| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
64,971 |
58,877 |
$28.90M |
| G0378 |
Hospital observation service, per hour |
5,814 |
3,665 |
$7.05M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
7,804 |
7,502 |
$5.78M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
9,733 |
9,559 |
$3.01M |
| 0450 |
Emergency room services |
62,123 |
55,946 |
$2.69M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
8,899 |
8,683 |
$2.25M |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
2,140 |
2,091 |
$1.82M |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
4,059 |
3,707 |
$1.18M |
| 70450 |
Computed tomography, head or brain; without contrast material |
11,261 |
10,989 |
$1.17M |
| 71045 |
Radiologic examination, chest; single view |
22,822 |
21,389 |
$1.05M |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
17,894 |
17,198 |
$884K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
533 |
531 |
$834K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,637 |
3,584 |
$663K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
6,026 |
6,025 |
$658K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
7,595 |
7,349 |
$629K |
| 76830 |
Ultrasound, transvaginal |
7,235 |
6,983 |
$594K |
| 71046 |
Radiologic examination, chest; 2 views |
12,024 |
11,741 |
$577K |
| 80051 |
|
112,376 |
95,476 |
$518K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
17,619 |
16,198 |
$514K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
17,635 |
16,212 |
$514K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
104,550 |
89,694 |
$514K |
| 82565 |
|
131,995 |
112,954 |
$504K |
| 86900 |
|
10,256 |
9,527 |
$487K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
2,263 |
2,233 |
$478K |
| 86885 |
|
7,118 |
6,780 |
$463K |
| 84443 |
Thyroid stimulating hormone (TSH) |
28,793 |
28,234 |
$456K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
4,845 |
4,756 |
$406K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,054 |
1,048 |
$398K |
| 93971 |
|
2,052 |
1,990 |
$395K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
41,567 |
41,121 |
$388K |
| 83880 |
|
15,919 |
14,369 |
$353K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,727 |
1,716 |
$349K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
11,375 |
11,317 |
$339K |
| 80061 |
Lipid panel |
25,917 |
25,750 |
$339K |
| 84460 |
|
73,299 |
66,815 |
$329K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,734 |
1,729 |
$326K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,408 |
1,397 |
$309K |
| 73562 |
|
5,276 |
4,994 |
$303K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
14,782 |
13,170 |
$295K |
| 73630 |
|
5,235 |
5,032 |
$286K |
| 78451 |
|
231 |
231 |
$276K |
| 76641 |
|
2,893 |
2,853 |
$269K |
| 83970 |
|
5,736 |
5,605 |
$256K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
11,878 |
11,791 |
$255K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
220 |
220 |
$248K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,246 |
5,338 |
$247K |
| 85027 |
|
48,049 |
46,217 |
$245K |
| 73030 |
|
4,254 |
4,062 |
$237K |
| 73610 |
|
4,325 |
4,100 |
$228K |
| 93017 |
|
522 |
520 |
$202K |
| 72100 |
|
2,463 |
2,450 |
$196K |
| 82247 |
|
51,259 |
45,130 |
$194K |
| 84702 |
|
20,769 |
18,386 |
$192K |
| 84520 |
|
87,953 |
74,230 |
$185K |
| 73130 |
|
3,501 |
3,285 |
$182K |
| 76770 |
|
1,901 |
1,894 |
$179K |
| 76536 |
|
1,808 |
1,786 |
$178K |
| 82728 |
|
12,926 |
12,636 |
$178K |
| 86780 |
|
14,524 |
14,018 |
$178K |
| 84075 |
|
45,759 |
41,590 |
$176K |
| 81513 |
|
2,053 |
2,018 |
$173K |
| 93970 |
|
712 |
703 |
$172K |
| 70486 |
|
1,365 |
1,352 |
$166K |
| 82947 |
|
78,847 |
69,981 |
$164K |
| 84450 |
|
42,846 |
39,093 |
$163K |
| 71250 |
|
1,275 |
1,273 |
$163K |
| 99199 |
Unlisted special service, procedure or report |
4,612 |
4,235 |
$156K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,641 |
1,639 |
$154K |
| 86901 |
|
10,275 |
9,545 |
$152K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
9,802 |
8,786 |
$151K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
3,393 |
3,258 |
$147K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
730 |
700 |
$145K |
| 73110 |
|
2,697 |
2,489 |
$144K |
| 86141 |
|
11,758 |
11,219 |
$142K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,981 |
2,026 |
$136K |
| 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 |
4,040 |
3,968 |
$135K |
| 87505 |
|
1,196 |
1,171 |
$135K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,563 |
1,559 |
$134K |
| 86803 |
|
8,889 |
8,805 |
$121K |
| 82310 |
|
29,871 |
27,293 |
$120K |
| 72141 |
|
592 |
591 |
$120K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
12,877 |
11,641 |
$119K |
| 86923 |
|
692 |
648 |
$116K |
| 83690 |
|
28,026 |
26,140 |
$115K |
| 84484 |
|
28,155 |
23,019 |
$113K |
| 83550 |
|
13,024 |
12,761 |
$113K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
495 |
495 |
$107K |
| 82607 |
|
7,063 |
7,022 |
$106K |
| 85610 |
|
33,490 |
26,266 |
$105K |
| 73502 |
|
1,759 |
1,663 |
$105K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
417 |
416 |
$103K |
| 86480 |
|
1,585 |
1,575 |
$103K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
760 |
751 |
$100K |
| 72170 |
|
1,222 |
1,185 |
$97K |
| 87088 |
|
19,795 |
19,076 |
$96K |
| 0637 |
|
93,782 |
37,688 |
$95K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
6,868 |
6,497 |
$95K |
| 73140 |
|
1,866 |
1,770 |
$93K |
| 87340 |
|
10,124 |
10,000 |
$93K |
| 81003 |
|
54,468 |
51,235 |
$92K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
1,199 |
1,181 |
$92K |
| 83735 |
|
19,228 |
16,463 |
$87K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
869 |
862 |
$87K |
| 87536 |
|
1,111 |
1,102 |
$87K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
27,443 |
22,170 |
$84K |
| 74018 |
|
1,603 |
1,501 |
$84K |
| 83540 |
|
13,111 |
12,848 |
$79K |
| 70496 |
|
333 |
329 |
$79K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
3,372 |
3,159 |
$78K |
| 87481 |
|
2,084 |
2,049 |
$78K |
| 82043 |
|
12,225 |
12,093 |
$78K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
2,046 |
2,010 |
$77K |
| 84153 |
|
4,072 |
3,981 |
$73K |
| 77080 |
|
478 |
478 |
$71K |
| 73564 |
|
699 |
595 |
$69K |
| 82040 |
|
14,862 |
14,078 |
$68K |
| 70498 |
|
290 |
289 |
$67K |
| J2785 |
Injection, regadenoson, 0.1 mg |
512 |
511 |
$64K |
| 93880 |
|
201 |
201 |
$63K |
| 73080 |
|
1,279 |
1,204 |
$63K |
| 83520 |
|
3,521 |
2,189 |
$62K |
| 84403 |
|
2,423 |
2,369 |
$61K |
| 77066 |
Tomosynthesis, mammo |
467 |
467 |
$55K |
| 90686 |
|
4,283 |
4,229 |
$55K |
| 76881 |
|
514 |
509 |
$54K |
| 86003 |
|
1,126 |
1,027 |
$53K |
| 70491 |
|
273 |
269 |
$53K |
| 84439 |
|
6,169 |
5,784 |
$51K |
| 82746 |
|
3,399 |
3,383 |
$50K |
| 87040 |
|
11,325 |
5,935 |
$49K |
| 76870 |
|
584 |
569 |
$48K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
438 |
435 |
$48K |
| 77065 |
Tomosynthesis, mammo |
533 |
530 |
$47K |
| 73590 |
|
949 |
882 |
$47K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
15,466 |
12,110 |
$45K |
| 82248 |
|
15,885 |
14,933 |
$44K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
1,097 |
1,080 |
$44K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,244 |
4,836 |
$43K |
| 83021 |
|
2,609 |
2,599 |
$43K |
| 84100 |
|
11,909 |
10,499 |
$42K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
600 |
513 |
$41K |
| P9021 |
Red blood cells, each unit |
583 |
483 |
$41K |
| 72040 |
|
786 |
781 |
$39K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
13,848 |
12,215 |
$39K |
| 82570 |
|
6,584 |
6,092 |
$38K |
| 83605 |
|
8,115 |
6,448 |
$38K |
| 86762 |
|
2,789 |
2,780 |
$37K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
365 |
355 |
$36K |
| 82105 |
|
2,123 |
2,091 |
$36K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
3,111 |
2,983 |
$36K |
| 85652 |
|
14,309 |
13,813 |
$36K |
| 87210 |
|
9,510 |
9,248 |
$35K |
| 83721 |
|
3,469 |
3,462 |
$35K |
| 86787 |
|
2,895 |
2,887 |
$34K |
| 71101 |
|
415 |
408 |
$32K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
7,074 |
6,017 |
$31K |
| 73560 |
|
631 |
563 |
$30K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
8,343 |
6,946 |
$30K |
| 86038 |
|
2,464 |
2,446 |
$28K |
| 90791 |
Psychiatric diagnostic evaluation |
411 |
392 |
$28K |
| 84165 |
|
2,375 |
2,292 |
$28K |
| 82784 |
|
1,253 |
1,192 |
$28K |
| Z7502 |
|
1,271 |
1,217 |
$28K |
| 82670 |
|
916 |
907 |
$27K |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
2,262 |
2,165 |
$26K |
| 86704 |
|
2,176 |
2,144 |
$25K |
| 83001 |
|
1,430 |
1,411 |
$25K |
| 86317 |
|
1,744 |
1,728 |
$25K |
| 80306 |
|
2,429 |
2,314 |
$25K |
| 84146 |
|
1,349 |
1,323 |
$25K |
| 83655 |
|
2,794 |
2,789 |
$25K |
| 84156 |
|
6,123 |
5,690 |
$24K |
| 80076 |
|
3,103 |
2,964 |
$24K |
| 73090 |
|
540 |
512 |
$24K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,190 |
1,169 |
$23K |
| 84132 |
|
4,806 |
4,278 |
$23K |
| 82077 |
|
3,092 |
2,757 |
$22K |
| 73660 |
|
457 |
445 |
$22K |
| J3490 |
Unclassified drugs |
6,727 |
5,425 |
$21K |
| 82378 |
|
1,079 |
980 |
$21K |
| 83718 |
|
2,719 |
2,717 |
$20K |
| 86360 |
|
700 |
694 |
$19K |
| 85379 |
|
3,452 |
3,374 |
$18K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
1,334 |
982 |
$18K |
| 85730 |
|
4,643 |
4,231 |
$17K |
| 76380 |
|
222 |
221 |
$17K |
| 88342 |
|
130 |
130 |
$17K |
| 82550 |
|
3,520 |
3,276 |
$17K |
| 83615 |
|
2,848 |
2,667 |
$16K |
| A9609 |
Fludeoxyglucose f18 up to 15 millicuries |
194 |
194 |
$16K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
4,004 |
3,369 |
$15K |
| 86359 |
|
699 |
693 |
$15K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
616 |
615 |
$15K |
| 80197 |
|
984 |
760 |
$15K |
| 84550 |
|
3,847 |
3,797 |
$15K |
| 86160 |
|
685 |
662 |
$14K |
| 74183 |
|
29 |
29 |
$14K |
| J1953 |
Injection, levetiracetam, 10 mg |
242 |
197 |
$14K |
| 84270 |
|
629 |
616 |
$14K |
| 73100 |
|
214 |
181 |
$13K |
| 73221 |
|
53 |
52 |
$13K |
| 97161 |
|
854 |
828 |
$13K |
| 80179 |
|
1,793 |
1,681 |
$13K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
354 |
353 |
$13K |
| 85014 |
|
5,008 |
4,881 |
$12K |
| 0250 |
|
10,792 |
7,175 |
$12K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
536 |
513 |
$12K |
| 86765 |
|
864 |
863 |
$11K |
| 90715 |
|
423 |
415 |
$11K |
| 84134 |
|
917 |
829 |
$11K |
| 84480 |
|
952 |
934 |
$11K |
| 82950 |
|
2,552 |
2,548 |
$11K |
| 82465 |
|
2,816 |
2,813 |
$11K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
184 |
101 |
$10K |
| 74178 |
|
24 |
24 |
$10K |
| 0258 |
|
4,798 |
4,033 |
$10K |
| 84295 |
|
2,044 |
1,841 |
$10K |
| 85018 |
|
3,471 |
3,381 |
$9K |
| J1644 |
Injection, heparin sodium, per 1000 units |
2,535 |
1,281 |
$9K |
| 72050 |
|
99 |
99 |
$9K |
| J2060 |
Injection, lorazepam, 2 mg |
2,805 |
2,349 |
$9K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,819 |
1,683 |
$9K |
| J1815 |
Injection, insulin, per 5 units |
3,724 |
2,073 |
$9K |
| 86225 |
|
630 |
625 |
$9K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,981 |
1,807 |
$9K |
| 71271 |
|
58 |
58 |
$9K |
| 83002 |
|
478 |
476 |
$8K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,807 |
1,579 |
$8K |
| J1940 |
Injection, furosemide, up to 20 mg |
2,102 |
1,308 |
$8K |
| 87186 |
|
1,808 |
1,785 |
$8K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
437 |
430 |
$8K |
| 86431 |
|
1,261 |
1,253 |
$7K |
| 82627 |
|
319 |
316 |
$7K |
| 85046 |
|
1,878 |
1,607 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
309 |
162 |
$7K |
| 84163 |
|
464 |
463 |
$7K |
| 87081 |
|
1,654 |
1,627 |
$7K |
| 87449 |
|
954 |
678 |
$7K |
| 96367 |
|
350 |
334 |
$7K |
| 81015 |
|
1,795 |
1,770 |
$6K |
| 87497 |
|
126 |
102 |
$6K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
2,872 |
2,452 |
$6K |
| 72131 |
|
44 |
44 |
$6K |
| 0710 |
|
833 |
820 |
$6K |
| 74174 |
|
12 |
12 |
$6K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,953 |
2,660 |
$6K |
| 72197 |
|
13 |
13 |
$6K |
| 87205 |
|
2,025 |
1,757 |
$6K |
| 73552 |
|
104 |
97 |
$6K |
| 86301 |
|
296 |
270 |
$6K |
| G0008 |
Administration of influenza virus vaccine |
2,038 |
2,029 |
$6K |
| 86769 |
|
260 |
260 |
$6K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
643 |
596 |
$5K |
| 73060 |
|
99 |
95 |
$5K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,306 |
1,284 |
$5K |
| 82677 |
|
216 |
216 |
$5K |
| 82805 |
|
263 |
235 |
$5K |
| 82962 |
|
2,544 |
1,766 |
$5K |
| 74022 |
|
59 |
57 |
$5K |
| 86334 |
|
177 |
175 |
$5K |
| 74181 |
|
13 |
12 |
$4K |
| 0255 |
|
709 |
555 |
$4K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
46 |
43 |
$4K |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
974 |
833 |
$4K |
| 87522 |
Neg quan hep c or qual rna |
105 |
102 |
$4K |
| 82977 |
|
439 |
426 |
$4K |
| 84478 |
|
735 |
640 |
$4K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,260 |
722 |
$4K |
| 86364 |
|
282 |
280 |
$3K |
| 73523 |
|
24 |
24 |
$3K |
| 10060 |
|
111 |
110 |
$3K |
| 86336 |
|
216 |
216 |
$3K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
116 |
116 |
$3K |
| 83921 |
|
137 |
136 |
$3K |
| J1630 |
Injection, haloperidol, up to 5 mg |
951 |
772 |
$3K |
| 84155 |
|
634 |
620 |
$3K |
| 82274 |
|
172 |
172 |
$3K |
| 86376 |
|
188 |
188 |
$3K |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
402 |
271 |
$3K |
| 72070 |
|
38 |
38 |
$3K |
| 90662 |
|
219 |
219 |
$3K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,397 |
1,335 |
$3K |
| 87517 |
|
52 |
48 |
$2K |
| 86677 |
|
370 |
368 |
$2K |
| 87070 |
|
510 |
477 |
$2K |
| 29125 |
|
83 |
80 |
$2K |
| 86304 |
|
115 |
108 |
$2K |
| 90656 |
|
178 |
178 |
$2K |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
765 |
648 |
$2K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,269 |
1,168 |
$2K |
| 86256 |
|
89 |
89 |
$2K |
| 86592 |
|
552 |
542 |
$2K |
| 99292 |
|
12 |
12 |
$2K |
| 87631 |
|
88 |
88 |
$2K |
| 81329 |
|
24 |
24 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
518 |
514 |
$2K |
| C1769 |
Guide wire |
45 |
42 |
$2K |
| 83993 |
|
96 |
95 |
$2K |
| J3480 |
Injection, potassium chloride, per 2 meq |
808 |
560 |
$2K |
| 86255 |
|
122 |
121 |
$2K |
| 80329 |
|
1,007 |
493 |
$2K |
| 85045 |
|
656 |
561 |
$2K |
| 82533 |
|
99 |
96 |
$2K |
| 84145 |
|
233 |
217 |
$2K |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
155 |
148 |
$2K |
| 29515 |
|
38 |
38 |
$2K |
| 76706 |
|
13 |
13 |
$2K |
| 80320 |
|
952 |
816 |
$2K |
| 80359 |
|
521 |
489 |
$2K |
| 86300 |
|
56 |
50 |
$1K |
| 80324 |
|
513 |
482 |
$1K |
| 36902 |
|
12 |
12 |
$1K |
| 0370 |
|
814 |
805 |
$1K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
140 |
99 |
$1K |
| 86665 |
|
80 |
40 |
$1K |
| J3371 |
Injection, vancomycin hcl (mylan), not therapeutically equivalent to j3370, 500 mg |
91 |
68 |
$1K |
| 12011 |
|
43 |
43 |
$1K |
| 77061 |
|
12 |
12 |
$1K |
| 12001 |
|
89 |
87 |
$1K |
| 82951 |
|
67 |
66 |
$1K |
| 86308 |
|
235 |
231 |
$1K |
| 88307 |
|
16 |
15 |
$998.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
850 |
814 |
$939.05 |
| 82150 |
|
145 |
142 |
$933.39 |
| 73120 |
|
14 |
12 |
$931.36 |
| 90674 |
|
49 |
49 |
$912.32 |
| 86880 |
|
18 |
17 |
$902.54 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
476 |
365 |
$880.03 |
| 86709 |
|
94 |
94 |
$879.53 |
| 73070 |
|
14 |
12 |
$876.54 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
554 |
528 |
$780.86 |
| 0272 |
|
78 |
78 |
$768.38 |
| J1836 |
Injection, metronidazole, 10 mg |
130 |
98 |
$746.94 |
| 82140 |
|
129 |
107 |
$737.43 |
| 90688 |
|
111 |
109 |
$717.79 |
| 86735 |
|
54 |
54 |
$691.00 |
| 84425 |
|
38 |
38 |
$681.85 |
| 86708 |
|
54 |
54 |
$654.67 |
| 0320 |
|
75 |
72 |
$632.12 |
| 86140 |
|
1,443 |
1,387 |
$627.38 |
| J0456 |
Injection, azithromycin, 500 mg |
298 |
221 |
$549.06 |
| E0110 |
Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips |
12 |
12 |
$529.63 |
| 86664 |
|
40 |
40 |
$480.90 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
193 |
184 |
$466.76 |
| 86235 |
|
26 |
24 |
$446.28 |
| 99499 |
|
23 |
12 |
$420.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
580 |
517 |
$419.48 |
| 80162 |
|
26 |
25 |
$357.00 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
428 |
412 |
$346.97 |
| 82103 |
|
24 |
24 |
$316.00 |
| 87807 |
|
27 |
27 |
$306.86 |
| 82952 |
|
67 |
66 |
$306.42 |
| 83010 |
|
28 |
26 |
$298.00 |
| 86696 |
|
13 |
13 |
$293.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
58 |
42 |
$292.56 |
| 87255 |
|
12 |
12 |
$290.33 |
| 86039 |
|
27 |
26 |
$290.00 |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
42 |
31 |
$250.00 |
| 87324 |
|
34 |
34 |
$240.78 |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
173 |
114 |
$224.53 |
| 90749 |
|
138 |
137 |
$215.08 |
| 86695 |
|
13 |
13 |
$208.00 |
| 82397 |
|
13 |
13 |
$179.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
354 |
240 |
$163.08 |
| 82164 |
|
12 |
12 |
$163.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,320 |
1,103 |
$161.53 |
| 87149 |
|
15 |
14 |
$132.68 |
| 86593 |
|
27 |
27 |
$129.79 |
| 89051 |
|
30 |
26 |
$117.94 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
129 |
83 |
$115.23 |
| 88304 |
|
114 |
105 |
$99.50 |
| 85613 |
|
12 |
12 |
$94.00 |
| 85660 |
|
13 |
12 |
$86.40 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
18 |
18 |
$85.86 |
| J7510 |
Prednisolone oral, per 5 mg |
244 |
239 |
$70.56 |
| 83930 |
|
14 |
13 |
$66.00 |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
42 |
26 |
$51.54 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
29 |
15 |
$49.43 |
| 82272 |
|
12 |
12 |
$49.00 |
| 82985 |
|
13 |
13 |
$45.00 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
44 |
27 |
$43.53 |
| 29130 |
|
13 |
13 |
$34.17 |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
14 |
14 |
$10.00 |
| 3051F |
|
395 |
391 |
$0.01 |
| 3052F |
|
144 |
143 |
$0.01 |
| 3046F |
|
322 |
317 |
$0.00 |
| 3078F |
|
136 |
133 |
$0.00 |
| 0760 |
|
14 |
14 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
12 |
12 |
$0.00 |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
13 |
13 |
$0.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
14 |
14 |
$0.00 |
| 3044F |
|
4,092 |
4,087 |
$0.00 |
| 3074F |
|
158 |
155 |
$0.00 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
12 |
12 |
$0.00 |
| 0771 |
|
23 |
23 |
$0.00 |