| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic service |
26,484 |
21,828 |
$1.69M |
| 99285 |
|
10,771 |
10,459 |
$1.68M |
| 99284 |
|
12,227 |
11,880 |
$1.41M |
| 99283 |
|
17,468 |
16,999 |
$1.41M |
| U0003 |
Cov-19 amp prb hgh thruput |
15,082 |
14,196 |
$1.40M |
| G0378 |
Hospital observation per hr |
980 |
704 |
$640K |
| X0621 |
|
2,319 |
1,657 |
$554K |
| 74177 |
|
2,526 |
2,465 |
$409K |
| U0005 |
Infec agen detec ampli probe |
13,537 |
12,770 |
$277K |
| 36415 |
|
64,858 |
56,094 |
$269K |
| U0004 |
Cov-19 test non-cdc hgh thru |
3,078 |
2,837 |
$259K |
| 99282 |
|
6,455 |
6,332 |
$257K |
| 99212 |
|
5,423 |
5,337 |
$248K |
| 93976 |
|
2,388 |
1,992 |
$201K |
| 80307 |
|
3,792 |
3,593 |
$196K |
| 99211 |
|
4,484 |
4,345 |
$190K |
| 84443 |
|
7,656 |
7,462 |
$185K |
| 76817 |
|
2,796 |
2,410 |
$174K |
| 85025 |
|
29,764 |
26,744 |
$168K |
| 80048 |
|
19,234 |
17,535 |
$165K |
| C9803 |
Hopd covid-19 spec collect |
11,294 |
10,841 |
$163K |
| 76816 |
|
3,307 |
3,085 |
$159K |
| 80053 |
|
13,155 |
11,908 |
$154K |
| 76819 |
|
2,426 |
1,459 |
$141K |
| 87491 |
|
4,904 |
4,807 |
$134K |
| 88175 |
|
3,643 |
3,638 |
$131K |
| 99213 |
|
2,927 |
2,903 |
$126K |
| 87591 |
|
4,610 |
4,515 |
$118K |
| 62323 |
|
1,123 |
1,119 |
$115K |
| 0241U |
|
3,023 |
2,987 |
$114K |
| 80061 |
|
7,437 |
7,314 |
$109K |
| 70450 |
|
1,763 |
1,698 |
$104K |
| 70553 |
|
402 |
400 |
$101K |
| 87624 |
|
2,378 |
2,363 |
$99K |
| 71275 |
|
561 |
547 |
$97K |
| 80050 |
|
1,943 |
1,897 |
$96K |
| 71046 |
|
6,457 |
6,226 |
$93K |
| 77067 |
|
995 |
995 |
$90K |
| 93306 |
|
1,206 |
1,184 |
$90K |
| 87389 |
|
2,821 |
2,792 |
$90K |
| 11042 |
|
1,858 |
1,058 |
$88K |
| 76811 |
|
821 |
817 |
$80K |
| 84484 |
|
9,464 |
7,173 |
$80K |
| 73721 |
|
271 |
269 |
$77K |
| G0463 |
Hospital outpt clinic visit |
6,674 |
6,391 |
$76K |
| 83735 |
|
11,584 |
10,399 |
$73K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
54 |
53 |
$73K |
| 11043 |
|
741 |
378 |
$72K |
| 76815 |
|
1,686 |
1,208 |
$72K |
| 72148 |
|
413 |
411 |
$71K |
| 78815 |
|
77 |
77 |
$69K |
| 82306 |
|
1,808 |
1,764 |
$67K |
| 74183 |
|
173 |
170 |
$66K |
| 84703 |
|
6,064 |
5,856 |
$64K |
| 76830 |
|
1,213 |
1,196 |
$60K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
7,512 |
7,227 |
$58K |
| 87635 |
|
1,362 |
1,263 |
$58K |
| 84100 |
|
10,180 |
9,311 |
$57K |
| 87086 |
|
6,444 |
6,166 |
$55K |
| 78452 |
|
305 |
301 |
$54K |
| 86780 |
|
3,085 |
3,044 |
$54K |
| 85027 |
|
6,579 |
5,989 |
$51K |
| 96374 |
|
4,383 |
4,188 |
$48K |
| 43239 |
|
422 |
416 |
$47K |
| 84439 |
|
5,703 |
5,543 |
$47K |
| 80076 |
|
5,255 |
5,006 |
$47K |
| 0002A |
|
970 |
968 |
$45K |
| 76821 |
|
741 |
414 |
$45K |
| A9500 |
Tc99m sestamibi |
560 |
548 |
$44K |
| 76820 |
|
1,500 |
987 |
$43K |
| 0001A |
|
1,048 |
1,045 |
$42K |
| 83036 |
|
5,896 |
5,777 |
$42K |
| 74176 |
|
523 |
509 |
$41K |
| 72141 |
|
179 |
177 |
$40K |
| 87150 |
|
770 |
764 |
$38K |
| 70551 |
|
176 |
175 |
$37K |
| 88342 |
|
879 |
837 |
$34K |
| 84702 |
|
1,669 |
1,242 |
$32K |
| 71250 |
|
506 |
495 |
$30K |
| 88341 |
|
559 |
523 |
$30K |
| 71260 |
|
453 |
445 |
$28K |
| 87804 |
|
1,368 |
1,117 |
$28K |
| 72125 |
|
515 |
495 |
$28K |
| 83615 |
|
3,750 |
3,245 |
$27K |
| 93970 |
|
312 |
308 |
$27K |
| 96365 |
|
1,064 |
703 |
$26K |
| A9577 |
Inj multihance |
2,407 |
2,340 |
$26K |
| 86803 |
|
1,195 |
1,167 |
$26K |
| 80074 |
|
430 |
420 |
$26K |
| 83690 |
|
5,429 |
5,204 |
$26K |
| 88305 |
|
2,090 |
2,024 |
$25K |
| 87081 |
|
3,995 |
3,925 |
$25K |
| 81001 |
|
8,017 |
7,664 |
$24K |
| G0480 |
Drug test def 1-7 classes |
506 |
484 |
$24K |
| 45380 |
|
137 |
133 |
$24K |
| 93880 |
|
353 |
351 |
$23K |
| 76642 |
|
508 |
489 |
$23K |
| 12001 |
|
166 |
165 |
$23K |
| 93000 |
|
1,194 |
1,104 |
$22K |
| 82607 |
|
1,633 |
1,598 |
$22K |
| 93005 |
|
9,534 |
8,939 |
$22K |
| G0108 |
Diab manage trn per indiv |
443 |
361 |
$21K |
| C1769 |
Guide wire |
588 |
543 |
$20K |
| 64721 |
|
40 |
40 |
$20K |
| 77066 |
Tomosynthesis, mammo |
206 |
205 |
$20K |
| 83605 |
|
2,886 |
2,581 |
$20K |
| G0444 |
Depression screen annual |
882 |
881 |
$19K |
| 76536 |
|
386 |
385 |
$19K |
| G0399 |
Home sleep test/type 3 porta |
142 |
141 |
$19K |
| 97162 |
|
387 |
381 |
$18K |
| 86762 |
|
770 |
765 |
$18K |
| 83516 |
|
279 |
270 |
$17K |
| 45378 |
|
82 |
82 |
$17K |
| 87340 |
|
1,042 |
1,028 |
$17K |
| 87077 |
|
2,039 |
1,959 |
$17K |
| 76705 |
|
455 |
451 |
$17K |
| 87522 |
Neg quan hep c or qual rna |
348 |
331 |
$16K |
| M0245 |
Bamlan and etesev infusion |
43 |
43 |
$16K |
| 77063 |
|
672 |
672 |
$16K |
| X0592 |
|
377 |
313 |
$16K |
| 93017 |
|
417 |
411 |
$15K |
| 93971 |
|
219 |
215 |
$15K |
| J2785 |
Regadenoson injection |
291 |
287 |
$15K |
| 82728 |
|
1,149 |
1,117 |
$15K |
| 83970 |
|
324 |
316 |
$14K |
| 76801 |
|
313 |
305 |
$14K |
| 83880 |
|
591 |
536 |
$14K |
| C1894 |
Intro/sheath, non-laser |
63 |
61 |
$14K |
| 93923 |
|
268 |
265 |
$14K |
| 73221 |
|
56 |
56 |
$14K |
| 96361 |
|
2,143 |
1,956 |
$14K |
| 86618 |
|
516 |
502 |
$14K |
| 76770 |
|
322 |
321 |
$14K |
| 96372 |
|
1,855 |
1,709 |
$13K |
| 82570 |
|
1,695 |
1,548 |
$13K |
| 96413 |
|
167 |
156 |
$13K |
| 73564 |
|
548 |
519 |
$13K |
| 95811 |
|
27 |
27 |
$13K |
| 87536 |
|
97 |
96 |
$13K |
| 84112 |
|
121 |
114 |
$13K |
| 73610 |
|
602 |
585 |
$12K |
| 86850 |
|
1,434 |
1,392 |
$12K |
| 93325 |
|
148 |
147 |
$12K |
| 45385 |
|
38 |
38 |
$11K |
| 82746 |
|
933 |
920 |
$11K |
| 81003 |
|
3,640 |
3,509 |
$11K |
| 87186 |
|
1,270 |
1,227 |
$11K |
| 84153 |
|
385 |
380 |
$11K |
| 84144 |
|
509 |
481 |
$11K |
| 76805 |
|
188 |
185 |
$10K |
| 76856 |
|
216 |
215 |
$10K |
| 84146 |
|
373 |
366 |
$10K |
| 70486 |
|
138 |
134 |
$10K |
| 83540 |
|
1,057 |
1,032 |
$10K |
| 75574 |
|
54 |
54 |
$10K |
| 82043 |
|
1,096 |
1,068 |
$10K |
| 73630 |
|
787 |
756 |
$10K |
| 77065 |
Tomosynthesis, mammo |
150 |
142 |
$9K |
| 94729 |
|
345 |
343 |
$9K |
| 90471 |
|
692 |
661 |
$9K |
| Q0162 |
Ondansetron oral |
1,879 |
1,786 |
$9K |
| 85610 |
|
2,731 |
1,997 |
$9K |
| 72100 |
|
453 |
444 |
$9K |
| 84403 |
|
286 |
274 |
$9K |
| 81420 |
|
13 |
12 |
$9K |
| 97110 |
|
840 |
248 |
$9K |
| 76700 |
|
177 |
176 |
$9K |
| 73030 |
|
553 |
535 |
$9K |
| 87040 |
|
816 |
455 |
$8K |
| 71271 |
|
86 |
85 |
$8K |
| 84481 |
|
316 |
304 |
$8K |
| 84460 |
|
1,006 |
892 |
$8K |
| J0585 |
Injection,onabotulinumtoxina |
330 |
245 |
$7K |
| 73130 |
|
570 |
533 |
$7K |
| 86038 |
|
417 |
404 |
$7K |
| G0008 |
Admin influenza virus vac |
739 |
732 |
$7K |
| 72110 |
|
328 |
328 |
$7K |
| 87070 |
|
1,016 |
983 |
$7K |
| 84550 |
|
1,031 |
848 |
$7K |
| 87426 |
|
190 |
184 |
$7K |
| 84450 |
|
976 |
860 |
$7K |
| 72197 |
|
12 |
12 |
$7K |
| 94726 |
|
259 |
257 |
$6K |
| 84466 |
|
331 |
324 |
$6K |
| 73502 |
|
302 |
294 |
$6K |
| 82565 |
|
929 |
809 |
$6K |
| 74018 |
|
393 |
365 |
$6K |
| 93226 |
|
157 |
154 |
$6K |
| 12002 |
|
27 |
27 |
$6K |
| 85730 |
|
1,088 |
969 |
$5K |
| 86900 |
|
1,290 |
1,248 |
$5K |
| 86901 |
|
1,267 |
1,227 |
$5K |
| 70491 |
|
72 |
71 |
$5K |
| 86360 |
|
73 |
71 |
$5K |
| 87205 |
|
1,024 |
976 |
$5K |
| 87807 |
|
331 |
328 |
$5K |
| J2791 |
Rhophylac injection |
97 |
95 |
$5K |
| 85652 |
|
1,535 |
1,419 |
$5K |
| 87210 |
|
473 |
445 |
$5K |
| 84270 |
|
155 |
147 |
$5K |
| 86147 |
|
95 |
90 |
$5K |
| 73110 |
|
393 |
379 |
$5K |
| 85379 |
|
468 |
436 |
$5K |
| 96375 |
|
838 |
744 |
$5K |
| 85007 |
|
1,114 |
858 |
$5K |
| 96366 |
|
409 |
302 |
$4K |
| 86800 |
|
212 |
204 |
$4K |
| 87899 |
|
110 |
101 |
$4K |
| 96360 |
|
315 |
310 |
$4K |
| 83655 |
|
336 |
331 |
$4K |
| 93458 |
|
12 |
12 |
$4K |
| 59025 |
|
725 |
437 |
$4K |
| 82550 |
|
865 |
712 |
$4K |
| 82950 |
|
534 |
530 |
$4K |
| 64615 |
|
37 |
37 |
$4K |
| 86235 |
|
47 |
44 |
$4K |
| 86146 |
|
77 |
75 |
$4K |
| G0279 |
Tomosynthesis, mammo |
197 |
197 |
$4K |
| 83001 |
|
184 |
180 |
$4K |
| 94060 |
|
396 |
393 |
$4K |
| 71045 |
|
661 |
607 |
$4K |
| 76827 |
|
81 |
78 |
$4K |
| 73590 |
|
215 |
203 |
$4K |
| 86359 |
|
73 |
71 |
$4K |
| 82803 |
|
162 |
146 |
$3K |
| J2704 |
Inj, propofol, 10 mg |
6,809 |
4,511 |
$3K |
| J1040 |
Methylprednisolone 80 mg inj |
1,205 |
1,192 |
$3K |
| 86376 |
|
365 |
359 |
$3K |
| 90686 |
|
747 |
739 |
$3K |
| 72040 |
|
219 |
212 |
$3K |
| 82248 |
|
485 |
428 |
$3K |
| 82533 |
|
236 |
209 |
$3K |
| 86140 |
|
1,027 |
909 |
$3K |
| Q9969 |
Non-heu tc-99m add-on/dose |
456 |
446 |
$3K |
| 73562 |
|
169 |
159 |
$3K |
| J7030 |
Normal saline solution infus |
5,734 |
5,241 |
$3K |
| 86706 |
|
190 |
184 |
$3K |
| 82784 |
|
104 |
101 |
$3K |
| 93225 |
|
158 |
155 |
$3K |
| J1815 |
Insulin injection |
141 |
108 |
$3K |
| 0004A |
|
59 |
59 |
$3K |
| 84480 |
|
296 |
292 |
$3K |
| 84156 |
|
560 |
446 |
$3K |
| 84436 |
|
242 |
237 |
$3K |
| 73090 |
|
195 |
192 |
$2K |
| 62321 |
|
29 |
29 |
$2K |
| 80069 |
|
227 |
157 |
$2K |
| 73080 |
|
208 |
201 |
$2K |
| 80164 |
|
137 |
126 |
$2K |
| 87798 |
|
41 |
40 |
$2K |
| 86430 |
|
285 |
279 |
$2K |
| 27096 |
|
27 |
27 |
$2K |
| 83550 |
|
434 |
424 |
$2K |
| A9552 |
F18 fdg |
24 |
24 |
$2K |
| 76825 |
|
95 |
91 |
$2K |
| 0124A |
|
58 |
56 |
$2K |
| 20553 |
|
70 |
70 |
$2K |
| 43235 |
|
24 |
24 |
$2K |
| 96376 |
|
256 |
214 |
$2K |
| 10061 |
|
13 |
13 |
$2K |
| 85018 |
|
564 |
548 |
$2K |
| 82670 |
|
69 |
68 |
$2K |
| 85014 |
|
522 |
508 |
$2K |
| 80051 |
|
275 |
246 |
$2K |
| U0002 |
Covid-19 lab test non-cdc |
66 |
66 |
$2K |
| J2310 |
Inj naloxone hydrochloride |
102 |
93 |
$2K |
| 76641 |
|
29 |
26 |
$2K |
| 84520 |
|
322 |
293 |
$2K |
| 76870 |
|
38 |
38 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
1,060 |
752 |
$2K |
| 82947 |
|
419 |
398 |
$2K |
| 82150 |
|
345 |
312 |
$2K |
| 97166 |
|
73 |
71 |
$2K |
| 87493 |
|
46 |
44 |
$2K |
| 82948 |
|
1,959 |
1,204 |
$2K |
| 85613 |
|
105 |
98 |
$1K |
| J2930 |
Methylprednisolone injection |
185 |
146 |
$1K |
| 86617 |
|
32 |
31 |
$1K |
| 83002 |
|
68 |
66 |
$1K |
| 90714 |
|
215 |
213 |
$1K |
| 76376 |
|
12 |
12 |
$1K |
| 86200 |
|
81 |
79 |
$1K |
| 72050 |
|
53 |
53 |
$1K |
| 90472 |
|
99 |
98 |
$1K |
| 81511 |
|
13 |
13 |
$1K |
| 82553 |
|
261 |
210 |
$1K |
| J7120 |
Ringers lactate infusion |
3,435 |
3,005 |
$1K |
| 88142 |
|
57 |
57 |
$1K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
459 |
416 |
$1K |
| G0328 |
Fecal blood scrn immunoassay |
66 |
64 |
$1K |
| 73560 |
|
73 |
67 |
$1K |
| 87801 |
|
26 |
26 |
$1K |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$1K |
| 83721 |
|
107 |
104 |
$1K |
| 95816 |
|
87 |
87 |
$1K |
| C1887 |
Catheter, guiding |
28 |
26 |
$990.64 |
| 97165 |
|
27 |
27 |
$986.77 |
| 82977 |
|
101 |
82 |
$935.69 |
| 29125 |
|
69 |
66 |
$932.10 |
| 82951 |
|
59 |
59 |
$889.48 |
| Q9957 |
Inj perflutren lip micros,ml |
13 |
13 |
$830.28 |
| J2370 |
Phenylephrine hcl injection |
385 |
350 |
$830.06 |
| 87046 |
|
187 |
89 |
$809.41 |
| J1885 |
Ketorolac tromethamine inj |
3,268 |
2,701 |
$792.69 |
| 99281 |
|
31 |
29 |
$786.45 |
| 87328 |
|
29 |
29 |
$751.64 |
| 93010 |
|
237 |
233 |
$743.90 |
| 77080 |
|
12 |
12 |
$734.40 |
| 82627 |
|
29 |
27 |
$728.07 |
| 87106 |
|
60 |
57 |
$669.12 |
| 20610 |
|
33 |
29 |
$654.41 |
| 83874 |
|
58 |
55 |
$590.10 |
| 86308 |
|
72 |
70 |
$580.43 |
| 87045 |
|
93 |
88 |
$569.29 |
| 96127 |
|
141 |
140 |
$545.00 |
| 87015 |
|
86 |
84 |
$504.27 |
| 86923 |
|
14 |
14 |
$501.90 |
| 85045 |
|
120 |
108 |
$491.15 |
| 86225 |
|
28 |
28 |
$480.90 |
| 71101 |
|
29 |
29 |
$480.86 |
| J8540 |
Oral dexamethasone |
488 |
474 |
$479.28 |
| 84132 |
|
104 |
97 |
$471.78 |
| J0702 |
Betamethasone acet&sod phosp |
25 |
12 |
$468.56 |
| 72052 |
|
16 |
16 |
$465.53 |
| 94640 |
|
90 |
41 |
$445.76 |
| S9470 |
Nutritional counseling, diet |
14 |
14 |
$433.84 |
| J2360 |
Orphenadrine injection |
177 |
168 |
$433.19 |
| J2405 |
Ondansetron hcl injection |
4,859 |
4,309 |
$394.65 |
| S0028 |
Injection, famotidine, 20 mg |
575 |
531 |
$393.66 |
| 83520 |
|
14 |
13 |
$390.35 |
| 87661 |
|
57 |
57 |
$373.46 |
| 97140 |
|
66 |
25 |
$365.41 |
| 83525 |
|
25 |
24 |
$364.32 |
| 80178 |
|
43 |
38 |
$363.77 |
| 90688 |
|
59 |
59 |
$362.50 |
| 86696 |
|
14 |
14 |
$361.87 |
| 87329 |
|
29 |
29 |
$349.16 |
| 73060 |
|
40 |
39 |
$347.26 |
| 76857 |
|
16 |
16 |
$341.41 |
| 87880 |
|
42 |
41 |
$331.00 |
| 94760 |
|
347 |
300 |
$329.69 |
| 86787 |
|
14 |
14 |
$323.59 |
| 84165 |
|
27 |
26 |
$323.26 |
| G0009 |
Admin pneumococcal vaccine |
28 |
27 |
$318.40 |
| 88112 |
|
12 |
12 |
$318.23 |
| 97161 |
|
12 |
12 |
$309.59 |
| J1170 |
Hydromorphone injection |
452 |
307 |
$300.18 |
| 83090 |
|
16 |
16 |
$291.93 |
| 73552 |
|
17 |
15 |
$291.61 |
| J7040 |
Normal saline solution infus |
851 |
787 |
$288.64 |
| 85306 |
|
13 |
13 |
$286.39 |
| 86695 |
|
14 |
14 |
$285.30 |
| 86694 |
|
13 |
13 |
$283.13 |
| 84145 |
|
32 |
29 |
$274.50 |
| J3301 |
Triamcinolone acet inj nos |
334 |
323 |
$274.13 |
| J3010 |
Fentanyl citrate injection |
3,135 |
2,770 |
$273.62 |
| J0690 |
Cefazolin sodium injection |
1,247 |
1,105 |
$269.74 |
| 12011 |
|
39 |
39 |
$269.36 |
| 72170 |
|
32 |
31 |
$265.10 |
| 73140 |
|
26 |
26 |
$264.69 |
| 90715 |
|
61 |
61 |
$239.05 |
| 86704 |
|
14 |
14 |
$234.90 |
| 82952 |
|
59 |
59 |
$232.71 |
| J1644 |
Inj heparin sodium per 1000u |
441 |
264 |
$230.97 |
| J1100 |
Dexamethasone sodium phos |
2,368 |
2,149 |
$225.46 |
| J2795 |
Ropivacaine hcl injection |
673 |
511 |
$217.41 |
| 86769 |
|
15 |
15 |
$211.48 |
| 86708 |
|
12 |
12 |
$198.83 |
| 82247 |
|
34 |
24 |
$195.93 |
| 80197 |
|
18 |
13 |
$174.63 |
| 82105 |
|
12 |
12 |
$167.15 |
| J7512 |
Prednisone ir or dr oral 1mg |
253 |
234 |
$162.53 |
| 88304 |
|
208 |
206 |
$157.45 |
| 36600 |
|
28 |
19 |
$152.08 |
| J7050 |
Normal saline solution infus |
1,984 |
1,470 |
$151.36 |
| 92551 |
|
24 |
24 |
$133.48 |
| J1650 |
Inj enoxaparin sodium |
152 |
82 |
$128.84 |
| J1030 |
Methylprednisolone 40 mg inj |
106 |
105 |
$127.36 |
| J0330 |
Succinycholine chloride inj |
141 |
123 |
$119.70 |
| 82010 |
|
36 |
30 |
$116.89 |
| 88307 |
|
28 |
24 |
$116.53 |
| 84155 |
|
29 |
28 |
$107.20 |
| 89055 |
|
28 |
26 |
$106.93 |
| 99173 |
|
24 |
24 |
$97.11 |
| S0077 |
Injection, clindamycin phosp |
23 |
15 |
$86.15 |
| J2710 |
Neostigmine methylslfte inj |
352 |
310 |
$84.87 |
| J2765 |
Metoclopramide hcl injection |
286 |
269 |
$83.98 |
| 82330 |
|
15 |
15 |
$81.53 |
| J1200 |
Diphenhydramine hcl injectio |
411 |
372 |
$70.28 |
| C1766 |
Intro/sheath,strble,non-peel |
28 |
27 |
$66.92 |
| J1642 |
Inj heparin sodium per 10 u |
268 |
201 |
$59.52 |
| 82140 |
|
13 |
13 |
$48.40 |
| 99392 |
|
14 |
14 |
$45.37 |
| J2250 |
Inj midazolam hydrochloride |
2,061 |
1,811 |
$44.54 |
| 82040 |
|
12 |
12 |
$43.50 |
| G0145 |
Scr c/v cyto,thinlayer,rescr |
17 |
17 |
$35.18 |
| G0283 |
Elec stim other than wound |
41 |
12 |
$33.32 |
| 81002 |
|
15 |
15 |
$26.87 |
| Q0163 |
Diphenhydramine hcl 50mg |
425 |
369 |
$25.24 |
| J3475 |
Inj magnesium sulfate |
12 |
12 |
$16.77 |
| J2060 |
Lorazepam injection |
30 |
28 |
$1.10 |
| G1004 |
Cdsm ndsc |
684 |
555 |
$0.12 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
484 |
293 |
$0.00 |
| 91312 |
|
218 |
216 |
$0.00 |
| 90710 |
|
24 |
24 |
$0.00 |
| J3370 |
Vancomycin hcl injection |
16 |
12 |
$0.00 |
| J1756 |
Iron sucrose injection |
56 |
30 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
18 |
13 |
$0.00 |
| 49452 |
|
12 |
12 |
$0.00 |
| J2916 |
Na ferric gluconate complex |
19 |
12 |
$0.00 |
| 90619 |
|
78 |
78 |
$0.00 |
| 91305 |
|
14 |
13 |
$0.00 |
| A9579 |
Gad-base mr contrast nos,1ml |
24 |
23 |
$0.00 |
| J1010 |
Inj, methylpred acetate 1 mg |
319 |
310 |
$0.00 |
| 90677 |
|
338 |
335 |
$0.00 |
| 90674 |
|
204 |
198 |
$0.00 |
| 90697 |
|
30 |
30 |
$0.00 |
| G0439 |
Ppps, subseq visit |
21 |
18 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
107 |
101 |
$0.00 |
| 90656 |
|
211 |
209 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
15 |
15 |
$0.00 |
| 90651 |
|
53 |
53 |
$0.00 |