| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
11,467 |
10,431 |
$8.56M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
30,329 |
28,383 |
$8.01M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
31,018 |
28,178 |
$7.04M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
17,419 |
14,487 |
$5.19M |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
4,210 |
3,781 |
$1.86M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
9,895 |
9,374 |
$1.39M |
| 72125 |
Computed tomography, cervical spine; without contrast material |
4,289 |
3,925 |
$1.15M |
| 70450 |
Computed tomography, head or brain; without contrast material |
9,672 |
8,691 |
$1.07M |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
8,831 |
4,331 |
$1.04M |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,719 |
3,421 |
$981K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,781 |
1,653 |
$806K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
424 |
388 |
$805K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
14,867 |
4,969 |
$702K |
| 95811 |
|
1,574 |
1,492 |
$667K |
| 72131 |
|
2,706 |
2,522 |
$645K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,977 |
3,037 |
$584K |
| G0378 |
Hospital observation service, per hour |
5,943 |
3,279 |
$495K |
| 11043 |
|
2,491 |
1,249 |
$494K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,607 |
2,450 |
$485K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,367 |
1,299 |
$430K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
11,431 |
7,954 |
$416K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,379 |
2,272 |
$409K |
| 93971 |
|
1,993 |
1,898 |
$349K |
| 59025 |
Fetal non-stress test |
2,939 |
1,894 |
$328K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
863 |
830 |
$316K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
489 |
460 |
$295K |
| 72100 |
|
2,701 |
2,645 |
$289K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
3,616 |
3,387 |
$269K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
5,469 |
2,797 |
$256K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,713 |
1,657 |
$253K |
| 70486 |
|
1,478 |
1,383 |
$247K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
3,786 |
3,748 |
$243K |
| 71046 |
Radiologic examination, chest; 2 views |
9,940 |
9,339 |
$212K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
3,698 |
3,527 |
$204K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
461 |
435 |
$203K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
5,335 |
2,247 |
$182K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
1,489 |
1,375 |
$169K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,939 |
1,016 |
$167K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
17,083 |
13,794 |
$162K |
| 64483 |
|
171 |
167 |
$156K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
2,294 |
2,145 |
$148K |
| 73030 |
|
3,330 |
3,146 |
$121K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
3,466 |
3,241 |
$118K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,364 |
1,332 |
$114K |
| 77066 |
Tomosynthesis, mammo |
744 |
727 |
$89K |
| 73562 |
|
3,197 |
2,987 |
$89K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
731 |
679 |
$84K |
| 73610 |
|
2,582 |
2,453 |
$80K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,906 |
1,693 |
$79K |
| 73110 |
|
2,266 |
2,153 |
$72K |
| 97113 |
|
1,271 |
446 |
$68K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
8,493 |
3,035 |
$67K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
4,951 |
4,217 |
$64K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,262 |
1,782 |
$59K |
| 73630 |
|
2,697 |
2,518 |
$59K |
| 73221 |
|
506 |
469 |
$57K |
| 72141 |
|
472 |
454 |
$57K |
| 70491 |
|
171 |
149 |
$56K |
| 73130 |
|
2,505 |
2,352 |
$56K |
| 70498 |
|
198 |
182 |
$55K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
4,131 |
2,781 |
$49K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
53,205 |
42,986 |
$48K |
| 76942 |
|
739 |
679 |
$47K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
27,671 |
21,210 |
$47K |
| 97162 |
|
607 |
551 |
$44K |
| 76642 |
|
1,529 |
1,468 |
$43K |
| 94060 |
|
159 |
151 |
$43K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
5,642 |
5,364 |
$41K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
27 |
25 |
$38K |
| 76536 |
|
631 |
607 |
$38K |
| 73502 |
|
1,746 |
1,650 |
$37K |
| 72072 |
|
1,038 |
1,020 |
$37K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
12,199 |
10,498 |
$35K |
| 72040 |
|
1,336 |
1,310 |
$35K |
| 97161 |
|
2,129 |
1,827 |
$35K |
| 99215 |
Prolong outpt/office vis |
572 |
500 |
$35K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
11,888 |
8,957 |
$33K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
3,222 |
3,012 |
$33K |
| 71250 |
|
346 |
324 |
$32K |
| 72110 |
|
222 |
216 |
$29K |
| 74018 |
|
1,324 |
1,235 |
$27K |
| 76830 |
Ultrasound, transvaginal |
1,316 |
1,253 |
$27K |
| 74178 |
|
59 |
56 |
$27K |
| 77080 |
|
365 |
356 |
$26K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
29,868 |
25,789 |
$25K |
| 97597 |
|
725 |
436 |
$24K |
| J2704 |
Injection, propofol, 10 mg |
8,312 |
7,203 |
$21K |
| 93970 |
|
121 |
113 |
$21K |
| 76770 |
|
343 |
333 |
$21K |
| 76818 |
|
135 |
85 |
$21K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
210 |
98 |
$20K |
| 80053 |
Comprehensive metabolic panel |
54,530 |
43,945 |
$20K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
4,568 |
4,062 |
$20K |
| 74019 |
|
304 |
290 |
$19K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
42 |
40 |
$19K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
17,930 |
16,052 |
$18K |
| 73140 |
|
642 |
621 |
$18K |
| 73700 |
|
143 |
135 |
$17K |
| 92523 |
|
73 |
66 |
$16K |
| 99453 |
|
189 |
164 |
$16K |
| 72128 |
|
1,717 |
1,593 |
$15K |
| 97803 |
|
481 |
409 |
$15K |
| 76801 |
|
1,201 |
1,079 |
$15K |
| 73080 |
|
851 |
798 |
$14K |
| 72114 |
|
99 |
99 |
$13K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
425 |
330 |
$13K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
945 |
341 |
$13K |
| 72074 |
|
68 |
67 |
$13K |
| 71271 |
|
265 |
261 |
$12K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
525 |
447 |
$10K |
| 87507 |
|
396 |
378 |
$10K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,121 |
933 |
$10K |
| 80329 |
|
4,238 |
3,102 |
$10K |
| 64415 |
|
13 |
12 |
$10K |
| 73564 |
|
196 |
179 |
$10K |
| 73590 |
|
885 |
814 |
$10K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
5,137 |
3,846 |
$9K |
| 87071 |
|
2,630 |
2,368 |
$9K |
| 71045 |
Radiologic examination, chest; single view |
16,138 |
14,128 |
$9K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
4,709 |
3,687 |
$9K |
| 64484 |
|
17 |
13 |
$8K |
| 11045 |
|
44 |
12 |
$8K |
| 96367 |
|
2,274 |
1,379 |
$7K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
23 |
23 |
$7K |
| 77065 |
Tomosynthesis, mammo |
74 |
72 |
$7K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
13 |
12 |
$6K |
| 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 |
1,426 |
1,097 |
$6K |
| 73523 |
|
53 |
51 |
$6K |
| 84443 |
Thyroid stimulating hormone (TSH) |
7,746 |
6,860 |
$6K |
| 83880 |
|
2,516 |
2,207 |
$5K |
| 87040 |
|
3,286 |
2,883 |
$5K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,507 |
1,317 |
$5K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
934 |
831 |
$5K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
105 |
104 |
$5K |
| J3480 |
Injection, potassium chloride, per 2 meq |
1,274 |
894 |
$5K |
| 76870 |
|
125 |
121 |
$5K |
| 96523 |
|
118 |
108 |
$4K |
| 85027 |
|
7,894 |
6,332 |
$4K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
5,540 |
3,314 |
$4K |
| J3360 |
Injection, diazepam, up to 5 mg |
766 |
607 |
$4K |
| 97802 |
|
82 |
79 |
$4K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
5,924 |
5,334 |
$4K |
| 86923 |
|
35 |
26 |
$4K |
| 73090 |
|
351 |
329 |
$4K |
| 70496 |
|
130 |
121 |
$4K |
| 73100 |
|
57 |
54 |
$4K |
| C1889 |
Implantable/insertable device, not otherwise classified |
62 |
61 |
$3K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,921 |
1,487 |
$3K |
| 96376 |
|
7,906 |
5,316 |
$3K |
| J3490 |
Unclassified drugs |
19,374 |
9,655 |
$3K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
11,439 |
9,886 |
$3K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
520 |
500 |
$3K |
| 85730 |
|
10,208 |
8,885 |
$3K |
| 71101 |
|
88 |
85 |
$3K |
| 86850 |
|
2,272 |
2,015 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,041 |
1,656 |
$2K |
| 12001 |
|
201 |
189 |
$2K |
| 73560 |
|
196 |
175 |
$2K |
| 84484 |
|
12,422 |
10,042 |
$2K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
3,481 |
3,319 |
$2K |
| 12002 |
|
40 |
40 |
$2K |
| 73120 |
|
75 |
61 |
$2K |
| 73620 |
|
70 |
63 |
$2K |
| 36591 |
|
39 |
25 |
$2K |
| 87506 |
|
27 |
24 |
$2K |
| 74022 |
|
310 |
285 |
$2K |
| 99195 |
|
17 |
12 |
$2K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
5,762 |
4,444 |
$2K |
| 85378 |
|
3,408 |
3,062 |
$1K |
| 81025 |
|
10,603 |
9,615 |
$1K |
| 87077 |
|
3,843 |
3,529 |
$1K |
| 82803 |
|
859 |
765 |
$1K |
| 84702 |
|
5,036 |
4,514 |
$1K |
| 83690 |
|
18,351 |
15,899 |
$1K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,346 |
2,248 |
$1K |
| 81001 |
|
28,425 |
24,362 |
$1K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
268 |
196 |
$1K |
| 83735 |
|
11,384 |
9,499 |
$1K |
| 80061 |
Lipid panel |
1,245 |
1,082 |
$1K |
| 80320 |
|
13,494 |
10,845 |
$1K |
| J1815 |
Injection, insulin, per 5 units |
316 |
175 |
$983.93 |
| 82140 |
|
625 |
518 |
$948.32 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
37 |
25 |
$936.75 |
| 72052 |
|
12 |
12 |
$936.74 |
| 90715 |
|
1,569 |
1,488 |
$897.45 |
| 97116 |
|
118 |
61 |
$751.98 |
| 73600 |
|
44 |
36 |
$744.21 |
| 85652 |
|
2,856 |
2,299 |
$738.24 |
| 93017 |
|
40 |
38 |
$717.45 |
| 64447 |
|
95 |
90 |
$707.53 |
| J7050 |
Infusion, normal saline solution, 250 cc |
4,604 |
2,538 |
$624.73 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
2,761 |
1,923 |
$603.91 |
| 29125 |
|
125 |
120 |
$581.27 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
1,244 |
1,182 |
$565.89 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
3,755 |
3,575 |
$559.87 |
| 82962 |
|
10,602 |
7,103 |
$558.87 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
22,163 |
18,089 |
$551.95 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,197 |
3,069 |
$549.76 |
| 85610 |
|
15,368 |
13,220 |
$546.01 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
16,983 |
14,785 |
$519.51 |
| 36415 |
Collection of venous blood by venipuncture |
17,403 |
13,406 |
$442.08 |
| 77085 |
|
12 |
12 |
$430.99 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
2,706 |
2,525 |
$428.96 |
| 87581 |
|
3,748 |
3,571 |
$419.40 |
| 82550 |
|
2,413 |
2,068 |
$417.59 |
| 87486 |
|
3,748 |
3,571 |
$413.16 |
| 51702 |
|
269 |
224 |
$409.77 |
| 73552 |
|
12 |
12 |
$408.66 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
2,396 |
1,990 |
$401.91 |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
38 |
27 |
$370.30 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
24,458 |
20,169 |
$363.25 |
| 82977 |
|
3,751 |
3,365 |
$337.69 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,753 |
1,588 |
$333.69 |
| 76857 |
|
14 |
13 |
$332.02 |
| 82150 |
|
1,455 |
1,295 |
$331.08 |
| 83605 |
|
7,135 |
5,937 |
$312.36 |
| 88304 |
|
643 |
595 |
$310.44 |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
1,210 |
928 |
$281.20 |
| 94726 |
|
137 |
132 |
$255.94 |
| 36430 |
|
37 |
27 |
$252.37 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
5,884 |
4,231 |
$243.20 |
| 82728 |
|
49 |
39 |
$233.03 |
| 93308 |
|
14 |
14 |
$230.67 |
| 82553 |
|
352 |
310 |
$220.25 |
| 86900 |
|
2,944 |
2,614 |
$209.53 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
7,691 |
5,975 |
$206.35 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
521 |
499 |
$204.71 |
| 85014 |
|
343 |
269 |
$201.70 |
| 94729 |
|
127 |
122 |
$201.02 |
| 84439 |
|
1,808 |
1,624 |
$189.42 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
206 |
173 |
$178.80 |
| 87186 |
|
3,254 |
3,004 |
$169.53 |
| 84550 |
|
515 |
401 |
$152.99 |
| 86140 |
|
3,757 |
3,078 |
$150.35 |
| 82565 |
|
1,233 |
1,150 |
$150.00 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
707 |
693 |
$146.66 |
| 87205 |
|
2,817 |
2,533 |
$140.32 |
| 86901 |
|
2,942 |
2,612 |
$133.71 |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,169 |
581 |
$130.36 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
2,399 |
1,955 |
$111.73 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
9,834 |
8,287 |
$97.28 |
| S0164 |
Injection, pantoprazole sodium, 40 mg |
1,552 |
1,214 |
$97.05 |
| Q3014 |
Telehealth originating site facility fee |
964 |
603 |
$87.39 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
997 |
886 |
$86.70 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
5,647 |
4,656 |
$82.89 |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
65 |
30 |
$77.72 |
| Q9963 |
High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml |
673 |
614 |
$74.96 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
8,760 |
7,048 |
$66.13 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
7,840 |
4,704 |
$64.69 |
| 87081 |
|
2,655 |
2,560 |
$61.88 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,623 |
3,777 |
$52.26 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,854 |
4,124 |
$45.24 |
| 96368 |
|
559 |
415 |
$40.74 |
| 82010 |
|
544 |
469 |
$40.65 |
| 99001 |
|
725 |
699 |
$38.98 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
346 |
258 |
$32.68 |
| J2060 |
Injection, lorazepam, 2 mg |
3,511 |
2,771 |
$32.25 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
1,408 |
897 |
$31.10 |
| 97014 |
|
68 |
27 |
$30.68 |
| 86905 |
|
70 |
68 |
$26.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
670 |
592 |
$15.04 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,722 |
2,376 |
$13.86 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
746 |
640 |
$11.58 |
| 84156 |
|
207 |
149 |
$11.24 |
| J1630 |
Injection, haloperidol, up to 5 mg |
767 |
660 |
$11.10 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
195 |
173 |
$10.01 |
| 97010 |
|
164 |
83 |
$9.55 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
194 |
151 |
$8.45 |
| 84100 |
|
211 |
150 |
$7.63 |
| C9113 |
Injection, pantoprazole sodium, per vial |
1,582 |
1,293 |
$6.97 |
| 82274 |
|
135 |
126 |
$4.76 |
| 97165 |
|
61 |
49 |
$4.42 |
| 82947 |
|
183 |
140 |
$3.99 |
| 82607 |
|
44 |
37 |
$3.91 |
| 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 |
1,122 |
1,067 |
$3.83 |
| 85018 |
|
389 |
299 |
$3.78 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
423 |
267 |
$2.67 |
| Q0177 |
Hydroxyzine pamoate, 25 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 |
244 |
207 |
$2.58 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
204 |
180 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
378 |
339 |
$0.00 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
50 |
29 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
798 |
715 |
$0.00 |
| 87073 |
|
1,681 |
1,497 |
$0.00 |
| J3411 |
Injection, thiamine hcl, 100 mg |
577 |
500 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
80 |
76 |
$0.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
158 |
128 |
$0.00 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,281 |
1,269 |
$0.00 |
| 51798 |
|
19 |
16 |
$0.00 |
| P9612 |
Catheterization for collection of specimen, single patient, all places of service |
696 |
641 |
$0.00 |
| C1769 |
Guide wire |
206 |
153 |
$0.00 |
| 88342 |
|
258 |
241 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
143 |
112 |
$0.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
13 |
12 |
$0.00 |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
97 |
89 |
$0.00 |
| 87807 |
|
67 |
64 |
$0.00 |
| 82746 |
|
13 |
12 |
$0.00 |
| J3535 |
Drug administered through a metered dose inhaler |
16 |
16 |
$0.00 |
| 96415 |
|
20 |
14 |
$0.00 |
| 83615 |
|
73 |
52 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
232 |
184 |
$0.00 |
| 83550 |
|
14 |
13 |
$0.00 |
| 99292 |
|
12 |
12 |
$0.00 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
13 |
12 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
27 |
25 |
$0.00 |
| C1781 |
Mesh (implantable) |
12 |
12 |
$0.00 |
| 64450 |
|
14 |
13 |
$0.00 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
374 |
365 |
$0.00 |
| 81003 |
|
610 |
540 |
$0.00 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
67 |
65 |
$0.00 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
247 |
172 |
$0.00 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
632 |
333 |
$0.00 |
| 84112 |
|
124 |
110 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
98 |
83 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
171 |
125 |
$0.00 |
| 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 |
115 |
93 |
$0.00 |
| 99152 |
|
26 |
25 |
$0.00 |
| 83630 |
|
31 |
27 |
$0.00 |
| 82570 |
|
82 |
66 |
$0.00 |
| 87210 |
|
38 |
36 |
$0.00 |
| 83540 |
|
29 |
26 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
30 |
30 |
$0.00 |
| G0390 |
Trauma response team associated with hospital critical care service |
13 |
12 |
$0.00 |
| 76000 |
|
17 |
14 |
$0.00 |
| 96417 |
|
91 |
40 |
$0.00 |
| 80076 |
|
14 |
14 |
$0.00 |
| 88302 |
|
19 |
16 |
$0.00 |
| S0077 |
Injection, clindamycin phosphate, 300 mg |
23 |
14 |
$0.00 |