| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
Emergency room services |
59,292 |
53,818 |
$8.23M |
| 0250 |
|
14,113 |
7,673 |
$1.75M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
7,484 |
7,054 |
$1.19M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,378 |
4,285 |
$963K |
| 70450 |
Computed tomography, head or brain; without contrast material |
6,289 |
6,135 |
$744K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
6,092 |
5,306 |
$582K |
| 0272 |
|
1,522 |
1,473 |
$554K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,690 |
3,625 |
$540K |
| 80053 |
Comprehensive metabolic panel |
27,383 |
25,193 |
$528K |
| 71045 |
Radiologic examination, chest; single view |
17,195 |
16,568 |
$505K |
| A9150 |
Non-prescription drugs |
4,275 |
2,617 |
$429K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
7,829 |
7,376 |
$423K |
| 36415 |
Collection of venous blood by venipuncture |
21,501 |
18,854 |
$420K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
2,534 |
2,456 |
$405K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
13,400 |
12,598 |
$355K |
| 0949 |
|
10,623 |
5,567 |
$337K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
3,509 |
3,396 |
$333K |
| 0360 |
|
3,248 |
3,027 |
$330K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
21,072 |
19,826 |
$320K |
| 0750 |
|
1,201 |
1,126 |
$284K |
| 71046 |
Radiologic examination, chest; 2 views |
5,028 |
4,921 |
$254K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
2,706 |
2,656 |
$248K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,344 |
4,117 |
$240K |
| J3490 |
Unclassified drugs |
16,091 |
9,891 |
$237K |
| 0710 |
|
4,937 |
4,741 |
$217K |
| 76801 |
|
2,543 |
2,220 |
$206K |
| Z7500 |
|
6,096 |
4,224 |
$204K |
| 59025 |
Fetal non-stress test |
3,277 |
1,287 |
$179K |
| 0301 |
|
1,442 |
1,348 |
$175K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
8,342 |
7,736 |
$174K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
31,949 |
28,872 |
$173K |
| Z7502 |
|
4,330 |
4,250 |
$163K |
| Z9725 |
|
3,715 |
3,657 |
$160K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
9,960 |
2,582 |
$158K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
7,411 |
6,964 |
$158K |
| 81025 |
|
8,289 |
7,917 |
$158K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
3,514 |
3,319 |
$144K |
| 82962 |
|
4,874 |
3,334 |
$143K |
| 99199 |
Unlisted special service, procedure or report |
12,420 |
8,959 |
$122K |
| 73564 |
|
1,316 |
1,280 |
$122K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,026 |
1,005 |
$119K |
| 73610 |
|
1,460 |
1,417 |
$119K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
2,303 |
2,181 |
$117K |
| 0762 |
|
963 |
553 |
$112K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,683 |
1,650 |
$112K |
| 72100 |
|
1,178 |
1,163 |
$110K |
| 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 |
2,002 |
1,846 |
$99K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,248 |
2,153 |
$99K |
| 76830 |
Ultrasound, transvaginal |
1,239 |
1,220 |
$99K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,393 |
1,308 |
$98K |
| 11043 |
|
1,481 |
498 |
$98K |
| 0760 |
|
11,987 |
8,491 |
$97K |
| 84484 |
|
13,181 |
12,070 |
$90K |
| 73030 |
|
1,370 |
1,342 |
$89K |
| 0214 |
|
250 |
244 |
$88K |
| 83880 |
|
7,310 |
7,007 |
$86K |
| A4217 |
Sterile water/saline, 500 ml |
794 |
638 |
$85K |
| 93458 |
|
77 |
64 |
$84K |
| 11044 |
|
309 |
98 |
$84K |
| 81001 |
|
16,773 |
15,961 |
$78K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,646 |
1,469 |
$77K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
4,656 |
4,467 |
$73K |
| 93971 |
|
927 |
900 |
$72K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
2,597 |
2,478 |
$70K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,892 |
2,131 |
$69K |
| 73630 |
|
1,508 |
1,476 |
$68K |
| J2704 |
Injection, propofol, 10 mg |
3,331 |
3,186 |
$65K |
| 0121 |
|
159 |
156 |
$65K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
410 |
399 |
$64K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
5,218 |
4,791 |
$62K |
| 73130 |
|
1,140 |
1,117 |
$61K |
| 0510 |
|
10,110 |
7,019 |
$59K |
| 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 |
1,350 |
1,272 |
$58K |
| 70496 |
|
302 |
296 |
$57K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,945 |
2,520 |
$56K |
| 99221 |
|
2,730 |
2,352 |
$56K |
| 46600 |
|
2,337 |
2,113 |
$54K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
675 |
658 |
$54K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
7,151 |
2,032 |
$53K |
| 83690 |
|
10,758 |
10,259 |
$52K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
10,036 |
9,311 |
$48K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
4,622 |
4,469 |
$47K |
| 71250 |
|
430 |
426 |
$46K |
| 72131 |
|
361 |
358 |
$46K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
356 |
345 |
$41K |
| 93798 |
|
1,239 |
211 |
$41K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
749 |
707 |
$38K |
| 85730 |
|
8,452 |
8,097 |
$36K |
| 90715 |
|
1,599 |
1,555 |
$35K |
| Z6500 |
|
177 |
177 |
$34K |
| 85610 |
|
10,110 |
9,658 |
$33K |
| 73110 |
|
719 |
702 |
$33K |
| Z6410 |
|
2,483 |
1,722 |
$33K |
| 0720 |
|
1,375 |
1,112 |
$32K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
389 |
349 |
$32K |
| 70498 |
|
328 |
320 |
$29K |
| 0270 |
|
10,850 |
5,969 |
$29K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,269 |
2,027 |
$28K |
| 87040 |
|
1,661 |
1,452 |
$27K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
914 |
888 |
$26K |
| 99153 |
Mod sedat endo service >5yrs |
550 |
514 |
$26K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
8,784 |
8,345 |
$24K |
| 97162 |
|
712 |
694 |
$24K |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,488 |
1,009 |
$23K |
| 93970 |
|
226 |
223 |
$23K |
| 73562 |
|
312 |
310 |
$22K |
| 70486 |
|
207 |
202 |
$22K |
| 0370 |
|
1,240 |
1,220 |
$21K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
467 |
452 |
$20K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
8,082 |
7,502 |
$20K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
440 |
425 |
$20K |
| J1815 |
Injection, insulin, per 5 units |
448 |
292 |
$17K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
711 |
693 |
$17K |
| 72040 |
|
307 |
306 |
$17K |
| 71101 |
|
84 |
84 |
$15K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
232 |
206 |
$15K |
| 83605 |
|
2,709 |
2,533 |
$14K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
9,973 |
6,240 |
$14K |
| 86850 |
|
1,036 |
986 |
$14K |
| 0761 |
|
906 |
722 |
$13K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
4,622 |
4,021 |
$13K |
| 81003 |
|
3,437 |
3,329 |
$13K |
| 0420 |
|
1,165 |
466 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
136 |
130 |
$12K |
| 97803 |
|
2,543 |
2,295 |
$12K |
| 99401 |
|
2,599 |
2,235 |
$12K |
| 0160 |
|
444 |
213 |
$11K |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
503 |
496 |
$11K |
| 87186 |
|
631 |
601 |
$11K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,477 |
1,445 |
$11K |
| A9270 |
Non-covered item or service |
3,540 |
1,669 |
$11K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
245 |
232 |
$10K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
54 |
51 |
$10K |
| 83735 |
|
2,255 |
2,015 |
$10K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,034 |
2,938 |
$10K |
| Z6400 |
|
443 |
441 |
$10K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,606 |
1,339 |
$10K |
| 36821 |
|
14 |
13 |
$10K |
| 99152 |
|
470 |
448 |
$9K |
| 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) |
284 |
267 |
$9K |
| 74018 |
|
232 |
224 |
$9K |
| 87077 |
|
1,679 |
1,584 |
$9K |
| 73140 |
|
255 |
250 |
$8K |
| 84443 |
Thyroid stimulating hormone (TSH) |
934 |
904 |
$8K |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
3,113 |
835 |
$8K |
| A4649 |
Surgical supply; miscellaneous |
441 |
272 |
$8K |
| 93976 |
|
40 |
39 |
$8K |
| 80076 |
|
519 |
485 |
$8K |
| 84702 |
|
1,817 |
1,626 |
$7K |
| 82805 |
|
214 |
197 |
$7K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,635 |
1,486 |
$7K |
| 73502 |
|
152 |
149 |
$7K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
164 |
161 |
$7K |
| 76536 |
|
24 |
24 |
$6K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
4,664 |
3,683 |
$6K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
45 |
45 |
$6K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
912 |
833 |
$6K |
| 86900 |
|
2,220 |
2,100 |
$6K |
| 87430 |
|
615 |
608 |
$6K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
192 |
187 |
$6K |
| Z1034 |
|
82 |
77 |
$6K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
197 |
192 |
$6K |
| 0278 |
|
105 |
105 |
$6K |
| 76376 |
|
174 |
171 |
$5K |
| G0378 |
Hospital observation service, per hour |
311 |
231 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,751 |
1,677 |
$5K |
| 51741 |
|
436 |
374 |
$5K |
| 86901 |
|
2,224 |
2,103 |
$5K |
| S3620 |
Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total) |
30 |
15 |
$5K |
| 73080 |
|
117 |
114 |
$5K |
| 97116 |
|
1,692 |
628 |
$5K |
| 87081 |
|
319 |
304 |
$4K |
| 84703 |
|
998 |
975 |
$4K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
60 |
51 |
$4K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
30 |
30 |
$4K |
| 96376 |
|
436 |
371 |
$4K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
202 |
100 |
$4K |
| 97802 |
|
297 |
249 |
$4K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,343 |
1,257 |
$4K |
| 85379 |
|
693 |
677 |
$4K |
| J2060 |
Injection, lorazepam, 2 mg |
2,139 |
1,973 |
$4K |
| 0514 |
|
1,030 |
455 |
$4K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,887 |
1,774 |
$4K |
| 80047 |
|
146 |
143 |
$3K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,715 |
2,508 |
$3K |
| 82553 |
|
350 |
334 |
$3K |
| 96156 |
|
1,884 |
1,854 |
$3K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,308 |
2,123 |
$3K |
| 87428 |
|
18 |
18 |
$3K |
| 85027 |
|
732 |
690 |
$3K |
| 80061 |
Lipid panel |
605 |
556 |
$3K |
| 76770 |
|
37 |
37 |
$3K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,307 |
1,216 |
$3K |
| 82550 |
|
603 |
592 |
$3K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,675 |
1,425 |
$3K |
| 99000 |
|
3,672 |
3,363 |
$3K |
| 10060 |
|
62 |
56 |
$2K |
| 87073 |
|
226 |
193 |
$2K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
306 |
298 |
$2K |
| 87070 |
|
227 |
209 |
$2K |
| 72082 |
|
26 |
26 |
$2K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
376 |
361 |
$2K |
| 88313 |
|
628 |
605 |
$2K |
| H2000 |
Comprehensive multidisciplinary evaluation |
517 |
509 |
$2K |
| 12001 |
|
89 |
88 |
$2K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
541 |
279 |
$2K |
| 84145 |
|
313 |
293 |
$2K |
| 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 |
666 |
631 |
$2K |
| 73590 |
|
66 |
62 |
$2K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
52 |
29 |
$2K |
| 82150 |
|
318 |
309 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
79 |
78 |
$2K |
| 29125 |
|
82 |
79 |
$1K |
| 81002 |
|
843 |
803 |
$1K |
| 0258 |
|
321 |
298 |
$1K |
| 88304 |
|
126 |
121 |
$1K |
| 87205 |
|
508 |
454 |
$1K |
| 76870 |
|
28 |
27 |
$1K |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
352 |
323 |
$1K |
| Z6304 |
|
83 |
83 |
$1K |
| Z6204 |
|
83 |
83 |
$1K |
| Z6406 |
|
83 |
83 |
$1K |
| 86140 |
|
291 |
278 |
$920.22 |
| 83874 |
|
314 |
298 |
$914.05 |
| 86308 |
|
51 |
51 |
$906.93 |
| 51702 |
|
56 |
56 |
$870.49 |
| 93017 |
|
40 |
38 |
$859.41 |
| 88312 |
|
571 |
559 |
$856.32 |
| H1000 |
Prenatal care, at-risk assessment |
54 |
53 |
$793.22 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
13 |
12 |
$791.57 |
| 59425 |
|
163 |
154 |
$779.60 |
| 29130 |
|
16 |
13 |
$774.60 |
| T5999 |
Supply, not otherwise specified |
171 |
166 |
$757.00 |
| 71010 |
|
48 |
21 |
$694.87 |
| 99386 |
|
44 |
43 |
$683.08 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
96 |
96 |
$630.52 |
| 97750 |
|
31 |
25 |
$615.20 |
| C1769 |
Guide wire |
137 |
129 |
$608.75 |
| 80305 |
|
163 |
152 |
$587.69 |
| 74022 |
|
27 |
26 |
$585.91 |
| Z7610 |
|
78 |
51 |
$535.20 |
| 76813 |
|
12 |
12 |
$531.95 |
| 85007 |
|
179 |
165 |
$471.78 |
| 84100 |
|
312 |
243 |
$469.44 |
| 87147 |
|
136 |
133 |
$457.87 |
| 51701 |
|
14 |
14 |
$438.85 |
| S9452 |
Nutrition classes, non-physician provider, per session |
387 |
381 |
$404.52 |
| 96151 |
|
375 |
369 |
$363.79 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
168 |
168 |
$346.86 |
| 73090 |
|
12 |
12 |
$346.84 |
| 87807 |
|
42 |
38 |
$336.13 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
139 |
131 |
$332.42 |
| 84132 |
|
115 |
106 |
$317.61 |
| 99385 |
|
20 |
19 |
$236.54 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
69 |
63 |
$194.27 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
41 |
38 |
$191.37 |
| 85384 |
|
13 |
13 |
$175.84 |
| 0430 |
|
287 |
164 |
$162.53 |
| S0164 |
Injection, pantoprazole sodium, 40 mg |
61 |
56 |
$134.44 |
| S0028 |
Injection, famotidine, 20 mg |
364 |
357 |
$134.34 |
| 0361 |
|
24 |
24 |
$124.50 |
| 85651 |
|
71 |
68 |
$115.83 |
| 0271 |
|
53 |
53 |
$84.00 |
| 96152 |
|
116 |
114 |
$77.33 |
| 0324 |
|
300 |
292 |
$69.75 |
| 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 |
128 |
$69.66 |
| 59430 |
|
18 |
15 |
$48.38 |
| 36600 |
|
13 |
12 |
$44.15 |
| 89055 |
|
12 |
12 |
$38.48 |
| J1940 |
Injection, furosemide, up to 20 mg |
26 |
24 |
$35.80 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
40 |
37 |
$33.11 |
| 97035 |
|
27 |
12 |
$26.25 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
27 |
25 |
$22.89 |
| 85014 |
|
13 |
13 |
$16.40 |
| 85018 |
|
13 |
13 |
$16.19 |
| 99070 |
|
70 |
57 |
$13.95 |
| 0305 |
|
782 |
728 |
$10.96 |
| 0636 |
|
183 |
167 |
$7.09 |
| 0730 |
|
477 |
464 |
$0.00 |
| 0300 |
|
906 |
819 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
112 |
102 |
$0.00 |
| 0402 |
|
37 |
36 |
$0.00 |
| E0601 |
Continuous positive airway pressure (cpap) device |
93 |
93 |
$0.00 |
| 0302 |
|
139 |
126 |
$0.00 |
| 0489 |
|
70 |
70 |
$0.00 |
| T4541 |
Incontinence product, disposable underpad, large, each |
272 |
272 |
$0.00 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
13 |
12 |
$0.00 |
| 0320 |
|
15 |
15 |
$0.00 |
| 0637 |
|
19 |
17 |
$0.00 |
| 0307 |
|
262 |
256 |
$0.00 |
| 0306 |
|
575 |
538 |
$0.00 |
| 0352 |
|
73 |
73 |
$0.00 |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
190 |
185 |
$0.00 |
| 0310 |
|
121 |
117 |
$0.00 |
| 88307 |
|
13 |
12 |
$0.00 |