| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
333 |
333 |
$0.00 |
| 90710 |
|
148 |
147 |
$0.00 |
| 84100 |
|
508 |
479 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,872 |
5,370 |
$0.00 |
| 86431 |
|
600 |
597 |
$0.00 |
| 81025 |
|
606 |
585 |
$0.00 |
| 83026 |
|
27 |
27 |
$0.00 |
| 85014 |
|
662 |
660 |
$0.00 |
| 92081 |
|
1,736 |
1,735 |
$0.00 |
| A0130 |
Non-emergency transportation: wheelchair van |
5,065 |
593 |
$0.00 |
| 3725F |
|
1,690 |
1,525 |
$0.00 |
| 84295 |
|
181 |
181 |
$0.00 |
| 84156 |
|
124 |
123 |
$0.00 |
| 92015 |
Determination of refractive state |
2,116 |
2,116 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
646 |
646 |
$0.00 |
| 87186 |
|
726 |
707 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
278 |
270 |
$0.00 |
| 83721 |
|
1,353 |
1,352 |
$0.00 |
| 86003 |
|
362 |
355 |
$0.00 |
| 86200 |
|
197 |
196 |
$0.00 |
| 80061 |
Lipid panel |
13,604 |
13,542 |
$0.00 |
| 81002 |
|
1,216 |
1,151 |
$0.00 |
| 3078F |
|
3,232 |
2,937 |
$0.00 |
| A0424 |
Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review) |
148 |
131 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,747 |
1,739 |
$0.00 |
| 86038 |
|
693 |
688 |
$0.00 |
| 84450 |
|
493 |
492 |
$0.00 |
| 99173 |
|
3,423 |
3,419 |
$0.00 |
| 1159F |
|
1,207 |
1,020 |
$0.00 |
| 85049 |
|
1,892 |
1,868 |
$0.00 |
| 84460 |
|
641 |
639 |
$0.00 |
| V2020 |
Frames, purchases |
653 |
653 |
$0.00 |
| 87177 |
|
86 |
85 |
$0.00 |
| A0425 |
Ground mileage, per statute mile |
1,614 |
1,420 |
$0.00 |
| G0270 |
Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes |
532 |
532 |
$0.00 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
616 |
566 |
$0.00 |
| 80076 |
|
1,639 |
1,503 |
$0.00 |
| 82947 |
|
779 |
778 |
$0.00 |
| 84439 |
|
2,840 |
2,817 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
5,892 |
5,826 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,470 |
1,462 |
$0.00 |
| 82948 |
|
319 |
236 |
$0.00 |
| 71046 |
Radiologic examination, chest; 2 views |
515 |
508 |
$0.00 |
| 99401 |
|
1,109 |
1,073 |
$0.00 |
| 73630 |
|
50 |
42 |
$0.00 |
| 90658 |
|
167 |
167 |
$0.00 |
| 76642 |
|
98 |
95 |
$0.00 |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
292 |
281 |
$0.00 |
| 92552 |
|
1,190 |
1,189 |
$0.00 |
| 86696 |
|
177 |
177 |
$0.00 |
| 84520 |
|
202 |
202 |
$0.00 |
| 96160 |
|
2,503 |
2,499 |
$0.00 |
| 82570 |
|
2,356 |
2,336 |
$0.00 |
| 84550 |
|
1,418 |
1,408 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,478 |
2,465 |
$0.00 |
| 90734 |
|
411 |
408 |
$0.00 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,039 |
398 |
$0.00 |
| 82274 |
|
1,216 |
1,192 |
$0.00 |
| 86900 |
|
320 |
270 |
$0.00 |
| 85610 |
|
1,578 |
1,370 |
$0.00 |
| 87660 |
|
194 |
191 |
$0.00 |
| 90633 |
|
212 |
212 |
$0.00 |
| 1160F |
|
1,318 |
1,146 |
$0.00 |
| 86480 |
|
229 |
229 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
246 |
246 |
$0.00 |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
2,045 |
1,939 |
$0.00 |
| 85007 |
|
1,094 |
1,017 |
$0.00 |
| 83516 |
|
144 |
144 |
$0.00 |
| 81003 |
|
3,434 |
3,356 |
$0.00 |
| T1003 |
Lpn/lvn services, up to 15 minutes |
93 |
81 |
$0.00 |
| 90700 |
|
219 |
219 |
$0.00 |
| 82565 |
|
315 |
314 |
$0.00 |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
202 |
202 |
$0.00 |
| 3077F |
|
390 |
362 |
$0.00 |
| S9083 |
Global fee urgent care centers |
280 |
262 |
$0.00 |
| S9999 |
Sales tax |
367 |
350 |
$0.00 |
| 82977 |
|
795 |
789 |
$0.00 |
| 85048 |
|
187 |
186 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
195 |
194 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
261 |
252 |
$0.00 |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
64 |
44 |
$0.00 |
| 82374 |
|
169 |
169 |
$0.00 |
| 0502F |
|
57 |
38 |
$0.00 |
| 85045 |
|
95 |
94 |
$0.00 |
| 86235 |
|
160 |
159 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
181 |
178 |
$0.00 |
| 90649 |
|
230 |
230 |
$0.00 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
898 |
898 |
$0.00 |
| 90713 |
|
144 |
144 |
$0.00 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
93 |
92 |
$0.00 |
| 83013 |
|
89 |
89 |
$0.00 |
| S3005 |
Performance measurement, evaluation of patient self assessment, depression |
371 |
316 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
405 |
403 |
$0.00 |
| 2028F |
|
13 |
12 |
$0.00 |
| 59425 |
|
1,139 |
625 |
$0.00 |
| 86708 |
|
241 |
241 |
$0.00 |
| 83655 |
|
1,727 |
1,725 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
12 |
12 |
$0.00 |
| 82248 |
|
486 |
478 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,309 |
1,302 |
$0.00 |
| 84481 |
|
423 |
420 |
$0.00 |
| 97039 |
|
863 |
254 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
458 |
449 |
$0.00 |
| 2022F |
|
30 |
30 |
$0.00 |
| E0601 |
Continuous positive airway pressure (cpap) device |
103 |
103 |
$0.00 |
| 90715 |
|
236 |
236 |
$0.00 |
| 87806 |
|
42 |
42 |
$0.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
1,270 |
1,270 |
$0.00 |
| 86703 |
|
68 |
68 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
462 |
456 |
$0.00 |
| 83037 |
|
66 |
66 |
$0.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
534 |
498 |
$0.00 |
| 84146 |
|
158 |
158 |
$0.00 |
| 95144 |
|
390 |
202 |
$0.00 |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
512 |
465 |
$0.00 |
| T4541 |
Incontinence product, disposable underpad, large, each |
831 |
831 |
$0.00 |
| 99001 |
|
119 |
87 |
$0.00 |
| 80164 |
|
14 |
13 |
$0.00 |
| 3016F |
|
69 |
69 |
$0.00 |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
89 |
89 |
$0.00 |
| 82785 |
|
271 |
271 |
$0.00 |
| 87210 |
|
26 |
25 |
$0.00 |
| 83718 |
|
147 |
147 |
$0.00 |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
48 |
48 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
582 |
549 |
$0.00 |
| 97803 |
|
490 |
480 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
219 |
217 |
$0.00 |
| 82465 |
|
579 |
567 |
$0.00 |
| 83020 |
|
30 |
30 |
$0.00 |
| 73610 |
|
14 |
13 |
$0.00 |
| 87799 |
|
88 |
87 |
$0.00 |
| 70450 |
Computed tomography, head or brain; without contrast material |
139 |
138 |
$0.00 |
| 80074 |
|
490 |
486 |
$0.00 |
| 83540 |
|
1,063 |
1,053 |
$0.00 |
| 1158F |
|
41 |
36 |
$0.00 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
67 |
49 |
$0.00 |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
62 |
57 |
$0.00 |
| 99051 |
|
77 |
75 |
$0.00 |
| 87075 |
|
13 |
13 |
$0.00 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
134 |
127 |
$0.00 |
| 90648 |
|
63 |
63 |
$0.00 |
| 82776 |
|
15 |
15 |
$0.00 |
| 90746 |
|
53 |
53 |
$0.00 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
150 |
150 |
$0.00 |
| 82310 |
|
184 |
184 |
$0.00 |
| A4927 |
Gloves, non-sterile, per 100 |
27 |
27 |
$0.00 |
| 82247 |
|
168 |
168 |
$0.00 |
| 84702 |
|
474 |
416 |
$0.00 |
| 83525 |
|
57 |
57 |
$0.00 |
| 84155 |
|
169 |
169 |
$0.00 |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
71 |
71 |
$0.00 |
| H0046 |
Mental health services, not otherwise specified |
2,566 |
416 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
41 |
32 |
$0.00 |
| 87512 |
|
85 |
85 |
$0.00 |
| 74018 |
|
47 |
42 |
$0.00 |
| 83970 |
|
107 |
105 |
$0.00 |
| 87338 |
|
275 |
274 |
$0.00 |
| 73562 |
|
33 |
28 |
$0.00 |
| 87209 |
|
84 |
83 |
$0.00 |
| 90707 |
|
73 |
73 |
$0.00 |
| 82652 |
|
73 |
73 |
$0.00 |
| 90461 |
|
179 |
179 |
$0.00 |
| S5111 |
Home care training, family; per session |
1,779 |
276 |
$0.00 |
| 77066 |
Tomosynthesis, mammo |
12 |
12 |
$0.00 |
| 11721 |
|
77 |
77 |
$0.00 |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
222 |
222 |
$0.00 |
| 86039 |
|
182 |
181 |
$0.00 |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
178 |
178 |
$0.00 |
| 99152 |
|
49 |
48 |
$0.00 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
161 |
161 |
$0.00 |
| A0100 |
Non-emergency transportation; taxi |
11,884 |
1,362 |
$0.00 |
| 87045 |
|
35 |
33 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
109 |
99 |
$0.00 |
| 85041 |
|
29 |
29 |
$0.00 |
| 90670 |
|
275 |
275 |
$0.00 |
| 86644 |
|
29 |
27 |
$0.00 |
| 99223 |
Prolong inpt eval add15 m |
12 |
12 |
$0.00 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
12 |
12 |
$0.00 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
83 |
50 |
$0.00 |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
13 |
13 |
$0.00 |
| G8511 |
Screening for depression documented as positive, follow-up plan not documented, reason not given |
30 |
30 |
$0.00 |
| 92134 |
|
12 |
12 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
61 |
61 |
$0.00 |
| 87427 |
|
19 |
18 |
$0.00 |
| 73110 |
|
12 |
12 |
$0.00 |
| 80299 |
|
18 |
18 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
52 |
50 |
$0.00 |
| 92557 |
|
14 |
14 |
$0.00 |
| 99199 |
Unlisted special service, procedure or report |
136 |
100 |
$0.00 |
| 86787 |
|
31 |
31 |
$0.00 |
| 81420 |
Fetal chromosomal aneuploidy genomic sequence analysis panel |
43 |
43 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
230 |
176 |
$0.00 |
| 84403 |
|
174 |
174 |
$0.00 |
| 90685 |
|
68 |
68 |
$0.00 |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
14 |
14 |
$0.00 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
24 |
24 |
$0.00 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
12 |
12 |
$0.00 |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
27 |
27 |
$0.00 |
| 86765 |
|
14 |
14 |
$0.00 |
| 99501 |
|
17 |
17 |
$0.00 |
| 99307 |
|
18 |
18 |
$0.00 |
| 92588 |
|
14 |
14 |
$0.00 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
12 |
12 |
$0.00 |
| 90621 |
|
17 |
17 |
$0.00 |
| 73130 |
|
16 |
14 |
$0.00 |
| 86709 |
|
12 |
12 |
$0.00 |
| G0483 |
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; 22 or more drug class(es), including metabolite(s) if performed |
18 |
18 |
$0.00 |
| 90655 |
|
17 |
17 |
$0.00 |
| 86735 |
|
14 |
14 |
$0.00 |
| 87481 |
|
12 |
12 |
$0.00 |
| 84165 |
|
13 |
13 |
$0.00 |
| 2010F |
|
1,598 |
1,348 |
$0.00 |
| 92002 |
|
13 |
13 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
17,508 |
16,340 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,869 |
5,436 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
3,335 |
2,656 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
4,158 |
3,990 |
$0.00 |
| 95115 |
|
389 |
201 |
$0.00 |
| 81001 |
|
7,831 |
7,611 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
10,240 |
10,152 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
36,647 |
32,323 |
$0.00 |
| 92499 |
|
906 |
905 |
$0.00 |
| 3080F |
|
218 |
206 |
$0.00 |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
1,699 |
1,577 |
$0.00 |
| 99383 |
|
153 |
153 |
$0.00 |
| 94760 |
|
910 |
824 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,085 |
2,068 |
$0.00 |
| 99000 |
|
1,607 |
1,537 |
$0.00 |
| 81000 |
|
2,417 |
2,387 |
$0.00 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
1,047 |
1,044 |
$0.00 |
| 84479 |
|
1,151 |
1,149 |
$0.00 |
| 82040 |
|
181 |
181 |
$0.00 |
| 85018 |
|
5,571 |
5,548 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
11,040 |
10,991 |
$0.00 |
| 80069 |
|
133 |
133 |
$0.00 |
| 3008F |
|
4,392 |
3,946 |
$0.00 |
| 3351F |
|
2,281 |
1,935 |
$0.00 |
| 84153 |
|
983 |
977 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
458 |
450 |
$0.00 |
| 3074F |
|
3,204 |
2,902 |
$0.00 |
| 83690 |
|
695 |
654 |
$0.00 |
| 3075F |
|
323 |
306 |
$0.00 |
| 84436 |
|
1,631 |
1,628 |
$0.00 |
| 86225 |
|
152 |
151 |
$0.00 |
| 92551 |
|
6,116 |
6,113 |
$0.00 |
| 87088 |
|
1,519 |
1,475 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
20,484 |
18,277 |
$0.00 |
| 87077 |
|
549 |
534 |
$0.00 |
| 1126F |
|
1,963 |
1,735 |
$0.00 |
| 97802 |
|
1,382 |
1,363 |
$0.00 |
| 86580 |
|
622 |
621 |
$0.00 |
| S9088 |
Services provided in an urgent care center (list in addition to code for service) |
301 |
283 |
$0.00 |
| 87480 |
|
194 |
191 |
$0.00 |
| 71045 |
Radiologic examination, chest; single view |
957 |
712 |
$0.00 |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
286 |
251 |
$0.00 |
| 2000F |
|
608 |
525 |
$0.00 |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
2,972 |
2,866 |
$0.00 |
| 1036F |
|
338 |
308 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
959 |
951 |
$0.00 |
| 82044 |
|
13 |
13 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
269 |
269 |
$0.00 |
| 82962 |
|
794 |
715 |
$0.00 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
188 |
187 |
$0.00 |
| 85730 |
|
898 |
838 |
$0.00 |
| 90651 |
|
606 |
593 |
$0.00 |
| 36416 |
|
66 |
66 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
8,944 |
8,416 |
$0.00 |
| 82746 |
|
688 |
686 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
562 |
549 |
$0.00 |
| 86317 |
|
121 |
120 |
$0.00 |
| 90732 |
|
12 |
12 |
$0.00 |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
401 |
218 |
$0.00 |
| 88142 |
|
689 |
686 |
$0.00 |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
583 |
273 |
$0.00 |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
116 |
115 |
$0.00 |
| 87340 |
|
743 |
742 |
$0.00 |
| 86850 |
|
211 |
203 |
$0.00 |
| 97162 |
|
42 |
40 |
$0.00 |
| 93000 |
|
172 |
171 |
$0.00 |
| 4559F |
|
396 |
325 |
$0.00 |
| 82550 |
|
127 |
123 |
$0.00 |
| 86592 |
|
3,336 |
3,316 |
$0.00 |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
67 |
40 |
$0.00 |
| 86803 |
|
1,038 |
1,037 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
5,854 |
5,789 |
$0.00 |
| 99344 |
|
50 |
50 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
4,218 |
4,200 |
$0.00 |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
475 |
449 |
$0.00 |
| 82728 |
|
706 |
700 |
$0.00 |
| H2019 |
Therapeutic behavioral services, per 15 minutes |
4,523 |
401 |
$0.00 |
| 87536 |
|
232 |
229 |
$0.00 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
188 |
188 |
$0.00 |
| 86140 |
|
628 |
595 |
$0.00 |
| 83615 |
|
276 |
268 |
$0.00 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
197 |
197 |
$0.00 |
| 85652 |
|
1,240 |
1,219 |
$0.00 |
| 0001F |
|
63 |
45 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
378 |
378 |
$0.00 |
| 84478 |
|
159 |
159 |
$0.00 |
| 86704 |
|
248 |
248 |
$0.00 |
| 90698 |
|
59 |
59 |
$0.00 |
| 87510 |
|
194 |
191 |
$0.00 |
| 2001F |
|
695 |
592 |
$0.00 |
| 87522 |
Neg quan hep c or qual rna |
155 |
150 |
$0.00 |
| 90620 |
|
75 |
75 |
$0.00 |
| 90688 |
|
1,277 |
1,277 |
$0.00 |
| 87081 |
|
521 |
518 |
$0.00 |
| 82607 |
|
953 |
951 |
$0.00 |
| 84703 |
|
241 |
233 |
$0.00 |
| 99241 |
|
80 |
80 |
$0.00 |
| 86593 |
|
126 |
122 |
$0.00 |
| 85027 |
|
3,303 |
3,055 |
$0.00 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
374 |
371 |
$0.00 |
| 84132 |
|
170 |
170 |
$0.00 |
| 96150 |
|
113 |
112 |
$0.00 |
| 92082 |
|
83 |
83 |
$0.00 |
| 97750 |
|
114 |
52 |
$0.00 |
| 86706 |
|
504 |
504 |
$0.00 |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
270 |
74 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
563 |
562 |
$0.00 |
| A4335 |
Incontinence supply; miscellaneous |
221 |
221 |
$0.00 |
| 82670 |
|
88 |
87 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
3,206 |
3,081 |
$0.00 |
| 86800 |
|
114 |
109 |
$0.00 |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
498 |
452 |
$0.00 |
| 87070 |
|
1,201 |
1,181 |
$0.00 |
| 3079F |
|
487 |
455 |
$0.00 |
| 97014 |
|
310 |
147 |
$0.00 |
| G9226 |
Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed) |
115 |
115 |
$0.00 |
| 95117 |
|
926 |
316 |
$0.00 |
| Q0092 |
Set-up portable x-ray equipment |
61 |
54 |
$0.00 |
| 97010 |
|
207 |
58 |
$0.00 |
| 84480 |
|
493 |
493 |
$0.00 |
| 82043 |
|
2,414 |
2,402 |
$0.00 |
| 3044F |
|
81 |
81 |
$0.00 |
| 92560 |
|
37 |
37 |
$0.00 |
| 83002 |
|
203 |
201 |
$0.00 |
| 88150 |
|
58 |
58 |
$0.00 |
| 83550 |
|
743 |
736 |
$0.00 |
| 80081 |
|
274 |
274 |
$0.00 |
| R0070 |
Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen |
25 |
24 |
$0.00 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
162 |
162 |
$0.00 |
| 84075 |
|
183 |
183 |
$0.00 |
| 85651 |
|
80 |
80 |
$0.00 |
| 86255 |
|
90 |
89 |
$0.00 |
| 86780 |
|
149 |
147 |
$0.00 |
| 82105 |
|
155 |
155 |
$0.00 |
| 84154 |
|
37 |
37 |
$0.00 |
| 83001 |
|
249 |
247 |
$0.00 |
| 92060 |
|
227 |
227 |
$0.00 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
57 |
41 |
$0.00 |
| A0999 |
Unlisted ambulance service |
12 |
12 |
$0.00 |
| 82950 |
|
326 |
325 |
$0.00 |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
90 |
90 |
$0.00 |
| 3061F |
|
53 |
53 |
$0.00 |
| 85008 |
|
136 |
135 |
$0.00 |
| 86160 |
|
158 |
157 |
$0.00 |
| 84134 |
|
13 |
12 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
3,263 |
3,259 |
$0.00 |
| 87147 |
|
291 |
289 |
$0.00 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
18 |
18 |
$0.00 |
| 90696 |
|
66 |
64 |
$0.00 |
| 83735 |
|
450 |
328 |
$0.00 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
13 |
13 |
$0.00 |
| 76830 |
Ultrasound, transvaginal |
42 |
42 |
$0.00 |
| 90680 |
|
38 |
38 |
$0.00 |
| 90656 |
|
58 |
58 |
$0.00 |
| 82435 |
|
181 |
181 |
$0.00 |
| 90686 |
|
460 |
444 |
$0.00 |
| 82951 |
|
81 |
81 |
$0.00 |
| 86695 |
|
172 |
172 |
$0.00 |
| 97139 |
|
165 |
40 |
$0.00 |
| 83605 |
|
17 |
15 |
$0.00 |
| 82150 |
|
59 |
59 |
$0.00 |
| 1125F |
|
110 |
108 |
$0.00 |
| 82945 |
|
63 |
63 |
$0.00 |
| 83050 |
|
55 |
55 |
$0.00 |
| 86901 |
|
327 |
277 |
$0.00 |
| 86300 |
|
97 |
90 |
$0.00 |
| 82378 |
|
170 |
159 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
77 |
77 |
$0.00 |
| K0001 |
Standard wheelchair |
154 |
150 |
$0.00 |
| 82270 |
|
41 |
41 |
$0.00 |
| 88141 |
|
141 |
141 |
$0.00 |
| 96127 |
|
280 |
277 |
$0.00 |
| 82784 |
|
70 |
70 |
$0.00 |
| 1170F |
|
128 |
116 |
$0.00 |
| 92226 |
|
13 |
13 |
$0.00 |
| 90647 |
|
93 |
93 |
$0.00 |
| 90716 |
|
93 |
93 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
37 |
36 |
$0.00 |
| 3072F |
|
16 |
16 |
$0.00 |
| 86376 |
|
220 |
218 |
$0.00 |
| 96151 |
|
235 |
235 |
$0.00 |
| 86361 |
|
129 |
129 |
$0.00 |
| 83021 |
|
59 |
59 |
$0.00 |
| 88304 |
|
12 |
12 |
$0.00 |
| 90674 |
|
61 |
61 |
$0.00 |
| 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 |
55 |
55 |
$0.00 |
| E0776 |
Iv pole |
24 |
24 |
$0.00 |
| A0398 |
Als routine disposable supplies |
26 |
24 |
$0.00 |
| 86880 |
|
13 |
12 |
$0.00 |
| 84484 |
|
110 |
82 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
14 |
12 |
$0.00 |
| 86060 |
|
12 |
12 |
$0.00 |
| 86762 |
|
126 |
126 |
$0.00 |
| 87517 |
|
33 |
33 |
$0.00 |
| 1000F |
|
12 |
12 |
$0.00 |
| 3060F |
|
12 |
12 |
$0.00 |
| 87040 |
|
45 |
43 |
$0.00 |
| 84144 |
|
15 |
15 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
13 |
13 |
$0.00 |
| 90744 |
|
26 |
26 |
$0.00 |
| 81015 |
|
26 |
26 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
13 |
13 |
$0.00 |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
25 |
25 |
$0.00 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
51 |
51 |
$0.00 |
| 86777 |
|
13 |
13 |
$0.00 |
| 83789 |
|
14 |
14 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
15 |
13 |
$0.00 |
| 83498 |
|
14 |
14 |
$0.00 |
| 84402 |
|
27 |
27 |
$0.00 |
| 99385 |
|
12 |
12 |
$0.00 |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
28 |
28 |
$0.00 |
| 96161 |
|
17 |
17 |
$0.00 |
| 86141 |
|
13 |
13 |
$0.00 |
| 86304 |
|
29 |
27 |
$0.00 |
| 87046 |
|
19 |
18 |
$0.00 |
| 76641 |
|
20 |
13 |
$0.00 |
| 87205 |
|
15 |
15 |
$0.00 |
| 82261 |
|
14 |
14 |
$0.00 |
| 86430 |
|
12 |
12 |
$0.00 |
| E0570 |
Nebulizer, with compressor |
14 |
14 |
$0.00 |