| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0378 |
Hospital observation per hr |
39,630 |
34,423 |
$27.22M |
| 99283 |
|
80,068 |
74,756 |
$27.19M |
| 99284 |
|
64,131 |
58,778 |
$25.73M |
| 99285 |
|
55,773 |
49,288 |
$18.54M |
| OP250 |
|
169,627 |
120,629 |
$4.71M |
| S9480 |
Intensive outpatient psychia |
5,529 |
5,023 |
$4.20M |
| 58558 |
|
1,981 |
1,875 |
$3.36M |
| 99282 |
|
14,993 |
14,018 |
$3.34M |
| 43239 |
|
2,591 |
2,375 |
$2.91M |
| T2034 |
Crisis interven waiver/diem |
2,223 |
2,086 |
$1.90M |
| 93306 |
|
3,277 |
3,072 |
$1.64M |
| 80053 |
|
91,988 |
78,800 |
$1.64M |
| 11042 |
|
7,305 |
2,990 |
$1.64M |
| 95810 |
|
586 |
563 |
$1.59M |
| 71046 |
|
28,660 |
27,220 |
$1.12M |
| OP710 |
|
21,022 |
18,765 |
$1.09M |
| 0202U |
|
12,984 |
12,288 |
$984K |
| 45378 |
|
664 |
655 |
$844K |
| 45380 |
|
1,019 |
932 |
$778K |
| 88305 |
|
8,875 |
8,266 |
$681K |
| 76811 |
|
2,128 |
2,095 |
$663K |
| 76819 |
|
4,478 |
3,173 |
$659K |
| 97803 |
|
3,760 |
3,702 |
$659K |
| 97530 |
|
23,708 |
5,473 |
$655K |
| 71045 |
|
17,475 |
15,676 |
$654K |
| 74177 |
|
8,911 |
8,420 |
$621K |
| 87633 |
|
4,991 |
4,736 |
$604K |
| 59425 |
|
8,631 |
5,169 |
$601K |
| S9484 |
Crisis intervention per hour |
885 |
851 |
$555K |
| 97110 |
|
37,170 |
8,583 |
$543K |
| 95811 |
|
162 |
161 |
$535K |
| 93017 |
|
2,876 |
2,670 |
$514K |
| OP258 |
|
68,870 |
55,186 |
$475K |
| OP272 |
|
21,265 |
18,965 |
$474K |
| 96374 |
|
44,137 |
39,158 |
$471K |
| 36415 |
|
112,434 |
90,105 |
$462K |
| 96361 |
|
33,163 |
29,304 |
$451K |
| 78452 |
|
2,727 |
2,548 |
$432K |
| 93005 |
|
39,996 |
35,352 |
$410K |
| 76700 |
|
5,112 |
4,934 |
$393K |
| 45385 |
|
785 |
671 |
$384K |
| 76856 |
|
4,314 |
4,173 |
$380K |
| 70450 |
|
10,270 |
9,342 |
$375K |
| 76801 |
|
3,832 |
3,546 |
$356K |
| 97802 |
|
1,360 |
1,353 |
$352K |
| 96375 |
|
31,984 |
27,318 |
$331K |
| 76816 |
|
2,686 |
2,550 |
$327K |
| 87426 |
|
10,124 |
9,207 |
$325K |
| 77067 |
|
2,152 |
2,152 |
$319K |
| 97140 |
|
23,556 |
5,390 |
$316K |
| 85025 |
|
92,498 |
78,811 |
$315K |
| 87636 |
|
19,121 |
17,204 |
$307K |
| OP370 |
|
16,573 |
14,844 |
$306K |
| 96365 |
|
6,271 |
5,523 |
$257K |
| A9500 |
Tc99m sestamibi |
2,830 |
2,528 |
$234K |
| 99281 |
|
1,184 |
1,093 |
$221K |
| 76817 |
|
3,068 |
2,693 |
$215K |
| 97112 |
|
18,502 |
4,113 |
$213K |
| 76805 |
|
1,799 |
1,767 |
$212K |
| 97010 |
|
10,524 |
2,565 |
$199K |
| 81001 |
|
38,707 |
35,454 |
$193K |
| U0004 |
Cov-19 test non-cdc hgh thru |
4,765 |
4,484 |
$183K |
| 73562 |
|
4,873 |
4,602 |
$181K |
| 0241U |
|
4,737 |
4,344 |
$178K |
| OP278 |
|
927 |
858 |
$177K |
| 74176 |
|
1,992 |
1,841 |
$170K |
| 96372 |
|
29,001 |
25,392 |
$166K |
| 73630 |
|
4,026 |
3,866 |
$155K |
| 87491 |
|
5,468 |
5,255 |
$154K |
| 93458 |
|
175 |
128 |
$154K |
| 73130 |
|
3,541 |
3,374 |
$141K |
| 88342 |
|
3,048 |
2,797 |
$139K |
| 96360 |
|
9,936 |
9,389 |
$139K |
| 81003 |
|
21,117 |
19,740 |
$135K |
| 73030 |
|
3,499 |
3,312 |
$131K |
| J2785 |
Regadenoson injection |
1,908 |
1,770 |
$129K |
| 42820 |
|
38 |
38 |
$122K |
| 93970 |
|
1,673 |
1,524 |
$121K |
| 73610 |
|
3,911 |
3,748 |
$118K |
| 82962 |
|
21,279 |
14,792 |
$118K |
| 81025 |
|
15,180 |
14,501 |
$113K |
| 87086 |
|
18,701 |
17,601 |
$110K |
| 97014 |
|
3,546 |
947 |
$108K |
| 97150 |
|
4,923 |
1,201 |
$105K |
| 66984 |
|
105 |
100 |
$105K |
| 71275 |
|
1,701 |
1,593 |
$105K |
| 74150 |
|
3,141 |
2,960 |
$99K |
| 76813 |
|
801 |
783 |
$98K |
| 87081 |
|
7,844 |
7,704 |
$98K |
| G0480 |
Drug test def 1-7 classes |
6,264 |
5,413 |
$97K |
| 59430 |
|
1,733 |
1,644 |
$96K |
| 59025 |
|
194 |
143 |
$91K |
| G0108 |
Diab manage trn per indiv |
545 |
451 |
$90K |
| 76815 |
|
1,140 |
1,058 |
$87K |
| 93975 |
|
1,084 |
1,014 |
$86K |
| 76770 |
|
921 |
894 |
$86K |
| 72125 |
|
1,843 |
1,649 |
$86K |
| 86900 |
|
14,611 |
13,385 |
$85K |
| G0379 |
Direct refer hospital observ |
2,568 |
2,191 |
$83K |
| 87651 |
|
2,844 |
2,704 |
$79K |
| 73110 |
|
2,058 |
1,960 |
$77K |
| 87631 |
|
2,617 |
2,578 |
$76K |
| 93971 |
|
1,995 |
1,860 |
$74K |
| 86850 |
|
14,635 |
13,392 |
$74K |
| 94640 |
|
5,168 |
3,809 |
$71K |
| G0463 |
Hospital outpt clinic visit |
5,976 |
4,116 |
$70K |
| 58661 |
|
98 |
83 |
$70K |
| 97162 |
|
2,944 |
2,626 |
$68K |
| 76705 |
|
810 |
750 |
$67K |
| 72100 |
|
2,222 |
2,077 |
$67K |
| 80048 |
|
7,075 |
5,783 |
$66K |
| 87070 |
|
3,663 |
3,388 |
$65K |
| 99213 |
|
1,704 |
1,421 |
$65K |
| 97161 |
|
2,218 |
2,030 |
$64K |
| 84484 |
|
22,082 |
18,075 |
$60K |
| 99202 |
|
1,089 |
1,085 |
$60K |
| 87635 |
|
4,855 |
4,559 |
$59K |
| 76830 |
|
497 |
489 |
$56K |
| 80307 |
|
1,038 |
1,014 |
$56K |
| 74246 |
|
402 |
394 |
$55K |
| 87591 |
|
5,471 |
5,257 |
$51K |
| 74018 |
|
1,692 |
1,586 |
$50K |
| 70486 |
|
1,129 |
1,065 |
$49K |
| 87430 |
|
11,490 |
11,113 |
$48K |
| 70551 |
|
630 |
533 |
$47K |
| J0131 |
Inj, acetaminophen (nos) |
13,172 |
11,320 |
$45K |
| 84703 |
|
27,693 |
25,808 |
$43K |
| J2405 |
Ondansetron hcl injection |
31,958 |
27,339 |
$43K |
| 47562 |
|
28 |
24 |
$41K |
| 96413 |
|
128 |
61 |
$41K |
| 96376 |
|
6,827 |
5,257 |
$40K |
| 76642 |
|
374 |
372 |
$38K |
| 43775 |
|
12 |
12 |
$38K |
| 99211 |
|
1,257 |
900 |
$38K |
| 85610 |
|
19,791 |
17,642 |
$38K |
| 87040 |
|
4,064 |
3,775 |
$37K |
| 77080 |
|
488 |
487 |
$37K |
| 80305 |
|
6,545 |
5,773 |
$37K |
| 73080 |
|
1,070 |
1,024 |
$37K |
| 83880 |
|
5,385 |
4,796 |
$36K |
| 86901 |
|
14,639 |
13,395 |
$36K |
| A9270 |
Non-covered item or service |
20,273 |
12,594 |
$34K |
| U0005 |
Infec agen detec ampli probe |
3,085 |
2,970 |
$33K |
| 72110 |
|
513 |
511 |
$32K |
| 83690 |
|
29,702 |
26,958 |
$32K |
| 72131 |
|
619 |
529 |
$32K |
| 87389 |
|
1,779 |
1,747 |
$32K |
| 85730 |
|
18,276 |
16,515 |
$31K |
| 84702 |
|
7,705 |
6,578 |
$31K |
| J1100 |
Dexamethasone sodium phos |
12,641 |
11,277 |
$31K |
| 29515 |
|
1,373 |
1,291 |
$31K |
| 87400 |
|
4,839 |
4,807 |
$30K |
| 71101 |
|
684 |
635 |
$29K |
| 73590 |
|
949 |
890 |
$29K |
| C1781 |
Mesh (implantable) |
54 |
54 |
$29K |
| 99212 |
|
940 |
696 |
$28K |
| 76641 |
|
191 |
191 |
$26K |
| 29581 |
|
477 |
144 |
$26K |
| 76870 |
|
341 |
308 |
$26K |
| C9290 |
Inj, bupivacaine liposome |
439 |
382 |
$25K |
| 82542 |
|
1,819 |
1,796 |
$25K |
| 29125 |
|
966 |
917 |
$25K |
| 88142 |
|
772 |
770 |
$25K |
| 84443 |
|
4,622 |
4,287 |
$24K |
| 67113 |
|
30 |
25 |
$24K |
| 93798 |
|
124 |
25 |
$24K |
| J1756 |
Iron sucrose injection |
1,245 |
533 |
$24K |
| 96366 |
|
531 |
429 |
$23K |
| 88304 |
|
3,407 |
3,088 |
$23K |
| J0500 |
Dicyclomine injection |
2,175 |
2,037 |
$23K |
| 12001 |
|
1,003 |
943 |
$23K |
| 10060 |
|
491 |
441 |
$23K |
| J2704 |
Inj, propofol, 10 mg |
13,355 |
12,160 |
$22K |
| 77065 |
Tomosynthesis, mammo |
161 |
161 |
$22K |
| 80061 |
|
2,785 |
2,623 |
$21K |
| 12011 |
|
825 |
766 |
$21K |
| 85027 |
|
8,537 |
7,548 |
$21K |
| 73502 |
|
1,369 |
1,243 |
$21K |
| 77336 |
|
202 |
76 |
$20K |
| J3010 |
Fentanyl citrate injection |
11,878 |
10,815 |
$20K |
| 86592 |
|
2,564 |
2,512 |
$20K |
| 71250 |
|
253 |
207 |
$19K |
| 95806 |
|
31 |
29 |
$19K |
| 95800 |
|
25 |
25 |
$19K |
| J0690 |
Cefazolin sodium injection |
5,038 |
4,185 |
$18K |
| 72040 |
|
467 |
430 |
$17K |
| J0561 |
Penicillin g benzathine inj |
214 |
207 |
$17K |
| 90715 |
|
3,174 |
3,043 |
$16K |
| 87186 |
|
1,956 |
1,744 |
$15K |
| 96367 |
|
478 |
391 |
$15K |
| 70496 |
|
149 |
126 |
$15K |
| 11045 |
|
125 |
51 |
$15K |
| 73140 |
|
484 |
471 |
$15K |
| 87147 |
|
1,683 |
1,608 |
$14K |
| 87340 |
|
1,963 |
1,874 |
$14K |
| 88307 |
|
1,546 |
1,388 |
$13K |
| V2632 |
Post chmbr intraocular lens |
341 |
278 |
$13K |
| 87205 |
|
1,384 |
1,248 |
$13K |
| 83036 |
|
2,742 |
2,578 |
$13K |
| 73090 |
|
333 |
322 |
$13K |
| C1769 |
Guide wire |
1,395 |
1,151 |
$12K |
| 83735 |
|
6,202 |
5,317 |
$12K |
| J1885 |
Ketorolac tromethamine inj |
25,318 |
22,773 |
$12K |
| M0222 |
Bebtelovimab injection |
270 |
219 |
$12K |
| 95816 |
|
43 |
43 |
$12K |
| J2060 |
Lorazepam injection |
3,136 |
2,443 |
$12K |
| 70498 |
|
127 |
106 |
$12K |
| 87637 |
|
142 |
137 |
$11K |
| 87077 |
|
1,651 |
1,584 |
$11K |
| J2270 |
Morphine sulfate injection |
11,272 |
8,823 |
$11K |
| 82950 |
|
557 |
498 |
$10K |
| 88341 |
|
446 |
427 |
$10K |
| 90471 |
|
3,697 |
3,302 |
$9K |
| 87088 |
|
3,758 |
3,549 |
$9K |
| J1644 |
Inj heparin sodium per 1000u |
1,041 |
771 |
$9K |
| 99214 |
|
125 |
98 |
$9K |
| 90791 |
|
1,011 |
719 |
$9K |
| 97124 |
|
570 |
148 |
$8K |
| OP270 |
|
4,414 |
4,181 |
$8K |
| C2617 |
Stent, non-cor, tem w/o del |
135 |
110 |
$8K |
| J0696 |
Ceftriaxone sodium injection |
7,335 |
6,255 |
$8K |
| Q0247 |
Sotrovimab |
59 |
41 |
$8K |
| 71260 |
|
43 |
40 |
$7K |
| J2250 |
Inj midazolam hydrochloride |
9,595 |
8,327 |
$7K |
| J1200 |
Diphenhydramine hcl injectio |
5,105 |
4,356 |
$7K |
| 74241 |
|
43 |
43 |
$7K |
| J1170 |
Hydromorphone injection |
5,633 |
4,599 |
$7K |
| 58662 |
|
12 |
12 |
$7K |
| 83605 |
|
1,770 |
1,615 |
$7K |
| 86787 |
|
538 |
532 |
$7K |
| 72082 |
|
85 |
85 |
$7K |
| J1650 |
Inj enoxaparin sodium |
1,523 |
849 |
$7K |
| C1894 |
Intro/sheath, non-laser |
888 |
739 |
$7K |
| 85007 |
|
4,999 |
4,569 |
$6K |
| M0244 |
Casirivi and imdevi inj hm |
48 |
47 |
$6K |
| 83021 |
|
329 |
329 |
$6K |
| 87807 |
|
427 |
424 |
$6K |
| 97166 |
|
159 |
145 |
$6K |
| 86765 |
|
619 |
611 |
$6K |
| 87486 |
|
357 |
345 |
$5K |
| 86703 |
|
424 |
396 |
$5K |
| S9451 |
Exercise class |
57 |
57 |
$5K |
| 15853 |
|
347 |
301 |
$5K |
| 88312 |
|
546 |
546 |
$5K |
| 87075 |
|
254 |
205 |
$4K |
| 77066 |
Tomosynthesis, mammo |
26 |
26 |
$4K |
| 87798 |
|
359 |
347 |
$4K |
| 82306 |
|
492 |
478 |
$4K |
| 36430 |
|
140 |
106 |
$4K |
| 93226 |
|
12 |
12 |
$4K |
| J2765 |
Metoclopramide hcl injection |
8,022 |
7,379 |
$4K |
| 72050 |
|
52 |
52 |
$4K |
| Q9957 |
Inj perflutren lip micros,ml |
151 |
135 |
$4K |
| 82248 |
|
113 |
102 |
$4K |
| 72070 |
|
165 |
160 |
$3K |
| J1815 |
Insulin injection |
1,721 |
1,275 |
$3K |
| 86480 |
|
94 |
88 |
$3K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
5,443 |
4,816 |
$3K |
| 84100 |
|
1,738 |
1,403 |
$3K |
| 87641 |
|
250 |
221 |
$3K |
| G8979 |
Mobility goal status |
530 |
506 |
$3K |
| G8978 |
Mobility current status |
513 |
495 |
$3K |
| 43235 |
|
12 |
12 |
$3K |
| 30520 |
|
12 |
12 |
$3K |
| 84550 |
|
1,297 |
1,179 |
$3K |
| 74420 |
|
175 |
143 |
$3K |
| M0245 |
Bamlan and etesev infusion |
122 |
121 |
$3K |
| 76536 |
|
30 |
28 |
$3K |
| 93225 |
|
12 |
12 |
$3K |
| 81002 |
|
1,104 |
606 |
$3K |
| J7512 |
Prednisone ir or dr oral 1mg |
845 |
802 |
$3K |
| 87581 |
|
357 |
345 |
$3K |
| 85378 |
|
3,244 |
3,086 |
$3K |
| 83615 |
|
879 |
787 |
$3K |
| 84439 |
|
433 |
393 |
$2K |
| 29505 |
|
49 |
46 |
$2K |
| 97535 |
|
250 |
213 |
$2K |
| 86308 |
|
347 |
329 |
$2K |
| M0239 |
Bamlanivimab-xxxx infusion |
82 |
81 |
$2K |
| 12002 |
|
108 |
102 |
$2K |
| 29130 |
|
96 |
88 |
$2K |
| P9016 |
Rbc leukocytes reduced |
137 |
106 |
$2K |
| J0171 |
Adrenalin epinephrine inject |
401 |
340 |
$2K |
| J2710 |
Neostigmine methylslfte inj |
423 |
422 |
$2K |
| 97116 |
|
358 |
117 |
$2K |
| G0008 |
Admin influenza virus vac |
89 |
89 |
$2K |
| 82805 |
|
88 |
86 |
$2K |
| 82728 |
|
157 |
144 |
$2K |
| 86780 |
|
207 |
195 |
$2K |
| OP637 |
|
2,124 |
1,271 |
$2K |
| J2930 |
Methylprednisolone injection |
1,547 |
1,386 |
$1K |
| C1887 |
Catheter, guiding |
200 |
153 |
$1K |
| 85379 |
|
536 |
496 |
$1K |
| C1765 |
Adhesion barrier |
20 |
14 |
$1K |
| 0001A |
|
51 |
51 |
$1K |
| 82010 |
|
644 |
545 |
$1K |
| 82607 |
|
95 |
89 |
$1K |
| 82803 |
|
99 |
84 |
$1K |
| J1335 |
Ertapenem injection |
134 |
108 |
$1K |
| 0002A |
|
29 |
29 |
$1K |
| C8929 |
Tte w or wo fol wcon,doppler |
23 |
16 |
$1K |
| M0247 |
Sotrovimab infusion |
63 |
45 |
$1K |
| 88302 |
|
271 |
228 |
$1K |
| 83540 |
|
284 |
259 |
$1K |
| 90792 |
|
214 |
166 |
$988.91 |
| 86140 |
|
969 |
907 |
$987.97 |
| 82746 |
|
70 |
66 |
$880.88 |
| J7613 |
Albuterol non-comp unit |
1,893 |
1,638 |
$879.51 |
| 86762 |
|
418 |
417 |
$745.39 |
| 80179 |
|
354 |
323 |
$732.43 |
| 85651 |
|
938 |
872 |
$731.28 |
| 97164 |
|
15 |
15 |
$727.00 |
| J7510 |
Prednisolone oral per 5 mg |
1,872 |
1,808 |
$649.35 |
| 82951 |
|
109 |
84 |
$630.03 |
| 82550 |
|
405 |
364 |
$604.23 |
| 85055 |
|
68 |
59 |
$604.16 |
| 83550 |
|
209 |
192 |
$564.51 |
| 86920 |
|
104 |
81 |
$562.51 |
| J3480 |
Inj potassium chloride |
38 |
26 |
$561.44 |
| 82247 |
|
195 |
167 |
$531.44 |
| J2543 |
Piperacillin/tazobactam |
419 |
237 |
$526.90 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
748 |
703 |
$524.21 |
| 83970 |
|
41 |
39 |
$510.83 |
| 73070 |
|
12 |
12 |
$481.44 |
| 93880 |
|
13 |
13 |
$466.75 |
| J2919 |
Inj, methylpred sod succ 5mg |
490 |
414 |
$462.91 |
| 82570 |
|
403 |
372 |
$454.89 |
| 88300 |
|
202 |
181 |
$448.46 |
| 84156 |
|
358 |
320 |
$408.06 |
| 90686 |
|
55 |
55 |
$381.54 |
| Q9968 |
Visualization adjunct |
19 |
13 |
$367.50 |
| J3475 |
Inj magnesium sulfate |
369 |
329 |
$360.66 |
| J2920 |
Methylprednisolone injection |
607 |
381 |
$357.36 |
| 80320 |
|
69 |
66 |
$349.03 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
166 |
144 |
$343.81 |
| 0031A |
|
24 |
24 |
$289.38 |
| 83020 |
|
56 |
51 |
$286.73 |
| J1630 |
Haloperidol injection |
976 |
683 |
$259.37 |
| G0283 |
Elec stim other than wound |
216 |
50 |
$243.58 |
| 74181 |
|
12 |
12 |
$242.40 |
| 80143 |
|
42 |
39 |
$235.48 |
| J0134 |
Inj acetaminophen -fresenius |
169 |
146 |
$214.69 |
| 87493 |
|
16 |
15 |
$192.46 |
| 90674 |
|
47 |
47 |
$181.40 |
| 84075 |
|
128 |
118 |
$174.33 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,159 |
1,033 |
$172.70 |
| 94760 |
|
81 |
70 |
$171.20 |
| 88311 |
|
169 |
155 |
$165.72 |
| J2370 |
Phenylephrine hcl injection |
239 |
211 |
$156.00 |
| 85652 |
|
216 |
204 |
$151.08 |
| J2272 |
Inj, morphine (fresenius) |
126 |
113 |
$136.95 |
| J3370 |
Vancomycin hcl injection |
252 |
199 |
$133.90 |
| 84450 |
|
128 |
118 |
$132.72 |
| 84145 |
|
17 |
17 |
$115.96 |
| J0360 |
Hydralazine hcl injection |
412 |
331 |
$110.47 |
| J0330 |
Succinycholine chloride inj |
286 |
222 |
$104.53 |
| 82040 |
|
128 |
118 |
$97.95 |
| C1758 |
Catheter, ureteral |
79 |
54 |
$93.38 |
| J3301 |
Triamcinolone acet inj nos |
190 |
142 |
$92.34 |
| 84155 |
|
127 |
117 |
$85.05 |
| 80055 |
|
14 |
13 |
$75.90 |
| J0280 |
Aminophyllin 250 mg inj |
67 |
55 |
$63.37 |
| J3535 |
Metered dose inhaler drug |
109 |
85 |
$59.95 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
272 |
257 |
$58.93 |
| 72148 |
|
13 |
12 |
$55.68 |
| 82043 |
|
13 |
12 |
$52.84 |
| Q0222 |
Bebtelovimab 175 mg |
277 |
225 |
$47.21 |
| J2471 |
Inj pantoprazole(hikma) 40mg |
107 |
98 |
$37.10 |
| J3360 |
Diazepam injection |
49 |
39 |
$35.98 |
| J0689 |
Inj cefazolin sodium, baxter |
34 |
30 |
$35.54 |
| J7620 |
Albuterol ipratrop non-comp |
140 |
95 |
$32.83 |
| J1836 |
Inj, metronidazole, 10 mg |
99 |
75 |
$31.06 |
| J1790 |
Droperidol injection |
59 |
54 |
$30.80 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
268 |
242 |
$26.88 |
| 80329 |
|
15 |
15 |
$25.74 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
120 |
99 |
$23.76 |
| Q0245 |
Bamlanivimab and etesevima |
123 |
122 |
$23.00 |
| J1940 |
Furosemide injection |
85 |
41 |
$21.13 |
| J1580 |
Garamycin gentamicin inj |
48 |
37 |
$17.44 |
| OP255 |
|
27 |
26 |
$16.61 |
| 82150 |
|
12 |
12 |
$14.78 |
| Q0239 |
Bamlanivimab-xxxx |
74 |
73 |
$14.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
38 |
28 |
$12.25 |
| Q0244 |
Casirivi and imdevi 1200 mg |
48 |
44 |
$12.00 |
| 85008 |
|
220 |
200 |
$12.00 |
| 84132 |
|
74 |
49 |
$9.19 |
| J0744 |
Ciprofloxacin iv |
12 |
12 |
$6.47 |
| J0687 |
Inj cefazolin (wg crit care) |
277 |
260 |
$0.77 |
| J2004 |
Inj, lidocaine w epinephrine |
18 |
18 |
$0.38 |
| 94669 |
|
19 |
13 |
$0.00 |
| 91300 |
|
84 |
70 |
$0.00 |
| 87899 |
|
12 |
12 |
$0.00 |
| 87045 |
|
12 |
12 |
$0.00 |
| 99242 |
|
44 |
36 |
$0.00 |
| J1956 |
Levofloxacin injection |
16 |
12 |
$0.00 |
| 87427 |
|
12 |
12 |
$0.00 |
| 99241 |
|
17 |
15 |
$0.00 |
| C1726 |
Cath, bal dil, non-vascular |
15 |
13 |
$0.00 |
| G8980 |
Mobility d/c status |
28 |
28 |
$0.00 |
| 87046 |
|
12 |
12 |
$0.00 |
| 81015 |
|
14 |
13 |
$0.00 |