| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
74,432 |
67,187 |
$30.22M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
55,730 |
48,092 |
$26.98M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
58,415 |
53,994 |
$18.85M |
| J9271 |
Injection, pembrolizumab, 1 mg |
1,918 |
1,379 |
$16.39M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
17,049 |
15,186 |
$10.74M |
| 70450 |
Computed tomography, head or brain; without contrast material |
20,733 |
17,952 |
$3.93M |
| J1561 |
Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg |
1,965 |
874 |
$3.43M |
| 77301 |
|
830 |
749 |
$3.32M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
9,093 |
8,296 |
$3.02M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
4,652 |
4,416 |
$2.99M |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
1,656 |
1,414 |
$2.72M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
19,525 |
17,950 |
$2.70M |
| G0378 |
Hospital observation service, per hour |
37,353 |
16,756 |
$2.68M |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
2,961 |
2,685 |
$2.61M |
| 77386 |
|
12,853 |
1,147 |
$2.57M |
| J2505 |
Injection, pegfilgrastim, 6 mg |
628 |
387 |
$2.55M |
| 80053 |
Comprehensive metabolic panel |
195,389 |
133,101 |
$2.43M |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
2,359 |
2,226 |
$1.85M |
| Q5111 |
Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg |
796 |
535 |
$1.85M |
| J9299 |
Injection, nivolumab, 1 mg |
411 |
238 |
$1.83M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
31,407 |
23,522 |
$1.82M |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
1,455 |
1,246 |
$1.62M |
| J9035 |
Injection, bevacizumab, 10 mg |
439 |
179 |
$1.50M |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,060 |
2,759 |
$1.50M |
| J9312 |
Injection, rituximab, 10 mg |
276 |
149 |
$1.31M |
| J9355 |
Injection, trastuzumab, excludes biosimilar, 10 mg |
558 |
198 |
$1.22M |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
1,628 |
1,551 |
$1.18M |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
2,085 |
1,959 |
$1.17M |
| 88185 |
|
2,220 |
1,398 |
$1.17M |
| 49083 |
|
2,321 |
1,103 |
$1.16M |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
23,815 |
12,007 |
$1.15M |
| J9144 |
Injection, daratumumab, 10 mg and hyaluronidase-fihj |
160 |
95 |
$1.13M |
| 95811 |
|
1,511 |
1,382 |
$1.12M |
| L8699 |
Prosthetic implant, not otherwise specified |
1,116 |
1,055 |
$1.12M |
| 77334 |
|
2,014 |
1,377 |
$967K |
| 92557 |
|
4,974 |
4,709 |
$945K |
| 72195 |
|
1,150 |
1,091 |
$922K |
| 36430 |
|
4,928 |
2,407 |
$896K |
| 94729 |
|
2,752 |
2,522 |
$893K |
| 47562 |
|
178 |
170 |
$872K |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
256 |
193 |
$736K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
1,161 |
1,105 |
$730K |
| 72197 |
|
1,170 |
1,053 |
$713K |
| C1776 |
Joint device (implantable) |
87 |
76 |
$707K |
| J0897 |
Injection, denosumab, 1 mg |
626 |
530 |
$687K |
| J0485 |
Injection, belatacept, 1 mg |
1,741 |
762 |
$661K |
| J9310 |
Injection, rituximab, 100 mg |
240 |
86 |
$653K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
167 |
163 |
$629K |
| J9306 |
Injection, pertuzumab, 1 mg |
100 |
67 |
$617K |
| 92579 |
|
2,003 |
1,923 |
$612K |
| J9263 |
Injection, oxaliplatin, 0.5 mg |
1,305 |
746 |
$578K |
| J1453 |
Injection, fosaprepitant, 1 mg |
3,428 |
1,994 |
$569K |
| 93798 |
|
7,815 |
1,458 |
$568K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,904 |
4,101 |
$568K |
| 43235 |
|
964 |
905 |
$526K |
| 36561 |
|
272 |
251 |
$504K |
| 44970 |
|
101 |
94 |
$504K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
9,010 |
7,803 |
$492K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,073 |
1,944 |
$478K |
| 96409 |
|
3,666 |
1,739 |
$445K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
9,391 |
7,037 |
$382K |
| C8929 |
Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography |
1,578 |
1,373 |
$375K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
11,006 |
6,924 |
$366K |
| C1769 |
Guide wire |
8,582 |
7,303 |
$364K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,010 |
905 |
$351K |
| 70498 |
|
1,354 |
1,267 |
$334K |
| 72141 |
|
1,122 |
1,001 |
$317K |
| J1568 |
Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg |
162 |
77 |
$310K |
| 93975 |
|
6,636 |
6,142 |
$299K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
8,224 |
4,580 |
$279K |
| 86832 |
|
808 |
658 |
$274K |
| 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 |
11,127 |
10,255 |
$245K |
| 96367 |
|
11,817 |
7,851 |
$245K |
| 77412 |
|
3,354 |
396 |
$241K |
| 93454 |
|
157 |
139 |
$240K |
| J9070 |
Cyclophosphamide, 100 mg |
715 |
200 |
$236K |
| P9073 |
Platelets, pheresis, pathogen-reduced, each unit |
392 |
133 |
$232K |
| 74183 |
|
1,842 |
1,693 |
$231K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,786 |
1,729 |
$221K |
| J2997 |
Injection, alteplase recombinant, 1 mg |
2,731 |
737 |
$210K |
| 70491 |
|
494 |
463 |
$207K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
5,754 |
2,329 |
$202K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
20,066 |
15,521 |
$200K |
| 93970 |
|
2,172 |
1,993 |
$199K |
| 81455 |
|
56 |
51 |
$192K |
| 95806 |
|
1,366 |
1,347 |
$184K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,999 |
1,499 |
$184K |
| 94060 |
|
2,853 |
2,623 |
$175K |
| J9217 |
Leuprolide acetate (for depot suspension), 7.5 mg |
453 |
421 |
$174K |
| Q5120 |
Injection, pegfilgrastim-bmez (ziextenzo), biosimilar, 0.5 mg |
133 |
105 |
$169K |
| 92587 |
|
3,344 |
3,207 |
$145K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
56,153 |
39,423 |
$143K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
9,636 |
8,293 |
$137K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,145 |
1,032 |
$136K |
| P9037 |
Platelets, pheresis, leukocytes reduced, irradiated, each unit |
586 |
137 |
$134K |
| 71046 |
Radiologic examination, chest; 2 views |
19,083 |
17,138 |
$134K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
2,539 |
2,397 |
$133K |
| 76770 |
|
2,291 |
2,180 |
$128K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
18,722 |
14,115 |
$127K |
| 74246 |
|
569 |
560 |
$125K |
| 96450 |
|
687 |
450 |
$120K |
| J1750 |
Injection, iron dextran, 50 mg |
524 |
264 |
$120K |
| 77295 |
|
80 |
51 |
$120K |
| C2617 |
Stent, non-coronary, temporary, without delivery system |
126 |
114 |
$118K |
| 93451 |
|
78 |
61 |
$114K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
5,474 |
4,893 |
$113K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
140 |
124 |
$111K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
747 |
607 |
$111K |
| 75574 |
|
942 |
874 |
$109K |
| 20680 |
|
69 |
64 |
$106K |
| 93308 |
|
2,045 |
1,655 |
$104K |
| 72131 |
|
1,140 |
1,013 |
$101K |
| 96411 |
|
3,283 |
1,899 |
$101K |
| 93922 |
|
1,794 |
1,619 |
$99K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
81 |
77 |
$98K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
2,797 |
1,207 |
$94K |
| 75561 |
|
163 |
150 |
$93K |
| 71250 |
|
2,061 |
1,900 |
$93K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
69,696 |
50,859 |
$93K |
| 77470 |
|
489 |
425 |
$88K |
| C2625 |
Stent, non-coronary, temporary, with delivery system |
87 |
78 |
$81K |
| P9047 |
Infusion, albumin (human), 25%, 50 ml |
598 |
305 |
$81K |
| 93971 |
|
3,490 |
3,173 |
$80K |
| 95812 |
|
277 |
273 |
$80K |
| C1889 |
Implantable/insertable device, not otherwise classified |
97 |
85 |
$80K |
| 87507 |
|
414 |
357 |
$79K |
| Q5130 |
Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg |
31 |
24 |
$79K |
| 93880 |
|
573 |
528 |
$79K |
| 80320 |
|
21,358 |
18,412 |
$78K |
| 86923 |
|
3,567 |
1,806 |
$75K |
| 31624 |
|
150 |
107 |
$73K |
| 72128 |
|
552 |
460 |
$71K |
| 93017 |
|
1,913 |
1,669 |
$70K |
| J1756 |
Injection, iron sucrose, 1 mg |
2,872 |
1,199 |
$67K |
| 71045 |
Radiologic examination, chest; single view |
45,545 |
39,278 |
$64K |
| J8670 |
Rolapitant, oral, 1 mg |
17 |
13 |
$63K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
51,180 |
43,883 |
$63K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
19,667 |
16,167 |
$62K |
| 86828 |
|
2,000 |
1,661 |
$62K |
| C9399 |
Unclassified drugs or biologicals |
692 |
614 |
$59K |
| 58571 |
|
13 |
12 |
$57K |
| 70496 |
|
670 |
632 |
$51K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
662 |
608 |
$51K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
817 |
731 |
$50K |
| J9045 |
Injection, carboplatin, 50 mg |
1,657 |
934 |
$49K |
| 70486 |
|
4,021 |
3,510 |
$49K |
| 80076 |
|
1,269 |
991 |
$46K |
| C1726 |
Catheter, balloon dilatation, non-vascular |
203 |
191 |
$46K |
| 0115U |
|
1,469 |
1,363 |
$45K |
| 92582 |
|
104 |
97 |
$44K |
| Q5107 |
Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg |
87 |
24 |
$40K |
| 86920 |
|
2,532 |
1,226 |
$39K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
20,451 |
13,006 |
$38K |
| 88341 |
|
3,050 |
1,816 |
$38K |
| 95782 |
|
38 |
38 |
$37K |
| 72146 |
|
355 |
325 |
$37K |
| 88377 |
|
442 |
302 |
$36K |
| 87799 |
|
6,963 |
3,010 |
$36K |
| 77012 |
|
107 |
78 |
$35K |
| J9202 |
Goserelin acetate implant, per 3.6 mg |
39 |
37 |
$34K |
| 74240 |
|
200 |
170 |
$34K |
| J9201 |
Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg |
473 |
190 |
$34K |
| 84443 |
Thyroid stimulating hormone (TSH) |
24,489 |
20,786 |
$33K |
| 96416 |
|
2,323 |
1,247 |
$33K |
| 85027 |
|
33,837 |
21,488 |
$32K |
| 74174 |
|
40 |
40 |
$31K |
| 96376 |
|
19,380 |
12,176 |
$31K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,776 |
2,618 |
$29K |
| 81382 |
|
21 |
12 |
$28K |
| 77290 |
|
159 |
125 |
$28K |
| 82728 |
|
7,564 |
6,239 |
$28K |
| P9040 |
Red blood cells, leukocytes reduced, irradiated, each unit |
1,858 |
974 |
$27K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
193,887 |
136,735 |
$27K |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
1,623 |
1,377 |
$26K |
| 97163 |
|
216 |
182 |
$25K |
| 86833 |
|
415 |
338 |
$24K |
| 36593 |
|
241 |
155 |
$23K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
1,643 |
1,080 |
$23K |
| 73562 |
|
6,622 |
5,364 |
$23K |
| 76536 |
|
348 |
330 |
$23K |
| 76881 |
|
214 |
167 |
$22K |
| J9395 |
Injection, fulvestrant, 25 mg |
27 |
24 |
$22K |
| 73130 |
|
5,055 |
4,212 |
$22K |
| J3490 |
Unclassified drugs |
140,228 |
61,482 |
$22K |
| 74220 |
|
164 |
144 |
$21K |
| 73700 |
|
354 |
314 |
$21K |
| 88342 |
|
4,134 |
3,422 |
$19K |
| 94618 |
|
438 |
388 |
$19K |
| 97535 |
Self-care/home management training, each 15 minutes |
3,365 |
2,098 |
$18K |
| 96523 |
|
1,436 |
1,161 |
$18K |
| 85576 |
|
1,300 |
973 |
$18K |
| 74018 |
|
4,152 |
3,590 |
$18K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
26,362 |
18,723 |
$18K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
27,463 |
16,894 |
$17K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
8,766 |
5,026 |
$17K |
| 20610 |
|
134 |
115 |
$17K |
| G0379 |
Direct admission of patient for hospital observation care |
1,346 |
1,273 |
$17K |
| 97162 |
|
1,962 |
1,683 |
$17K |
| 72100 |
|
1,140 |
1,030 |
$17K |
| 95819 |
|
74 |
68 |
$16K |
| C1781 |
Mesh (implantable) |
94 |
88 |
$16K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,540 |
1,298 |
$16K |
| 88307 |
|
3,757 |
2,767 |
$15K |
| 73630 |
|
4,627 |
3,889 |
$15K |
| 87631 |
|
6,769 |
6,602 |
$14K |
| 73610 |
|
4,774 |
4,047 |
$14K |
| 12001 |
|
1,945 |
1,799 |
$14K |
| 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 |
2,972 |
2,491 |
$14K |
| 94010 |
|
1,414 |
1,256 |
$13K |
| 10060 |
|
869 |
799 |
$13K |
| 86304 |
|
1,901 |
1,547 |
$13K |
| 71271 |
|
175 |
172 |
$13K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,952 |
3,562 |
$13K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
163 |
159 |
$12K |
| 94621 |
|
44 |
40 |
$12K |
| 88173 |
|
1,534 |
1,088 |
$12K |
| 74181 |
|
1,177 |
1,113 |
$12K |
| 99215 |
Prolong outpt/office vis |
30 |
29 |
$12K |
| 73030 |
|
5,162 |
4,284 |
$12K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
683 |
424 |
$11K |
| 70546 |
|
361 |
317 |
$11K |
| 73110 |
|
3,828 |
3,130 |
$11K |
| 36591 |
|
25,454 |
11,970 |
$11K |
| 87506 |
|
327 |
311 |
$10K |
| C1751 |
Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) |
1,256 |
1,052 |
$10K |
| 12002 |
|
1,725 |
1,562 |
$10K |
| 73080 |
|
2,633 |
2,308 |
$10K |
| 77300 |
|
1,800 |
1,503 |
$10K |
| 82378 |
|
7,502 |
5,909 |
$10K |
| 96417 |
|
6,340 |
3,632 |
$10K |
| 93976 |
|
2,754 |
2,554 |
$10K |
| 76942 |
|
242 |
205 |
$10K |
| 93458 |
|
14 |
13 |
$10K |
| C1729 |
Catheter, drainage |
1,534 |
884 |
$9K |
| 74230 |
|
63 |
53 |
$9K |
| 76857 |
|
1,986 |
1,867 |
$9K |
| 96401 |
|
1,163 |
480 |
$9K |
| G0424 |
Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day |
93 |
29 |
$8K |
| 73502 |
|
2,114 |
1,782 |
$8K |
| 76882 |
|
264 |
236 |
$8K |
| 70110 |
|
71 |
69 |
$8K |
| 70487 |
|
37 |
36 |
$8K |
| 43264 |
|
17 |
16 |
$7K |
| 38222 |
|
26 |
24 |
$7K |
| J9075 |
Injection, cyclophosphamide, not otherwise specified, 5 mg |
47 |
13 |
$7K |
| 97161 |
|
1,946 |
1,663 |
$7K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
4,422 |
2,596 |
$7K |
| J3489 |
Injection, zoledronic acid, 1 mg |
462 |
420 |
$7K |
| 85245 |
|
81 |
77 |
$6K |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
156 |
143 |
$6K |
| 92552 |
|
83 |
81 |
$6K |
| 95816 |
|
26 |
26 |
$6K |
| 92553 |
|
27 |
27 |
$6K |
| 73552 |
|
2,405 |
1,973 |
$6K |
| 12011 |
|
1,667 |
1,547 |
$6K |
| J8540 |
Dexamethasone, oral, 0.25 mg |
5,287 |
3,054 |
$6K |
| 78264 |
|
25 |
24 |
$6K |
| 93280 |
|
274 |
240 |
$6K |
| 72158 |
|
15 |
15 |
$5K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
9,702 |
9,304 |
$5K |
| 76870 |
|
1,196 |
1,125 |
$5K |
| 36589 |
|
12 |
12 |
$5K |
| Q5101 |
Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram |
47 |
12 |
$5K |
| J9190 |
Injection, fluorouracil, 500 mg |
2,270 |
1,141 |
$5K |
| 82607 |
|
2,045 |
1,876 |
$5K |
| 82803 |
|
10,975 |
8,395 |
$5K |
| 59025 |
Fetal non-stress test |
446 |
298 |
$5K |
| 92567 |
|
7,520 |
7,183 |
$5K |
| 85610 |
|
43,186 |
32,681 |
$5K |
| 86635 |
|
5,132 |
2,317 |
$5K |
| M0220 |
Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), includes injection and post administration monitoring |
42 |
36 |
$4K |
| 83970 |
|
1,326 |
958 |
$4K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
5,865 |
4,967 |
$4K |
| 96415 |
|
7,077 |
4,213 |
$4K |
| G0257 |
Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility |
89 |
51 |
$4K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
95,028 |
39,024 |
$4K |
| 82947 |
|
55,499 |
30,669 |
$4K |
| 82746 |
|
587 |
529 |
$3K |
| 83605 |
|
29,450 |
20,835 |
$3K |
| 87497 |
|
6,216 |
3,150 |
$3K |
| J2785 |
Injection, regadenoson, 0.1 mg |
1,124 |
968 |
$3K |
| 87186 |
|
8,236 |
6,874 |
$3K |
| 80197 |
|
8,764 |
3,241 |
$3K |
| 93926 |
|
276 |
250 |
$3K |
| 84484 |
|
43,974 |
26,250 |
$3K |
| 73590 |
|
5,071 |
4,099 |
$3K |
| 85520 |
|
213 |
105 |
$3K |
| 85055 |
|
10,721 |
4,627 |
$3K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,778 |
3,651 |
$3K |
| 72170 |
|
4,765 |
4,087 |
$2K |
| 76830 |
Ultrasound, transvaginal |
2,375 |
2,225 |
$2K |
| 94726 |
|
2,333 |
2,138 |
$2K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
3,945 |
3,739 |
$2K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
82 |
80 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
21,480 |
18,053 |
$2K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
7,637 |
7,134 |
$2K |
| 76801 |
|
2,635 |
2,344 |
$2K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
30,693 |
26,443 |
$2K |
| 70543 |
|
13 |
12 |
$2K |
| 73140 |
|
981 |
885 |
$2K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
23,021 |
20,659 |
$2K |
| 73090 |
|
4,347 |
3,502 |
$2K |
| 80074 |
|
527 |
507 |
$2K |
| 84702 |
|
10,676 |
9,416 |
$2K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
53,381 |
41,137 |
$2K |
| 90715 |
|
5,871 |
5,309 |
$2K |
| 74175 |
|
13 |
12 |
$2K |
| 87075 |
|
3,463 |
2,541 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
7,711 |
7,202 |
$2K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
10,487 |
8,612 |
$2K |
| A9270 |
Non-covered item or service |
114,934 |
18,076 |
$2K |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
3,676 |
3,222 |
$2K |
| 86480 |
|
510 |
419 |
$2K |
| 97014 |
|
2,146 |
834 |
$1K |
| 82784 |
|
8,704 |
4,489 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,390 |
5,641 |
$1K |
| 84153 |
|
1,326 |
1,076 |
$1K |
| 85240 |
|
169 |
158 |
$1K |
| 80329 |
|
2,051 |
1,676 |
$1K |
| 86850 |
|
16,207 |
12,503 |
$1K |
| 96402 |
|
2,340 |
2,033 |
$1K |
| 84703 |
|
24,026 |
21,732 |
$1K |
| 72082 |
|
27 |
25 |
$1K |
| 81025 |
|
11,979 |
11,111 |
$1K |
| 76604 |
|
239 |
185 |
$1K |
| 86703 |
|
4,690 |
4,278 |
$1K |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
1,300 |
935 |
$1K |
| 82024 |
|
83 |
68 |
$1K |
| 73120 |
|
696 |
571 |
$1K |
| 83690 |
|
36,921 |
31,852 |
$1K |
| 73060 |
|
2,276 |
1,839 |
$1K |
| 88374 |
|
187 |
122 |
$1K |
| 73070 |
|
1,821 |
1,440 |
$1K |
| 93296 |
|
44 |
33 |
$1K |
| 87040 |
|
12,191 |
6,615 |
$974.07 |
| 88304 |
|
2,396 |
2,095 |
$941.40 |
| 82533 |
|
186 |
154 |
$936.23 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,291 |
2,061 |
$893.36 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
101 |
89 |
$891.77 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
21,697 |
16,348 |
$887.83 |
| 87077 |
|
10,414 |
8,119 |
$887.55 |
| 81001 |
|
43,684 |
38,039 |
$858.75 |
| 88184 |
|
1,748 |
1,417 |
$785.28 |
| 86300 |
|
2,778 |
2,011 |
$714.84 |
| 86301 |
|
2,081 |
1,678 |
$690.86 |
| 83735 |
|
58,737 |
32,318 |
$651.06 |
| 93283 |
|
27 |
24 |
$603.86 |
| 83880 |
|
7,896 |
6,765 |
$593.88 |
| 90686 |
|
707 |
588 |
$588.83 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,619 |
1,575 |
$581.34 |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
767 |
215 |
$578.57 |
| 85670 |
|
14 |
13 |
$561.94 |
| 88313 |
|
3,008 |
1,915 |
$561.50 |
| 76377 |
|
6,602 |
5,307 |
$558.96 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
28,934 |
21,469 |
$554.90 |
| 73560 |
|
885 |
688 |
$532.42 |
| 95957 |
|
1,795 |
1,562 |
$527.17 |
| 72040 |
|
92 |
81 |
$522.36 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
3,623 |
2,939 |
$517.08 |
| 93299 |
|
19 |
16 |
$501.61 |
| 87088 |
|
17,717 |
15,018 |
$500.72 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
1,536 |
1,301 |
$480.72 |
| 70250 |
|
320 |
239 |
$480.32 |
| 75565 |
|
224 |
209 |
$459.11 |
| 85379 |
|
4,591 |
3,539 |
$458.55 |
| 97166 |
|
648 |
547 |
$452.03 |
| 93320 |
|
726 |
616 |
$439.12 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
59 |
52 |
$407.04 |
| 82105 |
|
1,330 |
1,079 |
$405.82 |
| 73620 |
|
543 |
455 |
$359.01 |
| 80061 |
Lipid panel |
2,969 |
2,517 |
$358.42 |
| 90632 |
|
46 |
44 |
$357.00 |
| 82330 |
|
2,765 |
2,120 |
$350.18 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
4,147 |
2,071 |
$341.17 |
| J2704 |
Injection, propofol, 10 mg |
29,156 |
21,895 |
$332.44 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
5,247 |
4,643 |
$317.55 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,370 |
3,810 |
$314.76 |
| 80164 |
|
306 |
231 |
$309.00 |
| 81003 |
|
22,256 |
19,501 |
$292.36 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
16,623 |
14,411 |
$288.40 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
12 |
12 |
$275.02 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
15,544 |
11,583 |
$274.50 |
| 74019 |
|
30 |
27 |
$270.08 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,459 |
2,353 |
$269.96 |
| J1815 |
Injection, insulin, per 5 units |
8,564 |
3,870 |
$269.33 |
| 86140 |
|
9,646 |
8,452 |
$266.38 |
| 36592 |
|
3,320 |
926 |
$263.48 |
| 85384 |
|
4,583 |
2,840 |
$263.07 |
| 84100 |
|
43,741 |
23,852 |
$258.95 |
| 94760 |
|
2,505 |
1,633 |
$257.63 |
| 97116 |
|
1,222 |
899 |
$243.90 |
| 86769 |
|
468 |
440 |
$240.91 |
| 70548 |
|
247 |
197 |
$240.58 |
| 86900 |
|
18,226 |
13,930 |
$233.52 |
| 77002 |
|
207 |
184 |
$223.40 |
| J3535 |
Drug administered through a metered dose inhaler |
210 |
180 |
$222.07 |
| 93325 |
|
1,795 |
1,539 |
$216.46 |
| J1644 |
Injection, heparin sodium, per 1000 units |
15,038 |
5,945 |
$208.77 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
27 |
25 |
$200.08 |
| 86901 |
|
18,314 |
14,005 |
$199.95 |
| 73600 |
|
915 |
714 |
$198.45 |
| G0008 |
Administration of influenza virus vaccine |
768 |
640 |
$196.88 |
| 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 |
6,573 |
6,143 |
$192.60 |
| 82565 |
|
1,272 |
1,069 |
$185.65 |
| 82247 |
|
107 |
79 |
$182.49 |
| 73100 |
|
875 |
705 |
$178.63 |
| 86780 |
|
1,032 |
954 |
$177.34 |
| 87081 |
|
125 |
112 |
$170.78 |
| 99152 |
|
4,137 |
3,559 |
$167.56 |
| 85730 |
|
15,361 |
12,001 |
$166.35 |
| 87076 |
|
16 |
14 |
$164.61 |
| 86645 |
|
306 |
264 |
$162.63 |
| 89051 |
|
4,655 |
3,041 |
$161.38 |
| J1953 |
Injection, levetiracetam, 10 mg |
727 |
539 |
$160.31 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
8,433 |
3,604 |
$156.84 |
| 88346 |
|
19 |
13 |
$151.77 |
| 77336 |
|
5,183 |
2,295 |
$150.20 |
| 88112 |
|
1,122 |
923 |
$147.42 |
| 80069 |
|
129 |
65 |
$142.38 |
| 87205 |
|
11,526 |
9,875 |
$142.26 |
| 88312 |
|
317 |
224 |
$142.19 |
| 87210 |
|
6,585 |
6,122 |
$136.80 |
| 87070 |
|
4,286 |
3,248 |
$131.94 |
| 82550 |
|
5,850 |
4,674 |
$126.29 |
| 12013 |
|
164 |
145 |
$118.00 |
| 84432 |
|
111 |
93 |
$114.24 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
32,613 |
27,169 |
$108.64 |
| 86592 |
|
2,862 |
2,559 |
$103.57 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
13,449 |
9,936 |
$98.61 |
| 97035 |
|
402 |
195 |
$98.32 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
283 |
190 |
$96.72 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
18,130 |
14,065 |
$95.48 |
| 86803 |
|
2,189 |
1,882 |
$91.80 |
| 84466 |
|
6,058 |
5,457 |
$87.60 |
| 83021 |
|
327 |
290 |
$83.50 |
| 84439 |
|
6,491 |
5,508 |
$81.87 |
| 87522 |
Neg quan hep c or qual rna |
344 |
287 |
$78.02 |
| 84481 |
|
624 |
579 |
$76.18 |
| 87102 |
|
1,947 |
1,520 |
$75.66 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
3,022 |
2,521 |
$73.71 |
| 83883 |
|
3,070 |
1,268 |
$73.07 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
22,782 |
19,769 |
$72.44 |
| J2060 |
Injection, lorazepam, 2 mg |
5,108 |
3,735 |
$70.29 |
| 86787 |
|
221 |
161 |
$69.46 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
9,643 |
6,895 |
$66.79 |
| 92555 |
|
221 |
209 |
$66.35 |
| 82270 |
|
837 |
756 |
$65.54 |
| 73564 |
|
31 |
24 |
$63.00 |
| 84132 |
|
3,603 |
2,929 |
$61.89 |
| 84145 |
|
1,985 |
1,839 |
$61.84 |
| J7999 |
Compounded drug, not otherwise classified |
4,133 |
3,797 |
$61.48 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
14,504 |
9,719 |
$60.15 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
3,293 |
1,720 |
$60.12 |
| 87340 |
|
2,785 |
2,345 |
$57.16 |
| 85014 |
|
3,355 |
2,778 |
$56.22 |
| J3480 |
Injection, potassium chloride, per 2 meq |
3,192 |
2,309 |
$55.61 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
4,321 |
3,021 |
$51.32 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
2,924 |
1,752 |
$49.97 |
| 83615 |
|
9,315 |
6,087 |
$46.79 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
1,568 |
889 |
$44.56 |
| 86334 |
|
1,479 |
1,183 |
$44.26 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
14,570 |
10,681 |
$42.80 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
2,055 |
1,444 |
$42.15 |
| 83020 |
|
329 |
315 |
$41.96 |
| 86706 |
|
1,738 |
1,412 |
$41.92 |
| 85652 |
|
5,104 |
4,497 |
$41.80 |
| 82140 |
|
2,043 |
1,719 |
$39.09 |
| J0692 |
Injection, cefepime hydrochloride, 500 mg |
1,400 |
998 |
$37.32 |
| 82977 |
|
1,431 |
727 |
$36.05 |
| 84156 |
|
4,072 |
2,975 |
$32.14 |
| 77338 |
|
845 |
757 |
$29.29 |
| J1630 |
Injection, haloperidol, up to 5 mg |
2,822 |
2,323 |
$25.27 |
| 85007 |
|
13,835 |
7,874 |
$24.90 |
| 84165 |
|
2,155 |
1,752 |
$24.77 |
| J1940 |
Injection, furosemide, up to 20 mg |
1,383 |
983 |
$24.31 |
| 82657 |
|
25 |
14 |
$22.49 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
109 |
102 |
$22.46 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
5,301 |
4,657 |
$22.25 |
| 86308 |
|
73 |
70 |
$21.70 |
| 86038 |
|
86 |
76 |
$20.15 |
| 85046 |
|
5,489 |
3,952 |
$19.21 |
| 82570 |
|
1,497 |
1,147 |
$17.63 |
| 99153 |
Mod sedat endo service >5yrs |
3,168 |
2,713 |
$17.61 |
| 85041 |
|
389 |
365 |
$17.35 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
9,484 |
5,721 |
$16.66 |
| 87147 |
|
1,273 |
1,075 |
$16.60 |
| 84295 |
|
1,885 |
1,601 |
$16.19 |
| 96368 |
|
1,593 |
1,250 |
$15.63 |
| 86704 |
|
1,378 |
1,108 |
$15.31 |
| 83540 |
|
6,081 |
5,467 |
$14.88 |
| 92611 |
|
49 |
39 |
$14.34 |
| 82310 |
|
1,749 |
790 |
$14.05 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
1,590 |
1,306 |
$14.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
1,239 |
1,073 |
$13.41 |
| 86682 |
|
66 |
54 |
$13.34 |
| 93321 |
|
192 |
169 |
$13.27 |
| 76376 |
|
1,123 |
1,002 |
$13.14 |
| 83010 |
|
171 |
141 |
$12.76 |
| J2800 |
Injection, methocarbamol, up to 10 ml |
1,129 |
929 |
$12.73 |
| 84550 |
|
3,371 |
2,015 |
$12.59 |
| 82232 |
|
2,188 |
1,566 |
$12.10 |
| 82150 |
|
1,412 |
948 |
$11.95 |
| 80177 |
|
294 |
256 |
$10.60 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
3,007 |
1,603 |
$10.60 |
| 77332 |
|
186 |
151 |
$10.08 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
792 |
447 |
$9.70 |
| 82010 |
|
1,540 |
1,325 |
$9.58 |
| 93041 |
|
113 |
107 |
$9.34 |
| 85018 |
|
3,531 |
2,746 |
$8.77 |
| 88108 |
|
280 |
221 |
$8.49 |
| 87807 |
|
210 |
202 |
$8.47 |
| 87324 |
|
172 |
144 |
$7.04 |
| 87449 |
|
454 |
393 |
$6.72 |
| 86762 |
|
356 |
294 |
$6.40 |
| 85390 |
|
860 |
719 |
$5.63 |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
456 |
362 |
$4.66 |
| 85347 |
|
2,430 |
1,625 |
$3.65 |
| 82248 |
|
4,589 |
2,719 |
$3.53 |
| 82945 |
|
1,600 |
1,240 |
$3.29 |
| 84157 |
|
1,984 |
1,500 |
$2.99 |
| 99157 |
|
81 |
67 |
$2.77 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
1,057 |
1,008 |
$2.07 |
| 87206 |
|
2,088 |
1,291 |
$1.92 |
| 87116 |
|
735 |
564 |
$1.92 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
366 |
327 |
$1.82 |
| 87015 |
|
262 |
205 |
$1.19 |
| 87071 |
|
129 |
95 |
$0.79 |
| 88311 |
|
1,337 |
1,082 |
$0.00 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
1,575 |
932 |
$0.00 |
| 92556 |
|
152 |
144 |
$0.00 |
| 36416 |
|
2,605 |
1,638 |
$0.00 |
| J1836 |
Injection, metronidazole, 10 mg |
252 |
184 |
$0.00 |
| 77001 |
|
381 |
349 |
$0.00 |
| 86664 |
|
228 |
207 |
$0.00 |
| 87516 |
|
114 |
90 |
$0.00 |
| A9573 |
Injection, gadopiclenol, 1 ml |
318 |
281 |
$0.00 |
| J2305 |
Injection, nitroglycerin, 5 mg |
52 |
50 |
$0.00 |
| 97165 |
|
62 |
54 |
$0.00 |
| J3590 |
Unclassified biologics |
336 |
296 |
$0.00 |
| 86320 |
|
537 |
456 |
$0.00 |
| 80051 |
|
268 |
206 |
$0.00 |
| 86777 |
|
355 |
285 |
$0.00 |
| J0461 |
Injection, atropine sulfate, 0.01 mg |
831 |
503 |
$0.00 |
| J9267 |
Injection, paclitaxel, 1 mg |
1,353 |
554 |
$0.00 |
| 88264 |
|
358 |
317 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
3,473 |
3,064 |
$0.00 |
| 83521 |
|
951 |
409 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
6,499 |
3,172 |
$0.00 |
| J3411 |
Injection, thiamine hcl, 100 mg |
405 |
309 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
172 |
148 |
$0.00 |
| 77280 |
|
286 |
184 |
$0.00 |
| J0456 |
Injection, azithromycin, 500 mg |
113 |
101 |
$0.00 |
| 83050 |
|
17 |
12 |
$0.00 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
167 |
102 |
$0.00 |
| J2560 |
Injection, phenobarbital sodium, up to 120 mg |
49 |
39 |
$0.00 |
| 83921 |
|
242 |
233 |
$0.00 |
| 86880 |
|
253 |
135 |
$0.00 |
| 86800 |
|
155 |
135 |
$0.00 |
| 87533 |
|
491 |
267 |
$0.00 |
| 84300 |
|
64 |
51 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
991 |
950 |
$0.00 |
| J1805 |
Injection, esmolol hydrochloride, 10 mg |
163 |
102 |
$0.00 |
| 74021 |
|
42 |
36 |
$0.00 |
| 87521 |
Neg quan hep c or qual rna |
114 |
90 |
$0.00 |
| 83090 |
|
12 |
12 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
794 |
721 |
$0.00 |
| 87176 |
|
75 |
55 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
43 |
32 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
79 |
63 |
$0.00 |
| J1720 |
Injection, hydrocortisone sodium succinate, up to 100 mg |
27 |
25 |
$0.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
109 |
74 |
$0.00 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
49 |
28 |
$0.00 |
| 80349 |
|
13 |
13 |
$0.00 |
| J0571 |
Buprenorphine, oral, 1 mg |
53 |
30 |
$0.00 |
| 86870 |
|
58 |
37 |
$0.00 |
| J0610 |
Injection, calcium gluconate (fresenius kabi), per 10 ml |
95 |
38 |
$0.00 |
| 83930 |
|
13 |
13 |
$0.00 |
| 88369 |
|
42 |
37 |
$0.00 |
| J9370 |
Vincristine sulfate, 1 mg |
2,122 |
1,267 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
1,032 |
886 |
$0.00 |
| 86922 |
|
315 |
159 |
$0.00 |
| 84460 |
|
484 |
451 |
$0.00 |
| 86644 |
|
457 |
379 |
$0.00 |
| 87535 |
|
115 |
91 |
$0.00 |
| J0744 |
Injection, ciprofloxacin for intravenous infusion, 200 mg |
322 |
240 |
$0.00 |
| S0028 |
Injection, famotidine, 20 mg |
1,961 |
1,619 |
$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 |
375 |
250 |
$0.00 |
| 86359 |
|
81 |
65 |
$0.00 |
| 85246 |
|
66 |
65 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
361 |
347 |
$0.00 |
| J9060 |
Injection, cisplatin, powder or solution, 10 mg |
95 |
50 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
347 |
235 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
1,646 |
956 |
$0.00 |
| 92550 |
|
170 |
142 |
$0.00 |
| 85049 |
|
129 |
40 |
$0.00 |
| 88368 |
|
41 |
37 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
1,325 |
976 |
$0.00 |
| J9206 |
Injection, irinotecan, 20 mg |
369 |
193 |
$0.00 |
| 82747 |
|
280 |
268 |
$0.00 |
| J0640 |
Injection, leucovorin calcium, per 50 mg |
857 |
464 |
$0.00 |
| 76937 |
|
648 |
595 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
161 |
152 |
$0.00 |
| J9260 |
Injection, methotrexate sodium, 50 mg |
1,209 |
707 |
$0.00 |
| J0694 |
Injection, cefoxitin sodium, 1 gm |
354 |
233 |
$0.00 |
| 86735 |
|
62 |
50 |
$0.00 |
| A9541 |
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries |
170 |
158 |
$0.00 |
| 84155 |
|
560 |
476 |
$0.00 |
| C1788 |
Port, indwelling (implantable) |
260 |
245 |
$0.00 |
| 86360 |
|
72 |
62 |
$0.00 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
29 |
25 |
$0.00 |
| 82042 |
|
58 |
44 |
$0.00 |
| 88237 |
|
375 |
332 |
$0.00 |
| C1758 |
Catheter, ureteral |
184 |
166 |
$0.00 |
| 84520 |
|
579 |
469 |
$0.00 |
| 86663 |
|
14 |
12 |
$0.00 |
| J0735 |
Injection, clonidine hydrochloride, 1 mg |
37 |
32 |
$0.00 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
111 |
108 |
$0.00 |
| 77387 |
|
177 |
26 |
$0.00 |
| 73000 |
|
70 |
62 |
$0.00 |
| G8984 |
Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals |
18 |
13 |
$0.00 |
| Q0114 |
Fern test |
76 |
71 |
$0.00 |
| 86765 |
|
60 |
49 |
$0.00 |
| 82800 |
|
18 |
12 |
$0.00 |
| 86665 |
|
439 |
207 |
$0.00 |
| 88367 |
|
31 |
29 |
$0.00 |
| J0612 |
Injection, calcium gluconate, not otherwise specified, 10 mg |
13 |
12 |
$0.00 |
| J2310 |
Injection, naloxone hydrochloride, per 1 mg |
41 |
38 |
$0.00 |
| 86708 |
|
49 |
41 |
$0.00 |
| 82375 |
|
18 |
13 |
$0.00 |
| Q0220 |
Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 300 mg |
16 |
15 |
$0.00 |
| 70330 |
|
30 |
29 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
288 |
228 |
$0.00 |
| 82668 |
|
28 |
27 |
$0.00 |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
29 |
12 |
$0.00 |
| 84403 |
|
14 |
13 |
$0.00 |
| 86790 |
|
14 |
12 |
$0.00 |
| 86709 |
|
55 |
50 |
$0.00 |
| 88373 |
|
31 |
29 |
$0.00 |
| J9000 |
Injection, doxorubicin hydrochloride, 10 mg |
45 |
26 |
$0.00 |
| C1760 |
Closure device, vascular (implantable/insertable) |
29 |
26 |
$0.00 |
| 88365 |
|
15 |
12 |
$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 |
19 |
14 |
$0.00 |