| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
55,781 |
53,515 |
$6.03M |
| G0378 |
Hospital observation service, per hour |
4,325 |
4,158 |
$3.22M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
37,621 |
36,134 |
$2.96M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
12,137 |
11,440 |
$1.37M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
5,836 |
5,724 |
$834K |
| 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 |
6,087 |
5,902 |
$489K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,190 |
2,110 |
$429K |
| 80053 |
Comprehensive metabolic panel |
38,746 |
35,267 |
$415K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
68,017 |
62,534 |
$345K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
13,344 |
11,811 |
$334K |
| 87536 |
|
2,566 |
2,502 |
$292K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
26,158 |
24,231 |
$272K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
10,024 |
9,261 |
$270K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
9,778 |
9,279 |
$266K |
| 80061 |
Lipid panel |
18,041 |
17,700 |
$258K |
| X0620 |
|
1,145 |
1,123 |
$252K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
33,227 |
28,853 |
$247K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
9,152 |
8,402 |
$240K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
5,146 |
4,958 |
$215K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
16,398 |
13,739 |
$202K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
5,029 |
4,859 |
$198K |
| 80050 |
General health panel |
4,125 |
4,050 |
$187K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,920 |
1,153 |
$184K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
1,467 |
1,420 |
$174K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,636 |
2,528 |
$173K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
454 |
445 |
$172K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
3,813 |
3,436 |
$169K |
| 71046 |
Radiologic examination, chest; 2 views |
11,216 |
10,800 |
$163K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
571 |
565 |
$157K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,858 |
1,834 |
$156K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
155 |
154 |
$147K |
| 84443 |
Thyroid stimulating hormone (TSH) |
6,205 |
6,006 |
$140K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
845 |
820 |
$132K |
| G0480 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed |
2,264 |
2,087 |
$122K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
5,171 |
4,866 |
$118K |
| J9271 |
Injection, pembrolizumab, 1 mg |
568 |
446 |
$117K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
2,441 |
2,371 |
$115K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,450 |
3,353 |
$114K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,121 |
1,076 |
$110K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
539 |
512 |
$105K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
1,834 |
1,223 |
$102K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
590 |
578 |
$100K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
2,920 |
2,880 |
$96K |
| 95811 |
|
199 |
192 |
$94K |
| 76830 |
Ultrasound, transvaginal |
1,850 |
1,794 |
$94K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
6,821 |
5,304 |
$93K |
| T1015 |
Clinic visit/encounter, all-inclusive |
1,959 |
1,254 |
$84K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
441 |
425 |
$81K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
172 |
170 |
$78K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,639 |
1,929 |
$76K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
10,980 |
10,727 |
$76K |
| 84484 |
|
10,430 |
8,993 |
$75K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,208 |
1,097 |
$71K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,382 |
2,315 |
$70K |
| 80081 |
|
710 |
696 |
$67K |
| 93971 |
|
1,065 |
1,009 |
$67K |
| 86803 |
|
3,247 |
3,178 |
$66K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
6,003 |
4,709 |
$65K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
254 |
249 |
$65K |
| 93320 |
|
1,501 |
1,450 |
$64K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
1,525 |
1,489 |
$63K |
| 85027 |
|
9,955 |
7,781 |
$59K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,597 |
1,547 |
$58K |
| 86480 |
|
786 |
756 |
$57K |
| 72141 |
|
213 |
206 |
$52K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,014 |
2,833 |
$51K |
| 76801 |
|
1,113 |
1,081 |
$50K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
6,200 |
5,864 |
$50K |
| 93970 |
|
530 |
520 |
$49K |
| 81001 |
|
17,939 |
16,908 |
$48K |
| 83735 |
|
9,765 |
7,340 |
$47K |
| 93976 |
|
832 |
801 |
$46K |
| J2785 |
Injection, regadenoson, 0.1 mg |
1,161 |
1,121 |
$46K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
596 |
581 |
$45K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
744 |
732 |
$44K |
| 71250 |
|
654 |
638 |
$44K |
| 76857 |
|
1,626 |
1,573 |
$44K |
| 93017 |
|
1,002 |
979 |
$44K |
| 74183 |
|
113 |
111 |
$43K |
| J0897 |
Injection, denosumab, 1 mg |
381 |
364 |
$43K |
| 76536 |
|
816 |
805 |
$42K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,515 |
2,090 |
$42K |
| 71045 |
Radiologic examination, chest; single view |
5,302 |
5,008 |
$41K |
| 86361 |
|
1,287 |
1,251 |
$41K |
| 83880 |
|
1,866 |
1,691 |
$40K |
| 93325 |
|
1,280 |
1,241 |
$40K |
| 88312 |
|
719 |
694 |
$38K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
110 |
98 |
$38K |
| 84702 |
|
2,320 |
1,918 |
$37K |
| 77066 |
Tomosynthesis, mammo |
417 |
409 |
$37K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,266 |
1,075 |
$35K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
438 |
424 |
$34K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,444 |
1,424 |
$33K |
| 97597 |
|
1,472 |
896 |
$32K |
| X0621 |
|
141 |
118 |
$29K |
| 76642 |
|
676 |
660 |
$29K |
| 83690 |
|
6,805 |
6,305 |
$29K |
| J1750 |
Injection, iron dextran, 50 mg |
219 |
109 |
$28K |
| 87150 |
|
653 |
632 |
$28K |
| 93798 |
|
612 |
101 |
$28K |
| 84439 |
|
3,419 |
3,316 |
$28K |
| 82607 |
|
2,136 |
2,089 |
$27K |
| 96417 |
|
468 |
292 |
$27K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
11,095 |
10,195 |
$26K |
| 77065 |
Tomosynthesis, mammo |
374 |
357 |
$26K |
| 70486 |
|
313 |
309 |
$26K |
| 74174 |
|
84 |
81 |
$25K |
| G0399 |
Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation |
91 |
88 |
$24K |
| 72100 |
|
998 |
978 |
$23K |
| 82728 |
|
1,843 |
1,792 |
$23K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
440 |
408 |
$22K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
775 |
698 |
$22K |
| 76770 |
|
559 |
537 |
$22K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
5,583 |
5,324 |
$22K |
| 93880 |
|
299 |
291 |
$21K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
87 |
84 |
$19K |
| 84703 |
|
2,122 |
2,020 |
$19K |
| 73564 |
|
802 |
723 |
$19K |
| 73221 |
|
82 |
78 |
$19K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
337 |
332 |
$19K |
| J1756 |
Injection, iron sucrose, 1 mg |
3,999 |
1,609 |
$19K |
| 83605 |
|
2,882 |
2,631 |
$19K |
| 82570 |
|
2,628 |
2,550 |
$19K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
2,607 |
2,505 |
$18K |
| 70496 |
|
155 |
143 |
$18K |
| 93925 |
|
230 |
224 |
$18K |
| 73610 |
|
886 |
844 |
$18K |
| 86592 |
|
3,998 |
3,886 |
$18K |
| 73030 |
|
991 |
933 |
$17K |
| 87481 |
|
366 |
241 |
$17K |
| 70498 |
|
141 |
133 |
$17K |
| 87522 |
Neg quan hep c or qual rna |
400 |
368 |
$17K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
749 |
580 |
$17K |
| 80076 |
|
2,204 |
2,090 |
$17K |
| 82043 |
|
2,007 |
1,967 |
$16K |
| 70491 |
|
183 |
180 |
$16K |
| 86003 |
|
222 |
164 |
$16K |
| 96415 |
|
418 |
281 |
$16K |
| 83970 |
|
395 |
382 |
$16K |
| 83540 |
|
1,889 |
1,834 |
$15K |
| 73630 |
|
1,087 |
1,023 |
$15K |
| 85610 |
|
4,430 |
3,262 |
$15K |
| 73130 |
|
897 |
834 |
$14K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
67 |
66 |
$13K |
| 96376 |
|
2,171 |
1,480 |
$13K |
| 86900 |
|
1,701 |
1,561 |
$13K |
| 84403 |
|
415 |
406 |
$13K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
670 |
659 |
$13K |
| 76870 |
|
280 |
267 |
$13K |
| 87186 |
|
1,430 |
1,367 |
$13K |
| 87340 |
|
836 |
817 |
$12K |
| 84481 |
|
519 |
488 |
$12K |
| 87081 |
|
1,442 |
1,396 |
$11K |
| 86235 |
|
304 |
252 |
$11K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
14 |
14 |
$11K |
| 77080 |
|
208 |
208 |
$11K |
| 87077 |
|
1,407 |
1,347 |
$11K |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
630 |
601 |
$11K |
| 74018 |
|
735 |
681 |
$11K |
| 86696 |
|
436 |
423 |
$11K |
| 12001 |
|
318 |
312 |
$11K |
| 73502 |
|
552 |
533 |
$10K |
| 86140 |
|
3,327 |
2,914 |
$10K |
| 87799 |
|
186 |
176 |
$10K |
| 80074 |
|
193 |
186 |
$10K |
| 83550 |
|
1,745 |
1,693 |
$9K |
| 86695 |
|
442 |
432 |
$9K |
| 96367 |
|
507 |
372 |
$9K |
| 86038 |
|
574 |
553 |
$9K |
| 93922 |
|
280 |
273 |
$9K |
| 86618 |
|
367 |
356 |
$9K |
| 93975 |
|
71 |
71 |
$8K |
| 85652 |
|
2,898 |
2,534 |
$8K |
| 58661 |
|
13 |
12 |
$8K |
| 73560 |
|
456 |
421 |
$8K |
| 86850 |
|
1,122 |
1,060 |
$8K |
| 72110 |
|
352 |
339 |
$8K |
| 87040 |
|
701 |
634 |
$8K |
| 90715 |
|
1,518 |
1,494 |
$8K |
| 73110 |
|
571 |
540 |
$8K |
| 84146 |
|
300 |
291 |
$8K |
| 73700 |
|
89 |
86 |
$8K |
| 82784 |
|
460 |
442 |
$8K |
| 85730 |
|
1,266 |
1,194 |
$7K |
| 93350 |
|
74 |
74 |
$7K |
| 86901 |
|
1,685 |
1,547 |
$7K |
| 82746 |
|
597 |
584 |
$7K |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
31 |
31 |
$7K |
| 72040 |
|
434 |
421 |
$7K |
| 85379 |
|
773 |
750 |
$7K |
| 36430 |
|
95 |
70 |
$7K |
| 86317 |
|
319 |
312 |
$7K |
| 80164 |
|
378 |
349 |
$7K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
1,622 |
1,582 |
$7K |
| 73590 |
|
387 |
364 |
$7K |
| 97802 |
|
319 |
315 |
$7K |
| 87486 |
|
171 |
169 |
$7K |
| 87625 |
|
165 |
162 |
$7K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
178 |
86 |
$7K |
| 73562 |
|
355 |
319 |
$6K |
| 74178 |
|
30 |
30 |
$6K |
| 84100 |
|
1,485 |
1,196 |
$6K |
| 73090 |
|
381 |
358 |
$6K |
| 72072 |
|
271 |
263 |
$6K |
| 72050 |
|
207 |
201 |
$6K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
116 |
113 |
$6K |
| 83001 |
|
293 |
288 |
$6K |
| 78264 |
|
54 |
54 |
$6K |
| 82550 |
|
831 |
704 |
$6K |
| 82950 |
|
749 |
734 |
$5K |
| 82565 |
|
831 |
780 |
$5K |
| 83655 |
|
446 |
438 |
$5K |
| 12011 |
|
146 |
145 |
$5K |
| 87070 |
|
830 |
799 |
$5K |
| 74022 |
|
209 |
193 |
$5K |
| 10061 |
|
92 |
90 |
$5K |
| 84153 |
|
205 |
202 |
$5K |
| 84550 |
|
818 |
765 |
$5K |
| 72197 |
|
12 |
12 |
$5K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
468 |
459 |
$5K |
| 87660 |
|
203 |
202 |
$5K |
| 83615 |
|
630 |
572 |
$4K |
| J3490 |
Unclassified drugs |
7,106 |
5,444 |
$4K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
1,654 |
1,046 |
$4K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
21,360 |
18,631 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
3,363 |
2,262 |
$4K |
| 12002 |
|
99 |
99 |
$4K |
| 86200 |
|
264 |
256 |
$4K |
| 83002 |
|
203 |
200 |
$4K |
| 71271 |
|
72 |
72 |
$4K |
| 84460 |
|
518 |
468 |
$4K |
| 87902 |
|
15 |
12 |
$4K |
| 73070 |
|
238 |
224 |
$4K |
| 86431 |
|
457 |
442 |
$4K |
| 83525 |
|
287 |
280 |
$4K |
| 72156 |
|
12 |
12 |
$4K |
| 84450 |
|
500 |
453 |
$4K |
| 73140 |
|
262 |
250 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
528 |
506 |
$3K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
25 |
25 |
$3K |
| 96368 |
|
204 |
151 |
$3K |
| 82803 |
|
217 |
204 |
$3K |
| 36591 |
|
354 |
248 |
$3K |
| 96401 |
|
123 |
95 |
$3K |
| 87512 |
|
124 |
119 |
$3K |
| 94729 |
|
70 |
69 |
$3K |
| 81003 |
|
926 |
899 |
$3K |
| 86704 |
|
203 |
194 |
$3K |
| 86800 |
|
147 |
142 |
$3K |
| C1769 |
Guide wire |
167 |
162 |
$3K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
38 |
36 |
$3K |
| 83516 |
|
385 |
375 |
$3K |
| 99000 |
|
572 |
554 |
$3K |
| 96523 |
|
168 |
143 |
$3K |
| 82951 |
|
181 |
179 |
$3K |
| 86832 |
|
30 |
28 |
$3K |
| 73120 |
|
175 |
147 |
$3K |
| 87205 |
|
642 |
615 |
$3K |
| 87147 |
|
637 |
617 |
$2K |
| 86833 |
|
30 |
28 |
$2K |
| J3489 |
Injection, zoledronic acid, 1 mg |
207 |
199 |
$2K |
| 84156 |
|
639 |
597 |
$2K |
| 82947 |
|
537 |
528 |
$2K |
| 80202 |
|
116 |
50 |
$2K |
| 85660 |
|
470 |
360 |
$2K |
| 73620 |
|
175 |
163 |
$2K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
326 |
318 |
$2K |
| 80069 |
|
233 |
206 |
$2K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
4,045 |
3,050 |
$2K |
| 88304 |
|
301 |
296 |
$2K |
| 82248 |
|
337 |
279 |
$2K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
9,048 |
6,749 |
$2K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,835 |
2,963 |
$2K |
| 80197 |
|
188 |
140 |
$2K |
| 82247 |
|
277 |
196 |
$2K |
| 97161 |
|
222 |
199 |
$2K |
| 73552 |
|
117 |
110 |
$2K |
| 82977 |
|
191 |
173 |
$2K |
| J1815 |
Injection, insulin, per 5 units |
202 |
113 |
$2K |
| 97803 |
|
144 |
135 |
$2K |
| 73080 |
|
124 |
118 |
$2K |
| 80143 |
|
143 |
135 |
$2K |
| 76882 |
|
135 |
132 |
$2K |
| 75574 |
|
12 |
12 |
$2K |
| 73060 |
|
130 |
126 |
$2K |
| 86160 |
|
56 |
55 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
3,455 |
2,317 |
$2K |
| 97165 |
|
199 |
186 |
$2K |
| 71101 |
|
84 |
84 |
$2K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
1,576 |
1,442 |
$2K |
| 86376 |
|
162 |
157 |
$2K |
| 82670 |
|
71 |
71 |
$2K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,017 |
819 |
$2K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
47 |
38 |
$2K |
| J2704 |
Injection, propofol, 10 mg |
3,355 |
2,551 |
$2K |
| 86304 |
|
86 |
75 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
172 |
167 |
$1K |
| 80178 |
|
182 |
167 |
$1K |
| 82785 |
|
81 |
80 |
$1K |
| J9045 |
Injection, carboplatin, 50 mg |
530 |
357 |
$1K |
| 82533 |
|
110 |
101 |
$1K |
| 80179 |
|
130 |
125 |
$1K |
| 36569 |
|
13 |
13 |
$1K |
| 86708 |
|
91 |
86 |
$1K |
| C1819 |
Surgical tissue localization and excision device (implantable) |
12 |
12 |
$1K |
| 87581 |
|
148 |
146 |
$1K |
| 94727 |
|
42 |
42 |
$1K |
| 86258 |
|
79 |
73 |
$1K |
| 72170 |
|
109 |
107 |
$1K |
| 73200 |
|
16 |
16 |
$1K |
| 82150 |
|
245 |
238 |
$1K |
| 88342 |
|
42 |
41 |
$1K |
| 84270 |
|
45 |
42 |
$1K |
| 77334 |
|
15 |
14 |
$1K |
| 84165 |
|
89 |
86 |
$1K |
| 82105 |
|
58 |
57 |
$1K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,810 |
1,246 |
$1K |
| J9267 |
Injection, paclitaxel, 1 mg |
254 |
133 |
$1K |
| 77336 |
|
20 |
12 |
$1K |
| 82140 |
|
187 |
154 |
$1K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
11,962 |
9,167 |
$1K |
| 84520 |
|
222 |
213 |
$1K |
| 87493 |
|
41 |
41 |
$1K |
| 82172 |
|
56 |
56 |
$1K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,827 |
1,269 |
$1K |
| 82310 |
|
156 |
148 |
$1K |
| 86923 |
|
32 |
29 |
$1K |
| 96402 |
|
30 |
28 |
$1K |
| 81513 |
|
59 |
57 |
$1K |
| 73100 |
|
78 |
73 |
$1K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
4,520 |
3,324 |
$999.06 |
| 94010 |
|
79 |
79 |
$983.47 |
| 81596 |
|
13 |
13 |
$983.45 |
| 84132 |
|
261 |
239 |
$953.44 |
| 82010 |
|
236 |
216 |
$928.27 |
| 85018 |
|
436 |
382 |
$903.61 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
26 |
25 |
$840.03 |
| 85014 |
|
423 |
371 |
$837.69 |
| 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 |
10,215 |
9,537 |
$836.88 |
| 86780 |
|
45 |
42 |
$750.08 |
| 84402 |
|
24 |
24 |
$726.41 |
| 87075 |
|
96 |
93 |
$715.08 |
| S9470 |
Nutritional counseling, dietitian visit |
17 |
17 |
$700.67 |
| 82024 |
|
17 |
14 |
$678.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,900 |
3,703 |
$664.11 |
| 87088 |
|
89 |
89 |
$660.26 |
| 86705 |
|
37 |
37 |
$653.50 |
| 82952 |
|
167 |
165 |
$644.33 |
| 86787 |
|
36 |
34 |
$639.98 |
| 59025 |
Fetal non-stress test |
13 |
12 |
$639.94 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
117 |
111 |
$626.60 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
90 |
86 |
$623.61 |
| 87563 |
|
31 |
30 |
$605.27 |
| 87807 |
|
41 |
41 |
$597.60 |
| 93308 |
|
34 |
30 |
$596.10 |
| 64400 |
|
28 |
27 |
$593.81 |
| 83721 |
|
46 |
46 |
$576.33 |
| 86762 |
|
25 |
25 |
$548.95 |
| J1630 |
Injection, haloperidol, up to 5 mg |
1,130 |
893 |
$514.67 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
415 |
400 |
$498.01 |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
26 |
24 |
$490.31 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
2,462 |
1,948 |
$461.45 |
| 84155 |
|
125 |
115 |
$457.64 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,102 |
1,809 |
$449.68 |
| J2060 |
Injection, lorazepam, 2 mg |
2,256 |
1,781 |
$419.31 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
3,901 |
2,155 |
$415.08 |
| 86039 |
|
25 |
25 |
$413.46 |
| 85384 |
|
39 |
38 |
$387.43 |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,506 |
878 |
$382.83 |
| 87209 |
|
13 |
13 |
$360.20 |
| 82627 |
|
14 |
14 |
$352.56 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
297 |
194 |
$351.84 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
27 |
27 |
$340.84 |
| 84305 |
|
12 |
12 |
$332.33 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,230 |
629 |
$331.39 |
| 84145 |
|
58 |
52 |
$329.94 |
| 82272 |
|
126 |
122 |
$308.64 |
| 72081 |
|
13 |
13 |
$308.62 |
| 87045 |
|
44 |
44 |
$308.24 |
| 83498 |
|
12 |
12 |
$307.18 |
| 72070 |
|
12 |
12 |
$298.40 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
385 |
309 |
$291.12 |
| 80299 |
|
14 |
13 |
$290.43 |
| 82040 |
|
84 |
80 |
$285.84 |
| 87046 |
|
44 |
44 |
$284.35 |
| 85044 |
|
79 |
72 |
$276.98 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
2,903 |
2,421 |
$257.16 |
| J3480 |
Injection, potassium chloride, per 2 meq |
1,129 |
671 |
$254.05 |
| 73660 |
|
13 |
13 |
$216.28 |
| 86308 |
|
29 |
29 |
$208.82 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
3,657 |
3,102 |
$207.25 |
| 80177 |
|
15 |
12 |
$195.99 |
| 36416 |
|
254 |
201 |
$183.65 |
| 81025 |
|
111 |
105 |
$178.90 |
| 83695 |
|
12 |
12 |
$165.68 |
| 97162 |
|
30 |
28 |
$165.16 |
| 87899 |
|
12 |
12 |
$140.68 |
| 87177 |
|
13 |
13 |
$136.92 |
| 95819 |
|
12 |
12 |
$132.30 |
| 84436 |
|
13 |
13 |
$129.20 |
| 93356 |
|
37 |
35 |
$128.49 |
| A9503 |
Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries |
39 |
39 |
$116.18 |
| 86593 |
|
14 |
14 |
$93.20 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
65 |
41 |
$92.84 |
| J7510 |
Prednisolone oral, per 5 mg |
471 |
450 |
$76.44 |
| 73600 |
|
13 |
13 |
$72.95 |
| 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 |
1,017 |
806 |
$71.48 |
| 89051 |
|
13 |
13 |
$69.76 |
| 81002 |
|
15 |
13 |
$58.97 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
14 |
14 |
$46.61 |
| 88307 |
|
15 |
15 |
$25.30 |
| 97166 |
|
14 |
12 |
$18.29 |
| A4215 |
Needle, sterile, any size, each |
47 |
44 |
$17.82 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
19 |
12 |
$17.70 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
119 |
98 |
$15.66 |
| A9270 |
Non-covered item or service |
268 |
169 |
$4.95 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
166 |
116 |
$4.80 |
| J2916 |
Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg |
750 |
311 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
501 |
474 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
43 |
34 |
$0.00 |
| J1453 |
Injection, fosaprepitant, 1 mg |
255 |
177 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
252 |
206 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
670 |
649 |
$0.00 |
| J9263 |
Injection, oxaliplatin, 0.5 mg |
54 |
26 |
$0.00 |
| J0640 |
Injection, leucovorin calcium, per 50 mg |
78 |
38 |
$0.00 |
| J1569 |
Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg |
23 |
12 |
$0.00 |
| J1437 |
Injection, ferric derisomaltose, 10 mg |
15 |
13 |
$0.00 |
| J9217 |
Leuprolide acetate (for depot suspension), 7.5 mg |
12 |
12 |
$0.00 |
| J9190 |
Injection, fluorouracil, 500 mg |
26 |
12 |
$0.00 |
| Q5108 |
Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg |
201 |
148 |
$0.00 |
| Q5121 |
Injection, infliximab-axxq, biosimilar, (avsola), 10 mg |
120 |
80 |
$0.00 |
| J0185 |
Injection, aprepitant, 1 mg |
585 |
388 |
$0.00 |
| Q5120 |
Injection, pegfilgrastim-bmez (ziextenzo), biosimilar, 0.5 mg |
56 |
39 |
$0.00 |
| A9573 |
Injection, gadopiclenol, 1 ml |
367 |
356 |
$0.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
125 |
110 |
$0.00 |