| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
Emergency room services |
104,353 |
88,414 |
$30.86M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
70,248 |
61,388 |
$24.04M |
| Q5108 |
Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg |
950 |
659 |
$9.90M |
| L8699 |
Prosthetic implant, not otherwise specified |
1,398 |
1,343 |
$7.59M |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
4,092 |
1,986 |
$5.03M |
| Q5127 |
Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg |
295 |
202 |
$3.03M |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
1,142 |
1,116 |
$1.71M |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
9,448 |
4,493 |
$1.58M |
| Q5114 |
Injection, trastuzumab-dkst, biosimilar, (ogivri), 10 mg |
85 |
65 |
$1.27M |
| J0690 |
Injection, cefazolin sodium, 500 mg |
4,617 |
3,978 |
$1.22M |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
9,600 |
8,530 |
$1.13M |
| 0510 |
|
31,915 |
27,343 |
$1.11M |
| J9271 |
Injection, pembrolizumab, 1 mg |
95 |
79 |
$955K |
| J1756 |
Injection, iron sucrose, 1 mg |
3,584 |
1,415 |
$938K |
| J2704 |
Injection, propofol, 10 mg |
7,127 |
6,674 |
$914K |
| J2505 |
Injection, pegfilgrastim, 6 mg |
196 |
142 |
$802K |
| Z7502 |
|
19,555 |
19,208 |
$735K |
| J0897 |
Injection, denosumab, 1 mg |
205 |
197 |
$709K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
20,494 |
17,568 |
$612K |
| 99499 |
|
6,079 |
4,886 |
$603K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
12,536 |
12,062 |
$599K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
4,607 |
4,376 |
$586K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
5,855 |
5,793 |
$578K |
| J1201 |
Injection, cetirizine hydrochloride, 0.5 mg |
638 |
382 |
$547K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
16,822 |
14,972 |
$477K |
| 0360 |
|
4,264 |
2,109 |
$458K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
9,531 |
9,050 |
$454K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
20,370 |
8,696 |
$452K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
19,670 |
3,210 |
$428K |
| J3490 |
Unclassified drugs |
33,254 |
26,683 |
$413K |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
2,264 |
1,203 |
$385K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
10,408 |
8,001 |
$376K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,869 |
4,574 |
$372K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
95,482 |
78,793 |
$352K |
| J2785 |
Injection, regadenoson, 0.1 mg |
1,187 |
1,153 |
$347K |
| 70450 |
Computed tomography, head or brain; without contrast material |
12,089 |
11,590 |
$332K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
26,932 |
21,918 |
$331K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
4,051 |
3,730 |
$330K |
| 99070 |
|
62,051 |
40,904 |
$324K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
28,039 |
24,989 |
$316K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,433 |
2,382 |
$309K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
6,025 |
5,627 |
$305K |
| 99221 |
|
1,905 |
1,884 |
$304K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
4,261 |
3,935 |
$300K |
| 77066 |
Tomosynthesis, mammo |
2,576 |
2,543 |
$296K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
3,083 |
2,970 |
$271K |
| J9306 |
Injection, pertuzumab, 1 mg |
33 |
25 |
$267K |
| 80053 |
Comprehensive metabolic panel |
23,992 |
19,211 |
$265K |
| J3489 |
Injection, zoledronic acid, 1 mg |
133 |
129 |
$260K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
6,328 |
5,299 |
$256K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
1,378 |
1,333 |
$246K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
315 |
313 |
$246K |
| 59025 |
Fetal non-stress test |
12,426 |
6,107 |
$246K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
5,006 |
3,107 |
$237K |
| 97803 |
|
3,992 |
3,147 |
$230K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
6,131 |
5,756 |
$230K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
4,224 |
3,880 |
$229K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
6,786 |
3,963 |
$225K |
| 97802 |
|
1,843 |
1,806 |
$224K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
32,859 |
27,636 |
$222K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
965 |
942 |
$215K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
18,594 |
14,740 |
$210K |
| J1454 |
Injection, fosnetupitant 235 mg and palonosetron 0.25 mg |
116 |
80 |
$206K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
5,677 |
5,479 |
$202K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
34,860 |
31,327 |
$193K |
| Q3014 |
Telehealth originating site facility fee |
7,515 |
7,192 |
$179K |
| 0762 |
|
2,911 |
1,317 |
$162K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
26,758 |
22,472 |
$161K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
488 |
424 |
$155K |
| J1644 |
Injection, heparin sodium, per 1000 units |
2,747 |
1,713 |
$145K |
| 76642 |
|
2,482 |
2,383 |
$143K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
1,399 |
1,354 |
$136K |
| J7050 |
Infusion, normal saline solution, 250 cc |
30,557 |
16,652 |
$130K |
| Z9725 |
|
3,999 |
3,956 |
$128K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
17,041 |
16,224 |
$116K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,714 |
3,558 |
$112K |
| 96367 |
|
3,329 |
2,364 |
$110K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
18,246 |
15,896 |
$108K |
| 0750 |
|
677 |
655 |
$106K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
4,710 |
3,860 |
$105K |
| 80076 |
|
30,299 |
26,467 |
$104K |
| 0710 |
|
3,337 |
3,119 |
$103K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
7,063 |
6,302 |
$101K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
9,928 |
8,937 |
$98K |
| 11043 |
|
3,204 |
1,877 |
$97K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
9,038 |
7,374 |
$97K |
| 72132 |
|
2,010 |
1,944 |
$95K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
4,444 |
4,320 |
$92K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,833 |
1,786 |
$92K |
| 72129 |
|
1,946 |
1,883 |
$92K |
| 97750 |
|
2,090 |
1,060 |
$88K |
| 77065 |
Tomosynthesis, mammo |
979 |
940 |
$85K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
14,639 |
12,632 |
$84K |
| 82378 |
|
3,481 |
3,252 |
$81K |
| 82962 |
|
16,165 |
7,902 |
$79K |
| 96417 |
|
2,393 |
1,506 |
$78K |
| 71250 |
|
580 |
564 |
$77K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
852 |
826 |
$77K |
| 97139 |
|
3,171 |
552 |
$77K |
| 82728 |
|
5,256 |
5,023 |
$76K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
1,178 |
1,117 |
$73K |
| 71046 |
Radiologic examination, chest; 2 views |
9,176 |
8,827 |
$73K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
7,495 |
6,938 |
$71K |
| 83615 |
|
10,014 |
8,184 |
$69K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
5,814 |
5,337 |
$69K |
| 96415 |
|
2,265 |
1,406 |
$67K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
3,074 |
2,996 |
$64K |
| G0277 |
Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval |
496 |
24 |
$60K |
| J2060 |
Injection, lorazepam, 2 mg |
5,783 |
4,601 |
$59K |
| 93017 |
|
1,677 |
1,626 |
$58K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,619 |
1,571 |
$57K |
| 71045 |
Radiologic examination, chest; single view |
25,018 |
23,453 |
$57K |
| 76830 |
Ultrasound, transvaginal |
2,506 |
2,440 |
$57K |
| H2000 |
Comprehensive multidisciplinary evaluation |
813 |
638 |
$54K |
| 0250 |
|
2,764 |
2,217 |
$54K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,253 |
2,245 |
$53K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
23,429 |
21,163 |
$53K |
| 94060 |
|
1,315 |
1,290 |
$52K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,664 |
1,644 |
$52K |
| 80047 |
|
45,770 |
41,520 |
$50K |
| 11045 |
|
5,613 |
1,576 |
$50K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
4,544 |
4,382 |
$48K |
| 94729 |
|
1,169 |
1,152 |
$48K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,301 |
1,272 |
$48K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
899 |
884 |
$47K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,400 |
3,038 |
$46K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
19,918 |
18,486 |
$46K |
| 82607 |
|
2,589 |
2,528 |
$46K |
| 90715 |
|
2,095 |
2,031 |
$45K |
| 83550 |
|
5,262 |
5,090 |
$43K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
851 |
779 |
$43K |
| G0378 |
Hospital observation service, per hour |
2,177 |
1,075 |
$43K |
| 73630 |
|
3,406 |
3,213 |
$41K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
1,383 |
1,376 |
$41K |
| 94726 |
|
1,108 |
1,091 |
$40K |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
966 |
895 |
$40K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
6,049 |
5,764 |
$39K |
| 82746 |
|
2,164 |
2,112 |
$39K |
| 83540 |
|
5,391 |
5,215 |
$38K |
| 73130 |
|
3,172 |
3,020 |
$37K |
| 93971 |
|
2,025 |
1,968 |
$36K |
| 87070 |
|
3,253 |
2,935 |
$35K |
| 86300 |
|
2,814 |
2,508 |
$34K |
| 88342 |
|
944 |
904 |
$32K |
| 76813 |
|
512 |
500 |
$31K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
658 |
641 |
$31K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
581 |
361 |
$31K |
| 73610 |
|
2,952 |
2,808 |
$31K |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
500 |
479 |
$30K |
| 84484 |
|
19,521 |
16,353 |
$30K |
| 87186 |
|
3,254 |
3,027 |
$30K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,682 |
1,324 |
$29K |
| 76801 |
|
3,329 |
2,936 |
$28K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
174 |
131 |
$27K |
| 70486 |
|
752 |
729 |
$27K |
| 88304 |
|
2,028 |
1,976 |
$26K |
| 77336 |
|
616 |
272 |
$25K |
| 81001 |
|
29,696 |
27,588 |
$25K |
| 85730 |
|
7,655 |
7,240 |
$24K |
| Z7610 |
|
1,824 |
1,724 |
$24K |
| 99218 |
|
165 |
160 |
$24K |
| 73030 |
|
2,937 |
2,795 |
$24K |
| 0272 |
|
1,846 |
1,540 |
$24K |
| Z7500 |
|
689 |
609 |
$23K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
6,865 |
4,085 |
$23K |
| 74246 |
|
379 |
379 |
$23K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
6,776 |
6,430 |
$23K |
| 97799 |
|
1,286 |
426 |
$22K |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
871 |
699 |
$21K |
| 85610 |
|
9,596 |
8,818 |
$21K |
| S0077 |
Injection, clindamycin phosphate, 300 mg |
597 |
541 |
$21K |
| 83690 |
|
22,589 |
20,744 |
$20K |
| J1630 |
Injection, haloperidol, up to 5 mg |
2,399 |
1,883 |
$20K |
| 73100 |
|
1,332 |
1,137 |
$20K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
54 |
51 |
$19K |
| 73564 |
|
1,639 |
1,549 |
$19K |
| 83735 |
|
5,276 |
3,791 |
$19K |
| 88313 |
|
974 |
949 |
$19K |
| 95819 |
|
419 |
419 |
$19K |
| 86850 |
|
5,209 |
4,852 |
$18K |
| 70498 |
|
472 |
469 |
$18K |
| 82375 |
|
1,005 |
986 |
$18K |
| 84703 |
|
2,865 |
2,746 |
$18K |
| 97763 |
|
522 |
162 |
$18K |
| 81025 |
|
25,348 |
23,557 |
$18K |
| 93312 |
|
160 |
159 |
$17K |
| 74178 |
|
132 |
131 |
$17K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
308 |
305 |
$17K |
| 93923 |
|
205 |
198 |
$17K |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
139 |
138 |
$17K |
| 29581 |
|
694 |
377 |
$17K |
| 87077 |
|
3,255 |
2,999 |
$16K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
260 |
259 |
$16K |
| 0681 |
|
25 |
25 |
$16K |
| 96368 |
|
1,150 |
762 |
$15K |
| 73110 |
|
1,461 |
1,397 |
$14K |
| 73562 |
|
2,008 |
1,952 |
$14K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
222 |
219 |
$14K |
| 84439 |
|
1,853 |
1,639 |
$14K |
| 72131 |
|
571 |
567 |
$14K |
| S9452 |
Nutrition classes, non-physician provider, per session |
129 |
110 |
$13K |
| A4217 |
Sterile water/saline, 500 ml |
1,780 |
1,297 |
$13K |
| 73590 |
|
1,633 |
1,566 |
$13K |
| 71270 |
|
68 |
68 |
$13K |
| 77080 |
|
472 |
471 |
$13K |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
393 |
336 |
$12K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
57 |
57 |
$12K |
| 88307 |
|
366 |
355 |
$12K |
| 74240 |
|
192 |
192 |
$11K |
| 20610 |
|
589 |
535 |
$11K |
| 81003 |
|
23,173 |
21,591 |
$11K |
| 11046 |
|
951 |
385 |
$11K |
| 96376 |
|
1,150 |
1,034 |
$11K |
| 84702 |
|
6,979 |
6,024 |
$11K |
| 86901 |
|
7,259 |
6,786 |
$11K |
| 0270 |
|
1,952 |
1,508 |
$11K |
| 83605 |
|
6,492 |
5,714 |
$11K |
| 72170 |
|
2,134 |
2,075 |
$10K |
| 72100 |
|
673 |
633 |
$10K |
| 12001 |
|
1,318 |
1,275 |
$10K |
| 73502 |
|
958 |
926 |
$10K |
| 73090 |
|
1,301 |
1,232 |
$10K |
| 80306 |
|
3,591 |
3,406 |
$10K |
| 77412 |
|
143 |
14 |
$10K |
| 96411 |
|
388 |
228 |
$10K |
| 10060 |
|
881 |
837 |
$9K |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
92 |
83 |
$9K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,361 |
2,229 |
$9K |
| 86900 |
|
7,266 |
6,787 |
$8K |
| S0164 |
Injection, pantoprazole sodium, 40 mg |
426 |
315 |
$8K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
367 |
356 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,898 |
2,793 |
$8K |
| 86923 |
|
111 |
77 |
$7K |
| 87040 |
|
2,355 |
1,942 |
$7K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
137 |
132 |
$7K |
| 96402 |
|
690 |
657 |
$7K |
| 73552 |
|
664 |
638 |
$7K |
| 76870 |
|
561 |
539 |
$7K |
| 12011 |
|
655 |
634 |
$6K |
| 29125 |
|
1,090 |
1,020 |
$6K |
| J0736 |
Injection, clindamycin phosphate, 300 mg |
151 |
134 |
$6K |
| J1171 |
Injection, hydromorphone, 0.1 mg |
101 |
85 |
$6K |
| 99199 |
Unlisted special service, procedure or report |
125 |
109 |
$6K |
| 94664 |
|
4,981 |
4,531 |
$6K |
| 87081 |
|
1,372 |
1,309 |
$6K |
| 96152 |
|
108 |
96 |
$6K |
| 80143 |
|
2,101 |
1,983 |
$6K |
| 70496 |
|
135 |
133 |
$5K |
| 72110 |
|
267 |
262 |
$5K |
| 83880 |
|
1,534 |
1,435 |
$5K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
313 |
305 |
$5K |
| 72128 |
|
153 |
151 |
$5K |
| 88341 |
|
33 |
30 |
$5K |
| 74018 |
|
1,536 |
1,446 |
$5K |
| 77062 |
|
59 |
59 |
$5K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
689 |
628 |
$5K |
| 72040 |
|
304 |
275 |
$4K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
12 |
12 |
$4K |
| 93970 |
|
96 |
95 |
$4K |
| 84153 |
|
258 |
245 |
$4K |
| 77300 |
|
13 |
13 |
$4K |
| 80179 |
|
2,098 |
1,982 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,403 |
1,360 |
$4K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,085 |
959 |
$4K |
| 12002 |
|
571 |
562 |
$4K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
136 |
125 |
$4K |
| 99217 |
|
138 |
138 |
$4K |
| 73070 |
|
278 |
246 |
$4K |
| 76536 |
|
78 |
75 |
$4K |
| 73080 |
|
705 |
685 |
$4K |
| 97597 |
|
128 |
90 |
$4K |
| 85379 |
|
2,121 |
2,056 |
$4K |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
282 |
278 |
$4K |
| 0002A |
|
89 |
89 |
$4K |
| 84100 |
|
1,500 |
1,082 |
$3K |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
108 |
102 |
$3K |
| 70491 |
|
79 |
76 |
$3K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
434 |
306 |
$3K |
| 82248 |
|
604 |
545 |
$3K |
| 85018 |
|
1,149 |
1,113 |
$3K |
| 0761 |
|
91 |
75 |
$3K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
1,226 |
1,190 |
$3K |
| 80061 |
Lipid panel |
1,024 |
983 |
$3K |
| 76641 |
|
27 |
27 |
$3K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
62 |
37 |
$3K |
| 77290 |
|
27 |
24 |
$3K |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
56 |
53 |
$2K |
| A9270 |
Non-covered item or service |
3,426 |
2,409 |
$2K |
| 0001A |
|
61 |
61 |
$2K |
| 73120 |
|
324 |
296 |
$2K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
84 |
80 |
$2K |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
66 |
52 |
$2K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
70 |
61 |
$2K |
| 73060 |
|
257 |
240 |
$2K |
| Z7506 |
|
15 |
15 |
$2K |
| 29515 |
|
193 |
181 |
$2K |
| 0271 |
|
42 |
40 |
$2K |
| 73620 |
|
375 |
363 |
$2K |
| J1953 |
Injection, levetiracetam, 10 mg |
31 |
27 |
$2K |
| 99402 |
|
25 |
24 |
$2K |
| 82077 |
|
758 |
728 |
$2K |
| 86304 |
|
146 |
127 |
$2K |
| 82550 |
|
1,649 |
1,555 |
$2K |
| 47562 |
|
12 |
12 |
$2K |
| 97161 |
|
107 |
106 |
$2K |
| 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 |
38 |
37 |
$2K |
| 73560 |
|
152 |
140 |
$2K |
| 0012A |
|
42 |
42 |
$2K |
| 88302 |
|
129 |
129 |
$2K |
| 29075 |
|
267 |
213 |
$2K |
| 96416 |
|
39 |
25 |
$2K |
| 49083 |
|
27 |
12 |
$2K |
| 85027 |
|
792 |
712 |
$2K |
| S0028 |
Injection, famotidine, 20 mg |
16 |
12 |
$1K |
| A9150 |
Non-prescription drugs |
346 |
268 |
$1K |
| 82150 |
|
733 |
707 |
$1K |
| 76770 |
|
37 |
37 |
$1K |
| 84550 |
|
752 |
622 |
$1K |
| 97165 |
|
44 |
27 |
$1K |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
14 |
12 |
$1K |
| 87147 |
|
321 |
308 |
$1K |
| J0640 |
Injection, leucovorin calcium, per 50 mg |
23 |
12 |
$1K |
| 86140 |
|
875 |
822 |
$1K |
| J9045 |
Injection, carboplatin, 50 mg |
32 |
26 |
$1K |
| 99224 |
|
17 |
17 |
$1K |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
46 |
37 |
$903.94 |
| J9267 |
Injection, paclitaxel, 1 mg |
59 |
24 |
$895.94 |
| 88300 |
|
204 |
200 |
$851.11 |
| 84145 |
|
333 |
315 |
$832.62 |
| 87075 |
|
62 |
57 |
$785.49 |
| 87593 |
|
14 |
12 |
$772.00 |
| 73600 |
|
80 |
79 |
$658.80 |
| 82105 |
|
54 |
50 |
$604.02 |
| 0011A |
|
15 |
15 |
$600.01 |
| 73140 |
|
68 |
66 |
$595.95 |
| 82570 |
|
497 |
402 |
$586.35 |
| J9190 |
Injection, fluorouracil, 500 mg |
47 |
24 |
$582.99 |
| J1815 |
Injection, insulin, per 5 units |
444 |
274 |
$541.98 |
| 82784 |
|
84 |
52 |
$533.49 |
| 76820 |
|
17 |
12 |
$531.70 |
| 85651 |
|
500 |
482 |
$526.43 |
| J2359 |
Injection, olanzapine, 0.5 mg |
84 |
69 |
$519.30 |
| 71020 |
|
122 |
117 |
$514.27 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
269 |
268 |
$509.83 |
| 71010 |
|
223 |
208 |
$483.45 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
103 |
98 |
$470.72 |
| 82731 |
|
364 |
353 |
$465.52 |
| 99195 |
|
31 |
27 |
$443.44 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
14 |
14 |
$439.59 |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
14 |
14 |
$438.87 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
31 |
31 |
$430.67 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
25 |
15 |
$391.97 |
| Z7512 |
|
15 |
15 |
$391.95 |
| 73700 |
|
14 |
12 |
$382.16 |
| J1940 |
Injection, furosemide, up to 20 mg |
57 |
44 |
$369.80 |
| J1790 |
Injection, droperidol, up to 5 mg |
309 |
281 |
$369.49 |
| 87430 |
|
405 |
388 |
$326.49 |
| 86703 |
|
73 |
69 |
$236.94 |
| 29065 |
|
35 |
14 |
$224.40 |
| 72070 |
|
15 |
12 |
$224.14 |
| 82805 |
|
13 |
12 |
$193.00 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
625 |
557 |
$192.64 |
| 73000 |
|
15 |
15 |
$191.82 |
| 84156 |
|
416 |
329 |
$187.19 |
| 36415 |
Collection of venous blood by venipuncture |
1,311 |
1,209 |
$177.48 |
| 90686 |
|
12 |
12 |
$168.72 |
| 87210 |
|
426 |
417 |
$127.85 |
| J3105 |
Injection, terbutaline sulfate, up to 1 mg |
15 |
15 |
$118.42 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
353 |
319 |
$104.43 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
13 |
12 |
$99.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
13 |
12 |
$99.00 |
| 29130 |
|
26 |
25 |
$97.41 |
| 87420 |
|
185 |
171 |
$96.33 |
| 82565 |
|
126 |
109 |
$93.44 |
| 84403 |
|
41 |
39 |
$88.02 |
| 87205 |
|
15 |
15 |
$70.37 |
| 84402 |
|
29 |
27 |
$68.46 |
| Q4051 |
Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies) |
69 |
43 |
$49.61 |
| 20550 |
|
16 |
13 |
$41.35 |
| 74022 |
|
12 |
12 |
$36.75 |
| 51702 |
|
19 |
17 |
$33.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
17 |
14 |
$32.56 |
| 74000 |
|
33 |
31 |
$32.28 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
23 |
23 |
$29.03 |
| 86592 |
|
14 |
12 |
$22.82 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
124 |
122 |
$14.67 |
| 84460 |
|
51 |
41 |
$7.67 |
| 84450 |
|
51 |
41 |
$7.67 |
| 85007 |
|
15 |
12 |
$4.80 |
| 84112 |
|
254 |
234 |
$0.00 |
| 96377 |
|
17 |
13 |
$0.00 |