| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
31,786 |
27,250 |
$3.53M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
29,072 |
25,876 |
$3.47M |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
13,953 |
13,176 |
$1.66M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
13,328 |
9,690 |
$993K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
6,318 |
3,041 |
$831K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
5,819 |
5,406 |
$731K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
3,701 |
2,978 |
$453K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,668 |
1,370 |
$422K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
21,051 |
16,055 |
$357K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
13,034 |
12,135 |
$315K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
52,775 |
40,547 |
$214K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
781 |
614 |
$207K |
| 87631 |
|
6,285 |
5,568 |
$181K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
10,051 |
7,000 |
$175K |
| 70450 |
Computed tomography, head or brain; without contrast material |
4,697 |
3,852 |
$175K |
| T1015 |
Clinic visit/encounter, all-inclusive |
2,403 |
1,772 |
$175K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
35,841 |
27,704 |
$158K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,111 |
1,013 |
$149K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
6,768 |
5,752 |
$147K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
8,255 |
4,918 |
$138K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
6,637 |
5,532 |
$131K |
| 80053 |
Comprehensive metabolic panel |
22,593 |
18,102 |
$130K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
4,799 |
830 |
$129K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,916 |
1,655 |
$123K |
| 80050 |
General health panel |
5,032 |
4,322 |
$123K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
3,902 |
2,030 |
$115K |
| 71045 |
Radiologic examination, chest; single view |
15,977 |
11,816 |
$107K |
| G0378 |
Hospital observation service, per hour |
992 |
879 |
$107K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
2,998 |
2,364 |
$101K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,160 |
3,392 |
$94K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,290 |
596 |
$93K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
1,326 |
1,148 |
$83K |
| 36415 |
Collection of venous blood by venipuncture |
40,958 |
35,147 |
$81K |
| 80061 |
Lipid panel |
10,799 |
9,969 |
$79K |
| 87481 |
|
2,568 |
1,527 |
$78K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
705 |
585 |
$77K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,678 |
718 |
$77K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,577 |
1,463 |
$75K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
16,451 |
13,697 |
$74K |
| 84484 |
|
14,748 |
9,679 |
$71K |
| 93971 |
|
1,267 |
1,080 |
$70K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
960 |
636 |
$68K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,220 |
1,062 |
$66K |
| 80076 |
|
14,863 |
11,846 |
$62K |
| 84443 |
Thyroid stimulating hormone (TSH) |
7,593 |
6,775 |
$61K |
| 83690 |
|
15,410 |
12,190 |
$60K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
384 |
358 |
$56K |
| 76830 |
Ultrasound, transvaginal |
1,241 |
1,150 |
$55K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,524 |
3,265 |
$50K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
3,381 |
3,000 |
$50K |
| 93970 |
|
674 |
529 |
$49K |
| 36591 |
|
1,449 |
521 |
$49K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,051 |
1,912 |
$48K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
4,218 |
3,168 |
$47K |
| 83735 |
|
15,059 |
9,749 |
$44K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,544 |
1,705 |
$43K |
| 71250 |
|
1,137 |
919 |
$42K |
| 71046 |
Radiologic examination, chest; 2 views |
5,499 |
4,915 |
$42K |
| 95811 |
|
157 |
151 |
$41K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
950 |
768 |
$41K |
| 76801 |
|
825 |
677 |
$38K |
| 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 |
655 |
501 |
$38K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
244 |
227 |
$37K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
732 |
614 |
$35K |
| 81001 |
|
19,820 |
16,218 |
$34K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
6,674 |
6,137 |
$34K |
| 87799 |
|
702 |
260 |
$34K |
| J2704 |
Injection, propofol, 10 mg |
8,240 |
4,245 |
$33K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,325 |
1,021 |
$33K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
1,190 |
1,092 |
$33K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
294 |
117 |
$32K |
| J7050 |
Infusion, normal saline solution, 250 cc |
4,186 |
2,667 |
$32K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
630 |
584 |
$31K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
6,856 |
5,587 |
$29K |
| 81025 |
|
6,684 |
5,742 |
$29K |
| 88142 |
|
2,301 |
2,162 |
$28K |
| 83880 |
|
2,597 |
1,964 |
$27K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
1,702 |
1,547 |
$26K |
| 84702 |
|
3,314 |
2,507 |
$26K |
| 82728 |
|
3,359 |
2,949 |
$25K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
476 |
371 |
$25K |
| 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 |
2,016 |
1,653 |
$24K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
626 |
560 |
$24K |
| 80320 |
|
947 |
514 |
$23K |
| 73130 |
|
1,669 |
1,436 |
$22K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
472 |
410 |
$22K |
| 85027 |
|
7,350 |
5,971 |
$21K |
| 87150 |
|
665 |
513 |
$21K |
| 86803 |
|
2,626 |
2,183 |
$21K |
| 73610 |
|
1,495 |
1,305 |
$20K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
94 |
37 |
$19K |
| 80081 |
|
939 |
801 |
$18K |
| 73030 |
|
1,600 |
1,396 |
$18K |
| 96367 |
|
452 |
262 |
$18K |
| 83605 |
|
3,930 |
2,912 |
$18K |
| 82607 |
|
2,244 |
2,100 |
$18K |
| 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 |
2,812 |
1,807 |
$17K |
| 87077 |
|
4,340 |
3,489 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
481 |
314 |
$17K |
| 73630 |
|
1,524 |
1,364 |
$16K |
| 73564 |
|
1,232 |
1,075 |
$16K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
8,370 |
6,336 |
$16K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
940 |
360 |
$16K |
| 84439 |
|
3,273 |
2,913 |
$15K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,031 |
1,897 |
$15K |
| 94726 |
|
727 |
634 |
$14K |
| 88342 |
|
356 |
292 |
$14K |
| 87040 |
|
2,404 |
1,741 |
$14K |
| 83550 |
|
2,952 |
2,587 |
$14K |
| 85610 |
|
9,716 |
6,836 |
$13K |
| 81513 |
|
152 |
142 |
$13K |
| 83540 |
|
3,551 |
3,161 |
$13K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
9,986 |
6,001 |
$12K |
| 73562 |
|
855 |
787 |
$11K |
| 85730 |
|
6,617 |
4,578 |
$11K |
| 84703 |
|
3,288 |
2,219 |
$11K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
5,518 |
2,843 |
$11K |
| 94729 |
|
755 |
656 |
$11K |
| 87184 |
|
3,744 |
3,040 |
$10K |
| 82805 |
|
934 |
577 |
$10K |
| 80329 |
|
133 |
109 |
$10K |
| 72100 |
|
1,024 |
940 |
$10K |
| 74018 |
|
1,262 |
1,148 |
$10K |
| 82947 |
|
5,347 |
3,087 |
$9K |
| 88304 |
|
738 |
390 |
$9K |
| 86140 |
|
3,337 |
2,787 |
$9K |
| 87512 |
|
317 |
248 |
$9K |
| 94060 |
|
462 |
400 |
$9K |
| 73110 |
|
793 |
700 |
$9K |
| 87070 |
|
2,892 |
2,301 |
$8K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
17 |
12 |
$8K |
| 83021 |
|
914 |
786 |
$8K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
5,550 |
2,911 |
$8K |
| 82150 |
|
5,484 |
3,694 |
$7K |
| 97010 |
|
2,197 |
389 |
$7K |
| 70486 |
|
208 |
190 |
$7K |
| 86850 |
|
1,848 |
1,421 |
$7K |
| 77066 |
Tomosynthesis, mammo |
280 |
253 |
$7K |
| 76642 |
|
450 |
391 |
$7K |
| 85379 |
|
2,150 |
1,503 |
$7K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
614 |
337 |
$7K |
| 82746 |
|
936 |
868 |
$6K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
4,191 |
2,496 |
$6K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
2,993 |
2,104 |
$6K |
| 76536 |
|
261 |
241 |
$6K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
147 |
142 |
$6K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,631 |
882 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
138 |
117 |
$5K |
| 81003 |
|
4,912 |
4,103 |
$5K |
| 82570 |
|
2,212 |
1,989 |
$5K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,988 |
2,600 |
$5K |
| 86038 |
|
1,065 |
896 |
$5K |
| 82043 |
|
1,770 |
1,623 |
$5K |
| 85652 |
|
3,842 |
3,254 |
$5K |
| 96376 |
|
1,380 |
829 |
$5K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,795 |
944 |
$5K |
| 90715 |
|
272 |
211 |
$5K |
| 83615 |
|
1,429 |
1,146 |
$5K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
172 |
129 |
$5K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
206 |
184 |
$5K |
| 87522 |
Neg quan hep c or qual rna |
391 |
296 |
$4K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,262 |
1,047 |
$4K |
| 82105 |
|
494 |
429 |
$4K |
| 87186 |
|
508 |
420 |
$4K |
| 73502 |
|
385 |
356 |
$4K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
146 |
115 |
$4K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,131 |
556 |
$4K |
| 87340 |
|
887 |
657 |
$4K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
234 |
74 |
$4K |
| 86901 |
|
2,752 |
2,206 |
$4K |
| 83970 |
|
278 |
257 |
$4K |
| 94762 |
|
713 |
224 |
$4K |
| 94618 |
|
171 |
153 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
379 |
297 |
$3K |
| 99152 |
|
713 |
510 |
$3K |
| 82950 |
|
1,274 |
1,146 |
$3K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
160 |
128 |
$3K |
| 76775 |
|
356 |
324 |
$3K |
| 99153 |
Mod sedat endo service >5yrs |
596 |
407 |
$3K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
2,884 |
760 |
$3K |
| 86376 |
|
407 |
356 |
$3K |
| C1780 |
Lens, intraocular (new technology) |
20 |
14 |
$3K |
| 86703 |
|
908 |
736 |
$3K |
| 93880 |
|
39 |
37 |
$3K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,632 |
1,181 |
$3K |
| 73080 |
|
273 |
249 |
$3K |
| 83516 |
|
233 |
210 |
$3K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
123 |
107 |
$3K |
| 97165 |
|
90 |
78 |
$2K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
13 |
12 |
$2K |
| 72040 |
|
351 |
324 |
$2K |
| 96417 |
|
40 |
25 |
$2K |
| 86900 |
|
1,964 |
1,502 |
$2K |
| 84425 |
|
197 |
186 |
$2K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
395 |
306 |
$2K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
542 |
512 |
$2K |
| 84403 |
|
84 |
77 |
$2K |
| 83020 |
|
172 |
145 |
$2K |
| 82784 |
|
295 |
247 |
$2K |
| 82247 |
|
586 |
448 |
$2K |
| 86235 |
|
158 |
91 |
$2K |
| 77065 |
Tomosynthesis, mammo |
68 |
63 |
$2K |
| 86480 |
|
67 |
64 |
$2K |
| J2060 |
Injection, lorazepam, 2 mg |
1,364 |
591 |
$2K |
| 84550 |
|
1,007 |
844 |
$2K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
953 |
656 |
$2K |
| J1756 |
Injection, iron sucrose, 1 mg |
33 |
13 |
$2K |
| J2310 |
Injection, naloxone hydrochloride, per 1 mg |
85 |
68 |
$2K |
| 82550 |
|
806 |
672 |
$2K |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
139 |
66 |
$2K |
| 86592 |
|
863 |
708 |
$2K |
| 87081 |
|
399 |
353 |
$1K |
| 84436 |
|
383 |
346 |
$1K |
| 84156 |
|
839 |
702 |
$1K |
| 86618 |
|
232 |
211 |
$1K |
| 84100 |
|
995 |
678 |
$1K |
| 84165 |
|
242 |
215 |
$1K |
| 97161 |
|
78 |
64 |
$1K |
| 87147 |
|
781 |
656 |
$1K |
| 97162 |
|
109 |
92 |
$1K |
| 74019 |
|
273 |
240 |
$1K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
12 |
12 |
$1K |
| 82977 |
|
312 |
283 |
$1K |
| 96523 |
|
17 |
13 |
$1K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
57 |
27 |
$1K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
35 |
30 |
$1K |
| 73590 |
|
168 |
126 |
$994.39 |
| 82803 |
|
220 |
149 |
$961.10 |
| 86160 |
|
97 |
87 |
$959.08 |
| 86431 |
|
531 |
426 |
$955.20 |
| 83655 |
|
299 |
268 |
$940.90 |
| 87641 |
|
103 |
94 |
$919.96 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
2,622 |
620 |
$914.24 |
| 80069 |
|
465 |
315 |
$877.45 |
| 84146 |
|
70 |
67 |
$856.12 |
| 93922 |
|
87 |
73 |
$854.42 |
| 82248 |
|
449 |
375 |
$850.61 |
| 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 |
235 |
130 |
$850.00 |
| 83525 |
|
118 |
115 |
$831.99 |
| 84460 |
|
429 |
368 |
$785.17 |
| 73560 |
|
122 |
99 |
$698.11 |
| 87899 |
|
72 |
66 |
$684.43 |
| 73565 |
|
39 |
39 |
$659.10 |
| 93925 |
|
29 |
28 |
$654.24 |
| 73090 |
|
47 |
43 |
$651.60 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
85 |
66 |
$538.68 |
| 83001 |
|
39 |
37 |
$525.41 |
| 36000 |
|
209 |
172 |
$506.63 |
| 86762 |
|
40 |
30 |
$469.60 |
| 86141 |
|
116 |
95 |
$461.68 |
| 82375 |
|
46 |
38 |
$461.33 |
| 12001 |
|
42 |
37 |
$456.62 |
| 85018 |
|
1,484 |
1,162 |
$454.60 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
209 |
151 |
$438.94 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
116 |
100 |
$434.02 |
| 72072 |
|
13 |
13 |
$429.16 |
| 73140 |
|
108 |
95 |
$429.09 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
183 |
63 |
$425.74 |
| C1769 |
Guide wire |
179 |
33 |
$423.02 |
| 84402 |
|
16 |
13 |
$399.75 |
| 86200 |
|
62 |
56 |
$393.64 |
| 80074 |
|
109 |
92 |
$386.51 |
| 86255 |
|
19 |
14 |
$386.01 |
| 71101 |
|
59 |
53 |
$375.20 |
| 85014 |
|
1,252 |
1,056 |
$374.02 |
| J7510 |
Prednisolone oral, per 5 mg |
236 |
208 |
$368.91 |
| 95816 |
|
15 |
12 |
$359.33 |
| 93225 |
|
60 |
56 |
$356.94 |
| 80055 |
|
47 |
40 |
$331.57 |
| 80177 |
|
102 |
81 |
$327.75 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
150 |
63 |
$319.50 |
| 87205 |
|
117 |
95 |
$318.14 |
| 10060 |
|
74 |
63 |
$310.49 |
| 82103 |
|
31 |
25 |
$297.81 |
| 85007 |
|
115 |
99 |
$282.24 |
| 87046 |
|
73 |
67 |
$266.06 |
| 97116 |
|
22 |
13 |
$263.92 |
| 86800 |
|
14 |
13 |
$260.43 |
| 93226 |
|
60 |
56 |
$257.30 |
| 81050 |
|
120 |
110 |
$254.94 |
| 82009 |
|
136 |
119 |
$251.23 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
648 |
538 |
$243.60 |
| 87045 |
|
72 |
66 |
$240.82 |
| 86021 |
|
19 |
14 |
$229.51 |
| 84155 |
|
228 |
202 |
$187.26 |
| 72131 |
|
13 |
12 |
$179.13 |
| 86225 |
|
53 |
49 |
$179.07 |
| 87088 |
|
26 |
24 |
$174.23 |
| 83010 |
|
12 |
12 |
$168.99 |
| J3490 |
Unclassified drugs |
1,095 |
288 |
$166.46 |
| 84450 |
|
153 |
118 |
$161.97 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
12 |
12 |
$148.06 |
| 85041 |
|
898 |
773 |
$122.93 |
| 87210 |
|
49 |
43 |
$115.34 |
| 74022 |
|
95 |
86 |
$115.29 |
| 76870 |
|
46 |
43 |
$110.30 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
38 |
26 |
$105.42 |
| 86308 |
|
18 |
16 |
$100.29 |
| 72110 |
|
35 |
30 |
$97.89 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
36 |
30 |
$93.09 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
210 |
157 |
$68.98 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
124 |
101 |
$59.16 |
| 87493 |
|
32 |
27 |
$47.18 |
| J3480 |
Injection, potassium chloride, per 2 meq |
79 |
40 |
$46.19 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
28 |
26 |
$45.95 |
| 82272 |
|
103 |
80 |
$42.26 |
| 84480 |
|
147 |
135 |
$38.19 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
20 |
14 |
$35.69 |
| 93017 |
|
13 |
12 |
$34.91 |
| 82140 |
|
16 |
12 |
$32.06 |
| 82565 |
|
81 |
69 |
$29.80 |
| 87209 |
|
14 |
12 |
$21.75 |
| J1630 |
Injection, haloperidol, up to 5 mg |
33 |
26 |
$21.38 |
| J2300 |
Injection, nalbuphine hydrochloride, per 10 mg |
16 |
12 |
$18.62 |
| 80185 |
|
116 |
25 |
$16.36 |
| 86704 |
|
95 |
28 |
$14.88 |
| 84520 |
|
32 |
28 |
$13.97 |
| 87177 |
|
14 |
12 |
$10.77 |
| J0290 |
Injection, ampicillin sodium, 500 mg |
27 |
26 |
$9.80 |
| A9270 |
Non-covered item or service |
2,597 |
1,221 |
$6.64 |
| 96160 |
|
15 |
13 |
$6.08 |
| 85045 |
|
16 |
14 |
$5.34 |
| J0713 |
Injection, ceftazidime, per 500 mg |
33 |
14 |
$3.81 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
103 |
70 |
$0.01 |
| 96127 |
|
27 |
13 |
$0.00 |
| 83002 |
|
12 |
12 |
$0.00 |
| 94010 |
|
13 |
12 |
$0.00 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
126 |
84 |
$0.00 |
| G8985 |
Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
37 |
27 |
$0.00 |
| 82785 |
|
29 |
27 |
$0.00 |
| 86003 |
|
14 |
12 |
$0.00 |
| 90658 |
|
30 |
29 |
$0.00 |
| G8984 |
Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals |
35 |
27 |
$0.00 |
| 83721 |
|
15 |
12 |
$0.00 |
| 86923 |
|
14 |
12 |
$0.00 |