| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
74,183 |
62,526 |
$10.98M |
| 99284 |
|
45,397 |
37,929 |
$7.15M |
| 97110 |
|
140,286 |
35,493 |
$5.67M |
| 99285 |
|
30,743 |
25,217 |
$5.10M |
| 97530 |
|
94,051 |
27,547 |
$5.02M |
| 96361 |
|
15,198 |
11,912 |
$3.79M |
| 99282 |
|
26,962 |
22,642 |
$3.47M |
| 74177 |
|
10,223 |
8,857 |
$2.10M |
| 96366 |
|
7,166 |
4,956 |
$1.91M |
| 70450 |
|
11,410 |
9,777 |
$1.86M |
| 97162 |
|
12,541 |
11,523 |
$1.38M |
| 96365 |
|
13,539 |
9,476 |
$1.36M |
| 97112 |
|
94,472 |
26,552 |
$1.07M |
| J2357 |
Omalizumab injection |
2,475 |
686 |
$970K |
| 97161 |
|
7,658 |
6,988 |
$877K |
| 99281 |
|
6,761 |
6,024 |
$854K |
| G0463 |
Hospital outpt clinic visit |
17,786 |
12,352 |
$841K |
| 74176 |
|
4,531 |
3,860 |
$741K |
| 80307 |
|
16,071 |
13,052 |
$688K |
| 71275 |
|
3,257 |
2,873 |
$661K |
| 97535 |
|
20,067 |
10,192 |
$627K |
| 96360 |
|
5,129 |
4,201 |
$543K |
| 93306 |
|
1,971 |
1,743 |
$542K |
| 72148 |
|
2,884 |
2,649 |
$517K |
| 77067 |
|
11,325 |
10,907 |
$515K |
| G0378 |
Hospital observation per hr |
4,510 |
2,562 |
$507K |
| 43239 |
|
1,184 |
985 |
$491K |
| 45385 |
|
958 |
839 |
$480K |
| 94640 |
|
8,817 |
5,363 |
$460K |
| 73721 |
|
2,326 |
2,076 |
$439K |
| 76642 |
|
4,417 |
3,516 |
$417K |
| 70551 |
|
1,826 |
1,655 |
$374K |
| 93975 |
|
4,196 |
3,701 |
$360K |
| 96413 |
|
4,228 |
2,213 |
$359K |
| 70553 |
|
1,142 |
1,025 |
$325K |
| J0517 |
Inj., benralizumab, 1 mg |
238 |
201 |
$319K |
| 87635 |
|
6,975 |
6,101 |
$313K |
| 76705 |
|
3,472 |
3,147 |
$305K |
| 80053 |
|
77,557 |
62,563 |
$291K |
| 97014 |
|
9,597 |
3,573 |
$283K |
| 71046 |
|
22,205 |
19,332 |
$264K |
| 45380 |
|
496 |
434 |
$239K |
| 93971 |
|
2,763 |
2,439 |
$239K |
| 45378 |
|
341 |
309 |
$220K |
| 97113 |
|
4,648 |
1,346 |
$214K |
| 72141 |
|
1,324 |
1,216 |
$210K |
| 76830 |
|
2,633 |
2,383 |
$201K |
| 78815 |
|
275 |
247 |
$190K |
| 73221 |
|
991 |
856 |
$188K |
| 97116 |
|
11,936 |
4,813 |
$187K |
| 77063 |
|
8,898 |
8,612 |
$172K |
| 92507 |
|
2,385 |
553 |
$152K |
| 78452 |
|
308 |
262 |
$148K |
| 93005 |
|
47,503 |
37,625 |
$146K |
| 99211 |
|
1,320 |
1,167 |
$143K |
| J1439 |
Inj ferric carboxymaltos 1mg |
1,241 |
715 |
$140K |
| P9016 |
Rbc leukocytes reduced |
533 |
413 |
$139K |
| 76856 |
|
1,441 |
1,314 |
$137K |
| J9271 |
Inj pembrolizumab |
56 |
36 |
$137K |
| 96415 |
|
700 |
410 |
$136K |
| 87591 |
|
14,484 |
12,743 |
$130K |
| U0003 |
Cov-19 amp prb hgh thruput |
6,390 |
5,674 |
$128K |
| 71250 |
|
2,182 |
1,921 |
$128K |
| 80048 |
|
31,585 |
24,781 |
$121K |
| 76536 |
|
1,118 |
1,051 |
$116K |
| 93970 |
|
1,070 |
936 |
$116K |
| 76770 |
|
1,028 |
945 |
$113K |
| 80061 |
|
16,313 |
15,296 |
$110K |
| 97165 |
|
1,986 |
1,723 |
$108K |
| 0202U |
|
1,066 |
977 |
$104K |
| 72125 |
|
3,132 |
2,761 |
$102K |
| 12001 |
|
530 |
477 |
$100K |
| 85025 |
|
100,261 |
75,130 |
$100K |
| 64483 |
|
178 |
152 |
$99K |
| J1756 |
Iron sucrose injection |
3,155 |
1,642 |
$99K |
| 97140 |
|
20,879 |
6,815 |
$95K |
| 96367 |
|
2,174 |
1,446 |
$94K |
| 82306 |
|
6,683 |
6,266 |
$94K |
| 77066 |
Tomosynthesis, mammo |
2,565 |
2,316 |
$87K |
| 71271 |
|
832 |
782 |
$83K |
| 77065 |
Tomosynthesis, mammo |
2,498 |
2,086 |
$82K |
| 71260 |
|
2,328 |
2,056 |
$81K |
| 84443 |
|
9,875 |
9,050 |
$80K |
| 97163 |
|
545 |
493 |
$76K |
| 36415 |
|
46,840 |
37,266 |
$73K |
| 77412 |
|
143 |
16 |
$73K |
| 97166 |
|
805 |
711 |
$73K |
| 76817 |
|
1,971 |
1,683 |
$72K |
| 83036 |
|
14,811 |
13,514 |
$70K |
| 10060 |
|
515 |
450 |
$70K |
| J2469 |
Palonosetron hcl |
792 |
412 |
$69K |
| 83880 |
|
8,865 |
7,271 |
$67K |
| 36430 |
|
761 |
537 |
$65K |
| J2505 |
Injection, pegfilgrastim 6mg |
43 |
26 |
$65K |
| 93458 |
|
62 |
43 |
$65K |
| 59025 |
|
717 |
485 |
$64K |
| 70498 |
|
394 |
344 |
$64K |
| 96372 |
|
25,364 |
18,355 |
$63K |
| 87491 |
|
14,340 |
12,606 |
$63K |
| 97016 |
|
2,349 |
751 |
$62K |
| 71045 |
|
22,886 |
18,513 |
$58K |
| 95810 |
|
111 |
101 |
$56K |
| 97035 |
|
1,966 |
767 |
$55K |
| 70486 |
|
1,362 |
1,239 |
$54K |
| J2182 |
Injection, mepolizumab, 1mg |
94 |
65 |
$54K |
| 70491 |
|
324 |
300 |
$53K |
| 93017 |
|
586 |
510 |
$53K |
| 97018 |
|
2,501 |
731 |
$52K |
| 19083 |
|
51 |
40 |
$51K |
| 72100 |
|
2,686 |
2,409 |
$49K |
| 96523 |
|
620 |
518 |
$47K |
| 87624 |
|
1,807 |
1,711 |
$45K |
| 77080 |
|
825 |
753 |
$43K |
| 90715 |
|
2,525 |
2,254 |
$42K |
| 99213 |
|
277 |
254 |
$42K |
| 88175 |
|
2,333 |
2,205 |
$41K |
| 86803 |
|
3,697 |
3,469 |
$41K |
| 87040 |
|
7,536 |
3,619 |
$41K |
| 80050 |
|
4,333 |
4,033 |
$38K |
| 96374 |
|
36,403 |
27,513 |
$38K |
| 73030 |
|
3,937 |
3,335 |
$35K |
| 72110 |
|
1,236 |
1,136 |
$35K |
| 87661 |
|
5,947 |
5,361 |
$35K |
| J1200 |
Diphenhydramine hcl injectio |
7,006 |
4,917 |
$35K |
| G0279 |
Tomosynthesis, mammo |
1,454 |
1,324 |
$32K |
| 99202 |
|
216 |
211 |
$32K |
| 74246 |
|
299 |
273 |
$31K |
| 73562 |
|
3,078 |
2,521 |
$30K |
| 84439 |
|
5,053 |
4,679 |
$30K |
| 95811 |
|
55 |
52 |
$29K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
1,581 |
1,287 |
$28K |
| 12011 |
|
157 |
138 |
$28K |
| 84484 |
|
35,585 |
22,341 |
$26K |
| 77336 |
|
324 |
135 |
$26K |
| 82607 |
|
3,550 |
3,272 |
$26K |
| 77002 |
|
192 |
165 |
$26K |
| 82728 |
|
4,430 |
4,028 |
$26K |
| 95800 |
|
162 |
155 |
$25K |
| 91200 |
|
333 |
311 |
$25K |
| 76805 |
|
318 |
298 |
$25K |
| 73630 |
|
3,782 |
3,194 |
$25K |
| 82553 |
|
10,877 |
7,492 |
$25K |
| 76815 |
|
436 |
381 |
$25K |
| 73700 |
|
283 |
236 |
$25K |
| J3490 |
Drugs unclassified injection |
14,453 |
8,531 |
$24K |
| 62323 |
|
62 |
54 |
$24K |
| 49083 |
|
37 |
12 |
$22K |
| 85027 |
|
7,627 |
6,399 |
$22K |
| 43235 |
|
66 |
52 |
$22K |
| 73502 |
|
2,186 |
1,929 |
$22K |
| 73610 |
|
3,274 |
2,831 |
$21K |
| 99212 |
|
143 |
131 |
$21K |
| 72040 |
|
1,054 |
977 |
$21K |
| 97802 |
|
517 |
508 |
$20K |
| 70496 |
|
361 |
319 |
$20K |
| J0401 |
Inj, abilify maintena, 1 mg |
29 |
25 |
$20K |
| 85379 |
|
4,858 |
4,217 |
$19K |
| 73130 |
|
3,059 |
2,558 |
$19K |
| 97032 |
|
443 |
210 |
$19K |
| 99214 |
|
135 |
123 |
$19K |
| 76942 |
|
336 |
300 |
$18K |
| 73564 |
|
1,623 |
1,310 |
$18K |
| 87389 |
|
2,538 |
2,348 |
$17K |
| 77062 |
|
1,086 |
1,022 |
$17K |
| 74018 |
|
1,793 |
1,491 |
$17K |
| 97803 |
|
410 |
339 |
$17K |
| 90471 |
|
3,342 |
2,902 |
$16K |
| 76700 |
|
132 |
128 |
$15K |
| 83550 |
|
4,174 |
3,846 |
$15K |
| 76937 |
|
408 |
324 |
$15K |
| 76801 |
|
183 |
165 |
$14K |
| 87636 |
|
7,882 |
6,996 |
$14K |
| 83540 |
|
4,831 |
4,444 |
$13K |
| 90677 |
|
166 |
150 |
$13K |
| 12002 |
|
65 |
57 |
$13K |
| 82746 |
|
2,531 |
2,337 |
$13K |
| 80076 |
|
4,489 |
3,750 |
$13K |
| 95819 |
|
66 |
62 |
$13K |
| 73560 |
|
1,192 |
892 |
$12K |
| 77061 |
|
826 |
790 |
$12K |
| 74183 |
|
33 |
33 |
$12K |
| 87086 |
|
11,755 |
9,759 |
$12K |
| 82570 |
|
4,070 |
3,777 |
$12K |
| 81001 |
|
37,654 |
31,399 |
$12K |
| J7050 |
Normal saline solution infus |
13,820 |
7,633 |
$11K |
| 99203 |
|
89 |
85 |
$11K |
| 81025 |
|
26,527 |
22,505 |
$11K |
| J1453 |
Fosaprepitant injection |
139 |
84 |
$11K |
| 64450 |
|
104 |
95 |
$11K |
| U0005 |
Infec agen detec ampli probe |
4,629 |
4,213 |
$10K |
| 94729 |
|
368 |
332 |
$10K |
| C1776 |
Joint device (implantable) |
135 |
99 |
$10K |
| J1885 |
Ketorolac tromethamine inj |
16,635 |
13,373 |
$10K |
| 73110 |
|
1,439 |
1,243 |
$10K |
| J7030 |
Normal saline solution infus |
27,626 |
20,929 |
$10K |
| 88305 |
|
5,565 |
4,483 |
$10K |
| 85652 |
|
2,280 |
1,962 |
$10K |
| 83970 |
|
563 |
491 |
$10K |
| G0008 |
Admin influenza virus vac |
528 |
424 |
$9K |
| 87798 |
|
496 |
441 |
$9K |
| 29125 |
|
84 |
78 |
$9K |
| 84153 |
|
982 |
936 |
$9K |
| J0885 |
Epoetin alfa, non-esrd |
91 |
24 |
$9K |
| 82565 |
|
4,786 |
4,095 |
$9K |
| 82043 |
|
3,688 |
3,462 |
$9K |
| 83605 |
|
7,528 |
5,793 |
$9K |
| 99204 |
|
62 |
58 |
$8K |
| 97012 |
|
302 |
105 |
$8K |
| 77334 |
|
43 |
30 |
$8K |
| 99218 |
|
980 |
573 |
$8K |
| 86850 |
|
4,565 |
3,751 |
$8K |
| 81003 |
|
17,792 |
15,032 |
$8K |
| J2405 |
Ondansetron hcl injection |
23,252 |
17,524 |
$8K |
| 83735 |
|
21,087 |
16,532 |
$8K |
| 86140 |
|
2,128 |
1,667 |
$7K |
| 76870 |
|
88 |
76 |
$7K |
| 85610 |
|
10,326 |
8,363 |
$7K |
| 96375 |
|
25,582 |
18,385 |
$7K |
| J2270 |
Morphine sulfate injection |
11,780 |
8,096 |
$7K |
| 90674 |
|
260 |
244 |
$7K |
| 82962 |
|
24,098 |
11,184 |
$7K |
| 87801 |
|
309 |
295 |
$6K |
| 92610 |
|
144 |
125 |
$6K |
| 73140 |
|
1,129 |
1,028 |
$6K |
| 93798 |
|
87 |
13 |
$6K |
| 94060 |
|
111 |
103 |
$6K |
| J1642 |
Inj heparin sodium per 10 u |
8,285 |
3,408 |
$6K |
| 93976 |
|
56 |
51 |
$6K |
| 90791 |
|
32 |
26 |
$6K |
| 72158 |
|
13 |
12 |
$6K |
| J1100 |
Dexamethasone sodium phos |
10,867 |
7,890 |
$5K |
| 86900 |
|
5,440 |
4,527 |
$5K |
| 94726 |
|
155 |
147 |
$5K |
| 77280 |
|
19 |
15 |
$5K |
| 72070 |
|
366 |
337 |
$5K |
| G0009 |
Admin pneumococcal vaccine |
187 |
169 |
$5K |
| 77295 |
|
16 |
12 |
$5K |
| 72050 |
|
148 |
143 |
$4K |
| 85730 |
|
5,700 |
4,520 |
$4K |
| 36591 |
|
488 |
331 |
$4K |
| J7120 |
Ringers lactate infusion |
14,896 |
10,618 |
$4K |
| G0283 |
Elec stim other than wound |
123 |
41 |
$4K |
| 84425 |
|
405 |
386 |
$4K |
| 93308 |
|
17 |
15 |
$4K |
| 84436 |
|
496 |
470 |
$4K |
| 80047 |
|
1,194 |
856 |
$4K |
| 84702 |
|
4,452 |
3,635 |
$4K |
| 82550 |
|
12,667 |
8,788 |
$4K |
| 90714 |
|
183 |
163 |
$4K |
| 74178 |
|
16 |
15 |
$4K |
| 80143 |
|
1,345 |
1,171 |
$3K |
| 72131 |
|
78 |
67 |
$3K |
| 96417 |
|
503 |
299 |
$3K |
| J2250 |
Inj midazolam hydrochloride |
9,839 |
7,492 |
$3K |
| 80179 |
|
1,303 |
1,140 |
$3K |
| 86592 |
|
599 |
562 |
$3K |
| G0103 |
Psa screening |
311 |
289 |
$3K |
| 73590 |
|
834 |
715 |
$3K |
| 86923 |
|
317 |
223 |
$3K |
| 86901 |
|
5,437 |
4,527 |
$3K |
| 94762 |
|
1,348 |
1,142 |
$3K |
| 80164 |
|
422 |
353 |
$3K |
| 64415 |
|
19 |
12 |
$3K |
| Q5106 |
Inj retacrit non-esrd use |
48 |
12 |
$3K |
| 87077 |
|
4,249 |
3,425 |
$3K |
| C1894 |
Intro/sheath, non-laser |
2,170 |
1,626 |
$3K |
| 83690 |
|
20,096 |
16,333 |
$3K |
| 95816 |
|
12 |
12 |
$3K |
| 85014 |
|
1,824 |
1,295 |
$3K |
| 29515 |
|
13 |
12 |
$3K |
| 84703 |
|
9,474 |
8,217 |
$2K |
| 86780 |
|
310 |
277 |
$2K |
| 95806 |
|
14 |
14 |
$2K |
| 93922 |
|
36 |
27 |
$2K |
| 82077 |
|
7,849 |
6,232 |
$2K |
| J3010 |
Fentanyl citrate injection |
11,558 |
8,289 |
$2K |
| U0002 |
Covid-19 lab test non-cdc |
302 |
262 |
$2K |
| 43450 |
|
48 |
40 |
$2K |
| 92526 |
|
69 |
38 |
$2K |
| 87070 |
|
5,123 |
4,321 |
$2K |
| 99152 |
|
2,366 |
1,822 |
$2K |
| 74022 |
|
496 |
426 |
$2K |
| 87340 |
|
596 |
539 |
$2K |
| 84550 |
|
1,091 |
967 |
$2K |
| 20610 |
|
14 |
12 |
$2K |
| 73080 |
|
403 |
363 |
$2K |
| 73620 |
|
299 |
242 |
$2K |
| 87186 |
|
3,880 |
3,106 |
$2K |
| 80069 |
|
354 |
320 |
$2K |
| 77300 |
|
35 |
29 |
$2K |
| 86706 |
|
338 |
308 |
$2K |
| J7040 |
Normal saline solution infus |
4,379 |
3,066 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
10,156 |
7,770 |
$2K |
| 74240 |
|
16 |
14 |
$2K |
| J3475 |
Inj magnesium sulfate |
2,337 |
1,824 |
$2K |
| 74019 |
|
137 |
120 |
$1K |
| 87804 |
|
11,476 |
5,127 |
$1K |
| J1650 |
Inj enoxaparin sodium |
2,456 |
1,174 |
$1K |
| 88304 |
|
816 |
687 |
$1K |
| 87210 |
|
9,346 |
8,096 |
$1K |
| 96376 |
|
8,528 |
5,188 |
$1K |
| G0297 |
Ldct for lung ca screen |
14 |
13 |
$1K |
| C1769 |
Guide wire |
2,351 |
1,792 |
$1K |
| 73090 |
|
290 |
256 |
$1K |
| 88307 |
|
127 |
95 |
$1K |
| 90750 |
|
13 |
12 |
$1K |
| 97164 |
|
39 |
35 |
$1K |
| 84100 |
|
2,265 |
1,591 |
$1K |
| 87880 |
|
6,497 |
5,759 |
$990.33 |
| J2001 |
Lidocaine injection |
3,359 |
2,405 |
$901.53 |
| J2930 |
Methylprednisolone injection |
2,828 |
2,134 |
$882.58 |
| 80177 |
|
240 |
207 |
$840.21 |
| J0690 |
Cefazolin sodium injection |
6,008 |
3,987 |
$820.19 |
| 73120 |
|
61 |
53 |
$776.29 |
| 87081 |
|
2,300 |
2,077 |
$769.73 |
| 83615 |
|
177 |
135 |
$761.03 |
| 90686 |
|
204 |
137 |
$750.27 |
| J2704 |
Inj, propofol, 10 mg |
14,887 |
9,775 |
$749.82 |
| J1940 |
Furosemide injection |
1,301 |
942 |
$690.88 |
| J7512 |
Prednisone ir or dr oral 1mg |
1,799 |
1,394 |
$680.77 |
| J1170 |
Hydromorphone injection |
6,948 |
3,945 |
$633.11 |
| 85045 |
|
518 |
309 |
$632.56 |
| 99153 |
Mod sedat endo service >5yrs |
1,464 |
1,151 |
$618.56 |
| 82040 |
|
223 |
200 |
$612.09 |
| 87205 |
|
887 |
674 |
$607.88 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
19,530 |
16,590 |
$550.80 |
| J2060 |
Lorazepam injection |
2,998 |
2,214 |
$547.97 |
| J2543 |
Piperacillin/tazobactam |
1,258 |
648 |
$450.41 |
| J1644 |
Inj heparin sodium per 1000u |
4,653 |
2,167 |
$445.19 |
| 82803 |
|
1,091 |
878 |
$442.82 |
| 84145 |
|
538 |
468 |
$441.39 |
| 87088 |
|
271 |
243 |
$361.85 |
| 84132 |
|
1,481 |
1,142 |
$361.81 |
| 86480 |
|
14 |
14 |
$350.27 |
| J3480 |
Inj potassium chloride |
2,216 |
1,296 |
$341.73 |
| J2765 |
Metoclopramide hcl injection |
2,414 |
2,069 |
$323.96 |
| J1815 |
Insulin injection |
1,020 |
573 |
$317.12 |
| 86431 |
|
29 |
26 |
$315.71 |
| J2550 |
Promethazine hcl injection |
1,091 |
729 |
$314.91 |
| 87147 |
|
1,739 |
1,249 |
$309.55 |
| 74230 |
|
20 |
12 |
$296.48 |
| 84520 |
|
1,085 |
776 |
$289.55 |
| 80074 |
|
26 |
25 |
$278.41 |
| L3908 |
Who cock-up nonmolde pre ots |
33 |
30 |
$251.25 |
| 73600 |
|
86 |
64 |
$237.15 |
| J3370 |
Vancomycin hcl injection |
2,860 |
1,722 |
$225.97 |
| G0480 |
Drug test def 1-7 classes |
12 |
12 |
$191.30 |
| 88342 |
|
144 |
102 |
$180.21 |
| 36600 |
|
81 |
63 |
$176.33 |
| 73552 |
|
60 |
55 |
$162.07 |
| 82330 |
|
282 |
241 |
$159.13 |
| 82947 |
|
1,284 |
992 |
$156.54 |
| 87651 |
|
339 |
328 |
$150.13 |
| 84480 |
|
25 |
24 |
$146.49 |
| 86235 |
|
15 |
14 |
$145.81 |
| 86920 |
|
94 |
58 |
$144.44 |
| 85018 |
|
301 |
171 |
$142.92 |
| 82435 |
|
969 |
712 |
$132.40 |
| J0330 |
Succinycholine chloride inj |
2,991 |
2,465 |
$131.96 |
| 51798 |
|
42 |
26 |
$131.96 |
| 92611 |
|
20 |
12 |
$129.67 |
| 82274 |
|
13 |
13 |
$119.24 |
| J0360 |
Hydralazine hcl injection |
597 |
427 |
$114.63 |
| 71101 |
|
40 |
38 |
$113.25 |
| J1953 |
Levetiracetam injection |
755 |
556 |
$111.74 |
| 90694 |
|
17 |
13 |
$106.78 |
| 86038 |
|
29 |
27 |
$103.76 |
| 82784 |
|
14 |
14 |
$98.08 |
| A9552 |
F18 fdg |
269 |
245 |
$92.69 |
| 84165 |
|
27 |
25 |
$92.62 |
| J0561 |
Penicillin g benzathine inj |
15 |
15 |
$84.55 |
| J2310 |
Inj naloxone hydrochloride |
405 |
309 |
$82.77 |
| C9113 |
Inj pantoprazole sodium, via |
1,641 |
1,090 |
$82.55 |
| 94761 |
|
4,688 |
3,230 |
$82.43 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
1,179 |
1,035 |
$82.26 |
| 86787 |
|
12 |
12 |
$75.45 |
| J0780 |
Prochlorperazine injection |
1,552 |
1,346 |
$67.81 |
| 73660 |
|
55 |
51 |
$64.51 |
| J2795 |
Ropivacaine hcl injection |
1,985 |
1,141 |
$62.78 |
| 82140 |
|
94 |
74 |
$61.46 |
| 84295 |
|
1,065 |
794 |
$60.84 |
| 86225 |
|
13 |
12 |
$59.60 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
1,963 |
1,643 |
$58.73 |
| J2710 |
Neostigmine methylslfte inj |
1,533 |
1,302 |
$54.94 |
| C1725 |
Cath, translumin non-laser |
119 |
93 |
$47.51 |
| J2370 |
Phenylephrine hcl injection |
857 |
632 |
$41.24 |
| J1630 |
Haloperidol injection |
714 |
548 |
$36.69 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
618 |
528 |
$33.56 |
| 73100 |
|
31 |
28 |
$31.76 |
| J7510 |
Prednisolone oral per 5 mg |
234 |
218 |
$22.71 |
| 82150 |
|
18 |
12 |
$21.64 |
| J0171 |
Adrenalin epinephrine inject |
458 |
362 |
$19.19 |
| J3411 |
Thiamine hcl 100 mg |
349 |
241 |
$18.74 |
| 84156 |
|
12 |
12 |
$15.45 |
| Q9969 |
Non-heu tc-99m add-on/dose |
1,830 |
1,533 |
$14.23 |
| 90653 |
|
37 |
22 |
$13.70 |
| 96368 |
|
214 |
157 |
$7.22 |
| 82272 |
|
87 |
74 |
$5.92 |
| J8540 |
Oral dexamethasone |
223 |
201 |
$3.72 |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
201 |
172 |
$3.22 |
| J3420 |
Vitamin b12 injection |
195 |
152 |
$2.45 |
| J0692 |
Cefepime hcl for injection |
20 |
12 |
$2.28 |
| J1956 |
Levofloxacin injection |
56 |
26 |
$1.49 |
| J0744 |
Ciprofloxacin iv |
21 |
12 |
$1.14 |
| C9290 |
Inj, bupivacaine liposome |
485 |
407 |
$0.34 |
| J0688 |
Inj cefazolin sodium, hikma |
595 |
524 |
$0.30 |
| A9270 |
Non-covered item or service |
3,904 |
1,500 |
$0.14 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
493 |
381 |
$0.06 |
| A4648 |
Implantable tissue marker |
409 |
332 |
$0.00 |
| C1781 |
Mesh (implantable) |
91 |
81 |
$0.00 |
| J0500 |
Dicyclomine injection |
103 |
97 |
$0.00 |
| A4217 |
Sterile water/saline, 500 ml |
837 |
584 |
$0.00 |
| A9500 |
Tc99m sestamibi |
198 |
169 |
$0.00 |
| Q0162 |
Ondansetron oral |
268 |
246 |
$0.00 |
| J2785 |
Regadenoson injection |
213 |
173 |
$0.00 |
| G8980 |
Mobility d/c status |
102 |
77 |
$0.00 |
| J1920 |
Inj, labetalol hcl, 5mg |
144 |
114 |
$0.00 |
| A9585 |
Gadobutrol injection |
30 |
25 |
$0.00 |
| 96377 |
|
17 |
12 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
120 |
102 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
95 |
78 |
$0.00 |
| G8982 |
Body pos goal status |
18 |
12 |
$0.00 |
| J2305 |
Inj, nitroglycerin, 5 mg |
17 |
15 |
$0.00 |
| J1805 |
Inj, esmolol hcl, 10mg |
37 |
32 |
$0.00 |
| 94760 |
|
13 |
12 |
$0.00 |
| 96411 |
|
27 |
12 |
$0.00 |
| A9503 |
Tc99m medronate |
12 |
12 |
$0.00 |
| 73060 |
|
13 |
12 |
$0.00 |
| G8978 |
Mobility current status |
622 |
417 |
$0.00 |
| C1729 |
Cath, drainage |
349 |
290 |
$0.00 |
| 76981 |
|
17 |
14 |
$0.00 |
| G8984 |
Carry current status |
50 |
39 |
$0.00 |
| A9502 |
Tc99m tetrofosmin |
115 |
98 |
$0.00 |
| A9576 |
Inj prohance multipack |
80 |
70 |
$0.00 |
| 93325 |
|
18 |
16 |
$0.00 |
| J3486 |
Ziprasidone mesylate |
18 |
12 |
$0.00 |
| G8985 |
Carry goal status |
68 |
47 |
$0.00 |
| G8979 |
Mobility goal status |
748 |
478 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
355 |
323 |
$0.00 |
| A9577 |
Inj multihance |
1,680 |
1,502 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
16 |
13 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
299 |
216 |
$0.00 |
| A4216 |
Sterile water/saline, 10 ml |
280 |
151 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
242 |
106 |
$0.00 |
| 73070 |
|
12 |
12 |
$0.00 |
| A4565 |
Slings |
38 |
36 |
$0.00 |
| C1760 |
Closure dev, vasc |
19 |
15 |
$0.00 |
| J2272 |
Inj, morphine (fresenius) |
59 |
43 |
$0.00 |
| 93321 |
|
18 |
16 |
$0.00 |
| 82800 |
|
67 |
54 |
$0.00 |
| 99001 |
|
16 |
14 |
$0.00 |
| J1580 |
Garamycin gentamicin inj |
13 |
12 |
$0.00 |