| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
Emergency room services |
91,811 |
81,388 |
$4.65M |
| 99199 |
Unlisted special service, procedure or report |
30,652 |
26,980 |
$1.47M |
| 0360 |
|
8,496 |
6,936 |
$1.10M |
| 70450 |
Computed tomography, head or brain; without contrast material |
8,111 |
7,891 |
$1.01M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,438 |
4,330 |
$824K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
14,559 |
13,578 |
$769K |
| 80053 |
Comprehensive metabolic panel |
54,287 |
48,008 |
$562K |
| 0270 |
|
26,977 |
17,602 |
$544K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
11,144 |
10,767 |
$529K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
4,713 |
4,606 |
$441K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
18,742 |
16,775 |
$421K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
60,375 |
52,803 |
$416K |
| 71046 |
Radiologic examination, chest; 2 views |
20,783 |
20,013 |
$406K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
5,150 |
5,033 |
$388K |
| 0760 |
|
12,153 |
10,087 |
$383K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
18,503 |
17,236 |
$369K |
| 0761 |
|
13,418 |
11,369 |
$352K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
7,304 |
6,707 |
$326K |
| 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 |
6,207 |
5,596 |
$324K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
13,657 |
13,219 |
$298K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,749 |
1,729 |
$296K |
| J3490 |
Unclassified drugs |
25,143 |
14,327 |
$287K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
5,643 |
5,416 |
$286K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
5,467 |
5,387 |
$255K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
20,130 |
6,340 |
$253K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
6,183 |
6,075 |
$235K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
17,335 |
9,150 |
$222K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,387 |
3,387 |
$217K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
2,397 |
2,243 |
$193K |
| A4649 |
Surgical supply; miscellaneous |
1,810 |
1,511 |
$185K |
| 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 |
6,246 |
5,920 |
$183K |
| 83880 |
|
7,301 |
6,879 |
$172K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
2,489 |
2,354 |
$171K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
5,295 |
4,543 |
$163K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
3,122 |
3,041 |
$158K |
| 76641 |
|
4,247 |
4,161 |
$155K |
| 0710 |
|
3,790 |
3,575 |
$153K |
| 84484 |
|
16,967 |
14,668 |
$149K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
3,284 |
3,256 |
$142K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
1,160 |
1,131 |
$138K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
7,222 |
6,116 |
$136K |
| 81001 |
|
40,453 |
37,430 |
$133K |
| 83690 |
|
19,756 |
18,443 |
$130K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,584 |
2,464 |
$124K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,036 |
1,019 |
$119K |
| 87634 |
|
2,353 |
2,315 |
$118K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,684 |
1,563 |
$116K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
5,965 |
5,201 |
$111K |
| 59025 |
Fetal non-stress test |
6,940 |
4,249 |
$110K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
4,837 |
4,449 |
$108K |
| 71045 |
Radiologic examination, chest; single view |
8,322 |
7,924 |
$107K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15,348 |
7,353 |
$105K |
| 71250 |
|
946 |
944 |
$102K |
| 76801 |
|
1,901 |
1,770 |
$95K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
7,101 |
5,518 |
$93K |
| 99070 |
|
5,684 |
3,974 |
$90K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
2,123 |
2,101 |
$89K |
| 93971 |
|
1,150 |
1,129 |
$85K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
649 |
621 |
$81K |
| 77065 |
Tomosynthesis, mammo |
1,977 |
1,954 |
$79K |
| 99000 |
|
44,301 |
38,548 |
$79K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
2,300 |
1,264 |
$77K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
907 |
769 |
$74K |
| 94760 |
|
11,385 |
10,352 |
$74K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
12,606 |
12,108 |
$71K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
68 |
67 |
$70K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
10,044 |
8,141 |
$70K |
| 87040 |
|
6,776 |
3,939 |
$70K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
5,464 |
5,384 |
$65K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
2,918 |
1,346 |
$65K |
| 81025 |
|
15,090 |
14,301 |
$63K |
| 87070 |
|
5,967 |
5,610 |
$62K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,163 |
618 |
$61K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
6,420 |
6,031 |
$61K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
5,940 |
5,763 |
$58K |
| 73630 |
|
2,880 |
2,811 |
$57K |
| J7050 |
Infusion, normal saline solution, 250 cc |
4,349 |
2,271 |
$56K |
| 99221 |
|
1,837 |
1,613 |
$56K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
9,455 |
8,867 |
$56K |
| 83605 |
|
5,272 |
4,547 |
$54K |
| 84145 |
|
3,120 |
3,024 |
$53K |
| 97161 |
|
2,276 |
2,099 |
$51K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
506 |
501 |
$51K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
8,180 |
7,074 |
$50K |
| 87400 |
|
4,936 |
4,857 |
$50K |
| 73562 |
|
2,893 |
2,830 |
$49K |
| 97139 |
|
1,887 |
675 |
$48K |
| 73130 |
|
2,491 |
2,408 |
$48K |
| 76770 |
|
1,030 |
1,013 |
$47K |
| 85730 |
|
9,204 |
8,726 |
$47K |
| 73610 |
|
2,276 |
2,226 |
$47K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
6,590 |
6,194 |
$46K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,199 |
3,012 |
$42K |
| 83735 |
|
6,822 |
6,243 |
$41K |
| 70486 |
|
338 |
334 |
$41K |
| 73030 |
|
2,118 |
2,061 |
$41K |
| 72131 |
|
261 |
258 |
$40K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,153 |
1,126 |
$39K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,153 |
1,126 |
$39K |
| 77066 |
Tomosynthesis, mammo |
718 |
710 |
$38K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
3,911 |
1,510 |
$38K |
| 74018 |
|
2,670 |
2,603 |
$38K |
| 73110 |
|
1,978 |
1,892 |
$37K |
| 85610 |
|
11,189 |
10,542 |
$36K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
4,622 |
3,840 |
$36K |
| 97750 |
|
1,781 |
1,762 |
$33K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
4,615 |
3,861 |
$30K |
| 84702 |
|
3,677 |
3,304 |
$29K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
224 |
224 |
$28K |
| 96367 |
|
1,073 |
667 |
$27K |
| 90715 |
|
671 |
669 |
$25K |
| 0720 |
|
762 |
595 |
$23K |
| 76830 |
Ultrasound, transvaginal |
514 |
504 |
$23K |
| 73221 |
|
206 |
201 |
$22K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
4,307 |
3,410 |
$22K |
| A4648 |
Tissue marker, implantable, any type, each |
25 |
25 |
$21K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
2,588 |
2,416 |
$21K |
| 76870 |
|
512 |
502 |
$21K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,409 |
3,680 |
$21K |
| 72100 |
|
861 |
851 |
$20K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
4,475 |
3,355 |
$20K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
474 |
333 |
$19K |
| 77061 |
|
1,193 |
1,187 |
$18K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,164 |
3,533 |
$18K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
117 |
115 |
$18K |
| 87420 |
|
2,752 |
2,630 |
$18K |
| 73080 |
|
775 |
753 |
$18K |
| 97597 |
|
876 |
622 |
$17K |
| 72110 |
|
861 |
850 |
$17K |
| 87186 |
|
3,194 |
3,082 |
$17K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
307 |
291 |
$16K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
68 |
67 |
$15K |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
997 |
977 |
$15K |
| 86901 |
|
3,941 |
3,639 |
$15K |
| 84703 |
|
4,706 |
4,536 |
$14K |
| 76536 |
|
489 |
485 |
$14K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
283 |
253 |
$14K |
| 36415 |
Collection of venous blood by venipuncture |
5,790 |
4,942 |
$14K |
| 73502 |
|
531 |
523 |
$14K |
| 86140 |
|
2,690 |
2,608 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
563 |
502 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
962 |
819 |
$12K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
611 |
602 |
$12K |
| 87077 |
|
3,208 |
3,102 |
$12K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
77 |
76 |
$12K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
274 |
255 |
$11K |
| 86850 |
|
1,827 |
1,681 |
$11K |
| 83615 |
|
1,251 |
1,143 |
$11K |
| 36591 |
|
524 |
294 |
$11K |
| 85379 |
|
1,028 |
1,011 |
$10K |
| 99215 |
Prolong outpt/office vis |
326 |
285 |
$10K |
| 73700 |
|
135 |
133 |
$10K |
| 84439 |
|
1,143 |
1,075 |
$10K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,510 |
1,484 |
$10K |
| J2704 |
Injection, propofol, 10 mg |
890 |
814 |
$10K |
| 86900 |
|
3,613 |
3,372 |
$9K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
312 |
311 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
894 |
769 |
$9K |
| 77062 |
|
475 |
470 |
$9K |
| 81003 |
|
4,207 |
3,932 |
$8K |
| 51701 |
|
92 |
88 |
$8K |
| 97010 |
|
420 |
187 |
$8K |
| A4217 |
Sterile water/saline, 500 ml |
494 |
452 |
$8K |
| 85652 |
|
1,249 |
1,207 |
$8K |
| 93970 |
|
86 |
86 |
$8K |
| 73590 |
|
439 |
426 |
$7K |
| A9270 |
Non-covered item or service |
29,378 |
18,777 |
$7K |
| 73564 |
|
480 |
477 |
$7K |
| J2060 |
Injection, lorazepam, 2 mg |
1,231 |
1,005 |
$7K |
| 0762 |
|
195 |
110 |
$6K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
558 |
498 |
$6K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
40 |
40 |
$6K |
| S8037 |
Magnetic resonance cholangiopancreatography (mrcp) |
15 |
14 |
$6K |
| 73090 |
|
349 |
338 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,346 |
1,318 |
$6K |
| 82378 |
|
443 |
345 |
$6K |
| 52281 |
|
193 |
190 |
$5K |
| 82010 |
|
683 |
628 |
$5K |
| 29126 |
|
94 |
91 |
$5K |
| 72141 |
|
48 |
43 |
$5K |
| 90714 |
|
182 |
176 |
$5K |
| 72040 |
|
221 |
220 |
$5K |
| 71020 |
|
200 |
102 |
$5K |
| 82803 |
|
328 |
313 |
$5K |
| 72072 |
|
210 |
209 |
$5K |
| 74022 |
|
125 |
117 |
$4K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
30 |
12 |
$4K |
| J1815 |
Injection, insulin, per 5 units |
574 |
339 |
$4K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
700 |
484 |
$4K |
| G0378 |
Hospital observation service, per hour |
367 |
330 |
$4K |
| 71101 |
|
126 |
123 |
$4K |
| 82150 |
|
666 |
640 |
$4K |
| 82550 |
|
699 |
610 |
$4K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
93 |
92 |
$4K |
| 73140 |
|
310 |
296 |
$4K |
| S0077 |
Injection, clindamycin phosphate, 300 mg |
281 |
259 |
$4K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
559 |
484 |
$4K |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
410 |
337 |
$3K |
| 80061 |
Lipid panel |
721 |
710 |
$3K |
| 87807 |
|
584 |
483 |
$3K |
| 29515 |
|
88 |
86 |
$3K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
582 |
558 |
$3K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
86 |
85 |
$3K |
| A4364 |
Adhesive, liquid or equal, any type, per oz |
54 |
51 |
$3K |
| 70491 |
|
24 |
24 |
$3K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
135 |
119 |
$3K |
| 0301 |
|
46 |
26 |
$3K |
| 95816 |
|
116 |
116 |
$3K |
| 82553 |
|
263 |
251 |
$3K |
| 97039 |
|
341 |
159 |
$3K |
| 77080 |
|
265 |
265 |
$3K |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
28 |
28 |
$3K |
| 20610 |
|
135 |
134 |
$2K |
| 49083 |
|
59 |
24 |
$2K |
| 96376 |
|
288 |
264 |
$2K |
| 96417 |
|
76 |
54 |
$2K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
71 |
70 |
$2K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
352 |
344 |
$2K |
| 72050 |
|
95 |
94 |
$2K |
| Q3014 |
Telehealth originating site facility fee |
172 |
156 |
$2K |
| 71010 |
|
111 |
48 |
$2K |
| 72082 |
|
80 |
80 |
$2K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
34 |
29 |
$2K |
| V2632 |
Posterior chamber intraocular lens |
28 |
22 |
$1K |
| 99152 |
|
32 |
31 |
$1K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
226 |
160 |
$1K |
| 84550 |
|
479 |
418 |
$1K |
| J1453 |
Injection, fosaprepitant, 1 mg |
51 |
41 |
$1K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
57 |
39 |
$1K |
| 77336 |
|
71 |
27 |
$1K |
| 82140 |
|
88 |
77 |
$984.52 |
| 90839 |
|
16 |
15 |
$928.57 |
| J7510 |
Prednisolone oral, per 5 mg |
151 |
140 |
$910.49 |
| J0694 |
Injection, cefoxitin sodium, 1 gm |
64 |
36 |
$906.84 |
| 29125 |
|
13 |
12 |
$783.19 |
| 77300 |
|
13 |
12 |
$773.30 |
| 84100 |
|
258 |
220 |
$743.20 |
| 19083 |
|
12 |
12 |
$713.27 |
| S0164 |
Injection, pantoprazole sodium, 40 mg |
70 |
53 |
$697.08 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
128 |
109 |
$677.07 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
58 |
58 |
$656.33 |
| 82731 |
|
15 |
13 |
$645.42 |
| 85027 |
|
108 |
97 |
$589.01 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
34 |
33 |
$537.39 |
| 73600 |
|
31 |
31 |
$531.90 |
| 96379 |
|
13 |
13 |
$528.55 |
| 96127 |
|
93 |
82 |
$497.05 |
| 70360 |
|
38 |
38 |
$438.77 |
| J0736 |
Injection, clindamycin phosphate, 300 mg |
45 |
43 |
$423.58 |
| 94644 |
|
24 |
13 |
$401.82 |
| 0272 |
|
172 |
156 |
$387.12 |
| 85384 |
|
67 |
52 |
$365.52 |
| 80069 |
|
118 |
97 |
$350.77 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
35 |
31 |
$336.26 |
| 82728 |
|
31 |
30 |
$313.40 |
| 90686 |
|
65 |
65 |
$281.85 |
| 84112 |
|
120 |
104 |
$281.08 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
80 |
49 |
$271.04 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
27 |
27 |
$270.29 |
| 85007 |
|
108 |
97 |
$270.20 |
| 36430 |
|
29 |
24 |
$267.81 |
| 73560 |
|
25 |
25 |
$265.56 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
26 |
26 |
$250.94 |
| 29131 |
|
12 |
12 |
$246.28 |
| 73000 |
|
12 |
12 |
$233.82 |
| 73100 |
|
13 |
13 |
$212.94 |
| 86780 |
|
19 |
15 |
$210.96 |
| 94664 |
|
19 |
14 |
$185.78 |
| 73120 |
|
12 |
12 |
$183.94 |
| 87205 |
|
48 |
41 |
$165.40 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
50 |
50 |
$162.96 |
| 83540 |
|
59 |
52 |
$158.70 |
| 70220 |
|
14 |
13 |
$152.34 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
40 |
27 |
$139.94 |
| 86635 |
|
14 |
13 |
$130.99 |
| 86308 |
|
27 |
27 |
$126.12 |
| 83550 |
|
44 |
37 |
$96.77 |
| 84450 |
|
31 |
30 |
$94.31 |
| 99173 |
|
72 |
71 |
$92.69 |
| 76882 |
|
13 |
12 |
$85.07 |
| 87430 |
|
29 |
28 |
$73.07 |
| 84153 |
|
24 |
24 |
$44.01 |
| 0516 |
|
49 |
45 |
$34.10 |
| 51741 |
|
12 |
12 |
$32.52 |
| 82043 |
|
24 |
24 |
$19.75 |
| 82570 |
|
37 |
37 |
$14.74 |
| 82565 |
|
27 |
25 |
$12.02 |
| 85018 |
|
13 |
13 |
$10.35 |
| 0637 |
|
70 |
30 |
$5.04 |
| 82607 |
|
12 |
12 |
$3.02 |
| 0258 |
|
220 |
93 |
$0.07 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
531 |
471 |
$0.05 |
| 0250 |
|
17 |
16 |
$0.02 |
| 0710R |
|
203 |
202 |
$0.00 |
| 0272R |
|
252 |
247 |
$0.00 |
| 0270R |
|
243 |
219 |
$0.00 |
| S0215 |
Non-emergency transportation; mileage, per mile |
24 |
12 |
$0.00 |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
47 |
33 |
$0.00 |
| 0370R |
|
21 |
17 |
$0.00 |
| 97035 |
|
174 |
80 |
$0.00 |
| 0250R |
|
72 |
68 |
$0.00 |
| 0271R |
|
21 |
17 |
$0.00 |
| J3471 |
Injection, hyaluronidase, ovine, preservative free, per 1 usp unit (up to 999 usp units) |
16 |
14 |
$0.00 |