| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
21,777 |
18,509 |
$2.94M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
6,249 |
5,427 |
$1.83M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
20,244 |
18,095 |
$1.65M |
| G0378 |
Hospital observation service, per hour |
6,976 |
4,589 |
$1.12M |
| 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 |
6,306 |
5,438 |
$952K |
| 36415 |
Collection of venous blood by venipuncture |
66,693 |
50,335 |
$865K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
61,029 |
46,270 |
$857K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
5,028 |
4,448 |
$702K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
6,134 |
5,387 |
$459K |
| 80053 |
Comprehensive metabolic panel |
35,177 |
27,884 |
$432K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
2,295 |
2,126 |
$363K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
22,217 |
18,575 |
$349K |
| 84484 |
|
19,647 |
12,624 |
$318K |
| 81001 |
|
27,778 |
23,186 |
$309K |
| 80047 |
|
8,667 |
7,320 |
$302K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
12,792 |
9,404 |
$298K |
| 83735 |
|
8,093 |
5,651 |
$291K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
3,664 |
2,359 |
$281K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
6,689 |
4,489 |
$277K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
7,461 |
6,190 |
$269K |
| 80076 |
|
7,833 |
6,696 |
$262K |
| 70450 |
Computed tomography, head or brain; without contrast material |
5,033 |
4,475 |
$261K |
| 71045 |
Radiologic examination, chest; single view |
11,730 |
10,030 |
$256K |
| 83880 |
|
8,564 |
7,288 |
$248K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
299 |
278 |
$237K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,663 |
9,015 |
$230K |
| 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 |
3,400 |
1,830 |
$230K |
| 83605 |
|
14,954 |
12,080 |
$226K |
| 85610 |
|
10,398 |
8,862 |
$226K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
5,505 |
3,519 |
$222K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
7,049 |
6,205 |
$222K |
| 84443 |
Thyroid stimulating hormone (TSH) |
8,880 |
7,820 |
$218K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,337 |
3,908 |
$174K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,240 |
1,325 |
$173K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,254 |
2,039 |
$167K |
| 93458 |
|
130 |
118 |
$164K |
| 85027 |
|
6,660 |
4,837 |
$162K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
3,329 |
3,011 |
$161K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
684 |
626 |
$161K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,231 |
1,090 |
$160K |
| 71046 |
Radiologic examination, chest; 2 views |
4,762 |
4,232 |
$160K |
| 59025 |
Fetal non-stress test |
4,138 |
2,327 |
$158K |
| 83690 |
|
11,430 |
9,629 |
$156K |
| 84702 |
|
3,243 |
2,701 |
$149K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
673 |
617 |
$146K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,020 |
1,782 |
$143K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,037 |
5,443 |
$136K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
16,241 |
14,123 |
$136K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
5,500 |
1,363 |
$135K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,092 |
1,879 |
$131K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,335 |
1,275 |
$124K |
| 88342 |
|
1,640 |
1,447 |
$118K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
9,031 |
7,658 |
$117K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,108 |
864 |
$115K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,402 |
1,284 |
$106K |
| 84703 |
|
4,459 |
3,864 |
$104K |
| 85730 |
|
9,127 |
7,976 |
$104K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,153 |
6,520 |
$99K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
4,065 |
3,591 |
$98K |
| 82948 |
|
1,299 |
669 |
$98K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
450 |
431 |
$97K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
613 |
555 |
$97K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
4,814 |
4,370 |
$95K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
6,093 |
5,356 |
$94K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
164 |
147 |
$92K |
| C1763 |
Connective tissue, non-human (includes synthetic) |
209 |
189 |
$83K |
| 80320 |
|
1,762 |
1,527 |
$83K |
| 87040 |
|
6,235 |
4,041 |
$83K |
| 86900 |
|
3,206 |
2,593 |
$83K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
797 |
457 |
$82K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
1,852 |
210 |
$81K |
| 86901 |
|
2,878 |
2,422 |
$80K |
| 00840 |
|
185 |
146 |
$80K |
| 86850 |
|
2,641 |
2,110 |
$75K |
| 80061 |
Lipid panel |
4,361 |
3,970 |
$71K |
| 76830 |
Ultrasound, transvaginal |
1,295 |
1,153 |
$70K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,903 |
2,767 |
$66K |
| 93970 |
|
517 |
462 |
$65K |
| 94664 |
|
1,022 |
818 |
$64K |
| 76536 |
|
1,223 |
1,117 |
$63K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
657 |
396 |
$58K |
| 80074 |
|
998 |
868 |
$58K |
| J8501 |
Aprepitant, oral, 5 mg |
2,135 |
1,877 |
$57K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
3,372 |
3,024 |
$57K |
| 96367 |
|
512 |
309 |
$56K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
5,365 |
4,428 |
$52K |
| 87077 |
|
3,264 |
2,896 |
$52K |
| 82962 |
|
5,927 |
4,294 |
$52K |
| 88304 |
|
304 |
271 |
$50K |
| 72141 |
|
117 |
106 |
$47K |
| 83615 |
|
3,429 |
2,340 |
$46K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
763 |
682 |
$44K |
| 88307 |
|
193 |
139 |
$44K |
| 93971 |
|
774 |
690 |
$43K |
| 82150 |
|
1,372 |
1,220 |
$42K |
| J2704 |
Injection, propofol, 10 mg |
3,663 |
3,363 |
$42K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
176 |
157 |
$41K |
| 96369 |
|
680 |
609 |
$41K |
| 76641 |
|
557 |
439 |
$39K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
480 |
397 |
$39K |
| 84550 |
|
2,911 |
1,889 |
$38K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,384 |
4,024 |
$38K |
| 58661 |
|
22 |
12 |
$38K |
| 74018 |
|
930 |
795 |
$37K |
| 87186 |
|
3,177 |
2,764 |
$37K |
| 72110 |
|
806 |
753 |
$36K |
| 85379 |
|
1,774 |
1,570 |
$36K |
| 84439 |
|
3,268 |
2,947 |
$33K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
3,598 |
3,311 |
$32K |
| G0379 |
Direct admission of patient for hospital observation care |
439 |
341 |
$32K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
872 |
750 |
$31K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
872 |
750 |
$31K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,539 |
1,416 |
$31K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
8,078 |
5,467 |
$31K |
| 86140 |
|
1,612 |
1,409 |
$29K |
| 70486 |
|
179 |
162 |
$29K |
| 20610 |
|
506 |
442 |
$28K |
| 96376 |
|
684 |
412 |
$27K |
| 80346 |
|
502 |
222 |
$27K |
| 36600 |
|
303 |
260 |
$27K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
99 |
91 |
$27K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
466 |
369 |
$27K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
1,321 |
366 |
$27K |
| J2780 |
Injection, ranitidine hydrochloride, 25 mg |
119 |
116 |
$27K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,609 |
1,373 |
$27K |
| 71250 |
|
1,297 |
1,135 |
$26K |
| 73130 |
|
604 |
552 |
$26K |
| 73630 |
|
851 |
779 |
$24K |
| 73562 |
|
839 |
762 |
$24K |
| C1769 |
Guide wire |
613 |
532 |
$24K |
| 43450 |
|
285 |
262 |
$22K |
| 82550 |
|
1,146 |
857 |
$22K |
| J1756 |
Injection, iron sucrose, 1 mg |
522 |
259 |
$21K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
2,812 |
2,486 |
$21K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,022 |
2,498 |
$20K |
| 73610 |
|
440 |
399 |
$19K |
| 73030 |
|
707 |
634 |
$19K |
| 84156 |
|
1,222 |
734 |
$18K |
| 64493 |
|
94 |
90 |
$18K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
92 |
90 |
$18K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,894 |
1,717 |
$18K |
| 84100 |
|
730 |
572 |
$17K |
| 82140 |
|
744 |
580 |
$17K |
| Q3014 |
Telehealth originating site facility fee |
622 |
579 |
$17K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
55 |
54 |
$17K |
| 82570 |
|
1,381 |
971 |
$17K |
| 97162 |
|
418 |
389 |
$16K |
| 82553 |
|
621 |
448 |
$16K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
587 |
191 |
$16K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
616 |
602 |
$16K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
107 |
96 |
$15K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
68 |
61 |
$15K |
| 74019 |
|
168 |
145 |
$15K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
572 |
555 |
$15K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
322 |
251 |
$15K |
| 87280 |
|
936 |
838 |
$14K |
| 87081 |
|
807 |
719 |
$14K |
| J1815 |
Injection, insulin, per 5 units |
695 |
438 |
$14K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,138 |
834 |
$14K |
| 87205 |
|
1,209 |
1,082 |
$13K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,126 |
1,096 |
$13K |
| 99218 |
|
351 |
247 |
$13K |
| 00731 |
|
1,070 |
992 |
$13K |
| 87070 |
|
981 |
892 |
$13K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
371 |
323 |
$13K |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
306 |
265 |
$13K |
| 85652 |
|
1,312 |
1,188 |
$12K |
| 84144 |
|
256 |
221 |
$12K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
45 |
41 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
259 |
251 |
$12K |
| 82805 |
|
234 |
205 |
$12K |
| 82803 |
|
448 |
360 |
$11K |
| 93017 |
|
119 |
106 |
$11K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
313 |
149 |
$11K |
| 82607 |
|
880 |
816 |
$11K |
| 94761 |
|
595 |
516 |
$11K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
609 |
601 |
$11K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
448 |
418 |
$11K |
| 82565 |
|
1,343 |
1,223 |
$10K |
| 73221 |
|
54 |
51 |
$10K |
| 80050 |
General health panel |
323 |
303 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
197 |
191 |
$9K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,101 |
1,060 |
$9K |
| 82728 |
|
926 |
848 |
$9K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,868 |
2,558 |
$9K |
| 84520 |
|
387 |
370 |
$9K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
86 |
75 |
$9K |
| 95806 |
|
116 |
110 |
$8K |
| 78227 |
|
26 |
26 |
$8K |
| 86790 |
|
476 |
347 |
$8K |
| 88341 |
|
45 |
37 |
$8K |
| 83540 |
|
1,161 |
1,057 |
$8K |
| 73110 |
|
306 |
276 |
$7K |
| 00811 |
|
272 |
253 |
$7K |
| A9537 |
Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries |
42 |
42 |
$7K |
| 84466 |
|
950 |
859 |
$7K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
55 |
49 |
$7K |
| 97161 |
|
212 |
193 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
835 |
817 |
$6K |
| 82746 |
|
432 |
394 |
$6K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
17 |
12 |
$6K |
| 76770 |
|
102 |
88 |
$6K |
| 73502 |
|
163 |
147 |
$6K |
| 99205 |
Prolong outpt/office vis |
105 |
105 |
$6K |
| 97116 |
|
466 |
225 |
$6K |
| 95811 |
|
17 |
15 |
$5K |
| 58558 |
|
13 |
12 |
$5K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
134 |
131 |
$5K |
| 80329 |
|
76 |
69 |
$5K |
| C1760 |
Closure device, vascular (implantable/insertable) |
35 |
28 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
83 |
83 |
$5K |
| 77066 |
Tomosynthesis, mammo |
74 |
68 |
$5K |
| 87279 |
|
377 |
347 |
$5K |
| 87260 |
|
376 |
346 |
$4K |
| 86703 |
|
276 |
251 |
$4K |
| 88313 |
|
39 |
37 |
$4K |
| 10060 |
|
26 |
26 |
$4K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
146 |
124 |
$4K |
| 94729 |
|
727 |
638 |
$3K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
233 |
182 |
$3K |
| 87276 |
|
269 |
247 |
$3K |
| 93880 |
|
28 |
24 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
28 |
24 |
$3K |
| 64635 |
|
15 |
15 |
$3K |
| 72050 |
|
47 |
43 |
$3K |
| 88302 |
|
75 |
68 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
26 |
26 |
$3K |
| 81000 |
|
1,548 |
1,397 |
$3K |
| Q0138 |
Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) |
26 |
13 |
$3K |
| 36430 |
|
30 |
24 |
$3K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
283 |
276 |
$2K |
| 80355 |
|
568 |
273 |
$2K |
| 72131 |
|
27 |
25 |
$2K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
182 |
134 |
$2K |
| 73590 |
|
14 |
14 |
$2K |
| 99215 |
Prolong outpt/office vis |
51 |
51 |
$2K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
14 |
14 |
$2K |
| 64490 |
|
12 |
12 |
$2K |
| 00813 |
|
64 |
60 |
$2K |
| 76818 |
|
33 |
25 |
$2K |
| 94060 |
|
675 |
593 |
$2K |
| 72100 |
|
13 |
12 |
$2K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
17 |
12 |
$2K |
| 77065 |
Tomosynthesis, mammo |
42 |
38 |
$2K |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
331 |
298 |
$2K |
| 96409 |
|
26 |
12 |
$2K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
85 |
71 |
$2K |
| 90832 |
Psychotherapy, 30 minutes with patient |
30 |
28 |
$2K |
| C2615 |
Sealant, pulmonary, liquid |
19 |
16 |
$2K |
| 84145 |
|
569 |
505 |
$1K |
| 90791 |
Psychiatric diagnostic evaluation |
13 |
13 |
$1K |
| 86592 |
|
359 |
284 |
$1K |
| 87634 |
|
94 |
80 |
$1K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
848 |
652 |
$1K |
| J2791 |
Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu |
19 |
13 |
$1K |
| 90671 |
|
76 |
76 |
$1K |
| 01400 |
|
14 |
14 |
$1K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,110 |
768 |
$1K |
| 90837 |
Psychotherapy, 53 minutes with patient |
13 |
13 |
$1K |
| 73080 |
|
13 |
13 |
$1K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
736 |
533 |
$1K |
| 90715 |
|
55 |
49 |
$1K |
| 86038 |
|
50 |
44 |
$1K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
161 |
83 |
$1K |
| 29515 |
|
14 |
13 |
$980.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
139 |
120 |
$972.37 |
| 81002 |
|
374 |
232 |
$970.46 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
549 |
454 |
$929.70 |
| 90656 |
|
309 |
309 |
$928.05 |
| 10005 |
|
13 |
12 |
$900.51 |
| 87210 |
|
92 |
76 |
$837.92 |
| 94727 |
|
237 |
210 |
$829.54 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
629 |
470 |
$821.89 |
| 87400 |
|
92 |
81 |
$811.93 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
749 |
560 |
$765.14 |
| 82010 |
|
13 |
12 |
$730.23 |
| G0008 |
Administration of influenza virus vaccine |
292 |
269 |
$702.30 |
| 82575 |
|
25 |
13 |
$700.53 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
12 |
$691.70 |
| 12001 |
|
13 |
13 |
$635.02 |
| 84132 |
|
27 |
16 |
$600.93 |
| 84436 |
|
59 |
56 |
$530.33 |
| 84480 |
|
47 |
46 |
$519.61 |
| 74230 |
|
41 |
40 |
$502.31 |
| 92611 |
|
42 |
41 |
$439.01 |
| 27096 |
|
16 |
15 |
$417.48 |
| 96127 |
|
222 |
213 |
$404.82 |
| 90723 |
|
196 |
194 |
$392.68 |
| 82043 |
|
50 |
45 |
$383.99 |
| 93226 |
|
16 |
13 |
$382.21 |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
43 |
38 |
$382.20 |
| 90686 |
|
71 |
68 |
$380.77 |
| 87481 |
|
14 |
12 |
$369.79 |
| 87275 |
|
58 |
52 |
$356.23 |
| 83655 |
|
31 |
29 |
$347.17 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
70 |
39 |
$322.69 |
| 87660 |
|
25 |
25 |
$318.00 |
| 90474 |
|
43 |
43 |
$310.20 |
| 52000 |
|
12 |
12 |
$308.26 |
| 99490 |
Ccm add 20min |
62 |
61 |
$280.61 |
| 84403 |
|
14 |
14 |
$246.45 |
| 81003 |
|
141 |
129 |
$241.94 |
| 82670 |
|
12 |
12 |
$239.93 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
196 |
103 |
$201.43 |
| 80164 |
|
16 |
13 |
$192.70 |
| 85046 |
|
83 |
80 |
$190.39 |
| 85018 |
|
116 |
106 |
$188.27 |
| 93225 |
|
16 |
13 |
$187.40 |
| J1626 |
Injection, granisetron hydrochloride, 100 mcg |
260 |
142 |
$185.71 |
| 86308 |
|
28 |
26 |
$185.49 |
| 86300 |
|
35 |
30 |
$173.24 |
| 76000 |
|
14 |
14 |
$156.15 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
55 |
41 |
$150.27 |
| 85014 |
|
74 |
67 |
$125.31 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
92 |
65 |
$103.83 |
| 86803 |
|
12 |
12 |
$103.62 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
99 |
83 |
$78.51 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
119 |
108 |
$74.81 |
| 80179 |
|
15 |
12 |
$69.29 |
| 72170 |
|
13 |
12 |
$68.94 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
94 |
69 |
$67.11 |
| 94618 |
|
85 |
69 |
$62.25 |
| J2060 |
Injection, lorazepam, 2 mg |
86 |
68 |
$60.27 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
43 |
43 |
$57.93 |
| 87340 |
|
14 |
13 |
$48.74 |
| 93922 |
|
16 |
15 |
$45.28 |
| 85045 |
|
14 |
14 |
$36.41 |
| J1644 |
Injection, heparin sodium, per 1000 units |
206 |
107 |
$35.95 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
18 |
14 |
$34.69 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
177 |
127 |
$18.26 |
| 82248 |
|
17 |
15 |
$18.08 |
| 90648 |
|
250 |
246 |
$15.18 |
| 90674 |
|
52 |
52 |
$10.83 |
| 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 |
286 |
225 |
$0.17 |
| 87102 |
|
15 |
14 |
$0.00 |
| 90633 |
|
37 |
37 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
48 |
37 |
$0.00 |
| G8997 |
Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
12 |
12 |
$0.00 |
| 99152 |
|
12 |
12 |
$0.00 |
| Q9960 |
High osmolar contrast material, 200-249 mg/ml iodine concentration, per ml |
79 |
78 |
$0.00 |
| C1780 |
Lens, intraocular (new technology) |
13 |
12 |
$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 |
63 |
56 |
$0.00 |
| G8996 |
Swallowing functional limitation, current status at therapy episode outset and at reporting intervals |
12 |
12 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
46 |
44 |
$0.00 |
| A4649 |
Surgical supply; miscellaneous |
15 |
13 |
$0.00 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
13 |
13 |
$0.00 |
| 90681 |
|
12 |
12 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
42 |
38 |
$0.00 |
| 82077 |
|
132 |
107 |
$0.00 |
| V2632 |
Posterior chamber intraocular lens |
43 |
38 |
$0.00 |
| 99000 |
|
14 |
13 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
16 |
13 |
$0.00 |
| J3490 |
Unclassified drugs |
16 |
13 |
$0.00 |