| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
67,320 |
48,088 |
$11.83M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
9,838 |
7,870 |
$6.23M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
32,860 |
8,093 |
$6.02M |
| G0378 |
Hospital observation service, per hour |
3,687 |
2,815 |
$4.25M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
11,412 |
9,504 |
$4.20M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
10,596 |
8,746 |
$2.74M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
35,495 |
25,818 |
$2.70M |
| 80048 |
Basic metabolic panel (calcium, ionized) |
24,135 |
17,749 |
$2.10M |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
16,724 |
6,416 |
$1.47M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
15,067 |
11,335 |
$1.43M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
4,635 |
3,878 |
$1.35M |
| 80053 |
Comprehensive metabolic panel |
14,252 |
11,660 |
$1.18M |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,841 |
4,736 |
$1.13M |
| 96375 |
Therapeutic injection; each additional sequential IV push |
5,731 |
3,588 |
$1.11M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
6,266 |
4,691 |
$1.06M |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
10,894 |
3,910 |
$1.01M |
| J7030 |
Infusion, normal saline solution , 1000 cc |
4,948 |
3,415 |
$961K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
3,608 |
2,311 |
$953K |
| 84484 |
|
7,349 |
3,899 |
$913K |
| 83735 |
|
10,082 |
6,855 |
$899K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
11,990 |
10,435 |
$893K |
| 80061 |
Lipid panel |
11,899 |
10,192 |
$872K |
| 82962 |
|
6,935 |
3,617 |
$872K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
13,917 |
3,953 |
$870K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
3,865 |
2,972 |
$750K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,392 |
3,213 |
$728K |
| 80076 |
|
7,092 |
5,452 |
$683K |
| 71045 |
Radiologic examination, chest; single view |
3,952 |
3,033 |
$654K |
| 84443 |
Thyroid stimulating hormone (TSH) |
10,327 |
8,546 |
$652K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,136 |
1,947 |
$596K |
| 85610 |
|
9,044 |
5,465 |
$591K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,785 |
2,073 |
$589K |
| 81001 |
|
9,931 |
7,920 |
$562K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
4,575 |
3,893 |
$560K |
| 83690 |
|
4,413 |
3,362 |
$541K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,876 |
1,262 |
$537K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,999 |
1,627 |
$532K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,903 |
1,274 |
$522K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,697 |
1,844 |
$510K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,227 |
2,514 |
$496K |
| 84100 |
|
6,040 |
4,142 |
$489K |
| 36415 |
Collection of venous blood by venipuncture |
6,197 |
5,385 |
$470K |
| 86803 |
|
4,053 |
3,455 |
$441K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
2,314 |
1,581 |
$436K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
19,667 |
15,886 |
$427K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
5,517 |
4,421 |
$420K |
| J2704 |
Injection, propofol, 10 mg |
1,900 |
1,229 |
$418K |
| 71046 |
Radiologic examination, chest; 2 views |
5,589 |
4,330 |
$415K |
| 97161 |
|
3,414 |
2,793 |
$404K |
| 96376 |
|
2,062 |
893 |
$398K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
5,288 |
4,185 |
$383K |
| 83605 |
|
2,621 |
1,774 |
$381K |
| 20610 |
|
739 |
454 |
$381K |
| 81025 |
|
4,482 |
3,443 |
$345K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,139 |
3,812 |
$342K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
1,786 |
1,716 |
$326K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,357 |
1,053 |
$324K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,467 |
929 |
$322K |
| 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 |
3,479 |
3,285 |
$320K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
6,343 |
5,135 |
$315K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
5,061 |
4,427 |
$306K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,588 |
965 |
$303K |
| 82728 |
|
4,534 |
3,949 |
$298K |
| 86850 |
|
3,872 |
3,104 |
$294K |
| 82607 |
|
4,453 |
3,947 |
$282K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,162 |
1,191 |
$274K |
| 85027 |
|
7,902 |
6,542 |
$271K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,675 |
2,235 |
$269K |
| 86900 |
|
3,920 |
3,130 |
$268K |
| 86901 |
|
3,936 |
3,145 |
$265K |
| 97116 |
|
1,201 |
540 |
$259K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,380 |
3,346 |
$247K |
| 83550 |
|
4,352 |
3,810 |
$246K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,308 |
659 |
$246K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,042 |
1,524 |
$239K |
| 80050 |
General health panel |
3,070 |
2,701 |
$235K |
| 95806 |
|
907 |
851 |
$229K |
| 81003 |
|
2,612 |
2,008 |
$226K |
| 93017 |
|
1,297 |
948 |
$219K |
| 85652 |
|
4,063 |
3,280 |
$211K |
| 83615 |
|
3,651 |
2,872 |
$205K |
| 84703 |
|
1,416 |
1,175 |
$202K |
| 87340 |
|
2,305 |
1,903 |
$201K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,433 |
1,119 |
$196K |
| J1644 |
Injection, heparin sodium, per 1000 units |
910 |
380 |
$192K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,226 |
657 |
$187K |
| 82565 |
|
3,890 |
2,880 |
$183K |
| 87088 |
|
3,066 |
2,531 |
$181K |
| 99219 |
|
64 |
39 |
$178K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
4,002 |
3,152 |
$175K |
| 97597 |
|
2,243 |
1,090 |
$173K |
| 80051 |
|
2,056 |
1,473 |
$170K |
| 59025 |
Fetal non-stress test |
923 |
331 |
$170K |
| 84439 |
|
2,677 |
2,199 |
$165K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
18,003 |
15,010 |
$165K |
| 86140 |
|
2,218 |
1,768 |
$164K |
| 87040 |
|
1,044 |
522 |
$162K |
| 87186 |
|
2,085 |
1,678 |
$159K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,080 |
727 |
$158K |
| 94060 |
|
663 |
497 |
$157K |
| 84520 |
|
2,411 |
1,718 |
$155K |
| 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 |
2,998 |
2,836 |
$154K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,342 |
964 |
$154K |
| 86780 |
|
4,704 |
3,859 |
$151K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,904 |
2,843 |
$150K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
712 |
358 |
$149K |
| 82784 |
|
756 |
514 |
$146K |
| 73560 |
|
1,134 |
925 |
$145K |
| 36416 |
|
475 |
297 |
$144K |
| 87070 |
|
2,072 |
1,632 |
$134K |
| 93971 |
|
996 |
774 |
$131K |
| 85730 |
|
1,643 |
1,276 |
$130K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
919 |
528 |
$129K |
| 20611 |
|
167 |
150 |
$125K |
| 82746 |
|
1,966 |
1,720 |
$124K |
| 87480 |
|
2,052 |
1,699 |
$123K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
698 |
554 |
$123K |
| 83880 |
|
1,527 |
1,124 |
$121K |
| 87510 |
|
1,971 |
1,622 |
$117K |
| 82043 |
|
2,423 |
2,102 |
$113K |
| 87660 |
|
2,066 |
1,707 |
$112K |
| J2060 |
Injection, lorazepam, 2 mg |
743 |
514 |
$112K |
| 97162 |
|
1,119 |
885 |
$111K |
| 76642 |
|
1,083 |
832 |
$108K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
258 |
220 |
$107K |
| 86618 |
|
1,179 |
970 |
$101K |
| 90461 |
|
1,883 |
1,498 |
$100K |
| 87077 |
|
1,602 |
1,273 |
$98K |
| 82550 |
|
1,313 |
1,033 |
$97K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
764 |
575 |
$95K |
| 99220 |
|
31 |
14 |
$94K |
| 94664 |
|
732 |
419 |
$93K |
| 72100 |
|
1,091 |
927 |
$93K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
68 |
55 |
$93K |
| 76830 |
Ultrasound, transvaginal |
458 |
382 |
$90K |
| 73030 |
|
1,131 |
958 |
$89K |
| 84145 |
|
474 |
383 |
$85K |
| 82310 |
|
707 |
533 |
$85K |
| 77066 |
Tomosynthesis, mammo |
529 |
425 |
$84K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
454 |
324 |
$81K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
432 |
382 |
$76K |
| 94729 |
|
1,805 |
1,567 |
$72K |
| 86706 |
|
819 |
690 |
$71K |
| 97165 |
|
549 |
438 |
$70K |
| 71250 |
|
434 |
377 |
$67K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
106 |
101 |
$66K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
155 |
73 |
$62K |
| 84702 |
|
874 |
595 |
$60K |
| 97014 |
|
814 |
172 |
$60K |
| 77065 |
Tomosynthesis, mammo |
471 |
417 |
$58K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
262 |
189 |
$57K |
| 76536 |
|
330 |
289 |
$54K |
| 86762 |
|
1,150 |
919 |
$52K |
| 82570 |
|
1,818 |
1,434 |
$52K |
| 84460 |
|
2,059 |
1,598 |
$52K |
| 84450 |
|
2,052 |
1,556 |
$52K |
| 71271 |
|
269 |
265 |
$46K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
1,015 |
753 |
$43K |
| 85046 |
|
1,040 |
965 |
$43K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
314 |
229 |
$43K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
828 |
646 |
$42K |
| 87205 |
|
469 |
350 |
$41K |
| 82248 |
|
1,103 |
725 |
$40K |
| 73630 |
|
566 |
405 |
$39K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
174 |
80 |
$39K |
| 85379 |
|
450 |
311 |
$39K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
62 |
58 |
$38K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,253 |
1,171 |
$37K |
| 73130 |
|
317 |
244 |
$36K |
| 73610 |
|
368 |
277 |
$36K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
592 |
467 |
$36K |
| 86704 |
|
264 |
260 |
$35K |
| 99152 |
|
202 |
145 |
$35K |
| 86481 |
|
282 |
275 |
$34K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
431 |
384 |
$33K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
385 |
212 |
$31K |
| 84165 |
|
132 |
124 |
$30K |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
106 |
97 |
$30K |
| 84155 |
|
135 |
126 |
$30K |
| 82803 |
|
158 |
126 |
$30K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
87 |
85 |
$29K |
| J7050 |
Infusion, normal saline solution, 250 cc |
416 |
221 |
$28K |
| 85018 |
|
714 |
412 |
$25K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
127 |
122 |
$24K |
| 86431 |
|
416 |
286 |
$24K |
| 86334 |
|
88 |
81 |
$24K |
| 86141 |
|
386 |
375 |
$23K |
| 87075 |
|
258 |
174 |
$23K |
| 73110 |
|
245 |
164 |
$23K |
| 82947 |
|
942 |
553 |
$23K |
| J1815 |
Injection, insulin, per 5 units |
204 |
43 |
$22K |
| 73562 |
|
433 |
355 |
$21K |
| 87430 |
|
286 |
205 |
$21K |
| 73565 |
|
665 |
542 |
$21K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
179 |
81 |
$21K |
| 81002 |
|
2,026 |
1,487 |
$20K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
158 |
114 |
$20K |
| 87581 |
|
109 |
104 |
$20K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
69 |
41 |
$20K |
| 93880 |
|
170 |
137 |
$19K |
| 97035 |
|
294 |
99 |
$19K |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
169 |
104 |
$18K |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
253 |
118 |
$18K |
| 94010 |
|
231 |
221 |
$18K |
| 86787 |
|
244 |
177 |
$18K |
| 83001 |
|
270 |
239 |
$18K |
| 94727 |
|
471 |
412 |
$17K |
| 97535 |
Self-care/home management training, each 15 minutes |
248 |
173 |
$16K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
215 |
113 |
$16K |
| 88307 |
|
222 |
198 |
$16K |
| 84481 |
|
271 |
221 |
$16K |
| 88304 |
|
117 |
86 |
$16K |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
151 |
91 |
$16K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
157 |
152 |
$15K |
| 84550 |
|
496 |
413 |
$15K |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
38 |
34 |
$15K |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
226 |
104 |
$15K |
| 85014 |
|
376 |
209 |
$15K |
| 94799 |
|
57 |
37 |
$15K |
| 87081 |
|
552 |
418 |
$14K |
| 90715 |
|
121 |
102 |
$14K |
| 87147 |
|
75 |
61 |
$13K |
| 93970 |
|
120 |
76 |
$13K |
| 94726 |
|
290 |
266 |
$13K |
| 83655 |
|
521 |
276 |
$13K |
| 82950 |
|
407 |
271 |
$12K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
128 |
79 |
$12K |
| 73502 |
|
375 |
286 |
$12K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
79 |
70 |
$12K |
| 77080 |
|
133 |
83 |
$11K |
| 80305 |
|
687 |
459 |
$11K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
226 |
67 |
$11K |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
13 |
12 |
$11K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
422 |
415 |
$10K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
32 |
24 |
$10K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
55 |
50 |
$10K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
370 |
282 |
$9K |
| 84403 |
|
111 |
109 |
$9K |
| J1630 |
Injection, haloperidol, up to 5 mg |
90 |
71 |
$9K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
302 |
114 |
$9K |
| 95819 |
|
69 |
64 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
74 |
74 |
$8K |
| C1769 |
Guide wire |
63 |
12 |
$8K |
| S0028 |
Injection, famotidine, 20 mg |
88 |
57 |
$7K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
20 |
12 |
$7K |
| 99153 |
Mod sedat endo service >5yrs |
33 |
24 |
$7K |
| 82105 |
|
139 |
48 |
$7K |
| 84425 |
|
115 |
88 |
$7K |
| 83516 |
|
59 |
42 |
$6K |
| 90686 |
|
332 |
310 |
$6K |
| 88342 |
|
37 |
25 |
$6K |
| 80164 |
|
91 |
62 |
$6K |
| 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 |
129 |
97 |
$6K |
| 92523 |
|
26 |
26 |
$6K |
| J1245 |
Injection, dipyridamole, per 10 mg |
16 |
12 |
$5K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
45 |
30 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
279 |
139 |
$5K |
| 83013 |
|
25 |
25 |
$5K |
| 83970 |
|
41 |
40 |
$5K |
| 86039 |
|
128 |
101 |
$5K |
| 80074 |
|
39 |
38 |
$4K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
87 |
85 |
$4K |
| 83921 |
|
124 |
87 |
$4K |
| 93225 |
|
72 |
65 |
$4K |
| 86617 |
|
45 |
29 |
$4K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
21 |
12 |
$4K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
49 |
30 |
$4K |
| 83540 |
|
131 |
88 |
$4K |
| M0239 |
Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring |
128 |
127 |
$3K |
| 83721 |
|
24 |
24 |
$3K |
| 84132 |
|
130 |
74 |
$3K |
| 76775 |
|
34 |
25 |
$3K |
| G8988 |
Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
13 |
12 |
$3K |
| 93350 |
|
19 |
13 |
$3K |
| 93270 |
|
38 |
38 |
$3K |
| 84207 |
|
56 |
41 |
$3K |
| 90750 |
|
16 |
16 |
$3K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
104 |
58 |
$3K |
| 84156 |
|
101 |
67 |
$3K |
| 76641 |
|
12 |
12 |
$2K |
| 96367 |
|
24 |
12 |
$2K |
| 84146 |
|
26 |
13 |
$2K |
| 71100 |
|
32 |
24 |
$2K |
| 82140 |
|
57 |
29 |
$2K |
| 86666 |
|
13 |
13 |
$2K |
| 82247 |
|
65 |
21 |
$2K |
| 97164 |
|
14 |
14 |
$1K |
| 83090 |
|
54 |
28 |
$1K |
| 93925 |
|
14 |
14 |
$1K |
| 86753 |
|
16 |
14 |
$1K |
| 74018 |
|
31 |
16 |
$993.58 |
| 86200 |
|
13 |
13 |
$896.95 |
| 82010 |
|
16 |
13 |
$824.48 |
| 73140 |
|
12 |
12 |
$812.82 |
| 83021 |
|
13 |
13 |
$771.25 |
| 80178 |
|
31 |
25 |
$766.51 |
| 73080 |
|
15 |
13 |
$702.44 |
| 85007 |
|
29 |
26 |
$637.00 |
| 90674 |
|
16 |
13 |
$587.10 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
14 |
14 |
$586.00 |
| 83014 |
|
25 |
25 |
$553.65 |
| G0499 |
Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result |
17 |
15 |
$538.49 |
| 86308 |
|
32 |
12 |
$492.68 |
| 86364 |
|
13 |
13 |
$479.50 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
27 |
14 |
$444.63 |
| 90662 |
|
17 |
17 |
$424.13 |
| 82150 |
|
14 |
12 |
$413.02 |
| 86580 |
|
35 |
25 |
$343.11 |
| 81005 |
|
26 |
13 |
$332.80 |
| 80047 |
|
44 |
12 |
$307.61 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
15 |
12 |
$286.48 |
| J3490 |
Unclassified drugs |
701 |
526 |
$200.75 |
| G0008 |
Administration of influenza virus vaccine |
148 |
145 |
$160.96 |
| 83986 |
|
17 |
13 |
$95.03 |
| A4649 |
Surgical supply; miscellaneous |
22 |
12 |
$0.00 |
| 0250 |
|
1,190 |
288 |
$0.00 |