| Code | Description | Claims | Beneficiaries | Total Paid |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
70,209 |
61,032 |
$12.74M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
45,707 |
38,469 |
$8.39M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
24,008 |
17,764 |
$7.20M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
25,950 |
21,372 |
$4.64M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
17,575 |
15,817 |
$2.90M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
10,118 |
8,903 |
$2.44M |
| 70450 |
Computed tomography, head or brain; without contrast material |
10,382 |
8,930 |
$2.05M |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
8,086 |
2,185 |
$1.48M |
| G0378 |
Hospital observation service, per hour |
4,717 |
3,241 |
$940K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
3,406 |
3,056 |
$907K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
6,129 |
5,431 |
$901K |
| 59025 |
Fetal non-stress test |
3,645 |
2,660 |
$785K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,323 |
2,906 |
$723K |
| J3490 |
Unclassified drugs |
207,433 |
67,681 |
$562K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
11,469 |
2,890 |
$513K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,934 |
3,820 |
$512K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
9,622 |
5,604 |
$457K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
8,419 |
7,035 |
$441K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,700 |
1,129 |
$404K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
5,173 |
4,925 |
$371K |
| 76830 |
Ultrasound, transvaginal |
3,847 |
3,485 |
$363K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
4,669 |
4,260 |
$351K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
3,256 |
2,989 |
$306K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
4,175 |
3,605 |
$287K |
| 0240U |
|
4,474 |
4,196 |
$287K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
2,048 |
1,862 |
$270K |
| 71046 |
Radiologic examination, chest; 2 views |
24,833 |
22,087 |
$266K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
894 |
800 |
$257K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
2,434 |
2,220 |
$250K |
| 76770 |
|
1,752 |
1,596 |
$223K |
| 93971 |
|
2,320 |
1,971 |
$212K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
425 |
355 |
$208K |
| 76801 |
|
3,971 |
3,227 |
$197K |
| 12001 |
|
806 |
753 |
$191K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
968 |
760 |
$180K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
5,694 |
2,243 |
$173K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
735 |
336 |
$167K |
| 97161 |
|
1,768 |
1,585 |
$158K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
3,819 |
3,607 |
$156K |
| 93976 |
|
2,681 |
2,405 |
$154K |
| 70496 |
|
666 |
617 |
$154K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
731 |
656 |
$150K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
32,353 |
24,827 |
$148K |
| 12011 |
|
611 |
565 |
$147K |
| 93970 |
|
1,152 |
1,029 |
$143K |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
3,706 |
3,165 |
$142K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
704 |
659 |
$140K |
| 76642 |
|
1,157 |
926 |
$136K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
5,341 |
1,647 |
$119K |
| 97162 |
|
788 |
719 |
$116K |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
4,273 |
1,240 |
$115K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,472 |
2,189 |
$114K |
| 29125 |
|
626 |
576 |
$108K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
249 |
240 |
$106K |
| 80053 |
Comprehensive metabolic panel |
24,948 |
20,276 |
$105K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,493 |
1,275 |
$100K |
| 80047 |
|
21,684 |
18,480 |
$99K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,668 |
2,531 |
$97K |
| 76536 |
|
786 |
727 |
$94K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
1,510 |
943 |
$86K |
| 70498 |
|
657 |
605 |
$86K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,050 |
950 |
$78K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
62,591 |
48,483 |
$74K |
| 71250 |
|
876 |
789 |
$68K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,502 |
1,178 |
$64K |
| 72110 |
|
2,856 |
2,552 |
$64K |
| 10060 |
|
352 |
309 |
$64K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
33,837 |
27,374 |
$61K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,415 |
1,956 |
$59K |
| 97165 |
|
767 |
688 |
$56K |
| 97535 |
Self-care/home management training, each 15 minutes |
1,893 |
1,202 |
$52K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
4,903 |
4,328 |
$52K |
| 73564 |
|
3,958 |
3,185 |
$51K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,448 |
920 |
$50K |
| 80076 |
|
16,748 |
14,344 |
$50K |
| 74018 |
|
3,579 |
3,165 |
$49K |
| 76775 |
|
556 |
519 |
$48K |
| 87040 |
|
6,742 |
3,393 |
$48K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
32,168 |
26,303 |
$47K |
| 71045 |
Radiologic examination, chest; single view |
13,349 |
11,370 |
$46K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
31 |
26 |
$44K |
| 84484 |
|
27,564 |
17,104 |
$42K |
| 70486 |
|
805 |
745 |
$41K |
| 85027 |
|
12,820 |
9,798 |
$41K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
184 |
163 |
$40K |
| 84703 |
|
22,713 |
19,439 |
$40K |
| 73630 |
|
3,446 |
2,911 |
$38K |
| 90715 |
|
1,760 |
1,603 |
$36K |
| 97116 |
|
1,493 |
874 |
$36K |
| 73030 |
|
2,946 |
2,500 |
$35K |
| 85379 |
|
6,069 |
5,446 |
$35K |
| 73610 |
|
3,381 |
2,980 |
$34K |
| 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 |
4,556 |
2,303 |
$31K |
| 83880 |
|
3,966 |
3,263 |
$29K |
| 70491 |
|
139 |
122 |
$29K |
| 76870 |
|
286 |
266 |
$29K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
3,155 |
2,984 |
$29K |
| 94799 |
|
5,756 |
2,346 |
$28K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
15,010 |
8,928 |
$27K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
4,507 |
4,126 |
$26K |
| 73130 |
|
2,746 |
2,304 |
$26K |
| 82962 |
|
19,074 |
6,481 |
$25K |
| 92523 |
|
150 |
133 |
$24K |
| 59050 |
|
156 |
133 |
$24K |
| 77066 |
Tomosynthesis, mammo |
578 |
531 |
$23K |
| 97129 |
|
678 |
257 |
$23K |
| 73110 |
|
2,044 |
1,788 |
$21K |
| 84443 |
Thyroid stimulating hormone (TSH) |
4,850 |
4,301 |
$20K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,079 |
976 |
$20K |
| 73502 |
|
1,513 |
1,229 |
$19K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,226 |
3,795 |
$19K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
21,896 |
16,609 |
$18K |
| 77080 |
|
246 |
240 |
$17K |
| 72050 |
|
654 |
585 |
$17K |
| 29515 |
|
83 |
78 |
$17K |
| 80143 |
|
4,085 |
3,430 |
$16K |
| 83605 |
|
8,706 |
6,816 |
$16K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,152 |
1,047 |
$16K |
| 80061 |
Lipid panel |
3,931 |
3,543 |
$16K |
| 12002 |
|
71 |
66 |
$15K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
14,516 |
12,386 |
$15K |
| 86850 |
|
2,979 |
2,541 |
$15K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
36 |
28 |
$15K |
| 73560 |
|
829 |
599 |
$14K |
| 81003 |
|
22,363 |
19,488 |
$12K |
| 81001 |
|
29,558 |
25,093 |
$11K |
| 83690 |
|
18,134 |
15,159 |
$11K |
| 97803 |
|
41 |
40 |
$11K |
| 76820 |
|
150 |
100 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
65 |
55 |
$9K |
| 86900 |
|
5,048 |
4,204 |
$9K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
18,393 |
14,387 |
$9K |
| 80179 |
|
4,065 |
3,415 |
$8K |
| 84439 |
|
1,170 |
1,051 |
$8K |
| 72100 |
|
553 |
505 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,026 |
1,658 |
$8K |
| 73140 |
|
1,059 |
955 |
$8K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
621 |
580 |
$8K |
| 96376 |
|
8,797 |
4,735 |
$8K |
| 29130 |
|
27 |
27 |
$8K |
| 72131 |
|
108 |
99 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14,333 |
13,125 |
$7K |
| 74019 |
|
165 |
158 |
$7K |
| 97166 |
|
94 |
85 |
$7K |
| 85610 |
|
7,135 |
5,804 |
$7K |
| 73590 |
|
959 |
809 |
$7K |
| 93017 |
|
55 |
41 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
45 |
38 |
$7K |
| 72072 |
|
398 |
363 |
$6K |
| 84702 |
|
6,107 |
5,052 |
$6K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
4,789 |
4,220 |
$6K |
| 88304 |
|
741 |
663 |
$6K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
19,334 |
14,738 |
$6K |
| 36415 |
Collection of venous blood by venipuncture |
4,075 |
3,233 |
$6K |
| 86140 |
|
1,771 |
1,544 |
$6K |
| 72141 |
|
24 |
24 |
$6K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
227 |
138 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
5,020 |
4,161 |
$5K |
| 87631 |
|
291 |
264 |
$5K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
859 |
826 |
$5K |
| 90675 |
|
37 |
13 |
$5K |
| 87186 |
|
3,903 |
3,251 |
$5K |
| 74174 |
|
30 |
25 |
$5K |
| 97533 |
|
67 |
27 |
$5K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
7,892 |
6,289 |
$5K |
| 82607 |
|
562 |
507 |
$4K |
| 77065 |
Tomosynthesis, mammo |
96 |
92 |
$4K |
| 73080 |
|
607 |
552 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
32 |
26 |
$4K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
16,873 |
14,143 |
$4K |
| 97750 |
|
211 |
177 |
$4K |
| 82553 |
|
969 |
601 |
$4K |
| 90791 |
Psychiatric diagnostic evaluation |
16 |
15 |
$4K |
| 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 |
7,070 |
6,429 |
$4K |
| 85730 |
|
5,173 |
4,412 |
$4K |
| 85014 |
|
6,106 |
5,126 |
$4K |
| 87634 |
|
211 |
196 |
$3K |
| 82565 |
|
2,191 |
1,871 |
$3K |
| 83735 |
|
6,470 |
4,814 |
$3K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,701 |
2,277 |
$3K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
7,219 |
6,419 |
$3K |
| 73090 |
|
736 |
648 |
$3K |
| 86901 |
|
5,050 |
4,205 |
$3K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
15 |
12 |
$3K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
1,232 |
1,127 |
$3K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,603 |
4,108 |
$3K |
| 86803 |
|
195 |
182 |
$3K |
| 85652 |
|
1,417 |
1,213 |
$3K |
| 86703 |
|
318 |
304 |
$3K |
| 87081 |
|
2,051 |
1,931 |
$3K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
11,281 |
7,385 |
$3K |
| 17250 |
|
22 |
14 |
$2K |
| 87077 |
|
4,549 |
3,849 |
$2K |
| 87210 |
|
3,502 |
3,068 |
$2K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
4,267 |
3,584 |
$2K |
| 95819 |
|
12 |
12 |
$2K |
| 87205 |
|
1,241 |
1,002 |
$2K |
| 82247 |
|
299 |
220 |
$2K |
| J2704 |
Injection, propofol, 10 mg |
4,986 |
4,525 |
$2K |
| 82728 |
|
271 |
245 |
$2K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
16 |
13 |
$2K |
| 82077 |
|
5,991 |
4,800 |
$2K |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
3,172 |
2,499 |
$2K |
| 96367 |
|
105 |
86 |
$2K |
| 82310 |
|
3,393 |
3,019 |
$2K |
| 72081 |
|
27 |
26 |
$1K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
5,443 |
3,977 |
$1K |
| J2060 |
Injection, lorazepam, 2 mg |
3,108 |
2,229 |
$1K |
| 82330 |
|
2,738 |
2,434 |
$1K |
| 73562 |
|
66 |
50 |
$1K |
| 82248 |
|
509 |
379 |
$1K |
| 87070 |
|
2,702 |
2,296 |
$1K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,654 |
1,231 |
$1K |
| 81025 |
|
4,576 |
4,072 |
$1K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
1,305 |
923 |
$1K |
| 97597 |
|
76 |
25 |
$1K |
| 74022 |
|
403 |
357 |
$1K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,000 |
470 |
$923.55 |
| 83550 |
|
207 |
186 |
$913.22 |
| 83540 |
|
308 |
280 |
$894.37 |
| 97035 |
|
32 |
13 |
$882.10 |
| 73552 |
|
72 |
63 |
$875.83 |
| 97802 |
|
14 |
13 |
$834.57 |
| 82803 |
|
2,145 |
1,610 |
$833.75 |
| J1644 |
Injection, heparin sodium, per 1000 units |
8,160 |
3,024 |
$798.64 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,926 |
3,852 |
$773.60 |
| 84100 |
|
1,809 |
1,397 |
$755.37 |
| 82550 |
|
1,813 |
1,437 |
$726.83 |
| 90686 |
|
80 |
67 |
$688.22 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,424 |
1,853 |
$663.57 |
| 71101 |
|
153 |
142 |
$615.62 |
| 84153 |
|
43 |
42 |
$577.93 |
| 82043 |
|
232 |
217 |
$521.59 |
| 70360 |
|
42 |
40 |
$513.01 |
| 87807 |
|
1,520 |
1,362 |
$492.35 |
| J1817 |
Insulin for administration through dme (i.e., insulin pump) per 50 units |
239 |
112 |
$425.21 |
| 82746 |
|
72 |
64 |
$365.15 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
27 |
25 |
$305.60 |
| 36000 |
|
47 |
40 |
$292.99 |
| 84550 |
|
240 |
217 |
$284.81 |
| 80069 |
|
93 |
68 |
$283.46 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,987 |
1,310 |
$277.42 |
| 72040 |
|
13 |
12 |
$251.54 |
| 73070 |
|
34 |
30 |
$230.68 |
| 87340 |
|
75 |
64 |
$222.30 |
| 73620 |
|
17 |
14 |
$215.04 |
| 76937 |
|
27 |
25 |
$211.88 |
| G0328 |
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous |
168 |
153 |
$202.02 |
| 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 |
285 |
260 |
$184.99 |
| 86923 |
|
30 |
25 |
$176.56 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
286 |
261 |
$174.75 |
| 86780 |
|
14 |
13 |
$167.47 |
| 86038 |
|
25 |
24 |
$164.10 |
| J1815 |
Injection, insulin, per 5 units |
852 |
399 |
$150.86 |
| 85018 |
|
87 |
66 |
$126.91 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
858 |
674 |
$119.39 |
| 73100 |
|
18 |
13 |
$113.21 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
185 |
161 |
$86.70 |
| 73660 |
|
30 |
26 |
$82.84 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
1,474 |
996 |
$82.43 |
| 84112 |
|
26 |
26 |
$79.46 |
| J1630 |
Injection, haloperidol, up to 5 mg |
658 |
500 |
$78.62 |
| 73060 |
|
42 |
37 |
$72.11 |
| 72170 |
|
12 |
12 |
$67.41 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
534 |
410 |
$62.22 |
| 82570 |
|
96 |
88 |
$62.04 |
| 82274 |
|
69 |
56 |
$58.59 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
539 |
507 |
$56.90 |
| J3535 |
Drug administered through a metered dose inhaler |
69 |
49 |
$53.40 |
| 88342 |
|
49 |
42 |
$35.34 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
1,044 |
467 |
$29.21 |
| 84156 |
|
28 |
25 |
$26.01 |
| 82150 |
|
15 |
14 |
$25.68 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
373 |
216 |
$21.65 |
| 87185 |
|
18 |
12 |
$13.87 |
| 83615 |
|
78 |
65 |
$11.82 |
| 85384 |
|
28 |
25 |
$9.32 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
116 |
109 |
$9.24 |
| 87150 |
|
14 |
12 |
$9.19 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
62 |
55 |
$8.59 |
| J0456 |
Injection, azithromycin, 500 mg |
29 |
13 |
$5.87 |
| J0692 |
Injection, cefepime hydrochloride, 500 mg |
35 |
13 |
$5.36 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
224 |
184 |
$5.07 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
305 |
209 |
$4.36 |
| J3360 |
Injection, diazepam, up to 5 mg |
157 |
126 |
$3.25 |
| J3480 |
Injection, potassium chloride, per 2 meq |
71 |
48 |
$2.85 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
12 |
12 |
$1.94 |
| C1769 |
Guide wire |
511 |
455 |
$1.35 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
358 |
312 |
$0.73 |
| 82374 |
|
15 |
12 |
$0.71 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
276 |
241 |
$0.00 |
| C1729 |
Catheter, drainage |
513 |
458 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
311 |
268 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
187 |
180 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
285 |
196 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
408 |
356 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
73 |
66 |
$0.00 |
| J1953 |
Injection, levetiracetam, 10 mg |
279 |
200 |
$0.00 |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
62 |
28 |
$0.00 |
| Q0177 |
Hydroxyzine pamoate, 25 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 |
207 |
116 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
218 |
211 |
$0.00 |
| 84145 |
|
46 |
37 |
$0.00 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
92 |
78 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
31 |
21 |
$0.00 |
| Q9963 |
High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml |
91 |
88 |
$0.00 |
| A6197 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
49 |
45 |
$0.00 |
| 36416 |
|
417 |
323 |
$0.00 |
| 86308 |
|
26 |
25 |
$0.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
470 |
361 |
$0.00 |
| J1940 |
Injection, furosemide, up to 20 mg |
79 |
36 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
25 |
14 |
$0.00 |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
21 |
13 |
$0.00 |