| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
29,151 |
26,901 |
$12.91M |
| 99284 |
|
38,491 |
35,989 |
$9.36M |
| 99283 |
|
45,857 |
42,855 |
$5.95M |
| G0463 |
Hospital outpt clinic visit |
55,268 |
46,830 |
$4.16M |
| 96374 |
|
35,867 |
32,180 |
$3.37M |
| 99282 |
|
20,293 |
19,394 |
$1.43M |
| U0003 |
Cov-19 amp prb hgh thruput |
23,565 |
22,611 |
$1.36M |
| 74177 |
|
10,370 |
10,116 |
$1.32M |
| G0480 |
Drug test def 1-7 classes |
24,257 |
21,684 |
$881K |
| 96361 |
|
24,989 |
21,095 |
$827K |
| 71046 |
|
21,529 |
20,675 |
$818K |
| 80061 |
|
38,502 |
38,325 |
$796K |
| 70450 |
|
7,787 |
7,417 |
$739K |
| 96375 |
|
27,027 |
21,797 |
$732K |
| 87491 |
|
38,539 |
37,663 |
$719K |
| 87591 |
|
37,854 |
37,030 |
$700K |
| 80307 |
|
31,971 |
27,976 |
$686K |
| 96360 |
|
6,880 |
6,431 |
$684K |
| 93306 |
|
3,242 |
3,231 |
$621K |
| 96365 |
|
7,056 |
6,667 |
$554K |
| G0378 |
Hospital observation per hr |
11,598 |
10,300 |
$512K |
| 70553 |
|
2,341 |
2,320 |
$491K |
| 96413 |
|
2,994 |
1,771 |
$473K |
| 43239 |
|
1,219 |
1,212 |
$411K |
| 87637 |
|
5,569 |
5,451 |
$396K |
| 84443 |
|
49,153 |
47,960 |
$390K |
| 78452 |
|
1,001 |
988 |
$378K |
| 93975 |
|
3,203 |
3,112 |
$372K |
| 80053 |
|
91,686 |
83,407 |
$342K |
| 59025 |
|
3,460 |
2,183 |
$339K |
| G0472 |
Hep c screen high risk/other |
9,948 |
9,933 |
$312K |
| U0002 |
Covid-19 lab test non-cdc |
13,837 |
12,836 |
$311K |
| 82306 |
|
17,180 |
17,107 |
$294K |
| 71045 |
|
8,309 |
7,915 |
$288K |
| 76830 |
|
5,054 |
4,945 |
$288K |
| 71260 |
|
2,647 |
2,623 |
$284K |
| 77067 |
|
5,762 |
5,761 |
$279K |
| 76705 |
|
4,927 |
4,833 |
$275K |
| 45385 |
|
569 |
563 |
$261K |
| 74176 |
|
2,441 |
2,366 |
$244K |
| 88305 |
|
13,190 |
12,827 |
$244K |
| 99291 |
|
383 |
366 |
$241K |
| 71275 |
|
3,017 |
2,952 |
$236K |
| U0005 |
Infec agen detec ampli probe |
12,223 |
11,787 |
$229K |
| 87624 |
|
10,842 |
10,835 |
$228K |
| G0475 |
Hiv combination assay |
12,583 |
12,537 |
$202K |
| 78815 |
|
259 |
259 |
$199K |
| 41899 |
|
596 |
594 |
$192K |
| 88142 |
|
15,324 |
15,310 |
$187K |
| 85025 |
|
90,491 |
80,070 |
$187K |
| 76856 |
|
3,210 |
3,181 |
$166K |
| 95811 |
|
341 |
338 |
$166K |
| 93970 |
|
1,560 |
1,527 |
$165K |
| 83036 |
|
27,747 |
27,610 |
$151K |
| 95810 |
|
266 |
265 |
$132K |
| 82728 |
|
16,587 |
16,365 |
$131K |
| 45380 |
|
238 |
237 |
$129K |
| 76770 |
|
2,107 |
2,081 |
$121K |
| 80048 |
|
39,925 |
34,168 |
$120K |
| 87635 |
|
5,117 |
4,837 |
$118K |
| 82607 |
|
13,764 |
13,697 |
$117K |
| 99281 |
|
2,690 |
2,589 |
$115K |
| 73721 |
|
934 |
921 |
$114K |
| 72148 |
|
1,137 |
1,128 |
$114K |
| 87086 |
|
29,887 |
28,242 |
$113K |
| 93971 |
|
2,187 |
2,139 |
$112K |
| 85027 |
|
49,476 |
44,039 |
$109K |
| 70496 |
|
911 |
902 |
$106K |
| 96366 |
|
4,549 |
3,740 |
$105K |
| 62323 |
|
339 |
337 |
$103K |
| 86780 |
|
11,933 |
11,779 |
$97K |
| 77066 |
Tomosynthesis, mammo |
1,678 |
1,670 |
$93K |
| 76642 |
|
2,413 |
2,398 |
$93K |
| 87661 |
|
4,490 |
4,449 |
$92K |
| 87081 |
|
25,732 |
25,370 |
$89K |
| 86900 |
|
11,309 |
10,340 |
$87K |
| 86480 |
|
2,406 |
2,390 |
$84K |
| 84466 |
|
11,218 |
11,106 |
$83K |
| 82947 |
|
2,230 |
2,143 |
$76K |
| 70491 |
|
690 |
676 |
$76K |
| 97161 |
|
769 |
762 |
$70K |
| 84439 |
|
18,049 |
17,699 |
$69K |
| 10060 |
|
748 |
726 |
$67K |
| 93017 |
|
1,738 |
1,717 |
$67K |
| 76805 |
|
1,120 |
1,117 |
$66K |
| 76700 |
|
1,083 |
1,081 |
$66K |
| 90471 |
|
6,338 |
6,193 |
$63K |
| J1750 |
Inj iron dextran |
644 |
387 |
$61K |
| 97110 |
|
3,087 |
1,283 |
$60K |
| 87808 |
|
10,865 |
10,714 |
$58K |
| 96372 |
|
16,229 |
12,063 |
$57K |
| 72100 |
|
2,441 |
2,424 |
$57K |
| 74183 |
|
384 |
382 |
$54K |
| 87340 |
|
10,506 |
10,438 |
$54K |
| 36415 |
|
104,315 |
94,796 |
$53K |
| 11042 |
|
296 |
204 |
$53K |
| 95806 |
|
658 |
658 |
$53K |
| 97162 |
|
339 |
330 |
$52K |
| 71250 |
|
1,023 |
1,009 |
$50K |
| 84702 |
|
17,515 |
15,137 |
$49K |
| 77065 |
Tomosynthesis, mammo |
1,146 |
1,106 |
$49K |
| 87077 |
|
10,355 |
10,114 |
$49K |
| 87389 |
|
5,888 |
5,846 |
$49K |
| 76536 |
|
887 |
884 |
$48K |
| 83540 |
|
12,567 |
12,382 |
$47K |
| 87529 |
|
1,654 |
1,296 |
$47K |
| 73564 |
|
1,103 |
1,100 |
$45K |
| 93005 |
|
38,340 |
30,828 |
$45K |
| 47562 |
|
12 |
12 |
$44K |
| 76816 |
|
1,122 |
1,065 |
$43K |
| 86850 |
|
11,949 |
11,176 |
$43K |
| 72141 |
|
325 |
324 |
$42K |
| 74018 |
|
2,088 |
1,946 |
$41K |
| 77386 |
|
138 |
12 |
$40K |
| 73630 |
|
3,727 |
3,662 |
$40K |
| 73610 |
|
3,404 |
3,274 |
$39K |
| 70486 |
|
1,170 |
1,159 |
$38K |
| 86235 |
|
657 |
645 |
$37K |
| 77063 |
|
2,883 |
2,883 |
$36K |
| 87798 |
|
1,076 |
731 |
$35K |
| 87186 |
|
8,184 |
7,967 |
$35K |
| 82746 |
|
4,223 |
4,197 |
$34K |
| 80074 |
|
1,566 |
1,550 |
$34K |
| 90686 |
|
2,044 |
2,038 |
$32K |
| 83970 |
|
1,359 |
1,338 |
$32K |
| 84403 |
|
2,352 |
2,311 |
$31K |
| 84481 |
|
3,343 |
3,294 |
$31K |
| 73130 |
|
3,380 |
3,302 |
$30K |
| 97530 |
|
1,294 |
639 |
$29K |
| G0103 |
Psa screening |
2,566 |
2,557 |
$29K |
| 96367 |
|
1,022 |
804 |
$28K |
| H0004 |
Alcohol and/or drug services |
373 |
150 |
$28K |
| 43235 |
|
70 |
69 |
$27K |
| 87147 |
|
8,774 |
7,479 |
$27K |
| 87070 |
|
6,411 |
6,243 |
$26K |
| 97165 |
|
352 |
347 |
$25K |
| 97140 |
|
1,457 |
608 |
$25K |
| G0108 |
Diab manage trn per indiv |
390 |
306 |
$25K |
| 99395 |
|
373 |
373 |
$25K |
| 83880 |
|
4,343 |
4,124 |
$24K |
| 82670 |
|
1,378 |
1,360 |
$24K |
| 73030 |
|
2,893 |
2,753 |
$24K |
| 82043 |
|
7,277 |
7,212 |
$24K |
| 72125 |
|
3,137 |
3,003 |
$24K |
| 86762 |
|
3,860 |
3,845 |
$23K |
| 83655 |
|
3,220 |
3,211 |
$23K |
| G0279 |
Tomosynthesis, mammo |
1,994 |
1,984 |
$23K |
| 73110 |
|
2,206 |
2,138 |
$23K |
| 71271 |
|
389 |
389 |
$23K |
| 83735 |
|
31,192 |
25,028 |
$23K |
| Q3014 |
Telehealth facility fee |
1,464 |
1,411 |
$22K |
| 81001 |
|
41,198 |
38,463 |
$22K |
| 93458 |
|
14 |
14 |
$22K |
| 83001 |
|
1,813 |
1,806 |
$21K |
| 93296 |
|
1,146 |
1,145 |
$20K |
| 88307 |
|
253 |
252 |
$20K |
| 88342 |
|
572 |
559 |
$20K |
| 87536 |
|
410 |
409 |
$20K |
| 82570 |
|
7,214 |
6,752 |
$19K |
| 86803 |
|
2,781 |
2,766 |
$19K |
| 84146 |
|
1,686 |
1,677 |
$19K |
| 86140 |
|
9,006 |
8,513 |
$18K |
| 86769 |
|
916 |
906 |
$18K |
| 87088 |
|
4,629 |
4,429 |
$18K |
| 82784 |
|
2,337 |
2,304 |
$18K |
| 19083 |
|
24 |
24 |
$17K |
| 86364 |
|
1,290 |
1,181 |
$17K |
| 87205 |
|
9,134 |
8,919 |
$17K |
| 83516 |
|
1,239 |
879 |
$16K |
| C9803 |
Hopd covid-19 spec collect |
3,698 |
3,486 |
$16K |
| 85610 |
|
13,164 |
10,381 |
$15K |
| 86258 |
|
955 |
950 |
$15K |
| 80076 |
|
7,064 |
6,737 |
$15K |
| G0123 |
Screen cerv/vag thin layer |
1,200 |
1,196 |
$15K |
| 88304 |
|
1,620 |
1,598 |
$15K |
| 45378 |
|
38 |
37 |
$14K |
| 96415 |
|
311 |
253 |
$14K |
| Q0111 |
Wet mounts/ w preparations |
1,513 |
1,436 |
$14K |
| Q5104 |
Injection, renflexis |
14 |
13 |
$13K |
| 73502 |
|
1,368 |
1,330 |
$13K |
| L4350 |
Ankle control ortho pre ots |
315 |
314 |
$13K |
| 99396 |
|
185 |
185 |
$13K |
| 82950 |
|
4,616 |
4,598 |
$13K |
| 64483 |
|
26 |
26 |
$13K |
| 87502 |
|
2,037 |
2,007 |
$12K |
| 72050 |
|
246 |
246 |
$12K |
| 88312 |
|
398 |
391 |
$12K |
| 76817 |
|
2,617 |
2,428 |
$12K |
| 86039 |
|
2,010 |
1,992 |
$12K |
| 72197 |
|
53 |
53 |
$12K |
| 73562 |
|
2,504 |
2,445 |
$11K |
| 73140 |
|
797 |
783 |
$11K |
| 86706 |
|
1,887 |
1,871 |
$10K |
| 85652 |
|
9,060 |
8,666 |
$10K |
| 86787 |
|
1,558 |
1,553 |
$10K |
| 80055 |
|
296 |
296 |
$10K |
| H0005 |
Alcohol and/or drug services |
244 |
101 |
$10K |
| 86200 |
|
1,242 |
1,242 |
$10K |
| 83721 |
|
1,449 |
1,438 |
$10K |
| 87522 |
Neg quan hep c or qual rna |
445 |
410 |
$9K |
| 70498 |
|
982 |
971 |
$9K |
| 74174 |
|
92 |
90 |
$9K |
| 87633 |
|
610 |
603 |
$9K |
| 83690 |
|
19,609 |
18,041 |
$9K |
| 86901 |
|
12,247 |
11,248 |
$9K |
| 83002 |
|
736 |
734 |
$9K |
| 87636 |
|
98 |
97 |
$8K |
| 86225 |
|
981 |
969 |
$8K |
| 73080 |
|
936 |
919 |
$8K |
| 93351 |
|
27 |
27 |
$8K |
| 96127 |
|
1,562 |
1,490 |
$8K |
| 87102 |
|
1,351 |
1,331 |
$8K |
| 86038 |
|
969 |
963 |
$8K |
| 94640 |
|
5,486 |
4,288 |
$7K |
| Q0138 |
Ferumoxytol, non-esrd |
49 |
32 |
$7K |
| 88341 |
|
124 |
121 |
$7K |
| 86431 |
|
2,119 |
2,113 |
$7K |
| 76870 |
|
332 |
315 |
$7K |
| 82565 |
|
3,918 |
3,714 |
$7K |
| 97597 |
|
84 |
54 |
$7K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
13,295 |
12,794 |
$7K |
| 87106 |
|
963 |
907 |
$7K |
| 82248 |
|
3,354 |
3,044 |
$7K |
| 80069 |
|
1,441 |
1,368 |
$6K |
| 84484 |
|
20,386 |
16,023 |
$6K |
| 93225 |
|
125 |
125 |
$6K |
| 73221 |
|
51 |
51 |
$6K |
| 87634 |
|
140 |
139 |
$6K |
| 87899 |
|
411 |
402 |
$6K |
| 84460 |
|
3,097 |
3,030 |
$6K |
| 96417 |
|
147 |
106 |
$6K |
| 86160 |
|
419 |
414 |
$6K |
| 76882 |
|
151 |
139 |
$6K |
| 86696 |
|
533 |
529 |
$6K |
| 0002A |
|
226 |
225 |
$6K |
| 88112 |
|
365 |
356 |
$6K |
| G2066 |
Inter devc remote 30d |
295 |
295 |
$6K |
| 84703 |
|
12,199 |
11,654 |
$6K |
| 82550 |
|
3,257 |
2,999 |
$6K |
| 86592 |
|
2,043 |
2,033 |
$6K |
| 84450 |
|
2,370 |
2,294 |
$6K |
| 85730 |
|
6,667 |
6,311 |
$6K |
| 90834 |
|
148 |
85 |
$5K |
| 97116 |
|
731 |
473 |
$5K |
| 84550 |
|
2,584 |
2,426 |
$5K |
| 86704 |
|
928 |
924 |
$5K |
| 76815 |
|
2,076 |
1,865 |
$5K |
| 86376 |
|
527 |
524 |
$5K |
| 81025 |
|
1,308 |
1,277 |
$5K |
| 84156 |
|
3,663 |
3,152 |
$5K |
| 84153 |
|
450 |
438 |
$5K |
| 93922 |
|
145 |
144 |
$4K |
| 93298 |
|
223 |
221 |
$4K |
| 86695 |
|
535 |
530 |
$4K |
| 73590 |
|
1,049 |
1,026 |
$4K |
| 84100 |
|
7,606 |
6,198 |
$4K |
| 77336 |
|
56 |
27 |
$4K |
| 76801 |
|
78 |
75 |
$4K |
| 83020 |
|
647 |
646 |
$4K |
| 0001A |
|
236 |
236 |
$4K |
| 72072 |
|
197 |
196 |
$4K |
| G0422 |
Intens cardiac rehab w/exerc |
61 |
13 |
$4K |
| 85007 |
|
3,941 |
3,593 |
$3K |
| 83615 |
|
1,488 |
1,355 |
$3K |
| M0245 |
Bamlan and etesev infusion |
18 |
18 |
$3K |
| 85379 |
|
7,032 |
6,847 |
$3K |
| 73090 |
|
830 |
803 |
$3K |
| 84165 |
|
494 |
476 |
$3K |
| 82247 |
|
1,544 |
1,330 |
$3K |
| 86870 |
|
38 |
27 |
$3K |
| 72146 |
|
14 |
14 |
$3K |
| 82533 |
|
261 |
248 |
$3K |
| 82150 |
|
821 |
793 |
$3K |
| 85018 |
|
2,056 |
1,963 |
$3K |
| 87338 |
|
310 |
310 |
$3K |
| 82951 |
|
296 |
296 |
$3K |
| 85045 |
|
1,259 |
1,181 |
$2K |
| 72170 |
|
296 |
288 |
$2K |
| 84630 |
|
312 |
312 |
$2K |
| 87046 |
|
499 |
496 |
$2K |
| 86665 |
|
119 |
119 |
$2K |
| 73700 |
|
52 |
52 |
$2K |
| 97166 |
|
53 |
52 |
$2K |
| 90656 |
|
115 |
115 |
$2K |
| 86765 |
|
510 |
510 |
$2K |
| 0012A |
|
59 |
59 |
$2K |
| 0011A |
|
82 |
82 |
$2K |
| 87045 |
|
504 |
501 |
$2K |
| 86360 |
|
92 |
92 |
$2K |
| 82525 |
|
264 |
261 |
$2K |
| 86694 |
|
267 |
264 |
$2K |
| 93271 |
|
38 |
38 |
$2K |
| 72158 |
|
25 |
24 |
$2K |
| 71101 |
|
106 |
105 |
$2K |
| 82040 |
|
1,516 |
1,486 |
$2K |
| 86735 |
|
424 |
422 |
$2K |
| 91320 |
|
16 |
16 |
$2K |
| 81003 |
|
4,916 |
4,830 |
$2K |
| G0328 |
Fecal blood scrn immunoassay |
211 |
206 |
$2K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
3,540 |
3,466 |
$2K |
| 77080 |
|
25 |
25 |
$2K |
| J1453 |
Fosaprepitant injection |
38 |
26 |
$1K |
| 82627 |
|
93 |
93 |
$1K |
| 36430 |
|
16 |
14 |
$1K |
| 0241U |
|
654 |
644 |
$1K |
| 86800 |
|
136 |
135 |
$1K |
| 82465 |
|
610 |
605 |
$1K |
| 99232 |
|
35 |
16 |
$1K |
| 96376 |
|
11,955 |
7,409 |
$1K |
| 82805 |
|
3,914 |
3,457 |
$1K |
| 87880 |
|
2,658 |
2,622 |
$1K |
| 86141 |
|
283 |
276 |
$1K |
| 83013 |
|
53 |
53 |
$1K |
| 76886 |
|
25 |
25 |
$1K |
| 74019 |
|
82 |
81 |
$1K |
| 0031A |
|
41 |
41 |
$1K |
| G0008 |
Admin influenza virus vac |
198 |
194 |
$1K |
| P9016 |
Rbc leukocytes reduced |
17 |
14 |
$1K |
| 86003 |
|
23 |
12 |
$1K |
| 85014 |
|
954 |
938 |
$1K |
| 80178 |
|
439 |
400 |
$1K |
| 87040 |
|
2,065 |
1,486 |
$985.71 |
| 84207 |
|
51 |
51 |
$980.70 |
| 84520 |
|
1,289 |
1,178 |
$906.84 |
| 84425 |
|
69 |
69 |
$903.47 |
| 80164 |
|
257 |
241 |
$900.01 |
| 90472 |
|
91 |
91 |
$893.85 |
| 86308 |
|
658 |
652 |
$878.58 |
| 86664 |
|
104 |
104 |
$869.05 |
| 87593 |
|
13 |
12 |
$867.48 |
| 97112 |
|
39 |
13 |
$863.84 |
| 82310 |
|
947 |
926 |
$862.63 |
| 82330 |
|
147 |
130 |
$858.08 |
| 0124A |
|
35 |
35 |
$825.97 |
| 70551 |
|
12 |
12 |
$817.97 |
| 29515 |
|
13 |
12 |
$758.23 |
| 86663 |
|
105 |
105 |
$755.00 |
| 83993 |
|
57 |
57 |
$738.78 |
| 76881 |
|
12 |
12 |
$722.30 |
| 99239 |
|
13 |
13 |
$717.96 |
| 86147 |
|
27 |
26 |
$714.58 |
| 83498 |
|
36 |
36 |
$683.60 |
| 87493 |
|
45 |
45 |
$682.39 |
| 86593 |
|
237 |
234 |
$682.29 |
| 90480 |
|
16 |
16 |
$574.58 |
| 83718 |
|
149 |
148 |
$562.25 |
| 82105 |
|
81 |
77 |
$553.63 |
| 84155 |
|
916 |
893 |
$548.80 |
| 73060 |
|
156 |
147 |
$537.35 |
| 84145 |
|
466 |
457 |
$524.71 |
| 84132 |
|
915 |
777 |
$519.77 |
| 87804 |
|
90 |
67 |
$517.07 |
| G0499 |
Hepb screen high risk indiv |
28 |
28 |
$501.11 |
| 82952 |
|
199 |
199 |
$487.51 |
| G0399 |
Home sleep test/type 3 porta |
78 |
78 |
$486.00 |
| 82274 |
|
60 |
60 |
$479.89 |
| 83605 |
|
7,810 |
6,793 |
$475.15 |
| 73552 |
|
129 |
122 |
$463.60 |
| 86708 |
|
64 |
64 |
$452.47 |
| 85651 |
|
330 |
300 |
$450.66 |
| 83520 |
|
1,974 |
1,731 |
$444.20 |
| 87209 |
|
193 |
189 |
$441.47 |
| 87498 |
|
16 |
16 |
$380.04 |
| 82652 |
|
24 |
24 |
$376.75 |
| 84075 |
|
766 |
750 |
$350.72 |
| 81002 |
|
208 |
195 |
$350.69 |
| 87177 |
|
192 |
189 |
$337.28 |
| 99213 |
|
34 |
29 |
$333.92 |
| 82044 |
|
121 |
121 |
$331.09 |
| 83521 |
|
13 |
13 |
$326.42 |
| 87210 |
|
1,066 |
845 |
$314.67 |
| 84255 |
|
15 |
15 |
$284.48 |
| 97535 |
|
71 |
64 |
$272.92 |
| 82803 |
|
183 |
179 |
$267.54 |
| 84144 |
|
16 |
15 |
$228.58 |
| J2370 |
Phenylephrine hcl injection |
1,184 |
1,063 |
$211.70 |
| 73560 |
|
14 |
14 |
$195.44 |
| 87015 |
|
54 |
54 |
$193.68 |
| 12001 |
|
519 |
516 |
$193.04 |
| 87324 |
|
42 |
42 |
$191.01 |
| 97802 |
|
58 |
58 |
$182.56 |
| 87449 |
|
45 |
45 |
$180.34 |
| 97022 |
|
34 |
16 |
$179.64 |
| 84295 |
|
720 |
698 |
$168.60 |
| 82140 |
|
40 |
39 |
$159.87 |
| 82374 |
|
712 |
695 |
$155.19 |
| P9612 |
Catheterize for urine spec |
113 |
112 |
$150.73 |
| 86304 |
|
15 |
13 |
$132.43 |
| J0330 |
Succinycholine chloride inj |
2,413 |
1,928 |
$129.05 |
| 82378 |
|
12 |
12 |
$125.79 |
| 86255 |
|
18 |
13 |
$123.72 |
| 86618 |
|
13 |
13 |
$120.70 |
| 97803 |
|
14 |
13 |
$120.00 |
| 74022 |
|
79 |
79 |
$116.52 |
| J7030 |
Normal saline solution infus |
26,233 |
22,507 |
$116.29 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
803 |
664 |
$114.28 |
| 84590 |
|
13 |
13 |
$112.45 |
| 82435 |
|
651 |
639 |
$97.00 |
| 83986 |
|
736 |
681 |
$71.12 |
| 90715 |
|
3,264 |
3,237 |
$69.53 |
| 29125 |
|
191 |
186 |
$67.94 |
| 97804 |
|
31 |
14 |
$64.00 |
| 83014 |
|
42 |
42 |
$63.57 |
| J1885 |
Ketorolac tromethamine inj |
18,876 |
16,589 |
$47.84 |
| 83550 |
|
17 |
17 |
$46.36 |
| 82010 |
|
248 |
228 |
$42.76 |
| J2405 |
Ondansetron hcl injection |
24,133 |
20,442 |
$41.75 |
| 86703 |
|
53 |
53 |
$36.17 |
| 87075 |
|
16 |
13 |
$34.14 |
| J1650 |
Inj enoxaparin sodium |
4,785 |
2,269 |
$33.47 |
| J2270 |
Morphine sulfate injection |
9,055 |
7,146 |
$26.65 |
| J3490 |
Drugs unclassified injection |
3,549 |
2,685 |
$19.57 |
| J7120 |
Ringers lactate infusion |
13,217 |
10,766 |
$19.23 |
| J2060 |
Lorazepam injection |
3,402 |
2,619 |
$13.30 |
| J1836 |
Inj, metronidazole, 10 mg |
226 |
161 |
$12.94 |
| J2704 |
Inj, propofol, 10 mg |
11,522 |
10,806 |
$12.21 |
| J2250 |
Inj midazolam hydrochloride |
11,081 |
10,623 |
$11.15 |
| J1630 |
Haloperidol injection |
2,478 |
2,129 |
$10.94 |
| J1100 |
Dexamethasone sodium phos |
8,004 |
6,990 |
$8.86 |
| 80051 |
|
26 |
25 |
$7.90 |
| J0780 |
Prochlorperazine injection |
2,393 |
1,938 |
$7.88 |
| J1170 |
Hydromorphone injection |
8,617 |
6,407 |
$7.50 |
| J3010 |
Fentanyl citrate injection |
11,655 |
10,951 |
$7.08 |
| J0696 |
Ceftriaxone sodium injection |
4,665 |
4,035 |
$6.46 |
| J1200 |
Diphenhydramine hcl injectio |
6,471 |
5,442 |
$5.07 |
| 82009 |
|
28 |
25 |
$2.97 |
| Q0162 |
Ondansetron oral |
499 |
456 |
$1.54 |
| J7512 |
Prednisone ir or dr oral 1mg |
1,515 |
997 |
$1.50 |
| J2765 |
Metoclopramide hcl injection |
3,652 |
3,247 |
$1.00 |
| A9270 |
Non-covered item or service |
1,957 |
995 |
$0.03 |
| J1642 |
Inj heparin sodium per 10 u |
2,175 |
1,239 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
60 |
59 |
$0.00 |
| J3480 |
Inj potassium chloride |
1,659 |
1,154 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
4,273 |
3,754 |
$0.00 |
| 96368 |
|
286 |
237 |
$0.00 |
| J7050 |
Normal saline solution infus |
6,436 |
4,466 |
$0.00 |
| C1769 |
Guide wire |
1,171 |
1,126 |
$0.00 |
| J1815 |
Insulin injection |
1,370 |
516 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
1,072 |
1,028 |
$0.00 |
| 94760 |
|
117 |
64 |
$0.00 |
| J2001 |
Lidocaine injection |
692 |
468 |
$0.00 |
| 36416 |
|
181 |
178 |
$0.00 |
| A9500 |
Tc99m sestamibi |
415 |
407 |
$0.00 |
| J2469 |
Palonosetron hcl |
552 |
340 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
592 |
584 |
$0.00 |
| J2785 |
Regadenoson injection |
374 |
373 |
$0.00 |
| J1040 |
Methylprednisolone 80 mg inj |
488 |
485 |
$0.00 |
| 12002 |
|
63 |
63 |
$0.00 |
| 99156 |
|
147 |
140 |
$0.00 |
| J3411 |
Thiamine hcl 100 mg |
384 |
261 |
$0.00 |
| A4648 |
Implantable tissue marker |
78 |
77 |
$0.00 |
| C1726 |
Cath, bal dil, non-vascular |
79 |
78 |
$0.00 |
| 0352U |
|
155 |
154 |
$0.00 |
| J1626 |
Granisetron hcl injection |
92 |
88 |
$0.00 |
| 80320 |
|
32 |
29 |
$0.00 |
| 87807 |
|
14 |
14 |
$0.00 |
| J7121 |
5% dextrose in lac ringers |
13 |
12 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
65 |
29 |
$0.00 |
| J7620 |
Albuterol ipratrop non-comp |
90 |
70 |
$0.00 |
| C1781 |
Mesh (implantable) |
13 |
12 |
$0.00 |
| A9585 |
Gadobutrol injection |
101 |
98 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
44 |
12 |
$0.00 |
| J1940 |
Furosemide injection |
46 |
38 |
$0.00 |
| J0456 |
Azithromycin |
17 |
14 |
$0.00 |
| J0610 |
Calcium glucon (fresenius) |
13 |
12 |
$0.00 |
| J7613 |
Albuterol non-comp unit |
31 |
22 |
$0.00 |
| J1010 |
Inj, methylpred acetate 1 mg |
30 |
30 |
$0.00 |
| J8540 |
Oral dexamethasone |
24 |
23 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
3,299 |
2,195 |
$0.00 |
| J7040 |
Normal saline solution infus |
4,566 |
4,099 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
280 |
263 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
3,452 |
2,882 |
$0.00 |
| J1050 |
Medroxyprogesterone acetate |
257 |
257 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
800 |
786 |
$0.00 |
| 76937 |
|
449 |
351 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
457 |
449 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
740 |
737 |
$0.00 |
| J2930 |
Methylprednisolone injection |
1,249 |
1,065 |
$0.00 |
| 12011 |
|
123 |
122 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
243 |
186 |
$0.00 |
| 99152 |
|
127 |
124 |
$0.00 |
| A9552 |
F18 fdg |
177 |
177 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
1,058 |
1,030 |
$0.00 |
| C1752 |
Cath,hemodialysis,short-term |
173 |
171 |
$0.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
140 |
71 |
$0.00 |
| J2550 |
Promethazine hcl injection |
183 |
160 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
502 |
498 |
$0.00 |
| J1756 |
Iron sucrose injection |
177 |
62 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
28 |
28 |
$0.00 |
| J3370 |
Vancomycin hcl injection |
450 |
264 |
$0.00 |
| 93226 |
|
85 |
85 |
$0.00 |
| J0736 |
Inj, clindamycin phosp 300mg |
15 |
12 |
$0.00 |
| 0202U |
|
69 |
69 |
$0.00 |
| 93356 |
|
136 |
135 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
217 |
120 |
$0.00 |
| A9502 |
Tc99m tetrofosmin |
12 |
12 |
$0.00 |
| Q9957 |
Inj perflutren lip micros,ml |
12 |
12 |
$0.00 |
| J1953 |
Levetiracetam injection |
89 |
64 |
$0.00 |
| L3908 |
Who cock-up nonmolde pre ots |
24 |
24 |
$0.00 |
| C1887 |
Catheter, guiding |
12 |
12 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
60 |
52 |
$0.00 |
| J3250 |
Trimethobenzamide hcl inj |
18 |
13 |
$0.00 |
| C1758 |
Catheter, ureteral |
13 |
13 |
$0.00 |