| Code | Description | Claims | Beneficiaries | Total Paid |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
51,216 |
46,204 |
$18.40M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
192,872 |
168,955 |
$16.16M |
| H2035 |
Alcohol and/or other drug treatment program, per hour |
72,447 |
5,693 |
$13.28M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
46,541 |
39,419 |
$9.73M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
55,477 |
48,186 |
$9.67M |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
26,165 |
3,556 |
$2.14M |
| Q9991 |
Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg |
1,013 |
940 |
$1.40M |
| D7140 |
Extraction, erupted tooth or exposed root |
1,234 |
618 |
$1.40M |
| 90791 |
Psychiatric diagnostic evaluation |
10,409 |
9,738 |
$1.20M |
| Q9992 |
Injection, buprenorphine extended-release (sublocade), greater than 100 mg |
804 |
737 |
$1.09M |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
7,520 |
7,377 |
$1.03M |
| 36415 |
Collection of venous blood by venipuncture |
52,720 |
44,143 |
$1.00M |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
1,068 |
740 |
$902K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
8,421 |
7,146 |
$858K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
9,880 |
7,947 |
$857K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
335 |
333 |
$699K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
16,098 |
10,479 |
$689K |
| 80053 |
Comprehensive metabolic panel |
40,494 |
34,266 |
$632K |
| D1206 |
Topical application of fluoride varnish |
1,099 |
975 |
$572K |
| H0001 |
Alcohol and/or drug assessment |
3,169 |
3,101 |
$571K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
5,115 |
4,844 |
$407K |
| 90870 |
|
1,549 |
542 |
$390K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
4,440 |
3,868 |
$388K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,566 |
1,052 |
$385K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
844 |
802 |
$364K |
| 92015 |
Determination of refractive state |
15,883 |
15,459 |
$356K |
| U0003 |
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, making use of high throughput technologies as described by cms-2020-01-r |
4,452 |
3,452 |
$265K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
795 |
738 |
$251K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,103 |
1,064 |
$223K |
| 92060 |
|
4,347 |
4,187 |
$214K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
189 |
174 |
$206K |
| H0035 |
Mental health partial hospitalization, treatment, less than 24 hours |
893 |
139 |
$202K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,766 |
4,652 |
$192K |
| 92587 |
|
1,116 |
1,058 |
$184K |
| H2012 |
Behavioral health day treatment, per hour |
4,888 |
730 |
$183K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,412 |
2,463 |
$176K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
1,266 |
1,244 |
$169K |
| J7050 |
Infusion, normal saline solution, 250 cc |
5,394 |
2,431 |
$160K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
9,534 |
9,174 |
$158K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
10,497 |
9,084 |
$156K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,303 |
933 |
$154K |
| G0378 |
Hospital observation service, per hour |
1,195 |
590 |
$138K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
586 |
275 |
$135K |
| 92134 |
|
7,388 |
6,768 |
$120K |
| 97803 |
|
1,732 |
1,644 |
$97K |
| 99233 |
Prolong inpt eval add15 m |
1,914 |
434 |
$97K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
64,323 |
54,167 |
$93K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
8,558 |
5,937 |
$91K |
| 71046 |
Radiologic examination, chest; 2 views |
2,370 |
2,058 |
$87K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
9,252 |
6,429 |
$84K |
| 92083 |
|
1,753 |
1,636 |
$78K |
| 92567 |
|
5,480 |
5,225 |
$77K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,789 |
1,564 |
$76K |
| 80197 |
|
9,004 |
5,616 |
$61K |
| 93296 |
|
1,754 |
1,683 |
$59K |
| 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 |
3,267 |
2,396 |
$59K |
| G0177 |
Training and educational services related to the care and treatment of patient's disabling mental health problems per session (45 minutes or more) |
15,969 |
2,674 |
$57K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
3,161 |
2,176 |
$57K |
| 92579 |
|
905 |
873 |
$52K |
| 92133 |
|
2,235 |
2,099 |
$51K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,282 |
337 |
$49K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
359 |
210 |
$49K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,496 |
1,048 |
$47K |
| 99223 |
Prolong inpt eval add15 m |
359 |
321 |
$42K |
| 96040 |
|
1,228 |
1,136 |
$39K |
| 93325 |
|
893 |
839 |
$38K |
| 86832 |
|
401 |
354 |
$37K |
| D1351 |
Sealant - per tooth |
99 |
66 |
$35K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
534 |
277 |
$34K |
| 86833 |
|
373 |
331 |
$32K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
46 |
44 |
$32K |
| 82962 |
|
2,035 |
974 |
$30K |
| 67311 |
|
12 |
12 |
$28K |
| 88307 |
|
442 |
365 |
$28K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
66 |
63 |
$27K |
| 81001 |
|
12,743 |
11,366 |
$27K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
38 |
25 |
$26K |
| 93320 |
|
850 |
804 |
$25K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
78 |
71 |
$25K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
269 |
102 |
$21K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
441 |
254 |
$21K |
| 80069 |
|
2,849 |
2,128 |
$20K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
314 |
291 |
$19K |
| 76770 |
|
233 |
194 |
$19K |
| 94375 |
|
178 |
138 |
$19K |
| 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 |
610 |
273 |
$19K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
170 |
164 |
$17K |
| 92582 |
|
281 |
254 |
$17K |
| 90832 |
Psychotherapy, 30 minutes with patient |
185 |
83 |
$17K |
| 77072 |
|
223 |
206 |
$15K |
| 85027 |
|
4,979 |
3,705 |
$14K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,444 |
2,105 |
$14K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
271 |
128 |
$13K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
10,289 |
5,769 |
$13K |
| 92557 |
|
223 |
212 |
$13K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,657 |
2,423 |
$13K |
| 87799 |
|
1,122 |
907 |
$12K |
| A9270 |
Non-covered item or service |
8,351 |
1,916 |
$12K |
| D2934 |
|
30 |
12 |
$11K |
| 82607 |
|
298 |
282 |
$11K |
| Q3014 |
Telehealth originating site facility fee |
497 |
459 |
$10K |
| 99220 |
|
86 |
86 |
$10K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
222 |
99 |
$10K |
| 91200 |
|
119 |
102 |
$10K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
290 |
274 |
$9K |
| 99217 |
|
187 |
184 |
$9K |
| 43762 |
|
53 |
50 |
$9K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,127 |
905 |
$9K |
| 83735 |
|
3,442 |
1,867 |
$8K |
| 84484 |
|
4,085 |
2,914 |
$8K |
| J3490 |
Unclassified drugs |
1,875 |
1,082 |
$8K |
| 86140 |
|
2,445 |
2,021 |
$7K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
7,060 |
5,255 |
$7K |
| 87088 |
|
343 |
300 |
$7K |
| 83970 |
|
169 |
152 |
$7K |
| 87070 |
|
536 |
372 |
$7K |
| D2932 |
|
14 |
12 |
$7K |
| 83880 |
|
598 |
479 |
$6K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
5,262 |
3,886 |
$6K |
| 80076 |
|
2,396 |
2,020 |
$6K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
9,878 |
7,228 |
$6K |
| 86780 |
|
375 |
337 |
$6K |
| 92250 |
|
157 |
144 |
$6K |
| 80061 |
Lipid panel |
333 |
264 |
$6K |
| 86481 |
|
238 |
206 |
$5K |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
144 |
137 |
$5K |
| 82728 |
|
720 |
618 |
$5K |
| 85610 |
|
5,786 |
4,354 |
$5K |
| 92630 |
|
33 |
12 |
$5K |
| 82565 |
|
868 |
677 |
$5K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
7,273 |
6,063 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
66 |
24 |
$4K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
2,982 |
963 |
$4K |
| 99219 |
|
48 |
47 |
$4K |
| 97802 |
|
52 |
51 |
$4K |
| 83690 |
|
4,248 |
3,686 |
$4K |
| 92550 |
|
88 |
83 |
$4K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
25 |
15 |
$4K |
| 84439 |
|
1,499 |
1,368 |
$4K |
| 99222 |
Initial hospital care, per day, moderate complexity |
56 |
50 |
$4K |
| 70450 |
Computed tomography, head or brain; without contrast material |
60 |
52 |
$4K |
| 71045 |
Radiologic examination, chest; single view |
209 |
146 |
$4K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
140 |
121 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,497 |
3,422 |
$4K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,781 |
1,375 |
$4K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
51 |
43 |
$4K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
33 |
28 |
$4K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
645 |
604 |
$4K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
330 |
295 |
$3K |
| 99215 |
Prolong outpt/office vis |
31 |
12 |
$3K |
| G0475 |
Hiv antigen/antibody, combination assay, screening |
148 |
139 |
$3K |
| 87186 |
|
760 |
584 |
$3K |
| 92235 |
|
13 |
12 |
$3K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
139 |
120 |
$3K |
| J2704 |
Injection, propofol, 10 mg |
5,586 |
4,298 |
$3K |
| 82043 |
|
689 |
614 |
$3K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
35 |
33 |
$3K |
| 87081 |
|
532 |
511 |
$3K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
60 |
58 |
$2K |
| 84510 |
|
205 |
186 |
$2K |
| 82570 |
|
1,402 |
424 |
$2K |
| 76820 |
|
38 |
28 |
$2K |
| 80158 |
|
268 |
214 |
$2K |
| 84156 |
|
1,423 |
1,193 |
$2K |
| 84100 |
|
932 |
477 |
$2K |
| 82784 |
|
126 |
90 |
$2K |
| 86803 |
|
145 |
129 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
19 |
15 |
$2K |
| 81025 |
|
2,495 |
2,282 |
$2K |
| 82977 |
|
322 |
175 |
$2K |
| 86900 |
|
563 |
299 |
$1K |
| 0064U |
|
20 |
13 |
$1K |
| 76801 |
|
14 |
13 |
$1K |
| 96138 |
|
21 |
12 |
$1K |
| 86850 |
|
508 |
287 |
$1K |
| 97165 |
|
28 |
14 |
$1K |
| 84030 |
|
205 |
186 |
$1K |
| 86706 |
|
112 |
108 |
$1K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
950 |
432 |
$1K |
| 86704 |
|
101 |
97 |
$1K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,814 |
1,199 |
$1K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
498 |
489 |
$1K |
| 87340 |
|
103 |
100 |
$1K |
| 87517 |
|
207 |
190 |
$1K |
| 92025 |
|
44 |
40 |
$1K |
| 83605 |
|
1,026 |
703 |
$1K |
| G0008 |
Administration of influenza virus vaccine |
333 |
234 |
$969.96 |
| 85730 |
|
884 |
732 |
$955.54 |
| 99225 |
|
19 |
12 |
$921.58 |
| V5264 |
Ear mold/insert, not disposable, any type |
12 |
12 |
$862.24 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,816 |
3,104 |
$860.53 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
183 |
162 |
$831.02 |
| G0124 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician |
43 |
39 |
$799.71 |
| 82248 |
|
198 |
120 |
$790.87 |
| 86901 |
|
528 |
288 |
$758.37 |
| 99221 |
|
12 |
12 |
$744.52 |
| 99153 |
Mod sedat endo service >5yrs |
46 |
29 |
$733.46 |
| 87536 |
|
100 |
92 |
$695.09 |
| 96139 |
|
21 |
12 |
$663.00 |
| 84305 |
|
195 |
168 |
$657.33 |
| 84403 |
|
79 |
76 |
$651.08 |
| 90785 |
|
520 |
326 |
$638.52 |
| 83550 |
|
283 |
247 |
$634.07 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
26 |
13 |
$606.57 |
| 81241 |
|
13 |
12 |
$600.65 |
| 81240 |
|
13 |
12 |
$586.23 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
3,026 |
2,934 |
$572.03 |
| 85652 |
|
922 |
770 |
$531.69 |
| 83540 |
|
326 |
277 |
$521.91 |
| 86905 |
|
13 |
12 |
$517.50 |
| 92285 |
|
15 |
13 |
$509.04 |
| 97162 |
|
17 |
13 |
$492.33 |
| 36591 |
|
15 |
14 |
$490.66 |
| 82157 |
|
38 |
36 |
$485.41 |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
100 |
17 |
$484.17 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
2,091 |
1,875 |
$470.15 |
| 85045 |
|
838 |
736 |
$465.85 |
| J7999 |
Compounded drug, not otherwise classified |
116 |
91 |
$408.70 |
| 84703 |
|
276 |
250 |
$402.09 |
| 83655 |
|
154 |
140 |
$396.31 |
| 87077 |
|
215 |
155 |
$395.07 |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
22 |
12 |
$388.15 |
| 86360 |
|
113 |
105 |
$383.55 |
| 82533 |
|
41 |
37 |
$375.93 |
| 97535 |
Self-care/home management training, each 15 minutes |
73 |
39 |
$354.36 |
| 82397 |
|
208 |
179 |
$343.52 |
| 86359 |
|
111 |
103 |
$326.22 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
78 |
75 |
$318.28 |
| 87522 |
Neg quan hep c or qual rna |
31 |
27 |
$313.22 |
| 87497 |
|
35 |
27 |
$312.93 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
12 |
$299.37 |
| 99152 |
|
105 |
67 |
$286.13 |
| 82024 |
|
27 |
24 |
$285.88 |
| 86003 |
|
14 |
14 |
$284.48 |
| 96376 |
|
151 |
93 |
$283.48 |
| 84460 |
|
111 |
105 |
$265.02 |
| 84450 |
|
108 |
101 |
$263.78 |
| C1769 |
Guide wire |
206 |
131 |
$241.70 |
| 83002 |
|
56 |
51 |
$235.88 |
| 90686 |
|
67 |
50 |
$233.60 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
820 |
733 |
$225.51 |
| 90662 |
|
59 |
50 |
$219.98 |
| 92555 |
|
29 |
29 |
$209.02 |
| 88300 |
|
13 |
12 |
$202.52 |
| 86708 |
|
14 |
13 |
$198.03 |
| 86160 |
|
41 |
39 |
$182.89 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
460 |
261 |
$180.06 |
| 86709 |
|
13 |
12 |
$174.02 |
| 83001 |
|
44 |
38 |
$171.23 |
| 36416 |
|
303 |
285 |
$166.09 |
| 82379 |
|
16 |
12 |
$163.69 |
| 80320 |
|
70 |
60 |
$149.13 |
| 84165 |
|
17 |
14 |
$148.48 |
| 99454 |
|
13 |
12 |
$140.20 |
| 83498 |
|
13 |
12 |
$138.73 |
| 84244 |
|
13 |
12 |
$133.36 |
| 84702 |
|
70 |
68 |
$125.52 |
| 82105 |
|
52 |
49 |
$107.15 |
| C9399 |
Unclassified drugs or biologicals |
57 |
54 |
$92.48 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
13 |
13 |
$86.14 |
| 82803 |
|
37 |
28 |
$77.02 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
937 |
376 |
$73.21 |
| 86225 |
|
42 |
40 |
$72.92 |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
13 |
13 |
$63.24 |
| 87581 |
|
13 |
13 |
$63.24 |
| 87486 |
|
13 |
13 |
$63.24 |
| 93017 |
|
17 |
12 |
$57.96 |
| 82075 |
|
70 |
64 |
$55.02 |
| 86665 |
|
41 |
28 |
$49.96 |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
48 |
29 |
$38.59 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
31 |
12 |
$30.39 |
| 87040 |
|
56 |
24 |
$29.07 |
| 83516 |
|
21 |
13 |
$28.46 |
| 86644 |
|
28 |
27 |
$28.09 |
| 85613 |
|
14 |
13 |
$27.73 |
| 86147 |
|
14 |
13 |
$27.45 |
| 86886 |
|
12 |
12 |
$27.23 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
105 |
73 |
$24.61 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
94 |
93 |
$17.98 |
| 86645 |
|
15 |
15 |
$16.84 |
| 86664 |
|
15 |
15 |
$15.28 |
| 85018 |
|
60 |
40 |
$13.35 |
| 84132 |
|
61 |
27 |
$13.08 |
| 82040 |
|
25 |
25 |
$12.40 |
| J2404 |
Injection, nicardipine, 0.1 mg |
18 |
12 |
$10.82 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
15 |
14 |
$4.17 |
| 82550 |
|
12 |
12 |
$3.94 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
74 |
71 |
$0.45 |
| 84550 |
|
13 |
13 |
$0.00 |
| 85670 |
|
14 |
13 |
$0.00 |
| 84466 |
|
20 |
14 |
$0.00 |
| 81003 |
|
12 |
12 |
$0.00 |
| G1010 |
Clinical decision support mechanism stanson, as defined by the medicare appropriate use criteria program |
30 |
24 |
$0.00 |
| 86787 |
|
14 |
13 |
$0.00 |
| S5102 |
Day care services, adult; per diem |
1,869 |
301 |
$0.00 |
| S5100 |
Day care services, adult; per 15 minutes |
248 |
89 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
18 |
12 |
$0.00 |