| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0431 |
Ambulance service, conventional air services, transport, one way (rotary wing) |
6,627 |
4,798 |
$15.40M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
90,266 |
81,883 |
$12.92M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
78,161 |
69,887 |
$10.72M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
67,584 |
57,896 |
$8.35M |
| A0425 |
Ground mileage, per statute mile |
98,262 |
73,158 |
$7.94M |
| A0436 |
Rotary wing air mileage, per statute mile |
6,627 |
4,798 |
$6.93M |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
22,987 |
18,713 |
$4.32M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
56,947 |
44,083 |
$4.26M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
67,663 |
57,424 |
$4.11M |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
19,693 |
14,771 |
$3.65M |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
42,966 |
33,558 |
$2.74M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
51,858 |
44,771 |
$2.70M |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
1,793 |
1,547 |
$2.48M |
| 71046 |
Radiologic examination, chest; 2 views |
20,933 |
18,090 |
$1.92M |
| 71045 |
Radiologic examination, chest; single view |
13,019 |
11,202 |
$1.76M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
13,900 |
4,485 |
$1.09M |
| A0433 |
Advanced life support, level 2 (als 2) |
2,081 |
1,812 |
$1.03M |
| 95811 |
|
889 |
751 |
$978K |
| 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 |
18,028 |
13,805 |
$892K |
| 77386 |
|
848 |
61 |
$862K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
22,873 |
18,649 |
$709K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,145 |
1,827 |
$676K |
| 62370 |
|
3,349 |
2,765 |
$670K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
162,581 |
122,359 |
$640K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
5,172 |
4,234 |
$628K |
| 36415 |
Collection of venous blood by venipuncture |
216,808 |
167,249 |
$566K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
3,721 |
1,746 |
$528K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
119,761 |
97,963 |
$502K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,381 |
5,512 |
$483K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,266 |
4,373 |
$463K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,291 |
1,055 |
$411K |
| 87536 |
|
6,971 |
6,267 |
$386K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
8,965 |
7,948 |
$382K |
| A0225 |
Ambulance service, neonatal transport, base rate, emergency transport, one way |
3,106 |
2,242 |
$368K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
3,796 |
3,436 |
$308K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,551 |
1,381 |
$308K |
| 80053 |
Comprehensive metabolic panel |
61,156 |
41,990 |
$291K |
| 59025 |
Fetal non-stress test |
1,371 |
1,103 |
$260K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
372 |
277 |
$240K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
7,302 |
5,972 |
$235K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,241 |
1,975 |
$215K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
3,168 |
2,700 |
$205K |
| 86360 |
|
6,792 |
5,972 |
$205K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
6,701 |
5,906 |
$197K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
6,393 |
5,638 |
$187K |
| 84484 |
|
31,389 |
17,427 |
$179K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,654 |
2,469 |
$177K |
| 91200 |
|
687 |
564 |
$168K |
| 81025 |
|
32,186 |
28,764 |
$159K |
| 86359 |
|
6,841 |
6,168 |
$158K |
| 36224 |
|
24 |
14 |
$153K |
| J0741 |
Injection, cabotegravir and rilpivirine, 2mg/3mg |
26 |
26 |
$151K |
| 92134 |
|
2,849 |
2,359 |
$149K |
| 77412 |
|
561 |
52 |
$148K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
12,819 |
8,475 |
$134K |
| 92567 |
|
2,673 |
2,504 |
$131K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
5,260 |
5,000 |
$128K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
16,832 |
13,326 |
$122K |
| 77336 |
|
817 |
344 |
$121K |
| 94010 |
|
1,376 |
1,185 |
$108K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
746 |
574 |
$106K |
| 80076 |
|
20,843 |
18,179 |
$99K |
| 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 |
6,064 |
5,217 |
$96K |
| 17311 |
|
239 |
169 |
$93K |
| 80050 |
General health panel |
719 |
635 |
$87K |
| 80061 |
Lipid panel |
9,194 |
8,340 |
$84K |
| 62369 |
|
600 |
522 |
$83K |
| 99221 |
|
151 |
135 |
$80K |
| 84443 |
Thyroid stimulating hormone (TSH) |
7,007 |
6,435 |
$75K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
13,030 |
11,436 |
$75K |
| 85027 |
|
24,153 |
20,046 |
$74K |
| 87503 |
|
3,102 |
2,817 |
$74K |
| 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 |
2,056 |
1,703 |
$70K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
416 |
379 |
$69K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
3,321 |
3,005 |
$67K |
| 77334 |
|
300 |
161 |
$66K |
| 73610 |
|
1,628 |
1,423 |
$65K |
| B9998 |
Noc for enteral supplies |
2,052 |
203 |
$64K |
| 73562 |
|
1,890 |
1,651 |
$63K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
346 |
258 |
$63K |
| 81003 |
|
45,479 |
39,677 |
$61K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,593 |
1,401 |
$59K |
| 62368 |
|
174 |
86 |
$59K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
98 |
75 |
$58K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,598 |
1,452 |
$57K |
| 86807 |
|
1,716 |
1,392 |
$57K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
3,346 |
354 |
$56K |
| 86832 |
|
610 |
466 |
$55K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
115 |
76 |
$54K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
809 |
674 |
$54K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,385 |
1,097 |
$53K |
| 86833 |
|
614 |
464 |
$53K |
| 80197 |
|
17,795 |
7,738 |
$51K |
| 86780 |
|
4,883 |
4,381 |
$51K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
561 |
444 |
$49K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
494 |
423 |
$48K |
| 83735 |
|
23,493 |
11,456 |
$45K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,450 |
2,241 |
$44K |
| 92555 |
|
969 |
914 |
$42K |
| 80365 |
|
500 |
390 |
$41K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,720 |
2,605 |
$41K |
| 83690 |
|
14,009 |
11,197 |
$39K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
1,274 |
1,124 |
$36K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
300 |
103 |
$35K |
| 82570 |
|
20,919 |
10,795 |
$34K |
| 87480 |
|
1,893 |
1,733 |
$33K |
| 87510 |
|
1,893 |
1,733 |
$33K |
| 82948 |
|
15,371 |
7,376 |
$33K |
| 87660 |
|
1,882 |
1,722 |
$32K |
| 92552 |
|
251 |
239 |
$32K |
| 82550 |
|
19,096 |
8,479 |
$30K |
| 84100 |
|
21,951 |
10,353 |
$28K |
| 76857 |
|
366 |
262 |
$27K |
| 81001 |
|
23,332 |
14,131 |
$26K |
| 73630 |
|
608 |
534 |
$24K |
| 31575 |
|
42 |
37 |
$24K |
| 82607 |
|
2,247 |
2,049 |
$23K |
| 80361 |
|
530 |
419 |
$23K |
| 84156 |
|
19,750 |
10,044 |
$21K |
| 93922 |
|
480 |
401 |
$21K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
369 |
315 |
$20K |
| 95700 |
|
48 |
36 |
$20K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
4,880 |
4,103 |
$19K |
| 86803 |
|
1,590 |
1,433 |
$19K |
| 73502 |
|
439 |
385 |
$19K |
| 72190 |
|
269 |
252 |
$18K |
| J7297 |
Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg |
15 |
12 |
$18K |
| 83655 |
|
1,248 |
1,226 |
$18K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
591 |
544 |
$17K |
| 87522 |
Neg quan hep c or qual rna |
587 |
521 |
$16K |
| 88142 |
|
1,127 |
1,030 |
$16K |
| 76801 |
|
95 |
84 |
$16K |
| 82728 |
|
1,697 |
1,479 |
$15K |
| 73130 |
|
274 |
227 |
$15K |
| 87563 |
|
455 |
422 |
$14K |
| 80348 |
|
107 |
77 |
$14K |
| 86849 |
|
441 |
372 |
$14K |
| 95716 |
|
37 |
12 |
$14K |
| 85610 |
|
5,324 |
4,511 |
$14K |
| 92579 |
|
392 |
363 |
$13K |
| 95806 |
|
101 |
88 |
$13K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
192 |
144 |
$12K |
| 77290 |
|
32 |
28 |
$11K |
| 93975 |
|
25 |
25 |
$11K |
| 84510 |
|
1,130 |
760 |
$10K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
370 |
323 |
$10K |
| 77300 |
|
99 |
79 |
$10K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
82 |
78 |
$9K |
| 87070 |
|
1,271 |
1,161 |
$9K |
| 82784 |
|
1,900 |
833 |
$9K |
| 87799 |
|
1,355 |
761 |
$9K |
| 85652 |
|
5,019 |
4,480 |
$9K |
| 97597 |
|
169 |
50 |
$9K |
| 82565 |
|
3,116 |
2,620 |
$8K |
| 83550 |
|
1,433 |
1,268 |
$8K |
| 81002 |
|
6,539 |
5,231 |
$8K |
| 82977 |
|
2,096 |
1,171 |
$8K |
| 92250 |
|
193 |
160 |
$8K |
| 84681 |
|
1,566 |
775 |
$7K |
| 84439 |
|
1,025 |
929 |
$7K |
| 87276 |
|
662 |
570 |
$7K |
| 76830 |
Ultrasound, transvaginal |
39 |
37 |
$7K |
| 84460 |
|
2,338 |
2,040 |
$7K |
| 84450 |
|
2,351 |
2,051 |
$7K |
| 83880 |
|
320 |
272 |
$7K |
| 87275 |
|
662 |
570 |
$7K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
202 |
178 |
$7K |
| 86160 |
|
965 |
476 |
$6K |
| 17110 |
|
27 |
27 |
$6K |
| 86140 |
|
1,603 |
1,481 |
$6K |
| 83540 |
|
1,494 |
1,310 |
$6K |
| M0222 |
Intravenous injection, bebtelovimab, includes injection and post administration monitoring |
76 |
52 |
$6K |
| 87340 |
|
750 |
666 |
$6K |
| 80305 |
|
1,945 |
1,612 |
$6K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
935 |
335 |
$6K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
430 |
327 |
$5K |
| 84030 |
|
1,130 |
760 |
$5K |
| 97165 |
|
47 |
38 |
$5K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
25 |
24 |
$5K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
58 |
48 |
$5K |
| 73030 |
|
187 |
167 |
$5K |
| 92587 |
|
254 |
236 |
$5K |
| 82746 |
|
530 |
455 |
$5K |
| 83516 |
|
431 |
410 |
$5K |
| 83883 |
|
777 |
346 |
$5K |
| 85045 |
|
1,357 |
1,244 |
$4K |
| 82465 |
|
1,887 |
914 |
$4K |
| 72100 |
|
107 |
96 |
$4K |
| 86850 |
|
847 |
736 |
$4K |
| 86762 |
|
362 |
319 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
383 |
330 |
$4K |
| 70486 |
|
12 |
12 |
$4K |
| 87497 |
|
158 |
103 |
$4K |
| 82040 |
|
1,436 |
1,255 |
$4K |
| 82105 |
|
371 |
325 |
$4K |
| M0239 |
Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring |
75 |
52 |
$4K |
| 86225 |
|
408 |
357 |
$4K |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
12 |
12 |
$4K |
| 90791 |
Psychiatric diagnostic evaluation |
31 |
25 |
$4K |
| 88300 |
|
90 |
89 |
$3K |
| 93320 |
|
177 |
114 |
$3K |
| 82150 |
|
2,131 |
1,012 |
$3K |
| 36592 |
|
44 |
25 |
$3K |
| 11900 |
|
13 |
12 |
$3K |
| 73110 |
|
67 |
52 |
$3K |
| 92553 |
|
26 |
24 |
$3K |
| 86334 |
|
355 |
274 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
24 |
22 |
$3K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
15 |
12 |
$3K |
| 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 |
563 |
148 |
$3K |
| 82248 |
|
932 |
682 |
$3K |
| 91010 |
|
61 |
53 |
$3K |
| 84403 |
|
124 |
117 |
$3K |
| 93351 |
|
46 |
27 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
28 |
27 |
$3K |
| 97760 |
|
129 |
106 |
$2K |
| 77295 |
|
15 |
12 |
$2K |
| 85379 |
|
416 |
346 |
$2K |
| 87641 |
|
91 |
80 |
$2K |
| 83615 |
|
513 |
427 |
$2K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
49 |
48 |
$2K |
| 11100 |
|
41 |
29 |
$2K |
| 86480 |
|
81 |
76 |
$2K |
| 87186 |
|
374 |
273 |
$2K |
| 80195 |
|
842 |
366 |
$2K |
| 84402 |
|
100 |
93 |
$2K |
| 83970 |
|
170 |
130 |
$2K |
| 84270 |
|
112 |
105 |
$2K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
73 |
57 |
$2K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
13 |
13 |
$2K |
| 73521 |
|
45 |
38 |
$2K |
| 97162 |
|
27 |
24 |
$2K |
| 82627 |
|
83 |
77 |
$2K |
| 82043 |
|
383 |
337 |
$1K |
| 84550 |
|
529 |
454 |
$1K |
| 86003 |
|
41 |
31 |
$1K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
25 |
24 |
$1K |
| L3808 |
Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment |
14 |
13 |
$1K |
| 97161 |
|
14 |
12 |
$1K |
| 86900 |
|
504 |
441 |
$1K |
| 84165 |
|
444 |
359 |
$1K |
| 80074 |
|
30 |
30 |
$1K |
| 51798 |
|
35 |
27 |
$1K |
| 84144 |
|
57 |
50 |
$987.80 |
| 93017 |
|
17 |
14 |
$987.48 |
| 94060 |
|
21 |
13 |
$978.34 |
| 86901 |
|
391 |
341 |
$949.10 |
| 76770 |
|
15 |
13 |
$949.06 |
| 73590 |
|
77 |
63 |
$944.85 |
| 86704 |
|
134 |
115 |
$924.13 |
| 82670 |
|
40 |
37 |
$912.25 |
| 92136 |
|
18 |
12 |
$903.56 |
| 92582 |
|
13 |
12 |
$860.58 |
| 93325 |
|
175 |
112 |
$837.88 |
| 86481 |
|
33 |
25 |
$825.88 |
| 72170 |
|
26 |
25 |
$785.71 |
| 86592 |
|
211 |
188 |
$783.25 |
| 86708 |
|
97 |
85 |
$772.28 |
| 83605 |
|
211 |
151 |
$771.15 |
| 92083 |
|
21 |
13 |
$734.40 |
| 82785 |
|
46 |
43 |
$727.89 |
| 91122 |
|
13 |
12 |
$707.40 |
| 82140 |
|
145 |
104 |
$701.29 |
| 83020 |
|
65 |
62 |
$624.36 |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
20 |
18 |
$621.50 |
| 72050 |
|
22 |
13 |
$557.04 |
| 87517 |
|
14 |
14 |
$556.90 |
| 80069 |
|
126 |
108 |
$535.61 |
| 86317 |
|
47 |
39 |
$520.77 |
| 86706 |
|
80 |
74 |
$487.37 |
| 87077 |
|
148 |
118 |
$484.48 |
| 87653 |
|
15 |
14 |
$476.56 |
| 85576 |
|
21 |
12 |
$463.02 |
| 87640 |
|
31 |
29 |
$458.12 |
| 86235 |
|
48 |
12 |
$434.75 |
| 86808 |
|
14 |
14 |
$419.06 |
| 84436 |
|
80 |
76 |
$393.91 |
| 87147 |
|
70 |
64 |
$329.76 |
| 80047 |
|
79 |
64 |
$304.78 |
| 73140 |
|
14 |
12 |
$249.75 |
| 91320 |
|
46 |
39 |
$249.13 |
| 86769 |
|
17 |
13 |
$209.62 |
| 87210 |
|
45 |
37 |
$204.57 |
| 87102 |
|
29 |
26 |
$196.34 |
| C1726 |
Catheter, balloon dilatation, non-vascular |
28 |
24 |
$187.20 |
| 84155 |
|
198 |
164 |
$173.44 |
| 87205 |
|
45 |
40 |
$168.34 |
| 83721 |
|
13 |
13 |
$122.16 |
| 85384 |
|
15 |
12 |
$122.10 |
| 86705 |
|
13 |
13 |
$109.92 |
| 84478 |
|
19 |
12 |
$109.06 |
| 84145 |
|
26 |
22 |
$105.60 |
| 85730 |
|
43 |
27 |
$87.74 |
| 90480 |
|
15 |
12 |
$85.12 |
| 82310 |
|
46 |
38 |
$84.55 |
| 84520 |
|
38 |
25 |
$80.41 |
| 82947 |
|
38 |
25 |
$79.90 |
| 86682 |
|
14 |
12 |
$78.06 |
| 85347 |
|
21 |
12 |
$59.22 |
| 96376 |
|
294 |
181 |
$51.03 |
| 0124A |
|
18 |
14 |
$46.83 |
| 84075 |
|
20 |
18 |
$31.08 |
| 36416 |
|
32 |
27 |
$25.20 |
| 82247 |
|
19 |
17 |
$25.10 |
| 85018 |
|
12 |
12 |
$23.70 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
844 |
532 |
$0.00 |
| 94729 |
|
66 |
56 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
74 |
72 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
39 |
25 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
71 |
49 |
$0.00 |
| 94726 |
|
50 |
41 |
$0.00 |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
110 |
69 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
54 |
25 |
$0.00 |
| C1776 |
Joint device (implantable) |
54 |
25 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
362 |
236 |
$0.00 |
| 0064U |
|
426 |
385 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
1,900 |
567 |
$0.00 |
| 90870 |
|
4,759 |
1,166 |
$0.00 |
| 99459 |
|
224 |
209 |
$0.00 |
| 80320 |
|
14 |
12 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
191 |
109 |
$0.00 |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
15 |
13 |
$0.00 |
| A0434 |
Specialty care transport (sct) |
74 |
64 |
$0.00 |
| C1769 |
Guide wire |
61 |
39 |
$0.00 |
| 81372 |
|
12 |
12 |
$0.00 |
| 99406 |
|
114 |
105 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
29 |
25 |
$0.00 |
| 0065U |
|
23 |
14 |
$0.00 |
| 81375 |
|
12 |
12 |
$0.00 |
| 17312 |
|
17 |
12 |
$0.00 |
| J1250 |
Injection, dobutamine hydrochloride, per 250 mg |
41 |
26 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
14 |
12 |
$0.00 |
| 90686 |
|
15 |
13 |
$0.00 |
| 92604 |
|
14 |
13 |
$0.00 |