| Code | Description | Claims | Beneficiaries | Total Paid |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
27,487 |
26,265 |
$3.85M |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
11,702 |
11,255 |
$2.49M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
20,204 |
19,403 |
$2.12M |
| G0378 |
Hospital observation service, per hour |
2,278 |
1,349 |
$1.84M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
22,056 |
21,400 |
$1.62M |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
19,053 |
15,505 |
$1.15M |
| 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 |
17,131 |
14,107 |
$1.00M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,370 |
4,217 |
$812K |
| 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 |
7,260 |
5,778 |
$592K |
| 80053 |
Comprehensive metabolic panel |
56,994 |
52,870 |
$588K |
| 87631 |
|
3,564 |
3,407 |
$475K |
| 70450 |
Computed tomography, head or brain; without contrast material |
5,395 |
5,259 |
$399K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
57,455 |
53,473 |
$300K |
| 71046 |
Radiologic examination, chest; 2 views |
13,991 |
13,568 |
$236K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
1,810 |
1,704 |
$209K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,400 |
2,362 |
$207K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
7,222 |
6,946 |
$202K |
| 84443 |
Thyroid stimulating hormone (TSH) |
8,205 |
8,001 |
$176K |
| 0100U |
|
460 |
402 |
$174K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,532 |
1,101 |
$158K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
18,290 |
17,442 |
$157K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,184 |
3,360 |
$146K |
| 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 |
1,636 |
1,533 |
$118K |
| 84484 |
|
10,351 |
8,389 |
$105K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
941 |
900 |
$105K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
451 |
448 |
$101K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,386 |
2,352 |
$92K |
| 80061 |
Lipid panel |
6,699 |
6,586 |
$85K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
156 |
149 |
$84K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
4,749 |
4,529 |
$81K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
5,863 |
5,623 |
$81K |
| 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 |
6,001 |
5,069 |
$80K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
90 |
79 |
$79K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
958 |
925 |
$77K |
| 87481 |
|
1,004 |
975 |
$69K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
227 |
223 |
$58K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
1,410 |
1,365 |
$57K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,210 |
2,166 |
$53K |
| 83690 |
|
10,454 |
9,923 |
$48K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
412 |
391 |
$48K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,015 |
1,974 |
$46K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,346 |
1,320 |
$45K |
| 300 |
Patient transfer system <300 |
529 |
147 |
$44K |
| 93971 |
|
563 |
547 |
$41K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
430 |
418 |
$41K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,470 |
1,453 |
$40K |
| T1015 |
Clinic visit/encounter, all-inclusive |
1,241 |
732 |
$40K |
| 87430 |
|
6,131 |
5,922 |
$39K |
| 84702 |
|
2,415 |
2,171 |
$39K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
793 |
772 |
$39K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
343 |
342 |
$38K |
| 85027 |
|
6,042 |
5,220 |
$38K |
| 81001 |
|
13,813 |
13,181 |
$38K |
| 36415 |
Collection of venous blood by venipuncture |
32,322 |
28,160 |
$38K |
| J1756 |
Injection, iron sucrose, 1 mg |
3,400 |
1,886 |
$37K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
4,771 |
4,042 |
$37K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,633 |
2,397 |
$35K |
| 76830 |
Ultrasound, transvaginal |
564 |
552 |
$35K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
4,443 |
4,283 |
$34K |
| 71250 |
|
367 |
364 |
$32K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,072 |
4,968 |
$32K |
| 93970 |
|
286 |
286 |
$30K |
| 81025 |
|
8,028 |
7,639 |
$30K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
118 |
117 |
$29K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
122 |
121 |
$29K |
| 82728 |
|
2,451 |
2,385 |
$28K |
| 83605 |
|
4,067 |
3,751 |
$27K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
872 |
867 |
$27K |
| 86803 |
|
1,391 |
1,376 |
$26K |
| 82607 |
|
2,133 |
2,113 |
$26K |
| 450 |
Pov group 1 hd 301-450 lbs |
71 |
38 |
$26K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
619 |
618 |
$24K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,270 |
1,026 |
$24K |
| 84439 |
|
3,054 |
2,975 |
$24K |
| 76770 |
|
348 |
346 |
$23K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
76 |
73 |
$22K |
| Q3014 |
Telehealth originating site facility fee |
1,625 |
1,597 |
$22K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
8,146 |
7,795 |
$21K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
288 |
261 |
$21K |
| 83540 |
|
2,634 |
2,561 |
$21K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
95 |
95 |
$20K |
| 83880 |
|
662 |
617 |
$20K |
| 95886 |
|
261 |
260 |
$20K |
| 76536 |
|
305 |
301 |
$19K |
| 93017 |
|
466 |
464 |
$19K |
| 88342 |
|
459 |
424 |
$19K |
| 87522 |
Neg quan hep c or qual rna |
466 |
452 |
$18K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
230 |
226 |
$17K |
| 94729 |
|
569 |
565 |
$16K |
| 86850 |
|
2,147 |
2,030 |
$16K |
| 80050 |
General health panel |
359 |
345 |
$16K |
| 71045 |
Radiologic examination, chest; single view |
1,679 |
1,584 |
$15K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
297 |
214 |
$15K |
| 73610 |
|
660 |
601 |
$14K |
| 95910 |
|
112 |
112 |
$14K |
| 86480 |
|
202 |
195 |
$14K |
| 86317 |
|
598 |
588 |
$14K |
| 87340 |
|
904 |
894 |
$13K |
| 94726 |
|
475 |
471 |
$13K |
| 86901 |
|
2,397 |
2,128 |
$12K |
| 86900 |
|
2,397 |
2,128 |
$12K |
| 83970 |
|
291 |
286 |
$12K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
458 |
439 |
$12K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
440 |
424 |
$11K |
| 83550 |
|
2,476 |
2,412 |
$11K |
| 87511 |
|
558 |
548 |
$11K |
| 73564 |
|
421 |
388 |
$11K |
| 87150 |
|
221 |
219 |
$11K |
| 87641 |
|
293 |
288 |
$11K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
103 |
99 |
$11K |
| 93296 |
|
770 |
766 |
$10K |
| 73630 |
|
749 |
664 |
$10K |
| 70486 |
|
104 |
103 |
$10K |
| 82805 |
|
319 |
296 |
$10K |
| 84481 |
|
425 |
420 |
$10K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
726 |
220 |
$10K |
| 85610 |
|
3,055 |
2,371 |
$10K |
| 86003 |
|
77 |
76 |
$10K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
320 |
315 |
$10K |
| 87040 |
|
493 |
431 |
$9K |
| 76870 |
|
150 |
145 |
$9K |
| 85379 |
|
860 |
849 |
$9K |
| 90715 |
|
849 |
822 |
$8K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
1,723 |
1,670 |
$8K |
| 83735 |
|
1,471 |
1,026 |
$8K |
| 70498 |
|
39 |
38 |
$8K |
| 86618 |
|
353 |
351 |
$8K |
| 95909 |
|
84 |
84 |
$8K |
| C1769 |
Guide wire |
285 |
261 |
$8K |
| J2785 |
Injection, regadenoson, 0.1 mg |
138 |
136 |
$8K |
| 84153 |
|
330 |
325 |
$8K |
| 82570 |
|
1,106 |
1,037 |
$8K |
| 87506 |
|
57 |
55 |
$7K |
| 82746 |
|
632 |
624 |
$7K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
391 |
116 |
$7K |
| 84403 |
|
254 |
245 |
$7K |
| 72100 |
|
244 |
237 |
$7K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
314 |
95 |
$6K |
| 94060 |
|
637 |
632 |
$6K |
| 73130 |
|
428 |
397 |
$6K |
| 73030 |
|
333 |
313 |
$6K |
| 82043 |
|
822 |
792 |
$6K |
| 80074 |
|
117 |
117 |
$6K |
| 96376 |
|
162 |
144 |
$6K |
| 82784 |
|
289 |
278 |
$6K |
| 84146 |
|
221 |
218 |
$5K |
| 87186 |
|
709 |
668 |
$5K |
| 90686 |
|
513 |
504 |
$5K |
| X0592 |
|
132 |
131 |
$5K |
| 85652 |
|
1,773 |
1,694 |
$5K |
| 83655 |
|
475 |
463 |
$5K |
| 93350 |
|
106 |
106 |
$5K |
| 86140 |
|
1,589 |
1,501 |
$5K |
| 83520 |
|
269 |
258 |
$4K |
| 93923 |
|
82 |
79 |
$4K |
| 95908 |
|
51 |
51 |
$4K |
| 73590 |
|
215 |
197 |
$4K |
| 74018 |
|
252 |
242 |
$4K |
| 86038 |
|
266 |
263 |
$4K |
| 82962 |
|
2,389 |
1,584 |
$4K |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
12 |
12 |
$4K |
| 85730 |
|
629 |
615 |
$4K |
| 93880 |
|
46 |
45 |
$4K |
| 29125 |
|
164 |
157 |
$4K |
| 12001 |
|
155 |
147 |
$4K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
13 |
13 |
$4K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
149 |
127 |
$4K |
| 88341 |
|
52 |
37 |
$4K |
| 80164 |
|
202 |
187 |
$4K |
| 81003 |
|
1,193 |
1,164 |
$4K |
| 73110 |
|
231 |
216 |
$3K |
| 83525 |
|
314 |
309 |
$3K |
| 84100 |
|
735 |
538 |
$3K |
| 70496 |
|
15 |
15 |
$3K |
| 87077 |
|
465 |
422 |
$3K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
159 |
152 |
$3K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
196 |
126 |
$3K |
| 73502 |
|
142 |
135 |
$3K |
| 82248 |
|
448 |
418 |
$3K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,216 |
1,911 |
$3K |
| 86780 |
|
176 |
176 |
$3K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,436 |
2,016 |
$3K |
| 80325 |
|
168 |
152 |
$3K |
| 97161 |
|
70 |
68 |
$3K |
| 80076 |
|
318 |
305 |
$3K |
| 84270 |
|
102 |
87 |
$3K |
| 85007 |
|
614 |
541 |
$3K |
| 81513 |
|
30 |
30 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
47 |
45 |
$2K |
| 76801 |
|
30 |
30 |
$2K |
| 87088 |
|
293 |
282 |
$2K |
| 87902 |
|
13 |
13 |
$2K |
| 94618 |
|
141 |
141 |
$2K |
| 85046 |
|
378 |
367 |
$2K |
| 82375 |
|
442 |
419 |
$2K |
| 12011 |
|
62 |
58 |
$2K |
| 82105 |
|
103 |
102 |
$2K |
| 82550 |
|
317 |
298 |
$2K |
| 95911 |
|
12 |
12 |
$2K |
| 17110 |
|
44 |
41 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
220 |
179 |
$2K |
| G0008 |
Administration of influenza virus vaccine |
220 |
217 |
$2K |
| 95885 |
|
41 |
41 |
$2K |
| 86592 |
|
475 |
465 |
$2K |
| 29515 |
|
58 |
54 |
$2K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
14 |
13 |
$2K |
| 86431 |
|
228 |
227 |
$2K |
| 82077 |
|
136 |
126 |
$2K |
| 86762 |
|
86 |
85 |
$2K |
| 83001 |
|
101 |
99 |
$2K |
| 97162 |
|
77 |
72 |
$2K |
| 93246 |
|
56 |
55 |
$2K |
| 43235 |
|
13 |
13 |
$2K |
| 95819 |
|
126 |
124 |
$2K |
| 83002 |
|
96 |
94 |
$2K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
7,011 |
4,411 |
$2K |
| J2704 |
Injection, propofol, 10 mg |
4,633 |
4,190 |
$2K |
| 86160 |
|
56 |
51 |
$2K |
| 36591 |
|
25 |
16 |
$1K |
| 86704 |
|
93 |
92 |
$1K |
| 82150 |
|
326 |
314 |
$1K |
| 86376 |
|
182 |
182 |
$1K |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
1,094 |
1,067 |
$1K |
| 84550 |
|
241 |
231 |
$1K |
| 96417 |
|
22 |
12 |
$1K |
| 73090 |
|
91 |
88 |
$1K |
| G2066 |
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results |
56 |
56 |
$1K |
| 73700 |
|
15 |
13 |
$1K |
| 97124 |
|
98 |
41 |
$1K |
| 86708 |
|
88 |
87 |
$1K |
| 82565 |
|
219 |
216 |
$1K |
| 88304 |
|
218 |
203 |
$1K |
| 87070 |
|
194 |
186 |
$1K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
3,021 |
2,700 |
$1K |
| 86039 |
|
86 |
84 |
$1K |
| 73552 |
|
57 |
56 |
$1K |
| 80069 |
|
161 |
133 |
$1K |
| 80179 |
|
101 |
100 |
$1K |
| 84630 |
|
77 |
77 |
$1K |
| 82785 |
|
60 |
59 |
$1K |
| 85018 |
|
310 |
300 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
17 |
17 |
$1K |
| 82533 |
|
86 |
82 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
6,191 |
5,727 |
$998.89 |
| 99152 |
|
115 |
113 |
$997.06 |
| 70491 |
|
12 |
12 |
$988.79 |
| 84156 |
|
238 |
225 |
$978.96 |
| 86800 |
|
52 |
50 |
$954.78 |
| 82040 |
|
270 |
261 |
$942.93 |
| 97165 |
|
30 |
29 |
$935.68 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
11,718 |
10,341 |
$902.78 |
| 95816 |
|
73 |
73 |
$871.01 |
| 85014 |
|
262 |
255 |
$868.21 |
| 84145 |
|
61 |
58 |
$864.49 |
| J7050 |
Infusion, normal saline solution, 250 cc |
8,103 |
5,052 |
$842.48 |
| 82670 |
|
40 |
39 |
$841.80 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
5,698 |
5,291 |
$787.90 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
5,776 |
5,086 |
$783.33 |
| 83050 |
|
319 |
296 |
$781.02 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,783 |
1,071 |
$775.81 |
| 74240 |
|
13 |
13 |
$748.20 |
| J8501 |
Aprepitant, oral, 5 mg |
704 |
686 |
$732.27 |
| 93298 |
|
14 |
14 |
$727.94 |
| 83721 |
|
66 |
66 |
$726.25 |
| 84480 |
|
94 |
93 |
$697.80 |
| 73080 |
|
41 |
40 |
$691.49 |
| 99153 |
Mod sedat endo service >5yrs |
100 |
98 |
$685.44 |
| 86225 |
|
49 |
49 |
$682.63 |
| 97803 |
|
12 |
12 |
$672.61 |
| 84460 |
|
92 |
90 |
$639.02 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
530 |
514 |
$634.96 |
| 82627 |
|
29 |
29 |
$634.83 |
| 73560 |
|
38 |
35 |
$634.06 |
| 86235 |
|
19 |
12 |
$621.36 |
| 88312 |
|
18 |
14 |
$602.17 |
| 87075 |
|
64 |
59 |
$569.33 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
620 |
576 |
$567.23 |
| 77002 |
|
15 |
14 |
$559.66 |
| 84520 |
|
109 |
109 |
$552.60 |
| 97802 |
|
12 |
12 |
$543.75 |
| 87205 |
|
132 |
124 |
$524.53 |
| 93320 |
|
12 |
12 |
$518.04 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
1,667 |
1,203 |
$515.32 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
2,626 |
2,427 |
$514.14 |
| 84425 |
|
72 |
72 |
$513.82 |
| 88307 |
|
17 |
13 |
$512.07 |
| 84165 |
|
36 |
36 |
$509.08 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,048 |
963 |
$504.58 |
| 82950 |
|
77 |
77 |
$503.37 |
| 83516 |
|
50 |
49 |
$484.10 |
| 84402 |
|
18 |
18 |
$471.50 |
| 84590 |
|
33 |
32 |
$451.23 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
420 |
378 |
$427.54 |
| 84450 |
|
61 |
60 |
$427.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,172 |
938 |
$423.50 |
| 12002 |
|
14 |
13 |
$415.05 |
| 80178 |
|
59 |
52 |
$413.71 |
| 73100 |
|
30 |
25 |
$396.26 |
| 93325 |
|
26 |
26 |
$388.50 |
| 86200 |
|
27 |
27 |
$376.04 |
| 0296T |
|
14 |
13 |
$371.52 |
| 76942 |
|
27 |
27 |
$371.52 |
| J1630 |
Injection, haloperidol, up to 5 mg |
644 |
571 |
$361.80 |
| 94010 |
|
47 |
47 |
$340.22 |
| J2060 |
Injection, lorazepam, 2 mg |
1,360 |
1,173 |
$311.97 |
| 82247 |
|
42 |
41 |
$303.20 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
27 |
27 |
$302.27 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
453 |
380 |
$290.69 |
| J1644 |
Injection, heparin sodium, per 1000 units |
545 |
381 |
$277.64 |
| 83615 |
|
44 |
42 |
$267.35 |
| 80143 |
|
20 |
20 |
$246.80 |
| 94664 |
|
20 |
19 |
$246.70 |
| 84134 |
|
12 |
12 |
$237.29 |
| 99406 |
|
30 |
30 |
$227.10 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
593 |
575 |
$216.22 |
| 82947 |
|
54 |
53 |
$212.96 |
| 82977 |
|
29 |
27 |
$208.36 |
| 76000 |
|
37 |
36 |
$196.25 |
| 73060 |
|
13 |
12 |
$195.25 |
| 80177 |
|
13 |
13 |
$189.24 |
| 84075 |
|
24 |
24 |
$157.44 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
15 |
14 |
$139.08 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,374 |
1,275 |
$134.24 |
| 87046 |
|
56 |
54 |
$131.92 |
| 84436 |
|
14 |
14 |
$131.43 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
5,256 |
5,037 |
$122.75 |
| 84155 |
|
24 |
24 |
$115.44 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
300 |
203 |
$106.82 |
| 83718 |
|
14 |
14 |
$94.77 |
| 84478 |
|
13 |
13 |
$90.20 |
| 82465 |
|
15 |
15 |
$87.55 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
530 |
507 |
$82.91 |
| 82140 |
|
14 |
12 |
$71.75 |
| J1815 |
Injection, insulin, per 5 units |
1,014 |
424 |
$69.90 |
| 87206 |
|
12 |
12 |
$52.32 |
| J1790 |
Injection, droperidol, up to 5 mg |
303 |
283 |
$51.86 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
115 |
114 |
$16.61 |
| J7510 |
Prednisolone oral, per 5 mg |
311 |
305 |
$9.24 |
| J3490 |
Unclassified drugs |
44 |
40 |
$7.09 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
117 |
110 |
$6.95 |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
486 |
479 |
$0.00 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
246 |
183 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
204 |
142 |
$0.00 |
| C9399 |
Unclassified drugs or biologicals |
122 |
122 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
161 |
150 |
$0.00 |
| J1597 |
Injection, glycopyrrolate (glyrx-pf), 0.1 mg |
174 |
172 |
$0.00 |
| 90656 |
|
84 |
84 |
$0.00 |
| J0173 |
Injection, epinephrine (belcher), not therapeutically equivalent to j0171, 0.1 mg |
55 |
49 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
62 |
41 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
28 |
27 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
17 |
12 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
155 |
149 |
$0.00 |
| J0688 |
Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg |
74 |
71 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
161 |
161 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
191 |
183 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
185 |
184 |
$0.00 |
| J1750 |
Injection, iron dextran, 50 mg |
21 |
15 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
883 |
822 |
$0.00 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
32 |
27 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
199 |
172 |
$0.00 |
| 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 |
28 |
13 |
$0.00 |