| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
285,933 |
239,871 |
$27.00M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
44,895 |
40,622 |
$5.28M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
28,212 |
24,768 |
$3.47M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
11,403 |
9,602 |
$1.36M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
8,736 |
8,013 |
$1.11M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,490 |
2,744 |
$919K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,793 |
3,261 |
$894K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
9,035 |
3,971 |
$870K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
8,073 |
7,231 |
$751K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,708 |
2,365 |
$744K |
| 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 |
4,038 |
3,846 |
$732K |
| 80053 |
Comprehensive metabolic panel |
56,899 |
47,358 |
$677K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
8,226 |
2,515 |
$631K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,069 |
1,718 |
$583K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
7,461 |
7,135 |
$571K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,540 |
1,359 |
$547K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
2,410 |
2,066 |
$474K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
1,474 |
1,294 |
$429K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
821 |
720 |
$419K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,837 |
4,590 |
$339K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
15,209 |
13,340 |
$338K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,615 |
2,440 |
$316K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
558 |
382 |
$284K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,781 |
1,498 |
$260K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
802 |
539 |
$252K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
2,503 |
1,097 |
$234K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
59,350 |
47,952 |
$230K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,778 |
2,603 |
$224K |
| 80061 |
Lipid panel |
14,828 |
13,920 |
$210K |
| 11721 |
|
6,816 |
5,997 |
$187K |
| G0378 |
Hospital observation service, per hour |
2,348 |
1,083 |
$184K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
2,083 |
735 |
$184K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
835 |
650 |
$179K |
| 84443 |
Thyroid stimulating hormone (TSH) |
11,458 |
10,422 |
$176K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
749 |
669 |
$176K |
| 20610 |
|
1,047 |
890 |
$176K |
| 36415 |
Collection of venous blood by venipuncture |
72,028 |
58,936 |
$160K |
| 98926 |
|
3,468 |
3,064 |
$159K |
| 95886 |
|
666 |
546 |
$150K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
115 |
101 |
$146K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
8,717 |
6,819 |
$145K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
9,958 |
9,263 |
$132K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,150 |
1,981 |
$131K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
994 |
860 |
$107K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
147 |
132 |
$105K |
| 71046 |
Radiologic examination, chest; 2 views |
4,933 |
4,459 |
$101K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
262 |
218 |
$100K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,413 |
507 |
$96K |
| 93975 |
|
600 |
494 |
$89K |
| 94060 |
|
1,483 |
1,247 |
$88K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
2,402 |
856 |
$85K |
| 71250 |
|
829 |
751 |
$79K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
4,065 |
3,734 |
$77K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
2,779 |
2,650 |
$77K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
378 |
299 |
$75K |
| 95117 |
|
4,126 |
1,445 |
$69K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
298 |
250 |
$61K |
| 92557 |
|
854 |
784 |
$61K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
3,904 |
3,328 |
$60K |
| 76770 |
|
327 |
295 |
$57K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
423 |
364 |
$56K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
3,789 |
3,567 |
$56K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
22,381 |
18,968 |
$54K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
11,365 |
9,993 |
$53K |
| 82607 |
|
3,143 |
2,811 |
$51K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,096 |
1,026 |
$48K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
187 |
175 |
$48K |
| 73630 |
|
2,055 |
1,788 |
$48K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
788 |
729 |
$47K |
| 82728 |
|
3,193 |
2,768 |
$45K |
| 73564 |
|
1,232 |
1,081 |
$44K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,108 |
1,896 |
$42K |
| 92134 |
|
1,885 |
1,647 |
$41K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
222 |
206 |
$41K |
| 97010 |
|
1,247 |
502 |
$40K |
| 87430 |
|
9,837 |
9,045 |
$40K |
| 76642 |
|
277 |
237 |
$38K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
922 |
857 |
$37K |
| 93017 |
|
397 |
339 |
$37K |
| 97161 |
|
686 |
626 |
$36K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,108 |
1,896 |
$36K |
| 85027 |
|
8,040 |
6,878 |
$36K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
647 |
624 |
$36K |
| 84439 |
|
2,005 |
1,737 |
$36K |
| 59025 |
Fetal non-stress test |
311 |
248 |
$35K |
| 80076 |
|
2,423 |
2,206 |
$35K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
193 |
173 |
$34K |
| 97533 |
|
480 |
188 |
$33K |
| 84484 |
|
10,339 |
8,469 |
$31K |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
1,177 |
509 |
$31K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
601 |
251 |
$31K |
| 73110 |
|
658 |
569 |
$30K |
| 73030 |
|
1,056 |
908 |
$30K |
| 86803 |
|
1,346 |
1,241 |
$30K |
| 93971 |
|
371 |
324 |
$30K |
| 36591 |
|
1,596 |
786 |
$30K |
| 94729 |
|
606 |
540 |
$29K |
| 81003 |
|
25,978 |
22,927 |
$29K |
| 90677 |
|
1,088 |
1,029 |
$29K |
| 83540 |
|
3,100 |
2,689 |
$29K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,846 |
5,903 |
$28K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,379 |
1,239 |
$28K |
| 74018 |
|
902 |
785 |
$28K |
| 97162 |
|
553 |
500 |
$27K |
| 86850 |
|
1,502 |
1,260 |
$27K |
| 94726 |
|
503 |
441 |
$26K |
| G0482 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed |
639 |
555 |
$26K |
| 73130 |
|
1,093 |
965 |
$25K |
| 73610 |
|
1,082 |
951 |
$25K |
| 71045 |
Radiologic examination, chest; single view |
12,710 |
10,898 |
$25K |
| 72100 |
|
921 |
803 |
$24K |
| 83970 |
|
842 |
783 |
$23K |
| 87070 |
|
3,629 |
3,110 |
$22K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
15,333 |
12,273 |
$22K |
| 83550 |
|
3,035 |
2,638 |
$22K |
| 76830 |
Ultrasound, transvaginal |
401 |
336 |
$21K |
| 76857 |
|
367 |
296 |
$21K |
| 83735 |
|
8,806 |
6,639 |
$20K |
| 76536 |
|
164 |
153 |
$20K |
| 92136 |
|
670 |
583 |
$20K |
| 85610 |
|
4,476 |
2,991 |
$20K |
| 59050 |
|
468 |
409 |
$19K |
| 82570 |
|
1,881 |
1,712 |
$19K |
| J3490 |
Unclassified drugs |
7,684 |
4,028 |
$18K |
| 94200 |
|
417 |
382 |
$18K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
658 |
547 |
$18K |
| 92567 |
|
1,210 |
1,127 |
$18K |
| 73502 |
|
581 |
511 |
$17K |
| 83655 |
|
894 |
807 |
$17K |
| 86140 |
|
1,814 |
1,535 |
$17K |
| 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 |
729 |
693 |
$17K |
| 80320 |
|
1,716 |
1,349 |
$17K |
| 86900 |
|
1,499 |
1,258 |
$16K |
| 86901 |
|
1,432 |
1,201 |
$15K |
| 62323 |
|
70 |
68 |
$15K |
| 12001 |
|
94 |
78 |
$15K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
86 |
79 |
$15K |
| 99381 |
|
129 |
117 |
$14K |
| 84436 |
|
907 |
848 |
$14K |
| 90698 |
|
2,044 |
1,777 |
$13K |
| 90715 |
|
1,032 |
864 |
$12K |
| 83615 |
|
1,662 |
1,298 |
$12K |
| 84153 |
|
622 |
567 |
$12K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
217 |
196 |
$12K |
| 82805 |
|
421 |
359 |
$12K |
| 51798 |
|
256 |
209 |
$12K |
| 90670 |
|
1,198 |
975 |
$12K |
| 69210 |
|
395 |
349 |
$11K |
| 87480 |
|
822 |
742 |
$11K |
| 82746 |
|
1,549 |
1,368 |
$11K |
| 97113 |
|
132 |
37 |
$10K |
| 86592 |
|
529 |
464 |
$10K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
18 |
12 |
$10K |
| 86038 |
|
444 |
396 |
$10K |
| 90686 |
|
1,242 |
958 |
$10K |
| 31231 |
|
44 |
42 |
$10K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
149 |
145 |
$9K |
| 82043 |
|
1,457 |
1,338 |
$9K |
| 84702 |
|
648 |
490 |
$9K |
| 87510 |
|
822 |
742 |
$9K |
| 95811 |
|
13 |
13 |
$9K |
| 90633 |
|
1,089 |
936 |
$8K |
| 92083 |
|
245 |
212 |
$8K |
| 70486 |
|
128 |
109 |
$8K |
| 90681 |
|
788 |
693 |
$8K |
| 80069 |
|
321 |
279 |
$8K |
| 87660 |
|
840 |
759 |
$8K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,552 |
3,957 |
$8K |
| 90651 |
|
950 |
803 |
$7K |
| 64615 |
|
30 |
28 |
$7K |
| G0481 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed |
102 |
91 |
$7K |
| 73221 |
|
30 |
28 |
$7K |
| 87634 |
|
520 |
495 |
$7K |
| 83520 |
|
251 |
209 |
$7K |
| 84550 |
|
1,133 |
1,037 |
$7K |
| 84480 |
|
690 |
624 |
$6K |
| 90619 |
|
806 |
686 |
$6K |
| J1097 |
Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml |
45 |
24 |
$6K |
| 36600 |
|
435 |
369 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
972 |
829 |
$6K |
| 87186 |
|
1,808 |
1,460 |
$6K |
| 82550 |
|
3,389 |
2,850 |
$6K |
| 87338 |
|
230 |
207 |
$6K |
| 90672 |
|
687 |
529 |
$6K |
| 84100 |
|
904 |
633 |
$5K |
| 81025 |
|
7,852 |
7,078 |
$5K |
| 86706 |
|
216 |
196 |
$5K |
| 73140 |
|
185 |
158 |
$5K |
| 84703 |
|
734 |
607 |
$5K |
| 76801 |
|
123 |
108 |
$5K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
174 |
151 |
$5K |
| 83880 |
|
986 |
812 |
$5K |
| 85652 |
|
1,260 |
1,080 |
$5K |
| 91320 |
|
84 |
78 |
$5K |
| 87521 |
Neg quan hep c or qual rna |
110 |
87 |
$5K |
| 87340 |
|
436 |
395 |
$5K |
| 87081 |
|
1,900 |
1,719 |
$5K |
| 90744 |
|
965 |
852 |
$5K |
| 82553 |
|
515 |
432 |
$5K |
| 72050 |
|
80 |
62 |
$4K |
| 87040 |
|
1,132 |
890 |
$4K |
| 87088 |
|
1,012 |
840 |
$4K |
| 73590 |
|
218 |
177 |
$4K |
| 73070 |
|
116 |
109 |
$4K |
| 96367 |
|
35 |
24 |
$4K |
| 86003 |
|
205 |
182 |
$4K |
| 82375 |
|
479 |
408 |
$4K |
| U0001 |
Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel |
127 |
118 |
$4K |
| 84146 |
|
288 |
264 |
$4K |
| 90696 |
|
520 |
456 |
$4K |
| 10060 |
|
19 |
18 |
$4K |
| 97750 |
|
118 |
99 |
$4K |
| 83690 |
|
4,992 |
4,195 |
$4K |
| 73090 |
|
158 |
124 |
$4K |
| 85379 |
|
1,299 |
1,073 |
$4K |
| 84156 |
|
572 |
514 |
$3K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
13,660 |
11,554 |
$3K |
| 82575 |
|
279 |
265 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
33 |
31 |
$3K |
| 98925 |
|
75 |
69 |
$3K |
| 93970 |
|
17 |
14 |
$3K |
| 83001 |
|
163 |
155 |
$3K |
| 90480 |
|
299 |
232 |
$3K |
| C1780 |
Lens, intraocular (new technology) |
483 |
336 |
$3K |
| 90707 |
|
431 |
379 |
$3K |
| 83993 |
|
144 |
131 |
$3K |
| 73560 |
|
198 |
174 |
$3K |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
19 |
19 |
$3K |
| 84460 |
|
434 |
414 |
$3K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
18 |
12 |
$3K |
| 99406 |
|
68 |
66 |
$3K |
| 72141 |
|
15 |
12 |
$3K |
| 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 |
182 |
163 |
$3K |
| 92250 |
|
93 |
83 |
$3K |
| 85018 |
|
675 |
557 |
$3K |
| 97116 |
|
77 |
28 |
$2K |
| 84403 |
|
122 |
115 |
$2K |
| 85014 |
|
410 |
356 |
$2K |
| 90710 |
|
549 |
471 |
$2K |
| J1756 |
Injection, iron sucrose, 1 mg |
225 |
107 |
$2K |
| 85046 |
|
535 |
436 |
$2K |
| 86431 |
|
142 |
121 |
$2K |
| J7050 |
Infusion, normal saline solution, 250 cc |
2,657 |
1,252 |
$2K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
7,292 |
5,569 |
$2K |
| 72040 |
|
55 |
42 |
$2K |
| 90716 |
|
368 |
323 |
$2K |
| 83002 |
|
129 |
123 |
$2K |
| 87522 |
Neg quan hep c or qual rna |
110 |
87 |
$2K |
| 20553 |
|
17 |
12 |
$2K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
97 |
96 |
$2K |
| 82784 |
|
141 |
126 |
$2K |
| 82150 |
|
1,915 |
1,637 |
$2K |
| 82950 |
|
208 |
199 |
$2K |
| 72110 |
|
84 |
70 |
$2K |
| 83605 |
|
763 |
608 |
$2K |
| 90658 |
|
121 |
114 |
$2K |
| 93880 |
|
31 |
27 |
$2K |
| 86762 |
|
232 |
213 |
$2K |
| 71101 |
|
112 |
95 |
$2K |
| 92523 |
|
20 |
15 |
$2K |
| 80074 |
|
108 |
82 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
9,335 |
7,806 |
$2K |
| 82670 |
|
56 |
52 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
4,855 |
4,653 |
$2K |
| 87077 |
|
628 |
545 |
$2K |
| 86663 |
|
113 |
99 |
$2K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,141 |
796 |
$1K |
| 90656 |
|
221 |
216 |
$1K |
| 97165 |
|
18 |
13 |
$1K |
| 90660 |
|
183 |
183 |
$1K |
| 86308 |
|
92 |
75 |
$1K |
| 85730 |
|
594 |
469 |
$1K |
| 86664 |
|
113 |
99 |
$1K |
| 86665 |
|
113 |
99 |
$1K |
| 86480 |
|
29 |
28 |
$1K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
2,676 |
1,041 |
$1K |
| 96376 |
|
573 |
399 |
$1K |
| 86694 |
|
41 |
37 |
$1K |
| 87449 |
|
79 |
68 |
$989.84 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
26 |
19 |
$988.41 |
| 86787 |
|
38 |
32 |
$965.28 |
| 87045 |
|
49 |
39 |
$964.17 |
| 87328 |
|
53 |
44 |
$940.21 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
754 |
713 |
$919.92 |
| 86701 |
|
157 |
147 |
$912.82 |
| J1815 |
Injection, insulin, per 5 units |
91 |
55 |
$899.87 |
| 90662 |
|
246 |
230 |
$868.14 |
| 86765 |
|
34 |
28 |
$857.73 |
| 86735 |
|
19 |
16 |
$854.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,058 |
1,361 |
$715.89 |
| 76870 |
|
12 |
12 |
$714.38 |
| 81001 |
|
229 |
222 |
$658.10 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
851 |
535 |
$625.01 |
| 80329 |
|
68 |
54 |
$589.22 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
777 |
587 |
$584.40 |
| 77066 |
Tomosynthesis, mammo |
14 |
14 |
$530.60 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
1,420 |
656 |
$528.35 |
| 82533 |
|
29 |
27 |
$523.90 |
| 86695 |
|
41 |
37 |
$513.74 |
| 96127 |
|
13 |
13 |
$511.72 |
| 96523 |
|
15 |
13 |
$508.62 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
4,004 |
3,311 |
$505.36 |
| J2704 |
Injection, propofol, 10 mg |
3,499 |
2,836 |
$492.43 |
| 84481 |
|
30 |
27 |
$459.97 |
| 82962 |
|
445 |
349 |
$455.54 |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
43 |
35 |
$436.97 |
| 86618 |
|
25 |
25 |
$434.48 |
| 72072 |
|
16 |
12 |
$421.20 |
| 72070 |
|
13 |
12 |
$410.69 |
| 51702 |
|
32 |
17 |
$408.22 |
| 97166 |
|
14 |
13 |
$398.82 |
| 88304 |
|
155 |
123 |
$397.89 |
| 92133 |
|
12 |
12 |
$387.85 |
| 00731 |
|
358 |
294 |
$383.12 |
| 00142 |
|
718 |
480 |
$381.37 |
| 74019 |
|
28 |
28 |
$342.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
911 |
642 |
$322.56 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
108 |
53 |
$304.08 |
| C9113 |
Injection, pantoprazole sodium, per vial |
116 |
71 |
$286.24 |
| C9257 |
Injection, bevacizumab, 0.25 mg |
49 |
41 |
$264.41 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
454 |
319 |
$259.95 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
2,646 |
1,884 |
$239.79 |
| 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 |
106 |
65 |
$227.05 |
| 88312 |
|
397 |
367 |
$220.74 |
| 82542 |
|
29 |
24 |
$209.34 |
| 84144 |
|
14 |
12 |
$208.46 |
| 86780 |
|
14 |
12 |
$197.38 |
| 82977 |
|
21 |
13 |
$197.34 |
| 84402 |
|
14 |
14 |
$195.32 |
| J3410 |
Injection, hydroxyzine hcl, up to 25 mg |
16 |
13 |
$192.65 |
| 87076 |
|
87 |
74 |
$172.75 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
120 |
54 |
$171.87 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
897 |
726 |
$160.25 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
289 |
217 |
$154.23 |
| 85045 |
|
30 |
30 |
$139.20 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
2,545 |
2,286 |
$137.30 |
| 86141 |
|
55 |
53 |
$133.68 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
15 |
14 |
$125.95 |
| 73100 |
|
13 |
13 |
$118.47 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
4,261 |
3,102 |
$112.65 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
553 |
332 |
$105.54 |
| 77065 |
Tomosynthesis, mammo |
14 |
14 |
$103.31 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
4,754 |
3,610 |
$97.33 |
| 82248 |
|
14 |
13 |
$90.15 |
| G0008 |
Administration of influenza virus vaccine |
629 |
555 |
$84.77 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
81 |
78 |
$73.20 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
172 |
144 |
$66.98 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
3,206 |
2,557 |
$54.77 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
54 |
28 |
$53.41 |
| J1644 |
Injection, heparin sodium, per 1000 units |
180 |
68 |
$46.63 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
44 |
42 |
$45.01 |
| 90461 |
|
141 |
141 |
$44.88 |
| 87205 |
|
36 |
34 |
$43.94 |
| 82077 |
|
70 |
67 |
$39.19 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
301 |
209 |
$33.70 |
| J2300 |
Injection, nalbuphine hydrochloride, per 10 mg |
143 |
114 |
$32.65 |
| G0009 |
Administration of pneumococcal vaccine |
218 |
195 |
$30.86 |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
73 |
37 |
$26.74 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
74 |
59 |
$25.70 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
72 |
51 |
$21.89 |
| J2060 |
Injection, lorazepam, 2 mg |
158 |
129 |
$18.33 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
716 |
623 |
$17.81 |
| J3480 |
Injection, potassium chloride, per 2 meq |
85 |
56 |
$17.78 |
| 94761 |
|
1,989 |
1,608 |
$14.94 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
840 |
689 |
$13.68 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
133 |
95 |
$12.48 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
197 |
168 |
$10.01 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
16 |
12 |
$5.99 |
| Q0169 |
Promethazine hydrochloride, 12.5 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 |
41 |
38 |
$3.72 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
91 |
89 |
$1.24 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
31 |
30 |
$1.03 |
| J2785 |
Injection, regadenoson, 0.1 mg |
57 |
46 |
$0.00 |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
420 |
357 |
$0.00 |
| 00126 |
|
107 |
98 |
$0.00 |
| 94760 |
|
122 |
77 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
36 |
25 |
$0.00 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
14 |
12 |
$0.00 |
| 00813 |
|
16 |
13 |
$0.00 |
| 91319 |
|
44 |
26 |
$0.00 |
| 01992 |
|
164 |
145 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
131 |
114 |
$0.00 |
| 00811 |
|
194 |
165 |
$0.00 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
264 |
219 |
$0.00 |
| 82009 |
|
38 |
27 |
$0.00 |
| 96417 |
|
27 |
13 |
$0.00 |
| 95912 |
|
12 |
12 |
$0.00 |
| 00812 |
|
17 |
12 |
$0.00 |
| 94664 |
|
14 |
12 |
$0.00 |