| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
28,652 |
24,447 |
$4.13M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
21,362 |
17,437 |
$2.69M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
8,843 |
6,305 |
$1.99M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
10,343 |
8,320 |
$1.34M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
8,824 |
7,853 |
$1.12M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
2,494 |
2,147 |
$1.08M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
3,994 |
3,437 |
$909K |
| 70450 |
Computed tomography, head or brain; without contrast material |
5,995 |
4,845 |
$819K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,214 |
3,638 |
$807K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
15,612 |
3,991 |
$607K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
1,681 |
1,382 |
$601K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
1,191 |
1,050 |
$558K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,532 |
3,002 |
$525K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,372 |
2,867 |
$419K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,404 |
2,076 |
$290K |
| G0378 |
Hospital observation service, per hour |
1,492 |
1,133 |
$286K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
399 |
368 |
$282K |
| 0240U |
|
4,415 |
4,081 |
$263K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,100 |
5,170 |
$251K |
| 43249 |
|
402 |
360 |
$188K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
419 |
382 |
$184K |
| 59025 |
Fetal non-stress test |
912 |
645 |
$175K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
743 |
668 |
$169K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
4,683 |
2,312 |
$160K |
| 93017 |
|
1,578 |
1,424 |
$154K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,786 |
1,609 |
$153K |
| 80053 |
Comprehensive metabolic panel |
36,157 |
28,163 |
$134K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,531 |
1,371 |
$134K |
| 71046 |
Radiologic examination, chest; 2 views |
6,795 |
5,884 |
$133K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
4,446 |
1,689 |
$126K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,744 |
1,652 |
$116K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,220 |
1,116 |
$115K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
607 |
361 |
$106K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,388 |
2,309 |
$87K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
4,970 |
1,639 |
$84K |
| 97161 |
|
1,052 |
941 |
$82K |
| 97162 |
|
621 |
544 |
$77K |
| 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 |
3,224 |
2,819 |
$67K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
5,268 |
1,790 |
$65K |
| J3490 |
Unclassified drugs |
89,209 |
30,328 |
$64K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
25,687 |
19,939 |
$63K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,603 |
1,340 |
$62K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,534 |
2,443 |
$60K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,960 |
2,767 |
$59K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
16,196 |
12,772 |
$58K |
| 76642 |
|
561 |
453 |
$53K |
| 76830 |
Ultrasound, transvaginal |
530 |
497 |
$53K |
| 84443 |
Thyroid stimulating hormone (TSH) |
7,279 |
6,493 |
$53K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
14,189 |
10,706 |
$48K |
| 85027 |
|
24,018 |
17,659 |
$46K |
| 93971 |
|
595 |
487 |
$43K |
| 74018 |
|
2,005 |
1,771 |
$38K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
542 |
464 |
$38K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,050 |
931 |
$37K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
397 |
376 |
$34K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
5,837 |
4,381 |
$32K |
| 73564 |
|
1,917 |
1,544 |
$32K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
488 |
440 |
$31K |
| 83880 |
|
5,079 |
3,900 |
$30K |
| 71250 |
|
550 |
490 |
$29K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
4,584 |
4,202 |
$27K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,973 |
1,780 |
$26K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,972 |
1,780 |
$25K |
| 93225 |
|
1,464 |
1,221 |
$25K |
| 71045 |
Radiologic examination, chest; single view |
13,735 |
11,112 |
$24K |
| 80050 |
General health panel |
340 |
340 |
$24K |
| 80061 |
Lipid panel |
5,892 |
5,421 |
$24K |
| 29515 |
|
228 |
198 |
$21K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,906 |
4,467 |
$21K |
| 82607 |
|
1,917 |
1,754 |
$20K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
13,281 |
10,610 |
$20K |
| 95806 |
|
83 |
77 |
$19K |
| 84439 |
|
2,895 |
2,662 |
$19K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12,591 |
9,196 |
$19K |
| 93226 |
|
1,439 |
1,199 |
$18K |
| 87070 |
|
2,537 |
2,178 |
$17K |
| H0015 |
Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education |
204 |
35 |
$16K |
| 72110 |
|
626 |
553 |
$15K |
| 29125 |
|
137 |
122 |
$15K |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
606 |
213 |
$13K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,055 |
910 |
$13K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,836 |
1,730 |
$12K |
| 81025 |
|
5,889 |
5,078 |
$12K |
| 73030 |
|
1,289 |
1,070 |
$12K |
| 97016 |
|
411 |
168 |
$11K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
10,498 |
8,510 |
$11K |
| 90715 |
|
679 |
615 |
$10K |
| 87040 |
|
3,088 |
1,429 |
$10K |
| 85379 |
|
2,312 |
2,009 |
$10K |
| 73630 |
|
1,573 |
1,321 |
$10K |
| 81001 |
|
15,314 |
12,739 |
$9K |
| 82728 |
|
1,427 |
1,291 |
$9K |
| 93976 |
|
93 |
81 |
$9K |
| 87077 |
|
4,227 |
3,353 |
$9K |
| 99218 |
|
831 |
606 |
$8K |
| 36415 |
Collection of venous blood by venipuncture |
21,371 |
15,478 |
$8K |
| 84484 |
|
9,964 |
5,779 |
$8K |
| 76536 |
|
67 |
67 |
$7K |
| 86762 |
|
122 |
116 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
6,904 |
3,144 |
$7K |
| 73610 |
|
1,347 |
1,136 |
$6K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
9,087 |
6,597 |
$6K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
5,790 |
4,603 |
$6K |
| 86901 |
|
2,005 |
1,421 |
$6K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
355 |
325 |
$5K |
| 82962 |
|
9,861 |
4,032 |
$5K |
| 84702 |
|
952 |
772 |
$5K |
| 88142 |
|
352 |
330 |
$5K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
235 |
223 |
$5K |
| 74022 |
|
369 |
322 |
$5K |
| 83735 |
|
7,767 |
5,864 |
$5K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
359 |
321 |
$5K |
| 96376 |
|
3,547 |
1,991 |
$5K |
| 90791 |
Psychiatric diagnostic evaluation |
60 |
54 |
$4K |
| 73130 |
|
651 |
551 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,096 |
878 |
$4K |
| 77065 |
Tomosynthesis, mammo |
101 |
80 |
$4K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
155 |
110 |
$4K |
| 85610 |
|
5,700 |
4,014 |
$4K |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
468 |
363 |
$4K |
| 84703 |
|
2,577 |
2,144 |
$4K |
| 83540 |
|
1,495 |
1,336 |
$3K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
15 |
12 |
$3K |
| 86900 |
|
2,005 |
1,421 |
$3K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
14 |
12 |
$3K |
| 74019 |
|
115 |
99 |
$3K |
| 87481 |
|
75 |
72 |
$3K |
| 77066 |
Tomosynthesis, mammo |
84 |
79 |
$3K |
| 83550 |
|
1,409 |
1,261 |
$3K |
| 87186 |
|
3,962 |
3,161 |
$3K |
| 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 |
290 |
224 |
$3K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
75 |
72 |
$2K |
| 82043 |
|
377 |
348 |
$2K |
| 87150 |
|
195 |
163 |
$2K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
13 |
13 |
$2K |
| 86703 |
|
339 |
304 |
$2K |
| 73502 |
|
319 |
267 |
$2K |
| 87081 |
|
3,063 |
2,807 |
$2K |
| 86140 |
|
724 |
571 |
$2K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
16 |
12 |
$2K |
| 80076 |
|
1,852 |
1,652 |
$2K |
| 84153 |
|
126 |
121 |
$2K |
| 85652 |
|
441 |
384 |
$2K |
| 86850 |
|
1,483 |
1,092 |
$2K |
| 76801 |
|
32 |
28 |
$2K |
| 84481 |
|
61 |
58 |
$2K |
| 87340 |
|
373 |
348 |
$2K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
164 |
153 |
$2K |
| 29505 |
|
14 |
12 |
$2K |
| 82746 |
|
317 |
282 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
31 |
28 |
$2K |
| 83605 |
|
2,770 |
2,266 |
$2K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
719 |
591 |
$1K |
| 83690 |
|
7,117 |
5,812 |
$1K |
| 73110 |
|
275 |
241 |
$1K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
75 |
71 |
$1K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
8,777 |
6,918 |
$1K |
| 99307 |
|
128 |
119 |
$1K |
| 97035 |
|
63 |
29 |
$1K |
| 97113 |
|
33 |
13 |
$1K |
| 84145 |
|
245 |
206 |
$1K |
| 85730 |
|
1,129 |
906 |
$1K |
| A4930 |
Gloves, sterile, per pair |
870 |
735 |
$1K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
3,116 |
2,338 |
$1K |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
827 |
671 |
$1K |
| 83516 |
|
95 |
63 |
$1K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,912 |
4,049 |
$1K |
| 87631 |
|
53 |
45 |
$1K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,031 |
793 |
$1K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
306 |
64 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
6,120 |
5,130 |
$1K |
| 81003 |
|
8,658 |
6,574 |
$1K |
| A4335 |
Incontinence supply; miscellaneous |
2,392 |
2,160 |
$1K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
7,255 |
5,934 |
$1K |
| 86003 |
|
155 |
118 |
$1K |
| 80329 |
|
212 |
178 |
$1K |
| 93288 |
|
132 |
100 |
$1K |
| 87634 |
|
61 |
60 |
$1K |
| 87205 |
|
1,208 |
948 |
$996.11 |
| 70486 |
|
34 |
29 |
$934.57 |
| 36430 |
|
13 |
12 |
$928.64 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,685 |
2,902 |
$883.12 |
| 82784 |
|
230 |
132 |
$874.09 |
| 83655 |
|
170 |
159 |
$830.21 |
| 36591 |
|
74 |
52 |
$817.94 |
| J7614 |
Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg |
145 |
79 |
$781.24 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
3,521 |
2,395 |
$763.95 |
| 97166 |
|
15 |
13 |
$759.05 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,573 |
1,771 |
$737.53 |
| 88312 |
|
1,375 |
890 |
$734.16 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
117 |
110 |
$731.66 |
| 80164 |
|
171 |
128 |
$702.18 |
| 85007 |
|
2,336 |
1,483 |
$660.50 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,608 |
2,114 |
$648.08 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
1,666 |
1,373 |
$608.11 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,658 |
1,204 |
$599.53 |
| 73080 |
|
55 |
50 |
$598.41 |
| 93298 |
|
16 |
15 |
$546.47 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
302 |
282 |
$541.35 |
| 82950 |
|
92 |
89 |
$513.62 |
| 87807 |
|
714 |
665 |
$510.50 |
| 82150 |
|
1,887 |
1,444 |
$483.38 |
| 36600 |
|
446 |
377 |
$480.52 |
| 82731 |
|
21 |
12 |
$475.70 |
| 86803 |
|
69 |
66 |
$463.40 |
| 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 |
1,730 |
1,305 |
$462.83 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
2,623 |
2,078 |
$441.52 |
| 82465 |
|
75 |
63 |
$432.66 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,300 |
3,024 |
$417.22 |
| J1756 |
Injection, iron sucrose, 1 mg |
48 |
26 |
$414.58 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,616 |
812 |
$400.66 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,818 |
2,804 |
$377.71 |
| 73590 |
|
103 |
91 |
$376.61 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
2,310 |
1,688 |
$355.50 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
1,042 |
918 |
$329.46 |
| 83718 |
|
75 |
63 |
$321.46 |
| 87653 |
|
27 |
27 |
$320.71 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
1,993 |
1,654 |
$311.88 |
| 83615 |
|
212 |
181 |
$310.88 |
| 86592 |
|
304 |
282 |
$262.13 |
| 82077 |
|
1,594 |
1,383 |
$256.97 |
| 86880 |
|
830 |
575 |
$243.79 |
| T4541 |
Incontinence product, disposable underpad, large, each |
475 |
427 |
$242.81 |
| 84550 |
|
457 |
330 |
$215.00 |
| 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 |
116 |
108 |
$194.38 |
| 88304 |
|
141 |
101 |
$185.46 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
353 |
305 |
$167.39 |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
13 |
12 |
$160.74 |
| 85046 |
|
103 |
86 |
$153.48 |
| A4215 |
Needle, sterile, any size, each |
3,381 |
2,871 |
$147.75 |
| 80320 |
|
121 |
100 |
$147.26 |
| 82550 |
|
218 |
176 |
$146.14 |
| 86780 |
|
12 |
12 |
$140.16 |
| 82803 |
|
971 |
734 |
$136.34 |
| Q3014 |
Telehealth originating site facility fee |
22 |
14 |
$121.80 |
| 85651 |
|
428 |
365 |
$97.62 |
| 86008 |
|
12 |
12 |
$87.57 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
963 |
691 |
$84.38 |
| 87185 |
|
81 |
71 |
$81.61 |
| 86038 |
|
44 |
40 |
$80.87 |
| 86308 |
|
28 |
27 |
$71.26 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
794 |
416 |
$64.67 |
| 82140 |
|
285 |
205 |
$62.27 |
| 82105 |
|
20 |
14 |
$59.72 |
| 73140 |
|
15 |
12 |
$58.01 |
| 82570 |
|
36 |
30 |
$54.98 |
| J7510 |
Prednisolone oral, per 5 mg |
509 |
467 |
$52.61 |
| 82565 |
|
48 |
40 |
$50.72 |
| E0275 |
Bed pan, standard, metal or plastic |
472 |
423 |
$45.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
994 |
483 |
$44.97 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
548 |
498 |
$43.89 |
| 82009 |
|
620 |
419 |
$42.29 |
| 87210 |
|
63 |
51 |
$33.12 |
| 82010 |
|
207 |
147 |
$33.07 |
| J7050 |
Infusion, normal saline solution, 250 cc |
971 |
515 |
$30.72 |
| J2785 |
Injection, regadenoson, 0.1 mg |
1,441 |
1,185 |
$26.15 |
| J7612 |
Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 0.5 mg |
442 |
255 |
$22.67 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
641 |
430 |
$20.79 |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
882 |
774 |
$18.60 |
| J1815 |
Injection, insulin, per 5 units |
198 |
124 |
$17.63 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
205 |
152 |
$16.76 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
251 |
214 |
$14.90 |
| J2060 |
Injection, lorazepam, 2 mg |
197 |
149 |
$8.45 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
71 |
47 |
$7.16 |
| 84132 |
|
15 |
12 |
$4.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
99 |
78 |
$3.45 |
| J1940 |
Injection, furosemide, up to 20 mg |
134 |
82 |
$3.07 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
17 |
13 |
$2.30 |
| 94760 |
|
1,032 |
510 |
$2.21 |
| J0280 |
Injection, aminophyllin, up to 250 mg |
38 |
29 |
$1.43 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
16 |
12 |
$1.38 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
17 |
12 |
$0.88 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
166 |
133 |
$0.11 |
| A4556 |
Electrodes, (e.g., apnea monitor), per pair |
831 |
760 |
$0.00 |
| C1769 |
Guide wire |
112 |
95 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
78 |
67 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
3,178 |
2,910 |
$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 |
135 |
116 |
$0.00 |
| A4620 |
Variable concentration mask |
217 |
204 |
$0.00 |
| J1817 |
Insulin for administration through dme (i.e., insulin pump) per 50 units |
23 |
12 |
$0.00 |
| 51798 |
|
38 |
24 |
$0.00 |
| A6454 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard |
13 |
13 |
$0.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
40 |
27 |
$0.00 |
| A4580 |
Cast supplies (e.g., plaster) |
41 |
39 |
$0.00 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
35 |
14 |
$0.00 |
| 85018 |
|
43 |
14 |
$0.00 |
| 94761 |
|
14 |
12 |
$0.00 |
| A6455 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard |
12 |
12 |
$0.00 |
| 73090 |
|
16 |
12 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
856 |
736 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
265 |
219 |
$0.00 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
307 |
295 |
$0.00 |
| A4565 |
Slings |
27 |
26 |
$0.00 |
| A4246 |
Betadine or phisohex solution, per pint |
184 |
170 |
$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 |
38 |
27 |
$0.00 |
| E0485 |
Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment |
80 |
77 |
$0.00 |
| 84100 |
|
75 |
62 |
$0.00 |
| A7000 |
Canister, disposable, used with suction pump, each |
142 |
139 |
$0.00 |
| A4649 |
Surgical supply; miscellaneous |
28 |
28 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
46 |
45 |
$0.00 |
| A4618 |
Breathing circuits |
226 |
212 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
205 |
163 |
$0.00 |
| 85045 |
|
30 |
24 |
$0.00 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
134 |
126 |
$0.00 |
| 80143 |
|
63 |
55 |
$0.00 |
| 80179 |
|
50 |
42 |
$0.00 |
| 85014 |
|
43 |
14 |
$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 |
44 |
30 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
18 |
13 |
$0.00 |
| L1906 |
Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf |
13 |
13 |
$0.00 |