| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90832 |
Psychotherapy, 30 minutes with patient |
146,136 |
96,258 |
$22.36M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
137,612 |
115,896 |
$17.97M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
122,595 |
99,540 |
$16.70M |
| H0020 |
Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) |
511,367 |
21,936 |
$15.06M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
62,391 |
58,358 |
$13.60M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
45,384 |
42,383 |
$9.00M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
28,700 |
27,071 |
$6.59M |
| 41899 |
Unlisted procedure, dentoalveolar structures |
3,261 |
3,242 |
$4.95M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
27,698 |
23,340 |
$2.89M |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
11,903 |
10,775 |
$2.75M |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
4,098 |
1,982 |
$2.18M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
11,938 |
11,556 |
$2.06M |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
61,190 |
21,371 |
$1.88M |
| 70450 |
Computed tomography, head or brain; without contrast material |
10,231 |
9,949 |
$1.72M |
| 80053 |
Comprehensive metabolic panel |
66,753 |
61,795 |
$1.59M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,839 |
1,834 |
$1.55M |
| H0033 |
Oral medication administration, direct observation |
46,992 |
1,842 |
$1.40M |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
1,218 |
1,210 |
$1.26M |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
25,058 |
19,863 |
$1.12M |
| 90791 |
Psychiatric diagnostic evaluation |
4,735 |
4,714 |
$1.07M |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
11,699 |
10,875 |
$1.04M |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
1,086 |
1,085 |
$952K |
| 90834 |
Psychotherapy, 45 minutes with patient |
4,824 |
3,949 |
$878K |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
8,221 |
5,538 |
$842K |
| H0005 |
Alcohol and/or drug services; group counseling by a clinician |
9,731 |
1,959 |
$746K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
5,577 |
5,112 |
$734K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
2,348 |
2,308 |
$699K |
| 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 |
11,022 |
9,548 |
$660K |
| J2357 |
Injection, omalizumab, 5 mg |
2,126 |
1,304 |
$647K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
2,465 |
2,419 |
$632K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
14,641 |
10,601 |
$596K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
3,358 |
3,237 |
$578K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
5,051 |
4,021 |
$575K |
| 99215 |
Prolong outpt/office vis |
3,119 |
3,012 |
$516K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,557 |
4,419 |
$502K |
| H2010 |
Comprehensive medication services, per 15 minutes |
5,860 |
5,242 |
$484K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,853 |
4,845 |
$483K |
| J2426 |
Injection, paliperidone palmitate extended release (invega sustenna), 1 mg |
945 |
887 |
$468K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
5,131 |
5,130 |
$465K |
| 12001 |
|
1,620 |
1,591 |
$431K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
17,262 |
16,831 |
$429K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
2,495 |
2,363 |
$428K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,359 |
3,315 |
$413K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
15,786 |
14,901 |
$412K |
| G0397 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes |
2,728 |
1,878 |
$406K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
3,682 |
3,562 |
$403K |
| 86902 |
|
12,159 |
10,487 |
$388K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
4,091 |
3,533 |
$387K |
| 77066 |
Tomosynthesis, mammo |
3,198 |
3,177 |
$369K |
| 12002 |
|
1,281 |
1,259 |
$357K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,592 |
3,587 |
$350K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
2,520 |
2,505 |
$343K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,668 |
2,646 |
$341K |
| 83992 |
|
25,948 |
6,361 |
$336K |
| 12011 |
|
1,299 |
1,279 |
$334K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
29,495 |
22,299 |
$331K |
| 36415 |
Collection of venous blood by venipuncture |
22,259 |
18,473 |
$324K |
| 99442 |
|
5,513 |
5,128 |
$314K |
| 76641 |
|
4,180 |
4,128 |
$294K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,991 |
1,914 |
$288K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
10,326 |
8,330 |
$286K |
| 98929 |
|
4,841 |
4,248 |
$285K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
433 |
433 |
$283K |
| 90935 |
Hemodialysis procedure with single evaluation by a physician |
2,118 |
212 |
$266K |
| 59025 |
Fetal non-stress test |
2,585 |
1,687 |
$263K |
| 99443 |
|
3,327 |
3,022 |
$259K |
| 76830 |
Ultrasound, transvaginal |
3,858 |
3,748 |
$251K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,449 |
2,446 |
$237K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
3,435 |
1,978 |
$234K |
| 90846 |
Family psychotherapy without the patient present, 50 minutes |
1,497 |
1,346 |
$225K |
| 90461 |
|
5,652 |
5,627 |
$221K |
| 90651 |
|
2,382 |
2,323 |
$216K |
| 76770 |
|
1,195 |
1,182 |
$214K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,637 |
1,625 |
$212K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
17,792 |
17,409 |
$196K |
| 81025 |
|
6,786 |
6,297 |
$194K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
6,073 |
4,548 |
$193K |
| J2182 |
Injection, mepolizumab, 1 mg |
99 |
97 |
$186K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
990 |
904 |
$183K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
18,432 |
16,943 |
$181K |
| 93970 |
|
884 |
869 |
$180K |
| 10060 |
|
848 |
810 |
$179K |
| 86480 |
|
3,984 |
3,123 |
$178K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15,971 |
15,664 |
$168K |
| 99406 |
|
5,768 |
5,478 |
$155K |
| 92551 |
|
4,884 |
4,871 |
$150K |
| 11721 |
|
2,551 |
2,369 |
$146K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
392 |
267 |
$145K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,725 |
980 |
$145K |
| 90671 |
|
1,345 |
1,343 |
$143K |
| 82962 |
|
18,578 |
11,919 |
$143K |
| D9222 |
|
1,856 |
1,786 |
$138K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
7,373 |
7,145 |
$137K |
| D7240 |
Removal of impacted tooth - completely bony |
499 |
247 |
$137K |
| 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 |
6,695 |
6,317 |
$132K |
| D7140 |
Extraction, erupted tooth or exposed root |
2,323 |
1,877 |
$132K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
3,001 |
2,959 |
$131K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
7,942 |
7,816 |
$131K |
| 77065 |
Tomosynthesis, mammo |
1,873 |
1,822 |
$130K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,283 |
2,182 |
$129K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,752 |
1,624 |
$128K |
| 90686 |
|
11,862 |
11,824 |
$125K |
| 15853 |
|
409 |
403 |
$123K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
4,324 |
4,324 |
$115K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
4,001 |
3,982 |
$114K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
837 |
793 |
$112K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
102 |
102 |
$111K |
| 76818 |
|
1,185 |
748 |
$104K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
1,864 |
1,823 |
$104K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
962 |
526 |
$103K |
| 92083 |
|
1,758 |
1,723 |
$103K |
| 29125 |
|
752 |
689 |
$102K |
| 83880 |
|
2,658 |
2,516 |
$99K |
| 99441 |
|
2,413 |
2,299 |
$95K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
543 |
542 |
$92K |
| 80061 |
Lipid panel |
13,821 |
13,713 |
$91K |
| 1159F |
|
22,659 |
15,268 |
$91K |
| 99173 |
|
4,780 |
4,769 |
$88K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
9,644 |
9,559 |
$87K |
| D0140 |
Limited oral evaluation - problem focused |
5,247 |
4,935 |
$85K |
| 99205 |
Prolong outpt/office vis |
477 |
472 |
$84K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
77 |
77 |
$84K |
| 90714 |
|
5,613 |
5,577 |
$82K |
| 92134 |
|
2,029 |
1,628 |
$82K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,676 |
4,514 |
$81K |
| G2067 |
Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatment program) |
1,665 |
533 |
$77K |
| 70486 |
|
2,396 |
2,372 |
$73K |
| 92133 |
|
1,681 |
1,610 |
$73K |
| 0002A |
|
2,047 |
1,804 |
$73K |
| 73130 |
|
4,944 |
4,135 |
$72K |
| 82803 |
|
7,524 |
7,195 |
$71K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
69,093 |
63,697 |
$71K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
3,882 |
3,795 |
$69K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
517 |
510 |
$69K |
| J0882 |
Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) |
321 |
97 |
$68K |
| 19083 |
|
42 |
41 |
$67K |
| 73700 |
|
564 |
545 |
$66K |
| D0367 |
|
249 |
249 |
$66K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
696 |
669 |
$65K |
| 71046 |
Radiologic examination, chest; 2 views |
12,987 |
12,629 |
$65K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,047 |
1,044 |
$64K |
| 90746 |
|
1,102 |
1,100 |
$64K |
| 0001A |
|
1,965 |
1,705 |
$63K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
12,074 |
7,580 |
$60K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
17,279 |
17,147 |
$59K |
| 82607 |
|
6,256 |
6,227 |
$58K |
| 90715 |
|
2,534 |
2,528 |
$58K |
| 90677 |
|
322 |
322 |
$57K |
| 73630 |
|
5,038 |
4,412 |
$57K |
| 12013 |
|
197 |
196 |
$56K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
1,627 |
1,611 |
$55K |
| J0897 |
Injection, denosumab, 1 mg |
174 |
174 |
$54K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
803 |
801 |
$54K |
| 71250 |
|
677 |
672 |
$54K |
| 86803 |
|
9,639 |
9,537 |
$53K |
| 73562 |
|
4,248 |
3,857 |
$52K |
| 73610 |
|
4,460 |
3,899 |
$51K |
| 90697 |
|
1,252 |
1,247 |
$50K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
33,478 |
30,812 |
$50K |
| 82947 |
|
9,391 |
5,881 |
$49K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
449 |
444 |
$47K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,590 |
1,571 |
$47K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
691 |
680 |
$47K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
4,550 |
4,453 |
$46K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
3,509 |
3,413 |
$45K |
| 93458 |
|
26 |
25 |
$45K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
7,907 |
7,435 |
$45K |
| 86359 |
|
1,798 |
1,774 |
$44K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
734 |
726 |
$44K |
| D0330 |
Panoramic radiographic image |
1,393 |
1,377 |
$43K |
| 96367 |
|
1,660 |
1,145 |
$42K |
| 11900 |
|
342 |
329 |
$42K |
| 88300 |
|
7,616 |
6,305 |
$41K |
| 76536 |
|
472 |
470 |
$40K |
| 76642 |
|
1,099 |
950 |
$38K |
| 86850 |
|
2,120 |
2,050 |
$36K |
| D9310 |
|
1,240 |
1,225 |
$35K |
| 86762 |
|
3,077 |
3,062 |
$34K |
| 86780 |
|
9,182 |
8,755 |
$34K |
| 99493 |
|
417 |
340 |
$34K |
| 73110 |
|
2,570 |
2,146 |
$34K |
| 86360 |
|
844 |
838 |
$34K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
7,722 |
5,465 |
$34K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
439 |
428 |
$33K |
| 99407 |
|
958 |
914 |
$33K |
| 90670 |
|
2,030 |
2,025 |
$32K |
| 86706 |
|
6,805 |
6,741 |
$32K |
| 80050 |
General health panel |
2,006 |
1,987 |
$31K |
| 73030 |
|
2,924 |
2,734 |
$30K |
| 86704 |
|
5,955 |
5,924 |
$30K |
| 73560 |
|
1,865 |
1,604 |
$30K |
| 90739 |
|
217 |
217 |
$29K |
| 87522 |
Neg quan hep c or qual rna |
730 |
720 |
$29K |
| 84443 |
Thyroid stimulating hormone (TSH) |
9,688 |
9,564 |
$29K |
| 80354 |
|
24,198 |
10,474 |
$28K |
| 82728 |
|
3,352 |
3,334 |
$28K |
| 77049 |
|
88 |
87 |
$28K |
| 86900 |
|
2,123 |
2,057 |
$28K |
| 72110 |
|
1,048 |
1,042 |
$28K |
| 3008F |
|
10,850 |
8,012 |
$28K |
| 91320 |
|
376 |
376 |
$28K |
| 71045 |
Radiologic examination, chest; single view |
11,688 |
11,271 |
$27K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
12,983 |
12,302 |
$27K |
| 97803 |
|
1,002 |
984 |
$27K |
| 29515 |
|
209 |
183 |
$26K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,428 |
2,344 |
$26K |
| 20552 |
|
340 |
284 |
$26K |
| 87340 |
|
9,573 |
9,479 |
$26K |
| 88142 |
|
1,105 |
1,100 |
$26K |
| 86765 |
|
2,505 |
2,495 |
$26K |
| 90674 |
|
1,060 |
1,059 |
$25K |
| 82746 |
|
2,678 |
2,671 |
$24K |
| 80076 |
|
2,969 |
2,947 |
$24K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
242 |
241 |
$24K |
| 76937 |
|
204 |
198 |
$23K |
| 80324 |
|
21,998 |
9,179 |
$23K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
595 |
591 |
$23K |
| 80365 |
|
4,092 |
1,930 |
$23K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
11,062 |
10,014 |
$22K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,570 |
1,564 |
$22K |
| 90707 |
|
897 |
896 |
$21K |
| 76942 |
|
419 |
413 |
$21K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,262 |
1,241 |
$21K |
| 90836 |
|
309 |
197 |
$21K |
| 82043 |
|
4,697 |
4,263 |
$21K |
| 80353 |
|
21,947 |
9,132 |
$21K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
15,918 |
15,007 |
$21K |
| 99051 |
|
1,139 |
1,093 |
$21K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
352 |
306 |
$20K |
| 64640 |
|
210 |
182 |
$20K |
| 80346 |
|
21,954 |
9,145 |
$20K |
| 96127 |
|
3,413 |
3,401 |
$20K |
| 80358 |
|
14,298 |
5,427 |
$20K |
| 90732 |
|
212 |
212 |
$20K |
| 94070 |
|
364 |
364 |
$20K |
| 93971 |
|
611 |
600 |
$20K |
| 77080 |
|
789 |
786 |
$20K |
| 81001 |
|
20,925 |
20,187 |
$19K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
70 |
69 |
$19K |
| 86787 |
|
2,776 |
2,769 |
$19K |
| C1780 |
Lens, intraocular (new technology) |
478 |
105 |
$19K |
| 86901 |
|
2,125 |
2,059 |
$18K |
| D9610 |
|
1,793 |
1,770 |
$18K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
82 |
73 |
$18K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
342 |
336 |
$18K |
| 92020 |
|
614 |
595 |
$17K |
| 90480 |
|
414 |
414 |
$17K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
84 |
84 |
$17K |
| 86735 |
|
2,192 |
2,181 |
$16K |
| 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 |
1,243 |
1,005 |
$16K |
| 57454 |
|
28 |
26 |
$16K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
12,903 |
12,387 |
$16K |
| 93017 |
|
429 |
425 |
$16K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,072 |
1,067 |
$16K |
| 85730 |
|
17,356 |
16,734 |
$15K |
| 90716 |
|
732 |
732 |
$15K |
| 90620 |
|
769 |
769 |
$15K |
| 73590 |
|
1,851 |
1,711 |
$14K |
| 73502 |
|
832 |
794 |
$14K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
13,451 |
12,310 |
$14K |
| 71271 |
|
219 |
219 |
$13K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
355 |
348 |
$13K |
| 86708 |
|
1,644 |
1,641 |
$13K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
68 |
66 |
$13K |
| 90681 |
|
1,467 |
1,464 |
$13K |
| J1756 |
Injection, iron sucrose, 1 mg |
597 |
190 |
$12K |
| 90691 |
|
135 |
135 |
$12K |
| 87077 |
|
3,852 |
3,553 |
$12K |
| 80361 |
|
11,993 |
6,733 |
$12K |
| 90619 |
|
328 |
326 |
$12K |
| 84439 |
|
1,934 |
1,912 |
$12K |
| 0003A |
|
340 |
229 |
$11K |
| 83550 |
|
3,383 |
3,364 |
$11K |
| 76514 |
|
318 |
316 |
$11K |
| 96415 |
|
234 |
118 |
$11K |
| 94010 |
|
582 |
451 |
$11K |
| 86141 |
|
2,367 |
2,309 |
$11K |
| H0001 |
Alcohol and/or drug assessment |
62 |
58 |
$11K |
| 88304 |
|
813 |
806 |
$11K |
| 90633 |
|
1,529 |
1,528 |
$10K |
| 94729 |
|
299 |
299 |
$10K |
| 64520 |
|
144 |
142 |
$10K |
| 72170 |
|
2,262 |
2,232 |
$10K |
| 94726 |
|
293 |
292 |
$9K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
62 |
59 |
$9K |
| 87070 |
|
2,828 |
2,643 |
$9K |
| 92202 |
|
316 |
315 |
$8K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
345 |
345 |
$8K |
| 90999 |
Unlisted dialysis procedure, inpatient or outpatient |
163 |
14 |
$8K |
| 80348 |
|
1,897 |
1,370 |
$8K |
| 88307 |
|
40 |
40 |
$8K |
| 90698 |
|
716 |
715 |
$8K |
| 90656 |
|
766 |
766 |
$8K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
2,305 |
1,969 |
$8K |
| 93298 |
|
255 |
245 |
$8K |
| 92283 |
|
146 |
145 |
$8K |
| 84702 |
|
5,006 |
4,524 |
$7K |
| 0031A |
|
209 |
200 |
$7K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
43 |
42 |
$7K |
| 73080 |
|
971 |
883 |
$7K |
| 73090 |
|
1,114 |
1,044 |
$7K |
| D0220 |
Intraoral - periapical first radiographic image |
783 |
757 |
$7K |
| J7050 |
Infusion, normal saline solution, 250 cc |
4,875 |
3,516 |
$7K |
| 11045 |
|
23 |
13 |
$6K |
| 73552 |
|
569 |
539 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,163 |
2,097 |
$6K |
| 72100 |
|
300 |
300 |
$6K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
41 |
41 |
$6K |
| 90750 |
|
244 |
244 |
$6K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
6,501 |
5,844 |
$6K |
| 87088 |
|
2,342 |
2,260 |
$6K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
59 |
56 |
$6K |
| 90662 |
|
261 |
259 |
$6K |
| 99381 |
|
87 |
87 |
$6K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
4,935 |
4,352 |
$6K |
| Q3014 |
Telehealth originating site facility fee |
858 |
656 |
$6K |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
885 |
860 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
308 |
298 |
$5K |
| 90710 |
|
393 |
393 |
$5K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
354 |
347 |
$5K |
| 90694 |
|
236 |
236 |
$5K |
| J2785 |
Injection, regadenoson, 0.1 mg |
51 |
51 |
$5K |
| 92002 |
|
53 |
52 |
$5K |
| 85027 |
|
2,098 |
2,081 |
$5K |
| 0072A |
|
105 |
97 |
$5K |
| 83516 |
|
527 |
520 |
$5K |
| 86592 |
|
3,165 |
3,125 |
$5K |
| J3490 |
Unclassified drugs |
5,381 |
4,213 |
$5K |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
2,877 |
2,067 |
$4K |
| J1631 |
Injection, haloperidol decanoate, per 50 mg |
1,157 |
1,096 |
$4K |
| 90837 |
Psychotherapy, 53 minutes with patient |
22 |
15 |
$4K |
| 94760 |
|
1,418 |
1,387 |
$4K |
| A4657 |
Syringe, with or without needle, each |
3,065 |
1,109 |
$4K |
| 97802 |
|
120 |
120 |
$4K |
| 84403 |
|
176 |
176 |
$4K |
| 83970 |
|
155 |
154 |
$4K |
| 82105 |
|
673 |
667 |
$4K |
| 29130 |
|
16 |
15 |
$4K |
| 84166 |
|
420 |
418 |
$4K |
| 90381 |
|
22 |
13 |
$4K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
1,431 |
1,427 |
$4K |
| 83001 |
|
242 |
240 |
$4K |
| 80320 |
|
14,115 |
13,209 |
$4K |
| 84460 |
|
1,201 |
1,190 |
$4K |
| 82570 |
|
1,295 |
1,222 |
$3K |
| 31500 |
|
12 |
12 |
$3K |
| 59430 |
|
26 |
26 |
$3K |
| 86703 |
|
311 |
308 |
$3K |
| 82785 |
|
321 |
319 |
$3K |
| 84436 |
|
1,335 |
1,310 |
$3K |
| 95822 |
|
12 |
12 |
$3K |
| 85018 |
|
1,656 |
1,617 |
$3K |
| D1208 |
Topical application of fluoride, excluding varnish |
276 |
272 |
$3K |
| 87186 |
|
2,681 |
2,603 |
$3K |
| 17110 |
|
25 |
24 |
$3K |
| J1630 |
Injection, haloperidol, up to 5 mg |
6,537 |
6,046 |
$3K |
| 80329 |
|
2,620 |
2,559 |
$3K |
| 64450 |
|
16 |
16 |
$3K |
| 85651 |
|
2,547 |
2,497 |
$3K |
| 98927 |
|
90 |
85 |
$3K |
| 99385 |
|
14 |
14 |
$3K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
140 |
140 |
$3K |
| 70360 |
|
212 |
211 |
$3K |
| 86038 |
|
612 |
600 |
$3K |
| 90380 |
|
19 |
19 |
$3K |
| 98926 |
|
75 |
70 |
$3K |
| 84146 |
|
187 |
179 |
$3K |
| 91318 |
|
76 |
76 |
$3K |
| 84484 |
|
11,961 |
11,293 |
$3K |
| 96368 |
|
190 |
188 |
$3K |
| 92136 |
|
68 |
68 |
$3K |
| 83021 |
|
337 |
333 |
$3K |
| 78469 |
|
56 |
56 |
$3K |
| C1819 |
Surgical tissue localization and excision device (implantable) |
41 |
41 |
$3K |
| 72040 |
|
108 |
108 |
$3K |
| 82009 |
|
1,858 |
1,753 |
$3K |
| 84402 |
|
122 |
121 |
$3K |
| 83002 |
|
154 |
152 |
$2K |
| 81002 |
|
1,061 |
972 |
$2K |
| 82248 |
|
868 |
846 |
$2K |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
13 |
13 |
$2K |
| 85610 |
|
1,991 |
1,957 |
$2K |
| 99397 |
|
46 |
46 |
$2K |
| 83615 |
|
1,212 |
1,121 |
$2K |
| 87338 |
|
299 |
297 |
$2K |
| 1126F |
|
2,083 |
1,492 |
$2K |
| 91319 |
|
43 |
43 |
$2K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
9,947 |
9,490 |
$2K |
| 0004A |
|
53 |
49 |
$2K |
| 76870 |
|
64 |
62 |
$2K |
| 93308 |
|
12 |
12 |
$2K |
| 80164 |
|
1,213 |
1,152 |
$2K |
| 69200 |
|
15 |
15 |
$2K |
| 87040 |
|
1,915 |
1,849 |
$2K |
| 80321 |
|
6,718 |
2,820 |
$2K |
| 83735 |
|
8,256 |
7,916 |
$2K |
| 96376 |
|
4,371 |
4,192 |
$2K |
| 93280 |
|
91 |
37 |
$2K |
| G0008 |
Administration of influenza virus vaccine |
362 |
358 |
$2K |
| 90733 |
|
311 |
311 |
$2K |
| 96417 |
|
35 |
26 |
$2K |
| 84153 |
|
330 |
323 |
$2K |
| D9430 |
|
91 |
83 |
$2K |
| 93291 |
|
24 |
24 |
$2K |
| 72141 |
|
12 |
12 |
$2K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
3,471 |
3,324 |
$2K |
| 87184 |
|
1,549 |
1,516 |
$2K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
100 |
98 |
$2K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
833 |
794 |
$2K |
| 82552 |
|
1,051 |
1,028 |
$2K |
| 82951 |
|
204 |
198 |
$2K |
| 86769 |
|
63 |
61 |
$2K |
| 86696 |
|
158 |
158 |
$2K |
| 86695 |
|
140 |
140 |
$2K |
| 90756 |
|
109 |
109 |
$2K |
| 76000 |
|
15 |
15 |
$1K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,362 |
2,917 |
$1K |
| 3075F |
|
3,206 |
3,016 |
$1K |
| 70496 |
|
12 |
12 |
$1K |
| J2704 |
Injection, propofol, 10 mg |
5,374 |
5,286 |
$1K |
| 73060 |
|
281 |
262 |
$1K |
| 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 |
4,368 |
4,253 |
$1K |
| T2022 |
Case management, per month |
14 |
14 |
$1K |
| G2066 |
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results |
40 |
40 |
$1K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
731 |
652 |
$1K |
| 0071A |
|
32 |
22 |
$1K |
| 99401 |
|
43 |
42 |
$1K |
| 90723 |
|
1,125 |
1,123 |
$1K |
| J1815 |
Injection, insulin, per 5 units |
727 |
648 |
$1K |
| 76801 |
|
15 |
15 |
$1K |
| J1644 |
Injection, heparin sodium, per 1000 units |
3,492 |
593 |
$1K |
| 90658 |
|
106 |
102 |
$1K |
| 82710 |
|
136 |
135 |
$1K |
| D7230 |
|
16 |
16 |
$1K |
| 84156 |
|
324 |
308 |
$1K |
| 84100 |
|
1,741 |
1,698 |
$1K |
| 88141 |
|
148 |
147 |
$1K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,374 |
2,294 |
$1K |
| 82784 |
|
159 |
153 |
$1K |
| 73200 |
|
12 |
12 |
$1K |
| 83690 |
|
8,313 |
7,892 |
$1K |
| J2310 |
Injection, naloxone hydrochloride, per 1 mg |
144 |
129 |
$1K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,582 |
1,479 |
$1K |
| 90696 |
|
358 |
358 |
$1K |
| 84703 |
|
8,070 |
7,788 |
$1K |
| 3074F |
|
14,548 |
12,817 |
$1K |
| 94400 |
|
29 |
29 |
$1K |
| 84550 |
|
451 |
421 |
$1K |
| 82550 |
|
1,159 |
1,131 |
$995.71 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
81 |
81 |
$990.40 |
| D0270 |
|
149 |
148 |
$924.39 |
| 87147 |
|
565 |
553 |
$899.94 |
| 73140 |
|
57 |
54 |
$895.74 |
| G2077 |
Periodic assessment; assessing periodically by an otp practitioner and includes a review of moud dosing, treatment response, other substance use disorder treatment needs, responses and patient-identified goals, and other relevant physical, nutrition and psychiatric treatment needs and goals; may be informed by administration of a standardized, evidence-based assessment, or the need and interest for harm reduction interventions and recovery support services (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to each primary code |
94 |
78 |
$851.79 |
| 86580 |
|
130 |
81 |
$850.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,649 |
2,595 |
$830.87 |
| 3044F |
|
3,732 |
3,053 |
$786.52 |
| 93297 |
|
41 |
41 |
$765.60 |
| D0120 |
Periodic oral evaluation - established patient |
34 |
34 |
$764.60 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,782 |
3,742 |
$756.69 |
| 80178 |
|
379 |
369 |
$736.48 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
579 |
574 |
$717.42 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
4,178 |
3,478 |
$696.37 |
| 85379 |
|
902 |
884 |
$680.12 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
793 |
577 |
$672.99 |
| 80345 |
|
987 |
939 |
$656.97 |
| 76376 |
|
1,101 |
1,084 |
$634.53 |
| 85652 |
|
672 |
658 |
$631.76 |
| J1626 |
Injection, granisetron hydrochloride, 100 mcg |
228 |
106 |
$603.20 |
| 80349 |
|
986 |
935 |
$574.06 |
| 86335 |
|
13 |
13 |
$568.31 |
| J2680 |
Injection, fluphenazine decanoate, up to 25 mg |
83 |
64 |
$559.42 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
2,928 |
2,727 |
$548.31 |
| 84155 |
|
638 |
620 |
$545.37 |
| 1160F |
|
16,684 |
14,071 |
$545.00 |
| R0075 |
Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, more than one patient seen |
308 |
308 |
$530.69 |
| 90653 |
|
156 |
156 |
$516.13 |
| J1817 |
Insulin for administration through dme (i.e., insulin pump) per 50 units |
16 |
16 |
$498.00 |
| 86430 |
|
132 |
130 |
$483.36 |
| A6549 |
Gradient compression garment, not otherwise specified, for daytime use, each |
210 |
210 |
$480.90 |
| 87075 |
|
326 |
320 |
$477.69 |
| 0124A |
|
13 |
13 |
$477.26 |
| J2060 |
Injection, lorazepam, 2 mg |
1,664 |
1,571 |
$465.27 |
| 1125F |
|
2,587 |
1,960 |
$436.49 |
| 84450 |
|
554 |
545 |
$435.16 |
| 3077F |
|
3,608 |
3,280 |
$415.27 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
386 |
361 |
$407.60 |
| 88104 |
|
52 |
49 |
$401.50 |
| 69209 |
|
60 |
59 |
$401.48 |
| 85045 |
|
161 |
160 |
$383.18 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,772 |
1,707 |
$371.49 |
| 99417 |
Prolong home eval add 15m |
27 |
27 |
$370.26 |
| 86705 |
|
337 |
334 |
$364.85 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
5,698 |
5,058 |
$357.82 |
| A6258 |
Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
215 |
215 |
$349.21 |
| 83930 |
|
1,078 |
1,038 |
$346.99 |
| 70498 |
|
12 |
12 |
$333.48 |
| 87081 |
|
89 |
89 |
$324.96 |
| 73070 |
|
94 |
87 |
$321.24 |
| 90734 |
|
653 |
653 |
$317.77 |
| 91308 |
|
83 |
80 |
$305.98 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
1,042 |
1,039 |
$294.16 |
| 82533 |
|
30 |
26 |
$290.96 |
| 74018 |
|
39 |
38 |
$285.88 |
| 90474 |
|
27 |
27 |
$277.99 |
| 86140 |
|
137 |
135 |
$275.48 |
| 36620 |
|
82 |
80 |
$262.72 |
| A7002 |
Tubing, used with suction pump, each |
916 |
822 |
$260.22 |
| 82247 |
|
590 |
562 |
$258.03 |
| 86200 |
|
26 |
26 |
$255.10 |
| J2501 |
Injection, paricalcitol, 1 mcg |
118 |
12 |
$253.54 |
| 87205 |
|
258 |
252 |
$252.62 |
| 86593 |
|
219 |
214 |
$245.77 |
| D0170 |
|
63 |
57 |
$245.68 |
| 85014 |
|
236 |
189 |
$231.65 |
| 76377 |
|
1,345 |
1,331 |
$228.82 |
| S0109 |
Methadone, oral, 5 mg |
15 |
14 |
$227.00 |
| 82652 |
|
17 |
17 |
$222.38 |
| 82310 |
|
567 |
557 |
$218.58 |
| Q0163 |
Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen |
1,518 |
1,445 |
$217.22 |
| 72070 |
|
13 |
13 |
$206.60 |
| 73600 |
|
27 |
27 |
$201.90 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
112 |
112 |
$184.42 |
| 86682 |
|
25 |
25 |
$176.70 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
469 |
462 |
$172.26 |
| 91300 |
|
1,699 |
1,237 |
$169.83 |
| 85008 |
|
278 |
273 |
$168.54 |
| S0028 |
Injection, famotidine, 20 mg |
5,910 |
5,549 |
$145.14 |
| 86376 |
|
12 |
12 |
$143.32 |
| J1953 |
Injection, levetiracetam, 10 mg |
84 |
75 |
$142.56 |
| J1741 |
Injection, ibuprofen, 100 mg |
261 |
260 |
$140.52 |
| 99152 |
|
180 |
178 |
$136.50 |
| 73120 |
|
15 |
15 |
$131.00 |
| 84075 |
|
519 |
509 |
$128.96 |
| C1769 |
Guide wire |
27 |
27 |
$125.25 |
| 86340 |
|
17 |
17 |
$121.33 |
| 90688 |
|
16 |
16 |
$120.58 |
| A4217 |
Sterile water/saline, 500 ml |
442 |
441 |
$109.84 |
| 99429 |
|
361 |
267 |
$100.50 |
| 83883 |
|
15 |
14 |
$93.10 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
261 |
240 |
$83.93 |
| 85007 |
|
214 |
214 |
$80.78 |
| 84165 |
|
14 |
14 |
$78.52 |
| 82565 |
|
548 |
536 |
$74.74 |
| 84520 |
|
581 |
567 |
$65.77 |
| 84540 |
|
61 |
60 |
$61.09 |
| 91303 |
|
47 |
47 |
$57.38 |
| A6253 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
110 |
110 |
$56.47 |
| J0290 |
Injection, ampicillin sodium, 500 mg |
1,500 |
1,497 |
$56.14 |
| 82040 |
|
524 |
515 |
$50.36 |
| 85384 |
|
25 |
24 |
$50.01 |
| J7510 |
Prednisolone oral, per 5 mg |
113 |
112 |
$48.71 |
| 86431 |
|
12 |
12 |
$47.25 |
| 83540 |
|
25 |
25 |
$44.33 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
243 |
232 |
$43.85 |
| 82270 |
|
31 |
29 |
$43.75 |
| 82950 |
|
12 |
12 |
$42.75 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
37 |
37 |
$41.74 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
87 |
85 |
$35.78 |
| 87210 |
|
14 |
14 |
$34.00 |
| A4364 |
Adhesive, liquid or equal, any type, per oz |
43 |
43 |
$32.84 |
| 84132 |
|
15 |
12 |
$31.58 |
| 82374 |
|
511 |
502 |
$28.55 |
| 99153 |
Mod sedat endo service >5yrs |
69 |
68 |
$28.44 |
| 99024 |
|
430 |
379 |
$27.98 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
233 |
222 |
$26.84 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
58 |
58 |
$26.23 |
| 80305 |
|
51 |
48 |
$25.25 |
| J0692 |
Injection, cefepime hydrochloride, 500 mg |
24 |
17 |
$25.20 |
| A4215 |
Needle, sterile, any size, each |
380 |
377 |
$22.80 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
17 |
17 |
$20.02 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
14 |
14 |
$15.30 |
| 84295 |
|
514 |
504 |
$13.71 |
| 82435 |
|
513 |
504 |
$13.11 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
12 |
12 |
$12.25 |
| J7642 |
Glycopyrrolate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram |
2,061 |
2,054 |
$12.16 |
| 90687 |
|
13 |
13 |
$10.45 |
| 87420 |
|
37 |
37 |
$8.03 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
12 |
12 |
$7.92 |
| J0456 |
Injection, azithromycin, 500 mg |
25 |
25 |
$5.71 |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
120 |
117 |
$5.00 |
| A6403 |
Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing |
12 |
12 |
$3.69 |
| A4550 |
Surgical trays |
135 |
135 |
$3.58 |
| 91307 |
|
370 |
341 |
$3.09 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
241 |
240 |
$1.80 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
256 |
245 |
$1.71 |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
12 |
12 |
$0.56 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
37 |
36 |
$0.27 |
| 3078F |
|
13,773 |
12,139 |
$0.24 |
| 91311 |
|
20 |
20 |
$0.18 |
| 3079F |
|
6,078 |
5,524 |
$0.10 |
| 91312 |
|
12 |
12 |
$0.08 |
| 3080F |
|
1,523 |
1,428 |
$0.08 |
| J2356 |
Injection, tezepelumab-ekko, 1 mg |
12 |
12 |
$0.08 |
| G9664 |
Patients who are currently statin therapy users or received an order (prescription) for statin therapy |
29 |
29 |
$0.07 |
| A4452 |
Tape, waterproof, per 18 square inches |
118 |
116 |
$0.00 |
| D0190 |
|
459 |
459 |
$0.00 |
| 4013F |
|
805 |
714 |
$0.00 |
| A4649 |
Surgical supply; miscellaneous |
1,682 |
1,577 |
$0.00 |
| 99499 |
|
65 |
25 |
$0.00 |
| 3051F |
|
605 |
473 |
$0.00 |
| 3046F |
|
301 |
239 |
$0.00 |
| 99080 |
|
4,409 |
1,380 |
$0.00 |
| 1158F |
|
195 |
181 |
$0.00 |
| G0390 |
Trauma response team associated with hospital critical care service |
99 |
97 |
$0.00 |
| 82375 |
|
27 |
26 |
$0.00 |
| C1758 |
Catheter, ureteral |
19 |
16 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
32 |
32 |
$0.00 |
| 3725F |
|
19 |
19 |
$0.00 |
| D1120 |
Prophylaxis - child |
16 |
16 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
33 |
33 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
25 |
24 |
$0.00 |
| 3052F |
|
254 |
201 |
$0.00 |
| D1351 |
Sealant - per tooth |
17 |
13 |
$0.00 |
| A4580 |
Cast supplies (e.g., plaster) |
163 |
163 |
$0.00 |
| 82553 |
|
38 |
37 |
$0.00 |
| 1170F |
|
145 |
137 |
$0.00 |
| 1036F |
|
49 |
48 |
$0.00 |
| D0240 |
|
14 |
14 |
$0.00 |
| A6024 |
Collagen dressing wound filler, sterile, per 6 inches |
12 |
12 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
133 |
133 |
$0.00 |
| A4930 |
Gloves, sterile, per pair |
13 |
13 |
$0.00 |