| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
140,499 |
128,177 |
$51.57M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
111,873 |
101,457 |
$45.47M |
| 0450 |
Emergency room services |
80,939 |
72,062 |
$18.13M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
4,227 |
3,970 |
$5.70M |
| 0762 |
|
5,782 |
2,658 |
$5.65M |
| J9271 |
Injection, pembrolizumab, 1 mg |
257 |
188 |
$3.45M |
| 45384 |
|
2,404 |
2,258 |
$2.81M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
5,665 |
5,394 |
$2.44M |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
1,404 |
1,315 |
$1.73M |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
1,452 |
1,367 |
$1.60M |
| Z7502 |
|
37,464 |
36,791 |
$1.35M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
16,230 |
9,151 |
$1.22M |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
648 |
619 |
$1.19M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
25,897 |
20,774 |
$1.13M |
| G0378 |
Hospital observation service, per hour |
1,143 |
967 |
$931K |
| 96367 |
|
12,719 |
5,127 |
$882K |
| 70450 |
Computed tomography, head or brain; without contrast material |
11,713 |
11,356 |
$826K |
| J1453 |
Injection, fosaprepitant, 1 mg |
3,806 |
1,721 |
$794K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
52,504 |
43,622 |
$794K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
22,010 |
18,411 |
$754K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
6,127 |
5,972 |
$717K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
61,020 |
55,840 |
$685K |
| 93458 |
|
355 |
341 |
$657K |
| Z9725 |
|
14,896 |
14,842 |
$641K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
11,260 |
5,018 |
$599K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
133,876 |
120,022 |
$561K |
| 0360 |
|
2,049 |
1,956 |
$533K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
1,286 |
1,005 |
$522K |
| 43450 |
|
506 |
435 |
$509K |
| 0270 |
|
25,660 |
15,055 |
$459K |
| 97802 |
|
3,546 |
3,482 |
$438K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
3,801 |
3,753 |
$429K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
16,726 |
11,669 |
$425K |
| J0185 |
Injection, aprepitant, 1 mg |
1,182 |
586 |
$404K |
| 71046 |
Radiologic examination, chest; 2 views |
34,213 |
33,205 |
$383K |
| 43249 |
|
312 |
311 |
$382K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
8,231 |
3,623 |
$376K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,657 |
1,612 |
$362K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
16,618 |
12,293 |
$360K |
| J3490 |
Unclassified drugs |
50,265 |
28,212 |
$350K |
| 80053 |
Comprehensive metabolic panel |
59,607 |
55,489 |
$343K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
72,594 |
66,279 |
$336K |
| J1750 |
Injection, iron dextran, 50 mg |
3,207 |
1,127 |
$318K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
7,891 |
7,830 |
$317K |
| 86803 |
|
38,721 |
38,618 |
$282K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,471 |
3,407 |
$272K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,228 |
6,008 |
$271K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
5,636 |
4,907 |
$256K |
| 96368 |
|
9,806 |
3,236 |
$248K |
| J1644 |
Injection, heparin sodium, per 1000 units |
26,565 |
12,149 |
$235K |
| 84484 |
|
46,201 |
40,044 |
$227K |
| 59025 |
Fetal non-stress test |
10,509 |
8,201 |
$215K |
| 0760 |
|
5,072 |
3,622 |
$209K |
| G0500 |
Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) |
7,589 |
6,829 |
$192K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
784 |
651 |
$186K |
| 47562 |
|
75 |
75 |
$182K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
27,650 |
20,415 |
$173K |
| 96415 |
|
4,018 |
1,811 |
$172K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
5,245 |
5,109 |
$172K |
| 86703 |
|
27,831 |
27,741 |
$162K |
| 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 |
3,017 |
2,840 |
$159K |
| 97803 |
|
2,428 |
2,373 |
$156K |
| 83690 |
|
40,824 |
38,606 |
$155K |
| J7050 |
Infusion, normal saline solution, 250 cc |
20,372 |
10,024 |
$151K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
12,467 |
10,128 |
$148K |
| 99070 |
|
216,947 |
112,411 |
$146K |
| 96417 |
|
3,455 |
1,673 |
$145K |
| 81001 |
|
65,354 |
62,386 |
$144K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,676 |
1,645 |
$140K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
24,232 |
18,568 |
$136K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
22,895 |
13,826 |
$134K |
| J1756 |
Injection, iron sucrose, 1 mg |
1,705 |
650 |
$129K |
| 71045 |
Radiologic examination, chest; single view |
20,780 |
19,665 |
$128K |
| 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 |
4,548 |
4,483 |
$127K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
3,879 |
3,799 |
$114K |
| J9217 |
Leuprolide acetate (for depot suspension), 7.5 mg |
417 |
395 |
$109K |
| 80076 |
|
27,343 |
26,370 |
$106K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
8,801 |
8,361 |
$105K |
| 87040 |
|
9,792 |
8,602 |
$102K |
| 86592 |
|
49,397 |
46,806 |
$102K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
25,716 |
24,706 |
$101K |
| 96523 |
|
4,190 |
3,547 |
$101K |
| 0160 |
|
598 |
209 |
$100K |
| 83880 |
|
6,764 |
6,100 |
$99K |
| 87507 |
|
796 |
787 |
$99K |
| 84703 |
|
15,200 |
14,492 |
$98K |
| 99153 |
Mod sedat endo service >5yrs |
7,710 |
7,023 |
$97K |
| 0710 |
|
2,644 |
2,496 |
$96K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
8,394 |
7,219 |
$94K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,971 |
978 |
$87K |
| Z7610 |
|
16,783 |
10,356 |
$87K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
883 |
843 |
$81K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,963 |
1,933 |
$81K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
21,807 |
20,575 |
$78K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,022 |
1,012 |
$73K |
| 84145 |
|
7,780 |
7,264 |
$72K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
15,655 |
11,921 |
$69K |
| 0761 |
|
1,208 |
965 |
$69K |
| 93971 |
|
1,326 |
1,301 |
$68K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
108 |
70 |
$68K |
| 99152 |
|
1,267 |
1,200 |
$67K |
| 82962 |
|
17,867 |
12,053 |
$67K |
| 83605 |
|
8,934 |
8,125 |
$64K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
10,074 |
6,996 |
$62K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,738 |
1,717 |
$62K |
| 84702 |
|
5,257 |
4,420 |
$59K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
748 |
741 |
$58K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
885 |
867 |
$58K |
| 95700 |
|
273 |
272 |
$56K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
10,078 |
7,425 |
$54K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
781 |
367 |
$53K |
| 16020 |
|
438 |
313 |
$51K |
| 85730 |
|
10,450 |
9,973 |
$51K |
| 0250 |
|
4,960 |
2,065 |
$51K |
| 81025 |
|
15,374 |
14,899 |
$50K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
10,657 |
9,135 |
$50K |
| 76801 |
|
2,002 |
1,878 |
$48K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
4,099 |
4,006 |
$48K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
4,088 |
3,996 |
$48K |
| 72100 |
|
2,775 |
2,746 |
$47K |
| 0750 |
|
6,417 |
5,866 |
$46K |
| A9270 |
Non-covered item or service |
2,845 |
1,115 |
$45K |
| 87631 |
|
1,568 |
1,501 |
$45K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
263 |
257 |
$44K |
| J2785 |
Injection, regadenoson, 0.1 mg |
899 |
880 |
$44K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
10,851 |
9,756 |
$43K |
| 73130 |
|
1,955 |
1,936 |
$41K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,214 |
1,191 |
$41K |
| 74018 |
|
4,678 |
4,552 |
$41K |
| 73562 |
|
2,893 |
2,836 |
$41K |
| 73610 |
|
2,469 |
2,441 |
$39K |
| 73630 |
|
2,566 |
2,530 |
$39K |
| 93976 |
|
203 |
187 |
$38K |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
5,713 |
4,248 |
$37K |
| 90715 |
|
1,000 |
995 |
$37K |
| Q5118 |
Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg |
34 |
13 |
$37K |
| 96411 |
|
1,423 |
774 |
$37K |
| 87186 |
|
4,782 |
4,602 |
$35K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
10,769 |
9,806 |
$35K |
| 85610 |
|
11,321 |
10,667 |
$35K |
| 96376 |
|
651 |
437 |
$33K |
| 83735 |
|
12,178 |
8,533 |
$33K |
| 86923 |
|
1,037 |
811 |
$32K |
| 70486 |
|
402 |
401 |
$32K |
| 81003 |
|
19,111 |
18,575 |
$32K |
| 99195 |
|
1,153 |
1,036 |
$31K |
| Q5119 |
Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg |
35 |
13 |
$31K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
5,469 |
5,399 |
$31K |
| 87077 |
|
6,434 |
6,193 |
$30K |
| C1769 |
Guide wire |
341 |
323 |
$29K |
| 73030 |
|
2,100 |
2,060 |
$29K |
| J9190 |
Injection, fluorouracil, 500 mg |
1,209 |
461 |
$28K |
| J0640 |
Injection, leucovorin calcium, per 50 mg |
488 |
166 |
$28K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
3,174 |
1,493 |
$27K |
| 36415 |
Collection of venous blood by venipuncture |
20,349 |
17,708 |
$27K |
| 96416 |
|
452 |
264 |
$27K |
| 86901 |
|
7,264 |
6,673 |
$25K |
| J9263 |
Injection, oxaliplatin, 0.5 mg |
125 |
37 |
$25K |
| 86140 |
|
6,591 |
6,157 |
$24K |
| 85027 |
|
4,877 |
4,574 |
$24K |
| 70496 |
|
331 |
327 |
$24K |
| 95714 |
|
63 |
37 |
$23K |
| 76870 |
|
808 |
794 |
$23K |
| 87081 |
|
6,361 |
6,140 |
$23K |
| 96402 |
|
1,419 |
1,175 |
$22K |
| Z7500 |
|
631 |
506 |
$21K |
| 87070 |
|
2,206 |
2,124 |
$21K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,666 |
844 |
$19K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
888 |
872 |
$19K |
| 70498 |
|
340 |
336 |
$19K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,306 |
1,010 |
$19K |
| 73110 |
|
1,090 |
1,077 |
$18K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
249 |
237 |
$18K |
| 86850 |
|
4,805 |
4,328 |
$18K |
| 88312 |
|
3,203 |
3,064 |
$17K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
183 |
182 |
$17K |
| 86900 |
|
5,776 |
5,426 |
$17K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,644 |
1,427 |
$15K |
| J1815 |
Injection, insulin, per 5 units |
3,429 |
1,387 |
$15K |
| 86635 |
|
1,504 |
1,254 |
$15K |
| G0109 |
Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes |
505 |
370 |
$15K |
| 0324 |
|
225 |
217 |
$15K |
| 99199 |
Unlisted special service, procedure or report |
402 |
344 |
$14K |
| 71020 |
|
271 |
191 |
$14K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
664 |
636 |
$14K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
157 |
150 |
$13K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
3,461 |
3,222 |
$13K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,289 |
2,254 |
$13K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
14 |
14 |
$13K |
| 72040 |
|
905 |
897 |
$12K |
| 0370 |
|
127 |
74 |
$12K |
| 87522 |
Neg quan hep c or qual rna |
1,547 |
1,543 |
$11K |
| 97750 |
|
799 |
775 |
$11K |
| 0097U |
|
99 |
98 |
$11K |
| 73090 |
|
597 |
589 |
$10K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,553 |
1,223 |
$10K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,476 |
2,316 |
$10K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,296 |
1,215 |
$10K |
| 0301 |
|
67 |
50 |
$10K |
| 73080 |
|
562 |
554 |
$9K |
| 96111 |
|
87 |
87 |
$9K |
| 93017 |
|
904 |
889 |
$9K |
| 94644 |
|
1,086 |
1,051 |
$9K |
| 82803 |
|
1,161 |
1,089 |
$9K |
| 73140 |
|
764 |
762 |
$8K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
158 |
154 |
$8K |
| 74019 |
|
838 |
832 |
$8K |
| 73590 |
|
755 |
744 |
$8K |
| 87205 |
|
1,829 |
1,752 |
$8K |
| 82550 |
|
1,924 |
1,821 |
$8K |
| 0258 |
|
1,657 |
723 |
$8K |
| J2704 |
Injection, propofol, 10 mg |
2,174 |
2,109 |
$7K |
| 73502 |
|
509 |
499 |
$7K |
| 87147 |
|
725 |
700 |
$7K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,937 |
1,908 |
$7K |
| J1953 |
Injection, levetiracetam, 10 mg |
553 |
479 |
$7K |
| 93970 |
|
179 |
178 |
$6K |
| 85379 |
|
1,833 |
1,774 |
$6K |
| S0077 |
Injection, clindamycin phosphate, 300 mg |
547 |
525 |
$6K |
| 80061 |
Lipid panel |
1,990 |
1,827 |
$6K |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
641 |
325 |
$6K |
| J3489 |
Injection, zoledronic acid, 1 mg |
166 |
135 |
$5K |
| 82247 |
|
1,477 |
1,236 |
$5K |
| C1760 |
Closure device, vascular (implantable/insertable) |
12 |
12 |
$5K |
| 93975 |
|
72 |
70 |
$5K |
| 82010 |
|
1,250 |
1,189 |
$5K |
| 72131 |
|
90 |
90 |
$5K |
| 36430 |
|
257 |
177 |
$5K |
| P9011 |
Blood, split unit |
1,409 |
1,158 |
$5K |
| 86780 |
|
2,094 |
2,092 |
$4K |
| J9045 |
Injection, carboplatin, 50 mg |
98 |
68 |
$4K |
| C1726 |
Catheter, balloon dilatation, non-vascular |
58 |
58 |
$4K |
| 92611 |
|
17 |
17 |
$4K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
1,013 |
299 |
$4K |
| J2060 |
Injection, lorazepam, 2 mg |
941 |
794 |
$4K |
| 97804 |
|
77 |
76 |
$4K |
| 82248 |
|
1,135 |
1,018 |
$4K |
| 94664 |
|
440 |
390 |
$4K |
| Z4307 |
|
152 |
152 |
$4K |
| 71101 |
|
270 |
269 |
$3K |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
137 |
120 |
$3K |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
289 |
180 |
$3K |
| 97162 |
|
387 |
384 |
$3K |
| 85007 |
|
2,128 |
1,966 |
$3K |
| 87210 |
|
1,382 |
1,361 |
$3K |
| S0164 |
Injection, pantoprazole sodium, 40 mg |
1,303 |
725 |
$3K |
| 84100 |
|
2,356 |
2,116 |
$3K |
| 86593 |
|
1,456 |
1,449 |
$3K |
| 71010 |
|
68 |
30 |
$3K |
| 90935 |
Hemodialysis procedure with single evaluation by a physician |
47 |
26 |
$3K |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
651 |
486 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
388 |
379 |
$3K |
| 73600 |
|
12 |
12 |
$2K |
| 95711 |
|
14 |
14 |
$2K |
| 85651 |
|
990 |
926 |
$2K |
| A9150 |
Non-prescription drugs |
1,649 |
763 |
$2K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
47 |
37 |
$2K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
698 |
390 |
$2K |
| J9267 |
Injection, paclitaxel, 1 mg |
58 |
26 |
$2K |
| J1940 |
Injection, furosemide, up to 20 mg |
1,260 |
683 |
$2K |
| 82140 |
|
476 |
445 |
$2K |
| 0949 |
|
185 |
154 |
$2K |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
424 |
307 |
$2K |
| Z4302 |
|
104 |
104 |
$1K |
| 71250 |
|
40 |
40 |
$1K |
| Z7514 |
|
27 |
12 |
$1K |
| S0028 |
Injection, famotidine, 20 mg |
506 |
441 |
$1K |
| 82805 |
|
273 |
264 |
$1K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
221 |
202 |
$937.17 |
| 88313 |
|
108 |
107 |
$867.11 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
51 |
41 |
$839.79 |
| 97116 |
|
394 |
310 |
$837.97 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
342 |
177 |
$832.92 |
| 88304 |
|
231 |
231 |
$821.90 |
| 84132 |
|
843 |
624 |
$815.16 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
91 |
90 |
$782.28 |
| 76830 |
Ultrasound, transvaginal |
31 |
31 |
$754.54 |
| 0320 |
|
14 |
14 |
$697.78 |
| 86308 |
|
90 |
90 |
$667.08 |
| 87634 |
|
31 |
31 |
$650.00 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
164 |
160 |
$624.85 |
| 74000 |
|
16 |
13 |
$585.00 |
| 12011 |
|
12 |
12 |
$570.42 |
| 36591 |
|
608 |
339 |
$556.20 |
| J2430 |
Injection, pamidronate disodium, per 30 mg |
16 |
12 |
$544.45 |
| J3480 |
Injection, potassium chloride, per 2 meq |
132 |
40 |
$540.53 |
| 76775 |
|
13 |
13 |
$536.60 |
| 73620 |
|
45 |
44 |
$534.64 |
| 84112 |
|
55 |
44 |
$533.75 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
46 |
40 |
$478.39 |
| 76010 |
|
48 |
46 |
$463.65 |
| 84550 |
|
278 |
275 |
$451.96 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
81 |
24 |
$404.53 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
24 |
24 |
$400.52 |
| 73552 |
|
69 |
68 |
$395.65 |
| 87420 |
|
407 |
359 |
$346.46 |
| 85018 |
|
41 |
40 |
$325.85 |
| 29580 |
|
55 |
26 |
$290.00 |
| 87428 |
|
20 |
20 |
$253.58 |
| 90686 |
|
35 |
35 |
$206.43 |
| J0736 |
Injection, clindamycin phosphate, 300 mg |
145 |
134 |
$191.61 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
123 |
123 |
$169.10 |
| 80074 |
|
20 |
20 |
$161.94 |
| 72070 |
|
12 |
12 |
$149.55 |
| 80164 |
|
31 |
25 |
$143.32 |
| 84439 |
|
51 |
50 |
$129.47 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
32 |
27 |
$123.23 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
90 |
90 |
$94.75 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
102 |
100 |
$91.04 |
| J3105 |
Injection, terbutaline sulfate, up to 1 mg |
22 |
19 |
$88.11 |
| 87340 |
|
86 |
84 |
$77.11 |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
39 |
26 |
$65.54 |
| 74230 |
|
17 |
17 |
$63.72 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
197 |
132 |
$60.57 |
| 84466 |
|
38 |
38 |
$58.52 |
| J0694 |
Injection, cefoxitin sodium, 1 gm |
26 |
25 |
$40.44 |
| 83540 |
|
41 |
40 |
$30.12 |
| 72170 |
|
16 |
16 |
$20.15 |
| J1836 |
Injection, metronidazole, 10 mg |
25 |
13 |
$19.70 |
| 80051 |
|
12 |
12 |
$8.70 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
17 |
13 |
$0.00 |
| 97167 |
|
59 |
58 |
$0.00 |
| 0258R |
|
165 |
77 |
$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 |
17 |
13 |
$0.00 |
| 73000 |
|
12 |
12 |
$0.00 |
| A4218 |
Sterile saline or water, metered dose dispenser, 10 ml |
15 |
12 |
$0.00 |
| 0250R |
|
6,432 |
2,329 |
$0.00 |
| Q4051 |
Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies) |
33 |
18 |
$0.00 |
| 72046 |
|
15 |
15 |
$0.00 |
| J0456 |
Injection, azithromycin, 500 mg |
44 |
30 |
$0.00 |
| 84436 |
|
14 |
14 |
$0.00 |
| 70491 |
|
15 |
15 |
$0.00 |