90 |
| 88175 |
|
14 |
14 |
$331.45 |
| 82670 |
|
15 |
14 |
$328.32 |
| 95250 |
|
12 |
12 |
$322.17 |
| 96127 |
|
103 |
98 |
$315.89 |
| J1642 |
Inj heparin sodium per 10 u |
1,043 |
624 |
$308.34 |
| 86147 |
|
14 |
12 |
$302.45 |
| 74220 |
|
13 |
12 |
$276.45 |
| 86705 |
|
30 |
25 |
$267.58 |
| 82784 |
|
40 |
24 |
$259.73 |
| J3480 |
Inj potassium chloride |
309 |
207 |
$254.01 |
| 93882 |
|
17 |
17 |
$251.69 |
| 84270 |
|
14 |
13 |
$246.65 |
| J1940 |
Furosemide injection |
130 |
90 |
$237.94 |
| 90694 |
|
100 |
99 |
$232.50 |
| J2919 |
Inj, methylpred sod succ 5mg |
156 |
111 |
$205.46 |
| 76857 |
|
17 |
17 |
$199.60 |
| 51798 |
|
171 |
160 |
$195.49 |
| 93298 |
|
49 |
49 |
$188.38 |
| 83520 |
|
14 |
14 |
$179.29 |
| 82272 |
|
46 |
39 |
$162.53 |
| J1040 |
Methylprednisolone 80 mg inj |
47 |
38 |
$144.27 |
| J1630 |
Haloperidol injection |
65 |
55 |
$133.09 |
| 70250 |
|
12 |
12 |
$131.46 |
| 36592 |
|
14 |
12 |
$129.14 |
| 73521 |
|
13 |
13 |
$115.97 |
| 92610 |
|
16 |
13 |
$102.99 |
| 82085 |
|
12 |
12 |
$102.24 |
| 81002 |
|
60 |
53 |
$95.06 |
| 90474 |
|
12 |
12 |
$94.90 |
| J7512 |
Prednisone ir or dr oral 1mg |
628 |
444 |
$92.83 |
| J2272 |
Inj, morphine (fresenius) |
173 |
141 |
$89.08 |
| 90653 |
|
38 |
38 |
$83.49 |
| J1010 |
Inj, methylpred acetate 1 mg |
163 |
157 |
$83.07 |
| C8929 |
Tte w or wo fol wcon,doppler |
14 |
14 |
$82.44 |
| J0689 |
Inj cefazolin sodium, baxter |
271 |
226 |
$78.65 |
| C1755 |
Catheter, intraspinal |
35 |
25 |
$76.53 |
| J3420 |
Vitamin b12 injection |
230 |
205 |
$70.88 |
| G1010 |
Cdsm stanson |
960 |
688 |
$59.34 |
| A4648 |
Implantable tissue marker |
286 |
265 |
$56.71 |
| 97535 |
|
79 |
53 |
$31.31 |
| A9573 |
Inj, gadopiclenol, 1 ml |
189 |
185 |
$25.76 |
| 93321 |
|
15 |
14 |
$23.84 |
| C9113 |
Inj pantoprazole sodium, via |
606 |
333 |
$23.37 |
| 80349 |
|
200 |
177 |
$15.89 |
| J2470 |
Inj pantoprazole sodium 40mg |
23 |
17 |
$12.99 |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
42 |
38 |
$12.03 |
| C1769 |
Guide wire |
266 |
180 |
$1.09 |
| S5553 |
Insulin long acting 5 u |
17 |
12 |
$0.60 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
78 |
50 |
$0.45 |
| 90671 |
|
45 |
44 |
$0.00 |
| C1751 |
Cath, inf, per/cent/midline |
76 |
67 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
118 |
78 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
75 |
68 |
$0.00 |
| C1758 |
Catheter, ureteral |
15 |
12 |
$0.00 |
| G8979 |
Mobility goal status |
15 |
12 |
$0.00 |
| J0134 |
Inj acetaminophen -fresenius |
29 |
26 |
$0.00 |
| G8978 |
Mobility current status |
15 |
12 |
$0.00 |
| 94070 |
|
14 |
13 |
$0.00 |
| 80324 |
|
60 |
54 |
$0.00 |
| G0123 |
Screen cerv/vag thin layer |
211 |
187 |
$0.00 |
| G0008 |
Admin influenza virus vac |
14 |
14 |
$0.00 |
| J7674 |
Methacholine chloride, neb |
14 |
13 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
13 |
12 |
$0.00 |