| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
27,194 |
24,701 |
$14.71M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
19,012 |
17,136 |
$13.09M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
18,840 |
17,608 |
$6.57M |
| G0378 |
Hospital observation service, per hour |
6,734 |
5,338 |
$5.74M |
| 59025 |
Fetal non-stress test |
3,307 |
1,101 |
$1.22M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,897 |
1,789 |
$883K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
3,710 |
3,502 |
$757K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,429 |
1,370 |
$637K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
18,608 |
16,182 |
$609K |
| OP710 |
|
5,181 |
4,636 |
$576K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
21,814 |
18,929 |
$512K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
6,156 |
5,767 |
$489K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
13,278 |
10,997 |
$463K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
2,131 |
1,456 |
$379K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
15,256 |
13,091 |
$335K |
| 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 |
2,925 |
2,789 |
$309K |
| OP279 |
|
5,992 |
5,478 |
$301K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
5,033 |
3,941 |
$282K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
126 |
111 |
$261K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
242 |
166 |
$258K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
2,710 |
2,621 |
$225K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
5,235 |
4,900 |
$224K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,446 |
2,250 |
$206K |
| OP272 |
|
4,770 |
4,315 |
$204K |
| 87631 |
|
7,978 |
7,518 |
$195K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
9,108 |
8,372 |
$193K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
173 |
166 |
$183K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
11,218 |
10,313 |
$170K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
9,208 |
5,863 |
$166K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
11,424 |
2,934 |
$166K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,876 |
3,491 |
$165K |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,504 |
6,917 |
$165K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,355 |
1,292 |
$164K |
| 76801 |
|
2,191 |
2,025 |
$162K |
| 93017 |
|
377 |
347 |
$144K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
7,485 |
6,474 |
$138K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
4,210 |
3,960 |
$138K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,123 |
1,084 |
$137K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
7,592 |
6,943 |
$137K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,624 |
1,417 |
$136K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,894 |
1,121 |
$133K |
| 93975 |
|
2,791 |
2,612 |
$132K |
| 71045 |
Radiologic examination, chest; single view |
12,936 |
11,872 |
$130K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
5,964 |
2,540 |
$128K |
| 76830 |
Ultrasound, transvaginal |
1,716 |
1,655 |
$128K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,178 |
2,092 |
$124K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
4,001 |
1,183 |
$123K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,622 |
5,466 |
$121K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,813 |
2,647 |
$118K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,892 |
1,800 |
$112K |
| 94060 |
|
404 |
386 |
$103K |
| 71046 |
Radiologic examination, chest; 2 views |
5,753 |
5,476 |
$100K |
| 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 |
2,585 |
2,455 |
$94K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
33,161 |
27,040 |
$91K |
| 11043 |
|
715 |
507 |
$86K |
| 93971 |
|
1,360 |
1,279 |
$82K |
| 93970 |
|
599 |
567 |
$73K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
45,573 |
35,747 |
$72K |
| 86901 |
|
4,142 |
3,804 |
$70K |
| 36415 |
Collection of venous blood by venipuncture |
53,034 |
38,282 |
$66K |
| 76642 |
|
709 |
678 |
$64K |
| 93041 |
|
7,727 |
6,983 |
$64K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
631 |
514 |
$64K |
| 87581 |
|
6,753 |
6,467 |
$64K |
| 87486 |
|
6,755 |
6,468 |
$63K |
| OP270 |
|
341 |
287 |
$63K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,697 |
1,611 |
$61K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
3,341 |
3,158 |
$57K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,110 |
1,066 |
$56K |
| 80053 |
Comprehensive metabolic panel |
13,275 |
11,245 |
$56K |
| 0001A |
|
1,711 |
1,701 |
$55K |
| 36000 |
|
6,707 |
6,306 |
$53K |
| 94760 |
|
21,811 |
17,943 |
$52K |
| 0002A |
|
1,507 |
1,494 |
$51K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,403 |
2,255 |
$50K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
207 |
184 |
$48K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
203 |
100 |
$46K |
| 97161 |
|
1,670 |
1,490 |
$42K |
| 84484 |
|
10,498 |
8,818 |
$40K |
| 47562 |
|
19 |
15 |
$39K |
| 86850 |
|
3,297 |
3,017 |
$39K |
| OP259 |
|
32,055 |
22,619 |
$39K |
| 95816 |
|
104 |
102 |
$38K |
| 86900 |
|
4,131 |
3,800 |
$36K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,147 |
780 |
$36K |
| 80076 |
|
17,680 |
15,786 |
$35K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,883 |
1,723 |
$34K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,242 |
1,058 |
$33K |
| 80320 |
|
6,671 |
5,493 |
$33K |
| 71250 |
|
791 |
744 |
$33K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
478 |
451 |
$32K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
78 |
69 |
$31K |
| 97602 |
|
500 |
340 |
$31K |
| 83880 |
|
3,533 |
3,256 |
$31K |
| 77066 |
Tomosynthesis, mammo |
125 |
119 |
$28K |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
34 |
34 |
$27K |
| J3490 |
Unclassified drugs |
15,324 |
10,082 |
$27K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
41 |
39 |
$27K |
| 76818 |
|
220 |
139 |
$26K |
| 96376 |
|
2,737 |
2,322 |
$26K |
| 58558 |
|
13 |
13 |
$25K |
| 80329 |
|
2,765 |
2,531 |
$25K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,694 |
1,625 |
$24K |
| 73630 |
|
1,775 |
1,675 |
$24K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
241 |
212 |
$24K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,764 |
1,690 |
$22K |
| 94729 |
|
422 |
408 |
$21K |
| 73564 |
|
1,479 |
1,407 |
$20K |
| 73610 |
|
1,592 |
1,480 |
$19K |
| 17250 |
|
211 |
168 |
$19K |
| 77065 |
Tomosynthesis, mammo |
147 |
135 |
$18K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
8,813 |
8,196 |
$18K |
| 76770 |
|
285 |
265 |
$18K |
| 83735 |
|
12,438 |
9,959 |
$18K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
18,420 |
14,530 |
$17K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,218 |
2,085 |
$17K |
| 73130 |
|
1,168 |
1,093 |
$17K |
| 73030 |
|
1,173 |
1,096 |
$16K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
397 |
103 |
$16K |
| 94726 |
|
318 |
305 |
$16K |
| 70486 |
|
624 |
592 |
$16K |
| 85055 |
|
1,582 |
1,325 |
$15K |
| 83690 |
|
10,393 |
9,461 |
$15K |
| 85610 |
|
13,656 |
12,125 |
$15K |
| OP250 |
|
6,058 |
4,914 |
$13K |
| 84703 |
|
12,092 |
11,008 |
$13K |
| J2916 |
Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg |
269 |
98 |
$13K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
15 |
13 |
$13K |
| 97803 |
|
307 |
292 |
$13K |
| 85730 |
|
11,337 |
10,424 |
$13K |
| 81003 |
|
25,134 |
22,657 |
$12K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
20 |
20 |
$12K |
| 97162 |
|
549 |
477 |
$12K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
109 |
103 |
$12K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
9,585 |
8,575 |
$11K |
| 83605 |
|
2,806 |
2,507 |
$10K |
| 97116 |
|
1,578 |
955 |
$10K |
| 82962 |
|
8,526 |
5,609 |
$10K |
| 73110 |
|
658 |
619 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
936 |
815 |
$9K |
| 87040 |
|
2,123 |
1,897 |
$9K |
| 84702 |
|
2,340 |
1,964 |
$9K |
| 0004A |
|
292 |
284 |
$9K |
| 97802 |
|
129 |
123 |
$9K |
| C1769 |
Guide wire |
314 |
231 |
$9K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
5,546 |
4,245 |
$9K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
12,957 |
10,598 |
$8K |
| 80306 |
|
425 |
405 |
$8K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
2,403 |
1,457 |
$8K |
| 76536 |
|
86 |
83 |
$8K |
| 70498 |
|
177 |
158 |
$8K |
| 90715 |
|
865 |
830 |
$8K |
| 97010 |
|
2,459 |
792 |
$7K |
| 11045 |
|
39 |
27 |
$7K |
| 81001 |
|
14,065 |
12,888 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,659 |
2,556 |
$7K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
83 |
67 |
$7K |
| 87081 |
|
2,544 |
2,460 |
$7K |
| 72131 |
|
274 |
256 |
$6K |
| 82248 |
|
1,021 |
624 |
$6K |
| 0071A |
|
177 |
175 |
$6K |
| 88304 |
|
631 |
597 |
$6K |
| 73502 |
|
524 |
482 |
$6K |
| 0072A |
|
164 |
159 |
$6K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
418 |
396 |
$6K |
| 97165 |
|
625 |
542 |
$6K |
| 73590 |
|
526 |
476 |
$6K |
| J2704 |
Injection, propofol, 10 mg |
4,507 |
4,173 |
$6K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,755 |
4,375 |
$5K |
| 70496 |
|
122 |
109 |
$5K |
| 76000 |
|
185 |
167 |
$5K |
| 87186 |
|
1,669 |
1,551 |
$5K |
| 80061 |
Lipid panel |
864 |
790 |
$5K |
| 76813 |
|
28 |
28 |
$5K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,431 |
1,401 |
$5K |
| 81025 |
|
4,646 |
4,343 |
$5K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
6,312 |
5,666 |
$5K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,975 |
3,636 |
$5K |
| 96367 |
|
203 |
145 |
$5K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,850 |
2,660 |
$5K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,015 |
963 |
$4K |
| 85379 |
|
2,431 |
2,323 |
$4K |
| 0012A |
|
107 |
107 |
$4K |
| 82550 |
|
1,634 |
1,493 |
$4K |
| 87077 |
|
1,499 |
1,396 |
$4K |
| 85027 |
|
1,300 |
1,092 |
$3K |
| 82803 |
|
594 |
537 |
$3K |
| 82247 |
|
456 |
227 |
$3K |
| A4648 |
Tissue marker, implantable, any type, each |
48 |
41 |
$3K |
| 73080 |
|
281 |
263 |
$3K |
| 73090 |
|
246 |
223 |
$3K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,778 |
3,094 |
$3K |
| 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 |
595 |
460 |
$3K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
16 |
13 |
$3K |
| 72110 |
|
117 |
109 |
$3K |
| 88342 |
|
212 |
200 |
$3K |
| J7050 |
Infusion, normal saline solution, 250 cc |
657 |
328 |
$3K |
| 87147 |
|
2,464 |
2,386 |
$3K |
| 74022 |
|
138 |
130 |
$3K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
938 |
878 |
$3K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
2,502 |
2,245 |
$2K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
4,457 |
3,782 |
$2K |
| 12001 |
|
69 |
65 |
$2K |
| 84100 |
|
2,271 |
1,978 |
$2K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
3,707 |
3,328 |
$2K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
45 |
44 |
$2K |
| 82728 |
|
308 |
273 |
$2K |
| 87071 |
|
628 |
557 |
$2K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
251 |
160 |
$2K |
| 97535 |
Self-care/home management training, each 15 minutes |
442 |
296 |
$2K |
| C9113 |
Injection, pantoprazole sodium, per vial |
1,185 |
845 |
$2K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,986 |
2,356 |
$2K |
| 80165 |
|
709 |
631 |
$2K |
| P9612 |
Catheterization for collection of specimen, single patient, all places of service |
2,266 |
2,197 |
$2K |
| J2060 |
Injection, lorazepam, 2 mg |
2,840 |
2,259 |
$2K |
| 0064A |
|
52 |
52 |
$2K |
| 82375 |
|
627 |
569 |
$2K |
| 82330 |
|
376 |
344 |
$2K |
| OP258 |
|
740 |
687 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
874 |
714 |
$1K |
| OP637 |
|
4,155 |
2,378 |
$1K |
| 0054A |
|
44 |
42 |
$1K |
| 86140 |
|
1,199 |
1,116 |
$1K |
| 76870 |
|
54 |
50 |
$1K |
| 83540 |
|
547 |
483 |
$1K |
| 74018 |
|
82 |
80 |
$1K |
| 82150 |
|
695 |
676 |
$1K |
| 12011 |
|
25 |
25 |
$1K |
| 36600 |
|
156 |
141 |
$1K |
| 10060 |
|
16 |
14 |
$1K |
| J3360 |
Injection, diazepam, up to 5 mg |
152 |
144 |
$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 |
2,239 |
1,978 |
$1K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
43 |
41 |
$1K |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
2,682 |
2,188 |
$1K |
| 84145 |
|
167 |
165 |
$987.96 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
14 |
13 |
$967.54 |
| 36591 |
|
295 |
167 |
$965.73 |
| 80178 |
|
328 |
292 |
$957.90 |
| 87073 |
|
328 |
276 |
$949.63 |
| 36430 |
|
36 |
28 |
$929.31 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
260 |
256 |
$927.80 |
| 83050 |
|
629 |
569 |
$918.77 |
| 0003A |
|
36 |
36 |
$891.98 |
| J1453 |
Injection, fosaprepitant, 1 mg |
20 |
12 |
$876.79 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,640 |
2,313 |
$872.86 |
| 82607 |
|
150 |
136 |
$846.00 |
| 78580 |
|
14 |
13 |
$773.36 |
| 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 |
124 |
91 |
$763.32 |
| 85652 |
|
1,070 |
1,003 |
$718.39 |
| 0011A |
|
28 |
28 |
$664.34 |
| J2790 |
Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) |
13 |
12 |
$641.26 |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
33 |
26 |
$632.01 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
55 |
50 |
$576.25 |
| 85018 |
|
1,039 |
911 |
$565.29 |
| J3486 |
Injection, ziprasidone mesylate, 10 mg |
16 |
13 |
$528.74 |
| 86308 |
|
465 |
455 |
$521.02 |
| 82947 |
|
494 |
437 |
$509.12 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
602 |
558 |
$490.13 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
425 |
395 |
$489.15 |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,447 |
755 |
$484.23 |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
20 |
12 |
$482.11 |
| 73552 |
|
38 |
36 |
$479.67 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
708 |
557 |
$425.95 |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
364 |
262 |
$424.96 |
| 0052A |
|
12 |
12 |
$423.07 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
186 |
150 |
$417.94 |
| 86592 |
|
301 |
286 |
$397.97 |
| J1790 |
Injection, droperidol, up to 5 mg |
123 |
113 |
$385.98 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
262 |
176 |
$374.70 |
| 85008 |
|
1,629 |
1,524 |
$348.37 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
42 |
41 |
$331.67 |
| 82746 |
|
43 |
39 |
$321.03 |
| 77062 |
|
62 |
54 |
$319.13 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
206 |
194 |
$301.83 |
| J1630 |
Injection, haloperidol, up to 5 mg |
1,126 |
879 |
$300.59 |
| 80354 |
|
58 |
54 |
$298.64 |
| 73620 |
|
15 |
15 |
$287.87 |
| 86787 |
|
13 |
13 |
$265.56 |
| 84132 |
|
387 |
347 |
$228.01 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
309 |
271 |
$204.31 |
| 86923 |
|
15 |
14 |
$190.84 |
| 96368 |
|
16 |
12 |
$188.00 |
| 72100 |
|
16 |
16 |
$175.23 |
| 97164 |
|
32 |
26 |
$172.93 |
| A9540 |
Technetium tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries |
17 |
13 |
$157.91 |
| 84295 |
|
297 |
267 |
$154.64 |
| 87340 |
|
53 |
51 |
$147.97 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
834 |
679 |
$137.27 |
| 91300 |
|
3,188 |
2,802 |
$135.01 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
61 |
52 |
$131.29 |
| 82435 |
|
282 |
254 |
$123.71 |
| 29530 |
|
12 |
12 |
$113.45 |
| 83615 |
|
92 |
79 |
$107.50 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
889 |
331 |
$100.24 |
| J1953 |
Injection, levetiracetam, 10 mg |
95 |
69 |
$93.44 |
| J3480 |
Injection, potassium chloride, per 2 meq |
67 |
50 |
$83.52 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
70 |
41 |
$78.39 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,801 |
1,399 |
$76.11 |
| 89220 |
|
13 |
13 |
$71.26 |
| 86618 |
|
14 |
12 |
$59.97 |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
17 |
14 |
$59.92 |
| 84156 |
|
157 |
128 |
$55.96 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
74 |
64 |
$35.92 |
| J3411 |
Injection, thiamine hcl, 100 mg |
14 |
13 |
$35.66 |
| J1836 |
Injection, metronidazole, 10 mg |
42 |
31 |
$34.59 |
| 82140 |
|
33 |
29 |
$30.64 |
| 87070 |
|
14 |
13 |
$28.24 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
25 |
19 |
$21.33 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
53 |
39 |
$18.17 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
12 |
12 |
$13.12 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
12 |
12 |
$11.93 |
| 84550 |
|
38 |
36 |
$10.67 |
| 91307 |
|
314 |
264 |
$9.01 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
13 |
13 |
$7.40 |
| 85007 |
|
381 |
317 |
$6.05 |
| 88311 |
|
17 |
14 |
$5.68 |
| 91306 |
|
51 |
51 |
$5.00 |
| J1940 |
Injection, furosemide, up to 20 mg |
30 |
12 |
$5.00 |
| 85045 |
|
16 |
12 |
$4.00 |
| 91305 |
|
115 |
108 |
$2.00 |
| 91301 |
|
102 |
99 |
$2.00 |
| Q0244 |
Injection, casirivimab and imdevimab, 1200 mg |
17 |
17 |
$1.00 |
| OP450 |
|
675 |
587 |
$0.00 |
| Q0245 |
Injection, bamlanivimab and etesevimab, 2100 mg |
28 |
28 |
$0.00 |