| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
57,271 |
54,501 |
$12.38M |
| G0378 |
Hospital observation service, per hour |
5,321 |
5,226 |
$7.80M |
| 41899 |
Unlisted procedure, dentoalveolar structures |
5,357 |
4,813 |
$6.46M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
56,342 |
50,048 |
$6.18M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
26,792 |
25,904 |
$5.70M |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
2,009 |
1,996 |
$2.64M |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
1,704 |
1,704 |
$2.31M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15,689 |
14,501 |
$1.91M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
8,385 |
8,247 |
$1.58M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
12,210 |
10,637 |
$1.55M |
| 87631 |
|
30,662 |
29,181 |
$1.55M |
| 99215 |
Prolong outpt/office vis |
8,777 |
8,384 |
$1.17M |
| 59025 |
Fetal non-stress test |
9,752 |
4,909 |
$1.16M |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
8,465 |
8,370 |
$1.15M |
| 90834 |
Psychotherapy, 45 minutes with patient |
8,777 |
5,406 |
$1.09M |
| 42830 |
|
808 |
807 |
$978K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
1,044 |
1,043 |
$802K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
21,642 |
21,047 |
$759K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,382 |
3,331 |
$749K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
4,057 |
2,895 |
$720K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
3,907 |
3,746 |
$720K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
5,426 |
5,314 |
$652K |
| 54161 |
|
609 |
609 |
$633K |
| 93975 |
|
1,662 |
1,621 |
$616K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,613 |
4,279 |
$596K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
5,774 |
4,744 |
$572K |
| Q5103 |
Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg |
416 |
356 |
$539K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,888 |
2,842 |
$538K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
21,334 |
20,899 |
$524K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
6,499 |
5,783 |
$522K |
| 96415 |
|
983 |
937 |
$502K |
| J1561 |
Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg |
169 |
128 |
$485K |
| 76770 |
|
2,280 |
2,251 |
$464K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
698 |
698 |
$449K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
21,658 |
21,187 |
$445K |
| 90832 |
Psychotherapy, 30 minutes with patient |
7,058 |
4,198 |
$436K |
| 80053 |
Comprehensive metabolic panel |
18,085 |
17,100 |
$418K |
| 96112 |
|
2,913 |
2,897 |
$413K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,501 |
1,473 |
$390K |
| 99205 |
Prolong outpt/office vis |
2,853 |
2,830 |
$387K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,789 |
2,764 |
$386K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,026 |
1,017 |
$367K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,449 |
2,444 |
$354K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,063 |
3,018 |
$318K |
| 12011 |
|
718 |
710 |
$295K |
| 95819 |
|
1,809 |
1,793 |
$278K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,606 |
2,374 |
$266K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
3,634 |
3,258 |
$248K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
9,721 |
8,903 |
$232K |
| 87481 |
|
3,997 |
3,931 |
$210K |
| 51600 |
|
368 |
367 |
$203K |
| 86900 |
|
5,857 |
5,665 |
$201K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
3,151 |
1,683 |
$197K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,046 |
876 |
$181K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
2,990 |
1,404 |
$178K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
2,400 |
2,353 |
$175K |
| 76801 |
|
2,444 |
2,306 |
$173K |
| 12001 |
|
426 |
426 |
$172K |
| 76818 |
|
2,072 |
1,054 |
$170K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,574 |
1,567 |
$166K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,467 |
1,464 |
$165K |
| D7140 |
Extraction, erupted tooth or exposed root |
454 |
449 |
$164K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
2,403 |
1,227 |
$163K |
| 76000 |
|
1,056 |
1,022 |
$161K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,355 |
1,336 |
$149K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
2,069 |
1,878 |
$147K |
| 36415 |
Collection of venous blood by venipuncture |
22,861 |
21,226 |
$146K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
4,820 |
4,804 |
$146K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
7,350 |
6,812 |
$140K |
| 90791 |
Psychiatric diagnostic evaluation |
782 |
766 |
$136K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
3,495 |
3,492 |
$135K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
557 |
550 |
$130K |
| 83655 |
|
8,786 |
8,661 |
$125K |
| 92567 |
|
3,433 |
3,390 |
$120K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
935 |
917 |
$115K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
599 |
599 |
$111K |
| 76813 |
|
1,514 |
1,462 |
$109K |
| 76820 |
|
2,501 |
964 |
$107K |
| 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 |
5,129 |
5,050 |
$106K |
| 76821 |
|
2,021 |
873 |
$98K |
| 86901 |
|
5,826 |
5,631 |
$97K |
| 86850 |
|
5,771 |
5,586 |
$94K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
654 |
650 |
$93K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
3,166 |
2,957 |
$91K |
| 96113 |
|
866 |
859 |
$86K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,668 |
5,375 |
$83K |
| 74455 |
|
367 |
366 |
$83K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
3,153 |
3,148 |
$82K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,692 |
2,669 |
$79K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
552 |
537 |
$73K |
| 86003 |
|
1,055 |
936 |
$73K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,271 |
2,255 |
$72K |
| 67311 |
|
26 |
26 |
$70K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
3,084 |
3,020 |
$69K |
| 97161 |
|
694 |
687 |
$68K |
| D2390 |
|
266 |
266 |
$65K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
7,192 |
7,138 |
$65K |
| 41010 |
|
128 |
128 |
$64K |
| 99385 |
|
460 |
457 |
$63K |
| 90846 |
Family psychotherapy without the patient present, 50 minutes |
546 |
431 |
$63K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,152 |
1,092 |
$62K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
544 |
258 |
$55K |
| 81025 |
|
14,267 |
13,745 |
$55K |
| 85027 |
|
10,110 |
9,645 |
$55K |
| 84443 |
Thyroid stimulating hormone (TSH) |
5,603 |
5,556 |
$54K |
| 81002 |
|
27,218 |
20,922 |
$53K |
| 71046 |
Radiologic examination, chest; 2 views |
10,162 |
9,957 |
$52K |
| 92552 |
|
986 |
972 |
$49K |
| 86780 |
|
6,964 |
6,906 |
$46K |
| 92610 |
|
374 |
371 |
$46K |
| 71045 |
Radiologic examination, chest; single view |
6,634 |
4,306 |
$46K |
| 74018 |
|
7,864 |
6,559 |
$45K |
| 92555 |
|
1,324 |
1,311 |
$45K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
14,277 |
13,566 |
$43K |
| 76830 |
Ultrasound, transvaginal |
752 |
748 |
$41K |
| 90715 |
|
1,219 |
1,217 |
$40K |
| 90686 |
|
2,932 |
2,472 |
$39K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
589 |
585 |
$39K |
| D2330 |
|
240 |
240 |
$38K |
| 93976 |
|
109 |
107 |
$38K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
879 |
864 |
$38K |
| 80061 |
Lipid panel |
3,354 |
3,337 |
$37K |
| 96910 |
|
628 |
184 |
$37K |
| 96900 |
|
1,228 |
316 |
$36K |
| 97113 |
|
585 |
249 |
$35K |
| 92579 |
|
634 |
633 |
$34K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
168 |
167 |
$33K |
| 94010 |
|
1,700 |
1,687 |
$31K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
36 |
36 |
$30K |
| 25605 |
|
68 |
67 |
$30K |
| 97802 |
|
1,326 |
1,305 |
$29K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
183 |
180 |
$29K |
| 86803 |
|
4,789 |
4,768 |
$29K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
10,902 |
10,619 |
$28K |
| 70486 |
|
205 |
205 |
$28K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
150 |
150 |
$28K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
80 |
80 |
$27K |
| 84439 |
|
3,041 |
3,018 |
$27K |
| 82803 |
|
1,118 |
1,046 |
$26K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
140 |
140 |
$26K |
| 92588 |
|
317 |
315 |
$24K |
| 90670 |
|
544 |
544 |
$24K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,206 |
1,192 |
$23K |
| 43762 |
|
132 |
123 |
$23K |
| D0120 |
Periodic oral evaluation - established patient |
442 |
100 |
$22K |
| 94060 |
|
733 |
729 |
$22K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,089 |
3,075 |
$22K |
| 86141 |
|
4,862 |
4,649 |
$21K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
924 |
911 |
$21K |
| 87070 |
|
9,526 |
9,309 |
$20K |
| 87340 |
|
4,296 |
4,279 |
$20K |
| 76800 |
|
341 |
341 |
$20K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
148 |
148 |
$20K |
| 81513 |
|
3,428 |
3,267 |
$19K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
134 |
134 |
$18K |
| 41520 |
|
12 |
12 |
$18K |
| 97803 |
|
753 |
744 |
$18K |
| 76885 |
|
507 |
504 |
$15K |
| 99386 |
|
118 |
118 |
$15K |
| 86762 |
|
2,445 |
2,435 |
$15K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
76 |
76 |
$15K |
| 83516 |
|
555 |
529 |
$15K |
| C1886 |
Catheter, extravascular tissue ablation, any modality (insertable) |
343 |
332 |
$15K |
| 76377 |
|
1,853 |
1,841 |
$15K |
| 84702 |
|
1,894 |
1,472 |
$14K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
5,612 |
5,227 |
$14K |
| 82784 |
|
1,229 |
1,211 |
$13K |
| 82785 |
|
854 |
852 |
$13K |
| 74019 |
|
3,465 |
3,362 |
$13K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
126 |
125 |
$12K |
| 72141 |
|
41 |
41 |
$12K |
| 76870 |
|
359 |
348 |
$11K |
| 84403 |
|
556 |
551 |
$11K |
| 86317 |
|
276 |
274 |
$11K |
| 90671 |
|
195 |
195 |
$11K |
| 12002 |
|
26 |
26 |
$10K |
| 29125 |
|
54 |
54 |
$10K |
| D1351 |
Sealant - per tooth |
116 |
116 |
$10K |
| 76536 |
|
380 |
373 |
$10K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
2,755 |
2,573 |
$9K |
| 86787 |
|
2,089 |
2,079 |
$9K |
| 87480 |
|
722 |
714 |
$9K |
| 87510 |
|
718 |
710 |
$9K |
| 82105 |
|
1,262 |
1,255 |
$9K |
| 99443 |
|
72 |
70 |
$9K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,984 |
3,371 |
$9K |
| 92652 |
|
150 |
148 |
$8K |
| 73070 |
|
1,619 |
1,337 |
$8K |
| 90680 |
|
278 |
274 |
$8K |
| 83735 |
|
2,260 |
2,024 |
$8K |
| 82728 |
|
1,006 |
981 |
$8K |
| 72170 |
|
1,418 |
1,401 |
$8K |
| 83020 |
|
1,092 |
1,086 |
$8K |
| 84146 |
|
538 |
536 |
$8K |
| 90651 |
|
145 |
145 |
$7K |
| 99441 |
|
105 |
99 |
$7K |
| 97162 |
|
63 |
63 |
$7K |
| 85018 |
|
1,930 |
1,913 |
$7K |
| 87147 |
|
2,668 |
2,630 |
$7K |
| 90633 |
|
251 |
250 |
$7K |
| 86480 |
|
95 |
93 |
$7K |
| 87660 |
|
865 |
855 |
$7K |
| 82570 |
|
2,095 |
1,883 |
$7K |
| 73610 |
|
1,524 |
1,405 |
$6K |
| 81001 |
|
8,189 |
7,903 |
$6K |
| 73090 |
|
1,580 |
1,330 |
$6K |
| 16020 |
|
21 |
12 |
$6K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
136 |
79 |
$6K |
| 88304 |
|
594 |
594 |
$6K |
| 77072 |
|
482 |
482 |
$6K |
| 73100 |
|
996 |
861 |
$6K |
| 84100 |
|
2,498 |
2,220 |
$6K |
| 87077 |
|
1,917 |
1,884 |
$6K |
| 87186 |
|
2,236 |
2,186 |
$6K |
| 80197 |
|
569 |
423 |
$6K |
| 98968 |
|
156 |
108 |
$6K |
| 82948 |
|
3,289 |
2,593 |
$6K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,363 |
3,281 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,659 |
1,616 |
$6K |
| 87088 |
|
2,162 |
2,126 |
$5K |
| 99442 |
|
96 |
96 |
$5K |
| 83001 |
|
395 |
390 |
$5K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,193 |
1,100 |
$5K |
| 90734 |
|
162 |
161 |
$5K |
| 73630 |
|
1,243 |
1,117 |
$5K |
| 85651 |
|
3,258 |
3,149 |
$5K |
| 83970 |
|
129 |
129 |
$5K |
| 98967 |
|
215 |
165 |
$5K |
| 69210 |
|
73 |
73 |
$5K |
| 73590 |
|
1,035 |
891 |
$4K |
| 82607 |
|
406 |
401 |
$4K |
| 36416 |
|
171 |
171 |
$4K |
| 85032 |
|
3,320 |
3,137 |
$4K |
| 84156 |
|
1,979 |
1,730 |
$4K |
| 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 |
167 |
167 |
$4K |
| 85610 |
|
1,773 |
1,695 |
$4K |
| 86710 |
|
1,701 |
1,545 |
$4K |
| 72082 |
|
589 |
583 |
$4K |
| 90672 |
|
262 |
131 |
$3K |
| 83540 |
|
907 |
896 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
5,506 |
5,437 |
$3K |
| 83002 |
|
229 |
226 |
$3K |
| 70491 |
|
12 |
12 |
$3K |
| Q9958 |
High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml |
266 |
265 |
$3K |
| 85730 |
|
1,224 |
1,183 |
$3K |
| 84436 |
|
675 |
665 |
$3K |
| 92002 |
|
33 |
33 |
$3K |
| 10060 |
|
12 |
12 |
$3K |
| 96376 |
|
780 |
750 |
$3K |
| 73560 |
|
873 |
801 |
$3K |
| 85008 |
|
498 |
486 |
$3K |
| 83550 |
|
698 |
691 |
$3K |
| 72146 |
|
25 |
25 |
$3K |
| 88342 |
|
39 |
38 |
$3K |
| 73110 |
|
385 |
366 |
$3K |
| 82746 |
|
238 |
234 |
$3K |
| 82670 |
|
112 |
109 |
$2K |
| 73130 |
|
919 |
856 |
$2K |
| 82627 |
|
148 |
147 |
$2K |
| 0001A |
|
79 |
79 |
$2K |
| 90480 |
|
43 |
43 |
$2K |
| 90647 |
|
120 |
120 |
$2K |
| 74240 |
|
52 |
52 |
$2K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
12 |
12 |
$2K |
| 92523 |
|
13 |
13 |
$2K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
29 |
27 |
$2K |
| 80076 |
|
210 |
202 |
$2K |
| 83615 |
|
1,281 |
1,158 |
$2K |
| 94761 |
|
672 |
570 |
$2K |
| D1120 |
Prophylaxis - child |
41 |
41 |
$2K |
| 92553 |
|
32 |
32 |
$2K |
| 83690 |
|
1,867 |
1,811 |
$2K |
| 81003 |
|
5,657 |
4,857 |
$2K |
| 82330 |
|
352 |
345 |
$2K |
| 88300 |
|
967 |
967 |
$2K |
| C9399 |
Unclassified drugs or biologicals |
686 |
683 |
$2K |
| 84132 |
|
590 |
572 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$2K |
| 98966 |
|
142 |
97 |
$2K |
| 85014 |
|
655 |
639 |
$2K |
| 76882 |
|
41 |
40 |
$2K |
| 94664 |
|
477 |
473 |
$2K |
| 70360 |
|
395 |
387 |
$2K |
| 90688 |
|
182 |
100 |
$2K |
| 90678 |
|
50 |
47 |
$2K |
| 90658 |
|
230 |
148 |
$2K |
| 77073 |
|
193 |
192 |
$2K |
| 90723 |
|
123 |
123 |
$1K |
| 86256 |
|
81 |
81 |
$1K |
| 73000 |
|
264 |
238 |
$1K |
| 0002A |
|
36 |
36 |
$1K |
| 84480 |
|
165 |
164 |
$1K |
| 90656 |
|
652 |
648 |
$1K |
| 99422 |
|
43 |
43 |
$1K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
72 |
72 |
$1K |
| 82677 |
|
98 |
98 |
$1K |
| 72040 |
|
347 |
332 |
$1K |
| 73140 |
|
222 |
209 |
$987.71 |
| 87210 |
|
758 |
753 |
$976.79 |
| 86376 |
|
89 |
89 |
$914.10 |
| 82040 |
|
185 |
168 |
$900.33 |
| 74430 |
|
25 |
25 |
$858.84 |
| 82150 |
|
493 |
482 |
$850.55 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
66 |
66 |
$836.07 |
| 99423 |
|
26 |
26 |
$828.62 |
| 84402 |
|
54 |
54 |
$802.60 |
| 86592 |
|
249 |
248 |
$774.24 |
| 90697 |
|
207 |
206 |
$770.79 |
| 80329 |
|
87 |
80 |
$756.48 |
| 87529 |
|
26 |
25 |
$743.62 |
| 94760 |
|
1,286 |
1,193 |
$699.71 |
| 86696 |
|
66 |
65 |
$681.20 |
| 86706 |
|
94 |
94 |
$676.51 |
| 82043 |
|
113 |
113 |
$671.81 |
| D1208 |
Topical application of fluoride, excluding varnish |
14 |
14 |
$652.26 |
| J3490 |
Unclassified drugs |
14 |
14 |
$648.19 |
| 82977 |
|
165 |
150 |
$624.36 |
| 59430 |
|
443 |
438 |
$619.90 |
| 82533 |
|
43 |
42 |
$597.13 |
| 86336 |
|
114 |
114 |
$571.81 |
| 0072A |
|
15 |
14 |
$561.60 |
| 87400 |
|
3,468 |
2,466 |
$558.98 |
| 86800 |
|
62 |
62 |
$548.86 |
| 90710 |
|
27 |
27 |
$542.30 |
| 87420 |
|
1,501 |
1,472 |
$536.77 |
| 87522 |
Neg quan hep c or qual rna |
13 |
13 |
$523.59 |
| 85045 |
|
441 |
407 |
$518.85 |
| C1769 |
Guide wire |
38 |
38 |
$499.96 |
| 84703 |
|
273 |
268 |
$496.99 |
| 87040 |
|
1,423 |
1,368 |
$491.45 |
| 87101 |
|
111 |
110 |
$470.50 |
| 84145 |
|
204 |
195 |
$456.66 |
| 90716 |
|
12 |
12 |
$449.23 |
| 0071A |
|
12 |
12 |
$448.00 |
| 82550 |
|
273 |
246 |
$446.40 |
| 86708 |
|
61 |
61 |
$421.21 |
| 86709 |
|
60 |
60 |
$384.49 |
| 74230 |
|
13 |
13 |
$366.07 |
| 82947 |
|
572 |
555 |
$357.35 |
| 73552 |
|
156 |
139 |
$352.23 |
| 82951 |
|
28 |
27 |
$327.23 |
| 90707 |
|
14 |
14 |
$325.02 |
| 88312 |
|
82 |
82 |
$317.63 |
| 84550 |
|
154 |
148 |
$308.70 |
| 88313 |
|
15 |
12 |
$289.04 |
| 72081 |
|
51 |
50 |
$279.05 |
| 83498 |
|
15 |
15 |
$278.50 |
| 84305 |
|
12 |
12 |
$263.31 |
| 73564 |
|
30 |
24 |
$247.08 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
9,024 |
8,649 |
$242.19 |
| G0145 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision |
12 |
12 |
$229.00 |
| 85246 |
|
12 |
12 |
$219.49 |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,001 |
966 |
$208.51 |
| 83525 |
|
28 |
28 |
$205.21 |
| 73060 |
|
58 |
52 |
$192.91 |
| 86769 |
|
12 |
12 |
$190.25 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,073 |
990 |
$187.98 |
| 90700 |
|
12 |
12 |
$166.63 |
| 99417 |
Prolong home eval add 15m |
822 |
811 |
$154.94 |
| 86038 |
|
36 |
36 |
$153.16 |
| 86704 |
|
17 |
17 |
$150.44 |
| 86695 |
|
15 |
14 |
$137.35 |
| 83605 |
|
129 |
121 |
$110.12 |
| G0432 |
Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening |
12 |
12 |
$109.60 |
| 84484 |
|
52 |
50 |
$106.73 |
| J2704 |
Injection, propofol, 10 mg |
10,785 |
10,534 |
$106.70 |
| 82248 |
|
43 |
39 |
$104.09 |
| 86160 |
|
13 |
12 |
$102.99 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
10,876 |
10,551 |
$101.96 |
| 73030 |
|
69 |
65 |
$101.78 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
12,800 |
12,484 |
$100.60 |
| 82010 |
|
118 |
106 |
$99.84 |
| 84295 |
|
389 |
380 |
$93.41 |
| 82952 |
|
25 |
25 |
$83.71 |
| 86644 |
|
38 |
38 |
$80.34 |
| 86645 |
|
37 |
37 |
$62.09 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
361 |
338 |
$59.34 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
447 |
363 |
$56.96 |
| 86308 |
|
136 |
135 |
$53.94 |
| J3480 |
Injection, potassium chloride, per 2 meq |
1,324 |
1,059 |
$53.56 |
| 84460 |
|
13 |
13 |
$51.21 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
13,235 |
13,016 |
$49.71 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
762 |
722 |
$48.95 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,545 |
1,515 |
$48.65 |
| 82247 |
|
15 |
13 |
$36.74 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,578 |
1,478 |
$30.05 |
| 87184 |
|
15 |
15 |
$19.92 |
| 86665 |
|
13 |
13 |
$19.30 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,375 |
2,364 |
$16.95 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
31 |
31 |
$15.96 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
250 |
244 |
$10.87 |
| 83935 |
|
15 |
15 |
$6.16 |
| 80320 |
|
53 |
53 |
$5.45 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
812 |
812 |
$1.58 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
39 |
38 |
$1.40 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
215 |
202 |
$0.37 |
| 99358 |
Prolong nursin fac eval 15m |
90 |
90 |
$0.00 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
211 |
205 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
23 |
22 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
13 |
13 |
$0.00 |
| 92015 |
Determination of refractive state |
15 |
13 |
$0.00 |
| 91321 |
|
35 |
35 |
$0.00 |
| 85384 |
|
12 |
12 |
$0.00 |
| 74022 |
|
14 |
14 |
$0.00 |
| 82435 |
|
15 |
15 |
$0.00 |