| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
77,186 |
72,226 |
$33.18M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
20,192 |
19,230 |
$16.54M |
| G0378 |
Hospital observation service, per hour |
13,906 |
8,438 |
$13.37M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
13,482 |
13,211 |
$3.98M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
1,803 |
1,774 |
$2.12M |
| 0450 |
Emergency room services |
57,595 |
52,611 |
$1.56M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
7,308 |
7,197 |
$1.50M |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
1,582 |
1,530 |
$1.45M |
| 70450 |
Computed tomography, head or brain; without contrast material |
15,172 |
14,741 |
$1.41M |
| 71045 |
Radiologic examination, chest; single view |
29,022 |
27,423 |
$1.36M |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
5,880 |
5,793 |
$959K |
| 59025 |
Fetal non-stress test |
4,665 |
1,892 |
$947K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
10,311 |
10,191 |
$810K |
| 76830 |
Ultrasound, transvaginal |
9,703 |
9,585 |
$770K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
9,467 |
9,287 |
$740K |
| 76818 |
|
7,872 |
2,471 |
$687K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
560 |
556 |
$635K |
| 86885 |
|
8,669 |
8,168 |
$598K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
23,072 |
22,261 |
$554K |
| 86900 |
|
12,725 |
11,709 |
$550K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
2,695 |
2,684 |
$543K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,306 |
1,294 |
$512K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
2,684 |
2,668 |
$507K |
| 93971 |
|
2,587 |
2,466 |
$435K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,864 |
2,863 |
$408K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,780 |
1,765 |
$367K |
| 77080 |
|
3,241 |
3,238 |
$363K |
| 83880 |
|
17,422 |
14,035 |
$351K |
| 76770 |
|
3,588 |
3,565 |
$329K |
| 80051 |
|
127,165 |
99,998 |
$322K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
25,570 |
22,849 |
$306K |
| 76641 |
|
3,223 |
3,216 |
$303K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,592 |
1,578 |
$301K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
116,602 |
95,330 |
$293K |
| 47562 |
|
79 |
78 |
$285K |
| 82565 |
|
130,929 |
104,150 |
$264K |
| 71046 |
Radiologic examination, chest; 2 views |
6,405 |
6,295 |
$257K |
| 76536 |
|
2,563 |
2,536 |
$248K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,612 |
2,350 |
$241K |
| 84702 |
|
37,367 |
33,375 |
$239K |
| 74183 |
|
533 |
529 |
$213K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,968 |
1,964 |
$201K |
| 70491 |
|
1,009 |
1,007 |
$195K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
8,758 |
8,313 |
$192K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
8,768 |
8,323 |
$192K |
| 74178 |
|
434 |
433 |
$190K |
| 86923 |
|
1,540 |
1,374 |
$189K |
| 71250 |
|
1,539 |
1,534 |
$188K |
| 70496 |
|
825 |
819 |
$185K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
12,131 |
11,435 |
$185K |
| 76801 |
|
2,839 |
2,575 |
$183K |
| 86901 |
|
12,740 |
11,721 |
$169K |
| 70498 |
|
746 |
741 |
$165K |
| 93970 |
|
688 |
682 |
$164K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
18,071 |
16,120 |
$156K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
7,284 |
6,166 |
$149K |
| 70486 |
|
1,507 |
1,498 |
$148K |
| 72141 |
|
732 |
731 |
$146K |
| 87505 |
|
1,702 |
1,683 |
$146K |
| 73630 |
|
3,202 |
3,065 |
$146K |
| 84460 |
|
59,731 |
52,837 |
$141K |
| 73030 |
|
2,788 |
2,632 |
$140K |
| 84443 |
Thyroid stimulating hormone (TSH) |
11,116 |
10,845 |
$140K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,360 |
1,345 |
$139K |
| 76870 |
|
1,768 |
1,735 |
$135K |
| 93017 |
|
387 |
386 |
$134K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
1,884 |
1,855 |
$133K |
| 72100 |
|
1,677 |
1,669 |
$131K |
| 77066 |
Tomosynthesis, mammo |
1,060 |
1,060 |
$128K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
17,167 |
16,196 |
$128K |
| 84520 |
|
112,907 |
89,654 |
$125K |
| 73610 |
|
2,955 |
2,826 |
$125K |
| 73562 |
|
2,483 |
2,352 |
$122K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
1,284 |
1,271 |
$121K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,121 |
608 |
$119K |
| 82247 |
|
55,737 |
47,488 |
$114K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,068 |
2,311 |
$107K |
| 76881 |
|
1,082 |
1,067 |
$106K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
480 |
466 |
$105K |
| 82947 |
|
100,408 |
86,081 |
$103K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12,179 |
11,949 |
$99K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
7,080 |
6,242 |
$96K |
| 0637 |
|
164,576 |
53,663 |
$95K |
| 84075 |
|
50,846 |
44,705 |
$95K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,121 |
1,114 |
$91K |
| 84484 |
|
40,776 |
30,668 |
$87K |
| 85610 |
|
60,970 |
51,193 |
$87K |
| 73130 |
|
1,966 |
1,850 |
$84K |
| 99199 |
Unlisted special service, procedure or report |
2,883 |
2,638 |
$82K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,261 |
1,200 |
$82K |
| 80061 |
Lipid panel |
6,830 |
6,737 |
$80K |
| 77065 |
Tomosynthesis, mammo |
895 |
893 |
$80K |
| 85027 |
|
16,787 |
15,869 |
$78K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
498 |
497 |
$78K |
| 73560 |
|
1,522 |
1,429 |
$74K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
45,798 |
36,256 |
$74K |
| 84450 |
|
45,697 |
40,862 |
$74K |
| 83690 |
|
40,200 |
35,888 |
$71K |
| 73502 |
|
1,262 |
1,214 |
$70K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,506 |
2,476 |
$69K |
| 0250 |
|
17,370 |
11,655 |
$69K |
| 74018 |
|
1,406 |
1,353 |
$64K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
10,638 |
10,263 |
$62K |
| 73110 |
|
1,391 |
1,322 |
$58K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
3,171 |
3,132 |
$57K |
| 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 |
2,794 |
2,747 |
$54K |
| P9021 |
Red blood cells, each unit |
1,196 |
992 |
$53K |
| 76380 |
|
771 |
770 |
$52K |
| 90674 |
|
3,880 |
3,830 |
$48K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
5,696 |
5,436 |
$46K |
| 83970 |
|
1,179 |
1,153 |
$44K |
| 82310 |
|
18,375 |
15,625 |
$42K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,803 |
1,665 |
$42K |
| 73221 |
|
189 |
181 |
$42K |
| 87040 |
|
19,261 |
10,165 |
$41K |
| 93880 |
|
120 |
120 |
$41K |
| 73080 |
|
934 |
889 |
$41K |
| 81003 |
|
60,515 |
56,993 |
$40K |
| 73140 |
|
985 |
920 |
$40K |
| 86141 |
|
6,233 |
5,582 |
$40K |
| 83735 |
|
18,411 |
13,928 |
$39K |
| 82728 |
|
3,617 |
3,448 |
$39K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
19,042 |
17,447 |
$38K |
| 82248 |
|
31,040 |
28,882 |
$37K |
| 87088 |
|
16,776 |
16,271 |
$36K |
| J2785 |
Injection, regadenoson, 0.1 mg |
251 |
251 |
$36K |
| Z7502 |
|
1,570 |
1,523 |
$35K |
| 72040 |
|
687 |
677 |
$35K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
23,766 |
20,969 |
$35K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
391 |
389 |
$34K |
| 72197 |
|
84 |
84 |
$34K |
| 73590 |
|
658 |
622 |
$33K |
| 86780 |
|
3,094 |
3,028 |
$32K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
13,519 |
10,860 |
$32K |
| 80076 |
|
4,469 |
4,247 |
$32K |
| 74174 |
|
78 |
78 |
$31K |
| 73100 |
|
409 |
338 |
$29K |
| 86803 |
|
2,664 |
2,612 |
$28K |
| 82607 |
|
2,535 |
2,501 |
$28K |
| 83605 |
|
11,879 |
9,510 |
$27K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
13,959 |
11,418 |
$27K |
| 73090 |
|
605 |
560 |
$26K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
1,646 |
1,168 |
$25K |
| 72131 |
|
183 |
182 |
$25K |
| 85379 |
|
5,637 |
5,427 |
$24K |
| 0258 |
|
7,787 |
6,544 |
$23K |
| J3490 |
Unclassified drugs |
12,868 |
9,588 |
$22K |
| 83550 |
|
3,135 |
3,075 |
$22K |
| 87340 |
|
3,154 |
3,082 |
$21K |
| 81513 |
|
268 |
264 |
$21K |
| 80306 |
|
3,446 |
3,260 |
$21K |
| 90686 |
|
2,541 |
2,514 |
$21K |
| 73120 |
|
203 |
194 |
$20K |
| 87449 |
|
2,759 |
2,100 |
$20K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,846 |
1,798 |
$20K |
| 87210 |
|
6,136 |
6,020 |
$20K |
| 78306 |
|
55 |
55 |
$20K |
| 90791 |
Psychiatric diagnostic evaluation |
581 |
568 |
$19K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
4,957 |
4,368 |
$19K |
| 97161 |
|
2,034 |
1,997 |
$18K |
| 77072 |
|
172 |
172 |
$18K |
| 84100 |
|
11,301 |
8,662 |
$17K |
| 73564 |
|
156 |
150 |
$17K |
| 82077 |
|
4,315 |
3,698 |
$17K |
| 99499 |
|
733 |
550 |
$17K |
| 88342 |
|
116 |
116 |
$17K |
| 82040 |
|
6,183 |
5,765 |
$16K |
| 82746 |
|
1,583 |
1,568 |
$16K |
| 84146 |
|
797 |
796 |
$16K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,210 |
1,200 |
$16K |
| 83540 |
|
3,178 |
3,117 |
$16K |
| 71101 |
|
154 |
153 |
$16K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,331 |
1,264 |
$15K |
| 90935 |
Hemodialysis procedure with single evaluation by a physician |
149 |
117 |
$15K |
| 82570 |
|
2,922 |
2,631 |
$14K |
| 82043 |
|
2,390 |
2,364 |
$14K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
755 |
747 |
$14K |
| 87324 |
|
1,604 |
1,581 |
$14K |
| 87481 |
|
599 |
582 |
$14K |
| 0710 |
|
2,366 |
2,343 |
$13K |
| 72050 |
|
100 |
100 |
$13K |
| 83520 |
|
832 |
460 |
$12K |
| J1815 |
Injection, insulin, per 5 units |
7,651 |
3,673 |
$12K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
5,184 |
4,229 |
$12K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
769 |
738 |
$12K |
| 85730 |
|
3,957 |
3,471 |
$12K |
| 96367 |
|
1,126 |
1,052 |
$11K |
| 84439 |
|
2,048 |
1,949 |
$11K |
| 80179 |
|
2,561 |
2,386 |
$11K |
| J1644 |
Injection, heparin sodium, per 1000 units |
6,044 |
3,206 |
$11K |
| 85652 |
|
6,441 |
5,964 |
$11K |
| 84132 |
|
4,035 |
3,668 |
$11K |
| J2060 |
Injection, lorazepam, 2 mg |
5,192 |
4,276 |
$10K |
| 73660 |
|
168 |
162 |
$10K |
| 83001 |
|
508 |
505 |
$10K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
269 |
264 |
$10K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
4,535 |
3,425 |
$9K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
3,322 |
3,046 |
$9K |
| 84156 |
|
2,492 |
2,316 |
$8K |
| 72070 |
|
82 |
82 |
$8K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,631 |
1,280 |
$8K |
| G0008 |
Administration of influenza virus vaccine |
3,151 |
3,143 |
$8K |
| 72081 |
|
133 |
132 |
$8K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
5,053 |
4,496 |
$8K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
5,859 |
5,164 |
$8K |
| 86480 |
|
136 |
136 |
$8K |
| 0370 |
|
2,320 |
2,297 |
$8K |
| 77061 |
|
75 |
74 |
$8K |
| 82550 |
|
3,263 |
2,855 |
$8K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
3,018 |
2,649 |
$7K |
| 74170 |
|
26 |
26 |
$7K |
| 84295 |
|
1,667 |
1,522 |
$7K |
| 87081 |
|
3,477 |
3,414 |
$7K |
| 87536 |
|
83 |
83 |
$7K |
| 87205 |
|
3,122 |
2,759 |
$7K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,591 |
1,346 |
$7K |
| 86880 |
|
156 |
150 |
$6K |
| 73060 |
|
106 |
99 |
$6K |
| 90656 |
|
733 |
728 |
$6K |
| 82962 |
|
4,610 |
2,799 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,915 |
954 |
$6K |
| 86704 |
|
913 |
883 |
$6K |
| 86787 |
|
413 |
412 |
$5K |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
44 |
44 |
$5K |
| 84550 |
|
1,961 |
1,903 |
$5K |
| 86762 |
|
354 |
353 |
$5K |
| 72170 |
|
42 |
42 |
$5K |
| 73200 |
|
40 |
40 |
$5K |
| 80164 |
|
450 |
429 |
$5K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
4,898 |
4,364 |
$5K |
| 83615 |
|
1,562 |
1,380 |
$5K |
| 87186 |
|
2,286 |
2,241 |
$5K |
| 84145 |
|
1,587 |
1,460 |
$5K |
| 73700 |
|
37 |
37 |
$5K |
| 84403 |
|
172 |
170 |
$5K |
| 82627 |
|
203 |
202 |
$5K |
| 44970 |
|
54 |
53 |
$5K |
| 90715 |
|
303 |
298 |
$4K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,159 |
1,353 |
$4K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
958 |
647 |
$4K |
| 86317 |
|
661 |
631 |
$4K |
| 97116 |
|
1,084 |
981 |
$4K |
| 84165 |
|
382 |
359 |
$4K |
| J3480 |
Injection, potassium chloride, per 2 meq |
3,453 |
2,297 |
$4K |
| 0255 |
|
762 |
460 |
$4K |
| 73070 |
|
59 |
57 |
$4K |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
1,866 |
1,520 |
$4K |
| 87631 |
|
295 |
291 |
$4K |
| 90662 |
|
597 |
597 |
$3K |
| 86665 |
|
197 |
99 |
$3K |
| 87070 |
|
991 |
930 |
$3K |
| 86038 |
|
354 |
349 |
$3K |
| 82140 |
|
626 |
476 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,153 |
1,153 |
$3K |
| 72146 |
|
13 |
13 |
$3K |
| 73522 |
|
25 |
24 |
$3K |
| J1940 |
Injection, furosemide, up to 20 mg |
3,089 |
1,733 |
$3K |
| 74240 |
|
16 |
16 |
$3K |
| 74181 |
|
13 |
12 |
$3K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
312 |
295 |
$3K |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
2,080 |
1,743 |
$3K |
| 70544 |
|
13 |
13 |
$3K |
| 84153 |
|
172 |
167 |
$3K |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
647 |
383 |
$2K |
| 86765 |
|
201 |
201 |
$2K |
| J0248 |
Injection, remdesivir, 1 mg |
49 |
31 |
$2K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
1,312 |
831 |
$2K |
| 80162 |
|
198 |
188 |
$2K |
| 83721 |
|
257 |
252 |
$2K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
450 |
174 |
$2K |
| S0164 |
Injection, pantoprazole sodium, 40 mg |
241 |
159 |
$2K |
| 82105 |
|
143 |
143 |
$2K |
| 82670 |
|
67 |
67 |
$2K |
| 74220 |
|
12 |
12 |
$2K |
| 86364 |
|
157 |
155 |
$2K |
| 74230 |
|
12 |
12 |
$2K |
| 81015 |
|
607 |
607 |
$2K |
| J3371 |
Injection, vancomycin hcl (mylan), not therapeutically equivalent to j3370, 500 mg |
319 |
221 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
26 |
26 |
$2K |
| 88341 |
|
13 |
13 |
$2K |
| 85014 |
|
832 |
747 |
$2K |
| 10060 |
|
28 |
27 |
$2K |
| 86664 |
|
99 |
99 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,659 |
1,592 |
$2K |
| 72110 |
|
12 |
12 |
$1K |
| 82977 |
|
168 |
168 |
$1K |
| 76706 |
|
25 |
25 |
$1K |
| J0456 |
Injection, azithromycin, 500 mg |
1,408 |
1,060 |
$1K |
| 86308 |
|
319 |
319 |
$1K |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
958 |
618 |
$1K |
| 83993 |
|
65 |
65 |
$1K |
| 82784 |
|
60 |
57 |
$1K |
| 85018 |
|
556 |
492 |
$1K |
| 80329 |
|
987 |
509 |
$1K |
| 80197 |
|
84 |
76 |
$1K |
| 83935 |
|
359 |
345 |
$1K |
| J1836 |
Injection, metronidazole, 10 mg |
820 |
470 |
$1K |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
607 |
452 |
$1K |
| 84155 |
|
269 |
256 |
$1K |
| 74022 |
|
25 |
25 |
$999.95 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
249 |
223 |
$936.25 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
663 |
649 |
$931.42 |
| 80324 |
|
1,036 |
991 |
$930.49 |
| 80359 |
|
1,060 |
1,010 |
$922.97 |
| 73600 |
|
14 |
14 |
$903.00 |
| 73552 |
|
12 |
12 |
$885.99 |
| A9503 |
Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries |
71 |
71 |
$846.91 |
| 86677 |
|
132 |
129 |
$843.30 |
| 83930 |
|
261 |
242 |
$831.36 |
| 85384 |
|
205 |
149 |
$810.99 |
| 82805 |
|
74 |
67 |
$775.10 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
14 |
14 |
$722.75 |
| J1630 |
Injection, haloperidol, up to 5 mg |
413 |
346 |
$717.99 |
| C9113 |
Injection, pantoprazole sodium, per vial |
2,384 |
1,587 |
$701.77 |
| 86769 |
|
70 |
70 |
$699.91 |
| 80320 |
|
1,205 |
882 |
$693.26 |
| 89051 |
|
102 |
83 |
$646.49 |
| 87149 |
|
252 |
250 |
$624.92 |
| 12011 |
|
73 |
73 |
$573.38 |
| 85046 |
|
148 |
136 |
$558.35 |
| 88304 |
|
378 |
333 |
$544.80 |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
31 |
31 |
$500.00 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
275 |
158 |
$487.44 |
| 80202 |
|
63 |
38 |
$466.33 |
| 12001 |
|
51 |
51 |
$462.60 |
| J3411 |
Injection, thiamine hcl, 100 mg |
175 |
136 |
$446.62 |
| 84134 |
|
104 |
104 |
$374.11 |
| 82950 |
|
93 |
93 |
$368.64 |
| 82951 |
|
26 |
26 |
$363.00 |
| 85045 |
|
149 |
139 |
$348.84 |
| J1953 |
Injection, levetiracetam, 10 mg |
48 |
39 |
$301.45 |
| 86140 |
|
512 |
450 |
$274.91 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
144 |
103 |
$259.86 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
381 |
377 |
$245.36 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
300 |
290 |
$241.78 |
| 83002 |
|
12 |
12 |
$241.38 |
| 82465 |
|
87 |
84 |
$225.48 |
| 90756 |
|
36 |
36 |
$225.12 |
| 84478 |
|
93 |
70 |
$220.23 |
| 83021 |
|
12 |
12 |
$219.00 |
| 80185 |
|
40 |
37 |
$217.87 |
| 90749 |
|
282 |
282 |
$211.17 |
| 83718 |
|
46 |
43 |
$204.00 |
| 82533 |
|
18 |
15 |
$197.98 |
| 29125 |
|
37 |
37 |
$196.47 |
| 92610 |
|
13 |
12 |
$173.93 |
| 87807 |
|
71 |
70 |
$169.29 |
| 86709 |
|
26 |
26 |
$155.64 |
| 82378 |
|
12 |
12 |
$146.00 |
| 88307 |
|
34 |
25 |
$127.53 |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
55 |
55 |
$127.00 |
| J7510 |
Prednisolone oral, per 5 mg |
884 |
828 |
$124.41 |
| 86225 |
|
26 |
26 |
$108.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
160 |
160 |
$106.98 |
| 82390 |
|
13 |
13 |
$103.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
375 |
240 |
$88.80 |
| 82705 |
|
14 |
14 |
$77.00 |
| J0737 |
Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg |
26 |
24 |
$74.52 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,327 |
1,033 |
$74.12 |
| 90688 |
|
36 |
35 |
$68.19 |
| 82150 |
|
12 |
12 |
$67.00 |
| 82952 |
|
14 |
14 |
$64.00 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
60 |
30 |
$62.42 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
50 |
50 |
$55.84 |
| 0272 |
|
179 |
178 |
$53.33 |
| 87184 |
|
16 |
15 |
$47.00 |
| 83090 |
|
12 |
12 |
$45.00 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
29 |
26 |
$44.10 |
| C1769 |
Guide wire |
43 |
40 |
$42.81 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
28 |
25 |
$19.66 |
| 12002 |
|
12 |
12 |
$12.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
112 |
71 |
$8.58 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
12 |
12 |
$4.77 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
23 |
13 |
$3.95 |
| J0744 |
Injection, ciprofloxacin for intravenous infusion, 200 mg |
15 |
12 |
$2.42 |
| 0320 |
|
21 |
17 |
$0.00 |
| 0302 |
|
17 |
15 |
$0.00 |
| 0301 |
|
94 |
44 |
$0.00 |
| 3044F |
|
670 |
670 |
$0.00 |
| 0305 |
|
52 |
45 |
$0.00 |
| G0257 |
Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility |
12 |
12 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
15 |
14 |
$0.00 |