| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
21,818 |
17,851 |
$4.53M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
21,893 |
18,373 |
$2.54M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,873 |
3,992 |
$2.19M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
6,370 |
4,973 |
$1.71M |
| 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 |
21,105 |
16,772 |
$1.31M |
| 70450 |
Computed tomography, head or brain; without contrast material |
5,273 |
4,098 |
$1.02M |
| G0378 |
Hospital observation service, per hour |
5,466 |
2,494 |
$998K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
26,118 |
22,855 |
$815K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
28,005 |
8,754 |
$754K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
18,875 |
14,576 |
$626K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
13,381 |
9,895 |
$610K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
11,564 |
8,077 |
$561K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,888 |
1,470 |
$552K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,633 |
7,358 |
$478K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
6,078 |
3,763 |
$464K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
17,679 |
14,724 |
$436K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
987 |
761 |
$406K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
16,136 |
13,291 |
$383K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,562 |
1,230 |
$382K |
| 71046 |
Radiologic examination, chest; 2 views |
8,425 |
6,887 |
$348K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
10,183 |
7,199 |
$323K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
555 |
442 |
$319K |
| 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 |
17,380 |
13,863 |
$312K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
925 |
735 |
$287K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
16,242 |
5,312 |
$285K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
931 |
725 |
$277K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
4,936 |
2,828 |
$275K |
| 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 |
5,271 |
4,032 |
$273K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
4,382 |
3,563 |
$264K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
3,105 |
1,625 |
$264K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,221 |
4,929 |
$239K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
56,129 |
38,969 |
$236K |
| 71045 |
Radiologic examination, chest; single view |
7,911 |
6,045 |
$228K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
733 |
525 |
$196K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
7,637 |
3,581 |
$187K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
17,771 |
11,667 |
$186K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
36,228 |
26,152 |
$171K |
| 80053 |
Comprehensive metabolic panel |
26,278 |
18,738 |
$145K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
3,473 |
2,795 |
$129K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,223 |
1,042 |
$129K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
997 |
896 |
$127K |
| 87428 |
|
2,126 |
1,507 |
$124K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,512 |
1,225 |
$121K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,397 |
2,222 |
$119K |
| 84443 |
Thyroid stimulating hormone (TSH) |
11,735 |
9,704 |
$118K |
| 80076 |
|
23,151 |
18,450 |
$107K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
3,822 |
3,402 |
$107K |
| 76830 |
Ultrasound, transvaginal |
902 |
765 |
$104K |
| 97161 |
|
2,349 |
1,872 |
$98K |
| 74018 |
|
1,837 |
1,416 |
$93K |
| 76770 |
|
1,102 |
891 |
$91K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
723 |
566 |
$88K |
| 97113 |
|
1,788 |
517 |
$87K |
| 64483 |
|
253 |
197 |
$86K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,895 |
2,755 |
$85K |
| 97162 |
|
2,536 |
1,993 |
$84K |
| 20553 |
|
633 |
480 |
$75K |
| 73630 |
|
1,371 |
1,113 |
$74K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
642 |
549 |
$73K |
| 73610 |
|
1,193 |
976 |
$73K |
| 84484 |
|
12,539 |
8,663 |
$70K |
| 93971 |
|
737 |
581 |
$65K |
| 59025 |
Fetal non-stress test |
1,188 |
760 |
$64K |
| 80061 |
Lipid panel |
6,823 |
6,089 |
$63K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
5,406 |
4,350 |
$61K |
| 83735 |
|
17,886 |
12,334 |
$60K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,811 |
2,477 |
$60K |
| J7050 |
Infusion, normal saline solution, 250 cc |
6,193 |
3,399 |
$59K |
| 93017 |
|
561 |
448 |
$58K |
| 72100 |
|
988 |
778 |
$55K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,054 |
741 |
$55K |
| 0240U |
|
399 |
392 |
$53K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,642 |
666 |
$48K |
| 97597 |
|
1,206 |
639 |
$48K |
| 73130 |
|
714 |
568 |
$47K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
11,194 |
9,043 |
$47K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
1,772 |
1,347 |
$42K |
| 73564 |
|
642 |
522 |
$41K |
| 71250 |
|
287 |
204 |
$41K |
| 83690 |
|
9,857 |
7,808 |
$38K |
| 81001 |
|
20,668 |
16,565 |
$37K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,487 |
1,313 |
$34K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,655 |
1,442 |
$34K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,655 |
1,442 |
$34K |
| 96376 |
|
1,224 |
911 |
$34K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
997 |
896 |
$33K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
122 |
92 |
$33K |
| 73030 |
|
702 |
566 |
$33K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
7,929 |
6,217 |
$32K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
66 |
54 |
$32K |
| 73110 |
|
497 |
399 |
$32K |
| 83880 |
|
1,745 |
1,309 |
$30K |
| 97165 |
|
759 |
543 |
$28K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
82 |
68 |
$28K |
| 82728 |
|
3,064 |
2,583 |
$27K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,171 |
3,601 |
$27K |
| 85027 |
|
6,960 |
5,323 |
$26K |
| 76642 |
|
353 |
259 |
$25K |
| 87040 |
|
2,390 |
1,801 |
$25K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
998 |
677 |
$24K |
| 94060 |
|
438 |
350 |
$24K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
188 |
182 |
$23K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,702 |
972 |
$23K |
| 84702 |
|
1,888 |
1,447 |
$22K |
| 64493 |
|
75 |
51 |
$22K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
786 |
689 |
$21K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
50 |
42 |
$21K |
| J2704 |
Injection, propofol, 10 mg |
9,156 |
6,979 |
$21K |
| J3490 |
Unclassified drugs |
3,863 |
2,687 |
$20K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
895 |
787 |
$19K |
| 80050 |
General health panel |
2,042 |
1,825 |
$19K |
| 73502 |
|
337 |
257 |
$19K |
| 84439 |
|
2,893 |
2,360 |
$18K |
| 84703 |
|
3,449 |
2,832 |
$18K |
| 93325 |
|
233 |
178 |
$18K |
| 83605 |
|
2,830 |
2,117 |
$17K |
| 87186 |
|
3,185 |
2,522 |
$16K |
| 87077 |
|
3,109 |
2,512 |
$16K |
| 82607 |
|
1,834 |
1,567 |
$15K |
| 86803 |
|
1,500 |
1,327 |
$15K |
| 87070 |
|
2,476 |
1,995 |
$15K |
| 70498 |
|
31 |
26 |
$15K |
| 83550 |
|
2,525 |
2,178 |
$15K |
| 87430 |
|
1,688 |
1,377 |
$14K |
| 87081 |
|
3,024 |
2,494 |
$14K |
| 70486 |
|
56 |
42 |
$14K |
| 81025 |
|
2,839 |
2,409 |
$14K |
| 86850 |
|
1,963 |
1,517 |
$14K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,031 |
1,370 |
$13K |
| 76536 |
|
148 |
118 |
$13K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
181 |
143 |
$13K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
58 |
39 |
$13K |
| 73140 |
|
163 |
147 |
$13K |
| 80320 |
|
109 |
76 |
$12K |
| 86618 |
|
752 |
592 |
$12K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
117 |
82 |
$12K |
| 83540 |
|
2,662 |
2,296 |
$12K |
| 36415 |
Collection of venous blood by venipuncture |
22,528 |
16,951 |
$11K |
| 64494 |
|
84 |
51 |
$11K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
161 |
127 |
$11K |
| 83516 |
|
759 |
605 |
$11K |
| 94729 |
|
357 |
277 |
$10K |
| 86140 |
|
3,056 |
2,505 |
$10K |
| 70496 |
|
15 |
14 |
$10K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
79 |
77 |
$10K |
| 85610 |
|
4,582 |
3,052 |
$10K |
| 96367 |
|
251 |
137 |
$10K |
| 80143 |
|
1,024 |
725 |
$9K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
6,103 |
4,347 |
$9K |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
1,541 |
1,166 |
$9K |
| 64635 |
|
19 |
13 |
$8K |
| 77066 |
Tomosynthesis, mammo |
84 |
66 |
$8K |
| 77336 |
|
105 |
38 |
$8K |
| 87340 |
|
1,086 |
930 |
$8K |
| 71271 |
|
13 |
12 |
$8K |
| 36591 |
|
1,104 |
454 |
$8K |
| 85379 |
|
1,232 |
979 |
$8K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
175 |
151 |
$8K |
| 80179 |
|
892 |
633 |
$8K |
| 62323 |
|
34 |
27 |
$8K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,903 |
1,901 |
$8K |
| 87807 |
|
761 |
601 |
$7K |
| 77065 |
Tomosynthesis, mammo |
99 |
58 |
$7K |
| 85651 |
|
2,982 |
2,442 |
$7K |
| 93225 |
|
95 |
83 |
$7K |
| 82784 |
|
650 |
527 |
$7K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
65 |
52 |
$6K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
8,833 |
6,134 |
$6K |
| 83970 |
|
190 |
154 |
$6K |
| 72141 |
|
15 |
13 |
$6K |
| 86780 |
|
599 |
542 |
$6K |
| 74019 |
|
90 |
70 |
$6K |
| J2785 |
Injection, regadenoson, 0.1 mg |
63 |
51 |
$6K |
| 87400 |
|
985 |
807 |
$6K |
| 74022 |
|
87 |
60 |
$6K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,400 |
2,116 |
$6K |
| J1756 |
Injection, iron sucrose, 1 mg |
243 |
80 |
$5K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
185 |
162 |
$5K |
| 95819 |
|
19 |
18 |
$5K |
| 64484 |
|
39 |
24 |
$5K |
| 97803 |
|
302 |
219 |
$5K |
| 86617 |
|
210 |
190 |
$5K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
8,106 |
5,942 |
$5K |
| 72110 |
|
59 |
52 |
$5K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
7,288 |
5,259 |
$5K |
| 87147 |
|
1,002 |
829 |
$5K |
| 97802 |
|
114 |
110 |
$5K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
806 |
499 |
$5K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
12,317 |
8,508 |
$4K |
| 81003 |
|
3,658 |
3,048 |
$4K |
| 10060 |
|
44 |
37 |
$4K |
| 87205 |
|
1,611 |
1,267 |
$4K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
897 |
651 |
$4K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,056 |
604 |
$4K |
| 86900 |
|
2,103 |
1,609 |
$4K |
| 86901 |
|
2,103 |
1,609 |
$4K |
| 99218 |
|
296 |
63 |
$4K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
9,141 |
6,152 |
$4K |
| 87522 |
Neg quan hep c or qual rna |
97 |
90 |
$3K |
| J2060 |
Injection, lorazepam, 2 mg |
2,062 |
1,449 |
$3K |
| 80047 |
|
556 |
471 |
$3K |
| 93321 |
|
70 |
51 |
$3K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
53 |
41 |
$3K |
| 86706 |
|
345 |
303 |
$3K |
| 73562 |
|
25 |
25 |
$3K |
| 84100 |
|
936 |
630 |
$3K |
| 82043 |
|
674 |
586 |
$3K |
| 82550 |
|
607 |
466 |
$2K |
| 87185 |
|
1,499 |
1,195 |
$2K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
1,551 |
1,154 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
278 |
206 |
$2K |
| 82948 |
|
1,711 |
791 |
$2K |
| 82150 |
|
598 |
452 |
$2K |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
1,354 |
1,000 |
$2K |
| 83615 |
|
560 |
433 |
$2K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
719 |
274 |
$2K |
| 0598T |
|
36 |
27 |
$2K |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,885 |
685 |
$2K |
| S9982 |
Medical records copying fee, per page |
105 |
92 |
$2K |
| 85730 |
|
422 |
339 |
$2K |
| 64636 |
|
17 |
12 |
$2K |
| 93970 |
|
20 |
13 |
$2K |
| 97116 |
|
179 |
89 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
387 |
303 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$2K |
| 87210 |
|
657 |
568 |
$2K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
126 |
69 |
$2K |
| 84403 |
|
72 |
65 |
$2K |
| 90715 |
|
156 |
139 |
$1K |
| 77080 |
|
17 |
12 |
$1K |
| 76870 |
|
12 |
12 |
$1K |
| 12001 |
|
25 |
24 |
$1K |
| 87476 |
|
72 |
69 |
$1K |
| 86762 |
|
115 |
96 |
$1K |
| 86704 |
|
140 |
120 |
$1K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
449 |
336 |
$1K |
| C1769 |
Guide wire |
35 |
27 |
$1K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,671 |
1,125 |
$1K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
181 |
116 |
$1K |
| 86039 |
|
134 |
121 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
121 |
97 |
$1K |
| 73080 |
|
26 |
24 |
$1K |
| J1815 |
Injection, insulin, per 5 units |
119 |
51 |
$1K |
| J3480 |
Injection, potassium chloride, per 2 meq |
312 |
168 |
$1K |
| 84425 |
|
52 |
38 |
$1K |
| 29125 |
|
12 |
12 |
$952.56 |
| 86787 |
|
94 |
76 |
$947.84 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
705 |
401 |
$922.27 |
| Q9950 |
Injection, sulfur hexafluoride lipid microspheres, per ml |
36 |
26 |
$898.71 |
| 94727 |
|
51 |
41 |
$889.75 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
82 |
24 |
$865.32 |
| 72050 |
|
16 |
13 |
$842.84 |
| 84402 |
|
42 |
36 |
$817.83 |
| 84460 |
|
254 |
211 |
$815.49 |
| 86308 |
|
190 |
161 |
$781.92 |
| 73090 |
|
14 |
12 |
$754.13 |
| 87902 |
|
13 |
13 |
$666.96 |
| 85048 |
|
492 |
422 |
$632.98 |
| 82565 |
|
197 |
165 |
$606.06 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
13 |
12 |
$549.10 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
740 |
511 |
$530.78 |
| 97535 |
Self-care/home management training, each 15 minutes |
68 |
42 |
$523.41 |
| 82746 |
|
42 |
27 |
$521.25 |
| 84270 |
|
26 |
24 |
$467.18 |
| 82570 |
|
120 |
106 |
$454.40 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
247 |
138 |
$451.88 |
| 94010 |
|
12 |
12 |
$450.12 |
| 82803 |
|
34 |
27 |
$442.26 |
| 93296 |
|
35 |
24 |
$390.34 |
| 82947 |
|
131 |
124 |
$383.56 |
| G0127 |
Trimming of dystrophic nails, any number |
30 |
25 |
$346.54 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
737 |
461 |
$341.11 |
| 86431 |
|
77 |
65 |
$332.50 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
56 |
51 |
$328.00 |
| 73590 |
|
16 |
12 |
$327.76 |
| 82105 |
|
29 |
24 |
$326.12 |
| 87207 |
|
61 |
55 |
$324.00 |
| 87150 |
|
15 |
15 |
$316.79 |
| 96415 |
|
20 |
13 |
$311.86 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,222 |
786 |
$296.05 |
| 80299 |
|
14 |
12 |
$280.48 |
| 84153 |
|
28 |
25 |
$272.29 |
| 85652 |
|
136 |
121 |
$237.11 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
39 |
26 |
$232.32 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
35 |
27 |
$231.35 |
| 84156 |
|
89 |
80 |
$228.77 |
| 86038 |
|
27 |
25 |
$228.05 |
| 84165 |
|
33 |
29 |
$228.04 |
| 86753 |
|
16 |
13 |
$227.20 |
| 82962 |
|
174 |
137 |
$222.17 |
| 84550 |
|
67 |
57 |
$221.46 |
| 83520 |
|
16 |
14 |
$217.61 |
| 85018 |
|
159 |
115 |
$200.38 |
| 88738 |
|
107 |
76 |
$199.35 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
684 |
575 |
$198.38 |
| 87045 |
|
30 |
25 |
$197.95 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
20 |
12 |
$192.10 |
| S0028 |
Injection, famotidine, 20 mg |
254 |
191 |
$191.46 |
| 87177 |
|
28 |
26 |
$173.32 |
| J7999 |
Compounded drug, not otherwise classified |
472 |
329 |
$169.58 |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
23 |
12 |
$166.29 |
| 88304 |
|
14 |
12 |
$147.78 |
| 83655 |
|
18 |
13 |
$137.93 |
| 82247 |
|
41 |
27 |
$132.68 |
| 87427 |
|
15 |
12 |
$117.59 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
42 |
24 |
$109.85 |
| G0008 |
Administration of influenza virus vaccine |
19 |
18 |
$106.88 |
| J1020 |
Injection, methylprednisolone acetate, 20 mg |
46 |
37 |
$105.31 |
| 90686 |
|
44 |
41 |
$104.23 |
| 86708 |
|
12 |
12 |
$103.94 |
| C9113 |
Injection, pantoprazole sodium, per vial |
101 |
64 |
$99.65 |
| J0574 |
Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine |
43 |
17 |
$91.55 |
| 85007 |
|
76 |
41 |
$85.65 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
107 |
97 |
$83.16 |
| 84075 |
|
28 |
24 |
$69.58 |
| 84450 |
|
13 |
12 |
$42.93 |
| 36416 |
|
17 |
12 |
$24.48 |
| 84132 |
|
12 |
12 |
$21.55 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
122 |
100 |
$16.24 |
| ATP17 |
|
13 |
12 |
$11.12 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
18 |
15 |
$5.36 |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
31 |
12 |
$4.26 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
492 |
333 |
$0.00 |
| G8985 |
Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
213 |
142 |
$0.00 |
| G8984 |
Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals |
118 |
80 |
$0.00 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
590 |
385 |
$0.00 |
| G8982 |
Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
44 |
28 |
$0.00 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
67 |
42 |
$0.00 |