| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
42,289 |
36,146 |
$7.74M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
28,788 |
27,294 |
$4.69M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
16,980 |
16,097 |
$4.03M |
| 0450 |
Emergency room services |
107,714 |
91,919 |
$3.89M |
| 0121 |
|
258 |
232 |
$3.25M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
9,084 |
8,932 |
$2.21M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
3,965 |
3,721 |
$1.95M |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
21,221 |
19,729 |
$1.67M |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
15,231 |
14,821 |
$1.34M |
| 70450 |
Computed tomography, head or brain; without contrast material |
12,240 |
11,809 |
$1.10M |
| G0378 |
Hospital observation service, per hour |
3,232 |
2,523 |
$1.03M |
| 71046 |
Radiologic examination, chest; 2 views |
26,485 |
25,641 |
$939K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
17,807 |
16,165 |
$677K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
41,430 |
37,367 |
$642K |
| 99199 |
Unlisted special service, procedure or report |
11,250 |
9,441 |
$587K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
3,465 |
3,434 |
$524K |
| 71045 |
Radiologic examination, chest; single view |
17,049 |
16,037 |
$483K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,328 |
3,296 |
$441K |
| 0270 |
|
10,277 |
8,426 |
$438K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
2,210 |
2,193 |
$437K |
| 0200 |
|
45 |
43 |
$437K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
92,297 |
78,312 |
$426K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
5,346 |
5,247 |
$407K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
13,319 |
12,715 |
$394K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
2,145 |
2,135 |
$372K |
| 73630 |
|
7,566 |
6,490 |
$350K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
12,864 |
11,698 |
$344K |
| 76830 |
Ultrasound, transvaginal |
3,524 |
3,485 |
$340K |
| 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 |
5,564 |
5,482 |
$332K |
| 36415 |
Collection of venous blood by venipuncture |
115,795 |
98,782 |
$326K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
14,031 |
12,901 |
$301K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
903 |
893 |
$300K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
14,032 |
12,902 |
$298K |
| 80051 |
|
54,405 |
49,088 |
$298K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
9,006 |
8,430 |
$293K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
3,173 |
3,147 |
$285K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,679 |
6,090 |
$282K |
| 73564 |
|
3,418 |
2,419 |
$277K |
| J3490 |
Unclassified drugs |
39,217 |
22,239 |
$267K |
| 73610 |
|
5,787 |
5,304 |
$260K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
5,758 |
5,411 |
$252K |
| 70486 |
|
1,922 |
1,913 |
$238K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
10,233 |
9,549 |
$236K |
| 73130 |
|
5,656 |
4,776 |
$235K |
| 73030 |
|
5,082 |
4,577 |
$224K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
170 |
167 |
$222K |
| 83880 |
|
11,026 |
10,132 |
$217K |
| 72141 |
|
1,094 |
1,087 |
$213K |
| 82565 |
|
77,966 |
69,600 |
$209K |
| 73560 |
|
5,925 |
5,185 |
$205K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
799 |
748 |
$198K |
| 93971 |
|
1,821 |
1,798 |
$198K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
10,663 |
10,053 |
$189K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,481 |
1,467 |
$185K |
| 72100 |
|
3,066 |
3,041 |
$181K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
382 |
381 |
$181K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
789 |
787 |
$172K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
6,339 |
6,270 |
$171K |
| 73110 |
|
3,924 |
3,494 |
$159K |
| 84484 |
|
20,448 |
18,205 |
$149K |
| 84460 |
|
54,909 |
48,918 |
$148K |
| 99070 |
|
8,754 |
4,367 |
$144K |
| 83690 |
|
32,805 |
30,224 |
$139K |
| 82947 |
|
62,221 |
55,724 |
$138K |
| 82247 |
|
44,480 |
38,425 |
$128K |
| 86900 |
|
5,473 |
5,135 |
$124K |
| 84450 |
|
43,594 |
38,899 |
$124K |
| 70491 |
|
840 |
833 |
$124K |
| 84520 |
|
54,719 |
49,256 |
$119K |
| 73502 |
|
2,388 |
2,299 |
$112K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,905 |
2,838 |
$111K |
| 84075 |
|
37,257 |
33,899 |
$105K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,523 |
1,466 |
$105K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
16,968 |
15,736 |
$102K |
| J2560 |
Injection, phenobarbital sodium, up to 120 mg |
762 |
611 |
$102K |
| 73140 |
|
2,723 |
2,580 |
$101K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,941 |
2,937 |
$100K |
| 74018 |
|
1,877 |
1,760 |
$99K |
| 86923 |
|
537 |
488 |
$98K |
| 73080 |
|
2,362 |
2,153 |
$98K |
| 93976 |
|
367 |
364 |
$95K |
| 71250 |
|
927 |
926 |
$90K |
| 84702 |
|
9,540 |
7,972 |
$89K |
| 83735 |
|
23,005 |
19,921 |
$89K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
7,429 |
7,354 |
$86K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
20,939 |
18,513 |
$86K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
9,398 |
9,224 |
$85K |
| 84443 |
Thyroid stimulating hormone (TSH) |
14,844 |
14,555 |
$84K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
999 |
930 |
$83K |
| 80306 |
|
7,217 |
6,762 |
$82K |
| 81001 |
|
39,060 |
36,819 |
$80K |
| 72040 |
|
1,574 |
1,558 |
$77K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
19,909 |
18,176 |
$76K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
121 |
120 |
$76K |
| 93308 |
|
408 |
402 |
$76K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
19,164 |
16,268 |
$75K |
| 59025 |
Fetal non-stress test |
1,167 |
977 |
$72K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,539 |
1,521 |
$69K |
| 87631 |
|
1,482 |
1,458 |
$68K |
| 73590 |
|
2,014 |
1,805 |
$67K |
| 83605 |
|
8,339 |
7,755 |
$64K |
| 86850 |
|
4,524 |
4,279 |
$64K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
1,368 |
1,343 |
$62K |
| 87506 |
|
502 |
499 |
$61K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
16,357 |
14,521 |
$58K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
69 |
69 |
$57K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
19,768 |
19,636 |
$56K |
| 70496 |
|
244 |
243 |
$56K |
| 87088 |
|
13,930 |
13,445 |
$55K |
| 73562 |
|
1,517 |
1,178 |
$54K |
| 87040 |
|
4,963 |
4,728 |
$53K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
47 |
46 |
$52K |
| 80061 |
Lipid panel |
10,140 |
10,073 |
$50K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,530 |
1,457 |
$47K |
| 86780 |
|
7,487 |
7,407 |
$46K |
| Z7502 |
|
2,383 |
2,211 |
$46K |
| 76857 |
|
433 |
429 |
$46K |
| 82077 |
|
4,813 |
4,387 |
$45K |
| 73090 |
|
1,415 |
1,254 |
$44K |
| 73660 |
|
848 |
812 |
$43K |
| 86901 |
|
5,480 |
5,141 |
$43K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
7,329 |
6,395 |
$42K |
| 36430 |
|
994 |
728 |
$40K |
| 77080 |
|
622 |
622 |
$39K |
| 84100 |
|
14,476 |
13,033 |
$39K |
| 82330 |
|
3,789 |
3,714 |
$39K |
| 70498 |
|
177 |
176 |
$38K |
| 73620 |
|
1,123 |
977 |
$38K |
| 99218 |
|
58 |
37 |
$37K |
| 82962 |
|
14,650 |
12,569 |
$36K |
| 82728 |
|
7,137 |
7,057 |
$36K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
6,626 |
6,252 |
$36K |
| 81003 |
|
25,060 |
24,079 |
$36K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
6,131 |
4,692 |
$33K |
| 84132 |
|
17,139 |
15,762 |
$32K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,728 |
2,715 |
$32K |
| 85027 |
|
13,894 |
13,541 |
$32K |
| 72070 |
|
476 |
468 |
$31K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
5,663 |
5,295 |
$31K |
| 85652 |
|
15,755 |
15,136 |
$31K |
| 86803 |
|
5,176 |
5,141 |
$30K |
| 90715 |
|
802 |
794 |
$29K |
| 85610 |
|
14,906 |
12,187 |
$29K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
266 |
265 |
$29K |
| 0250 |
|
30,568 |
17,496 |
$28K |
| 0710 |
|
3,426 |
3,404 |
$26K |
| 0762 |
|
493 |
340 |
$26K |
| 80179 |
|
2,606 |
2,436 |
$25K |
| 76770 |
|
249 |
249 |
$25K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
454 |
451 |
$24K |
| 76536 |
|
195 |
195 |
$24K |
| 73600 |
|
966 |
894 |
$24K |
| 84295 |
|
8,990 |
8,111 |
$20K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
742 |
565 |
$19K |
| 73060 |
|
422 |
378 |
$18K |
| 82248 |
|
5,735 |
4,543 |
$18K |
| 73522 |
|
209 |
208 |
$18K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
5,171 |
4,689 |
$18K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
2,803 |
2,556 |
$18K |
| 86235 |
|
217 |
215 |
$17K |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
3,759 |
3,619 |
$17K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
278 |
277 |
$17K |
| 72131 |
|
129 |
127 |
$16K |
| 85379 |
|
2,830 |
2,779 |
$16K |
| 10060 |
|
1,169 |
1,136 |
$16K |
| 87210 |
|
4,120 |
4,047 |
$16K |
| 72170 |
|
252 |
250 |
$15K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,587 |
4,045 |
$15K |
| 87340 |
|
3,989 |
3,951 |
$14K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
2,040 |
1,943 |
$14K |
| 88342 |
|
138 |
138 |
$14K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
745 |
736 |
$13K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
13 |
12 |
$13K |
| J1815 |
Injection, insulin, per 5 units |
2,850 |
1,614 |
$13K |
| 82310 |
|
5,516 |
4,504 |
$13K |
| 86140 |
|
5,978 |
5,739 |
$13K |
| J2060 |
Injection, lorazepam, 2 mg |
3,067 |
2,683 |
$13K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
14 |
13 |
$13K |
| 73221 |
|
58 |
57 |
$12K |
| 82607 |
|
2,581 |
2,575 |
$12K |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
1,471 |
1,389 |
$12K |
| 73120 |
|
418 |
363 |
$12K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
67 |
67 |
$11K |
| 0637 |
|
61,087 |
26,202 |
$11K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,157 |
1,983 |
$11K |
| 73552 |
|
237 |
217 |
$10K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
68 |
62 |
$10K |
| 72146 |
|
64 |
64 |
$10K |
| 86480 |
|
362 |
361 |
$10K |
| 12011 |
|
511 |
506 |
$10K |
| 85378 |
|
1,961 |
1,906 |
$10K |
| 84703 |
|
2,316 |
2,275 |
$10K |
| 85014 |
|
6,728 |
6,449 |
$9K |
| 12001 |
|
1,024 |
1,022 |
$9K |
| 82570 |
|
3,497 |
3,286 |
$9K |
| 76882 |
|
133 |
126 |
$9K |
| 83550 |
|
3,034 |
3,001 |
$8K |
| 71101 |
|
125 |
125 |
$8K |
| J1940 |
Injection, furosemide, up to 20 mg |
1,592 |
1,208 |
$8K |
| 73020 |
|
299 |
278 |
$8K |
| 82040 |
|
4,190 |
3,647 |
$8K |
| 84439 |
|
2,596 |
2,425 |
$8K |
| 76801 |
|
94 |
90 |
$8K |
| 80047 |
|
1,240 |
1,204 |
$8K |
| 86704 |
|
1,317 |
1,299 |
$8K |
| 86706 |
|
1,764 |
1,754 |
$7K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
701 |
694 |
$7K |
| 84153 |
|
987 |
973 |
$7K |
| J1953 |
Injection, levetiracetam, 10 mg |
320 |
282 |
$7K |
| 73700 |
|
35 |
32 |
$7K |
| 82550 |
|
1,733 |
1,639 |
$7K |
| 83970 |
|
201 |
199 |
$6K |
| 76870 |
|
64 |
62 |
$6K |
| 85730 |
|
1,605 |
1,516 |
$6K |
| J1630 |
Injection, haloperidol, up to 5 mg |
1,490 |
1,273 |
$6K |
| 82043 |
|
3,759 |
3,721 |
$6K |
| 83540 |
|
3,041 |
3,008 |
$6K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
61 |
61 |
$5K |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
277 |
240 |
$5K |
| 87070 |
|
995 |
958 |
$5K |
| 87449 |
|
603 |
596 |
$5K |
| 72197 |
|
12 |
12 |
$5K |
| 83655 |
|
1,018 |
1,008 |
$5K |
| 87324 |
|
579 |
572 |
$5K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,754 |
3,537 |
$5K |
| 83516 |
|
358 |
356 |
$5K |
| 73100 |
|
329 |
299 |
$5K |
| 70360 |
|
71 |
71 |
$5K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
233 |
232 |
$4K |
| 80069 |
|
682 |
604 |
$4K |
| 82803 |
|
421 |
407 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
893 |
876 |
$4K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
569 |
540 |
$4K |
| 84156 |
|
2,687 |
2,494 |
$4K |
| 96376 |
|
3,627 |
3,188 |
$4K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,928 |
2,741 |
$4K |
| 88313 |
|
44 |
42 |
$4K |
| 83615 |
|
1,103 |
1,008 |
$4K |
| 84403 |
|
182 |
181 |
$4K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
1,046 |
1,017 |
$4K |
| 88307 |
|
160 |
160 |
$4K |
| 86762 |
|
428 |
427 |
$3K |
| 0272 |
|
322 |
322 |
$3K |
| 70460 |
|
37 |
37 |
$3K |
| 87209 |
|
284 |
282 |
$3K |
| 86225 |
|
341 |
337 |
$3K |
| 84550 |
|
1,404 |
1,360 |
$3K |
| 0370 |
|
2,910 |
2,897 |
$3K |
| 29125 |
|
663 |
652 |
$2K |
| 96367 |
|
131 |
129 |
$2K |
| C1769 |
Guide wire |
274 |
263 |
$2K |
| 85045 |
|
972 |
718 |
$2K |
| 76775 |
|
31 |
31 |
$2K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
17 |
17 |
$2K |
| 76000 |
|
195 |
194 |
$2K |
| 12002 |
|
211 |
211 |
$2K |
| 80349 |
|
2,266 |
2,151 |
$2K |
| 87329 |
|
272 |
270 |
$2K |
| 84146 |
|
159 |
157 |
$2K |
| 86665 |
|
69 |
68 |
$2K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
96 |
64 |
$2K |
| 85018 |
|
1,538 |
1,452 |
$2K |
| 86038 |
|
216 |
215 |
$1K |
| 70543 |
|
12 |
12 |
$1K |
| 81025 |
|
830 |
810 |
$1K |
| J1644 |
Injection, heparin sodium, per 1000 units |
288 |
164 |
$1K |
| 83721 |
|
1,072 |
1,068 |
$1K |
| 87338 |
|
273 |
272 |
$1K |
| 90686 |
|
81 |
81 |
$1K |
| 88304 |
|
362 |
357 |
$1K |
| 82746 |
|
159 |
159 |
$1K |
| 87205 |
|
532 |
500 |
$1K |
| J2785 |
Injection, regadenoson, 0.1 mg |
13 |
13 |
$1K |
| 82985 |
|
121 |
120 |
$1K |
| 86160 |
|
33 |
28 |
$1K |
| 83001 |
|
58 |
58 |
$1K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
260 |
242 |
$995.88 |
| 74170 |
|
12 |
12 |
$943.00 |
| 87536 |
|
25 |
25 |
$915.18 |
| 72082 |
|
12 |
12 |
$912.46 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
90 |
80 |
$888.02 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
459 |
436 |
$848.80 |
| 0636 |
|
406 |
375 |
$841.78 |
| 82105 |
|
82 |
80 |
$778.00 |
| 86664 |
|
69 |
68 |
$768.91 |
| 0300 |
|
110 |
102 |
$768.43 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
39 |
39 |
$735.90 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
139 |
110 |
$735.09 |
| 84165 |
|
120 |
117 |
$725.55 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
165 |
126 |
$693.70 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
113 |
112 |
$680.20 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
69 |
44 |
$675.02 |
| 87529 |
|
29 |
29 |
$657.29 |
| 82140 |
|
93 |
87 |
$611.90 |
| 73000 |
|
40 |
36 |
$589.92 |
| 72220 |
|
13 |
13 |
$584.29 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
29 |
12 |
$548.79 |
| 86593 |
|
185 |
180 |
$545.17 |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
13 |
13 |
$532.26 |
| 85007 |
|
858 |
652 |
$520.35 |
| 82150 |
|
106 |
98 |
$513.38 |
| 89051 |
|
110 |
95 |
$474.97 |
| 0301 |
|
1,063 |
709 |
$469.63 |
| 29515 |
|
145 |
142 |
$460.83 |
| 80197 |
|
46 |
37 |
$422.63 |
| 99221 |
|
13 |
13 |
$409.29 |
| 87517 |
|
14 |
14 |
$402.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
1,242 |
1,204 |
$401.56 |
| 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 |
146 |
141 |
$381.16 |
| 87081 |
|
126 |
122 |
$362.19 |
| 82950 |
|
238 |
222 |
$359.71 |
| 97161 |
|
132 |
129 |
$332.47 |
| Z7610 |
|
264 |
126 |
$294.78 |
| S0164 |
Injection, pantoprazole sodium, 40 mg |
30 |
28 |
$294.51 |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
34 |
34 |
$287.89 |
| 85008 |
|
1,090 |
971 |
$287.36 |
| 84155 |
|
122 |
117 |
$261.69 |
| 83993 |
|
14 |
14 |
$234.00 |
| 82374 |
|
87 |
48 |
$232.72 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
24 |
23 |
$212.92 |
| 80325 |
|
1,086 |
1,030 |
$177.53 |
| 73070 |
|
15 |
13 |
$172.82 |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
35 |
28 |
$167.66 |
| 80164 |
|
25 |
24 |
$162.24 |
| 82945 |
|
56 |
48 |
$159.83 |
| 82784 |
|
26 |
25 |
$159.00 |
| 84157 |
|
57 |
49 |
$158.77 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
2,231 |
2,015 |
$157.96 |
| 74022 |
|
13 |
12 |
$152.80 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
156 |
132 |
$144.60 |
| 59899 |
|
18 |
15 |
$140.50 |
| 90749 |
|
753 |
752 |
$129.05 |
| J3480 |
Injection, potassium chloride, per 2 meq |
52 |
40 |
$109.35 |
| 82977 |
|
12 |
12 |
$106.00 |
| 73501 |
|
32 |
28 |
$99.41 |
| 96368 |
|
12 |
12 |
$91.12 |
| 29130 |
|
17 |
16 |
$72.00 |
| 80346 |
|
321 |
296 |
$66.00 |
| 83718 |
|
249 |
249 |
$54.34 |
| 82435 |
|
37 |
34 |
$53.01 |
| 86677 |
|
14 |
14 |
$51.80 |
| 86431 |
|
12 |
12 |
$42.00 |
| 86787 |
|
40 |
40 |
$37.38 |
| 83930 |
|
12 |
12 |
$35.76 |
| J1836 |
Injection, metronidazole, 10 mg |
13 |
12 |
$34.76 |
| 0258 |
|
820 |
715 |
$33.93 |
| 82465 |
|
276 |
276 |
$27.42 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
75 |
59 |
$15.68 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
14 |
12 |
$12.39 |
| 0306 |
|
213 |
200 |
$6.97 |
| 0305 |
|
274 |
255 |
$6.76 |
| 0307 |
|
139 |
135 |
$2.76 |
| 0730 |
|
200 |
186 |
$0.00 |
| 76376 |
|
335 |
335 |
$0.00 |
| 0320 |
|
213 |
199 |
$0.00 |
| 80361 |
|
106 |
105 |
$0.00 |
| 80356 |
|
28 |
27 |
$0.00 |
| 80365 |
|
26 |
25 |
$0.00 |
| 0302 |
|
27 |
27 |
$0.00 |
| J7510 |
Prednisolone oral, per 5 mg |
15 |
15 |
$0.00 |
| 82272 |
|
12 |
12 |
$0.00 |
| 0351 |
|
13 |
13 |
$0.00 |
| 3046F |
|
14 |
14 |
$0.00 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
13 |
13 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
26 |
24 |
$0.00 |
| 0424 |
|
49 |
44 |
$0.00 |
| 3051F |
|
20 |
20 |
$0.00 |
| 80324 |
|
387 |
357 |
$0.00 |
| 80329 |
|
570 |
517 |
$0.00 |
| 0410 |
|
99 |
92 |
$0.00 |
| 80353 |
|
103 |
98 |
$0.00 |
| 80320 |
|
1,058 |
942 |
$0.00 |
| 0255 |
|
69 |
69 |
$0.00 |
| J3411 |
Injection, thiamine hcl, 100 mg |
29 |
25 |
$0.00 |
| 97162 |
|
35 |
35 |
$0.00 |
| 0420 |
|
13 |
12 |
$0.00 |
| 0324 |
|
12 |
12 |
$0.00 |
| 3044F |
|
116 |
116 |
$0.00 |