| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
11,560 |
10,941 |
$1.40M |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
13,878 |
4,908 |
$1.35M |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
10,000 |
8,410 |
$1.03M |
| 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 |
9,126 |
8,338 |
$774K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
6,215 |
5,357 |
$761K |
| 80053 |
Comprehensive metabolic panel |
36,504 |
26,891 |
$696K |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,746 |
6,648 |
$669K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
6,774 |
6,244 |
$666K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
4,080 |
2,150 |
$438K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
6,971 |
4,151 |
$418K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
24,708 |
18,800 |
$362K |
| 80047 |
|
12,607 |
10,458 |
$362K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,167 |
5,035 |
$341K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
50,286 |
35,269 |
$301K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
9,745 |
2,755 |
$283K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
26,726 |
20,331 |
$259K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,319 |
1,995 |
$244K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,544 |
3,019 |
$213K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,768 |
1,547 |
$204K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
2,406 |
2,030 |
$196K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14,331 |
9,547 |
$184K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
2,139 |
1,931 |
$182K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,345 |
3,561 |
$176K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
563 |
472 |
$151K |
| 71045 |
Radiologic examination, chest; single view |
17,102 |
14,170 |
$149K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
1,129 |
973 |
$147K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,204 |
1,059 |
$147K |
| 80050 |
General health panel |
3,498 |
2,686 |
$134K |
| 96367 |
|
2,671 |
1,278 |
$131K |
| T1015 |
Clinic visit/encounter, all-inclusive |
10,466 |
8,271 |
$129K |
| 71250 |
|
1,795 |
1,523 |
$125K |
| 84484 |
|
13,998 |
8,430 |
$124K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,426 |
2,222 |
$114K |
| 80061 |
Lipid panel |
10,870 |
9,381 |
$112K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
8,419 |
5,983 |
$112K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
521 |
446 |
$112K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
247 |
212 |
$103K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,298 |
1,257 |
$103K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
988 |
872 |
$101K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
10,188 |
8,492 |
$93K |
| 84443 |
Thyroid stimulating hormone (TSH) |
10,415 |
8,639 |
$92K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
494 |
437 |
$90K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,904 |
1,719 |
$86K |
| 36415 |
Collection of venous blood by venipuncture |
26,134 |
21,276 |
$84K |
| 71046 |
Radiologic examination, chest; 2 views |
5,286 |
4,465 |
$82K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
3,300 |
2,824 |
$76K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,939 |
1,582 |
$74K |
| 86901 |
|
4,249 |
3,281 |
$73K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
278 |
227 |
$71K |
| 83880 |
|
3,455 |
2,741 |
$70K |
| 85027 |
|
12,495 |
10,143 |
$68K |
| 81025 |
|
8,644 |
7,220 |
$65K |
| 43248 |
|
814 |
696 |
$63K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
1,006 |
851 |
$62K |
| 83735 |
|
10,101 |
6,381 |
$62K |
| 93975 |
|
853 |
729 |
$62K |
| 73560 |
|
1,498 |
1,278 |
$61K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,704 |
1,391 |
$60K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
4,189 |
2,829 |
$59K |
| 73630 |
|
2,144 |
1,772 |
$58K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,704 |
1,391 |
$58K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,736 |
3,088 |
$58K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,300 |
2,710 |
$57K |
| 87088 |
|
6,944 |
5,724 |
$57K |
| 80081 |
|
564 |
544 |
$54K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
285 |
260 |
$54K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
3,162 |
2,614 |
$51K |
| 83690 |
|
8,427 |
6,733 |
$50K |
| 81001 |
|
17,410 |
14,077 |
$45K |
| J2785 |
Injection, regadenoson, 0.1 mg |
370 |
315 |
$45K |
| 70486 |
|
351 |
313 |
$42K |
| 85014 |
|
11,695 |
9,570 |
$42K |
| 73030 |
|
1,433 |
1,239 |
$42K |
| 82150 |
|
6,466 |
5,301 |
$37K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,959 |
5,148 |
$35K |
| 82077 |
|
2,368 |
1,913 |
$35K |
| 72100 |
|
1,587 |
1,394 |
$35K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,811 |
1,539 |
$34K |
| 12001 |
|
184 |
147 |
$33K |
| 86900 |
|
4,261 |
3,293 |
$33K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
8,102 |
5,863 |
$32K |
| 73610 |
|
1,488 |
1,274 |
$31K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
18,739 |
13,144 |
$31K |
| 80076 |
|
2,979 |
2,464 |
$31K |
| 96376 |
|
4,358 |
2,432 |
$29K |
| 76000 |
|
450 |
344 |
$29K |
| 80074 |
|
831 |
661 |
$29K |
| 73130 |
|
1,058 |
924 |
$28K |
| 97162 |
|
601 |
492 |
$28K |
| 82962 |
|
5,410 |
2,413 |
$28K |
| 80306 |
|
1,715 |
1,428 |
$27K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
15,258 |
13,091 |
$27K |
| 87040 |
|
2,641 |
1,551 |
$27K |
| 84703 |
|
2,148 |
1,749 |
$26K |
| 82728 |
|
3,171 |
2,477 |
$26K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
4,332 |
3,428 |
$26K |
| 87077 |
|
3,253 |
2,683 |
$26K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,416 |
2,212 |
$25K |
| 82378 |
|
1,060 |
779 |
$25K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
7,062 |
5,022 |
$25K |
| 82947 |
|
5,049 |
2,349 |
$25K |
| 87081 |
|
4,074 |
3,260 |
$24K |
| 88304 |
|
615 |
495 |
$24K |
| 85730 |
|
4,142 |
3,194 |
$23K |
| 70498 |
|
246 |
206 |
$23K |
| 70496 |
|
219 |
185 |
$23K |
| 85610 |
|
7,187 |
5,476 |
$23K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,855 |
1,000 |
$22K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
369 |
313 |
$22K |
| 82565 |
|
1,449 |
1,194 |
$22K |
| 93017 |
|
1,209 |
1,042 |
$19K |
| 83605 |
|
2,156 |
1,635 |
$19K |
| 87070 |
|
1,183 |
869 |
$19K |
| 97161 |
|
445 |
355 |
$18K |
| 93971 |
|
503 |
439 |
$18K |
| 86803 |
|
1,482 |
1,286 |
$17K |
| 81003 |
|
8,055 |
6,880 |
$17K |
| 82607 |
|
2,096 |
1,673 |
$17K |
| 76642 |
|
708 |
594 |
$17K |
| 87186 |
|
2,899 |
2,391 |
$15K |
| 83550 |
|
2,859 |
2,261 |
$15K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,630 |
1,342 |
$15K |
| 82550 |
|
3,060 |
1,752 |
$15K |
| 72141 |
|
64 |
53 |
$14K |
| 84439 |
|
1,900 |
1,609 |
$14K |
| 84702 |
|
1,566 |
1,155 |
$14K |
| 73502 |
|
507 |
434 |
$14K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,482 |
1,341 |
$14K |
| 84153 |
|
1,065 |
925 |
$13K |
| 74018 |
|
787 |
693 |
$13K |
| 80320 |
|
890 |
733 |
$13K |
| 83540 |
|
3,036 |
2,404 |
$12K |
| 73110 |
|
416 |
374 |
$12K |
| 77066 |
Tomosynthesis, mammo |
266 |
227 |
$12K |
| 72131 |
|
111 |
91 |
$11K |
| 86780 |
|
683 |
568 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
937 |
811 |
$10K |
| 88312 |
|
1,501 |
1,212 |
$10K |
| 82803 |
|
555 |
441 |
$10K |
| 80143 |
|
512 |
420 |
$10K |
| 86850 |
|
3,774 |
2,914 |
$10K |
| 97001 |
|
414 |
346 |
$9K |
| 72040 |
|
514 |
457 |
$9K |
| 94060 |
|
279 |
257 |
$9K |
| 85018 |
|
3,213 |
2,728 |
$9K |
| 80179 |
|
472 |
396 |
$9K |
| 80051 |
|
460 |
311 |
$8K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
242 |
213 |
$8K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
470 |
218 |
$8K |
| 82746 |
|
980 |
801 |
$8K |
| 93458 |
|
120 |
107 |
$8K |
| 87340 |
|
1,739 |
1,420 |
$8K |
| 86762 |
|
1,290 |
1,029 |
$7K |
| 83970 |
|
255 |
224 |
$7K |
| 80069 |
|
1,342 |
985 |
$7K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,979 |
1,560 |
$7K |
| 87807 |
|
868 |
768 |
$6K |
| 82570 |
|
1,541 |
1,294 |
$6K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
61 |
39 |
$6K |
| 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 |
3,435 |
3,206 |
$5K |
| 77336 |
|
31 |
12 |
$5K |
| 12011 |
|
33 |
24 |
$5K |
| 83615 |
|
1,017 |
745 |
$5K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
7,194 |
5,855 |
$5K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
107 |
100 |
$4K |
| 84100 |
|
1,137 |
656 |
$4K |
| J1644 |
Injection, heparin sodium, per 1000 units |
5,710 |
2,544 |
$4K |
| 82105 |
|
292 |
223 |
$4K |
| 86140 |
|
847 |
679 |
$4K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
166 |
146 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
805 |
640 |
$4K |
| 99152 |
|
1,289 |
1,097 |
$4K |
| 95811 |
|
29 |
24 |
$4K |
| 88307 |
|
34 |
24 |
$3K |
| 77062 |
|
75 |
54 |
$3K |
| 82330 |
|
239 |
211 |
$3K |
| 93296 |
|
258 |
240 |
$3K |
| 94729 |
|
212 |
195 |
$3K |
| G0378 |
Hospital observation service, per hour |
1,012 |
844 |
$3K |
| 84145 |
|
246 |
210 |
$3K |
| 94726 |
|
214 |
196 |
$3K |
| J7050 |
Infusion, normal saline solution, 250 cc |
11,577 |
5,169 |
$3K |
| 73562 |
|
92 |
84 |
$3K |
| 90715 |
|
189 |
167 |
$3K |
| 77080 |
|
82 |
73 |
$3K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
47 |
43 |
$3K |
| 85049 |
|
541 |
460 |
$3K |
| 77065 |
Tomosynthesis, mammo |
96 |
82 |
$3K |
| 87205 |
|
820 |
618 |
$3K |
| 73590 |
|
129 |
110 |
$3K |
| 86704 |
|
247 |
223 |
$3K |
| 76801 |
|
91 |
66 |
$3K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
15 |
13 |
$3K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
3,492 |
2,700 |
$3K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
6,272 |
5,042 |
$2K |
| 76775 |
|
174 |
137 |
$2K |
| J2704 |
Injection, propofol, 10 mg |
8,674 |
7,102 |
$2K |
| 84550 |
|
669 |
568 |
$2K |
| 85652 |
|
1,258 |
1,034 |
$2K |
| 80329 |
|
165 |
124 |
$2K |
| 82248 |
|
541 |
457 |
$2K |
| 74178 |
|
31 |
27 |
$2K |
| 0225U |
|
501 |
463 |
$2K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
3,663 |
2,727 |
$2K |
| 84156 |
|
860 |
712 |
$2K |
| 71271 |
|
26 |
25 |
$2K |
| 97166 |
|
62 |
48 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
8,081 |
6,285 |
$2K |
| 82043 |
|
589 |
533 |
$2K |
| A9578 |
Injection, gadobenate dimeglumine (multihance multipack), per ml |
71 |
63 |
$2K |
| C1769 |
Guide wire |
123 |
108 |
$2K |
| J1815 |
Injection, insulin, per 5 units |
3,990 |
1,687 |
$2K |
| 82010 |
|
316 |
240 |
$2K |
| 88342 |
|
130 |
108 |
$2K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
13 |
12 |
$2K |
| 81002 |
|
466 |
381 |
$2K |
| 86592 |
|
1,313 |
1,047 |
$2K |
| 84520 |
|
475 |
329 |
$2K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
2,442 |
1,763 |
$2K |
| 85379 |
|
172 |
151 |
$2K |
| 87210 |
|
324 |
256 |
$1K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
16 |
12 |
$1K |
| 76830 |
Ultrasound, transvaginal |
28 |
24 |
$1K |
| 73090 |
|
44 |
39 |
$1K |
| 84403 |
|
59 |
48 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
78 |
64 |
$1K |
| 80349 |
|
45 |
41 |
$1K |
| 76536 |
|
54 |
37 |
$1K |
| 86709 |
|
227 |
205 |
$1K |
| 93880 |
|
32 |
28 |
$962.13 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
242 |
204 |
$939.32 |
| 86141 |
|
136 |
97 |
$926.08 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
2,311 |
1,875 |
$919.14 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
2,446 |
1,599 |
$916.98 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
6,476 |
4,541 |
$914.91 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
6,515 |
4,494 |
$903.82 |
| 93225 |
|
34 |
31 |
$875.97 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
7,578 |
5,180 |
$847.42 |
| 96417 |
|
54 |
36 |
$826.50 |
| J2060 |
Injection, lorazepam, 2 mg |
1,728 |
1,323 |
$823.50 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
27 |
15 |
$760.50 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
159 |
126 |
$730.09 |
| 85007 |
|
636 |
510 |
$725.64 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
10,630 |
8,391 |
$679.87 |
| 0353U |
|
285 |
255 |
$644.53 |
| J1940 |
Injection, furosemide, up to 20 mg |
1,510 |
950 |
$638.82 |
| 84132 |
|
126 |
105 |
$610.34 |
| 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 |
35 |
30 |
$590.61 |
| 36430 |
|
20 |
13 |
$572.74 |
| 82950 |
|
119 |
88 |
$568.74 |
| 82805 |
|
31 |
25 |
$568.48 |
| 93925 |
|
12 |
12 |
$552.68 |
| 83520 |
|
41 |
24 |
$540.96 |
| 86705 |
|
184 |
165 |
$528.74 |
| 82784 |
|
83 |
51 |
$499.92 |
| 73070 |
|
19 |
16 |
$479.50 |
| 87522 |
Neg quan hep c or qual rna |
13 |
12 |
$451.65 |
| 86300 |
|
54 |
51 |
$436.10 |
| 97597 |
|
19 |
13 |
$403.71 |
| A9270 |
Non-covered item or service |
7,180 |
1,082 |
$362.38 |
| 87147 |
|
54 |
33 |
$354.72 |
| 81015 |
|
271 |
236 |
$341.58 |
| 86923 |
|
12 |
12 |
$311.07 |
| 82677 |
|
24 |
13 |
$310.86 |
| 86038 |
|
47 |
43 |
$310.68 |
| M0239 |
Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring |
14 |
12 |
$309.60 |
| 82800 |
|
41 |
37 |
$299.69 |
| 82140 |
|
57 |
48 |
$293.50 |
| 80324 |
|
13 |
13 |
$283.20 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
198 |
187 |
$280.38 |
| 84165 |
|
20 |
13 |
$280.32 |
| 85380 |
|
40 |
40 |
$241.74 |
| 80346 |
|
13 |
12 |
$240.48 |
| J0595 |
Injection, butorphanol tartrate, 1 mg |
483 |
388 |
$235.11 |
| 83521 |
|
14 |
12 |
$226.16 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
950 |
757 |
$216.33 |
| 90714 |
|
16 |
15 |
$216.07 |
| J0744 |
Injection, ciprofloxacin for intravenous infusion, 200 mg |
128 |
79 |
$212.98 |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
159 |
140 |
$207.14 |
| 0004A |
|
17 |
15 |
$200.00 |
| 86336 |
|
24 |
13 |
$195.93 |
| 90686 |
|
27 |
27 |
$177.54 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
543 |
397 |
$158.84 |
| 87430 |
|
210 |
167 |
$141.57 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
806 |
682 |
$138.88 |
| 0001A |
|
20 |
20 |
$128.45 |
| 36600 |
|
249 |
210 |
$124.44 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
730 |
546 |
$107.20 |
| 83986 |
|
19 |
14 |
$92.16 |
| J1790 |
Injection, droperidol, up to 5 mg |
144 |
123 |
$90.47 |
| 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 |
24 |
24 |
$80.36 |
| 84295 |
|
13 |
12 |
$80.20 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
76 |
54 |
$64.98 |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
189 |
172 |
$64.53 |
| 97116 |
|
470 |
203 |
$58.36 |
| J3480 |
Injection, potassium chloride, per 2 meq |
102 |
61 |
$50.50 |
| J3489 |
Injection, zoledronic acid, 1 mg |
14 |
12 |
$39.35 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
144 |
114 |
$37.26 |
| 86334 |
|
13 |
12 |
$31.90 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
258 |
182 |
$27.47 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
182 |
170 |
$25.36 |
| 85651 |
|
49 |
27 |
$25.35 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
2,053 |
1,614 |
$24.02 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
208 |
79 |
$18.10 |
| 76937 |
|
13 |
13 |
$17.63 |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
199 |
63 |
$12.88 |
| 97535 |
Self-care/home management training, each 15 minutes |
18 |
16 |
$12.18 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
126 |
123 |
$7.10 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
150 |
133 |
$6.39 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
339 |
278 |
$6.24 |
| J2305 |
Injection, nitroglycerin, 5 mg |
34 |
31 |
$5.20 |
| 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 |
628 |
516 |
$4.80 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
45 |
27 |
$3.71 |
| J3490 |
Unclassified drugs |
949 |
787 |
$2.16 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
1,176 |
976 |
$0.04 |
| C9113 |
Injection, pantoprazole sodium, per vial |
938 |
417 |
$0.03 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
132 |
122 |
$0.01 |
| 99153 |
Mod sedat endo service >5yrs |
145 |
132 |
$0.00 |
| 36591 |
|
88 |
65 |
$0.00 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
553 |
474 |
$0.00 |
| 96368 |
|
37 |
25 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
151 |
98 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
17 |
16 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
14 |
12 |
$0.00 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
23 |
12 |
$0.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
35 |
26 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,939 |
1,203 |
$0.00 |
| J1953 |
Injection, levetiracetam, 10 mg |
14 |
12 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
220 |
191 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
31 |
30 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
108 |
82 |
$0.00 |
| 87400 |
|
56 |
45 |
$0.00 |
| 36592 |
|
68 |
39 |
$0.00 |