| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
45,947 |
43,161 |
$7.11M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
25,772 |
23,606 |
$4.83M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
10,482 |
8,841 |
$3.98M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,361 |
3,605 |
$3.08M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
18,864 |
17,995 |
$1.63M |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
15,061 |
5,297 |
$1.42M |
| 80053 |
Comprehensive metabolic panel |
25,925 |
22,286 |
$1.15M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
17,936 |
5,539 |
$1.09M |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,648 |
1,278 |
$1.06M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
32,084 |
27,474 |
$1.02M |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,944 |
2,106 |
$993K |
| G0378 |
Hospital observation service, per hour |
1,872 |
1,306 |
$942K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
4,771 |
4,553 |
$862K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
5,335 |
3,618 |
$663K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
8,507 |
4,658 |
$654K |
| 76830 |
Ultrasound, transvaginal |
3,899 |
3,708 |
$652K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
3,945 |
3,877 |
$607K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,173 |
1,635 |
$580K |
| 71046 |
Radiologic examination, chest; 2 views |
8,566 |
7,209 |
$560K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
5,807 |
5,374 |
$534K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
12,284 |
4,664 |
$530K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
8,818 |
7,512 |
$523K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
8,816 |
7,890 |
$476K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
3,345 |
1,666 |
$451K |
| 36415 |
Collection of venous blood by venipuncture |
46,881 |
38,106 |
$435K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
8,833 |
3,212 |
$420K |
| A0425 |
Ground mileage, per statute mile |
4,226 |
3,479 |
$416K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
9,854 |
9,341 |
$414K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
6,663 |
5,333 |
$401K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
3,887 |
3,566 |
$394K |
| 81001 |
|
17,913 |
16,072 |
$380K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
3,761 |
3,581 |
$373K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
5,607 |
5,353 |
$347K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
6,479 |
5,542 |
$331K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
7,067 |
6,305 |
$319K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,195 |
7,848 |
$302K |
| 71045 |
Radiologic examination, chest; single view |
7,170 |
5,390 |
$282K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
4,186 |
3,626 |
$259K |
| 84443 |
Thyroid stimulating hormone (TSH) |
7,933 |
7,702 |
$250K |
| 76801 |
|
1,720 |
1,507 |
$249K |
| 84145 |
|
2,259 |
2,031 |
$249K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,792 |
1,521 |
$240K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,031 |
1,758 |
$231K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,532 |
4,317 |
$218K |
| 59025 |
Fetal non-stress test |
2,825 |
2,102 |
$216K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
4,595 |
4,334 |
$207K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,658 |
2,576 |
$200K |
| 73630 |
|
2,752 |
2,098 |
$199K |
| 83690 |
|
6,340 |
5,734 |
$189K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,299 |
4,276 |
$189K |
| 84484 |
|
5,105 |
3,777 |
$179K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,586 |
5,427 |
$168K |
| 87040 |
|
4,077 |
2,256 |
$167K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
3,445 |
1,425 |
$160K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
6,457 |
6,060 |
$158K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
312 |
298 |
$157K |
| 80061 |
Lipid panel |
4,516 |
4,412 |
$157K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
10,323 |
7,519 |
$156K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
3,358 |
3,268 |
$141K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
1,474 |
1,267 |
$139K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
247 |
185 |
$134K |
| 80050 |
General health panel |
1,026 |
1,014 |
$132K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
146 |
121 |
$131K |
| 74018 |
|
1,180 |
1,056 |
$123K |
| 84702 |
|
2,723 |
1,863 |
$120K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
3,997 |
3,641 |
$116K |
| 96376 |
|
2,184 |
1,590 |
$116K |
| 73610 |
|
1,656 |
1,459 |
$114K |
| 73562 |
|
1,830 |
1,375 |
$112K |
| 73030 |
|
1,291 |
944 |
$111K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
684 |
661 |
$108K |
| 84439 |
|
3,515 |
3,419 |
$107K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
782 |
252 |
$106K |
| 81025 |
|
8,933 |
8,463 |
$106K |
| 86850 |
|
2,717 |
2,556 |
$106K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,060 |
1,479 |
$97K |
| 87186 |
|
3,178 |
2,806 |
$95K |
| 97161 |
|
1,462 |
1,430 |
$94K |
| 76642 |
|
958 |
782 |
$94K |
| J7050 |
Infusion, normal saline solution, 250 cc |
8,328 |
4,899 |
$90K |
| 86140 |
|
4,566 |
4,137 |
$84K |
| 87486 |
|
688 |
665 |
$84K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
876 |
672 |
$83K |
| 80306 |
|
1,513 |
1,419 |
$83K |
| 87581 |
|
688 |
665 |
$81K |
| 73110 |
|
954 |
763 |
$79K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
4,460 |
4,085 |
$77K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
88 |
69 |
$68K |
| 83605 |
|
3,030 |
2,526 |
$62K |
| 84481 |
|
1,499 |
1,461 |
$60K |
| 86900 |
|
3,097 |
2,904 |
$59K |
| 87077 |
|
1,893 |
1,742 |
$57K |
| 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 |
1,148 |
1,124 |
$56K |
| 83735 |
|
2,489 |
1,883 |
$55K |
| 86901 |
|
3,098 |
2,905 |
$55K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
7,722 |
6,754 |
$53K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
98 |
93 |
$52K |
| 85379 |
|
1,357 |
1,290 |
$49K |
| 72100 |
|
690 |
557 |
$49K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
766 |
692 |
$48K |
| 76536 |
|
365 |
325 |
$48K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
407 |
365 |
$47K |
| 83880 |
|
1,108 |
1,001 |
$47K |
| 76770 |
|
316 |
269 |
$46K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
4,549 |
3,816 |
$46K |
| 87081 |
|
2,418 |
2,351 |
$46K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
7,122 |
5,997 |
$43K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,858 |
1,665 |
$43K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
3,024 |
2,889 |
$43K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,193 |
1,164 |
$42K |
| 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 |
825 |
740 |
$42K |
| J2704 |
Injection, propofol, 10 mg |
4,505 |
4,276 |
$41K |
| 85652 |
|
2,117 |
1,898 |
$41K |
| 88304 |
|
448 |
412 |
$40K |
| 85027 |
|
2,130 |
1,951 |
$40K |
| 87070 |
|
1,207 |
1,107 |
$39K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
633 |
529 |
$39K |
| 85610 |
|
2,322 |
2,081 |
$38K |
| 84703 |
|
1,306 |
1,249 |
$38K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
74 |
55 |
$38K |
| 82570 |
|
1,506 |
1,307 |
$37K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
314 |
310 |
$36K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,813 |
1,781 |
$36K |
| 83655 |
|
691 |
690 |
$35K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,637 |
1,540 |
$35K |
| 59426 |
|
44 |
44 |
$34K |
| 86780 |
|
1,506 |
1,473 |
$34K |
| 97113 |
|
281 |
106 |
$34K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
4,692 |
4,235 |
$33K |
| 81003 |
|
2,608 |
2,456 |
$32K |
| 97162 |
|
427 |
422 |
$32K |
| 87088 |
|
1,256 |
1,101 |
$32K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,225 |
1,196 |
$31K |
| 82728 |
|
1,007 |
971 |
$31K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
319 |
293 |
$29K |
| 97597 |
|
519 |
206 |
$28K |
| 93017 |
|
169 |
165 |
$27K |
| 87507 |
|
107 |
106 |
$27K |
| 87340 |
|
1,699 |
1,665 |
$25K |
| 82950 |
|
1,178 |
1,128 |
$25K |
| 87430 |
|
962 |
939 |
$24K |
| 73140 |
|
446 |
402 |
$24K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
129 |
111 |
$24K |
| 73130 |
|
291 |
242 |
$23K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
374 |
326 |
$23K |
| 43235 |
|
17 |
15 |
$22K |
| 86762 |
|
1,280 |
1,252 |
$19K |
| 73564 |
|
294 |
196 |
$19K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,833 |
1,371 |
$19K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,011 |
1,706 |
$19K |
| 92523 |
|
199 |
198 |
$18K |
| 82962 |
|
2,829 |
2,022 |
$18K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
3,520 |
2,803 |
$17K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,276 |
1,551 |
$17K |
| 82247 |
|
603 |
417 |
$17K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
12 |
12 |
$17K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
33 |
25 |
$17K |
| 82553 |
|
570 |
464 |
$16K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
51 |
35 |
$16K |
| 83540 |
|
941 |
908 |
$16K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
463 |
225 |
$16K |
| 87807 |
|
354 |
349 |
$16K |
| 12001 |
|
111 |
105 |
$16K |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
464 |
358 |
$15K |
| 85018 |
|
1,262 |
1,172 |
$15K |
| 80305 |
|
469 |
422 |
$15K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
32 |
25 |
$15K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
48 |
28 |
$15K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,626 |
1,451 |
$14K |
| 70486 |
|
30 |
25 |
$14K |
| 82550 |
|
735 |
605 |
$14K |
| 85730 |
|
931 |
850 |
$14K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
17 |
12 |
$14K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
5,713 |
5,245 |
$14K |
| 84156 |
|
530 |
430 |
$13K |
| 36416 |
|
1,476 |
1,268 |
$13K |
| 86803 |
|
935 |
921 |
$13K |
| 96367 |
|
236 |
171 |
$13K |
| 87400 |
|
394 |
192 |
$13K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,094 |
962 |
$12K |
| J3490 |
Unclassified drugs |
319 |
277 |
$12K |
| 84030 |
|
323 |
318 |
$12K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,910 |
1,613 |
$11K |
| 83550 |
|
708 |
692 |
$11K |
| 82607 |
|
348 |
339 |
$11K |
| 99460 |
|
129 |
126 |
$10K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
454 |
447 |
$10K |
| 97535 |
Self-care/home management training, each 15 minutes |
360 |
321 |
$10K |
| 94761 |
|
289 |
148 |
$10K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
124 |
117 |
$9K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
12 |
12 |
$8K |
| 01967 |
Neuraxial labor analgesia/anesthesia for planned vaginal delivery |
14 |
14 |
$8K |
| 76882 |
|
59 |
48 |
$8K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
127 |
127 |
$8K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
17 |
13 |
$7K |
| 87420 |
|
259 |
255 |
$7K |
| 99223 |
Prolong inpt eval add15 m |
100 |
96 |
$7K |
| 82043 |
|
281 |
277 |
$7K |
| 82150 |
|
314 |
293 |
$7K |
| 73502 |
|
145 |
106 |
$6K |
| 59425 |
|
15 |
15 |
$6K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
958 |
877 |
$6K |
| 93971 |
|
53 |
38 |
$6K |
| 97035 |
|
192 |
77 |
$5K |
| 74019 |
|
45 |
37 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
63 |
63 |
$5K |
| 82803 |
|
109 |
95 |
$5K |
| 90715 |
|
169 |
169 |
$5K |
| 97014 |
|
363 |
159 |
$5K |
| 92558 |
|
59 |
58 |
$5K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
17 |
12 |
$4K |
| 99233 |
Prolong inpt eval add15 m |
118 |
84 |
$4K |
| 80069 |
|
126 |
115 |
$4K |
| 84403 |
|
77 |
75 |
$4K |
| 87205 |
|
186 |
160 |
$4K |
| 73590 |
|
86 |
69 |
$4K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
705 |
658 |
$4K |
| 11721 |
|
503 |
490 |
$4K |
| 80179 |
|
57 |
54 |
$4K |
| 82746 |
|
108 |
102 |
$4K |
| 73080 |
|
47 |
40 |
$4K |
| 99215 |
Prolong outpt/office vis |
62 |
52 |
$4K |
| 82248 |
|
169 |
134 |
$3K |
| 84100 |
|
263 |
217 |
$3K |
| 73090 |
|
44 |
39 |
$3K |
| 84550 |
|
201 |
175 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
38 |
32 |
$3K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
211 |
167 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
111 |
100 |
$3K |
| 83615 |
|
163 |
141 |
$3K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
55 |
55 |
$3K |
| 84112 |
|
133 |
114 |
$3K |
| 76775 |
|
48 |
37 |
$3K |
| 92567 |
|
330 |
328 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
246 |
240 |
$3K |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
480 |
405 |
$2K |
| 93356 |
|
19 |
13 |
$2K |
| 87210 |
|
148 |
145 |
$2K |
| 80076 |
|
55 |
53 |
$2K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
12 |
12 |
$2K |
| 17110 |
|
35 |
34 |
$2K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
44 |
41 |
$2K |
| J2060 |
Injection, lorazepam, 2 mg |
209 |
178 |
$2K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
121 |
61 |
$2K |
| 29125 |
|
15 |
12 |
$1K |
| J2916 |
Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg |
30 |
12 |
$1K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
60 |
41 |
$1K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
167 |
84 |
$1K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
25 |
25 |
$1K |
| 83013 |
|
12 |
12 |
$1K |
| 86038 |
|
34 |
31 |
$1K |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
1,291 |
504 |
$1K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
96 |
89 |
$1K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
229 |
221 |
$1K |
| 92557 |
|
54 |
54 |
$1K |
| 97116 |
|
52 |
24 |
$1K |
| 97165 |
|
26 |
26 |
$1K |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
359 |
346 |
$965.43 |
| C9113 |
Injection, pantoprazole sodium, per vial |
129 |
103 |
$965.39 |
| 90686 |
|
65 |
65 |
$880.96 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
16 |
16 |
$864.75 |
| J1815 |
Injection, insulin, per 5 units |
79 |
63 |
$770.58 |
| 73560 |
|
22 |
16 |
$768.74 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
172 |
111 |
$668.54 |
| 82951 |
|
13 |
13 |
$663.95 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
12 |
12 |
$633.77 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
78 |
67 |
$582.93 |
| 99205 |
Prolong outpt/office vis |
36 |
26 |
$549.71 |
| 82948 |
|
16 |
15 |
$545.99 |
| 84153 |
|
15 |
15 |
$442.39 |
| 95117 |
|
68 |
24 |
$438.96 |
| 82805 |
|
13 |
12 |
$411.84 |
| 87806 |
|
565 |
556 |
$411.00 |
| 86308 |
|
14 |
12 |
$353.79 |
| 83001 |
|
16 |
16 |
$320.65 |
| 92588 |
|
21 |
17 |
$320.16 |
| 64488 |
|
13 |
13 |
$313.63 |
| 86704 |
|
12 |
12 |
$280.58 |
| J3480 |
Injection, potassium chloride, per 2 meq |
18 |
13 |
$279.34 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
57 |
55 |
$276.38 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
12 |
12 |
$225.40 |
| 82565 |
|
13 |
13 |
$223.30 |
| J1790 |
Injection, droperidol, up to 5 mg |
22 |
14 |
$199.72 |
| 82952 |
|
12 |
12 |
$198.64 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
15 |
13 |
$186.15 |
| 82272 |
|
12 |
12 |
$184.18 |
| 85007 |
|
12 |
12 |
$182.25 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
30 |
29 |
$170.64 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
152 |
137 |
$145.25 |
| 83014 |
|
12 |
12 |
$141.74 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
14 |
13 |
$137.22 |
| 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 |
72 |
68 |
$104.21 |
| 85014 |
|
13 |
12 |
$103.41 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
12 |
12 |
$81.00 |
| 51798 |
|
13 |
13 |
$62.81 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
26 |
26 |
$61.03 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
37 |
37 |
$56.37 |
| 99001 |
|
64 |
62 |
$33.83 |
| A9270 |
Non-covered item or service |
3,305 |
814 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
169 |
164 |
$0.00 |
| 80320 |
|
47 |
37 |
$0.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
46 |
43 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
1,703 |
1,411 |
$0.00 |