| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
15,334 |
13,393 |
$757K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
22,695 |
20,052 |
$299K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
19,791 |
16,710 |
$276K |
| 70450 |
Computed tomography, head or brain; without contrast material |
10,637 |
9,394 |
$238K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
17,289 |
6,579 |
$228K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,112 |
3,065 |
$184K |
| 71046 |
Radiologic examination, chest; 2 views |
17,162 |
16,079 |
$122K |
| 71045 |
Radiologic examination, chest; single view |
23,838 |
20,550 |
$114K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
9,219 |
7,605 |
$108K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
15,298 |
13,882 |
$95K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
11,943 |
4,436 |
$94K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
14,168 |
12,698 |
$94K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
5,374 |
5,004 |
$74K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,071 |
813 |
$70K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
24,145 |
8,932 |
$69K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,817 |
2,395 |
$69K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
1,665 |
1,508 |
$68K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
3,916 |
3,879 |
$53K |
| G0378 |
Hospital observation service, per hour |
4,474 |
1,885 |
$50K |
| 99223 |
Prolong inpt eval add15 m |
326 |
314 |
$44K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
74,276 |
57,422 |
$39K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
871 |
378 |
$37K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
15,277 |
12,212 |
$35K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
8,194 |
7,764 |
$35K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
14,376 |
12,851 |
$32K |
| 74018 |
|
3,906 |
3,506 |
$32K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,744 |
2,725 |
$32K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,272 |
3,178 |
$30K |
| 80053 |
Comprehensive metabolic panel |
64,326 |
51,427 |
$28K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
2,888 |
2,644 |
$27K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
3,150 |
2,937 |
$26K |
| 80050 |
General health panel |
7,326 |
6,708 |
$25K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
9,945 |
7,863 |
$24K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,918 |
1,614 |
$23K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,220 |
965 |
$21K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,880 |
2,431 |
$20K |
| 99215 |
Prolong outpt/office vis |
224 |
138 |
$19K |
| 81001 |
|
33,280 |
27,320 |
$19K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,921 |
1,503 |
$18K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
5,661 |
4,714 |
$18K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,033 |
1,883 |
$16K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
10,189 |
9,164 |
$16K |
| 93976 |
|
1,383 |
1,300 |
$15K |
| 99233 |
Prolong inpt eval add15 m |
218 |
102 |
$14K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
10,235 |
9,826 |
$14K |
| 73630 |
|
3,489 |
3,184 |
$13K |
| 73110 |
|
2,421 |
2,131 |
$13K |
| 36415 |
Collection of venous blood by venipuncture |
81,832 |
65,353 |
$13K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
10,183 |
7,682 |
$13K |
| 73610 |
|
3,157 |
2,805 |
$12K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,261 |
771 |
$12K |
| 84439 |
|
10,144 |
9,312 |
$12K |
| 73130 |
|
2,488 |
2,240 |
$11K |
| 88304 |
|
1,614 |
1,335 |
$11K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
6,197 |
2,827 |
$10K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
16,365 |
13,261 |
$10K |
| 83690 |
|
11,923 |
9,734 |
$10K |
| 94010 |
|
372 |
363 |
$10K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
110 |
109 |
$9K |
| 76642 |
|
1,445 |
1,345 |
$9K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,752 |
1,593 |
$9K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,906 |
1,610 |
$9K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
11,343 |
5,811 |
$9K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,410 |
1,329 |
$9K |
| 84703 |
|
7,621 |
6,563 |
$8K |
| 86140 |
|
12,461 |
10,802 |
$7K |
| 80061 |
Lipid panel |
14,424 |
13,720 |
$7K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
178 |
163 |
$7K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
6,501 |
6,160 |
$7K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
6,463 |
6,127 |
$7K |
| 70486 |
|
633 |
580 |
$7K |
| 84443 |
Thyroid stimulating hormone (TSH) |
22,548 |
20,676 |
$7K |
| 73562 |
|
1,756 |
1,614 |
$7K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
10,844 |
9,533 |
$6K |
| 76770 |
|
612 |
575 |
$6K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
12,782 |
11,074 |
$6K |
| 84702 |
|
5,069 |
3,911 |
$6K |
| 73030 |
|
3,190 |
2,796 |
$6K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
14,610 |
13,828 |
$5K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
10,489 |
4,099 |
$5K |
| 82728 |
|
5,290 |
4,941 |
$5K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
417 |
388 |
$5K |
| 97162 |
|
2,449 |
2,112 |
$5K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
13,267 |
10,409 |
$5K |
| 87486 |
|
648 |
581 |
$5K |
| 97161 |
|
1,388 |
1,166 |
$5K |
| 87581 |
|
648 |
582 |
$4K |
| 76830 |
Ultrasound, transvaginal |
1,381 |
1,298 |
$4K |
| 73080 |
|
774 |
686 |
$4K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
1,092 |
1,052 |
$4K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,554 |
1,410 |
$4K |
| 73564 |
|
2,103 |
1,839 |
$4K |
| 73140 |
|
968 |
852 |
$4K |
| 70491 |
|
101 |
92 |
$4K |
| 99222 |
Initial hospital care, per day, moderate complexity |
26 |
26 |
$4K |
| 97113 |
|
3,219 |
1,171 |
$3K |
| 84484 |
|
11,670 |
7,578 |
$3K |
| 84146 |
|
1,876 |
1,657 |
$3K |
| 81025 |
|
5,856 |
5,187 |
$3K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
7,009 |
4,889 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,703 |
5,412 |
$3K |
| 85652 |
|
8,525 |
7,674 |
$3K |
| 96376 |
|
2,588 |
1,937 |
$3K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
6,131 |
5,283 |
$3K |
| A4649 |
Surgical supply; miscellaneous |
1,445 |
1,014 |
$3K |
| 12001 |
|
193 |
183 |
$3K |
| 95816 |
|
26 |
26 |
$3K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
216 |
166 |
$3K |
| 83550 |
|
5,000 |
4,715 |
$2K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
366 |
338 |
$2K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
669 |
630 |
$2K |
| 87186 |
|
4,589 |
4,119 |
$2K |
| 87040 |
|
3,236 |
1,679 |
$2K |
| 82784 |
|
2,233 |
2,057 |
$2K |
| 83735 |
|
9,809 |
7,397 |
$2K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
28 |
25 |
$2K |
| 82803 |
|
1,828 |
1,480 |
$2K |
| 73502 |
|
1,664 |
1,534 |
$2K |
| 84145 |
|
2,210 |
1,832 |
$2K |
| 83605 |
|
4,187 |
2,889 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
8,719 |
6,760 |
$2K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
245 |
149 |
$2K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
224 |
191 |
$2K |
| 85379 |
|
3,792 |
3,348 |
$2K |
| 87506 |
|
326 |
297 |
$2K |
| 87070 |
|
3,169 |
2,876 |
$2K |
| 83516 |
|
1,530 |
1,207 |
$2K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
180 |
172 |
$2K |
| 87081 |
|
1,211 |
1,146 |
$2K |
| 87510 |
|
4,635 |
4,305 |
$2K |
| 87480 |
|
4,636 |
4,306 |
$2K |
| 86308 |
|
1,423 |
1,354 |
$2K |
| 83540 |
|
5,388 |
5,082 |
$2K |
| 87660 |
|
4,637 |
4,306 |
$2K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,144 |
1,095 |
$2K |
| 77065 |
Tomosynthesis, mammo |
491 |
447 |
$2K |
| 71250 |
|
304 |
277 |
$2K |
| 87077 |
|
3,108 |
2,784 |
$2K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
3,814 |
2,471 |
$2K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
255 |
240 |
$1K |
| 72110 |
|
1,551 |
1,490 |
$1K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,566 |
1,299 |
$1K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
44 |
44 |
$1K |
| 84600 |
|
45 |
39 |
$1K |
| 87205 |
|
3,213 |
2,874 |
$1K |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
1,843 |
1,526 |
$1K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
7,053 |
5,410 |
$1K |
| 90839 |
|
254 |
210 |
$1K |
| 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 |
2,355 |
1,949 |
$1K |
| 82948 |
|
6,051 |
3,433 |
$1K |
| 93000 |
|
1,292 |
1,115 |
$1K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
11,090 |
8,349 |
$1K |
| 74019 |
|
206 |
192 |
$1K |
| 72050 |
|
777 |
752 |
$1K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
603 |
395 |
$1K |
| 84100 |
|
2,457 |
1,684 |
$1K |
| 97166 |
|
145 |
131 |
$1K |
| 85730 |
|
3,218 |
2,662 |
$1K |
| 85027 |
|
3,743 |
3,392 |
$943.40 |
| 36591 |
|
2,961 |
1,599 |
$923.12 |
| 86364 |
|
759 |
702 |
$904.58 |
| 86901 |
|
3,810 |
3,065 |
$903.46 |
| 93971 |
|
1,190 |
1,091 |
$897.24 |
| 82248 |
|
4,455 |
3,387 |
$895.12 |
| 80329 |
|
2,876 |
2,183 |
$864.13 |
| 86038 |
|
1,731 |
1,660 |
$855.17 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
1,799 |
1,323 |
$847.45 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,280 |
1,117 |
$832.89 |
| 90832 |
Psychotherapy, 30 minutes with patient |
149 |
122 |
$774.50 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
673 |
475 |
$774.28 |
| J2704 |
Injection, propofol, 10 mg |
4,750 |
3,434 |
$761.01 |
| J7050 |
Infusion, normal saline solution, 250 cc |
3,545 |
1,588 |
$753.76 |
| 86900 |
|
3,762 |
3,037 |
$733.39 |
| 95819 |
|
12 |
12 |
$704.75 |
| 82607 |
|
2,627 |
2,488 |
$679.36 |
| 76857 |
|
28 |
24 |
$671.14 |
| 72170 |
|
382 |
340 |
$666.89 |
| 80076 |
|
1,511 |
1,385 |
$625.62 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
8,375 |
5,164 |
$606.68 |
| 73590 |
|
344 |
317 |
$606.00 |
| 83880 |
|
2,604 |
2,134 |
$585.08 |
| 85610 |
|
8,187 |
5,833 |
$552.91 |
| 83615 |
|
1,417 |
1,050 |
$525.49 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
6,506 |
5,079 |
$519.90 |
| 0352U |
|
104 |
98 |
$518.31 |
| 97116 |
|
1,316 |
604 |
$515.26 |
| 80320 |
|
4,002 |
3,298 |
$511.54 |
| 87507 |
|
195 |
179 |
$508.64 |
| 82274 |
|
188 |
180 |
$482.12 |
| 84403 |
|
1,244 |
1,167 |
$480.73 |
| 73090 |
|
140 |
126 |
$480.58 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,173 |
2,542 |
$468.68 |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
1,000 |
974 |
$461.71 |
| 80178 |
|
1,273 |
1,069 |
$461.03 |
| 90715 |
|
665 |
619 |
$440.88 |
| 83970 |
|
325 |
305 |
$435.51 |
| 82150 |
|
1,160 |
1,039 |
$397.66 |
| 72141 |
|
228 |
213 |
$387.96 |
| 87340 |
|
2,007 |
1,908 |
$386.41 |
| 82550 |
|
772 |
639 |
$383.37 |
| 86235 |
|
151 |
103 |
$372.07 |
| 72072 |
|
54 |
52 |
$362.95 |
| 87427 |
|
306 |
179 |
$321.96 |
| 87046 |
|
238 |
216 |
$314.82 |
| 76801 |
|
107 |
94 |
$312.81 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
71 |
65 |
$312.81 |
| 82570 |
|
3,183 |
2,775 |
$306.55 |
| 86592 |
|
2,680 |
2,567 |
$306.17 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
49 |
46 |
$291.54 |
| 12002 |
|
14 |
13 |
$289.67 |
| 72040 |
|
105 |
101 |
$279.17 |
| 36416 |
|
334 |
208 |
$277.13 |
| 86850 |
|
3,997 |
3,336 |
$267.82 |
| 76536 |
|
78 |
77 |
$261.63 |
| 88342 |
|
308 |
253 |
$254.40 |
| 84550 |
|
1,808 |
1,576 |
$253.02 |
| 82140 |
|
582 |
481 |
$250.91 |
| 94060 |
|
210 |
202 |
$246.38 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,856 |
2,794 |
$245.39 |
| 84436 |
|
182 |
157 |
$230.50 |
| 87147 |
|
445 |
417 |
$226.60 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
15 |
14 |
$223.28 |
| 87075 |
|
130 |
117 |
$220.00 |
| 83993 |
|
65 |
64 |
$219.15 |
| J3490 |
Unclassified drugs |
11,788 |
4,673 |
$213.49 |
| 80069 |
|
1,797 |
1,525 |
$211.56 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
816 |
521 |
$210.81 |
| G0237 |
Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring) |
268 |
237 |
$208.77 |
| 82670 |
|
252 |
249 |
$204.60 |
| 80324 |
|
235 |
200 |
$203.49 |
| J2060 |
Injection, lorazepam, 2 mg |
2,350 |
1,859 |
$203.46 |
| 72100 |
|
409 |
388 |
$200.15 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
45 |
42 |
$198.12 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
380 |
294 |
$177.31 |
| 82247 |
|
636 |
504 |
$174.23 |
| 87634 |
|
35 |
35 |
$171.34 |
| 87529 |
|
19 |
14 |
$170.40 |
| 87631 |
|
38 |
37 |
$167.44 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
33,241 |
23,949 |
$161.01 |
| 82310 |
|
757 |
683 |
$158.83 |
| 83001 |
|
274 |
264 |
$158.53 |
| 86430 |
|
1,038 |
1,008 |
$158.52 |
| 87045 |
|
233 |
217 |
$157.44 |
| 84450 |
|
558 |
513 |
$156.05 |
| 84460 |
|
540 |
500 |
$152.41 |
| 83520 |
|
147 |
129 |
$147.22 |
| 83630 |
|
28 |
26 |
$146.08 |
| C1769 |
Guide wire |
19 |
13 |
$145.84 |
| 81003 |
|
3,531 |
2,919 |
$139.82 |
| 87653 |
|
1,300 |
1,247 |
$139.34 |
| 86039 |
|
283 |
269 |
$136.09 |
| 94729 |
|
131 |
127 |
$123.34 |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
257 |
193 |
$122.22 |
| 82565 |
|
546 |
467 |
$122.17 |
| 84156 |
|
1,308 |
1,001 |
$116.22 |
| 84075 |
|
411 |
374 |
$114.02 |
| J1790 |
Injection, droperidol, up to 5 mg |
813 |
656 |
$113.70 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
50 |
39 |
$113.56 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
965 |
778 |
$105.73 |
| 86200 |
|
604 |
587 |
$105.10 |
| 85007 |
|
77 |
73 |
$101.64 |
| 82746 |
|
431 |
409 |
$99.12 |
| G0432 |
Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening |
165 |
161 |
$90.63 |
| 87522 |
Neg quan hep c or qual rna |
681 |
655 |
$89.58 |
| 84155 |
|
418 |
381 |
$89.49 |
| 86376 |
|
87 |
83 |
$88.63 |
| 80051 |
|
336 |
291 |
$82.74 |
| 71101 |
|
125 |
118 |
$81.51 |
| 82040 |
|
417 |
380 |
$81.43 |
| 59025 |
Fetal non-stress test |
1,712 |
1,220 |
$79.64 |
| A4217 |
Sterile water/saline, 500 ml |
304 |
265 |
$73.60 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
892 |
770 |
$73.34 |
| 84481 |
|
339 |
314 |
$68.76 |
| 82977 |
|
320 |
290 |
$65.96 |
| 97597 |
|
267 |
101 |
$63.78 |
| 84402 |
|
110 |
104 |
$62.16 |
| 82947 |
|
452 |
401 |
$62.04 |
| 86762 |
|
628 |
597 |
$61.70 |
| 82785 |
|
15 |
14 |
$60.27 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
13 |
13 |
$56.80 |
| 84270 |
|
119 |
114 |
$53.04 |
| J1630 |
Injection, haloperidol, up to 5 mg |
199 |
166 |
$52.54 |
| 86706 |
|
518 |
495 |
$52.44 |
| 88142 |
|
4,650 |
4,544 |
$48.80 |
| 82043 |
|
1,515 |
1,463 |
$44.61 |
| 85045 |
|
29 |
28 |
$44.34 |
| 80164 |
|
125 |
117 |
$43.82 |
| 97535 |
Self-care/home management training, each 15 minutes |
55 |
37 |
$41.61 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
3,186 |
3,128 |
$39.23 |
| 86160 |
|
126 |
116 |
$38.82 |
| 84520 |
|
130 |
117 |
$38.40 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
342 |
276 |
$38.14 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
566 |
480 |
$35.94 |
| A4615 |
Cannula, nasal |
448 |
353 |
$33.97 |
| 86225 |
|
27 |
25 |
$33.54 |
| A4215 |
Needle, sterile, any size, each |
135 |
109 |
$28.68 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
174 |
158 |
$25.92 |
| 84144 |
|
128 |
108 |
$25.46 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
202 |
191 |
$24.31 |
| A7002 |
Tubing, used with suction pump, each |
62 |
56 |
$21.68 |
| 90686 |
|
670 |
638 |
$20.42 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
178 |
159 |
$16.83 |
| 83655 |
|
26 |
26 |
$14.78 |
| 93017 |
|
234 |
188 |
$8.69 |
| 86431 |
|
66 |
64 |
$6.92 |
| 82950 |
|
168 |
158 |
$5.79 |
| C9113 |
Injection, pantoprazole sodium, per vial |
43 |
38 |
$5.25 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
122 |
96 |
$3.46 |
| 85014 |
|
107 |
96 |
$2.89 |
| 86701 |
|
585 |
560 |
$2.67 |
| 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 |
80 |
66 |
$2.63 |
| A4600 |
Sleeve for intermittent limb compression device, replacement only, each |
47 |
36 |
$0.00 |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
2,323 |
1,173 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
429 |
204 |
$0.00 |
| 87641 |
|
142 |
134 |
$0.00 |
| 86703 |
|
255 |
248 |
$0.00 |
| 84112 |
|
43 |
36 |
$0.00 |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
112 |
64 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
26 |
13 |
$0.00 |
| 77066 |
Tomosynthesis, mammo |
129 |
123 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
111 |
84 |
$0.00 |
| 90662 |
|
13 |
13 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
213 |
177 |
$0.00 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
235 |
193 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
616 |
393 |
$0.00 |
| 87177 |
|
13 |
12 |
$0.00 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
341 |
298 |
$0.00 |
| 83721 |
|
62 |
61 |
$0.00 |
| 84165 |
|
71 |
64 |
$0.00 |
| 77080 |
|
122 |
118 |
$0.00 |
| 91322 |
|
62 |
56 |
$0.00 |
| 80074 |
|
77 |
76 |
$0.00 |
| J1750 |
Injection, iron dextran, 50 mg |
13 |
12 |
$0.00 |
| 97163 |
|
58 |
56 |
$0.00 |
| 82374 |
|
108 |
102 |
$0.00 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
16 |
14 |
$0.00 |
| Q0244 |
Injection, casirivimab and imdevimab, 1200 mg |
22 |
22 |
$0.00 |
| 62323 |
|
15 |
13 |
$0.00 |
| 85048 |
|
13 |
13 |
$0.00 |
| 90653 |
|
100 |
96 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
37 |
24 |
$0.00 |
| 87209 |
|
13 |
12 |
$0.00 |
| 94726 |
|
27 |
24 |
$0.00 |
| 85049 |
|
13 |
13 |
$0.00 |
| 84295 |
|
116 |
104 |
$0.00 |
| 86696 |
|
14 |
14 |
$0.00 |
| 90670 |
|
13 |
12 |
$0.00 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
73 |
64 |
$0.00 |
| 86480 |
|
56 |
54 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
40 |
39 |
$0.00 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
16 |
13 |
$0.00 |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
21 |
17 |
$0.00 |
| 20561 |
|
17 |
12 |
$0.00 |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
14 |
13 |
$0.00 |
| 29125 |
|
16 |
15 |
$0.00 |
| 86003 |
|
18 |
16 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
20 |
15 |
$0.00 |
| J0595 |
Injection, butorphanol tartrate, 1 mg |
12 |
12 |
$0.00 |
| 82105 |
|
24 |
24 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
883 |
853 |
$0.00 |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
688 |
588 |
$0.00 |
| 86300 |
|
312 |
264 |
$0.00 |
| 84153 |
|
990 |
932 |
$0.00 |
| 82378 |
|
585 |
432 |
$0.00 |
| 86803 |
|
2,882 |
2,800 |
$0.00 |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
659 |
614 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
376 |
243 |
$0.00 |
| 90656 |
|
14 |
14 |
$0.00 |
| 90694 |
|
109 |
105 |
$0.00 |
| 64483 |
|
13 |
12 |
$0.00 |
| A9270 |
Non-covered item or service |
35,519 |
17,542 |
$0.00 |
| 73120 |
|
113 |
107 |
$0.00 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
463 |
449 |
$0.00 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
78 |
76 |
$0.00 |
| 83883 |
|
24 |
24 |
$0.00 |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
247 |
117 |
$0.00 |
| 73660 |
|
15 |
12 |
$0.00 |
| 86704 |
|
97 |
92 |
$0.00 |
| 73560 |
|
18 |
12 |
$0.00 |
| 86812 |
|
66 |
65 |
$0.00 |
| 92523 |
|
33 |
26 |
$0.00 |
| 88307 |
|
135 |
79 |
$0.00 |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
60 |
57 |
$0.00 |
| 84160 |
|
30 |
24 |
$0.00 |
| 70498 |
|
29 |
25 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
54 |
48 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
130 |
98 |
$0.00 |
| 85018 |
|
55 |
47 |
$0.00 |
| 82435 |
|
109 |
103 |
$0.00 |
| Q0240 |
Injection, casirivimab and imdevimab, 600 mg |
32 |
30 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
49 |
47 |
$0.00 |
| 64615 |
|
17 |
14 |
$0.00 |
| 97035 |
|
73 |
30 |
$0.00 |
| 70496 |
|
16 |
14 |
$0.00 |
| 90480 |
|
61 |
55 |
$0.00 |
| 80055 |
|
15 |
15 |
$0.00 |
| 90732 |
|
14 |
14 |
$0.00 |
| 97750 |
|
32 |
27 |
$0.00 |
| 73221 |
|
54 |
52 |
$0.00 |
| 82533 |
|
18 |
14 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
20 |
15 |
$0.00 |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
12 |
12 |
$0.00 |
| 96415 |
|
15 |
12 |
$0.00 |
| 83002 |
|
39 |
38 |
$0.00 |
| J3411 |
Injection, thiamine hcl, 100 mg |
16 |
12 |
$0.00 |
| 84132 |
|
111 |
105 |
$0.00 |
| 97165 |
|
17 |
13 |
$0.00 |