| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
81,217 |
74,282 |
$12.49M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
8,648 |
8,173 |
$2.37M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
9,317 |
8,934 |
$1.31M |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
1,339 |
1,284 |
$1.07M |
| G0378 |
Hospital observation service, per hour |
9,073 |
4,338 |
$1.03M |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
1,320 |
1,316 |
$1.02M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
11,514 |
11,274 |
$885K |
| 70450 |
Computed tomography, head or brain; without contrast material |
9,515 |
9,091 |
$415K |
| 71045 |
Radiologic examination, chest; single view |
17,444 |
16,014 |
$339K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
2,334 |
2,302 |
$325K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
523 |
519 |
$315K |
| 0450 |
Emergency room services |
23,731 |
20,626 |
$295K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
16,909 |
16,156 |
$291K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
4,310 |
4,119 |
$271K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
2,901 |
2,877 |
$215K |
| 86900 |
|
9,127 |
8,199 |
$180K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
2,461 |
2,296 |
$179K |
| 93017 |
|
591 |
590 |
$174K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
2,203 |
2,165 |
$166K |
| 86885 |
|
5,382 |
4,982 |
$159K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,018 |
988 |
$144K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
18,219 |
15,945 |
$130K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,533 |
1,515 |
$121K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
5,746 |
5,472 |
$120K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
85,541 |
70,369 |
$117K |
| 80051 |
|
86,711 |
71,107 |
$113K |
| 72141 |
|
1,563 |
1,553 |
$112K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
4,707 |
4,505 |
$111K |
| 82565 |
|
102,322 |
85,052 |
$104K |
| 76830 |
Ultrasound, transvaginal |
4,395 |
4,171 |
$93K |
| 71250 |
|
1,277 |
1,263 |
$91K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
7,106 |
5,858 |
$89K |
| 78451 |
|
71 |
71 |
$84K |
| 94060 |
|
712 |
711 |
$77K |
| 73221 |
|
689 |
653 |
$75K |
| 71046 |
Radiologic examination, chest; 2 views |
6,685 |
6,511 |
$72K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
14,804 |
5,946 |
$71K |
| 83880 |
|
8,483 |
7,810 |
$66K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
12,017 |
10,545 |
$64K |
| 93971 |
|
1,585 |
1,500 |
$63K |
| 70486 |
|
1,271 |
1,255 |
$60K |
| 84443 |
Thyroid stimulating hormone (TSH) |
22,389 |
22,039 |
$59K |
| 84460 |
|
57,960 |
51,200 |
$58K |
| 87505 |
|
1,815 |
1,790 |
$56K |
| 86923 |
|
435 |
366 |
$56K |
| 70496 |
|
258 |
253 |
$54K |
| 86901 |
|
9,131 |
8,203 |
$53K |
| 84702 |
|
16,021 |
13,985 |
$52K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
453 |
449 |
$52K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
710 |
683 |
$48K |
| 84520 |
|
74,099 |
60,046 |
$48K |
| 70498 |
|
233 |
230 |
$46K |
| 70491 |
|
332 |
331 |
$46K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
31,884 |
26,395 |
$45K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
8,088 |
7,785 |
$45K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
8,054 |
7,751 |
$45K |
| 82247 |
|
43,747 |
37,139 |
$44K |
| 74183 |
|
165 |
160 |
$43K |
| 82947 |
|
68,709 |
58,443 |
$42K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
22,677 |
22,323 |
$41K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
11,909 |
11,191 |
$40K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
8,174 |
8,115 |
$39K |
| 83970 |
|
2,748 |
2,699 |
$38K |
| 73562 |
|
2,441 |
2,312 |
$38K |
| 80061 |
Lipid panel |
18,016 |
17,854 |
$38K |
| 73630 |
|
2,847 |
2,718 |
$37K |
| 94726 |
|
376 |
375 |
$37K |
| 84075 |
|
39,178 |
34,132 |
$37K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
1,626 |
1,601 |
$37K |
| 85027 |
|
46,535 |
44,321 |
$37K |
| 90686 |
|
6,350 |
5,925 |
$36K |
| 81003 |
|
69,848 |
64,133 |
$36K |
| 74178 |
|
85 |
85 |
$35K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
580 |
580 |
$35K |
| 72100 |
|
1,557 |
1,519 |
$33K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
3,399 |
3,194 |
$33K |
| 73610 |
|
2,491 |
2,383 |
$33K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
5,338 |
4,942 |
$32K |
| 84450 |
|
31,100 |
27,193 |
$31K |
| 73030 |
|
2,230 |
2,098 |
$31K |
| J2785 |
Injection, regadenoson, 0.1 mg |
420 |
419 |
$31K |
| A9609 |
Fludeoxyglucose f18 up to 15 millicuries |
339 |
338 |
$30K |
| 74018 |
|
2,335 |
2,209 |
$30K |
| 94729 |
|
371 |
370 |
$30K |
| 83690 |
|
24,028 |
21,752 |
$29K |
| 99199 |
Unlisted special service, procedure or report |
597 |
550 |
$29K |
| 76801 |
|
1,207 |
1,104 |
$29K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
3,507 |
3,284 |
$28K |
| 86141 |
|
7,426 |
6,906 |
$28K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
6,447 |
6,279 |
$28K |
| 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 |
2,120 |
1,926 |
$27K |
| 82310 |
|
23,368 |
20,261 |
$26K |
| 72197 |
|
64 |
64 |
$26K |
| 85610 |
|
25,381 |
21,115 |
$26K |
| 88184 |
|
85 |
81 |
$25K |
| 72146 |
|
174 |
174 |
$25K |
| 78306 |
|
80 |
80 |
$25K |
| 0637 |
|
87,819 |
32,647 |
$24K |
| 86780 |
|
7,266 |
7,179 |
$23K |
| 84484 |
|
16,721 |
13,472 |
$23K |
| 83735 |
|
17,742 |
13,632 |
$23K |
| 82728 |
|
7,385 |
7,143 |
$22K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
1,971 |
1,480 |
$21K |
| 93970 |
|
225 |
218 |
$21K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,394 |
2,393 |
$20K |
| 81513 |
|
452 |
446 |
$20K |
| 86803 |
|
4,698 |
4,646 |
$19K |
| 80076 |
|
3,475 |
2,999 |
$19K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
16,019 |
12,856 |
$19K |
| 86480 |
|
880 |
871 |
$18K |
| 73502 |
|
873 |
834 |
$17K |
| 82570 |
|
9,696 |
8,771 |
$17K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
17,224 |
14,887 |
$16K |
| 73110 |
|
1,401 |
1,327 |
$16K |
| 72131 |
|
111 |
108 |
$16K |
| 87088 |
|
12,945 |
12,293 |
$16K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
9,453 |
7,578 |
$15K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
3,910 |
3,699 |
$15K |
| 82607 |
|
4,533 |
4,489 |
$14K |
| 83520 |
|
1,949 |
1,290 |
$14K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,662 |
1,602 |
$14K |
| 73130 |
|
1,316 |
1,239 |
$14K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
634 |
564 |
$14K |
| 87340 |
|
6,217 |
6,037 |
$14K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,917 |
3,545 |
$13K |
| 82077 |
|
3,984 |
3,387 |
$12K |
| 87040 |
|
7,901 |
3,990 |
$12K |
| 76870 |
|
535 |
514 |
$12K |
| 83550 |
|
6,873 |
6,735 |
$12K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
207 |
104 |
$12K |
| 76380 |
|
156 |
156 |
$12K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
1,582 |
1,536 |
$11K |
| 84156 |
|
9,163 |
8,418 |
$10K |
| 73080 |
|
725 |
691 |
$10K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,681 |
3,364 |
$10K |
| 87497 |
|
302 |
269 |
$10K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
1,295 |
1,143 |
$10K |
| 84100 |
|
10,000 |
7,936 |
$10K |
| 72156 |
|
24 |
24 |
$9K |
| 80306 |
|
2,292 |
2,105 |
$9K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
762 |
746 |
$9K |
| 87481 |
|
493 |
486 |
$9K |
| 83021 |
|
2,869 |
2,725 |
$9K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
453 |
447 |
$9K |
| 73718 |
|
43 |
42 |
$9K |
| 73140 |
|
977 |
926 |
$9K |
| 83540 |
|
7,041 |
6,895 |
$9K |
| 86762 |
|
3,188 |
3,042 |
$8K |
| P9021 |
Red blood cells, each unit |
220 |
187 |
$8K |
| 80179 |
|
2,618 |
2,406 |
$8K |
| 82746 |
|
2,316 |
2,299 |
$8K |
| 82040 |
|
7,749 |
7,367 |
$8K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
788 |
781 |
$8K |
| 82248 |
|
9,366 |
8,532 |
$8K |
| 85730 |
|
5,712 |
5,225 |
$8K |
| 86787 |
|
3,296 |
3,147 |
$7K |
| 82043 |
|
4,057 |
4,012 |
$7K |
| 82105 |
|
1,293 |
1,257 |
$7K |
| 70544 |
|
25 |
24 |
$7K |
| 84439 |
|
3,593 |
3,435 |
$7K |
| 87449 |
|
2,304 |
1,920 |
$7K |
| 72040 |
|
498 |
482 |
$7K |
| 73590 |
|
344 |
324 |
$7K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
4,783 |
3,943 |
$7K |
| 83605 |
|
4,446 |
3,392 |
$7K |
| 83615 |
|
4,259 |
3,872 |
$7K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
167 |
161 |
$6K |
| 86765 |
|
1,717 |
1,705 |
$6K |
| 71101 |
|
268 |
261 |
$6K |
| 73564 |
|
487 |
460 |
$6K |
| 86665 |
|
1,304 |
650 |
$6K |
| 82950 |
|
5,835 |
5,767 |
$6K |
| 76770 |
|
389 |
379 |
$6K |
| 86038 |
|
1,762 |
1,724 |
$6K |
| 84403 |
|
1,109 |
1,099 |
$6K |
| 97161 |
|
725 |
694 |
$5K |
| 84132 |
|
4,883 |
4,324 |
$5K |
| 82951 |
|
1,598 |
1,595 |
$5K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
8,116 |
7,182 |
$5K |
| 84153 |
|
1,347 |
1,334 |
$5K |
| 86225 |
|
1,533 |
1,501 |
$5K |
| 86880 |
|
102 |
98 |
$5K |
| 84165 |
|
878 |
844 |
$5K |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
2,371 |
2,210 |
$5K |
| 87324 |
|
1,609 |
1,580 |
$5K |
| 90656 |
|
731 |
730 |
$5K |
| 86704 |
|
1,240 |
1,214 |
$5K |
| 82784 |
|
755 |
726 |
$5K |
| 84550 |
|
4,603 |
4,200 |
$5K |
| 85379 |
|
2,366 |
2,210 |
$4K |
| 85652 |
|
7,904 |
7,494 |
$4K |
| J2060 |
Injection, lorazepam, 2 mg |
2,813 |
2,303 |
$4K |
| 86317 |
|
936 |
925 |
$4K |
| J3490 |
Unclassified drugs |
8,137 |
6,714 |
$4K |
| 80197 |
|
480 |
412 |
$4K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,320 |
3,835 |
$4K |
| 81015 |
|
2,589 |
2,536 |
$4K |
| 99499 |
|
66 |
30 |
$4K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
458 |
457 |
$4K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,513 |
2,800 |
$4K |
| 86364 |
|
339 |
337 |
$4K |
| 74170 |
|
14 |
14 |
$4K |
| 82550 |
|
2,431 |
2,144 |
$4K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
312 |
255 |
$4K |
| 0710 |
|
6,100 |
5,676 |
$3K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,628 |
1,462 |
$3K |
| J1815 |
Injection, insulin, per 5 units |
3,067 |
1,479 |
$3K |
| 76536 |
|
318 |
313 |
$3K |
| 82962 |
|
2,689 |
1,772 |
$3K |
| 86334 |
|
151 |
146 |
$3K |
| 84295 |
|
3,288 |
3,077 |
$3K |
| 82378 |
|
325 |
274 |
$3K |
| 62323 |
|
242 |
242 |
$3K |
| 88342 |
|
761 |
731 |
$3K |
| 84146 |
|
979 |
975 |
$3K |
| 77080 |
|
204 |
202 |
$3K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
3,401 |
3,033 |
$3K |
| 86664 |
|
655 |
650 |
$3K |
| 87210 |
|
6,453 |
6,292 |
$3K |
| 89051 |
|
880 |
550 |
$3K |
| 88307 |
|
421 |
328 |
$2K |
| 0250 |
|
11,393 |
7,866 |
$2K |
| 88341 |
|
233 |
214 |
$2K |
| G0008 |
Administration of influenza virus vaccine |
4,741 |
4,478 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,375 |
1,216 |
$2K |
| 86160 |
|
545 |
525 |
$2K |
| 87205 |
|
2,477 |
2,237 |
$2K |
| 87081 |
|
2,049 |
1,960 |
$2K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
225 |
218 |
$2K |
| 83993 |
|
113 |
113 |
$2K |
| 87517 |
|
58 |
54 |
$2K |
| 73660 |
|
173 |
165 |
$2K |
| 87186 |
|
1,142 |
1,093 |
$2K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
1,256 |
1,191 |
$2K |
| 82670 |
|
569 |
565 |
$2K |
| 83001 |
|
898 |
894 |
$2K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
273 |
190 |
$2K |
| Z7502 |
|
258 |
241 |
$2K |
| 86308 |
|
1,411 |
1,395 |
$2K |
| 82952 |
|
1,560 |
1,558 |
$2K |
| 73560 |
|
203 |
186 |
$2K |
| 83721 |
|
999 |
989 |
$2K |
| 90662 |
|
240 |
239 |
$1K |
| 90688 |
|
248 |
242 |
$1K |
| 86431 |
|
765 |
750 |
$1K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,300 |
1,943 |
$1K |
| 76642 |
|
278 |
275 |
$1K |
| 82977 |
|
255 |
239 |
$1K |
| 73552 |
|
29 |
28 |
$1K |
| V2632 |
Posterior chamber intraocular lens |
116 |
104 |
$1K |
| 85014 |
|
3,052 |
2,969 |
$1K |
| 97116 |
|
294 |
233 |
$1K |
| 82150 |
|
556 |
535 |
$1K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
210 |
200 |
$1K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
582 |
346 |
$1K |
| 72070 |
|
96 |
95 |
$1K |
| J3480 |
Injection, potassium chloride, per 2 meq |
1,628 |
1,052 |
$1K |
| 96367 |
|
137 |
128 |
$1K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
426 |
424 |
$1K |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
716 |
578 |
$1K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
51 |
49 |
$1K |
| A9503 |
Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries |
86 |
86 |
$988.36 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,154 |
677 |
$987.45 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
60 |
58 |
$987.18 |
| 84134 |
|
157 |
156 |
$982.02 |
| 73090 |
|
300 |
259 |
$975.88 |
| 82805 |
|
161 |
145 |
$974.59 |
| 85018 |
|
1,474 |
1,433 |
$949.36 |
| 84155 |
|
1,056 |
947 |
$944.50 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
3,058 |
2,819 |
$932.99 |
| 85046 |
|
874 |
822 |
$902.63 |
| 73100 |
|
211 |
190 |
$861.52 |
| 72050 |
|
97 |
96 |
$854.67 |
| 83718 |
|
850 |
843 |
$807.20 |
| 87522 |
Neg quan hep c or qual rna |
17 |
17 |
$762.00 |
| 87070 |
|
791 |
717 |
$749.53 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
575 |
390 |
$739.52 |
| 90715 |
|
71 |
70 |
$729.29 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,140 |
2,040 |
$727.84 |
| 82140 |
|
85 |
82 |
$714.45 |
| 83655 |
|
2,693 |
2,676 |
$664.62 |
| 88304 |
|
1,320 |
1,125 |
$655.95 |
| 72158 |
|
12 |
12 |
$632.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,064 |
1,061 |
$615.71 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
215 |
107 |
$594.69 |
| 82627 |
|
94 |
93 |
$564.00 |
| 77066 |
Tomosynthesis, mammo |
73 |
71 |
$563.32 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
953 |
896 |
$553.65 |
| 76881 |
|
94 |
91 |
$538.93 |
| 86708 |
|
92 |
91 |
$521.26 |
| 86335 |
|
15 |
14 |
$521.00 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
27 |
26 |
$497.71 |
| 83935 |
|
104 |
103 |
$486.70 |
| 92610 |
|
12 |
12 |
$484.41 |
| 82465 |
|
875 |
869 |
$479.63 |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
382 |
362 |
$478.35 |
| J1940 |
Injection, furosemide, up to 20 mg |
786 |
422 |
$472.10 |
| 84145 |
|
103 |
97 |
$468.76 |
| 0258 |
|
1,832 |
1,649 |
$462.83 |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
24 |
24 |
$462.20 |
| 83930 |
|
107 |
104 |
$457.72 |
| 73522 |
|
35 |
35 |
$437.87 |
| 72081 |
|
118 |
117 |
$432.00 |
| 82390 |
|
40 |
40 |
$425.00 |
| 73120 |
|
29 |
27 |
$415.94 |
| 74022 |
|
75 |
67 |
$414.04 |
| 84478 |
|
96 |
94 |
$405.00 |
| 82232 |
|
27 |
24 |
$394.86 |
| C1769 |
Guide wire |
313 |
289 |
$391.20 |
| C9113 |
Injection, pantoprazole sodium, per vial |
895 |
660 |
$353.69 |
| 86003 |
|
397 |
353 |
$353.65 |
| 87631 |
|
96 |
96 |
$330.21 |
| 87536 |
|
183 |
178 |
$327.72 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
286 |
274 |
$325.36 |
| 86304 |
|
16 |
13 |
$319.00 |
| 83002 |
|
281 |
280 |
$310.00 |
| 82330 |
|
27 |
26 |
$304.32 |
| J1644 |
Injection, heparin sodium, per 1000 units |
589 |
281 |
$295.53 |
| 80324 |
|
704 |
631 |
$294.05 |
| 86677 |
|
653 |
644 |
$293.32 |
| 85246 |
|
14 |
13 |
$289.00 |
| 97165 |
|
14 |
13 |
$284.82 |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
161 |
146 |
$278.10 |
| 90749 |
|
256 |
248 |
$271.89 |
| 86769 |
|
175 |
174 |
$252.24 |
| 86235 |
|
12 |
12 |
$240.00 |
| 82705 |
|
52 |
52 |
$231.00 |
| 82272 |
|
192 |
191 |
$220.56 |
| 73070 |
|
56 |
52 |
$219.88 |
| 12001 |
|
82 |
82 |
$216.38 |
| 85240 |
|
13 |
13 |
$199.00 |
| 84480 |
|
243 |
240 |
$186.66 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
619 |
594 |
$179.34 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
613 |
493 |
$171.00 |
| 82533 |
|
12 |
12 |
$169.00 |
| 83010 |
|
28 |
26 |
$156.49 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
971 |
920 |
$146.96 |
| 86140 |
|
1,062 |
992 |
$141.42 |
| J7510 |
Prednisolone oral, per 5 mg |
160 |
153 |
$134.47 |
| 73000 |
|
39 |
38 |
$117.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
95 |
60 |
$114.51 |
| 86709 |
|
13 |
13 |
$112.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
159 |
126 |
$106.90 |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
90 |
63 |
$104.82 |
| 80320 |
|
372 |
315 |
$99.20 |
| 77072 |
|
13 |
13 |
$97.00 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
95 |
75 |
$92.28 |
| 80329 |
|
328 |
160 |
$86.75 |
| 80359 |
|
654 |
588 |
$81.32 |
| J3360 |
Injection, diazepam, up to 5 mg |
12 |
12 |
$79.36 |
| 87184 |
|
13 |
12 |
$67.46 |
| 87807 |
|
93 |
93 |
$64.71 |
| 10060 |
|
15 |
15 |
$60.00 |
| 86256 |
|
31 |
29 |
$58.00 |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
33 |
30 |
$55.88 |
| 85045 |
|
14 |
13 |
$54.00 |
| J1953 |
Injection, levetiracetam, 10 mg |
23 |
12 |
$53.96 |
| 80164 |
|
41 |
39 |
$53.35 |
| J0456 |
Injection, azithromycin, 500 mg |
81 |
58 |
$52.41 |
| J1836 |
Injection, metronidazole, 10 mg |
92 |
54 |
$43.80 |
| 12011 |
|
41 |
41 |
$36.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
12 |
12 |
$35.33 |
| 87045 |
|
47 |
43 |
$33.28 |
| J2280 |
Injection, moxifloxacin, 100 mg |
138 |
130 |
$31.17 |
| J3411 |
Injection, thiamine hcl, 100 mg |
17 |
15 |
$31.13 |
| 88108 |
|
16 |
12 |
$30.00 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
56 |
43 |
$29.19 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
223 |
218 |
$27.59 |
| 47562 |
|
14 |
14 |
$24.95 |
| 85384 |
|
34 |
13 |
$24.26 |
| 84270 |
|
14 |
14 |
$23.00 |
| 87046 |
|
13 |
13 |
$15.66 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
16 |
14 |
$10.05 |
| J1630 |
Injection, haloperidol, up to 5 mg |
63 |
51 |
$6.27 |
| 29125 |
|
12 |
12 |
$5.00 |
| J0744 |
Injection, ciprofloxacin for intravenous infusion, 200 mg |
32 |
24 |
$3.26 |
| 3074F |
|
372 |
365 |
$0.00 |
| 0370 |
|
6,272 |
5,809 |
$0.00 |
| 73650 |
|
14 |
12 |
$0.00 |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
12 |
12 |
$0.00 |
| 88185 |
|
58 |
57 |
$0.00 |
| 3044F |
|
4,159 |
4,144 |
$0.00 |
| 0636 |
|
1,156 |
561 |
$0.00 |
| 0350 |
|
76 |
73 |
$0.00 |
| 0307 |
|
620 |
594 |
$0.00 |
| 86376 |
|
13 |
13 |
$0.00 |
| 0306 |
|
887 |
428 |
$0.00 |
| 0305 |
|
1,989 |
1,432 |
$0.00 |
| 0301 |
|
8,683 |
1,430 |
$0.00 |
| 0610 |
|
24 |
22 |
$0.00 |
| 0352 |
|
43 |
39 |
$0.00 |
| 0612 |
Calcium glucon (wg critical) |
35 |
31 |
$0.00 |
| J7121 |
5% dextrose in lactated ringers infusion, up to 1000 cc |
19 |
12 |
$0.00 |
| 3052F |
|
38 |
38 |
$0.00 |
| 0611 |
|
18 |
18 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
25 |
25 |
$0.00 |
| 0300 |
|
680 |
446 |
$0.00 |
| 0272 |
|
1,568 |
1,451 |
$0.00 |
| 86359 |
|
159 |
153 |
$0.00 |
| 3046F |
|
119 |
118 |
$0.00 |
| 86360 |
|
159 |
153 |
$0.00 |
| 0320 |
|
1,320 |
1,128 |
$0.00 |
| 3078F |
|
364 |
354 |
$0.00 |
| 0402 |
|
406 |
321 |
$0.00 |
| 3051F |
|
119 |
119 |
$0.00 |
| 0302 |
|
638 |
328 |
$0.00 |
| 0351 |
|
106 |
101 |
$0.00 |
| 0403 |
|
70 |
70 |
$0.00 |
| 0360 |
|
119 |
89 |
$0.00 |
| 0921 |
|
14 |
14 |
$0.00 |
| 87149 |
|
12 |
12 |
$0.00 |
| 82274 |
|
13 |
13 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
19 |
19 |
$0.00 |
| 0312 |
|
104 |
68 |
$0.00 |
| 87338 |
|
22 |
22 |
$0.00 |
| 0278 |
|
14 |
14 |
$0.00 |
| 87329 |
|
12 |
12 |
$0.00 |