| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
137,471 |
113,521 |
$23.61M |
| 00003 |
Internal/system code - not a standard HCPCS code |
45,306 |
27,557 |
$17.65M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
55,682 |
39,263 |
$5.67M |
| 0121 |
|
509 |
493 |
$2.64M |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
18,123 |
15,317 |
$2.41M |
| 0111 |
|
133 |
124 |
$1.60M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
25,379 |
3,951 |
$1.42M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
6,238 |
5,801 |
$1.38M |
| 0122 |
|
149 |
149 |
$1.37M |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
9,939 |
2,958 |
$1.15M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
6,799 |
6,170 |
$680K |
| 97139 |
|
16,686 |
2,548 |
$605K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
7,952 |
7,548 |
$603K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,047 |
1,031 |
$549K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,543 |
1,539 |
$542K |
| 99070 |
|
32,215 |
25,389 |
$518K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,030 |
1,976 |
$506K |
| 97750 |
|
5,468 |
2,894 |
$506K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
70,672 |
55,231 |
$484K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
88,176 |
65,682 |
$473K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,017 |
2,017 |
$444K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
3,181 |
3,029 |
$396K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
4,732 |
4,317 |
$391K |
| 99201 |
|
1,996 |
1,307 |
$369K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
7,341 |
6,697 |
$364K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
3,267 |
2,176 |
$281K |
| 80053 |
Comprehensive metabolic panel |
26,835 |
24,255 |
$267K |
| J3490 |
Unclassified drugs |
9,280 |
7,802 |
$232K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
31,574 |
27,909 |
$213K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
1,748 |
1,677 |
$208K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
7,407 |
7,339 |
$201K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,177 |
814 |
$197K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,825 |
3,460 |
$185K |
| 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 |
2,938 |
2,756 |
$182K |
| 84443 |
Thyroid stimulating hormone (TSH) |
11,541 |
11,284 |
$181K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
157 |
157 |
$165K |
| 0201 |
|
17 |
14 |
$163K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
435 |
428 |
$162K |
| 71046 |
Radiologic examination, chest; 2 views |
4,197 |
4,062 |
$156K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,373 |
1,285 |
$143K |
| 59425 |
|
1,601 |
1,145 |
$140K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,187 |
1,185 |
$140K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
290 |
290 |
$125K |
| 97010 |
|
2,642 |
526 |
$122K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,555 |
2,869 |
$119K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
751 |
743 |
$119K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,346 |
2,173 |
$116K |
| 73130 |
|
2,087 |
1,843 |
$115K |
| 73630 |
|
2,292 |
2,173 |
$114K |
| 84145 |
|
4,894 |
4,582 |
$112K |
| 80061 |
Lipid panel |
8,455 |
8,413 |
$108K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
2,106 |
2,041 |
$107K |
| 87631 |
|
1,437 |
1,402 |
$105K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
237 |
235 |
$102K |
| 99000 |
|
17,543 |
15,776 |
$102K |
| 74022 |
|
1,573 |
1,494 |
$99K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,973 |
1,973 |
$99K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
832 |
817 |
$96K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,810 |
2,751 |
$94K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,781 |
2,723 |
$92K |
| 73610 |
|
1,789 |
1,614 |
$86K |
| 73562 |
|
1,934 |
1,900 |
$86K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
2,242 |
2,163 |
$86K |
| 71045 |
Radiologic examination, chest; single view |
4,049 |
3,826 |
$85K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
9,234 |
9,134 |
$84K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
216 |
204 |
$83K |
| 73030 |
|
1,620 |
1,567 |
$83K |
| 73110 |
|
1,622 |
1,371 |
$80K |
| 80306 |
|
4,938 |
4,540 |
$79K |
| 0171 |
Inj, epinephrine (belcher) |
157 |
150 |
$78K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,242 |
1,105 |
$77K |
| 83880 |
|
2,237 |
2,065 |
$69K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
355 |
339 |
$63K |
| 82746 |
|
4,028 |
4,004 |
$59K |
| 83605 |
|
5,407 |
4,902 |
$58K |
| 76830 |
Ultrasound, transvaginal |
314 |
311 |
$57K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
5,686 |
5,135 |
$55K |
| 74178 |
|
151 |
151 |
$54K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
6,476 |
5,994 |
$50K |
| 72100 |
|
658 |
657 |
$50K |
| 84484 |
|
5,016 |
3,790 |
$47K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
9,006 |
6,687 |
$43K |
| 81003 |
|
16,387 |
14,738 |
$41K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,768 |
2,178 |
$41K |
| 80074 |
|
1,013 |
1,005 |
$40K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,058 |
2,047 |
$40K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
318 |
292 |
$38K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,340 |
3,998 |
$36K |
| 87040 |
|
2,215 |
1,979 |
$35K |
| 83690 |
|
5,529 |
5,090 |
$34K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,624 |
1,575 |
$33K |
| 90686 |
|
2,972 |
2,937 |
$32K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,225 |
2,451 |
$32K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
3,960 |
3,656 |
$32K |
| 59025 |
Fetal non-stress test |
754 |
482 |
$31K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
148 |
142 |
$30K |
| 87077 |
|
3,376 |
3,190 |
$29K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
1,799 |
1,667 |
$28K |
| 72110 |
|
416 |
413 |
$26K |
| 71250 |
|
110 |
110 |
$25K |
| 76770 |
|
193 |
192 |
$25K |
| 84439 |
|
2,874 |
2,824 |
$24K |
| 85730 |
|
4,250 |
3,987 |
$24K |
| 73502 |
|
415 |
408 |
$24K |
| J2704 |
Injection, propofol, 10 mg |
2,396 |
2,295 |
$23K |
| 87186 |
|
2,504 |
2,377 |
$23K |
| 84466 |
|
1,873 |
1,839 |
$23K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,389 |
1,305 |
$23K |
| 85610 |
|
5,918 |
5,300 |
$23K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
516 |
481 |
$22K |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
1,308 |
1,226 |
$22K |
| 80305 |
|
2,106 |
1,895 |
$22K |
| 95806 |
|
51 |
51 |
$22K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,607 |
1,045 |
$22K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,382 |
753 |
$21K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
55 |
55 |
$19K |
| 97799 |
|
573 |
75 |
$19K |
| 99215 |
Prolong outpt/office vis |
3,526 |
2,850 |
$19K |
| 82607 |
|
1,414 |
1,407 |
$18K |
| Q3014 |
Telehealth originating site facility fee |
806 |
777 |
$18K |
| 81025 |
|
5,477 |
5,127 |
$17K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
562 |
557 |
$17K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,618 |
3,840 |
$16K |
| 76536 |
|
110 |
109 |
$16K |
| 76942 |
|
589 |
446 |
$16K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
3,201 |
2,839 |
$15K |
| 76642 |
|
94 |
94 |
$15K |
| 76641 |
|
109 |
93 |
$15K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
470 |
466 |
$14K |
| 81002 |
|
6,085 |
4,639 |
$14K |
| 87070 |
|
1,582 |
1,529 |
$14K |
| 87081 |
|
2,142 |
2,096 |
$14K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,987 |
1,924 |
$13K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
107 |
106 |
$13K |
| 76801 |
|
144 |
135 |
$13K |
| 82728 |
|
1,047 |
1,022 |
$13K |
| 81001 |
|
2,163 |
2,049 |
$12K |
| 83540 |
|
1,956 |
1,919 |
$12K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
41 |
36 |
$12K |
| U0001 |
Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel |
352 |
347 |
$12K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,461 |
1,359 |
$12K |
| 0001A |
|
498 |
452 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,636 |
1,920 |
$11K |
| 82570 |
|
2,038 |
1,974 |
$11K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
87 |
78 |
$10K |
| 0002A |
|
457 |
457 |
$10K |
| 84152 |
|
454 |
454 |
$10K |
| 82043 |
|
1,643 |
1,628 |
$9K |
| 73560 |
|
232 |
218 |
$9K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
55 |
55 |
$9K |
| 83655 |
|
874 |
835 |
$9K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,282 |
1,123 |
$9K |
| 0450 |
Emergency room services |
945 |
625 |
$9K |
| 90670 |
|
1,034 |
1,012 |
$9K |
| 72040 |
|
155 |
154 |
$9K |
| 83735 |
|
1,433 |
1,234 |
$9K |
| G9012 |
Other specified case management service not elsewhere classified |
48 |
24 |
$8K |
| G0202 |
Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed |
45 |
23 |
$8K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
25 |
25 |
$8K |
| 90715 |
|
407 |
406 |
$8K |
| 87653 |
|
235 |
235 |
$7K |
| 71271 |
|
50 |
50 |
$7K |
| G0481 |
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; 8-14 drug class(es), including metabolite(s) if performed |
81 |
78 |
$7K |
| 86592 |
|
1,881 |
1,860 |
$7K |
| 85379 |
|
813 |
785 |
$7K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
973 |
895 |
$7K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,219 |
1,168 |
$7K |
| 86762 |
|
479 |
476 |
$7K |
| 73080 |
|
151 |
127 |
$7K |
| 86803 |
|
545 |
542 |
$7K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
568 |
466 |
$7K |
| 85018 |
|
6,807 |
6,297 |
$7K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
436 |
399 |
$6K |
| 74018 |
|
182 |
177 |
$6K |
| 90648 |
|
679 |
672 |
$6K |
| 85652 |
|
2,180 |
2,115 |
$6K |
| S9083 |
Global fee urgent care centers |
118 |
106 |
$6K |
| 92522 |
|
25 |
24 |
$6K |
| 76775 |
|
95 |
95 |
$6K |
| G0204 |
Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral |
28 |
14 |
$5K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
611 |
572 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
267 |
193 |
$5K |
| 92551 |
|
4,506 |
3,647 |
$5K |
| 86850 |
|
1,706 |
1,654 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
729 |
565 |
$5K |
| 90633 |
|
858 |
849 |
$4K |
| 84153 |
|
268 |
264 |
$4K |
| 0410 |
|
510 |
496 |
$4K |
| 86901 |
|
1,556 |
1,504 |
$4K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
452 |
426 |
$4K |
| 88142 |
|
160 |
159 |
$4K |
| 86900 |
|
1,513 |
1,464 |
$4K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
230 |
205 |
$4K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
456 |
443 |
$4K |
| 87522 |
Neg quan hep c or qual rna |
110 |
106 |
$4K |
| 93971 |
|
25 |
25 |
$4K |
| 85027 |
|
683 |
627 |
$4K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
606 |
546 |
$4K |
| J2060 |
Injection, lorazepam, 2 mg |
720 |
627 |
$4K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
389 |
340 |
$4K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
202 |
193 |
$3K |
| 87340 |
|
409 |
408 |
$3K |
| 84134 |
|
195 |
192 |
$3K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
12 |
12 |
$3K |
| 86140 |
|
729 |
707 |
$3K |
| 77066 |
Tomosynthesis, mammo |
12 |
12 |
$3K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
78 |
78 |
$3K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
39 |
38 |
$3K |
| 86769 |
|
76 |
76 |
$3K |
| 90671 |
|
403 |
388 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
16 |
15 |
$3K |
| 77080 |
|
50 |
50 |
$3K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
285 |
244 |
$3K |
| T1014 |
Telehealth transmission, per minute, professional services bill separately |
479 |
449 |
$3K |
| 90723 |
|
299 |
295 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
155 |
150 |
$3K |
| 73140 |
|
69 |
63 |
$2K |
| J7050 |
Infusion, normal saline solution, 250 cc |
601 |
403 |
$2K |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
353 |
308 |
$2K |
| 82550 |
|
382 |
364 |
$2K |
| 82962 |
|
913 |
724 |
$2K |
| 20552 |
|
50 |
32 |
$2K |
| 88342 |
|
41 |
41 |
$2K |
| 90697 |
|
232 |
221 |
$2K |
| 80076 |
|
223 |
217 |
$2K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
26 |
26 |
$2K |
| J1790 |
Injection, droperidol, up to 5 mg |
125 |
106 |
$2K |
| 97165 |
|
22 |
22 |
$2K |
| 86039 |
|
148 |
147 |
$2K |
| 90651 |
|
143 |
143 |
$1K |
| 83516 |
|
147 |
147 |
$1K |
| 99243 |
|
30 |
15 |
$1K |
| 90832 |
Psychotherapy, 30 minutes with patient |
42 |
42 |
$1K |
| 90656 |
|
150 |
150 |
$1K |
| 0270 |
|
872 |
826 |
$1K |
| 87205 |
|
317 |
302 |
$1K |
| 73040 |
|
12 |
12 |
$1K |
| 99242 |
|
29 |
15 |
$1K |
| 64450 |
|
31 |
29 |
$1K |
| 92552 |
|
489 |
278 |
$865.90 |
| 20611 |
|
14 |
12 |
$849.83 |
| 84402 |
|
55 |
55 |
$822.86 |
| 90680 |
|
82 |
78 |
$738.00 |
| 87210 |
|
185 |
182 |
$709.03 |
| 96127 |
|
269 |
155 |
$707.07 |
| 73090 |
|
26 |
24 |
$700.56 |
| 84100 |
|
149 |
133 |
$673.26 |
| 84550 |
|
122 |
110 |
$671.83 |
| 84156 |
|
202 |
193 |
$626.57 |
| 87150 |
|
29 |
29 |
$599.30 |
| 90696 |
|
66 |
66 |
$594.00 |
| 90710 |
|
63 |
62 |
$567.00 |
| 82150 |
|
86 |
84 |
$564.98 |
| Z9725 |
|
12 |
12 |
$516.36 |
| 84403 |
|
39 |
38 |
$511.39 |
| 90672 |
|
99 |
98 |
$508.34 |
| 99188 |
|
35 |
30 |
$490.43 |
| 94010 |
|
16 |
16 |
$489.02 |
| 99406 |
|
118 |
82 |
$478.86 |
| 99381 |
|
25 |
13 |
$453.30 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
52 |
51 |
$432.48 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
27 |
27 |
$416.46 |
| 82553 |
|
46 |
46 |
$409.41 |
| 72170 |
|
12 |
12 |
$399.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
36 |
29 |
$396.77 |
| 90716 |
|
53 |
51 |
$369.00 |
| 90700 |
|
39 |
39 |
$351.00 |
| 23350 |
|
12 |
12 |
$304.04 |
| 86003 |
|
31 |
27 |
$288.57 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
14 |
14 |
$286.44 |
| S0164 |
Injection, pantoprazole sodium, 40 mg |
19 |
16 |
$283.15 |
| 82805 |
|
12 |
12 |
$243.00 |
| 90707 |
|
51 |
49 |
$234.00 |
| 84154 |
|
14 |
14 |
$228.90 |
| 90677 |
|
25 |
24 |
$225.00 |
| 90734 |
|
25 |
25 |
$216.00 |
| 96160 |
|
128 |
93 |
$205.92 |
| 86200 |
|
28 |
28 |
$198.80 |
| 83001 |
|
12 |
12 |
$196.92 |
| 86431 |
|
38 |
38 |
$185.17 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
15 |
15 |
$181.64 |
| 84481 |
|
12 |
12 |
$179.64 |
| 0250 |
|
766 |
734 |
$166.82 |
| 86141 |
|
13 |
12 |
$145.47 |
| 90660 |
|
14 |
14 |
$134.88 |
| 99384 |
|
24 |
12 |
$131.56 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
107 |
103 |
$125.44 |
| 90619 |
|
12 |
12 |
$108.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
49 |
48 |
$102.90 |
| 0124A |
|
24 |
24 |
$88.00 |
| 86430 |
|
12 |
12 |
$60.96 |
| 81015 |
|
12 |
12 |
$30.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$13.20 |
| Z1034 |
|
2,506 |
1,740 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
675 |
670 |
$0.00 |
| 0636 |
|
371 |
363 |
$0.00 |
| 90480 |
|
20 |
20 |
$0.00 |
| 0370 |
|
88 |
87 |
$0.00 |
| 0720 |
|
66 |
66 |
$0.00 |
| 0740 |
|
92 |
90 |
$0.00 |
| 9214 |
|
13 |
13 |
$0.00 |
| 0350 |
|
73 |
73 |
$0.00 |
| 0420 |
|
29 |
28 |
$0.00 |
| 99441 |
|
20 |
20 |
$0.00 |
| 0310 |
|
14 |
14 |
$0.00 |
| 0460 |
|
191 |
187 |
$0.00 |
| 0730 |
|
171 |
167 |
$0.00 |
| 0300 |
|
758 |
723 |
$0.00 |
| G0490 |
Face-to-face home health nursing visit by a rural health clinic (rhc) or federally qualified health center (fqhc) in an area with a shortage of home health agencies; (services limited to rn or lpn only) |
1,110 |
272 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
49 |
49 |
$0.00 |
| 0320 |
|
415 |
403 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
60 |
60 |
$0.00 |
| 90461 |
|
18 |
18 |
$0.00 |
| 0360 |
|
101 |
100 |
$0.00 |
| 91320 |
|
20 |
20 |
$0.00 |
| 99173 |
|
12 |
12 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
14 |
14 |
$0.00 |
| 99382 |
|
31 |
16 |
$0.00 |