| Code | Description | Claims | Beneficiaries | Total Paid |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
29,015 |
26,636 |
$12.51M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
29,071 |
26,898 |
$4.58M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
25,858 |
23,495 |
$2.19M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
19,338 |
18,220 |
$2.07M |
| 41899 |
Unlisted procedure, dentoalveolar structures |
554 |
549 |
$940K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
6,603 |
6,332 |
$781K |
| 71045 |
Radiologic examination, chest; single view |
16,999 |
15,827 |
$635K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
927 |
893 |
$569K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
15,515 |
11,647 |
$464K |
| G0378 |
Hospital observation service, per hour |
13,538 |
9,553 |
$459K |
| 59025 |
Fetal non-stress test |
4,694 |
1,985 |
$411K |
| 70450 |
Computed tomography, head or brain; without contrast material |
5,811 |
5,586 |
$387K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
16,409 |
13,950 |
$340K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
3,495 |
3,232 |
$305K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,457 |
3,313 |
$303K |
| 47562 |
|
108 |
108 |
$243K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
800 |
778 |
$233K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,226 |
1,213 |
$208K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,658 |
2,599 |
$167K |
| 86900 |
|
7,194 |
6,500 |
$161K |
| 76801 |
|
2,903 |
2,597 |
$161K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
2,938 |
2,822 |
$145K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,295 |
1,265 |
$140K |
| 80061 |
Lipid panel |
4,614 |
4,588 |
$134K |
| 71046 |
Radiologic examination, chest; 2 views |
3,602 |
3,484 |
$123K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,043 |
1,654 |
$122K |
| 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 |
4,290 |
4,136 |
$120K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,540 |
2,460 |
$118K |
| 76830 |
Ultrasound, transvaginal |
2,202 |
2,132 |
$112K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,091 |
1,624 |
$110K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,718 |
1,671 |
$110K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
451 |
449 |
$108K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,265 |
2,227 |
$77K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
834 |
827 |
$77K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
2,374 |
2,326 |
$73K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
4,776 |
4,662 |
$66K |
| 36415 |
Collection of venous blood by venipuncture |
64,255 |
47,600 |
$58K |
| 50590 |
|
47 |
40 |
$58K |
| 82465 |
|
2,559 |
2,131 |
$58K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
4,768 |
4,660 |
$58K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
6,128 |
5,849 |
$55K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
369 |
223 |
$54K |
| 87800 |
|
4,616 |
4,302 |
$50K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
397 |
396 |
$50K |
| 80053 |
Comprehensive metabolic panel |
46,919 |
39,217 |
$49K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
429 |
423 |
$49K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,520 |
1,344 |
$48K |
| 93971 |
|
1,013 |
981 |
$44K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
66,288 |
52,486 |
$43K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,033 |
1,980 |
$43K |
| 84443 |
Thyroid stimulating hormone (TSH) |
10,106 |
9,759 |
$41K |
| 76770 |
|
840 |
809 |
$38K |
| 95811 |
|
84 |
82 |
$34K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,275 |
5,558 |
$32K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
75 |
71 |
$31K |
| G0475 |
Hiv antigen/antibody, combination assay, screening |
2,457 |
2,445 |
$30K |
| 52356 |
|
13 |
13 |
$30K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
367 |
360 |
$26K |
| 88307 |
|
304 |
285 |
$25K |
| 72141 |
|
218 |
213 |
$24K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
210 |
208 |
$24K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
1,536 |
1,529 |
$23K |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
2,302 |
2,287 |
$23K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,650 |
1,180 |
$23K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
7,881 |
7,664 |
$21K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
19,555 |
17,686 |
$20K |
| 88304 |
|
2,478 |
2,435 |
$18K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
10,932 |
8,891 |
$18K |
| 93017 |
|
1,701 |
1,666 |
$17K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,410 |
1,402 |
$16K |
| 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 |
1,795 |
1,743 |
$16K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
273 |
267 |
$15K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,304 |
1,210 |
$15K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
3,663 |
3,580 |
$14K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
7,110 |
6,625 |
$14K |
| 93350 |
|
170 |
167 |
$13K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,576 |
1,539 |
$13K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
29 |
27 |
$12K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
16,044 |
14,069 |
$12K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
712 |
535 |
$11K |
| 86592 |
|
2,531 |
2,493 |
$10K |
| 87070 |
|
5,865 |
5,444 |
$10K |
| 52260 |
|
12 |
12 |
$10K |
| 84702 |
|
5,765 |
4,927 |
$9K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
25 |
24 |
$9K |
| 52332 |
|
14 |
13 |
$9K |
| 73221 |
|
80 |
77 |
$8K |
| 87653 |
|
577 |
560 |
$8K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
14 |
14 |
$8K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
25 |
24 |
$7K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
144 |
132 |
$7K |
| 83615 |
|
34,626 |
29,194 |
$7K |
| 95806 |
|
96 |
95 |
$7K |
| 82607 |
|
1,577 |
1,551 |
$7K |
| 86803 |
|
898 |
897 |
$7K |
| 97163 |
|
45 |
39 |
$6K |
| 84100 |
|
36,283 |
29,732 |
$6K |
| 82550 |
|
4,788 |
3,625 |
$5K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
4,205 |
2,723 |
$5K |
| 86140 |
|
3,904 |
2,829 |
$5K |
| 84439 |
|
1,767 |
1,739 |
$5K |
| 85651 |
|
4,042 |
3,036 |
$4K |
| 88342 |
|
279 |
268 |
$4K |
| 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 |
2,521 |
2,351 |
$4K |
| 83735 |
|
11,063 |
8,757 |
$4K |
| 87186 |
|
1,871 |
1,726 |
$3K |
| 90715 |
|
675 |
662 |
$3K |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
239 |
237 |
$3K |
| 82728 |
|
827 |
797 |
$3K |
| 94761 |
|
2,508 |
2,413 |
$3K |
| 82962 |
|
17,052 |
8,791 |
$3K |
| 87340 |
|
630 |
628 |
$3K |
| 76818 |
|
44 |
25 |
$3K |
| 87081 |
|
759 |
546 |
$3K |
| 83880 |
|
2,397 |
2,279 |
$3K |
| 87088 |
|
1,430 |
1,309 |
$3K |
| 86850 |
|
6,985 |
6,320 |
$3K |
| 81003 |
|
26,149 |
23,422 |
$3K |
| 82043 |
|
969 |
964 |
$2K |
| 87631 |
|
1,717 |
1,689 |
$2K |
| 80074 |
|
193 |
192 |
$2K |
| 82746 |
|
529 |
519 |
$2K |
| 85610 |
|
7,877 |
6,835 |
$2K |
| 84550 |
|
1,559 |
1,381 |
$2K |
| 81025 |
|
11,141 |
10,496 |
$2K |
| 73564 |
|
1,249 |
1,186 |
$2K |
| 90686 |
|
15 |
15 |
$2K |
| 83550 |
|
667 |
650 |
$2K |
| C8929 |
Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography |
38 |
38 |
$2K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
130 |
129 |
$2K |
| 88302 |
|
163 |
163 |
$2K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
10,080 |
8,199 |
$2K |
| 97166 |
|
58 |
55 |
$2K |
| 84484 |
|
14,148 |
10,243 |
$2K |
| 74018 |
|
1,337 |
1,193 |
$2K |
| 83540 |
|
794 |
769 |
$2K |
| A9270 |
Non-covered item or service |
45,951 |
35,452 |
$2K |
| 83690 |
|
14,731 |
13,277 |
$2K |
| 82805 |
|
2,788 |
2,557 |
$1K |
| 84703 |
|
12,108 |
11,262 |
$1K |
| 72110 |
|
252 |
245 |
$1K |
| 73630 |
|
1,246 |
1,170 |
$1K |
| 74420 |
|
302 |
284 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
3,120 |
2,812 |
$990.82 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
2,821 |
1,934 |
$958.02 |
| 85730 |
|
5,258 |
4,786 |
$930.61 |
| 71250 |
|
13 |
13 |
$850.85 |
| 73130 |
|
768 |
674 |
$844.96 |
| 86901 |
|
7,017 |
6,345 |
$824.14 |
| 93970 |
|
12 |
12 |
$818.23 |
| 29505 |
|
12 |
12 |
$779.32 |
| 73610 |
|
1,399 |
1,227 |
$743.22 |
| 82248 |
|
518 |
437 |
$687.86 |
| 82570 |
|
680 |
599 |
$614.82 |
| 84436 |
|
1,421 |
1,345 |
$596.48 |
| 87486 |
|
1,716 |
1,688 |
$594.12 |
| 87581 |
|
1,715 |
1,687 |
$594.12 |
| 84156 |
|
674 |
576 |
$486.96 |
| 83655 |
|
195 |
194 |
$467.53 |
| 80055 |
|
14 |
14 |
$420.91 |
| Q0114 |
Fern test |
83 |
72 |
$401.46 |
| 73030 |
|
792 |
749 |
$352.77 |
| 93880 |
|
31 |
24 |
$352.03 |
| 82247 |
|
146 |
94 |
$284.96 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
2,150 |
2,089 |
$284.49 |
| 82330 |
|
463 |
388 |
$278.20 |
| 85378 |
|
2,577 |
2,488 |
$276.76 |
| 82950 |
|
108 |
106 |
$261.58 |
| 73110 |
|
521 |
489 |
$258.18 |
| 83605 |
|
5,779 |
4,902 |
$254.48 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
205 |
199 |
$249.73 |
| 86038 |
|
54 |
54 |
$235.87 |
| 74021 |
|
51 |
50 |
$233.04 |
| 82977 |
|
69 |
67 |
$232.01 |
| 94760 |
|
767 |
753 |
$226.76 |
| 87040 |
|
2,423 |
1,768 |
$210.23 |
| 87075 |
|
282 |
223 |
$199.45 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,625 |
2,652 |
$198.00 |
| 96376 |
|
8,518 |
5,451 |
$189.73 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
7,731 |
7,312 |
$185.61 |
| 97116 |
|
153 |
101 |
$164.18 |
| 87077 |
|
113 |
104 |
$143.44 |
| 73080 |
|
146 |
138 |
$139.41 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
13 |
13 |
$138.44 |
| 86762 |
|
66 |
64 |
$131.82 |
| 76820 |
|
794 |
380 |
$129.68 |
| 86039 |
|
37 |
37 |
$125.91 |
| 73502 |
|
30 |
28 |
$111.69 |
| 12001 |
|
92 |
88 |
$107.29 |
| 73590 |
|
433 |
402 |
$96.47 |
| 87449 |
|
177 |
156 |
$93.16 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
3,771 |
3,647 |
$89.37 |
| 84146 |
|
14 |
12 |
$87.34 |
| 82010 |
|
522 |
461 |
$75.31 |
| 72170 |
|
471 |
462 |
$74.83 |
| G0008 |
Administration of influenza virus vaccine |
17 |
17 |
$70.00 |
| 80143 |
|
175 |
157 |
$69.65 |
| 84112 |
|
75 |
67 |
$64.62 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
1,691 |
1,656 |
$64.00 |
| 83516 |
|
19 |
14 |
$59.49 |
| 97535 |
Self-care/home management training, each 15 minutes |
16 |
13 |
$58.84 |
| 85027 |
|
98 |
83 |
$53.24 |
| 73140 |
|
106 |
93 |
$48.33 |
| 83001 |
|
12 |
12 |
$46.38 |
| 80076 |
|
32 |
30 |
$45.15 |
| 82140 |
|
53 |
50 |
$42.70 |
| 82533 |
|
40 |
39 |
$41.19 |
| 86308 |
|
55 |
53 |
$40.82 |
| 82310 |
|
43 |
40 |
$29.13 |
| 82947 |
|
12 |
12 |
$28.23 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
7,914 |
5,854 |
$24.03 |
| 82565 |
|
20 |
16 |
$22.38 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
18,658 |
15,924 |
$18.64 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,452 |
2,179 |
$18.13 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
10,778 |
10,191 |
$12.62 |
| 84460 |
|
15 |
12 |
$11.93 |
| 84450 |
|
16 |
13 |
$11.65 |
| 84520 |
|
17 |
13 |
$11.26 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
20,631 |
17,254 |
$10.05 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
449 |
261 |
$9.65 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
221 |
174 |
$9.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
9,954 |
9,444 |
$8.56 |
| 85018 |
|
82 |
63 |
$7.15 |
| 85014 |
|
82 |
63 |
$7.15 |
| 87181 |
|
13 |
13 |
$6.94 |
| C1769 |
Guide wire |
1,097 |
1,025 |
$3.97 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
9,985 |
9,491 |
$3.42 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
6,902 |
6,182 |
$0.95 |
| J2704 |
Injection, propofol, 10 mg |
9,992 |
9,574 |
$0.37 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
519 |
501 |
$0.32 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
4,797 |
4,322 |
$0.18 |
| J1644 |
Injection, heparin sodium, per 1000 units |
805 |
575 |
$0.05 |
| C2617 |
Stent, non-coronary, temporary, without delivery system |
65 |
64 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
541 |
524 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
872 |
714 |
$0.00 |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
816 |
728 |
$0.00 |
| 73090 |
|
278 |
245 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
223 |
156 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
874 |
790 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
333 |
331 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
1,514 |
1,187 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
100 |
99 |
$0.00 |
| S2900 |
Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) |
79 |
76 |
$0.00 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
442 |
423 |
$0.00 |
| 93320 |
|
546 |
541 |
$0.00 |
| J2791 |
Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu |
109 |
109 |
$0.00 |
| J1630 |
Injection, haloperidol, up to 5 mg |
303 |
251 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
198 |
172 |
$0.00 |
| J0280 |
Injection, aminophyllin, up to 250 mg |
26 |
26 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
111 |
107 |
$0.00 |
| J3411 |
Injection, thiamine hcl, 100 mg |
17 |
12 |
$0.00 |
| 82553 |
|
26 |
25 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
20 |
15 |
$0.00 |
| 73552 |
|
12 |
12 |
$0.00 |
| 99156 |
|
12 |
12 |
$0.00 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
15 |
14 |
$0.00 |
| J3360 |
Injection, diazepam, up to 5 mg |
15 |
12 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
7,510 |
6,522 |
$0.00 |
| 88312 |
|
112 |
105 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,831 |
2,475 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
2,007 |
1,783 |
$0.00 |
| J3250 |
Injection, trimethobenzamide hcl, up to 200 mg |
141 |
126 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
198 |
167 |
$0.00 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,938 |
1,038 |
$0.00 |
| 93325 |
|
779 |
767 |
$0.00 |
| J1245 |
Injection, dipyridamole, per 10 mg |
175 |
174 |
$0.00 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
220 |
170 |
$0.00 |
| C1758 |
Catheter, ureteral |
192 |
168 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
998 |
842 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
96 |
90 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
36 |
28 |
$0.00 |
| 85384 |
|
42 |
41 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
65 |
65 |
$0.00 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
28 |
12 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
27 |
23 |
$0.00 |
| 89050 |
|
46 |
29 |
$0.00 |
| 86923 |
|
13 |
12 |
$0.00 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
12 |
12 |
$0.00 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
14 |
12 |
$0.00 |