| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
127,689 |
104,828 |
$3.70M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
13,644 |
12,157 |
$2.40M |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
12,710 |
11,492 |
$1.35M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27,204 |
23,461 |
$1.17M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
35,764 |
29,609 |
$1.10M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
5,591 |
5,127 |
$1.10M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,063 |
3,922 |
$903K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
20,543 |
14,107 |
$729K |
| 87631 |
|
4,947 |
4,638 |
$613K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
3,742 |
3,412 |
$553K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
7,155 |
5,106 |
$489K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,325 |
2,266 |
$395K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
3,354 |
3,070 |
$357K |
| 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 |
5,346 |
5,035 |
$352K |
| 93975 |
|
1,495 |
1,381 |
$335K |
| 99215 |
Prolong outpt/office vis |
3,508 |
3,272 |
$333K |
| 76801 |
|
3,147 |
2,786 |
$323K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
7,178 |
6,304 |
$292K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
3,476 |
2,016 |
$282K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
56,794 |
45,364 |
$276K |
| 59025 |
Fetal non-stress test |
7,630 |
4,744 |
$271K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,755 |
5,946 |
$270K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
3,706 |
2,547 |
$262K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,123 |
2,965 |
$258K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
9,620 |
9,081 |
$237K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
9,618 |
9,079 |
$236K |
| 87536 |
|
4,483 |
3,918 |
$228K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
5,231 |
4,929 |
$223K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
32,642 |
25,663 |
$211K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,417 |
2,072 |
$209K |
| 80053 |
Comprehensive metabolic panel |
27,019 |
22,107 |
$207K |
| 76818 |
|
1,735 |
1,093 |
$205K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,815 |
1,792 |
$200K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,114 |
1,079 |
$192K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
344 |
326 |
$179K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
31,804 |
23,991 |
$169K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
4,316 |
3,748 |
$166K |
| 80061 |
Lipid panel |
20,628 |
19,542 |
$163K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,447 |
945 |
$163K |
| 86703 |
|
15,901 |
15,169 |
$162K |
| 71046 |
Radiologic examination, chest; 2 views |
6,321 |
5,920 |
$155K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,086 |
4,171 |
$149K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
22,491 |
21,394 |
$130K |
| 86780 |
|
13,301 |
12,481 |
$128K |
| 84443 |
Thyroid stimulating hormone (TSH) |
12,313 |
11,684 |
$116K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,402 |
2,090 |
$112K |
| 90677 |
|
1,437 |
1,412 |
$108K |
| G0257 |
Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility |
1,744 |
984 |
$100K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,567 |
3,160 |
$100K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,291 |
1,245 |
$100K |
| 86360 |
|
3,661 |
3,224 |
$99K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,631 |
1,983 |
$96K |
| 86850 |
|
9,049 |
8,247 |
$92K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
2,105 |
644 |
$92K |
| 76830 |
Ultrasound, transvaginal |
954 |
924 |
$92K |
| 71045 |
Radiologic examination, chest; single view |
5,179 |
4,489 |
$87K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
5,750 |
5,558 |
$82K |
| J9271 |
Injection, pembrolizumab, 1 mg |
27 |
25 |
$81K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
3,168 |
1,606 |
$80K |
| 76770 |
|
899 |
878 |
$78K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
4,603 |
4,238 |
$77K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
346 |
341 |
$74K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,181 |
1,879 |
$73K |
| 49083 |
|
224 |
148 |
$68K |
| 84484 |
|
11,815 |
6,701 |
$68K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
2,385 |
1,863 |
$67K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
773 |
766 |
$66K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
11,734 |
10,859 |
$66K |
| 93017 |
|
332 |
313 |
$65K |
| 83880 |
|
3,139 |
2,912 |
$65K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,268 |
1,969 |
$64K |
| 87088 |
|
11,719 |
10,845 |
$63K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
404 |
398 |
$61K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,228 |
1,151 |
$58K |
| 80076 |
|
11,690 |
10,703 |
$58K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
758 |
734 |
$55K |
| 85027 |
|
13,066 |
10,729 |
$54K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
3,756 |
2,955 |
$50K |
| 86592 |
|
16,825 |
14,028 |
$49K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
2,117 |
2,051 |
$48K |
| 93308 |
|
657 |
627 |
$48K |
| 97161 |
|
1,111 |
1,078 |
$47K |
| 93971 |
|
515 |
478 |
$47K |
| 80074 |
|
3,292 |
3,194 |
$47K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
172 |
168 |
$46K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,771 |
1,721 |
$46K |
| 82947 |
|
30,108 |
11,677 |
$43K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
11,533 |
10,630 |
$43K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,032 |
2,005 |
$43K |
| 94618 |
|
217 |
176 |
$42K |
| 86923 |
|
1,624 |
851 |
$42K |
| 90715 |
|
3,408 |
3,315 |
$42K |
| 88720 |
|
9,115 |
8,132 |
$41K |
| 76857 |
|
932 |
903 |
$40K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
1,386 |
1,146 |
$40K |
| J1453 |
Injection, fosaprepitant, 1 mg |
768 |
542 |
$38K |
| 93970 |
|
274 |
268 |
$38K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,071 |
989 |
$38K |
| 97162 |
|
856 |
816 |
$37K |
| 90750 |
|
1,153 |
1,141 |
$37K |
| 73630 |
|
1,393 |
1,160 |
$35K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,033 |
846 |
$34K |
| 83735 |
|
9,190 |
5,880 |
$33K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,671 |
5,355 |
$33K |
| 86762 |
|
3,809 |
3,643 |
$33K |
| 82803 |
|
2,678 |
2,019 |
$32K |
| 83655 |
|
3,125 |
2,900 |
$32K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
37 |
37 |
$32K |
| 73562 |
|
1,054 |
920 |
$31K |
| 0002A |
|
3,116 |
3,072 |
$31K |
| 96417 |
|
1,298 |
862 |
$31K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,506 |
747 |
$30K |
| 84702 |
|
3,184 |
2,664 |
$30K |
| 81001 |
|
14,878 |
13,458 |
$29K |
| 87340 |
|
5,780 |
5,490 |
$28K |
| 73030 |
|
1,146 |
1,014 |
$27K |
| G0378 |
Hospital observation service, per hour |
328 |
139 |
$27K |
| 73130 |
|
978 |
793 |
$27K |
| 83020 |
|
2,719 |
2,541 |
$27K |
| 73610 |
|
931 |
788 |
$26K |
| 0012A |
|
2,748 |
2,679 |
$26K |
| 71250 |
|
392 |
387 |
$26K |
| 90834 |
Psychotherapy, 45 minutes with patient |
598 |
470 |
$26K |
| 70496 |
|
159 |
157 |
$26K |
| 96415 |
|
1,561 |
973 |
$25K |
| 84439 |
|
4,682 |
4,488 |
$25K |
| 72100 |
|
884 |
860 |
$25K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,097 |
841 |
$24K |
| 20610 |
|
560 |
490 |
$24K |
| 82607 |
|
3,217 |
3,127 |
$23K |
| 96367 |
|
1,403 |
998 |
$23K |
| 82728 |
|
3,207 |
3,090 |
$23K |
| 83690 |
|
5,646 |
5,182 |
$22K |
| 0001A |
|
2,896 |
2,852 |
$22K |
| 70498 |
|
140 |
136 |
$22K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
1,163 |
1,121 |
$21K |
| 90686 |
|
2,986 |
2,827 |
$21K |
| 86803 |
|
2,832 |
2,718 |
$21K |
| 83970 |
|
1,055 |
1,019 |
$20K |
| 87522 |
Neg quan hep c or qual rna |
763 |
732 |
$20K |
| 88142 |
|
1,395 |
1,342 |
$20K |
| 85610 |
|
7,938 |
6,209 |
$20K |
| 83605 |
|
3,082 |
2,266 |
$19K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
544 |
452 |
$19K |
| 88342 |
|
688 |
499 |
$18K |
| 94760 |
|
759 |
447 |
$18K |
| 76820 |
|
368 |
214 |
$18K |
| 76642 |
|
316 |
273 |
$17K |
| 86900 |
|
9,208 |
8,352 |
$17K |
| 86901 |
|
9,202 |
8,350 |
$17K |
| 87040 |
|
2,556 |
1,276 |
$17K |
| 81002 |
|
6,184 |
4,940 |
$17K |
| 87081 |
|
3,126 |
2,995 |
$17K |
| 0011A |
|
2,444 |
2,394 |
$16K |
| 87077 |
|
3,678 |
2,596 |
$16K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
101 |
100 |
$16K |
| G0328 |
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous |
2,000 |
1,988 |
$16K |
| 80047 |
|
3,451 |
3,042 |
$16K |
| 73110 |
|
485 |
364 |
$15K |
| 73590 |
|
630 |
561 |
$15K |
| 82570 |
|
5,529 |
5,050 |
$15K |
| 84153 |
|
1,507 |
1,399 |
$14K |
| 87210 |
|
3,336 |
3,188 |
$14K |
| 85730 |
|
4,462 |
3,705 |
$14K |
| 81025 |
|
2,294 |
2,194 |
$14K |
| 85007 |
|
6,323 |
4,769 |
$14K |
| 82950 |
|
3,554 |
3,437 |
$14K |
| 82565 |
|
6,265 |
5,738 |
$13K |
| 86480 |
|
403 |
389 |
$13K |
| A0425 |
Ground mileage, per statute mile |
1,506 |
1,327 |
$13K |
| 82746 |
|
1,746 |
1,701 |
$13K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
2,162 |
1,437 |
$12K |
| 87186 |
|
2,600 |
1,949 |
$12K |
| 84460 |
|
3,922 |
3,716 |
$12K |
| 84450 |
|
3,914 |
3,704 |
$12K |
| 76821 |
|
118 |
68 |
$12K |
| 85018 |
|
4,799 |
4,506 |
$12K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
540 |
293 |
$11K |
| J2426 |
Injection, paliperidone palmitate extended release (invega sustenna), 1 mg |
15 |
12 |
$11K |
| 73502 |
|
342 |
317 |
$11K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
3,883 |
1,823 |
$11K |
| 73565 |
|
412 |
408 |
$11K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
246 |
225 |
$11K |
| 94010 |
|
246 |
208 |
$10K |
| 87070 |
|
1,577 |
1,402 |
$10K |
| 94726 |
|
175 |
135 |
$10K |
| 83540 |
|
3,093 |
2,988 |
$10K |
| 83550 |
|
2,215 |
2,133 |
$10K |
| 97597 |
|
462 |
212 |
$10K |
| 90756 |
|
1,319 |
1,311 |
$9K |
| 96416 |
|
214 |
124 |
$9K |
| 82378 |
|
799 |
711 |
$9K |
| J3490 |
Unclassified drugs |
3,739 |
1,794 |
$9K |
| 82247 |
|
3,131 |
2,469 |
$9K |
| J2785 |
Injection, regadenoson, 0.1 mg |
233 |
227 |
$9K |
| 82043 |
|
3,052 |
2,993 |
$9K |
| 77066 |
Tomosynthesis, mammo |
162 |
162 |
$8K |
| 81003 |
|
5,882 |
5,610 |
$8K |
| 99001 |
|
703 |
660 |
$8K |
| 97165 |
|
193 |
192 |
$8K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
31 |
30 |
$8K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
362 |
345 |
$8K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
12,607 |
5,243 |
$7K |
| 96376 |
|
477 |
420 |
$7K |
| 94729 |
|
144 |
118 |
$7K |
| 85014 |
|
2,890 |
2,683 |
$7K |
| 84100 |
|
5,432 |
3,842 |
$7K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
162 |
71 |
$7K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
954 |
514 |
$7K |
| 76536 |
|
81 |
80 |
$7K |
| 91320 |
|
318 |
311 |
$6K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
12 |
12 |
$6K |
| 86706 |
|
1,200 |
1,141 |
$6K |
| 86140 |
|
2,209 |
2,075 |
$6K |
| 97163 |
|
123 |
107 |
$6K |
| 80050 |
General health panel |
308 |
302 |
$6K |
| 92250 |
|
1,077 |
1,066 |
$6K |
| J1644 |
Injection, heparin sodium, per 1000 units |
3,396 |
1,017 |
$6K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
155 |
135 |
$6K |
| 78306 |
|
24 |
24 |
$6K |
| 85651 |
|
2,118 |
2,021 |
$5K |
| 70486 |
|
66 |
64 |
$5K |
| 90656 |
|
723 |
710 |
$5K |
| 86704 |
|
799 |
759 |
$5K |
| 90732 |
|
322 |
321 |
$5K |
| J0692 |
Injection, cefepime hydrochloride, 500 mg |
1,450 |
502 |
$5K |
| 36430 |
|
1,048 |
836 |
$5K |
| 84403 |
|
533 |
480 |
$5K |
| 77080 |
|
321 |
319 |
$5K |
| 0004A |
|
558 |
558 |
$5K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,200 |
1,656 |
$5K |
| 0064A |
|
441 |
437 |
$5K |
| 82550 |
|
1,270 |
1,066 |
$5K |
| 84156 |
|
2,072 |
1,946 |
$4K |
| 86255 |
|
665 |
642 |
$4K |
| 80051 |
|
1,449 |
1,356 |
$4K |
| 82533 |
|
495 |
405 |
$4K |
| 82105 |
|
564 |
529 |
$4K |
| 73552 |
|
159 |
143 |
$4K |
| J1940 |
Injection, furosemide, up to 20 mg |
2,279 |
1,127 |
$4K |
| 83615 |
|
1,114 |
963 |
$4K |
| J9190 |
Injection, fluorouracil, 500 mg |
402 |
193 |
$4K |
| 84520 |
|
2,341 |
2,243 |
$4K |
| 85378 |
|
610 |
587 |
$4K |
| 74018 |
|
162 |
147 |
$4K |
| 73090 |
|
153 |
133 |
$4K |
| 84703 |
|
758 |
730 |
$3K |
| P9046 |
Infusion, albumin (human), 25%, 20 ml |
116 |
52 |
$3K |
| 86160 |
|
529 |
256 |
$3K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
2,265 |
1,873 |
$3K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,567 |
2,162 |
$3K |
| 82248 |
|
1,819 |
1,567 |
$3K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
7,022 |
2,733 |
$3K |
| 84165 |
|
524 |
495 |
$3K |
| 77065 |
Tomosynthesis, mammo |
120 |
117 |
$3K |
| 87205 |
|
1,110 |
920 |
$3K |
| 80320 |
|
307 |
296 |
$3K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
462 |
333 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
932 |
818 |
$3K |
| 82951 |
|
272 |
266 |
$3K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
966 |
796 |
$3K |
| 97116 |
|
132 |
86 |
$3K |
| 0124A |
|
215 |
214 |
$3K |
| 0054A |
|
168 |
164 |
$3K |
| 93296 |
|
126 |
121 |
$3K |
| 72141 |
|
14 |
14 |
$2K |
| 90480 |
|
320 |
313 |
$2K |
| 76886 |
|
27 |
27 |
$2K |
| 82274 |
|
121 |
121 |
$2K |
| 92550 |
|
54 |
52 |
$2K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
5,550 |
3,953 |
$2K |
| J7050 |
Infusion, normal saline solution, 250 cc |
2,184 |
1,100 |
$2K |
| 82140 |
|
208 |
178 |
$2K |
| 86225 |
|
240 |
234 |
$2K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
42 |
24 |
$2K |
| 84075 |
|
1,005 |
893 |
$2K |
| 88341 |
|
376 |
82 |
$2K |
| 90670 |
|
37 |
37 |
$2K |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
717 |
561 |
$2K |
| 87338 |
|
236 |
230 |
$2K |
| 97535 |
Self-care/home management training, each 15 minutes |
300 |
202 |
$2K |
| 0134A |
|
121 |
121 |
$2K |
| 80069 |
|
986 |
849 |
$1K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
12 |
12 |
$1K |
| 94660 |
|
20 |
12 |
$1K |
| 70491 |
|
12 |
12 |
$1K |
| J9045 |
Injection, carboplatin, 50 mg |
107 |
65 |
$1K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,403 |
810 |
$1K |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
3,755 |
1,744 |
$1K |
| 84550 |
|
579 |
540 |
$1K |
| 82330 |
|
537 |
381 |
$1K |
| Q3014 |
Telehealth originating site facility fee |
799 |
684 |
$1K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,372 |
1,041 |
$1K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
12 |
12 |
$1K |
| 90662 |
|
867 |
859 |
$1K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,585 |
1,911 |
$1K |
| 92557 |
|
28 |
26 |
$1K |
| C1769 |
Guide wire |
490 |
290 |
$984.51 |
| 96368 |
|
76 |
54 |
$942.42 |
| 88307 |
|
23 |
14 |
$912.42 |
| 94762 |
|
15 |
12 |
$881.54 |
| J1750 |
Injection, iron dextran, 50 mg |
23 |
12 |
$873.26 |
| 82553 |
|
129 |
104 |
$836.77 |
| 72040 |
|
25 |
25 |
$833.98 |
| J3489 |
Injection, zoledronic acid, 1 mg |
12 |
12 |
$789.73 |
| 85045 |
|
281 |
246 |
$714.95 |
| 85384 |
|
89 |
75 |
$711.59 |
| 82310 |
|
456 |
431 |
$663.18 |
| 86790 |
|
71 |
67 |
$649.06 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,245 |
918 |
$611.17 |
| 70355 |
|
27 |
27 |
$610.62 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,052 |
1,527 |
$557.91 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,803 |
1,699 |
$549.34 |
| 86431 |
|
182 |
177 |
$526.10 |
| 80164 |
|
93 |
78 |
$506.94 |
| 31575 |
|
13 |
12 |
$462.05 |
| 82784 |
|
79 |
39 |
$444.24 |
| 84295 |
|
343 |
326 |
$436.94 |
| 73521 |
|
13 |
13 |
$410.22 |
| 82374 |
|
320 |
306 |
$403.27 |
| 82435 |
|
328 |
314 |
$394.20 |
| 89051 |
|
91 |
82 |
$384.89 |
| 96402 |
|
15 |
12 |
$382.55 |
| 90688 |
|
38 |
37 |
$326.82 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
559 |
424 |
$296.45 |
| C9257 |
Injection, bevacizumab, 0.25 mg |
68 |
51 |
$252.40 |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
468 |
327 |
$231.27 |
| 90674 |
|
32 |
32 |
$208.48 |
| 87147 |
|
54 |
54 |
$206.29 |
| 83930 |
|
48 |
39 |
$204.36 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
53 |
41 |
$201.65 |
| 90682 |
|
13 |
13 |
$186.40 |
| 0013A |
|
15 |
15 |
$174.21 |
| 92083 |
|
24 |
24 |
$170.13 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
3,697 |
3,205 |
$153.98 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
335 |
331 |
$153.15 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
65 |
54 |
$147.51 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
27 |
26 |
$130.96 |
| Q0163 |
Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen |
2,487 |
1,877 |
$117.79 |
| 90694 |
|
173 |
152 |
$116.84 |
| 90746 |
|
12 |
12 |
$111.28 |
| 85597 |
|
14 |
12 |
$109.31 |
| 0003A |
|
19 |
19 |
$108.42 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
1,596 |
1,041 |
$95.66 |
| H0049 |
Alcohol and/or drug screening |
25 |
25 |
$89.76 |
| 87181 |
|
79 |
27 |
$83.62 |
| J2060 |
Injection, lorazepam, 2 mg |
61 |
41 |
$82.73 |
| 90654 |
|
19 |
18 |
$78.64 |
| 83935 |
|
18 |
13 |
$74.49 |
| 97164 |
|
13 |
12 |
$70.16 |
| 92134 |
|
270 |
263 |
$69.74 |
| J1836 |
Injection, metronidazole, 10 mg |
25 |
12 |
$69.25 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
68 |
68 |
$61.16 |
| 85613 |
|
12 |
12 |
$58.29 |
| J0461 |
Injection, atropine sulfate, 0.01 mg |
18 |
12 |
$57.04 |
| J1817 |
Insulin for administration through dme (i.e., insulin pump) per 50 units |
820 |
210 |
$56.19 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
14 |
12 |
$43.37 |
| J2704 |
Injection, propofol, 10 mg |
1,736 |
1,464 |
$41.07 |
| J1815 |
Injection, insulin, per 5 units |
186 |
37 |
$37.69 |
| 11721 |
|
17 |
17 |
$35.78 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
14 |
13 |
$35.40 |
| A9503 |
Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries |
24 |
24 |
$27.16 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
30 |
28 |
$24.17 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
120 |
101 |
$7.68 |
| J1630 |
Injection, haloperidol, up to 5 mg |
19 |
14 |
$1.37 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
78 |
70 |
$0.27 |
| 91301 |
|
1,670 |
1,532 |
$0.09 |
| 91300 |
|
2,217 |
2,066 |
$0.05 |
| 91313 |
|
132 |
131 |
$0.00 |
| J7070 |
Infusion, d5w, 1000 cc |
35 |
25 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
665 |
466 |
$0.00 |
| 91312 |
|
208 |
208 |
$0.00 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
51 |
51 |
$0.00 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
13 |
13 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
868 |
864 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
1,808 |
1,783 |
$0.00 |
| 59430 |
|
167 |
153 |
$0.00 |
| 91306 |
|
34 |
34 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
296 |
151 |
$0.00 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
13 |
13 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
31 |
25 |
$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 |
26 |
24 |
$0.00 |
| 91305 |
|
209 |
204 |
$0.00 |