| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
|
39,111 |
34,300 |
$8.15M |
| 41899 |
|
6,131 |
4,632 |
$7.10M |
| 99283 |
|
42,968 |
37,637 |
$6.24M |
| 74177 |
|
5,145 |
4,542 |
$3.34M |
| 99285 |
|
8,447 |
7,230 |
$2.66M |
| 93306 |
|
7,627 |
6,807 |
$2.52M |
| G0330 |
Facility svs dental rehab |
984 |
907 |
$2.40M |
| 93303 |
|
6,375 |
5,666 |
$2.10M |
| 70450 |
|
5,264 |
4,673 |
$1.35M |
| 99212 |
|
40,057 |
35,809 |
$973K |
| 93320 |
|
7,065 |
6,286 |
$924K |
| 87635 |
|
21,833 |
19,932 |
$917K |
| 93325 |
|
7,311 |
6,485 |
$863K |
| G0378 |
Hospital observation per hr |
4,893 |
4,258 |
$802K |
| 99282 |
|
10,060 |
9,126 |
$706K |
| 74176 |
|
1,196 |
1,082 |
$614K |
| 96374 |
|
16,156 |
13,637 |
$601K |
| 80053 |
|
68,529 |
57,848 |
$579K |
| 93005 |
|
19,034 |
16,036 |
$557K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
787 |
610 |
$546K |
| 85027 |
|
86,782 |
70,418 |
$513K |
| 72125 |
|
1,991 |
1,750 |
$507K |
| 71275 |
|
1,251 |
1,143 |
$500K |
| 43239 |
|
634 |
598 |
$499K |
| 70553 |
|
791 |
669 |
$468K |
| 71260 |
|
1,398 |
1,202 |
$375K |
| 95810 |
|
845 |
799 |
$375K |
| 71046 |
|
6,934 |
6,253 |
$350K |
| 80307 |
|
7,204 |
6,191 |
$332K |
| 96375 |
|
7,095 |
5,219 |
$321K |
| 71045 |
|
7,939 |
7,032 |
$321K |
| 84443 |
|
20,452 |
18,636 |
$316K |
| 97530 |
|
8,977 |
3,866 |
$298K |
| 81229 |
|
392 |
301 |
$296K |
| 78815 |
|
493 |
422 |
$296K |
| 95816 |
|
1,679 |
1,605 |
$289K |
| 82306 |
|
9,428 |
8,818 |
$278K |
| 87801 |
|
5,949 |
5,406 |
$272K |
| 78452 |
|
733 |
651 |
$269K |
| 96360 |
|
2,987 |
2,353 |
$268K |
| 70551 |
|
556 |
467 |
$242K |
| 87798 |
|
8,950 |
8,354 |
$242K |
| 96372 |
|
6,461 |
5,110 |
$238K |
| 88305 |
|
3,468 |
2,865 |
$213K |
| 93017 |
|
1,519 |
1,322 |
$212K |
| 96413 |
|
2,640 |
1,646 |
$206K |
| 74018 |
|
3,591 |
3,290 |
$199K |
| 81220 |
|
520 |
450 |
$193K |
| 87651 |
|
7,066 |
6,671 |
$188K |
| 96376 |
|
3,407 |
2,383 |
$177K |
| 96365 |
|
2,167 |
1,719 |
$169K |
| 69436 |
|
291 |
271 |
$156K |
| 93976 |
|
996 |
884 |
$151K |
| 76705 |
|
1,452 |
1,307 |
$150K |
| 99152 |
|
1,978 |
1,775 |
$148K |
| 96361 |
|
7,057 |
5,586 |
$142K |
| 99153 |
Mod sedat endo service >5yrs |
1,091 |
978 |
$139K |
| 99211 |
|
5,355 |
4,243 |
$136K |
| J1453 |
Fosaprepitant injection |
496 |
292 |
$134K |
| 93922 |
|
3,398 |
2,756 |
$128K |
| 64483 |
|
656 |
581 |
$126K |
| 83036 |
|
13,119 |
12,243 |
$124K |
| 0241U |
|
1,179 |
1,127 |
$124K |
| 36415 |
|
52,130 |
45,039 |
$123K |
| 42820 |
|
140 |
136 |
$121K |
| G0463 |
Hospital outpt clinic visit |
9,789 |
6,639 |
$118K |
| 92507 |
|
4,488 |
2,027 |
$118K |
| 93880 |
|
1,445 |
1,197 |
$116K |
| 93971 |
|
1,128 |
1,008 |
$113K |
| C1769 |
Guide wire |
2,588 |
2,230 |
$113K |
| G0480 |
Drug test def 1-7 classes |
3,084 |
2,580 |
$108K |
| 99213 |
|
3,867 |
2,518 |
$107K |
| 80061 |
|
8,148 |
7,619 |
$95K |
| 87502 |
|
1,732 |
1,585 |
$93K |
| 87086 |
|
12,459 |
11,076 |
$92K |
| 72081 |
|
1,099 |
956 |
$92K |
| Q5104 |
Injection, renflexis |
42 |
39 |
$90K |
| 83880 |
|
3,969 |
3,524 |
$89K |
| 94640 |
|
1,990 |
1,701 |
$88K |
| 59025 |
|
3,259 |
2,404 |
$87K |
| 72170 |
|
1,422 |
1,231 |
$83K |
| 73610 |
|
1,739 |
1,512 |
$81K |
| J0897 |
Denosumab injection |
112 |
91 |
$80K |
| 93970 |
|
548 |
473 |
$79K |
| 87426 |
|
3,845 |
3,379 |
$77K |
| 93351 |
|
272 |
246 |
$74K |
| 73630 |
|
1,529 |
1,376 |
$74K |
| 80048 |
|
11,858 |
9,722 |
$73K |
| 72148 |
|
182 |
149 |
$73K |
| 84484 |
|
10,032 |
8,072 |
$71K |
| 81001 |
|
24,884 |
21,696 |
$70K |
| 86780 |
|
5,224 |
4,745 |
$69K |
| 76830 |
|
781 |
691 |
$66K |
| 73564 |
|
1,214 |
1,065 |
$65K |
| 87389 |
|
2,692 |
2,534 |
$65K |
| 70486 |
|
227 |
199 |
$63K |
| 97165 |
|
2,229 |
2,050 |
$63K |
| 87633 |
|
294 |
270 |
$62K |
| 76817 |
|
674 |
564 |
$61K |
| 29581 |
|
1,873 |
572 |
$61K |
| 84439 |
|
6,323 |
5,949 |
$60K |
| 76700 |
|
406 |
359 |
$58K |
| A9500 |
Tc99m sestamibi |
758 |
674 |
$57K |
| A0431 |
Rotary wing air transport |
616 |
404 |
$54K |
| A9552 |
F18 fdg |
567 |
483 |
$54K |
| 83690 |
|
9,628 |
8,254 |
$54K |
| 73100 |
|
1,132 |
805 |
$53K |
| 44970 |
|
16 |
13 |
$53K |
| 99281 |
|
2,022 |
1,740 |
$52K |
| 97110 |
|
1,912 |
990 |
$52K |
| 92610 |
|
730 |
652 |
$51K |
| 76770 |
|
471 |
419 |
$50K |
| J3490 |
Drugs unclassified injection |
10,139 |
5,944 |
$50K |
| 73502 |
|
736 |
618 |
$50K |
| 92523 |
|
1,250 |
1,159 |
$48K |
| 73030 |
|
1,220 |
1,075 |
$48K |
| 87070 |
|
5,314 |
4,886 |
$48K |
| C1894 |
Intro/sheath, non-laser |
1,856 |
1,539 |
$47K |
| 77067 |
|
1,133 |
1,077 |
$47K |
| 73130 |
|
1,024 |
916 |
$47K |
| 73090 |
|
1,142 |
821 |
$47K |
| 82728 |
|
3,590 |
3,285 |
$46K |
| 86850 |
|
4,925 |
4,104 |
$46K |
| 88307 |
|
513 |
414 |
$46K |
| 87653 |
|
1,855 |
1,650 |
$44K |
| 84466 |
|
3,397 |
3,147 |
$44K |
| 73110 |
|
765 |
675 |
$44K |
| 96417 |
|
594 |
395 |
$43K |
| 96131 |
|
882 |
723 |
$42K |
| 36902 |
|
103 |
98 |
$41K |
| 12001 |
|
341 |
308 |
$41K |
| 77334 |
|
144 |
93 |
$40K |
| 84703 |
|
5,385 |
4,769 |
$40K |
| 97161 |
|
1,465 |
1,351 |
$40K |
| 76642 |
|
972 |
828 |
$40K |
| 87077 |
|
4,719 |
4,260 |
$40K |
| 0240U |
|
644 |
624 |
$39K |
| 87186 |
|
4,591 |
4,152 |
$39K |
| 94010 |
|
1,436 |
1,398 |
$38K |
| 83735 |
|
7,427 |
5,922 |
$37K |
| 73560 |
|
860 |
693 |
$37K |
| 81025 |
|
5,917 |
5,143 |
$37K |
| 93458 |
|
15 |
15 |
$36K |
| 82607 |
|
2,950 |
2,726 |
$36K |
| 86803 |
|
2,768 |
2,494 |
$35K |
| 73590 |
|
1,001 |
779 |
$35K |
| 96367 |
|
686 |
418 |
$32K |
| 86703 |
|
2,962 |
2,641 |
$32K |
| C1776 |
Joint device (implantable) |
20 |
13 |
$31K |
| 73080 |
|
606 |
519 |
$31K |
| J2785 |
Regadenoson injection |
459 |
424 |
$30K |
| 76942 |
|
306 |
249 |
$30K |
| 82784 |
|
2,274 |
2,137 |
$30K |
| 87591 |
|
1,096 |
1,020 |
$30K |
| 87491 |
|
1,095 |
1,019 |
$30K |
| 97162 |
|
1,128 |
1,015 |
$29K |
| 72100 |
|
821 |
744 |
$29K |
| C1725 |
Cath, translumin non-laser |
449 |
402 |
$28K |
| 85610 |
|
9,309 |
6,542 |
$27K |
| J2323 |
Natalizumab injection |
13 |
12 |
$27K |
| 83605 |
|
3,339 |
2,826 |
$26K |
| 76937 |
|
845 |
751 |
$26K |
| A0436 |
Rotary wing air mileage |
615 |
404 |
$26K |
| 83540 |
|
3,987 |
3,692 |
$26K |
| 86140 |
|
4,762 |
4,229 |
$25K |
| 12011 |
|
208 |
187 |
$24K |
| 99214 |
|
714 |
580 |
$23K |
| 96112 |
|
460 |
427 |
$23K |
| 73070 |
|
510 |
393 |
$22K |
| 76816 |
|
303 |
267 |
$22K |
| 10060 |
|
116 |
101 |
$21K |
| 86762 |
|
1,510 |
1,333 |
$21K |
| 87040 |
|
2,190 |
1,723 |
$21K |
| 77073 |
|
534 |
486 |
$20K |
| 87661 |
|
940 |
861 |
$20K |
| 73552 |
|
508 |
439 |
$20K |
| 87340 |
|
2,196 |
1,986 |
$20K |
| 83516 |
|
1,436 |
1,350 |
$19K |
| 77336 |
|
363 |
160 |
$19K |
| 73140 |
|
488 |
403 |
$19K |
| 88304 |
|
513 |
460 |
$18K |
| U0002 |
Covid-19 lab test non-cdc |
525 |
391 |
$18K |
| 96415 |
|
934 |
684 |
$18K |
| 96130 |
|
908 |
734 |
$17K |
| 29065 |
|
435 |
320 |
$17K |
| 84702 |
|
2,141 |
1,509 |
$17K |
| 82746 |
|
1,411 |
1,302 |
$17K |
| 77300 |
|
97 |
81 |
$16K |
| 82951 |
|
1,205 |
1,099 |
$16K |
| 87634 |
|
801 |
730 |
$16K |
| 83970 |
|
452 |
399 |
$16K |
| 80050 |
|
1,398 |
1,339 |
$15K |
| 97166 |
|
599 |
544 |
$15K |
| 80074 |
|
323 |
297 |
$15K |
| 87522 |
Neg quan hep c or qual rna |
492 |
445 |
$15K |
| 86738 |
|
857 |
812 |
$15K |
| 36430 |
|
125 |
84 |
$15K |
| 84403 |
|
549 |
510 |
$15K |
| 99202 |
|
467 |
451 |
$14K |
| 85730 |
|
3,070 |
2,679 |
$13K |
| 87880 |
|
1,102 |
1,032 |
$13K |
| 77072 |
|
337 |
312 |
$13K |
| 80164 |
|
1,059 |
939 |
$13K |
| 86901 |
|
5,262 |
4,376 |
$13K |
| 86900 |
|
5,261 |
4,376 |
$13K |
| 77066 |
Tomosynthesis, mammo |
463 |
418 |
$13K |
| 72141 |
|
32 |
30 |
$12K |
| 88342 |
|
412 |
365 |
$12K |
| 71250 |
|
172 |
133 |
$12K |
| 85379 |
|
1,576 |
1,424 |
$11K |
| C1887 |
Catheter, guiding |
207 |
180 |
$11K |
| G0379 |
Direct refer hospital observ |
94 |
82 |
$11K |
| 84146 |
|
531 |
504 |
$11K |
| 87210 |
|
2,684 |
2,362 |
$11K |
| 96366 |
|
544 |
371 |
$10K |
| 99406 |
|
1,016 |
863 |
$10K |
| 90471 |
|
828 |
731 |
$10K |
| 86923 |
|
130 |
102 |
$10K |
| 87205 |
|
2,595 |
2,350 |
$10K |
| 83001 |
|
514 |
475 |
$10K |
| 90834 |
|
617 |
562 |
$9K |
| 92567 |
|
442 |
400 |
$9K |
| 88341 |
|
114 |
104 |
$9K |
| 90847 |
|
1,504 |
1,193 |
$9K |
| 87449 |
|
622 |
556 |
$8K |
| 82077 |
|
2,667 |
2,241 |
$8K |
| 86038 |
|
677 |
617 |
$8K |
| C1751 |
Cath, inf, per/cent/midline |
599 |
534 |
$8K |
| 76818 |
|
108 |
73 |
$8K |
| 87581 |
|
294 |
270 |
$8K |
| 87486 |
|
294 |
270 |
$8K |
| 83002 |
|
378 |
351 |
$8K |
| 86304 |
|
534 |
422 |
$8K |
| 82565 |
|
2,093 |
1,754 |
$8K |
| 82670 |
|
301 |
275 |
$7K |
| 87427 |
|
469 |
360 |
$7K |
| 81243 |
|
183 |
146 |
$7K |
| 29075 |
|
483 |
363 |
$7K |
| G0279 |
Tomosynthesis, mammo |
1,901 |
1,747 |
$7K |
| 87075 |
|
809 |
708 |
$7K |
| 82140 |
|
576 |
476 |
$7K |
| 72050 |
|
84 |
69 |
$7K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
2,459 |
2,230 |
$7K |
| 85652 |
|
2,649 |
2,381 |
$7K |
| 88185 |
|
18 |
14 |
$6K |
| 80076 |
|
910 |
841 |
$6K |
| 96137 |
|
618 |
510 |
$6K |
| 85651 |
|
1,702 |
1,519 |
$6K |
| J3010 |
Fentanyl citrate injection |
3,021 |
2,817 |
$6K |
| 80177 |
|
467 |
418 |
$6K |
| 96040 |
|
873 |
664 |
$6K |
| 74230 |
|
89 |
81 |
$6K |
| 12002 |
|
42 |
39 |
$6K |
| 95819 |
|
43 |
42 |
$6K |
| 82550 |
|
982 |
842 |
$6K |
| 76870 |
|
72 |
65 |
$6K |
| J2795 |
Ropivacaine hcl injection |
237 |
223 |
$6K |
| 86364 |
|
937 |
903 |
$6K |
| 84436 |
|
901 |
832 |
$5K |
| 82533 |
|
285 |
259 |
$5K |
| 95782 |
|
12 |
12 |
$5K |
| 82330 |
|
598 |
519 |
$5K |
| 84270 |
|
193 |
182 |
$5K |
| 45385 |
|
15 |
15 |
$5K |
| 77290 |
|
15 |
12 |
$5K |
| Q9957 |
Inj perflutren lip micros,ml |
115 |
112 |
$5K |
| 87116 |
|
402 |
367 |
$5K |
| 82274 |
|
274 |
262 |
$5K |
| 77001 |
|
109 |
103 |
$4K |
| 84100 |
|
1,274 |
993 |
$4K |
| 90791 |
|
185 |
161 |
$4K |
| 36591 |
|
100 |
69 |
$4K |
| 82043 |
|
827 |
779 |
$4K |
| 84156 |
|
1,170 |
932 |
$4K |
| 84305 |
|
264 |
253 |
$4K |
| 84481 |
|
261 |
240 |
$4K |
| 82947 |
|
1,229 |
1,152 |
$4K |
| 82570 |
|
878 |
825 |
$4K |
| 86665 |
|
148 |
119 |
$4K |
| 87046 |
|
386 |
360 |
$4K |
| 82247 |
|
831 |
575 |
$4K |
| 82977 |
|
709 |
661 |
$4K |
| 80178 |
|
574 |
496 |
$4K |
| 82105 |
|
274 |
228 |
$4K |
| C1768 |
Graft, vascular |
75 |
61 |
$4K |
| 97116 |
|
488 |
303 |
$4K |
| 87045 |
|
383 |
360 |
$4K |
| 85049 |
|
976 |
735 |
$4K |
| 92579 |
|
215 |
197 |
$4K |
| 73060 |
|
110 |
90 |
$4K |
| 99215 |
Prolong outpt/office vis |
70 |
52 |
$4K |
| 87102 |
|
404 |
366 |
$4K |
| 96136 |
|
833 |
698 |
$4K |
| 86300 |
|
96 |
87 |
$4K |
| 85046 |
|
577 |
502 |
$4K |
| 87641 |
|
300 |
254 |
$3K |
| 80069 |
|
493 |
424 |
$3K |
| 84112 |
|
52 |
45 |
$3K |
| 86039 |
|
299 |
272 |
$3K |
| J2704 |
Inj, propofol, 10 mg |
2,304 |
2,132 |
$3K |
| 96127 |
|
3,679 |
3,550 |
$3K |
| 83655 |
|
281 |
258 |
$3K |
| 71101 |
|
49 |
40 |
$3K |
| 76805 |
|
31 |
26 |
$3K |
| 82375 |
|
356 |
319 |
$3K |
| 96110 |
|
622 |
596 |
$3K |
| 87015 |
|
376 |
342 |
$3K |
| 76885 |
|
148 |
112 |
$3K |
| 82677 |
|
146 |
119 |
$3K |
| 86787 |
|
209 |
178 |
$3K |
| 82248 |
|
913 |
757 |
$3K |
| 82150 |
|
406 |
379 |
$3K |
| 86376 |
|
168 |
161 |
$3K |
| 74240 |
|
13 |
13 |
$3K |
| 49083 |
|
26 |
14 |
$3K |
| 77075 |
|
14 |
12 |
$2K |
| 84153 |
|
168 |
151 |
$2K |
| 87206 |
|
402 |
367 |
$2K |
| 83615 |
|
444 |
370 |
$2K |
| 86336 |
|
166 |
136 |
$2K |
| 92611 |
|
43 |
39 |
$2K |
| 86003 |
|
49 |
37 |
$2K |
| 82010 |
|
292 |
244 |
$2K |
| 97163 |
|
126 |
107 |
$2K |
| P9016 |
Rbc leukocytes reduced |
16 |
15 |
$2K |
| 87329 |
|
160 |
153 |
$2K |
| 93926 |
|
65 |
54 |
$2K |
| 72131 |
|
15 |
14 |
$2K |
| 74019 |
|
48 |
41 |
$2K |
| 87804 |
|
75 |
57 |
$2K |
| 81003 |
|
869 |
792 |
$2K |
| 83050 |
|
354 |
318 |
$2K |
| 84402 |
|
59 |
58 |
$2K |
| 87147 |
|
352 |
323 |
$2K |
| 87328 |
|
141 |
135 |
$2K |
| 86431 |
|
324 |
295 |
$2K |
| 29125 |
|
26 |
24 |
$2K |
| 92228 |
|
99 |
55 |
$2K |
| 76820 |
|
21 |
15 |
$2K |
| 86800 |
|
90 |
87 |
$2K |
| 83993 |
|
71 |
67 |
$2K |
| 83021 |
|
89 |
82 |
$2K |
| 86706 |
|
150 |
136 |
$2K |
| 85018 |
|
904 |
704 |
$2K |
| 74022 |
|
29 |
26 |
$2K |
| 84450 |
|
855 |
665 |
$1K |
| 72072 |
|
29 |
25 |
$1K |
| 82803 |
|
108 |
96 |
$1K |
| 76380 |
|
13 |
12 |
$1K |
| 82024 |
|
33 |
28 |
$1K |
| 88313 |
|
13 |
12 |
$1K |
| 73620 |
|
44 |
25 |
$1K |
| 97167 |
|
60 |
55 |
$1K |
| 87640 |
|
102 |
86 |
$1K |
| 84132 |
|
907 |
734 |
$1K |
| 96411 |
|
60 |
28 |
$1K |
| 93978 |
|
26 |
25 |
$1K |
| 87081 |
|
158 |
155 |
$1K |
| 84425 |
|
71 |
59 |
$1K |
| S9480 |
Intensive outpatient psychia |
92 |
91 |
$1K |
| A9270 |
Non-covered item or service |
340 |
179 |
$999.85 |
| 87338 |
|
61 |
61 |
$991.98 |
| 95886 |
|
13 |
13 |
$982.94 |
| 82627 |
|
38 |
37 |
$977.36 |
| 99170 |
|
53 |
53 |
$968.45 |
| 76377 |
|
27 |
25 |
$955.32 |
| 84550 |
|
357 |
320 |
$937.73 |
| 96523 |
|
48 |
31 |
$887.01 |
| 88142 |
|
43 |
40 |
$877.90 |
| 88184 |
|
19 |
15 |
$834.86 |
| 96368 |
|
24 |
14 |
$828.59 |
| 92586 |
|
13 |
12 |
$808.51 |
| C2617 |
Stent, non-cor, tem w/o del |
12 |
12 |
$774.22 |
| 86361 |
|
28 |
27 |
$759.07 |
| 97112 |
|
105 |
54 |
$756.84 |
| 76825 |
|
18 |
13 |
$697.05 |
| J1642 |
Inj heparin sodium per 10 u |
40 |
20 |
$696.12 |
| 62321 |
|
12 |
12 |
$693.80 |
| G0008 |
Admin influenza virus vac |
47 |
40 |
$625.81 |
| 80143 |
|
342 |
316 |
$613.77 |
| 82785 |
|
39 |
36 |
$581.80 |
| 77065 |
Tomosynthesis, mammo |
30 |
26 |
$569.78 |
| 76827 |
|
18 |
13 |
$535.23 |
| 81002 |
|
192 |
166 |
$503.86 |
| 94664 |
|
34 |
31 |
$484.01 |
| 73000 |
|
19 |
15 |
$466.51 |
| 87324 |
|
42 |
41 |
$438.34 |
| 83498 |
|
12 |
12 |
$426.36 |
| 80183 |
|
29 |
27 |
$379.94 |
| 83883 |
|
31 |
25 |
$371.64 |
| 82040 |
|
140 |
115 |
$365.29 |
| J1100 |
Dexamethasone sodium phos |
1,278 |
1,200 |
$349.07 |
| 93990 |
|
16 |
16 |
$344.57 |
| 86258 |
|
38 |
37 |
$337.97 |
| J7999 |
Compounded drug, noc |
339 |
318 |
$329.07 |
| 80179 |
|
301 |
282 |
$326.78 |
| 85014 |
|
209 |
151 |
$308.50 |
| 86708 |
|
29 |
24 |
$293.36 |
| 87624 |
|
13 |
12 |
$287.10 |
| 82378 |
|
14 |
13 |
$260.04 |
| 84165 |
|
41 |
37 |
$245.01 |
| J1885 |
Ketorolac tromethamine inj |
1,351 |
1,150 |
$242.31 |
| 82106 |
|
13 |
13 |
$241.45 |
| 82310 |
|
108 |
85 |
$230.67 |
| 87252 |
|
15 |
15 |
$223.30 |
| 83520 |
|
12 |
12 |
$203.28 |
| 29705 |
|
18 |
18 |
$194.14 |
| J7050 |
Normal saline solution infus |
1,042 |
793 |
$188.80 |
| J2060 |
Lorazepam injection |
70 |
53 |
$180.56 |
| 82397 |
|
17 |
12 |
$172.80 |
| 86200 |
|
14 |
13 |
$148.13 |
| J1170 |
Hydromorphone injection |
651 |
531 |
$135.99 |
| 86308 |
|
26 |
24 |
$135.45 |
| 86880 |
|
29 |
25 |
$109.83 |
| J2250 |
Inj midazolam hydrochloride |
1,523 |
1,399 |
$108.97 |
| J2270 |
Morphine sulfate injection |
499 |
415 |
$99.62 |
| 84460 |
|
264 |
244 |
$92.41 |
| J0690 |
Cefazolin sodium injection |
840 |
720 |
$87.27 |
| 11719 |
|
16 |
12 |
$84.54 |
| J2405 |
Ondansetron hcl injection |
2,169 |
1,869 |
$82.93 |
| A6253 |
Absorpt drg > 48 sq in w/o b |
737 |
572 |
$73.58 |
| 88311 |
|
25 |
15 |
$56.52 |
| J0330 |
Succinycholine chloride inj |
126 |
111 |
$55.47 |
| A9585 |
Gadobutrol injection |
67 |
56 |
$53.80 |
| J2001 |
Lidocaine injection |
389 |
333 |
$53.42 |
| 84295 |
|
73 |
51 |
$51.43 |
| 92587 |
|
44 |
40 |
$49.75 |
| 90715 |
|
14 |
12 |
$46.80 |
| A6222 |
Gauze <=16 in no w/sal w/o b |
129 |
67 |
$43.91 |
| 95012 |
|
14 |
12 |
$40.70 |
| J2710 |
Neostigmine methylslfte inj |
13 |
12 |
$23.93 |
| J1644 |
Inj heparin sodium per 1000u |
313 |
250 |
$22.14 |
| J3475 |
Inj magnesium sulfate |
81 |
56 |
$19.33 |
| J1815 |
Insulin injection |
68 |
44 |
$11.85 |
| J7030 |
Normal saline solution infus |
30 |
18 |
$10.14 |
| J1200 |
Diphenhydramine hcl injectio |
99 |
78 |
$6.26 |
| J0696 |
Ceftriaxone sodium injection |
60 |
47 |
$6.10 |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
17 |
15 |
$5.50 |
| J2370 |
Phenylephrine hcl injection |
138 |
120 |
$5.34 |
| J7512 |
Prednisone ir or dr oral 1mg |
16 |
13 |
$2.16 |
| J2765 |
Metoclopramide hcl injection |
16 |
12 |
$1.67 |
| J1630 |
Haloperidol injection |
19 |
12 |
$1.45 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
15 |
15 |
$0.73 |
| G1004 |
Cdsm ndsc |
924 |
891 |
$0.00 |
| 81329 |
|
56 |
50 |
$0.00 |
| G0476 |
Hpv combo assay ca screen |
28 |
24 |
$0.00 |
| 83631 |
|
19 |
14 |
$0.00 |
| C9399 |
Unclassified drugs or biolog |
25 |
25 |
$0.00 |
| G0145 |
Scr c/v cyto,thinlayer,rescr |
112 |
95 |
$0.00 |