| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
101,982 |
100,790 |
$17.04M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
53,432 |
52,701 |
$14.06M |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
1,260 |
1,257 |
$4.66M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
25,525 |
25,093 |
$3.48M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
8,126 |
8,061 |
$2.78M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
25,827 |
25,711 |
$2.60M |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
4,133 |
4,094 |
$1.54M |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
3,123 |
1,774 |
$1.23M |
| 36415 |
Collection of venous blood by venipuncture |
86,020 |
79,736 |
$965K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
3,769 |
2,243 |
$774K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
13,896 |
13,831 |
$746K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
5,161 |
5,112 |
$660K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
13,062 |
12,830 |
$659K |
| 80053 |
Comprehensive metabolic panel |
69,864 |
63,955 |
$628K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
13,855 |
12,802 |
$570K |
| 42830 |
|
320 |
320 |
$487K |
| 76770 |
|
6,670 |
6,638 |
$390K |
| D9999 |
Unspecified adjunctive procedure, by report |
374 |
374 |
$347K |
| 54161 |
|
360 |
360 |
$340K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
48,721 |
43,675 |
$321K |
| 85027 |
|
52,301 |
47,107 |
$307K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,629 |
1,611 |
$294K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
676 |
676 |
$294K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,883 |
1,817 |
$273K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,404 |
1,403 |
$266K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,820 |
5,803 |
$256K |
| 70450 |
Computed tomography, head or brain; without contrast material |
4,651 |
4,569 |
$243K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,855 |
1,850 |
$197K |
| 71046 |
Radiologic examination, chest; 2 views |
9,906 |
9,810 |
$190K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
3,441 |
3,281 |
$186K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,398 |
3,235 |
$177K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
3,503 |
3,397 |
$176K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
2,093 |
2,089 |
$173K |
| 71045 |
Radiologic examination, chest; single view |
13,760 |
13,542 |
$170K |
| 84443 |
Thyroid stimulating hormone (TSH) |
11,155 |
11,043 |
$166K |
| 81001 |
|
47,291 |
46,552 |
$163K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
7,884 |
7,509 |
$150K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,526 |
1,433 |
$139K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
324 |
324 |
$130K |
| 72170 |
|
7,503 |
7,441 |
$126K |
| 73590 |
|
4,485 |
4,302 |
$124K |
| 72082 |
|
2,913 |
2,910 |
$123K |
| 87536 |
|
1,666 |
1,662 |
$120K |
| 82805 |
|
1,715 |
1,618 |
$119K |
| 80047 |
|
10,694 |
10,298 |
$118K |
| 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 |
1,471 |
1,461 |
$113K |
| 95782 |
|
163 |
163 |
$111K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
2,160 |
2,143 |
$105K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
349 |
337 |
$98K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,869 |
2,841 |
$89K |
| 87088 |
|
12,065 |
11,874 |
$89K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
15,807 |
15,104 |
$88K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,100 |
1,100 |
$85K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,704 |
2,678 |
$84K |
| 84484 |
|
7,084 |
4,955 |
$81K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,171 |
1,167 |
$77K |
| 84439 |
|
9,440 |
9,348 |
$75K |
| 74019 |
|
3,775 |
3,725 |
$75K |
| 83880 |
|
1,985 |
1,883 |
$67K |
| 90670 |
|
275 |
275 |
$66K |
| J0897 |
Injection, denosumab, 1 mg |
51 |
51 |
$62K |
| 83605 |
|
6,136 |
5,044 |
$62K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
7,061 |
6,993 |
$61K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,881 |
1,837 |
$58K |
| 77072 |
|
677 |
677 |
$58K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,335 |
1,323 |
$54K |
| 82803 |
|
2,345 |
2,190 |
$53K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
645 |
645 |
$53K |
| 88142 |
|
2,176 |
2,174 |
$46K |
| 81025 |
|
6,389 |
6,249 |
$45K |
| 80061 |
Lipid panel |
3,773 |
3,762 |
$45K |
| 93304 |
|
117 |
116 |
$43K |
| 96409 |
|
280 |
169 |
$43K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
543 |
541 |
$38K |
| 86480 |
|
746 |
746 |
$38K |
| 83690 |
|
6,289 |
6,170 |
$38K |
| 90677 |
|
486 |
486 |
$38K |
| 83520 |
|
1,917 |
1,063 |
$37K |
| 86361 |
|
1,632 |
1,627 |
$37K |
| 87070 |
|
4,435 |
4,377 |
$36K |
| 86140 |
|
7,902 |
7,734 |
$36K |
| 87430 |
|
2,500 |
2,468 |
$35K |
| 73100 |
|
1,660 |
1,537 |
$34K |
| 73551 |
|
2,011 |
1,997 |
$33K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,185 |
1,179 |
$32K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,532 |
1,529 |
$32K |
| 54300 |
|
12 |
12 |
$31K |
| 83735 |
|
5,457 |
4,714 |
$31K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
4,181 |
3,918 |
$30K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
805 |
802 |
$30K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,012 |
1,981 |
$29K |
| 12011 |
|
270 |
268 |
$29K |
| 84702 |
|
2,096 |
1,932 |
$28K |
| 94010 |
|
1,391 |
1,386 |
$27K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
1,492 |
1,437 |
$27K |
| 94060 |
|
894 |
869 |
$27K |
| 96367 |
|
563 |
296 |
$26K |
| 86780 |
|
2,309 |
2,279 |
$26K |
| 82977 |
|
4,192 |
3,944 |
$26K |
| 74018 |
|
1,695 |
1,623 |
$25K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
284 |
284 |
$25K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
224 |
224 |
$24K |
| 90697 |
|
492 |
492 |
$24K |
| 87077 |
|
2,543 |
2,416 |
$24K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
796 |
709 |
$23K |
| 42821 |
|
12 |
12 |
$23K |
| 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 |
236 |
236 |
$23K |
| 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 |
315 |
310 |
$22K |
| 82570 |
|
4,091 |
3,276 |
$22K |
| 85610 |
|
5,809 |
5,604 |
$22K |
| 82784 |
|
2,236 |
2,142 |
$21K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,827 |
1,507 |
$21K |
| 73090 |
|
1,310 |
1,207 |
$21K |
| 85014 |
|
9,379 |
9,138 |
$20K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
125 |
125 |
$19K |
| 84145 |
|
799 |
788 |
$19K |
| 84305 |
|
941 |
939 |
$19K |
| 88342 |
|
260 |
259 |
$18K |
| 87040 |
|
1,883 |
1,657 |
$18K |
| 82728 |
|
1,448 |
1,392 |
$17K |
| 87400 |
|
1,246 |
708 |
$17K |
| 73070 |
|
1,071 |
950 |
$17K |
| 81003 |
|
981 |
957 |
$17K |
| 80069 |
|
2,195 |
2,093 |
$17K |
| 85651 |
|
4,445 |
4,272 |
$16K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
28 |
28 |
$16K |
| 83970 |
|
467 |
456 |
$15K |
| 84466 |
|
1,303 |
1,281 |
$15K |
| 73630 |
|
622 |
612 |
$15K |
| 83519 |
|
915 |
913 |
$14K |
| 85730 |
|
2,647 |
2,568 |
$14K |
| 86850 |
|
1,707 |
1,651 |
$14K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,711 |
1,403 |
$14K |
| 93298 |
|
239 |
228 |
$13K |
| 87186 |
|
1,495 |
1,441 |
$13K |
| 96402 |
|
267 |
241 |
$13K |
| 82248 |
|
2,679 |
2,382 |
$12K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
824 |
818 |
$12K |
| 84100 |
|
2,829 |
2,395 |
$12K |
| 86803 |
|
961 |
961 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
115 |
115 |
$10K |
| 86255 |
|
1,111 |
1,109 |
$10K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,047 |
1,043 |
$10K |
| 86704 |
|
948 |
948 |
$9K |
| 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 |
311 |
305 |
$9K |
| 85044 |
|
2,390 |
2,236 |
$9K |
| 86682 |
|
866 |
866 |
$9K |
| 86665 |
|
482 |
292 |
$9K |
| 83540 |
|
1,568 |
1,539 |
$9K |
| 73562 |
|
349 |
349 |
$8K |
| 90734 |
|
63 |
63 |
$8K |
| 90723 |
|
101 |
101 |
$8K |
| 87631 |
|
121 |
121 |
$8K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,628 |
1,307 |
$8K |
| 87799 |
|
174 |
114 |
$8K |
| 73610 |
|
353 |
340 |
$8K |
| 80076 |
|
999 |
993 |
$7K |
| 86317 |
|
614 |
614 |
$7K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
142 |
38 |
$7K |
| 83655 |
|
596 |
595 |
$7K |
| 84156 |
|
2,204 |
2,082 |
$7K |
| 76870 |
|
119 |
118 |
$6K |
| 36416 |
|
4,958 |
3,828 |
$6K |
| 86364 |
|
413 |
325 |
$6K |
| 86900 |
|
2,145 |
2,096 |
$6K |
| 87340 |
|
669 |
669 |
$6K |
| 86901 |
|
2,093 |
2,046 |
$6K |
| 86162 |
|
301 |
301 |
$5K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
110 |
110 |
$5K |
| 86376 |
|
381 |
381 |
$5K |
| 86762 |
|
399 |
398 |
$5K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
690 |
677 |
$5K |
| 82330 |
|
388 |
352 |
$5K |
| 82565 |
|
942 |
810 |
$5K |
| 82136 |
|
280 |
214 |
$5K |
| 86787 |
|
438 |
438 |
$5K |
| 83516 |
|
273 |
201 |
$5K |
| 86800 |
|
311 |
310 |
$5K |
| 73030 |
|
305 |
304 |
$5K |
| 86038 |
|
411 |
408 |
$4K |
| 90716 |
|
29 |
29 |
$4K |
| 83615 |
|
798 |
727 |
$4K |
| 90686 |
|
1,264 |
1,264 |
$4K |
| 73130 |
|
199 |
193 |
$4K |
| 86258 |
|
231 |
212 |
$4K |
| 87522 |
Neg quan hep c or qual rna |
96 |
96 |
$4K |
| 96450 |
|
15 |
12 |
$4K |
| 83020 |
|
320 |
293 |
$4K |
| 90681 |
|
131 |
131 |
$4K |
| 85045 |
|
1,155 |
1,088 |
$3K |
| 92551 |
|
353 |
353 |
$3K |
| 84481 |
|
221 |
221 |
$3K |
| 95816 |
|
12 |
12 |
$3K |
| 86231 |
|
327 |
326 |
$3K |
| 77336 |
|
57 |
24 |
$3K |
| 76536 |
|
42 |
42 |
$3K |
| 84425 |
|
190 |
190 |
$3K |
| 72158 |
|
15 |
14 |
$3K |
| 86592 |
|
824 |
823 |
$3K |
| 72081 |
|
131 |
131 |
$3K |
| 84403 |
|
120 |
112 |
$3K |
| 73502 |
|
120 |
117 |
$3K |
| 72100 |
|
147 |
146 |
$3K |
| 87467 |
|
207 |
207 |
$3K |
| 72156 |
|
14 |
13 |
$3K |
| 93325 |
|
7,823 |
7,700 |
$3K |
| 12001 |
|
30 |
30 |
$3K |
| 76000 |
|
122 |
122 |
$3K |
| 72157 |
|
13 |
12 |
$3K |
| 86735 |
|
227 |
227 |
$3K |
| 90656 |
|
195 |
195 |
$3K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
715 |
432 |
$2K |
| 82533 |
|
159 |
116 |
$2K |
| 73080 |
|
112 |
107 |
$2K |
| 84436 |
|
366 |
366 |
$2K |
| 86765 |
|
198 |
198 |
$2K |
| 84134 |
|
199 |
199 |
$2K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
282 |
282 |
$2K |
| 94644 |
|
59 |
59 |
$2K |
| 83001 |
|
114 |
111 |
$2K |
| 82105 |
|
136 |
135 |
$2K |
| 86060 |
|
319 |
318 |
$2K |
| 87081 |
|
337 |
336 |
$2K |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
13 |
12 |
$2K |
| 82150 |
|
445 |
436 |
$2K |
| 84450 |
|
405 |
398 |
$2K |
| 82043 |
|
383 |
378 |
$2K |
| 86706 |
|
197 |
197 |
$2K |
| 87497 |
|
58 |
36 |
$2K |
| 82747 |
|
146 |
146 |
$2K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
44 |
13 |
$2K |
| 17110 |
|
44 |
44 |
$2K |
| 86160 |
|
109 |
64 |
$2K |
| 85652 |
|
733 |
727 |
$2K |
| 82550 |
|
290 |
273 |
$2K |
| 82247 |
|
483 |
458 |
$2K |
| J1626 |
Injection, granisetron hydrochloride, 100 mcg |
718 |
314 |
$2K |
| 93296 |
|
106 |
106 |
$2K |
| 82610 |
|
105 |
105 |
$2K |
| 83525 |
|
150 |
150 |
$2K |
| 90674 |
|
55 |
55 |
$2K |
| 81002 |
|
64 |
42 |
$2K |
| 84460 |
|
436 |
427 |
$1K |
| 83002 |
|
86 |
82 |
$1K |
| 73600 |
|
73 |
71 |
$1K |
| 80074 |
|
33 |
33 |
$1K |
| 85240 |
|
87 |
70 |
$1K |
| 82947 |
|
382 |
364 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
96 |
77 |
$1K |
| 84075 |
|
394 |
387 |
$1K |
| 84550 |
|
313 |
284 |
$1K |
| 82340 |
|
166 |
162 |
$1K |
| 84432 |
|
131 |
131 |
$1K |
| 82040 |
|
397 |
390 |
$1K |
| 80197 |
|
93 |
63 |
$1K |
| 96417 |
|
16 |
12 |
$1K |
| 93970 |
|
12 |
12 |
$1K |
| 96401 |
|
40 |
39 |
$1K |
| 82785 |
|
81 |
81 |
$1K |
| 86753 |
|
105 |
105 |
$1K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
12 |
12 |
$1K |
| 85018 |
|
455 |
450 |
$1K |
| 82103 |
|
82 |
82 |
$938.50 |
| 84155 |
|
393 |
386 |
$932.36 |
| 85660 |
|
197 |
154 |
$921.20 |
| 72040 |
|
38 |
38 |
$883.23 |
| 76642 |
|
30 |
29 |
$871.49 |
| 82104 |
|
81 |
81 |
$751.10 |
| 84520 |
|
220 |
215 |
$740.61 |
| 82310 |
|
160 |
153 |
$716.04 |
| 73140 |
|
28 |
26 |
$710.42 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
12 |
12 |
$686.84 |
| 82657 |
|
36 |
36 |
$659.88 |
| 84703 |
|
102 |
102 |
$648.56 |
| 84132 |
|
162 |
158 |
$647.19 |
| 84295 |
|
152 |
149 |
$631.60 |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
13 |
12 |
$595.01 |
| 82950 |
|
138 |
136 |
$585.56 |
| 82374 |
|
139 |
137 |
$577.22 |
| 73110 |
|
25 |
24 |
$568.50 |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
202 |
202 |
$549.02 |
| 89051 |
|
105 |
84 |
$522.90 |
| 90651 |
|
52 |
52 |
$503.14 |
| 73521 |
|
18 |
18 |
$466.92 |
| 87205 |
|
112 |
104 |
$447.80 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
15 |
15 |
$440.16 |
| G0008 |
Administration of influenza virus vaccine |
197 |
197 |
$413.52 |
| 82670 |
|
14 |
14 |
$409.08 |
| 93299 |
|
13 |
13 |
$388.92 |
| 86664 |
|
25 |
25 |
$373.43 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
240 |
232 |
$335.20 |
| 85379 |
|
37 |
24 |
$334.85 |
| 86663 |
|
25 |
25 |
$320.39 |
| 73560 |
|
13 |
13 |
$311.22 |
| 84157 |
|
87 |
67 |
$309.72 |
| 82945 |
|
87 |
67 |
$301.00 |
| 86015 |
|
27 |
27 |
$283.92 |
| 86225 |
|
21 |
12 |
$271.74 |
| 80051 |
|
44 |
43 |
$263.10 |
| 86708 |
|
18 |
18 |
$198.36 |
| 87420 |
|
16 |
16 |
$194.72 |
| 82962 |
|
66 |
42 |
$192.72 |
| A4364 |
Adhesive, liquid or equal, any type, per oz |
57 |
57 |
$184.70 |
| 86709 |
|
18 |
18 |
$180.36 |
| 80305 |
|
15 |
15 |
$164.15 |
| 83550 |
|
26 |
25 |
$163.17 |
| 82390 |
|
16 |
16 |
$152.80 |
| 84446 |
|
12 |
12 |
$151.32 |
| 87147 |
|
29 |
29 |
$141.19 |
| 86200 |
|
12 |
12 |
$140.80 |
| 85384 |
|
15 |
14 |
$138.40 |
| 84590 |
|
12 |
12 |
$123.96 |
| 84478 |
|
28 |
28 |
$91.98 |
| 84479 |
|
15 |
15 |
$86.25 |
| 86431 |
|
13 |
13 |
$67.32 |
| 87210 |
|
12 |
12 |
$57.48 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
25 |
25 |
$19.58 |
| 59025 |
Fetal non-stress test |
16 |
15 |
$16.84 |
| 90671 |
|
321 |
321 |
$3.21 |
| 90619 |
|
14 |
14 |
$0.14 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,978 |
1,975 |
$0.00 |
| J9370 |
Vincristine sulfate, 1 mg |
413 |
249 |
$0.00 |
| J9260 |
Injection, methotrexate sodium, 50 mg |
79 |
53 |
$0.00 |
| C1751 |
Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) |
212 |
212 |
$0.00 |
| 93321 |
|
195 |
192 |
$0.00 |
| 90633 |
|
194 |
194 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
175 |
163 |
$0.00 |
| 90707 |
|
39 |
39 |
$0.00 |
| 99152 |
|
14 |
14 |
$0.00 |
| 90715 |
|
18 |
18 |
$0.00 |
| 90648 |
|
52 |
52 |
$0.00 |
| 90710 |
|
14 |
14 |
$0.00 |
| 90700 |
|
17 |
17 |
$0.00 |
| 29125 |
|
15 |
14 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
13 |
13 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
15 |
15 |
$0.00 |
| 93320 |
|
4,188 |
4,146 |
$0.00 |
| 36000 |
|
1,214 |
1,211 |
$0.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
1,460 |
1,447 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
382 |
339 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
64 |
64 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
55 |
42 |
$0.00 |
| 96376 |
|
485 |
401 |
$0.00 |
| 90474 |
|
83 |
83 |
$0.00 |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
28 |
25 |
$0.00 |
| C1769 |
Guide wire |
42 |
41 |
$0.00 |
| 41899 |
Unlisted procedure, dentoalveolar structures |
12 |
12 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
14 |
14 |
$0.00 |
| J3490 |
Unclassified drugs |
21 |
14 |
$0.00 |