| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
176,176 |
155,316 |
$20.26M |
| 0450 |
Emergency room services |
66,251 |
58,956 |
$9.08M |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
5,071 |
3,318 |
$8.01M |
| G0390 |
Trauma response team associated with hospital critical care service |
951 |
938 |
$6.93M |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
115,163 |
93,471 |
$4.54M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
67,785 |
63,163 |
$3.57M |
| 0761 |
|
120,524 |
94,221 |
$3.55M |
| 0160 |
|
8,166 |
4,786 |
$3.55M |
| J9271 |
Injection, pembrolizumab, 1 mg |
593 |
450 |
$3.31M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
13,872 |
12,351 |
$2.40M |
| A4649 |
Surgical supply; miscellaneous |
103,714 |
53,320 |
$2.38M |
| 0360 |
|
16,124 |
13,240 |
$2.14M |
| 85027 |
|
142,139 |
123,999 |
$1.98M |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
42,818 |
41,750 |
$1.74M |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
42,820 |
41,750 |
$1.73M |
| 97139 |
|
60,426 |
14,453 |
$1.67M |
| J3490 |
Unclassified drugs |
33,203 |
17,786 |
$1.58M |
| J9035 |
Injection, bevacizumab, 10 mg |
655 |
282 |
$1.54M |
| J0897 |
Injection, denosumab, 1 mg |
1,576 |
1,524 |
$1.46M |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
4,572 |
3,247 |
$1.28M |
| 99215 |
Prolong outpt/office vis |
13,559 |
11,372 |
$1.25M |
| 80053 |
Comprehensive metabolic panel |
128,431 |
114,271 |
$1.19M |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
24,436 |
23,341 |
$1.17M |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
2,042 |
1,430 |
$1.05M |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
12,085 |
10,987 |
$1.03M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
7,054 |
6,890 |
$933K |
| J2505 |
Injection, pegfilgrastim, 6 mg |
441 |
311 |
$896K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
9,369 |
9,285 |
$877K |
| 90378 |
|
510 |
456 |
$827K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
6,463 |
6,425 |
$799K |
| J9299 |
Injection, nivolumab, 1 mg |
120 |
91 |
$785K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
3,906 |
2,870 |
$775K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
13,394 |
12,040 |
$767K |
| 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 |
8,509 |
7,903 |
$744K |
| 84443 |
Thyroid stimulating hormone (TSH) |
45,565 |
44,341 |
$737K |
| 90837 |
Psychotherapy, 53 minutes with patient |
7,204 |
3,698 |
$707K |
| Z7502 |
|
18,508 |
18,267 |
$696K |
| S3620 |
Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total) |
4,493 |
4,311 |
$668K |
| 97799 |
|
21,621 |
5,030 |
$657K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
13,726 |
5,620 |
$654K |
| 0760 |
|
12,933 |
11,188 |
$638K |
| J2506 |
Injection, pegfilgrastim, excludes biosimilar, 0.5 mg |
690 |
512 |
$603K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
11,543 |
11,195 |
$575K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
1,333 |
1,220 |
$574K |
| 99223 |
Prolong inpt eval add15 m |
5,288 |
4,642 |
$574K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14,294 |
12,751 |
$528K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
16,844 |
12,145 |
$512K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,422 |
1,393 |
$492K |
| 0762 |
|
405 |
266 |
$479K |
| 71046 |
Radiologic examination, chest; 2 views |
12,569 |
12,242 |
$464K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
42,969 |
42,645 |
$460K |
| 86003 |
|
2,636 |
1,462 |
$457K |
| 99233 |
Prolong inpt eval add15 m |
6,508 |
2,759 |
$449K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
5,498 |
5,443 |
$398K |
| 99222 |
Initial hospital care, per day, moderate complexity |
4,430 |
4,055 |
$389K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
11,388 |
6,954 |
$386K |
| 0710 |
|
14,260 |
13,944 |
$385K |
| 97750 |
|
6,567 |
4,737 |
$373K |
| 93975 |
|
3,919 |
3,807 |
$368K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
23,856 |
22,446 |
$367K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,711 |
1,578 |
$360K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
6,215 |
4,554 |
$353K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
46,241 |
36,574 |
$351K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,696 |
1,661 |
$339K |
| Z7500 |
|
9,775 |
7,125 |
$333K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
14,232 |
13,322 |
$323K |
| J9355 |
Injection, trastuzumab, excludes biosimilar, 10 mg |
193 |
133 |
$311K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
15,429 |
14,649 |
$299K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
800 |
712 |
$296K |
| 83721 |
|
29,263 |
29,143 |
$289K |
| 76641 |
|
2,795 |
2,650 |
$288K |
| 86703 |
|
45,175 |
43,537 |
$273K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
662 |
575 |
$272K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
2,617 |
2,605 |
$268K |
| 86780 |
|
18,951 |
18,210 |
$257K |
| 86140 |
|
33,683 |
31,255 |
$256K |
| 59425 |
|
3,428 |
2,289 |
$256K |
| 81511 |
|
1,133 |
1,111 |
$255K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,151 |
1,125 |
$254K |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,128 |
6,878 |
$253K |
| 83718 |
|
29,699 |
29,563 |
$249K |
| 0510 |
|
8,414 |
7,087 |
$248K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
3,598 |
3,539 |
$242K |
| 71250 |
|
1,677 |
1,664 |
$237K |
| 76770 |
|
3,284 |
3,228 |
$235K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
9,431 |
9,399 |
$230K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
4,865 |
4,506 |
$229K |
| 88312 |
|
2,183 |
2,088 |
$223K |
| 88307 |
|
2,758 |
2,665 |
$223K |
| 81025 |
|
30,828 |
28,507 |
$215K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,757 |
2,712 |
$214K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
4,438 |
4,043 |
$211K |
| 86480 |
|
3,326 |
3,278 |
$210K |
| 77066 |
Tomosynthesis, mammo |
1,209 |
1,199 |
$208K |
| 17110 |
|
1,510 |
1,415 |
$208K |
| 88304 |
|
8,551 |
8,250 |
$208K |
| 84478 |
|
31,569 |
31,412 |
$197K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
2,546 |
2,319 |
$190K |
| 74183 |
|
251 |
246 |
$184K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
668 |
610 |
$183K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
8,829 |
2,805 |
$182K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,175 |
2,114 |
$176K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
5,258 |
4,834 |
$175K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
6,575 |
6,557 |
$163K |
| J7050 |
Infusion, normal saline solution, 250 cc |
7,650 |
4,389 |
$162K |
| 97161 |
|
2,869 |
2,029 |
$160K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
5,854 |
5,591 |
$154K |
| 77065 |
Tomosynthesis, mammo |
1,140 |
1,118 |
$154K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
7,085 |
6,845 |
$153K |
| 82465 |
|
31,393 |
31,254 |
$152K |
| 81002 |
|
14,895 |
12,849 |
$151K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
28,280 |
26,093 |
$150K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,908 |
2,859 |
$147K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
7,325 |
6,963 |
$145K |
| 59025 |
Fetal non-stress test |
4,675 |
3,530 |
$143K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,420 |
6,153 |
$141K |
| 76830 |
Ultrasound, transvaginal |
2,893 |
2,834 |
$140K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
3,733 |
3,417 |
$139K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
791 |
774 |
$139K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
1,449 |
1,421 |
$137K |
| 74174 |
|
1,191 |
1,172 |
$137K |
| 82746 |
|
8,224 |
8,166 |
$134K |
| 87536 |
|
1,171 |
1,148 |
$133K |
| Z7610 |
|
14,734 |
8,323 |
$130K |
| 99243 |
|
1,736 |
1,717 |
$129K |
| 87503 |
|
3,964 |
3,920 |
$127K |
| 81508 |
|
554 |
533 |
$125K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
4,587 |
4,466 |
$124K |
| 90750 |
|
721 |
713 |
$123K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
7,199 |
7,167 |
$122K |
| 76536 |
|
1,960 |
1,927 |
$121K |
| 99443 |
|
1,074 |
908 |
$121K |
| 17000 |
|
1,459 |
1,425 |
$120K |
| 0121 |
|
184 |
184 |
$120K |
| 0250 |
|
5,125 |
3,906 |
$119K |
| 74178 |
|
207 |
200 |
$118K |
| 96367 |
|
3,276 |
2,116 |
$118K |
| 73562 |
|
4,320 |
3,890 |
$118K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
2,735 |
2,697 |
$117K |
| 81000 |
|
16,513 |
15,898 |
$117K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
717 |
712 |
$116K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,076 |
2,047 |
$114K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
366 |
363 |
$114K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
1,439 |
668 |
$111K |
| 74018 |
|
4,127 |
3,975 |
$110K |
| 86803 |
|
7,158 |
7,109 |
$109K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
8,038 |
7,022 |
$108K |
| 86901 |
|
8,658 |
8,005 |
$105K |
| 90686 |
|
6,778 |
6,742 |
$105K |
| 90715 |
|
5,325 |
5,276 |
$103K |
| 95819 |
|
2,133 |
2,066 |
$103K |
| 80069 |
|
2,575 |
2,240 |
$102K |
| 96417 |
|
2,757 |
1,792 |
$102K |
| 83013 |
|
1,313 |
1,310 |
$100K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
4,592 |
4,483 |
$100K |
| 84439 |
|
10,339 |
10,210 |
$99K |
| 96523 |
|
1,853 |
1,464 |
$98K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
3,043 |
2,330 |
$98K |
| 99406 |
|
7,679 |
7,159 |
$96K |
| 87088 |
|
14,062 |
13,476 |
$96K |
| 73610 |
|
3,383 |
3,175 |
$95K |
| 70498 |
|
768 |
753 |
$94K |
| 93017 |
|
1,241 |
1,220 |
$94K |
| 70486 |
|
1,186 |
1,164 |
$93K |
| 73630 |
|
3,392 |
3,147 |
$93K |
| 70496 |
|
790 |
780 |
$92K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
2,545 |
2,542 |
$89K |
| 72131 |
|
950 |
934 |
$88K |
| 82728 |
|
5,906 |
5,652 |
$87K |
| 73130 |
|
2,832 |
2,531 |
$87K |
| G0481 |
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; 8-14 drug class(es), including metabolite(s) if performed |
4,886 |
4,497 |
$86K |
| 71045 |
Radiologic examination, chest; single view |
18,155 |
17,236 |
$84K |
| J1453 |
Injection, fosaprepitant, 1 mg |
1,560 |
1,005 |
$84K |
| 73030 |
|
3,400 |
3,148 |
$84K |
| 90651 |
|
1,466 |
1,455 |
$83K |
| 83735 |
|
55,452 |
48,923 |
$83K |
| 0720 |
|
1,756 |
1,435 |
$82K |
| 72197 |
|
54 |
54 |
$80K |
| 84403 |
|
2,942 |
2,912 |
$80K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
455 |
426 |
$79K |
| 94729 |
|
1,219 |
1,174 |
$78K |
| 93226 |
|
811 |
793 |
$77K |
| 71271 |
|
429 |
421 |
$75K |
| 96415 |
|
2,472 |
1,728 |
$74K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
6,386 |
6,128 |
$74K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
496 |
494 |
$72K |
| 93970 |
|
1,039 |
1,014 |
$71K |
| 73110 |
|
2,484 |
2,313 |
$70K |
| J9395 |
Injection, fulvestrant, 25 mg |
191 |
177 |
$70K |
| 94060 |
|
1,818 |
1,800 |
$70K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,444 |
3,120 |
$69K |
| 87340 |
|
6,076 |
6,029 |
$65K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
2,869 |
1,781 |
$64K |
| 72141 |
|
309 |
300 |
$64K |
| 51798 |
|
1,058 |
1,046 |
$64K |
| 99245 |
|
486 |
484 |
$62K |
| 99358 |
Prolong nursin fac eval 15m |
1,031 |
952 |
$62K |
| 31575 |
|
568 |
551 |
$61K |
| 84481 |
|
3,184 |
3,148 |
$60K |
| 82378 |
|
2,605 |
2,231 |
$60K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,939 |
6,792 |
$60K |
| 47562 |
|
196 |
191 |
$59K |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
3,157 |
1,863 |
$59K |
| 83690 |
|
51,453 |
47,386 |
$59K |
| 84153 |
|
2,836 |
2,802 |
$58K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
12,153 |
8,647 |
$57K |
| J2704 |
Injection, propofol, 10 mg |
10,973 |
10,317 |
$57K |
| 93225 |
|
1,109 |
1,077 |
$56K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
22,875 |
19,493 |
$56K |
| 73502 |
|
1,864 |
1,682 |
$56K |
| 86850 |
|
7,934 |
7,368 |
$55K |
| 76801 |
|
1,823 |
1,620 |
$54K |
| 73140 |
|
1,507 |
1,417 |
$54K |
| 83540 |
|
7,031 |
6,865 |
$54K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,306 |
1,268 |
$53K |
| 87522 |
Neg quan hep c or qual rna |
1,073 |
1,039 |
$52K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,255 |
1,251 |
$52K |
| 86756 |
|
439 |
431 |
$52K |
| 83550 |
|
5,782 |
5,646 |
$51K |
| 72100 |
|
1,990 |
1,952 |
$51K |
| 87081 |
|
2,089 |
2,061 |
$50K |
| 43235 |
|
177 |
161 |
$50K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,131 |
1,127 |
$50K |
| 11102 |
|
469 |
458 |
$49K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
8,000 |
4,540 |
$49K |
| 90677 |
|
347 |
346 |
$48K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
15,914 |
14,912 |
$48K |
| 73080 |
|
1,422 |
1,329 |
$48K |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
1,554 |
1,501 |
$47K |
| 69210 |
|
1,146 |
968 |
$46K |
| 82043 |
|
7,177 |
7,137 |
$46K |
| 96416 |
|
917 |
552 |
$45K |
| 87186 |
|
5,043 |
4,905 |
$45K |
| J9217 |
Leuprolide acetate (for depot suspension), 7.5 mg |
180 |
178 |
$45K |
| 90670 |
|
1,723 |
1,701 |
$45K |
| 52000 |
|
340 |
339 |
$44K |
| 87070 |
|
3,512 |
3,365 |
$43K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,529 |
1,494 |
$43K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
6,016 |
5,328 |
$42K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
289 |
288 |
$42K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
598 |
376 |
$42K |
| 86360 |
|
693 |
686 |
$42K |
| 93971 |
|
1,341 |
1,294 |
$42K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
8,687 |
8,368 |
$41K |
| 73590 |
|
1,892 |
1,723 |
$41K |
| 85730 |
|
10,420 |
9,814 |
$40K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
4,183 |
4,044 |
$39K |
| 85610 |
|
13,785 |
12,537 |
$38K |
| 76870 |
|
1,112 |
1,081 |
$38K |
| 59514 |
|
144 |
142 |
$38K |
| 72040 |
|
1,349 |
1,304 |
$36K |
| 84702 |
|
2,898 |
2,377 |
$36K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
5,456 |
4,516 |
$36K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
9,362 |
9,047 |
$35K |
| J9202 |
Goserelin acetate implant, per 3.6 mg |
39 |
36 |
$35K |
| G9012 |
Other specified case management service not elsewhere classified |
2,619 |
1,377 |
$34K |
| 86706 |
|
2,869 |
2,858 |
$34K |
| 86705 |
|
2,881 |
2,857 |
$34K |
| 0270 |
|
5,539 |
4,316 |
$34K |
| 99152 |
|
539 |
521 |
$33K |
| 0750 |
|
2,177 |
2,083 |
$33K |
| H0033 |
Oral medication administration, direct observation |
1,358 |
96 |
$33K |
| 72082 |
|
390 |
385 |
$33K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
889 |
535 |
$32K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
415 |
405 |
$32K |
| 0129 |
|
108 |
104 |
$31K |
| 96411 |
|
1,333 |
882 |
$31K |
| 83615 |
|
4,284 |
3,613 |
$31K |
| 83880 |
|
3,709 |
3,538 |
$30K |
| 86762 |
|
1,889 |
1,880 |
$30K |
| 0420 |
|
1,186 |
322 |
$30K |
| 84146 |
|
1,347 |
1,338 |
$29K |
| 17003 |
|
873 |
841 |
$29K |
| 92551 |
|
2,582 |
2,576 |
$29K |
| 83001 |
|
1,383 |
1,376 |
$29K |
| 90834 |
Psychotherapy, 45 minutes with patient |
391 |
233 |
$28K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
152 |
151 |
$28K |
| 94727 |
|
732 |
690 |
$28K |
| 86038 |
|
2,063 |
2,045 |
$28K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
419 |
392 |
$28K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,084 |
957 |
$28K |
| 82274 |
|
1,516 |
1,264 |
$27K |
| 84402 |
|
1,267 |
1,237 |
$27K |
| 85018 |
|
6,394 |
6,386 |
$26K |
| J2785 |
Injection, regadenoson, 0.1 mg |
236 |
234 |
$26K |
| 81003 |
|
6,796 |
6,621 |
$26K |
| 0430 |
|
691 |
215 |
$26K |
| 90716 |
|
1,115 |
1,100 |
$26K |
| 99255 |
|
276 |
258 |
$26K |
| 83655 |
|
3,589 |
3,579 |
$25K |
| G0378 |
Hospital observation service, per hour |
1,352 |
815 |
$25K |
| 86900 |
|
8,883 |
8,168 |
$24K |
| 87205 |
|
3,993 |
3,822 |
$24K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
26 |
26 |
$24K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
9,742 |
8,299 |
$23K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
608 |
607 |
$23K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
497 |
497 |
$23K |
| 0721 |
|
766 |
668 |
$23K |
| 0636 |
|
1,066 |
419 |
$23K |
| 82670 |
|
810 |
794 |
$23K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
2,064 |
1,012 |
$21K |
| 86235 |
|
656 |
648 |
$21K |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
187 |
187 |
$21K |
| 99201 |
|
719 |
718 |
$21K |
| 82784 |
|
1,502 |
1,476 |
$20K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,013 |
1,010 |
$20K |
| 85651 |
|
8,286 |
7,966 |
$20K |
| 73090 |
|
818 |
761 |
$20K |
| 86580 |
|
1,156 |
1,131 |
$20K |
| 83002 |
|
943 |
938 |
$19K |
| 92511 |
|
370 |
366 |
$19K |
| 96402 |
|
1,933 |
1,828 |
$19K |
| 90707 |
|
875 |
864 |
$19K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
208 |
208 |
$19K |
| 80076 |
|
2,134 |
2,061 |
$18K |
| 83516 |
|
1,438 |
1,392 |
$18K |
| 90734 |
|
719 |
717 |
$18K |
| 82570 |
|
1,337 |
1,277 |
$18K |
| J9264 |
Injection, paclitaxel protein-bound particles, 1 mg |
37 |
13 |
$18K |
| 87902 |
|
130 |
128 |
$17K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
520 |
225 |
$17K |
| 90682 |
|
327 |
327 |
$17K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
307 |
306 |
$17K |
| 0258 |
|
2,280 |
1,880 |
$16K |
| 82105 |
|
1,057 |
1,031 |
$16K |
| 86708 |
|
1,121 |
1,120 |
$16K |
| 97165 |
|
123 |
123 |
$15K |
| 84156 |
|
674 |
638 |
$15K |
| 86709 |
|
1,385 |
1,381 |
$15K |
| 86787 |
|
1,152 |
1,127 |
$15K |
| S9470 |
Nutritional counseling, dietitian visit |
325 |
324 |
$15K |
| 84480 |
|
943 |
936 |
$15K |
| 73560 |
|
1,046 |
893 |
$15K |
| 83525 |
|
1,100 |
1,094 |
$15K |
| 84425 |
|
607 |
603 |
$14K |
| 20550 |
|
247 |
230 |
$14K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
4,701 |
4,301 |
$14K |
| 0969 |
|
205 |
138 |
$14K |
| Z9725 |
|
326 |
316 |
$14K |
| 87338 |
|
852 |
846 |
$14K |
| 82550 |
|
11,022 |
10,121 |
$14K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,660 |
2,601 |
$14K |
| 82652 |
|
606 |
606 |
$13K |
| 99254 |
|
204 |
200 |
$13K |
| 90744 |
|
1,092 |
1,006 |
$13K |
| 84484 |
|
13,043 |
11,686 |
$13K |
| 99205 |
Prolong outpt/office vis |
119 |
119 |
$13K |
| 82785 |
|
1,084 |
780 |
$13K |
| 84550 |
|
2,270 |
2,198 |
$13K |
| 91322 |
|
123 |
123 |
$13K |
| 90698 |
|
1,171 |
1,152 |
$13K |
| 72128 |
|
188 |
187 |
$13K |
| 73620 |
|
619 |
534 |
$13K |
| 72120 |
|
373 |
370 |
$13K |
| 20610 |
|
368 |
351 |
$13K |
| 94664 |
|
972 |
929 |
$12K |
| 87045 |
|
868 |
848 |
$12K |
| 82247 |
|
509 |
367 |
$12K |
| 90633 |
|
1,116 |
1,100 |
$12K |
| 90832 |
Psychotherapy, 30 minutes with patient |
203 |
182 |
$12K |
| 99460 |
|
206 |
206 |
$12K |
| 82950 |
|
1,384 |
1,262 |
$11K |
| 86592 |
|
2,194 |
2,181 |
$11K |
| 85014 |
|
4,120 |
4,112 |
$11K |
| J9190 |
Injection, fluorouracil, 500 mg |
492 |
281 |
$11K |
| 77077 |
|
311 |
299 |
$11K |
| 76942 |
|
317 |
243 |
$11K |
| 83883 |
|
631 |
603 |
$11K |
| 86635 |
|
842 |
823 |
$11K |
| 11100 |
|
225 |
225 |
$11K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,638 |
3,134 |
$11K |
| 87507 |
|
108 |
108 |
$11K |
| 86593 |
|
1,709 |
1,666 |
$11K |
| 90732 |
|
177 |
177 |
$11K |
| 90791 |
Psychiatric diagnostic evaluation |
80 |
69 |
$11K |
| 81001 |
|
7,646 |
7,248 |
$10K |
| 84100 |
|
10,579 |
9,123 |
$10K |
| 86376 |
|
801 |
796 |
$10K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
187 |
187 |
$10K |
| 87154 |
|
424 |
417 |
$10K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
16 |
15 |
$10K |
| 99451 |
|
249 |
248 |
$10K |
| 90739 |
|
98 |
98 |
$10K |
| 99442 |
|
103 |
101 |
$9K |
| 70491 |
|
55 |
54 |
$9K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
153 |
91 |
$9K |
| 86696 |
|
426 |
423 |
$9K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
4,528 |
4,249 |
$9K |
| 17004 |
|
38 |
37 |
$9K |
| J1815 |
Injection, insulin, per 5 units |
1,013 |
690 |
$9K |
| 82985 |
|
451 |
448 |
$8K |
| 86430 |
|
1,329 |
1,326 |
$8K |
| 82533 |
|
429 |
415 |
$8K |
| 86334 |
|
392 |
389 |
$8K |
| 86255 |
|
593 |
586 |
$8K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
982 |
954 |
$8K |
| 86765 |
|
557 |
531 |
$8K |
| 86039 |
|
631 |
627 |
$8K |
| 94726 |
|
106 |
101 |
$8K |
| 0424 |
|
183 |
137 |
$8K |
| 86200 |
|
890 |
885 |
$8K |
| 85007 |
|
2,766 |
2,217 |
$8K |
| 99153 |
Mod sedat endo service >5yrs |
216 |
213 |
$8K |
| 87177 |
|
543 |
508 |
$8K |
| 82172 |
|
462 |
461 |
$8K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
91 |
75 |
$7K |
| 72170 |
|
502 |
501 |
$7K |
| 84165 |
|
621 |
605 |
$7K |
| 0439 |
|
348 |
138 |
$7K |
| 90480 |
|
181 |
181 |
$7K |
| J1790 |
Injection, droperidol, up to 5 mg |
733 |
661 |
$7K |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
1,001 |
496 |
$7K |
| 96368 |
|
279 |
187 |
$7K |
| 0124A |
|
167 |
167 |
$7K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
19 |
15 |
$7K |
| 45384 |
|
15 |
15 |
$7K |
| 83090 |
|
342 |
341 |
$6K |
| 90696 |
|
432 |
431 |
$6K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
207 |
185 |
$6K |
| 95886 |
|
129 |
93 |
$6K |
| 90688 |
|
330 |
330 |
$6K |
| 82248 |
|
567 |
523 |
$6K |
| J9070 |
Cyclophosphamide, 100 mg |
44 |
25 |
$6K |
| 73070 |
|
237 |
213 |
$6K |
| 83921 |
|
340 |
337 |
$6K |
| 73552 |
|
172 |
161 |
$6K |
| 87040 |
|
3,713 |
3,485 |
$6K |
| 59020 |
|
247 |
221 |
$6K |
| 86695 |
|
392 |
390 |
$6K |
| 90710 |
|
365 |
363 |
$6K |
| 82977 |
|
719 |
706 |
$6K |
| 0001A |
|
143 |
143 |
$6K |
| 82947 |
|
1,326 |
1,301 |
$6K |
| 86735 |
|
532 |
530 |
$6K |
| 19301 |
|
13 |
13 |
$5K |
| 82077 |
|
1,612 |
1,524 |
$5K |
| C1781 |
Mesh (implantable) |
12 |
12 |
$5K |
| 84134 |
|
337 |
337 |
$5K |
| 90662 |
|
579 |
577 |
$5K |
| 84432 |
|
311 |
305 |
$5K |
| 84445 |
|
95 |
94 |
$5K |
| 90680 |
|
470 |
460 |
$5K |
| 90685 |
|
412 |
411 |
$5K |
| 72110 |
|
139 |
138 |
$5K |
| 73100 |
|
305 |
274 |
$5K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
183 |
183 |
$5K |
| J0694 |
Injection, cefoxitin sodium, 1 gm |
456 |
428 |
$5K |
| 0002A |
|
117 |
117 |
$5K |
| 90746 |
|
119 |
118 |
$5K |
| 84305 |
|
225 |
225 |
$5K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,381 |
916 |
$5K |
| 86308 |
|
419 |
416 |
$4K |
| 82150 |
|
814 |
798 |
$4K |
| 73564 |
|
154 |
141 |
$4K |
| 92504 |
|
206 |
187 |
$4K |
| J9267 |
Injection, paclitaxel, 1 mg |
186 |
80 |
$4K |
| 86812 |
|
199 |
196 |
$4K |
| 86141 |
|
277 |
276 |
$4K |
| 0272 |
|
3,069 |
2,917 |
$4K |
| 87493 |
|
198 |
191 |
$4K |
| 0004A |
|
91 |
91 |
$4K |
| 87529 |
|
50 |
49 |
$4K |
| 83010 |
|
390 |
383 |
$4K |
| 73000 |
|
85 |
78 |
$3K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
27 |
27 |
$3K |
| 96409 |
|
136 |
60 |
$3K |
| 86615 |
|
195 |
195 |
$3K |
| 86304 |
|
534 |
456 |
$3K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
152 |
149 |
$3K |
| 96127 |
|
405 |
394 |
$3K |
| 85044 |
|
1,167 |
1,074 |
$3K |
| 86800 |
|
410 |
404 |
$3K |
| 73660 |
|
72 |
63 |
$3K |
| 82565 |
|
606 |
601 |
$3K |
| 10060 |
|
302 |
293 |
$3K |
| 84145 |
|
1,623 |
1,532 |
$3K |
| 73060 |
|
64 |
57 |
$3K |
| 83605 |
|
4,052 |
3,724 |
$3K |
| 49650 |
|
16 |
13 |
$3K |
| 76000 |
|
87 |
78 |
$3K |
| 83993 |
|
121 |
120 |
$3K |
| 74022 |
|
118 |
117 |
$3K |
| 82627 |
|
319 |
316 |
$3K |
| 86147 |
|
79 |
77 |
$3K |
| 76937 |
|
81 |
80 |
$3K |
| 0064A |
|
67 |
67 |
$3K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,865 |
2,656 |
$3K |
| 85378 |
|
734 |
702 |
$3K |
| 82803 |
|
2,402 |
2,250 |
$3K |
| 83520 |
|
195 |
195 |
$3K |
| 73221 |
|
12 |
12 |
$3K |
| 83498 |
|
141 |
140 |
$3K |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
325 |
300 |
$2K |
| 99497 |
|
29 |
24 |
$2K |
| 86701 |
|
133 |
133 |
$2K |
| 95885 |
|
83 |
55 |
$2K |
| 84460 |
|
400 |
399 |
$2K |
| 0637 |
|
6,551 |
4,475 |
$2K |
| L3808 |
Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment |
12 |
12 |
$2K |
| 87102 |
|
238 |
231 |
$2K |
| 93289 |
|
50 |
50 |
$2K |
| 90713 |
|
122 |
117 |
$2K |
| 94010 |
|
89 |
89 |
$2K |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
235 |
230 |
$2K |
| 80164 |
|
123 |
111 |
$2K |
| 85379 |
|
2,145 |
2,075 |
$2K |
| 0012A |
|
47 |
47 |
$2K |
| 97166 |
|
29 |
29 |
$2K |
| 82330 |
|
2,005 |
1,901 |
$2K |
| 85613 |
|
165 |
163 |
$2K |
| 90619 |
|
78 |
76 |
$2K |
| 72072 |
|
42 |
41 |
$2K |
| 76881 |
|
13 |
13 |
$2K |
| 87427 |
|
202 |
201 |
$2K |
| V5008 |
Hearing screening |
45 |
44 |
$2K |
| 99441 |
|
69 |
69 |
$2K |
| 70360 |
|
25 |
25 |
$2K |
| J3489 |
Injection, zoledronic acid, 1 mg |
67 |
64 |
$2K |
| 99242 |
|
26 |
26 |
$2K |
| 83021 |
|
59 |
59 |
$2K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
27 |
24 |
$2K |
| 96401 |
|
93 |
39 |
$2K |
| J0640 |
Injection, leucovorin calcium, per 50 mg |
180 |
104 |
$2K |
| 0054A |
|
38 |
38 |
$2K |
| 84630 |
|
141 |
141 |
$2K |
| 84450 |
|
268 |
267 |
$1K |
| J9370 |
Vincristine sulfate, 1 mg |
135 |
49 |
$1K |
| 84155 |
|
408 |
402 |
$1K |
| 95816 |
|
28 |
28 |
$1K |
| J9394 |
Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg |
43 |
37 |
$1K |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
327 |
319 |
$1K |
| 81015 |
|
226 |
224 |
$1K |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
156 |
150 |
$1K |
| 64721 |
|
15 |
13 |
$1K |
| 84270 |
|
53 |
52 |
$1K |
| J2780 |
Injection, ranitidine hydrochloride, 25 mg |
177 |
177 |
$1K |
| 73120 |
|
81 |
72 |
$1K |
| 73551 |
|
40 |
40 |
$1K |
| 71020 |
|
48 |
29 |
$1K |
| 99173 |
|
404 |
403 |
$1K |
| Q9959 |
High osmolar contrast material, 150-199 mg/ml iodine concentration, per ml |
12 |
12 |
$1K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
194 |
194 |
$1K |
| G9621 |
Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method and received brief counseling |
159 |
144 |
$1K |
| J2060 |
Injection, lorazepam, 2 mg |
3,099 |
2,740 |
$1K |
| 86665 |
|
28 |
28 |
$1K |
| 82024 |
|
63 |
63 |
$1K |
| 86920 |
|
26 |
24 |
$1K |
| 86146 |
|
27 |
25 |
$997.44 |
| 72081 |
|
25 |
25 |
$942.28 |
| J3300 |
Injection, triamcinolone acetonide, preservative free, 1 mg |
27 |
27 |
$894.10 |
| 84681 |
|
69 |
69 |
$886.60 |
| 77001 |
|
12 |
12 |
$874.70 |
| 83519 |
|
54 |
53 |
$867.11 |
| 83789 |
|
35 |
35 |
$856.64 |
| 86021 |
|
40 |
40 |
$832.68 |
| 99199 |
Unlisted special service, procedure or report |
16 |
16 |
$826.83 |
| J9045 |
Injection, carboplatin, 50 mg |
43 |
28 |
$820.15 |
| 99462 |
|
27 |
13 |
$811.98 |
| 0071A |
|
20 |
20 |
$800.00 |
| 90681 |
|
78 |
78 |
$782.15 |
| 93018 |
|
44 |
44 |
$752.50 |
| 82140 |
|
123 |
114 |
$739.79 |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
22 |
17 |
$726.57 |
| 0300 |
|
523 |
480 |
$723.19 |
| 99422 |
|
26 |
26 |
$694.85 |
| 90697 |
|
65 |
65 |
$676.06 |
| 88342 |
|
14 |
14 |
$669.38 |
| 82310 |
|
108 |
95 |
$643.69 |
| 86603 |
|
36 |
36 |
$634.24 |
| 99423 |
|
14 |
14 |
$601.07 |
| 0072A |
|
15 |
15 |
$600.00 |
| 93925 |
|
13 |
13 |
$571.50 |
| 11901 |
|
15 |
15 |
$570.88 |
| 72050 |
|
13 |
13 |
$563.94 |
| 82261 |
|
33 |
33 |
$562.65 |
| J1644 |
Injection, heparin sodium, per 1000 units |
275 |
205 |
$560.20 |
| 89051 |
|
207 |
179 |
$559.80 |
| 88300 |
|
99 |
96 |
$540.39 |
| 83992 |
|
77 |
76 |
$530.00 |
| 82948 |
|
308 |
299 |
$521.06 |
| 73600 |
|
41 |
38 |
$518.75 |
| 90700 |
|
40 |
38 |
$512.80 |
| 0301 |
|
533 |
489 |
$511.62 |
| 94760 |
|
58 |
58 |
$499.90 |
| 76642 |
|
13 |
13 |
$498.12 |
| 86664 |
|
28 |
28 |
$453.60 |
| 93246 |
|
26 |
26 |
$452.08 |
| 71100 |
|
13 |
13 |
$448.16 |
| 86663 |
|
28 |
28 |
$430.38 |
| 90674 |
|
43 |
43 |
$426.60 |
| 0255 |
|
158 |
156 |
$425.46 |
| 86316 |
|
17 |
15 |
$424.83 |
| 87255 |
|
14 |
13 |
$402.75 |
| 64493 |
|
12 |
12 |
$397.23 |
| 82525 |
|
30 |
30 |
$382.24 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
43 |
41 |
$349.74 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
55 |
38 |
$339.53 |
| 82776 |
|
33 |
33 |
$320.76 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
26 |
25 |
$294.67 |
| 11900 |
|
12 |
12 |
$291.76 |
| 97162 |
|
25 |
25 |
$289.51 |
| 77072 |
|
12 |
12 |
$249.84 |
| 90648 |
|
25 |
25 |
$248.40 |
| 83835 |
|
12 |
12 |
$246.96 |
| 0306 |
|
267 |
258 |
$240.44 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
27 |
26 |
$239.54 |
| 82390 |
|
29 |
29 |
$232.00 |
| 82668 |
|
13 |
13 |
$231.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
79 |
69 |
$209.93 |
| 87075 |
|
27 |
27 |
$200.82 |
| 0370 |
|
634 |
618 |
$154.92 |
| 64483 |
|
13 |
13 |
$147.60 |
| 99000 |
|
31 |
29 |
$145.28 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
28 |
28 |
$131.44 |
| 87116 |
|
16 |
16 |
$123.42 |
| 87329 |
|
12 |
12 |
$122.98 |
| 80178 |
|
27 |
24 |
$122.80 |
| 88302 |
|
13 |
12 |
$112.95 |
| 84132 |
|
25 |
24 |
$110.67 |
| 0302 |
|
280 |
270 |
$100.95 |
| 87015 |
|
16 |
16 |
$78.64 |
| 86431 |
|
12 |
12 |
$74.58 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
17 |
13 |
$66.23 |
| 87206 |
|
16 |
16 |
$65.89 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
304 |
291 |
$63.75 |
| 0307 |
|
281 |
280 |
$59.89 |
| 82553 |
|
142 |
129 |
$47.61 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
184 |
139 |
$41.42 |
| 0324 |
|
300 |
300 |
$35.52 |
| 84157 |
|
15 |
12 |
$32.31 |
| 80051 |
|
46 |
41 |
$21.52 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
1,453 |
1,309 |
$17.95 |
| 84300 |
|
12 |
12 |
$16.17 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
897 |
823 |
$16.01 |
| 0305 |
|
306 |
305 |
$15.30 |
| 12001 |
|
28 |
28 |
$12.00 |
| J3360 |
Injection, diazepam, up to 5 mg |
26 |
25 |
$9.62 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
13 |
12 |
$8.66 |
| 0260 |
|
241 |
239 |
$0.00 |
| 0730 |
|
285 |
285 |
$0.00 |
| J7610 |
Albuterol, inhalation solution, compounded product, administered through dme, concentrated form, 1 mg |
994 |
890 |
$0.00 |
| H0043 |
Supported housing, per diem |
217 |
152 |
$0.00 |
| J7510 |
Prednisolone oral, per 5 mg |
26 |
26 |
$0.00 |
| 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 |
64 |
60 |
$0.00 |
| 0351 |
|
14 |
14 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
359 |
339 |
$0.00 |
| 0352 |
|
116 |
116 |
$0.00 |
| 0434 |
|
26 |
26 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
44 |
38 |
$0.00 |
| 0410 |
|
31 |
31 |
$0.00 |
| J1940 |
Injection, furosemide, up to 20 mg |
14 |
13 |
$0.00 |
| 12002 |
|
13 |
13 |
$0.00 |
| 80329 |
|
24 |
23 |
$0.00 |
| J3411 |
Injection, thiamine hcl, 100 mg |
14 |
13 |
$0.00 |