| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
33,165 |
30,583 |
$10.61M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
41,159 |
34,363 |
$8.64M |
| 0450 |
Emergency room services |
36,746 |
33,189 |
$3.26M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
55,657 |
8,461 |
$1.75M |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
9,759 |
9,710 |
$644K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
1,779 |
1,695 |
$477K |
| Z7502 |
|
10,264 |
10,027 |
$357K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,627 |
4,316 |
$328K |
| 0270 |
|
21,591 |
11,560 |
$320K |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,375 |
6,884 |
$291K |
| 80053 |
Comprehensive metabolic panel |
58,361 |
52,510 |
$277K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
20,115 |
17,163 |
$268K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
4,424 |
4,026 |
$242K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
4,986 |
4,857 |
$238K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
72,225 |
64,136 |
$237K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
6,353 |
6,196 |
$234K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
1,581 |
1,457 |
$232K |
| 71046 |
Radiologic examination, chest; 2 views |
19,432 |
18,471 |
$211K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
9,643 |
1,992 |
$196K |
| 99199 |
Unlisted special service, procedure or report |
2,866 |
2,611 |
$193K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
6,882 |
6,778 |
$191K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
3,589 |
2,523 |
$187K |
| 76830 |
Ultrasound, transvaginal |
4,190 |
4,104 |
$171K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,363 |
4,917 |
$152K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
2,514 |
2,452 |
$150K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
9,025 |
1,936 |
$143K |
| S3620 |
Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total) |
1,029 |
994 |
$138K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
989 |
966 |
$132K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
5,339 |
5,329 |
$129K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
18,829 |
16,766 |
$118K |
| 84443 |
Thyroid stimulating hormone (TSH) |
9,955 |
9,722 |
$117K |
| 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 |
6,882 |
5,631 |
$114K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
10,374 |
8,720 |
$99K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,788 |
2,430 |
$98K |
| 71045 |
Radiologic examination, chest; single view |
19,343 |
18,091 |
$97K |
| 76641 |
|
1,482 |
1,442 |
$95K |
| Z7610 |
|
8,443 |
5,373 |
$94K |
| 0250 |
|
2,705 |
1,556 |
$92K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,659 |
999 |
$90K |
| 97161 |
|
2,037 |
2,001 |
$89K |
| 86480 |
|
1,534 |
1,511 |
$88K |
| 80061 |
Lipid panel |
8,458 |
8,343 |
$85K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
8,762 |
8,358 |
$83K |
| T1015 |
Clinic visit/encounter, all-inclusive |
1,476 |
1,136 |
$82K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
5,158 |
4,776 |
$80K |
| J3490 |
Unclassified drugs |
9,702 |
4,561 |
$78K |
| Z9725 |
|
1,605 |
1,571 |
$69K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
9,070 |
8,890 |
$67K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
3,159 |
2,962 |
$67K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,237 |
3,204 |
$67K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,173 |
3,021 |
$66K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,195 |
3,040 |
$66K |
| 99070 |
|
104,310 |
41,851 |
$63K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
7,902 |
6,660 |
$60K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,150 |
3,748 |
$58K |
| 71250 |
|
773 |
758 |
$56K |
| 87806 |
|
2,111 |
2,070 |
$55K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
4,670 |
3,782 |
$54K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
3,059 |
1,402 |
$52K |
| 99223 |
Prolong inpt eval add15 m |
584 |
509 |
$50K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
411 |
379 |
$49K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
15,418 |
14,155 |
$47K |
| 81001 |
|
34,670 |
31,882 |
$47K |
| 86780 |
|
6,158 |
5,961 |
$47K |
| 99460 |
|
712 |
700 |
$46K |
| 81025 |
|
24,063 |
21,717 |
$45K |
| 97116 |
|
3,419 |
802 |
$44K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
6,510 |
5,699 |
$44K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
591 |
544 |
$43K |
| 73030 |
|
2,983 |
2,831 |
$42K |
| 72100 |
|
2,525 |
2,443 |
$42K |
| 0360 |
|
524 |
399 |
$41K |
| G0481 |
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; 8-14 drug class(es), including metabolite(s) if performed |
2,887 |
2,799 |
$39K |
| 97163 |
|
930 |
929 |
$37K |
| 73630 |
|
2,929 |
2,813 |
$36K |
| 84484 |
|
13,020 |
11,142 |
$35K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
70 |
70 |
$35K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
4,953 |
4,564 |
$35K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
135 |
125 |
$34K |
| 74018 |
|
3,185 |
3,038 |
$33K |
| 73610 |
|
2,547 |
2,445 |
$32K |
| 86481 |
|
491 |
482 |
$32K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
265 |
257 |
$30K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
746 |
709 |
$30K |
| 73221 |
|
232 |
218 |
$30K |
| 74178 |
|
177 |
142 |
$29K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,835 |
1,730 |
$28K |
| 83690 |
|
14,854 |
13,174 |
$28K |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
6,690 |
4,409 |
$27K |
| 76770 |
|
531 |
513 |
$27K |
| 73562 |
|
2,023 |
1,961 |
$26K |
| 76536 |
|
662 |
647 |
$25K |
| 84702 |
|
3,741 |
2,837 |
$25K |
| 59025 |
Fetal non-stress test |
1,462 |
706 |
$25K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
641 |
634 |
$24K |
| 97162 |
|
360 |
358 |
$23K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
5,883 |
5,293 |
$22K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
839 |
812 |
$22K |
| 83880 |
|
3,141 |
2,883 |
$22K |
| 73130 |
|
1,525 |
1,464 |
$20K |
| 87040 |
|
5,566 |
4,636 |
$20K |
| 73560 |
|
1,471 |
1,409 |
$20K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
13,206 |
10,881 |
$20K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
319 |
318 |
$19K |
| 84439 |
|
2,709 |
2,681 |
$19K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,747 |
2,676 |
$18K |
| 82951 |
|
1,745 |
1,562 |
$18K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,421 |
3,132 |
$18K |
| 59514 |
|
56 |
55 |
$18K |
| 73110 |
|
1,161 |
1,103 |
$18K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,075 |
2,792 |
$16K |
| 90715 |
|
902 |
871 |
$16K |
| 85730 |
|
5,032 |
4,476 |
$16K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
144 |
143 |
$15K |
| 87186 |
|
4,358 |
4,056 |
$15K |
| 73564 |
|
1,050 |
991 |
$14K |
| 93971 |
|
395 |
372 |
$14K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
2,696 |
2,302 |
$13K |
| 0710 |
|
1,725 |
1,426 |
$13K |
| 83605 |
|
4,690 |
4,020 |
$13K |
| 85610 |
|
7,402 |
6,608 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
333 |
318 |
$13K |
| 87340 |
|
1,476 |
1,461 |
$13K |
| 83001 |
|
841 |
833 |
$12K |
| 72040 |
|
767 |
741 |
$12K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
259 |
257 |
$12K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
205 |
108 |
$12K |
| 87341 |
|
1,143 |
1,127 |
$12K |
| 87081 |
|
5,373 |
4,799 |
$11K |
| 73502 |
|
546 |
515 |
$11K |
| 83002 |
|
752 |
744 |
$11K |
| 76801 |
|
378 |
359 |
$11K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
7,299 |
5,977 |
$11K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,030 |
1,012 |
$11K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
187 |
180 |
$11K |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
1,361 |
1,329 |
$10K |
| 93041 |
|
7,147 |
6,525 |
$10K |
| 47563 |
|
13 |
13 |
$10K |
| 86850 |
|
2,454 |
2,312 |
$10K |
| 87088 |
|
3,391 |
3,163 |
$9K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
128 |
50 |
$9K |
| 80055 |
|
246 |
238 |
$9K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
208 |
204 |
$9K |
| 80076 |
|
1,854 |
1,739 |
$9K |
| 72081 |
|
392 |
390 |
$9K |
| 84436 |
|
1,705 |
1,656 |
$9K |
| 86140 |
|
4,208 |
3,857 |
$9K |
| 83540 |
|
1,742 |
1,709 |
$8K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
4,269 |
3,861 |
$8K |
| 83655 |
|
889 |
876 |
$8K |
| 87070 |
|
3,051 |
2,847 |
$8K |
| 81003 |
|
12,646 |
10,764 |
$8K |
| 86762 |
|
651 |
640 |
$8K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
214 |
203 |
$8K |
| 77066 |
Tomosynthesis, mammo |
78 |
77 |
$8K |
| 80074 |
|
269 |
260 |
$8K |
| 84146 |
|
485 |
478 |
$7K |
| 73140 |
|
763 |
742 |
$7K |
| 76870 |
|
253 |
249 |
$7K |
| 82962 |
|
4,564 |
3,605 |
$7K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
350 |
149 |
$7K |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
4,018 |
3,655 |
$7K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,914 |
1,450 |
$7K |
| 84144 |
|
436 |
432 |
$7K |
| 82043 |
|
1,497 |
1,482 |
$7K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,331 |
1,630 |
$7K |
| 82248 |
|
1,747 |
1,377 |
$7K |
| 84466 |
|
667 |
658 |
$7K |
| 77080 |
|
196 |
196 |
$6K |
| 82570 |
|
1,511 |
1,489 |
$6K |
| 88307 |
|
90 |
88 |
$6K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,681 |
2,207 |
$6K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
925 |
917 |
$6K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
234 |
207 |
$6K |
| 73080 |
|
449 |
414 |
$6K |
| 86147 |
|
345 |
329 |
$6K |
| 86803 |
|
2,171 |
2,132 |
$6K |
| 83735 |
|
2,676 |
2,477 |
$6K |
| 84481 |
|
466 |
460 |
$6K |
| 86901 |
|
3,447 |
3,176 |
$5K |
| 86038 |
|
584 |
570 |
$5K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,252 |
2,925 |
$5K |
| 86171 |
|
728 |
699 |
$5K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,756 |
1,323 |
$5K |
| 82746 |
|
451 |
449 |
$5K |
| 59050 |
|
95 |
75 |
$5K |
| 73590 |
|
439 |
419 |
$5K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,837 |
2,378 |
$5K |
| 82670 |
|
215 |
214 |
$5K |
| 84479 |
|
1,002 |
965 |
$5K |
| 86592 |
|
1,465 |
1,409 |
$5K |
| 85379 |
|
1,641 |
1,554 |
$4K |
| 84550 |
|
1,335 |
1,207 |
$4K |
| 82247 |
|
1,229 |
788 |
$4K |
| 78227 |
|
12 |
12 |
$4K |
| 84402 |
|
230 |
227 |
$4K |
| 74022 |
|
382 |
354 |
$4K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
225 |
222 |
$4K |
| 97803 |
|
346 |
253 |
$4K |
| 0942 |
|
162 |
67 |
$4K |
| J2704 |
Injection, propofol, 10 mg |
1,240 |
1,034 |
$4K |
| 99233 |
Prolong inpt eval add15 m |
117 |
96 |
$4K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
2,188 |
1,863 |
$4K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
71 |
69 |
$3K |
| 82552 |
|
787 |
693 |
$3K |
| 85651 |
|
1,790 |
1,717 |
$3K |
| 82465 |
|
847 |
846 |
$3K |
| A4217 |
Sterile water/saline, 500 ml |
786 |
712 |
$3K |
| 0272 |
|
901 |
797 |
$3K |
| 73090 |
|
319 |
302 |
$3K |
| 86900 |
|
1,772 |
1,680 |
$3K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
680 |
554 |
$3K |
| 82550 |
|
1,579 |
1,427 |
$3K |
| 87077 |
|
866 |
812 |
$3K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
729 |
719 |
$3K |
| 73620 |
|
198 |
196 |
$3K |
| 86141 |
|
631 |
612 |
$3K |
| 73120 |
|
226 |
221 |
$3K |
| 82607 |
|
266 |
264 |
$3K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
362 |
305 |
$2K |
| 82105 |
|
153 |
153 |
$2K |
| 86696 |
|
194 |
189 |
$2K |
| 70486 |
|
60 |
59 |
$2K |
| 97032 |
|
230 |
65 |
$2K |
| 0301 |
|
42 |
40 |
$2K |
| 86635 |
|
241 |
160 |
$2K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
468 |
336 |
$2K |
| J7510 |
Prednisolone oral, per 5 mg |
182 |
177 |
$2K |
| 71020 |
|
89 |
55 |
$2K |
| 72110 |
|
72 |
71 |
$2K |
| 0451 |
|
38 |
38 |
$2K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
37 |
25 |
$2K |
| 99236 |
Prolong inpt eval add15 m |
14 |
14 |
$2K |
| 72070 |
|
120 |
119 |
$2K |
| 82947 |
|
553 |
543 |
$2K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
725 |
562 |
$2K |
| 81002 |
|
2,112 |
1,807 |
$2K |
| 82728 |
|
156 |
151 |
$2K |
| 94761 |
|
122 |
97 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
16 |
16 |
$1K |
| 87536 |
|
21 |
19 |
$1K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
24 |
24 |
$1K |
| 0760 |
|
41 |
37 |
$1K |
| 84153 |
|
98 |
94 |
$1K |
| 88304 |
|
129 |
98 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
34 |
34 |
$1K |
| 86765 |
|
145 |
143 |
$1K |
| 96367 |
|
199 |
186 |
$1K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
229 |
229 |
$1K |
| 84703 |
|
630 |
524 |
$1K |
| 72131 |
|
29 |
28 |
$1K |
| 82652 |
|
38 |
38 |
$1K |
| 73600 |
|
81 |
77 |
$1K |
| 97750 |
|
15 |
12 |
$1K |
| 86735 |
|
146 |
144 |
$1K |
| 85060 |
|
80 |
80 |
$985.01 |
| 86317 |
|
95 |
92 |
$981.61 |
| J7050 |
Infusion, normal saline solution, 250 cc |
421 |
374 |
$953.80 |
| J2060 |
Injection, lorazepam, 2 mg |
548 |
458 |
$932.83 |
| 87420 |
|
741 |
689 |
$920.58 |
| 72170 |
|
63 |
61 |
$911.59 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
17 |
13 |
$900.82 |
| 0324 |
|
63 |
63 |
$866.94 |
| 86431 |
|
178 |
172 |
$843.84 |
| 83721 |
|
124 |
123 |
$831.48 |
| 97014 |
|
68 |
31 |
$800.65 |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
12 |
12 |
$778.56 |
| 85652 |
|
358 |
340 |
$778.54 |
| 87522 |
Neg quan hep c or qual rna |
94 |
94 |
$718.30 |
| 70498 |
|
59 |
56 |
$707.72 |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
17 |
15 |
$706.60 |
| 82140 |
|
143 |
142 |
$675.83 |
| 73100 |
|
38 |
36 |
$649.51 |
| 0271 |
|
279 |
266 |
$646.80 |
| 76857 |
|
55 |
52 |
$599.32 |
| 86695 |
|
65 |
64 |
$546.06 |
| 82805 |
|
223 |
212 |
$530.44 |
| 74021 |
|
31 |
27 |
$528.22 |
| 86787 |
|
66 |
64 |
$526.23 |
| 82272 |
|
186 |
169 |
$525.71 |
| 86376 |
|
42 |
42 |
$520.40 |
| 85007 |
|
306 |
299 |
$484.76 |
| 12001 |
|
42 |
42 |
$469.60 |
| A9537 |
Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries |
12 |
12 |
$456.57 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
301 |
265 |
$451.22 |
| 97010 |
|
28 |
12 |
$448.36 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
189 |
109 |
$440.99 |
| 71010 |
|
30 |
12 |
$429.08 |
| 86694 |
|
34 |
27 |
$426.57 |
| 99000 |
|
114 |
113 |
$410.19 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
1,312 |
1,099 |
$406.68 |
| 84100 |
|
172 |
163 |
$348.30 |
| 87076 |
|
98 |
89 |
$347.13 |
| 36415 |
Collection of venous blood by venipuncture |
929 |
855 |
$345.73 |
| 83970 |
|
12 |
12 |
$293.10 |
| 84403 |
|
13 |
13 |
$292.56 |
| 70496 |
|
44 |
42 |
$278.38 |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
12 |
12 |
$275.94 |
| J1815 |
Injection, insulin, per 5 units |
82 |
57 |
$266.00 |
| 86703 |
|
28 |
26 |
$260.82 |
| 73552 |
|
26 |
25 |
$243.26 |
| P9011 |
Blood, split unit |
134 |
130 |
$230.97 |
| 82677 |
|
12 |
12 |
$227.91 |
| 99401 |
|
27 |
25 |
$227.09 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
652 |
543 |
$222.16 |
| 82150 |
|
87 |
71 |
$197.25 |
| 84145 |
|
22 |
13 |
$195.47 |
| 83516 |
|
17 |
14 |
$174.95 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
49 |
49 |
$164.60 |
| 74019 |
|
24 |
24 |
$164.12 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
64 |
34 |
$163.50 |
| 84480 |
|
14 |
14 |
$133.51 |
| 73060 |
|
13 |
12 |
$131.31 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
54 |
30 |
$127.23 |
| 82010 |
|
117 |
112 |
$120.61 |
| 82950 |
|
26 |
25 |
$103.75 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
62 |
62 |
$95.06 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
146 |
109 |
$93.52 |
| 82009 |
|
79 |
77 |
$86.55 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
13 |
12 |
$85.00 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
123 |
111 |
$83.84 |
| 80143 |
|
60 |
58 |
$83.80 |
| 73070 |
|
14 |
14 |
$78.22 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
53 |
53 |
$64.85 |
| 96376 |
|
65 |
40 |
$64.80 |
| 85027 |
|
12 |
12 |
$60.64 |
| 86922 |
|
20 |
12 |
$54.56 |
| 0258 |
|
58 |
52 |
$54.54 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
28 |
27 |
$52.36 |
| 80179 |
|
53 |
53 |
$50.28 |
| J0456 |
Injection, azithromycin, 500 mg |
15 |
14 |
$50.04 |
| 82565 |
|
13 |
13 |
$45.65 |
| E0275 |
Bed pan, standard, metal or plastic |
36 |
26 |
$42.65 |
| 99173 |
|
17 |
17 |
$41.06 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
35 |
33 |
$38.53 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
68 |
38 |
$37.86 |
| 84520 |
|
12 |
12 |
$30.34 |
| 87205 |
|
27 |
27 |
$29.87 |
| 86308 |
|
19 |
19 |
$29.26 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
28 |
28 |
$12.39 |
| 94664 |
|
33 |
33 |
$11.09 |
| 1160F |
|
73 |
66 |
$0.00 |
| 0272R |
|
1,279 |
1,177 |
$0.00 |
| 1159F |
|
94 |
85 |
$0.00 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
15 |
14 |
$0.00 |
| 74300 |
|
14 |
14 |
$0.00 |
| S0028 |
Injection, famotidine, 20 mg |
12 |
12 |
$0.00 |
| 0250R |
|
1,667 |
1,567 |
$0.00 |
| 0271R |
|
511 |
490 |
$0.00 |
| 80050 |
General health panel |
38 |
38 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
18 |
18 |
$0.00 |
| 3008F |
|
17 |
16 |
$0.00 |
| 80320 |
|
17 |
13 |
$0.00 |