| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
62,737 |
56,131 |
$5.08M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
64,330 |
57,198 |
$4.86M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
22,712 |
20,962 |
$2.76M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
20,044 |
18,755 |
$2.33M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
46,404 |
40,451 |
$1.42M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
10,150 |
8,906 |
$1.25M |
| 31231 |
|
3,890 |
3,473 |
$738K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,992 |
1,709 |
$593K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
7,256 |
2,666 |
$582K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
8,759 |
2,264 |
$522K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,251 |
2,010 |
$475K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,117 |
4,374 |
$464K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
1,118 |
832 |
$461K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
3,463 |
3,223 |
$449K |
| 20610 |
|
2,748 |
2,363 |
$408K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
2,997 |
1,307 |
$347K |
| 80053 |
Comprehensive metabolic panel |
34,535 |
29,620 |
$335K |
| 95811 |
|
607 |
425 |
$270K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
936 |
790 |
$269K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
3,064 |
1,249 |
$262K |
| 99215 |
Prolong outpt/office vis |
2,086 |
1,820 |
$232K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
549 |
483 |
$216K |
| 95117 |
|
7,968 |
3,526 |
$194K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
901 |
847 |
$169K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
547 |
475 |
$163K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,679 |
912 |
$152K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,559 |
1,425 |
$126K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,271 |
1,025 |
$125K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,569 |
3,309 |
$112K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
437 |
399 |
$111K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
18,788 |
15,215 |
$106K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
888 |
726 |
$105K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
34,895 |
29,593 |
$102K |
| 51798 |
|
3,832 |
3,426 |
$101K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
822 |
755 |
$99K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
6,539 |
5,348 |
$98K |
| 59025 |
Fetal non-stress test |
548 |
192 |
$97K |
| 36415 |
Collection of venous blood by venipuncture |
56,220 |
45,815 |
$94K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,236 |
660 |
$84K |
| 84443 |
Thyroid stimulating hormone (TSH) |
6,373 |
5,914 |
$79K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
294 |
144 |
$75K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
612 |
549 |
$69K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,426 |
5,061 |
$68K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
7,003 |
6,707 |
$62K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
190 |
174 |
$62K |
| G0378 |
Hospital observation service, per hour |
963 |
758 |
$62K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
6,536 |
5,703 |
$60K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
496 |
478 |
$59K |
| 97535 |
Self-care/home management training, each 15 minutes |
1,623 |
1,223 |
$56K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
491 |
347 |
$54K |
| 80061 |
Lipid panel |
3,212 |
2,976 |
$50K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,890 |
2,585 |
$50K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,101 |
1,935 |
$47K |
| 86900 |
|
1,839 |
1,576 |
$46K |
| 31575 |
|
237 |
216 |
$44K |
| 97161 |
|
830 |
724 |
$41K |
| 70486 |
|
374 |
335 |
$40K |
| 84439 |
|
2,446 |
2,289 |
$39K |
| 59430 |
|
499 |
420 |
$38K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
387 |
351 |
$37K |
| 31237 |
|
86 |
51 |
$37K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
8,118 |
7,549 |
$36K |
| 83970 |
|
1,140 |
1,086 |
$35K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
293 |
167 |
$35K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
403 |
359 |
$33K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
12,089 |
10,572 |
$33K |
| 84484 |
|
8,085 |
6,733 |
$33K |
| 85027 |
|
5,558 |
4,540 |
$32K |
| 76801 |
|
384 |
321 |
$30K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,628 |
1,535 |
$30K |
| 88142 |
|
1,933 |
1,795 |
$30K |
| 82607 |
|
1,549 |
1,462 |
$28K |
| 71046 |
Radiologic examination, chest; 2 views |
2,806 |
2,579 |
$27K |
| 76536 |
|
258 |
232 |
$26K |
| 76830 |
Ultrasound, transvaginal |
237 |
213 |
$26K |
| 87806 |
|
699 |
639 |
$26K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
759 |
707 |
$26K |
| 86850 |
|
1,772 |
1,530 |
$25K |
| 76642 |
|
189 |
177 |
$24K |
| 73564 |
|
1,923 |
1,561 |
$24K |
| 71045 |
Radiologic examination, chest; single view |
7,868 |
6,990 |
$22K |
| 99233 |
Prolong inpt eval add15 m |
1,299 |
565 |
$21K |
| 52000 |
|
33 |
26 |
$21K |
| 97165 |
|
361 |
311 |
$20K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
630 |
591 |
$20K |
| 80320 |
|
1,620 |
1,345 |
$20K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,324 |
2,200 |
$20K |
| 99223 |
Prolong inpt eval add15 m |
405 |
375 |
$19K |
| 81001 |
|
15,360 |
13,729 |
$19K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,055 |
516 |
$19K |
| 83735 |
|
9,259 |
7,941 |
$18K |
| 92557 |
|
407 |
381 |
$17K |
| 93017 |
|
246 |
228 |
$17K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
702 |
673 |
$16K |
| 84481 |
|
1,023 |
958 |
$16K |
| 86803 |
|
825 |
751 |
$16K |
| 83655 |
|
676 |
588 |
$16K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
106 |
101 |
$15K |
| 76770 |
|
119 |
101 |
$15K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
823 |
762 |
$14K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
111 |
90 |
$14K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,578 |
1,175 |
$13K |
| 0002A |
|
355 |
347 |
$13K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
321 |
279 |
$13K |
| 86901 |
|
1,721 |
1,465 |
$12K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
68 |
66 |
$12K |
| 0001A |
|
376 |
363 |
$12K |
| 99406 |
|
940 |
846 |
$12K |
| 82728 |
|
899 |
827 |
$12K |
| 71250 |
|
144 |
135 |
$12K |
| 97162 |
|
298 |
273 |
$11K |
| 73630 |
|
1,087 |
934 |
$11K |
| 90715 |
|
603 |
497 |
$11K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
446 |
390 |
$11K |
| 85610 |
|
5,229 |
4,380 |
$11K |
| 74018 |
|
601 |
528 |
$11K |
| 73030 |
|
851 |
719 |
$11K |
| 93971 |
|
157 |
148 |
$10K |
| 90686 |
|
1,120 |
861 |
$10K |
| 84100 |
|
1,634 |
1,481 |
$10K |
| 86140 |
|
769 |
553 |
$9K |
| 84153 |
|
546 |
503 |
$9K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
379 |
347 |
$9K |
| 83550 |
|
866 |
803 |
$9K |
| 84450 |
|
1,021 |
900 |
$9K |
| 92567 |
|
560 |
522 |
$9K |
| 73130 |
|
858 |
677 |
$9K |
| 94060 |
|
177 |
160 |
$8K |
| 96127 |
|
147 |
139 |
$8K |
| 87340 |
|
530 |
497 |
$8K |
| 94729 |
|
157 |
143 |
$8K |
| 97113 |
|
177 |
44 |
$8K |
| 70496 |
|
30 |
26 |
$8K |
| 69210 |
|
562 |
523 |
$8K |
| 80076 |
|
521 |
476 |
$8K |
| 84702 |
|
1,099 |
887 |
$8K |
| 93225 |
|
106 |
94 |
$8K |
| 83540 |
|
952 |
883 |
$8K |
| 72100 |
|
230 |
203 |
$7K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
236 |
224 |
$7K |
| 73610 |
|
938 |
791 |
$7K |
| 73110 |
|
662 |
547 |
$7K |
| 97116 |
|
262 |
115 |
$7K |
| 93922 |
|
88 |
73 |
$7K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
18 |
17 |
$7K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,537 |
1,314 |
$6K |
| 95886 |
|
84 |
68 |
$6K |
| 86592 |
|
395 |
377 |
$6K |
| 82570 |
|
732 |
692 |
$6K |
| 83605 |
|
1,697 |
1,320 |
$6K |
| 73502 |
|
425 |
369 |
$6K |
| 92587 |
|
252 |
229 |
$6K |
| 84460 |
|
1,037 |
913 |
$5K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
725 |
541 |
$5K |
| 84156 |
|
659 |
556 |
$5K |
| 87077 |
|
1,696 |
1,375 |
$5K |
| 87186 |
|
1,696 |
1,379 |
$5K |
| 87070 |
|
1,002 |
829 |
$5K |
| 93970 |
|
29 |
25 |
$5K |
| 96376 |
|
1,305 |
648 |
$5K |
| 83690 |
|
8,868 |
7,847 |
$5K |
| 84403 |
|
330 |
309 |
$4K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
300 |
242 |
$4K |
| 82043 |
|
694 |
658 |
$4K |
| 86762 |
|
309 |
270 |
$4K |
| 84402 |
|
222 |
195 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
117 |
117 |
$4K |
| 73560 |
|
490 |
403 |
$4K |
| 86038 |
|
280 |
260 |
$4K |
| 93226 |
|
109 |
95 |
$4K |
| 82565 |
|
635 |
542 |
$4K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
105 |
85 |
$4K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
131 |
129 |
$4K |
| 85007 |
|
1,427 |
1,001 |
$4K |
| 82948 |
|
1,980 |
915 |
$4K |
| 82950 |
|
300 |
272 |
$4K |
| 51741 |
|
835 |
747 |
$4K |
| 94726 |
|
130 |
120 |
$4K |
| 86787 |
|
292 |
255 |
$4K |
| 81025 |
|
2,077 |
1,857 |
$3K |
| 85652 |
|
780 |
571 |
$3K |
| 84703 |
|
2,684 |
2,247 |
$3K |
| 87522 |
Neg quan hep c or qual rna |
98 |
77 |
$3K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
4,341 |
3,908 |
$3K |
| 81003 |
|
5,307 |
4,602 |
$3K |
| 73620 |
|
530 |
416 |
$3K |
| 11720 |
|
175 |
168 |
$3K |
| 93296 |
|
263 |
251 |
$3K |
| 85014 |
|
542 |
449 |
$3K |
| 72110 |
|
172 |
161 |
$3K |
| 70498 |
|
50 |
45 |
$3K |
| 86200 |
|
79 |
78 |
$3K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
13 |
13 |
$3K |
| 87631 |
|
69 |
69 |
$3K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
102 |
99 |
$2K |
| 93299 |
|
101 |
98 |
$2K |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
14 |
12 |
$2K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
20 |
14 |
$2K |
| 87081 |
|
309 |
263 |
$2K |
| 73221 |
|
12 |
12 |
$2K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
2,151 |
1,521 |
$2K |
| G2066 |
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results |
224 |
212 |
$2K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,682 |
1,735 |
$2K |
| 86003 |
|
176 |
79 |
$2K |
| 12001 |
|
16 |
13 |
$2K |
| 82040 |
|
190 |
174 |
$2K |
| 85018 |
|
555 |
452 |
$2K |
| 85730 |
|
3,989 |
3,468 |
$2K |
| 84550 |
|
360 |
283 |
$2K |
| 85379 |
|
916 |
798 |
$2K |
| 99217 |
|
75 |
71 |
$2K |
| 80329 |
|
219 |
194 |
$2K |
| 84436 |
|
1,211 |
1,084 |
$2K |
| 83880 |
|
798 |
678 |
$1K |
| 82746 |
|
150 |
143 |
$1K |
| 99220 |
|
34 |
32 |
$1K |
| 76827 |
|
111 |
93 |
$1K |
| 76937 |
|
63 |
56 |
$1K |
| 0004A |
|
36 |
35 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,327 |
2,300 |
$1K |
| 72131 |
|
29 |
24 |
$1K |
| 72072 |
|
54 |
49 |
$1K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
7,756 |
6,748 |
$1K |
| 90656 |
|
155 |
155 |
$1K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
55 |
41 |
$1K |
| 88304 |
|
218 |
168 |
$1K |
| 73590 |
|
79 |
71 |
$1K |
| 82550 |
|
365 |
287 |
$1K |
| 97802 |
|
13 |
12 |
$1K |
| 88341 |
|
19 |
14 |
$973.38 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
4,152 |
3,275 |
$944.93 |
| 80349 |
|
44 |
39 |
$931.59 |
| 80361 |
|
27 |
27 |
$915.34 |
| 87040 |
|
770 |
542 |
$909.09 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,009 |
660 |
$879.23 |
| 82652 |
|
52 |
51 |
$810.76 |
| 84146 |
|
39 |
38 |
$809.31 |
| 86376 |
|
47 |
38 |
$799.69 |
| 83615 |
|
184 |
140 |
$781.03 |
| 86705 |
|
47 |
40 |
$745.90 |
| 95909 |
|
12 |
12 |
$720.73 |
| 73140 |
|
61 |
58 |
$666.87 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
1,209 |
577 |
$646.03 |
| 93976 |
|
19 |
17 |
$644.03 |
| 86709 |
|
46 |
39 |
$625.94 |
| 83001 |
|
40 |
36 |
$611.04 |
| 82670 |
|
37 |
36 |
$605.02 |
| 77066 |
Tomosynthesis, mammo |
26 |
26 |
$585.07 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,472 |
1,403 |
$554.59 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
652 |
263 |
$536.55 |
| 99152 |
|
51 |
46 |
$506.85 |
| Q3014 |
Telehealth originating site facility fee |
75 |
72 |
$489.97 |
| 86431 |
|
40 |
39 |
$488.42 |
| 82140 |
|
127 |
106 |
$474.64 |
| 91035 |
|
122 |
117 |
$446.35 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
141 |
60 |
$439.74 |
| 80358 |
|
27 |
27 |
$433.22 |
| 83883 |
|
15 |
12 |
$401.40 |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,018 |
459 |
$395.06 |
| 83516 |
|
14 |
13 |
$377.80 |
| 80324 |
|
27 |
27 |
$356.23 |
| 80346 |
|
27 |
27 |
$356.22 |
| 80345 |
|
27 |
27 |
$356.22 |
| 87481 |
|
12 |
12 |
$332.00 |
| 82951 |
|
12 |
12 |
$328.32 |
| 80306 |
|
325 |
295 |
$321.23 |
| 69209 |
|
32 |
29 |
$319.49 |
| 00731 |
|
133 |
119 |
$317.69 |
| 86703 |
|
37 |
30 |
$304.43 |
| 86618 |
|
29 |
27 |
$302.61 |
| 72052 |
|
12 |
12 |
$295.49 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
3,186 |
2,771 |
$287.10 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
92 |
57 |
$270.59 |
| 86800 |
|
16 |
12 |
$260.38 |
| 82784 |
|
14 |
12 |
$246.24 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
652 |
414 |
$233.76 |
| 80353 |
|
27 |
27 |
$216.60 |
| 73080 |
|
14 |
13 |
$204.34 |
| 86706 |
|
16 |
12 |
$200.05 |
| J2060 |
Injection, lorazepam, 2 mg |
624 |
372 |
$185.71 |
| 82248 |
|
30 |
25 |
$182.91 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
7,311 |
5,821 |
$172.09 |
| 71101 |
|
25 |
24 |
$170.19 |
| 84207 |
|
13 |
13 |
$168.50 |
| 11721 |
|
14 |
14 |
$166.97 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,177 |
897 |
$160.70 |
| 99490 |
Ccm add 20min |
403 |
344 |
$159.23 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
2,464 |
1,848 |
$156.96 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
204 |
101 |
$148.10 |
| 73070 |
|
13 |
13 |
$145.95 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
362 |
296 |
$140.42 |
| 72040 |
|
14 |
12 |
$131.94 |
| 84425 |
|
12 |
12 |
$131.53 |
| 80366 |
|
29 |
26 |
$116.41 |
| G0008 |
Administration of influenza virus vaccine |
132 |
123 |
$111.46 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,107 |
1,576 |
$99.94 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
639 |
446 |
$93.46 |
| 87147 |
|
34 |
24 |
$91.71 |
| 82150 |
|
76 |
71 |
$88.51 |
| J2704 |
Injection, propofol, 10 mg |
4,168 |
3,546 |
$72.76 |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,550 |
887 |
$65.93 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
4,117 |
3,456 |
$63.17 |
| 85055 |
|
19 |
13 |
$62.86 |
| 82800 |
|
67 |
60 |
$53.92 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
34 |
14 |
$37.82 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
168 |
122 |
$29.36 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
82 |
55 |
$26.92 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
56 |
42 |
$25.99 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,108 |
3,520 |
$23.08 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
65 |
54 |
$22.92 |
| C9113 |
Injection, pantoprazole sodium, per vial |
22 |
13 |
$18.60 |
| J3480 |
Injection, potassium chloride, per 2 meq |
55 |
25 |
$16.05 |
| 87075 |
|
16 |
14 |
$15.36 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
48 |
39 |
$14.87 |
| 90670 |
|
77 |
76 |
$10.98 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
366 |
327 |
$9.84 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
15 |
12 |
$8.84 |
| 91300 |
|
800 |
647 |
$7.57 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
63 |
56 |
$6.60 |
| J1940 |
Injection, furosemide, up to 20 mg |
59 |
28 |
$4.08 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
56 |
54 |
$2.56 |
| 94760 |
|
1,856 |
976 |
$1.19 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
169 |
148 |
$0.31 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
80 |
74 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
76 |
64 |
$0.00 |
| 87400 |
|
14 |
14 |
$0.00 |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
13 |
12 |
$0.00 |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
203 |
140 |
$0.00 |
| 80143 |
|
15 |
12 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
331 |
311 |
$0.00 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
17 |
13 |
$0.00 |
| 00840 |
|
19 |
14 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
108 |
103 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
130 |
123 |
$0.00 |
| 73090 |
|
15 |
13 |
$0.00 |
| G0480 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed |
24 |
24 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
12 |
12 |
$0.00 |
| 00160 |
|
13 |
12 |
$0.00 |