| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
98,943 |
75,092 |
$3.60M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
28,766 |
23,984 |
$1.85M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
29,750 |
24,233 |
$1.38M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
15,202 |
12,269 |
$896K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
12,715 |
10,782 |
$812K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
7,411 |
4,843 |
$729K |
| 80053 |
Comprehensive metabolic panel |
66,639 |
48,806 |
$715K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
10,970 |
3,280 |
$561K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
3,207 |
1,926 |
$505K |
| 70450 |
Computed tomography, head or brain; without contrast material |
6,312 |
5,044 |
$484K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
3,588 |
3,016 |
$379K |
| 36415 |
Collection of venous blood by venipuncture |
59,952 |
37,045 |
$335K |
| J9271 |
Injection, pembrolizumab, 1 mg |
214 |
91 |
$228K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
7,269 |
5,641 |
$212K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
2,194 |
1,400 |
$212K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,941 |
1,619 |
$204K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,907 |
1,564 |
$202K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
4,772 |
2,370 |
$200K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
1,838 |
441 |
$188K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,043 |
870 |
$153K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
12,297 |
8,244 |
$125K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,796 |
1,859 |
$125K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
21,802 |
17,015 |
$112K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
9,016 |
2,737 |
$110K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
11,471 |
7,680 |
$101K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
6,270 |
5,044 |
$94K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
74,781 |
52,793 |
$91K |
| 20611 |
|
911 |
606 |
$86K |
| 71046 |
Radiologic examination, chest; 2 views |
8,212 |
6,857 |
$83K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,141 |
1,699 |
$80K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
8,252 |
6,694 |
$72K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,300 |
1,089 |
$70K |
| 84703 |
|
15,529 |
13,044 |
$69K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,480 |
840 |
$67K |
| 97162 |
|
1,353 |
1,186 |
$67K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
6,194 |
4,348 |
$67K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
17,361 |
11,150 |
$66K |
| 20610 |
|
1,097 |
787 |
$64K |
| 86900 |
|
2,072 |
1,678 |
$64K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
199 |
168 |
$63K |
| 81003 |
|
14,527 |
11,064 |
$63K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
468 |
390 |
$60K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,064 |
1,782 |
$60K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
14,401 |
10,703 |
$59K |
| 76830 |
Ultrasound, transvaginal |
1,296 |
1,115 |
$58K |
| 11043 |
|
676 |
467 |
$55K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,305 |
1,120 |
$54K |
| 97161 |
|
965 |
842 |
$54K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
897 |
788 |
$54K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
22,654 |
17,783 |
$52K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
738 |
629 |
$49K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,909 |
1,661 |
$47K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
634 |
525 |
$47K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,043 |
967 |
$47K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,363 |
1,036 |
$46K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,718 |
2,136 |
$45K |
| 73130 |
|
1,691 |
1,364 |
$44K |
| 73610 |
|
1,785 |
1,483 |
$43K |
| 88304 |
|
1,260 |
910 |
$43K |
| 96401 |
|
919 |
528 |
$43K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
9,888 |
7,409 |
$41K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
5,582 |
4,301 |
$41K |
| 97016 |
|
1,902 |
512 |
$40K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,943 |
691 |
$40K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
621 |
394 |
$40K |
| 73030 |
|
2,013 |
1,611 |
$39K |
| 76642 |
|
845 |
765 |
$38K |
| 73564 |
|
1,808 |
1,537 |
$37K |
| 84443 |
Thyroid stimulating hormone (TSH) |
14,755 |
11,442 |
$37K |
| 81001 |
|
25,115 |
20,639 |
$36K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
4,760 |
3,469 |
$36K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
8,684 |
6,767 |
$35K |
| 73630 |
|
2,004 |
1,663 |
$34K |
| 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 |
648 |
547 |
$33K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,927 |
3,950 |
$33K |
| C1769 |
Guide wire |
1,042 |
827 |
$30K |
| 92557 |
|
609 |
516 |
$30K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
2,969 |
2,069 |
$30K |
| J2704 |
Injection, propofol, 10 mg |
5,471 |
4,305 |
$30K |
| 81025 |
|
1,406 |
1,195 |
$29K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
836 |
711 |
$28K |
| 72100 |
|
1,719 |
1,436 |
$28K |
| 73110 |
|
1,237 |
963 |
$27K |
| 10060 |
|
239 |
210 |
$25K |
| 71045 |
Radiologic examination, chest; single view |
11,304 |
9,054 |
$25K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
300 |
244 |
$25K |
| 73562 |
|
1,026 |
856 |
$25K |
| J3490 |
Unclassified drugs |
5,344 |
3,472 |
$23K |
| 70486 |
|
787 |
658 |
$22K |
| 99218 |
|
1,727 |
1,144 |
$21K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
7,060 |
5,761 |
$21K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
110 |
91 |
$20K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,818 |
1,367 |
$20K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
117 |
42 |
$19K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
3,339 |
2,232 |
$19K |
| 83735 |
|
15,835 |
11,480 |
$19K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
222 |
188 |
$19K |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
390 |
139 |
$19K |
| 74018 |
|
854 |
723 |
$18K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
312 |
269 |
$18K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
2,745 |
2,400 |
$18K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
11,974 |
9,304 |
$18K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
1,199 |
949 |
$17K |
| 80047 |
|
1,413 |
1,092 |
$17K |
| 80061 |
Lipid panel |
12,614 |
10,083 |
$17K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
145 |
127 |
$17K |
| 87077 |
|
6,370 |
4,673 |
$16K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
653 |
542 |
$16K |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,686 |
820 |
$15K |
| 82728 |
|
3,090 |
2,315 |
$15K |
| 96367 |
|
486 |
245 |
$15K |
| J0897 |
Injection, denosumab, 1 mg |
145 |
104 |
$15K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,003 |
911 |
$15K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
157 |
135 |
$14K |
| 73502 |
|
1,105 |
907 |
$14K |
| 85610 |
|
6,783 |
3,874 |
$14K |
| 85027 |
|
8,963 |
6,251 |
$13K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
967 |
739 |
$13K |
| 87070 |
|
1,099 |
843 |
$13K |
| 36591 |
|
1,833 |
810 |
$13K |
| 93971 |
|
1,047 |
871 |
$13K |
| 87186 |
|
6,189 |
4,548 |
$13K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
693 |
602 |
$12K |
| 85730 |
|
2,799 |
2,116 |
$11K |
| 76536 |
|
205 |
181 |
$10K |
| 86140 |
|
2,953 |
1,963 |
$10K |
| 83690 |
|
19,401 |
15,843 |
$10K |
| 82550 |
|
12,600 |
9,551 |
$9K |
| G0378 |
Hospital observation service, per hour |
934 |
655 |
$9K |
| 93325 |
|
247 |
205 |
$9K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
1,805 |
1,492 |
$9K |
| 83970 |
|
1,689 |
1,277 |
$9K |
| 84484 |
|
13,286 |
9,992 |
$8K |
| 76770 |
|
196 |
165 |
$8K |
| 93970 |
|
250 |
216 |
$8K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
4,776 |
3,007 |
$8K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
7,820 |
5,710 |
$8K |
| 99152 |
|
954 |
769 |
$8K |
| 77066 |
Tomosynthesis, mammo |
368 |
318 |
$7K |
| 96376 |
|
4,557 |
2,680 |
$7K |
| 80076 |
|
1,379 |
1,045 |
$7K |
| 73140 |
|
94 |
80 |
$7K |
| 72040 |
|
250 |
212 |
$7K |
| 95886 |
|
376 |
302 |
$7K |
| 71250 |
|
146 |
118 |
$6K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
43 |
29 |
$6K |
| 77334 |
|
19 |
13 |
$6K |
| 97535 |
Self-care/home management training, each 15 minutes |
474 |
386 |
$6K |
| 31575 |
|
152 |
125 |
$6K |
| 86850 |
|
1,539 |
1,237 |
$6K |
| 97597 |
|
385 |
236 |
$6K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
6,488 |
5,272 |
$5K |
| C1758 |
Catheter, ureteral |
659 |
545 |
$5K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,029 |
894 |
$5K |
| 84480 |
|
606 |
512 |
$5K |
| 87210 |
|
1,737 |
1,545 |
$5K |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
1,215 |
992 |
$5K |
| 81002 |
|
331 |
286 |
$4K |
| 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 |
1,923 |
1,546 |
$4K |
| 82607 |
|
4,571 |
3,521 |
$4K |
| 84702 |
|
2,055 |
1,558 |
$4K |
| 82553 |
|
5,795 |
4,540 |
$4K |
| 12001 |
|
62 |
50 |
$4K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,306 |
2,014 |
$4K |
| 86901 |
|
2,073 |
1,678 |
$4K |
| 74021 |
|
1,404 |
1,191 |
$4K |
| 0399T |
|
34 |
26 |
$4K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,305 |
2,014 |
$3K |
| 80320 |
|
2,059 |
1,734 |
$3K |
| 76801 |
|
952 |
764 |
$3K |
| 84439 |
|
4,167 |
3,345 |
$3K |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
596 |
442 |
$3K |
| 72110 |
|
80 |
68 |
$3K |
| 72141 |
|
34 |
26 |
$3K |
| 93017 |
|
201 |
164 |
$3K |
| 83550 |
|
2,193 |
1,691 |
$3K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
31 |
26 |
$3K |
| 77065 |
Tomosynthesis, mammo |
320 |
284 |
$3K |
| 83540 |
|
2,674 |
2,031 |
$3K |
| 70491 |
|
22 |
17 |
$3K |
| 83880 |
|
3,147 |
2,069 |
$3K |
| 31231 |
|
36 |
35 |
$3K |
| 99001 |
|
312 |
282 |
$3K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
474 |
186 |
$3K |
| 80055 |
|
116 |
90 |
$3K |
| 85652 |
|
2,831 |
1,852 |
$3K |
| 88150 |
|
93 |
87 |
$3K |
| 87205 |
|
1,077 |
825 |
$2K |
| 84146 |
|
586 |
502 |
$2K |
| 29125 |
|
203 |
183 |
$2K |
| 92567 |
|
624 |
542 |
$2K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
89 |
78 |
$2K |
| 82746 |
|
2,554 |
1,974 |
$2K |
| 87340 |
|
603 |
526 |
$2K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
166 |
127 |
$2K |
| 93041 |
|
4,625 |
3,877 |
$2K |
| 84156 |
|
1,901 |
1,469 |
$2K |
| 80074 |
|
529 |
402 |
$2K |
| 73590 |
|
136 |
116 |
$2K |
| 87040 |
|
1,066 |
861 |
$2K |
| 77080 |
|
63 |
54 |
$2K |
| 82140 |
|
1,829 |
1,256 |
$2K |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
464 |
386 |
$2K |
| 96417 |
|
87 |
38 |
$2K |
| 80164 |
|
1,573 |
1,141 |
$2K |
| 93880 |
|
89 |
71 |
$2K |
| 84100 |
|
2,111 |
1,388 |
$2K |
| 82565 |
|
303 |
192 |
$1K |
| 82570 |
|
2,770 |
2,200 |
$1K |
| 73080 |
|
98 |
79 |
$1K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
1,835 |
1,339 |
$1K |
| 87430 |
|
368 |
307 |
$1K |
| 85379 |
|
2,071 |
1,484 |
$1K |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
24 |
21 |
$1K |
| 84153 |
|
399 |
317 |
$1K |
| 99153 |
Mod sedat endo service >5yrs |
465 |
366 |
$1K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
16 |
13 |
$1K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
15 |
14 |
$1K |
| 88342 |
|
240 |
194 |
$1K |
| 87807 |
|
126 |
111 |
$1K |
| 86803 |
|
1,161 |
986 |
$1K |
| 73560 |
|
52 |
43 |
$1K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
100 |
64 |
$1K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
134 |
105 |
$1K |
| 86592 |
|
1,170 |
983 |
$1K |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
216 |
180 |
$1K |
| J1453 |
Injection, fosaprepitant, 1 mg |
28 |
12 |
$998.45 |
| 84436 |
|
864 |
713 |
$891.80 |
| 96415 |
|
22 |
14 |
$887.89 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
445 |
364 |
$871.49 |
| 85018 |
|
533 |
299 |
$844.69 |
| 77061 |
|
12 |
12 |
$816.49 |
| 71271 |
|
19 |
17 |
$810.05 |
| J2060 |
Injection, lorazepam, 2 mg |
784 |
607 |
$734.76 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
131 |
52 |
$723.11 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,313 |
1,135 |
$704.66 |
| 73503 |
|
48 |
37 |
$698.02 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
16 |
12 |
$690.73 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
344 |
202 |
$686.28 |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
84 |
80 |
$602.01 |
| 97116 |
|
219 |
110 |
$595.36 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,117 |
434 |
$550.01 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
128 |
124 |
$538.99 |
| 84550 |
|
1,067 |
832 |
$537.88 |
| 94760 |
|
68 |
27 |
$528.35 |
| 82043 |
|
1,376 |
1,145 |
$479.82 |
| 74178 |
|
17 |
12 |
$470.33 |
| 82040 |
|
1,073 |
858 |
$460.14 |
| 93458 |
|
17 |
13 |
$459.95 |
| Q3014 |
Telehealth originating site facility fee |
1,902 |
1,589 |
$430.54 |
| 72072 |
|
17 |
15 |
$429.73 |
| 84481 |
|
99 |
78 |
$419.26 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
857 |
672 |
$409.45 |
| 83605 |
|
1,282 |
1,015 |
$397.69 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,943 |
1,704 |
$375.58 |
| 88307 |
|
150 |
109 |
$353.04 |
| 86038 |
|
277 |
219 |
$318.84 |
| 94664 |
|
20 |
13 |
$317.01 |
| 90715 |
|
546 |
434 |
$303.93 |
| 82150 |
|
1,449 |
1,163 |
$294.54 |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
16 |
12 |
$292.74 |
| 86706 |
|
40 |
26 |
$280.95 |
| 95911 |
|
14 |
12 |
$274.71 |
| 96523 |
|
30 |
12 |
$237.67 |
| 72170 |
|
18 |
13 |
$232.66 |
| 73552 |
|
27 |
24 |
$221.15 |
| 80069 |
|
164 |
77 |
$211.44 |
| 73090 |
|
13 |
12 |
$207.89 |
| 29515 |
|
61 |
51 |
$189.00 |
| 84165 |
|
53 |
41 |
$170.75 |
| 84403 |
|
134 |
113 |
$153.56 |
| 84460 |
|
1,136 |
915 |
$152.54 |
| 93225 |
|
30 |
26 |
$144.31 |
| 84075 |
|
1,053 |
843 |
$137.66 |
| 96368 |
|
19 |
12 |
$134.45 |
| G0008 |
Administration of influenza virus vaccine |
218 |
176 |
$129.06 |
| 84134 |
|
403 |
308 |
$127.78 |
| J1815 |
Injection, insulin, per 5 units |
590 |
186 |
$124.21 |
| 84132 |
|
294 |
211 |
$121.72 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
271 |
209 |
$118.52 |
| 82247 |
|
1,043 |
834 |
$116.78 |
| 85046 |
|
124 |
100 |
$115.17 |
| 87324 |
|
121 |
80 |
$114.38 |
| 87634 |
|
41 |
29 |
$113.39 |
| 82977 |
|
1,081 |
863 |
$106.71 |
| C1729 |
Catheter, drainage |
19 |
13 |
$105.60 |
| 84450 |
|
1,070 |
857 |
$104.69 |
| 84155 |
|
1,029 |
825 |
$103.18 |
| 80177 |
|
226 |
171 |
$97.37 |
| 83874 |
|
38 |
30 |
$90.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
231 |
186 |
$85.73 |
| J3480 |
Injection, potassium chloride, per 2 meq |
45 |
17 |
$81.09 |
| 80202 |
|
151 |
43 |
$76.04 |
| 82009 |
|
361 |
298 |
$71.74 |
| 69210 |
|
96 |
80 |
$71.70 |
| 93321 |
|
14 |
12 |
$69.17 |
| 86480 |
|
81 |
54 |
$67.83 |
| 86787 |
|
21 |
19 |
$65.50 |
| 84681 |
|
98 |
82 |
$56.86 |
| 74022 |
|
22 |
18 |
$55.06 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
114 |
93 |
$50.07 |
| J2785 |
Injection, regadenoson, 0.1 mg |
67 |
50 |
$46.07 |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
90 |
74 |
$45.39 |
| 82248 |
|
64 |
53 |
$42.60 |
| 90686 |
|
344 |
286 |
$41.87 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
832 |
669 |
$40.34 |
| 86431 |
|
71 |
48 |
$38.90 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
17 |
13 |
$32.66 |
| 87449 |
|
121 |
80 |
$30.08 |
| 84144 |
|
23 |
14 |
$19.20 |
| 80156 |
|
12 |
12 |
$18.42 |
| 84145 |
|
170 |
110 |
$18.28 |
| 83615 |
|
248 |
157 |
$11.57 |
| 85014 |
|
37 |
24 |
$11.09 |
| 83001 |
|
14 |
13 |
$8.10 |
| 80185 |
|
33 |
28 |
$7.96 |
| 86141 |
|
134 |
64 |
$6.61 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
105 |
88 |
$0.00 |
| 87181 |
|
19 |
15 |
$0.00 |
| 76377 |
|
24 |
15 |
$0.00 |
| J1940 |
Injection, furosemide, up to 20 mg |
119 |
72 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
31 |
25 |
$0.00 |
| 99406 |
|
46 |
42 |
$0.00 |
| 88341 |
|
12 |
12 |
$0.00 |
| 82784 |
|
15 |
12 |
$0.00 |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
14 |
14 |
$0.00 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
66 |
57 |
$0.00 |
| J1956 |
Injection, levofloxacin, 250 mg |
31 |
25 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
40 |
38 |
$0.00 |
| 36600 |
|
16 |
14 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
15 |
13 |
$0.00 |
| 77336 |
|
28 |
13 |
$0.00 |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
17 |
13 |
$0.00 |
| 99221 |
|
53 |
49 |
$0.00 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
14 |
12 |
$0.00 |
| 82805 |
|
15 |
13 |
$0.00 |
| S0077 |
Injection, clindamycin phosphate, 300 mg |
15 |
12 |
$0.00 |