| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
24,014 |
20,107 |
$3.73M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
21,614 |
16,834 |
$3.64M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
57,522 |
45,596 |
$1.75M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,263 |
2,016 |
$1.73M |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,950 |
2,684 |
$1.69M |
| 80053 |
Comprehensive metabolic panel |
54,798 |
47,118 |
$1.54M |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
9,026 |
7,730 |
$1.38M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
7,865 |
5,924 |
$1.27M |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,721 |
1,546 |
$1.08M |
| 84443 |
Thyroid stimulating hormone (TSH) |
21,635 |
19,517 |
$962K |
| 71045 |
Radiologic examination, chest; single view |
8,428 |
7,188 |
$678K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
20,506 |
18,587 |
$648K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
14,441 |
12,587 |
$618K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
11,785 |
9,822 |
$616K |
| 80061 |
Lipid panel |
23,661 |
21,613 |
$604K |
| 81001 |
|
20,334 |
17,049 |
$579K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
9,920 |
8,139 |
$576K |
| 36415 |
Collection of venous blood by venipuncture |
54,347 |
45,703 |
$568K |
| 71046 |
Radiologic examination, chest; 2 views |
4,821 |
4,314 |
$560K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
7,945 |
6,065 |
$522K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,071 |
2,533 |
$483K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
5,523 |
4,916 |
$464K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,770 |
1,080 |
$447K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
22,670 |
17,921 |
$438K |
| G0378 |
Hospital observation service, per hour |
3,362 |
1,440 |
$400K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
15,530 |
12,111 |
$384K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,538 |
964 |
$381K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
6,702 |
6,177 |
$356K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
3,742 |
3,206 |
$309K |
| 76830 |
Ultrasound, transvaginal |
871 |
828 |
$306K |
| 73630 |
|
3,004 |
2,330 |
$297K |
| 85027 |
|
9,808 |
8,722 |
$289K |
| 82248 |
|
14,261 |
11,722 |
$266K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
5,133 |
4,676 |
$266K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
5,131 |
4,674 |
$259K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
5,532 |
5,015 |
$256K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
5,662 |
4,479 |
$255K |
| 86803 |
|
5,701 |
5,037 |
$251K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
3,679 |
2,947 |
$245K |
| 59025 |
Fetal non-stress test |
2,117 |
1,375 |
$231K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,912 |
14,950 |
$226K |
| 84484 |
|
9,164 |
7,092 |
$224K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
324 |
281 |
$223K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
4,013 |
3,587 |
$222K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
805 |
748 |
$217K |
| 83690 |
|
9,647 |
8,134 |
$216K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
315 |
292 |
$210K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
1,997 |
1,052 |
$201K |
| 92134 |
|
3,078 |
1,810 |
$201K |
| 87186 |
|
4,328 |
3,832 |
$199K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
3,821 |
2,879 |
$185K |
| 85610 |
|
8,063 |
6,214 |
$185K |
| 82607 |
|
3,306 |
3,126 |
$177K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,664 |
1,503 |
$176K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
723 |
683 |
$162K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,418 |
4,905 |
$161K |
| 82803 |
|
3,693 |
2,855 |
$151K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,504 |
1,283 |
$148K |
| 73610 |
|
1,064 |
942 |
$144K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
5,677 |
4,738 |
$140K |
| 83880 |
|
3,523 |
2,939 |
$139K |
| 87077 |
|
4,304 |
3,840 |
$137K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
203 |
187 |
$136K |
| 73564 |
|
1,176 |
1,013 |
$133K |
| 87040 |
|
2,019 |
1,391 |
$132K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
920 |
872 |
$129K |
| 87340 |
|
2,291 |
2,065 |
$128K |
| 82728 |
|
2,598 |
2,432 |
$128K |
| 84466 |
|
2,693 |
2,521 |
$123K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
4,315 |
3,943 |
$120K |
| 85730 |
|
3,470 |
3,062 |
$115K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
17,294 |
13,596 |
$115K |
| 72110 |
|
634 |
601 |
$114K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
5,561 |
4,428 |
$108K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
395 |
363 |
$106K |
| 81025 |
|
3,996 |
3,467 |
$105K |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
779 |
716 |
$104K |
| 73030 |
|
1,105 |
973 |
$103K |
| 74018 |
|
979 |
903 |
$93K |
| 45384 |
|
197 |
127 |
$92K |
| 73130 |
|
762 |
634 |
$89K |
| 87522 |
Neg quan hep c or qual rna |
581 |
528 |
$88K |
| 85652 |
|
2,889 |
2,589 |
$88K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
1,160 |
1,060 |
$86K |
| 86706 |
|
1,373 |
1,253 |
$84K |
| 84702 |
|
1,224 |
902 |
$84K |
| 84439 |
|
2,187 |
2,047 |
$83K |
| 87070 |
|
1,170 |
992 |
$82K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,427 |
1,227 |
$80K |
| 82570 |
|
3,545 |
3,345 |
$80K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
2,531 |
808 |
$79K |
| 80050 |
General health panel |
843 |
822 |
$78K |
| 96376 |
|
2,211 |
1,347 |
$78K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,090 |
1,451 |
$74K |
| 73110 |
|
672 |
581 |
$74K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
2,453 |
2,237 |
$74K |
| 87807 |
|
1,955 |
1,750 |
$73K |
| 83605 |
|
2,867 |
2,332 |
$71K |
| 88142 |
|
1,469 |
1,371 |
$71K |
| 87481 |
|
376 |
336 |
$70K |
| 83735 |
|
5,726 |
4,684 |
$70K |
| 71250 |
|
185 |
168 |
$69K |
| 82746 |
|
1,127 |
1,073 |
$65K |
| 87081 |
|
1,410 |
1,304 |
$61K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,737 |
5,476 |
$60K |
| 82043 |
|
3,426 |
3,254 |
$58K |
| 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 |
969 |
793 |
$58K |
| 86592 |
|
1,582 |
1,419 |
$57K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,780 |
2,592 |
$57K |
| 74019 |
|
427 |
384 |
$56K |
| 86850 |
|
1,628 |
1,429 |
$56K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
6,109 |
4,585 |
$55K |
| 83540 |
|
2,877 |
2,702 |
$53K |
| 82962 |
|
4,723 |
2,156 |
$51K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
537 |
418 |
$50K |
| 82550 |
|
2,424 |
2,102 |
$48K |
| 76642 |
|
335 |
286 |
$47K |
| 86140 |
|
3,196 |
2,781 |
$45K |
| 74022 |
|
409 |
359 |
$45K |
| 93971 |
|
268 |
211 |
$43K |
| 87506 |
|
132 |
128 |
$42K |
| 84153 |
|
1,053 |
989 |
$42K |
| 90715 |
|
930 |
849 |
$42K |
| 85379 |
|
911 |
801 |
$41K |
| 86704 |
|
1,164 |
1,060 |
$40K |
| 84145 |
|
1,516 |
1,159 |
$40K |
| 93017 |
|
97 |
93 |
$38K |
| 87205 |
|
1,283 |
1,081 |
$37K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
223 |
201 |
$37K |
| 86901 |
|
1,672 |
1,465 |
$36K |
| 86618 |
|
989 |
616 |
$36K |
| 84100 |
|
2,791 |
2,328 |
$35K |
| 88342 |
|
492 |
370 |
$34K |
| 86900 |
|
1,674 |
1,467 |
$34K |
| 87653 |
|
395 |
383 |
$33K |
| 96367 |
|
280 |
216 |
$30K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
677 |
635 |
$30K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
819 |
766 |
$30K |
| 83970 |
|
258 |
235 |
$30K |
| 86762 |
|
697 |
624 |
$29K |
| 82274 |
|
766 |
699 |
$29K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
567 |
355 |
$27K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,711 |
1,262 |
$25K |
| 76536 |
|
135 |
124 |
$24K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
63 |
40 |
$24K |
| 76770 |
|
92 |
90 |
$24K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
150 |
122 |
$24K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
98 |
97 |
$23K |
| 76813 |
|
263 |
238 |
$23K |
| 11721 |
|
4,095 |
2,086 |
$22K |
| 82947 |
|
720 |
628 |
$20K |
| 73501 |
|
162 |
145 |
$19K |
| 87799 |
|
74 |
69 |
$19K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,811 |
1,320 |
$18K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,005 |
744 |
$18K |
| J0178 |
Injection, aflibercept, 1 mg |
55 |
52 |
$18K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
251 |
243 |
$17K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,476 |
1,218 |
$16K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
38 |
24 |
$16K |
| 87493 |
|
203 |
196 |
$15K |
| 82565 |
|
840 |
706 |
$15K |
| 72072 |
|
83 |
79 |
$15K |
| 86787 |
|
763 |
679 |
$15K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
44 |
40 |
$15K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,356 |
1,439 |
$14K |
| 86038 |
|
411 |
378 |
$14K |
| 73080 |
|
124 |
112 |
$14K |
| 85007 |
|
427 |
364 |
$13K |
| 82105 |
|
366 |
352 |
$12K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
406 |
332 |
$12K |
| 80076 |
|
408 |
378 |
$12K |
| 90686 |
|
880 |
838 |
$12K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,087 |
810 |
$12K |
| 84460 |
|
416 |
374 |
$11K |
| 84703 |
|
341 |
300 |
$11K |
| 93226 |
|
13 |
13 |
$11K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
625 |
588 |
$11K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
901 |
700 |
$11K |
| 86780 |
|
663 |
560 |
$11K |
| 10060 |
|
37 |
32 |
$10K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
499 |
351 |
$10K |
| 84156 |
|
264 |
239 |
$10K |
| 84550 |
|
478 |
438 |
$9K |
| 83001 |
|
205 |
185 |
$9K |
| 82150 |
|
365 |
349 |
$9K |
| 73140 |
|
76 |
67 |
$9K |
| 76801 |
|
78 |
66 |
$8K |
| G0475 |
Hiv antigen/antibody, combination assay, screening |
146 |
135 |
$8K |
| 97597 |
|
549 |
162 |
$8K |
| 82950 |
|
328 |
314 |
$8K |
| 87147 |
|
248 |
221 |
$8K |
| 81596 |
|
61 |
58 |
$7K |
| J2704 |
Injection, propofol, 10 mg |
2,292 |
1,740 |
$7K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
3,765 |
3,134 |
$7K |
| 86430 |
|
165 |
151 |
$7K |
| 84520 |
|
291 |
237 |
$7K |
| 84450 |
|
289 |
262 |
$7K |
| 86200 |
|
109 |
103 |
$7K |
| 82010 |
|
153 |
128 |
$6K |
| 20610 |
|
155 |
85 |
$6K |
| 83721 |
|
501 |
463 |
$6K |
| 86695 |
|
219 |
202 |
$6K |
| 87045 |
|
57 |
51 |
$6K |
| 83002 |
|
88 |
80 |
$5K |
| 87339 |
|
166 |
152 |
$5K |
| 73090 |
|
30 |
27 |
$5K |
| 86696 |
|
205 |
188 |
$5K |
| 73562 |
|
32 |
25 |
$5K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
15 |
15 |
$5K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
34 |
24 |
$4K |
| 84146 |
|
25 |
25 |
$4K |
| 84481 |
|
78 |
70 |
$4K |
| 82140 |
|
187 |
154 |
$4K |
| 81514 |
|
56 |
55 |
$4K |
| 99173 |
|
241 |
228 |
$4K |
| 87512 |
|
59 |
56 |
$4K |
| 80164 |
|
67 |
64 |
$3K |
| 80179 |
|
100 |
93 |
$3K |
| 87075 |
|
31 |
27 |
$3K |
| 73590 |
|
28 |
26 |
$3K |
| 82553 |
|
70 |
65 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
12 |
12 |
$3K |
| 83704 |
|
73 |
72 |
$3K |
| 87427 |
|
66 |
51 |
$3K |
| 83516 |
|
79 |
51 |
$3K |
| 99219 |
|
99 |
91 |
$3K |
| 93225 |
|
13 |
13 |
$3K |
| 86431 |
|
63 |
57 |
$3K |
| 73620 |
|
27 |
25 |
$3K |
| 92551 |
|
174 |
166 |
$3K |
| 86665 |
|
19 |
12 |
$3K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
400 |
229 |
$3K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
31 |
28 |
$3K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
338 |
280 |
$2K |
| 87046 |
|
57 |
51 |
$2K |
| 84403 |
|
82 |
75 |
$2K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
22 |
13 |
$2K |
| 99222 |
Initial hospital care, per day, moderate complexity |
119 |
105 |
$2K |
| 90670 |
|
204 |
193 |
$2K |
| 73502 |
|
37 |
37 |
$2K |
| 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 |
113 |
89 |
$2K |
| 86617 |
|
109 |
71 |
$2K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
13 |
12 |
$2K |
| J3490 |
Unclassified drugs |
3,175 |
1,703 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
109 |
107 |
$2K |
| 87177 |
|
39 |
39 |
$1K |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
12 |
12 |
$1K |
| 87328 |
|
24 |
24 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
120 |
92 |
$1K |
| 84112 |
|
20 |
13 |
$1K |
| 90658 |
|
100 |
99 |
$1K |
| 87209 |
|
39 |
39 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
81 |
80 |
$1K |
| 87329 |
|
24 |
24 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
78 |
76 |
$888.12 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
61 |
53 |
$874.24 |
| 82784 |
|
13 |
13 |
$862.89 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
108 |
100 |
$825.16 |
| 12001 |
|
16 |
14 |
$757.77 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
176 |
121 |
$723.40 |
| 86308 |
|
30 |
26 |
$722.30 |
| C9257 |
Injection, bevacizumab, 0.25 mg |
54 |
52 |
$719.38 |
| 84436 |
|
12 |
12 |
$711.19 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
64 |
40 |
$654.51 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
103 |
84 |
$641.30 |
| 92136 |
|
21 |
13 |
$588.95 |
| 90648 |
|
152 |
150 |
$578.47 |
| 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 |
29 |
25 |
$565.33 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
58 |
40 |
$555.37 |
| 82247 |
|
12 |
12 |
$542.18 |
| 80143 |
|
49 |
46 |
$453.12 |
| 36600 |
|
14 |
12 |
$432.35 |
| 99217 |
|
42 |
41 |
$401.66 |
| 81002 |
|
12 |
12 |
$394.41 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
43 |
43 |
$368.49 |
| 86664 |
|
19 |
12 |
$353.65 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
31 |
28 |
$317.08 |
| 94760 |
|
31 |
24 |
$310.25 |
| T1015 |
Clinic visit/encounter, all-inclusive |
112 |
102 |
$300.22 |
| 90474 |
|
25 |
25 |
$270.12 |
| 82977 |
|
14 |
13 |
$245.99 |
| 83550 |
|
28 |
27 |
$227.95 |
| J2060 |
Injection, lorazepam, 2 mg |
64 |
41 |
$207.42 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
92 |
83 |
$206.12 |
| 90680 |
|
27 |
26 |
$183.50 |
| 90723 |
|
27 |
27 |
$179.50 |
| 83020 |
|
15 |
14 |
$150.04 |
| 90651 |
|
16 |
15 |
$143.33 |
| 83695 |
|
29 |
25 |
$142.23 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
250 |
214 |
$127.84 |
| 90620 |
|
12 |
12 |
$116.39 |
| G0008 |
Administration of influenza virus vaccine |
74 |
74 |
$103.68 |
| 90710 |
|
15 |
15 |
$71.61 |
| 11056 |
|
23 |
12 |
$67.76 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
15 |
15 |
$60.54 |
| 82172 |
|
42 |
38 |
$57.45 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
43 |
33 |
$56.62 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
61 |
56 |
$52.81 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
99 |
99 |
$40.33 |
| 90633 |
|
12 |
12 |
$34.36 |
| 99305 |
|
38 |
38 |
$30.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
17 |
12 |
$7.41 |
| 99442 |
|
28 |
26 |
$4.93 |
| 90734 |
|
29 |
29 |
$0.00 |
| 99024 |
|
34 |
25 |
$0.00 |
| 99441 |
|
22 |
22 |
$0.00 |
| Q0240 |
Injection, casirivimab and imdevimab, 600 mg |
20 |
20 |
$0.00 |