| Code | Description | Claims | Beneficiaries | Total Paid |
| 99283 |
|
140,351 |
131,137 |
$28.48M |
| 92507 |
|
72,448 |
18,048 |
$14.67M |
| 99284 |
|
60,077 |
56,612 |
$14.37M |
| 97530 |
|
70,918 |
17,913 |
$13.00M |
| 97110 |
|
47,678 |
13,708 |
$10.32M |
| 99282 |
|
32,173 |
30,886 |
$6.17M |
| 87804 |
|
64,480 |
57,514 |
$4.19M |
| G0378 |
Hospital observation per hr |
28,258 |
14,253 |
$3.78M |
| 93306 |
|
5,664 |
5,515 |
$3.34M |
| 41899 |
|
3,410 |
3,218 |
$2.83M |
| 87635 |
|
37,698 |
35,491 |
$2.77M |
| 44970 |
|
947 |
890 |
$2.69M |
| 97112 |
|
14,550 |
4,551 |
$2.68M |
| J1745 |
Infliximab not biosimil 10mg |
2,038 |
1,888 |
$2.41M |
| 99285 |
|
12,878 |
11,962 |
$2.26M |
| 99213 |
|
14,666 |
13,066 |
$2.04M |
| 96365 |
|
10,793 |
9,836 |
$2.02M |
| 93303 |
|
2,633 |
2,482 |
$1.57M |
| 71046 |
|
25,546 |
24,347 |
$1.44M |
| 70553 |
|
4,792 |
4,413 |
$1.39M |
| 76775 |
|
9,052 |
8,781 |
$1.37M |
| 92587 |
|
5,760 |
5,333 |
$1.36M |
| 76705 |
|
15,306 |
14,459 |
$1.36M |
| 92526 |
|
12,602 |
3,868 |
$1.29M |
| 72082 |
|
12,925 |
12,660 |
$1.26M |
| 84703 |
|
11,105 |
10,349 |
$1.15M |
| 87633 |
|
7,289 |
7,019 |
$1.14M |
| 96374 |
|
10,038 |
8,192 |
$1.12M |
| 96372 |
|
8,761 |
8,220 |
$1.12M |
| 99214 |
|
20,616 |
19,618 |
$1.11M |
| 87086 |
|
17,682 |
16,878 |
$1.02M |
| 92523 |
|
4,438 |
4,357 |
$988K |
| 70551 |
|
3,725 |
3,586 |
$973K |
| 95810 |
|
1,012 |
979 |
$968K |
| 01922 |
|
5,612 |
5,302 |
$814K |
| 80053 |
|
12,997 |
11,708 |
$779K |
| 76700 |
|
3,456 |
3,364 |
$728K |
| 76536 |
|
4,251 |
4,129 |
$716K |
| S0119 |
Ondansetron 4 mg |
2,448 |
2,342 |
$702K |
| 77072 |
|
7,373 |
7,254 |
$695K |
| 73610 |
|
6,814 |
5,954 |
$677K |
| 95816 |
|
2,216 |
2,147 |
$649K |
| 97168 |
|
1,909 |
1,877 |
$642K |
| 95715 |
|
1,232 |
1,086 |
$629K |
| 73140 |
|
5,672 |
5,115 |
$628K |
| 87651 |
|
16,153 |
15,653 |
$625K |
| 0202U |
|
2,665 |
2,581 |
$593K |
| C9399 |
Unclassified drugs or biolog |
5,989 |
5,638 |
$591K |
| 76856 |
|
4,397 |
4,265 |
$575K |
| 97164 |
|
1,522 |
1,478 |
$568K |
| 95782 |
|
612 |
595 |
$562K |
| 73630 |
|
6,928 |
5,962 |
$540K |
| 97161 |
|
2,249 |
2,119 |
$513K |
| 0241U |
|
1,789 |
1,742 |
$478K |
| 80048 |
|
10,910 |
9,301 |
$457K |
| 70450 |
|
2,532 |
2,393 |
$451K |
| 73721 |
|
1,386 |
1,350 |
$449K |
| 74455 |
|
857 |
830 |
$448K |
| 99215 |
Prolong outpt/office vis |
12,484 |
11,940 |
$429K |
| 94640 |
|
10,927 |
8,685 |
$419K |
| 93976 |
|
2,608 |
2,511 |
$408K |
| 92610 |
|
1,591 |
1,548 |
$408K |
| 87070 |
|
12,517 |
11,991 |
$399K |
| J1561 |
Gamunex-c/gammaked |
306 |
172 |
$394K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
1,382 |
1,283 |
$387K |
| Q0163 |
Diphenhydramine hcl 50mg |
720 |
669 |
$383K |
| 73090 |
|
6,296 |
4,763 |
$374K |
| 73130 |
|
4,403 |
3,871 |
$368K |
| 85027 |
|
30,958 |
26,405 |
$364K |
| 74019 |
|
6,525 |
6,230 |
$331K |
| 72170 |
|
3,975 |
3,880 |
$330K |
| 73100 |
|
3,786 |
3,254 |
$327K |
| 74177 |
|
1,157 |
1,089 |
$325K |
| 76885 |
|
1,629 |
1,532 |
$325K |
| 73070 |
|
5,078 |
3,895 |
$323K |
| 80306 |
|
2,043 |
1,950 |
$312K |
| 43239 |
|
887 |
856 |
$312K |
| 97116 |
|
3,807 |
1,242 |
$306K |
| 97162 |
|
932 |
917 |
$304K |
| 73110 |
|
3,837 |
3,503 |
$298K |
| 93005 |
|
19,279 |
18,332 |
$288K |
| 74018 |
|
3,571 |
3,334 |
$283K |
| 81001 |
|
26,205 |
24,807 |
$280K |
| 96361 |
|
4,507 |
3,345 |
$278K |
| 73590 |
|
3,678 |
2,933 |
$277K |
| 87426 |
|
21,903 |
20,590 |
$275K |
| 76882 |
|
1,811 |
1,767 |
$271K |
| 99203 |
|
1,643 |
1,611 |
$264K |
| 87880 |
|
18,207 |
17,523 |
$245K |
| 24640 |
|
516 |
481 |
$245K |
| 36430 |
|
529 |
301 |
$244K |
| 96413 |
|
3,932 |
2,879 |
$241K |
| 88305 |
|
4,277 |
4,110 |
$231K |
| 80047 |
|
2,363 |
2,260 |
$227K |
| 73564 |
|
2,464 |
2,241 |
$226K |
| 97167 |
|
767 |
754 |
$224K |
| 76770 |
|
1,316 |
1,270 |
$201K |
| 12011 |
|
1,709 |
1,652 |
$200K |
| 73521 |
|
2,293 |
2,226 |
$197K |
| 96415 |
|
2,738 |
2,101 |
$191K |
| 96375 |
|
9,790 |
7,461 |
$186K |
| 87807 |
|
11,906 |
11,281 |
$184K |
| 88312 |
|
2,529 |
2,432 |
$184K |
| 99281 |
|
1,915 |
1,759 |
$182K |
| 82962 |
|
2,976 |
2,362 |
$173K |
| 73560 |
|
2,925 |
2,454 |
$171K |
| 96366 |
|
1,144 |
931 |
$165K |
| 73000 |
|
1,807 |
1,552 |
$162K |
| 87045 |
|
2,471 |
2,380 |
$162K |
| 96360 |
|
1,487 |
1,346 |
$161K |
| J1741 |
Ibuprofen injection |
802 |
764 |
$160K |
| 99212 |
|
2,117 |
1,443 |
$148K |
| 86140 |
|
12,520 |
11,542 |
$146K |
| 97166 |
|
457 |
448 |
$146K |
| 94664 |
|
10,481 |
9,293 |
$145K |
| 96450 |
|
259 |
198 |
$138K |
| U0003 |
Cov-19 amp prb hgh thruput |
851 |
824 |
$136K |
| 76641 |
|
1,317 |
740 |
$132K |
| 99202 |
|
663 |
658 |
$132K |
| 74240 |
|
703 |
694 |
$128K |
| 76506 |
|
766 |
747 |
$127K |
| J1569 |
Gammagard liquid injection |
57 |
28 |
$125K |
| J1642 |
Inj heparin sodium per 10 u |
6,186 |
2,140 |
$125K |
| 82805 |
|
2,004 |
1,768 |
$123K |
| 97760 |
|
538 |
467 |
$122K |
| 99204 |
|
2,438 |
2,402 |
$121K |
| 70360 |
|
1,936 |
1,904 |
$118K |
| 95819 |
|
337 |
333 |
$111K |
| 12001 |
|
904 |
877 |
$107K |
| 81003 |
|
2,205 |
2,082 |
$106K |
| 49452 |
|
191 |
183 |
$102K |
| 36000 |
|
1,231 |
1,130 |
$101K |
| 77073 |
|
1,000 |
965 |
$100K |
| 87507 |
|
1,656 |
1,577 |
$99K |
| 97140 |
|
1,799 |
882 |
$97K |
| 74183 |
|
163 |
150 |
$92K |
| 84100 |
|
4,235 |
2,083 |
$89K |
| 73080 |
|
1,350 |
1,163 |
$85K |
| 73660 |
|
797 |
700 |
$85K |
| 73030 |
|
1,221 |
1,132 |
$85K |
| 73552 |
|
1,550 |
1,268 |
$83K |
| 72100 |
|
1,056 |
1,024 |
$82K |
| 64450 |
|
262 |
243 |
$75K |
| 96376 |
|
2,835 |
2,037 |
$75K |
| 82247 |
|
1,100 |
776 |
$74K |
| 95951 |
|
439 |
384 |
$74K |
| 97113 |
|
220 |
111 |
$71K |
| 92579 |
|
3,381 |
3,082 |
$69K |
| 80076 |
|
4,592 |
3,448 |
$69K |
| 82657 |
|
1,631 |
1,576 |
$67K |
| 72148 |
|
454 |
430 |
$67K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
3,363 |
2,289 |
$65K |
| 73060 |
|
938 |
770 |
$65K |
| 97163 |
|
170 |
167 |
$64K |
| 00140 |
|
229 |
221 |
$62K |
| 95822 |
|
1,058 |
1,021 |
$58K |
| 87077 |
|
5,411 |
5,174 |
$57K |
| 70220 |
|
565 |
555 |
$57K |
| P9040 |
Rbc leukoreduced irradiated |
80 |
66 |
$57K |
| 82397 |
|
519 |
485 |
$54K |
| 43762 |
|
499 |
473 |
$54K |
| 76010 |
|
350 |
328 |
$54K |
| J1644 |
Inj heparin sodium per 1000u |
888 |
242 |
$54K |
| 95700 |
|
1,227 |
1,156 |
$53K |
| 82728 |
|
1,125 |
935 |
$52K |
| 90999 |
|
360 |
14 |
$51K |
| 69436 |
|
190 |
168 |
$51K |
| J0585 |
Injection,onabotulinumtoxina |
71 |
65 |
$51K |
| 74241 |
|
299 |
295 |
$51K |
| 78700 |
|
99 |
97 |
$49K |
| 92588 |
|
418 |
409 |
$49K |
| 86665 |
|
1,097 |
1,011 |
$45K |
| 99205 |
Prolong outpt/office vis |
1,708 |
1,678 |
$45K |
| 83735 |
|
3,155 |
1,976 |
$45K |
| 88304 |
|
2,118 |
2,000 |
$44K |
| 70260 |
|
358 |
354 |
$44K |
| 76800 |
|
239 |
233 |
$43K |
| 92557 |
|
577 |
553 |
$42K |
| 01999 |
|
388 |
378 |
$40K |
| 93325 |
|
3,000 |
2,823 |
$35K |
| 82947 |
|
3,411 |
2,790 |
$34K |
| 82565 |
|
1,025 |
812 |
$33K |
| 96409 |
|
503 |
333 |
$33K |
| 84295 |
|
1,501 |
1,264 |
$33K |
| 77077 |
|
496 |
482 |
$33K |
| 73565 |
|
448 |
446 |
$33K |
| 84132 |
|
1,762 |
1,480 |
$32K |
| 69210 |
|
444 |
396 |
$31K |
| 83970 |
|
462 |
346 |
$31K |
| 89050 |
|
644 |
486 |
$31K |
| 76857 |
|
274 |
269 |
$30K |
| 71045 |
|
1,061 |
950 |
$30K |
| 72146 |
|
197 |
193 |
$29K |
| 99211 |
|
786 |
505 |
$29K |
| 73620 |
|
561 |
446 |
$29K |
| C2617 |
Stent, non-cor, tem w/o del |
243 |
235 |
$29K |
| 82550 |
|
2,411 |
2,186 |
$28K |
| 72040 |
|
443 |
417 |
$28K |
| 42820 |
|
160 |
135 |
$28K |
| 85045 |
|
1,446 |
931 |
$28K |
| 97535 |
|
364 |
222 |
$27K |
| 72197 |
|
132 |
110 |
$26K |
| 87798 |
|
7,796 |
7,103 |
$26K |
| 36591 |
|
932 |
531 |
$25K |
| 74230 |
|
99 |
96 |
$24K |
| 83550 |
|
596 |
488 |
$24K |
| 83540 |
|
694 |
575 |
$23K |
| 00400 |
|
410 |
390 |
$23K |
| 97763 |
|
568 |
438 |
$23K |
| 70543 |
|
82 |
77 |
$22K |
| 85007 |
|
23,897 |
20,979 |
$22K |
| 29075 |
|
1,769 |
1,686 |
$22K |
| 82306 |
|
1,857 |
1,742 |
$22K |
| 86850 |
|
2,050 |
1,782 |
$21K |
| 73221 |
|
83 |
80 |
$21K |
| 84439 |
|
2,561 |
2,443 |
$21K |
| 80061 |
|
754 |
673 |
$20K |
| 29065 |
|
1,410 |
1,356 |
$20K |
| 94010 |
|
226 |
207 |
$19K |
| J2405 |
Ondansetron hcl injection |
26,306 |
23,069 |
$18K |
| 29125 |
|
811 |
740 |
$18K |
| 88300 |
|
1,792 |
1,736 |
$18K |
| 29130 |
|
908 |
807 |
$18K |
| 87181 |
|
631 |
611 |
$17K |
| 54161 |
|
46 |
46 |
$17K |
| 85014 |
|
3,375 |
3,208 |
$17K |
| 84520 |
|
552 |
422 |
$17K |
| J1610 |
Glucagon hydrochloride/1 mg |
139 |
130 |
$16K |
| J1100 |
Dexamethasone sodium phos |
23,478 |
21,265 |
$16K |
| J7120 |
Ringers lactate infusion |
15,199 |
14,096 |
$14K |
| 70486 |
|
122 |
120 |
$14K |
| 83615 |
|
1,936 |
1,245 |
$14K |
| 93226 |
|
305 |
284 |
$14K |
| 73700 |
|
55 |
54 |
$13K |
| 87040 |
|
6,107 |
5,710 |
$13K |
| 95716 |
|
14 |
14 |
$13K |
| 10060 |
|
168 |
161 |
$13K |
| 78262 |
|
25 |
25 |
$13K |
| 29405 |
|
972 |
903 |
$12K |
| 92552 |
|
655 |
595 |
$12K |
| J0690 |
Cefazolin sodium injection |
5,057 |
3,634 |
$12K |
| 69200 |
|
79 |
69 |
$11K |
| J2250 |
Inj midazolam hydrochloride |
8,558 |
7,960 |
$11K |
| 43760 |
|
38 |
31 |
$11K |
| J0131 |
Inj, acetaminophen (nos) |
10,433 |
8,672 |
$10K |
| S9083 |
Urgent care center global |
431 |
411 |
$10K |
| 76377 |
|
1,761 |
1,656 |
$10K |
| 97165 |
|
32 |
32 |
$9K |
| 25605 |
|
146 |
136 |
$9K |
| 86403 |
|
995 |
963 |
$9K |
| 92585 |
|
162 |
159 |
$9K |
| 72081 |
|
110 |
106 |
$9K |
| 76604 |
|
59 |
57 |
$9K |
| 00300 |
|
440 |
419 |
$9K |
| 87581 |
|
6,916 |
6,626 |
$9K |
| J0696 |
Ceftriaxone sodium injection |
4,219 |
3,303 |
$9K |
| 93308 |
|
13 |
13 |
$8K |
| 73562 |
|
107 |
98 |
$8K |
| 93320 |
|
2,543 |
2,383 |
$8K |
| 87102 |
|
228 |
218 |
$8K |
| 75565 |
|
30 |
25 |
$8K |
| 29105 |
|
344 |
331 |
$8K |
| 82150 |
|
1,010 |
939 |
$8K |
| 87491 |
|
675 |
657 |
$8K |
| 76881 |
|
69 |
69 |
$8K |
| J7613 |
Albuterol non-comp unit |
4,946 |
4,381 |
$8K |
| J2704 |
Inj, propofol, 10 mg |
10,110 |
9,457 |
$7K |
| 84443 |
|
2,951 |
2,818 |
$7K |
| J3010 |
Fentanyl citrate injection |
9,572 |
8,944 |
$7K |
| J1756 |
Iron sucrose injection |
218 |
105 |
$7K |
| 72070 |
|
158 |
157 |
$7K |
| 87340 |
|
127 |
98 |
$6K |
| 92018 |
|
31 |
30 |
$6K |
| 87075 |
|
84 |
74 |
$6K |
| 94060 |
|
115 |
111 |
$6K |
| 51600 |
|
855 |
827 |
$6K |
| 72141 |
|
306 |
293 |
$6K |
| 84484 |
|
404 |
358 |
$6K |
| 00148 |
|
147 |
143 |
$6K |
| 94621 |
|
53 |
51 |
$6K |
| 83993 |
|
181 |
171 |
$6K |
| J7644 |
Ipratropium bromide non-comp |
5,422 |
4,766 |
$6K |
| B4087 |
Gastro/jejuno tube, std |
13 |
13 |
$6K |
| 73600 |
|
71 |
64 |
$5K |
| 92555 |
|
553 |
524 |
$5K |
| 82310 |
|
276 |
80 |
$5K |
| J2270 |
Morphine sulfate injection |
4,210 |
3,599 |
$5K |
| 93356 |
|
14 |
14 |
$5K |
| 87205 |
|
1,270 |
1,174 |
$5K |
| 86480 |
|
194 |
184 |
$5K |
| 87486 |
|
6,754 |
6,485 |
$5K |
| 00170 |
|
3,678 |
3,445 |
$4K |
| 92652 |
|
83 |
83 |
$4K |
| J1885 |
Ketorolac tromethamine inj |
6,353 |
5,201 |
$4K |
| 10120 |
|
12 |
12 |
$4K |
| 71260 |
|
26 |
25 |
$4K |
| 73718 |
|
15 |
12 |
$4K |
| 85610 |
|
1,850 |
1,688 |
$4K |
| 85652 |
|
4,281 |
3,952 |
$4K |
| 85730 |
|
1,668 |
1,537 |
$4K |
| 87186 |
|
4,533 |
4,337 |
$4K |
| 29515 |
|
967 |
911 |
$4K |
| C1769 |
Guide wire |
67 |
63 |
$4K |
| 82330 |
|
1,050 |
962 |
$4K |
| 76870 |
|
924 |
884 |
$4K |
| 92611 |
|
94 |
94 |
$3K |
| 78708 |
|
12 |
12 |
$3K |
| 86900 |
|
2,052 |
1,789 |
$3K |
| 92567 |
|
6,408 |
5,943 |
$3K |
| 92586 |
|
22 |
21 |
$3K |
| 86901 |
|
2,048 |
1,788 |
$3K |
| 88342 |
|
117 |
115 |
$3K |
| 12051 |
|
43 |
43 |
$3K |
| 83690 |
|
2,832 |
2,606 |
$3K |
| 82272 |
|
35 |
35 |
$3K |
| J1170 |
Hydromorphone injection |
180 |
169 |
$3K |
| 51701 |
|
414 |
408 |
$3K |
| 16020 |
|
13 |
12 |
$3K |
| 82784 |
|
1,847 |
1,326 |
$2K |
| 93886 |
|
15 |
15 |
$2K |
| 70546 |
|
18 |
12 |
$2K |
| 29505 |
|
445 |
412 |
$2K |
| J3480 |
Inj potassium chloride |
6,555 |
4,768 |
$2K |
| 83520 |
|
355 |
337 |
$2K |
| J3490 |
Drugs unclassified injection |
4,008 |
3,323 |
$2K |
| J1200 |
Diphenhydramine hcl injectio |
2,426 |
1,566 |
$2K |
| 88325 |
|
93 |
88 |
$2K |
| 86923 |
|
192 |
171 |
$2K |
| 83036 |
|
521 |
508 |
$2K |
| 87641 |
|
55 |
54 |
$2K |
| A9585 |
Gadobutrol injection |
6,233 |
5,541 |
$2K |
| J2175 |
Meperidine hydrochl /100 mg |
4,616 |
4,294 |
$2K |
| 64611 |
|
12 |
12 |
$2K |
| 69209 |
|
14 |
14 |
$1K |
| 86235 |
|
1,134 |
1,096 |
$1K |
| 92582 |
|
786 |
728 |
$1K |
| G0382 |
Lev 3 hosp type b ed visit |
15 |
12 |
$1K |
| 87591 |
|
676 |
658 |
$1K |
| 70250 |
|
25 |
25 |
$1K |
| 76510 |
|
28 |
28 |
$961.41 |
| 93225 |
|
305 |
284 |
$923.03 |
| C9113 |
Inj pantoprazole sodium, via |
725 |
461 |
$852.19 |
| 00840 |
|
1,102 |
1,039 |
$778.48 |
| 92556 |
|
800 |
731 |
$752.12 |
| 36415 |
|
128 |
122 |
$738.54 |
| 00920 |
|
341 |
316 |
$734.60 |
| 97542 |
|
14 |
13 |
$665.73 |
| 96523 |
|
20 |
12 |
$650.34 |
| J2920 |
Methylprednisolone injection |
1,192 |
972 |
$622.39 |
| J0694 |
Cefoxitin sodium injection |
1,169 |
845 |
$618.43 |
| 72156 |
|
15 |
12 |
$617.75 |
| J8540 |
Oral dexamethasone |
293 |
271 |
$549.56 |
| J0561 |
Penicillin g benzathine inj |
674 |
652 |
$548.23 |
| U0002 |
Covid-19 lab test non-cdc |
136 |
135 |
$543.01 |
| J0290 |
Ampicillin 500 mg inj |
465 |
253 |
$495.39 |
| 92653 |
|
73 |
73 |
$476.65 |
| 92235 |
|
17 |
17 |
$464.56 |
| A9539 |
Tc99m pentetate |
381 |
371 |
$454.27 |
| 82785 |
|
12 |
12 |
$404.84 |
| J7626 |
Budesonide non-comp unit |
105 |
57 |
$390.88 |
| 00731 |
|
603 |
579 |
$390.22 |
| 83605 |
|
516 |
445 |
$371.66 |
| 88302 |
|
13 |
13 |
$305.07 |
| J7512 |
Prednisone ir or dr oral 1mg |
356 |
310 |
$298.68 |
| 88341 |
|
13 |
13 |
$297.94 |
| 29086 |
|
13 |
13 |
$290.01 |
| 87177 |
|
92 |
92 |
$278.31 |
| 88346 |
|
172 |
166 |
$254.35 |
| 84145 |
|
506 |
464 |
$251.54 |
| 87427 |
|
1,161 |
1,124 |
$235.94 |
| 92250 |
|
30 |
29 |
$192.18 |
| J0780 |
Prochlorperazine injection |
278 |
254 |
$187.68 |
| 82248 |
|
86 |
82 |
$168.70 |
| J9370 |
Vincristine sulfate 1 mg inj |
416 |
269 |
$147.05 |
| S0028 |
Injection, famotidine, 20 mg |
1,099 |
876 |
$100.34 |
| J0330 |
Succinycholine chloride inj |
128 |
119 |
$96.90 |
| 76942 |
|
85 |
80 |
$94.08 |
| S0077 |
Injection, clindamycin phosp |
381 |
325 |
$90.45 |
| 80051 |
|
46 |
46 |
$89.48 |
| 80349 |
|
107 |
102 |
$88.36 |
| Q0144 |
Azithromycin dihydrate, oral |
31 |
27 |
$87.60 |
| 82977 |
|
105 |
101 |
$83.66 |
| 88108 |
|
329 |
259 |
$82.32 |
| 85379 |
|
64 |
58 |
$76.99 |
| 82533 |
|
27 |
26 |
$72.47 |
| 87497 |
|
126 |
63 |
$52.61 |
| 87640 |
|
39 |
39 |
$45.92 |
| 01400 |
|
34 |
28 |
$44.62 |
| 00160 |
|
151 |
124 |
$43.74 |
| 84550 |
|
42 |
38 |
$35.60 |
| 87209 |
|
16 |
16 |
$23.52 |
| 00126 |
|
139 |
119 |
$23.52 |
| 94760 |
|
14 |
12 |
$22.20 |
| 82607 |
|
14 |
13 |
$19.82 |
| 87305 |
|
88 |
38 |
$18.72 |
| J9260 |
Inj methotrexate sodium 50mg |
64 |
40 |
$11.76 |
| 96367 |
|
223 |
209 |
$11.76 |
| 94799 |
|
28 |
27 |
$11.76 |
| 84436 |
|
12 |
12 |
$11.10 |
| 82374 |
|
22 |
14 |
$0.01 |
| J0171 |
Adrenalin epinephrine inject |
53 |
51 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
1,268 |
1,090 |
$0.00 |
| 90853 |
|
1,795 |
131 |
$0.00 |
| 76937 |
|
27 |
24 |
$0.00 |
| 87338 |
|
14 |
14 |
$0.00 |
| 94642 |
|
12 |
12 |
$0.00 |
| 00635 |
|
35 |
27 |
$0.00 |
| A9551 |
Tc99m succimer |
43 |
43 |
$0.00 |
| 90460 |
|
13 |
12 |
$0.00 |
| 83516 |
|
12 |
12 |
$0.00 |
| 82010 |
|
12 |
12 |
$0.00 |
| 29345 |
|
105 |
101 |
$0.00 |
| 86160 |
|
26 |
26 |
$0.00 |
| 49465 |
|
26 |
24 |
$0.00 |
| 96411 |
|
80 |
48 |
$0.00 |
| 72158 |
|
15 |
13 |
$0.00 |
| J1720 |
Hydrocortisone sodium succ i |
82 |
61 |
$0.00 |
| 86920 |
|
13 |
12 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
116 |
79 |
$0.00 |
| 00813 |
|
12 |
12 |
$0.00 |
| 96368 |
|
43 |
42 |
$0.00 |
| J9250 |
Methotrexate sodium inj |
39 |
25 |
$0.00 |
| J0713 |
Inj ceftazidime per 500 mg |
15 |
13 |
$0.00 |
| 30802 |
|
28 |
26 |
$0.00 |
| 45380 |
|
16 |
16 |
$0.00 |
| J2060 |
Lorazepam injection |
27 |
14 |
$0.00 |
| 81382 |
|
12 |
12 |
$0.00 |
| 83880 |
|
13 |
13 |
$0.00 |