| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
|
82,795 |
66,586 |
$25.52M |
| 99283 |
|
90,211 |
78,673 |
$24.81M |
| 74177 |
|
17,425 |
14,832 |
$11.48M |
| 99285 |
|
33,977 |
20,500 |
$9.78M |
| J9271 |
Inj pembrolizumab |
1,056 |
760 |
$9.54M |
| 99282 |
|
36,822 |
32,646 |
$8.77M |
| C1776 |
Joint device (implantable) |
880 |
640 |
$8.24M |
| 70450 |
|
19,606 |
15,226 |
$6.40M |
| 93306 |
|
11,025 |
9,653 |
$6.20M |
| C1713 |
Anchor/screw bn/bn,tis/bn |
3,888 |
2,627 |
$5.94M |
| 87637 |
|
49,359 |
44,591 |
$5.81M |
| J3490 |
Drugs unclassified injection |
99,742 |
25,842 |
$5.44M |
| 70551 |
|
6,386 |
5,539 |
$4.06M |
| 70553 |
|
6,136 |
4,572 |
$3.88M |
| 72148 |
|
4,988 |
4,530 |
$3.41M |
| J0585 |
Injection,onabotulinumtoxina |
5,575 |
3,835 |
$3.37M |
| 96375 |
|
28,995 |
19,402 |
$3.21M |
| 74176 |
|
6,802 |
5,515 |
$3.12M |
| 71275 |
|
6,203 |
5,223 |
$3.12M |
| 96374 |
|
54,864 |
26,139 |
$2.48M |
| 96365 |
|
29,410 |
12,042 |
$2.40M |
| 93005 |
|
46,072 |
35,822 |
$2.34M |
| 87633 |
|
7,051 |
6,608 |
$2.17M |
| 43239 |
|
5,208 |
3,357 |
$2.10M |
| 77386 |
|
4,590 |
416 |
$2.05M |
| 72141 |
|
2,815 |
2,491 |
$1.98M |
| 78452 |
|
4,929 |
2,135 |
$1.95M |
| 72125 |
|
4,770 |
4,107 |
$1.95M |
| 96361 |
|
31,007 |
18,855 |
$1.85M |
| 99281 |
|
8,231 |
7,309 |
$1.76M |
| 71260 |
|
4,972 |
3,342 |
$1.73M |
| 80053 |
|
139,764 |
93,208 |
$1.72M |
| 76770 |
|
7,651 |
7,176 |
$1.71M |
| 71045 |
|
31,660 |
23,028 |
$1.61M |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
34,342 |
28,952 |
$1.60M |
| G0378 |
Hospital observation per hr |
16,992 |
8,440 |
$1.53M |
| 78815 |
|
1,193 |
1,021 |
$1.53M |
| 71046 |
|
17,876 |
15,730 |
$1.49M |
| 96413 |
|
10,214 |
5,331 |
$1.49M |
| 58571 |
|
757 |
297 |
$1.46M |
| 76705 |
|
7,734 |
7,087 |
$1.31M |
| 74019 |
|
9,383 |
8,770 |
$1.28M |
| 93458 |
|
701 |
321 |
$1.27M |
| 96372 |
|
25,811 |
11,255 |
$1.23M |
| 72131 |
|
2,817 |
2,275 |
$1.17M |
| 71250 |
|
4,766 |
3,654 |
$1.16M |
| 73721 |
|
2,201 |
1,958 |
$1.15M |
| 42820 |
|
1,299 |
1,178 |
$1.15M |
| 93017 |
|
3,307 |
2,995 |
$1.13M |
| 36415 |
|
198,260 |
72,004 |
$1.11M |
| 47562 |
|
853 |
527 |
$1.10M |
| 70496 |
|
1,962 |
1,626 |
$1.10M |
| 93320 |
|
3,372 |
3,153 |
$1.09M |
| 99291 |
|
2,286 |
1,312 |
$1.06M |
| 58661 |
|
700 |
526 |
$1.04M |
| G0330 |
Facility svs dental rehab |
1,049 |
970 |
$1.03M |
| 45380 |
|
2,422 |
1,627 |
$985K |
| 96360 |
|
11,663 |
8,022 |
$975K |
| Q5121 |
Inj. avsola, 10 mg |
516 |
343 |
$967K |
| 85025 |
|
143,952 |
101,520 |
$960K |
| 88305 |
|
7,439 |
6,351 |
$954K |
| G0463 |
Hospital outpt clinic visit |
28,959 |
17,665 |
$944K |
| 70498 |
|
1,918 |
1,632 |
$916K |
| 76830 |
|
4,894 |
4,348 |
$897K |
| 44970 |
|
526 |
456 |
$897K |
| J2350 |
Injection, ocrelizumab, 1 mg |
53 |
37 |
$895K |
| 74018 |
|
7,599 |
6,872 |
$876K |
| J0741 |
Inj, cabote rilpivir 2mg 3mg |
147 |
126 |
$874K |
| 62323 |
|
3,169 |
1,676 |
$864K |
| 93303 |
|
3,496 |
3,078 |
$858K |
| C1762 |
Conn tiss, human(inc fascia) |
287 |
222 |
$834K |
| 95713 |
|
2,702 |
1,559 |
$834K |
| G0480 |
Drug test def 1-7 classes |
10,533 |
8,916 |
$811K |
| 72146 |
|
1,153 |
1,024 |
$770K |
| 93975 |
|
3,429 |
3,112 |
$755K |
| 70486 |
|
1,844 |
1,672 |
$753K |
| 95810 |
|
1,450 |
1,304 |
$733K |
| 45378 |
|
1,356 |
1,140 |
$723K |
| 64615 |
|
5,208 |
3,629 |
$723K |
| 70491 |
|
1,912 |
1,426 |
$694K |
| J3380 |
Inj vedolizumab iv 1 mg |
106 |
99 |
$684K |
| 45385 |
|
1,723 |
1,138 |
$678K |
| 69436 |
|
1,893 |
1,804 |
$659K |
| 83880 |
|
19,748 |
17,158 |
$650K |
| 64643 |
|
747 |
656 |
$638K |
| 77067 |
|
8,928 |
8,674 |
$635K |
| C1769 |
Guide wire |
4,013 |
3,361 |
$634K |
| 74178 |
|
1,153 |
761 |
$624K |
| P9016 |
Rbc leukocytes reduced |
2,365 |
1,458 |
$615K |
| 76856 |
|
4,097 |
3,863 |
$599K |
| 93971 |
|
3,534 |
3,261 |
$590K |
| 76536 |
|
3,788 |
3,478 |
$587K |
| 77063 |
|
10,270 |
9,295 |
$584K |
| C1889 |
Implant/insert device, noc |
301 |
251 |
$574K |
| 87651 |
|
20,494 |
19,485 |
$568K |
| 27447 |
|
699 |
139 |
$563K |
| 73221 |
|
1,122 |
1,035 |
$562K |
| J1745 |
Infliximab not biosimil 10mg |
152 |
131 |
$561K |
| 97110 |
|
12,059 |
3,809 |
$554K |
| J0185 |
Inj., aprepitant, 1 mg |
1,811 |
1,068 |
$553K |
| 72156 |
|
803 |
637 |
$543K |
| 74183 |
|
1,005 |
723 |
$543K |
| 72197 |
|
877 |
660 |
$540K |
| 80307 |
|
11,739 |
10,096 |
$538K |
| C1874 |
Stent, coated/cov w/del sys |
198 |
178 |
$535K |
| 76817 |
|
3,271 |
2,812 |
$535K |
| 97530 |
|
11,580 |
4,651 |
$534K |
| 36512 |
|
1,081 |
508 |
$534K |
| 76801 |
|
3,936 |
3,304 |
$523K |
| 73630 |
|
5,677 |
4,706 |
$514K |
| 84484 |
|
31,915 |
22,963 |
$492K |
| 95812 |
|
1,619 |
1,534 |
$489K |
| 41899 |
|
672 |
544 |
$487K |
| J9173 |
Inj., durvalumab, 10 mg |
137 |
50 |
$476K |
| C1725 |
Cath, translumin non-laser |
958 |
773 |
$468K |
| 99211 |
|
23,751 |
20,751 |
$465K |
| 96415 |
|
2,607 |
1,875 |
$462K |
| J1756 |
Iron sucrose injection |
6,004 |
2,752 |
$453K |
| 72158 |
|
752 |
589 |
$450K |
| 93970 |
|
1,965 |
1,813 |
$431K |
| 77334 |
|
866 |
504 |
$428K |
| 54161 |
|
1,028 |
985 |
$423K |
| 76642 |
|
4,445 |
4,217 |
$422K |
| 76700 |
|
1,773 |
1,600 |
$418K |
| 93325 |
|
4,434 |
4,109 |
$413K |
| C1781 |
Mesh (implantable) |
538 |
413 |
$398K |
| 11042 |
|
2,171 |
970 |
$384K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
12,674 |
7,317 |
$380K |
| 95716 |
|
856 |
669 |
$370K |
| 76870 |
|
1,943 |
1,783 |
$369K |
| 72157 |
|
551 |
472 |
$369K |
| 64642 |
|
698 |
523 |
$358K |
| 73130 |
|
5,094 |
3,790 |
$355K |
| 73610 |
|
4,677 |
3,917 |
$351K |
| 59025 |
|
5,263 |
4,289 |
$347K |
| 73562 |
|
4,696 |
3,358 |
$347K |
| 43235 |
|
686 |
462 |
$345K |
| 54300 |
|
561 |
546 |
$342K |
| 94640 |
|
12,501 |
10,188 |
$337K |
| 96367 |
|
3,216 |
1,586 |
$337K |
| 77066 |
Tomosynthesis, mammo |
2,606 |
2,388 |
$330K |
| 96366 |
|
4,117 |
2,584 |
$328K |
| 62321 |
|
908 |
573 |
$325K |
| 73030 |
|
4,240 |
2,931 |
$323K |
| 64721 |
|
732 |
455 |
$322K |
| 36561 |
|
776 |
251 |
$322K |
| J0897 |
Denosumab injection |
240 |
158 |
$321K |
| 36430 |
|
1,765 |
1,133 |
$317K |
| Q5103 |
Injection, inflectra |
126 |
96 |
$316K |
| 80048 |
|
23,118 |
14,646 |
$316K |
| 72128 |
|
962 |
797 |
$315K |
| 74455 |
|
1,445 |
1,357 |
$314K |
| A9552 |
F18 fdg |
2,265 |
1,420 |
$301K |
| 95700 |
|
2,377 |
2,123 |
$299K |
| 77412 |
|
1,393 |
177 |
$299K |
| 77295 |
|
418 |
244 |
$294K |
| 70544 |
|
862 |
679 |
$293K |
| J0561 |
Penicillin g benzathine inj |
1,071 |
843 |
$293K |
| C8908 |
Mri w/o fol w/cont, breast, |
520 |
391 |
$293K |
| 87798 |
|
10,020 |
9,094 |
$292K |
| 58558 |
|
451 |
285 |
$291K |
| 96376 |
|
3,439 |
2,500 |
$288K |
| C1887 |
Catheter, guiding |
1,229 |
1,063 |
$284K |
| 88342 |
|
4,395 |
3,788 |
$284K |
| J2997 |
Alteplase recombinant |
2,576 |
859 |
$272K |
| 96417 |
|
1,880 |
1,124 |
$270K |
| 97112 |
|
4,817 |
1,774 |
$269K |
| 88341 |
|
1,699 |
1,337 |
$268K |
| 78431 |
|
215 |
153 |
$259K |
| 20680 |
|
293 |
231 |
$257K |
| 93225 |
|
1,560 |
1,274 |
$255K |
| 83735 |
|
30,991 |
22,071 |
$255K |
| 74174 |
|
448 |
339 |
$253K |
| 51600 |
|
1,402 |
1,341 |
$251K |
| 95782 |
|
393 |
327 |
$250K |
| Q5118 |
Inj., zirabev, 10 mg |
187 |
51 |
$249K |
| 52332 |
|
604 |
276 |
$247K |
| 77300 |
|
837 |
517 |
$246K |
| 73590 |
|
3,333 |
2,769 |
$246K |
| C1894 |
Intro/sheath, non-laser |
1,922 |
1,667 |
$245K |
| 78264 |
|
856 |
587 |
$244K |
| 49083 |
|
768 |
266 |
$239K |
| 73090 |
|
3,342 |
2,812 |
$238K |
| 50590 |
|
139 |
78 |
$236K |
| 87486 |
|
8,580 |
7,833 |
$232K |
| 75574 |
|
506 |
401 |
$230K |
| 92507 |
|
4,096 |
1,636 |
$229K |
| 97161 |
|
5,232 |
2,885 |
$223K |
| 87581 |
|
8,448 |
7,829 |
$220K |
| 77336 |
|
2,510 |
814 |
$217K |
| 19083 |
|
522 |
306 |
$215K |
| 49650 |
|
63 |
52 |
$213K |
| 64644 |
|
460 |
305 |
$212K |
| 87491 |
|
7,822 |
7,141 |
$211K |
| 95811 |
|
454 |
406 |
$211K |
| 51728 |
|
873 |
834 |
$210K |
| 87591 |
|
7,718 |
7,131 |
$207K |
| 93351 |
|
495 |
380 |
$204K |
| 73110 |
|
2,871 |
2,367 |
$203K |
| 95886 |
|
1,080 |
1,032 |
$203K |
| 72100 |
|
2,202 |
1,859 |
$198K |
| J2785 |
Regadenoson injection |
1,524 |
1,426 |
$194K |
| 78227 |
|
575 |
396 |
$193K |
| 95813 |
|
589 |
557 |
$188K |
| C1768 |
Graft, vascular |
79 |
56 |
$186K |
| 84443 |
|
10,248 |
9,217 |
$182K |
| 83690 |
|
27,331 |
23,675 |
$181K |
| 74230 |
|
1,131 |
904 |
$181K |
| 73700 |
|
617 |
507 |
$179K |
| 77062 |
|
2,769 |
2,240 |
$179K |
| 72040 |
|
1,902 |
1,628 |
$177K |
| 27130 |
|
154 |
38 |
$175K |
| 88307 |
|
1,409 |
1,172 |
$175K |
| 93798 |
|
5,117 |
786 |
$171K |
| 73560 |
|
2,125 |
1,728 |
$169K |
| 51784 |
|
902 |
872 |
$166K |
| J2704 |
Inj, propofol, 10 mg |
57,622 |
30,302 |
$164K |
| 72110 |
|
1,548 |
1,296 |
$163K |
| 36593 |
|
964 |
638 |
$161K |
| 10060 |
|
871 |
783 |
$161K |
| 76882 |
|
1,291 |
1,193 |
$161K |
| 12011 |
|
1,427 |
1,351 |
$159K |
| 84703 |
|
26,156 |
22,608 |
$157K |
| 86850 |
|
15,328 |
12,035 |
$156K |
| 76819 |
|
1,115 |
942 |
$156K |
| 77065 |
Tomosynthesis, mammo |
2,191 |
1,816 |
$155K |
| 70487 |
|
353 |
308 |
$154K |
| 73070 |
|
2,361 |
1,932 |
$154K |
| C1726 |
Cath, bal dil, non-vascular |
502 |
441 |
$153K |
| 80061 |
|
9,874 |
4,497 |
$153K |
| J9299 |
Injection, nivolumab |
28 |
13 |
$153K |
| G0260 |
Inj for sacroiliac jt anesth |
353 |
260 |
$153K |
| 74240 |
|
993 |
892 |
$153K |
| A9500 |
Tc99m sestamibi |
1,759 |
1,641 |
$150K |
| 96411 |
|
1,128 |
673 |
$147K |
| 54640 |
|
196 |
184 |
$144K |
| 49591 |
|
123 |
108 |
$143K |
| 94660 |
|
968 |
544 |
$143K |
| 81025 |
|
20,151 |
17,833 |
$142K |
| 77290 |
|
940 |
408 |
$140K |
| 88185 |
|
514 |
371 |
$139K |
| 97535 |
|
5,690 |
3,249 |
$138K |
| 87661 |
|
5,675 |
5,259 |
$136K |
| 12001 |
|
1,200 |
1,114 |
$135K |
| 77080 |
|
2,136 |
1,631 |
$134K |
| 55175 |
|
463 |
446 |
$133K |
| 73521 |
|
1,218 |
1,139 |
$132K |
| 73502 |
|
1,854 |
1,413 |
$132K |
| 76885 |
|
967 |
921 |
$131K |
| 93308 |
|
830 |
513 |
$130K |
| 99213 |
|
5,378 |
4,364 |
$127K |
| 82728 |
|
10,579 |
9,061 |
$127K |
| 97162 |
|
3,045 |
1,489 |
$125K |
| 93880 |
|
876 |
701 |
$123K |
| 72132 |
|
428 |
239 |
$122K |
| C2617 |
Stent, non-cor, tem w/o del |
741 |
644 |
$122K |
| 92526 |
|
1,801 |
983 |
$122K |
| 93922 |
|
964 |
753 |
$122K |
| 54360 |
|
375 |
366 |
$121K |
| 73552 |
|
1,501 |
1,224 |
$121K |
| 86920 |
|
1,498 |
1,107 |
$120K |
| 94060 |
|
1,009 |
732 |
$120K |
| 88360 |
|
682 |
522 |
$120K |
| J9171 |
Docetaxel injection |
92 |
64 |
$116K |
| 72082 |
|
832 |
730 |
$115K |
| 71271 |
|
2,705 |
2,376 |
$114K |
| 88304 |
|
2,468 |
2,173 |
$114K |
| 78306 |
|
748 |
302 |
$113K |
| 97116 |
|
3,722 |
1,858 |
$111K |
| 85730 |
|
17,537 |
14,862 |
$110K |
| 99157 |
|
1,469 |
1,332 |
$109K |
| 92611 |
|
869 |
809 |
$108K |
| 95910 |
|
611 |
484 |
$107K |
| J1569 |
Gammagard liquid injection |
24 |
12 |
$104K |
| 85027 |
|
19,598 |
15,786 |
$103K |
| 86900 |
|
17,360 |
13,081 |
$101K |
| 77072 |
|
1,034 |
979 |
$101K |
| Q9950 |
Inj sulf hexa lipid microsph |
2,378 |
1,312 |
$101K |
| 51797 |
|
678 |
658 |
$101K |
| 76825 |
|
460 |
424 |
$101K |
| A9555 |
Rb82 rubidium |
617 |
290 |
$100K |
| 87086 |
|
14,634 |
13,437 |
$99K |
| 83605 |
|
6,292 |
4,992 |
$99K |
| 76815 |
|
616 |
554 |
$99K |
| 77061 |
|
1,931 |
1,538 |
$98K |
| 73060 |
|
1,517 |
1,273 |
$96K |
| 77387 |
|
761 |
96 |
$96K |
| 77002 |
|
521 |
436 |
$96K |
| 97140 |
|
2,195 |
1,001 |
$94K |
| 94726 |
|
913 |
822 |
$93K |
| 14040 |
|
302 |
279 |
$93K |
| G0382 |
Lev 3 hosp type b ed visit |
474 |
468 |
$93K |
| 36902 |
|
179 |
39 |
$92K |
| 87389 |
|
5,120 |
4,588 |
$92K |
| 96416 |
|
424 |
247 |
$92K |
| 85610 |
|
21,010 |
17,274 |
$91K |
| 96409 |
|
773 |
447 |
$90K |
| 81001 |
|
35,945 |
31,576 |
$90K |
| 82803 |
|
3,189 |
2,625 |
$89K |
| C1760 |
Closure dev, vasc |
223 |
188 |
$87K |
| 95874 |
|
578 |
532 |
$85K |
| 73200 |
|
252 |
218 |
$84K |
| J2469 |
Palonosetron hcl |
2,285 |
1,333 |
$84K |
| 95911 |
|
351 |
275 |
$82K |
| 29580 |
|
1,920 |
580 |
$81K |
| 77075 |
|
261 |
247 |
$81K |
| J2323 |
Natalizumab injection |
14 |
12 |
$80K |
| 95819 |
|
372 |
334 |
$80K |
| 10005 |
|
191 |
151 |
$80K |
| 42830 |
|
169 |
165 |
$79K |
| 70543 |
|
107 |
95 |
$79K |
| 95816 |
|
389 |
353 |
$79K |
| 82306 |
|
3,358 |
3,046 |
$79K |
| 64483 |
|
168 |
122 |
$79K |
| 84439 |
|
5,932 |
5,261 |
$78K |
| 96401 |
|
1,518 |
337 |
$78K |
| 84702 |
|
6,045 |
4,979 |
$77K |
| Q9969 |
Non-heu tc-99m add-on/dose |
3,521 |
3,273 |
$76K |
| 92610 |
|
644 |
592 |
$76K |
| 77001 |
|
499 |
406 |
$75K |
| 94010 |
|
1,130 |
786 |
$75K |
| 91200 |
|
618 |
584 |
$74K |
| 72072 |
|
854 |
668 |
$74K |
| C1788 |
Port, indwelling, imp |
198 |
184 |
$73K |
| 87040 |
|
7,148 |
5,644 |
$73K |
| 83036 |
|
6,752 |
5,963 |
$73K |
| 96402 |
|
872 |
659 |
$72K |
| 73140 |
|
1,201 |
1,099 |
$72K |
| 67311 |
|
90 |
78 |
$72K |
| J0696 |
Ceftriaxone sodium injection |
9,938 |
6,308 |
$71K |
| 54163 |
|
119 |
113 |
$70K |
| 82565 |
|
5,030 |
3,244 |
$70K |
| J2795 |
Ropivacaine hcl injection |
8,532 |
4,540 |
$70K |
| A4648 |
Implantable tissue marker |
766 |
485 |
$67K |
| 77301 |
|
35 |
28 |
$67K |
| 80069 |
|
6,950 |
4,931 |
$64K |
| J3370 |
Vancomycin hcl injection |
4,618 |
2,201 |
$64K |
| 95806 |
|
549 |
479 |
$63K |
| 64493 |
|
133 |
99 |
$63K |
| 51741 |
|
485 |
471 |
$63K |
| 84112 |
|
900 |
797 |
$62K |
| C1751 |
Cath, inf, per/cent/midline |
379 |
296 |
$62K |
| 82607 |
|
3,646 |
3,124 |
$61K |
| 93226 |
|
1,285 |
1,191 |
$61K |
| 72050 |
|
628 |
469 |
$61K |
| 12002 |
|
565 |
524 |
$60K |
| 86481 |
|
788 |
723 |
$59K |
| 73718 |
|
119 |
106 |
$59K |
| 90677 |
|
198 |
183 |
$58K |
| 86140 |
|
12,730 |
10,926 |
$58K |
| 84100 |
|
10,220 |
6,472 |
$57K |
| 84145 |
|
2,715 |
2,422 |
$56K |
| 99212 |
|
2,555 |
2,146 |
$56K |
| 86901 |
|
15,849 |
12,935 |
$56K |
| J0690 |
Cefazolin sodium injection |
18,807 |
11,662 |
$56K |
| 76937 |
|
584 |
483 |
$56K |
| 95885 |
|
503 |
478 |
$54K |
| 10061 |
|
240 |
187 |
$54K |
| 72070 |
|
611 |
506 |
$54K |
| 85007 |
|
16,128 |
13,372 |
$53K |
| 83540 |
|
7,732 |
7,004 |
$53K |
| 90715 |
|
1,882 |
1,751 |
$53K |
| 94760 |
|
2,062 |
1,354 |
$53K |
| J1885 |
Ketorolac tromethamine inj |
36,240 |
22,354 |
$52K |
| 29125 |
|
579 |
511 |
$52K |
| 80074 |
|
1,131 |
963 |
$51K |
| 86902 |
|
1,394 |
754 |
$51K |
| 70480 |
|
134 |
121 |
$51K |
| 70360 |
|
821 |
780 |
$50K |
| 54304 |
|
68 |
68 |
$50K |
| 76000 |
|
437 |
358 |
$50K |
| 97166 |
|
776 |
662 |
$50K |
| 76800 |
|
282 |
275 |
$50K |
| J1100 |
Dexamethasone sodium phos |
44,638 |
30,469 |
$49K |
| J1459 |
Inj ivig privigen 500 mg |
22 |
12 |
$49K |
| J3489 |
Zoledronic acid 1mg |
585 |
496 |
$49K |
| 94644 |
|
1,563 |
1,476 |
$49K |
| 86003 |
|
627 |
582 |
$48K |
| 43762 |
|
188 |
169 |
$48K |
| 97165 |
|
776 |
643 |
$48K |
| 72170 |
|
973 |
701 |
$48K |
| 99153 |
Mod sedat endo service >5yrs |
600 |
516 |
$47K |
| 81003 |
|
25,319 |
22,742 |
$46K |
| 87536 |
|
741 |
662 |
$46K |
| 82330 |
|
2,286 |
1,739 |
$45K |
| G1004 |
Cdsm ndsc |
4,219 |
710 |
$45K |
| 77280 |
|
691 |
179 |
$45K |
| 64645 |
|
60 |
53 |
$44K |
| 71101 |
|
720 |
518 |
$44K |
| 70250 |
|
379 |
312 |
$44K |
| 31575 |
|
394 |
286 |
$44K |
| 94729 |
|
721 |
690 |
$44K |
| J9202 |
Goserelin acetate implant |
86 |
79 |
$42K |
| C1729 |
Cath, drainage |
830 |
323 |
$42K |
| 73080 |
|
701 |
513 |
$41K |
| 88313 |
|
545 |
450 |
$41K |
| 72195 |
|
72 |
66 |
$41K |
| 73000 |
|
618 |
548 |
$40K |
| 29581 |
|
781 |
191 |
$39K |
| 86922 |
|
625 |
436 |
$39K |
| 86870 |
|
557 |
384 |
$39K |
| 75565 |
|
94 |
89 |
$39K |
| J7060 |
5% dextrose/water |
20,214 |
7,484 |
$38K |
| 95909 |
|
333 |
248 |
$38K |
| 93321 |
|
336 |
301 |
$38K |
| 31624 |
|
54 |
40 |
$38K |
| 25605 |
|
114 |
85 |
$37K |
| 36600 |
|
1,386 |
1,178 |
$37K |
| 82550 |
|
3,814 |
3,083 |
$37K |
| J3480 |
Inj potassium chloride |
3,101 |
1,594 |
$37K |
| 49500 |
|
12 |
12 |
$37K |
| 82784 |
|
2,605 |
2,131 |
$36K |
| 87070 |
|
4,140 |
3,339 |
$36K |
| 29881 |
|
57 |
28 |
$36K |
| 76857 |
|
420 |
320 |
$36K |
| 76942 |
|
221 |
178 |
$35K |
| J1650 |
Inj enoxaparin sodium |
6,591 |
2,775 |
$35K |
| Q9958 |
Hocm <=149 mg/ml iodine, 1ml |
2,033 |
1,599 |
$35K |
| 83970 |
|
995 |
863 |
$35K |
| J2405 |
Ondansetron hcl injection |
51,227 |
35,791 |
$35K |
| 83516 |
|
1,189 |
1,084 |
$35K |
| 86945 |
|
751 |
415 |
$35K |
| 99155 |
|
993 |
921 |
$34K |
| G0121 |
Colon ca scrn not hi rsk ind |
55 |
44 |
$33K |
| 86923 |
|
1,063 |
768 |
$33K |
| 82150 |
|
2,770 |
2,404 |
$33K |
| 78708 |
|
111 |
99 |
$32K |
| 87077 |
|
4,699 |
4,226 |
$32K |
| 85379 |
|
4,298 |
3,969 |
$32K |
| 38222 |
|
205 |
55 |
$32K |
| 76805 |
|
189 |
179 |
$31K |
| 86360 |
|
815 |
718 |
$31K |
| 72081 |
|
209 |
203 |
$30K |
| 29105 |
|
262 |
241 |
$30K |
| 77373 |
|
40 |
12 |
$30K |
| 64616 |
|
117 |
56 |
$30K |
| 94762 |
|
444 |
327 |
$30K |
| 72126 |
|
126 |
64 |
$29K |
| 97750 |
|
992 |
777 |
$29K |
| J2250 |
Inj midazolam hydrochloride |
41,260 |
26,079 |
$29K |
| G0257 |
Unsched dialysis esrd pt hos |
353 |
106 |
$28K |
| 95912 |
|
104 |
78 |
$28K |
| 97168 |
|
607 |
562 |
$28K |
| 99152 |
|
545 |
467 |
$28K |
| 87186 |
|
3,930 |
3,563 |
$28K |
| 82746 |
|
1,868 |
1,715 |
$27K |
| 83021 |
|
1,792 |
1,164 |
$27K |
| 72020 |
|
244 |
212 |
$27K |
| 97164 |
|
657 |
600 |
$26K |
| J1170 |
Hydromorphone injection |
15,652 |
9,996 |
$26K |
| J3301 |
Triamcinolone acet inj nos |
2,451 |
2,310 |
$26K |
| 70470 |
|
87 |
49 |
$26K |
| 20930 |
|
44 |
37 |
$25K |
| 76604 |
|
234 |
210 |
$25K |
| 99214 |
|
991 |
855 |
$25K |
| 64494 |
|
76 |
53 |
$25K |
| 26055 |
|
58 |
37 |
$25K |
| 96368 |
|
937 |
348 |
$25K |
| 76827 |
|
436 |
415 |
$25K |
| 87522 |
Neg quan hep c or qual rna |
708 |
656 |
$24K |
| 72083 |
|
184 |
162 |
$24K |
| 86664 |
|
1,251 |
1,020 |
$23K |
| J0330 |
Succinycholine chloride inj |
6,481 |
5,124 |
$23K |
| 90651 |
|
126 |
114 |
$23K |
| 85652 |
|
8,831 |
7,901 |
$23K |
| 90471 |
|
3,087 |
2,825 |
$23K |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
2,883 |
2,323 |
$22K |
| J3010 |
Fentanyl citrate injection |
30,793 |
23,127 |
$22K |
| J9045 |
Carboplatin injection |
811 |
446 |
$22K |
| 62328 |
|
52 |
50 |
$22K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
1,698 |
1,105 |
$22K |
| 73620 |
|
366 |
277 |
$22K |
| 11043 |
|
86 |
52 |
$22K |
| 84132 |
|
3,584 |
2,961 |
$22K |
| 83615 |
|
2,907 |
2,418 |
$21K |
| 86780 |
|
2,128 |
1,733 |
$21K |
| 87205 |
|
6,008 |
5,373 |
$21K |
| 94664 |
|
3,740 |
2,628 |
$21K |
| J1750 |
Inj iron dextran |
132 |
111 |
$21K |
| 87529 |
|
525 |
432 |
$20K |
| 92523 |
|
209 |
176 |
$20K |
| J0171 |
Adrenalin epinephrine inject |
3,496 |
1,899 |
$20K |
| J0780 |
Prochlorperazine injection |
4,696 |
3,678 |
$20K |
| 36591 |
|
987 |
707 |
$20K |
| 74170 |
|
31 |
25 |
$20K |
| 43245 |
|
75 |
29 |
$20K |
| 93976 |
|
161 |
144 |
$19K |
| J2930 |
Methylprednisolone injection |
3,074 |
2,274 |
$19K |
| 76816 |
|
177 |
167 |
$19K |
| 62304 |
|
31 |
25 |
$18K |
| 74328 |
|
161 |
141 |
$18K |
| C9113 |
Inj pantoprazole sodium, via |
4,412 |
2,420 |
$18K |
| J9070 |
Cyclophosphamide 100 mg inj |
35 |
27 |
$18K |
| 85045 |
|
4,889 |
3,470 |
$17K |
| 72202 |
|
240 |
190 |
$17K |
| J0295 |
Ampicillin sulbactam 1.5 gm |
2,828 |
708 |
$17K |
| 88377 |
|
116 |
78 |
$17K |
| 95873 |
|
141 |
134 |
$17K |
| 82947 |
|
2,990 |
1,281 |
$17K |
| 64718 |
|
28 |
27 |
$16K |
| J9263 |
Oxaliplatin |
278 |
75 |
$16K |
| C1763 |
Conn tiss, non-human |
27 |
24 |
$16K |
| 84156 |
|
2,615 |
2,175 |
$16K |
| 82810 |
|
185 |
130 |
$16K |
| 82378 |
|
741 |
560 |
$16K |
| 73720 |
|
18 |
14 |
$16K |
| 96450 |
|
80 |
54 |
$16K |
| 88302 |
|
511 |
440 |
$15K |
| A9562 |
Tc99m mertiatide |
180 |
174 |
$15K |
| P9041 |
Albumin (human),5%, 50ml |
241 |
189 |
$15K |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
674 |
544 |
$15K |
| J3475 |
Inj magnesium sulfate |
5,057 |
3,516 |
$15K |
| J2543 |
Piperacillin/tazobactam |
3,084 |
1,019 |
$15K |
| J0500 |
Dicyclomine injection |
415 |
383 |
$15K |
| J9190 |
Fluorouracil injection |
1,302 |
327 |
$15K |
| 80197 |
|
950 |
615 |
$15K |
| 64635 |
|
20 |
12 |
$15K |
| A9537 |
Tc99m mebrofenin |
369 |
340 |
$15K |
| 86038 |
|
995 |
885 |
$15K |
| 86665 |
|
1,115 |
1,023 |
$14K |
| 88184 |
|
652 |
386 |
$14K |
| 74181 |
|
27 |
26 |
$14K |
| 93923 |
|
108 |
97 |
$14K |
| 87902 |
|
69 |
67 |
$14K |
| J2274 |
Inj morphine pf epid ithc |
8,705 |
6,515 |
$14K |
| 88312 |
|
296 |
259 |
$14K |
| 82785 |
|
609 |
571 |
$14K |
| 94645 |
|
370 |
345 |
$14K |
| 73660 |
|
249 |
227 |
$13K |
| 77338 |
|
35 |
28 |
$13K |
| G0279 |
Tomosynthesis, mammo |
835 |
545 |
$13K |
| 87340 |
|
1,728 |
1,508 |
$13K |
| 43275 |
|
14 |
13 |
$13K |
| 82140 |
|
735 |
591 |
$13K |
| C2628 |
Catheter, occlusion |
117 |
100 |
$13K |
| 82570 |
|
2,538 |
2,225 |
$12K |
| 86803 |
|
1,151 |
1,063 |
$12K |
| J2270 |
Morphine sulfate injection |
7,554 |
5,947 |
$12K |
| 70260 |
|
83 |
81 |
$12K |
| A9541 |
Tc99m sulfur colloid |
580 |
549 |
$12K |
| 94621 |
|
33 |
25 |
$12K |
| J7042 |
5% dextrose/normal saline |
3,626 |
2,467 |
$12K |
| 86147 |
|
293 |
241 |
$12K |
| C1758 |
Catheter, ureteral |
444 |
378 |
$12K |
| J9267 |
Paclitaxel injection |
307 |
161 |
$12K |
| J1453 |
Fosaprepitant injection |
66 |
47 |
$11K |
| 93312 |
|
66 |
28 |
$11K |
| 84460 |
|
2,159 |
1,974 |
$11K |
| 94618 |
|
342 |
301 |
$11K |
| 99156 |
|
511 |
448 |
$11K |
| 87075 |
|
1,199 |
1,036 |
$11K |
| J1644 |
Inj heparin sodium per 1000u |
4,197 |
2,163 |
$11K |
| 20610 |
|
52 |
40 |
$11K |
| 83655 |
|
865 |
828 |
$11K |
| 86706 |
|
1,223 |
1,125 |
$11K |
| 88112 |
|
256 |
197 |
$10K |
| 86663 |
|
1,110 |
1,020 |
$10K |
| J2919 |
Inj, methylpred sod succ 5mg |
1,637 |
1,001 |
$10K |
| 84403 |
|
432 |
408 |
$10K |
| 90686 |
|
776 |
722 |
$10K |
| 77076 |
|
81 |
72 |
$10K |
| 43249 |
|
13 |
13 |
$10K |
| 86160 |
|
623 |
562 |
$10K |
| 86704 |
|
880 |
782 |
$10K |
| 87046 |
|
838 |
689 |
$10K |
| 86304 |
|
508 |
394 |
$10K |
| 64484 |
|
29 |
26 |
$10K |
| 85240 |
|
567 |
527 |
$10K |
| 80076 |
|
694 |
592 |
$10K |
| J1200 |
Diphenhydramine hcl injectio |
8,964 |
6,746 |
$9K |
| 23350 |
|
40 |
40 |
$9K |
| J2916 |
Na ferric gluconate complex |
256 |
141 |
$9K |
| 27096 |
|
15 |
15 |
$9K |
| J1626 |
Granisetron hcl injection |
1,137 |
543 |
$9K |
| 74270 |
|
41 |
39 |
$9K |
| 97167 |
|
125 |
107 |
$9K |
| J1610 |
Glucagon hydrochloride/1 mg |
64 |
58 |
$9K |
| 88173 |
|
151 |
127 |
$9K |
| 82010 |
|
1,162 |
998 |
$9K |
| J0360 |
Hydralazine hcl injection |
1,870 |
1,293 |
$9K |
| G0381 |
Lev 2 hosp type b ed visit |
72 |
72 |
$8K |
| 75573 |
|
15 |
15 |
$8K |
| 29826 |
|
17 |
12 |
$8K |
| 82533 |
|
471 |
383 |
$8K |
| 24640 |
|
64 |
62 |
$8K |
| 36416 |
|
1,613 |
1,155 |
$8K |
| 36590 |
|
21 |
12 |
$8K |
| 83550 |
|
1,069 |
986 |
$8K |
| 76506 |
|
48 |
42 |
$8K |
| 85576 |
|
265 |
227 |
$8K |
| 91320 |
|
95 |
84 |
$8K |
| 87210 |
|
3,850 |
3,593 |
$8K |
| G0283 |
Elec stim other than wound |
361 |
166 |
$8K |
| 76820 |
|
47 |
38 |
$8K |
| 84450 |
|
1,706 |
1,624 |
$8K |
| 72192 |
|
29 |
24 |
$7K |
| 84295 |
|
1,313 |
1,116 |
$7K |
| 85384 |
|
971 |
818 |
$7K |
| Q0222 |
Bebtelovimab 175 mg |
21 |
12 |
$7K |
| 84550 |
|
1,425 |
1,097 |
$7K |
| 87088 |
|
1,177 |
1,067 |
$7K |
| 82247 |
|
1,032 |
707 |
$7K |
| 87799 |
|
337 |
222 |
$7K |
| 86146 |
|
263 |
233 |
$7K |
| 83520 |
|
335 |
274 |
$7K |
| A9585 |
Gadobutrol injection |
208 |
112 |
$7K |
| J1953 |
Levetiracetam injection |
1,463 |
934 |
$7K |
| 72220 |
|
106 |
88 |
$7K |
| 86301 |
|
443 |
302 |
$7K |
| 10120 |
|
33 |
30 |
$7K |
| 90460 |
|
1,022 |
950 |
$7K |
| 75625 |
|
22 |
17 |
$7K |
| 85347 |
|
600 |
502 |
$7K |
| J2710 |
Neostigmine methylslfte inj |
645 |
563 |
$6K |
| 96523 |
|
333 |
262 |
$6K |
| J0640 |
Leucovorin calcium injection |
222 |
78 |
$6K |
| 22853 |
|
14 |
13 |
$6K |
| 86334 |
|
397 |
359 |
$6K |
| J2310 |
Inj naloxone hydrochloride |
407 |
292 |
$6K |
| 73222 |
|
16 |
12 |
$6K |
| 87045 |
|
792 |
742 |
$6K |
| 72052 |
|
47 |
42 |
$6K |
| 80164 |
|
431 |
353 |
$6K |
| 83521 |
|
321 |
235 |
$6K |
| 85014 |
|
2,220 |
1,559 |
$6K |
| 87427 |
|
699 |
656 |
$6K |
| 19081 |
|
35 |
12 |
$6K |
| 84165 |
|
702 |
613 |
$6K |
| 90688 |
|
577 |
520 |
$6K |
| 80143 |
|
364 |
323 |
$6K |
| 82248 |
|
1,191 |
870 |
$6K |
| J3411 |
Thiamine hcl 100 mg |
1,437 |
1,015 |
$5K |
| 86800 |
|
450 |
423 |
$5K |
| 83010 |
|
387 |
340 |
$5K |
| 82435 |
|
855 |
735 |
$5K |
| 59820 |
|
12 |
12 |
$5K |
| 86308 |
|
1,355 |
1,264 |
$5K |
| J0692 |
Cefepime hcl for injection |
973 |
276 |
$5K |
| J9370 |
Vincristine sulfate 1 mg inj |
769 |
431 |
$5K |
| 82945 |
|
686 |
545 |
$5K |
| 29827 |
|
17 |
12 |
$5K |
| 85660 |
|
886 |
563 |
$5K |
| 82977 |
|
705 |
589 |
$5K |
| 85018 |
|
2,424 |
1,788 |
$5K |
| 86235 |
|
88 |
77 |
$5K |
| P9073 |
Platelets pheresis path redu |
23 |
12 |
$5K |
| 82270 |
|
1,445 |
796 |
$5K |
| 84153 |
|
195 |
175 |
$5K |
| 80179 |
|
360 |
320 |
$5K |
| 73100 |
|
97 |
71 |
$5K |
| 83921 |
|
293 |
269 |
$5K |
| 99195 |
|
149 |
110 |
$5K |
| J3420 |
Vitamin b12 injection |
1,110 |
830 |
$5K |
| 88182 |
|
125 |
95 |
$5K |
| A9503 |
Tc99m medronate |
195 |
185 |
$4K |
| J2920 |
Methylprednisolone injection |
840 |
348 |
$4K |
| 83930 |
|
715 |
552 |
$4K |
| 89051 |
|
1,070 |
848 |
$4K |
| 84146 |
|
253 |
239 |
$4K |
| J9201 |
In gemcitabine hcl nos 200mg |
131 |
39 |
$4K |
| J1040 |
Methylprednisolone 80 mg inj |
421 |
376 |
$4K |
| 12013 |
|
45 |
41 |
$4K |
| J0694 |
Cefoxitin sodium injection |
421 |
311 |
$4K |
| 86703 |
|
423 |
386 |
$4K |
| J1642 |
Inj heparin sodium per 10 u |
7,174 |
2,279 |
$4K |
| U0004 |
Cov-19 test non-cdc hgh thru |
74 |
71 |
$4K |
| 94667 |
|
155 |
143 |
$4K |
| J0248 |
Inj, remdesivir, 1 mg |
51 |
26 |
$4K |
| 74220 |
|
30 |
24 |
$4K |
| 84157 |
|
725 |
583 |
$4K |
| 80202 |
|
281 |
180 |
$4K |
| 85597 |
|
488 |
275 |
$4K |
| J1940 |
Furosemide injection |
1,917 |
920 |
$4K |
| 85245 |
|
193 |
184 |
$4K |
| J0456 |
Azithromycin |
974 |
598 |
$3K |
| 88300 |
|
217 |
183 |
$3K |
| J3360 |
Diazepam injection |
330 |
165 |
$3K |
| 82310 |
|
390 |
326 |
$3K |
| 84481 |
|
182 |
175 |
$3K |
| 88311 |
|
208 |
183 |
$3K |
| J2371 |
Inj phenylephrine hcl 20 mcg |
2,654 |
1,289 |
$3K |
| G0008 |
Admin influenza virus vac |
187 |
172 |
$3K |
| Q3014 |
Telehealth facility fee |
182 |
155 |
$3K |
| 90739 |
|
32 |
28 |
$3K |
| 87497 |
|
118 |
91 |
$3K |
| J2370 |
Phenylephrine hcl injection |
2,757 |
1,794 |
$3K |
| 87102 |
|
424 |
354 |
$3K |
| 87635 |
|
81 |
79 |
$3K |
| 87901 |
|
15 |
12 |
$3K |
| J1720 |
Hydrocortisone sodium succ i |
269 |
193 |
$3K |
| 84305 |
|
171 |
166 |
$3K |
| 95711 |
|
76 |
71 |
$3K |
| 86200 |
|
243 |
225 |
$3K |
| 76811 |
|
26 |
25 |
$3K |
| J2560 |
Phenobarbital sodium inj |
49 |
41 |
$3K |
| 69200 |
|
40 |
39 |
$3K |
| 86592 |
|
510 |
409 |
$3K |
| 90461 |
|
213 |
197 |
$3K |
| J9060 |
Cisplatin 10 mg injection |
136 |
67 |
$3K |
| 86225 |
|
315 |
298 |
$3K |
| J2765 |
Metoclopramide hcl injection |
3,042 |
2,271 |
$3K |
| J2060 |
Lorazepam injection |
2,613 |
1,977 |
$3K |
| 88331 |
|
49 |
37 |
$2K |
| J8540 |
Oral dexamethasone |
1,717 |
1,476 |
$2K |
| 86762 |
|
254 |
230 |
$2K |
| 85397 |
|
111 |
107 |
$2K |
| J7040 |
Normal saline solution infus |
2,058 |
637 |
$2K |
| 77399 |
|
36 |
32 |
$2K |
| 83001 |
|
141 |
129 |
$2K |
| 87899 |
|
189 |
177 |
$2K |
| 81002 |
|
247 |
205 |
$2K |
| P9047 |
Albumin (human), 25%, 50ml |
32 |
15 |
$2K |
| J2001 |
Lidocaine injection |
3,260 |
2,271 |
$2K |
| 87015 |
|
427 |
338 |
$2K |
| 87116 |
|
306 |
242 |
$2K |
| 87177 |
|
270 |
248 |
$2K |
| J2805 |
Sincalide injection |
77 |
68 |
$2K |
| 85244 |
|
126 |
116 |
$2K |
| 80177 |
|
201 |
182 |
$2K |
| 69209 |
|
14 |
14 |
$2K |
| 82525 |
|
134 |
114 |
$2K |
| 86431 |
|
442 |
407 |
$2K |
| J2790 |
Rho d immune globulin inj |
27 |
26 |
$2K |
| 86708 |
|
238 |
204 |
$2K |
| 85613 |
|
299 |
274 |
$2K |
| 76828 |
|
16 |
12 |
$2K |
| J1171 |
Inj, hydromorphone, 0.1 mg |
1,267 |
523 |
$2K |
| 29505 |
|
12 |
12 |
$2K |
| J1956 |
Levofloxacin injection |
395 |
276 |
$2K |
| 86341 |
|
45 |
41 |
$2K |
| 30300 |
|
27 |
25 |
$2K |
| 76826 |
|
16 |
12 |
$2K |
| 86757 |
|
63 |
51 |
$2K |
| 84480 |
|
129 |
117 |
$2K |
| J1010 |
Inj, methylpred acetate 1 mg |
149 |
138 |
$2K |
| 87900 |
|
15 |
12 |
$2K |
| 85246 |
|
101 |
97 |
$2K |
| J1790 |
Droperidol injection |
976 |
861 |
$2K |
| 86618 |
|
100 |
79 |
$2K |
| 87081 |
|
274 |
245 |
$2K |
| 82043 |
|
333 |
309 |
$2K |
| 86376 |
|
85 |
75 |
$2K |
| 87449 |
|
204 |
190 |
$2K |
| 83002 |
|
83 |
77 |
$1K |
| 84270 |
|
79 |
77 |
$1K |
| 81243 |
|
48 |
47 |
$1K |
| 82397 |
|
89 |
89 |
$1K |
| 88108 |
|
69 |
53 |
$1K |
| 99215 |
Prolong outpt/office vis |
51 |
44 |
$1K |
| 0279U |
|
97 |
93 |
$1K |
| 82657 |
|
43 |
25 |
$1K |
| 86593 |
|
246 |
229 |
$1K |
| 84134 |
|
147 |
118 |
$1K |
| 84432 |
|
111 |
91 |
$1K |
| 94625 |
|
139 |
24 |
$1K |
| J0461 |
Atropine sulfate injection |
178 |
104 |
$1K |
| J2470 |
Inj pantoprazole sodium 40mg |
529 |
258 |
$1K |
| 86617 |
|
65 |
46 |
$1K |
| 84436 |
|
195 |
179 |
$1K |
| 86812 |
|
42 |
41 |
$1K |
| J2598 |
Inj, vasopressin, 1 unit |
21 |
12 |
$1K |
| 86039 |
|
131 |
121 |
$1K |
| 94668 |
|
19 |
12 |
$988.20 |
| 87498 |
|
40 |
38 |
$947.43 |
| 87206 |
|
300 |
235 |
$944.44 |
| J0290 |
Ampicillin 500 mg inj |
201 |
83 |
$908.13 |
| 82668 |
|
61 |
52 |
$897.72 |
| 82805 |
|
13 |
13 |
$894.05 |
| A9270 |
Non-covered item or service |
7,805 |
1,573 |
$878.25 |
| 84681 |
|
78 |
69 |
$876.10 |
| 83525 |
|
84 |
81 |
$833.03 |
| J0702 |
Betamethasone acet&sod phosp |
44 |
26 |
$798.08 |
| 86705 |
|
83 |
77 |
$781.03 |
| 84300 |
|
230 |
186 |
$757.02 |
| 86880 |
|
79 |
53 |
$748.38 |
| 82670 |
|
27 |
27 |
$748.08 |
| 87496 |
|
27 |
26 |
$701.80 |
| 83986 |
|
196 |
179 |
$689.00 |
| 90472 |
|
90 |
84 |
$686.90 |
| 83498 |
|
30 |
26 |
$671.38 |
| 87532 |
|
26 |
25 |
$666.71 |
| 86644 |
|
31 |
27 |
$660.45 |
| 82180 |
|
74 |
67 |
$628.30 |
| 82985 |
|
60 |
59 |
$621.38 |
| 85303 |
|
88 |
68 |
$595.15 |
| 83876 |
|
16 |
14 |
$559.46 |
| 82627 |
|
26 |
24 |
$545.52 |
| J3372 |
Inj, vancomycin hcl (xellia) |
87 |
42 |
$539.58 |
| 82365 |
|
52 |
50 |
$519.13 |
| J7120 |
Ringers lactate infusion |
153 |
114 |
$480.04 |
| 84402 |
|
28 |
28 |
$479.07 |
| 90656 |
|
36 |
33 |
$462.73 |
| 0124A |
|
20 |
14 |
$440.14 |
| 82652 |
|
12 |
12 |
$439.70 |
| 93271 |
|
18 |
14 |
$435.40 |
| J2800 |
Methocarbamol injection |
95 |
89 |
$424.33 |
| 88333 |
|
14 |
12 |
$419.86 |
| 85300 |
|
55 |
49 |
$417.95 |
| J0612 |
Inj, calcium gluconate, nos |
35 |
26 |
$410.89 |
| J9260 |
Inj methotrexate sodium 50mg |
226 |
141 |
$403.99 |
| 82379 |
|
29 |
27 |
$392.91 |
| 82164 |
|
13 |
13 |
$378.67 |
| 84630 |
|
57 |
40 |
$368.35 |
| 90662 |
|
106 |
100 |
$357.44 |
| 84238 |
|
12 |
12 |
$329.13 |
| 86355 |
|
19 |
13 |
$301.84 |
| 86359 |
|
21 |
14 |
$301.84 |
| J1030 |
Methylprednisolone 40 mg inj |
28 |
28 |
$297.41 |
| 86645 |
|
13 |
12 |
$294.70 |
| 84207 |
|
15 |
13 |
$282.41 |
| 85306 |
|
29 |
26 |
$235.00 |
| J0610 |
Calcium glucon (fresenius) |
16 |
13 |
$228.23 |
| 84075 |
|
13 |
12 |
$209.88 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
278 |
210 |
$194.41 |
| 82105 |
|
13 |
13 |
$184.47 |
| J2004 |
Inj, lidocaine w epinephrine |
99 |
84 |
$173.00 |
| 83993 |
|
12 |
12 |
$162.64 |
| 86682 |
|
13 |
12 |
$158.33 |
| 87106 |
|
14 |
12 |
$113.52 |
| J1630 |
Haloperidol injection |
158 |
123 |
$108.34 |
| 86008 |
|
13 |
12 |
$107.58 |
| 84133 |
|
30 |
28 |
$96.68 |
| C8937 |
Cad breast mri |
321 |
288 |
$32.04 |
| A0425 |
Ground mileage |
42 |
32 |
$1.74 |
| 91312 |
|
20 |
14 |
$0.12 |
| T2005 |
N-et; stretcher van |
16 |
13 |
$0.00 |