| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
63,177 |
56,660 |
$14.49M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
71,053 |
64,520 |
$12.35M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
31,236 |
27,861 |
$8.98M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
38,325 |
35,553 |
$5.20M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
15,030 |
14,120 |
$4.84M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
50,031 |
36,014 |
$3.08M |
| G0378 |
Hospital observation service, per hour |
22,054 |
20,134 |
$2.88M |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
8,605 |
8,239 |
$2.81M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
11,192 |
10,641 |
$2.11M |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
20,831 |
19,610 |
$2.00M |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
6,832 |
6,431 |
$1.61M |
| 96375 |
Therapeutic injection; each additional sequential IV push |
45,184 |
35,653 |
$1.60M |
| 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 |
19,380 |
16,879 |
$1.57M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
23,711 |
16,710 |
$1.56M |
| 70450 |
Computed tomography, head or brain; without contrast material |
13,974 |
12,866 |
$1.46M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
49,535 |
43,435 |
$1.38M |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
1,563 |
1,325 |
$1.29M |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
3,128 |
2,997 |
$1.21M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
67,281 |
54,557 |
$1.20M |
| 59025 |
Fetal non-stress test |
11,462 |
8,434 |
$1.14M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
43,042 |
13,083 |
$1.06M |
| 71046 |
Radiologic examination, chest; 2 views |
23,868 |
22,032 |
$1.04M |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
5,290 |
4,939 |
$928K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
11,480 |
10,829 |
$832K |
| 80053 |
Comprehensive metabolic panel |
143,426 |
114,520 |
$816K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
10,814 |
9,648 |
$806K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
30,595 |
19,248 |
$731K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
2,125 |
2,020 |
$727K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
22,193 |
19,815 |
$654K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
6,848 |
6,517 |
$622K |
| 36415 |
Collection of venous blood by venipuncture |
44,843 |
34,094 |
$614K |
| 71045 |
Radiologic examination, chest; single view |
43,069 |
36,832 |
$604K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
157,132 |
114,943 |
$603K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
3,766 |
3,642 |
$596K |
| 70496 |
|
2,598 |
2,447 |
$588K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
3,380 |
3,181 |
$578K |
| G6015 |
Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session |
1,575 |
147 |
$572K |
| 70498 |
|
2,926 |
2,758 |
$566K |
| 47562 |
|
556 |
531 |
$559K |
| 96376 |
|
17,271 |
10,904 |
$553K |
| 77336 |
|
3,827 |
1,677 |
$539K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
4,600 |
3,897 |
$522K |
| 93458 |
|
694 |
644 |
$483K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
3,544 |
3,388 |
$463K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
4,306 |
4,026 |
$429K |
| 93017 |
|
5,205 |
4,963 |
$428K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
49,501 |
37,787 |
$420K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
1,702 |
1,559 |
$417K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
2,521 |
2,425 |
$398K |
| 72141 |
|
2,218 |
2,143 |
$384K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
9,747 |
6,489 |
$376K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
607 |
592 |
$376K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
10,840 |
8,683 |
$374K |
| 49083 |
|
1,678 |
575 |
$353K |
| 77412 |
|
3,262 |
354 |
$323K |
| 93970 |
|
2,918 |
2,750 |
$316K |
| 84484 |
|
59,192 |
40,247 |
$310K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
33,566 |
29,090 |
$304K |
| 77334 |
|
1,304 |
902 |
$290K |
| 76770 |
|
2,887 |
2,719 |
$284K |
| 93971 |
|
3,437 |
3,200 |
$274K |
| 71250 |
|
2,605 |
2,465 |
$269K |
| J2785 |
Injection, regadenoson, 0.1 mg |
4,445 |
4,225 |
$265K |
| 82553 |
|
43,013 |
29,718 |
$243K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
13,723 |
9,102 |
$242K |
| 96367 |
|
3,890 |
3,055 |
$239K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
3,529 |
1,973 |
$230K |
| 87070 |
|
23,790 |
20,956 |
$227K |
| D9420 |
|
406 |
360 |
$225K |
| 93880 |
|
3,197 |
3,093 |
$224K |
| 84443 |
Thyroid stimulating hormone (TSH) |
21,241 |
19,734 |
$224K |
| 76830 |
Ultrasound, transvaginal |
3,033 |
2,858 |
$222K |
| 77300 |
|
913 |
770 |
$220K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
14,249 |
3,990 |
$220K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
16,532 |
5,982 |
$213K |
| 82803 |
|
19,532 |
16,162 |
$198K |
| 97161 |
|
8,325 |
7,653 |
$197K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,786 |
2,714 |
$194K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
1,143 |
1,060 |
$191K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,473 |
877 |
$187K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
18,463 |
5,972 |
$177K |
| 83880 |
|
9,343 |
8,382 |
$177K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,769 |
3,916 |
$176K |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
7,222 |
6,701 |
$174K |
| 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 |
7,148 |
5,997 |
$171K |
| 99152 |
|
7,698 |
7,026 |
$164K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
2,595 |
2,284 |
$158K |
| 87088 |
|
28,845 |
25,923 |
$156K |
| 88342 |
|
4,825 |
4,060 |
$155K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
550 |
469 |
$155K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
4,055 |
3,226 |
$153K |
| 73610 |
|
3,407 |
3,139 |
$151K |
| 83735 |
|
49,238 |
35,071 |
$148K |
| 73030 |
|
3,291 |
3,013 |
$148K |
| 73130 |
|
3,075 |
2,814 |
$144K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
6,170 |
5,890 |
$140K |
| 78227 |
|
365 |
358 |
$140K |
| 12001 |
|
1,863 |
1,754 |
$139K |
| 84703 |
|
40,257 |
35,064 |
$135K |
| 36430 |
|
937 |
638 |
$133K |
| 72100 |
|
2,386 |
2,240 |
$131K |
| 72131 |
|
1,148 |
1,096 |
$130K |
| 73630 |
|
3,517 |
3,205 |
$130K |
| 88307 |
|
2,593 |
1,902 |
$126K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
30,643 |
20,876 |
$125K |
| 73564 |
|
3,210 |
2,895 |
$124K |
| 74018 |
|
5,527 |
4,886 |
$122K |
| APT15 |
|
10,208 |
8,449 |
$120K |
| J3490 |
Unclassified drugs |
26,518 |
18,139 |
$120K |
| 81001 |
|
56,858 |
49,930 |
$119K |
| 76536 |
|
1,293 |
1,257 |
$115K |
| 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 |
1,958 |
1,894 |
$115K |
| 93356 |
|
2,221 |
2,128 |
$114K |
| 73110 |
|
2,334 |
2,134 |
$114K |
| 83690 |
|
31,629 |
27,991 |
$110K |
| 47563 |
|
99 |
96 |
$110K |
| 96368 |
|
1,881 |
1,094 |
$109K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
24,563 |
20,713 |
$108K |
| 74183 |
|
458 |
436 |
$107K |
| 70486 |
|
1,029 |
956 |
$107K |
| 86850 |
|
13,529 |
11,874 |
$107K |
| 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 |
7,115 |
6,497 |
$106K |
| 83605 |
|
22,688 |
17,759 |
$106K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,432 |
2,095 |
$101K |
| 87631 |
|
2,251 |
2,047 |
$97K |
| 97014 |
|
8,367 |
3,066 |
$97K |
| 58661 |
|
130 |
104 |
$96K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
5,578 |
5,176 |
$95K |
| 73590 |
|
1,831 |
1,638 |
$93K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
24,931 |
20,374 |
$93K |
| 64488 |
|
1,683 |
1,502 |
$90K |
| 87077 |
|
15,083 |
13,535 |
$90K |
| 80061 |
Lipid panel |
18,752 |
17,783 |
$88K |
| 93925 |
|
1,197 |
1,157 |
$88K |
| 88341 |
|
5,063 |
1,805 |
$85K |
| 73090 |
|
1,973 |
1,789 |
$84K |
| 82550 |
|
51,265 |
35,613 |
$84K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
5,566 |
5,170 |
$84K |
| 84702 |
|
15,442 |
12,551 |
$82K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
16,959 |
13,755 |
$82K |
| 70491 |
|
398 |
378 |
$81K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
485 |
475 |
$78K |
| 12011 |
|
1,588 |
1,489 |
$77K |
| 97162 |
|
3,343 |
2,804 |
$77K |
| 72040 |
|
1,372 |
1,285 |
$74K |
| 93325 |
|
1,732 |
1,601 |
$73K |
| 82607 |
|
7,501 |
6,976 |
$72K |
| 85027 |
|
21,307 |
16,451 |
$71K |
| 77066 |
Tomosynthesis, mammo |
1,249 |
1,205 |
$70K |
| 84439 |
|
13,703 |
12,635 |
$70K |
| J1815 |
Injection, insulin, per 5 units |
7,974 |
4,543 |
$69K |
| 85730 |
|
25,325 |
21,797 |
$69K |
| J2704 |
Injection, propofol, 10 mg |
25,660 |
21,712 |
$68K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
852 |
784 |
$68K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
532 |
503 |
$67K |
| 81003 |
|
29,835 |
26,938 |
$67K |
| 93320 |
|
876 |
834 |
$66K |
| 86901 |
|
18,313 |
15,378 |
$65K |
| 87430 |
|
12,267 |
11,641 |
$65K |
| 76870 |
|
653 |
619 |
$64K |
| 73502 |
|
2,016 |
1,847 |
$64K |
| 82330 |
|
19,458 |
16,071 |
$64K |
| 85610 |
|
33,013 |
26,600 |
$63K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,939 |
1,685 |
$63K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
10,482 |
9,821 |
$61K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,919 |
1,737 |
$60K |
| 77301 |
|
44 |
40 |
$59K |
| 87040 |
|
15,732 |
8,877 |
$57K |
| APT17 |
|
3,803 |
3,777 |
$56K |
| 87186 |
|
10,586 |
9,712 |
$56K |
| 93351 |
|
221 |
213 |
$55K |
| 82731 |
|
880 |
800 |
$55K |
| APT16 |
|
3,931 |
3,611 |
$54K |
| C1769 |
Guide wire |
6,353 |
5,582 |
$52K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
118 |
76 |
$51K |
| 72110 |
|
664 |
641 |
$50K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
922 |
862 |
$50K |
| 86900 |
|
18,330 |
15,382 |
$49K |
| 88304 |
|
3,236 |
3,006 |
$49K |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
477 |
454 |
$49K |
| 76937 |
|
767 |
668 |
$46K |
| J7050 |
Infusion, normal saline solution, 250 cc |
26,042 |
15,061 |
$45K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
251 |
243 |
$44K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,348 |
2,189 |
$44K |
| 44970 |
|
31 |
31 |
$43K |
| 73552 |
|
964 |
863 |
$43K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
3,469 |
3,135 |
$42K |
| 82728 |
|
4,885 |
4,347 |
$42K |
| 86403 |
|
1,401 |
1,015 |
$41K |
| 12002 |
|
665 |
599 |
$41K |
| 74022 |
|
676 |
632 |
$41K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
556 |
423 |
$40K |
| 73221 |
|
213 |
198 |
$39K |
| 85379 |
|
7,924 |
7,129 |
$39K |
| 80074 |
|
1,258 |
1,186 |
$39K |
| 95811 |
|
55 |
53 |
$39K |
| 81025 |
|
4,974 |
4,631 |
$37K |
| 93923 |
|
528 |
519 |
$37K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,326 |
2,294 |
$36K |
| 74178 |
|
119 |
118 |
$36K |
| J8501 |
Aprepitant, oral, 5 mg |
1,042 |
978 |
$36K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
34,440 |
26,716 |
$36K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
15,985 |
10,958 |
$36K |
| 76642 |
|
1,562 |
1,435 |
$35K |
| 82746 |
|
4,242 |
3,877 |
$34K |
| 82077 |
|
5,489 |
4,826 |
$34K |
| 73560 |
|
1,536 |
1,333 |
$34K |
| 58571 |
|
55 |
53 |
$34K |
| 90715 |
|
2,233 |
1,971 |
$33K |
| 86140 |
|
11,725 |
10,145 |
$33K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
3,563 |
3,272 |
$33K |
| 73060 |
|
722 |
669 |
$33K |
| 95816 |
|
186 |
177 |
$30K |
| 75574 |
|
147 |
142 |
$30K |
| 78431 |
|
898 |
831 |
$29K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
51,543 |
41,479 |
$29K |
| J1756 |
Injection, iron sucrose, 1 mg |
1,330 |
653 |
$28K |
| 95819 |
|
153 |
148 |
$28K |
| P9047 |
Infusion, albumin (human), 25%, 50 ml |
578 |
166 |
$28K |
| 73080 |
|
741 |
697 |
$27K |
| 73070 |
|
600 |
533 |
$26K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
14,116 |
10,624 |
$26K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
722 |
669 |
$26K |
| 99153 |
Mod sedat endo service >5yrs |
2,624 |
2,397 |
$26K |
| 99215 |
Prolong outpt/office vis |
559 |
511 |
$25K |
| 82565 |
|
20,751 |
17,600 |
$25K |
| 76641 |
|
457 |
399 |
$25K |
| C2617 |
Stent, non-coronary, temporary, without delivery system |
298 |
268 |
$24K |
| 83550 |
|
4,245 |
3,911 |
$24K |
| 97116 |
|
4,890 |
1,833 |
$24K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
15,077 |
5,126 |
$23K |
| J3480 |
Injection, potassium chloride, per 2 meq |
6,483 |
4,146 |
$23K |
| 94060 |
|
308 |
300 |
$23K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
14,026 |
10,486 |
$23K |
| 64415 |
|
823 |
779 |
$22K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
4,310 |
3,707 |
$22K |
| 72170 |
|
820 |
741 |
$22K |
| 73140 |
|
396 |
366 |
$22K |
| 83718 |
|
1,898 |
1,840 |
$22K |
| 72072 |
|
289 |
271 |
$22K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
22,945 |
19,349 |
$21K |
| 72146 |
|
171 |
165 |
$21K |
| 84112 |
|
375 |
353 |
$21K |
| D7140 |
Extraction, erupted tooth or exposed root |
153 |
135 |
$21K |
| 97165 |
|
1,624 |
1,410 |
$20K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
610 |
174 |
$20K |
| 86923 |
|
1,473 |
772 |
$20K |
| 93308 |
|
430 |
386 |
$20K |
| 86803 |
|
2,250 |
2,143 |
$19K |
| 94664 |
|
1,577 |
1,164 |
$19K |
| 0399T |
|
698 |
669 |
$19K |
| 83540 |
|
4,393 |
4,047 |
$19K |
| 87340 |
|
2,201 |
1,935 |
$18K |
| 80069 |
|
4,694 |
2,139 |
$18K |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
7,830 |
6,304 |
$18K |
| 51701 |
|
1,139 |
1,034 |
$18K |
| 75625 |
|
50 |
46 |
$18K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
11,392 |
8,714 |
$17K |
| 97597 |
|
429 |
327 |
$17K |
| 93990 |
|
734 |
706 |
$17K |
| 74174 |
|
57 |
57 |
$17K |
| 86762 |
|
1,421 |
1,236 |
$16K |
| 73100 |
|
217 |
177 |
$16K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
5,111 |
4,576 |
$16K |
| 94729 |
|
296 |
287 |
$15K |
| 77065 |
Tomosynthesis, mammo |
572 |
545 |
$15K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
3,911 |
3,338 |
$15K |
| 52356 |
|
16 |
16 |
$15K |
| 93321 |
|
523 |
468 |
$15K |
| 84132 |
|
22,613 |
17,491 |
$15K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
25,038 |
21,054 |
$15K |
| 82435 |
|
18,371 |
15,226 |
$15K |
| C9399 |
Unclassified drugs or biologicals |
776 |
655 |
$14K |
| 82570 |
|
3,615 |
2,991 |
$14K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
816 |
803 |
$14K |
| 96417 |
|
201 |
127 |
$14K |
| 36561 |
|
13 |
12 |
$14K |
| 78264 |
|
56 |
53 |
$14K |
| 88112 |
|
720 |
588 |
$14K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
3,861 |
3,620 |
$13K |
| 74019 |
|
274 |
262 |
$13K |
| 88142 |
|
1,043 |
975 |
$13K |
| 87653 |
|
711 |
686 |
$13K |
| 82140 |
|
2,057 |
1,689 |
$13K |
| 64447 |
|
376 |
355 |
$13K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
3,060 |
1,308 |
$13K |
| 94644 |
|
1,335 |
1,244 |
$13K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,733 |
2,177 |
$13K |
| 84145 |
|
3,378 |
2,864 |
$12K |
| 94726 |
|
181 |
178 |
$12K |
| A9555 |
Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries |
1,329 |
1,242 |
$12K |
| 85520 |
|
3,302 |
1,447 |
$12K |
| 83615 |
|
4,038 |
3,170 |
$12K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
8,871 |
6,684 |
$12K |
| 70360 |
|
377 |
362 |
$12K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
1,685 |
1,420 |
$12K |
| 87205 |
|
6,110 |
5,483 |
$12K |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
700 |
659 |
$12K |
| 87427 |
|
995 |
871 |
$12K |
| 82947 |
|
19,039 |
15,703 |
$12K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
90 |
85 |
$12K |
| 10060 |
|
154 |
147 |
$11K |
| 88173 |
|
270 |
228 |
$11K |
| 73600 |
|
229 |
195 |
$11K |
| 80164 |
|
1,164 |
1,042 |
$11K |
| 58558 |
|
26 |
24 |
$11K |
| G0379 |
Direct admission of patient for hospital observation care |
294 |
276 |
$11K |
| 85652 |
|
6,397 |
5,435 |
$11K |
| 80143 |
|
1,338 |
1,212 |
$11K |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
2,257 |
2,044 |
$10K |
| C9113 |
Injection, pantoprazole sodium, per vial |
6,446 |
3,243 |
$10K |
| 86703 |
|
911 |
797 |
$10K |
| 84295 |
|
18,779 |
15,358 |
$10K |
| J1805 |
Injection, esmolol hydrochloride, 10 mg |
1,965 |
959 |
$10K |
| 73700 |
|
90 |
84 |
$10K |
| 85014 |
|
7,752 |
6,028 |
$10K |
| 36591 |
|
352 |
166 |
$9K |
| 93225 |
|
156 |
152 |
$9K |
| 77080 |
|
139 |
139 |
$9K |
| 84156 |
|
3,198 |
2,552 |
$9K |
| 86038 |
|
887 |
851 |
$9K |
| 80179 |
|
1,176 |
1,075 |
$9K |
| P9045 |
Infusion, albumin (human), 5%, 250 ml |
281 |
238 |
$9K |
| 80047 |
|
1,218 |
1,052 |
$9K |
| A9537 |
Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries |
477 |
468 |
$9K |
| 84550 |
|
3,540 |
3,016 |
$9K |
| 77386 |
|
236 |
24 |
$9K |
| 87045 |
|
1,030 |
974 |
$8K |
| 71101 |
|
155 |
152 |
$8K |
| 82010 |
|
2,000 |
1,716 |
$8K |
| 29105 |
|
351 |
338 |
$8K |
| 36600 |
|
697 |
646 |
$8K |
| 77290 |
|
27 |
25 |
$8K |
| 77338 |
|
95 |
80 |
$8K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
3,880 |
2,104 |
$8K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
5,207 |
3,528 |
$8K |
| 77280 |
|
32 |
25 |
$7K |
| C1776 |
Joint device (implantable) |
168 |
149 |
$7K |
| 86592 |
|
2,229 |
2,017 |
$7K |
| J1790 |
Injection, droperidol, up to 5 mg |
3,277 |
2,937 |
$7K |
| D1120 |
Prophylaxis - child |
131 |
104 |
$7K |
| 82247 |
|
2,126 |
1,333 |
$7K |
| 85046 |
|
2,595 |
2,319 |
$7K |
| 84450 |
|
2,130 |
1,789 |
$7K |
| J0248 |
Injection, remdesivir, 1 mg |
43 |
19 |
$7K |
| C1729 |
Catheter, drainage |
765 |
643 |
$7K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
545 |
508 |
$7K |
| C1781 |
Mesh (implantable) |
279 |
260 |
$7K |
| 83970 |
|
220 |
200 |
$7K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
52 |
51 |
$6K |
| 74246 |
|
77 |
74 |
$6K |
| 82040 |
|
2,165 |
1,818 |
$6K |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
447 |
408 |
$6K |
| 92526 |
|
678 |
214 |
$6K |
| 82248 |
|
2,640 |
1,646 |
$6K |
| 93226 |
|
156 |
152 |
$6K |
| 97035 |
|
1,035 |
468 |
$6K |
| 95800 |
|
87 |
85 |
$6K |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
1,314 |
1,109 |
$6K |
| 84520 |
|
2,174 |
1,760 |
$5K |
| 82272 |
|
2,131 |
1,978 |
$5K |
| 74220 |
|
91 |
90 |
$5K |
| J1980 |
Injection, hyoscyamine sulfate, up to 0.25 mg |
449 |
396 |
$5K |
| 10005 |
|
53 |
51 |
$5K |
| 87420 |
|
175 |
151 |
$5K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
10,006 |
7,797 |
$5K |
| 51702 |
|
183 |
124 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
106 |
99 |
$5K |
| 73620 |
|
192 |
161 |
$5K |
| 84481 |
|
341 |
315 |
$5K |
| 84153 |
|
284 |
279 |
$5K |
| J1953 |
Injection, levetiracetam, 10 mg |
467 |
285 |
$4K |
| 27447 |
|
17 |
12 |
$4K |
| 72050 |
|
63 |
63 |
$4K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
579 |
541 |
$4K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
48 |
38 |
$4K |
| 77062 |
|
498 |
492 |
$4K |
| A9541 |
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries |
196 |
189 |
$4K |
| 85018 |
|
3,412 |
2,164 |
$4K |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
2,049 |
916 |
$4K |
| 96415 |
|
239 |
184 |
$4K |
| 76885 |
|
70 |
68 |
$4K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
647 |
625 |
$4K |
| 77012 |
|
43 |
41 |
$4K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
2,308 |
2,055 |
$4K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
27 |
27 |
$4K |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
55 |
53 |
$4K |
| 73200 |
|
25 |
25 |
$4K |
| 80055 |
|
126 |
126 |
$4K |
| 95886 |
|
44 |
39 |
$4K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
3,863 |
3,224 |
$4K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
14,207 |
12,612 |
$4K |
| 87081 |
|
814 |
545 |
$4K |
| 97166 |
|
196 |
165 |
$4K |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
1,398 |
1,235 |
$4K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
954 |
821 |
$4K |
| 36416 |
|
979 |
726 |
$3K |
| 80081 |
|
85 |
84 |
$3K |
| 80076 |
|
706 |
584 |
$3K |
| D2330 |
|
28 |
26 |
$3K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
57 |
54 |
$3K |
| J1644 |
Injection, heparin sodium, per 1000 units |
10,441 |
4,355 |
$3K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
35 |
32 |
$3K |
| 97535 |
Self-care/home management training, each 15 minutes |
1,686 |
993 |
$3K |
| 86308 |
|
1,046 |
978 |
$3K |
| 73562 |
|
29 |
25 |
$3K |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
2,913 |
2,223 |
$3K |
| 82652 |
|
105 |
100 |
$3K |
| 88302 |
|
195 |
167 |
$3K |
| 29125 |
|
136 |
129 |
$3K |
| J1453 |
Injection, fosaprepitant, 1 mg |
91 |
52 |
$3K |
| 88313 |
|
105 |
57 |
$3K |
| 80050 |
General health panel |
2,279 |
2,198 |
$3K |
| C1726 |
Catheter, balloon dilatation, non-vascular |
67 |
62 |
$3K |
| J2060 |
Injection, lorazepam, 2 mg |
4,946 |
3,799 |
$3K |
| 64450 |
|
39 |
37 |
$3K |
| 87075 |
|
373 |
348 |
$3K |
| 82784 |
|
218 |
198 |
$3K |
| 92610 |
|
610 |
537 |
$3K |
| 84100 |
|
3,826 |
2,041 |
$3K |
| J2800 |
Injection, methocarbamol, up to 10 ml |
589 |
517 |
$2K |
| 95911 |
|
13 |
13 |
$2K |
| 72070 |
|
27 |
26 |
$2K |
| J0456 |
Injection, azithromycin, 500 mg |
945 |
588 |
$2K |
| A9578 |
Injection, gadobenate dimeglumine (multihance multipack), per ml |
497 |
460 |
$2K |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
1,126 |
390 |
$2K |
| 85384 |
|
589 |
340 |
$2K |
| H0031 |
Mental health assessment, by non-physician |
28 |
26 |
$2K |
| J7510 |
Prednisolone oral, per 5 mg |
2,179 |
1,813 |
$2K |
| 82950 |
|
623 |
574 |
$2K |
| J0885 |
Injection, epoetin alfa, (for non-esrd use), 1000 units |
60 |
25 |
$2K |
| J1817 |
Insulin for administration through dme (i.e., insulin pump) per 50 units |
383 |
311 |
$2K |
| L4386 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
28 |
26 |
$2K |
| 43249 |
|
12 |
12 |
$2K |
| 93978 |
|
37 |
37 |
$2K |
| 78492 |
|
155 |
148 |
$2K |
| 87493 |
|
290 |
263 |
$2K |
| 87210 |
|
767 |
731 |
$2K |
| C1758 |
Catheter, ureteral |
271 |
241 |
$2K |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
636 |
541 |
$2K |
| 97016 |
|
368 |
152 |
$2K |
| A9540 |
Technetium tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries |
29 |
29 |
$2K |
| D1206 |
Topical application of fluoride varnish |
51 |
42 |
$2K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
13 |
13 |
$2K |
| M0222 |
Intravenous injection, bebtelovimab, includes injection and post administration monitoring |
15 |
15 |
$2K |
| J0595 |
Injection, butorphanol tartrate, 1 mg |
598 |
450 |
$2K |
| L0150 |
Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece) |
13 |
13 |
$2K |
| 80177 |
|
162 |
155 |
$2K |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
1,491 |
1,245 |
$2K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
97 |
49 |
$2K |
| 83525 |
|
131 |
127 |
$1K |
| 93975 |
|
13 |
13 |
$1K |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
923 |
784 |
$1K |
| J1630 |
Injection, haloperidol, up to 5 mg |
3,740 |
3,049 |
$1K |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
17 |
17 |
$1K |
| 75710 |
|
14 |
14 |
$1K |
| J0736 |
Injection, clindamycin phosphate, 300 mg |
255 |
217 |
$1K |
| J0744 |
Injection, ciprofloxacin for intravenous infusion, 200 mg |
702 |
489 |
$1K |
| J1643 |
Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units |
157 |
141 |
$1K |
| 83930 |
|
412 |
377 |
$1K |
| 87899 |
|
147 |
84 |
$1K |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
2,027 |
1,526 |
$1K |
| 89051 |
|
634 |
527 |
$1K |
| J3411 |
Injection, thiamine hcl, 100 mg |
453 |
282 |
$1K |
| 73660 |
|
12 |
12 |
$1K |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
347 |
234 |
$1K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
27 |
24 |
$1K |
| 93926 |
|
12 |
12 |
$1K |
| C1760 |
Closure device, vascular (implantable/insertable) |
443 |
409 |
$1K |
| 84146 |
|
70 |
68 |
$987.72 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
142 |
128 |
$962.76 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
296 |
245 |
$945.72 |
| 77387 |
|
59 |
13 |
$889.10 |
| J0694 |
Injection, cefoxitin sodium, 1 gm |
96 |
89 |
$870.50 |
| 86706 |
|
323 |
286 |
$866.46 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
1,860 |
1,047 |
$846.63 |
| APT04 |
|
96 |
92 |
$836.94 |
| J1940 |
Injection, furosemide, up to 20 mg |
3,348 |
1,835 |
$797.43 |
| 85055 |
|
46 |
24 |
$792.93 |
| APT18 |
|
60 |
56 |
$788.40 |
| 87177 |
|
99 |
93 |
$761.62 |
| APT09 |
|
74 |
62 |
$738.42 |
| 80320 |
|
306 |
296 |
$724.17 |
| 87102 |
|
103 |
97 |
$712.88 |
| 86431 |
|
146 |
139 |
$698.36 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
14 |
$628.65 |
| 77332 |
|
15 |
14 |
$605.47 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
292 |
155 |
$603.81 |
| 83516 |
|
67 |
52 |
$600.37 |
| 71271 |
|
30 |
29 |
$583.74 |
| C9145 |
Injection, aprepitant, (aponvie), 1 mg |
32 |
30 |
$577.56 |
| 78434 |
|
845 |
782 |
$571.54 |
| 94667 |
|
12 |
12 |
$567.83 |
| 87641 |
|
58 |
56 |
$564.96 |
| 87220 |
|
161 |
154 |
$558.41 |
| 94660 |
|
18 |
13 |
$553.35 |
| 77061 |
|
122 |
119 |
$545.41 |
| J7999 |
Compounded drug, not otherwise classified |
1,158 |
929 |
$510.27 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
13 |
13 |
$509.30 |
| 85347 |
|
352 |
315 |
$479.71 |
| 88172 |
|
43 |
38 |
$475.16 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
246 |
147 |
$473.92 |
| Q4081 |
Injection, epoetin alfa, 100 units (for esrd on dialysis) |
78 |
39 |
$439.80 |
| J1836 |
Injection, metronidazole, 10 mg |
212 |
157 |
$430.09 |
| 97012 |
|
33 |
13 |
$426.60 |
| J2720 |
Injection, protamine sulfate, per 10 mg |
428 |
384 |
$421.13 |
| 82274 |
|
45 |
39 |
$411.99 |
| 87338 |
|
32 |
31 |
$410.86 |
| S0028 |
Injection, famotidine, 20 mg |
331 |
298 |
$375.25 |
| 97163 |
|
26 |
15 |
$353.51 |
| 83655 |
|
43 |
42 |
$344.21 |
| APT11 |
|
25 |
25 |
$315.12 |
| 74230 |
|
18 |
12 |
$308.46 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
393 |
220 |
$307.58 |
| J3105 |
Injection, terbutaline sulfate, up to 1 mg |
129 |
109 |
$305.34 |
| 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 |
1,714 |
1,400 |
$278.26 |
| 81015 |
|
135 |
131 |
$276.38 |
| 29515 |
|
12 |
12 |
$272.78 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
2,265 |
1,389 |
$267.36 |
| 85007 |
|
82 |
79 |
$246.25 |
| J3486 |
Injection, ziprasidone mesylate, 10 mg |
21 |
13 |
$244.74 |
| 84403 |
|
12 |
12 |
$241.28 |
| 87116 |
|
25 |
24 |
$238.44 |
| 82150 |
|
46 |
40 |
$236.32 |
| S0077 |
Injection, clindamycin phosphate, 300 mg |
19 |
14 |
$233.10 |
| 83001 |
|
13 |
13 |
$225.54 |
| 86780 |
|
572 |
499 |
$216.57 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
480 |
418 |
$215.08 |
| 80202 |
|
38 |
15 |
$213.47 |
| 51798 |
|
18 |
13 |
$207.84 |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
12 |
12 |
$203.15 |
| 87015 |
|
72 |
65 |
$199.62 |
| 87449 |
|
48 |
37 |
$191.12 |
| 85045 |
|
65 |
54 |
$180.12 |
| J0280 |
Injection, aminophyllin, up to 250 mg |
73 |
67 |
$174.79 |
| C1751 |
Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) |
35 |
25 |
$172.88 |
| J7070 |
Infusion, d5w, 1000 cc |
103 |
42 |
$161.43 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
117 |
116 |
$154.84 |
| C1788 |
Port, indwelling (implantable) |
13 |
12 |
$151.53 |
| 97803 |
|
13 |
12 |
$147.24 |
| 84376 |
|
28 |
27 |
$141.66 |
| APT06 |
|
13 |
12 |
$139.74 |
| 84480 |
|
13 |
12 |
$135.68 |
| 90686 |
|
13 |
12 |
$127.74 |
| 82805 |
|
16 |
13 |
$126.47 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
80 |
32 |
$126.27 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,068 |
936 |
$124.41 |
| 82043 |
|
25 |
25 |
$123.26 |
| 83986 |
|
40 |
38 |
$118.33 |
| APT02 |
|
16 |
15 |
$113.60 |
| J3360 |
Injection, diazepam, up to 5 mg |
66 |
58 |
$111.53 |
| 86039 |
|
12 |
12 |
$103.71 |
| P9612 |
Catheterization for collection of specimen, single patient, all places of service |
1,604 |
1,475 |
$102.08 |
| 82533 |
|
15 |
13 |
$95.46 |
| 87324 |
|
34 |
25 |
$94.63 |
| Q5106 |
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units |
21 |
12 |
$90.18 |
| 84157 |
|
17 |
14 |
$86.98 |
| 87181 |
|
30 |
28 |
$73.64 |
| 85390 |
|
30 |
24 |
$59.06 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
279 |
158 |
$51.46 |
| 85576 |
|
15 |
13 |
$49.82 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
14 |
12 |
$49.59 |
| 84300 |
|
74 |
51 |
$49.44 |
| 84478 |
|
67 |
44 |
$35.52 |
| A9270 |
Non-covered item or service |
53,704 |
8,615 |
$22.38 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
18 |
12 |
$12.89 |
| Q0169 |
Promethazine hydrochloride, 12.5 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 |
202 |
145 |
$10.03 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
17 |
12 |
$8.44 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
14 |
13 |
$0.94 |
| J1956 |
Injection, levofloxacin, 250 mg |
16 |
12 |
$0.00 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
140 |
131 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
4,633 |
3,559 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
124 |
119 |
$0.00 |
| J0692 |
Injection, cefepime hydrochloride, 500 mg |
38 |
12 |
$0.00 |
| G8985 |
Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
12 |
12 |
$0.00 |
| Q0177 |
Hydroxyzine pamoate, 25 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 |
133 |
99 |
$0.00 |
| C1874 |
Stent, coated/covered, with delivery system |
30 |
24 |
$0.00 |
| 93798 |
|
208 |
30 |
$0.00 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
61 |
38 |
$0.00 |
| 90935 |
Hemodialysis procedure with single evaluation by a physician |
598 |
266 |
$0.00 |