| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
84,138 |
82,633 |
$80.49M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
66,205 |
65,501 |
$52.69M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
56,219 |
19,214 |
$12.58M |
| 41899 |
Unlisted procedure, dentoalveolar structures |
3,610 |
3,558 |
$8.12M |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
3,241 |
3,169 |
$7.95M |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
32,139 |
12,249 |
$7.50M |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
72,366 |
71,355 |
$4.87M |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
2,821 |
2,779 |
$4.65M |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
38,389 |
13,550 |
$4.55M |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
11,574 |
11,419 |
$4.40M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
25,162 |
24,160 |
$4.19M |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
18,028 |
17,437 |
$4.07M |
| G0378 |
Hospital observation service, per hour |
5,670 |
2,902 |
$3.97M |
| 87632 |
|
10,739 |
10,553 |
$3.67M |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
16,306 |
6,486 |
$3.62M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
63,971 |
63,342 |
$3.54M |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
2,290 |
2,253 |
$3.44M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
3,413 |
3,315 |
$3.25M |
| 80048 |
Basic metabolic panel (calcium, ionized) |
21,400 |
18,556 |
$2.99M |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
3,633 |
3,457 |
$2.88M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
69,365 |
60,520 |
$2.44M |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
9,360 |
9,225 |
$2.26M |
| 92567 |
|
41,504 |
40,551 |
$2.03M |
| 93325 |
|
11,269 |
10,636 |
$2.02M |
| 92579 |
|
15,702 |
15,249 |
$2.01M |
| 92587 |
|
30,639 |
29,941 |
$1.83M |
| 59025 |
Fetal non-stress test |
5,813 |
4,521 |
$1.83M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
121,585 |
115,045 |
$1.77M |
| 93320 |
|
3,807 |
3,547 |
$1.52M |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
1,012 |
994 |
$1.45M |
| 72082 |
|
6,220 |
6,085 |
$1.25M |
| 94010 |
|
6,693 |
6,568 |
$1.19M |
| 71046 |
Radiologic examination, chest; 2 views |
9,552 |
9,319 |
$1.14M |
| 76770 |
|
4,202 |
4,162 |
$1.08M |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
4,530 |
4,331 |
$941K |
| 83735 |
|
32,596 |
27,076 |
$902K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
77,195 |
73,755 |
$875K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
2,149 |
1,778 |
$791K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,347 |
2,329 |
$749K |
| 94060 |
|
2,404 |
2,353 |
$718K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
18,541 |
18,250 |
$712K |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
148 |
135 |
$696K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
85,243 |
83,658 |
$648K |
| J3490 |
Unclassified drugs |
31,500 |
21,559 |
$632K |
| 42830 |
|
352 |
343 |
$617K |
| A0425 |
Ground mileage, per statute mile |
2,378 |
1,876 |
$529K |
| J0475 |
Injection, baclofen, 10 mg |
471 |
456 |
$503K |
| 81001 |
|
12,307 |
12,044 |
$501K |
| 80069 |
|
4,855 |
3,440 |
$474K |
| G0330 |
Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room |
778 |
767 |
$469K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
309 |
292 |
$453K |
| 85046 |
|
15,667 |
14,049 |
$444K |
| 73140 |
|
3,459 |
3,074 |
$439K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
507 |
497 |
$437K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
4,032 |
2,166 |
$425K |
| 73100 |
|
3,274 |
2,788 |
$408K |
| 54161 |
|
273 |
271 |
$397K |
| 90935 |
Hemodialysis procedure with single evaluation by a physician |
688 |
53 |
$391K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,782 |
1,752 |
$387K |
| 80053 |
Comprehensive metabolic panel |
2,440 |
2,266 |
$375K |
| 97597 |
|
1,407 |
1,240 |
$371K |
| 82977 |
|
13,352 |
10,381 |
$345K |
| 84460 |
|
17,207 |
13,991 |
$338K |
| 84100 |
|
16,691 |
14,021 |
$321K |
| 82247 |
|
14,697 |
11,358 |
$315K |
| 84450 |
|
15,911 |
12,806 |
$312K |
| 82248 |
|
14,464 |
11,295 |
$311K |
| 93226 |
|
584 |
572 |
$296K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
10,163 |
9,810 |
$295K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
29,917 |
25,854 |
$291K |
| 92582 |
|
2,551 |
2,499 |
$270K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
227 |
226 |
$259K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,179 |
990 |
$251K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
36,073 |
35,611 |
$247K |
| 99215 |
Prolong outpt/office vis |
25,861 |
24,502 |
$237K |
| 72081 |
|
1,760 |
1,714 |
$236K |
| 95012 |
|
2,475 |
2,408 |
$226K |
| 84075 |
|
13,222 |
10,226 |
$225K |
| 74018 |
|
2,068 |
2,018 |
$214K |
| 93321 |
|
905 |
848 |
$214K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
29,426 |
23,616 |
$213K |
| 72170 |
|
1,595 |
1,562 |
$211K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,325 |
924 |
$211K |
| 80197 |
|
3,994 |
2,930 |
$206K |
| 76820 |
|
1,218 |
858 |
$190K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
26,471 |
26,074 |
$184K |
| 82728 |
|
4,454 |
4,237 |
$182K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
7,041 |
6,941 |
$181K |
| 92526 |
|
1,706 |
824 |
$177K |
| 70360 |
|
1,214 |
1,205 |
$170K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
10,742 |
9,775 |
$169K |
| 99243 |
|
25,597 |
25,299 |
$162K |
| 83880 |
|
3,083 |
2,000 |
$155K |
| 95812 |
|
252 |
249 |
$154K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
1,923 |
829 |
$151K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
9,311 |
8,605 |
$147K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
435 |
401 |
$145K |
| 17110 |
|
1,727 |
1,680 |
$143K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,757 |
2,718 |
$142K |
| 73090 |
|
1,005 |
738 |
$137K |
| 73130 |
|
1,042 |
955 |
$137K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
13,802 |
11,419 |
$136K |
| 93225 |
|
308 |
303 |
$127K |
| 87040 |
|
2,015 |
1,777 |
$126K |
| 81025 |
|
3,343 |
3,297 |
$125K |
| 93308 |
|
530 |
482 |
$121K |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
6,104 |
5,896 |
$118K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
2,062 |
2,003 |
$117K |
| 92611 |
|
608 |
605 |
$112K |
| 97165 |
|
754 |
740 |
$111K |
| 92555 |
|
3,479 |
3,432 |
$101K |
| 95782 |
|
57 |
57 |
$100K |
| 87799 |
|
1,071 |
831 |
$94K |
| 73564 |
|
621 |
603 |
$92K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
485 |
324 |
$90K |
| 92018 |
|
84 |
83 |
$90K |
| 77073 |
|
600 |
584 |
$87K |
| A0435 |
Fixed wing air mileage, per statute mile |
31 |
29 |
$85K |
| 74230 |
|
447 |
444 |
$82K |
| 82040 |
|
6,420 |
5,322 |
$82K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,053 |
1,694 |
$78K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
655 |
603 |
$77K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
48 |
48 |
$76K |
| 92557 |
|
625 |
619 |
$75K |
| 11772 |
|
30 |
29 |
$74K |
| 75565 |
|
264 |
258 |
$71K |
| 97162 |
|
506 |
496 |
$71K |
| A0430 |
Ambulance service, conventional air services, transport, one way (fixed wing) |
31 |
29 |
$71K |
| 44970 |
|
24 |
24 |
$70K |
| 73080 |
|
450 |
392 |
$70K |
| 77072 |
|
628 |
627 |
$68K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
9,751 |
9,609 |
$67K |
| 85027 |
|
3,536 |
3,096 |
$66K |
| 95117 |
|
6,566 |
4,354 |
$65K |
| 87497 |
|
767 |
675 |
$61K |
| J0882 |
Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) |
536 |
63 |
$61K |
| 73610 |
|
415 |
382 |
$60K |
| 70450 |
Computed tomography, head or brain; without contrast material |
164 |
153 |
$59K |
| 85007 |
|
3,525 |
3,083 |
$56K |
| 83615 |
|
3,161 |
1,719 |
$56K |
| 94760 |
|
1,795 |
1,771 |
$55K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
8,246 |
8,102 |
$54K |
| 62369 |
|
409 |
400 |
$52K |
| 43762 |
|
356 |
350 |
$51K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
7,125 |
6,827 |
$47K |
| 77075 |
|
191 |
190 |
$44K |
| 76801 |
|
207 |
201 |
$43K |
| 97161 |
|
320 |
312 |
$42K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
81 |
80 |
$42K |
| 84466 |
|
1,678 |
1,634 |
$41K |
| 64642 |
|
196 |
193 |
$40K |
| 51741 |
|
313 |
307 |
$39K |
| 87631 |
|
230 |
230 |
$38K |
| 86140 |
|
1,362 |
1,285 |
$38K |
| 73560 |
|
339 |
335 |
$38K |
| 92552 |
|
771 |
758 |
$37K |
| 92133 |
|
449 |
438 |
$37K |
| 83020 |
|
1,013 |
963 |
$36K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
2,542 |
2,407 |
$35K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,387 |
3,305 |
$35K |
| 71045 |
Radiologic examination, chest; single view |
444 |
431 |
$34K |
| 51798 |
|
423 |
419 |
$33K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
827 |
803 |
$33K |
| 85652 |
|
1,772 |
1,713 |
$32K |
| A0382 |
Bls routine disposable supplies |
1,932 |
1,798 |
$32K |
| 76981 |
|
96 |
94 |
$32K |
| J1644 |
Injection, heparin sodium, per 1000 units |
2,140 |
107 |
$31K |
| 83540 |
|
1,725 |
1,680 |
$30K |
| 93296 |
|
144 |
142 |
$30K |
| 83690 |
|
1,213 |
1,169 |
$29K |
| 73110 |
|
173 |
161 |
$29K |
| 87070 |
|
597 |
568 |
$28K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
379 |
364 |
$27K |
| 73630 |
|
179 |
168 |
$27K |
| 54640 |
|
12 |
12 |
$27K |
| 92588 |
|
218 |
216 |
$26K |
| 95873 |
|
177 |
173 |
$25K |
| 87077 |
|
704 |
615 |
$25K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
129 |
108 |
$25K |
| 38222 |
|
13 |
12 |
$24K |
| J0586 |
Injection, abobotulinumtoxina, 5 units |
37 |
24 |
$24K |
| 97802 |
|
1,368 |
1,357 |
$24K |
| 86900 |
|
1,739 |
1,363 |
$22K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,510 |
2,217 |
$21K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,830 |
3,710 |
$21K |
| 86901 |
|
1,737 |
1,360 |
$21K |
| 86885 |
|
1,477 |
1,276 |
$20K |
| 84145 |
|
490 |
474 |
$20K |
| A0434 |
Specialty care transport (sct) |
41 |
38 |
$19K |
| 82565 |
|
1,420 |
1,350 |
$19K |
| 73070 |
|
140 |
121 |
$19K |
| 86902 |
|
98 |
79 |
$19K |
| 96415 |
|
176 |
162 |
$19K |
| 93886 |
|
52 |
52 |
$18K |
| 80061 |
Lipid panel |
346 |
343 |
$18K |
| 73620 |
|
130 |
127 |
$18K |
| 0074A |
|
1,075 |
1,067 |
$17K |
| 85610 |
|
1,184 |
979 |
$17K |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
1,113 |
782 |
$17K |
| 82784 |
|
413 |
298 |
$17K |
| 0081A |
|
934 |
931 |
$17K |
| 95115 |
|
1,726 |
1,195 |
$16K |
| 81003 |
|
1,081 |
1,043 |
$16K |
| 74019 |
|
202 |
197 |
$16K |
| 73562 |
|
115 |
113 |
$16K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
13 |
13 |
$15K |
| 97164 |
|
111 |
109 |
$15K |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
158 |
90 |
$15K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
12 |
12 |
$15K |
| 54150 |
|
39 |
39 |
$15K |
| 88304 |
|
93 |
91 |
$14K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
55 |
40 |
$14K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
190 |
160 |
$14K |
| 99205 |
Prolong outpt/office vis |
1,841 |
1,821 |
$13K |
| 31526 |
|
13 |
13 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,842 |
1,816 |
$12K |
| 90688 |
|
831 |
818 |
$12K |
| 93975 |
|
41 |
40 |
$12K |
| 93356 |
|
1,222 |
1,134 |
$12K |
| 0082A |
|
677 |
675 |
$11K |
| 88185 |
|
20 |
12 |
$11K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
211 |
209 |
$11K |
| 99245 |
|
1,526 |
1,508 |
$11K |
| 93304 |
|
26 |
26 |
$10K |
| 92083 |
|
122 |
121 |
$10K |
| 92652 |
|
25 |
24 |
$10K |
| 71555 |
|
12 |
12 |
$10K |
| 64643 |
|
57 |
56 |
$9K |
| 90686 |
|
2,239 |
2,198 |
$9K |
| 86356 |
|
15 |
12 |
$9K |
| 70480 |
|
13 |
13 |
$9K |
| 84520 |
|
720 |
675 |
$8K |
| 0054A |
|
553 |
553 |
$8K |
| 81002 |
|
347 |
336 |
$8K |
| 86835 |
|
15 |
14 |
$8K |
| 92585 |
|
24 |
24 |
$8K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
641 |
609 |
$8K |
| 83970 |
|
125 |
117 |
$8K |
| 85730 |
|
626 |
556 |
$8K |
| 97605 |
|
44 |
38 |
$8K |
| 87081 |
|
193 |
192 |
$8K |
| 0071A |
|
502 |
496 |
$8K |
| 80195 |
|
149 |
135 |
$8K |
| 0111A |
|
410 |
410 |
$7K |
| J3535 |
Drug administered through a metered dose inhaler |
252 |
238 |
$7K |
| 73590 |
|
60 |
54 |
$7K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
19 |
12 |
$6K |
| 86834 |
|
13 |
12 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
135 |
135 |
$6K |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
381 |
284 |
$6K |
| 36430 |
|
112 |
92 |
$6K |
| 80306 |
|
137 |
134 |
$6K |
| 80305 |
|
123 |
121 |
$6K |
| J3480 |
Injection, potassium chloride, per 2 meq |
290 |
214 |
$6K |
| 0072A |
|
399 |
396 |
$6K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
797 |
658 |
$6K |
| 87449 |
|
65 |
38 |
$6K |
| 87535 |
|
88 |
87 |
$6K |
| 81378 |
|
17 |
16 |
$5K |
| 87186 |
|
192 |
171 |
$5K |
| 82570 |
|
328 |
323 |
$5K |
| 0112A |
|
316 |
316 |
$5K |
| 80329 |
|
118 |
81 |
$5K |
| 0124A |
|
296 |
296 |
$5K |
| 86807 |
|
32 |
30 |
$5K |
| 76885 |
|
46 |
45 |
$5K |
| 82043 |
|
290 |
287 |
$5K |
| 73000 |
|
25 |
24 |
$5K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
2,659 |
2,617 |
$5K |
| 76821 |
|
32 |
25 |
$5K |
| 96409 |
|
32 |
25 |
$5K |
| 86923 |
|
64 |
51 |
$4K |
| 82010 |
|
130 |
130 |
$4K |
| 82610 |
|
188 |
176 |
$4K |
| 87340 |
|
127 |
123 |
$4K |
| 76827 |
|
33 |
27 |
$4K |
| 82805 |
|
40 |
38 |
$4K |
| 85397 |
|
38 |
38 |
$4K |
| 99242 |
|
491 |
478 |
$4K |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
40 |
36 |
$4K |
| 92523 |
|
26 |
25 |
$4K |
| 97804 |
|
203 |
192 |
$4K |
| 0154A |
|
189 |
189 |
$4K |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
197 |
184 |
$4K |
| 84134 |
|
184 |
105 |
$4K |
| 85240 |
|
38 |
38 |
$4K |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
227 |
163 |
$4K |
| 92550 |
|
37 |
37 |
$4K |
| 0083A |
|
230 |
226 |
$4K |
| 88271 |
|
13 |
12 |
$4K |
| 88237 |
|
15 |
14 |
$3K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
230 |
210 |
$3K |
| 83021 |
|
59 |
55 |
$3K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
246 |
171 |
$3K |
| 92553 |
|
53 |
51 |
$3K |
| 92524 |
|
24 |
24 |
$3K |
| 87147 |
|
111 |
94 |
$3K |
| 95076 |
|
13 |
12 |
$3K |
| 93786 |
|
48 |
45 |
$3K |
| 88275 |
|
13 |
12 |
$3K |
| 82803 |
|
41 |
36 |
$3K |
| 84550 |
|
226 |
203 |
$3K |
| 85520 |
|
46 |
43 |
$3K |
| 36591 |
|
41 |
40 |
$3K |
| 84478 |
|
84 |
79 |
$3K |
| 92556 |
|
39 |
39 |
$3K |
| 82962 |
|
6,192 |
6,100 |
$3K |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
3,289 |
3,246 |
$3K |
| 85246 |
|
38 |
38 |
$3K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
48 |
25 |
$3K |
| 84439 |
|
94 |
94 |
$3K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
407 |
276 |
$2K |
| 86357 |
|
27 |
24 |
$2K |
| 86355 |
|
27 |
24 |
$2K |
| 86359 |
|
27 |
24 |
$2K |
| 84443 |
Thyroid stimulating hormone (TSH) |
67 |
67 |
$2K |
| 86360 |
|
12 |
12 |
$2K |
| 85660 |
|
94 |
54 |
$2K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
299 |
276 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
72 |
40 |
$2K |
| 97168 |
|
13 |
12 |
$2K |
| 90656 |
|
353 |
353 |
$2K |
| 86592 |
|
85 |
84 |
$2K |
| 86803 |
|
55 |
55 |
$2K |
| 51784 |
|
25 |
25 |
$2K |
| V5264 |
Ear mold/insert, not disposable, any type |
25 |
25 |
$2K |
| J2704 |
Injection, propofol, 10 mg |
5,760 |
5,632 |
$2K |
| 88184 |
|
15 |
14 |
$2K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
274 |
220 |
$2K |
| 87185 |
|
60 |
56 |
$2K |
| 81382 |
|
17 |
16 |
$1K |
| 87536 |
|
12 |
12 |
$1K |
| 80320 |
|
53 |
51 |
$1K |
| 82465 |
|
81 |
79 |
$1K |
| 82550 |
|
59 |
56 |
$1K |
| 83516 |
|
75 |
67 |
$1K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
284 |
247 |
$1K |
| 83605 |
|
41 |
36 |
$1K |
| 80180 |
|
44 |
38 |
$1K |
| 82104 |
|
21 |
21 |
$1K |
| 51728 |
|
13 |
13 |
$1K |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
5,767 |
5,633 |
$1K |
| 80339 |
|
30 |
27 |
$1K |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
497 |
479 |
$1K |
| 86704 |
|
40 |
40 |
$1K |
| 94664 |
|
1,722 |
1,681 |
$1K |
| 86480 |
|
14 |
14 |
$1K |
| 86708 |
|
27 |
27 |
$910.88 |
| 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 |
2,801 |
2,710 |
$905.46 |
| 51797 |
|
13 |
13 |
$849.47 |
| 92583 |
|
40 |
40 |
$842.12 |
| 93788 |
|
41 |
41 |
$807.85 |
| 82390 |
|
21 |
21 |
$801.34 |
| 97124 |
|
26 |
12 |
$786.28 |
| 84702 |
|
46 |
38 |
$619.74 |
| A9150 |
Non-prescription drugs |
206 |
179 |
$608.01 |
| 36592 |
|
163 |
74 |
$602.86 |
| 0051A |
|
38 |
38 |
$599.82 |
| 86709 |
|
13 |
13 |
$588.16 |
| 84703 |
|
53 |
53 |
$544.35 |
| 84156 |
|
25 |
25 |
$489.16 |
| 0173A |
|
24 |
20 |
$482.99 |
| 88311 |
|
13 |
12 |
$459.22 |
| 82330 |
|
13 |
12 |
$441.64 |
| 0052A |
|
25 |
25 |
$406.79 |
| J0290 |
Injection, ampicillin sodium, 500 mg |
39 |
38 |
$396.68 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
14 |
12 |
$379.75 |
| J9370 |
Vincristine sulfate, 1 mg |
17 |
13 |
$365.79 |
| 86376 |
|
13 |
13 |
$363.66 |
| 86317 |
|
15 |
15 |
$358.71 |
| 99241 |
|
33 |
33 |
$342.88 |
| 86880 |
|
80 |
52 |
$327.34 |
| V5275 |
Ear impression, each |
13 |
12 |
$310.42 |
| 85018 |
|
50 |
41 |
$309.93 |
| 92002 |
|
52 |
51 |
$296.05 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
20 |
14 |
$280.22 |
| 90791 |
Psychiatric diagnostic evaluation |
51 |
51 |
$210.83 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
13 |
13 |
$188.51 |
| 85651 |
|
60 |
54 |
$188.36 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
33 |
29 |
$176.20 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
25 |
24 |
$167.84 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
13 |
13 |
$153.06 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
14 |
12 |
$110.93 |
| 86703 |
|
13 |
12 |
$96.88 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
16 |
16 |
$89.57 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
98 |
97 |
$67.87 |
| 86780 |
|
13 |
13 |
$59.10 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$52.97 |
| 91307 |
|
2,058 |
1,982 |
$0.00 |
| C1889 |
Implantable/insertable device, not otherwise classified |
178 |
172 |
$0.00 |
| 91305 |
|
786 |
766 |
$0.00 |
| 91315 |
|
188 |
188 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
76 |
41 |
$0.00 |
| C1769 |
Guide wire |
28 |
27 |
$0.00 |
| 91317 |
|
24 |
20 |
$0.00 |
| 91308 |
|
1,988 |
1,824 |
$0.00 |
| 91312 |
|
294 |
294 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$0.00 |
| 91311 |
|
788 |
770 |
$0.00 |
| G0390 |
Trauma response team associated with hospital critical care service |
13 |
12 |
$0.00 |