| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
26,930 |
24,918 |
$7.91M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
21,658 |
19,823 |
$7.31M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
14,225 |
12,675 |
$6.49M |
| G0378 |
Hospital observation service, per hour |
7,899 |
6,931 |
$4.50M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
9,877 |
9,478 |
$1.77M |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
918 |
896 |
$1.19M |
| OP250 |
|
63,731 |
34,866 |
$948K |
| H0035 |
Mental health partial hospitalization, treatment, less than 24 hours |
6,515 |
660 |
$907K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
17,221 |
4,466 |
$467K |
| OP370 |
|
3,245 |
2,920 |
$431K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
3,970 |
3,796 |
$431K |
| OP710 |
|
3,769 |
3,448 |
$410K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,825 |
1,754 |
$391K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
21,867 |
18,813 |
$372K |
| 80053 |
Comprehensive metabolic panel |
43,785 |
36,340 |
$359K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
7,126 |
5,822 |
$346K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
9,190 |
7,783 |
$341K |
| 70450 |
Computed tomography, head or brain; without contrast material |
5,392 |
5,062 |
$280K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,423 |
863 |
$276K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
42,612 |
34,426 |
$271K |
| OP272 |
|
5,078 |
4,657 |
$270K |
| 93975 |
|
2,394 |
2,256 |
$252K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
14,201 |
12,615 |
$231K |
| 36415 |
Collection of venous blood by venipuncture |
47,736 |
38,668 |
$209K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
3,194 |
1,354 |
$198K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,849 |
6,109 |
$188K |
| 76642 |
|
1,796 |
1,672 |
$154K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,473 |
2,412 |
$142K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
6,517 |
2,040 |
$140K |
| 71045 |
Radiologic examination, chest; single view |
10,946 |
10,150 |
$138K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,527 |
1,460 |
$133K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
8,173 |
6,331 |
$131K |
| 93970 |
|
1,083 |
1,030 |
$126K |
| 76830 |
Ultrasound, transvaginal |
1,733 |
1,681 |
$124K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,349 |
2,190 |
$120K |
| 71046 |
Radiologic examination, chest; 2 views |
6,856 |
6,587 |
$118K |
| 90791 |
Psychiatric diagnostic evaluation |
3,812 |
3,253 |
$118K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
3,824 |
2,058 |
$117K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
993 |
977 |
$115K |
| 95782 |
|
96 |
94 |
$109K |
| 95806 |
|
392 |
379 |
$107K |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
2,747 |
2,087 |
$106K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,492 |
1,446 |
$104K |
| 97161 |
|
2,477 |
2,373 |
$88K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,483 |
2,979 |
$86K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
797 |
750 |
$81K |
| 77066 |
Tomosynthesis, mammo |
1,005 |
983 |
$79K |
| 84443 |
Thyroid stimulating hormone (TSH) |
5,531 |
5,091 |
$78K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
859 |
787 |
$75K |
| 93971 |
|
857 |
823 |
$74K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,222 |
2,037 |
$73K |
| 81001 |
|
20,092 |
18,532 |
$70K |
| OP258 |
|
23,723 |
15,963 |
$67K |
| 95800 |
|
321 |
321 |
$65K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,681 |
1,457 |
$64K |
| 84484 |
|
12,760 |
10,453 |
$61K |
| 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 |
2,562 |
2,143 |
$53K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,066 |
2,535 |
$51K |
| 80061 |
Lipid panel |
4,070 |
3,903 |
$49K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,448 |
1,380 |
$49K |
| 84702 |
|
7,086 |
6,406 |
$48K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
2,071 |
1,842 |
$48K |
| 93017 |
|
398 |
376 |
$48K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
1,211 |
1,157 |
$48K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
703 |
682 |
$47K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
3,768 |
2,396 |
$45K |
| 83735 |
|
12,138 |
9,610 |
$45K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
202 |
187 |
$41K |
| 83605 |
|
6,896 |
6,252 |
$40K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
5,106 |
4,411 |
$40K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,632 |
2,015 |
$40K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
845 |
756 |
$39K |
| 73630 |
|
1,752 |
1,641 |
$39K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,336 |
440 |
$38K |
| 73562 |
|
1,762 |
1,643 |
$38K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,007 |
977 |
$36K |
| 85610 |
|
9,014 |
8,100 |
$35K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
31 |
28 |
$35K |
| 85027 |
|
7,727 |
6,938 |
$35K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
439 |
421 |
$34K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,046 |
995 |
$33K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
488 |
448 |
$33K |
| 86900 |
|
3,724 |
3,425 |
$31K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
397 |
383 |
$31K |
| 86850 |
|
3,464 |
3,148 |
$30K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
101 |
94 |
$30K |
| A9270 |
Non-covered item or service |
10,075 |
3,648 |
$29K |
| 88142 |
|
793 |
784 |
$29K |
| OP278 |
|
124 |
116 |
$28K |
| 83690 |
|
9,163 |
8,366 |
$28K |
| 73610 |
|
1,508 |
1,446 |
$28K |
| 73030 |
|
1,158 |
1,087 |
$27K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
1,514 |
1,436 |
$27K |
| 86803 |
|
4,800 |
4,475 |
$27K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
731 |
710 |
$26K |
| 73130 |
|
1,066 |
997 |
$26K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
189 |
170 |
$26K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,363 |
836 |
$26K |
| 85730 |
|
6,506 |
6,021 |
$25K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,689 |
2,389 |
$25K |
| 90832 |
Psychotherapy, 30 minutes with patient |
407 |
85 |
$24K |
| 81025 |
|
6,484 |
6,153 |
$23K |
| 77065 |
Tomosynthesis, mammo |
521 |
482 |
$23K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,464 |
4,170 |
$23K |
| 82948 |
|
2,987 |
2,014 |
$23K |
| 96376 |
|
2,267 |
1,827 |
$23K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
826 |
105 |
$20K |
| 80320 |
|
3,124 |
2,804 |
$20K |
| 85007 |
|
5,154 |
4,574 |
$19K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
44 |
39 |
$18K |
| 83880 |
|
2,006 |
1,835 |
$17K |
| 87631 |
|
423 |
418 |
$16K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
126 |
94 |
$16K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
2,515 |
2,342 |
$15K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
689 |
503 |
$15K |
| OP271 |
|
2,110 |
2,039 |
$15K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,082 |
1,027 |
$15K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
166 |
161 |
$13K |
| J2060 |
Injection, lorazepam, 2 mg |
2,477 |
1,948 |
$13K |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
1,451 |
1,072 |
$13K |
| 96417 |
|
58 |
41 |
$13K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
777 |
731 |
$12K |
| 29125 |
|
340 |
330 |
$12K |
| 96367 |
|
329 |
234 |
$12K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
595 |
556 |
$12K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,553 |
2,264 |
$12K |
| 72110 |
|
256 |
256 |
$11K |
| 73110 |
|
570 |
544 |
$11K |
| 87040 |
|
1,394 |
1,288 |
$11K |
| 77080 |
|
184 |
179 |
$11K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,319 |
1,278 |
$11K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
3,355 |
3,024 |
$11K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
7,255 |
6,169 |
$10K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
601 |
559 |
$10K |
| J2704 |
Injection, propofol, 10 mg |
2,496 |
2,147 |
$10K |
| 84439 |
|
1,266 |
1,114 |
$9K |
| 87186 |
|
812 |
776 |
$9K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,897 |
1,562 |
$9K |
| 12001 |
|
283 |
277 |
$9K |
| 87340 |
|
2,174 |
1,928 |
$8K |
| 88313 |
|
389 |
363 |
$8K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
44 |
38 |
$8K |
| 73502 |
|
430 |
405 |
$8K |
| 86901 |
|
1,927 |
1,708 |
$8K |
| 82150 |
|
1,417 |
1,263 |
$8K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,456 |
1,147 |
$8K |
| 90715 |
|
1,076 |
1,044 |
$7K |
| 71250 |
|
65 |
64 |
$7K |
| 82607 |
|
881 |
802 |
$7K |
| 87806 |
|
453 |
419 |
$7K |
| 74018 |
|
294 |
267 |
$7K |
| 88342 |
|
587 |
558 |
$7K |
| OP259 |
|
9,817 |
4,688 |
$6K |
| J1756 |
Injection, iron sucrose, 1 mg |
234 |
100 |
$6K |
| 82962 |
|
3,913 |
2,552 |
$6K |
| 97162 |
|
248 |
231 |
$6K |
| 87081 |
|
1,397 |
1,379 |
$6K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,218 |
1,084 |
$6K |
| J1630 |
Injection, haloperidol, up to 5 mg |
772 |
589 |
$6K |
| 0001A |
|
189 |
189 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,157 |
1,039 |
$6K |
| OP270 |
|
814 |
800 |
$5K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
888 |
693 |
$5K |
| 12011 |
|
202 |
199 |
$5K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
8,635 |
7,593 |
$5K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
29 |
28 |
$5K |
| 80329 |
|
826 |
749 |
$5K |
| 0002A |
|
157 |
157 |
$5K |
| 85379 |
|
2,613 |
2,500 |
$5K |
| 86703 |
|
195 |
193 |
$5K |
| 76770 |
|
106 |
104 |
$5K |
| 77336 |
|
52 |
24 |
$4K |
| 0240U |
|
186 |
172 |
$4K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
48 |
29 |
$4K |
| 73140 |
|
178 |
170 |
$4K |
| 84100 |
|
2,256 |
1,809 |
$4K |
| 90837 |
Psychotherapy, 53 minutes with patient |
68 |
39 |
$4K |
| 87653 |
|
296 |
295 |
$4K |
| 0071A |
|
113 |
111 |
$4K |
| Q9963 |
High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml |
1,289 |
1,190 |
$3K |
| 84145 |
|
386 |
370 |
$3K |
| 0004A |
|
103 |
103 |
$3K |
| 70486 |
|
28 |
27 |
$3K |
| 97165 |
|
160 |
141 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
209 |
155 |
$3K |
| 87430 |
|
1,063 |
1,053 |
$3K |
| 73590 |
|
101 |
100 |
$3K |
| OP279 |
|
411 |
409 |
$3K |
| 72100 |
|
122 |
109 |
$3K |
| 86780 |
|
467 |
404 |
$3K |
| 92587 |
|
25 |
25 |
$3K |
| C1769 |
Guide wire |
267 |
213 |
$3K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,792 |
1,600 |
$2K |
| 88341 |
|
16 |
14 |
$2K |
| 97116 |
|
263 |
127 |
$2K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
207 |
185 |
$2K |
| 82550 |
|
876 |
765 |
$2K |
| 84703 |
|
627 |
601 |
$2K |
| 82746 |
|
352 |
309 |
$2K |
| 97597 |
|
19 |
12 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
151 |
151 |
$2K |
| 83540 |
|
716 |
668 |
$2K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,709 |
1,806 |
$2K |
| 94060 |
|
17 |
15 |
$2K |
| 80164 |
|
303 |
271 |
$2K |
| 84466 |
|
395 |
368 |
$2K |
| 80143 |
|
398 |
359 |
$2K |
| 29130 |
|
39 |
39 |
$1K |
| 82728 |
|
244 |
231 |
$1K |
| 80050 |
General health panel |
38 |
37 |
$1K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
507 |
470 |
$1K |
| 20999 |
|
67 |
67 |
$1K |
| 87070 |
|
350 |
309 |
$1K |
| J2785 |
Injection, regadenoson, 0.1 mg |
44 |
40 |
$1K |
| 10060 |
|
26 |
24 |
$1K |
| 0072A |
|
40 |
40 |
$1K |
| 84481 |
|
137 |
115 |
$1K |
| 84436 |
|
179 |
175 |
$1K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
233 |
194 |
$1K |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
216 |
206 |
$1K |
| 88307 |
|
25 |
25 |
$1K |
| 85651 |
|
593 |
559 |
$1K |
| 80179 |
|
377 |
339 |
$1K |
| 73070 |
|
42 |
42 |
$1K |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
223 |
206 |
$1K |
| 76870 |
|
14 |
13 |
$1K |
| 76536 |
|
12 |
12 |
$1K |
| 87088 |
|
168 |
158 |
$1K |
| 97602 |
|
16 |
13 |
$995.80 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$983.96 |
| 87147 |
|
237 |
236 |
$976.61 |
| OP637 |
|
1,628 |
719 |
$928.83 |
| 82247 |
|
763 |
747 |
$807.74 |
| 0064A |
|
28 |
28 |
$784.54 |
| A4648 |
Tissue marker, implantable, any type, each |
26 |
25 |
$778.81 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,407 |
1,304 |
$740.81 |
| 90834 |
Psychotherapy, 45 minutes with patient |
16 |
12 |
$718.39 |
| OP229 |
|
13 |
13 |
$667.29 |
| J1644 |
Injection, heparin sodium, per 1000 units |
484 |
194 |
$658.94 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
792 |
484 |
$637.90 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
84 |
75 |
$616.07 |
| 83020 |
|
107 |
74 |
$566.53 |
| 0003A |
|
19 |
18 |
$563.16 |
| 92567 |
|
13 |
12 |
$543.81 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
201 |
192 |
$525.75 |
| 74019 |
|
41 |
39 |
$509.89 |
| 83615 |
|
273 |
243 |
$503.34 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
294 |
278 |
$478.99 |
| 83550 |
|
144 |
136 |
$472.18 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
597 |
420 |
$454.23 |
| 84460 |
|
325 |
315 |
$442.09 |
| 84153 |
|
52 |
44 |
$425.01 |
| 0011A |
|
13 |
13 |
$417.10 |
| 84480 |
|
47 |
42 |
$414.30 |
| 87077 |
|
62 |
61 |
$411.66 |
| 84075 |
|
320 |
310 |
$407.83 |
| 97803 |
|
27 |
24 |
$395.69 |
| 0012A |
|
13 |
13 |
$388.85 |
| 82248 |
|
133 |
121 |
$384.27 |
| 86141 |
|
49 |
48 |
$362.79 |
| 86140 |
|
195 |
179 |
$361.51 |
| 29515 |
|
12 |
12 |
$360.06 |
| 86762 |
|
54 |
45 |
$343.59 |
| 94729 |
|
17 |
15 |
$340.95 |
| 82009 |
|
128 |
112 |
$332.80 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
468 |
349 |
$330.88 |
| 36592 |
|
18 |
13 |
$327.54 |
| 84450 |
|
318 |
308 |
$326.26 |
| 85652 |
|
484 |
446 |
$318.11 |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
14 |
14 |
$286.65 |
| 94727 |
|
17 |
15 |
$277.74 |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
25 |
24 |
$277.34 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
14 |
13 |
$270.56 |
| 82951 |
|
30 |
29 |
$248.35 |
| 86317 |
|
80 |
52 |
$243.03 |
| 71100 |
|
14 |
14 |
$234.11 |
| 84479 |
|
38 |
38 |
$199.90 |
| 84155 |
|
321 |
309 |
$195.74 |
| 82040 |
|
318 |
308 |
$192.42 |
| 82043 |
|
118 |
112 |
$188.34 |
| 73090 |
|
16 |
14 |
$180.45 |
| 87185 |
|
130 |
108 |
$177.41 |
| 82570 |
|
133 |
123 |
$136.52 |
| 83655 |
|
13 |
13 |
$124.74 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
202 |
177 |
$121.83 |
| 84550 |
|
55 |
52 |
$120.37 |
| 73660 |
|
13 |
12 |
$95.20 |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
23 |
19 |
$73.79 |
| J1790 |
Injection, droperidol, up to 5 mg |
185 |
156 |
$70.50 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
129 |
115 |
$67.56 |
| 86706 |
|
14 |
12 |
$67.08 |
| 86592 |
|
25 |
25 |
$60.92 |
| J3480 |
Injection, potassium chloride, per 2 meq |
97 |
63 |
$57.39 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
38 |
28 |
$56.34 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
95 |
38 |
$52.38 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
12 |
12 |
$47.44 |
| G0008 |
Administration of influenza virus vaccine |
13 |
13 |
$44.59 |
| J1643 |
Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units |
525 |
227 |
$37.94 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
55 |
50 |
$29.12 |
| 81002 |
|
15 |
15 |
$28.63 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
73 |
67 |
$25.96 |
| OP255 |
|
21 |
12 |
$13.31 |
| 91307 |
|
123 |
110 |
$12.00 |
| J7510 |
Prednisolone oral, per 5 mg |
29 |
26 |
$6.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
53 |
44 |
$4.58 |
| 91306 |
|
25 |
25 |
$4.00 |
| 85384 |
|
14 |
14 |
$1.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
12 |
12 |
$1.00 |
| J0687 |
Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg |
97 |
87 |
$0.35 |
| 91300 |
|
147 |
141 |
$0.00 |
| Q0247 |
Injection, sotrovimab, 500 mg |
13 |
13 |
$0.00 |