| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
Emergency room services |
106,171 |
92,674 |
$5.88M |
| 0510 |
|
98,685 |
80,787 |
$3.96M |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
38,167 |
30,019 |
$2.09M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
9,242 |
9,064 |
$1.92M |
| J9271 |
Injection, pembrolizumab, 1 mg |
248 |
206 |
$1.89M |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
10,117 |
9,601 |
$1.84M |
| G0378 |
Hospital observation service, per hour |
49,935 |
40,938 |
$1.78M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
42,785 |
12,470 |
$1.62M |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
23,823 |
20,756 |
$1.48M |
| 0250 |
|
99,774 |
46,589 |
$1.19M |
| 80053 |
Comprehensive metabolic panel |
100,281 |
84,196 |
$1.19M |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
6,289 |
5,828 |
$1.13M |
| 70450 |
Computed tomography, head or brain; without contrast material |
9,129 |
8,882 |
$1.11M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
35,866 |
32,944 |
$980K |
| 99199 |
Unlisted special service, procedure or report |
17,701 |
14,933 |
$897K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
104,833 |
87,392 |
$890K |
| A0431 |
Ambulance service, conventional air services, transport, one way (rotary wing) |
581 |
576 |
$882K |
| A0436 |
Rotary wing air mileage, per statute mile |
566 |
561 |
$680K |
| 0762 |
|
9,656 |
5,148 |
$650K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
11,353 |
10,158 |
$637K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
3,720 |
3,705 |
$634K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
5,913 |
5,806 |
$611K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
12,531 |
9,795 |
$598K |
| 87428 |
|
12,354 |
12,041 |
$595K |
| 0750 |
|
3,470 |
3,424 |
$581K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
1,462 |
1,450 |
$578K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
15,117 |
13,033 |
$537K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
7,470 |
5,901 |
$525K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,956 |
2,923 |
$523K |
| A0425 |
Ground mileage, per statute mile |
19,900 |
18,248 |
$504K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
12,389 |
9,997 |
$496K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
332 |
331 |
$476K |
| 97139 |
|
10,493 |
3,189 |
$459K |
| 0761 |
|
3,580 |
2,920 |
$421K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
2,286 |
2,277 |
$384K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
11,273 |
8,789 |
$324K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
27,327 |
22,408 |
$311K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
641 |
641 |
$302K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
5,614 |
5,468 |
$301K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,441 |
1,423 |
$267K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
6,381 |
6,265 |
$266K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
6,382 |
6,266 |
$264K |
| 93971 |
|
2,256 |
2,196 |
$263K |
| 59025 |
Fetal non-stress test |
9,387 |
3,192 |
$253K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
4,240 |
4,110 |
$251K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
3,666 |
3,611 |
$249K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
4,233 |
3,634 |
$244K |
| 82077 |
|
6,168 |
5,585 |
$238K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
19,609 |
15,462 |
$237K |
| 71045 |
Radiologic examination, chest; single view |
19,626 |
18,355 |
$235K |
| 97161 |
|
4,044 |
3,990 |
$234K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
3,471 |
2,235 |
$232K |
| 84443 |
Thyroid stimulating hormone (TSH) |
11,780 |
10,973 |
$232K |
| 97010 |
|
5,513 |
1,914 |
$227K |
| 76830 |
Ultrasound, transvaginal |
3,155 |
3,113 |
$217K |
| 84484 |
|
19,618 |
17,377 |
$210K |
| 83880 |
|
6,845 |
6,480 |
$203K |
| 71046 |
Radiologic examination, chest; 2 views |
10,492 |
10,225 |
$200K |
| 76801 |
|
3,480 |
3,242 |
$196K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
5,161 |
3,293 |
$195K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
18,351 |
13,965 |
$195K |
| 83690 |
|
23,209 |
21,398 |
$191K |
| Z7502 |
|
5,070 |
4,967 |
$187K |
| 96367 |
|
3,017 |
2,040 |
$182K |
| 73610 |
|
6,384 |
5,523 |
$180K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
651 |
644 |
$171K |
| 90715 |
|
4,129 |
4,117 |
$166K |
| J3490 |
Unclassified drugs |
34,810 |
16,692 |
$161K |
| 0361 |
|
961 |
867 |
$158K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
3,919 |
3,853 |
$152K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
3,913 |
3,607 |
$144K |
| 93976 |
|
685 |
675 |
$143K |
| 73630 |
|
5,383 |
4,796 |
$139K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
16,225 |
15,464 |
$138K |
| 73110 |
|
4,845 |
3,929 |
$136K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12,192 |
11,943 |
$133K |
| 81001 |
|
34,055 |
31,857 |
$133K |
| 71250 |
|
1,001 |
998 |
$132K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,910 |
1,229 |
$126K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,059 |
1,940 |
$124K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,414 |
1,413 |
$123K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
2,629 |
2,573 |
$123K |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
2,494 |
2,482 |
$121K |
| 73130 |
|
4,333 |
3,573 |
$121K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
5,053 |
4,241 |
$113K |
| 80305 |
|
9,162 |
8,650 |
$112K |
| 73030 |
|
4,136 |
3,747 |
$108K |
| 0710 |
|
3,617 |
3,580 |
$107K |
| 83605 |
|
8,338 |
7,917 |
$103K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
779 |
768 |
$99K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
416 |
415 |
$99K |
| 70496 |
|
544 |
541 |
$97K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
13,282 |
11,440 |
$96K |
| 85610 |
|
23,103 |
19,032 |
$93K |
| 73562 |
|
3,807 |
3,533 |
$92K |
| 70486 |
|
586 |
579 |
$91K |
| 80055 |
|
1,847 |
1,837 |
$88K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
7,846 |
7,782 |
$88K |
| 86140 |
|
14,248 |
13,023 |
$87K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
6,337 |
3,593 |
$86K |
| Z7500 |
|
2,415 |
2,258 |
$81K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
3,472 |
3,410 |
$80K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,615 |
2,604 |
$79K |
| 87077 |
|
9,976 |
9,374 |
$75K |
| 73080 |
|
2,610 |
2,153 |
$74K |
| 81003 |
|
26,974 |
21,098 |
$73K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
14,633 |
13,610 |
$73K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
16,073 |
13,627 |
$72K |
| 87040 |
|
4,039 |
3,394 |
$71K |
| J9202 |
Goserelin acetate implant, per 3.6 mg |
119 |
111 |
$71K |
| 76770 |
|
880 |
870 |
$70K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
274 |
273 |
$70K |
| 93017 |
|
1,224 |
1,213 |
$70K |
| 87186 |
|
7,340 |
7,114 |
$70K |
| 81025 |
|
8,852 |
8,649 |
$68K |
| 93970 |
|
347 |
343 |
$64K |
| 83735 |
|
8,594 |
6,636 |
$64K |
| 99201 |
|
1,265 |
989 |
$63K |
| 97799 |
|
1,570 |
628 |
$63K |
| 72100 |
|
2,103 |
2,089 |
$63K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
1,001 |
423 |
$63K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,351 |
1,350 |
$63K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
6,821 |
6,169 |
$62K |
| 80143 |
|
1,555 |
1,450 |
$60K |
| 85027 |
|
8,305 |
7,516 |
$59K |
| 96415 |
|
1,827 |
1,358 |
$59K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
1,728 |
1,576 |
$58K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,079 |
1,040 |
$57K |
| 97750 |
|
938 |
785 |
$56K |
| 70491 |
|
246 |
243 |
$56K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
1,708 |
1,035 |
$56K |
| J1453 |
Injection, fosaprepitant, 1 mg |
658 |
409 |
$55K |
| 0260 |
|
408 |
229 |
$54K |
| 73502 |
|
1,847 |
1,758 |
$54K |
| 80179 |
|
1,419 |
1,324 |
$54K |
| 85730 |
|
7,717 |
7,452 |
$53K |
| 93041 |
|
3,741 |
3,560 |
$52K |
| 70498 |
|
404 |
402 |
$52K |
| 92557 |
|
974 |
972 |
$50K |
| 97165 |
|
609 |
503 |
$50K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
764 |
704 |
$50K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,197 |
2,193 |
$50K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
5,672 |
3,064 |
$49K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
352 |
347 |
$49K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
7,251 |
6,161 |
$48K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
39 |
39 |
$47K |
| 87400 |
|
7,540 |
7,425 |
$47K |
| 73590 |
|
2,074 |
1,799 |
$46K |
| 72141 |
|
193 |
193 |
$46K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
6,365 |
5,372 |
$46K |
| J2704 |
Injection, propofol, 10 mg |
7,108 |
6,153 |
$45K |
| 85379 |
|
3,745 |
3,678 |
$45K |
| 87807 |
|
4,740 |
4,615 |
$44K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
446 |
444 |
$44K |
| 72040 |
|
1,618 |
1,590 |
$43K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,972 |
1,959 |
$43K |
| 73140 |
|
2,416 |
2,054 |
$43K |
| 80061 |
Lipid panel |
3,373 |
3,333 |
$41K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
673 |
665 |
$39K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
7,527 |
4,956 |
$37K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
408 |
408 |
$37K |
| 74018 |
|
2,068 |
1,976 |
$37K |
| 87075 |
|
3,433 |
3,253 |
$37K |
| 73090 |
|
1,548 |
1,244 |
$36K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
125 |
120 |
$36K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,424 |
1,273 |
$35K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
3,994 |
3,029 |
$35K |
| 73564 |
|
1,118 |
1,028 |
$34K |
| 82728 |
|
2,609 |
2,479 |
$34K |
| 76870 |
|
610 |
592 |
$33K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
356 |
351 |
$32K |
| J2785 |
Injection, regadenoson, 0.1 mg |
262 |
259 |
$31K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
405 |
402 |
$31K |
| 87150 |
|
1,430 |
1,388 |
$31K |
| 0360 |
|
158 |
131 |
$30K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
6,354 |
5,358 |
$30K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,941 |
1,708 |
$29K |
| J1815 |
Injection, insulin, per 5 units |
1,605 |
934 |
$29K |
| 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 |
581 |
535 |
$28K |
| 73100 |
|
1,493 |
1,190 |
$28K |
| 96417 |
|
834 |
554 |
$28K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
5,059 |
3,047 |
$28K |
| 84439 |
|
2,647 |
2,547 |
$27K |
| 90651 |
|
109 |
109 |
$26K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
5,739 |
5,554 |
$25K |
| 73560 |
|
1,206 |
1,101 |
$25K |
| 72131 |
|
152 |
147 |
$24K |
| 0700 |
|
483 |
413 |
$24K |
| 86703 |
|
1,384 |
1,374 |
$23K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
419 |
416 |
$23K |
| 87340 |
|
1,834 |
1,811 |
$22K |
| 87081 |
|
2,864 |
2,857 |
$22K |
| 82951 |
|
1,390 |
1,377 |
$21K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,436 |
2,178 |
$21K |
| 82746 |
|
1,261 |
1,247 |
$21K |
| J7050 |
Infusion, normal saline solution, 250 cc |
4,188 |
2,701 |
$20K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
1,892 |
1,801 |
$20K |
| 86901 |
|
5,426 |
5,030 |
$20K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
194 |
192 |
$20K |
| 83540 |
|
3,041 |
2,943 |
$19K |
| 83550 |
|
2,672 |
2,596 |
$19K |
| 73221 |
|
58 |
57 |
$18K |
| 87507 |
|
49 |
49 |
$18K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
207 |
189 |
$18K |
| 47562 |
|
62 |
61 |
$18K |
| 76813 |
|
286 |
286 |
$17K |
| 82378 |
|
853 |
661 |
$17K |
| 85651 |
|
6,158 |
5,388 |
$17K |
| 77336 |
|
179 |
90 |
$17K |
| 76536 |
|
316 |
315 |
$17K |
| J2060 |
Injection, lorazepam, 2 mg |
3,411 |
2,945 |
$17K |
| 74178 |
|
80 |
80 |
$17K |
| J0897 |
Injection, denosumab, 1 mg |
30 |
30 |
$17K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
62 |
50 |
$16K |
| 86900 |
|
5,149 |
4,850 |
$16K |
| 87205 |
|
3,595 |
3,412 |
$16K |
| 87070 |
|
1,487 |
1,472 |
$16K |
| 82803 |
|
1,005 |
944 |
$16K |
| 73552 |
|
742 |
689 |
$15K |
| 97803 |
|
568 |
500 |
$15K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
38 |
24 |
$15K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
2,389 |
2,011 |
$15K |
| 82550 |
|
1,904 |
1,760 |
$15K |
| 93226 |
|
232 |
232 |
$15K |
| 94664 |
|
1,532 |
1,447 |
$14K |
| 86850 |
|
3,412 |
3,198 |
$14K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
3,721 |
3,018 |
$14K |
| 83615 |
|
2,301 |
2,026 |
$13K |
| 92550 |
|
629 |
627 |
$13K |
| 86922 |
|
179 |
134 |
$13K |
| 86592 |
|
2,845 |
2,727 |
$13K |
| 92588 |
|
155 |
155 |
$12K |
| J1756 |
Injection, iron sucrose, 1 mg |
238 |
115 |
$12K |
| 82247 |
|
2,081 |
1,411 |
$12K |
| 0258 |
|
865 |
545 |
$11K |
| 74183 |
|
49 |
49 |
$11K |
| 96523 |
|
247 |
241 |
$11K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,688 |
915 |
$11K |
| 85007 |
|
3,517 |
3,184 |
$11K |
| 96402 |
|
967 |
910 |
$11K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,505 |
1,283 |
$11K |
| 72170 |
|
556 |
546 |
$10K |
| 93225 |
|
246 |
246 |
$10K |
| 73000 |
|
431 |
373 |
$10K |
| 74175 |
|
41 |
41 |
$10K |
| 82607 |
|
593 |
588 |
$9K |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,752 |
970 |
$9K |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
1,325 |
1,185 |
$9K |
| 93880 |
|
78 |
77 |
$9K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
381 |
381 |
$9K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
730 |
421 |
$9K |
| 90674 |
|
258 |
258 |
$9K |
| 82950 |
|
1,534 |
1,528 |
$8K |
| 74019 |
|
355 |
351 |
$8K |
| J7070 |
Infusion, d5w, 1000 cc |
1,001 |
539 |
$8K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,308 |
758 |
$8K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,643 |
1,439 |
$8K |
| 80069 |
|
836 |
678 |
$7K |
| 87209 |
|
478 |
327 |
$7K |
| 73700 |
|
44 |
42 |
$7K |
| 82570 |
|
1,276 |
1,143 |
$7K |
| 82948 |
|
1,584 |
1,061 |
$7K |
| 73660 |
|
394 |
366 |
$7K |
| 76642 |
|
130 |
128 |
$7K |
| 0255 |
|
703 |
632 |
$7K |
| 93247 |
|
85 |
85 |
$7K |
| 84153 |
|
411 |
399 |
$6K |
| 82784 |
|
946 |
560 |
$6K |
| 99070 |
|
502 |
447 |
$6K |
| 82670 |
|
210 |
203 |
$6K |
| 77049 |
|
24 |
24 |
$6K |
| 0391 |
|
33 |
24 |
$6K |
| 77066 |
Tomosynthesis, mammo |
59 |
59 |
$6K |
| 74170 |
|
29 |
29 |
$6K |
| S0164 |
Injection, pantoprazole sodium, 40 mg |
635 |
428 |
$6K |
| 86403 |
|
453 |
451 |
$6K |
| 86705 |
|
420 |
419 |
$6K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
550 |
493 |
$6K |
| 76000 |
|
336 |
317 |
$6K |
| 82731 |
|
92 |
87 |
$5K |
| 84145 |
|
228 |
220 |
$5K |
| 92504 |
|
252 |
218 |
$5K |
| 72110 |
|
100 |
100 |
$5K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,184 |
1,057 |
$5K |
| 96368 |
|
230 |
165 |
$5K |
| 82248 |
|
874 |
599 |
$5K |
| 84550 |
|
993 |
785 |
$5K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
991 |
882 |
$5K |
| 87430 |
|
306 |
305 |
$5K |
| 90630 |
|
185 |
185 |
$4K |
| 86709 |
|
338 |
337 |
$4K |
| 0402 |
|
28 |
28 |
$4K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
491 |
447 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
3,395 |
2,957 |
$4K |
| J3480 |
Injection, potassium chloride, per 2 meq |
246 |
146 |
$4K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
55 |
55 |
$4K |
| 92553 |
|
140 |
139 |
$4K |
| 84403 |
|
269 |
262 |
$4K |
| 78264 |
|
36 |
36 |
$3K |
| 86762 |
|
205 |
205 |
$3K |
| 80076 |
|
413 |
374 |
$3K |
| 86706 |
|
289 |
283 |
$3K |
| 86704 |
|
253 |
247 |
$3K |
| 87045 |
|
289 |
287 |
$3K |
| 95913 |
|
13 |
13 |
$3K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
275 |
261 |
$3K |
| 83516 |
|
383 |
260 |
$3K |
| 97802 |
|
92 |
92 |
$3K |
| 93325 |
|
25 |
25 |
$3K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
225 |
171 |
$3K |
| 76882 |
|
333 |
330 |
$3K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
25 |
25 |
$3K |
| 77300 |
|
17 |
17 |
$3K |
| A9541 |
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries |
67 |
67 |
$3K |
| 72070 |
|
82 |
82 |
$3K |
| 82010 |
|
303 |
286 |
$3K |
| 84155 |
|
847 |
718 |
$2K |
| 84702 |
|
169 |
140 |
$2K |
| 77334 |
|
16 |
13 |
$2K |
| 87641 |
|
91 |
91 |
$2K |
| 82105 |
|
153 |
150 |
$2K |
| 82040 |
|
546 |
475 |
$2K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
45 |
44 |
$2K |
| J3372 |
Injection, vancomycin hcl (xellia), not therapeutically equivalent to j3370, 500 mg |
126 |
77 |
$2K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
533 |
518 |
$2K |
| 94644 |
|
106 |
101 |
$2K |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
1,412 |
1,340 |
$2K |
| 0481 |
|
12 |
12 |
$2K |
| 87803 |
|
193 |
192 |
$2K |
| 12002 |
|
88 |
86 |
$2K |
| 80047 |
|
254 |
243 |
$2K |
| 73060 |
|
104 |
92 |
$2K |
| 74174 |
|
12 |
12 |
$2K |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
500 |
389 |
$2K |
| 72081 |
|
77 |
77 |
$2K |
| J3360 |
Injection, diazepam, up to 5 mg |
189 |
124 |
$2K |
| 10061 |
|
54 |
51 |
$2K |
| 72120 |
|
45 |
45 |
$2K |
| 0160 |
|
34 |
15 |
$2K |
| 77061 |
|
14 |
14 |
$2K |
| 31575 |
|
30 |
30 |
$2K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
514 |
215 |
$2K |
| Z9725 |
|
39 |
39 |
$2K |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
379 |
316 |
$2K |
| 12001 |
|
70 |
70 |
$2K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
170 |
114 |
$2K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
62 |
62 |
$2K |
| 83001 |
|
79 |
78 |
$2K |
| 87449 |
|
179 |
178 |
$2K |
| 96411 |
|
78 |
47 |
$2K |
| 82375 |
|
127 |
123 |
$2K |
| 84100 |
|
366 |
298 |
$2K |
| 83655 |
|
116 |
115 |
$1K |
| 84165 |
|
251 |
230 |
$1K |
| 93702 |
|
15 |
14 |
$1K |
| 71271 |
|
35 |
35 |
$1K |
| 12011 |
|
39 |
39 |
$1K |
| 86334 |
|
219 |
200 |
$1K |
| 96156 |
|
13 |
13 |
$1K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
832 |
386 |
$1K |
| 86920 |
|
14 |
12 |
$1K |
| 71101 |
|
43 |
43 |
$1K |
| 84703 |
|
768 |
739 |
$1K |
| 0636 |
|
131 |
123 |
$1K |
| 87899 |
|
159 |
110 |
$1K |
| 85045 |
|
323 |
300 |
$1K |
| 77065 |
Tomosynthesis, mammo |
14 |
14 |
$1K |
| Q3014 |
Telehealth originating site facility fee |
34 |
33 |
$1K |
| 87634 |
|
16 |
16 |
$1K |
| 83520 |
|
102 |
79 |
$1K |
| 92587 |
|
15 |
15 |
$1K |
| 20610 |
|
90 |
75 |
$1K |
| 51798 |
|
122 |
122 |
$1K |
| 82810 |
|
127 |
123 |
$1K |
| 93246 |
|
85 |
85 |
$1K |
| 84425 |
|
64 |
64 |
$1K |
| 73620 |
|
55 |
50 |
$1K |
| 10060 |
|
38 |
38 |
$1K |
| Z7610 |
|
100 |
73 |
$1K |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
163 |
124 |
$938.64 |
| 90686 |
|
51 |
51 |
$911.29 |
| 84207 |
|
38 |
38 |
$898.90 |
| 83050 |
|
127 |
123 |
$892.61 |
| 0760 |
|
46 |
37 |
$880.86 |
| 0270 |
|
146 |
94 |
$872.59 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
19 |
12 |
$847.40 |
| 87177 |
|
70 |
66 |
$790.29 |
| 84144 |
|
32 |
25 |
$776.55 |
| 73070 |
|
30 |
25 |
$744.00 |
| J9190 |
Injection, fluorouracil, 500 mg |
35 |
14 |
$724.70 |
| 83521 |
|
205 |
126 |
$699.02 |
| 95886 |
|
15 |
15 |
$695.82 |
| 29515 |
|
54 |
51 |
$690.34 |
| 97016 |
|
302 |
94 |
$675.63 |
| 29105 |
|
60 |
59 |
$671.40 |
| 0335 |
|
17 |
13 |
$668.80 |
| 83883 |
|
92 |
52 |
$661.47 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
71 |
63 |
$659.18 |
| 84478 |
|
106 |
101 |
$657.26 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
197 |
136 |
$654.46 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
77 |
75 |
$654.26 |
| 0271 |
|
66 |
50 |
$621.30 |
| 29125 |
|
55 |
53 |
$609.91 |
| J1630 |
Injection, haloperidol, up to 5 mg |
123 |
103 |
$604.27 |
| A4217 |
Sterile water/saline, 500 ml |
33 |
33 |
$600.00 |
| 77338 |
|
12 |
12 |
$589.00 |
| 86317 |
|
65 |
65 |
$580.50 |
| 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 |
968 |
883 |
$575.52 |
| 93922 |
|
25 |
25 |
$562.34 |
| J1836 |
Injection, metronidazole, 10 mg |
341 |
228 |
$550.92 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
109 |
100 |
$505.59 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
63 |
42 |
$475.67 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
30 |
30 |
$475.49 |
| 73120 |
|
31 |
18 |
$471.33 |
| 83970 |
|
15 |
15 |
$463.66 |
| 83090 |
|
31 |
30 |
$452.64 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
860 |
813 |
$438.69 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
48 |
38 |
$419.91 |
| 86038 |
|
51 |
51 |
$411.58 |
| 85018 |
|
175 |
161 |
$405.72 |
| 82465 |
|
88 |
88 |
$404.41 |
| 0272 |
|
43 |
42 |
$400.60 |
| 43235 |
|
13 |
13 |
$383.28 |
| 77062 |
|
13 |
13 |
$360.00 |
| 86787 |
|
31 |
30 |
$353.77 |
| J1020 |
Injection, methylprednisolone acetate, 20 mg |
36 |
36 |
$340.59 |
| 77080 |
|
13 |
13 |
$338.65 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
68 |
67 |
$321.01 |
| 82270 |
|
76 |
74 |
$313.16 |
| 82140 |
|
26 |
26 |
$304.04 |
| 83010 |
|
16 |
13 |
$278.85 |
| 84466 |
|
27 |
27 |
$274.16 |
| 0370 |
|
37 |
36 |
$270.54 |
| 84160 |
|
77 |
70 |
$266.37 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
28 |
27 |
$260.13 |
| 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 |
641 |
530 |
$259.64 |
| 87210 |
|
72 |
71 |
$258.03 |
| 87147 |
|
48 |
48 |
$246.26 |
| 82952 |
|
62 |
62 |
$243.56 |
| 86304 |
|
13 |
12 |
$240.50 |
| 29065 |
|
21 |
18 |
$234.99 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
186 |
117 |
$195.41 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
1,364 |
1,291 |
$183.36 |
| 97116 |
|
241 |
110 |
$181.75 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
177 |
177 |
$175.57 |
| 0278 |
|
15 |
13 |
$167.76 |
| 29075 |
|
18 |
17 |
$163.44 |
| 86803 |
|
12 |
12 |
$150.63 |
| 49083 |
|
12 |
12 |
$147.12 |
| J1940 |
Injection, furosemide, up to 20 mg |
21 |
14 |
$133.90 |
| J1953 |
Injection, levetiracetam, 10 mg |
15 |
14 |
$115.56 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
44 |
39 |
$107.04 |
| J3411 |
Injection, thiamine hcl, 100 mg |
41 |
17 |
$96.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
654 |
598 |
$92.26 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
12 |
12 |
$75.28 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
12 |
12 |
$63.78 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
56 |
33 |
$56.50 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
77 |
57 |
$51.37 |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
28 |
14 |
$49.66 |
| 82043 |
|
12 |
12 |
$43.92 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
210 |
201 |
$39.44 |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
64 |
64 |
$32.00 |
| 84132 |
|
14 |
12 |
$30.24 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
12 |
12 |
$30.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
173 |
165 |
$23.94 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
20 |
12 |
$13.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
15 |
15 |
$8.50 |
| J7510 |
Prednisolone oral, per 5 mg |
12 |
12 |
$1.90 |
| A9270 |
Non-covered item or service |
185 |
123 |
$0.00 |
| 96376 |
|
67 |
45 |
$0.00 |
| 80050 |
General health panel |
114 |
111 |
$0.00 |
| 0250R |
|
76 |
38 |
$0.00 |
| 80320 |
|
199 |
191 |
$0.00 |
| 0370R |
|
120 |
119 |
$0.00 |
| 0710R |
|
180 |
173 |
$0.00 |