| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
29,296 |
24,689 |
$3.63M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
23,879 |
17,621 |
$3.47M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
5,949 |
4,838 |
$3.32M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
15,933 |
10,617 |
$2.47M |
| 41899 |
Unlisted procedure, dentoalveolar structures |
1,888 |
1,641 |
$1.73M |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,684 |
2,858 |
$1.60M |
| 70450 |
Computed tomography, head or brain; without contrast material |
6,249 |
4,600 |
$1.23M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,458 |
1,971 |
$977K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
14,384 |
3,574 |
$873K |
| 71046 |
Radiologic examination, chest; 2 views |
11,124 |
8,905 |
$705K |
| 71045 |
Radiologic examination, chest; single view |
15,761 |
10,630 |
$669K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
2,659 |
1,904 |
$650K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
8,886 |
2,781 |
$607K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
8,334 |
2,707 |
$556K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
27,679 |
12,618 |
$555K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,414 |
981 |
$550K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
17,742 |
13,600 |
$539K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
12,793 |
5,041 |
$527K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
9,935 |
8,120 |
$465K |
| 80053 |
Comprehensive metabolic panel |
40,637 |
31,624 |
$452K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
2,623 |
2,237 |
$449K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
4,587 |
3,996 |
$444K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,147 |
955 |
$423K |
| 36415 |
Collection of venous blood by venipuncture |
77,663 |
41,707 |
$402K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
1,058 |
818 |
$392K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,189 |
989 |
$347K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,305 |
967 |
$324K |
| 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 |
4,676 |
2,706 |
$303K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
12,858 |
9,735 |
$291K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
40,719 |
32,453 |
$279K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
446 |
279 |
$255K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
9,064 |
4,813 |
$247K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
6,396 |
5,262 |
$246K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
3,193 |
2,436 |
$232K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
841 |
688 |
$226K |
| 72100 |
|
2,844 |
2,274 |
$217K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
11,879 |
5,451 |
$205K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
4,629 |
1,921 |
$168K |
| 73630 |
|
2,821 |
2,307 |
$160K |
| G0378 |
Hospital observation service, per hour |
917 |
683 |
$160K |
| 93971 |
|
1,171 |
936 |
$155K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
3,118 |
2,928 |
$155K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,351 |
826 |
$149K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
680 |
563 |
$148K |
| 72131 |
|
433 |
369 |
$146K |
| 84484 |
|
14,438 |
9,906 |
$142K |
| 0240U |
|
1,951 |
1,407 |
$136K |
| 74018 |
|
2,918 |
2,279 |
$125K |
| 97161 |
|
1,854 |
1,397 |
$124K |
| 73130 |
|
2,144 |
1,768 |
$121K |
| 73030 |
|
2,153 |
1,622 |
$116K |
| 73610 |
|
2,195 |
1,825 |
$109K |
| 73564 |
|
1,863 |
1,397 |
$108K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
486 |
408 |
$107K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
522 |
174 |
$106K |
| 71250 |
|
576 |
440 |
$104K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
2,852 |
831 |
$102K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
461 |
115 |
$101K |
| 59025 |
Fetal non-stress test |
916 |
600 |
$100K |
| 83880 |
|
3,720 |
2,877 |
$95K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
1,237 |
1,008 |
$95K |
| 93017 |
|
754 |
659 |
$89K |
| 96376 |
|
3,465 |
2,309 |
$84K |
| 73110 |
|
1,375 |
1,096 |
$76K |
| 96367 |
|
2,623 |
1,094 |
$74K |
| 84443 |
Thyroid stimulating hormone (TSH) |
5,296 |
4,617 |
$74K |
| 83690 |
|
10,910 |
9,257 |
$73K |
| 80305 |
|
5,332 |
4,557 |
$67K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,265 |
1,654 |
$67K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
5,024 |
2,774 |
$67K |
| J2704 |
Injection, propofol, 10 mg |
10,142 |
8,039 |
$67K |
| 73502 |
|
1,113 |
809 |
$65K |
| 81025 |
|
7,886 |
6,814 |
$63K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
4,926 |
2,658 |
$63K |
| 83605 |
|
5,749 |
4,485 |
$58K |
| 76536 |
|
654 |
553 |
$57K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
643 |
580 |
$54K |
| 78264 |
|
201 |
135 |
$53K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,817 |
1,680 |
$52K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
550 |
516 |
$50K |
| 87040 |
|
5,832 |
3,224 |
$50K |
| 82805 |
|
985 |
683 |
$45K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,206 |
2,884 |
$43K |
| 83735 |
|
7,453 |
5,588 |
$42K |
| 71271 |
|
128 |
124 |
$39K |
| 70486 |
|
107 |
89 |
$36K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
3,867 |
2,944 |
$36K |
| 72040 |
|
704 |
552 |
$35K |
| 72072 |
|
387 |
299 |
$35K |
| 12001 |
|
324 |
296 |
$34K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,261 |
755 |
$34K |
| 81001 |
|
12,531 |
10,725 |
$34K |
| 80061 |
Lipid panel |
3,137 |
2,747 |
$34K |
| 76770 |
|
336 |
257 |
$34K |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
1,192 |
1,023 |
$33K |
| 90715 |
|
1,134 |
1,026 |
$33K |
| 74022 |
|
243 |
222 |
$33K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
5,079 |
4,285 |
$33K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
4,433 |
3,438 |
$33K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,560 |
1,290 |
$33K |
| 72141 |
|
83 |
63 |
$29K |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
163 |
144 |
$28K |
| 45384 |
|
78 |
58 |
$28K |
| 76642 |
|
255 |
225 |
$26K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
416 |
181 |
$25K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
653 |
524 |
$25K |
| 82150 |
|
3,775 |
3,317 |
$24K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,337 |
2,640 |
$24K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
5,512 |
4,333 |
$23K |
| 85379 |
|
2,735 |
2,368 |
$23K |
| 85027 |
|
4,264 |
3,008 |
$23K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
2,864 |
2,098 |
$22K |
| 87077 |
|
2,840 |
2,204 |
$22K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
299 |
241 |
$20K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
9,881 |
8,249 |
$20K |
| 85610 |
|
5,972 |
4,805 |
$20K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
415 |
196 |
$20K |
| 81003 |
|
8,544 |
7,203 |
$20K |
| 82607 |
|
1,595 |
1,381 |
$19K |
| 76830 |
Ultrasound, transvaginal |
92 |
82 |
$17K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
3,613 |
2,357 |
$17K |
| 73080 |
|
294 |
248 |
$17K |
| 87186 |
|
2,216 |
1,919 |
$17K |
| V2632 |
Posterior chamber intraocular lens |
213 |
148 |
$17K |
| 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 |
144 |
126 |
$17K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
16,287 |
12,316 |
$16K |
| 86140 |
|
4,038 |
3,190 |
$16K |
| 76942 |
|
306 |
246 |
$16K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
8,883 |
7,254 |
$16K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,268 |
2,006 |
$16K |
| 73090 |
|
233 |
190 |
$15K |
| D0220 |
Intraoral - periapical first radiographic image |
76 |
65 |
$14K |
| 84702 |
|
1,060 |
869 |
$14K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
71 |
61 |
$14K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
2,172 |
1,680 |
$14K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
30 |
25 |
$14K |
| 80074 |
|
304 |
262 |
$13K |
| 76775 |
|
146 |
105 |
$13K |
| 47562 |
|
15 |
15 |
$13K |
| D0230 |
Intraoral - periapical each additional radiographic image |
71 |
62 |
$13K |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
821 |
599 |
$13K |
| D0272 |
Bitewings - two radiographic images |
71 |
65 |
$12K |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
789 |
650 |
$12K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,493 |
2,013 |
$12K |
| 97165 |
|
181 |
158 |
$12K |
| 73562 |
|
154 |
130 |
$12K |
| 36600 |
|
877 |
644 |
$12K |
| 84439 |
|
1,392 |
1,219 |
$12K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
8,498 |
6,467 |
$12K |
| 82746 |
|
984 |
860 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
224 |
197 |
$12K |
| 85730 |
|
2,493 |
2,019 |
$11K |
| 82962 |
|
3,348 |
1,719 |
$10K |
| 80050 |
General health panel |
356 |
261 |
$10K |
| 84145 |
|
465 |
394 |
$10K |
| 81596 |
|
383 |
215 |
$10K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
60 |
53 |
$10K |
| 82728 |
|
888 |
763 |
$10K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
397 |
324 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,192 |
1,071 |
$9K |
| 73222 |
|
20 |
16 |
$9K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,096 |
840 |
$9K |
| 82565 |
|
1,432 |
1,090 |
$8K |
| 73590 |
|
166 |
135 |
$8K |
| J3490 |
Unclassified drugs |
820 |
301 |
$8K |
| 80076 |
|
1,084 |
926 |
$8K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
5,655 |
3,507 |
$8K |
| 78227 |
|
31 |
24 |
$7K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
20 |
19 |
$7K |
| 87807 |
|
548 |
520 |
$7K |
| 87522 |
Neg quan hep c or qual rna |
160 |
140 |
$7K |
| D7140 |
Extraction, erupted tooth or exposed root |
25 |
21 |
$7K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,814 |
2,245 |
$7K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
5,615 |
4,335 |
$7K |
| 93880 |
|
53 |
38 |
$6K |
| 84703 |
|
838 |
755 |
$6K |
| J2785 |
Injection, regadenoson, 0.1 mg |
48 |
45 |
$6K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
1,274 |
681 |
$6K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
4,115 |
3,442 |
$6K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
476 |
292 |
$6K |
| 73140 |
|
161 |
132 |
$6K |
| 94760 |
|
753 |
265 |
$6K |
| 87071 |
|
693 |
507 |
$6K |
| 85652 |
|
2,517 |
2,122 |
$6K |
| 36416 |
|
1,006 |
767 |
$5K |
| 80179 |
|
378 |
327 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
141 |
118 |
$5K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
15 |
12 |
$4K |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,025 |
636 |
$4K |
| 83516 |
|
560 |
175 |
$4K |
| 97116 |
|
145 |
78 |
$4K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,801 |
1,079 |
$4K |
| D2330 |
|
15 |
13 |
$4K |
| 88346 |
|
87 |
52 |
$4K |
| 82550 |
|
699 |
565 |
$4K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
17 |
15 |
$4K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
212 |
184 |
$4K |
| 83540 |
|
802 |
690 |
$4K |
| 64721 |
|
16 |
14 |
$4K |
| 72128 |
|
14 |
13 |
$4K |
| C9113 |
Injection, pantoprazole sodium, per vial |
972 |
770 |
$4K |
| 87902 |
|
16 |
12 |
$4K |
| 86038 |
|
393 |
339 |
$4K |
| 82140 |
|
247 |
208 |
$4K |
| 73040 |
|
21 |
16 |
$3K |
| 83520 |
|
306 |
54 |
$3K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
2,135 |
1,566 |
$3K |
| A9541 |
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries |
82 |
76 |
$3K |
| 82947 |
|
1,551 |
733 |
$3K |
| 71101 |
|
45 |
26 |
$3K |
| 83550 |
|
535 |
460 |
$3K |
| 88350 |
|
59 |
48 |
$3K |
| 73560 |
|
73 |
53 |
$3K |
| 92523 |
|
38 |
34 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
12 |
12 |
$3K |
| D3910 |
|
13 |
13 |
$3K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
16 |
12 |
$3K |
| 80320 |
|
133 |
112 |
$3K |
| 88304 |
|
108 |
99 |
$2K |
| 86901 |
|
1,103 |
879 |
$2K |
| 86900 |
|
1,088 |
867 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
69 |
58 |
$2K |
| 87400 |
|
240 |
119 |
$2K |
| 23350 |
|
21 |
16 |
$2K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
586 |
82 |
$2K |
| 81256 |
|
73 |
63 |
$2K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
20 |
17 |
$2K |
| 82948 |
|
413 |
267 |
$2K |
| 12002 |
|
18 |
16 |
$2K |
| 86850 |
|
335 |
248 |
$2K |
| 82397 |
|
203 |
50 |
$2K |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
281 |
258 |
$2K |
| 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 |
22 |
20 |
$2K |
| 76870 |
|
16 |
12 |
$2K |
| 77080 |
|
13 |
12 |
$2K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
252 |
215 |
$2K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
1,533 |
1,082 |
$2K |
| 10060 |
|
14 |
13 |
$2K |
| 12011 |
|
12 |
12 |
$1K |
| 97167 |
|
20 |
19 |
$1K |
| 80143 |
|
86 |
78 |
$1K |
| 84100 |
|
389 |
253 |
$1K |
| 64450 |
|
38 |
25 |
$1K |
| 97535 |
Self-care/home management training, each 15 minutes |
40 |
31 |
$1K |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
175 |
142 |
$1K |
| 81479 |
Unlisted molecular pathology procedure |
153 |
48 |
$1K |
| 86704 |
|
154 |
123 |
$1K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
558 |
235 |
$1K |
| 86803 |
|
133 |
101 |
$1K |
| 86706 |
|
155 |
123 |
$1K |
| 86376 |
|
121 |
97 |
$1K |
| 86480 |
|
17 |
16 |
$1K |
| 82104 |
|
77 |
47 |
$972.07 |
| 86708 |
|
115 |
97 |
$897.21 |
| 82172 |
|
42 |
40 |
$859.35 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
114 |
93 |
$851.64 |
| 83010 |
|
59 |
56 |
$837.86 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
29 |
28 |
$798.92 |
| 80329 |
|
14 |
12 |
$789.49 |
| 87340 |
|
123 |
98 |
$756.73 |
| 29125 |
|
16 |
15 |
$728.24 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
335 |
267 |
$716.16 |
| 82525 |
|
96 |
76 |
$693.89 |
| 83883 |
|
57 |
42 |
$678.26 |
| 94664 |
|
346 |
283 |
$663.98 |
| 82103 |
|
73 |
63 |
$628.34 |
| 82390 |
|
95 |
75 |
$600.36 |
| 77065 |
Tomosynthesis, mammo |
17 |
14 |
$566.93 |
| 87081 |
|
137 |
95 |
$553.12 |
| J2060 |
Injection, lorazepam, 2 mg |
873 |
666 |
$532.24 |
| J3480 |
Injection, potassium chloride, per 2 meq |
83 |
52 |
$509.54 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
83 |
77 |
$507.83 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
184 |
161 |
$488.12 |
| 82977 |
|
56 |
53 |
$461.67 |
| 86677 |
|
29 |
27 |
$460.50 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
15 |
12 |
$444.29 |
| U0001 |
Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel |
65 |
62 |
$433.06 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
29 |
24 |
$374.49 |
| 84436 |
|
102 |
91 |
$342.89 |
| 84550 |
|
90 |
79 |
$314.53 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
347 |
266 |
$305.77 |
| J1815 |
Injection, insulin, per 5 units |
182 |
95 |
$300.52 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
15 |
13 |
$289.47 |
| 83993 |
|
14 |
14 |
$259.10 |
| 36591 |
|
28 |
12 |
$245.56 |
| 82248 |
|
68 |
52 |
$234.52 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
185 |
165 |
$223.75 |
| 87070 |
|
52 |
26 |
$213.14 |
| 81015 |
|
374 |
296 |
$207.41 |
| 88312 |
|
20 |
19 |
$195.38 |
| 86804 |
|
17 |
12 |
$171.45 |
| 87420 |
|
18 |
18 |
$168.60 |
| 82272 |
|
63 |
56 |
$168.31 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
145 |
105 |
$159.01 |
| J7510 |
Prednisolone oral, per 5 mg |
15 |
15 |
$122.97 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
125 |
95 |
$105.93 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
43 |
34 |
$101.76 |
| 82570 |
|
24 |
24 |
$83.63 |
| 84479 |
|
44 |
39 |
$79.00 |
| 86592 |
|
12 |
12 |
$57.68 |
| J0687 |
Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg |
42 |
38 |
$55.57 |
| 87205 |
|
14 |
12 |
$43.57 |
| 89055 |
|
31 |
27 |
$34.97 |
| 82784 |
|
18 |
12 |
$28.37 |
| 84460 |
|
27 |
26 |
$26.35 |
| 84450 |
|
26 |
25 |
$20.30 |
| Q0177 |
Hydroxyzine pamoate, 25 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
38 |
32 |
$16.74 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
28 |
26 |
$10.10 |
| A9270 |
Non-covered item or service |
541 |
389 |
$0.00 |