| Code | Description | Claims | Beneficiaries | Total Paid |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
23,376 |
20,474 |
$5.53M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
20,983 |
17,458 |
$4.68M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
16,035 |
13,175 |
$3.50M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
10,667 |
8,000 |
$3.28M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,465 |
3,882 |
$1.40M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
26,752 |
6,257 |
$1.31M |
| 70450 |
Computed tomography, head or brain; without contrast material |
5,866 |
4,943 |
$1.21M |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
6,198 |
1,569 |
$1.10M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
4,182 |
3,817 |
$893K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,557 |
2,170 |
$864K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,193 |
2,666 |
$809K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,664 |
2,473 |
$714K |
| G0378 |
Hospital observation service, per hour |
4,230 |
2,478 |
$697K |
| 59025 |
Fetal non-stress test |
2,348 |
1,346 |
$631K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
2,315 |
1,613 |
$621K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
6,395 |
4,959 |
$582K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
3,102 |
2,628 |
$467K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,627 |
5,420 |
$441K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
2,995 |
1,593 |
$402K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
7,196 |
3,444 |
$399K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
11,651 |
3,358 |
$382K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
765 |
677 |
$285K |
| 97161 |
|
2,263 |
1,917 |
$269K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
288 |
253 |
$234K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,215 |
1,789 |
$228K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
3,672 |
3,471 |
$201K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
1,941 |
1,777 |
$188K |
| 80053 |
Comprehensive metabolic panel |
36,324 |
27,151 |
$184K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
4,872 |
3,500 |
$179K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
347 |
309 |
$168K |
| J9271 |
Injection, pembrolizumab, 1 mg |
33 |
24 |
$165K |
| 76830 |
Ultrasound, transvaginal |
1,120 |
1,025 |
$153K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
499 |
282 |
$150K |
| 59899 |
|
211 |
148 |
$147K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,095 |
1,002 |
$127K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,159 |
1,510 |
$115K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,725 |
2,582 |
$112K |
| 97113 |
|
1,341 |
445 |
$110K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,312 |
1,163 |
$105K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
680 |
612 |
$96K |
| 97035 |
|
1,933 |
567 |
$93K |
| 71250 |
|
1,126 |
1,018 |
$93K |
| 87632 |
|
657 |
629 |
$82K |
| 76642 |
|
533 |
433 |
$76K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
4,253 |
3,681 |
$71K |
| 71046 |
Radiologic examination, chest; 2 views |
4,366 |
3,869 |
$71K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
4,283 |
3,705 |
$67K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
106 |
86 |
$59K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,118 |
1,003 |
$56K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
40,829 |
29,715 |
$54K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
510 |
416 |
$54K |
| 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 |
2,784 |
1,843 |
$54K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
12,307 |
8,645 |
$52K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
61 |
49 |
$48K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
4,249 |
3,897 |
$45K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
142 |
134 |
$43K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,590 |
466 |
$40K |
| 84443 |
Thyroid stimulating hormone (TSH) |
4,687 |
3,968 |
$39K |
| 85027 |
|
9,988 |
7,341 |
$37K |
| 97162 |
|
220 |
179 |
$36K |
| 76801 |
|
471 |
403 |
$35K |
| 93971 |
|
288 |
254 |
$35K |
| 36415 |
Collection of venous blood by venipuncture |
17,569 |
13,305 |
$34K |
| 83880 |
|
3,438 |
2,842 |
$33K |
| 70498 |
|
73 |
66 |
$33K |
| 94726 |
|
402 |
363 |
$31K |
| 94727 |
|
525 |
480 |
$29K |
| 96367 |
|
818 |
596 |
$27K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
1,738 |
1,517 |
$24K |
| 93017 |
|
375 |
331 |
$24K |
| 97165 |
|
323 |
272 |
$23K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
7,339 |
6,116 |
$23K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,224 |
1,724 |
$23K |
| 84702 |
|
3,020 |
2,375 |
$22K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
2,306 |
2,151 |
$22K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
11,015 |
6,973 |
$22K |
| 64483 |
|
17 |
13 |
$21K |
| 81420 |
Fetal chromosomal aneuploidy genomic sequence analysis panel |
30 |
26 |
$20K |
| 94729 |
|
464 |
423 |
$20K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
15,877 |
12,460 |
$20K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,095 |
997 |
$19K |
| 43235 |
|
109 |
82 |
$19K |
| 71045 |
Radiologic examination, chest; single view |
11,026 |
8,974 |
$19K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
150 |
127 |
$19K |
| 87040 |
|
2,139 |
1,645 |
$18K |
| 88142 |
|
872 |
700 |
$18K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
14,466 |
11,379 |
$17K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,111 |
2,755 |
$17K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
95 |
86 |
$15K |
| 82948 |
|
11,748 |
3,385 |
$15K |
| 80061 |
Lipid panel |
2,964 |
2,660 |
$15K |
| 94060 |
|
186 |
172 |
$15K |
| 86780 |
|
1,331 |
1,205 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
111 |
87 |
$14K |
| 96523 |
|
226 |
162 |
$14K |
| 84484 |
|
11,722 |
8,757 |
$14K |
| 70486 |
|
174 |
163 |
$14K |
| 87486 |
|
2,301 |
2,147 |
$13K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
14 |
12 |
$13K |
| 90715 |
|
498 |
468 |
$13K |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
288 |
269 |
$13K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
768 |
685 |
$13K |
| 99215 |
Prolong outpt/office vis |
120 |
87 |
$12K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
35 |
21 |
$12K |
| 76536 |
|
81 |
78 |
$12K |
| 87581 |
|
2,300 |
2,146 |
$12K |
| 73030 |
|
878 |
737 |
$12K |
| 83735 |
|
13,332 |
8,605 |
$11K |
| 86803 |
|
622 |
516 |
$11K |
| 87631 |
|
859 |
744 |
$10K |
| 97116 |
|
408 |
184 |
$10K |
| 86900 |
|
3,213 |
2,611 |
$10K |
| 87340 |
|
1,697 |
1,448 |
$10K |
| 36430 |
|
14 |
12 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
79 |
64 |
$9K |
| 81025 |
|
9,886 |
8,179 |
$9K |
| 85379 |
|
1,956 |
1,698 |
$9K |
| 71271 |
|
74 |
67 |
$9K |
| 81001 |
|
20,817 |
16,776 |
$9K |
| 92523 |
|
31 |
30 |
$8K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
15,706 |
11,082 |
$8K |
| 74018 |
|
444 |
390 |
$8K |
| 86850 |
|
2,885 |
2,367 |
$8K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
313 |
254 |
$8K |
| 81003 |
|
5,217 |
4,125 |
$8K |
| 36591 |
|
1,559 |
784 |
$7K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
476 |
371 |
$7K |
| 84145 |
|
502 |
408 |
$7K |
| 73630 |
|
806 |
700 |
$7K |
| 12001 |
|
29 |
25 |
$7K |
| 87634 |
|
239 |
226 |
$7K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,293 |
1,090 |
$7K |
| 93799 |
|
1,582 |
655 |
$7K |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
228 |
205 |
$6K |
| 81329 |
|
180 |
146 |
$6K |
| 87653 |
|
145 |
130 |
$6K |
| 87081 |
|
3,400 |
3,075 |
$6K |
| G0476 |
Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test |
114 |
108 |
$6K |
| 72100 |
|
249 |
224 |
$6K |
| 83605 |
|
4,820 |
3,823 |
$6K |
| 85610 |
|
5,430 |
3,789 |
$6K |
| 80320 |
|
1,933 |
1,644 |
$5K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
11,997 |
8,694 |
$5K |
| J1610 |
Injection, glucagon hydrochloride, per 1 mg |
197 |
129 |
$5K |
| 86140 |
|
771 |
695 |
$5K |
| 86901 |
|
3,212 |
2,611 |
$5K |
| 82607 |
|
567 |
509 |
$5K |
| 73610 |
|
692 |
622 |
$5K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
10,081 |
7,460 |
$5K |
| 82728 |
|
496 |
440 |
$5K |
| 77066 |
Tomosynthesis, mammo |
102 |
97 |
$5K |
| 80143 |
|
672 |
588 |
$4K |
| 0064U |
|
337 |
284 |
$4K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
20 |
14 |
$4K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
15 |
13 |
$4K |
| 76775 |
|
41 |
38 |
$4K |
| 94618 |
|
27 |
24 |
$4K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
5,346 |
3,714 |
$4K |
| 80329 |
|
261 |
202 |
$4K |
| G0475 |
Hiv antigen/antibody, combination assay, screening |
363 |
344 |
$4K |
| 73130 |
|
375 |
325 |
$4K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
15 |
12 |
$4K |
| 85652 |
|
1,035 |
908 |
$3K |
| 73502 |
|
245 |
224 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,352 |
2,998 |
$3K |
| 82950 |
|
401 |
367 |
$3K |
| 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 |
798 |
425 |
$3K |
| 83021 |
|
367 |
305 |
$3K |
| 86787 |
|
305 |
250 |
$3K |
| 96376 |
|
4,534 |
2,414 |
$3K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
9,243 |
7,415 |
$3K |
| 80076 |
|
541 |
359 |
$3K |
| 77080 |
|
46 |
38 |
$3K |
| 84153 |
|
253 |
229 |
$3K |
| 87077 |
|
2,538 |
2,134 |
$2K |
| 84100 |
|
3,442 |
1,909 |
$2K |
| 36600 |
|
420 |
328 |
$2K |
| 96415 |
|
93 |
39 |
$2K |
| 80179 |
|
631 |
555 |
$2K |
| 83690 |
|
7,288 |
5,975 |
$2K |
| 83540 |
|
514 |
454 |
$2K |
| 82248 |
|
2,053 |
1,446 |
$2K |
| 86762 |
|
314 |
266 |
$2K |
| 84466 |
|
321 |
285 |
$2K |
| 87205 |
|
631 |
522 |
$2K |
| 87102 |
|
124 |
117 |
$2K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
3,299 |
2,485 |
$2K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
5,200 |
3,373 |
$2K |
| 85730 |
|
3,721 |
2,960 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
57 |
52 |
$2K |
| 73564 |
|
357 |
305 |
$2K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
3,174 |
2,259 |
$2K |
| 87184 |
|
1,864 |
1,563 |
$2K |
| 94010 |
|
62 |
56 |
$2K |
| 74022 |
|
415 |
354 |
$2K |
| 82105 |
|
111 |
95 |
$2K |
| 82746 |
|
188 |
172 |
$1K |
| A9270 |
Non-covered item or service |
629 |
471 |
$1K |
| 82565 |
|
979 |
869 |
$1K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,874 |
2,733 |
$1K |
| 84550 |
|
475 |
358 |
$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 |
2,014 |
1,405 |
$1K |
| 84156 |
|
286 |
222 |
$1K |
| 73562 |
|
83 |
68 |
$1K |
| 82550 |
|
819 |
644 |
$950.77 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
629 |
560 |
$917.71 |
| 70496 |
|
47 |
42 |
$892.63 |
| 82077 |
|
1,022 |
874 |
$783.83 |
| 97535 |
Self-care/home management training, each 15 minutes |
61 |
39 |
$763.08 |
| 82805 |
|
1,240 |
1,003 |
$756.10 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
362 |
292 |
$706.52 |
| 82150 |
|
372 |
310 |
$684.35 |
| 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 |
12 |
12 |
$649.02 |
| 87088 |
|
649 |
527 |
$622.89 |
| 73110 |
|
114 |
97 |
$571.35 |
| 86336 |
|
34 |
29 |
$544.63 |
| 76000 |
|
153 |
133 |
$530.40 |
| 73560 |
|
29 |
26 |
$520.40 |
| 84132 |
|
814 |
658 |
$518.12 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,271 |
466 |
$515.29 |
| J1644 |
Injection, heparin sodium, per 1000 units |
2,965 |
1,031 |
$510.71 |
| 87210 |
|
657 |
568 |
$502.58 |
| 96402 |
|
13 |
12 |
$498.15 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,627 |
2,681 |
$496.41 |
| J3490 |
Unclassified drugs |
6,210 |
3,477 |
$473.69 |
| 77062 |
|
14 |
12 |
$471.72 |
| 86038 |
|
29 |
28 |
$462.07 |
| J7050 |
Infusion, normal saline solution, 250 cc |
6,079 |
2,607 |
$455.45 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
4,705 |
4,146 |
$435.62 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
42 |
35 |
$414.85 |
| J2060 |
Injection, lorazepam, 2 mg |
1,071 |
728 |
$393.38 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
327 |
263 |
$392.36 |
| 94761 |
|
1,392 |
1,113 |
$381.46 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,889 |
2,816 |
$379.16 |
| 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 |
761 |
477 |
$367.06 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
433 |
359 |
$355.25 |
| 86480 |
|
15 |
13 |
$345.94 |
| 87070 |
|
145 |
119 |
$345.30 |
| 82677 |
|
34 |
29 |
$341.20 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,384 |
2,257 |
$300.72 |
| 72040 |
|
13 |
13 |
$282.43 |
| J1815 |
Injection, insulin, per 5 units |
1,165 |
449 |
$271.51 |
| 84439 |
|
29 |
25 |
$255.11 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,752 |
1,373 |
$252.94 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
3,003 |
1,990 |
$252.91 |
| 86592 |
|
27 |
24 |
$233.99 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
425 |
185 |
$172.20 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
979 |
771 |
$168.48 |
| 83615 |
|
85 |
62 |
$164.47 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,361 |
1,406 |
$162.16 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,159 |
1,377 |
$160.16 |
| 90686 |
|
22 |
18 |
$159.77 |
| 80050 |
General health panel |
25 |
23 |
$153.93 |
| 87220 |
|
351 |
294 |
$148.34 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,077 |
803 |
$145.44 |
| 87147 |
|
141 |
135 |
$134.28 |
| 88342 |
|
19 |
13 |
$121.82 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
854 |
340 |
$117.19 |
| 83718 |
|
15 |
14 |
$113.21 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
1,201 |
787 |
$106.61 |
| 82553 |
|
108 |
73 |
$94.73 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,220 |
991 |
$91.78 |
| 86706 |
|
13 |
13 |
$72.48 |
| C9399 |
Unclassified drugs or biologicals |
19 |
12 |
$70.69 |
| 82465 |
|
15 |
14 |
$61.88 |
| 82784 |
|
18 |
12 |
$57.36 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
285 |
238 |
$38.17 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
367 |
241 |
$37.79 |
| 88304 |
|
17 |
14 |
$33.80 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
236 |
189 |
$31.95 |
| 84478 |
|
15 |
14 |
$31.52 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
498 |
452 |
$29.28 |
| 86403 |
|
39 |
31 |
$28.19 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
292 |
257 |
$21.36 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
488 |
386 |
$20.48 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
471 |
265 |
$19.59 |
| J2704 |
Injection, propofol, 10 mg |
3,646 |
2,744 |
$15.81 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
76 |
49 |
$7.52 |
| A4600 |
Sleeve for intermittent limb compression device, replacement only, each |
194 |
130 |
$7.31 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
96 |
50 |
$7.27 |
| J1940 |
Injection, furosemide, up to 20 mg |
165 |
104 |
$6.60 |
| C9113 |
Injection, pantoprazole sodium, per vial |
458 |
262 |
$5.60 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
100 |
92 |
$1.92 |
| J1630 |
Injection, haloperidol, up to 5 mg |
20 |
12 |
$1.38 |
| J7510 |
Prednisolone oral, per 5 mg |
16 |
14 |
$1.38 |
| 90662 |
|
17 |
14 |
$0.97 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
325 |
68 |
$0.43 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
28 |
28 |
$0.00 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
112 |
94 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
172 |
145 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
111 |
101 |
$0.00 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
202 |
179 |
$0.00 |
| J3535 |
Drug administered through a metered dose inhaler |
89 |
53 |
$0.00 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
75 |
62 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
17 |
14 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
58 |
38 |
$0.00 |
| 94760 |
|
41 |
12 |
$0.00 |
| C1889 |
Implantable/insertable device, not otherwise classified |
12 |
12 |
$0.00 |
| V2632 |
Posterior chamber intraocular lens |
14 |
14 |
$0.00 |
| 82140 |
|
13 |
12 |
$0.00 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
569 |
460 |
$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 |
176 |
125 |
$0.00 |
| 94664 |
|
29 |
25 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
114 |
87 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
209 |
155 |
$0.00 |
| A4550 |
Surgical trays |
114 |
90 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
49 |
36 |
$0.00 |
| A9700 |
Supply of injectable contrast material for use in echocardiography, per study |
16 |
12 |
$0.00 |
| J7342 |
Instillation, ciprofloxacin otic suspension, 6 mg |
34 |
25 |
$0.00 |
| J1953 |
Injection, levetiracetam, 10 mg |
14 |
12 |
$0.00 |
| J1020 |
Injection, methylprednisolone acetate, 20 mg |
14 |
14 |
$0.00 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
27 |
24 |
$0.00 |
| 82247 |
|
36 |
12 |
$0.00 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
19 |
13 |
$0.00 |