| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
74,797 |
65,204 |
$10.63M |
| 99284 |
|
46,203 |
38,769 |
$10.19M |
| 78452 |
|
24,318 |
9,229 |
$7.72M |
| 93306 |
|
19,006 |
17,212 |
$7.20M |
| 0202U |
|
15,837 |
14,771 |
$4.85M |
| 74177 |
|
12,600 |
11,025 |
$4.40M |
| 99285 |
|
15,011 |
11,276 |
$4.30M |
| 74176 |
|
12,558 |
11,022 |
$3.73M |
| 93017 |
|
10,734 |
10,032 |
$2.76M |
| 96365 |
|
33,852 |
14,615 |
$2.52M |
| 70450 |
|
14,816 |
12,113 |
$2.40M |
| 47562 |
|
1,929 |
1,391 |
$2.10M |
| G0378 |
Hospital observation per hr |
4,115 |
3,217 |
$1.62M |
| 87636 |
|
21,795 |
18,375 |
$1.50M |
| 96413 |
|
5,969 |
2,294 |
$1.46M |
| 80053 |
|
183,546 |
107,944 |
$1.37M |
| 96375 |
|
29,412 |
21,895 |
$1.18M |
| 80307 |
|
22,709 |
17,100 |
$1.14M |
| 93005 |
|
36,997 |
29,769 |
$1.03M |
| 43239 |
|
3,499 |
2,441 |
$945K |
| 96372 |
|
34,491 |
18,017 |
$943K |
| 96374 |
|
52,683 |
25,121 |
$929K |
| 71275 |
|
4,515 |
3,873 |
$920K |
| A9500 |
Tc99m sestamibi |
6,828 |
6,234 |
$890K |
| 99282 |
|
9,336 |
8,424 |
$883K |
| 85025 |
|
123,555 |
100,344 |
$843K |
| J0875 |
Injection, dalbavancin |
488 |
401 |
$806K |
| 59025 |
|
8,869 |
5,123 |
$796K |
| 74178 |
|
1,595 |
1,229 |
$796K |
| J2785 |
Regadenoson injection |
5,020 |
4,699 |
$780K |
| 71045 |
|
29,583 |
24,533 |
$778K |
| 72125 |
|
4,583 |
3,960 |
$737K |
| U0004 |
Cov-19 test non-cdc hgh thru |
11,922 |
10,522 |
$735K |
| 36415 |
|
187,473 |
93,477 |
$716K |
| 96361 |
|
14,475 |
10,297 |
$702K |
| 72110 |
|
5,411 |
4,770 |
$702K |
| 72148 |
|
3,113 |
2,886 |
$699K |
| 74018 |
|
10,937 |
9,499 |
$661K |
| 72131 |
|
3,834 |
3,369 |
$648K |
| 71260 |
|
4,125 |
2,729 |
$624K |
| 77067 |
|
8,138 |
7,934 |
$618K |
| 76705 |
|
7,424 |
6,868 |
$587K |
| 71250 |
|
5,441 |
4,467 |
$573K |
| 71046 |
|
18,518 |
16,260 |
$526K |
| 93971 |
|
3,378 |
3,074 |
$518K |
| H0015 |
Alcohol and/or drug services |
3,734 |
532 |
$509K |
| 80050 |
|
14,348 |
13,382 |
$497K |
| 76700 |
|
5,889 |
5,404 |
$473K |
| 96367 |
|
6,754 |
3,050 |
$452K |
| 0099U |
|
1,904 |
1,541 |
$449K |
| 73630 |
|
5,574 |
5,000 |
$449K |
| 96360 |
|
5,403 |
4,417 |
$445K |
| 73562 |
|
5,669 |
5,001 |
$431K |
| 73030 |
|
6,466 |
5,285 |
$422K |
| 11042 |
|
2,579 |
1,016 |
$410K |
| 70551 |
|
1,919 |
1,698 |
$407K |
| 45378 |
|
1,134 |
951 |
$405K |
| J9271 |
Inj pembrolizumab |
86 |
38 |
$402K |
| 73610 |
|
5,259 |
4,601 |
$401K |
| 42820 |
|
373 |
369 |
$371K |
| 96366 |
|
4,655 |
2,902 |
$366K |
| 70486 |
|
1,899 |
1,770 |
$365K |
| 93880 |
|
2,715 |
2,467 |
$364K |
| 72050 |
|
3,414 |
2,680 |
$349K |
| 73130 |
|
4,441 |
3,832 |
$347K |
| 84484 |
|
35,061 |
21,133 |
$342K |
| 70553 |
|
1,337 |
1,014 |
$330K |
| 72128 |
|
2,159 |
1,882 |
$327K |
| S9480 |
Intensive outpatient psychia |
2,421 |
289 |
$326K |
| 76775 |
|
2,686 |
2,212 |
$324K |
| 83880 |
|
10,775 |
9,215 |
$321K |
| 73110 |
|
3,871 |
3,286 |
$315K |
| 92507 |
|
5,846 |
1,785 |
$309K |
| 72141 |
|
1,407 |
1,209 |
$306K |
| 80061 |
|
25,075 |
21,747 |
$304K |
| 82306 |
|
12,322 |
11,393 |
$300K |
| 93970 |
|
1,581 |
1,434 |
$299K |
| 84443 |
|
20,626 |
18,989 |
$291K |
| 73721 |
|
1,149 |
1,035 |
$290K |
| 76642 |
|
3,078 |
2,912 |
$276K |
| 87804 |
|
9,529 |
8,805 |
$264K |
| 78815 |
|
643 |
485 |
$260K |
| 96376 |
|
6,689 |
4,834 |
$256K |
| 76536 |
|
3,154 |
2,895 |
$253K |
| 58571 |
|
268 |
104 |
$250K |
| 82805 |
|
5,882 |
4,376 |
$247K |
| 77066 |
Tomosynthesis, mammo |
3,578 |
2,907 |
$233K |
| 87040 |
|
26,903 |
13,483 |
$219K |
| 50590 |
|
276 |
173 |
$214K |
| 73564 |
|
1,774 |
1,562 |
$209K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
25,683 |
19,212 |
$208K |
| H0035 |
Mh partial hosp tx under 24h |
1,084 |
134 |
$206K |
| 45385 |
|
690 |
420 |
$199K |
| 74022 |
|
1,897 |
1,806 |
$195K |
| 87507 |
|
740 |
676 |
$193K |
| 97110 |
|
4,173 |
1,246 |
$191K |
| 69436 |
|
379 |
345 |
$183K |
| 72072 |
|
2,080 |
1,810 |
$182K |
| 87880 |
|
12,753 |
12,108 |
$172K |
| 76856 |
|
2,276 |
2,127 |
$171K |
| 80074 |
|
4,414 |
3,766 |
$171K |
| 87633 |
|
600 |
556 |
$169K |
| 94640 |
|
7,148 |
6,427 |
$168K |
| 78227 |
|
531 |
411 |
$168K |
| 10060 |
|
596 |
549 |
$167K |
| 83735 |
|
26,281 |
21,857 |
$163K |
| 82607 |
|
13,077 |
11,167 |
$159K |
| 87086 |
|
22,000 |
19,271 |
$153K |
| C9803 |
Hopd covid-19 spec collect |
23,021 |
17,285 |
$151K |
| 83605 |
|
17,665 |
13,856 |
$147K |
| 0097U |
|
617 |
501 |
$147K |
| 93225 |
|
1,977 |
1,667 |
$147K |
| 94060 |
|
2,075 |
1,518 |
$143K |
| 83036 |
|
17,547 |
16,537 |
$142K |
| 73090 |
|
2,050 |
1,754 |
$142K |
| 93226 |
|
1,118 |
1,052 |
$139K |
| 73502 |
|
2,949 |
2,373 |
$137K |
| 83690 |
|
24,507 |
21,871 |
$137K |
| 73080 |
|
2,013 |
1,742 |
$136K |
| 78226 |
|
520 |
401 |
$134K |
| 80048 |
|
22,376 |
14,608 |
$134K |
| 96368 |
|
1,561 |
985 |
$132K |
| 86140 |
|
34,612 |
29,946 |
$130K |
| 77065 |
Tomosynthesis, mammo |
2,423 |
1,939 |
$130K |
| 97112 |
|
2,438 |
810 |
$128K |
| 82077 |
|
9,149 |
7,670 |
$128K |
| 72100 |
|
1,953 |
1,674 |
$127K |
| 73590 |
|
1,991 |
1,713 |
$125K |
| 74240 |
|
586 |
550 |
$125K |
| 73221 |
|
527 |
478 |
$123K |
| 76830 |
|
1,442 |
1,347 |
$119K |
| 87637 |
|
1,513 |
1,415 |
$118K |
| G0463 |
Hospital outpt clinic visit |
9,801 |
6,165 |
$117K |
| U0003 |
Cov-19 amp prb hgh thruput |
2,015 |
1,764 |
$117K |
| 76870 |
|
1,501 |
1,394 |
$116K |
| 97602 |
|
3,612 |
1,750 |
$116K |
| 77080 |
|
3,481 |
2,431 |
$115K |
| 84439 |
|
13,970 |
13,002 |
$113K |
| A9552 |
F18 fdg |
787 |
554 |
$107K |
| M0243 |
Casirivi and imdevi inj |
560 |
533 |
$107K |
| 81001 |
|
39,863 |
32,935 |
$107K |
| 87522 |
Neg quan hep c or qual rna |
2,778 |
2,505 |
$101K |
| 84112 |
|
1,144 |
994 |
$99K |
| 80306 |
|
6,655 |
5,848 |
$99K |
| J7050 |
Normal saline solution infus |
3,276 |
1,088 |
$99K |
| 81025 |
|
19,979 |
17,900 |
$98K |
| A9577 |
Inj multihance |
1,860 |
1,731 |
$97K |
| 82728 |
|
9,405 |
7,350 |
$97K |
| 72040 |
|
1,154 |
947 |
$95K |
| 87081 |
|
13,110 |
12,264 |
$91K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
157 |
108 |
$90K |
| 12001 |
|
1,179 |
1,083 |
$90K |
| C1769 |
Guide wire |
1,087 |
954 |
$90K |
| 70491 |
|
542 |
365 |
$88K |
| 45380 |
|
329 |
265 |
$88K |
| 87491 |
|
2,802 |
2,600 |
$86K |
| G0483 |
Drug test def 22+ classes |
447 |
364 |
$83K |
| 87902 |
|
406 |
374 |
$83K |
| 87591 |
|
2,747 |
2,589 |
$82K |
| 87150 |
|
364 |
331 |
$79K |
| 0002A |
|
3,750 |
3,511 |
$77K |
| 96415 |
|
493 |
328 |
$77K |
| 36600 |
|
5,027 |
4,122 |
$75K |
| 84466 |
|
6,615 |
6,121 |
$75K |
| 97530 |
|
2,216 |
836 |
$74K |
| 85027 |
|
12,958 |
11,498 |
$74K |
| 84703 |
|
10,619 |
9,795 |
$72K |
| 71271 |
|
1,424 |
1,288 |
$72K |
| 0001A |
|
4,028 |
3,714 |
$68K |
| 58661 |
|
68 |
61 |
$68K |
| 84403 |
|
2,884 |
2,747 |
$66K |
| 70498 |
|
431 |
365 |
$66K |
| C1889 |
Implant/insert device, noc |
991 |
739 |
$66K |
| 84145 |
|
3,484 |
3,094 |
$65K |
| 84702 |
|
4,517 |
3,662 |
$65K |
| 97140 |
|
1,112 |
316 |
$65K |
| J2704 |
Inj, propofol, 10 mg |
18,762 |
15,474 |
$64K |
| 85379 |
|
7,185 |
6,591 |
$63K |
| A9537 |
Tc99m mebrofenin |
1,274 |
1,207 |
$63K |
| 85610 |
|
19,889 |
14,535 |
$63K |
| 86003 |
|
935 |
885 |
$62K |
| J2505 |
Injection, pegfilgrastim 6mg |
16 |
12 |
$60K |
| 87635 |
|
1,615 |
1,418 |
$60K |
| 86850 |
|
6,790 |
5,926 |
$60K |
| 94726 |
|
2,213 |
1,569 |
$59K |
| 81003 |
|
27,386 |
24,573 |
$59K |
| 70496 |
|
356 |
287 |
$57K |
| 71101 |
|
820 |
616 |
$56K |
| 99281 |
|
926 |
838 |
$56K |
| 82375 |
|
5,624 |
4,170 |
$55K |
| 90715 |
|
2,151 |
2,010 |
$55K |
| 87186 |
|
7,081 |
5,879 |
$54K |
| 76817 |
|
672 |
605 |
$54K |
| 84153 |
|
4,574 |
3,887 |
$53K |
| 85730 |
|
9,548 |
8,278 |
$52K |
| 95819 |
|
195 |
151 |
$51K |
| 94729 |
|
1,442 |
1,388 |
$47K |
| 96417 |
|
391 |
237 |
$47K |
| 83540 |
|
7,895 |
7,233 |
$46K |
| J2469 |
Palonosetron hcl |
1,121 |
663 |
$46K |
| 93925 |
|
453 |
408 |
$46K |
| 77336 |
|
482 |
89 |
$45K |
| 77063 |
|
11,078 |
9,298 |
$44K |
| 64488 |
|
101 |
84 |
$44K |
| 75574 |
|
174 |
147 |
$43K |
| 12002 |
|
470 |
440 |
$42K |
| 82746 |
|
3,395 |
3,162 |
$42K |
| 82150 |
|
7,451 |
6,730 |
$42K |
| 82670 |
|
2,442 |
1,706 |
$41K |
| G0432 |
Eia hiv-1/hiv-2 screen |
3,822 |
2,482 |
$40K |
| 99211 |
|
2,694 |
1,608 |
$39K |
| J7030 |
Normal saline solution infus |
9,114 |
4,409 |
$39K |
| 76819 |
|
507 |
409 |
$37K |
| J3010 |
Fentanyl citrate injection |
20,788 |
13,842 |
$36K |
| G0283 |
Elec stim other than wound |
1,774 |
438 |
$35K |
| 82550 |
|
5,946 |
4,671 |
$35K |
| 0100U |
|
71 |
69 |
$35K |
| 87077 |
|
4,861 |
3,866 |
$33K |
| 85652 |
|
15,032 |
13,447 |
$33K |
| 82962 |
|
10,288 |
5,540 |
$31K |
| 74019 |
|
483 |
430 |
$31K |
| 74220 |
|
278 |
253 |
$31K |
| J2805 |
Sincalide injection |
281 |
267 |
$31K |
| 73060 |
|
489 |
413 |
$30K |
| 87070 |
|
5,259 |
3,556 |
$30K |
| 86803 |
|
2,309 |
2,209 |
$30K |
| 83050 |
|
5,343 |
4,125 |
$30K |
| 81596 |
|
493 |
452 |
$29K |
| 76801 |
|
425 |
391 |
$29K |
| 73523 |
|
223 |
158 |
$28K |
| J0696 |
Ceftriaxone sodium injection |
11,157 |
8,974 |
$28K |
| 90471 |
|
2,407 |
2,157 |
$27K |
| 87807 |
|
1,808 |
1,702 |
$26K |
| J1885 |
Ketorolac tromethamine inj |
22,469 |
19,264 |
$26K |
| 82105 |
|
1,408 |
1,280 |
$26K |
| 87147 |
|
3,384 |
2,296 |
$26K |
| G0297 |
Ldct for lung ca screen |
480 |
409 |
$25K |
| 73560 |
|
333 |
302 |
$24K |
| 80143 |
|
1,472 |
1,330 |
$24K |
| 86038 |
|
2,243 |
2,087 |
$24K |
| P9612 |
Catheterize for urine spec |
5,687 |
3,298 |
$23K |
| 19081 |
|
32 |
27 |
$23K |
| G0279 |
Tomosynthesis, mammo |
5,548 |
4,575 |
$23K |
| 86901 |
|
6,865 |
6,018 |
$23K |
| 86900 |
|
6,998 |
6,036 |
$23K |
| M0245 |
Bamlan and etesev infusion |
107 |
103 |
$23K |
| 82043 |
|
4,388 |
4,012 |
$23K |
| 92526 |
|
459 |
154 |
$23K |
| J7040 |
Normal saline solution infus |
2,656 |
939 |
$22K |
| 73552 |
|
403 |
345 |
$22K |
| 87493 |
|
827 |
741 |
$22K |
| 73700 |
|
85 |
75 |
$22K |
| 76882 |
|
240 |
225 |
$22K |
| J2710 |
Neostigmine methylslfte inj |
4,825 |
4,134 |
$21K |
| 86677 |
|
762 |
730 |
$21K |
| J1170 |
Hydromorphone injection |
7,938 |
5,771 |
$21K |
| J2405 |
Ondansetron hcl injection |
31,460 |
25,699 |
$20K |
| 94727 |
|
496 |
474 |
$20K |
| 76805 |
|
868 |
789 |
$20K |
| 84481 |
|
1,350 |
1,253 |
$19K |
| J2930 |
Methylprednisolone injection |
4,378 |
3,960 |
$19K |
| 82784 |
|
2,020 |
1,787 |
$19K |
| 80179 |
|
1,404 |
1,286 |
$18K |
| J0694 |
Cefoxitin sodium injection |
1,702 |
1,280 |
$18K |
| 83615 |
|
3,327 |
2,813 |
$17K |
| 12011 |
|
189 |
173 |
$17K |
| 83516 |
|
1,031 |
631 |
$17K |
| J0780 |
Prochlorperazine injection |
3,654 |
3,167 |
$17K |
| 78264 |
|
55 |
43 |
$17K |
| Q9969 |
Non-heu tc-99m add-on/dose |
9,095 |
8,428 |
$16K |
| 36430 |
|
77 |
50 |
$16K |
| J1100 |
Dexamethasone sodium phos |
13,335 |
10,935 |
$16K |
| J3370 |
Vancomycin hcl injection |
2,401 |
1,559 |
$16K |
| 73140 |
|
245 |
223 |
$16K |
| 83655 |
|
1,327 |
1,305 |
$16K |
| 82948 |
|
3,316 |
1,823 |
$16K |
| J2270 |
Morphine sulfate injection |
7,978 |
6,164 |
$15K |
| 72146 |
|
61 |
56 |
$15K |
| J7120 |
Ringers lactate infusion |
3,034 |
2,538 |
$15K |
| 87205 |
|
3,821 |
3,277 |
$15K |
| 84550 |
|
3,507 |
2,976 |
$15K |
| C1751 |
Cath, inf, per/cent/midline |
253 |
167 |
$14K |
| 72081 |
|
80 |
80 |
$14K |
| C1894 |
Intro/sheath, non-laser |
314 |
275 |
$14K |
| 84100 |
|
3,491 |
2,586 |
$14K |
| J1756 |
Iron sucrose injection |
231 |
84 |
$13K |
| 86706 |
|
1,450 |
1,321 |
$13K |
| 82570 |
|
2,914 |
2,612 |
$13K |
| 82553 |
|
1,235 |
776 |
$12K |
| 92609 |
|
167 |
67 |
$12K |
| 83993 |
|
648 |
619 |
$11K |
| 86364 |
|
1,027 |
988 |
$11K |
| 97016 |
|
1,002 |
134 |
$11K |
| J2543 |
Piperacillin/tazobactam |
2,649 |
1,793 |
$11K |
| 93308 |
|
78 |
68 |
$11K |
| 84134 |
|
885 |
778 |
$11K |
| U0002 |
Covid-19 lab test non-cdc |
600 |
465 |
$11K |
| 82785 |
|
587 |
534 |
$11K |
| 86704 |
|
1,044 |
957 |
$11K |
| 97035 |
|
385 |
136 |
$10K |
| 92523 |
|
126 |
119 |
$10K |
| 93798 |
|
726 |
103 |
$10K |
| 97162 |
|
227 |
214 |
$10K |
| 93325 |
|
110 |
101 |
$10K |
| 86708 |
|
951 |
866 |
$10K |
| 82140 |
|
971 |
708 |
$9K |
| 77300 |
|
51 |
14 |
$9K |
| J1453 |
Fosaprepitant injection |
94 |
65 |
$9K |
| J3475 |
Inj magnesium sulfate |
1,512 |
1,066 |
$9K |
| 82248 |
|
1,917 |
1,526 |
$9K |
| J2250 |
Inj midazolam hydrochloride |
14,471 |
12,581 |
$9K |
| G0480 |
Drug test def 1-7 classes |
110 |
51 |
$9K |
| 93320 |
|
68 |
51 |
$9K |
| 87661 |
|
382 |
366 |
$9K |
| A4648 |
Implantable tissue marker |
96 |
92 |
$8K |
| J2795 |
Ropivacaine hcl injection |
1,583 |
1,340 |
$8K |
| 36416 |
|
4,509 |
1,482 |
$8K |
| J0592 |
Buprenorphine hydrochloride |
995 |
830 |
$8K |
| 86308 |
|
1,712 |
1,643 |
$8K |
| 76506 |
|
95 |
94 |
$8K |
| 93356 |
|
412 |
372 |
$8K |
| 84156 |
|
2,313 |
2,080 |
$8K |
| 84402 |
|
384 |
352 |
$8K |
| Q9968 |
Visualization adjunct |
117 |
73 |
$8K |
| 86231 |
|
796 |
771 |
$8K |
| 87899 |
|
441 |
299 |
$8K |
| 87340 |
|
953 |
881 |
$8K |
| 87088 |
|
1,101 |
1,028 |
$8K |
| 84436 |
|
1,252 |
1,150 |
$7K |
| 83550 |
|
795 |
730 |
$7K |
| J1644 |
Inj heparin sodium per 1000u |
2,956 |
1,458 |
$7K |
| 93923 |
|
117 |
100 |
$7K |
| 29125 |
|
111 |
95 |
$7K |
| G0103 |
Psa screening |
1,302 |
540 |
$7K |
| 86376 |
|
553 |
527 |
$7K |
| P9016 |
Rbc leukocytes reduced |
90 |
38 |
$7K |
| 99195 |
|
213 |
176 |
$7K |
| 86431 |
|
1,379 |
1,302 |
$7K |
| J2360 |
Orphenadrine injection |
2,387 |
2,207 |
$7K |
| J1040 |
Methylprednisolone 80 mg inj |
412 |
376 |
$7K |
| 87631 |
|
42 |
40 |
$7K |
| 93922 |
|
121 |
102 |
$7K |
| 82247 |
|
1,390 |
1,020 |
$7K |
| J1650 |
Inj enoxaparin sodium |
1,350 |
742 |
$6K |
| 82977 |
|
966 |
863 |
$6K |
| J3490 |
Drugs unclassified injection |
91 |
84 |
$6K |
| 97163 |
|
167 |
149 |
$6K |
| 36591 |
|
460 |
153 |
$6K |
| 83010 |
|
563 |
462 |
$6K |
| 83874 |
|
473 |
271 |
$6K |
| 87798 |
|
208 |
177 |
$6K |
| 87046 |
|
442 |
289 |
$6K |
| J1580 |
Garamycin gentamicin inj |
2,384 |
2,036 |
$6K |
| 96411 |
|
50 |
28 |
$6K |
| 80076 |
|
726 |
632 |
$6K |
| 73120 |
|
87 |
80 |
$6K |
| 99291 |
|
14 |
12 |
$6K |
| 72220 |
|
100 |
69 |
$6K |
| J0500 |
Dicyclomine injection |
71 |
69 |
$5K |
| 87209 |
|
274 |
244 |
$5K |
| Q0138 |
Ferumoxytol, non-esrd |
30 |
13 |
$5K |
| J1642 |
Inj heparin sodium per 10 u |
4,137 |
2,220 |
$5K |
| M0239 |
Bamlanivimab-xxxx infusion |
43 |
38 |
$5K |
| 74246 |
|
55 |
50 |
$5K |
| C1781 |
Mesh (implantable) |
15 |
12 |
$5K |
| 72082 |
|
13 |
13 |
$5K |
| A9541 |
Tc99m sulfur colloid |
45 |
42 |
$4K |
| J1200 |
Diphenhydramine hcl injectio |
3,687 |
2,812 |
$4K |
| J0690 |
Cefazolin sodium injection |
1,459 |
1,213 |
$4K |
| J0561 |
Penicillin g benzathine inj |
28 |
28 |
$4K |
| 91035 |
|
16 |
14 |
$4K |
| 0042T |
|
15 |
12 |
$4K |
| J2272 |
Inj, morphine (fresenius) |
2,085 |
1,732 |
$4K |
| 94010 |
|
93 |
71 |
$4K |
| 84146 |
|
217 |
204 |
$3K |
| J2060 |
Lorazepam injection |
2,656 |
2,104 |
$3K |
| 43248 |
|
15 |
14 |
$3K |
| 51702 |
|
45 |
30 |
$3K |
| 78306 |
|
28 |
13 |
$3K |
| 83883 |
|
213 |
158 |
$3K |
| M0247 |
Sotrovimab infusion |
17 |
14 |
$3K |
| 94761 |
|
429 |
217 |
$3K |
| 87581 |
|
115 |
111 |
$3K |
| 87486 |
|
115 |
111 |
$3K |
| 74241 |
|
12 |
12 |
$3K |
| 87045 |
|
355 |
297 |
$3K |
| 82378 |
|
147 |
130 |
$3K |
| 0004A |
|
216 |
202 |
$3K |
| 87177 |
|
287 |
250 |
$3K |
| 82172 |
|
140 |
121 |
$3K |
| 82525 |
|
263 |
132 |
$3K |
| 82009 |
|
707 |
607 |
$2K |
| 86618 |
|
170 |
145 |
$2K |
| 83525 |
|
237 |
229 |
$2K |
| J2919 |
Inj, methylpred sod succ 5mg |
369 |
321 |
$2K |
| J2550 |
Promethazine hcl injection |
2,534 |
1,823 |
$2K |
| J3411 |
Thiamine hcl 100 mg |
503 |
418 |
$2K |
| J1030 |
Methylprednisolone 40 mg inj |
460 |
373 |
$2K |
| 96523 |
|
312 |
209 |
$2K |
| 76885 |
|
24 |
24 |
$2K |
| J2175 |
Meperidine hydrochl /100 mg |
630 |
566 |
$2K |
| 72170 |
|
46 |
38 |
$2K |
| J0702 |
Betamethasone acet&sod phosp |
136 |
81 |
$2K |
| 83970 |
|
67 |
65 |
$2K |
| 86258 |
|
125 |
124 |
$2K |
| 80202 |
|
138 |
61 |
$2K |
| C1726 |
Cath, bal dil, non-vascular |
13 |
12 |
$2K |
| 83001 |
|
128 |
121 |
$2K |
| 81050 |
|
547 |
388 |
$2K |
| 86008 |
|
219 |
213 |
$2K |
| 86800 |
|
134 |
124 |
$2K |
| 86757 |
|
31 |
28 |
$2K |
| 84132 |
|
505 |
344 |
$2K |
| J0595 |
Butorphanol tartrate 1 mg |
416 |
293 |
$2K |
| 82270 |
|
404 |
365 |
$2K |
| 83002 |
|
112 |
103 |
$2K |
| 82652 |
|
40 |
37 |
$2K |
| 94664 |
|
82 |
55 |
$2K |
| J0360 |
Hydralazine hcl injection |
389 |
327 |
$2K |
| 73000 |
|
18 |
16 |
$1K |
| 84479 |
|
268 |
251 |
$1K |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
664 |
607 |
$1K |
| 80164 |
|
162 |
135 |
$1K |
| 82653 |
|
27 |
27 |
$1K |
| 85014 |
|
310 |
177 |
$1K |
| 81206 |
|
15 |
14 |
$1K |
| 73070 |
|
13 |
12 |
$1K |
| J1790 |
Droperidol injection |
322 |
274 |
$1K |
| J2920 |
Methylprednisolone injection |
261 |
225 |
$1K |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
504 |
466 |
$1K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
92 |
77 |
$1K |
| 82103 |
|
87 |
86 |
$1K |
| 83921 |
|
63 |
62 |
$1K |
| 81207 |
|
15 |
14 |
$1K |
| 83631 |
|
56 |
54 |
$1K |
| 73503 |
|
14 |
13 |
$1K |
| 93246 |
|
27 |
27 |
$992.63 |
| 84630 |
|
77 |
75 |
$977.28 |
| 86592 |
|
283 |
258 |
$974.79 |
| 85045 |
|
256 |
209 |
$934.79 |
| 86666 |
|
28 |
27 |
$869.92 |
| 83520 |
|
40 |
25 |
$862.72 |
| J2765 |
Metoclopramide hcl injection |
984 |
816 |
$850.63 |
| 86255 |
|
56 |
55 |
$821.65 |
| 85049 |
|
61 |
26 |
$796.38 |
| 93242 |
|
24 |
24 |
$727.68 |
| 74230 |
|
23 |
12 |
$714.04 |
| 0003A |
|
59 |
56 |
$679.20 |
| 82533 |
|
44 |
41 |
$657.72 |
| 86200 |
|
58 |
55 |
$654.60 |
| 82272 |
|
261 |
195 |
$648.99 |
| 86769 |
|
17 |
13 |
$639.26 |
| 97535 |
|
43 |
13 |
$628.22 |
| 94760 |
|
83 |
79 |
$588.10 |
| J0330 |
Succinycholine chloride inj |
91 |
78 |
$579.60 |
| 84460 |
|
118 |
96 |
$570.44 |
| 84144 |
|
32 |
25 |
$557.09 |
| 85007 |
|
191 |
174 |
$525.52 |
| J3480 |
Inj potassium chloride |
57 |
28 |
$515.90 |
| 97139 |
|
156 |
42 |
$493.57 |
| 87484 |
|
23 |
16 |
$458.12 |
| 83630 |
|
28 |
25 |
$450.08 |
| J2370 |
Phenylephrine hcl injection |
43 |
37 |
$445.86 |
| 82104 |
|
31 |
31 |
$433.80 |
| 84478 |
|
95 |
59 |
$431.43 |
| 87468 |
|
23 |
16 |
$382.71 |
| 86753 |
|
17 |
16 |
$327.75 |
| 87389 |
|
15 |
14 |
$324.70 |
| 86015 |
|
25 |
25 |
$289.20 |
| J1940 |
Furosemide injection |
128 |
94 |
$289.04 |
| 87210 |
|
57 |
56 |
$277.87 |
| 82390 |
|
24 |
24 |
$277.26 |
| 84480 |
|
35 |
27 |
$273.48 |
| 86381 |
|
12 |
12 |
$249.41 |
| 86668 |
|
14 |
14 |
$237.38 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
110 |
98 |
$236.49 |
| 87220 |
|
45 |
44 |
$229.13 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
127 |
105 |
$208.12 |
| 85018 |
|
103 |
64 |
$192.95 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
301 |
273 |
$191.29 |
| 90686 |
|
17 |
14 |
$183.97 |
| J0171 |
Adrenalin epinephrine inject |
13 |
12 |
$173.20 |
| Q3014 |
Telehealth facility fee |
33 |
26 |
$163.76 |
| G0008 |
Admin influenza virus vac |
17 |
14 |
$151.91 |
| 76999 |
|
32 |
24 |
$146.22 |
| J3105 |
Terbutaline sulfate inj |
120 |
94 |
$146.20 |
| 86141 |
|
12 |
12 |
$142.45 |
| 82330 |
|
13 |
12 |
$136.80 |
| 82465 |
|
30 |
30 |
$117.54 |
| J1953 |
Levetiracetam injection |
12 |
12 |
$103.00 |
| J2001 |
Lidocaine injection |
158 |
132 |
$99.26 |
| 85384 |
|
12 |
12 |
$98.17 |
| 80178 |
|
14 |
12 |
$86.98 |
| J7121 |
5% dextrose in lac ringers |
14 |
12 |
$81.41 |
| 85651 |
|
18 |
16 |
$57.58 |
| 82947 |
|
12 |
12 |
$12.26 |
| 99499 |
|
106 |
97 |
$0.00 |