| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0360 |
|
18,412 |
15,778 |
$11.57M |
| 0450 |
|
285,149 |
265,979 |
$10.39M |
| Z7500 |
|
153,745 |
146,634 |
$5.21M |
| 99211 |
|
80,185 |
75,038 |
$4.76M |
| 0710 |
|
17,231 |
16,491 |
$3.81M |
| 99213 |
|
24,974 |
21,009 |
$3.66M |
| 70553 |
|
2,967 |
2,865 |
$3.10M |
| 99281 |
|
30,820 |
29,089 |
$2.60M |
| 70551 |
|
4,202 |
4,100 |
$2.32M |
| G0463 |
Hospital outpt clinic visit |
31,372 |
29,915 |
$1.81M |
| V5298 |
Hearing aid noc |
1,435 |
1,435 |
$1.77M |
| U0003 |
Cov-19 amp prb hgh thruput |
43,330 |
42,044 |
$1.74M |
| Z7506 |
|
13,062 |
10,836 |
$1.58M |
| 93325 |
|
14,888 |
14,579 |
$1.56M |
| 0510 |
|
20,328 |
19,593 |
$1.52M |
| 99285 |
|
3,021 |
2,675 |
$1.51M |
| 99283 |
|
2,425 |
2,330 |
$1.45M |
| 42820 |
|
3,478 |
3,280 |
$1.44M |
| 95810 |
|
2,641 |
2,631 |
$1.29M |
| 95782 |
|
1,034 |
1,023 |
$1.14M |
| 99215 |
Prolong outpt/office vis |
6,961 |
6,260 |
$1.09M |
| 76770 |
|
12,395 |
12,317 |
$1.06M |
| 0760 |
|
121,586 |
114,818 |
$1.00M |
| 80053 |
|
92,690 |
85,426 |
$902K |
| 99214 |
|
11,530 |
10,793 |
$866K |
| Z4300 |
|
8,396 |
8,389 |
$865K |
| Z7502 |
|
23,176 |
22,993 |
$849K |
| J0586 |
Abobotulinumtoxina |
1,790 |
648 |
$849K |
| 92567 |
|
12,036 |
11,955 |
$767K |
| 85025 |
|
87,153 |
81,946 |
$749K |
| S0302 |
Completed epsdt |
7,038 |
3,259 |
$723K |
| J1745 |
Infliximab not biosimil 10mg |
343 |
240 |
$717K |
| 76811 |
|
9,273 |
9,163 |
$687K |
| 92557 |
|
5,054 |
5,035 |
$675K |
| 93306 |
|
3,347 |
3,318 |
$620K |
| 76816 |
|
16,067 |
15,565 |
$619K |
| 0761 |
|
38,430 |
36,315 |
$566K |
| 69436 |
|
2,005 |
1,779 |
$555K |
| 43239 |
|
1,259 |
1,243 |
$548K |
| Z4304 |
|
7,052 |
7,045 |
$545K |
| 72148 |
|
894 |
877 |
$534K |
| 93304 |
|
7,207 |
7,091 |
$509K |
| Q3014 |
Telehealth facility fee |
16,133 |
15,737 |
$507K |
| 73721 |
|
1,318 |
1,244 |
$499K |
| Q5103 |
Injection, inflectra |
222 |
180 |
$478K |
| Z4301 |
|
16,986 |
16,901 |
$435K |
| Z7610 |
|
22,779 |
14,269 |
$425K |
| 76705 |
|
13,984 |
13,603 |
$419K |
| 70450 |
|
4,201 |
4,165 |
$403K |
| L8699 |
Prosthetic implant nos |
697 |
361 |
$403K |
| 83036 |
|
29,896 |
29,555 |
$398K |
| 92507 |
|
6,224 |
3,532 |
$391K |
| 96361 |
|
15,398 |
13,568 |
$389K |
| 93975 |
|
5,270 |
5,133 |
$389K |
| 99203 |
|
8,949 |
8,610 |
$373K |
| 0202U |
|
3,925 |
3,878 |
$369K |
| 93005 |
|
23,146 |
22,633 |
$367K |
| 71046 |
|
25,587 |
25,116 |
$365K |
| 84443 |
|
18,592 |
18,306 |
$356K |
| Z5822 |
|
6,058 |
4,581 |
$353K |
| Z4307 |
|
14,303 |
14,256 |
$347K |
| 96112 |
|
2,144 |
2,137 |
$322K |
| Z4308 |
|
12,854 |
12,813 |
$309K |
| T1014 |
Telehealth transmit, per min |
19,020 |
18,564 |
$286K |
| 97799 |
|
8,803 |
3,194 |
$278K |
| 93321 |
|
7,849 |
7,742 |
$274K |
| 74177 |
|
1,219 |
1,214 |
$244K |
| 92552 |
|
3,991 |
3,949 |
$242K |
| 95819 |
|
2,385 |
2,359 |
$242K |
| 73070 |
|
6,944 |
6,402 |
$241K |
| 82728 |
|
8,137 |
7,415 |
$239K |
| 87636 |
|
7,442 |
7,385 |
$234K |
| 73100 |
|
6,900 |
6,284 |
$230K |
| 81001 |
|
66,499 |
64,178 |
$229K |
| 96365 |
|
5,053 |
4,798 |
$227K |
| 96360 |
|
9,408 |
9,219 |
$227K |
| 96374 |
|
11,333 |
10,920 |
$226K |
| 76700 |
|
5,448 |
5,382 |
$224K |
| 76819 |
|
3,804 |
3,239 |
$217K |
| 93303 |
|
1,894 |
1,873 |
$209K |
| 86140 |
|
32,535 |
31,175 |
$206K |
| 87088 |
|
35,425 |
34,491 |
$202K |
| 73090 |
|
8,206 |
7,359 |
$196K |
| 92523 |
|
1,837 |
1,833 |
$193K |
| 77077 |
|
3,342 |
3,248 |
$192K |
| 94010 |
|
5,930 |
5,900 |
$187K |
| T1024 |
Team evaluation & management |
4,314 |
2,600 |
$182K |
| 72141 |
|
281 |
273 |
$181K |
| 0700 |
|
9,077 |
8,420 |
$180K |
| 97750 |
|
4,644 |
3,295 |
$178K |
| 87633 |
|
2,395 |
2,324 |
$172K |
| 92700 |
|
2,738 |
2,728 |
$165K |
| 94060 |
|
3,316 |
3,280 |
$164K |
| Z4311 |
|
13,571 |
13,458 |
$164K |
| J3490 |
Drugs unclassified injection |
81,047 |
52,991 |
$163K |
| 97802 |
|
3,107 |
3,078 |
$162K |
| 88305 |
|
3,306 |
2,584 |
$160K |
| 84439 |
|
11,223 |
11,047 |
$154K |
| 74018 |
|
9,491 |
9,296 |
$148K |
| 92587 |
|
3,067 |
3,057 |
$143K |
| 96375 |
|
7,625 |
6,845 |
$141K |
| J0585 |
Injection,onabotulinumtoxina |
407 |
92 |
$133K |
| 87502 |
|
6,729 |
6,525 |
$132K |
| Z4312 |
|
10,772 |
10,708 |
$130K |
| 96413 |
|
2,807 |
2,584 |
$128K |
| 0160 |
|
2,108 |
1,506 |
$126K |
| 92558 |
|
593 |
593 |
$124K |
| 76536 |
|
2,321 |
2,300 |
$122K |
| 72082 |
|
2,638 |
2,621 |
$121K |
| 73630 |
|
6,333 |
5,689 |
$120K |
| 73610 |
|
6,821 |
6,535 |
$116K |
| 76805 |
|
2,695 |
2,682 |
$115K |
| 73590 |
|
4,987 |
4,533 |
$115K |
| 97139 |
|
10,133 |
3,045 |
$115K |
| J7120 |
Ringers lactate infusion |
19,228 |
16,948 |
$115K |
| 97165 |
|
2,765 |
2,274 |
$114K |
| 72146 |
|
232 |
226 |
$113K |
| 74455 |
|
1,012 |
981 |
$113K |
| 85651 |
|
18,049 |
17,332 |
$109K |
| 94375 |
|
1,590 |
1,568 |
$109K |
| 76870 |
|
3,066 |
2,980 |
$108K |
| 95816 |
|
1,136 |
1,124 |
$107K |
| 85007 |
|
16,092 |
14,142 |
$106K |
| 85610 |
|
6,448 |
6,140 |
$105K |
| 97110 |
|
10,374 |
5,741 |
$104K |
| 85730 |
|
5,413 |
5,282 |
$104K |
| 94640 |
|
9,935 |
8,411 |
$100K |
| 99202 |
|
1,546 |
1,487 |
$99K |
| 80069 |
|
8,524 |
8,209 |
$94K |
| 72170 |
|
4,309 |
4,256 |
$94K |
| 76827 |
|
1,263 |
1,242 |
$94K |
| P9040 |
Rbc leukoreduced irradiated |
203 |
189 |
$92K |
| 76817 |
|
2,716 |
2,385 |
$92K |
| 73140 |
|
5,911 |
5,513 |
$91K |
| 76856 |
|
3,835 |
3,756 |
$90K |
| U0005 |
Infec agen detec ampli probe |
8,829 |
8,692 |
$89K |
| 97803 |
|
3,783 |
3,741 |
$88K |
| 73000 |
|
3,326 |
3,249 |
$87K |
| 99244 |
|
2,522 |
2,508 |
$85K |
| 93320 |
|
1,613 |
1,581 |
$82K |
| Z4310 |
|
6,193 |
6,145 |
$81K |
| 99368 |
|
3,841 |
2,311 |
$81K |
| J1100 |
Dexamethasone sodium phos |
46,359 |
35,890 |
$81K |
| J2405 |
Ondansetron hcl injection |
30,974 |
25,118 |
$81K |
| 92555 |
|
3,420 |
3,404 |
$80K |
| 82784 |
|
7,632 |
7,296 |
$80K |
| 82570 |
|
8,827 |
8,243 |
$78K |
| 99212 |
|
3,928 |
3,715 |
$78K |
| 97530 |
|
1,208 |
868 |
$77K |
| 87505 |
|
2,226 |
2,193 |
$73K |
| 96450 |
|
278 |
266 |
$72K |
| 93229 |
|
264 |
263 |
$72K |
| 76815 |
|
1,896 |
1,678 |
$70K |
| 70360 |
|
4,049 |
3,987 |
$69K |
| 74019 |
|
4,676 |
4,588 |
$69K |
| T1999 |
Noc retail items andsupplies |
26,515 |
18,009 |
$68K |
| 73130 |
|
4,104 |
3,834 |
$67K |
| 87081 |
|
12,254 |
12,142 |
$67K |
| 73560 |
|
2,731 |
2,378 |
$66K |
| 86160 |
|
2,957 |
1,636 |
$66K |
| 82306 |
|
9,780 |
9,667 |
$66K |
| 0636 |
|
2,635 |
1,651 |
$65K |
| 85045 |
|
6,541 |
5,984 |
$65K |
| 87186 |
|
6,869 |
6,293 |
$65K |
| J2704 |
Inj, propofol, 10 mg |
16,920 |
12,771 |
$65K |
| J3010 |
Fentanyl citrate injection |
24,110 |
17,485 |
$63K |
| 85240 |
|
2,845 |
2,606 |
$63K |
| 83970 |
|
1,342 |
1,317 |
$62K |
| 92522 |
|
949 |
948 |
$61K |
| 76825 |
|
1,215 |
1,192 |
$61K |
| 85397 |
|
2,493 |
2,429 |
$61K |
| 88304 |
|
6,157 |
5,704 |
$60K |
| 0270 |
|
48,255 |
32,581 |
$58K |
| 96409 |
|
2,250 |
1,892 |
$57K |
| 85246 |
|
2,534 |
2,467 |
$57K |
| 73564 |
|
1,789 |
1,629 |
$57K |
| 94664 |
|
3,885 |
3,861 |
$56K |
| 87040 |
|
4,753 |
4,474 |
$55K |
| 73110 |
|
3,083 |
2,760 |
$53K |
| 87798 |
|
3,573 |
3,466 |
$52K |
| V5010 |
Assessment for hearing aid |
574 |
573 |
$52K |
| 84156 |
|
7,529 |
6,992 |
$51K |
| 70220 |
|
1,495 |
1,483 |
$51K |
| 87077 |
|
7,411 |
6,623 |
$51K |
| 84466 |
|
3,761 |
3,685 |
$50K |
| 83540 |
|
3,859 |
3,782 |
$49K |
| V5008 |
Hearing screening |
759 |
756 |
$49K |
| J9370 |
Vincristine sulfate 1 mg inj |
3,573 |
2,369 |
$48K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
2,499 |
2,074 |
$46K |
| X4544 |
|
356 |
356 |
$43K |
| 82785 |
|
1,926 |
1,902 |
$43K |
| 74230 |
|
383 |
378 |
$43K |
| 74240 |
|
397 |
394 |
$43K |
| 87070 |
|
3,214 |
3,157 |
$42K |
| 83690 |
|
12,539 |
12,117 |
$42K |
| 73562 |
|
2,252 |
2,051 |
$41K |
| 73080 |
|
2,182 |
2,072 |
$40K |
| 87631 |
|
1,831 |
1,826 |
$40K |
| 92521 |
|
1,967 |
1,940 |
$40K |
| 86480 |
|
1,380 |
1,370 |
$39K |
| 80061 |
|
5,720 |
5,679 |
$39K |
| J0690 |
Cefazolin sodium injection |
7,599 |
5,880 |
$38K |
| 87581 |
|
2,455 |
2,376 |
$37K |
| G0378 |
Hospital observation per hr |
1,313 |
1,289 |
$37K |
| 76801 |
|
1,137 |
1,126 |
$37K |
| 87486 |
|
2,395 |
2,323 |
$36K |
| 96111 |
|
340 |
339 |
$36K |
| 76813 |
|
1,659 |
1,641 |
$36K |
| 93308 |
|
731 |
723 |
$35K |
| 73060 |
|
1,293 |
1,239 |
$34K |
| 87880 |
|
7,778 |
7,724 |
$34K |
| 97010 |
|
5,193 |
3,380 |
$34K |
| A9585 |
Gadobutrol injection |
1,665 |
1,045 |
$34K |
| 97161 |
|
986 |
564 |
$34K |
| 80307 |
|
4,533 |
4,415 |
$33K |
| 82803 |
|
3,367 |
3,210 |
$33K |
| 70486 |
|
275 |
274 |
$33K |
| 92611 |
|
275 |
268 |
$32K |
| 83735 |
|
5,115 |
4,400 |
$31K |
| 92570 |
|
2,182 |
2,162 |
$31K |
| J7030 |
Normal saline solution infus |
15,418 |
14,612 |
$29K |
| 84145 |
|
3,162 |
3,061 |
$29K |
| 73552 |
|
1,619 |
1,500 |
$29K |
| 95012 |
|
1,302 |
1,296 |
$29K |
| 83516 |
|
6,912 |
5,485 |
$29K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
4,005 |
3,611 |
$28K |
| 87430 |
|
5,577 |
5,516 |
$28K |
| 83605 |
|
3,206 |
3,055 |
$27K |
| 84305 |
|
1,285 |
1,280 |
$27K |
| G0480 |
Drug test def 1-7 classes |
2,326 |
2,018 |
$27K |
| 91065 |
|
1,194 |
1,079 |
$27K |
| Q9958 |
Hocm <=149 mg/ml iodine, 1ml |
1,265 |
1,207 |
$26K |
| 86171 |
|
1,976 |
1,765 |
$26K |
| 73030 |
|
1,427 |
1,336 |
$26K |
| 94760 |
|
11,649 |
11,451 |
$25K |
| 80197 |
|
1,414 |
1,099 |
$25K |
| 71045 |
|
2,297 |
2,206 |
$24K |
| 85384 |
|
731 |
718 |
$24K |
| 87635 |
|
2,450 |
2,439 |
$24K |
| 73620 |
|
1,153 |
889 |
$23K |
| X4540 |
|
714 |
714 |
$23K |
| 87799 |
|
418 |
325 |
$23K |
| X4110 |
|
766 |
493 |
$23K |
| 82330 |
|
3,471 |
3,279 |
$23K |
| 86635 |
|
2,212 |
2,172 |
$23K |
| 76885 |
|
283 |
276 |
$22K |
| 94644 |
|
1,670 |
1,529 |
$22K |
| 86850 |
|
1,800 |
1,730 |
$21K |
| Z7504 |
|
422 |
288 |
$21K |
| 83615 |
|
3,138 |
3,045 |
$21K |
| 54640 |
|
74 |
68 |
$21K |
| 84703 |
|
9,850 |
9,518 |
$21K |
| 73600 |
|
646 |
553 |
$20K |
| 93226 |
|
477 |
471 |
$20K |
| 92579 |
|
519 |
515 |
$19K |
| 97804 |
|
759 |
759 |
$19K |
| 76820 |
|
1,296 |
890 |
$19K |
| 87497 |
|
316 |
278 |
$19K |
| 70491 |
|
83 |
82 |
$19K |
| 86235 |
|
993 |
644 |
$19K |
| 86923 |
|
509 |
431 |
$18K |
| 80048 |
|
3,072 |
2,923 |
$18K |
| 82977 |
|
3,130 |
2,789 |
$18K |
| Z7512 |
|
673 |
666 |
$17K |
| 77072 |
|
1,135 |
1,132 |
$17K |
| 70543 |
|
14 |
14 |
$17K |
| 72100 |
|
1,166 |
1,162 |
$17K |
| 99204 |
|
443 |
438 |
$17K |
| Z4303 |
|
387 |
383 |
$17K |
| J7050 |
Normal saline solution infus |
3,502 |
3,013 |
$16K |
| 99243 |
|
182 |
182 |
$16K |
| 76010 |
|
1,101 |
1,089 |
$15K |
| 0324 |
|
187 |
184 |
$15K |
| 82610 |
|
1,090 |
1,074 |
$15K |
| 84550 |
|
2,491 |
2,442 |
$15K |
| 85027 |
|
2,200 |
2,159 |
$15K |
| 94621 |
|
102 |
102 |
$14K |
| X3920 |
|
278 |
278 |
$14K |
| 82947 |
|
4,938 |
4,438 |
$14K |
| 86901 |
|
2,689 |
1,742 |
$14K |
| 93225 |
|
481 |
473 |
$14K |
| 96367 |
|
291 |
266 |
$13K |
| 86900 |
|
2,602 |
1,694 |
$13K |
| 76821 |
|
355 |
319 |
$13K |
| X4304 |
|
400 |
196 |
$13K |
| 84100 |
|
3,040 |
2,760 |
$12K |
| 92556 |
|
156 |
156 |
$12K |
| 14040 |
|
29 |
27 |
$12K |
| 80076 |
|
1,439 |
1,358 |
$12K |
| X4500 |
|
123 |
123 |
$12K |
| 85390 |
|
1,107 |
1,085 |
$11K |
| Z7510 |
|
111 |
104 |
$11K |
| 82550 |
|
2,401 |
2,303 |
$11K |
| J2930 |
Methylprednisolone injection |
435 |
365 |
$11K |
| 86038 |
|
2,292 |
2,080 |
$11K |
| Z7508 |
|
184 |
175 |
$11K |
| Q9960 |
Hocm 200-249mg/ml iodine,1ml |
550 |
492 |
$11K |
| 84484 |
|
1,390 |
1,315 |
$11K |
| 99231 |
|
2,286 |
2,192 |
$11K |
| 87507 |
|
178 |
176 |
$11K |
| 29075 |
|
1,629 |
1,527 |
$11K |
| X4112 |
|
577 |
367 |
$11K |
| 86003 |
|
2,732 |
2,087 |
$10K |
| J0696 |
Ceftriaxone sodium injection |
3,324 |
2,681 |
$10K |
| 96372 |
|
2,228 |
1,979 |
$10K |
| 80074 |
|
571 |
566 |
$10K |
| J2270 |
Morphine sulfate injection |
3,917 |
3,304 |
$10K |
| 96379 |
|
3,031 |
2,754 |
$9K |
| 99199 |
|
153 |
150 |
$9K |
| 86359 |
|
567 |
545 |
$9K |
| 86357 |
|
558 |
536 |
$9K |
| 86355 |
|
557 |
535 |
$9K |
| 96366 |
|
363 |
244 |
$9K |
| 86360 |
|
557 |
535 |
$9K |
| 72040 |
|
621 |
616 |
$9K |
| 77073 |
|
200 |
200 |
$9K |
| 72197 |
|
18 |
16 |
$8K |
| 72125 |
|
33 |
33 |
$8K |
| 76882 |
|
327 |
312 |
$8K |
| S0020 |
Injection, bupivicaine hydro |
1,531 |
1,306 |
$8K |
| 77075 |
|
109 |
101 |
$8K |
| 70250 |
|
320 |
315 |
$8K |
| 88184 |
|
184 |
183 |
$8K |
| 86225 |
|
1,656 |
1,492 |
$8K |
| 87046 |
|
875 |
855 |
$8K |
| 73723 |
|
12 |
12 |
$8K |
| 84403 |
|
583 |
572 |
$8K |
| 71020 |
|
572 |
350 |
$7K |
| 86255 |
|
1,788 |
1,749 |
$7K |
| 84132 |
|
3,256 |
3,106 |
$7K |
| J9260 |
Inj methotrexate sodium 50mg |
915 |
506 |
$7K |
| 84295 |
|
3,177 |
3,039 |
$7K |
| X4530 |
|
149 |
149 |
$7K |
| J7040 |
Normal saline solution infus |
3,979 |
3,846 |
$7K |
| 83520 |
|
889 |
865 |
$7K |
| 83021 |
|
491 |
445 |
$7K |
| 82340 |
|
521 |
519 |
$6K |
| 70260 |
|
117 |
115 |
$6K |
| 84702 |
|
755 |
735 |
$6K |
| 96132 |
|
54 |
54 |
$6K |
| 99366 |
|
193 |
193 |
$6K |
| 87660 |
|
866 |
844 |
$5K |
| 54300 |
|
14 |
12 |
$5K |
| 93786 |
|
413 |
404 |
$5K |
| A9577 |
Inj multihance |
227 |
222 |
$5K |
| Z4309 |
|
215 |
215 |
$5K |
| 80180 |
|
1,016 |
918 |
$5K |
| J1885 |
Ketorolac tromethamine inj |
4,792 |
4,170 |
$5K |
| 86200 |
|
500 |
474 |
$5K |
| V5264 |
Ear mold/insert |
93 |
93 |
$5K |
| 87491 |
|
998 |
928 |
$5K |
| 87591 |
|
995 |
927 |
$5K |
| 86331 |
|
499 |
447 |
$5K |
| 84436 |
|
622 |
609 |
$5K |
| 83993 |
|
927 |
915 |
$5K |
| 84480 |
|
177 |
171 |
$4K |
| 86308 |
|
1,364 |
1,343 |
$4K |
| 82657 |
|
426 |
422 |
$4K |
| 54161 |
|
13 |
13 |
$4K |
| 90832 |
|
53 |
39 |
$4K |
| 86481 |
|
116 |
114 |
$4K |
| 87420 |
|
394 |
358 |
$4K |
| 89051 |
|
550 |
529 |
$4K |
| 88187 |
|
114 |
113 |
$4K |
| 82043 |
|
641 |
635 |
$4K |
| X4301 |
|
43 |
43 |
$4K |
| 85014 |
|
3,226 |
3,090 |
$4K |
| 86376 |
|
906 |
887 |
$4K |
| A4217 |
Sterile water/saline, 500 ml |
3,898 |
3,637 |
$4K |
| 82105 |
|
295 |
281 |
$4K |
| 82150 |
|
595 |
579 |
$4K |
| 90686 |
|
234 |
224 |
$4K |
| 86039 |
|
395 |
352 |
$4K |
| 90471 |
|
824 |
823 |
$4K |
| 87205 |
|
930 |
907 |
$3K |
| 76886 |
|
53 |
53 |
$3K |
| 85247 |
|
94 |
93 |
$3K |
| 0320 |
|
49 |
47 |
$3K |
| 0369 |
|
26 |
26 |
$3K |
| J7611 |
Albuterol non-comp con |
7,237 |
5,904 |
$3K |
| 96113 |
|
45 |
43 |
$3K |
| 88108 |
|
205 |
193 |
$3K |
| 86147 |
|
194 |
173 |
$3K |
| 86800 |
|
548 |
534 |
$3K |
| 76881 |
|
27 |
27 |
$3K |
| 86146 |
|
181 |
161 |
$3K |
| 93270 |
|
65 |
65 |
$3K |
| J7042 |
5% dextrose/normal saline |
1,486 |
1,316 |
$3K |
| 0271 |
|
288 |
276 |
$3K |
| 73660 |
|
527 |
515 |
$3K |
| 94729 |
|
24 |
24 |
$3K |
| 92550 |
|
76 |
75 |
$3K |
| 96415 |
|
61 |
57 |
$3K |
| 99070 |
|
3,001 |
1,757 |
$3K |
| 83880 |
|
216 |
211 |
$3K |
| 82533 |
|
97 |
79 |
$3K |
| 88185 |
|
118 |
117 |
$3K |
| 86431 |
|
742 |
711 |
$3K |
| 88104 |
|
339 |
325 |
$2K |
| Z9725 |
|
56 |
56 |
$2K |
| 59025 |
|
324 |
141 |
$2K |
| J2250 |
Inj midazolam hydrochloride |
2,446 |
2,213 |
$2K |
| 72070 |
|
195 |
194 |
$2K |
| 76000 |
|
41 |
40 |
$2K |
| 82103 |
|
460 |
436 |
$2K |
| 74183 |
|
13 |
13 |
$2K |
| X4535 |
|
43 |
43 |
$2K |
| 44970 |
|
12 |
12 |
$2K |
| 0300 |
|
18 |
17 |
$2K |
| X3908 |
|
63 |
27 |
$2K |
| 82272 |
|
323 |
316 |
$2K |
| 87389 |
|
156 |
151 |
$2K |
| 94645 |
|
400 |
367 |
$2K |
| 95812 |
|
13 |
13 |
$2K |
| 86777 |
|
99 |
95 |
$2K |
| 80195 |
|
124 |
73 |
$2K |
| J1200 |
Diphenhydramine hcl injectio |
1,382 |
1,307 |
$2K |
| 84520 |
|
192 |
189 |
$2K |
| 82248 |
|
1,279 |
1,054 |
$1K |
| J0780 |
Prochlorperazine injection |
840 |
813 |
$1K |
| V5267 |
Hearing aid sup/access/dev |
12 |
12 |
$1K |
| 82247 |
|
1,168 |
962 |
$1K |
| 82945 |
|
329 |
314 |
$1K |
| 82810 |
|
28 |
12 |
$1K |
| 76800 |
|
53 |
52 |
$1K |
| 85245 |
|
67 |
66 |
$1K |
| 84157 |
|
329 |
314 |
$1K |
| 76506 |
|
30 |
30 |
$1K |
| 76499 |
|
26 |
25 |
$1K |
| 74000 |
|
144 |
108 |
$1K |
| 81374 |
|
100 |
98 |
$981.03 |
| 42821 |
|
14 |
13 |
$934.39 |
| 86317 |
|
103 |
88 |
$928.03 |
| 96136 |
|
24 |
24 |
$921.36 |
| 96411 |
|
33 |
25 |
$903.24 |
| Z4302 |
|
71 |
70 |
$873.63 |
| Z5406 |
|
55 |
44 |
$843.50 |
| 94770 |
|
43 |
43 |
$826.46 |
| 86592 |
|
325 |
309 |
$810.02 |
| 84446 |
|
81 |
81 |
$789.75 |
| 73120 |
|
58 |
51 |
$769.14 |
| 83002 |
|
476 |
462 |
$712.52 |
| 77080 |
|
26 |
26 |
$698.21 |
| 86664 |
|
512 |
501 |
$688.95 |
| 82565 |
|
161 |
157 |
$667.85 |
| 84590 |
|
56 |
56 |
$658.00 |
| X3910 |
|
35 |
14 |
$649.44 |
| J2272 |
Inj, morphine (fresenius) |
631 |
602 |
$647.50 |
| 45380 |
|
12 |
12 |
$643.90 |
| 83001 |
|
382 |
360 |
$627.20 |
| 83655 |
|
704 |
699 |
$613.90 |
| 86902 |
|
52 |
48 |
$606.03 |
| J7613 |
Albuterol non-comp unit |
4,577 |
4,125 |
$595.28 |
| 85379 |
|
103 |
102 |
$574.75 |
| 96040 |
|
31 |
29 |
$571.20 |
| 85290 |
|
25 |
25 |
$559.99 |
| Z5910 |
|
12 |
12 |
$559.44 |
| G0108 |
Diab manage trn per indiv |
12 |
12 |
$548.88 |
| 86665 |
|
495 |
489 |
$545.29 |
| 74020 |
|
48 |
43 |
$526.92 |
| 84402 |
|
57 |
55 |
$435.00 |
| S0077 |
Injection, clindamycin phosp |
182 |
136 |
$434.92 |
| 98960 |
|
26 |
26 |
$428.05 |
| 82670 |
|
205 |
200 |
$425.02 |
| 85230 |
|
13 |
13 |
$424.86 |
| 87101 |
|
36 |
36 |
$404.26 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
245 |
161 |
$394.53 |
| 82104 |
|
137 |
136 |
$386.00 |
| 82270 |
|
179 |
175 |
$381.10 |
| 93271 |
|
13 |
13 |
$368.34 |
| 83498 |
|
58 |
54 |
$360.40 |
| 96127 |
|
24 |
24 |
$350.37 |
| 71010 |
|
43 |
27 |
$349.07 |
| 87184 |
|
27 |
27 |
$342.30 |
| 74220 |
|
13 |
13 |
$305.43 |
| 82390 |
|
302 |
298 |
$292.50 |
| 82435 |
|
117 |
115 |
$273.73 |
| 84460 |
|
43 |
42 |
$209.95 |
| 84450 |
|
41 |
40 |
$206.21 |
| J0171 |
Adrenalin epinephrine inject |
109 |
97 |
$191.56 |
| 87338 |
|
413 |
410 |
$184.46 |
| 84681 |
|
61 |
61 |
$183.00 |
| 87206 |
|
23 |
23 |
$182.64 |
| 91200 |
|
14 |
14 |
$179.36 |
| 96376 |
|
128 |
94 |
$162.91 |
| 84244 |
|
38 |
38 |
$162.25 |
| 82652 |
|
13 |
12 |
$128.00 |
| 87340 |
|
81 |
80 |
$120.96 |
| 82157 |
|
16 |
15 |
$115.28 |
| 83525 |
|
13 |
13 |
$108.61 |
| 84146 |
|
28 |
27 |
$104.80 |
| Q4051 |
Splint supplies misc |
501 |
481 |
$104.62 |
| 87177 |
|
132 |
118 |
$103.73 |
| 83625 |
|
173 |
170 |
$102.34 |
| J1953 |
Levetiracetam injection |
39 |
28 |
$101.64 |
| 84478 |
|
42 |
38 |
$84.26 |
| 72110 |
|
13 |
13 |
$74.87 |
| 87328 |
|
36 |
36 |
$65.72 |
| 82040 |
|
14 |
14 |
$60.71 |
| 86803 |
|
24 |
24 |
$49.60 |
| 93788 |
|
16 |
16 |
$48.99 |
| J0736 |
Inj, clindamycin phosp 300mg |
18 |
12 |
$46.89 |
| 86663 |
|
42 |
38 |
$45.69 |
| 82627 |
|
29 |
29 |
$43.20 |
| Q0162 |
Ondansetron oral |
4,066 |
4,022 |
$32.22 |
| T5999 |
Supply, nos |
38 |
37 |
$30.38 |
| 82607 |
|
24 |
24 |
$22.80 |
| J2765 |
Metoclopramide hcl injection |
12 |
12 |
$13.94 |
| J8499 |
Oral prescrip drug non chemo |
245 |
179 |
$9.14 |
| 70160 |
|
33 |
33 |
$0.00 |
| 29065 |
|
668 |
654 |
$0.00 |
| 29405 |
|
60 |
52 |
$0.00 |
| 94762 |
|
70 |
69 |
$0.00 |
| A4216 |
Sterile water/saline, 10 ml |
14 |
14 |
$0.00 |