| Code | Description | Claims | Beneficiaries | Total Paid |
| H2018 |
Psychosocial rehabilitation services, per diem |
2,001 |
1,935 |
$8.45M |
| H2019 |
Therapeutic behavioral services, per 15 minutes |
4,344 |
4,339 |
$3.65M |
| 90832 |
Psychotherapy, 30 minutes with patient |
39,698 |
18,196 |
$3.44M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
23,320 |
20,382 |
$2.58M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
17,133 |
16,107 |
$2.48M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
3,093 |
3,085 |
$2.32M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
9,378 |
8,074 |
$1.83M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
11,876 |
11,517 |
$1.79M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
9,831 |
9,489 |
$1.50M |
| G0378 |
Hospital observation service, per hour |
3,635 |
3,524 |
$1.17M |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
1,325 |
1,322 |
$834K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
3,595 |
3,534 |
$760K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
5,194 |
4,658 |
$722K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,442 |
3,381 |
$701K |
| H2036 |
Alcohol and/or other drug treatment program, per diem |
4,088 |
442 |
$591K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,886 |
4,458 |
$588K |
| T1015 |
Clinic visit/encounter, all-inclusive |
1,635 |
1,634 |
$552K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
3,510 |
3,331 |
$544K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
8,434 |
1,296 |
$496K |
| 80053 |
Comprehensive metabolic panel |
27,938 |
25,104 |
$495K |
| 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 |
5,841 |
5,613 |
$425K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
962 |
939 |
$387K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,258 |
2,177 |
$382K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
652 |
647 |
$265K |
| 36415 |
Collection of venous blood by venipuncture |
46,206 |
35,763 |
$254K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
5,639 |
4,778 |
$232K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,099 |
2,095 |
$220K |
| 93975 |
|
562 |
554 |
$218K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
923 |
917 |
$216K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,045 |
1,030 |
$213K |
| 86850 |
|
9,682 |
8,616 |
$195K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
3,970 |
3,352 |
$182K |
| 95806 |
|
1,754 |
1,728 |
$179K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,126 |
1,076 |
$175K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
3,214 |
743 |
$168K |
| 76818 |
|
3,680 |
1,644 |
$167K |
| 76801 |
|
2,146 |
1,859 |
$163K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
4,521 |
4,424 |
$157K |
| 86900 |
|
9,697 |
8,633 |
$154K |
| 86901 |
|
9,694 |
8,629 |
$152K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
870 |
866 |
$147K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
3,351 |
3,245 |
$146K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,880 |
1,446 |
$142K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
5,232 |
5,042 |
$135K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
158 |
158 |
$133K |
| 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 |
5,568 |
5,351 |
$130K |
| 95811 |
|
212 |
212 |
$126K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
581 |
576 |
$113K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
9,984 |
8,137 |
$110K |
| 90791 |
Psychiatric diagnostic evaluation |
639 |
602 |
$100K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
793 |
731 |
$99K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
2,305 |
2,010 |
$98K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,007 |
3,960 |
$93K |
| 96367 |
|
1,648 |
1,353 |
$93K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
2,355 |
1,501 |
$84K |
| 95715 |
|
422 |
234 |
$80K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
865 |
818 |
$71K |
| 97802 |
|
988 |
985 |
$69K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
933 |
931 |
$65K |
| 80061 |
Lipid panel |
5,129 |
5,063 |
$59K |
| 70544 |
|
200 |
197 |
$59K |
| 71046 |
Radiologic examination, chest; 2 views |
6,544 |
6,472 |
$57K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
540 |
329 |
$54K |
| 76820 |
|
2,726 |
1,542 |
$54K |
| 83880 |
|
2,196 |
2,110 |
$52K |
| 87631 |
|
1,076 |
1,059 |
$51K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
3,769 |
3,537 |
$49K |
| 76821 |
|
1,364 |
746 |
$47K |
| 81025 |
|
18,433 |
17,066 |
$45K |
| 85610 |
|
13,258 |
12,694 |
$45K |
| 90834 |
Psychotherapy, 45 minutes with patient |
382 |
261 |
$44K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,415 |
1,393 |
$40K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
14,514 |
12,563 |
$38K |
| 90670 |
|
1,807 |
1,736 |
$35K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
8,499 |
6,461 |
$35K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,202 |
1,201 |
$34K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
685 |
679 |
$34K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
25,326 |
22,811 |
$34K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,407 |
297 |
$33K |
| 70547 |
|
174 |
173 |
$30K |
| J3490 |
Unclassified drugs |
4,963 |
3,480 |
$29K |
| 95700 |
|
244 |
241 |
$28K |
| 88342 |
|
410 |
408 |
$28K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
832 |
262 |
$27K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
7,252 |
6,989 |
$26K |
| 76813 |
|
613 |
612 |
$24K |
| 85730 |
|
11,064 |
10,682 |
$24K |
| 90680 |
|
1,716 |
1,656 |
$24K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
923 |
864 |
$23K |
| 76830 |
Ultrasound, transvaginal |
859 |
816 |
$22K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
67 |
66 |
$21K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,412 |
1,390 |
$21K |
| 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 |
268 |
267 |
$19K |
| 70496 |
|
82 |
82 |
$19K |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
98 |
67 |
$18K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
6,204 |
6,165 |
$18K |
| 99051 |
|
1,349 |
822 |
$18K |
| 90648 |
|
1,250 |
1,197 |
$17K |
| G0009 |
Administration of pneumococcal vaccine |
1,435 |
1,431 |
$17K |
| 93970 |
|
39 |
39 |
$17K |
| 90715 |
|
847 |
843 |
$17K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
539 |
534 |
$16K |
| 76641 |
|
431 |
399 |
$14K |
| 84443 |
Thyroid stimulating hormone (TSH) |
5,521 |
5,454 |
$14K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,602 |
571 |
$14K |
| 90686 |
|
769 |
751 |
$12K |
| 87486 |
|
694 |
688 |
$12K |
| G0008 |
Administration of influenza virus vaccine |
984 |
980 |
$12K |
| 59025 |
Fetal non-stress test |
134 |
122 |
$12K |
| 85027 |
|
5,634 |
5,224 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,150 |
2,136 |
$12K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
14 |
14 |
$11K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
515 |
511 |
$11K |
| 12001 |
|
26 |
25 |
$11K |
| 83655 |
|
857 |
853 |
$11K |
| 80050 |
General health panel |
427 |
423 |
$10K |
| C1889 |
Implantable/insertable device, not otherwise classified |
163 |
159 |
$10K |
| 90677 |
|
587 |
584 |
$10K |
| 87581 |
|
693 |
687 |
$10K |
| 64483 |
|
13 |
13 |
$10K |
| 95816 |
|
64 |
63 |
$10K |
| 90723 |
|
856 |
813 |
$9K |
| 82607 |
|
1,820 |
1,811 |
$9K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
5,755 |
4,500 |
$9K |
| 82947 |
|
6,847 |
4,280 |
$8K |
| 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 |
357 |
331 |
$8K |
| 90697 |
|
396 |
395 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
63 |
63 |
$7K |
| 94729 |
|
256 |
256 |
$7K |
| 94060 |
|
262 |
262 |
$7K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
288 |
287 |
$6K |
| 84425 |
|
1,213 |
1,213 |
$6K |
| 82746 |
|
1,570 |
1,568 |
$6K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
28 |
27 |
$6K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,087 |
1,073 |
$6K |
| 71045 |
Radiologic examination, chest; single view |
6,517 |
6,285 |
$6K |
| 87088 |
|
8,107 |
7,780 |
$5K |
| 84439 |
|
1,653 |
1,622 |
$5K |
| 90461 |
|
1,273 |
1,270 |
$5K |
| 94727 |
|
259 |
259 |
$5K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
171 |
170 |
$5K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
76 |
76 |
$4K |
| 72131 |
|
29 |
29 |
$4K |
| 84702 |
|
3,457 |
3,211 |
$4K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
240 |
69 |
$4K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
943 |
933 |
$4K |
| 86780 |
|
990 |
954 |
$4K |
| 90698 |
|
261 |
251 |
$4K |
| 90685 |
|
288 |
287 |
$4K |
| 96376 |
|
1,841 |
1,400 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
978 |
950 |
$4K |
| 81003 |
|
13,233 |
12,526 |
$4K |
| 90633 |
|
245 |
244 |
$4K |
| 97161 |
|
39 |
37 |
$3K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
15,777 |
13,724 |
$3K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,060 |
1,512 |
$3K |
| 76825 |
|
41 |
36 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
22 |
22 |
$3K |
| 93971 |
|
40 |
39 |
$3K |
| 80076 |
|
303 |
298 |
$3K |
| 90474 |
|
540 |
539 |
$3K |
| 71250 |
|
29 |
29 |
$3K |
| M0239 |
Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring |
15 |
14 |
$3K |
| 82652 |
|
83 |
83 |
$2K |
| 87641 |
|
126 |
126 |
$2K |
| 81015 |
|
4,470 |
3,555 |
$2K |
| 70498 |
|
51 |
51 |
$2K |
| 90656 |
|
143 |
143 |
$2K |
| 83735 |
|
7,003 |
6,351 |
$2K |
| 86480 |
|
26 |
26 |
$2K |
| 90716 |
|
76 |
71 |
$1K |
| 83615 |
|
755 |
511 |
$1K |
| 83540 |
|
1,534 |
1,523 |
$1K |
| 84481 |
|
154 |
153 |
$1K |
| 84484 |
|
7,831 |
5,382 |
$1K |
| 90707 |
|
78 |
73 |
$1K |
| 83550 |
|
1,493 |
1,480 |
$1K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,555 |
1,484 |
$1K |
| 76827 |
|
41 |
36 |
$1K |
| 99173 |
|
13 |
13 |
$1K |
| 93325 |
|
15 |
13 |
$1K |
| 90674 |
|
75 |
75 |
$1K |
| 88304 |
|
128 |
126 |
$987.73 |
| S0028 |
Injection, famotidine, 20 mg |
2,173 |
1,843 |
$943.98 |
| C1769 |
Guide wire |
40 |
38 |
$936.00 |
| Q9963 |
High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml |
387 |
357 |
$923.16 |
| 87077 |
|
1,050 |
1,025 |
$897.41 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,148 |
2,119 |
$889.80 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
64 |
64 |
$866.84 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
137 |
136 |
$828.88 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,183 |
2,129 |
$799.33 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
5,693 |
4,953 |
$762.73 |
| 85007 |
|
829 |
795 |
$736.31 |
| 87340 |
|
199 |
197 |
$730.01 |
| 90700 |
|
54 |
54 |
$716.80 |
| J1756 |
Injection, iron sucrose, 1 mg |
27 |
12 |
$708.60 |
| 90473 |
|
253 |
251 |
$706.07 |
| 87186 |
|
1,055 |
1,025 |
$664.05 |
| 90651 |
|
12 |
12 |
$661.22 |
| 83970 |
|
15 |
15 |
$641.04 |
| J1631 |
Injection, haloperidol decanoate, per 50 mg |
44 |
40 |
$614.14 |
| 87040 |
|
3,220 |
1,891 |
$544.66 |
| 80164 |
|
65 |
61 |
$522.97 |
| J2704 |
Injection, propofol, 10 mg |
7,136 |
5,163 |
$510.07 |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
15 |
12 |
$502.23 |
| 86141 |
|
239 |
235 |
$456.84 |
| 80323 |
|
373 |
373 |
$449.50 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
12 |
12 |
$440.54 |
| 87428 |
|
104 |
102 |
$421.81 |
| 90687 |
|
25 |
25 |
$410.55 |
| 82550 |
|
2,752 |
2,626 |
$407.85 |
| 83690 |
|
5,580 |
5,299 |
$406.88 |
| 86803 |
|
192 |
192 |
$369.75 |
| 84100 |
|
2,266 |
2,060 |
$340.02 |
| 84436 |
|
97 |
96 |
$331.31 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,444 |
2,758 |
$296.97 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
1,024 |
933 |
$286.72 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,503 |
1,256 |
$254.79 |
| 82803 |
|
15 |
14 |
$248.75 |
| 87081 |
|
1,638 |
1,619 |
$243.64 |
| 73564 |
|
204 |
201 |
$220.75 |
| 73630 |
|
300 |
297 |
$216.57 |
| 87430 |
|
1,658 |
1,638 |
$215.87 |
| J7050 |
Infusion, normal saline solution, 250 cc |
2,916 |
2,020 |
$197.86 |
| 85379 |
|
1,080 |
1,064 |
$189.70 |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
342 |
170 |
$188.80 |
| 82565 |
|
1,225 |
1,207 |
$188.03 |
| 82077 |
|
1,011 |
975 |
$160.04 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
122 |
80 |
$145.76 |
| 94200 |
|
72 |
69 |
$128.48 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,877 |
1,818 |
$125.67 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,280 |
1,003 |
$118.06 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,060 |
1,880 |
$112.56 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
7,028 |
5,613 |
$108.61 |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
174 |
98 |
$107.95 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
603 |
399 |
$103.13 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,538 |
1,386 |
$101.10 |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
684 |
628 |
$97.54 |
| 80179 |
|
418 |
406 |
$86.61 |
| 80143 |
|
437 |
423 |
$86.61 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,354 |
1,081 |
$81.94 |
| 82950 |
|
27 |
27 |
$75.29 |
| 86592 |
|
70 |
68 |
$72.71 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
18 |
18 |
$71.16 |
| 82465 |
|
113 |
110 |
$66.63 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
12 |
12 |
$66.18 |
| 90647 |
|
16 |
16 |
$61.23 |
| 73610 |
|
266 |
264 |
$51.25 |
| 84145 |
|
427 |
415 |
$48.62 |
| 82728 |
|
12 |
12 |
$48.27 |
| 83605 |
|
1,122 |
1,004 |
$48.09 |
| 84156 |
|
41 |
40 |
$46.61 |
| 84550 |
|
44 |
38 |
$43.38 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
15 |
15 |
$40.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,317 |
1,117 |
$39.94 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
306 |
282 |
$35.61 |
| 85008 |
|
122 |
113 |
$33.80 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
38 |
38 |
$33.75 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
287 |
285 |
$31.72 |
| 82570 |
|
45 |
42 |
$30.23 |
| 82248 |
|
64 |
51 |
$26.84 |
| 73130 |
|
174 |
171 |
$25.13 |
| 73030 |
|
139 |
136 |
$24.09 |
| J1644 |
Injection, heparin sodium, per 1000 units |
446 |
286 |
$21.11 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
99 |
95 |
$20.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
95 |
44 |
$15.02 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
691 |
626 |
$13.60 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
42 |
31 |
$11.80 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
29 |
25 |
$11.39 |
| 74018 |
|
12 |
12 |
$10.00 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
22 |
16 |
$8.14 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
282 |
202 |
$5.61 |
| 81001 |
|
13 |
12 |
$5.38 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
360 |
356 |
$5.32 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
159 |
152 |
$5.20 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
115 |
63 |
$4.36 |
| J3411 |
Injection, thiamine hcl, 100 mg |
63 |
53 |
$2.46 |
| J3480 |
Injection, potassium chloride, per 2 meq |
40 |
26 |
$1.10 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
443 |
441 |
$1.00 |
| J2060 |
Injection, lorazepam, 2 mg |
226 |
199 |
$0.36 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
69 |
66 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
76 |
38 |
$0.00 |
| 86762 |
|
13 |
13 |
$0.00 |
| 87070 |
|
12 |
12 |
$0.00 |
| 99080 |
|
2,457 |
498 |
$0.00 |
| 73110 |
|
52 |
50 |
$0.00 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
13 |
13 |
$0.00 |
| 73080 |
|
13 |
13 |
$0.00 |
| 86787 |
|
12 |
12 |
$0.00 |