| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H2011 |
Crisis interven svc, 15 min |
51,356 |
30,846 |
$14.36M |
| T1017 |
Targeted case management |
121,901 |
41,585 |
$14.02M |
| H0039 |
Asser com tx face-face/15min |
77,931 |
8,297 |
$10.56M |
| S9485 |
Crisis intervention mental h |
12,804 |
2,400 |
$7.51M |
| 90834 |
|
85,097 |
46,274 |
$7.45M |
| 99284 |
|
43,738 |
41,152 |
$6.71M |
| 90792 |
|
17,179 |
15,387 |
$6.64M |
| H0037 |
Comm psy sup tx pgm per diem |
18,073 |
634 |
$5.70M |
| H0004 |
Alcohol and/or drug services |
13,107 |
2,039 |
$4.42M |
| 90837 |
|
24,588 |
19,060 |
$3.90M |
| H2021 |
Com wrap-around sv, 15 min |
28,370 |
3,933 |
$3.80M |
| 90853 |
|
52,311 |
10,349 |
$3.70M |
| G0378 |
Hospital observation per hr |
12,039 |
4,456 |
$3.53M |
| H0035 |
Mh partial hosp tx under 24h |
18,194 |
2,016 |
$2.94M |
| 99285 |
|
13,212 |
12,329 |
$2.29M |
| T1015 |
Clinic service |
74,251 |
69,908 |
$2.23M |
| H0046 |
Mental health service, nos |
14,592 |
2,674 |
$1.88M |
| 97153 |
|
10,854 |
1,058 |
$1.49M |
| 99283 |
|
14,103 |
13,158 |
$1.35M |
| 90847 |
|
14,278 |
7,909 |
$1.33M |
| 97151 |
|
4,769 |
1,210 |
$1.30M |
| 90832 |
|
32,814 |
23,599 |
$1.27M |
| 90870 |
|
3,036 |
1,020 |
$1.07M |
| H0034 |
Med trng & support per 15min |
14,053 |
10,512 |
$1.03M |
| 97155 |
|
4,334 |
1,186 |
$931K |
| 99211 |
|
15,226 |
11,866 |
$921K |
| H0038 |
Self-help/peer svc per 15min |
5,069 |
2,125 |
$834K |
| H0036 |
Comm psy face-face per 15min |
12,228 |
2,851 |
$727K |
| 74177 |
|
4,339 |
4,196 |
$547K |
| T1016 |
Case management |
2,563 |
1,198 |
$494K |
| 96374 |
|
25,780 |
23,276 |
$435K |
| H2015 |
Comp comm supp svc, 15 min |
2,209 |
212 |
$430K |
| 70553 |
|
1,586 |
1,544 |
$322K |
| 85025 |
|
64,436 |
53,104 |
$282K |
| 78815 |
|
337 |
330 |
$278K |
| Q3014 |
Telehealth facility fee |
16,555 |
15,371 |
$252K |
| 70551 |
|
1,174 |
1,143 |
$227K |
| H0001 |
Alcohol and/or drug assess |
2,091 |
1,980 |
$209K |
| 80053 |
|
24,363 |
21,531 |
$207K |
| H2010 |
Comprehensive med svc 15 min |
5,793 |
4,688 |
$197K |
| 70450 |
|
4,253 |
4,011 |
$191K |
| 90846 |
|
2,302 |
1,648 |
$180K |
| H2019 |
Ther behav svc, per 15 min |
10,324 |
3,567 |
$170K |
| 80048 |
|
29,069 |
22,811 |
$159K |
| 87536 |
|
1,579 |
1,524 |
$158K |
| 77386 |
|
603 |
66 |
$151K |
| 73721 |
|
609 |
602 |
$147K |
| 71275 |
|
1,062 |
1,030 |
$144K |
| H0047 |
Alcohol/drug abuse svc nos |
2,956 |
1,305 |
$140K |
| 96375 |
|
12,543 |
10,390 |
$137K |
| 93005 |
|
21,633 |
19,793 |
$137K |
| J3490 |
Drugs unclassified injection |
14,432 |
9,904 |
$133K |
| 72141 |
|
649 |
634 |
$130K |
| 80307 |
|
3,609 |
3,271 |
$128K |
| 74183 |
|
344 |
337 |
$126K |
| 72148 |
|
878 |
862 |
$121K |
| 71260 |
|
1,979 |
1,941 |
$115K |
| 0241U |
|
2,024 |
1,972 |
$103K |
| 99214 |
|
1,774 |
1,354 |
$93K |
| U0003 |
Cov-19 amp prb hgh thruput |
1,814 |
1,717 |
$85K |
| 77301 |
|
182 |
176 |
$82K |
| 64415 |
|
193 |
191 |
$80K |
| 71250 |
|
1,434 |
1,389 |
$74K |
| 84484 |
|
11,902 |
10,518 |
$73K |
| 74176 |
|
1,326 |
1,272 |
$73K |
| 73221 |
|
308 |
302 |
$71K |
| G0399 |
Home sleep test/type 3 porta |
634 |
627 |
$70K |
| 93306 |
|
1,330 |
1,303 |
$70K |
| 99241 |
|
705 |
678 |
$70K |
| H0030 |
Alcohol and/or drug hotline |
23,600 |
18,070 |
$70K |
| 83735 |
|
15,481 |
10,923 |
$69K |
| 72125 |
|
1,348 |
1,308 |
$67K |
| 70496 |
|
498 |
482 |
$64K |
| 97156 |
|
545 |
286 |
$64K |
| 45380 |
|
363 |
362 |
$62K |
| 85610 |
|
13,615 |
11,312 |
$60K |
| 93975 |
|
735 |
713 |
$59K |
| 71046 |
|
5,088 |
4,825 |
$58K |
| 78452 |
|
405 |
396 |
$57K |
| 71045 |
|
12,160 |
11,275 |
$56K |
| 45385 |
|
243 |
243 |
$54K |
| 86832 |
|
582 |
541 |
$54K |
| 74178 |
|
308 |
302 |
$52K |
| 43239 |
|
654 |
649 |
$52K |
| 70498 |
|
431 |
416 |
$52K |
| 70544 |
|
299 |
291 |
$51K |
| 43248 |
|
130 |
120 |
$49K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
22,289 |
20,639 |
$49K |
| 76705 |
|
1,763 |
1,678 |
$47K |
| 74174 |
|
208 |
204 |
$46K |
| 84443 |
|
2,795 |
2,704 |
$44K |
| 76536 |
|
1,058 |
1,037 |
$43K |
| 72197 |
|
122 |
121 |
$41K |
| 80050 |
|
1,061 |
1,046 |
$41K |
| 62323 |
|
586 |
564 |
$40K |
| 70491 |
|
709 |
692 |
$40K |
| 96365 |
|
1,663 |
1,250 |
$40K |
| 99213 |
|
522 |
432 |
$39K |
| 80061 |
|
3,965 |
3,846 |
$39K |
| 10005 |
|
115 |
111 |
$38K |
| 66984 |
|
40 |
38 |
$38K |
| 75561 |
|
109 |
108 |
$34K |
| 72146 |
|
249 |
244 |
$32K |
| 87491 |
|
1,629 |
1,570 |
$32K |
| 96372 |
|
4,441 |
3,261 |
$31K |
| X0616 |
|
150 |
150 |
$31K |
| 20610 |
|
201 |
187 |
$31K |
| 70486 |
|
554 |
549 |
$31K |
| 72110 |
|
1,785 |
1,755 |
$31K |
| 87591 |
|
1,628 |
1,571 |
$31K |
| 99282 |
|
566 |
542 |
$30K |
| 88185 |
|
197 |
185 |
$30K |
| 85730 |
|
6,987 |
6,336 |
$30K |
| 96158 |
|
766 |
604 |
$30K |
| 96376 |
|
1,517 |
748 |
$29K |
| 77334 |
|
591 |
424 |
$29K |
| 72158 |
|
174 |
165 |
$29K |
| 86480 |
|
449 |
438 |
$29K |
| 80076 |
|
5,081 |
4,642 |
$29K |
| J2785 |
Regadenoson injection |
1,118 |
1,098 |
$29K |
| 73610 |
|
1,858 |
1,741 |
$27K |
| 96361 |
|
1,248 |
820 |
$27K |
| 82306 |
|
1,702 |
1,668 |
$27K |
| 83605 |
|
5,146 |
4,493 |
$26K |
| 93970 |
|
391 |
384 |
$26K |
| 83880 |
|
1,313 |
1,220 |
$26K |
| 83690 |
|
8,575 |
7,853 |
$26K |
| 93971 |
|
555 |
525 |
$26K |
| 88341 |
|
535 |
515 |
$24K |
| 83036 |
|
5,202 |
5,037 |
$24K |
| 86833 |
|
412 |
380 |
$24K |
| 86235 |
|
384 |
359 |
$23K |
| 84703 |
|
3,599 |
3,433 |
$22K |
| A9577 |
Inj multihance |
3,734 |
3,590 |
$22K |
| 88305 |
|
2,149 |
2,093 |
$21K |
| 73030 |
|
1,719 |
1,641 |
$20K |
| 73630 |
|
2,289 |
2,180 |
$20K |
| 95886 |
|
656 |
639 |
$19K |
| 84100 |
|
6,422 |
4,244 |
$19K |
| 72156 |
|
113 |
108 |
$19K |
| 95913 |
|
264 |
255 |
$19K |
| 45378 |
|
127 |
126 |
$18K |
| 96366 |
|
921 |
593 |
$18K |
| 72082 |
|
727 |
712 |
$18K |
| G0480 |
Drug test def 1-7 classes |
561 |
522 |
$18K |
| 73130 |
|
1,802 |
1,681 |
$17K |
| 82728 |
|
2,146 |
2,023 |
$17K |
| 73502 |
|
1,251 |
1,196 |
$17K |
| 72100 |
|
980 |
952 |
$17K |
| J2405 |
Ondansetron hcl injection |
23,815 |
16,977 |
$17K |
| J1815 |
Insulin injection |
4,381 |
1,659 |
$17K |
| 72131 |
|
323 |
314 |
$16K |
| 96159 |
|
486 |
385 |
$16K |
| 72050 |
|
755 |
747 |
$16K |
| 73562 |
|
1,261 |
1,216 |
$16K |
| 86003 |
|
181 |
169 |
$16K |
| 99281 |
|
521 |
483 |
$16K |
| 82565 |
|
5,190 |
4,897 |
$16K |
| 94010 |
|
1,642 |
1,568 |
$16K |
| 43235 |
|
260 |
257 |
$16K |
| 88342 |
|
825 |
799 |
$16K |
| 90715 |
|
2,319 |
2,259 |
$15K |
| G0463 |
Hospital outpt clinic visit |
2,702 |
2,205 |
$15K |
| 82607 |
|
1,910 |
1,846 |
$15K |
| 87040 |
|
1,534 |
1,055 |
$15K |
| 73110 |
|
1,577 |
1,439 |
$15K |
| 88112 |
|
566 |
528 |
$15K |
| 76770 |
|
438 |
426 |
$15K |
| 81003 |
|
7,417 |
6,987 |
$15K |
| A9500 |
Tc99m sestamibi |
181 |
166 |
$14K |
| 86702 |
|
1,217 |
1,190 |
$14K |
| 76700 |
|
296 |
292 |
$14K |
| 94729 |
|
649 |
630 |
$14K |
| 73564 |
|
889 |
853 |
$14K |
| 77300 |
|
258 |
243 |
$14K |
| 17110 |
|
295 |
289 |
$14K |
| 82784 |
|
619 |
572 |
$14K |
| 86780 |
|
1,021 |
989 |
$14K |
| 77336 |
|
454 |
224 |
$14K |
| 84134 |
|
937 |
835 |
$13K |
| 87086 |
|
2,978 |
2,768 |
$13K |
| G0008 |
Admin influenza virus vac |
1,446 |
1,409 |
$13K |
| J1170 |
Hydromorphone injection |
28,279 |
11,266 |
$13K |
| 83970 |
|
400 |
390 |
$13K |
| 93017 |
|
472 |
460 |
$13K |
| 86850 |
|
2,525 |
2,362 |
$13K |
| 73718 |
|
57 |
55 |
$13K |
| 97161 |
|
736 |
713 |
$12K |
| 73560 |
|
1,059 |
1,005 |
$12K |
| 71271 |
|
153 |
152 |
$12K |
| 87497 |
|
410 |
302 |
$12K |
| M0243 |
Casirivi and imdevi inj |
28 |
28 |
$11K |
| 86701 |
|
1,217 |
1,190 |
$11K |
| 82977 |
|
1,644 |
1,395 |
$11K |
| 99201 |
|
269 |
256 |
$11K |
| 85027 |
|
3,228 |
2,410 |
$11K |
| 73700 |
|
219 |
212 |
$11K |
| 80197 |
|
1,292 |
825 |
$11K |
| 87522 |
Neg quan hep c or qual rna |
355 |
336 |
$10K |
| 73590 |
|
858 |
801 |
$10K |
| 82105 |
|
785 |
755 |
$10K |
| 36415 |
|
6,450 |
5,516 |
$10K |
| J3535 |
Metered dose inhaler drug |
762 |
723 |
$10K |
| J2001 |
Lidocaine injection |
96 |
70 |
$10K |
| 86803 |
|
665 |
653 |
$10K |
| G0472 |
Hep c screen high risk/other |
657 |
645 |
$10K |
| J7120 |
Ringers lactate infusion |
35,327 |
18,291 |
$10K |
| 81025 |
|
3,806 |
3,619 |
$10K |
| 82803 |
|
605 |
555 |
$10K |
| 87390 |
|
1,205 |
1,178 |
$9K |
| 82962 |
|
7,325 |
4,199 |
$9K |
| 86923 |
|
252 |
224 |
$9K |
| 72157 |
|
58 |
58 |
$9K |
| J1756 |
Iron sucrose injection |
2,245 |
1,164 |
$9K |
| 87081 |
|
2,400 |
2,117 |
$9K |
| 83540 |
|
1,553 |
1,476 |
$8K |
| 97162 |
|
486 |
470 |
$8K |
| 84702 |
|
704 |
655 |
$8K |
| 72128 |
|
154 |
151 |
$8K |
| 87661 |
|
309 |
298 |
$8K |
| 78264 |
|
91 |
91 |
$8K |
| 81001 |
|
3,746 |
3,463 |
$8K |
| 87340 |
|
731 |
708 |
$8K |
| 84439 |
|
1,266 |
1,228 |
$8K |
| 76856 |
|
219 |
217 |
$8K |
| 76830 |
|
238 |
236 |
$8K |
| 36430 |
|
184 |
151 |
$7K |
| 73552 |
|
611 |
570 |
$7K |
| 85379 |
|
1,059 |
1,026 |
$7K |
| 86706 |
|
706 |
685 |
$7K |
| 84153 |
|
325 |
317 |
$7K |
| 95911 |
|
121 |
119 |
$7K |
| 72040 |
|
535 |
521 |
$7K |
| 86361 |
|
274 |
264 |
$7K |
| 87070 |
|
1,540 |
1,415 |
$7K |
| 94726 |
|
311 |
306 |
$7K |
| 86901 |
|
2,534 |
2,368 |
$6K |
| 86900 |
|
2,527 |
2,362 |
$6K |
| 93320 |
|
174 |
172 |
$6K |
| 92250 |
|
193 |
180 |
$6K |
| 11102 |
|
144 |
143 |
$6K |
| 82550 |
|
1,360 |
1,256 |
$6K |
| 82746 |
|
942 |
921 |
$6K |
| 70487 |
|
118 |
114 |
$6K |
| 80329 |
|
619 |
585 |
$6K |
| 86038 |
|
485 |
474 |
$6K |
| 82043 |
|
964 |
936 |
$6K |
| 77002 |
|
281 |
280 |
$6K |
| 86704 |
|
478 |
467 |
$5K |
| 87077 |
|
1,031 |
969 |
$5K |
| P9021 |
Red blood cells unit |
104 |
88 |
$5K |
| J8501 |
Oral aprepitant |
395 |
360 |
$5K |
| 94060 |
|
624 |
610 |
$5K |
| 74018 |
|
632 |
568 |
$5K |
| 87624 |
|
162 |
159 |
$5K |
| 90682 |
|
543 |
504 |
$5K |
| 95810 |
|
25 |
25 |
$5K |
| 83550 |
|
1,509 |
1,434 |
$5K |
| 86140 |
|
2,505 |
2,334 |
$5K |
| 93226 |
|
162 |
159 |
$5K |
| 72070 |
|
294 |
287 |
$5K |
| 80047 |
|
689 |
667 |
$5K |
| 88175 |
|
186 |
184 |
$5K |
| 83615 |
|
996 |
822 |
$4K |
| 80051 |
|
1,258 |
1,158 |
$4K |
| 95885 |
|
200 |
195 |
$4K |
| 73140 |
|
560 |
493 |
$4K |
| 84520 |
|
1,514 |
1,401 |
$4K |
| 86708 |
|
313 |
302 |
$4K |
| 99212 |
|
41 |
34 |
$4K |
| 88313 |
|
258 |
244 |
$4K |
| A9579 |
Gad-base mr contrast nos,1ml |
2,231 |
2,194 |
$4K |
| 88184 |
|
200 |
188 |
$4K |
| 73070 |
|
447 |
414 |
$4K |
| 75574 |
|
26 |
26 |
$4K |
| 76870 |
|
119 |
119 |
$4K |
| 74220 |
|
276 |
268 |
$4K |
| 99215 |
Prolong outpt/office vis |
45 |
38 |
$4K |
| 86831 |
|
70 |
67 |
$4K |
| 73222 |
|
13 |
13 |
$4K |
| 83021 |
|
275 |
187 |
$4K |
| 90674 |
|
1,104 |
1,085 |
$4K |
| 86160 |
|
248 |
237 |
$4K |
| 87905 |
|
391 |
380 |
$4K |
| 73090 |
|
399 |
376 |
$4K |
| 84165 |
|
313 |
300 |
$4K |
| 78227 |
|
12 |
12 |
$4K |
| 93350 |
|
92 |
92 |
$3K |
| 87205 |
|
1,367 |
1,270 |
$3K |
| 87186 |
|
726 |
684 |
$3K |
| 86592 |
|
1,016 |
986 |
$3K |
| 97165 |
|
283 |
270 |
$3K |
| 92540 |
|
366 |
363 |
$3K |
| 76942 |
|
529 |
519 |
$3K |
| 82570 |
|
738 |
691 |
$3K |
| G0108 |
Diab manage trn per indiv |
142 |
127 |
$3K |
| 85014 |
|
1,765 |
1,609 |
$3K |
| 85652 |
|
1,524 |
1,414 |
$3K |
| 87808 |
|
386 |
374 |
$3K |
| J0690 |
Cefazolin sodium injection |
5,282 |
3,598 |
$3K |
| A9552 |
F18 fdg |
100 |
80 |
$3K |
| 46600 |
|
192 |
188 |
$3K |
| G0297 |
Ldct for lung ca screen |
46 |
46 |
$3K |
| 73060 |
|
358 |
342 |
$3K |
| 86618 |
|
190 |
184 |
$3K |
| 84403 |
|
117 |
112 |
$3K |
| 90471 |
|
321 |
296 |
$3K |
| J1644 |
Inj heparin sodium per 1000u |
8,029 |
3,191 |
$3K |
| 85018 |
|
1,376 |
1,225 |
$3K |
| 80069 |
|
539 |
425 |
$3K |
| 72190 |
|
149 |
142 |
$3K |
| 82947 |
|
1,159 |
1,104 |
$3K |
| J1650 |
Inj enoxaparin sodium |
9,051 |
3,697 |
$3K |
| 73200 |
|
56 |
54 |
$3K |
| 86902 |
|
93 |
76 |
$3K |
| 93880 |
|
29 |
29 |
$3K |
| C1769 |
Guide wire |
446 |
413 |
$3K |
| 96156 |
|
60 |
60 |
$3K |
| 95819 |
|
260 |
252 |
$2K |
| 78306 |
|
52 |
52 |
$2K |
| J7999 |
Compounded drug, noc |
2,564 |
2,107 |
$2K |
| 72195 |
|
14 |
13 |
$2K |
| M0247 |
Sotrovimab infusion |
12 |
12 |
$2K |
| 85045 |
|
824 |
718 |
$2K |
| 82785 |
|
169 |
167 |
$2K |
| J7030 |
Normal saline solution infus |
6,492 |
4,835 |
$2K |
| 90732 |
|
116 |
110 |
$2K |
| 73080 |
|
263 |
253 |
$2K |
| 84550 |
|
611 |
525 |
$2K |
| 84132 |
|
569 |
533 |
$2K |
| 74160 |
|
43 |
43 |
$2K |
| J0780 |
Prochlorperazine injection |
4,212 |
3,252 |
$2K |
| 92546 |
|
381 |
377 |
$2K |
| 95708 |
|
22 |
13 |
$2K |
| 64483 |
|
30 |
30 |
$2K |
| 87517 |
|
77 |
73 |
$2K |
| 82533 |
|
195 |
167 |
$2K |
| 86800 |
|
135 |
122 |
$2K |
| 95912 |
|
27 |
27 |
$2K |
| C1725 |
Cath, translumin non-laser |
54 |
47 |
$2K |
| 93923 |
|
43 |
41 |
$2K |
| 93225 |
|
163 |
160 |
$2K |
| 88312 |
|
106 |
101 |
$2K |
| 84402 |
|
73 |
72 |
$2K |
| 84146 |
|
84 |
84 |
$2K |
| 81002 |
|
736 |
706 |
$2K |
| 86256 |
|
146 |
141 |
$2K |
| 73501 |
|
191 |
183 |
$2K |
| 80321 |
|
147 |
144 |
$2K |
| 97166 |
|
162 |
157 |
$2K |
| 83001 |
|
92 |
91 |
$2K |
| G0009 |
Admin pneumococcal vaccine |
218 |
206 |
$2K |
| J2795 |
Ropivacaine hcl injection |
679 |
641 |
$2K |
| 94640 |
|
861 |
369 |
$2K |
| 87102 |
|
377 |
357 |
$2K |
| 88237 |
|
13 |
13 |
$2K |
| 72170 |
|
238 |
233 |
$2K |
| 73000 |
|
149 |
142 |
$2K |
| J0171 |
Adrenalin epinephrine inject |
498 |
477 |
$2K |
| 85651 |
|
823 |
776 |
$1K |
| J3010 |
Fentanyl citrate injection |
9,739 |
8,209 |
$1K |
| J2930 |
Methylprednisolone injection |
1,001 |
850 |
$1K |
| 84295 |
|
360 |
338 |
$1K |
| 86334 |
|
76 |
73 |
$1K |
| 93271 |
|
42 |
42 |
$1K |
| 86644 |
|
80 |
76 |
$1K |
| J2997 |
Alteplase recombinant |
24 |
13 |
$1K |
| 85240 |
|
93 |
84 |
$1K |
| 70547 |
|
12 |
12 |
$1K |
| 96360 |
|
70 |
67 |
$1K |
| 80177 |
|
158 |
144 |
$1K |
| 82310 |
|
380 |
326 |
$1K |
| 88307 |
|
408 |
394 |
$1K |
| 86431 |
|
219 |
216 |
$1K |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
1,615 |
1,571 |
$1K |
| 87075 |
|
283 |
265 |
$1K |
| 92537 |
|
254 |
251 |
$1K |
| 89051 |
|
413 |
298 |
$1K |
| J2270 |
Morphine sulfate injection |
2,529 |
1,474 |
$1K |
| 77412 |
|
43 |
12 |
$1K |
| 84432 |
|
60 |
53 |
$1K |
| J3475 |
Inj magnesium sulfate |
3,122 |
2,595 |
$1K |
| 82040 |
|
547 |
514 |
$1K |
| 86580 |
|
249 |
211 |
$1K |
| J0295 |
Ampicillin sulbactam 1.5 gm |
1,978 |
1,004 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
16,764 |
12,735 |
$1K |
| 88264 |
|
13 |
13 |
$1K |
| 82810 |
|
108 |
99 |
$1K |
| 82330 |
|
262 |
203 |
$1K |
| J3370 |
Vancomycin hcl injection |
1,712 |
926 |
$1K |
| 82103 |
|
72 |
71 |
$1K |
| 92547 |
|
411 |
407 |
$1K |
| 84460 |
|
280 |
240 |
$1K |
| C9399 |
Unclassified drugs or biolog |
269 |
259 |
$1K |
| S0119 |
Ondansetron 4 mg |
1,990 |
1,280 |
$1K |
| 82104 |
|
69 |
68 |
$1K |
| 82150 |
|
325 |
303 |
$1K |
| 84156 |
|
426 |
390 |
$1K |
| 72114 |
|
76 |
75 |
$1K |
| 29826 |
|
12 |
12 |
$1K |
| 74019 |
|
96 |
89 |
$980.74 |
| 86200 |
|
83 |
82 |
$968.87 |
| C1894 |
Intro/sheath, non-laser |
341 |
321 |
$966.82 |
| 86713 |
|
76 |
76 |
$965.62 |
| J1030 |
Methylprednisolone 40 mg inj |
209 |
207 |
$918.16 |
| 90750 |
|
85 |
84 |
$859.88 |
| 87426 |
|
213 |
210 |
$841.98 |
| J2543 |
Piperacillin/tazobactam |
893 |
342 |
$838.93 |
| 76937 |
|
287 |
275 |
$832.18 |
| 82248 |
|
139 |
131 |
$825.12 |
| 99153 |
Mod sedat endo service >5yrs |
606 |
587 |
$818.93 |
| J1100 |
Dexamethasone sodium phos |
5,233 |
4,488 |
$806.94 |
| 94618 |
|
87 |
84 |
$806.21 |
| 86787 |
|
50 |
49 |
$786.65 |
| 73620 |
|
120 |
116 |
$782.49 |
| 85049 |
|
489 |
458 |
$780.22 |
| 86617 |
|
28 |
26 |
$779.60 |
| 87799 |
|
101 |
52 |
$750.23 |
| 84450 |
|
177 |
160 |
$749.49 |
| 73521 |
|
75 |
71 |
$748.72 |
| 94760 |
|
1,726 |
1,570 |
$747.69 |
| 80164 |
|
65 |
60 |
$744.05 |
| 77012 |
|
30 |
27 |
$718.46 |
| 87635 |
|
28 |
28 |
$709.83 |
| 92611 |
|
29 |
29 |
$699.55 |
| 70480 |
|
12 |
12 |
$698.32 |
| 86255 |
|
31 |
30 |
$692.68 |
| 74230 |
|
39 |
39 |
$691.04 |
| 83010 |
|
103 |
92 |
$688.32 |
| 86376 |
|
107 |
102 |
$672.98 |
| 85576 |
|
61 |
57 |
$644.61 |
| 82164 |
|
45 |
40 |
$638.63 |
| 82390 |
|
63 |
61 |
$630.81 |
| J1040 |
Methylprednisolone 80 mg inj |
145 |
141 |
$629.16 |
| 95910 |
|
12 |
12 |
$624.72 |
| J0696 |
Ceftriaxone sodium injection |
3,193 |
2,570 |
$623.57 |
| 96136 |
|
128 |
122 |
$623.00 |
| 82140 |
|
249 |
235 |
$615.84 |
| 84425 |
|
164 |
159 |
$612.34 |
| Q9957 |
Inj perflutren lip micros,ml |
50 |
50 |
$605.42 |
| 86695 |
|
38 |
37 |
$600.35 |
| 91322 |
|
14 |
14 |
$585.92 |
| 86317 |
|
30 |
29 |
$571.70 |
| 84446 |
|
60 |
59 |
$567.31 |
| J2250 |
Inj midazolam hydrochloride |
10,051 |
8,687 |
$559.08 |
| 84157 |
|
228 |
206 |
$519.55 |
| 84590 |
|
45 |
44 |
$515.11 |
| 86664 |
|
30 |
29 |
$508.76 |
| J7050 |
Normal saline solution infus |
7,663 |
4,382 |
$508.60 |
| 87116 |
|
151 |
140 |
$501.76 |
| 82375 |
|
140 |
134 |
$501.24 |
| 99152 |
|
155 |
148 |
$493.80 |
| 84155 |
|
175 |
170 |
$481.98 |
| J1200 |
Diphenhydramine hcl injectio |
4,686 |
3,402 |
$462.27 |
| 86777 |
|
26 |
25 |
$458.74 |
| 80074 |
|
13 |
13 |
$458.36 |
| J0360 |
Hydralazine hcl injection |
396 |
275 |
$440.27 |
| 86663 |
|
30 |
29 |
$440.17 |
| 86645 |
|
15 |
14 |
$427.77 |
| 72020 |
|
46 |
41 |
$424.64 |
| 86021 |
|
115 |
112 |
$423.77 |
| 84075 |
|
104 |
90 |
$410.68 |
| J3411 |
Thiamine hcl 100 mg |
400 |
209 |
$407.30 |
| 93270 |
|
39 |
39 |
$403.87 |
| 86665 |
|
30 |
29 |
$401.28 |
| 84480 |
|
73 |
70 |
$398.47 |
| 87015 |
|
109 |
99 |
$397.05 |
| 85660 |
|
101 |
88 |
$376.72 |
| 73120 |
|
46 |
45 |
$373.72 |
| 84436 |
|
54 |
53 |
$364.61 |
| 0001A |
|
101 |
61 |
$360.00 |
| J3360 |
Diazepam injection |
127 |
88 |
$345.51 |
| 87184 |
|
59 |
56 |
$325.54 |
| 73600 |
|
57 |
54 |
$322.02 |
| J1630 |
Haloperidol injection |
1,170 |
938 |
$311.96 |
| 86696 |
|
13 |
12 |
$311.88 |
| 82247 |
|
108 |
86 |
$293.30 |
| 97542 |
|
16 |
12 |
$285.37 |
| J2060 |
Lorazepam injection |
2,628 |
2,044 |
$278.15 |
| S0020 |
Injection, bupivicaine hydro |
745 |
721 |
$276.40 |
| J3480 |
Inj potassium chloride |
1,568 |
686 |
$274.91 |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
424 |
414 |
$272.32 |
| L4360 |
Pneumat walking boot pre cst |
12 |
12 |
$264.37 |
| 97163 |
|
14 |
12 |
$263.82 |
| 73100 |
|
29 |
27 |
$254.25 |
| J2765 |
Metoclopramide hcl injection |
1,515 |
1,238 |
$242.31 |
| J0330 |
Succinycholine chloride inj |
466 |
413 |
$241.31 |
| 70250 |
|
16 |
13 |
$239.03 |
| 95816 |
|
46 |
44 |
$238.71 |
| J3420 |
Vitamin b12 injection |
1,136 |
943 |
$235.22 |
| 97167 |
|
12 |
12 |
$232.70 |
| 76882 |
|
39 |
39 |
$225.70 |
| 82805 |
|
12 |
12 |
$222.68 |
| 93041 |
|
96 |
89 |
$221.27 |
| 80202 |
|
26 |
12 |
$217.14 |
| 84300 |
|
56 |
55 |
$210.91 |
| 87206 |
|
156 |
146 |
$206.78 |
| 87880 |
|
60 |
60 |
$192.34 |
| 88304 |
|
232 |
230 |
$184.12 |
| 36600 |
|
26 |
26 |
$176.76 |
| S0028 |
Injection, famotidine, 20 mg |
1,550 |
1,172 |
$176.06 |
| 87430 |
|
39 |
39 |
$169.66 |
| 84630 |
|
14 |
14 |
$161.21 |
| A9503 |
Tc99m medronate |
27 |
27 |
$160.92 |
| 87181 |
|
24 |
24 |
$159.50 |
| 89050 |
|
236 |
154 |
$158.40 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
248 |
229 |
$157.81 |
| 94761 |
|
108 |
97 |
$154.82 |
| 80178 |
|
30 |
27 |
$149.60 |
| 85097 |
|
13 |
13 |
$147.84 |
| 86705 |
|
12 |
12 |
$144.00 |
| 82378 |
|
12 |
12 |
$141.30 |
| C9803 |
Hopd covid-19 spec collect |
357 |
330 |
$138.77 |
| 86769 |
|
14 |
14 |
$136.83 |
| 86141 |
|
13 |
12 |
$127.17 |
| 71101 |
|
13 |
13 |
$119.02 |
| 86308 |
|
29 |
29 |
$118.76 |
| J1940 |
Furosemide injection |
723 |
488 |
$115.87 |
| 82652 |
|
12 |
12 |
$112.94 |
| G0379 |
Direct refer hospital observ |
16 |
15 |
$109.87 |
| 82525 |
|
14 |
12 |
$106.76 |
| J1953 |
Levetiracetam injection |
137 |
94 |
$99.00 |
| J7040 |
Normal saline solution infus |
534 |
431 |
$89.68 |
| 83930 |
|
47 |
42 |
$88.80 |
| 80158 |
|
15 |
12 |
$87.15 |
| J2704 |
Inj, propofol, 10 mg |
2,111 |
1,761 |
$78.91 |
| C1887 |
Catheter, guiding |
114 |
106 |
$68.29 |
| J7060 |
5% dextrose/water |
105 |
77 |
$64.72 |
| 85732 |
|
15 |
13 |
$64.66 |
| J0610 |
Calcium glucon (fresenius) |
14 |
12 |
$57.89 |
| J7620 |
Albuterol ipratrop non-comp |
4,295 |
2,178 |
$51.42 |
| J7512 |
Prednisone ir or dr oral 1mg |
3,787 |
2,237 |
$46.90 |
| J1580 |
Garamycin gentamicin inj |
45 |
42 |
$46.22 |
| 0002A |
|
87 |
44 |
$40.00 |
| J7613 |
Albuterol non-comp unit |
2,127 |
1,498 |
$39.14 |
| 88300 |
|
115 |
108 |
$37.50 |
| 85048 |
|
15 |
15 |
$34.48 |
| 77003 |
|
14 |
14 |
$31.01 |
| 83935 |
|
14 |
12 |
$29.40 |
| J2920 |
Methylprednisolone injection |
118 |
66 |
$26.40 |
| J0692 |
Cefepime hcl for injection |
46 |
27 |
$20.16 |
| S0077 |
Injection, clindamycin phosp |
115 |
97 |
$19.26 |
| J3301 |
Triamcinolone acet inj nos |
108 |
106 |
$15.92 |
| J0744 |
Ciprofloxacin iv |
49 |
36 |
$14.16 |
| J7042 |
5% dextrose/normal saline |
40 |
26 |
$13.60 |
| J7507 |
Tacrolimus imme rel oral 1mg |
52 |
12 |
$10.23 |
| 85041 |
|
18 |
12 |
$7.64 |
| J8540 |
Oral dexamethasone |
89 |
75 |
$6.24 |
| J1642 |
Inj heparin sodium per 10 u |
61 |
59 |
$5.50 |
| A4216 |
Sterile water/saline, 10 ml |
88 |
87 |
$3.60 |
| 91300 |
|
77 |
61 |
$0.76 |
| 90677 |
|
374 |
373 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
2,546 |
2,305 |
$0.00 |
| J1790 |
Droperidol injection |
12 |
12 |
$0.00 |
| J7644 |
Ipratropium bromide non-comp |
58 |
54 |
$0.00 |
| Q0240 |
Casirivi and imdevi 600 mg |
35 |
35 |
$0.00 |
| Q0247 |
Sotrovimab |
53 |
51 |
$0.00 |
| 90673 |
|
237 |
237 |
$0.00 |
| A9585 |
Gadobutrol injection |
112 |
109 |
$0.00 |
| Q0222 |
Bebtelovimab 175 mg |
15 |
15 |
$0.00 |
| J1610 |
Glucagon hydrochloride/1 mg |
26 |
25 |
$0.00 |
| 90480 |
|
15 |
14 |
$0.00 |
| J0280 |
Aminophyllin 250 mg inj |
13 |
13 |
$0.00 |
| J2916 |
Na ferric gluconate complex |
118 |
71 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
38 |
36 |
$0.00 |
| 90611 |
|
28 |
28 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
640 |
336 |
$0.00 |
| 88173 |
|
27 |
26 |
$0.00 |
| C1751 |
Cath, inf, per/cent/midline |
98 |
92 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
182 |
157 |
$0.00 |
| 90661 |
|
189 |
187 |
$0.00 |
| J2800 |
Methocarbamol injection |
97 |
69 |
$0.00 |
| J0134 |
Inj acetaminophen -fresenius |
39 |
39 |
$0.00 |
| Q0245 |
Bamlanivimab and etesevima |
15 |
13 |
$0.00 |
| Q5106 |
Inj retacrit non-esrd use |
34 |
17 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
38 |
15 |
$0.00 |
| 90734 |
|
13 |
13 |
$0.00 |
| S0030 |
Injection, metronidazole |
69 |
16 |
$0.00 |
| C1760 |
Closure dev, vasc |
17 |
15 |
$0.00 |