| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S9088 |
Services provided in an urgent care center (list in addition to code for service) |
630 |
585 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28,945 |
25,006 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
224 |
184 |
$0.00 |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
402 |
171 |
$0.00 |
| 86592 |
|
893 |
858 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
583 |
540 |
$0.00 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
553 |
529 |
$0.00 |
| 97014 |
|
2,389 |
765 |
$0.00 |
| 90686 |
|
342 |
342 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
3,969 |
3,624 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
936 |
910 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,161 |
2,032 |
$0.00 |
| 96151 |
|
480 |
381 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13,766 |
12,586 |
$0.00 |
| 93000 |
|
293 |
291 |
$0.00 |
| 20610 |
|
31 |
29 |
$0.00 |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
3,776 |
3,426 |
$0.00 |
| A7030 |
Full face mask used with positive airway pressure device, each |
26 |
26 |
$0.00 |
| 99239 |
Hospital discharge day management, more than 30 minutes |
411 |
378 |
$0.00 |
| 86706 |
|
266 |
262 |
$0.00 |
| 84436 |
|
404 |
383 |
$0.00 |
| 3074F |
|
125 |
110 |
$0.00 |
| 80349 |
|
622 |
443 |
$0.00 |
| 95115 |
|
336 |
109 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
958 |
923 |
$0.00 |
| 85018 |
|
1,309 |
1,249 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,028 |
3,889 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
460 |
459 |
$0.00 |
| 84153 |
|
473 |
457 |
$0.00 |
| 87077 |
|
180 |
170 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
950 |
884 |
$0.00 |
| 99000 |
|
1,132 |
1,060 |
$0.00 |
| 88342 |
|
88 |
79 |
$0.00 |
| 84402 |
|
47 |
43 |
$0.00 |
| 87070 |
|
259 |
249 |
$0.00 |
| 83880 |
|
56 |
55 |
$0.00 |
| 84075 |
|
38 |
37 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
10,486 |
9,627 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,063 |
1,988 |
$0.00 |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,265 |
1,038 |
$0.00 |
| 87147 |
|
90 |
89 |
$0.00 |
| 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 |
65 |
61 |
$0.00 |
| 85027 |
|
1,109 |
1,060 |
$0.00 |
| 83021 |
|
228 |
222 |
$0.00 |
| 81000 |
|
204 |
188 |
$0.00 |
| 86140 |
|
430 |
391 |
$0.00 |
| 83690 |
|
155 |
146 |
$0.00 |
| 85730 |
|
248 |
230 |
$0.00 |
| 83986 |
|
109 |
100 |
$0.00 |
| 87522 |
Neg quan hep c or qual rna |
114 |
112 |
$0.00 |
| 86704 |
|
232 |
231 |
$0.00 |
| J3490 |
Unclassified drugs |
490 |
409 |
$0.00 |
| 90698 |
|
26 |
26 |
$0.00 |
| 86800 |
|
82 |
78 |
$0.00 |
| 88141 |
|
106 |
102 |
$0.00 |
| 82746 |
|
447 |
433 |
$0.00 |
| 80178 |
|
44 |
32 |
$0.00 |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
82 |
79 |
$0.00 |
| 82378 |
|
116 |
109 |
$0.00 |
| 90716 |
|
17 |
16 |
$0.00 |
| 84480 |
|
229 |
221 |
$0.00 |
| 82043 |
|
951 |
910 |
$0.00 |
| 76801 |
|
34 |
30 |
$0.00 |
| 82040 |
|
65 |
61 |
$0.00 |
| A4556 |
Electrodes, (e.g., apnea monitor), per pair |
71 |
71 |
$0.00 |
| 88304 |
|
112 |
104 |
$0.00 |
| 86803 |
|
688 |
678 |
$0.00 |
| 84270 |
|
30 |
24 |
$0.00 |
| 82728 |
|
890 |
842 |
$0.00 |
| 80371 |
|
39 |
39 |
$0.00 |
| 83002 |
|
145 |
142 |
$0.00 |
| 86160 |
|
12 |
12 |
$0.00 |
| 83001 |
|
193 |
188 |
$0.00 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
879 |
814 |
$0.00 |
| 92551 |
|
410 |
406 |
$0.00 |
| 73560 |
|
91 |
67 |
$0.00 |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
143 |
139 |
$0.00 |
| E0570 |
Nebulizer, with compressor |
264 |
255 |
$0.00 |
| 80358 |
|
124 |
114 |
$0.00 |
| 80324 |
|
278 |
185 |
$0.00 |
| A7037 |
Tubing used with positive airway pressure device |
78 |
76 |
$0.00 |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
1,350 |
1,211 |
$0.00 |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
221 |
206 |
$0.00 |
| 72040 |
|
85 |
81 |
$0.00 |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,194 |
339 |
$0.00 |
| 86580 |
|
146 |
146 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
3,645 |
3,287 |
$0.00 |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
97 |
86 |
$0.00 |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
461 |
311 |
$0.00 |
| 71045 |
Radiologic examination, chest; single view |
961 |
655 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
705 |
674 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
270 |
269 |
$0.00 |
| 97162 |
|
157 |
148 |
$0.00 |
| 73564 |
|
111 |
85 |
$0.00 |
| 88142 |
|
315 |
313 |
$0.00 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
699 |
678 |
$0.00 |
| 86762 |
|
66 |
61 |
$0.00 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
138 |
127 |
$0.00 |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
269 |
109 |
$0.00 |
| 88307 |
|
50 |
48 |
$0.00 |
| 83789 |
|
149 |
145 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
12 |
12 |
$0.00 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
238 |
235 |
$0.00 |
| 82150 |
|
106 |
100 |
$0.00 |
| 95117 |
|
21 |
13 |
$0.00 |
| 86695 |
|
193 |
187 |
$0.00 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
659 |
617 |
$0.00 |
| 82670 |
|
48 |
41 |
$0.00 |
| 87088 |
|
636 |
599 |
$0.00 |
| 93971 |
|
31 |
31 |
$0.00 |
| 76536 |
|
68 |
64 |
$0.00 |
| 82607 |
|
905 |
869 |
$0.00 |
| 80353 |
|
161 |
145 |
$0.00 |
| 86317 |
|
117 |
95 |
$0.00 |
| 81001 |
|
1,973 |
1,870 |
$0.00 |
| 85652 |
|
591 |
545 |
$0.00 |
| 80357 |
|
30 |
30 |
$0.00 |
| 97802 |
|
286 |
285 |
$0.00 |
| 86901 |
|
119 |
111 |
$0.00 |
| 83735 |
|
322 |
264 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
98 |
98 |
$0.00 |
| 87081 |
|
319 |
313 |
$0.00 |
| 97035 |
|
198 |
70 |
$0.00 |
| 83550 |
|
761 |
724 |
$0.00 |
| 86225 |
|
41 |
38 |
$0.00 |
| 82105 |
|
39 |
38 |
$0.00 |
| 82784 |
|
93 |
89 |
$0.00 |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
67 |
63 |
$0.00 |
| 1036F |
|
14 |
13 |
$0.00 |
| K0001 |
Standard wheelchair |
113 |
109 |
$0.00 |
| 83014 |
|
71 |
69 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
245 |
244 |
$0.00 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
408 |
388 |
$0.00 |
| 80081 |
|
251 |
248 |
$0.00 |
| 82550 |
|
165 |
137 |
$0.00 |
| 80352 |
|
39 |
39 |
$0.00 |
| 84479 |
|
295 |
275 |
$0.00 |
| 96150 |
|
41 |
41 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
12 |
12 |
$0.00 |
| 73502 |
|
82 |
76 |
$0.00 |
| 80069 |
|
285 |
259 |
$0.00 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
394 |
388 |
$0.00 |
| 70486 |
|
13 |
12 |
$0.00 |
| H2000 |
Comprehensive multidisciplinary evaluation |
83 |
82 |
$0.00 |
| 76830 |
Ultrasound, transvaginal |
309 |
295 |
$0.00 |
| 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 |
30 |
27 |
$0.00 |
| 80359 |
|
43 |
43 |
$0.00 |
| 51798 |
|
42 |
40 |
$0.00 |
| 82950 |
|
201 |
197 |
$0.00 |
| 86376 |
|
142 |
137 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,220 |
2,097 |
$0.00 |
| 87340 |
|
409 |
402 |
$0.00 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
91 |
79 |
$0.00 |
| 80050 |
General health panel |
2,855 |
2,782 |
$0.00 |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
88 |
85 |
$0.00 |
| 80345 |
|
15 |
15 |
$0.00 |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
191 |
176 |
$0.00 |
| 99050 |
|
48 |
47 |
$0.00 |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
35 |
30 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 92226 |
|
24 |
12 |
$0.00 |
| 82951 |
|
31 |
29 |
$0.00 |
| 3008F |
|
52 |
45 |
$0.00 |
| 90744 |
|
14 |
14 |
$0.00 |
| 84315 |
|
15 |
15 |
$0.00 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
278 |
191 |
$0.00 |
| 3079F |
|
37 |
37 |
$0.00 |
| 84703 |
|
29 |
26 |
$0.00 |
| 80184 |
|
34 |
34 |
$0.00 |
| 87046 |
|
13 |
13 |
$0.00 |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
12 |
12 |
$0.00 |
| 99243 |
|
25 |
25 |
$0.00 |
| 76870 |
|
14 |
14 |
$0.00 |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
13 |
13 |
$0.00 |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
13 |
12 |
$0.00 |
| 94760 |
|
36 |
34 |
$0.00 |
| 83615 |
|
50 |
43 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
16 |
14 |
$0.00 |
| 90680 |
|
14 |
14 |
$0.00 |
| 73090 |
|
15 |
12 |
$0.00 |
| 95024 |
|
16 |
12 |
$0.00 |
| 80363 |
|
33 |
33 |
$0.00 |
| 84144 |
|
30 |
29 |
$0.00 |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
99 |
75 |
$0.00 |
| 95886 |
|
13 |
13 |
$0.00 |
| 84132 |
|
14 |
12 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
868 |
808 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,066 |
2,031 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
128 |
128 |
$0.00 |
| 86696 |
|
194 |
190 |
$0.00 |
| 82274 |
|
440 |
426 |
$0.00 |
| 99173 |
|
950 |
943 |
$0.00 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
95 |
88 |
$0.00 |
| 84702 |
|
189 |
150 |
$0.00 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
3,605 |
1,162 |
$0.00 |
| 95811 |
|
119 |
72 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,548 |
1,737 |
$0.00 |
| 82247 |
|
66 |
62 |
$0.00 |
| 90670 |
|
262 |
249 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
233 |
232 |
$0.00 |
| 80074 |
|
453 |
433 |
$0.00 |
| 92552 |
|
631 |
628 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
576 |
555 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,415 |
2,218 |
$0.00 |
| 83540 |
|
832 |
786 |
$0.00 |
| 99223 |
Prolong inpt eval add15 m |
423 |
357 |
$0.00 |
| E0601 |
Continuous positive airway pressure (cpap) device |
792 |
763 |
$0.00 |
| 80346 |
|
575 |
406 |
$0.00 |
| 93229 |
|
24 |
24 |
$0.00 |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
2,150 |
1,956 |
$0.00 |
| 73562 |
|
154 |
127 |
$0.00 |
| 84403 |
|
285 |
254 |
$0.00 |
| 70450 |
Computed tomography, head or brain; without contrast material |
392 |
355 |
$0.00 |
| A4267 |
Contraceptive supply, condom, male, each |
190 |
181 |
$0.00 |
| 51741 |
|
42 |
40 |
$0.00 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
17 |
14 |
$0.00 |
| 81002 |
|
902 |
695 |
$0.00 |
| 59425 |
|
2,043 |
1,456 |
$0.00 |
| 72100 |
|
186 |
175 |
$0.00 |
| 87338 |
|
44 |
43 |
$0.00 |
| 71046 |
Radiologic examination, chest; 2 views |
1,218 |
1,148 |
$0.00 |
| 80061 |
Lipid panel |
5,050 |
4,845 |
$0.00 |
| 81025 |
|
771 |
732 |
$0.00 |
| 73030 |
|
183 |
165 |
$0.00 |
| 99001 |
|
104 |
89 |
$0.00 |
| 80348 |
|
706 |
317 |
$0.00 |
| G0482 |
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; 15-21 drug class(es), including metabolite(s) if performed |
209 |
200 |
$0.00 |
| 99222 |
Initial hospital care, per day, moderate complexity |
110 |
95 |
$0.00 |
| 82542 |
|
174 |
169 |
$0.00 |
| 11100 |
|
128 |
127 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
586 |
569 |
$0.00 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
318 |
310 |
$0.00 |
| 80361 |
|
605 |
479 |
$0.00 |
| 17110 |
|
115 |
104 |
$0.00 |
| 99401 |
|
1,101 |
959 |
$0.00 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
1,660 |
1,385 |
$0.00 |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
149 |
135 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
110 |
106 |
$0.00 |
| 86735 |
|
21 |
21 |
$0.00 |
| 76770 |
|
96 |
91 |
$0.00 |
| 99354 |
|
106 |
100 |
$0.00 |
| 97803 |
|
759 |
690 |
$0.00 |
| 84550 |
|
369 |
351 |
$0.00 |
| 99201 |
|
82 |
76 |
$0.00 |
| 99233 |
Prolong inpt eval add15 m |
1,063 |
342 |
$0.00 |
| 72110 |
|
62 |
62 |
$0.00 |
| 80372 |
|
149 |
140 |
$0.00 |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
29 |
27 |
$0.00 |
| 84460 |
|
182 |
180 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
278 |
251 |
$0.00 |
| 73130 |
|
197 |
154 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
104 |
79 |
$0.00 |
| 82785 |
|
143 |
135 |
$0.00 |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
293 |
270 |
$0.00 |
| 82947 |
|
151 |
136 |
$0.00 |
| 98940 |
|
498 |
326 |
$0.00 |
| 99245 |
|
108 |
107 |
$0.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
882 |
853 |
$0.00 |
| 86038 |
|
327 |
315 |
$0.00 |
| 97164 |
|
152 |
140 |
$0.00 |
| 82565 |
|
121 |
118 |
$0.00 |
| 84450 |
|
164 |
162 |
$0.00 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
177 |
162 |
$0.00 |
| A9279 |
Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified |
63 |
63 |
$0.00 |
| 76642 |
|
121 |
86 |
$0.00 |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
77 |
70 |
$0.00 |
| 99051 |
|
204 |
193 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
173 |
166 |
$0.00 |
| 92550 |
|
120 |
119 |
$0.00 |
| 84481 |
|
571 |
548 |
$0.00 |
| 84146 |
|
181 |
179 |
$0.00 |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
812 |
766 |
$0.00 |
| 1159F |
|
45 |
39 |
$0.00 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
363 |
347 |
$0.00 |
| 80369 |
|
76 |
71 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
381 |
362 |
$0.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
555 |
434 |
$0.00 |
| 73610 |
|
195 |
159 |
$0.00 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
1,427 |
914 |
$0.00 |
| 83992 |
|
42 |
42 |
$0.00 |
| 99497 |
|
185 |
185 |
$0.00 |
| 90734 |
|
41 |
41 |
$0.00 |
| 85610 |
|
490 |
401 |
$0.00 |
| 80356 |
|
171 |
155 |
$0.00 |
| 74018 |
|
152 |
118 |
$0.00 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
569 |
562 |
$0.00 |
| 99221 |
|
30 |
25 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
83 |
75 |
$0.00 |
| 86003 |
|
203 |
195 |
$0.00 |
| 86708 |
|
195 |
191 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,164 |
2,036 |
$0.00 |
| 87186 |
|
243 |
227 |
$0.00 |
| 86787 |
|
33 |
33 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
121 |
114 |
$0.00 |
| 90649 |
|
19 |
14 |
$0.00 |
| 95887 |
|
13 |
13 |
$0.00 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
12 |
12 |
$0.00 |
| 95144 |
|
341 |
107 |
$0.00 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
46 |
45 |
$0.00 |
| 80321 |
|
288 |
231 |
$0.00 |
| 3078F |
|
106 |
91 |
$0.00 |
| 93325 |
|
17 |
12 |
$0.00 |
| A7035 |
Headgear used with positive airway pressure device |
172 |
169 |
$0.00 |
| 88312 |
|
60 |
59 |
$0.00 |
| 83970 |
|
74 |
68 |
$0.00 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
105 |
104 |
$0.00 |
| 81003 |
|
657 |
615 |
$0.00 |
| 73140 |
|
39 |
38 |
$0.00 |
| 84439 |
|
1,664 |
1,592 |
$0.00 |
| 82652 |
|
246 |
243 |
$0.00 |
| 71250 |
|
49 |
44 |
$0.00 |
| 82570 |
|
1,184 |
1,097 |
$0.00 |
| 73630 |
|
298 |
251 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
384 |
375 |
$0.00 |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
60 |
60 |
$0.00 |
| 99199 |
Unlisted special service, procedure or report |
72 |
65 |
$0.00 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
43 |
42 |
$0.00 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
86 |
82 |
$0.00 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
80 |
32 |
$0.00 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
137 |
128 |
$0.00 |
| 87177 |
|
68 |
68 |
$0.00 |
| 90685 |
|
14 |
14 |
$0.00 |
| 80365 |
|
604 |
477 |
$0.00 |
| 87799 |
|
1,047 |
344 |
$0.00 |
| 84156 |
|
70 |
52 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
231 |
166 |
$0.00 |
| 80323 |
|
55 |
55 |
$0.00 |
| 82248 |
|
211 |
196 |
$0.00 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
79 |
77 |
$0.00 |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
66 |
59 |
$0.00 |
| 87209 |
|
68 |
68 |
$0.00 |
| 83655 |
|
383 |
368 |
$0.00 |
| 83525 |
|
51 |
51 |
$0.00 |
| 80076 |
|
225 |
213 |
$0.00 |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
54 |
54 |
$0.00 |
| 73110 |
|
157 |
125 |
$0.00 |
| 72070 |
|
12 |
12 |
$0.00 |
| 80373 |
|
118 |
109 |
$0.00 |
| 86480 |
|
176 |
170 |
$0.00 |
| 80355 |
|
70 |
67 |
$0.00 |
| 86431 |
|
273 |
266 |
$0.00 |
| 80325 |
|
13 |
12 |
$0.00 |
| 87806 |
|
98 |
96 |
$0.00 |
| 90648 |
|
13 |
13 |
$0.00 |
| 90715 |
|
49 |
45 |
$0.00 |
| 87512 |
|
342 |
335 |
$0.00 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
44 |
40 |
$0.00 |
| S0199 |
Medically induced abortion by oral ingestion of medication including all associated services and supplies (e.g., patient counseling, office visits, confirmation of pregnancy by hcg, ultrasound to confirm duration of pregnancy, ultrasound to confirm completion of abortion) except drugs |
39 |
39 |
$0.00 |
| 93015 |
|
25 |
25 |
$0.00 |
| 93975 |
|
102 |
99 |
$0.00 |
| 80360 |
|
92 |
88 |
$0.00 |
| 80366 |
|
68 |
65 |
$0.00 |
| 83516 |
|
59 |
52 |
$0.00 |
| T4541 |
Incontinence product, disposable underpad, large, each |
137 |
131 |
$0.00 |
| A7036 |
Chinstrap used with positive airway pressure device |
13 |
13 |
$0.00 |
| 80354 |
|
121 |
112 |
$0.00 |
| 92134 |
|
27 |
26 |
$0.00 |
| 87481 |
|
179 |
65 |
$0.00 |
| S0191 |
Misoprostol, oral, 200 mcg |
40 |
38 |
$0.00 |
| 86200 |
|
118 |
115 |
$0.00 |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
39 |
37 |
$0.00 |
| 90700 |
|
82 |
80 |
$0.00 |
| S0190 |
Mifepristone, oral, 200 mg |
25 |
25 |
$0.00 |
| J0135 |
Injection, adalimumab, 20 mg |
57 |
47 |
$0.00 |
| 77066 |
Tomosynthesis, mammo |
54 |
52 |
$0.00 |
| 72141 |
|
27 |
25 |
$0.00 |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
71 |
64 |
$0.00 |
| 83013 |
|
107 |
107 |
$0.00 |
| 86235 |
|
50 |
46 |
$0.00 |
| 01967 |
Neuraxial labor analgesia/anesthesia for planned vaginal delivery |
27 |
27 |
$0.00 |
| 90633 |
|
45 |
44 |
$0.00 |
| S4993 |
Contraceptive pills for birth control |
85 |
85 |
$0.00 |
| 3077F |
|
12 |
12 |
$0.00 |
| 80305 |
|
12 |
12 |
$0.00 |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
46 |
31 |
$0.00 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
31 |
31 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
13 |
13 |
$0.00 |
| 99152 |
|
46 |
42 |
$0.00 |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
19 |
13 |
$0.00 |
| 84100 |
|
39 |
26 |
$0.00 |
| 80299 |
|
38 |
38 |
$0.00 |
| 90707 |
|
15 |
14 |
$0.00 |
| 93970 |
|
20 |
18 |
$0.00 |
| 73080 |
|
20 |
18 |
$0.00 |
| 29125 |
|
18 |
17 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
36 |
33 |
$0.00 |
| G0483 |
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; 22 or more drug class(es), including metabolite(s) if performed |
17 |
16 |
$0.00 |
| 86765 |
|
21 |
21 |
$0.00 |
| 87427 |
|
13 |
13 |
$0.00 |
| 82310 |
|
16 |
16 |
$0.00 |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
32 |
26 |
$0.00 |
| 86900 |
|
51 |
48 |
$0.00 |
| 0403T |
|
21 |
15 |
$0.00 |
| 87045 |
|
14 |
14 |
$0.00 |
| 73590 |
|
14 |
14 |
$0.00 |
| 86039 |
|
16 |
14 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
14 |
13 |
$0.00 |