| Code | Description | Claims | Beneficiaries | Total Paid |
| 99285 |
|
35,772 |
27,112 |
$10.05M |
| 87637 |
|
31,624 |
28,270 |
$4.14M |
| 99284 |
|
18,398 |
14,936 |
$3.77M |
| 99283 |
|
26,574 |
22,299 |
$3.17M |
| 74177 |
|
6,330 |
4,963 |
$2.59M |
| 99213 |
|
67,228 |
60,749 |
$2.07M |
| G0378 |
Hospital observation per hr |
7,494 |
5,178 |
$1.99M |
| 97110 |
|
43,225 |
12,168 |
$1.29M |
| 71046 |
|
22,831 |
18,480 |
$1.04M |
| 70450 |
|
7,589 |
5,716 |
$993K |
| U0004 |
Cov-19 test non-cdc hgh thru |
11,188 |
9,177 |
$908K |
| 99212 |
|
31,471 |
28,535 |
$815K |
| 80307 |
|
21,030 |
15,414 |
$743K |
| 76705 |
|
5,317 |
4,284 |
$730K |
| 87651 |
|
21,948 |
20,336 |
$625K |
| 70551 |
|
1,355 |
1,078 |
$593K |
| 96361 |
|
12,885 |
9,615 |
$592K |
| 93005 |
|
24,731 |
18,194 |
$553K |
| 97530 |
|
9,340 |
2,648 |
$547K |
| 80053 |
|
81,078 |
59,954 |
$542K |
| 95810 |
|
667 |
519 |
$527K |
| 71275 |
|
1,656 |
1,238 |
$524K |
| G0463 |
Hospital outpt clinic visit |
71,922 |
40,901 |
$508K |
| 70553 |
|
1,014 |
808 |
$507K |
| 96374 |
|
15,097 |
11,399 |
$479K |
| 76816 |
|
3,221 |
2,470 |
$427K |
| 97140 |
|
20,318 |
6,513 |
$408K |
| 93975 |
|
2,177 |
1,740 |
$401K |
| 85025 |
|
78,896 |
56,426 |
$378K |
| 43239 |
|
1,571 |
1,124 |
$361K |
| 96365 |
|
5,950 |
3,670 |
$360K |
| 74176 |
|
1,048 |
800 |
$355K |
| 93306 |
|
2,205 |
1,703 |
$353K |
| 72148 |
|
1,076 |
868 |
$338K |
| 76856 |
|
2,796 |
2,249 |
$338K |
| 93971 |
|
2,958 |
2,280 |
$332K |
| 72125 |
|
2,827 |
2,158 |
$330K |
| 96375 |
|
10,929 |
7,783 |
$313K |
| 90378 |
|
231 |
92 |
$308K |
| 99282 |
|
4,307 |
3,786 |
$300K |
| 76770 |
|
2,181 |
1,761 |
$296K |
| 77067 |
|
2,972 |
2,459 |
$279K |
| 99214 |
|
5,787 |
5,179 |
$274K |
| 71260 |
|
1,178 |
916 |
$270K |
| 88305 |
|
9,109 |
5,151 |
$264K |
| 84443 |
|
23,803 |
18,687 |
$264K |
| 76830 |
|
1,984 |
1,596 |
$259K |
| 87491 |
|
11,770 |
10,060 |
$252K |
| 73721 |
|
542 |
440 |
$251K |
| 76801 |
|
1,558 |
1,210 |
$251K |
| 87591 |
|
11,762 |
10,056 |
$251K |
| 97597 |
|
5,622 |
2,086 |
$236K |
| 73610 |
|
3,785 |
3,028 |
$230K |
| 71045 |
|
5,854 |
4,238 |
$210K |
| 80061 |
|
20,270 |
16,702 |
$205K |
| 96360 |
|
4,561 |
3,368 |
$202K |
| 73564 |
|
3,473 |
2,738 |
$197K |
| 87631 |
|
2,487 |
2,132 |
$196K |
| 73630 |
|
4,065 |
3,236 |
$193K |
| 73110 |
|
2,951 |
2,255 |
$185K |
| 73130 |
|
3,000 |
2,283 |
$182K |
| 92507 |
|
3,935 |
1,279 |
$178K |
| 45380 |
|
741 |
536 |
$175K |
| 78452 |
|
600 |
420 |
$172K |
| 96372 |
|
9,502 |
6,717 |
$172K |
| 76811 |
|
688 |
603 |
$169K |
| 73030 |
|
3,173 |
2,420 |
$167K |
| 74018 |
|
3,311 |
2,596 |
$164K |
| 83036 |
|
21,983 |
18,082 |
$156K |
| 87502 |
|
3,726 |
3,318 |
$156K |
| 93970 |
|
828 |
661 |
$150K |
| G0480 |
Drug test def 1-7 classes |
5,540 |
4,175 |
$147K |
| U0005 |
Infec agen detec ampli probe |
6,208 |
5,195 |
$142K |
| 87635 |
|
2,880 |
2,692 |
$142K |
| 82306 |
|
6,610 |
5,355 |
$141K |
| 76805 |
|
784 |
712 |
$140K |
| 72100 |
|
2,268 |
1,834 |
$136K |
| 96413 |
|
1,241 |
661 |
$134K |
| 76642 |
|
1,492 |
1,204 |
$127K |
| 83789 |
|
10,067 |
7,723 |
$125K |
| 74019 |
|
2,314 |
1,754 |
$124K |
| 87389 |
|
4,757 |
3,951 |
$122K |
| 96376 |
|
4,241 |
2,419 |
$122K |
| 76700 |
|
708 |
586 |
$120K |
| 76536 |
|
1,115 |
922 |
$119K |
| 71250 |
|
843 |
640 |
$119K |
| 76817 |
|
1,003 |
701 |
$118K |
| 87661 |
|
3,904 |
3,259 |
$109K |
| 76819 |
|
808 |
492 |
$106K |
| 73080 |
|
1,610 |
1,218 |
$103K |
| 20610 |
|
2,638 |
1,801 |
$102K |
| 84484 |
|
14,916 |
10,195 |
$102K |
| 97161 |
|
3,628 |
2,981 |
$95K |
| 99215 |
Prolong outpt/office vis |
1,091 |
1,017 |
$95K |
| 80074 |
|
2,399 |
1,935 |
$90K |
| 87086 |
|
19,998 |
15,946 |
$88K |
| H2036 |
A/d tx program, per diem |
461 |
57 |
$86K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
8,892 |
6,733 |
$82K |
| 73502 |
|
1,846 |
1,397 |
$81K |
| 70486 |
|
565 |
440 |
$80K |
| 76882 |
|
1,016 |
834 |
$80K |
| 81025 |
|
17,709 |
14,033 |
$80K |
| 94640 |
|
6,601 |
4,026 |
$79K |
| 83880 |
|
4,593 |
3,384 |
$78K |
| 88175 |
|
3,532 |
3,188 |
$78K |
| 97162 |
|
3,086 |
2,403 |
$76K |
| 95957 |
|
641 |
540 |
$74K |
| 10061 |
|
542 |
462 |
$72K |
| 73140 |
|
1,789 |
1,445 |
$72K |
| 76870 |
|
640 |
542 |
$71K |
| 45385 |
|
239 |
162 |
$71K |
| 82728 |
|
6,477 |
5,246 |
$70K |
| 97112 |
|
2,485 |
746 |
$68K |
| 71271 |
|
192 |
158 |
$67K |
| 93017 |
|
1,013 |
730 |
$67K |
| 96366 |
|
1,653 |
959 |
$66K |
| 73590 |
|
1,127 |
864 |
$65K |
| 83690 |
|
15,120 |
11,219 |
$65K |
| 77063 |
|
2,930 |
2,428 |
$65K |
| 97113 |
|
1,461 |
435 |
$64K |
| 72141 |
|
202 |
158 |
$59K |
| 92526 |
|
1,035 |
442 |
$55K |
| 12001 |
|
985 |
878 |
$54K |
| 94729 |
|
956 |
754 |
$51K |
| 73090 |
|
785 |
616 |
$50K |
| 97116 |
|
2,570 |
892 |
$50K |
| 83655 |
|
4,744 |
4,104 |
$50K |
| 62323 |
|
291 |
205 |
$49K |
| 80048 |
|
10,382 |
6,804 |
$49K |
| 87624 |
|
2,422 |
2,172 |
$49K |
| 12011 |
|
780 |
677 |
$48K |
| 99202 |
|
1,721 |
1,652 |
$48K |
| 73562 |
|
1,065 |
838 |
$47K |
| 94060 |
|
802 |
628 |
$45K |
| 10060 |
|
482 |
408 |
$45K |
| 87522 |
Neg quan hep c or qual rna |
1,302 |
963 |
$44K |
| A9500 |
Tc99m sestamibi |
644 |
449 |
$42K |
| 80081 |
|
689 |
600 |
$42K |
| 99203 |
|
1,114 |
1,042 |
$40K |
| G0390 |
Trauma respons w/hosp criti |
55 |
51 |
$40K |
| 87070 |
|
6,800 |
5,364 |
$40K |
| 87186 |
|
6,826 |
5,331 |
$39K |
| 70496 |
|
243 |
182 |
$38K |
| 86618 |
|
1,766 |
1,412 |
$38K |
| 87081 |
|
7,605 |
6,851 |
$38K |
| 87811 |
|
2,470 |
1,837 |
$37K |
| 97533 |
|
1,009 |
375 |
$37K |
| 83550 |
|
5,351 |
4,348 |
$37K |
| 71101 |
|
561 |
465 |
$35K |
| 84702 |
|
2,865 |
1,961 |
$35K |
| 73221 |
|
74 |
56 |
$35K |
| C9290 |
Inj, bupivacaine liposome |
539 |
396 |
$34K |
| 84439 |
|
5,126 |
4,063 |
$34K |
| 86481 |
|
667 |
567 |
$33K |
| 88341 |
|
619 |
468 |
$33K |
| 85027 |
|
7,266 |
5,433 |
$33K |
| 70498 |
|
217 |
165 |
$32K |
| 81001 |
|
16,553 |
12,629 |
$32K |
| 86803 |
|
3,062 |
2,467 |
$32K |
| 99211 |
|
2,679 |
1,546 |
$30K |
| 87040 |
|
2,931 |
2,071 |
$30K |
| 77002 |
|
436 |
340 |
$30K |
| 83540 |
|
5,802 |
4,716 |
$30K |
| 88312 |
|
1,756 |
1,373 |
$29K |
| H0015 |
Alcohol and/or drug services |
293 |
39 |
$29K |
| 77066 |
Tomosynthesis, mammo |
303 |
249 |
$29K |
| 97165 |
|
924 |
712 |
$28K |
| 97803 |
|
1,405 |
1,026 |
$28K |
| 85610 |
|
12,120 |
6,995 |
$27K |
| 77336 |
|
329 |
119 |
$27K |
| 72070 |
|
490 |
403 |
$27K |
| 82607 |
|
3,275 |
2,560 |
$27K |
| 76815 |
|
207 |
166 |
$26K |
| 94726 |
|
445 |
353 |
$26K |
| U0003 |
Cov-19 amp prb hgh thruput |
304 |
270 |
$26K |
| 81003 |
|
20,420 |
16,812 |
$25K |
| J2785 |
Regadenoson injection |
496 |
346 |
$25K |
| 80050 |
|
3,269 |
3,152 |
$24K |
| 93351 |
|
89 |
70 |
$24K |
| 86850 |
|
3,208 |
2,262 |
$24K |
| 83735 |
|
6,298 |
4,376 |
$24K |
| A9585 |
Gadobutrol injection |
1,726 |
1,328 |
$23K |
| 88304 |
|
1,093 |
841 |
$23K |
| 97163 |
|
852 |
617 |
$22K |
| 70491 |
|
107 |
85 |
$22K |
| 95819 |
|
69 |
63 |
$22K |
| 88342 |
|
1,756 |
1,320 |
$22K |
| 87205 |
|
7,081 |
5,559 |
$21K |
| 86140 |
|
5,524 |
4,037 |
$21K |
| 97535 |
|
824 |
407 |
$21K |
| 0202U |
|
70 |
69 |
$21K |
| 97035 |
|
1,770 |
578 |
$20K |
| 59025 |
|
600 |
405 |
$20K |
| 82805 |
|
863 |
599 |
$20K |
| 90715 |
|
1,668 |
1,339 |
$19K |
| 83605 |
|
3,125 |
2,183 |
$19K |
| J7120 |
Ringers lactate infusion |
4,863 |
3,309 |
$19K |
| 83516 |
|
1,562 |
1,262 |
$18K |
| 85379 |
|
2,714 |
2,074 |
$18K |
| 87880 |
|
1,980 |
1,609 |
$18K |
| J7030 |
Normal saline solution infus |
5,967 |
3,794 |
$17K |
| 76813 |
|
128 |
116 |
$16K |
| 86364 |
|
281 |
211 |
$16K |
| 64493 |
|
86 |
51 |
$16K |
| 72050 |
|
197 |
176 |
$15K |
| 77065 |
Tomosynthesis, mammo |
234 |
166 |
$15K |
| 84403 |
|
724 |
586 |
$15K |
| 97166 |
|
520 |
371 |
$15K |
| G0103 |
Psa screening |
977 |
833 |
$14K |
| 80047 |
|
2,889 |
2,323 |
$14K |
| 86038 |
|
1,582 |
1,262 |
$14K |
| 82746 |
|
1,389 |
1,078 |
$14K |
| 82784 |
|
1,470 |
1,162 |
$14K |
| 95811 |
|
15 |
14 |
$14K |
| J2704 |
Inj, propofol, 10 mg |
9,654 |
6,359 |
$13K |
| 82043 |
|
3,389 |
2,750 |
$13K |
| 87427 |
|
923 |
680 |
$13K |
| 72110 |
|
154 |
124 |
$13K |
| 80076 |
|
2,041 |
1,573 |
$13K |
| 82962 |
|
5,630 |
3,442 |
$13K |
| 93325 |
|
159 |
121 |
$13K |
| 99291 |
|
45 |
29 |
$12K |
| 87798 |
|
469 |
307 |
$12K |
| 87075 |
|
1,965 |
1,450 |
$12K |
| 93880 |
|
145 |
102 |
$12K |
| 97802 |
|
279 |
221 |
$12K |
| 93296 |
|
683 |
493 |
$11K |
| 85652 |
|
5,911 |
4,359 |
$11K |
| 93320 |
|
141 |
109 |
$11K |
| 87633 |
|
58 |
57 |
$11K |
| 86592 |
|
2,928 |
2,397 |
$10K |
| 29125 |
|
269 |
232 |
$10K |
| 72040 |
|
168 |
147 |
$10K |
| 82550 |
|
2,239 |
1,572 |
$10K |
| 86376 |
|
865 |
698 |
$10K |
| 82570 |
|
2,699 |
2,068 |
$10K |
| 83970 |
|
332 |
251 |
$9K |
| 85018 |
|
4,823 |
3,782 |
$9K |
| 87493 |
|
505 |
389 |
$9K |
| 85014 |
|
4,732 |
3,724 |
$9K |
| 84481 |
|
676 |
524 |
$9K |
| 87077 |
|
1,361 |
1,040 |
$9K |
| 77334 |
|
24 |
12 |
$9K |
| 97016 |
|
620 |
224 |
$9K |
| 87340 |
|
1,073 |
899 |
$9K |
| J0690 |
Cefazolin sodium injection |
3,220 |
1,989 |
$8K |
| 84480 |
|
744 |
580 |
$8K |
| G0297 |
Ldct for lung ca screen |
31 |
25 |
$8K |
| 29580 |
|
154 |
50 |
$8K |
| J1100 |
Dexamethasone sodium phos |
6,371 |
4,915 |
$8K |
| 88307 |
|
280 |
185 |
$7K |
| 86900 |
|
3,744 |
2,676 |
$7K |
| 86901 |
|
3,744 |
2,676 |
$7K |
| J0696 |
Ceftriaxone sodium injection |
2,528 |
1,558 |
$7K |
| J1040 |
Methylprednisolone 80 mg inj |
3,499 |
2,517 |
$7K |
| J1885 |
Ketorolac tromethamine inj |
13,010 |
9,362 |
$7K |
| 87804 |
|
826 |
560 |
$7K |
| 36415 |
|
69,247 |
44,711 |
$7K |
| 82105 |
|
496 |
438 |
$7K |
| 73660 |
|
124 |
107 |
$6K |
| G0379 |
Direct refer hospital observ |
232 |
164 |
$6K |
| 87328 |
|
565 |
466 |
$6K |
| U0002 |
Covid-19 lab test non-cdc |
139 |
127 |
$6K |
| 87430 |
|
655 |
554 |
$6K |
| 90471 |
|
2,314 |
1,751 |
$6K |
| 87045 |
|
859 |
709 |
$6K |
| 64494 |
|
74 |
39 |
$5K |
| 86706 |
|
617 |
482 |
$5K |
| 93226 |
|
96 |
78 |
$5K |
| 78264 |
|
19 |
12 |
$5K |
| 82950 |
|
1,251 |
1,051 |
$5K |
| 97010 |
|
1,144 |
454 |
$5K |
| 87329 |
|
584 |
480 |
$5K |
| J1170 |
Hydromorphone injection |
3,697 |
2,086 |
$5K |
| 73560 |
|
52 |
42 |
$5K |
| 94375 |
|
111 |
90 |
$5K |
| 82248 |
|
1,218 |
733 |
$4K |
| 80164 |
|
551 |
383 |
$4K |
| 96367 |
|
120 |
81 |
$4K |
| 86308 |
|
971 |
836 |
$4K |
| 77080 |
|
44 |
36 |
$4K |
| 73552 |
|
66 |
54 |
$4K |
| 36416 |
|
1,468 |
1,075 |
$4K |
| J3301 |
Triamcinolone acet inj nos |
1,928 |
1,386 |
$4K |
| 87046 |
|
862 |
709 |
$4K |
| 84100 |
|
1,122 |
728 |
$4K |
| 87902 |
|
51 |
43 |
$4K |
| 76376 |
|
32 |
26 |
$3K |
| 96401 |
|
62 |
18 |
$3K |
| 99281 |
|
69 |
55 |
$3K |
| G2066 |
Inter devc remote 30d |
207 |
146 |
$3K |
| 93308 |
|
23 |
17 |
$3K |
| 82247 |
|
871 |
383 |
$3K |
| J7050 |
Normal saline solution infus |
1,737 |
815 |
$3K |
| 95816 |
|
14 |
13 |
$3K |
| 70360 |
|
44 |
40 |
$3K |
| J7040 |
Normal saline solution infus |
760 |
514 |
$3K |
| 87015 |
|
538 |
404 |
$3K |
| J3010 |
Fentanyl citrate injection |
6,743 |
4,650 |
$3K |
| 74246 |
|
19 |
12 |
$3K |
| 76857 |
|
22 |
14 |
$2K |
| 83001 |
|
176 |
137 |
$2K |
| 86762 |
|
294 |
242 |
$2K |
| 82274 |
|
211 |
181 |
$2K |
| 84703 |
|
377 |
341 |
$2K |
| 82565 |
|
916 |
679 |
$2K |
| 12002 |
|
33 |
31 |
$2K |
| 74230 |
|
21 |
12 |
$2K |
| 92610 |
|
29 |
25 |
$2K |
| 86430 |
|
534 |
402 |
$2K |
| J2405 |
Ondansetron hcl injection |
12,045 |
8,604 |
$2K |
| 86003 |
|
38 |
37 |
$2K |
| 77061 |
|
75 |
62 |
$2K |
| 96415 |
|
42 |
25 |
$2K |
| 84146 |
|
138 |
104 |
$2K |
| 84156 |
|
766 |
523 |
$2K |
| 93225 |
|
58 |
40 |
$2K |
| P9604 |
One-way allow prorated trip |
2,527 |
955 |
$2K |
| 69209 |
|
68 |
57 |
$2K |
| 77062 |
|
65 |
58 |
$2K |
| 36591 |
|
231 |
109 |
$2K |
| 87581 |
|
58 |
57 |
$2K |
| 87486 |
|
58 |
57 |
$2K |
| 86431 |
|
390 |
306 |
$2K |
| J2270 |
Morphine sulfate injection |
2,181 |
1,423 |
$2K |
| 90686 |
|
1,383 |
983 |
$2K |
| G0008 |
Admin influenza virus vac |
1,574 |
1,151 |
$2K |
| 82553 |
|
322 |
231 |
$2K |
| 84153 |
|
125 |
85 |
$1K |
| 73060 |
|
35 |
27 |
$1K |
| J1030 |
Methylprednisolone 40 mg inj |
834 |
607 |
$1K |
| J0780 |
Prochlorperazine injection |
237 |
161 |
$1K |
| 74240 |
|
15 |
12 |
$1K |
| 93976 |
|
12 |
12 |
$1K |
| 88313 |
|
94 |
64 |
$1K |
| 82272 |
|
688 |
514 |
$1K |
| 93299 |
|
68 |
60 |
$1K |
| 88112 |
|
60 |
39 |
$1K |
| 59020 |
|
15 |
13 |
$1K |
| J2930 |
Methylprednisolone injection |
400 |
266 |
$1K |
| 85730 |
|
243 |
212 |
$1K |
| 94150 |
|
47 |
35 |
$1K |
| 84402 |
|
57 |
39 |
$1K |
| J3370 |
Vancomycin hcl injection |
354 |
165 |
$1K |
| 84550 |
|
378 |
266 |
$1K |
| 85007 |
|
862 |
457 |
$1K |
| 99152 |
|
41 |
27 |
$1K |
| 94762 |
|
24 |
15 |
$1K |
| J0171 |
Adrenalin epinephrine inject |
189 |
116 |
$988.86 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
384 |
300 |
$977.40 |
| 87807 |
|
93 |
66 |
$937.48 |
| 99153 |
Mod sedat endo service >5yrs |
17 |
12 |
$928.73 |
| 83721 |
|
180 |
147 |
$919.29 |
| J2060 |
Lorazepam injection |
2,438 |
1,676 |
$903.68 |
| A9541 |
Tc99m sulfur colloid |
33 |
24 |
$799.32 |
| 87634 |
|
21 |
13 |
$794.39 |
| 51798 |
|
39 |
24 |
$781.68 |
| 73000 |
|
13 |
12 |
$769.04 |
| 80178 |
|
213 |
142 |
$745.24 |
| J1815 |
Insulin injection |
104 |
66 |
$705.00 |
| J2765 |
Metoclopramide hcl injection |
1,884 |
1,403 |
$700.50 |
| J2250 |
Inj midazolam hydrochloride |
3,249 |
2,382 |
$693.35 |
| 86480 |
|
12 |
12 |
$684.96 |
| 86617 |
|
33 |
24 |
$657.64 |
| J3475 |
Inj magnesium sulfate |
349 |
254 |
$656.76 |
| 83615 |
|
175 |
121 |
$633.94 |
| 87176 |
|
160 |
116 |
$596.44 |
| Q3014 |
Telehealth facility fee |
233 |
144 |
$580.97 |
| 86787 |
|
29 |
29 |
$547.59 |
| 81015 |
|
206 |
159 |
$522.93 |
| J1200 |
Diphenhydramine hcl injectio |
1,798 |
1,317 |
$467.05 |
| 97760 |
|
15 |
12 |
$464.22 |
| J2543 |
Piperacillin/tazobactam |
105 |
52 |
$399.50 |
| C1769 |
Guide wire |
15 |
12 |
$399.39 |
| J1010 |
Inj, methylpred acetate 1 mg |
352 |
243 |
$362.44 |
| J2001 |
Lidocaine injection |
1,252 |
712 |
$328.69 |
| 86702 |
|
23 |
12 |
$326.88 |
| J1790 |
Droperidol injection |
127 |
92 |
$325.72 |
| 86800 |
|
31 |
29 |
$318.94 |
| J7512 |
Prednisone ir or dr oral 1mg |
1,941 |
1,356 |
$286.16 |
| 82010 |
|
33 |
27 |
$284.62 |
| 86708 |
|
35 |
25 |
$280.85 |
| 86701 |
|
23 |
12 |
$260.34 |
| 82977 |
|
38 |
24 |
$230.72 |
| 0054A |
|
91 |
59 |
$219.18 |
| J1644 |
Inj heparin sodium per 1000u |
375 |
173 |
$218.06 |
| 84520 |
|
114 |
89 |
$207.46 |
| 82947 |
|
60 |
55 |
$190.63 |
| 86704 |
|
16 |
14 |
$180.23 |
| C9113 |
Inj pantoprazole sodium, via |
274 |
133 |
$174.15 |
| 82465 |
|
44 |
41 |
$163.89 |
| 83002 |
|
14 |
12 |
$150.11 |
| 82365 |
|
19 |
12 |
$142.21 |
| 81508 |
|
14 |
14 |
$134.04 |
| 84165 |
|
17 |
13 |
$130.70 |
| J3480 |
Inj potassium chloride |
82 |
59 |
$124.58 |
| 82140 |
|
15 |
13 |
$124.11 |
| 84436 |
|
38 |
29 |
$122.40 |
| 80177 |
|
16 |
12 |
$121.01 |
| 86200 |
|
12 |
12 |
$117.94 |
| G1004 |
Cdsm ndsc |
4,655 |
2,672 |
$112.90 |
| 84132 |
|
42 |
25 |
$108.95 |
| 82150 |
|
21 |
12 |
$103.69 |
| 83718 |
|
12 |
12 |
$86.79 |
| J1642 |
Inj heparin sodium per 10 u |
435 |
223 |
$86.25 |
| 87207 |
|
13 |
13 |
$86.19 |
| J0131 |
Inj, acetaminophen (nos) |
28 |
24 |
$78.97 |
| 80069 |
|
13 |
12 |
$78.91 |
| 99406 |
|
44 |
27 |
$73.95 |
| J7999 |
Compounded drug, noc |
24 |
18 |
$71.67 |
| G0009 |
Admin pneumococcal vaccine |
71 |
49 |
$70.64 |
| 91322 |
|
12 |
12 |
$57.28 |
| J2370 |
Phenylephrine hcl injection |
84 |
63 |
$54.91 |
| G0475 |
Hiv combination assay |
21 |
13 |
$54.22 |
| 84460 |
|
14 |
13 |
$48.80 |
| J3490 |
Drugs unclassified injection |
27 |
18 |
$44.01 |
| 0004A |
|
27 |
19 |
$39.24 |
| J1650 |
Inj enoxaparin sodium |
30 |
13 |
$36.15 |
| J0330 |
Succinycholine chloride inj |
14 |
12 |
$35.28 |
| J1630 |
Haloperidol injection |
92 |
59 |
$33.00 |
| 90732 |
|
19 |
13 |
$31.93 |
| G0279 |
Tomosynthesis, mammo |
20 |
13 |
$30.81 |
| 85046 |
|
18 |
12 |
$29.87 |
| 90662 |
|
105 |
93 |
$25.79 |
| J0689 |
Inj cefazolin sodium, baxter |
50 |
39 |
$16.43 |
| 91305 |
|
146 |
92 |
$0.00 |
| G8987 |
Self care current status |
104 |
50 |
$0.00 |
| 90480 |
|
12 |
12 |
$0.00 |
| G8980 |
Mobility d/c status |
254 |
142 |
$0.00 |
| G8988 |
Self care goal status |
106 |
50 |
$0.00 |
| 90656 |
|
19 |
19 |
$0.00 |
| G8985 |
Carry goal status |
231 |
119 |
$0.00 |
| G8984 |
Carry current status |
84 |
46 |
$0.00 |
| 80356 |
|
14 |
13 |
$0.00 |
| G8979 |
Mobility goal status |
837 |
439 |
$0.00 |
| G8978 |
Mobility current status |
656 |
358 |
$0.00 |
| 0124A |
|
33 |
33 |
$0.00 |