| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
40,151 |
34,804 |
$6.42M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
24,722 |
20,237 |
$3.73M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
14,335 |
10,146 |
$3.41M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
14,160 |
12,758 |
$2.15M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
12,907 |
10,315 |
$1.92M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
7,158 |
6,207 |
$1.37M |
| 70450 |
Computed tomography, head or brain; without contrast material |
4,965 |
4,149 |
$845K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,706 |
2,324 |
$489K |
| G0378 |
Hospital observation service, per hour |
2,885 |
1,982 |
$449K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
3,428 |
2,814 |
$421K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,562 |
1,411 |
$382K |
| 29581 |
|
1,853 |
660 |
$263K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,986 |
2,170 |
$260K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,867 |
989 |
$219K |
| 0240U |
|
3,668 |
3,461 |
$218K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
873 |
759 |
$216K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
3,018 |
2,864 |
$211K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
2,279 |
2,066 |
$190K |
| 80053 |
Comprehensive metabolic panel |
43,568 |
33,765 |
$159K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
609 |
400 |
$139K |
| 76830 |
Ultrasound, transvaginal |
1,546 |
1,390 |
$126K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
4,350 |
2,661 |
$125K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
194 |
168 |
$122K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
380 |
333 |
$117K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,743 |
1,567 |
$117K |
| 93971 |
|
1,370 |
1,179 |
$117K |
| J3490 |
Unclassified drugs |
110,266 |
29,554 |
$107K |
| 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 |
3,131 |
2,817 |
$101K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,878 |
749 |
$98K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,358 |
2,242 |
$96K |
| 71046 |
Radiologic examination, chest; 2 views |
9,680 |
8,260 |
$93K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
829 |
756 |
$88K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,874 |
2,701 |
$83K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
109 |
100 |
$73K |
| 59025 |
Fetal non-stress test |
462 |
334 |
$73K |
| 93976 |
|
1,028 |
907 |
$71K |
| 76642 |
|
550 |
466 |
$57K |
| 84443 |
Thyroid stimulating hormone (TSH) |
8,332 |
7,431 |
$51K |
| 97161 |
|
864 |
717 |
$47K |
| 70496 |
|
186 |
166 |
$46K |
| 76801 |
|
1,092 |
912 |
$46K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
13,128 |
9,647 |
$44K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
18,882 |
15,026 |
$43K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,763 |
3,432 |
$41K |
| 71250 |
|
609 |
551 |
$41K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,769 |
3,439 |
$40K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
40,324 |
30,298 |
$39K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
4,770 |
4,433 |
$37K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
188 |
173 |
$35K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
275 |
191 |
$31K |
| 80061 |
Lipid panel |
5,098 |
4,741 |
$31K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
448 |
407 |
$30K |
| 73630 |
|
2,720 |
2,370 |
$29K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,492 |
609 |
$29K |
| 85027 |
|
14,992 |
12,006 |
$28K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
270 |
213 |
$28K |
| 83880 |
|
3,733 |
2,918 |
$28K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
129 |
128 |
$28K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,478 |
1,375 |
$27K |
| 12001 |
|
109 |
102 |
$26K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
122 |
104 |
$26K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
1,530 |
989 |
$25K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
815 |
725 |
$25K |
| 97602 |
|
76 |
42 |
$24K |
| 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 |
2,285 |
1,436 |
$24K |
| 71271 |
|
213 |
207 |
$23K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,299 |
4,844 |
$22K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
19,931 |
15,727 |
$22K |
| 29125 |
|
160 |
138 |
$22K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,732 |
1,480 |
$22K |
| 97165 |
|
526 |
445 |
$22K |
| 87040 |
|
4,183 |
1,937 |
$20K |
| 73564 |
|
2,409 |
2,005 |
$20K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
14,633 |
10,811 |
$19K |
| 81025 |
|
13,414 |
11,612 |
$19K |
| 73030 |
|
1,523 |
1,310 |
$17K |
| 73610 |
|
2,392 |
2,126 |
$17K |
| 95806 |
|
128 |
121 |
$17K |
| 84484 |
|
15,691 |
9,535 |
$16K |
| 71045 |
Radiologic examination, chest; single view |
8,609 |
7,217 |
$16K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
571 |
484 |
$16K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
2,418 |
2,304 |
$16K |
| 85379 |
|
3,785 |
3,337 |
$15K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
11,777 |
9,900 |
$14K |
| 59050 |
|
58 |
41 |
$14K |
| 82728 |
|
2,142 |
1,939 |
$13K |
| 82607 |
|
1,473 |
1,330 |
$13K |
| 97597 |
|
146 |
78 |
$13K |
| 90715 |
|
546 |
513 |
$12K |
| 86703 |
|
1,147 |
1,077 |
$12K |
| 73130 |
|
1,585 |
1,412 |
$12K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
9,733 |
6,063 |
$11K |
| 73110 |
|
1,414 |
1,269 |
$11K |
| 97535 |
Self-care/home management training, each 15 minutes |
954 |
600 |
$11K |
| 87510 |
|
1,397 |
1,251 |
$11K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
49 |
43 |
$10K |
| 88142 |
|
748 |
702 |
$10K |
| 97116 |
|
611 |
325 |
$10K |
| 93296 |
|
491 |
434 |
$9K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
79 |
38 |
$9K |
| 93922 |
|
154 |
131 |
$9K |
| 72110 |
|
386 |
343 |
$9K |
| 87077 |
|
3,500 |
3,027 |
$8K |
| 84439 |
|
1,559 |
1,420 |
$8K |
| 82962 |
|
13,646 |
4,660 |
$8K |
| 10060 |
|
106 |
90 |
$8K |
| 73502 |
|
841 |
740 |
$8K |
| 96376 |
|
6,384 |
3,613 |
$7K |
| 94799 |
|
1,615 |
936 |
$7K |
| 36415 |
Collection of venous blood by venipuncture |
5,445 |
4,678 |
$7K |
| 87660 |
|
1,397 |
1,251 |
$7K |
| 83605 |
|
7,295 |
5,545 |
$7K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
13,571 |
10,291 |
$7K |
| 72100 |
|
500 |
447 |
$7K |
| 84100 |
|
1,458 |
990 |
$7K |
| 93017 |
|
62 |
50 |
$6K |
| 83735 |
|
7,881 |
5,588 |
$6K |
| 86803 |
|
644 |
595 |
$6K |
| 81001 |
|
23,727 |
19,576 |
$6K |
| 85610 |
|
3,718 |
2,730 |
$6K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
468 |
427 |
$6K |
| 87186 |
|
3,349 |
2,891 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
40 |
37 |
$6K |
| 73140 |
|
488 |
461 |
$6K |
| 84702 |
|
2,475 |
1,990 |
$6K |
| 87653 |
|
298 |
278 |
$5K |
| 74018 |
|
282 |
220 |
$5K |
| 12002 |
|
27 |
27 |
$5K |
| 84145 |
|
597 |
461 |
$5K |
| 83550 |
|
1,487 |
1,352 |
$5K |
| 77065 |
Tomosynthesis, mammo |
139 |
129 |
$5K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
418 |
204 |
$5K |
| J8540 |
Dexamethasone, oral, 0.25 mg |
1,822 |
1,239 |
$5K |
| 82746 |
|
809 |
737 |
$5K |
| 83690 |
|
12,743 |
10,291 |
$5K |
| 76536 |
|
39 |
38 |
$4K |
| 83540 |
|
1,634 |
1,489 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
802 |
685 |
$4K |
| 77066 |
Tomosynthesis, mammo |
114 |
102 |
$4K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
259 |
248 |
$4K |
| 36592 |
|
185 |
131 |
$4K |
| 84153 |
|
349 |
329 |
$4K |
| 87070 |
|
867 |
765 |
$4K |
| 82565 |
|
1,553 |
1,299 |
$4K |
| 93925 |
|
25 |
25 |
$4K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
14,006 |
10,577 |
$4K |
| 86140 |
|
1,160 |
1,017 |
$4K |
| 80050 |
General health panel |
153 |
152 |
$4K |
| 87480 |
|
1,388 |
1,242 |
$3K |
| 80305 |
|
2,795 |
2,395 |
$3K |
| 76770 |
|
29 |
24 |
$2K |
| J1756 |
Injection, iron sucrose, 1 mg |
37 |
13 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
8,944 |
7,278 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,818 |
1,570 |
$2K |
| 87081 |
|
347 |
325 |
$2K |
| 87205 |
|
886 |
763 |
$2K |
| 80076 |
|
885 |
796 |
$2K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
14 |
14 |
$2K |
| 93970 |
|
15 |
12 |
$2K |
| 86780 |
|
194 |
181 |
$2K |
| 70498 |
|
188 |
165 |
$2K |
| 85652 |
|
999 |
889 |
$2K |
| 82951 |
|
190 |
160 |
$1K |
| 86901 |
|
1,621 |
1,308 |
$1K |
| 73080 |
|
304 |
266 |
$1K |
| 82043 |
|
384 |
360 |
$1K |
| 70486 |
|
28 |
25 |
$1K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
1,667 |
1,194 |
$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 |
4,275 |
3,629 |
$1K |
| 86618 |
|
61 |
54 |
$1K |
| 70491 |
|
14 |
12 |
$952.74 |
| 80055 |
|
56 |
51 |
$936.27 |
| 86900 |
|
1,619 |
1,308 |
$912.57 |
| 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 |
206 |
196 |
$863.83 |
| 99234 |
|
27 |
26 |
$804.90 |
| 93246 |
|
14 |
13 |
$770.33 |
| 90686 |
|
49 |
45 |
$713.96 |
| 83615 |
|
291 |
238 |
$686.19 |
| 86850 |
|
570 |
484 |
$602.98 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
259 |
249 |
$565.56 |
| 73590 |
|
49 |
41 |
$565.03 |
| 81003 |
|
1,526 |
1,256 |
$540.73 |
| 97162 |
|
28 |
24 |
$490.68 |
| 74022 |
|
22 |
13 |
$461.59 |
| 80143 |
|
118 |
104 |
$450.85 |
| 97166 |
|
14 |
12 |
$416.24 |
| 85018 |
|
263 |
197 |
$390.49 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
2,930 |
2,241 |
$386.82 |
| 87634 |
|
31 |
26 |
$386.39 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,532 |
2,262 |
$382.44 |
| 83516 |
|
25 |
14 |
$380.27 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
4,754 |
3,759 |
$368.77 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
401 |
309 |
$350.13 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
4,769 |
2,900 |
$337.80 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,290 |
2,355 |
$325.03 |
| 85730 |
|
959 |
749 |
$305.62 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,645 |
2,578 |
$304.05 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
728 |
558 |
$299.30 |
| 82077 |
|
1,053 |
917 |
$263.82 |
| 87340 |
|
61 |
54 |
$260.57 |
| 84403 |
|
13 |
12 |
$246.27 |
| 82784 |
|
40 |
27 |
$244.87 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,447 |
2,132 |
$237.44 |
| 80179 |
|
101 |
92 |
$234.60 |
| 87150 |
|
12 |
12 |
$227.05 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,611 |
703 |
$214.47 |
| 73090 |
|
26 |
24 |
$196.65 |
| J1644 |
Injection, heparin sodium, per 1000 units |
3,068 |
1,339 |
$190.46 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
595 |
511 |
$188.20 |
| J2060 |
Injection, lorazepam, 2 mg |
1,128 |
842 |
$168.41 |
| 82950 |
|
47 |
46 |
$164.49 |
| 87185 |
|
131 |
110 |
$146.66 |
| 88304 |
|
102 |
91 |
$133.92 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,092 |
561 |
$128.11 |
| 82550 |
|
88 |
72 |
$126.39 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
1,296 |
950 |
$121.99 |
| 84550 |
|
120 |
106 |
$113.04 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
571 |
398 |
$100.22 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,662 |
1,101 |
$71.88 |
| 73660 |
|
12 |
12 |
$71.37 |
| J2704 |
Injection, propofol, 10 mg |
2,768 |
2,531 |
$69.69 |
| 71101 |
|
14 |
12 |
$60.35 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
1,008 |
780 |
$49.33 |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
38 |
13 |
$47.08 |
| C1769 |
Guide wire |
836 |
647 |
$39.01 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
700 |
322 |
$22.80 |
| J1815 |
Injection, insulin, per 5 units |
126 |
81 |
$20.08 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
1,546 |
1,166 |
$17.67 |
| 85014 |
|
19 |
12 |
$15.24 |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
254 |
230 |
$14.70 |
| G0008 |
Administration of influenza virus vaccine |
14 |
12 |
$11.46 |
| J3535 |
Drug administered through a metered dose inhaler |
87 |
77 |
$11.03 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
137 |
125 |
$7.05 |
| J1630 |
Injection, haloperidol, up to 5 mg |
112 |
92 |
$5.79 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
156 |
114 |
$5.48 |
| 82009 |
|
87 |
79 |
$5.46 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
196 |
163 |
$4.83 |
| 94760 |
|
661 |
453 |
$1.33 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
376 |
287 |
$1.00 |
| A6443 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard |
830 |
274 |
$0.00 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
247 |
80 |
$0.00 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
332 |
243 |
$0.00 |
| A6449 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
1,649 |
506 |
$0.00 |
| A6197 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
153 |
121 |
$0.00 |
| J1817 |
Insulin for administration through dme (i.e., insulin pump) per 50 units |
120 |
47 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
346 |
278 |
$0.00 |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
28 |
26 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
19 |
13 |
$0.00 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
42 |
36 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
15 |
12 |
$0.00 |
| 88342 |
|
56 |
39 |
$0.00 |
| 84703 |
|
39 |
39 |
$0.00 |
| J1940 |
Injection, furosemide, up to 20 mg |
29 |
12 |
$0.00 |
| 87449 |
|
13 |
12 |
$0.00 |
| C1729 |
Catheter, drainage |
135 |
102 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
112 |
97 |
$0.00 |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
595 |
240 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
1,270 |
1,076 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
45 |
43 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
30 |
28 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
100 |
78 |
$0.00 |
| Q0177 |
Hydroxyzine pamoate, 25 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 |
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 |
44 |
29 |
$0.00 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
12 |
12 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
175 |
110 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
135 |
95 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
44 |
29 |
$0.00 |
| 84450 |
|
16 |
12 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
17 |
12 |
$0.00 |