| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
21,567 |
20,450 |
$3.45M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
18,237 |
17,175 |
$2.92M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
12,197 |
11,810 |
$1.90M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
5,179 |
4,797 |
$1.39M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
6,062 |
4,234 |
$1.30M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,201 |
4,147 |
$1.04M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,605 |
7,567 |
$1.00M |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,630 |
3,557 |
$964K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
6,994 |
6,512 |
$949K |
| 36415 |
Collection of venous blood by venipuncture |
103,992 |
36,655 |
$932K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,383 |
5,349 |
$836K |
| 80053 |
Comprehensive metabolic panel |
37,227 |
33,527 |
$770K |
| G0397 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes |
3,594 |
1,755 |
$548K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,861 |
2,735 |
$450K |
| H0005 |
Alcohol and/or drug services; group counseling by a clinician |
5,754 |
1,455 |
$344K |
| 59025 |
Fetal non-stress test |
2,030 |
1,499 |
$342K |
| G0378 |
Hospital observation service, per hour |
2,268 |
1,370 |
$334K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,703 |
2,434 |
$304K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,525 |
1,358 |
$243K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,684 |
1,151 |
$198K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
4,064 |
3,885 |
$182K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
631 |
628 |
$181K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
341 |
338 |
$173K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
731 |
724 |
$172K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
579 |
575 |
$168K |
| J1756 |
Injection, iron sucrose, 1 mg |
3,026 |
1,803 |
$161K |
| 90791 |
Psychiatric diagnostic evaluation |
1,069 |
381 |
$155K |
| 86900 |
|
4,645 |
4,122 |
$150K |
| 86885 |
|
3,300 |
3,054 |
$145K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
5,219 |
4,945 |
$138K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,824 |
1,331 |
$119K |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
1,096 |
608 |
$119K |
| 12001 |
|
256 |
255 |
$118K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
4,078 |
1,719 |
$115K |
| 59050 |
|
480 |
394 |
$111K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
198 |
198 |
$108K |
| 76801 |
|
911 |
851 |
$105K |
| 93975 |
|
198 |
198 |
$102K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
5,192 |
4,728 |
$102K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,354 |
2,287 |
$100K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
11,205 |
10,357 |
$97K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,559 |
1,549 |
$97K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,863 |
688 |
$95K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
956 |
841 |
$94K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,291 |
1,088 |
$86K |
| 93970 |
|
152 |
149 |
$79K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
1,378 |
362 |
$77K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,257 |
5,357 |
$75K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,792 |
1,768 |
$70K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,207 |
1,193 |
$69K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
326 |
296 |
$69K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,335 |
2,294 |
$64K |
| 96415 |
|
97 |
66 |
$62K |
| T1030 |
Nursing care, in the home, by registered nurse, per diem |
288 |
49 |
$55K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
529 |
499 |
$51K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,267 |
1,255 |
$47K |
| 59430 |
|
216 |
198 |
$45K |
| 93976 |
|
92 |
88 |
$45K |
| 12011 |
|
92 |
92 |
$44K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,324 |
2,285 |
$44K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
281 |
280 |
$44K |
| 87503 |
|
1,177 |
1,165 |
$42K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
36,867 |
32,320 |
$42K |
| 84100 |
|
29,904 |
24,297 |
$42K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
40 |
36 |
$37K |
| 82728 |
|
8,047 |
7,259 |
$34K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
347 |
345 |
$34K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
4,068 |
3,782 |
$33K |
| 84443 |
Thyroid stimulating hormone (TSH) |
5,578 |
5,428 |
$33K |
| 86850 |
|
903 |
783 |
$32K |
| 80061 |
Lipid panel |
5,298 |
5,230 |
$32K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
348 |
315 |
$31K |
| 82607 |
|
5,200 |
4,855 |
$30K |
| 99215 |
Prolong outpt/office vis |
244 |
230 |
$29K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
172 |
161 |
$29K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
114 |
114 |
$29K |
| S9480 |
Intensive outpatient psychiatric services, per diem |
188 |
40 |
$28K |
| 90375 |
|
17 |
17 |
$27K |
| 77065 |
Tomosynthesis, mammo |
454 |
434 |
$27K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
5,959 |
5,101 |
$27K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
8,577 |
8,129 |
$26K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,259 |
4,207 |
$26K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
38 |
37 |
$26K |
| 19318 |
|
13 |
13 |
$25K |
| 99000 |
|
1,582 |
1,429 |
$25K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
91 |
91 |
$25K |
| 76641 |
|
965 |
960 |
$24K |
| 83880 |
|
731 |
719 |
$21K |
| 86480 |
|
355 |
355 |
$19K |
| 93971 |
|
301 |
297 |
$18K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
7,602 |
6,644 |
$18K |
| 86901 |
|
978 |
819 |
$18K |
| 88304 |
|
563 |
560 |
$17K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
227 |
210 |
$16K |
| 99222 |
Initial hospital care, per day, moderate complexity |
172 |
172 |
$15K |
| 85610 |
|
4,972 |
4,703 |
$15K |
| 82746 |
|
1,945 |
1,907 |
$15K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
827 |
759 |
$15K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
541 |
540 |
$14K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
6,780 |
6,554 |
$14K |
| 90715 |
|
521 |
519 |
$14K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
565 |
559 |
$14K |
| 84153 |
|
1,004 |
987 |
$14K |
| 87631 |
|
213 |
213 |
$13K |
| 83540 |
|
6,503 |
5,949 |
$13K |
| 96367 |
|
172 |
122 |
$13K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,403 |
1,396 |
$13K |
| 83550 |
|
6,450 |
5,899 |
$13K |
| 71250 |
|
176 |
176 |
$13K |
| 76830 |
Ultrasound, transvaginal |
451 |
447 |
$13K |
| 71046 |
Radiologic examination, chest; 2 views |
5,131 |
5,044 |
$12K |
| 87481 |
|
301 |
291 |
$12K |
| 82784 |
|
1,257 |
992 |
$12K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
774 |
522 |
$12K |
| 81025 |
|
4,068 |
4,001 |
$12K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
7,474 |
7,013 |
$12K |
| 99233 |
Prolong inpt eval add15 m |
552 |
241 |
$11K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,559 |
1,549 |
$11K |
| J3490 |
Unclassified drugs |
627 |
471 |
$11K |
| 99221 |
|
256 |
253 |
$11K |
| 76770 |
|
25 |
25 |
$11K |
| 81003 |
|
13,871 |
13,294 |
$11K |
| J7050 |
Infusion, normal saline solution, 250 cc |
6,543 |
4,139 |
$11K |
| 83735 |
|
6,586 |
5,763 |
$10K |
| 86141 |
|
2,507 |
2,299 |
$10K |
| 29125 |
|
41 |
41 |
$9K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
495 |
485 |
$9K |
| 84550 |
|
4,775 |
4,222 |
$9K |
| 80076 |
|
723 |
712 |
$8K |
| 84702 |
|
5,693 |
5,341 |
$8K |
| 84403 |
|
386 |
385 |
$8K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
101 |
39 |
$8K |
| 86769 |
|
279 |
278 |
$8K |
| 81002 |
|
3,690 |
2,679 |
$8K |
| 81513 |
|
293 |
286 |
$8K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
370 |
363 |
$8K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
222 |
220 |
$8K |
| 77066 |
Tomosynthesis, mammo |
141 |
141 |
$7K |
| 86617 |
|
552 |
549 |
$7K |
| J2704 |
Injection, propofol, 10 mg |
2,516 |
2,492 |
$6K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,433 |
2,347 |
$6K |
| 86880 |
|
179 |
150 |
$6K |
| 94760 |
|
329 |
322 |
$6K |
| 88342 |
|
86 |
83 |
$5K |
| 83970 |
|
161 |
159 |
$5K |
| 82378 |
|
1,396 |
1,046 |
$5K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
81 |
81 |
$5K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
14 |
14 |
$5K |
| 86803 |
|
740 |
739 |
$5K |
| 86762 |
|
455 |
455 |
$5K |
| 84436 |
|
937 |
916 |
$4K |
| 83615 |
|
4,037 |
3,343 |
$4K |
| 86334 |
|
901 |
822 |
$4K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,019 |
1,867 |
$4K |
| 99401 |
|
91 |
87 |
$4K |
| 86765 |
|
456 |
456 |
$4K |
| 82570 |
|
1,038 |
1,003 |
$4K |
| 87340 |
|
711 |
708 |
$4K |
| 0002A |
|
111 |
111 |
$4K |
| 90675 |
|
25 |
21 |
$4K |
| 84439 |
|
530 |
524 |
$4K |
| 98967 |
|
31 |
31 |
$4K |
| 0012A |
|
138 |
137 |
$4K |
| 87077 |
|
1,813 |
1,761 |
$4K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,629 |
4,414 |
$4K |
| 90834 |
Psychotherapy, 45 minutes with patient |
30 |
13 |
$3K |
| 80069 |
|
318 |
298 |
$3K |
| 86592 |
|
1,576 |
1,552 |
$3K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,822 |
3,449 |
$3K |
| 85651 |
|
3,399 |
3,078 |
$3K |
| 83021 |
|
217 |
214 |
$3K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,136 |
953 |
$3K |
| 82550 |
|
1,205 |
1,178 |
$3K |
| 0001A |
|
111 |
110 |
$3K |
| 71045 |
Radiologic examination, chest; single view |
3,134 |
3,046 |
$3K |
| 98966 |
|
27 |
26 |
$3K |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
622 |
546 |
$3K |
| 82248 |
|
5,187 |
4,651 |
$3K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
978 |
876 |
$3K |
| 84238 |
|
103 |
102 |
$3K |
| 85730 |
|
3,854 |
3,702 |
$3K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
53 |
37 |
$3K |
| 87070 |
|
3,301 |
3,254 |
$3K |
| 0011A |
|
162 |
155 |
$3K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,826 |
2,730 |
$3K |
| 97802 |
|
87 |
87 |
$3K |
| 70486 |
|
40 |
40 |
$3K |
| 84479 |
|
834 |
829 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,242 |
2,083 |
$2K |
| 77061 |
|
166 |
163 |
$2K |
| 86038 |
|
597 |
595 |
$2K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
204 |
204 |
$2K |
| 82043 |
|
528 |
526 |
$2K |
| 83690 |
|
5,552 |
5,310 |
$2K |
| 77062 |
|
88 |
88 |
$2K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
7,237 |
6,470 |
$2K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,124 |
992 |
$2K |
| 86735 |
|
301 |
301 |
$2K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
12 |
12 |
$2K |
| 83655 |
|
152 |
152 |
$2K |
| 84402 |
|
87 |
87 |
$2K |
| 87184 |
|
1,123 |
1,087 |
$2K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,268 |
1,055 |
$2K |
| 83883 |
|
127 |
118 |
$2K |
| 86787 |
|
323 |
322 |
$2K |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
418 |
417 |
$2K |
| 83525 |
|
151 |
151 |
$2K |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
421 |
419 |
$2K |
| 99223 |
Prolong inpt eval add15 m |
56 |
56 |
$2K |
| 82670 |
|
76 |
75 |
$2K |
| 84484 |
|
4,267 |
3,895 |
$2K |
| 86618 |
|
129 |
128 |
$1K |
| 85379 |
|
1,954 |
1,880 |
$1K |
| 82947 |
|
4,227 |
3,337 |
$1K |
| 84156 |
|
520 |
491 |
$1K |
| 86706 |
|
185 |
184 |
$1K |
| 83695 |
|
28 |
28 |
$1K |
| 83521 |
|
368 |
301 |
$1K |
| 86431 |
|
314 |
313 |
$1K |
| 86300 |
|
232 |
172 |
$1K |
| 81243 |
|
14 |
14 |
$1K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
42 |
42 |
$1K |
| 73610 |
|
383 |
380 |
$1K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,268 |
1,133 |
$1K |
| 73630 |
|
242 |
239 |
$999.20 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,182 |
1,020 |
$951.37 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
872 |
828 |
$917.66 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
125 |
109 |
$840.03 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
66 |
54 |
$800.30 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
440 |
314 |
$761.68 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$740.71 |
| 82150 |
|
717 |
711 |
$697.39 |
| 82747 |
|
30 |
30 |
$680.25 |
| 82105 |
|
157 |
154 |
$607.93 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,669 |
2,638 |
$603.28 |
| 82950 |
|
230 |
229 |
$601.41 |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
91 |
56 |
$594.45 |
| 87040 |
|
1,556 |
1,437 |
$592.63 |
| 83001 |
|
31 |
30 |
$556.70 |
| 85245 |
|
12 |
12 |
$465.91 |
| 76642 |
|
27 |
27 |
$439.94 |
| 83090 |
|
43 |
42 |
$417.36 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
2,917 |
2,783 |
$415.19 |
| 74018 |
|
209 |
207 |
$412.87 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
385 |
383 |
$372.17 |
| 86140 |
|
299 |
275 |
$350.41 |
| 86360 |
|
12 |
12 |
$347.59 |
| 83605 |
|
796 |
726 |
$342.52 |
| 84165 |
|
99 |
93 |
$320.23 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,183 |
2,170 |
$287.24 |
| 73030 |
|
226 |
225 |
$286.94 |
| 85045 |
|
368 |
312 |
$258.91 |
| 85246 |
|
12 |
12 |
$244.48 |
| 83002 |
|
14 |
14 |
$240.43 |
| 82310 |
|
134 |
133 |
$232.18 |
| 72100 |
|
39 |
39 |
$221.55 |
| 96368 |
|
16 |
13 |
$206.28 |
| 80329 |
|
57 |
57 |
$206.25 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
944 |
812 |
$183.08 |
| 80179 |
|
475 |
472 |
$163.24 |
| 86301 |
|
19 |
14 |
$146.54 |
| 85041 |
|
206 |
205 |
$144.78 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
38 |
38 |
$137.52 |
| 83010 |
|
86 |
85 |
$131.97 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
39 |
37 |
$131.08 |
| 80143 |
|
525 |
515 |
$129.21 |
| 82077 |
|
998 |
947 |
$127.01 |
| 80320 |
|
481 |
456 |
$112.50 |
| 85018 |
|
228 |
226 |
$107.47 |
| 85014 |
|
243 |
241 |
$105.90 |
| 84481 |
|
12 |
12 |
$102.88 |
| 87186 |
|
41 |
41 |
$90.10 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
96 |
65 |
$89.24 |
| 96376 |
|
214 |
208 |
$88.00 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
42 |
26 |
$85.24 |
| J2060 |
Injection, lorazepam, 2 mg |
126 |
104 |
$79.43 |
| 86704 |
|
13 |
13 |
$78.91 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
27 |
26 |
$78.45 |
| C1889 |
Implantable/insertable device, not otherwise classified |
30 |
29 |
$70.82 |
| 82040 |
|
371 |
342 |
$69.54 |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
42 |
42 |
$67.42 |
| 84480 |
|
16 |
15 |
$67.12 |
| 84155 |
|
151 |
133 |
$64.48 |
| 82668 |
|
16 |
16 |
$51.18 |
| 87490 |
|
196 |
194 |
$46.00 |
| 87899 |
|
262 |
259 |
$44.03 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
26 |
26 |
$39.32 |
| J1630 |
Injection, haloperidol, up to 5 mg |
29 |
24 |
$39.08 |
| 87590 |
|
196 |
194 |
$36.91 |
| 73080 |
|
14 |
14 |
$31.12 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
47 |
42 |
$29.43 |
| 85384 |
|
14 |
13 |
$26.97 |
| 73564 |
|
55 |
55 |
$25.00 |
| 73130 |
|
53 |
53 |
$25.00 |
| 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 |
574 |
561 |
$23.60 |
| 85240 |
|
12 |
12 |
$17.90 |
| 87205 |
|
25 |
25 |
$16.65 |
| 81001 |
|
235 |
235 |
$14.22 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
40 |
38 |
$13.40 |
| 73110 |
|
31 |
30 |
$13.13 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
82 |
78 |
$11.99 |
| J7510 |
Prednisolone oral, per 5 mg |
12 |
12 |
$10.44 |
| Q0163 |
Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen |
486 |
425 |
$7.31 |
| 85027 |
|
130 |
129 |
$6.34 |
| J1644 |
Injection, heparin sodium, per 1000 units |
14 |
12 |
$5.20 |
| 80349 |
|
25 |
25 |
$5.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
143 |
137 |
$2.38 |
| 85007 |
|
306 |
288 |
$1.43 |
| S2900 |
Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) |
12 |
12 |
$0.00 |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
34 |
34 |
$0.00 |
| A4648 |
Tissue marker, implantable, any type, each |
15 |
15 |
$0.00 |
| 99080 |
|
1,759 |
370 |
$0.00 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
26 |
25 |
$0.00 |
| 73140 |
|
25 |
25 |
$0.00 |
| 80354 |
|
13 |
13 |
$0.00 |
| 84145 |
|
12 |
12 |
$0.00 |