| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
3,766 |
3,456 |
$316K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
5,259 |
5,033 |
$248K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
7,655 |
7,261 |
$231K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17,834 |
17,218 |
$208K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
68,341 |
64,568 |
$181K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
8,095 |
2,459 |
$129K |
| 99215 |
Prolong outpt/office vis |
2,242 |
2,167 |
$129K |
| 99223 |
Prolong inpt eval add15 m |
665 |
617 |
$118K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,089 |
1,079 |
$92K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
534 |
335 |
$76K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
158 |
158 |
$70K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,751 |
1,738 |
$61K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
1,706 |
483 |
$57K |
| 99222 |
Initial hospital care, per day, moderate complexity |
273 |
267 |
$57K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
420 |
411 |
$54K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,315 |
1,244 |
$49K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,793 |
493 |
$48K |
| 01967 |
Neuraxial labor analgesia/anesthesia for planned vaginal delivery |
123 |
123 |
$46K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
739 |
739 |
$43K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
11,137 |
9,495 |
$42K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,781 |
1,771 |
$41K |
| 99233 |
Prolong inpt eval add15 m |
1,344 |
490 |
$35K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
11,244 |
10,680 |
$34K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
142 |
139 |
$32K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
133 |
133 |
$30K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
817 |
806 |
$30K |
| 76641 |
|
479 |
326 |
$28K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,391 |
493 |
$27K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
479 |
464 |
$26K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
356 |
355 |
$24K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
358 |
341 |
$24K |
| 70450 |
Computed tomography, head or brain; without contrast material |
726 |
671 |
$23K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
1,391 |
1,383 |
$23K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
489 |
469 |
$22K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
76 |
74 |
$22K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
95 |
91 |
$22K |
| 71045 |
Radiologic examination, chest; single view |
3,244 |
2,466 |
$22K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
415 |
413 |
$21K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
4,348 |
1,191 |
$21K |
| 00731 |
|
215 |
211 |
$20K |
| 76830 |
Ultrasound, transvaginal |
455 |
441 |
$20K |
| S0199 |
Medically induced abortion by oral ingestion of medication including all associated services and supplies (e.g., patient counseling, office visits, confirmation of pregnancy by hcg, ultrasound to confirm duration of pregnancy, ultrasound to confirm completion of abortion) except drugs |
39 |
39 |
$18K |
| 00790 |
|
66 |
66 |
$18K |
| 97001 |
|
448 |
431 |
$17K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
2,084 |
1,823 |
$17K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,253 |
6,590 |
$16K |
| 77066 |
Tomosynthesis, mammo |
138 |
138 |
$16K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
296 |
291 |
$16K |
| 72141 |
|
60 |
60 |
$16K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
464 |
458 |
$15K |
| 95117 |
|
1,148 |
358 |
$15K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
670 |
657 |
$15K |
| 88307 |
|
146 |
146 |
$14K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
360 |
350 |
$14K |
| 95811 |
|
101 |
101 |
$13K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
7,374 |
2,188 |
$13K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
265 |
262 |
$12K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
40 |
40 |
$12K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
78 |
76 |
$12K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
266 |
258 |
$12K |
| A4335 |
Incontinence supply; miscellaneous |
1,378 |
1,353 |
$11K |
| 00811 |
|
146 |
146 |
$10K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
201 |
201 |
$10K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
425 |
370 |
$10K |
| 71046 |
Radiologic examination, chest; 2 views |
1,152 |
1,117 |
$10K |
| 31231 |
|
50 |
49 |
$10K |
| A4322 |
Irrigation syringe, bulb or piston, each |
414 |
411 |
$10K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
22,663 |
20,944 |
$10K |
| 99201 |
|
80 |
80 |
$10K |
| 99243 |
|
273 |
270 |
$9K |
| 76813 |
|
163 |
163 |
$9K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
232 |
230 |
$9K |
| A4267 |
Contraceptive supply, condom, male, each |
447 |
435 |
$9K |
| 00840 |
|
44 |
44 |
$9K |
| 88304 |
|
278 |
277 |
$8K |
| 76770 |
|
159 |
157 |
$8K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
124 |
124 |
$7K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
331 |
307 |
$7K |
| 74178 |
|
28 |
28 |
$7K |
| 76801 |
|
160 |
150 |
$7K |
| 77065 |
Tomosynthesis, mammo |
60 |
60 |
$7K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
442 |
435 |
$7K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
188 |
188 |
$7K |
| 85018 |
|
3,556 |
3,530 |
$7K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
286 |
274 |
$6K |
| 80053 |
Comprehensive metabolic panel |
24,804 |
23,662 |
$6K |
| 71250 |
|
61 |
59 |
$6K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
130 |
130 |
$6K |
| 99205 |
Prolong outpt/office vis |
60 |
59 |
$5K |
| 92134 |
|
193 |
181 |
$5K |
| 93351 |
|
16 |
16 |
$5K |
| 93970 |
|
97 |
94 |
$5K |
| 92250 |
|
501 |
498 |
$5K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
2,374 |
2,009 |
$5K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
66 |
64 |
$5K |
| 95144 |
|
60 |
60 |
$5K |
| 76536 |
|
109 |
109 |
$5K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
108 |
100 |
$4K |
| 73221 |
|
13 |
12 |
$4K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
235 |
235 |
$4K |
| A4927 |
Gloves, non-sterile, per 100 |
275 |
269 |
$4K |
| 81025 |
|
1,672 |
1,594 |
$4K |
| 95115 |
|
717 |
270 |
$3K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
52 |
52 |
$3K |
| J3490 |
Unclassified drugs |
656 |
579 |
$3K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
65 |
64 |
$3K |
| 92557 |
|
38 |
38 |
$3K |
| 93971 |
|
93 |
92 |
$3K |
| 95913 |
|
12 |
12 |
$3K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
26 |
25 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
33 |
33 |
$3K |
| 95816 |
|
12 |
12 |
$3K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
663 |
616 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
149 |
148 |
$2K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
73 |
71 |
$2K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
37 |
36 |
$2K |
| 72100 |
|
163 |
162 |
$2K |
| 93975 |
|
12 |
12 |
$2K |
| 90686 |
|
4,867 |
4,860 |
$2K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
359 |
351 |
$2K |
| 87806 |
|
167 |
167 |
$2K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,182 |
3,170 |
$2K |
| 73610 |
|
221 |
198 |
$2K |
| 73030 |
|
150 |
124 |
$2K |
| 99607 |
|
113 |
104 |
$2K |
| 73130 |
|
213 |
183 |
$2K |
| 83615 |
|
338 |
295 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
17,249 |
17,017 |
$2K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
101 |
94 |
$2K |
| 81001 |
|
6,369 |
6,192 |
$2K |
| 99606 |
|
95 |
93 |
$2K |
| 73562 |
|
172 |
150 |
$1K |
| 74018 |
|
226 |
207 |
$1K |
| 73630 |
|
227 |
203 |
$1K |
| 87040 |
|
240 |
201 |
$1K |
| 96127 |
|
806 |
802 |
$1K |
| 93224 |
|
14 |
14 |
$1K |
| 93000 |
|
408 |
405 |
$1K |
| 77080 |
|
31 |
31 |
$1K |
| 73110 |
|
138 |
118 |
$1K |
| 70486 |
|
12 |
12 |
$1K |
| 97161 |
|
25 |
24 |
$963.31 |
| 81002 |
|
3,054 |
2,527 |
$956.88 |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
17 |
17 |
$951.49 |
| 80076 |
|
875 |
814 |
$925.52 |
| 94621 |
|
16 |
16 |
$896.49 |
| 86038 |
|
959 |
952 |
$881.32 |
| 76870 |
|
32 |
29 |
$859.86 |
| 72040 |
|
61 |
58 |
$822.40 |
| 99460 |
|
13 |
12 |
$770.00 |
| 88313 |
|
113 |
99 |
$759.71 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
427 |
426 |
$678.50 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
4,922 |
4,700 |
$672.72 |
| 94060 |
|
12 |
12 |
$655.75 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
362 |
362 |
$622.19 |
| 86592 |
|
5,194 |
5,142 |
$619.81 |
| 12001 |
|
39 |
39 |
$618.82 |
| 17110 |
|
14 |
14 |
$598.68 |
| S4993 |
Contraceptive pills for birth control |
80 |
80 |
$567.82 |
| 11721 |
|
135 |
134 |
$551.07 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
39 |
38 |
$533.70 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,566 |
1,562 |
$518.28 |
| 92523 |
|
12 |
12 |
$515.18 |
| 82728 |
|
1,065 |
962 |
$501.38 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,551 |
1,551 |
$477.56 |
| 85007 |
|
107 |
66 |
$472.05 |
| 85027 |
|
2,382 |
2,251 |
$453.72 |
| 73090 |
|
94 |
84 |
$446.81 |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
25 |
25 |
$442.29 |
| 87088 |
|
3,023 |
2,930 |
$426.62 |
| 73590 |
|
84 |
76 |
$405.86 |
| 92226 |
|
13 |
13 |
$382.86 |
| 76642 |
|
19 |
15 |
$381.13 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
119 |
119 |
$377.74 |
| 90734 |
|
159 |
158 |
$377.35 |
| 90746 |
|
13 |
13 |
$370.48 |
| 82607 |
|
1,202 |
1,194 |
$340.66 |
| 92552 |
|
106 |
106 |
$330.40 |
| 73080 |
|
73 |
63 |
$321.79 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
40 |
39 |
$307.32 |
| 73560 |
|
33 |
28 |
$297.30 |
| 85610 |
|
1,871 |
1,639 |
$294.11 |
| 84460 |
|
312 |
307 |
$286.62 |
| A4657 |
Syringe, with or without needle, each |
30 |
26 |
$278.22 |
| 94150 |
|
1,146 |
358 |
$271.89 |
| 86361 |
|
740 |
738 |
$263.08 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
12 |
12 |
$259.11 |
| 97032 |
|
1,711 |
528 |
$254.37 |
| 84481 |
|
271 |
268 |
$247.76 |
| 71010 |
|
112 |
52 |
$244.11 |
| 90698 |
|
45 |
45 |
$233.29 |
| A4245 |
Alcohol wipes, per box |
120 |
119 |
$224.06 |
| 69210 |
|
96 |
95 |
$217.53 |
| 83540 |
|
961 |
945 |
$217.52 |
| 82947 |
|
162 |
161 |
$211.94 |
| 83605 |
|
76 |
61 |
$210.79 |
| 87536 |
|
787 |
780 |
$209.65 |
| 73140 |
|
100 |
96 |
$204.90 |
| 29125 |
|
26 |
24 |
$200.01 |
| 12011 |
|
30 |
30 |
$184.04 |
| 87070 |
|
1,131 |
1,084 |
$183.29 |
| 84100 |
|
567 |
422 |
$182.38 |
| 86803 |
|
2,434 |
2,429 |
$175.98 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
2,419 |
2,407 |
$170.46 |
| 73564 |
|
29 |
28 |
$169.74 |
| 87340 |
|
688 |
685 |
$139.53 |
| 83970 |
|
171 |
163 |
$139.36 |
| 90834 |
Psychotherapy, 45 minutes with patient |
301 |
141 |
$133.00 |
| 82962 |
|
530 |
468 |
$132.79 |
| 87077 |
|
1,084 |
1,043 |
$131.99 |
| 3077F |
|
2,514 |
2,415 |
$130.00 |
| 86901 |
|
85 |
81 |
$126.41 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
54 |
54 |
$125.47 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
11,221 |
10,657 |
$124.48 |
| 92551 |
|
6,816 |
6,798 |
$121.22 |
| 87081 |
|
632 |
598 |
$120.23 |
| 73502 |
|
13 |
13 |
$119.64 |
| 71020 |
|
78 |
41 |
$116.08 |
| 83690 |
|
808 |
754 |
$115.07 |
| 85730 |
|
1,417 |
1,359 |
$112.28 |
| 83550 |
|
888 |
873 |
$110.66 |
| 82120 |
|
30 |
29 |
$102.31 |
| 84480 |
|
303 |
299 |
$94.94 |
| 86706 |
|
1,051 |
1,050 |
$93.15 |
| 80061 |
Lipid panel |
17,930 |
17,844 |
$90.14 |
| 81003 |
|
990 |
961 |
$87.16 |
| 83735 |
|
764 |
587 |
$86.28 |
| 90744 |
|
34 |
34 |
$83.56 |
| 80081 |
|
535 |
533 |
$81.58 |
| 1126F |
|
70,818 |
66,789 |
$77.26 |
| 92133 |
|
18 |
18 |
$71.58 |
| 80305 |
|
868 |
858 |
$71.40 |
| 88312 |
|
60 |
47 |
$69.76 |
| 86704 |
|
157 |
156 |
$68.88 |
| 84703 |
|
195 |
189 |
$68.40 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
25 |
25 |
$68.06 |
| 87210 |
|
493 |
484 |
$66.75 |
| 88141 |
|
381 |
381 |
$63.89 |
| 84484 |
|
404 |
341 |
$62.61 |
| 84153 |
|
830 |
827 |
$60.60 |
| 92015 |
Determination of refractive state |
160 |
160 |
$59.48 |
| 90710 |
|
30 |
30 |
$56.04 |
| 87205 |
|
107 |
97 |
$54.19 |
| 92060 |
|
28 |
28 |
$51.77 |
| 82570 |
|
5,012 |
4,925 |
$49.01 |
| 83880 |
|
93 |
79 |
$47.98 |
| 82652 |
|
142 |
142 |
$47.94 |
| 97003 |
|
17 |
17 |
$44.46 |
| 81000 |
|
313 |
294 |
$42.72 |
| 36415 |
Collection of venous blood by venipuncture |
20,600 |
19,669 |
$42.65 |
| 97014 |
|
982 |
430 |
$40.00 |
| 3008F |
|
5,535 |
5,446 |
$37.50 |
| 84443 |
Thyroid stimulating hormone (TSH) |
13,781 |
13,641 |
$34.34 |
| 99000 |
|
170 |
167 |
$33.48 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
812 |
795 |
$32.87 |
| 87186 |
|
1,116 |
1,064 |
$32.69 |
| 84156 |
|
283 |
276 |
$31.27 |
| 99497 |
|
20 |
20 |
$30.00 |
| 88142 |
|
87 |
87 |
$28.84 |
| 88342 |
|
331 |
325 |
$27.49 |
| 87045 |
|
100 |
99 |
$26.83 |
| 83986 |
|
56 |
55 |
$25.81 |
| 87522 |
Neg quan hep c or qual rna |
195 |
190 |
$24.95 |
| 87177 |
|
63 |
63 |
$24.23 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
3,210 |
3,189 |
$23.50 |
| 84450 |
|
263 |
257 |
$23.36 |
| 86140 |
|
1,229 |
1,143 |
$23.36 |
| 82378 |
|
168 |
161 |
$23.01 |
| 86780 |
|
276 |
272 |
$22.80 |
| 85045 |
|
160 |
155 |
$20.48 |
| 86039 |
|
223 |
221 |
$20.28 |
| 87147 |
|
494 |
487 |
$19.30 |
| 84702 |
|
724 |
625 |
$17.76 |
| 86880 |
|
15 |
15 |
$17.31 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
128 |
127 |
$14.00 |
| 90677 |
|
38 |
38 |
$13.38 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$11.05 |
| 83655 |
|
400 |
393 |
$10.63 |
| 85014 |
|
29 |
29 |
$9.71 |
| 80074 |
|
1,337 |
1,334 |
$8.36 |
| 82247 |
|
14 |
12 |
$8.17 |
| 86900 |
|
34 |
32 |
$6.95 |
| 82565 |
|
48 |
41 |
$6.33 |
| 84550 |
|
830 |
825 |
$6.16 |
| 82550 |
|
311 |
300 |
$5.80 |
| 81015 |
|
134 |
132 |
$5.80 |
| 85652 |
|
1,377 |
1,340 |
$5.34 |
| 82043 |
|
4,707 |
4,653 |
$5.08 |
| 87400 |
|
13 |
12 |
$2.32 |
| 84165 |
|
49 |
49 |
$1.92 |
| 84436 |
|
653 |
650 |
$1.21 |
| 84479 |
|
469 |
467 |
$1.14 |
| 82248 |
|
806 |
755 |
$0.88 |
| 86593 |
|
225 |
219 |
$0.80 |
| 1158F |
|
28,621 |
27,377 |
$0.00 |
| 1160F |
|
37,737 |
35,463 |
$0.00 |
| 99173 |
|
7,164 |
7,143 |
$0.00 |
| 3078F |
|
57,541 |
54,372 |
$0.00 |
| 82274 |
|
2,351 |
2,335 |
$0.00 |
| 0575F |
|
5,442 |
5,416 |
$0.00 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
761 |
648 |
$0.00 |
| 84439 |
|
2,871 |
2,847 |
$0.00 |
| 86708 |
|
706 |
706 |
$0.00 |
| J7610 |
Albuterol, inhalation solution, compounded product, administered through dme, concentrated form, 1 mg |
611 |
462 |
$0.00 |
| 99334 |
|
438 |
343 |
$0.00 |
| 87338 |
|
411 |
410 |
$0.00 |
| 84403 |
|
463 |
462 |
$0.00 |
| 76942 |
|
26 |
25 |
$0.00 |
| 86431 |
|
702 |
698 |
$0.00 |
| 82785 |
|
304 |
302 |
$0.00 |
| 86480 |
|
450 |
445 |
$0.00 |
| 99199 |
Unlisted special service, procedure or report |
273 |
250 |
$0.00 |
| 90648 |
|
14 |
14 |
$0.00 |
| 90670 |
|
218 |
215 |
$0.00 |
| 85378 |
|
16 |
14 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
14 |
13 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
378 |
375 |
$0.00 |
| 1159F |
|
164 |
157 |
$0.00 |
| 83516 |
|
84 |
75 |
$0.00 |
| 86003 |
|
366 |
364 |
$0.00 |
| 86200 |
|
221 |
220 |
$0.00 |
| 87427 |
|
96 |
95 |
$0.00 |
| 87075 |
|
52 |
49 |
$0.00 |
| 99358 |
Prolong nursin fac eval 15m |
98 |
97 |
$0.00 |
| 76775 |
|
13 |
12 |
$0.00 |
| B9002 |
Enteral nutrition infusion pump, any type |
170 |
170 |
$0.00 |
| E0601 |
Continuous positive airway pressure (cpap) device |
80 |
79 |
$0.00 |
| 87209 |
|
63 |
63 |
$0.00 |
| 84146 |
|
376 |
371 |
$0.00 |
| 82272 |
|
202 |
199 |
$0.00 |
| 83013 |
|
84 |
83 |
$0.00 |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
26 |
26 |
$0.00 |
| 82977 |
|
54 |
54 |
$0.00 |
| 90715 |
|
83 |
83 |
$0.00 |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
195 |
195 |
$0.00 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
225 |
148 |
$0.00 |
| 86765 |
|
31 |
31 |
$0.00 |
| 99401 |
|
106 |
79 |
$0.00 |
| 97116 |
|
690 |
205 |
$0.00 |
| 0001M |
|
12 |
12 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
35 |
35 |
$0.00 |
| 86705 |
|
13 |
13 |
$0.00 |
| J0135 |
Injection, adalimumab, 20 mg |
12 |
12 |
$0.00 |
| 86735 |
|
31 |
31 |
$0.00 |
| 86787 |
|
39 |
39 |
$0.00 |
| 90633 |
|
79 |
77 |
$0.00 |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
195 |
191 |
$0.00 |
| 90700 |
|
14 |
14 |
$0.00 |
| 86235 |
|
527 |
526 |
$0.00 |
| 92504 |
|
16 |
16 |
$0.00 |
| 86696 |
|
138 |
137 |
$0.00 |
| 99242 |
|
30 |
30 |
$0.00 |
| 90713 |
|
12 |
12 |
$0.00 |
| 90685 |
|
29 |
29 |
$0.00 |
| 74000 |
|
23 |
14 |
$0.00 |
| 90461 |
|
183 |
182 |
$0.00 |
| 92550 |
|
12 |
12 |
$0.00 |
| 87799 |
|
159 |
58 |
$0.00 |
| 3045F |
|
52 |
52 |
$0.00 |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
12 |
12 |
$0.00 |
| 2028F |
|
41 |
41 |
$0.00 |
| 87512 |
|
38 |
38 |
$0.00 |
| J7699 |
Noc drugs, inhalation solution administered through dme |
14 |
13 |
$0.00 |
| 92083 |
|
16 |
16 |
$0.00 |
| 0502F |
|
91 |
59 |
$0.00 |
| 84681 |
|
13 |
13 |
$0.00 |
| 99152 |
|
38 |
38 |
$0.00 |
| 67028 |
Intravitreal injection of a pharmacologic agent |
12 |
12 |
$0.00 |
| 93015 |
|
15 |
15 |
$0.00 |
| 99336 |
|
13 |
13 |
$0.00 |
| 1033F |
|
130 |
120 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
12 |
12 |
$0.00 |
| 93325 |
|
17 |
17 |
$0.00 |
| 99051 |
|
16 |
14 |
$0.00 |
| 11056 |
|
12 |
12 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
40 |
40 |
$0.00 |
| 2024F |
|
19 |
13 |
$0.00 |
| 1125F |
|
12,063 |
11,747 |
$0.00 |
| 3351F |
|
72,448 |
62,934 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
23,062 |
20,641 |
$0.00 |
| 36416 |
|
3,353 |
3,287 |
$0.00 |
| 3079F |
|
9,489 |
9,186 |
$0.00 |
| 81508 |
|
5,073 |
5,056 |
$0.00 |
| 3075F |
|
4,610 |
4,505 |
$0.00 |
| 3074F |
|
57,294 |
54,040 |
$0.00 |
| 86701 |
|
2,839 |
2,832 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
37,088 |
27,569 |
$0.00 |
| 82270 |
|
189 |
187 |
$0.00 |
| 84402 |
|
197 |
196 |
$0.00 |
| 82746 |
|
955 |
951 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
7,812 |
7,783 |
$0.00 |
| 86702 |
|
2,840 |
2,833 |
$0.00 |
| 83002 |
|
342 |
341 |
$0.00 |
| 82951 |
|
143 |
143 |
$0.00 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
1,040 |
1,034 |
$0.00 |
| 0501F |
|
3,247 |
2,345 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
26 |
26 |
$0.00 |
| G9226 |
Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed) |
1,184 |
1,128 |
$0.00 |
| 86255 |
|
397 |
337 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
43 |
39 |
$0.00 |
| 87625 |
|
510 |
508 |
$0.00 |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
13 |
12 |
$0.00 |
| 99335 |
|
250 |
235 |
$0.00 |
| 82271 |
|
202 |
199 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$0.00 |
| 95886 |
|
16 |
16 |
$0.00 |
| 86376 |
|
166 |
165 |
$0.00 |
| 82950 |
|
835 |
833 |
$0.00 |
| 84144 |
|
14 |
14 |
$0.00 |
| 3353F |
|
14 |
13 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
15 |
15 |
$0.00 |
| E0776 |
Iv pole |
153 |
153 |
$0.00 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
77 |
59 |
$0.00 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
62 |
61 |
$0.00 |
| 82150 |
|
148 |
144 |
$0.00 |
| 82670 |
|
202 |
201 |
$0.00 |
| 86762 |
|
52 |
52 |
$0.00 |
| 83001 |
|
414 |
413 |
$0.00 |
| 90651 |
|
464 |
463 |
$0.00 |
| 87046 |
|
95 |
94 |
$0.00 |
| 86225 |
|
226 |
224 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
246 |
227 |
$0.00 |
| 1000F |
|
35 |
33 |
$0.00 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
158 |
156 |
$0.00 |
| G0480 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed |
109 |
109 |
$0.00 |
| G0328 |
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous |
201 |
197 |
$0.00 |
| 84154 |
|
66 |
66 |
$0.00 |
| 86800 |
|
91 |
90 |
$0.00 |
| B9998 |
Noc for enteral supplies |
99 |
85 |
$0.00 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
38 |
38 |
$0.00 |
| 97035 |
|
92 |
39 |
$0.00 |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
234 |
216 |
$0.00 |
| 86695 |
|
134 |
133 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
128 |
128 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
26 |
26 |
$0.00 |
| 96415 |
|
12 |
12 |
$0.00 |
| 1036F |
|
209 |
196 |
$0.00 |
| 86160 |
|
172 |
167 |
$0.00 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
95 |
95 |
$0.00 |
| 3352F |
|
31 |
25 |
$0.00 |
| 1031F |
|
118 |
108 |
$0.00 |
| 86317 |
|
17 |
17 |
$0.00 |
| 88341 |
|
25 |
25 |
$0.00 |
| 90688 |
|
26 |
26 |
$0.00 |
| 82105 |
|
65 |
65 |
$0.00 |
| 3080F |
|
26 |
26 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
15 |
15 |
$0.00 |
| 3072F |
|
20 |
20 |
$0.00 |
| 94760 |
|
43 |
43 |
$0.00 |
| 92567 |
|
12 |
12 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
131 |
96 |
$0.00 |
| 88311 |
|
12 |
12 |
$0.00 |
| K0001 |
Standard wheelchair |
25 |
25 |
$0.00 |
| 86850 |
|
15 |
13 |
$0.00 |
| 3044F |
|
13 |
12 |
$0.00 |
| 83520 |
|
15 |
15 |
$0.00 |
| 86304 |
|
27 |
27 |
$0.00 |
| 82784 |
|
31 |
31 |
$0.00 |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
13 |
13 |
$0.00 |
| 82952 |
|
58 |
58 |
$0.00 |
| G9637 |
Final reports with documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique) |
22 |
15 |
$0.00 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
12 |
12 |
$0.00 |
| 93320 |
|
17 |
17 |
$0.00 |