| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
37,627 |
33,832 |
$11.87M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
42,994 |
40,225 |
$11.73M |
| G0378 |
Hospital observation service, per hour |
6,111 |
5,197 |
$4.89M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
14,717 |
13,951 |
$2.52M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
36,434 |
7,640 |
$2.32M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
8,829 |
8,096 |
$1.90M |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,729 |
1,031 |
$1.26M |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
14,561 |
4,220 |
$807K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,031 |
983 |
$713K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
13,643 |
4,353 |
$645K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,622 |
622 |
$624K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
15,454 |
12,981 |
$622K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
5,847 |
5,536 |
$527K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
25,185 |
22,200 |
$438K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
6,146 |
4,993 |
$414K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
13,580 |
12,000 |
$387K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
19,939 |
17,886 |
$381K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,925 |
2,796 |
$367K |
| 70450 |
Computed tomography, head or brain; without contrast material |
8,107 |
7,502 |
$306K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
393 |
375 |
$286K |
| 80053 |
Comprehensive metabolic panel |
47,319 |
37,149 |
$265K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
4,734 |
4,270 |
$231K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,583 |
3,392 |
$209K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
535 |
493 |
$200K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
54,525 |
41,092 |
$195K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
10,776 |
9,730 |
$188K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
10,972 |
8,018 |
$179K |
| OP370 |
|
3,185 |
2,831 |
$178K |
| 93971 |
|
1,749 |
1,623 |
$155K |
| 93970 |
|
1,120 |
1,059 |
$153K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,104 |
2,050 |
$150K |
| 97162 |
|
2,739 |
2,555 |
$144K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
3,275 |
3,170 |
$143K |
| 71045 |
Radiologic examination, chest; single view |
15,777 |
14,407 |
$139K |
| OP710 |
|
1,619 |
1,450 |
$132K |
| 97010 |
|
17,617 |
4,171 |
$131K |
| 96367 |
|
1,019 |
731 |
$130K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
4,093 |
3,944 |
$121K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
1,608 |
461 |
$118K |
| 71046 |
Radiologic examination, chest; 2 views |
9,496 |
9,156 |
$117K |
| 76830 |
Ultrasound, transvaginal |
2,188 |
2,105 |
$102K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
2,472 |
1,103 |
$94K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
217 |
213 |
$93K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,368 |
1,305 |
$82K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
3,150 |
3,003 |
$80K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
107 |
105 |
$80K |
| 93017 |
|
84 |
79 |
$79K |
| 97161 |
|
1,181 |
1,117 |
$79K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
51 |
50 |
$79K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
949 |
746 |
$76K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
8,273 |
6,564 |
$72K |
| 36415 |
Collection of venous blood by venipuncture |
44,718 |
35,665 |
$69K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,600 |
1,309 |
$62K |
| 84484 |
|
17,215 |
12,858 |
$61K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,591 |
1,474 |
$59K |
| OP272 |
|
5,510 |
4,669 |
$55K |
| 76642 |
|
1,044 |
965 |
$55K |
| 96376 |
|
3,808 |
2,917 |
$52K |
| 36591 |
|
476 |
293 |
$51K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
9,949 |
8,128 |
$50K |
| 71250 |
|
602 |
570 |
$50K |
| OP250 |
|
69,059 |
38,454 |
$49K |
| 84443 |
Thyroid stimulating hormone (TSH) |
5,367 |
4,846 |
$49K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
5,308 |
4,523 |
$47K |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
1,101 |
429 |
$46K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,744 |
1,692 |
$46K |
| OP379 |
|
415 |
410 |
$44K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
637 |
624 |
$42K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
6,602 |
5,910 |
$42K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
688 |
618 |
$40K |
| 97164 |
|
559 |
542 |
$39K |
| 97116 |
|
2,369 |
1,308 |
$39K |
| 90791 |
Psychiatric diagnostic evaluation |
2,659 |
2,257 |
$38K |
| 95800 |
|
147 |
143 |
$36K |
| 80061 |
Lipid panel |
3,372 |
3,185 |
$34K |
| 86885 |
|
3,570 |
3,196 |
$33K |
| 72110 |
|
1,514 |
1,455 |
$31K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,098 |
1,019 |
$31K |
| 96415 |
|
96 |
53 |
$29K |
| 81003 |
|
10,529 |
9,752 |
$29K |
| 85610 |
|
10,027 |
8,871 |
$29K |
| OP279 |
|
1,416 |
1,310 |
$29K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
582 |
510 |
$28K |
| 86901 |
|
4,285 |
3,706 |
$28K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,618 |
1,472 |
$27K |
| 86900 |
|
4,254 |
3,688 |
$26K |
| 81025 |
|
14,935 |
13,532 |
$26K |
| 83690 |
|
10,137 |
9,212 |
$23K |
| 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 |
1,356 |
1,173 |
$23K |
| 76536 |
|
430 |
405 |
$22K |
| 0002A |
|
766 |
760 |
$22K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
3,580 |
3,227 |
$22K |
| 76770 |
|
504 |
475 |
$22K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
204 |
191 |
$22K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
520 |
468 |
$21K |
| 73630 |
|
2,455 |
2,345 |
$21K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
715 |
678 |
$21K |
| 85730 |
|
7,049 |
6,415 |
$20K |
| 0001A |
|
728 |
726 |
$20K |
| 81001 |
|
16,780 |
15,127 |
$20K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
25 |
12 |
$20K |
| 93976 |
|
107 |
102 |
$19K |
| 73610 |
|
2,285 |
2,184 |
$19K |
| OP259 |
|
8,087 |
5,889 |
$19K |
| OP258 |
|
33,026 |
22,625 |
$19K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
413 |
401 |
$18K |
| 87070 |
|
6,024 |
5,775 |
$18K |
| 87040 |
|
1,879 |
1,643 |
$18K |
| 73030 |
|
1,820 |
1,754 |
$18K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
12,389 |
9,726 |
$17K |
| 83735 |
|
8,257 |
5,795 |
$17K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
171 |
156 |
$17K |
| 82077 |
|
4,842 |
4,073 |
$16K |
| 74018 |
|
1,759 |
1,694 |
$15K |
| 73562 |
|
1,262 |
1,216 |
$15K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,593 |
2,404 |
$15K |
| 85027 |
|
4,004 |
3,445 |
$14K |
| 90715 |
|
1,492 |
1,423 |
$14K |
| 93975 |
|
252 |
248 |
$14K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
3,284 |
2,814 |
$14K |
| 80076 |
|
2,340 |
2,157 |
$14K |
| 77065 |
Tomosynthesis, mammo |
197 |
179 |
$13K |
| 84439 |
|
1,977 |
1,785 |
$13K |
| 73130 |
|
1,643 |
1,574 |
$13K |
| 82962 |
|
7,231 |
4,390 |
$13K |
| 84702 |
|
3,169 |
2,826 |
$13K |
| 83880 |
|
2,364 |
2,158 |
$13K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
6,199 |
5,682 |
$12K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
5,176 |
3,736 |
$12K |
| 36430 |
|
35 |
25 |
$11K |
| 77066 |
Tomosynthesis, mammo |
109 |
103 |
$11K |
| 73110 |
|
1,138 |
1,086 |
$11K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,691 |
1,587 |
$10K |
| 83605 |
|
2,624 |
2,276 |
$10K |
| 80143 |
|
3,154 |
2,682 |
$10K |
| 80179 |
|
3,115 |
2,653 |
$10K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,005 |
2,190 |
$9K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
4,922 |
3,896 |
$9K |
| 82728 |
|
1,170 |
975 |
$9K |
| 73564 |
|
679 |
648 |
$9K |
| 97535 |
Self-care/home management training, each 15 minutes |
969 |
677 |
$9K |
| 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 |
129 |
125 |
$8K |
| 73502 |
|
905 |
848 |
$8K |
| 82607 |
|
1,205 |
1,081 |
$8K |
| J2060 |
Injection, lorazepam, 2 mg |
2,890 |
2,115 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,021 |
2,983 |
$7K |
| 10060 |
|
228 |
218 |
$7K |
| 95819 |
|
12 |
12 |
$7K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,297 |
2,045 |
$7K |
| 70491 |
|
51 |
49 |
$7K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,464 |
2,202 |
$7K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
11,162 |
9,689 |
$6K |
| 83789 |
|
1,944 |
1,732 |
$6K |
| 87088 |
|
1,108 |
1,082 |
$6K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
42 |
37 |
$6K |
| J2704 |
Injection, propofol, 10 mg |
3,091 |
2,606 |
$6K |
| 70486 |
|
199 |
193 |
$6K |
| 85379 |
|
2,535 |
2,369 |
$6K |
| 72100 |
|
418 |
405 |
$6K |
| 97166 |
|
319 |
266 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
4,187 |
4,034 |
$5K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
393 |
330 |
$5K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
600 |
574 |
$5K |
| 83550 |
|
1,009 |
852 |
$5K |
| M0222 |
Intravenous injection, bebtelovimab, includes injection and post administration monitoring |
57 |
57 |
$5K |
| 77336 |
|
34 |
14 |
$5K |
| 12001 |
|
381 |
370 |
$5K |
| 84100 |
|
3,666 |
2,451 |
$5K |
| 96417 |
|
15 |
12 |
$4K |
| 87186 |
|
1,503 |
1,364 |
$4K |
| 29125 |
|
492 |
479 |
$4K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
167 |
109 |
$4K |
| 73080 |
|
433 |
419 |
$4K |
| J1644 |
Injection, heparin sodium, per 1000 units |
2,049 |
850 |
$4K |
| 59025 |
Fetal non-stress test |
30 |
26 |
$4K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
174 |
133 |
$4K |
| 72052 |
|
194 |
191 |
$4K |
| 92550 |
|
27 |
26 |
$4K |
| 87077 |
|
1,750 |
1,548 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,752 |
1,585 |
$4K |
| 73140 |
|
558 |
537 |
$4K |
| J3490 |
Unclassified drugs |
1,906 |
1,496 |
$4K |
| 0004A |
|
103 |
103 |
$4K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
18 |
14 |
$3K |
| 80047 |
|
3,308 |
3,070 |
$3K |
| 76775 |
|
90 |
90 |
$3K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,489 |
1,344 |
$3K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
422 |
411 |
$3K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
107 |
107 |
$3K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
422 |
411 |
$3K |
| 86140 |
|
1,605 |
1,450 |
$3K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
812 |
765 |
$3K |
| OP229 |
|
58 |
56 |
$3K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
327 |
313 |
$3K |
| 88313 |
|
360 |
336 |
$3K |
| 74022 |
|
113 |
111 |
$3K |
| OP270 |
|
1,491 |
1,335 |
$3K |
| 72050 |
|
140 |
140 |
$3K |
| 77080 |
|
42 |
41 |
$2K |
| 73590 |
|
222 |
212 |
$2K |
| 82248 |
|
318 |
291 |
$2K |
| 76870 |
|
80 |
75 |
$2K |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
45 |
43 |
$2K |
| 83540 |
|
895 |
735 |
$2K |
| 87205 |
|
239 |
235 |
$2K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
72 |
70 |
$2K |
| 0031A |
|
60 |
60 |
$2K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
824 |
743 |
$2K |
| 82550 |
|
742 |
652 |
$2K |
| 82746 |
|
525 |
442 |
$2K |
| 84703 |
|
908 |
886 |
$2K |
| 72170 |
|
101 |
101 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
13 |
13 |
$2K |
| 0012A |
|
57 |
57 |
$2K |
| 0064A |
|
57 |
54 |
$2K |
| 85651 |
|
384 |
368 |
$2K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,214 |
829 |
$2K |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
85 |
85 |
$1K |
| 82570 |
|
958 |
639 |
$1K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,171 |
847 |
$1K |
| 29515 |
|
96 |
96 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
12 |
$1K |
| 80320 |
|
339 |
311 |
$1K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
4,400 |
3,180 |
$1K |
| 88342 |
|
106 |
103 |
$1K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,878 |
1,569 |
$1K |
| 88312 |
|
205 |
192 |
$1K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
534 |
369 |
$1K |
| 82150 |
|
302 |
292 |
$1K |
| 73090 |
|
137 |
134 |
$1K |
| 0011A |
|
39 |
39 |
$1K |
| 12002 |
|
63 |
63 |
$1K |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
1,044 |
779 |
$1K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,523 |
1,124 |
$979.14 |
| J3480 |
Injection, potassium chloride, per 2 meq |
131 |
88 |
$939.77 |
| C1769 |
Guide wire |
133 |
110 |
$911.16 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
623 |
290 |
$897.32 |
| C9113 |
Injection, pantoprazole sodium, per vial |
889 |
496 |
$891.18 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
300 |
277 |
$885.36 |
| 87999 |
|
561 |
555 |
$872.10 |
| 71101 |
|
129 |
127 |
$869.78 |
| 76801 |
|
13 |
12 |
$851.00 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
560 |
223 |
$811.42 |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
38 |
38 |
$735.84 |
| 85652 |
|
638 |
544 |
$709.44 |
| 0072A |
|
14 |
14 |
$693.53 |
| 82378 |
|
124 |
95 |
$651.41 |
| 84145 |
|
138 |
121 |
$649.62 |
| 87420 |
|
366 |
364 |
$630.64 |
| 74019 |
|
102 |
100 |
$617.98 |
| 97165 |
|
77 |
63 |
$609.77 |
| 86923 |
|
43 |
37 |
$593.86 |
| 0071A |
|
12 |
12 |
$582.26 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
294 |
259 |
$567.42 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
55 |
51 |
$552.07 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
61 |
55 |
$552.07 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
248 |
212 |
$550.99 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
457 |
388 |
$538.90 |
| 85378 |
|
187 |
185 |
$519.51 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
36 |
24 |
$479.59 |
| 87147 |
|
401 |
390 |
$460.23 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
271 |
224 |
$458.97 |
| 85014 |
|
138 |
115 |
$457.29 |
| 81002 |
|
1,445 |
1,311 |
$399.07 |
| 82803 |
|
109 |
96 |
$387.98 |
| 0124A |
|
28 |
24 |
$381.05 |
| 84156 |
|
339 |
175 |
$380.12 |
| 0054A |
|
16 |
16 |
$359.72 |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
78 |
70 |
$350.29 |
| 83615 |
|
160 |
124 |
$349.71 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
508 |
348 |
$325.53 |
| 86308 |
|
263 |
259 |
$298.49 |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
21 |
21 |
$296.35 |
| J3360 |
Injection, diazepam, up to 5 mg |
163 |
139 |
$290.13 |
| 86618 |
|
27 |
26 |
$271.87 |
| 72072 |
|
16 |
14 |
$221.29 |
| 82043 |
|
95 |
85 |
$204.91 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
50 |
50 |
$177.68 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
44 |
40 |
$177.35 |
| 88304 |
|
63 |
57 |
$173.38 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
12 |
12 |
$169.19 |
| J1815 |
Injection, insulin, per 5 units |
502 |
169 |
$166.05 |
| 86617 |
|
29 |
29 |
$163.98 |
| J3411 |
Injection, thiamine hcl, 100 mg |
28 |
25 |
$160.98 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
31 |
24 |
$152.52 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
59 |
43 |
$132.68 |
| J7510 |
Prednisolone oral, per 5 mg |
662 |
636 |
$132.41 |
| 29130 |
|
42 |
39 |
$129.59 |
| 12011 |
|
26 |
26 |
$113.60 |
| 87581 |
|
38 |
38 |
$96.68 |
| 87486 |
|
38 |
38 |
$96.68 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
151 |
101 |
$91.41 |
| C1729 |
Catheter, drainage |
22 |
12 |
$88.44 |
| 84436 |
|
37 |
37 |
$83.62 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
62 |
53 |
$82.25 |
| 84153 |
|
13 |
12 |
$80.74 |
| J1630 |
Injection, haloperidol, up to 5 mg |
301 |
203 |
$60.78 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
41 |
24 |
$51.97 |
| OP255 |
|
29 |
29 |
$46.96 |
| 86592 |
|
12 |
12 |
$42.81 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
61 |
44 |
$41.43 |
| OP637 |
|
16,062 |
2,162 |
$28.52 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
85 |
60 |
$23.36 |
| 84550 |
|
13 |
12 |
$21.88 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
266 |
247 |
$21.30 |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
19 |
18 |
$19.84 |
| 85018 |
|
20 |
13 |
$15.84 |
| 86803 |
|
14 |
13 |
$14.27 |
| 87340 |
|
16 |
13 |
$13.41 |
| G0008 |
Administration of influenza virus vaccine |
19 |
16 |
$10.76 |
| 90686 |
|
15 |
12 |
$8.98 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
30 |
26 |
$6.44 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
88 |
71 |
$6.00 |
| J3590 |
Unclassified biologics |
28 |
27 |
$3.21 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
15 |
14 |
$3.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
46 |
33 |
$2.55 |
| Q0247 |
Injection, sotrovimab, 500 mg |
38 |
36 |
$1.00 |
| Q0244 |
Injection, casirivimab and imdevimab, 1200 mg |
102 |
85 |
$1.00 |
| J3371 |
Injection, vancomycin hcl (mylan), not therapeutically equivalent to j3370, 500 mg |
83 |
40 |
$0.13 |
| 91300 |
|
1,372 |
1,234 |
$0.01 |
| Q0222 |
Injection, bebtelovimab, 175 mg |
58 |
58 |
$0.00 |
| 91305 |
|
36 |
35 |
$0.00 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
25 |
19 |
$0.00 |
| 91301 |
|
93 |
93 |
$0.00 |
| 91303 |
|
47 |
47 |
$0.00 |
| 91307 |
|
36 |
34 |
$0.00 |
| 91306 |
|
50 |
48 |
$0.00 |
| 91312 |
|
28 |
24 |
$0.00 |
| Q0245 |
Injection, bamlanivimab and etesevimab, 2100 mg |
20 |
20 |
$0.00 |
| 80164 |
|
17 |
13 |
$0.00 |