| Code | Description | Claims | Beneficiaries | Total Paid |
| 99283 |
|
28,862 |
27,652 |
$6.71M |
| 99284 |
|
25,113 |
23,937 |
$4.89M |
| 69436 |
|
1,861 |
1,851 |
$3.00M |
| 96361 |
|
8,502 |
7,797 |
$2.54M |
| 99282 |
|
10,479 |
10,122 |
$2.41M |
| 99213 |
|
13,480 |
11,414 |
$2.04M |
| 43239 |
|
2,320 |
2,308 |
$1.87M |
| 99285 |
|
9,699 |
9,388 |
$1.82M |
| 42820 |
|
1,007 |
1,006 |
$1.75M |
| 70450 |
|
4,500 |
4,379 |
$1.31M |
| 99214 |
|
9,155 |
7,989 |
$1.26M |
| 76856 |
|
2,938 |
2,854 |
$1.18M |
| 80053 |
|
70,238 |
56,436 |
$1.14M |
| 70553 |
|
3,024 |
2,960 |
$1.09M |
| 99212 |
|
6,655 |
6,041 |
$1.05M |
| 96365 |
|
7,892 |
6,178 |
$1.04M |
| G0378 |
Hospital observation per hr |
5,802 |
4,386 |
$1.03M |
| 87635 |
|
22,876 |
20,834 |
$967K |
| 90834 |
|
6,372 |
2,977 |
$947K |
| 70551 |
|
2,713 |
2,621 |
$941K |
| 42830 |
|
560 |
560 |
$934K |
| 87633 |
|
9,854 |
9,627 |
$929K |
| 96360 |
|
3,798 |
3,682 |
$920K |
| 41899 |
|
659 |
654 |
$878K |
| 74177 |
|
2,968 |
2,935 |
$732K |
| 86832 |
|
1,097 |
895 |
$728K |
| 86833 |
|
1,077 |
882 |
$664K |
| 45380 |
|
841 |
836 |
$640K |
| 93976 |
|
2,450 |
2,371 |
$620K |
| 86850 |
|
19,955 |
17,139 |
$587K |
| 44970 |
|
200 |
198 |
$578K |
| 93306 |
|
3,233 |
3,100 |
$549K |
| U0003 |
Cov-19 amp prb hgh thruput |
5,899 |
4,700 |
$468K |
| 86901 |
|
22,917 |
17,460 |
$443K |
| 86900 |
|
22,939 |
17,473 |
$389K |
| 87486 |
|
10,334 |
10,083 |
$377K |
| 74183 |
|
1,054 |
1,030 |
$366K |
| 88305 |
|
8,196 |
5,181 |
$359K |
| 76770 |
|
1,282 |
1,244 |
$341K |
| D0140 |
|
8,016 |
6,408 |
$337K |
| 93970 |
|
913 |
894 |
$275K |
| D7140 |
|
4,249 |
3,727 |
$275K |
| 95810 |
|
297 |
297 |
$271K |
| 72148 |
|
870 |
857 |
$269K |
| 87799 |
|
1,672 |
862 |
$265K |
| 76705 |
|
3,785 |
3,671 |
$254K |
| 99291 |
|
1,256 |
1,240 |
$229K |
| 96366 |
|
1,769 |
1,276 |
$228K |
| 36415 |
|
66,548 |
50,595 |
$225K |
| 72141 |
|
711 |
699 |
$225K |
| 87798 |
|
10,379 |
10,093 |
$214K |
| 76819 |
|
5,819 |
3,015 |
$206K |
| 87581 |
|
10,340 |
10,089 |
$198K |
| 87507 |
|
521 |
515 |
$195K |
| P9040 |
Rbc leukoreduced irradiated |
376 |
249 |
$189K |
| 36430 |
|
831 |
521 |
$188K |
| U0004 |
Cov-19 test non-cdc hgh thru |
2,510 |
2,378 |
$184K |
| 82306 |
|
6,280 |
6,061 |
$176K |
| 88304 |
|
3,116 |
2,757 |
$170K |
| 90832 |
|
1,615 |
1,077 |
$170K |
| 87497 |
|
4,879 |
3,188 |
$167K |
| 12011 |
|
301 |
298 |
$162K |
| 96413 |
|
1,093 |
737 |
$156K |
| 76700 |
|
1,775 |
1,743 |
$153K |
| 0241U |
|
7,988 |
5,211 |
$152K |
| 87491 |
|
5,002 |
4,362 |
$149K |
| 80048 |
|
9,125 |
8,085 |
$148K |
| 72197 |
|
419 |
405 |
$147K |
| 99391 |
|
865 |
832 |
$146K |
| 88342 |
|
2,252 |
1,940 |
$146K |
| 71260 |
|
1,018 |
1,001 |
$145K |
| 74176 |
|
629 |
610 |
$141K |
| 99203 |
|
794 |
789 |
$135K |
| 87536 |
|
2,067 |
1,949 |
$128K |
| 86835 |
|
292 |
261 |
$127K |
| 96375 |
|
7,009 |
5,875 |
$127K |
| 76816 |
|
4,028 |
3,462 |
$127K |
| 85730 |
|
19,354 |
15,353 |
$124K |
| 71275 |
|
384 |
368 |
$114K |
| 80307 |
|
3,472 |
2,180 |
$111K |
| 45378 |
|
117 |
117 |
$109K |
| 70496 |
|
372 |
364 |
$104K |
| 85025 |
|
43,173 |
37,753 |
$102K |
| 83970 |
|
2,619 |
2,485 |
$102K |
| 87591 |
|
4,978 |
4,341 |
$100K |
| 88307 |
|
871 |
735 |
$92K |
| 99392 |
|
511 |
510 |
$88K |
| 96367 |
|
932 |
787 |
$87K |
| 96450 |
|
102 |
87 |
$86K |
| 77067 |
|
1,303 |
1,275 |
$85K |
| 82784 |
|
6,751 |
4,201 |
$84K |
| 72195 |
|
201 |
198 |
$84K |
| 71250 |
|
888 |
849 |
$81K |
| 87636 |
|
756 |
716 |
$81K |
| 80061 |
|
9,656 |
9,069 |
$81K |
| H0040 |
Assert comm tx pgm per diem |
53 |
53 |
$79K |
| 86481 |
|
1,648 |
1,627 |
$79K |
| 83880 |
|
2,618 |
2,397 |
$79K |
| 76830 |
|
1,973 |
1,913 |
$79K |
| 76775 |
|
1,382 |
1,357 |
$77K |
| 12001 |
|
144 |
141 |
$77K |
| 96374 |
|
8,469 |
7,930 |
$76K |
| 82728 |
|
6,339 |
6,000 |
$75K |
| 82610 |
|
1,051 |
859 |
$75K |
| 83735 |
|
20,009 |
13,441 |
$74K |
| 83036 |
|
9,668 |
9,440 |
$73K |
| 76805 |
|
742 |
633 |
$72K |
| 99204 |
|
429 |
426 |
$72K |
| 71046 |
|
8,717 |
8,409 |
$69K |
| 86003 |
|
1,834 |
950 |
$68K |
| 96372 |
|
4,218 |
3,644 |
$67K |
| D2930 |
|
121 |
104 |
$64K |
| 84443 |
|
8,953 |
8,723 |
$64K |
| 85610 |
|
21,651 |
18,901 |
$63K |
| 99393 |
|
363 |
362 |
$62K |
| 90833 |
|
850 |
657 |
$61K |
| 90836 |
|
539 |
298 |
$56K |
| 72146 |
|
202 |
201 |
$55K |
| 88300 |
|
1,701 |
1,645 |
$54K |
| 80197 |
|
6,177 |
3,504 |
$54K |
| 83615 |
|
12,737 |
8,198 |
$53K |
| G0463 |
Hospital outpt clinic visit |
1,508 |
1,096 |
$52K |
| 87389 |
|
3,955 |
3,890 |
$51K |
| 84100 |
|
14,481 |
9,724 |
$51K |
| 86360 |
|
1,436 |
1,399 |
$50K |
| 87624 |
|
1,852 |
1,833 |
$50K |
| 76641 |
|
1,838 |
1,386 |
$49K |
| 99215 |
Prolong outpt/office vis |
269 |
249 |
$48K |
| 88142 |
|
2,247 |
2,227 |
$48K |
| 82805 |
|
2,634 |
2,450 |
$48K |
| 86923 |
|
271 |
164 |
$47K |
| 92012 |
|
285 |
229 |
$46K |
| 76811 |
|
647 |
630 |
$45K |
| D9430 |
|
1,041 |
958 |
$45K |
| 76817 |
|
707 |
596 |
$44K |
| 88112 |
|
782 |
684 |
$44K |
| 85027 |
|
17,740 |
14,901 |
$41K |
| D0330 |
|
2,356 |
2,355 |
$40K |
| 94060 |
|
1,468 |
1,420 |
$40K |
| 74230 |
|
209 |
209 |
$40K |
| 86317 |
|
265 |
206 |
$38K |
| 86359 |
|
1,421 |
1,382 |
$38K |
| 86769 |
|
1,113 |
1,104 |
$38K |
| 72125 |
|
716 |
707 |
$38K |
| 59025 |
|
132 |
107 |
$37K |
| 86480 |
|
655 |
646 |
$36K |
| 87522 |
Neg quan hep c or qual rna |
983 |
824 |
$36K |
| 84550 |
|
9,834 |
6,454 |
$36K |
| 87086 |
|
9,644 |
9,101 |
$35K |
| 87517 |
|
316 |
269 |
$35K |
| 99394 |
|
202 |
201 |
$35K |
| 70486 |
|
355 |
347 |
$34K |
| 84439 |
|
4,606 |
4,453 |
$34K |
| 93005 |
|
8,527 |
8,020 |
$34K |
| 87661 |
|
1,522 |
1,499 |
$32K |
| 81001 |
|
15,735 |
14,210 |
$32K |
| 82607 |
|
3,052 |
2,998 |
$32K |
| 87340 |
|
4,087 |
4,020 |
$31K |
| 94726 |
|
1,717 |
1,659 |
$31K |
| 0012A |
|
984 |
976 |
$31K |
| 87077 |
|
5,136 |
3,922 |
$30K |
| 87070 |
|
5,619 |
5,277 |
$30K |
| 78815 |
|
65 |
64 |
$30K |
| 83021 |
|
1,649 |
1,565 |
$30K |
| 94729 |
|
1,824 |
1,764 |
$29K |
| 54640 |
|
26 |
26 |
$29K |
| 83540 |
|
6,341 |
6,002 |
$29K |
| 84702 |
|
3,800 |
3,489 |
$28K |
| 83550 |
|
6,085 |
5,781 |
$27K |
| 82570 |
|
6,426 |
5,316 |
$27K |
| 85576 |
|
1,084 |
564 |
$27K |
| 80321 |
|
1,004 |
653 |
$27K |
| 88341 |
|
550 |
322 |
$26K |
| 86803 |
|
3,418 |
3,364 |
$25K |
| 96415 |
|
54 |
39 |
$24K |
| 82803 |
|
847 |
804 |
$24K |
| 86160 |
|
2,448 |
1,236 |
$22K |
| 0011A |
|
864 |
851 |
$22K |
| 86140 |
|
8,758 |
8,351 |
$21K |
| 92611 |
|
139 |
139 |
$21K |
| 74240 |
|
486 |
474 |
$21K |
| 82746 |
|
1,911 |
1,874 |
$20K |
| 84156 |
|
6,147 |
4,930 |
$19K |
| 83655 |
|
1,413 |
1,404 |
$19K |
| 82977 |
|
3,900 |
3,077 |
$18K |
| 84153 |
|
1,145 |
1,126 |
$18K |
| D0150 |
|
317 |
226 |
$17K |
| 72158 |
|
52 |
52 |
$17K |
| 99202 |
|
98 |
98 |
$17K |
| 97161 |
|
155 |
153 |
$17K |
| 51600 |
|
55 |
53 |
$17K |
| 76818 |
|
240 |
202 |
$17K |
| 84403 |
|
679 |
671 |
$16K |
| 82248 |
|
4,232 |
3,235 |
$16K |
| 93971 |
|
209 |
193 |
$16K |
| J0131 |
Inj, acetaminophen (nos) |
4,015 |
3,348 |
$16K |
| 71045 |
|
4,003 |
3,719 |
$16K |
| 85007 |
|
12,306 |
10,094 |
$15K |
| 86765 |
|
1,297 |
1,277 |
$15K |
| 96376 |
|
1,590 |
1,284 |
$14K |
| 90686 |
|
591 |
579 |
$14K |
| 86665 |
|
1,104 |
722 |
$14K |
| 86706 |
|
2,061 |
2,024 |
$14K |
| C8929 |
Tte w or wo fol wcon,doppler |
12 |
12 |
$14K |
| 86704 |
|
1,760 |
1,732 |
$13K |
| 86880 |
|
1,028 |
720 |
$13K |
| 76536 |
|
342 |
336 |
$13K |
| 87186 |
|
3,022 |
2,449 |
$13K |
| 82785 |
|
1,030 |
974 |
$13K |
| 86364 |
|
1,752 |
1,312 |
$12K |
| 77063 |
|
1,258 |
1,217 |
$12K |
| 85384 |
|
2,415 |
2,125 |
$12K |
| 95816 |
|
70 |
69 |
$12K |
| 86780 |
|
1,489 |
1,394 |
$12K |
| 45385 |
|
12 |
12 |
$12K |
| 95782 |
|
12 |
12 |
$12K |
| 11042 |
|
21 |
13 |
$12K |
| G0390 |
Trauma respons w/hosp criti |
163 |
158 |
$11K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
341 |
334 |
$11K |
| 94010 |
|
303 |
291 |
$11K |
| 76870 |
|
289 |
281 |
$10K |
| 74455 |
|
78 |
73 |
$10K |
| 85651 |
|
6,614 |
6,428 |
$10K |
| 85045 |
|
3,475 |
3,057 |
$10K |
| 70546 |
|
29 |
29 |
$10K |
| 82105 |
|
1,522 |
1,454 |
$10K |
| 83002 |
|
574 |
561 |
$10K |
| 25605 |
|
16 |
15 |
$10K |
| 85240 |
|
904 |
835 |
$9K |
| 86762 |
|
746 |
724 |
$9K |
| 73721 |
|
27 |
27 |
$9K |
| 86357 |
|
391 |
378 |
$9K |
| 86038 |
|
1,867 |
1,794 |
$9K |
| 86355 |
|
382 |
369 |
$9K |
| 0002A |
|
265 |
265 |
$9K |
| 0001A |
|
260 |
259 |
$9K |
| 16020 |
|
15 |
15 |
$9K |
| 83001 |
|
519 |
510 |
$9K |
| 84703 |
|
5,550 |
5,136 |
$9K |
| 83690 |
|
5,283 |
4,985 |
$8K |
| 72156 |
|
28 |
28 |
$8K |
| 93303 |
|
95 |
92 |
$8K |
| 82947 |
|
8,157 |
5,076 |
$8K |
| D1110 |
|
128 |
121 |
$8K |
| 82670 |
|
299 |
293 |
$8K |
| 95819 |
|
40 |
40 |
$8K |
| 76801 |
|
95 |
91 |
$8K |
| 85246 |
|
667 |
621 |
$8K |
| 84402 |
|
321 |
318 |
$8K |
| 82378 |
|
433 |
414 |
$8K |
| 92604 |
|
68 |
68 |
$7K |
| 85245 |
|
589 |
548 |
$7K |
| 86376 |
|
558 |
543 |
$7K |
| 70491 |
|
25 |
25 |
$7K |
| 86787 |
|
953 |
926 |
$7K |
| 86592 |
|
2,180 |
2,121 |
$7K |
| 77072 |
|
551 |
510 |
$7K |
| 86147 |
|
770 |
414 |
$7K |
| J1756 |
Iron sucrose injection |
155 |
81 |
$6K |
| 81003 |
|
5,432 |
5,194 |
$6K |
| 76820 |
|
321 |
127 |
$6K |
| 84146 |
|
385 |
382 |
$6K |
| 74018 |
|
1,419 |
1,329 |
$6K |
| C1887 |
Catheter, guiding |
247 |
239 |
$6K |
| 72082 |
|
449 |
445 |
$6K |
| 82077 |
|
213 |
204 |
$6K |
| 70498 |
|
66 |
66 |
$6K |
| 86618 |
|
562 |
554 |
$6K |
| 86235 |
|
696 |
391 |
$6K |
| 86708 |
|
779 |
737 |
$6K |
| 88302 |
|
98 |
80 |
$6K |
| 86735 |
|
747 |
737 |
$6K |
| 93320 |
|
156 |
147 |
$5K |
| 82550 |
|
2,351 |
2,200 |
$5K |
| 83010 |
|
481 |
394 |
$5K |
| 80069 |
|
632 |
591 |
$5K |
| 85379 |
|
1,376 |
1,268 |
$5K |
| 99281 |
|
24 |
24 |
$5K |
| 92507 |
|
241 |
125 |
$5K |
| 87254 |
|
650 |
318 |
$5K |
| 74021 |
|
667 |
635 |
$5K |
| 80076 |
|
520 |
498 |
$5K |
| 80320 |
|
1,820 |
1,669 |
$5K |
| 90715 |
|
220 |
219 |
$5K |
| 73130 |
|
736 |
707 |
$4K |
| 86644 |
|
375 |
369 |
$4K |
| 95716 |
|
33 |
29 |
$4K |
| 82043 |
|
963 |
941 |
$4K |
| 84484 |
|
4,072 |
3,140 |
$4K |
| 92567 |
|
75 |
74 |
$4K |
| 84480 |
|
834 |
804 |
$4K |
| 72157 |
|
12 |
12 |
$4K |
| 81220 |
|
15 |
15 |
$4K |
| 82330 |
|
2,124 |
1,826 |
$4K |
| 73610 |
|
766 |
717 |
$4K |
| 86225 |
|
745 |
726 |
$4K |
| 82150 |
|
2,865 |
2,708 |
$4K |
| 84145 |
|
1,431 |
1,342 |
$4K |
| 87205 |
|
1,482 |
1,419 |
$4K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
2,615 |
2,549 |
$4K |
| C1894 |
Intro/sheath, non-laser |
732 |
676 |
$3K |
| 83605 |
|
3,315 |
2,895 |
$3K |
| 93325 |
|
176 |
164 |
$3K |
| 73560 |
|
547 |
529 |
$3K |
| J2704 |
Inj, propofol, 10 mg |
10,398 |
9,628 |
$3K |
| D0210 |
|
57 |
55 |
$3K |
| C1769 |
Guide wire |
764 |
703 |
$3K |
| 87040 |
|
3,925 |
2,979 |
$3K |
| 84590 |
|
312 |
309 |
$3K |
| 87338 |
|
373 |
370 |
$3K |
| 84305 |
|
135 |
133 |
$3K |
| 93017 |
|
94 |
94 |
$3K |
| 73110 |
|
528 |
485 |
$3K |
| 85247 |
|
214 |
204 |
$3K |
| 70544 |
|
13 |
13 |
$3K |
| 84436 |
|
1,090 |
1,067 |
$3K |
| 86231 |
|
359 |
359 |
$3K |
| A9585 |
Gadobutrol injection |
2,168 |
2,125 |
$3K |
| 86039 |
|
532 |
523 |
$3K |
| 73562 |
|
310 |
307 |
$3K |
| 83521 |
|
156 |
80 |
$2K |
| 83003 |
|
70 |
36 |
$2K |
| 95715 |
|
41 |
40 |
$2K |
| 82950 |
|
518 |
516 |
$2K |
| 86870 |
|
73 |
60 |
$2K |
| 88313 |
|
226 |
148 |
$2K |
| 86431 |
|
477 |
474 |
$2K |
| 74174 |
|
17 |
13 |
$2K |
| 90853 |
|
56 |
27 |
$2K |
| 73090 |
|
715 |
645 |
$2K |
| 73700 |
|
18 |
13 |
$2K |
| 95700 |
|
60 |
58 |
$2K |
| 84446 |
|
181 |
180 |
$2K |
| 83516 |
|
52 |
40 |
$2K |
| 73030 |
|
313 |
296 |
$2K |
| 90471 |
|
1,206 |
1,139 |
$2K |
| 84425 |
|
138 |
138 |
$2K |
| 82533 |
|
188 |
168 |
$2K |
| 73630 |
|
387 |
373 |
$2K |
| 72170 |
|
298 |
297 |
$2K |
| 94640 |
|
359 |
306 |
$2K |
| 83993 |
|
156 |
156 |
$2K |
| 90750 |
|
13 |
13 |
$2K |
| 90688 |
|
57 |
57 |
$2K |
| 75574 |
|
12 |
12 |
$2K |
| 86301 |
|
93 |
90 |
$2K |
| 86146 |
|
157 |
84 |
$1K |
| 87185 |
|
410 |
334 |
$1K |
| 84630 |
|
205 |
203 |
$1K |
| 86800 |
|
115 |
115 |
$1K |
| 73590 |
|
496 |
461 |
$1K |
| 87804 |
|
1,252 |
645 |
$1K |
| 77073 |
|
66 |
66 |
$1K |
| 84154 |
|
111 |
110 |
$1K |
| D0220 |
|
128 |
127 |
$1K |
| 84207 |
|
50 |
49 |
$1K |
| 70480 |
|
12 |
12 |
$1K |
| 85055 |
|
48 |
41 |
$1K |
| 94760 |
|
266 |
261 |
$1K |
| 73521 |
|
210 |
208 |
$1K |
| 87177 |
|
136 |
98 |
$1K |
| 0064A |
|
31 |
31 |
$1K |
| 86334 |
|
56 |
54 |
$1K |
| J3490 |
Drugs unclassified injection |
653 |
536 |
$1K |
| 72100 |
|
107 |
107 |
$1K |
| 82565 |
|
243 |
241 |
$1K |
| 77066 |
Tomosynthesis, mammo |
15 |
15 |
$1K |
| 86304 |
|
53 |
51 |
$1K |
| 82438 |
|
230 |
131 |
$1K |
| 82103 |
|
87 |
83 |
$975.05 |
| 73552 |
|
178 |
159 |
$950.69 |
| 87209 |
|
155 |
113 |
$895.26 |
| J1100 |
Dexamethasone sodium phos |
7,557 |
7,077 |
$891.48 |
| 86015 |
|
135 |
134 |
$828.49 |
| 89230 |
|
131 |
131 |
$794.73 |
| 73070 |
|
242 |
218 |
$776.79 |
| 73080 |
|
127 |
115 |
$754.85 |
| D0230 |
|
39 |
39 |
$748.82 |
| 83525 |
|
61 |
57 |
$708.66 |
| 80329 |
|
116 |
65 |
$695.00 |
| 82390 |
|
95 |
95 |
$684.65 |
| 84132 |
|
2,181 |
1,999 |
$681.41 |
| J2405 |
Ondansetron hcl injection |
10,069 |
9,459 |
$668.78 |
| 82787 |
|
52 |
27 |
$625.56 |
| 77080 |
|
12 |
12 |
$606.00 |
| 90656 |
|
45 |
45 |
$593.66 |
| 86255 |
|
62 |
40 |
$566.80 |
| 84295 |
|
2,128 |
1,957 |
$555.99 |
| C9399 |
Unclassified drugs or biolog |
551 |
545 |
$550.80 |
| 85732 |
|
81 |
81 |
$513.18 |
| 90461 |
|
74 |
73 |
$476.80 |
| 85290 |
|
54 |
52 |
$472.98 |
| 72040 |
|
84 |
83 |
$471.37 |
| 87880 |
|
904 |
885 |
$468.83 |
| 82525 |
|
51 |
50 |
$465.86 |
| 83519 |
|
14 |
14 |
$450.07 |
| J1626 |
Granisetron hcl injection |
212 |
124 |
$444.37 |
| 87106 |
|
49 |
43 |
$419.70 |
| J2370 |
Phenylephrine hcl injection |
496 |
475 |
$407.90 |
| 73060 |
|
76 |
67 |
$407.31 |
| 94621 |
|
13 |
13 |
$389.48 |
| 0031A |
|
28 |
28 |
$357.21 |
| 82465 |
|
92 |
91 |
$336.87 |
| J1200 |
Diphenhydramine hcl injectio |
1,587 |
1,242 |
$335.87 |
| 82104 |
|
27 |
27 |
$333.39 |
| 73502 |
|
62 |
62 |
$316.60 |
| L8699 |
Prosthetic implant nos |
631 |
629 |
$316.27 |
| 81050 |
|
25 |
25 |
$315.58 |
| 87493 |
|
15 |
15 |
$313.21 |
| 94770 |
|
43 |
42 |
$301.66 |
| 86709 |
|
39 |
39 |
$295.76 |
| 86258 |
|
51 |
27 |
$287.94 |
| J7050 |
Normal saline solution infus |
111 |
69 |
$250.78 |
| 76857 |
|
13 |
12 |
$242.80 |
| 99211 |
|
13 |
13 |
$240.00 |
| 90633 |
|
12 |
12 |
$214.20 |
| 85250 |
|
12 |
12 |
$213.25 |
| J0690 |
Cefazolin sodium injection |
3,104 |
2,858 |
$206.71 |
| 85613 |
|
27 |
27 |
$204.54 |
| 87081 |
|
90 |
87 |
$202.44 |
| 89051 |
|
141 |
121 |
$201.38 |
| 86849 |
|
12 |
12 |
$172.20 |
| 87807 |
|
196 |
187 |
$168.73 |
| 82272 |
|
13 |
13 |
$156.69 |
| A4649 |
Surgical supplies |
212 |
208 |
$152.34 |
| 82553 |
|
117 |
112 |
$149.89 |
| 82139 |
|
14 |
13 |
$144.13 |
| 87147 |
|
59 |
33 |
$137.46 |
| 96523 |
|
72 |
44 |
$135.22 |
| J3010 |
Fentanyl citrate injection |
8,603 |
8,258 |
$133.86 |
| J3535 |
Metered dose inhaler drug |
77 |
76 |
$109.60 |
| 83718 |
|
47 |
47 |
$102.51 |
| 84466 |
|
16 |
16 |
$101.04 |
| J1885 |
Ketorolac tromethamine inj |
4,560 |
4,172 |
$98.74 |
| 86036 |
|
19 |
12 |
$94.90 |
| 73000 |
|
14 |
13 |
$90.87 |
| J2270 |
Morphine sulfate injection |
2,617 |
2,399 |
$90.62 |
| 82951 |
|
14 |
14 |
$88.82 |
| J2250 |
Inj midazolam hydrochloride |
4,280 |
4,133 |
$86.27 |
| 82140 |
|
27 |
25 |
$83.05 |
| 84481 |
|
16 |
16 |
$80.48 |
| J0696 |
Ceftriaxone sodium injection |
993 |
817 |
$74.22 |
| J1642 |
Inj heparin sodium per 10 u |
460 |
312 |
$72.36 |
| J1170 |
Hydromorphone injection |
1,028 |
834 |
$70.83 |
| J7120 |
Ringers lactate infusion |
795 |
689 |
$70.08 |
| 87045 |
|
12 |
12 |
$58.97 |
| 90460 |
|
235 |
231 |
$53.28 |
| 83930 |
|
86 |
84 |
$48.56 |
| 87046 |
|
24 |
12 |
$48.31 |
| 84520 |
|
12 |
12 |
$46.98 |
| J9250 |
Methotrexate sodium inj |
28 |
25 |
$44.24 |
| 86705 |
|
14 |
13 |
$41.94 |
| C1729 |
Cath, drainage |
64 |
56 |
$37.59 |
| J1644 |
Inj heparin sodium per 1000u |
515 |
356 |
$30.57 |
| J0134 |
Inj acetaminophen -fresenius |
1,597 |
1,473 |
$26.74 |
| 87075 |
|
13 |
13 |
$23.82 |
| J2795 |
Ropivacaine hcl injection |
66 |
65 |
$20.97 |
| J3370 |
Vancomycin hcl injection |
15 |
12 |
$16.12 |
| 82945 |
|
17 |
13 |
$14.55 |
| J2765 |
Metoclopramide hcl injection |
385 |
367 |
$13.72 |
| 84157 |
|
17 |
13 |
$13.59 |
| J2001 |
Lidocaine injection |
862 |
854 |
$12.67 |
| J2710 |
Neostigmine methylslfte inj |
134 |
132 |
$10.27 |
| J1650 |
Inj enoxaparin sodium |
99 |
49 |
$8.89 |
| J0330 |
Succinycholine chloride inj |
132 |
132 |
$8.61 |
| C1751 |
Cath, inf, per/cent/midline |
136 |
121 |
$8.20 |
| C1776 |
Joint device (implantable) |
33 |
33 |
$4.02 |
| C1889 |
Implant/insert device, noc |
12 |
12 |
$2.91 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
24 |
24 |
$2.52 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
13 |
12 |
$1.44 |
| J2060 |
Lorazepam injection |
47 |
40 |
$1.08 |
| 94799 |
|
85 |
80 |
$1.01 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
299 |
295 |
$0.38 |
| J7613 |
Albuterol non-comp unit |
20 |
13 |
$0.09 |
| L8613 |
Ossicular implant |
78 |
78 |
$0.00 |
| 99080 |
|
3,953 |
1,003 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
65 |
40 |
$0.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
133 |
95 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
13 |
13 |
$0.00 |
| 90472 |
|
13 |
13 |
$0.00 |
| J7611 |
Albuterol non-comp con |
103 |
69 |
$0.00 |
| J1815 |
Insulin injection |
81 |
57 |
$0.00 |
| C1781 |
Mesh (implantable) |
54 |
54 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
49 |
48 |
$0.00 |
| J8540 |
Oral dexamethasone |
13 |
12 |
$0.00 |
| 82657 |
|
24 |
12 |
$0.00 |