| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90791 |
|
13,009 |
11,740 |
$13.13M |
| 99283 |
|
56,088 |
53,442 |
$9.77M |
| G0378 |
Hospital observation per hr |
12,354 |
11,105 |
$7.40M |
| 99213 |
|
52,323 |
48,476 |
$6.75M |
| 99284 |
|
36,146 |
33,649 |
$5.74M |
| 99214 |
|
34,669 |
33,022 |
$4.94M |
| 99282 |
|
18,610 |
18,110 |
$3.18M |
| 99391 |
|
18,629 |
17,250 |
$2.22M |
| 99392 |
|
17,699 |
17,673 |
$1.83M |
| 96110 |
|
14,437 |
13,706 |
$1.65M |
| 74177 |
|
8,863 |
8,598 |
$1.51M |
| 96365 |
|
9,598 |
8,504 |
$1.46M |
| 93975 |
|
4,784 |
4,623 |
$1.46M |
| 99285 |
|
8,708 |
8,454 |
$1.41M |
| 99393 |
|
12,574 |
12,545 |
$1.40M |
| 70450 |
|
7,491 |
7,252 |
$1.32M |
| 43239 |
|
2,476 |
2,468 |
$1.29M |
| 80048 |
|
91,522 |
68,105 |
$1.23M |
| 99212 |
|
8,805 |
6,307 |
$1.13M |
| 76856 |
|
3,284 |
3,214 |
$1.11M |
| 97110 |
|
11,142 |
3,547 |
$1.10M |
| 96415 |
|
2,127 |
1,731 |
$983K |
| 99394 |
|
7,844 |
7,828 |
$936K |
| U0004 |
Cov-19 test non-cdc hgh thru |
13,156 |
12,153 |
$911K |
| G0463 |
Hospital outpt clinic visit |
8,723 |
8,001 |
$881K |
| S9485 |
Crisis intervention mental h |
635 |
625 |
$792K |
| 99244 |
|
4,707 |
4,681 |
$785K |
| 96361 |
|
4,288 |
3,779 |
$772K |
| 96413 |
|
5,206 |
3,353 |
$734K |
| 45380 |
|
1,137 |
1,136 |
$731K |
| J1745 |
Infliximab not biosimil 10mg |
308 |
291 |
$688K |
| 99215 |
Prolong outpt/office vis |
4,015 |
3,875 |
$679K |
| 92552 |
|
9,007 |
8,945 |
$654K |
| 70553 |
|
1,572 |
1,535 |
$636K |
| 95810 |
|
864 |
783 |
$577K |
| 45385 |
|
754 |
751 |
$552K |
| 93303 |
|
2,028 |
1,965 |
$548K |
| 80076 |
|
56,103 |
47,057 |
$532K |
| 80307 |
|
13,882 |
11,537 |
$530K |
| G0439 |
Ppps, subseq visit |
5,037 |
4,949 |
$507K |
| 93306 |
|
2,194 |
2,091 |
$492K |
| J9271 |
Inj pembrolizumab |
73 |
56 |
$479K |
| 99281 |
|
2,732 |
2,665 |
$466K |
| 86850 |
|
19,930 |
16,981 |
$460K |
| 76815 |
|
6,181 |
5,338 |
$439K |
| 99204 |
|
2,669 |
2,658 |
$424K |
| 45378 |
|
519 |
519 |
$401K |
| 71275 |
|
2,087 |
2,060 |
$380K |
| 70551 |
|
1,443 |
1,412 |
$361K |
| 76770 |
|
1,340 |
1,298 |
$361K |
| 86901 |
|
20,663 |
17,336 |
$346K |
| 93970 |
|
821 |
807 |
$345K |
| 74176 |
|
2,012 |
1,949 |
$342K |
| 99395 |
|
2,686 |
2,684 |
$342K |
| 59025 |
|
2,274 |
1,980 |
$333K |
| 87635 |
|
7,847 |
7,475 |
$328K |
| Q5103 |
Injection, inflectra |
320 |
301 |
$317K |
| 96360 |
|
1,796 |
1,577 |
$300K |
| U0005 |
Infec agen detec ampli probe |
12,931 |
11,947 |
$298K |
| 92550 |
|
4,004 |
3,981 |
$252K |
| 86900 |
|
20,695 |
17,363 |
$252K |
| 99245 |
|
1,338 |
1,331 |
$250K |
| 41899 |
|
231 |
228 |
$243K |
| 96366 |
|
1,433 |
1,165 |
$238K |
| H0037 |
Comm psy sup tx pgm per diem |
449 |
417 |
$236K |
| 96367 |
|
2,326 |
1,818 |
$227K |
| P9040 |
Rbc leukoreduced irradiated |
528 |
351 |
$221K |
| 92587 |
|
4,564 |
4,532 |
$218K |
| 88305 |
|
7,928 |
7,701 |
$216K |
| 99203 |
|
1,478 |
1,476 |
$213K |
| 70496 |
|
1,221 |
1,213 |
$209K |
| 95004 |
|
1,029 |
1,005 |
$189K |
| 12011 |
|
612 |
608 |
$187K |
| 36430 |
|
1,033 |
619 |
$186K |
| 97161 |
|
1,448 |
1,439 |
$183K |
| 76705 |
|
4,627 |
4,506 |
$174K |
| 95813 |
|
523 |
506 |
$169K |
| 97140 |
|
5,281 |
1,746 |
$151K |
| 99381 |
|
1,233 |
1,221 |
$151K |
| 36415 |
|
26,099 |
20,216 |
$148K |
| 44970 |
|
68 |
68 |
$145K |
| 71260 |
|
1,516 |
1,484 |
$141K |
| 77067 |
|
1,305 |
1,284 |
$131K |
| 69436 |
|
116 |
115 |
$125K |
| 99243 |
|
813 |
813 |
$123K |
| 42820 |
|
92 |
92 |
$122K |
| 92012 |
|
741 |
663 |
$120K |
| 85025 |
|
78,639 |
63,578 |
$119K |
| 96374 |
|
20,207 |
18,626 |
$116K |
| 93325 |
|
2,816 |
2,672 |
$116K |
| 95816 |
|
483 |
474 |
$115K |
| 99205 |
Prolong outpt/office vis |
612 |
612 |
$113K |
| 72082 |
|
1,486 |
1,421 |
$109K |
| 92014 |
|
625 |
610 |
$109K |
| 87633 |
|
2,602 |
2,565 |
$107K |
| 73564 |
|
2,510 |
1,963 |
$104K |
| 88185 |
|
605 |
522 |
$100K |
| 0223U |
|
5,590 |
5,551 |
$99K |
| 83880 |
|
4,421 |
4,194 |
$98K |
| 99383 |
|
716 |
715 |
$98K |
| 92555 |
|
1,704 |
1,682 |
$95K |
| 82306 |
|
3,920 |
3,872 |
$94K |
| 73610 |
|
4,516 |
4,019 |
$92K |
| 12001 |
|
328 |
326 |
$92K |
| 86618 |
|
4,964 |
4,926 |
$91K |
| 87491 |
|
5,456 |
5,351 |
$88K |
| 73630 |
|
4,394 |
3,768 |
$87K |
| 92557 |
|
1,688 |
1,676 |
$85K |
| 93005 |
|
23,355 |
22,151 |
$85K |
| 96372 |
|
7,207 |
5,594 |
$84K |
| 97162 |
|
735 |
727 |
$84K |
| 92004 |
|
436 |
434 |
$83K |
| 94060 |
|
378 |
358 |
$81K |
| 96375 |
|
17,150 |
14,709 |
$77K |
| 76641 |
|
1,242 |
798 |
$76K |
| 71250 |
|
978 |
963 |
$75K |
| 87624 |
|
2,845 |
2,836 |
$75K |
| 92579 |
|
1,581 |
1,554 |
$74K |
| U0001 |
2019-ncov diagnostic p |
2,412 |
2,310 |
$73K |
| 86617 |
|
4,358 |
4,331 |
$72K |
| 85610 |
|
19,276 |
16,858 |
$71K |
| G0438 |
Ppps, initial visit |
417 |
416 |
$70K |
| 87591 |
|
5,469 |
5,365 |
$69K |
| 76817 |
|
1,513 |
1,394 |
$68K |
| C8929 |
Tte w or wo fol wcon,doppler |
294 |
294 |
$67K |
| 96132 |
|
664 |
532 |
$66K |
| J1569 |
Gammagard liquid injection |
67 |
36 |
$64K |
| 92567 |
|
1,213 |
1,206 |
$63K |
| 73110 |
|
3,014 |
2,590 |
$61K |
| 97010 |
|
5,054 |
1,747 |
$60K |
| 88342 |
|
1,811 |
1,738 |
$60K |
| 92556 |
|
1,369 |
1,365 |
$60K |
| 97535 |
|
1,791 |
1,478 |
$59K |
| 99173 |
|
2,491 |
2,489 |
$58K |
| 36591 |
|
1,292 |
931 |
$57K |
| 99396 |
|
384 |
382 |
$57K |
| 99384 |
|
393 |
392 |
$56K |
| 96116 |
|
312 |
282 |
$55K |
| 94640 |
|
5,486 |
4,955 |
$55K |
| 93320 |
|
1,970 |
1,907 |
$55K |
| 88307 |
|
906 |
889 |
$54K |
| 96127 |
|
10,463 |
10,231 |
$53K |
| 87651 |
|
2,677 |
2,660 |
$51K |
| 82728 |
|
5,053 |
4,753 |
$50K |
| H0049 |
Alcohol/drug screening |
2,057 |
2,001 |
$50K |
| 73030 |
|
2,874 |
2,585 |
$50K |
| G0123 |
Screen cerv/vag thin layer |
3,091 |
3,087 |
$50K |
| 75574 |
|
245 |
245 |
$50K |
| 0202U |
|
8,683 |
8,559 |
$50K |
| 70491 |
|
230 |
221 |
$49K |
| 99385 |
|
351 |
351 |
$48K |
| 87086 |
|
20,660 |
19,423 |
$47K |
| 77336 |
|
220 |
88 |
$46K |
| 93017 |
|
365 |
365 |
$45K |
| G0480 |
Drug test def 1-7 classes |
1,918 |
1,421 |
$44K |
| 87536 |
|
501 |
493 |
$44K |
| 76000 |
|
373 |
368 |
$43K |
| 86480 |
|
857 |
855 |
$43K |
| 93971 |
|
1,082 |
1,046 |
$42K |
| 92582 |
|
598 |
592 |
$41K |
| 86923 |
|
1,354 |
878 |
$41K |
| 73130 |
|
2,622 |
2,292 |
$41K |
| 96409 |
|
456 |
264 |
$40K |
| 70486 |
|
1,042 |
1,027 |
$39K |
| 92610 |
|
319 |
319 |
$38K |
| 88304 |
|
2,321 |
2,300 |
$38K |
| 10060 |
|
160 |
159 |
$38K |
| 76825 |
|
235 |
224 |
$38K |
| 83735 |
|
32,227 |
23,195 |
$37K |
| 41800 |
|
649 |
639 |
$37K |
| 95700 |
|
434 |
424 |
$37K |
| 84702 |
|
20,834 |
19,346 |
$37K |
| 88108 |
|
1,596 |
1,414 |
$37K |
| 72170 |
|
1,503 |
1,438 |
$36K |
| 80061 |
|
5,252 |
5,113 |
$36K |
| 72100 |
|
762 |
742 |
$36K |
| 81513 |
|
812 |
808 |
$36K |
| 86360 |
|
800 |
790 |
$36K |
| 73590 |
|
2,563 |
2,260 |
$36K |
| 70544 |
|
132 |
132 |
$35K |
| 97530 |
|
269 |
108 |
$35K |
| 96136 |
|
349 |
313 |
$35K |
| 73080 |
|
2,264 |
2,063 |
$35K |
| D7111 |
|
248 |
245 |
$35K |
| 82784 |
|
2,223 |
2,040 |
$34K |
| 84443 |
|
13,919 |
13,391 |
$34K |
| 73502 |
|
1,565 |
1,492 |
$33K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
661 |
655 |
$32K |
| 76700 |
|
127 |
126 |
$32K |
| 81001 |
|
33,256 |
31,188 |
$31K |
| 70498 |
|
1,124 |
1,114 |
$31K |
| 71046 |
|
7,572 |
7,387 |
$31K |
| 80053 |
|
3,022 |
2,939 |
$31K |
| 73090 |
|
2,306 |
1,957 |
$31K |
| 84466 |
|
3,103 |
3,030 |
$31K |
| 85730 |
|
17,885 |
16,057 |
$31K |
| J1439 |
Inj ferric carboxymaltos 1mg |
58 |
37 |
$30K |
| 87481 |
|
850 |
845 |
$30K |
| 96137 |
|
349 |
313 |
$29K |
| 83970 |
|
725 |
639 |
$28K |
| 77063 |
|
1,174 |
1,153 |
$27K |
| 82378 |
|
2,198 |
1,666 |
$27K |
| 73140 |
|
914 |
811 |
$27K |
| 85027 |
|
14,962 |
12,916 |
$26K |
| 82607 |
|
2,727 |
2,686 |
$26K |
| 97802 |
|
394 |
394 |
$26K |
| 72125 |
|
2,533 |
2,485 |
$25K |
| 87799 |
|
552 |
379 |
$25K |
| 76830 |
|
2,171 |
2,123 |
$24K |
| P9016 |
Rbc leukocytes reduced |
46 |
38 |
$23K |
| 90715 |
|
1,351 |
1,350 |
$23K |
| 88341 |
|
832 |
804 |
$23K |
| 96417 |
|
503 |
314 |
$23K |
| 73562 |
|
2,638 |
2,349 |
$22K |
| 80069 |
|
2,448 |
1,575 |
$22K |
| 87631 |
|
605 |
604 |
$21K |
| 87497 |
|
810 |
535 |
$21K |
| 83615 |
|
6,475 |
5,008 |
$21K |
| 94727 |
|
394 |
374 |
$20K |
| 87661 |
|
990 |
985 |
$20K |
| 72081 |
|
375 |
355 |
$20K |
| 71045 |
|
12,757 |
12,108 |
$19K |
| 83036 |
|
5,558 |
5,535 |
$19K |
| 93458 |
|
12 |
12 |
$19K |
| 82746 |
|
2,241 |
2,212 |
$18K |
| 84100 |
|
29,398 |
21,528 |
$18K |
| 86359 |
|
814 |
804 |
$18K |
| 78452 |
|
28 |
28 |
$18K |
| 77073 |
|
412 |
393 |
$18K |
| 95811 |
|
26 |
26 |
$17K |
| 74174 |
|
137 |
135 |
$17K |
| 90471 |
|
2,809 |
2,789 |
$17K |
| 83020 |
|
1,377 |
1,142 |
$16K |
| 76818 |
|
418 |
391 |
$16K |
| 94729 |
|
415 |
395 |
$16K |
| 87798 |
|
556 |
539 |
$16K |
| 88184 |
|
525 |
446 |
$16K |
| 83540 |
|
3,476 |
3,397 |
$15K |
| 92551 |
|
483 |
483 |
$15K |
| J1756 |
Iron sucrose injection |
370 |
132 |
$15K |
| 54161 |
|
13 |
13 |
$15K |
| 87507 |
|
248 |
246 |
$14K |
| 86300 |
|
892 |
654 |
$14K |
| 73552 |
|
1,086 |
982 |
$14K |
| 29125 |
|
94 |
93 |
$14K |
| 73560 |
|
634 |
548 |
$14K |
| 72148 |
|
82 |
81 |
$14K |
| J3010 |
Fentanyl citrate injection |
4,462 |
4,331 |
$14K |
| 91065 |
|
164 |
157 |
$14K |
| 52356 |
|
12 |
12 |
$14K |
| 64400 |
|
44 |
44 |
$13K |
| 85045 |
|
4,794 |
4,141 |
$13K |
| 99211 |
|
932 |
819 |
$13K |
| 58558 |
|
12 |
12 |
$13K |
| 84460 |
|
3,283 |
1,685 |
$13K |
| 95782 |
|
13 |
13 |
$13K |
| 90833 |
|
215 |
207 |
$13K |
| 76827 |
|
235 |
224 |
$12K |
| 87077 |
|
3,961 |
3,860 |
$12K |
| A0425 |
Ground mileage |
1,464 |
1,432 |
$12K |
| 84439 |
|
2,575 |
2,501 |
$12K |
| G0108 |
Diab manage trn per indiv |
152 |
146 |
$11K |
| 73000 |
|
413 |
387 |
$11K |
| 84450 |
|
3,263 |
1,676 |
$11K |
| 86140 |
|
8,122 |
7,494 |
$11K |
| 99382 |
|
103 |
102 |
$11K |
| 99386 |
|
77 |
77 |
$11K |
| 82248 |
|
3,619 |
1,945 |
$11K |
| 36416 |
|
544 |
544 |
$11K |
| 82247 |
|
3,512 |
1,849 |
$10K |
| 94010 |
|
213 |
201 |
$10K |
| A0428 |
Bls |
347 |
343 |
$10K |
| 87070 |
|
2,958 |
2,836 |
$10K |
| 20553 |
|
38 |
38 |
$10K |
| 87389 |
|
2,849 |
2,824 |
$10K |
| 73060 |
|
1,042 |
979 |
$10K |
| 43235 |
|
17 |
17 |
$9K |
| 84484 |
|
14,787 |
12,816 |
$9K |
| Q9957 |
Inj perflutren lip micros,ml |
171 |
171 |
$9K |
| 12002 |
|
27 |
27 |
$9K |
| 87081 |
|
2,518 |
2,467 |
$9K |
| 86769 |
|
227 |
226 |
$9K |
| C1769 |
Guide wire |
1,145 |
1,062 |
$9K |
| 86803 |
|
1,669 |
1,636 |
$9K |
| 74230 |
|
74 |
73 |
$8K |
| 80197 |
|
955 |
555 |
$8K |
| 96376 |
|
5,573 |
5,197 |
$8K |
| 87184 |
|
3,054 |
3,001 |
$8K |
| 86304 |
|
720 |
577 |
$8K |
| 95715 |
|
42 |
36 |
$8K |
| 96133 |
|
129 |
109 |
$8K |
| 83690 |
|
18,598 |
17,322 |
$8K |
| 76937 |
|
55 |
54 |
$7K |
| 62321 |
|
12 |
12 |
$7K |
| 72020 |
|
326 |
322 |
$7K |
| 82570 |
|
2,180 |
1,992 |
$7K |
| 92585 |
|
57 |
56 |
$7K |
| 0042T |
|
170 |
170 |
$7K |
| 76870 |
|
428 |
419 |
$7K |
| 72131 |
|
78 |
77 |
$7K |
| 88312 |
|
273 |
273 |
$7K |
| 87186 |
|
2,937 |
2,848 |
$6K |
| Q0162 |
Ondansetron oral |
8,917 |
7,993 |
$6K |
| 77065 |
Tomosynthesis, mammo |
84 |
78 |
$6K |
| 96523 |
|
173 |
124 |
$6K |
| 85652 |
|
7,986 |
7,395 |
$6K |
| 84550 |
|
1,841 |
1,548 |
$6K |
| 70547 |
|
37 |
37 |
$6K |
| 83010 |
|
641 |
610 |
$6K |
| 17250 |
|
32 |
29 |
$6K |
| 72141 |
|
26 |
25 |
$6K |
| 69210 |
|
81 |
68 |
$6K |
| J1200 |
Diphenhydramine hcl injectio |
3,462 |
2,810 |
$5K |
| 59430 |
|
112 |
108 |
$5K |
| 81025 |
|
2,111 |
2,062 |
$5K |
| 87040 |
|
6,257 |
5,774 |
$5K |
| 16020 |
|
13 |
13 |
$5K |
| 91010 |
|
12 |
12 |
$5K |
| 83605 |
|
9,426 |
8,395 |
$5K |
| 84703 |
|
6,268 |
6,071 |
$5K |
| J1100 |
Dexamethasone sodium phos |
1,823 |
1,539 |
$5K |
| 73070 |
|
119 |
99 |
$5K |
| 80074 |
|
310 |
308 |
$5K |
| J7030 |
Normal saline solution infus |
9,934 |
7,310 |
$5K |
| 93308 |
|
13 |
13 |
$4K |
| 77066 |
Tomosynthesis, mammo |
39 |
38 |
$4K |
| J2001 |
Lidocaine injection |
272 |
256 |
$4K |
| 82805 |
|
645 |
592 |
$4K |
| 87468 |
|
149 |
148 |
$4K |
| 92653 |
|
51 |
51 |
$4K |
| 72040 |
|
159 |
155 |
$4K |
| 82150 |
|
2,265 |
2,146 |
$4K |
| M0243 |
Casirivi and imdevi inj |
30 |
28 |
$4K |
| 99152 |
|
576 |
567 |
$4K |
| 84156 |
|
1,696 |
1,502 |
$4K |
| 86160 |
|
211 |
203 |
$4K |
| 82550 |
|
2,914 |
2,670 |
$4K |
| J7120 |
Ringers lactate infusion |
20,598 |
17,831 |
$4K |
| 85379 |
|
2,950 |
2,831 |
$4K |
| 90686 |
|
231 |
231 |
$4K |
| 86038 |
|
775 |
772 |
$3K |
| A0426 |
Als 1 |
260 |
258 |
$3K |
| 89051 |
|
607 |
491 |
$3K |
| 96368 |
|
156 |
106 |
$3K |
| C1894 |
Intro/sheath, non-laser |
730 |
652 |
$3K |
| 96411 |
|
92 |
53 |
$3K |
| 87205 |
|
2,714 |
2,609 |
$3K |
| 92526 |
|
26 |
14 |
$3K |
| A9552 |
F18 fdg |
16 |
16 |
$3K |
| 76604 |
|
45 |
45 |
$3K |
| J7060 |
5% dextrose/water |
1,766 |
1,268 |
$3K |
| 91037 |
|
12 |
12 |
$3K |
| 87340 |
|
696 |
680 |
$3K |
| 74220 |
|
24 |
24 |
$3K |
| 87484 |
|
149 |
148 |
$2K |
| 74019 |
|
586 |
574 |
$2K |
| J8540 |
Oral dexamethasone |
2,229 |
1,611 |
$2K |
| J2405 |
Ondansetron hcl injection |
10,576 |
8,355 |
$2K |
| J1885 |
Ketorolac tromethamine inj |
7,918 |
7,204 |
$2K |
| 92002 |
|
37 |
36 |
$2K |
| 86592 |
|
1,665 |
1,646 |
$2K |
| J0131 |
Inj, acetaminophen (nos) |
2,010 |
1,835 |
$2K |
| 82310 |
|
3,022 |
2,883 |
$2K |
| 82565 |
|
3,059 |
2,977 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
3,198 |
2,495 |
$2K |
| 87088 |
|
863 |
844 |
$2K |
| D9210 |
|
267 |
262 |
$2K |
| M0245 |
Bamlan and etesev infusion |
16 |
16 |
$2K |
| 84436 |
|
674 |
663 |
$2K |
| 0241U |
|
833 |
832 |
$2K |
| J3535 |
Metered dose inhaler drug |
1,099 |
1,010 |
$2K |
| 83516 |
|
181 |
142 |
$2K |
| 86880 |
|
182 |
165 |
$2K |
| M0222 |
Bebtelovimab injection |
13 |
13 |
$2K |
| 86870 |
|
100 |
78 |
$2K |
| J0136 |
Inj, acetaminophen (b braun) |
3,551 |
3,271 |
$2K |
| 74018 |
|
846 |
794 |
$2K |
| 84165 |
|
270 |
250 |
$2K |
| 72110 |
|
90 |
86 |
$2K |
| 97803 |
|
39 |
37 |
$2K |
| D9211 |
|
358 |
349 |
$2K |
| 77003 |
|
14 |
13 |
$1K |
| 96121 |
|
12 |
12 |
$1K |
| 86364 |
|
214 |
193 |
$1K |
| 86706 |
|
221 |
211 |
$1K |
| 97165 |
|
12 |
12 |
$1K |
| J2469 |
Palonosetron hcl |
183 |
101 |
$1K |
| 84520 |
|
3,037 |
2,950 |
$1K |
| D2930 |
|
12 |
12 |
$1K |
| 92134 |
|
13 |
13 |
$1K |
| G0279 |
Tomosynthesis, mammo |
57 |
57 |
$1K |
| J2704 |
Inj, propofol, 10 mg |
775 |
679 |
$1K |
| 76642 |
|
29 |
27 |
$1K |
| 82374 |
|
2,745 |
2,669 |
$1K |
| J2543 |
Piperacillin/tazobactam |
1,131 |
669 |
$1K |
| 99151 |
|
85 |
85 |
$1K |
| 92060 |
|
14 |
14 |
$999.68 |
| J3490 |
Drugs unclassified injection |
3,466 |
2,787 |
$998.39 |
| Q0163 |
Diphenhydramine hcl 50mg |
2,143 |
1,886 |
$992.98 |
| 84403 |
|
72 |
72 |
$988.16 |
| 86235 |
|
66 |
63 |
$974.49 |
| 73700 |
|
16 |
12 |
$937.13 |
| J1630 |
Haloperidol injection |
1,278 |
1,071 |
$926.36 |
| 92553 |
|
14 |
14 |
$916.59 |
| 83521 |
|
76 |
68 |
$915.08 |
| J8501 |
Oral aprepitant |
55 |
54 |
$858.55 |
| J7050 |
Normal saline solution infus |
4,512 |
3,330 |
$849.29 |
| 87147 |
|
435 |
430 |
$825.46 |
| 96402 |
|
12 |
12 |
$816.85 |
| 82465 |
|
524 |
503 |
$816.41 |
| 86431 |
|
166 |
165 |
$766.60 |
| 99499 |
|
55 |
51 |
$763.79 |
| J7040 |
Normal saline solution infus |
2,668 |
2,035 |
$744.43 |
| 86665 |
|
124 |
122 |
$742.10 |
| 92083 |
|
14 |
13 |
$734.40 |
| 83001 |
|
43 |
41 |
$728.07 |
| 84153 |
|
53 |
51 |
$687.09 |
| 82077 |
|
2,889 |
2,722 |
$685.91 |
| 86334 |
|
38 |
38 |
$668.13 |
| 99417 |
Prolong home eval add 15m |
26 |
26 |
$661.40 |
| 82043 |
|
144 |
142 |
$660.41 |
| 82947 |
|
2,726 |
2,654 |
$653.26 |
| 93321 |
|
26 |
24 |
$608.67 |
| 83655 |
|
88 |
88 |
$604.42 |
| 87522 |
Neg quan hep c or qual rna |
12 |
12 |
$601.45 |
| 82435 |
|
2,744 |
2,668 |
$589.68 |
| 84295 |
|
2,758 |
2,681 |
$587.96 |
| 86225 |
|
135 |
132 |
$582.79 |
| 86258 |
|
62 |
61 |
$571.16 |
| 86376 |
|
76 |
76 |
$543.59 |
| 82040 |
|
196 |
194 |
$542.64 |
| J3475 |
Inj magnesium sulfate |
2,990 |
2,309 |
$538.39 |
| 73100 |
|
17 |
12 |
$517.79 |
| J0184 |
Inj, amisulpride, 1 mg |
50 |
50 |
$510.17 |
| 86328 |
|
14 |
14 |
$483.27 |
| 86800 |
|
65 |
63 |
$476.90 |
| 84480 |
|
189 |
179 |
$476.17 |
| 80143 |
|
1,614 |
1,542 |
$453.05 |
| 84145 |
|
932 |
862 |
$445.40 |
| 86039 |
|
113 |
113 |
$444.09 |
| 80179 |
|
1,561 |
1,477 |
$438.29 |
| 87493 |
|
16 |
15 |
$413.70 |
| 80180 |
|
56 |
39 |
$400.77 |
| 97116 |
|
31 |
12 |
$400.34 |
| 94761 |
|
218 |
218 |
$399.57 |
| J7042 |
5% dextrose/normal saline |
1,793 |
1,332 |
$385.61 |
| 86580 |
|
50 |
50 |
$382.29 |
| 99408 |
|
31 |
26 |
$366.36 |
| J1644 |
Inj heparin sodium per 1000u |
4,694 |
2,326 |
$357.22 |
| A9500 |
Tc99m sestamibi |
14 |
14 |
$352.95 |
| 82670 |
|
14 |
13 |
$346.38 |
| J1650 |
Inj enoxaparin sodium |
1,053 |
427 |
$333.22 |
| 88189 |
|
12 |
12 |
$317.18 |
| 84132 |
|
1,471 |
1,432 |
$313.80 |
| 86664 |
|
127 |
124 |
$297.55 |
| 84112 |
|
12 |
12 |
$289.75 |
| 87660 |
|
25 |
25 |
$279.00 |
| 87480 |
|
25 |
25 |
$279.00 |
| 87510 |
|
25 |
25 |
$279.00 |
| 85245 |
|
25 |
25 |
$276.55 |
| C1887 |
Catheter, guiding |
51 |
51 |
$276.12 |
| 86663 |
|
128 |
125 |
$254.61 |
| J2930 |
Methylprednisolone injection |
517 |
431 |
$252.00 |
| 0097U |
|
42 |
41 |
$246.87 |
| 85240 |
|
18 |
18 |
$243.55 |
| 85246 |
|
25 |
25 |
$236.69 |
| 82977 |
|
61 |
54 |
$211.64 |
| 86762 |
|
12 |
12 |
$205.49 |
| J0780 |
Prochlorperazine injection |
304 |
286 |
$203.49 |
| 82731 |
|
12 |
12 |
$192.15 |
| J2800 |
Methocarbamol injection |
547 |
505 |
$191.11 |
| J3480 |
Inj potassium chloride |
552 |
364 |
$187.59 |
| 99024 |
|
153 |
138 |
$185.12 |
| J0690 |
Cefazolin sodium injection |
524 |
409 |
$181.91 |
| 86147 |
|
13 |
12 |
$179.86 |
| J1642 |
Inj heparin sodium per 10 u |
719 |
506 |
$169.26 |
| 81003 |
|
172 |
162 |
$162.82 |
| 87449 |
|
95 |
75 |
$162.56 |
| C9153 |
Inj, amisulpride, 1 mg |
30 |
30 |
$157.50 |
| J2270 |
Morphine sulfate injection |
4,652 |
3,706 |
$151.89 |
| 90656 |
|
19 |
19 |
$142.25 |
| 87076 |
|
144 |
139 |
$136.55 |
| J0571 |
Buprenorphine oral 1mg |
125 |
74 |
$134.60 |
| 85384 |
|
32 |
30 |
$128.53 |
| C9113 |
Inj pantoprazole sodium, via |
1,508 |
874 |
$123.43 |
| 87880 |
|
401 |
398 |
$115.53 |
| 82010 |
|
650 |
566 |
$106.47 |
| 85613 |
|
12 |
12 |
$100.88 |
| 86787 |
|
13 |
12 |
$86.73 |
| J2919 |
Inj, methylpred sod succ 5mg |
100 |
69 |
$81.00 |
| 87015 |
|
277 |
270 |
$64.33 |
| 93356 |
|
27 |
27 |
$54.90 |
| J0736 |
Inj, clindamycin phosp 300mg |
103 |
70 |
$52.83 |
| J2765 |
Metoclopramide hcl injection |
2,536 |
2,209 |
$49.75 |
| J0134 |
Inj acetaminophen -fresenius |
82 |
80 |
$49.10 |
| J2060 |
Lorazepam injection |
2,541 |
2,021 |
$45.14 |
| J2250 |
Inj midazolam hydrochloride |
1,619 |
1,558 |
$44.94 |
| 80164 |
|
57 |
49 |
$42.11 |
| J1170 |
Hydromorphone injection |
1,579 |
1,089 |
$40.15 |
| 87207 |
|
211 |
202 |
$36.05 |
| J3411 |
Thiamine hcl 100 mg |
1,145 |
726 |
$32.54 |
| 83930 |
|
30 |
28 |
$30.20 |
| 86308 |
|
170 |
170 |
$28.15 |
| S0077 |
Injection, clindamycin phosp |
135 |
103 |
$27.89 |
| J1790 |
Droperidol injection |
987 |
900 |
$26.80 |
| 84300 |
|
14 |
13 |
$24.65 |
| J7699 |
Inhalation solution for dme |
368 |
336 |
$24.63 |
| 82365 |
|
13 |
13 |
$23.54 |
| 84479 |
|
12 |
12 |
$23.10 |
| C1758 |
Catheter, ureteral |
45 |
37 |
$21.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
28 |
14 |
$20.10 |
| 80320 |
|
1,440 |
1,325 |
$20.00 |
| J7510 |
Prednisolone oral per 5 mg |
221 |
187 |
$18.89 |
| J7613 |
Albuterol non-comp unit |
963 |
747 |
$17.95 |
| J7644 |
Ipratropium bromide non-comp |
555 |
442 |
$17.63 |
| S0028 |
Injection, famotidine, 20 mg |
50 |
38 |
$14.44 |
| Q0144 |
Azithromycin dihydrate, oral |
34 |
31 |
$14.21 |
| J7512 |
Prednisone ir or dr oral 1mg |
910 |
706 |
$7.64 |
| J3370 |
Vancomycin hcl injection |
186 |
97 |
$6.67 |
| J2274 |
Inj morphine pf epid ithc |
638 |
567 |
$5.36 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
47 |
44 |
$4.68 |
| 82272 |
|
147 |
142 |
$3.34 |
| J7620 |
Albuterol ipratrop non-comp |
79 |
49 |
$2.18 |
| Q0177 |
Hydroxyzine pamoate 25mg |
370 |
289 |
$1.51 |
| 92015 |
|
40 |
40 |
$0.00 |
| 99080 |
|
4,779 |
1,162 |
$0.00 |
| J7070 |
D5w infusion |
18 |
12 |
$0.00 |
| 88302 |
|
76 |
76 |
$0.00 |
| 95712 |
|
28 |
25 |
$0.00 |
| J7627 |
Budesonide comp unit |
264 |
224 |
$0.00 |
| 80329 |
|
1,502 |
732 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
49 |
28 |
$0.00 |
| S2900 |
Robotic surgical system |
12 |
12 |
$0.00 |
| J1815 |
Insulin injection |
127 |
87 |
$0.00 |
| J8597 |
Antiemetic drug oral nos |
136 |
106 |
$0.00 |