| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 97110 |
|
59,145 |
13,082 |
$2.06M |
| 93306 |
|
10,622 |
8,948 |
$1.36M |
| 74177 |
|
8,398 |
7,462 |
$1.14M |
| 80053 |
|
97,109 |
74,659 |
$1.09M |
| 72148 |
|
3,865 |
3,365 |
$1.02M |
| 70450 |
|
9,408 |
8,188 |
$1.01M |
| 73721 |
|
2,935 |
2,444 |
$896K |
| J9271 |
Inj pembrolizumab |
241 |
169 |
$896K |
| 70553 |
|
2,281 |
2,017 |
$784K |
| U0003 |
Cov-19 amp prb hgh thruput |
9,170 |
7,838 |
$727K |
| 85025 |
|
94,685 |
70,905 |
$696K |
| 96365 |
|
8,317 |
6,482 |
$665K |
| G0463 |
Hospital outpt clinic visit |
55,852 |
36,852 |
$663K |
| T1015 |
Clinic service |
56,267 |
38,655 |
$649K |
| J0897 |
Denosumab injection |
1,767 |
1,542 |
$648K |
| 93005 |
|
62,749 |
46,901 |
$630K |
| 96413 |
|
3,540 |
2,007 |
$629K |
| 11042 |
|
5,049 |
2,907 |
$593K |
| 78452 |
|
2,991 |
2,701 |
$528K |
| 72141 |
|
2,016 |
1,764 |
$510K |
| 71260 |
|
3,930 |
3,468 |
$469K |
| 72125 |
|
3,521 |
3,092 |
$461K |
| 97530 |
|
13,504 |
3,544 |
$457K |
| 99283 |
|
9,947 |
7,479 |
$412K |
| 71275 |
|
1,955 |
1,742 |
$410K |
| 83880 |
|
15,429 |
12,753 |
$376K |
| 97162 |
|
4,645 |
3,842 |
$347K |
| 70551 |
|
1,359 |
1,179 |
$347K |
| 80307 |
|
6,861 |
4,627 |
$325K |
| 96374 |
|
6,866 |
5,311 |
$316K |
| 87491 |
|
6,412 |
5,836 |
$303K |
| 87591 |
|
6,344 |
5,773 |
$300K |
| 99284 |
|
9,370 |
7,376 |
$283K |
| 80081 |
|
2,700 |
2,505 |
$252K |
| 84484 |
|
26,252 |
16,610 |
$246K |
| 71045 |
|
24,697 |
20,355 |
$240K |
| 84443 |
|
20,659 |
18,011 |
$237K |
| J1439 |
Inj ferric carboxymaltos 1mg |
641 |
404 |
$236K |
| 74176 |
|
3,337 |
2,928 |
$234K |
| 93351 |
|
1,320 |
1,182 |
$231K |
| 99285 |
|
6,880 |
5,476 |
$225K |
| 80061 |
|
21,588 |
18,814 |
$209K |
| 77067 |
|
4,132 |
3,933 |
$205K |
| 36415 |
|
51,108 |
33,452 |
$194K |
| 80048 |
|
29,348 |
23,621 |
$193K |
| 70486 |
|
1,465 |
1,319 |
$191K |
| 71046 |
|
11,135 |
9,973 |
$188K |
| 93458 |
|
1,619 |
1,451 |
$184K |
| 76805 |
|
4,580 |
4,137 |
$181K |
| 87086 |
|
19,534 |
16,873 |
$168K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
4,883 |
4,284 |
$167K |
| 81001 |
|
42,043 |
34,215 |
$164K |
| 83735 |
|
25,586 |
18,920 |
$162K |
| 80050 |
|
3,380 |
3,301 |
$161K |
| 82306 |
|
6,383 |
5,508 |
$156K |
| 71250 |
|
1,813 |
1,561 |
$148K |
| 96375 |
|
6,756 |
4,219 |
$142K |
| 97161 |
|
2,368 |
1,954 |
$135K |
| 83690 |
|
16,965 |
14,343 |
$132K |
| 77066 |
Tomosynthesis, mammo |
1,741 |
1,590 |
$131K |
| J2357 |
Omalizumab injection |
668 |
321 |
$127K |
| 73221 |
|
546 |
473 |
$125K |
| 72131 |
|
1,058 |
953 |
$121K |
| 96361 |
|
4,339 |
2,658 |
$121K |
| 88305 |
|
5,414 |
4,702 |
$115K |
| 85027 |
|
21,434 |
17,528 |
$113K |
| 83036 |
|
13,573 |
11,763 |
$110K |
| 96367 |
|
2,325 |
1,214 |
$109K |
| H0018 |
Alcohol and/or drug services |
284 |
81 |
$109K |
| 76801 |
|
2,852 |
2,447 |
$105K |
| J2505 |
Injection, pegfilgrastim 6mg |
101 |
69 |
$100K |
| 76700 |
|
2,125 |
1,968 |
$98K |
| 84703 |
|
8,648 |
7,706 |
$96K |
| A9500 |
Tc99m sestamibi |
2,748 |
2,478 |
$94K |
| 93880 |
|
3,197 |
2,696 |
$94K |
| 80074 |
|
1,923 |
1,688 |
$93K |
| 93971 |
|
2,260 |
1,906 |
$91K |
| J2469 |
Palonosetron hcl |
3,353 |
1,808 |
$90K |
| 96372 |
|
9,669 |
6,122 |
$88K |
| 97001 |
|
2,195 |
2,037 |
$88K |
| 87428 |
|
1,304 |
1,121 |
$86K |
| 73562 |
|
2,988 |
2,289 |
$84K |
| 87880 |
|
6,652 |
5,906 |
$81K |
| 87631 |
|
869 |
844 |
$80K |
| 80305 |
|
7,129 |
6,293 |
$80K |
| 70491 |
|
538 |
457 |
$80K |
| 73222 |
|
212 |
178 |
$80K |
| 70498 |
|
652 |
534 |
$80K |
| 74018 |
|
4,584 |
3,933 |
$79K |
| 82728 |
|
6,730 |
5,750 |
$78K |
| 87081 |
|
9,966 |
8,985 |
$77K |
| 87040 |
|
6,904 |
3,797 |
$73K |
| 76705 |
|
3,884 |
3,486 |
$73K |
| 95810 |
|
669 |
596 |
$72K |
| 93976 |
|
1,190 |
1,071 |
$72K |
| 70496 |
|
572 |
469 |
$72K |
| 77065 |
Tomosynthesis, mammo |
1,480 |
1,257 |
$72K |
| 93017 |
|
3,113 |
2,772 |
$72K |
| 73630 |
|
2,867 |
2,439 |
$71K |
| 76830 |
|
1,157 |
1,063 |
$70K |
| 86901 |
|
3,365 |
2,737 |
$69K |
| 87077 |
|
8,215 |
6,844 |
$69K |
| 82607 |
|
5,323 |
4,577 |
$67K |
| J2785 |
Regadenoson injection |
1,937 |
1,712 |
$64K |
| 85730 |
|
14,212 |
11,988 |
$63K |
| 83605 |
|
5,658 |
4,572 |
$63K |
| 85610 |
|
20,956 |
16,535 |
$62K |
| J1100 |
Dexamethasone sodium phos |
6,838 |
3,431 |
$58K |
| 76642 |
|
1,770 |
1,430 |
$57K |
| 84146 |
|
2,124 |
1,873 |
$57K |
| 72146 |
|
180 |
153 |
$56K |
| 93320 |
|
2,368 |
2,079 |
$56K |
| 0241U |
|
1,639 |
1,244 |
$55K |
| 86703 |
|
3,073 |
2,833 |
$54K |
| C1725 |
Cath, translumin non-laser |
221 |
175 |
$53K |
| 73130 |
|
2,286 |
1,874 |
$53K |
| 95911 |
|
931 |
540 |
$52K |
| 82962 |
|
16,333 |
7,661 |
$51K |
| U0002 |
Covid-19 lab test non-cdc |
985 |
846 |
$51K |
| 81025 |
|
5,647 |
5,194 |
$50K |
| C1769 |
Guide wire |
2,186 |
1,846 |
$50K |
| M0243 |
Casirivi and imdevi inj |
236 |
227 |
$49K |
| 87186 |
|
9,028 |
7,413 |
$49K |
| 76856 |
|
1,302 |
1,208 |
$49K |
| 17110 |
|
419 |
266 |
$48K |
| 93970 |
|
1,813 |
1,525 |
$47K |
| 73030 |
|
2,657 |
2,098 |
$47K |
| 96360 |
|
1,096 |
903 |
$46K |
| 36410 |
|
1,813 |
1,384 |
$46K |
| 51798 |
|
1,105 |
889 |
$46K |
| 93922 |
|
3,211 |
2,598 |
$45K |
| 77336 |
|
647 |
302 |
$44K |
| 76536 |
|
1,083 |
961 |
$44K |
| 84702 |
|
3,914 |
3,118 |
$43K |
| 73610 |
|
2,531 |
2,170 |
$43K |
| 84439 |
|
4,480 |
3,847 |
$43K |
| 76641 |
|
1,005 |
605 |
$42K |
| 76770 |
|
1,261 |
1,129 |
$42K |
| 95886 |
|
1,059 |
614 |
$42K |
| 76815 |
|
2,850 |
2,547 |
$41K |
| C8929 |
Tte w or wo fol wcon,doppler |
830 |
689 |
$41K |
| 74178 |
|
357 |
313 |
$41K |
| 83615 |
|
6,698 |
5,243 |
$40K |
| 94726 |
|
1,525 |
1,049 |
$40K |
| 88342 |
|
1,929 |
1,636 |
$39K |
| 76937 |
|
3,917 |
3,150 |
$39K |
| 77063 |
|
3,236 |
3,092 |
$39K |
| 87400 |
|
6,337 |
5,547 |
$39K |
| 86803 |
|
2,298 |
2,058 |
$38K |
| 77386 |
|
239 |
24 |
$38K |
| 47562 |
|
101 |
97 |
$38K |
| 83550 |
|
5,686 |
4,832 |
$38K |
| 86140 |
|
6,353 |
5,410 |
$38K |
| 82803 |
|
1,835 |
1,490 |
$37K |
| 93225 |
|
1,282 |
1,209 |
$37K |
| 82746 |
|
3,038 |
2,554 |
$37K |
| 80076 |
|
5,697 |
4,944 |
$37K |
| 77062 |
|
501 |
475 |
$35K |
| 72100 |
|
1,534 |
1,342 |
$35K |
| 83540 |
|
6,632 |
5,676 |
$35K |
| 82105 |
|
2,117 |
1,861 |
$34K |
| 73110 |
|
1,500 |
1,299 |
$33K |
| 88304 |
|
1,553 |
1,406 |
$33K |
| 88341 |
|
629 |
504 |
$33K |
| 36430 |
|
306 |
180 |
$32K |
| 84153 |
|
2,218 |
1,867 |
$31K |
| G0378 |
Hospital observation per hr |
4,777 |
3,694 |
$31K |
| 82565 |
|
6,512 |
5,531 |
$31K |
| 83516 |
|
1,936 |
810 |
$30K |
| 99282 |
|
430 |
306 |
$30K |
| 23350 |
|
166 |
147 |
$30K |
| 87070 |
|
3,164 |
2,713 |
$28K |
| 73502 |
|
1,486 |
1,254 |
$28K |
| C8930 |
Tte w or w/o contr, cont ecg |
327 |
300 |
$27K |
| 93308 |
|
670 |
578 |
$26K |
| 72110 |
|
1,029 |
806 |
$25K |
| 12001 |
|
109 |
105 |
$25K |
| 86756 |
|
1,382 |
1,323 |
$24K |
| J2506 |
Inj pegfilgrast ex bio 0.5mg |
22 |
12 |
$24K |
| 93325 |
|
2,577 |
2,233 |
$23K |
| 80164 |
|
1,842 |
1,608 |
$22K |
| 49083 |
|
105 |
53 |
$22K |
| 81003 |
|
7,663 |
4,769 |
$21K |
| 43235 |
|
122 |
107 |
$20K |
| 96417 |
|
348 |
188 |
$20K |
| 74183 |
|
47 |
40 |
$20K |
| 86038 |
|
1,632 |
1,456 |
$18K |
| 87205 |
|
3,944 |
3,328 |
$18K |
| 85379 |
|
1,619 |
1,498 |
$18K |
| 82550 |
|
2,486 |
2,038 |
$18K |
| 82570 |
|
3,415 |
2,690 |
$18K |
| J1453 |
Fosaprepitant injection |
171 |
118 |
$17K |
| 77334 |
|
132 |
71 |
$17K |
| 94010 |
|
859 |
729 |
$17K |
| 82533 |
|
1,014 |
863 |
$16K |
| 73590 |
|
746 |
587 |
$16K |
| 74022 |
|
507 |
459 |
$16K |
| 86592 |
|
3,050 |
2,790 |
$16K |
| 87502 |
|
126 |
123 |
$16K |
| 82677 |
|
461 |
435 |
$15K |
| 95811 |
|
132 |
126 |
$15K |
| 84436 |
|
2,173 |
1,921 |
$15K |
| 81002 |
|
4,252 |
2,334 |
$15K |
| 73560 |
|
1,008 |
715 |
$14K |
| 82950 |
|
2,192 |
2,058 |
$14K |
| J2405 |
Ondansetron hcl injection |
8,449 |
5,849 |
$14K |
| 83970 |
|
876 |
633 |
$14K |
| 94640 |
|
4,264 |
1,942 |
$14K |
| 96366 |
|
2,515 |
1,385 |
$14K |
| 97150 |
|
3,927 |
1,348 |
$13K |
| 73090 |
|
740 |
635 |
$13K |
| 84550 |
|
2,803 |
2,359 |
$13K |
| 88307 |
|
395 |
326 |
$13K |
| 73080 |
|
734 |
644 |
$13K |
| 77080 |
|
285 |
269 |
$13K |
| 84479 |
|
1,766 |
1,567 |
$12K |
| 86900 |
|
3,366 |
2,740 |
$12K |
| C1894 |
Intro/sheath, non-laser |
2,121 |
1,796 |
$12K |
| 82947 |
|
1,917 |
1,808 |
$12K |
| 84156 |
|
2,833 |
2,112 |
$12K |
| 85014 |
|
4,648 |
3,837 |
$11K |
| 71271 |
|
294 |
260 |
$11K |
| 86850 |
|
3,241 |
2,647 |
$11K |
| 71020 |
|
914 |
882 |
$11K |
| 84403 |
|
491 |
400 |
$11K |
| 72040 |
|
510 |
413 |
$11K |
| 93226 |
|
413 |
400 |
$11K |
| M0245 |
Bamlan and etesev infusion |
71 |
70 |
$11K |
| 73521 |
|
532 |
450 |
$11K |
| G0283 |
Elec stim other than wound |
2,195 |
429 |
$11K |
| 76817 |
|
205 |
192 |
$10K |
| 96376 |
|
3,037 |
1,492 |
$10K |
| 85660 |
|
1,394 |
1,252 |
$10K |
| 74246 |
|
310 |
257 |
$10K |
| 84207 |
|
397 |
302 |
$10K |
| J0185 |
Inj., aprepitant, 1 mg |
348 |
159 |
$10K |
| 86336 |
|
461 |
435 |
$10K |
| 82784 |
|
1,762 |
667 |
$10K |
| 85652 |
|
3,749 |
3,064 |
$9K |
| 71010 |
|
1,400 |
1,277 |
$9K |
| 84425 |
|
502 |
394 |
$9K |
| 85018 |
|
3,907 |
3,225 |
$9K |
| 84132 |
|
2,796 |
2,002 |
$9K |
| 97140 |
|
4,215 |
837 |
$8K |
| 77300 |
|
90 |
39 |
$8K |
| 96415 |
|
346 |
183 |
$8K |
| 72072 |
|
314 |
271 |
$8K |
| 75635 |
|
80 |
63 |
$8K |
| 78227 |
|
30 |
25 |
$7K |
| G0279 |
Tomosynthesis, mammo |
413 |
374 |
$7K |
| 82378 |
|
551 |
440 |
$7K |
| 72050 |
|
306 |
253 |
$7K |
| 86003 |
|
251 |
43 |
$6K |
| 82140 |
|
1,135 |
910 |
$6K |
| 87522 |
Neg quan hep c or qual rna |
228 |
214 |
$6K |
| 82150 |
|
876 |
816 |
$6K |
| 97165 |
|
131 |
100 |
$6K |
| 72170 |
|
356 |
300 |
$6K |
| 93242 |
|
1,022 |
752 |
$6K |
| 83090 |
|
445 |
336 |
$6K |
| 29581 |
|
233 |
81 |
$6K |
| 84252 |
|
348 |
262 |
$6K |
| 83921 |
|
403 |
305 |
$6K |
| 80069 |
|
1,317 |
933 |
$6K |
| 82248 |
|
1,178 |
832 |
$5K |
| 85049 |
|
1,218 |
1,072 |
$5K |
| 85045 |
|
1,537 |
1,238 |
$5K |
| 87210 |
|
874 |
792 |
$5K |
| J1650 |
Inj enoxaparin sodium |
1,301 |
535 |
$5K |
| J1885 |
Ketorolac tromethamine inj |
3,870 |
2,733 |
$5K |
| 86920 |
|
264 |
138 |
$5K |
| 95912 |
|
70 |
66 |
$4K |
| 87045 |
|
412 |
386 |
$4K |
| 76819 |
|
241 |
170 |
$4K |
| 84446 |
|
369 |
279 |
$4K |
| 82043 |
|
1,206 |
936 |
$4K |
| 97163 |
|
38 |
31 |
$4K |
| 97003 |
|
102 |
91 |
$4K |
| C9803 |
Hopd covid-19 spec collect |
1,485 |
1,224 |
$4K |
| 77412 |
|
89 |
15 |
$4K |
| 78264 |
|
90 |
79 |
$4K |
| 84100 |
|
1,253 |
875 |
$4K |
| 80055 |
|
105 |
105 |
$4K |
| 90715 |
|
238 |
203 |
$4K |
| 93923 |
|
139 |
136 |
$4K |
| 74000 |
|
264 |
251 |
$4K |
| 87902 |
|
17 |
12 |
$4K |
| Q3014 |
Telehealth facility fee |
1,522 |
1,177 |
$4K |
| A9541 |
Tc99m sulfur colloid |
124 |
112 |
$3K |
| 72128 |
|
38 |
27 |
$3K |
| 12011 |
|
16 |
14 |
$3K |
| M0239 |
Bamlanivimab-xxxx infusion |
72 |
70 |
$3K |
| 84590 |
|
365 |
274 |
$3K |
| A6196 |
Alginate dressing <=16 sq in |
278 |
114 |
$3K |
| 72158 |
|
12 |
12 |
$3K |
| J1626 |
Granisetron hcl injection |
272 |
129 |
$3K |
| 86308 |
|
406 |
381 |
$3K |
| 97112 |
|
1,113 |
225 |
$3K |
| J2250 |
Inj midazolam hydrochloride |
7,066 |
5,370 |
$3K |
| C1887 |
Catheter, guiding |
469 |
368 |
$3K |
| 87340 |
|
439 |
399 |
$3K |
| 97597 |
|
203 |
165 |
$3K |
| 87661 |
|
66 |
58 |
$3K |
| 17000 |
|
144 |
108 |
$3K |
| 74230 |
|
90 |
74 |
$3K |
| J1642 |
Inj heparin sodium per 10 u |
889 |
534 |
$3K |
| A6197 |
Alginate drsg >16 <=48 sq in |
245 |
149 |
$3K |
| 90471 |
|
1,014 |
904 |
$3K |
| 86376 |
|
172 |
137 |
$3K |
| 86480 |
|
54 |
44 |
$3K |
| 83001 |
|
105 |
91 |
$2K |
| 94729 |
|
124 |
60 |
$2K |
| 10060 |
|
12 |
12 |
$2K |
| 82172 |
|
256 |
194 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
1,306 |
770 |
$2K |
| 82553 |
|
200 |
175 |
$2K |
| 84450 |
|
292 |
258 |
$2K |
| 95913 |
|
26 |
25 |
$2K |
| G0103 |
Psa screening |
856 |
730 |
$2K |
| 99152 |
|
1,435 |
1,115 |
$2K |
| 86431 |
|
384 |
339 |
$2K |
| 43239 |
|
12 |
12 |
$2K |
| 64447 |
|
15 |
12 |
$2K |
| 94760 |
|
1,039 |
608 |
$2K |
| 74174 |
|
23 |
14 |
$2K |
| A9579 |
Gad-base mr contrast nos,1ml |
36 |
34 |
$2K |
| 84460 |
|
242 |
217 |
$2K |
| 83013 |
|
60 |
51 |
$2K |
| 19083 |
|
14 |
13 |
$2K |
| 72020 |
|
103 |
69 |
$2K |
| 84591 |
|
381 |
128 |
$2K |
| 87046 |
|
531 |
386 |
$2K |
| 76870 |
|
61 |
52 |
$2K |
| A6022 |
Collagen drsg>16<=48 sq in |
64 |
43 |
$2K |
| A9576 |
Inj prohance multipack |
58 |
46 |
$2K |
| 11102 |
|
52 |
37 |
$2K |
| 93567 |
|
219 |
181 |
$2K |
| 73140 |
|
94 |
91 |
$2K |
| 72070 |
|
75 |
71 |
$2K |
| 96368 |
|
467 |
263 |
$1K |
| 80185 |
|
134 |
110 |
$1K |
| 82951 |
|
103 |
89 |
$1K |
| J1644 |
Inj heparin sodium per 1000u |
4,384 |
2,591 |
$1K |
| J3475 |
Inj magnesium sulfate |
676 |
293 |
$1K |
| 82010 |
|
152 |
134 |
$1K |
| 86762 |
|
155 |
140 |
$1K |
| 84630 |
|
131 |
102 |
$1K |
| J1200 |
Diphenhydramine hcl injectio |
3,137 |
1,854 |
$1K |
| J9190 |
Fluorouracil injection |
364 |
106 |
$1K |
| 80143 |
|
139 |
107 |
$1K |
| 90834 |
|
175 |
108 |
$1K |
| 82077 |
|
244 |
182 |
$1K |
| 87493 |
|
36 |
36 |
$1K |
| 97166 |
|
529 |
387 |
$1K |
| U0005 |
Infec agen detec ampli probe |
1,159 |
1,095 |
$1K |
| A6257 |
Transparent film <= 16 sq in |
832 |
607 |
$1K |
| 82180 |
|
139 |
102 |
$1K |
| J1815 |
Insulin injection |
535 |
250 |
$1K |
| 97602 |
|
49 |
36 |
$1K |
| 84445 |
|
15 |
12 |
$1K |
| 80179 |
|
118 |
91 |
$1K |
| J0690 |
Cefazolin sodium injection |
3,332 |
2,102 |
$1K |
| 86696 |
|
56 |
44 |
$1K |
| 97535 |
|
1,578 |
738 |
$1K |
| 72081 |
|
40 |
40 |
$1K |
| J2704 |
Inj, propofol, 10 mg |
3,816 |
2,524 |
$989.69 |
| 82272 |
|
274 |
240 |
$944.69 |
| C1893 |
Intro/sheath, fixed,non-peel |
459 |
361 |
$936.27 |
| 99153 |
Mod sedat endo service >5yrs |
1,195 |
934 |
$932.87 |
| Q9969 |
Non-heu tc-99m add-on/dose |
1,920 |
1,656 |
$909.18 |
| J3010 |
Fentanyl citrate injection |
6,609 |
5,053 |
$892.64 |
| 73060 |
|
48 |
40 |
$883.81 |
| 84145 |
|
56 |
53 |
$883.46 |
| 86039 |
|
102 |
95 |
$853.83 |
| 82525 |
|
75 |
55 |
$845.23 |
| A6212 |
Foam drg <=16 sq in w/border |
178 |
117 |
$818.77 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
17 |
13 |
$789.73 |
| 92611 |
|
61 |
50 |
$783.09 |
| 87426 |
|
66 |
48 |
$782.64 |
| 52000 |
|
16 |
13 |
$759.56 |
| 77072 |
|
26 |
25 |
$731.43 |
| 82247 |
|
134 |
94 |
$731.34 |
| C1874 |
Stent, coated/cov w/del sys |
15 |
13 |
$730.80 |
| 85347 |
|
315 |
239 |
$730.40 |
| 93280 |
|
30 |
29 |
$726.32 |
| J9045 |
Carboplatin injection |
58 |
39 |
$714.02 |
| J1170 |
Hydromorphone injection |
1,839 |
1,080 |
$703.92 |
| 84481 |
|
50 |
39 |
$703.07 |
| 82785 |
|
35 |
26 |
$697.47 |
| 93312 |
|
33 |
27 |
$692.35 |
| 80178 |
|
62 |
50 |
$689.90 |
| 17311 |
|
19 |
12 |
$677.91 |
| J2270 |
Morphine sulfate injection |
3,947 |
2,414 |
$658.11 |
| J3480 |
Inj potassium chloride |
151 |
79 |
$657.00 |
| 83520 |
|
55 |
42 |
$636.10 |
| 74019 |
|
24 |
24 |
$622.11 |
| A9537 |
Tc99m mebrofenin |
32 |
28 |
$621.13 |
| 84520 |
|
130 |
92 |
$618.61 |
| 83519 |
|
88 |
68 |
$617.96 |
| 84165 |
|
121 |
83 |
$607.46 |
| 86695 |
|
57 |
44 |
$531.81 |
| Q9956 |
Inj octafluoropropane mic,ml |
1,843 |
1,548 |
$527.03 |
| 86665 |
|
24 |
12 |
$525.90 |
| 97116 |
|
1,374 |
818 |
$525.31 |
| 86225 |
|
52 |
41 |
$514.61 |
| A6258 |
Transparent film >16<=48 in |
501 |
340 |
$501.79 |
| 85384 |
|
73 |
68 |
$500.61 |
| J3490 |
Drugs unclassified injection |
3,800 |
1,963 |
$490.85 |
| 86694 |
|
36 |
27 |
$489.28 |
| 88185 |
|
16 |
12 |
$471.87 |
| C1760 |
Closure dev, vasc |
20 |
12 |
$470.00 |
| 82952 |
|
104 |
89 |
$459.49 |
| A4338 |
Indwelling catheter latex |
24 |
17 |
$394.66 |
| 83721 |
|
82 |
65 |
$381.42 |
| J0640 |
Leucovorin calcium injection |
93 |
29 |
$373.49 |
| 73564 |
|
18 |
13 |
$370.07 |
| 83002 |
|
14 |
12 |
$367.75 |
| 86235 |
|
66 |
15 |
$349.68 |
| J0131 |
Inj, acetaminophen (nos) |
1,182 |
736 |
$346.50 |
| 90674 |
|
32 |
31 |
$311.41 |
| 91200 |
|
12 |
12 |
$304.57 |
| 96523 |
|
122 |
94 |
$296.32 |
| 82330 |
|
13 |
13 |
$290.28 |
| 81291 |
|
18 |
12 |
$287.24 |
| 83655 |
|
14 |
13 |
$271.10 |
| A6450 |
Lt compres band >=5"/yd |
43 |
29 |
$270.57 |
| 82365 |
|
13 |
13 |
$268.33 |
| 82310 |
|
31 |
28 |
$262.53 |
| 95800 |
|
18 |
14 |
$251.17 |
| 90686 |
|
133 |
109 |
$242.03 |
| 86160 |
|
34 |
12 |
$239.96 |
| 81050 |
|
63 |
56 |
$232.23 |
| 86664 |
|
12 |
12 |
$225.86 |
| J2780 |
Ranitidine hydrochloride inj |
386 |
224 |
$222.46 |
| 86663 |
|
12 |
12 |
$201.22 |
| 88184 |
|
16 |
12 |
$194.51 |
| P9016 |
Rbc leukocytes reduced |
130 |
92 |
$180.54 |
| 76882 |
|
19 |
14 |
$180.00 |
| 86705 |
|
15 |
15 |
$179.87 |
| 84295 |
|
55 |
39 |
$174.38 |
| 73552 |
|
15 |
12 |
$169.44 |
| 90658 |
|
16 |
14 |
$168.84 |
| 84480 |
|
17 |
14 |
$162.00 |
| 82652 |
|
12 |
12 |
$157.48 |
| 76376 |
|
14 |
13 |
$140.00 |
| J3370 |
Vancomycin hcl injection |
300 |
159 |
$139.51 |
| 96411 |
|
20 |
13 |
$123.01 |
| 87184 |
|
32 |
30 |
$121.21 |
| 83010 |
|
44 |
27 |
$118.27 |
| 89055 |
|
28 |
24 |
$116.67 |
| J2930 |
Methylprednisolone injection |
288 |
209 |
$111.42 |
| 88313 |
|
18 |
14 |
$105.00 |
| J2550 |
Promethazine hcl injection |
18 |
12 |
$87.69 |
| G8987 |
Self care current status |
60 |
53 |
$85.53 |
| 0297T |
|
13 |
13 |
$79.08 |
| 88311 |
|
12 |
12 |
$78.00 |
| 0296T |
|
13 |
12 |
$69.45 |
| 90656 |
|
35 |
33 |
$68.74 |
| C9399 |
Unclassified drugs or biolog |
218 |
185 |
$57.16 |
| J2001 |
Lidocaine injection |
183 |
142 |
$56.17 |
| J2370 |
Phenylephrine hcl injection |
369 |
287 |
$50.77 |
| 83521 |
|
38 |
12 |
$48.84 |
| G0008 |
Admin influenza virus vac |
225 |
194 |
$46.78 |
| 82435 |
|
13 |
13 |
$41.88 |
| 36600 |
|
78 |
62 |
$41.73 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
225 |
145 |
$38.62 |
| J1940 |
Furosemide injection |
247 |
139 |
$34.56 |
| J0780 |
Prochlorperazine injection |
76 |
52 |
$30.06 |
| G8978 |
Mobility current status |
366 |
349 |
$29.53 |
| 76000 |
|
226 |
183 |
$25.73 |
| C1758 |
Catheter, ureteral |
171 |
135 |
$24.00 |
| J0360 |
Hydralazine hcl injection |
292 |
179 |
$19.78 |
| J2765 |
Metoclopramide hcl injection |
91 |
82 |
$3.95 |
| J1817 |
Insulin for insulin pump use |
613 |
214 |
$0.60 |
| G1004 |
Cdsm ndsc |
874 |
409 |
$0.38 |
| G8979 |
Mobility goal status |
397 |
366 |
$0.11 |
| J2175 |
Meperidine hydrochl /100 mg |
32 |
29 |
$0.10 |
| G8988 |
Self care goal status |
60 |
53 |
$0.01 |
| 77012 |
|
48 |
41 |
$0.00 |
| 94667 |
|
16 |
12 |
$0.00 |
| 0202U |
|
149 |
144 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
14 |
12 |
$0.00 |
| 90662 |
|
17 |
17 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
18 |
12 |
$0.00 |
| J1250 |
Inj dobutamine hcl/250 mg |
44 |
38 |
$0.00 |
| 36591 |
|
304 |
175 |
$0.00 |
| 87635 |
|
301 |
289 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
22 |
15 |
$0.00 |
| C9290 |
Inj, bupivacaine liposome |
247 |
179 |
$0.00 |
| G0480 |
Drug test def 1-7 classes |
27 |
27 |
$0.00 |
| J3420 |
Vitamin b12 injection |
67 |
37 |
$0.00 |
| J1010 |
Inj, methylpred acetate 1 mg |
71 |
43 |
$0.00 |