| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
80,111 |
74,447 |
$6.65M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
68,487 |
61,640 |
$6.08M |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
69,599 |
52,691 |
$2.01M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
11,569 |
10,168 |
$1.19M |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
5,838 |
5,017 |
$739K |
| 80053 |
Comprehensive metabolic panel |
86,661 |
71,894 |
$662K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
8,821 |
7,857 |
$653K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
21,002 |
19,035 |
$587K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
14,912 |
13,423 |
$557K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16,400 |
14,794 |
$547K |
| 71045 |
Radiologic examination, chest; single view |
12,047 |
10,440 |
$543K |
| G0378 |
Hospital observation service, per hour |
3,251 |
2,523 |
$481K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
8,053 |
6,785 |
$466K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
31,471 |
26,736 |
$446K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
8,187 |
7,706 |
$445K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
13,028 |
11,714 |
$392K |
| 85027 |
|
84,723 |
67,842 |
$389K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
11,332 |
2,372 |
$372K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,152 |
6,004 |
$360K |
| 71046 |
Radiologic examination, chest; 2 views |
6,594 |
5,961 |
$354K |
| 87481 |
|
8,054 |
6,807 |
$350K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
14,700 |
11,757 |
$346K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
14,235 |
12,931 |
$345K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
14,320 |
13,019 |
$344K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
12,830 |
10,397 |
$337K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
7,266 |
6,399 |
$334K |
| 81025 |
|
44,234 |
39,596 |
$285K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
2,835 |
2,203 |
$247K |
| 76801 |
|
2,609 |
2,294 |
$176K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
760 |
682 |
$174K |
| 80081 |
|
2,263 |
2,024 |
$168K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
31,407 |
22,914 |
$166K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
1,649 |
1,122 |
$164K |
| 83735 |
|
33,247 |
25,765 |
$150K |
| 84484 |
|
16,260 |
12,182 |
$148K |
| 36415 |
Collection of venous blood by venipuncture |
57,857 |
46,926 |
$141K |
| 83880 |
|
5,076 |
4,477 |
$123K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
5,988 |
5,386 |
$122K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,115 |
1,022 |
$111K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
554 |
389 |
$108K |
| 81001 |
|
44,229 |
39,121 |
$106K |
| 70450 |
Computed tomography, head or brain; without contrast material |
612 |
548 |
$103K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
17,859 |
15,049 |
$89K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
2,906 |
2,667 |
$86K |
| 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 |
1,564 |
1,464 |
$85K |
| 86480 |
|
1,672 |
1,417 |
$84K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,769 |
1,270 |
$83K |
| 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 |
1,423 |
1,211 |
$81K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
6,551 |
4,397 |
$77K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
5,450 |
4,956 |
$75K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
8,727 |
7,597 |
$64K |
| 87150 |
|
1,881 |
1,762 |
$63K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
10,989 |
7,998 |
$60K |
| 72082 |
|
542 |
503 |
$59K |
| 76536 |
|
666 |
604 |
$58K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
1,063 |
713 |
$56K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,854 |
3,364 |
$55K |
| 99215 |
Prolong outpt/office vis |
908 |
690 |
$43K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
3,314 |
2,065 |
$41K |
| 31575 |
|
429 |
329 |
$39K |
| 86803 |
|
3,043 |
2,653 |
$38K |
| 93976 |
|
405 |
352 |
$37K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
142 |
105 |
$36K |
| 83690 |
|
7,180 |
6,259 |
$36K |
| 84100 |
|
10,482 |
8,446 |
$34K |
| 84702 |
|
2,373 |
2,056 |
$32K |
| 59025 |
Fetal non-stress test |
1,185 |
614 |
$31K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
411 |
253 |
$30K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
152 |
138 |
$30K |
| A0425 |
Ground mileage, per statute mile |
2,801 |
1,815 |
$28K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
44 |
40 |
$28K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,182 |
1,087 |
$27K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
114 |
106 |
$27K |
| 86703 |
|
2,005 |
1,879 |
$23K |
| 85610 |
|
8,075 |
6,969 |
$22K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
612 |
588 |
$21K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
10,448 |
8,024 |
$21K |
| 92134 |
|
942 |
816 |
$19K |
| 82677 |
|
844 |
790 |
$19K |
| 36592 |
|
1,411 |
1,250 |
$18K |
| 81002 |
|
6,425 |
5,104 |
$18K |
| 93325 |
|
149 |
133 |
$18K |
| 76820 |
|
311 |
221 |
$18K |
| 36512 |
|
33 |
25 |
$18K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
618 |
594 |
$17K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
3,228 |
2,254 |
$16K |
| 93320 |
|
113 |
105 |
$16K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
569 |
183 |
$16K |
| 82105 |
|
967 |
915 |
$14K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
286 |
142 |
$14K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
611 |
543 |
$14K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
160 |
138 |
$14K |
| 73630 |
|
421 |
358 |
$14K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
574 |
490 |
$13K |
| 86336 |
|
843 |
790 |
$12K |
| 87430 |
|
861 |
757 |
$11K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
368 |
233 |
$11K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
5,491 |
4,268 |
$11K |
| 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 |
327 |
256 |
$11K |
| 82550 |
|
2,425 |
1,943 |
$10K |
| 88142 |
|
742 |
689 |
$10K |
| 83970 |
|
326 |
283 |
$10K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
151 |
89 |
$10K |
| 76942 |
|
197 |
181 |
$9K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
14 |
14 |
$9K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
369 |
350 |
$9K |
| 82950 |
|
1,997 |
1,852 |
$9K |
| 77073 |
|
129 |
108 |
$9K |
| 72190 |
|
102 |
97 |
$8K |
| 82784 |
|
359 |
256 |
$8K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
169 |
147 |
$8K |
| 87807 |
|
669 |
622 |
$8K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
599 |
200 |
$8K |
| 94060 |
|
170 |
146 |
$8K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,141 |
882 |
$7K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
16 |
15 |
$7K |
| 87077 |
|
909 |
788 |
$7K |
| 82947 |
|
1,918 |
1,644 |
$6K |
| 73564 |
|
76 |
71 |
$6K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
87 |
67 |
$6K |
| 74240 |
|
33 |
32 |
$6K |
| 93017 |
|
45 |
38 |
$6K |
| 72081 |
|
53 |
48 |
$6K |
| 71250 |
|
14 |
12 |
$6K |
| 86592 |
|
1,262 |
1,126 |
$6K |
| 87040 |
|
562 |
421 |
$6K |
| 76830 |
Ultrasound, transvaginal |
68 |
64 |
$5K |
| 74019 |
|
91 |
81 |
$5K |
| 84425 |
|
286 |
259 |
$5K |
| 73610 |
|
167 |
148 |
$5K |
| 99173 |
|
633 |
606 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
642 |
576 |
$4K |
| 87340 |
|
501 |
427 |
$4K |
| 82607 |
|
329 |
293 |
$4K |
| 87081 |
|
641 |
593 |
$4K |
| 86787 |
|
356 |
300 |
$4K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
30 |
24 |
$4K |
| 80143 |
|
366 |
321 |
$4K |
| 92133 |
|
278 |
242 |
$4K |
| 82728 |
|
315 |
292 |
$4K |
| 84207 |
|
250 |
226 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,060 |
988 |
$3K |
| 92551 |
|
480 |
463 |
$3K |
| 83605 |
|
419 |
347 |
$3K |
| 97167 |
|
102 |
85 |
$3K |
| 77336 |
|
51 |
26 |
$3K |
| 83550 |
|
438 |
403 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
13 |
12 |
$3K |
| 97163 |
|
91 |
78 |
$3K |
| 73030 |
|
61 |
50 |
$3K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
30 |
24 |
$3K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,431 |
979 |
$3K |
| 38222 |
|
14 |
13 |
$3K |
| 80061 |
Lipid panel |
287 |
242 |
$3K |
| 85730 |
|
792 |
684 |
$3K |
| G0475 |
Hiv antigen/antibody, combination assay, screening |
666 |
490 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
787 |
738 |
$2K |
| 82746 |
|
210 |
180 |
$2K |
| 81003 |
|
1,517 |
1,272 |
$2K |
| 82553 |
|
332 |
232 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
129 |
70 |
$2K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
674 |
534 |
$2K |
| 86334 |
|
203 |
167 |
$2K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
13 |
12 |
$2K |
| 84439 |
|
245 |
226 |
$2K |
| 90686 |
|
181 |
141 |
$2K |
| 92083 |
|
141 |
120 |
$2K |
| 83521 |
|
172 |
130 |
$2K |
| 20552 |
|
109 |
92 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
701 |
572 |
$2K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
28 |
26 |
$2K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
64 |
57 |
$2K |
| 87186 |
|
225 |
191 |
$2K |
| 86850 |
|
317 |
276 |
$2K |
| 92557 |
|
82 |
74 |
$2K |
| 92504 |
|
388 |
314 |
$2K |
| 84446 |
|
137 |
119 |
$2K |
| 36593 |
|
14 |
12 |
$2K |
| 80074 |
|
97 |
57 |
$1K |
| 91200 |
|
13 |
13 |
$1K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
20 |
16 |
$1K |
| 73562 |
|
33 |
26 |
$1K |
| 84165 |
|
232 |
192 |
$1K |
| 85651 |
|
412 |
385 |
$1K |
| 95950 |
|
12 |
12 |
$1K |
| 82747 |
|
88 |
84 |
$1K |
| 73560 |
|
60 |
53 |
$1K |
| 86235 |
|
28 |
28 |
$1K |
| 86140 |
|
352 |
307 |
$1K |
| 94729 |
|
26 |
24 |
$1K |
| 94727 |
|
30 |
24 |
$1K |
| 83540 |
|
270 |
247 |
$1K |
| 80320 |
|
2,346 |
1,709 |
$1K |
| 84703 |
|
198 |
176 |
$1K |
| 84590 |
|
116 |
111 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
418 |
375 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
833 |
758 |
$1K |
| 87210 |
|
313 |
268 |
$1K |
| 85045 |
|
268 |
228 |
$1K |
| 87070 |
|
120 |
106 |
$964.84 |
| 83021 |
|
43 |
31 |
$929.16 |
| 81229 |
|
18 |
13 |
$900.04 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
267 |
104 |
$876.25 |
| 86900 |
|
356 |
308 |
$875.91 |
| 86901 |
|
355 |
308 |
$853.58 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
47 |
36 |
$828.62 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
26 |
25 |
$809.87 |
| 86780 |
|
74 |
62 |
$797.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
130 |
89 |
$762.87 |
| 73130 |
|
14 |
12 |
$726.93 |
| 99201 |
|
34 |
32 |
$721.16 |
| 83020 |
|
64 |
40 |
$696.51 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
232 |
178 |
$693.64 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,302 |
2,020 |
$693.55 |
| C1769 |
Guide wire |
598 |
405 |
$684.75 |
| 20610 |
|
84 |
55 |
$643.35 |
| 80197 |
|
189 |
123 |
$641.64 |
| 92567 |
|
56 |
52 |
$634.50 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
313 |
238 |
$586.67 |
| 87563 |
|
98 |
46 |
$574.88 |
| 94664 |
|
19 |
13 |
$570.33 |
| 85018 |
|
213 |
206 |
$556.84 |
| 80050 |
General health panel |
16 |
15 |
$547.39 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,255 |
4,566 |
$531.97 |
| 87522 |
Neg quan hep c or qual rna |
13 |
13 |
$519.26 |
| 80305 |
|
58 |
50 |
$505.81 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
14 |
14 |
$480.56 |
| 86800 |
|
33 |
27 |
$455.64 |
| 86376 |
|
33 |
27 |
$419.72 |
| 84480 |
|
92 |
80 |
$406.50 |
| 84597 |
|
41 |
40 |
$390.97 |
| 87806 |
|
14 |
13 |
$385.91 |
| 82570 |
|
127 |
107 |
$376.77 |
| 83883 |
|
44 |
39 |
$360.17 |
| 86225 |
|
27 |
27 |
$347.82 |
| 86038 |
|
31 |
31 |
$342.36 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
111 |
96 |
$335.90 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
12 |
12 |
$331.33 |
| 95012 |
|
40 |
37 |
$331.32 |
| 69210 |
|
29 |
28 |
$326.80 |
| 86902 |
|
14 |
12 |
$314.60 |
| 82951 |
|
24 |
24 |
$310.44 |
| J1815 |
Injection, insulin, per 5 units |
78 |
41 |
$297.74 |
| 76514 |
|
29 |
27 |
$272.84 |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
17 |
12 |
$256.36 |
| 84436 |
|
81 |
69 |
$255.92 |
| 88112 |
|
12 |
12 |
$229.28 |
| 88173 |
|
12 |
12 |
$223.72 |
| 84156 |
|
108 |
90 |
$222.65 |
| G0379 |
Direct admission of patient for hospital observation care |
19 |
17 |
$221.65 |
| 93298 |
|
12 |
12 |
$206.82 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
591 |
400 |
$203.04 |
| 82726 |
|
18 |
12 |
$200.15 |
| 85379 |
|
35 |
28 |
$198.90 |
| 87799 |
|
73 |
52 |
$185.91 |
| 82962 |
|
202 |
52 |
$180.61 |
| 83615 |
|
55 |
36 |
$176.47 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
349 |
234 |
$159.23 |
| 82150 |
|
29 |
27 |
$155.11 |
| 92020 |
|
46 |
45 |
$154.97 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
28 |
24 |
$152.24 |
| 84153 |
|
14 |
12 |
$148.23 |
| 84478 |
|
26 |
24 |
$140.16 |
| 82525 |
|
22 |
12 |
$137.01 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
632 |
529 |
$135.47 |
| 80047 |
|
13 |
12 |
$132.78 |
| 92002 |
|
30 |
27 |
$128.92 |
| 84630 |
|
22 |
12 |
$125.75 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
60 |
52 |
$118.89 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
93 |
77 |
$113.07 |
| 82465 |
|
26 |
24 |
$98.88 |
| 80069 |
|
13 |
13 |
$86.80 |
| 82373 |
|
18 |
12 |
$86.58 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
12 |
12 |
$83.49 |
| 92556 |
|
12 |
12 |
$81.64 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
15 |
12 |
$80.53 |
| 88342 |
|
89 |
81 |
$74.40 |
| 82248 |
|
68 |
40 |
$73.00 |
| 82043 |
|
12 |
12 |
$64.42 |
| 90474 |
|
212 |
193 |
$54.15 |
| 36416 |
|
27 |
26 |
$51.18 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
14 |
12 |
$45.15 |
| 81000 |
|
18 |
13 |
$35.54 |
| 88313 |
|
38 |
28 |
$35.09 |
| J1644 |
Injection, heparin sodium, per 1000 units |
316 |
212 |
$30.48 |
| 85652 |
|
12 |
12 |
$27.40 |
| S0028 |
Injection, famotidine, 20 mg |
13 |
13 |
$26.88 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
28 |
26 |
$23.93 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
141 |
98 |
$18.90 |
| 99406 |
|
64 |
42 |
$17.32 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
351 |
212 |
$16.17 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
27 |
25 |
$12.54 |
| 80329 |
|
211 |
149 |
$7.73 |
| G0008 |
Administration of influenza virus vaccine |
30 |
30 |
$5.68 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
317 |
204 |
$4.94 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
51 |
38 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
63 |
41 |
$0.00 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
12 |
12 |
$0.00 |
| 99152 |
|
32 |
26 |
$0.00 |
| 88280 |
|
13 |
12 |
$0.00 |
| 88237 |
|
14 |
13 |
$0.00 |
| S5000 |
Prescription drug, generic |
15 |
14 |
$0.00 |
| A9270 |
Non-covered item or service |
180 |
74 |
$0.00 |
| V2632 |
Posterior chamber intraocular lens |
14 |
12 |
$0.00 |
| C2623 |
Catheter, transluminal angioplasty, drug-coated, non-laser |
21 |
12 |
$0.00 |
| 88185 |
|
13 |
12 |
$0.00 |
| C1781 |
Mesh (implantable) |
14 |
12 |
$0.00 |
| 88184 |
|
13 |
12 |
$0.00 |
| 88311 |
|
14 |
13 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
33 |
29 |
$0.00 |
| S2900 |
Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) |
27 |
12 |
$0.00 |
| 88271 |
|
13 |
12 |
$0.00 |
| 88264 |
|
14 |
13 |
$0.00 |
| 88273 |
|
13 |
12 |
$0.00 |