| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90791 |
Psychiatric diagnostic evaluation |
30,256 |
23,617 |
$20.18M |
| 90834 |
Psychotherapy, 45 minutes with patient |
96,989 |
59,639 |
$14.45M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
134,597 |
21,308 |
$13.82M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
96,117 |
81,941 |
$12.77M |
| 90832 |
Psychotherapy, 30 minutes with patient |
84,712 |
53,713 |
$11.93M |
| J9271 |
Injection, pembrolizumab, 1 mg |
1,294 |
1,012 |
$11.16M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
56,745 |
53,006 |
$10.66M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
71,832 |
62,623 |
$9.73M |
| S9485 |
Crisis intervention mental health services, per diem |
7,605 |
6,943 |
$9.26M |
| 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 |
110,219 |
104,712 |
$8.82M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
51,733 |
48,740 |
$8.78M |
| J2350 |
Injection, ocrelizumab, 1 mg |
358 |
343 |
$8.68M |
| H0040 |
Assertive community treatment program, per diem |
4,801 |
4,760 |
$8.11M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
95,523 |
47,540 |
$7.99M |
| H0020 |
Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) |
261,949 |
22,221 |
$7.61M |
| H2011 |
Crisis intervention service, per 15 minutes |
37,895 |
15,727 |
$5.18M |
| Q5103 |
Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg |
4,473 |
4,091 |
$4.93M |
| J1459 |
Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg |
1,830 |
1,061 |
$4.58M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
32,491 |
26,429 |
$4.23M |
| 90837 |
Psychotherapy, 53 minutes with patient |
24,356 |
15,244 |
$4.02M |
| H0035 |
Mental health partial hospitalization, treatment, less than 24 hours |
16,448 |
2,305 |
$3.81M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
24,501 |
23,201 |
$3.61M |
| J3380 |
Injection, vedolizumab, intravenous, 1 mg |
1,052 |
991 |
$3.41M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
17,053 |
16,295 |
$3.31M |
| H0005 |
Alcohol and/or drug services; group counseling by a clinician |
14,833 |
4,116 |
$3.18M |
| 41899 |
Unlisted procedure, dentoalveolar structures |
2,904 |
2,900 |
$3.16M |
| 96415 |
|
6,475 |
5,575 |
$3.14M |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
13,402 |
9,326 |
$3.13M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
17,134 |
11,303 |
$3.04M |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
84,865 |
81,675 |
$2.97M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
22,774 |
18,868 |
$2.95M |
| 99215 |
Prolong outpt/office vis |
21,061 |
18,709 |
$2.94M |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
83,390 |
81,200 |
$2.73M |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
12,957 |
9,416 |
$2.70M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
12,517 |
10,810 |
$2.68M |
| 87631 |
|
25,903 |
25,532 |
$2.60M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
3,512 |
3,502 |
$2.52M |
| G0397 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes |
9,950 |
6,059 |
$2.41M |
| J2426 |
Injection, paliperidone palmitate extended release (invega sustenna), 1 mg |
2,127 |
1,747 |
$2.30M |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
805 |
729 |
$2.30M |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
3,217 |
3,216 |
$2.26M |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,732 |
7,583 |
$2.11M |
| 80053 |
Comprehensive metabolic panel |
165,677 |
148,013 |
$2.06M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
8,653 |
8,306 |
$1.97M |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
5,393 |
3,961 |
$1.92M |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
1,270 |
1,268 |
$1.83M |
| G0378 |
Hospital observation service, per hour |
4,102 |
3,202 |
$1.81M |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
1,387 |
1,385 |
$1.80M |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
15,144 |
5,886 |
$1.77M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
7,185 |
7,109 |
$1.75M |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
16,432 |
14,267 |
$1.74M |
| J0490 |
Injection, belimumab, 10 mg |
732 |
508 |
$1.74M |
| 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 |
69,411 |
66,449 |
$1.70M |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
4,563 |
4,541 |
$1.60M |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
6,801 |
6,685 |
$1.59M |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
2,163 |
2,161 |
$1.53M |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
47,881 |
47,060 |
$1.44M |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
31,652 |
26,485 |
$1.39M |
| 97161 |
|
13,427 |
13,326 |
$1.37M |
| 84443 |
Thyroid stimulating hormone (TSH) |
90,755 |
89,672 |
$1.35M |
| 80048 |
Basic metabolic panel (calcium, ionized) |
79,247 |
71,302 |
$1.24M |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
5,522 |
3,898 |
$1.19M |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
10,628 |
2,368 |
$1.16M |
| 52000 |
|
962 |
959 |
$1.12M |
| D7240 |
Removal of impacted tooth - completely bony |
3,324 |
1,277 |
$1.10M |
| 59025 |
Fetal non-stress test |
7,627 |
4,697 |
$1.08M |
| 80061 |
Lipid panel |
89,332 |
88,849 |
$1.06M |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
2,542 |
2,238 |
$1.04M |
| 64483 |
|
1,808 |
1,777 |
$1.03M |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
7,101 |
6,524 |
$1.03M |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
12,871 |
7,629 |
$984K |
| J2323 |
Injection, natalizumab, 1 mg |
771 |
734 |
$969K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
34,895 |
34,790 |
$968K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
8,101 |
2,184 |
$923K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
140,516 |
128,028 |
$893K |
| 59841 |
|
990 |
989 |
$886K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
2,849 |
2,796 |
$877K |
| 36415 |
Collection of venous blood by venipuncture |
183,369 |
131,299 |
$874K |
| J1950 |
Injection, leuprolide acetate (for depot suspension), per 3.75 mg |
429 |
413 |
$869K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
4,784 |
3,234 |
$867K |
| D7140 |
Extraction, erupted tooth or exposed root |
8,476 |
2,803 |
$825K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
40,900 |
40,680 |
$819K |
| 76770 |
|
6,589 |
6,553 |
$815K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
3,676 |
3,209 |
$809K |
| D9222 |
|
4,134 |
3,816 |
$804K |
| 95782 |
|
1,141 |
1,138 |
$800K |
| H0038 |
Self-help/peer services, per 15 minutes |
3,520 |
1,719 |
$772K |
| 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 |
14,519 |
13,257 |
$767K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
3,842 |
3,822 |
$761K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,315 |
2,298 |
$711K |
| 97162 |
|
5,772 |
5,720 |
$705K |
| 12001 |
|
1,752 |
1,745 |
$652K |
| 64493 |
|
1,072 |
938 |
$646K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
2,125 |
2,121 |
$635K |
| D0120 |
Periodic oral evaluation - established patient |
15,947 |
5,049 |
$627K |
| T1016 |
Case management, each 15 minutes |
3,626 |
1,541 |
$620K |
| 87536 |
|
7,476 |
7,341 |
$591K |
| G0145 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision |
19,124 |
19,113 |
$586K |
| 77336 |
|
1,639 |
842 |
$583K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
11,333 |
9,335 |
$582K |
| 87480 |
|
31,445 |
30,696 |
$573K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
9,756 |
8,882 |
$566K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
17,854 |
17,829 |
$565K |
| 90846 |
Family psychotherapy without the patient present, 50 minutes |
3,589 |
2,991 |
$565K |
| 87510 |
|
30,956 |
30,233 |
$561K |
| 86780 |
|
41,521 |
41,223 |
$551K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,537 |
2,517 |
$550K |
| 12011 |
|
1,400 |
1,391 |
$532K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
59,004 |
58,519 |
$530K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
12,570 |
12,127 |
$519K |
| 64615 |
|
1,386 |
1,385 |
$511K |
| 86803 |
|
39,333 |
39,101 |
$508K |
| 74183 |
|
1,471 |
1,470 |
$495K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
3,562 |
3,549 |
$466K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
2,996 |
1,758 |
$460K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,493 |
1,484 |
$452K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
837 |
836 |
$447K |
| 36430 |
|
1,064 |
778 |
$442K |
| 90378 |
|
382 |
377 |
$439K |
| 93975 |
|
1,475 |
1,433 |
$439K |
| 87660 |
|
24,250 |
23,736 |
$436K |
| 86850 |
|
19,306 |
16,824 |
$417K |
| J2506 |
Injection, pegfilgrastim, excludes biosimilar, 0.5 mg |
312 |
244 |
$404K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
8,053 |
4,329 |
$400K |
| 80076 |
|
33,665 |
31,757 |
$398K |
| H0037 |
Community psychiatric supportive treatment program, per diem |
298 |
277 |
$397K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
1,372 |
1,371 |
$385K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
5,886 |
5,771 |
$382K |
| J0178 |
Injection, aflibercept, 1 mg |
238 |
238 |
$381K |
| 92567 |
|
6,655 |
6,613 |
$380K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
913 |
799 |
$371K |
| 72141 |
|
1,226 |
1,223 |
$369K |
| 86480 |
|
6,355 |
6,317 |
$365K |
| 58999 |
|
761 |
743 |
$362K |
| 84439 |
|
42,070 |
41,382 |
$355K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
48,037 |
46,003 |
$355K |
| 73221 |
|
1,171 |
1,151 |
$351K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
834 |
591 |
$347K |
| 97113 |
|
3,148 |
1,350 |
$346K |
| 82607 |
|
24,434 |
24,289 |
$331K |
| 70496 |
|
1,211 |
1,196 |
$325K |
| J1631 |
Injection, haloperidol decanoate, per 50 mg |
3,746 |
1,230 |
$312K |
| 92557 |
|
4,510 |
4,483 |
$305K |
| 12002 |
|
755 |
754 |
$298K |
| J0741 |
Injection, cabotegravir and rilpivirine, 2mg/3mg |
77 |
77 |
$284K |
| 82728 |
|
23,019 |
22,447 |
$284K |
| D7230 |
|
906 |
476 |
$283K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
379 |
379 |
$281K |
| 84403 |
|
11,792 |
11,593 |
$280K |
| S9484 |
Crisis intervention mental health services, per hour |
2,899 |
2,090 |
$280K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,719 |
1,715 |
$276K |
| 93320 |
|
4,684 |
4,671 |
$271K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
9,687 |
7,798 |
$270K |
| 86008 |
|
2,569 |
2,079 |
$270K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
5,362 |
5,257 |
$267K |
| 83970 |
|
7,022 |
6,829 |
$267K |
| 85027 |
|
47,713 |
44,509 |
$262K |
| 86901 |
|
19,718 |
17,283 |
$260K |
| 97165 |
|
2,695 |
2,680 |
$255K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
2,394 |
1,537 |
$255K |
| 93970 |
|
907 |
899 |
$249K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
11,021 |
5,915 |
$249K |
| 87340 |
|
25,415 |
25,265 |
$247K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
8,882 |
7,126 |
$246K |
| Q0138 |
Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) |
1,087 |
778 |
$245K |
| 87506 |
|
1,338 |
1,330 |
$243K |
| 20553 |
|
1,164 |
1,152 |
$243K |
| 80051 |
|
11,765 |
10,868 |
$243K |
| H0001 |
Alcohol and/or drug assessment |
891 |
818 |
$241K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
578 |
451 |
$231K |
| 95812 |
|
1,591 |
1,586 |
$230K |
| 97164 |
|
2,354 |
2,333 |
$228K |
| 86900 |
|
19,768 |
17,302 |
$226K |
| Q5111 |
Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg |
176 |
139 |
$224K |
| 71046 |
Radiologic examination, chest; 2 views |
10,013 |
9,779 |
$222K |
| 86360 |
|
6,102 |
6,010 |
$220K |
| Q3014 |
Telehealth originating site facility fee |
2,905 |
2,543 |
$220K |
| 92134 |
|
4,537 |
4,409 |
$219K |
| 70491 |
|
946 |
940 |
$217K |
| 20611 |
|
506 |
497 |
$213K |
| 94060 |
|
2,561 |
2,556 |
$212K |
| 97803 |
|
4,866 |
4,706 |
$211K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
5,449 |
4,734 |
$205K |
| 27096 |
|
419 |
418 |
$203K |
| 83880 |
|
6,429 |
5,720 |
$203K |
| 87081 |
|
29,719 |
29,287 |
$202K |
| 88342 |
|
2,746 |
2,608 |
$199K |
| 82670 |
|
7,506 |
7,377 |
$199K |
| 83655 |
|
17,038 |
16,962 |
$198K |
| 77334 |
|
744 |
599 |
$197K |
| 97010 |
|
12,765 |
6,861 |
$196K |
| J0185 |
Injection, aprepitant, 1 mg |
1,644 |
1,178 |
$194K |
| 71250 |
|
1,927 |
1,918 |
$192K |
| 86359 |
|
5,900 |
5,809 |
$189K |
| 93350 |
|
1,470 |
1,470 |
$188K |
| 93971 |
|
2,249 |
2,193 |
$188K |
| 76830 |
Ultrasound, transvaginal |
3,903 |
3,886 |
$187K |
| 81329 |
|
1,961 |
1,958 |
$186K |
| 88185 |
|
1,302 |
823 |
$183K |
| J2997 |
Injection, alteplase recombinant, 1 mg |
967 |
393 |
$179K |
| H2017 |
Psychosocial rehabilitation services, per 15 minutes |
1,253 |
513 |
$177K |
| 20610 |
|
765 |
721 |
$175K |
| 84702 |
|
12,739 |
9,586 |
$175K |
| 87522 |
Neg quan hep c or qual rna |
4,355 |
4,246 |
$174K |
| 96367 |
|
1,083 |
843 |
$173K |
| D1120 |
Prophylaxis - child |
3,465 |
2,583 |
$170K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
723 |
570 |
$169K |
| J2680 |
Injection, fluphenazine decanoate, up to 25 mg |
1,966 |
495 |
$168K |
| D9310 |
|
2,276 |
2,234 |
$167K |
| 88112 |
|
2,157 |
2,134 |
$166K |
| 87529 |
|
2,813 |
2,788 |
$164K |
| 70486 |
|
1,143 |
1,140 |
$160K |
| 92579 |
|
2,439 |
2,410 |
$160K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
1,926 |
1,173 |
$159K |
| 92552 |
|
2,150 |
2,149 |
$159K |
| 97166 |
|
1,362 |
1,348 |
$158K |
| 77386 |
|
872 |
92 |
$155K |
| 88341 |
|
1,285 |
1,049 |
$154K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
2,235 |
2,233 |
$154K |
| 93976 |
|
741 |
724 |
$153K |
| J1756 |
Injection, iron sucrose, 1 mg |
3,339 |
1,628 |
$153K |
| 96416 |
|
352 |
234 |
$152K |
| 72156 |
|
472 |
469 |
$151K |
| 92611 |
|
802 |
801 |
$151K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
17,817 |
11,852 |
$150K |
| 86706 |
|
14,856 |
14,778 |
$148K |
| 74178 |
|
1,145 |
1,142 |
$147K |
| 86704 |
|
13,355 |
13,280 |
$147K |
| 42830 |
|
107 |
107 |
$144K |
| 87150 |
|
4,276 |
4,248 |
$143K |
| 72197 |
|
447 |
445 |
$141K |
| 29125 |
|
701 |
695 |
$140K |
| 93017 |
|
2,384 |
2,375 |
$139K |
| 93325 |
|
5,392 |
5,347 |
$139K |
| 87505 |
|
1,319 |
1,291 |
$139K |
| Q9956 |
Injection, octafluoropropane microspheres, per ml |
2,358 |
1,771 |
$138K |
| 99401 |
|
1,397 |
596 |
$136K |
| 76801 |
|
2,894 |
2,840 |
$135K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
3,614 |
3,591 |
$132K |
| 94010 |
|
2,963 |
2,953 |
$131K |
| J2505 |
Injection, pegfilgrastim, 6 mg |
68 |
53 |
$130K |
| 97802 |
|
2,759 |
2,754 |
$128K |
| 83540 |
|
22,307 |
21,822 |
$127K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
3,138 |
2,620 |
$127K |
| 70498 |
|
600 |
594 |
$122K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
7,047 |
7,034 |
$118K |
| 93308 |
|
551 |
544 |
$117K |
| 83735 |
|
20,901 |
14,577 |
$116K |
| 64405 |
|
293 |
282 |
$116K |
| 77300 |
|
306 |
295 |
$116K |
| 82570 |
|
26,757 |
25,704 |
$115K |
| 88307 |
|
1,226 |
1,130 |
$115K |
| 10060 |
|
428 |
420 |
$115K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,769 |
1,768 |
$113K |
| 84146 |
|
5,927 |
5,842 |
$109K |
| 87186 |
|
12,412 |
12,128 |
$109K |
| 83001 |
|
6,159 |
6,124 |
$108K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,276 |
1,228 |
$108K |
| 82746 |
|
8,649 |
8,600 |
$107K |
| 99417 |
Prolong home eval add 15m |
821 |
336 |
$106K |
| 87158 |
|
19,368 |
18,987 |
$105K |
| D9420 |
|
1,225 |
1,224 |
$105K |
| 64450 |
|
315 |
302 |
$103K |
| 81420 |
Fetal chromosomal aneuploidy genomic sequence analysis panel |
191 |
190 |
$103K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
8,206 |
7,494 |
$102K |
| 85610 |
|
27,066 |
20,827 |
$102K |
| A0225 |
Ambulance service, neonatal transport, base rate, emergency transport, one way |
168 |
168 |
$101K |
| 83550 |
|
13,597 |
13,255 |
$101K |
| 86762 |
|
9,857 |
9,821 |
$100K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
909 |
908 |
$97K |
| 64635 |
|
172 |
161 |
$97K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,955 |
1,942 |
$96K |
| J2357 |
Injection, omalizumab, 5 mg |
130 |
87 |
$95K |
| 84402 |
|
4,195 |
4,166 |
$94K |
| 82043 |
|
17,858 |
17,723 |
$94K |
| 95886 |
|
1,810 |
1,806 |
$93K |
| 86140 |
|
25,170 |
23,078 |
$93K |
| 84270 |
|
4,646 |
4,567 |
$92K |
| 76942 |
|
674 |
656 |
$91K |
| 81001 |
|
31,060 |
29,716 |
$90K |
| 92133 |
|
2,713 |
2,678 |
$90K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
694 |
687 |
$89K |
| 86708 |
|
7,892 |
7,865 |
$89K |
| 80069 |
|
9,470 |
8,058 |
$89K |
| 62323 |
|
186 |
185 |
$87K |
| 88142 |
|
1,102 |
1,101 |
$87K |
| C7901 |
Service for diagnosis, evaluation, or treatment of a mental health or substance use disorder, 30-60 minutes, provided remotely by hospital staff who are licensed to provided mental health services under applicable state law(s), when the patient is in their home, and there is no associated professional service |
799 |
458 |
$86K |
| 73610 |
|
5,270 |
4,902 |
$85K |
| 96402 |
|
1,595 |
1,506 |
$84K |
| 92556 |
|
2,265 |
2,259 |
$83K |
| J1602 |
Injection, golimumab, 1 mg, for intravenous use |
63 |
61 |
$82K |
| 76882 |
|
2,216 |
2,047 |
$82K |
| 64400 |
|
138 |
130 |
$81K |
| 76536 |
|
2,695 |
2,685 |
$81K |
| 86923 |
|
1,794 |
1,225 |
$80K |
| 90715 |
|
3,097 |
3,090 |
$80K |
| 86235 |
|
1,859 |
1,842 |
$79K |
| 86038 |
|
7,459 |
7,406 |
$78K |
| 84466 |
|
6,842 |
6,765 |
$78K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
5,708 |
5,291 |
$76K |
| 0071A |
|
1,859 |
1,830 |
$76K |
| 97035 |
|
5,157 |
2,660 |
$76K |
| 0001A |
|
2,434 |
2,381 |
$75K |
| 82784 |
|
6,482 |
6,319 |
$74K |
| A9573 |
Injection, gadopiclenol, 1 ml |
2,083 |
1,225 |
$74K |
| 83002 |
|
4,186 |
4,156 |
$73K |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
2,884 |
2,843 |
$70K |
| G0124 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician |
2,534 |
2,530 |
$70K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
106 |
106 |
$69K |
| 87497 |
|
1,763 |
1,118 |
$68K |
| 70543 |
|
181 |
180 |
$67K |
| 76000 |
|
483 |
479 |
$66K |
| 73630 |
|
4,999 |
4,666 |
$65K |
| 92083 |
|
2,114 |
2,090 |
$65K |
| 83690 |
|
13,769 |
13,039 |
$64K |
| 99152 |
|
1,806 |
1,783 |
$62K |
| 87799 |
|
1,538 |
1,135 |
$62K |
| 86160 |
|
4,104 |
2,788 |
$61K |
| 73030 |
|
3,525 |
3,376 |
$58K |
| 81025 |
|
10,468 |
10,223 |
$58K |
| 87632 |
|
331 |
330 |
$57K |
| 82105 |
|
4,046 |
3,975 |
$57K |
| V5264 |
Ear mold/insert, not disposable, any type |
1,150 |
1,147 |
$57K |
| S9342 |
Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem |
122 |
98 |
$56K |
| 93225 |
|
1,059 |
1,054 |
$56K |
| J0897 |
Injection, denosumab, 1 mg |
38 |
38 |
$55K |
| 80197 |
|
4,522 |
2,810 |
$55K |
| 86355 |
|
1,557 |
1,538 |
$54K |
| 87070 |
|
6,521 |
6,389 |
$54K |
| 82533 |
|
3,235 |
2,892 |
$54K |
| 83516 |
|
4,243 |
4,095 |
$54K |
| 85652 |
|
22,702 |
21,542 |
$52K |
| J9312 |
Injection, rituximab, 10 mg |
22 |
12 |
$52K |
| D2710 |
|
361 |
354 |
$51K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
167 |
161 |
$51K |
| L3808 |
Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment |
204 |
192 |
$51K |
| 73130 |
|
3,158 |
2,880 |
$50K |
| 86364 |
|
5,946 |
5,758 |
$50K |
| 92250 |
|
1,099 |
1,079 |
$50K |
| D1110 |
Prophylaxis - adult |
1,242 |
380 |
$50K |
| 74230 |
|
781 |
780 |
$50K |
| 80050 |
General health panel |
1,580 |
1,561 |
$50K |
| 82150 |
|
14,215 |
13,363 |
$50K |
| J9217 |
Leuprolide acetate (for depot suspension), 7.5 mg |
194 |
186 |
$49K |
| 86376 |
|
3,577 |
3,550 |
$49K |
| 84480 |
|
4,027 |
3,863 |
$49K |
| 90686 |
|
2,218 |
2,216 |
$48K |
| 99205 |
Prolong outpt/office vis |
355 |
345 |
$48K |
| 96411 |
|
1,327 |
923 |
$48K |
| L2280 |
Addition to lower extremity, molded inner boot |
152 |
112 |
$47K |
| 95909 |
|
667 |
667 |
$47K |
| 87338 |
|
3,585 |
3,578 |
$46K |
| 84481 |
|
3,064 |
3,012 |
$46K |
| 72100 |
|
2,627 |
2,610 |
$46K |
| 83993 |
|
2,603 |
2,585 |
$46K |
| 0124A |
|
1,091 |
1,091 |
$45K |
| 84100 |
|
11,387 |
7,753 |
$45K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
1,424 |
1,410 |
$45K |
| 0002A |
|
1,504 |
1,504 |
$44K |
| 73562 |
|
2,682 |
2,606 |
$44K |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
1,758 |
1,742 |
$44K |
| 88304 |
|
785 |
750 |
$44K |
| 86787 |
|
4,692 |
4,676 |
$43K |
| 82565 |
|
11,654 |
10,990 |
$42K |
| 86357 |
|
1,559 |
1,539 |
$41K |
| 92551 |
|
710 |
206 |
$41K |
| 55899 |
|
40 |
40 |
$41K |
| 93922 |
|
741 |
736 |
$41K |
| D1206 |
Topical application of fluoride varnish |
1,259 |
1,213 |
$40K |
| 82805 |
|
1,280 |
1,170 |
$40K |
| D0330 |
Panoramic radiographic image |
842 |
793 |
$40K |
| 86800 |
|
3,262 |
3,244 |
$40K |
| 96376 |
|
2,388 |
1,710 |
$40K |
| 73700 |
|
240 |
235 |
$40K |
| 0072A |
|
944 |
944 |
$39K |
| 73564 |
|
1,794 |
1,777 |
$39K |
| 82627 |
|
1,800 |
1,787 |
$38K |
| 86665 |
|
2,210 |
1,794 |
$38K |
| 71045 |
Radiologic examination, chest; single view |
1,243 |
1,207 |
$38K |
| 74018 |
|
3,216 |
3,082 |
$38K |
| D9610 |
|
2,358 |
2,284 |
$38K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,000 |
647 |
$37K |
| 96409 |
|
763 |
526 |
$37K |
| 83020 |
|
2,919 |
2,809 |
$37K |
| 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 |
3,498 |
2,071 |
$37K |
| 86225 |
|
3,118 |
3,032 |
$37K |
| 84460 |
|
8,164 |
8,032 |
$37K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
402 |
374 |
$36K |
| 84156 |
|
10,610 |
9,561 |
$36K |
| D1208 |
Topical application of fluoride, excluding varnish |
875 |
833 |
$36K |
| 71271 |
|
1,321 |
1,321 |
$35K |
| G0121 |
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk |
54 |
54 |
$35K |
| 99091 |
|
746 |
741 |
$35K |
| 73110 |
|
2,682 |
2,450 |
$35K |
| 86765 |
|
3,553 |
3,540 |
$35K |
| 72082 |
|
1,626 |
1,622 |
$34K |
| 86696 |
|
1,915 |
1,911 |
$33K |
| J0401 |
Injection, aripiprazole (abilify maintena), 1 mg |
24 |
24 |
$33K |
| 16020 |
|
78 |
77 |
$33K |
| J1437 |
Injection, ferric derisomaltose, 10 mg |
56 |
55 |
$33K |
| 82785 |
|
2,202 |
2,197 |
$33K |
| D9999 |
Unspecified adjunctive procedure, by report |
237 |
202 |
$33K |
| J0640 |
Injection, leucovorin calcium, per 50 mg |
772 |
466 |
$33K |
| 76870 |
|
868 |
856 |
$33K |
| 84144 |
|
1,704 |
1,585 |
$33K |
| 83520 |
|
2,494 |
2,302 |
$33K |
| 83615 |
|
6,464 |
4,841 |
$32K |
| 87517 |
|
827 |
796 |
$32K |
| 99406 |
|
876 |
842 |
$32K |
| 86618 |
|
2,951 |
2,941 |
$32K |
| 86304 |
|
1,651 |
1,403 |
$32K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
955 |
955 |
$32K |
| 72146 |
|
108 |
106 |
$32K |
| 82248 |
|
7,317 |
6,606 |
$31K |
| G0328 |
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous |
2,508 |
2,495 |
$31K |
| D1351 |
Sealant - per tooth |
892 |
616 |
$31K |
| 86200 |
|
2,615 |
2,605 |
$31K |
| 81511 |
|
300 |
297 |
$31K |
| 31575 |
|
235 |
233 |
$31K |
| 99153 |
Mod sedat endo service >5yrs |
709 |
700 |
$30K |
| 77412 |
|
105 |
12 |
$30K |
| 92610 |
|
236 |
234 |
$30K |
| C7900 |
Service for diagnosis, evaluation, or treatment of a mental health or substance use disorder, 15-29 minutes, provided remotely by hospital staff who are licensed to provide mental health services under applicable state law(s), when the patient is in their home, and there is no associated professional service |
139 |
116 |
$30K |
| 82977 |
|
4,639 |
4,098 |
$30K |
| 10061 |
|
98 |
95 |
$30K |
| 96401 |
|
585 |
341 |
$30K |
| 64721 |
|
31 |
30 |
$30K |
| 73560 |
|
2,850 |
2,775 |
$29K |
| 86735 |
|
3,141 |
3,131 |
$29K |
| 88321 |
|
457 |
432 |
$29K |
| 73502 |
|
2,218 |
2,169 |
$29K |
| 84153 |
|
1,766 |
1,721 |
$28K |
| 85380 |
|
2,145 |
2,120 |
$28K |
| 86141 |
|
2,392 |
2,352 |
$28K |
| 95885 |
|
579 |
576 |
$28K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
577 |
539 |
$28K |
| 82947 |
|
9,424 |
8,636 |
$28K |
| 84207 |
|
1,077 |
1,073 |
$28K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
27 |
27 |
$28K |
| 85730 |
|
5,180 |
5,046 |
$27K |
| 73140 |
|
2,274 |
2,046 |
$27K |
| 99442 |
|
257 |
157 |
$27K |
| J9070 |
Cyclophosphamide, 100 mg |
81 |
54 |
$27K |
| 86305 |
|
1,391 |
1,183 |
$27K |
| 92524 |
|
187 |
187 |
$27K |
| 76825 |
|
423 |
407 |
$26K |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
1,038 |
1,036 |
$26K |
| 85007 |
|
8,864 |
7,305 |
$26K |
| 82550 |
|
4,524 |
4,199 |
$26K |
| 73590 |
|
2,084 |
1,884 |
$26K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
1,061 |
1,049 |
$26K |
| 82610 |
|
2,279 |
2,181 |
$26K |
| 87581 |
|
750 |
744 |
$26K |
| 82950 |
|
6,007 |
5,999 |
$26K |
| 84450 |
|
5,460 |
5,376 |
$25K |
| 86147 |
|
938 |
931 |
$25K |
| 87493 |
|
770 |
764 |
$25K |
| 86430 |
|
4,635 |
4,617 |
$25K |
| 84703 |
|
4,716 |
4,572 |
$24K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
381 |
194 |
$24K |
| 92582 |
|
381 |
379 |
$24K |
| 97116 |
|
663 |
435 |
$24K |
| G0176 |
Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more) |
164 |
35 |
$24K |
| 83498 |
|
918 |
914 |
$24K |
| 85014 |
|
10,403 |
10,300 |
$24K |
| 0054A |
|
565 |
565 |
$24K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
577 |
573 |
$23K |
| 86769 |
|
548 |
548 |
$23K |
| 97535 |
Self-care/home management training, each 15 minutes |
319 |
248 |
$23K |
| 88184 |
|
378 |
355 |
$23K |
| 94729 |
|
1,450 |
1,447 |
$23K |
| 77002 |
|
81 |
76 |
$23K |
| 95911 |
|
175 |
173 |
$23K |
| 91322 |
|
174 |
174 |
$22K |
| 87102 |
|
2,786 |
2,744 |
$22K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
2,539 |
1,648 |
$22K |
| L1970 |
Ankle foot orthosis, plastic with ankle joint, custom fabricated |
28 |
24 |
$22K |
| 72157 |
|
80 |
79 |
$22K |
| 92587 |
|
310 |
306 |
$22K |
| D7220 |
|
181 |
96 |
$21K |
| 0012A |
|
1,025 |
1,023 |
$21K |
| 84134 |
|
1,679 |
1,385 |
$20K |
| 0011A |
|
1,183 |
1,183 |
$20K |
| 72158 |
|
68 |
67 |
$20K |
| 95910 |
|
304 |
304 |
$20K |
| 76821 |
|
843 |
411 |
$20K |
| 82024 |
|
548 |
539 |
$20K |
| 73100 |
|
1,641 |
1,391 |
$20K |
| 87641 |
|
732 |
731 |
$20K |
| D0272 |
Bitewings - two radiographic images |
1,176 |
1,175 |
$20K |
| 83525 |
|
1,828 |
1,815 |
$20K |
| 72170 |
|
1,171 |
1,146 |
$20K |
| 87902 |
|
76 |
75 |
$20K |
| 84425 |
|
1,041 |
1,032 |
$19K |
| 84305 |
|
1,038 |
1,036 |
$19K |
| 81003 |
|
8,545 |
8,405 |
$19K |
| 0004A |
|
453 |
453 |
$19K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
16 |
13 |
$18K |
| 58661 |
|
12 |
12 |
$18K |
| J9045 |
Injection, carboplatin, 50 mg |
679 |
478 |
$18K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,299 |
1,272 |
$18K |
| 86077 |
|
511 |
372 |
$18K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
360 |
358 |
$18K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
349 |
342 |
$18K |
| L3913 |
Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
86 |
84 |
$18K |
| 85576 |
|
551 |
543 |
$18K |
| 84165 |
|
1,922 |
1,776 |
$18K |
| 80159 |
|
1,091 |
762 |
$18K |
| 88312 |
|
207 |
192 |
$18K |
| 43235 |
|
26 |
26 |
$18K |
| 73090 |
|
1,356 |
1,134 |
$17K |
| 84550 |
|
4,188 |
3,987 |
$17K |
| 20680 |
|
12 |
12 |
$17K |
| 82247 |
|
4,510 |
4,021 |
$17K |
| 87901 |
|
76 |
76 |
$17K |
| 76937 |
|
98 |
91 |
$17K |
| 92526 |
|
186 |
138 |
$17K |
| J9190 |
Injection, fluorouracil, 500 mg |
1,182 |
685 |
$17K |
| 77073 |
|
664 |
659 |
$17K |
| 84484 |
|
2,840 |
1,779 |
$17K |
| 85390 |
|
2,391 |
2,349 |
$16K |
| T1023 |
Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter |
88 |
87 |
$16K |
| 77072 |
|
910 |
910 |
$16K |
| 81507 |
|
30 |
30 |
$16K |
| 73080 |
|
1,009 |
926 |
$16K |
| 72040 |
|
923 |
917 |
$16K |
| 87535 |
|
520 |
519 |
$15K |
| G0008 |
Administration of influenza virus vaccine |
1,289 |
1,287 |
$15K |
| 87538 |
|
482 |
481 |
$15K |
| 70487 |
|
47 |
47 |
$15K |
| 87205 |
|
4,783 |
4,693 |
$15K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,127 |
1,127 |
$15K |
| 64490 |
|
29 |
26 |
$14K |
| 84520 |
|
6,967 |
6,282 |
$14K |
| 73070 |
|
1,247 |
1,076 |
$14K |
| 82378 |
|
906 |
775 |
$14K |
| H2014 |
Skills training and development, per 15 minutes |
41 |
24 |
$14K |
| J9267 |
Injection, paclitaxel, 1 mg |
485 |
261 |
$14K |
| 82330 |
|
1,328 |
1,281 |
$13K |
| 82951 |
|
1,242 |
1,239 |
$13K |
| 76642 |
|
338 |
333 |
$13K |
| 74220 |
|
518 |
518 |
$13K |
| 92025 |
|
339 |
337 |
$13K |
| 82040 |
|
3,592 |
3,471 |
$13K |
| 87040 |
|
1,757 |
1,459 |
$13K |
| 72110 |
|
511 |
510 |
$13K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,619 |
1,590 |
$13K |
| 82626 |
|
540 |
538 |
$13K |
| 29515 |
|
62 |
62 |
$13K |
| 54161 |
|
13 |
13 |
$13K |
| V5266 |
Battery for use in hearing device |
1,498 |
1,495 |
$12K |
| 99443 |
|
120 |
86 |
$12K |
| 83090 |
|
768 |
766 |
$12K |
| 0051A |
|
283 |
283 |
$12K |
| 86039 |
|
1,230 |
1,214 |
$12K |
| 76376 |
|
200 |
199 |
$12K |
| 93226 |
|
203 |
203 |
$11K |
| 76813 |
|
316 |
315 |
$11K |
| 81508 |
|
307 |
305 |
$11K |
| 86695 |
|
1,277 |
1,273 |
$11K |
| 82103 |
|
888 |
882 |
$11K |
| 85244 |
|
485 |
476 |
$11K |
| 0081A |
|
263 |
262 |
$11K |
| 96417 |
|
278 |
198 |
$11K |
| 0154A |
|
265 |
265 |
$11K |
| 85045 |
|
3,184 |
2,871 |
$11K |
| 86003 |
|
681 |
486 |
$11K |
| 86902 |
|
417 |
369 |
$11K |
| 43762 |
|
203 |
91 |
$11K |
| 0052A |
|
254 |
254 |
$11K |
| 73552 |
|
986 |
914 |
$11K |
| 86709 |
|
1,016 |
1,015 |
$10K |
| 88173 |
|
156 |
145 |
$10K |
| V5257 |
Hearing aid, digital, monaural, bte |
12 |
12 |
$10K |
| 95819 |
|
69 |
69 |
$10K |
| 80164 |
|
869 |
837 |
$10K |
| 85384 |
|
1,425 |
1,381 |
$10K |
| 81002 |
|
1,192 |
1,146 |
$10K |
| 84075 |
|
2,718 |
2,671 |
$10K |
| 82310 |
|
2,841 |
2,755 |
$10K |
| 88189 |
|
189 |
186 |
$10K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
238 |
176 |
$10K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
7,593 |
7,213 |
$10K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
32 |
32 |
$10K |
| 95811 |
|
12 |
12 |
$10K |
| 82677 |
|
466 |
465 |
$9K |
| 73718 |
|
28 |
27 |
$9K |
| 99195 |
|
155 |
107 |
$9K |
| 97167 |
|
70 |
70 |
$9K |
| 86592 |
|
3,013 |
2,959 |
$9K |
| 83521 |
|
712 |
386 |
$9K |
| 95908 |
|
138 |
136 |
$9K |
| 85245 |
|
436 |
429 |
$9K |
| D9997 |
|
159 |
55 |
$9K |
| D2330 |
|
102 |
84 |
$9K |
| 0082A |
|
199 |
199 |
$8K |
| 86334 |
|
433 |
389 |
$8K |
| 82088 |
|
229 |
226 |
$8K |
| 70546 |
|
24 |
24 |
$8K |
| 90677 |
|
130 |
130 |
$8K |
| C1769 |
Guide wire |
438 |
432 |
$8K |
| 84630 |
|
883 |
880 |
$8K |
| 87449 |
|
820 |
806 |
$8K |
| 76820 |
|
714 |
379 |
$8K |
| 72070 |
|
515 |
508 |
$8K |
| 88262 |
|
40 |
39 |
$8K |
| 87906 |
|
71 |
71 |
$8K |
| A9541 |
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries |
49 |
49 |
$8K |
| 64494 |
|
37 |
29 |
$8K |
| 46607 |
|
14 |
14 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
105 |
105 |
$8K |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
121 |
111 |
$8K |
| 84140 |
|
390 |
389 |
$8K |
| V2632 |
Posterior chamber intraocular lens |
542 |
25 |
$8K |
| 87101 |
|
1,002 |
1,001 |
$8K |
| 84155 |
|
3,019 |
2,951 |
$7K |
| D0140 |
Limited oral evaluation - problem focused |
287 |
231 |
$7K |
| 82390 |
|
816 |
811 |
$7K |
| 84163 |
|
547 |
547 |
$7K |
| 84295 |
|
2,697 |
2,582 |
$7K |
| 86146 |
|
278 |
278 |
$7K |
| 95012 |
|
330 |
329 |
$7K |
| 87900 |
|
61 |
61 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
197 |
146 |
$7K |
| 10005 |
|
16 |
16 |
$7K |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
101 |
101 |
$7K |
| 0064A |
|
161 |
161 |
$7K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
188 |
159 |
$7K |
| 86308 |
|
1,238 |
1,230 |
$7K |
| 95700 |
|
81 |
81 |
$6K |
| 82397 |
|
439 |
437 |
$6K |
| L1960 |
Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated |
15 |
12 |
$6K |
| 76827 |
|
372 |
357 |
$6K |
| 86336 |
|
466 |
464 |
$6K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
38 |
24 |
$6K |
| 90480 |
|
169 |
169 |
$6K |
| 83921 |
|
386 |
386 |
$6K |
| 36591 |
|
134 |
100 |
$6K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
37 |
37 |
$6K |
| J2704 |
Injection, propofol, 10 mg |
5,633 |
5,472 |
$6K |
| 88313 |
|
102 |
89 |
$6K |
| 64454 |
|
19 |
15 |
$6K |
| 83605 |
|
962 |
898 |
$6K |
| 85240 |
|
324 |
317 |
$6K |
| 88300 |
|
269 |
255 |
$6K |
| D0230 |
Intraoral - periapical each additional radiographic image |
683 |
683 |
$6K |
| 95708 |
|
52 |
52 |
$6K |
| 74170 |
|
36 |
36 |
$6K |
| L3002 |
Foot, insert, removable, molded to patient model, plastazote or equal, each |
27 |
24 |
$6K |
| 46601 |
|
13 |
13 |
$5K |
| 92136 |
|
174 |
173 |
$5K |
| 93880 |
|
51 |
51 |
$5K |
| 86664 |
|
521 |
521 |
$5K |
| 86593 |
|
1,317 |
1,292 |
$5K |
| 82166 |
|
164 |
164 |
$5K |
| 96127 |
|
479 |
477 |
$5K |
| 90661 |
|
198 |
198 |
$5K |
| 77066 |
Tomosynthesis, mammo |
84 |
82 |
$5K |
| 73000 |
|
351 |
317 |
$5K |
| 80178 |
|
823 |
774 |
$5K |
| 86663 |
|
511 |
511 |
$5K |
| 87324 |
|
568 |
555 |
$5K |
| 82374 |
|
1,878 |
1,815 |
$5K |
| 82435 |
|
2,026 |
1,960 |
$5K |
| 0031A |
|
185 |
185 |
$5K |
| 0083A |
|
116 |
116 |
$5K |
| 92593 |
|
53 |
53 |
$5K |
| 82525 |
|
405 |
398 |
$5K |
| 86481 |
|
83 |
83 |
$5K |
| 85613 |
|
528 |
526 |
$5K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
69 |
69 |
$5K |
| 80299 |
|
190 |
180 |
$5K |
| 84132 |
|
1,530 |
1,477 |
$4K |
| 84436 |
|
743 |
733 |
$4K |
| 82952 |
|
1,238 |
1,236 |
$4K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
12 |
12 |
$4K |
| 87206 |
|
673 |
659 |
$4K |
| 77049 |
|
12 |
12 |
$4K |
| 86301 |
|
238 |
225 |
$4K |
| D0999 |
Unspecified diagnostic procedure, by report |
26 |
25 |
$4K |
| 77290 |
|
12 |
12 |
$4K |
| 87184 |
|
592 |
585 |
$4K |
| 75561 |
|
12 |
12 |
$4K |
| 86381 |
|
264 |
262 |
$4K |
| 76641 |
|
75 |
75 |
$4K |
| 87507 |
|
14 |
14 |
$4K |
| 78264 |
|
43 |
43 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
33 |
25 |
$4K |
| 84478 |
|
797 |
676 |
$4K |
| 64484 |
|
13 |
13 |
$4K |
| 94726 |
|
51 |
51 |
$4K |
| 86255 |
|
254 |
240 |
$4K |
| 97537 |
|
53 |
42 |
$4K |
| 84681 |
|
196 |
194 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
891 |
883 |
$4K |
| 86644 |
|
373 |
371 |
$4K |
| 73060 |
|
239 |
221 |
$4K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
55 |
54 |
$4K |
| 74240 |
|
72 |
72 |
$4K |
| 92520 |
|
57 |
57 |
$4K |
| 86317 |
|
67 |
67 |
$4K |
| 0003A |
|
88 |
88 |
$3K |
| 99441 |
|
34 |
16 |
$3K |
| J9263 |
Injection, oxaliplatin, 0.5 mg |
153 |
91 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
32 |
17 |
$3K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
6,043 |
5,404 |
$3K |
| 86015 |
|
403 |
397 |
$3K |
| 87593 |
|
25 |
18 |
$3K |
| 93321 |
|
88 |
87 |
$3K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
2,481 |
1,526 |
$3K |
| 72050 |
|
178 |
178 |
$3K |
| 85018 |
|
1,435 |
1,414 |
$3K |
| 72081 |
|
258 |
252 |
$3K |
| 80074 |
|
107 |
107 |
$3K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
698 |
688 |
$3K |
| 82104 |
|
217 |
215 |
$3K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
1,386 |
1,163 |
$3K |
| M0220 |
Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), includes injection and post administration monitoring |
28 |
27 |
$3K |
| 82340 |
|
497 |
488 |
$3K |
| J2794 |
Injection, risperidone (risperdal consta), 0.5 mg |
48 |
12 |
$3K |
| 76818 |
|
71 |
53 |
$3K |
| 96377 |
|
114 |
94 |
$3K |
| 0173A |
|
70 |
70 |
$3K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
5,126 |
4,797 |
$3K |
| 77001 |
|
12 |
12 |
$3K |
| 73522 |
|
195 |
193 |
$3K |
| G0009 |
Administration of pneumococcal vaccine |
201 |
201 |
$3K |
| 82523 |
|
162 |
160 |
$3K |
| 86999 |
|
66 |
27 |
$3K |
| 92592 |
|
38 |
38 |
$3K |
| 81050 |
|
928 |
912 |
$3K |
| 88333 |
|
28 |
28 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
26 |
14 |
$2K |
| 74455 |
|
24 |
24 |
$2K |
| 95912 |
|
24 |
24 |
$2K |
| 84244 |
|
126 |
123 |
$2K |
| 92558 |
|
76 |
67 |
$2K |
| 0134A |
|
51 |
51 |
$2K |
| 20552 |
|
12 |
12 |
$2K |
| 90750 |
|
14 |
14 |
$2K |
| 84445 |
|
65 |
65 |
$2K |
| 0053A |
|
47 |
47 |
$2K |
| 86036 |
|
205 |
203 |
$2K |
| 69209 |
|
25 |
25 |
$2K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
361 |
172 |
$2K |
| 83789 |
|
114 |
114 |
$2K |
| 86677 |
|
234 |
233 |
$2K |
| 83010 |
|
158 |
136 |
$2K |
| 94727 |
|
114 |
114 |
$2K |
| 87075 |
|
265 |
260 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
37 |
37 |
$2K |
| D9920 |
|
31 |
13 |
$2K |
| 74174 |
|
12 |
12 |
$2K |
| 80143 |
|
409 |
364 |
$2K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
144 |
143 |
$2K |
| J9370 |
Vincristine sulfate, 1 mg |
265 |
176 |
$2K |
| 99493 |
|
16 |
14 |
$2K |
| D0367 |
|
12 |
12 |
$2K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
223 |
219 |
$2K |
| 83721 |
|
585 |
576 |
$2K |
| 80175 |
|
138 |
135 |
$2K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
5,194 |
5,089 |
$2K |
| 92555 |
|
37 |
37 |
$2K |
| 87634 |
|
30 |
30 |
$2K |
| 83630 |
|
94 |
94 |
$2K |
| 96368 |
|
18 |
13 |
$2K |
| J2785 |
Injection, regadenoson, 0.1 mg |
14 |
14 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
19 |
12 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
5,520 |
5,414 |
$2K |
| 73200 |
|
12 |
12 |
$2K |
| 76885 |
|
74 |
73 |
$2K |
| 90785 |
|
115 |
27 |
$1K |
| J1720 |
Injection, hydrocortisone sodium succinate, up to 100 mg |
222 |
180 |
$1K |
| 77263 |
|
12 |
12 |
$1K |
| 82157 |
|
51 |
50 |
$1K |
| J1630 |
Injection, haloperidol, up to 5 mg |
626 |
586 |
$1K |
| 83835 |
|
88 |
86 |
$1K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,751 |
1,432 |
$1K |
| 0074A |
|
32 |
32 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
46 |
46 |
$1K |
| 92652 |
|
12 |
12 |
$1K |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,068 |
503 |
$1K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,824 |
1,632 |
$1K |
| 86341 |
|
38 |
38 |
$1K |
| 87116 |
|
110 |
107 |
$1K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
18 |
12 |
$1K |
| 76775 |
|
12 |
12 |
$1K |
| D2140 |
|
13 |
13 |
$1K |
| J9206 |
Injection, irinotecan, 20 mg |
47 |
25 |
$1K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
13 |
13 |
$1K |
| J8540 |
Dexamethasone, oral, 0.25 mg |
2,667 |
1,469 |
$1K |
| 86617 |
|
37 |
37 |
$1K |
| 90619 |
|
50 |
41 |
$1K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
8,047 |
7,222 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
109 |
109 |
$1K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,632 |
1,259 |
$999.38 |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
120 |
117 |
$987.06 |
| 74022 |
|
24 |
24 |
$979.79 |
| 84080 |
|
77 |
77 |
$979.20 |
| 0073A |
|
19 |
19 |
$966.49 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
30 |
30 |
$965.86 |
| 84432 |
|
107 |
106 |
$960.87 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
228 |
225 |
$955.57 |
| J9060 |
Injection, cisplatin, powder or solution, 10 mg |
86 |
52 |
$953.07 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
380 |
375 |
$934.64 |
| 88311 |
|
42 |
40 |
$909.02 |
| 82010 |
|
129 |
118 |
$879.52 |
| 76512 |
|
15 |
12 |
$840.02 |
| 88302 |
|
14 |
13 |
$830.54 |
| 86645 |
|
88 |
88 |
$826.62 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
597 |
400 |
$820.65 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,095 |
992 |
$805.03 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
642 |
546 |
$751.59 |
| L3040 |
Foot, arch support, removable, premolded, longitudinal, each |
35 |
29 |
$732.28 |
| 82140 |
|
58 |
54 |
$724.08 |
| 80177 |
|
58 |
55 |
$719.77 |
| L3933 |
Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment |
12 |
12 |
$715.00 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
25 |
25 |
$704.86 |
| J2060 |
Injection, lorazepam, 2 mg |
156 |
150 |
$696.86 |
| L3420 |
Full sole and heel wedge, between sole |
16 |
13 |
$646.79 |
| 82465 |
|
153 |
153 |
$624.65 |
| 74019 |
|
13 |
13 |
$616.40 |
| 85046 |
|
136 |
135 |
$612.51 |
| 80179 |
|
327 |
316 |
$612.47 |
| 92553 |
|
12 |
12 |
$601.94 |
| J9201 |
Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg |
26 |
12 |
$594.97 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
38 |
38 |
$583.47 |
| 82172 |
|
40 |
40 |
$552.68 |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
397 |
357 |
$551.66 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
290 |
277 |
$541.05 |
| 80047 |
|
42 |
41 |
$537.68 |
| 84446 |
|
39 |
39 |
$521.64 |
| 87110 |
|
30 |
30 |
$509.49 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
120 |
103 |
$504.68 |
| 84255 |
|
24 |
24 |
$498.07 |
| 86063 |
|
116 |
116 |
$456.27 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
82 |
72 |
$452.43 |
| 83883 |
|
39 |
39 |
$410.60 |
| J3489 |
Injection, zoledronic acid, 1 mg |
12 |
12 |
$392.55 |
| 85660 |
|
80 |
80 |
$388.81 |
| 70355 |
|
12 |
12 |
$388.62 |
| 90670 |
|
21 |
21 |
$380.60 |
| 97012 |
|
24 |
12 |
$364.12 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
63 |
63 |
$360.55 |
| 80165 |
|
25 |
24 |
$347.69 |
| 88141 |
|
12 |
12 |
$346.92 |
| 87045 |
|
38 |
38 |
$319.47 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
115 |
80 |
$314.32 |
| 87046 |
|
38 |
38 |
$303.87 |
| J1815 |
Injection, insulin, per 5 units |
243 |
142 |
$290.28 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
25 |
25 |
$282.34 |
| 87640 |
|
14 |
14 |
$281.32 |
| 82239 |
|
45 |
39 |
$278.78 |
| 90662 |
|
40 |
40 |
$248.14 |
| P9603 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled |
140 |
89 |
$234.72 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
41 |
33 |
$223.69 |
| 82077 |
|
141 |
136 |
$223.36 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
644 |
585 |
$223.08 |
| 87088 |
|
27 |
27 |
$216.73 |
| 73600 |
|
31 |
25 |
$210.61 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
43 |
38 |
$206.71 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
12 |
12 |
$206.38 |
| 84510 |
|
18 |
12 |
$205.68 |
| 86431 |
|
39 |
39 |
$202.83 |
| C1729 |
Catheter, drainage |
12 |
12 |
$197.00 |
| 90656 |
|
20 |
20 |
$190.76 |
| 85060 |
|
12 |
12 |
$189.07 |
| 73660 |
|
26 |
24 |
$185.27 |
| 86258 |
|
22 |
13 |
$176.82 |
| 87015 |
|
72 |
71 |
$173.78 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
215 |
208 |
$167.93 |
| 84482 |
|
24 |
24 |
$164.29 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
159 |
112 |
$135.58 |
| 82379 |
|
12 |
12 |
$132.84 |
| 82274 |
|
12 |
12 |
$130.24 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
19 |
12 |
$130.05 |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
297 |
296 |
$126.81 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
212 |
174 |
$122.60 |
| 90734 |
|
12 |
12 |
$119.00 |
| 93296 |
|
13 |
12 |
$118.79 |
| J7510 |
Prednisolone oral, per 5 mg |
131 |
129 |
$115.47 |
| 84030 |
|
18 |
12 |
$108.65 |
| C9257 |
Injection, bevacizumab, 0.25 mg |
13 |
12 |
$108.64 |
| 85347 |
|
31 |
27 |
$107.76 |
| 84300 |
|
25 |
24 |
$105.20 |
| 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 |
1,440 |
1,383 |
$90.16 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
419 |
408 |
$88.78 |
| J2310 |
Injection, naloxone hydrochloride, per 1 mg |
13 |
12 |
$88.51 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
46 |
45 |
$81.33 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
29 |
29 |
$78.51 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
136 |
117 |
$62.09 |
| 85049 |
|
16 |
13 |
$61.89 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
13 |
13 |
$58.81 |
| Q0164 |
Prochlorperazine maleate, 5 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 |
259 |
175 |
$54.45 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
315 |
314 |
$49.70 |
| J3480 |
Injection, potassium chloride, per 2 meq |
18 |
12 |
$41.92 |
| 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 |
602 |
446 |
$33.97 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
52 |
52 |
$29.64 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
51 |
49 |
$25.97 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
334 |
258 |
$25.93 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
56 |
56 |
$24.37 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
19 |
19 |
$16.51 |
| J0744 |
Injection, ciprofloxacin for intravenous infusion, 200 mg |
14 |
14 |
$11.61 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
117 |
103 |
$10.71 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
14 |
13 |
$0.94 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
15 |
13 |
$0.90 |
| 90723 |
|
12 |
12 |
$0.00 |
| D9995 |
|
80 |
80 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
12 |
12 |
$0.00 |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
12 |
12 |
$0.00 |
| G2212 |
Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes) |
14 |
14 |
$0.00 |
| 90648 |
|
16 |
16 |
$0.00 |