|
Inj onase abepar-xioi treat
|
$4,972,500.00 |
$4,972,500.00 |
$4,972,500.00 |
$3,572,794.09
|
|
Inj ontruzant 10 mg
|
$11,572.21 |
$11,572.21 |
$11,572.21 |
$6,706.27
|
|
Inj, pafolacianine, 0.1 mg
|
$6,215.63 |
$6,215.63 |
$6,215.63 |
$6,897.80
|
|
Inj pantoprazole(hikma) 40mg
|
$11.88 |
$11.88 |
$11.88 |
$34.67
|
|
Inj, pasireotide long acting
|
$50,915.83 |
$50,915.83 |
$50,915.83 |
$33,745.84
|
|
Inj., patisiran, 0.1 mg
|
$4,579.38 |
$4,579.38 |
$4,579.38 |
$17,613.00
|
|
Inj, pegcetacoplan, 1mg
|
$54,905.53 |
$54,905.53 |
$54,905.53 |
$3,662.96
|
|
Inj pemetrexed (accord) 10mg
|
$12,614.16 |
$12,614.16 |
$12,614.16 |
$579.77
|
|
Inj pemetrexed, hospira 10mg
|
$64.35 |
$64.35 |
$64.35 |
$64.35
|
|
Inj, pemivibart, 4500 mg
|
$412.76 |
$412.76 |
$412.76 |
$1,235.55
|
|
Inj peritoneal venous shunt
|
$254.80 |
$254.80 |
$254.80 |
$406.80
|
|
Inj., perseris, 0.5 mg
|
$6,783.29 |
$6,783.29 |
$6,783.29 |
$5,146.85
|
|
Inj proc ankle arthr
|
$249.60 |
$249.60 |
$249.60 |
$405.31
|
|
Inj proc elbow arthro
|
$359.45 |
$359.45 |
$359.45 |
$432.00
|
|
Inj proc for lymphang
|
$3,052.40 |
$3,052.40 |
$3,052.40 |
$742.40
|
|
Inj proc lumbr disk ea lvl
|
$1,708.85 |
$1,708.85 |
$1,708.85 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$1,283.10 |
$1,283.10 |
$1,283.10 |
$838.30
|
|
Inj proc sialogram
|
$325.00 |
$325.00 |
$325.00 |
$373.00
|
|
Inj progesterone per 50 mg
|
$7.57 |
$7.57 |
$7.57 |
$13.76
|
|
Inj prohance multipack
|
$10.58 |
$10.58 |
$10.58 |
$10.40
|
|
Inj recombin esperoct per iu
|
$6.63 |
$6.63 |
$6.63 |
$6.63
|
|
Inj retro urethrocysto
|
$1,084.85 |
$1,084.85 |
$1,084.85 |
$447.74
|
|
Inj, rimabotulinumtoxinb
|
$1,486.10 |
$1,486.10 |
$1,486.10 |
$714.24
|
|
Inj romidepsin non-lyo 0.1mg
|
$4,740.40 |
$4,740.40 |
$4,740.40 |
$9,892.69
|
|
Inj scleros sol mult veins
|
$1,866.15 |
$1,866.15 |
$1,866.15 |
$692.90
|
|
Inj scleros sol sgl vein
|
$1,866.15 |
$1,866.15 |
$1,866.15 |
$561.88
|
|
Inj secretin synthetic human
|
$1,546.74 |
$1,546.74 |
$1,546.74 |
$1,253.09
|
|
Inj secukinumab intrav 1mg
|
$1,029.91 |
$1,029.91 |
$1,029.91 |
$4,413.21
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$1,866.15 |
$1,866.15 |
$1,866.15 |
$436.80
|
|
Inj sulf hexa lipid microsph
|
$339.30 |
$339.30 |
$339.30 |
$256.14
|
|
Inj, susvimo 0.1 mg
|
$187,200.00 |
$187,200.00 |
$187,200.00 |
$2,598.44
|
|
Inj. tagraxofusp-erzs 10 mcg
|
$105,320.75 |
$105,320.75 |
$105,320.75 |
$67,538.30
|
|
Inj, taliglucerace alfa 10 u
|
$2,208.47 |
$2,208.47 |
$2,208.47 |
$1,573.27
|
|
Inj teclistamab cqyv 0.5 mg
|
$19,174.32 |
$19,174.32 |
$19,174.32 |
$17,517.56
|
|
Inj tedizolid phosphate
|
$866.93 |
$866.93 |
$866.93 |
$664.72
|
|
Inj. teprotumumab-trbw 10 mg
|
$42,164.34 |
$42,164.34 |
$42,164.34 |
$35,034.78
|
|
Inj testostero enanthate 1mg
|
$33.13 |
$33.13 |
$33.13 |
$123.09
|
|
Inj testosterone cypionate
|
$55.67 |
$55.67 |
$55.67 |
$64.96
|
|
Inj thiotepa nos 1 mg
|
$5,616.00 |
$5,616.00 |
$5,616.00 |
$3,170.16
|
|
Inj thrc fascial pln blk bi w/wo image
|
$477.75 |
$477.75 |
$477.75 |
$1,049.50
|
|
Inj thrc fascial pln blk uni w/wo image
|
$429.00 |
$429.00 |
$429.00 |
$818.00
|
|
Inj. tigecycline (accord)
|
$365.04 |
$365.04 |
$365.04 |
$188.03
|
|
Inj., tildrakizumab, 1 mg
|
$42,029.77 |
$42,029.77 |
$42,029.77 |
$26,635.60
|
|
Inj tofersen intrathec 1 mg
|
$2,355.07 |
$2,355.07 |
$2,355.07 |
$293.34
|
|
Inj, tofidence, 1 mg
|
$346.32 |
$346.32 |
$346.32 |
$86.87
|
|
Inj, tyenne, 1 mg
|
$2,647.24 |
$2,647.24 |
$2,647.24 |
$3,525.12
|
|
Inj ustekinumab-aekn, 1 mg
|
$126.01 |
$126.01 |
$126.01 |
$47.80
|
|
Inj ustekinumab-kfce, 1 mg
|
$7,019.96 |
$7,019.96 |
$7,019.96 |
$5,244.37
|
|
Inj ustekinumab-stba, 1 mg
|
$27.34 |
$27.34 |
$27.34 |
$16.36
|
|
Inj, uzedy, 1 mg
|
$21,951.72 |
$21,951.72 |
$21,951.72 |
$11,475.96
|
|
Inj, vancomycin hcl (mylan)
|
$211.20 |
$211.20 |
$211.20 |
$72.33
|
|
Inj, vancomycin hcl (xellia)
|
$497.25 |
$497.25 |
$497.25 |
$85.20
|
|
Inj, vegzelma, 10 mg
|
$528.37 |
$528.37 |
$528.37 |
$1,186.35
|
|
Inj velmanase alfa-tycv 1 mg
|
$10,578.36 |
$10,578.36 |
$10,578.36 |
$7,123.31
|
|
Inj w/fluor eval cv device
|
$984.10 |
$984.10 |
$984.10 |
$504.40
|
|
Inj xipere 1 mg
|
$4,290.00 |
$4,290.00 |
$4,290.00 |
$93.00
|
|
Inj., yutiq, 0.01 mg
|
$14,458.60 |
$14,458.60 |
$14,458.60 |
$14,458.60
|
|
Inj zanidatamab-hrii, 2 mg
|
$11,091.60 |
$11,091.60 |
$11,091.60 |
$8,532.00
|
|
Inj zenocutuzumab-zbco 1 mg
|
$1,993.78 |
$1,993.78 |
$1,993.78 |
$19,177.20
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$76,110.11 |
$76,110.11 |
$76,110.11 |
$41,083.73
|
|
Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy
|
$271.70 |
$271.70 |
$271.70 |
$54.24
|
|
Inpt/ed teleconsult30
|
$549.25 |
$549.25 |
$549.25 |
$164.40
|
|
Inpt/ed teleconsult50
|
$746.20 |
$746.20 |
$746.20 |
$223.80
|
|
Inpt/ed teleconsult70
|
$1,103.70 |
$1,103.70 |
$1,103.70 |
$330.60
|
|
Inpt/tele follow up 15
|
$217.10 |
$217.10 |
$217.10 |
$64.80
|
|
Inpt/tele follow up 25
|
$397.80 |
$397.80 |
$397.80 |
$118.80
|
|
Inpt/tele follow up 35
|
$572.00 |
$572.00 |
$572.00 |
$171.60
|
|
Ins cath ren art 1st bi
|
$14,704.95 |
$14,704.95 |
$14,704.95 |
$5,974.80
|
|
Ins cath ren art 1st uni
|
$14,704.95 |
$14,704.95 |
$14,704.95 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$2,054.00 |
$2,054.00 |
$2,054.00 |
$5,663.98
|
|
Ins cath ren art 2nd+ uni
|
$25,255.10 |
$25,255.10 |
$25,255.10 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$988.65 |
$988.65 |
$988.65 |
$490.73
|
|
Insert abdomen-venous drain
|
$9,510.15 |
$9,510.15 |
$9,510.15 |
$4,039.47
|
|
Insert cannula vein-to-vein hemodialysis
|
$25,255.10 |
$25,255.10 |
$25,255.10 |
$7,279.50
|
|
Insert cath pleura with image
|
$5,806.45 |
$5,806.45 |
$5,806.45 |
$2,194.40
|
|
Insert cath pleura without image
|
$7,090.20 |
$7,090.20 |
$7,090.20 |
$2,099.70
|
|
Insert drug delivery implant
|
$326.30 |
$326.30 |
$326.30 |
$280.00
|
|
Insert electrodes for eeg
|
$705.25 |
$705.25 |
$705.25 |
$564.20
|
|
Insert epicardial lead open 33202
|
$3,775.20 |
$3,775.20 |
$3,775.20 |
$3,775.20
|
|
Insert hepatic shunt (tips)
|
$13,919.10 |
$13,919.10 |
$13,919.10 |
$7,571.20
|
|
Insert intervert bimech device 22854
|
$1,573.00 |
$1,573.00 |
$1,573.00 |
$1,573.00
|
|
Insert intrauterine device iud
|
$408.20 |
$408.20 |
$408.20 |
$347.10
|
|
Insertion catheter artery nfs ther chemotx 36640
|
$14,704.95 |
$14,704.95 |
$14,704.95 |
$3,594.47
|
|
Insertion catheter bladder non indwelling
|
$481.65 |
$481.65 |
$481.65 |
$208.01
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$13,190.45 |
$13,190.45 |
$13,190.45 |
$4,897.20
|
|
Insertion intra aortic balloon assist device percutaneous
|
$2,549.95 |
$2,549.95 |
$2,549.95 |
$2,447.63
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$14,933.10 |
$14,933.10 |
$14,933.10 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$14,704.95 |
$14,704.95 |
$14,704.95 |
$2,585.25
|
|
Insertion of catheter vein
|
$1,749.80 |
$1,749.80 |
$1,749.80 |
$1,525.80
|
|
Insertion of catheter vein
|
$1,348.75 |
$1,348.75 |
$1,348.75 |
$870.59
|
|
Insertion of heart electrode 33211
|
$38,664.60 |
$38,664.60 |
$38,664.60 |
$6,820.50
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$20,838.35 |
$20,838.35 |
$20,838.35 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$22,554.35 |
$22,554.35 |
$22,554.35 |
$12,324.60
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$13,499.20 |
$13,499.20 |
$13,499.20 |
$9,884.16
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$7,257.25 |
$7,257.25 |
$7,257.25 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$7,257.25 |
$7,257.25 |
$7,257.25 |
$2,453.83
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$45,535.75 |
$45,535.75 |
$45,535.75 |
$29,180.00
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$38,664.60 |
$38,664.60 |
$38,664.60 |
$7,183.68
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$24,957.40 |
$24,957.40 |
$24,957.40 |
$7,267.20
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$11,839.10 |
$11,839.10 |
$11,839.10 |
$9,332.50
|
