| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
78,360 |
66,748 |
$14.44M |
| 99283 |
|
52,939 |
46,908 |
$9.08M |
| 96361 |
|
35,318 |
25,888 |
$8.50M |
| 99285 |
|
22,821 |
19,793 |
$4.51M |
| G0378 |
Hospital observation per hr |
16,415 |
13,147 |
$4.00M |
| 92507 |
|
13,887 |
3,335 |
$3.36M |
| G0463 |
Hospital outpt clinic visit |
25,623 |
17,776 |
$3.35M |
| 99282 |
|
19,755 |
17,679 |
$3.17M |
| 70450 |
|
14,643 |
12,853 |
$2.83M |
| 74177 |
|
11,418 |
10,304 |
$2.42M |
| 43239 |
|
3,669 |
3,310 |
$1.74M |
| 96360 |
|
11,306 |
9,185 |
$1.34M |
| 71275 |
|
5,429 |
4,902 |
$1.33M |
| 78452 |
|
1,506 |
1,328 |
$1.09M |
| 96365 |
|
11,409 |
9,415 |
$1.06M |
| 96366 |
|
6,204 |
3,767 |
$1.02M |
| 93306 |
|
2,924 |
2,637 |
$898K |
| 45380 |
|
1,661 |
1,520 |
$895K |
| 74176 |
|
4,420 |
4,006 |
$882K |
| 97110 |
|
19,125 |
5,569 |
$831K |
| 99291 |
|
3,066 |
2,827 |
$599K |
| 97530 |
|
15,960 |
5,101 |
$485K |
| U0003 |
Cov-19 amp prb hgh thruput |
14,383 |
13,122 |
$481K |
| 94640 |
|
8,287 |
5,351 |
$471K |
| 99211 |
|
3,587 |
2,444 |
$432K |
| 80053 |
|
92,668 |
70,380 |
$399K |
| 76705 |
|
4,301 |
3,877 |
$372K |
| 59025 |
|
2,155 |
1,801 |
$358K |
| 76816 |
|
5,182 |
4,430 |
$330K |
| 0241U |
|
5,256 |
4,940 |
$329K |
| 76817 |
|
3,781 |
3,101 |
$323K |
| 29580 |
|
1,779 |
562 |
$306K |
| 93971 |
|
3,235 |
2,876 |
$282K |
| 97140 |
|
13,746 |
3,842 |
$260K |
| 97161 |
|
2,253 |
2,060 |
$254K |
| 11042 |
|
1,485 |
777 |
$230K |
| 76815 |
|
2,306 |
1,953 |
$220K |
| 76819 |
|
4,382 |
2,375 |
$210K |
| 99281 |
|
1,197 |
1,068 |
$203K |
| 93017 |
|
1,959 |
1,743 |
$203K |
| 76811 |
|
2,456 |
2,290 |
$203K |
| 87635 |
|
2,279 |
2,088 |
$192K |
| 97150 |
|
5,110 |
1,644 |
$189K |
| 76856 |
|
2,846 |
2,597 |
$188K |
| 70551 |
|
962 |
859 |
$187K |
| 70496 |
|
686 |
634 |
$183K |
| 97112 |
|
8,771 |
2,803 |
$172K |
| P9016 |
Rbc leukocytes reduced |
707 |
537 |
$169K |
| 97602 |
|
1,026 |
440 |
$169K |
| 76830 |
|
2,213 |
2,020 |
$168K |
| 95810 |
|
224 |
209 |
$165K |
| 12001 |
|
729 |
696 |
$161K |
| 93458 |
|
105 |
90 |
$151K |
| 45378 |
|
143 |
138 |
$130K |
| 36430 |
|
768 |
558 |
$130K |
| 87651 |
|
13,778 |
12,972 |
$129K |
| 76801 |
|
2,879 |
2,464 |
$123K |
| 87400 |
|
9,097 |
8,284 |
$119K |
| 93970 |
|
1,109 |
998 |
$118K |
| 45385 |
|
274 |
252 |
$116K |
| 29125 |
|
915 |
844 |
$111K |
| 72125 |
|
3,815 |
3,424 |
$108K |
| 80329 |
|
8,323 |
5,913 |
$104K |
| 97162 |
|
701 |
661 |
$94K |
| G0390 |
Trauma respons w/hosp criti |
1,034 |
955 |
$92K |
| 83880 |
|
9,469 |
8,239 |
$83K |
| 97116 |
|
3,090 |
1,370 |
$83K |
| 88305 |
|
8,657 |
7,777 |
$79K |
| 92523 |
|
308 |
301 |
$77K |
| 12011 |
|
334 |
317 |
$75K |
| 87040 |
|
7,514 |
5,020 |
$75K |
| 85025 |
|
94,736 |
70,116 |
$70K |
| C9803 |
Hopd covid-19 spec collect |
3,017 |
2,821 |
$69K |
| G0108 |
Diab manage trn per indiv |
1,751 |
1,373 |
$67K |
| 70498 |
|
1,055 |
973 |
$66K |
| 96413 |
|
383 |
269 |
$66K |
| 96374 |
|
34,756 |
28,298 |
$65K |
| 71046 |
|
19,554 |
17,405 |
$63K |
| 10060 |
|
440 |
396 |
$60K |
| 93000 |
|
33,415 |
27,940 |
$60K |
| 87591 |
|
6,038 |
5,508 |
$56K |
| 80048 |
|
13,662 |
9,918 |
$56K |
| 96367 |
|
2,410 |
1,768 |
$53K |
| 95816 |
|
275 |
256 |
$53K |
| 76818 |
|
1,370 |
743 |
$50K |
| 97535 |
|
1,631 |
1,170 |
$49K |
| 99213 |
|
373 |
276 |
$48K |
| 84484 |
|
32,993 |
22,511 |
$47K |
| 71250 |
|
554 |
519 |
$44K |
| 85379 |
|
8,537 |
7,595 |
$44K |
| 93798 |
|
246 |
40 |
$43K |
| 71045 |
|
26,484 |
23,224 |
$41K |
| M0243 |
Casirivi and imdevi inj |
141 |
137 |
$41K |
| 76770 |
|
379 |
353 |
$40K |
| U0005 |
Infec agen detec ampli probe |
9,172 |
8,489 |
$37K |
| 95811 |
|
62 |
57 |
$37K |
| 87491 |
|
5,992 |
5,456 |
$37K |
| 29515 |
|
313 |
287 |
$36K |
| 73564 |
|
4,086 |
3,493 |
$35K |
| 12002 |
|
177 |
169 |
$34K |
| 97016 |
|
1,102 |
402 |
$34K |
| 84443 |
|
7,982 |
7,080 |
$32K |
| 87653 |
|
1,095 |
1,053 |
$27K |
| 70486 |
|
748 |
694 |
$27K |
| 87086 |
|
18,284 |
16,085 |
$26K |
| 80061 |
|
8,142 |
7,306 |
$23K |
| 77295 |
|
16 |
12 |
$23K |
| 93005 |
|
14,751 |
11,280 |
$22K |
| 82306 |
|
1,879 |
1,672 |
$20K |
| 83735 |
|
43,352 |
32,180 |
$20K |
| 77336 |
|
277 |
104 |
$20K |
| J1200 |
Diphenhydramine hcl injectio |
7,028 |
5,474 |
$19K |
| 87070 |
|
4,189 |
3,728 |
$19K |
| 72110 |
|
2,190 |
2,006 |
$18K |
| 80320 |
|
10,387 |
8,732 |
$17K |
| 70553 |
|
41 |
37 |
$16K |
| J1650 |
Inj enoxaparin sodium |
11,543 |
4,607 |
$16K |
| 90471 |
|
2,602 |
2,227 |
$16K |
| 36415 |
|
15,157 |
12,382 |
$16K |
| 90714 |
|
742 |
691 |
$16K |
| 76700 |
|
101 |
98 |
$15K |
| 62323 |
|
18 |
18 |
$15K |
| 83605 |
|
9,864 |
7,469 |
$15K |
| C8929 |
Tte w or wo fol wcon,doppler |
45 |
43 |
$14K |
| 88304 |
|
1,166 |
1,110 |
$14K |
| 70491 |
|
70 |
69 |
$14K |
| 83036 |
|
6,486 |
5,807 |
$13K |
| 96372 |
|
20,189 |
12,237 |
$13K |
| 96375 |
|
29,424 |
21,662 |
$13K |
| A9270 |
Non-covered item or service |
212,648 |
65,348 |
$12K |
| 86140 |
|
4,105 |
3,047 |
$12K |
| 74018 |
|
3,979 |
3,628 |
$12K |
| 87428 |
|
13,151 |
12,363 |
$12K |
| 95800 |
|
72 |
71 |
$12K |
| 76813 |
|
143 |
135 |
$12K |
| 73030 |
|
2,878 |
2,544 |
$11K |
| 84702 |
|
4,583 |
3,703 |
$11K |
| 72100 |
|
2,633 |
2,414 |
$11K |
| 97605 |
|
52 |
12 |
$11K |
| 80306 |
|
10,717 |
9,258 |
$10K |
| 72050 |
|
1,232 |
1,135 |
$10K |
| 88342 |
|
2,012 |
1,791 |
$10K |
| 81001 |
|
34,141 |
29,734 |
$10K |
| 93010 |
|
8,939 |
7,093 |
$9K |
| 84703 |
|
21,236 |
18,548 |
$9K |
| 84439 |
|
2,393 |
2,119 |
$9K |
| 97802 |
|
64 |
57 |
$9K |
| J3490 |
Drugs unclassified injection |
18,357 |
9,914 |
$9K |
| 82728 |
|
2,480 |
2,140 |
$9K |
| 85027 |
|
8,600 |
6,888 |
$8K |
| 76820 |
|
501 |
240 |
$8K |
| 86923 |
|
478 |
397 |
$8K |
| 43248 |
|
24 |
24 |
$8K |
| 82607 |
|
2,713 |
2,406 |
$8K |
| 87633 |
|
158 |
147 |
$7K |
| 82948 |
|
27,837 |
11,259 |
$7K |
| 90686 |
|
490 |
426 |
$7K |
| 83690 |
|
26,419 |
22,261 |
$7K |
| 86780 |
|
1,312 |
1,201 |
$7K |
| 90832 |
|
43 |
26 |
$7K |
| 85610 |
|
22,032 |
16,745 |
$7K |
| 84145 |
|
793 |
653 |
$6K |
| J8540 |
Oral dexamethasone |
1,155 |
952 |
$6K |
| 73630 |
|
3,427 |
3,069 |
$6K |
| 73610 |
|
3,227 |
2,948 |
$6K |
| G0283 |
Elec stim other than wound |
213 |
77 |
$6K |
| 76870 |
|
91 |
81 |
$6K |
| 72072 |
|
1,376 |
1,261 |
$6K |
| 20610 |
|
26 |
25 |
$6K |
| 87510 |
|
590 |
566 |
$6K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
174 |
151 |
$6K |
| 73130 |
|
2,564 |
2,235 |
$6K |
| 90715 |
|
266 |
250 |
$6K |
| M0245 |
Bamlan and etesev infusion |
18 |
16 |
$5K |
| 29581 |
|
33 |
24 |
$5K |
| 95819 |
|
30 |
27 |
$5K |
| 86850 |
|
5,641 |
4,971 |
$5K |
| 86900 |
|
9,031 |
7,091 |
$5K |
| 87641 |
|
351 |
321 |
$5K |
| 73502 |
|
1,641 |
1,477 |
$5K |
| 87205 |
|
3,430 |
2,858 |
$5K |
| 20552 |
|
14 |
13 |
$5K |
| 82550 |
|
3,728 |
2,858 |
$5K |
| 87186 |
|
5,425 |
4,793 |
$5K |
| 85007 |
|
6,040 |
4,937 |
$5K |
| 76805 |
|
203 |
192 |
$4K |
| 75574 |
|
27 |
26 |
$4K |
| 96376 |
|
14,541 |
7,960 |
$4K |
| J2405 |
Ondansetron hcl injection |
27,404 |
20,945 |
$4K |
| 81003 |
|
24,644 |
21,703 |
$4K |
| 87480 |
|
590 |
566 |
$4K |
| 87147 |
|
2,301 |
2,070 |
$4K |
| 99495 |
|
28 |
28 |
$3K |
| 87660 |
|
595 |
570 |
$3K |
| 73110 |
|
1,825 |
1,642 |
$3K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
21,294 |
17,860 |
$3K |
| 86901 |
|
9,027 |
7,090 |
$3K |
| 82247 |
|
670 |
387 |
$3K |
| 83550 |
|
2,073 |
1,826 |
$3K |
| 97167 |
|
13 |
13 |
$3K |
| 83970 |
|
285 |
244 |
$3K |
| J7120 |
Ringers lactate infusion |
11,579 |
8,705 |
$3K |
| 93880 |
|
75 |
70 |
$3K |
| 82570 |
|
2,166 |
1,890 |
$3K |
| 85014 |
|
2,052 |
1,501 |
$3K |
| 88142 |
|
179 |
163 |
$3K |
| 83540 |
|
2,257 |
1,986 |
$3K |
| 77334 |
|
31 |
19 |
$3K |
| 90656 |
|
74 |
74 |
$3K |
| 87088 |
|
4,519 |
4,011 |
$3K |
| 87389 |
|
871 |
799 |
$3K |
| 81025 |
|
8,179 |
7,445 |
$2K |
| 72040 |
|
393 |
371 |
$2K |
| 77300 |
|
23 |
18 |
$2K |
| 97165 |
|
49 |
42 |
$2K |
| 84100 |
|
2,865 |
2,028 |
$2K |
| 85651 |
|
1,967 |
1,441 |
$2K |
| 0352U |
|
354 |
337 |
$2K |
| U0002 |
Covid-19 lab test non-cdc |
157 |
143 |
$2K |
| 85652 |
|
1,824 |
1,393 |
$2K |
| 87624 |
|
91 |
85 |
$2K |
| 87807 |
|
5,111 |
4,753 |
$2K |
| 86803 |
|
541 |
494 |
$2K |
| 82746 |
|
1,605 |
1,430 |
$2K |
| 97166 |
|
27 |
26 |
$2K |
| M0239 |
Bamlanivimab-xxxx infusion |
17 |
16 |
$2K |
| 77280 |
|
21 |
13 |
$2K |
| 82947 |
|
2,421 |
2,043 |
$2K |
| 73590 |
|
1,344 |
1,195 |
$2K |
| 80074 |
|
233 |
220 |
$1K |
| J1885 |
Ketorolac tromethamine inj |
18,639 |
13,576 |
$1K |
| M0247 |
Sotrovimab infusion |
15 |
14 |
$1K |
| 85018 |
|
3,110 |
2,322 |
$1K |
| 88173 |
|
126 |
93 |
$1K |
| 82330 |
|
2,643 |
2,144 |
$1K |
| 87426 |
|
3,735 |
3,231 |
$1K |
| 84132 |
|
2,751 |
2,087 |
$1K |
| 87077 |
|
1,062 |
944 |
$1K |
| 82248 |
|
931 |
667 |
$1K |
| 87340 |
|
900 |
820 |
$1K |
| Q0162 |
Ondansetron oral |
2,337 |
1,929 |
$1K |
| 87081 |
|
293 |
274 |
$1K |
| J1756 |
Iron sucrose injection |
84 |
55 |
$1K |
| 82565 |
|
4,109 |
3,858 |
$1K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
173 |
165 |
$1K |
| 73090 |
|
918 |
833 |
$1K |
| J2270 |
Morphine sulfate injection |
12,811 |
8,834 |
$1K |
| 87210 |
|
2,687 |
2,441 |
$1K |
| J1100 |
Dexamethasone sodium phos |
9,032 |
5,698 |
$1K |
| 73080 |
|
627 |
589 |
$984.04 |
| 85730 |
|
3,485 |
2,902 |
$979.63 |
| 80202 |
|
91 |
52 |
$869.75 |
| J1170 |
Hydromorphone injection |
10,491 |
6,561 |
$867.34 |
| 80051 |
|
568 |
452 |
$853.32 |
| 83615 |
|
895 |
702 |
$801.46 |
| J7510 |
Prednisolone oral per 5 mg |
1,552 |
1,454 |
$791.50 |
| J0696 |
Ceftriaxone sodium injection |
9,232 |
6,353 |
$783.35 |
| 86308 |
|
2,481 |
2,317 |
$748.52 |
| 86625 |
|
166 |
148 |
$747.38 |
| S0028 |
Injection, famotidine, 20 mg |
162 |
94 |
$729.10 |
| 71101 |
|
582 |
559 |
$705.04 |
| 82043 |
|
646 |
583 |
$681.59 |
| 84156 |
|
953 |
764 |
$676.28 |
| J2930 |
Methylprednisolone injection |
2,795 |
2,017 |
$599.39 |
| J2250 |
Inj midazolam hydrochloride |
6,238 |
4,355 |
$591.20 |
| 88141 |
|
36 |
36 |
$566.03 |
| J3010 |
Fentanyl citrate injection |
7,473 |
5,621 |
$556.34 |
| 74022 |
|
157 |
138 |
$555.20 |
| 88341 |
|
68 |
63 |
$551.64 |
| J2704 |
Inj, propofol, 10 mg |
10,752 |
8,477 |
$526.49 |
| J2060 |
Lorazepam injection |
4,263 |
3,024 |
$510.11 |
| 82803 |
|
2,077 |
1,690 |
$509.84 |
| 86706 |
|
150 |
130 |
$498.05 |
| G0480 |
Drug test def 1-7 classes |
356 |
288 |
$491.49 |
| 99152 |
|
1,120 |
996 |
$484.68 |
| J7512 |
Prednisone ir or dr oral 1mg |
5,444 |
4,068 |
$478.56 |
| J0131 |
Inj, acetaminophen (nos) |
794 |
681 |
$474.41 |
| 84520 |
|
181 |
155 |
$465.70 |
| 88172 |
|
12 |
12 |
$456.50 |
| A9500 |
Tc99m sestamibi |
1,555 |
1,355 |
$436.39 |
| 86480 |
|
14 |
14 |
$423.47 |
| 88175 |
|
36 |
36 |
$402.64 |
| J3475 |
Inj magnesium sulfate |
3,678 |
2,662 |
$398.83 |
| J1644 |
Inj heparin sodium per 1000u |
3,818 |
1,531 |
$397.99 |
| J7030 |
Normal saline solution infus |
1,229 |
682 |
$397.64 |
| 80164 |
|
53 |
39 |
$389.21 |
| J2765 |
Metoclopramide hcl injection |
1,804 |
1,539 |
$360.41 |
| 87899 |
|
616 |
462 |
$345.07 |
| 94644 |
|
199 |
180 |
$327.43 |
| J0780 |
Prochlorperazine injection |
2,816 |
2,510 |
$325.42 |
| 87116 |
|
16 |
12 |
$317.52 |
| J0692 |
Cefepime hcl for injection |
3,342 |
724 |
$307.58 |
| 73140 |
|
543 |
502 |
$304.59 |
| J2550 |
Promethazine hcl injection |
3,441 |
2,376 |
$298.80 |
| J0690 |
Cefazolin sodium injection |
4,379 |
2,764 |
$294.95 |
| C1751 |
Cath, inf, per/cent/midline |
38 |
35 |
$283.99 |
| 88307 |
|
12 |
12 |
$273.57 |
| 84550 |
|
572 |
467 |
$260.82 |
| 86703 |
|
117 |
96 |
$240.56 |
| 36600 |
|
164 |
139 |
$228.63 |
| 70360 |
|
76 |
70 |
$225.78 |
| 72170 |
|
188 |
171 |
$213.24 |
| 86762 |
|
63 |
58 |
$203.87 |
| J7070 |
D5w infusion |
1,731 |
993 |
$202.46 |
| 73060 |
|
87 |
79 |
$202.15 |
| J1642 |
Inj heparin sodium per 10 u |
4,016 |
1,070 |
$199.94 |
| J3370 |
Vancomycin hcl injection |
2,367 |
973 |
$195.25 |
| 87798 |
|
27 |
27 |
$187.79 |
| 73552 |
|
155 |
139 |
$160.54 |
| 99153 |
Mod sedat endo service >5yrs |
734 |
656 |
$159.77 |
| S0119 |
Ondansetron 4 mg |
238 |
220 |
$159.03 |
| 80307 |
|
25 |
22 |
$157.58 |
| 84295 |
|
719 |
613 |
$154.37 |
| 73560 |
|
15 |
13 |
$150.52 |
| 87045 |
|
182 |
162 |
$146.81 |
| Q0163 |
Diphenhydramine hcl 50mg |
1,572 |
1,214 |
$145.77 |
| J1953 |
Levetiracetam injection |
248 |
139 |
$122.28 |
| J0360 |
Hydralazine hcl injection |
1,781 |
1,275 |
$112.49 |
| C1769 |
Guide wire |
769 |
659 |
$91.41 |
| J2370 |
Phenylephrine hcl injection |
942 |
788 |
$86.33 |
| G1004 |
Cdsm ndsc |
4,018 |
2,801 |
$85.49 |
| J0330 |
Succinycholine chloride inj |
1,088 |
993 |
$83.16 |
| J2001 |
Lidocaine injection |
933 |
753 |
$81.27 |
| J3411 |
Thiamine hcl 100 mg |
816 |
359 |
$79.04 |
| 87102 |
|
48 |
37 |
$73.71 |
| 87181 |
|
74 |
69 |
$69.05 |
| 85384 |
|
170 |
139 |
$66.36 |
| 94664 |
|
391 |
299 |
$60.65 |
| J7050 |
Normal saline solution infus |
464 |
199 |
$57.92 |
| 81015 |
|
544 |
472 |
$55.54 |
| C9113 |
Inj pantoprazole sodium, via |
886 |
387 |
$53.56 |
| J1940 |
Furosemide injection |
799 |
422 |
$48.04 |
| 87075 |
|
20 |
15 |
$46.26 |
| 86038 |
|
12 |
12 |
$46.20 |
| 89051 |
|
37 |
25 |
$37.13 |
| 36416 |
|
40 |
25 |
$35.25 |
| 84481 |
|
17 |
15 |
$34.52 |
| J0456 |
Azithromycin |
263 |
185 |
$33.58 |
| 73070 |
|
27 |
24 |
$30.54 |
| 98960 |
|
18 |
14 |
$29.91 |
| J2785 |
Regadenoson injection |
133 |
98 |
$28.48 |
| 87450 |
|
15 |
14 |
$28.45 |
| J1956 |
Levofloxacin injection |
251 |
138 |
$28.31 |
| 82150 |
|
15 |
12 |
$24.52 |
| J3480 |
Inj potassium chloride |
270 |
168 |
$23.69 |
| 87449 |
|
30 |
24 |
$23.60 |
| 87015 |
|
38 |
28 |
$23.12 |
| J7040 |
Normal saline solution infus |
234 |
113 |
$18.05 |
| J1817 |
Insulin for insulin pump use |
29 |
25 |
$15.34 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
618 |
445 |
$14.61 |
| 85008 |
|
212 |
149 |
$11.00 |
| J7060 |
5% dextrose/water |
50 |
38 |
$9.42 |
| 87324 |
|
12 |
12 |
$8.51 |
| 82435 |
|
85 |
69 |
$7.71 |
| J1790 |
Droperidol injection |
325 |
302 |
$7.70 |
| J2919 |
Inj, methylpred sod succ 5mg |
226 |
174 |
$6.75 |
| J2710 |
Neostigmine methylslfte inj |
40 |
36 |
$6.04 |
| J7620 |
Albuterol ipratrop non-comp |
50 |
34 |
$5.70 |
| J2920 |
Methylprednisolone injection |
74 |
37 |
$4.50 |
| J1815 |
Insulin injection |
36 |
26 |
$4.04 |
| J1630 |
Haloperidol injection |
49 |
38 |
$3.68 |
| J7042 |
5% dextrose/normal saline |
14 |
12 |
$2.88 |
| J3410 |
Hydroxyzine hcl injection |
20 |
13 |
$1.25 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
874 |
697 |
$1.06 |
| J7613 |
Albuterol non-comp unit |
19 |
15 |
$0.46 |
| J1836 |
Inj, metronidazole, 10 mg |
195 |
97 |
$0.25 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
306 |
176 |
$0.15 |
| A9585 |
Gadobutrol injection |
275 |
248 |
$0.00 |
| J1920 |
Inj, labetalol hcl, 5mg |
97 |
86 |
$0.00 |
| A4217 |
Sterile water/saline, 500 ml |
21 |
16 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
53 |
33 |
$0.00 |
| 73660 |
|
13 |
13 |
$0.00 |
| C1889 |
Implant/insert device, noc |
14 |
14 |
$0.00 |
| C1725 |
Cath, translumin non-laser |
14 |
14 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
77 |
70 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
216 |
198 |
$0.00 |
| A4216 |
Sterile water/saline, 10 ml |
34 |
16 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
142 |
122 |
$0.00 |
| G8978 |
Mobility current status |
119 |
85 |
$0.00 |
| G8979 |
Mobility goal status |
156 |
105 |
$0.00 |
| C1887 |
Catheter, guiding |
96 |
89 |
$0.00 |
| J0136 |
Inj, acetaminophen (b braun) |
72 |
69 |
$0.00 |
| Q9950 |
Inj sulf hexa lipid microsph |
43 |
40 |
$0.00 |
| Q9957 |
Inj perflutren lip micros,ml |
44 |
41 |
$0.00 |
| J0153 |
Adenosine inj 1mg |
114 |
105 |
$0.00 |
| 76937 |
|
12 |
12 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
22 |
12 |
$0.00 |
| 51702 |
|
119 |
110 |
$0.00 |
| C1760 |
Closure dev, vasc |
71 |
65 |
$0.00 |
| 85347 |
|
19 |
12 |
$0.00 |
| J0736 |
Inj, clindamycin phosp 300mg |
17 |
13 |
$0.00 |
| 93325 |
|
15 |
12 |
$0.00 |