| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
33,607 |
29,024 |
$4.01M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
12,258 |
9,450 |
$3.57M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
31,005 |
27,933 |
$3.28M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
12,804 |
10,929 |
$1.56M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
3,242 |
2,437 |
$790K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,876 |
2,280 |
$627K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,477 |
1,630 |
$545K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,483 |
5,532 |
$462K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
5,190 |
1,763 |
$401K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
5,204 |
2,005 |
$391K |
| 64483 |
|
889 |
797 |
$359K |
| 80053 |
Comprehensive metabolic panel |
42,908 |
35,002 |
$348K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,689 |
2,340 |
$270K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,621 |
2,961 |
$263K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,044 |
784 |
$263K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
810 |
690 |
$262K |
| 84443 |
Thyroid stimulating hormone (TSH) |
14,206 |
12,520 |
$262K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
3,206 |
1,954 |
$241K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
5,793 |
5,190 |
$241K |
| 80061 |
Lipid panel |
11,523 |
10,482 |
$218K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,641 |
2,614 |
$217K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,730 |
1,317 |
$206K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
60,674 |
48,156 |
$192K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,102 |
549 |
$177K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,945 |
1,673 |
$164K |
| G0378 |
Hospital observation service, per hour |
4,035 |
1,997 |
$160K |
| 64635 |
|
407 |
351 |
$158K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
748 |
629 |
$156K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
778 |
611 |
$155K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
5,679 |
5,045 |
$142K |
| 64493 |
|
350 |
283 |
$137K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
5,776 |
5,186 |
$133K |
| 90839 |
|
1,418 |
1,103 |
$126K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
9,788 |
8,791 |
$107K |
| 59025 |
Fetal non-stress test |
676 |
432 |
$100K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
322 |
256 |
$99K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
152 |
137 |
$96K |
| 87081 |
|
4,626 |
4,138 |
$93K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,514 |
702 |
$91K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,317 |
1,087 |
$88K |
| 36415 |
Collection of venous blood by venipuncture |
33,097 |
26,164 |
$86K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
502 |
452 |
$83K |
| 64494 |
|
404 |
280 |
$83K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
390 |
326 |
$80K |
| 64636 |
|
436 |
336 |
$70K |
| 85027 |
|
6,543 |
5,655 |
$69K |
| 71046 |
Radiologic examination, chest; 2 views |
3,109 |
2,728 |
$69K |
| 93975 |
|
470 |
340 |
$63K |
| 82607 |
|
3,567 |
3,125 |
$63K |
| 27096 |
|
163 |
156 |
$63K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
13,394 |
10,460 |
$60K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,782 |
2,563 |
$59K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
4,593 |
3,404 |
$53K |
| 87088 |
|
5,050 |
4,047 |
$50K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
555 |
333 |
$49K |
| 97161 |
|
769 |
648 |
$49K |
| 87506 |
|
428 |
357 |
$46K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
314 |
263 |
$44K |
| 93971 |
|
547 |
471 |
$41K |
| 78264 |
|
196 |
177 |
$41K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
14,221 |
11,653 |
$39K |
| 88142 |
|
1,853 |
1,668 |
$39K |
| 76642 |
|
347 |
304 |
$38K |
| 84466 |
|
2,224 |
1,917 |
$37K |
| 86140 |
|
2,558 |
2,074 |
$37K |
| 64479 |
|
114 |
91 |
$37K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
825 |
747 |
$36K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
103 |
69 |
$36K |
| 82746 |
|
3,025 |
2,636 |
$35K |
| 76536 |
|
305 |
262 |
$34K |
| 84439 |
|
3,123 |
2,690 |
$34K |
| 96367 |
|
515 |
289 |
$33K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
673 |
576 |
$33K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,152 |
976 |
$32K |
| 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 |
201 |
198 |
$32K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,087 |
986 |
$31K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
1,580 |
1,388 |
$30K |
| 76981 |
|
323 |
285 |
$30K |
| 72131 |
|
319 |
285 |
$30K |
| 73630 |
|
1,155 |
936 |
$29K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
450 |
345 |
$29K |
| 70498 |
|
148 |
132 |
$28K |
| 86900 |
|
1,505 |
1,185 |
$27K |
| 86803 |
|
1,590 |
1,383 |
$27K |
| 83655 |
|
909 |
846 |
$27K |
| 94729 |
|
305 |
276 |
$26K |
| 82728 |
|
2,506 |
2,167 |
$26K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
7,086 |
6,053 |
$25K |
| 93017 |
|
327 |
271 |
$25K |
| 71250 |
|
359 |
325 |
$25K |
| 80076 |
|
3,210 |
2,600 |
$25K |
| 83540 |
|
2,479 |
2,129 |
$24K |
| 72141 |
|
210 |
192 |
$24K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
352 |
281 |
$24K |
| 70486 |
|
315 |
245 |
$23K |
| 84702 |
|
1,275 |
784 |
$22K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
433 |
357 |
$22K |
| 87340 |
|
1,511 |
1,301 |
$22K |
| 74018 |
|
693 |
589 |
$21K |
| 83735 |
|
7,781 |
5,728 |
$21K |
| J1756 |
Injection, iron sucrose, 1 mg |
626 |
239 |
$21K |
| 71045 |
Radiologic examination, chest; single view |
8,827 |
7,434 |
$21K |
| 72100 |
|
669 |
565 |
$21K |
| 90840 |
|
130 |
85 |
$20K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
267 |
243 |
$19K |
| 86780 |
|
988 |
913 |
$19K |
| 87186 |
|
1,739 |
1,420 |
$18K |
| 94060 |
|
301 |
278 |
$18K |
| 94726 |
|
238 |
220 |
$17K |
| 86850 |
|
1,481 |
1,162 |
$17K |
| 83970 |
|
710 |
622 |
$17K |
| 99215 |
Prolong outpt/office vis |
360 |
318 |
$17K |
| 87660 |
|
832 |
633 |
$16K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,232 |
1,068 |
$16K |
| 93970 |
|
110 |
95 |
$16K |
| 64484 |
|
62 |
52 |
$16K |
| 86762 |
|
552 |
475 |
$15K |
| 81001 |
|
25,144 |
21,092 |
$15K |
| 97165 |
|
305 |
238 |
$15K |
| 86901 |
|
1,639 |
1,288 |
$15K |
| 87150 |
|
544 |
474 |
$15K |
| 87077 |
|
2,299 |
1,861 |
$15K |
| 84484 |
|
7,646 |
5,726 |
$15K |
| 47562 |
|
16 |
12 |
$15K |
| 85651 |
|
1,789 |
1,429 |
$14K |
| 64634 |
|
72 |
52 |
$14K |
| 74183 |
|
61 |
43 |
$14K |
| 86592 |
|
563 |
444 |
$14K |
| 73560 |
|
701 |
591 |
$13K |
| 97162 |
|
218 |
190 |
$13K |
| 73030 |
|
661 |
558 |
$13K |
| 87522 |
Neg quan hep c or qual rna |
287 |
250 |
$13K |
| 80069 |
|
867 |
716 |
$13K |
| 95811 |
|
33 |
27 |
$13K |
| J3490 |
Unclassified drugs |
2,530 |
2,087 |
$13K |
| 82570 |
|
1,696 |
1,425 |
$12K |
| 82805 |
|
423 |
287 |
$12K |
| 86038 |
|
741 |
606 |
$12K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
925 |
726 |
$12K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
1,422 |
1,086 |
$12K |
| 73610 |
|
778 |
636 |
$11K |
| 86364 |
|
591 |
395 |
$11K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
778 |
402 |
$11K |
| 70491 |
|
40 |
26 |
$11K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
64 |
56 |
$11K |
| 88307 |
|
93 |
51 |
$11K |
| 88342 |
|
689 |
431 |
$10K |
| 84153 |
|
642 |
559 |
$10K |
| 73130 |
|
671 |
548 |
$10K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
8,501 |
6,839 |
$10K |
| 84403 |
|
426 |
361 |
$9K |
| 73502 |
|
415 |
367 |
$9K |
| 86706 |
|
557 |
475 |
$9K |
| 84550 |
|
1,134 |
950 |
$9K |
| 72110 |
|
211 |
186 |
$8K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,565 |
1,259 |
$8K |
| 83525 |
|
436 |
332 |
$8K |
| 82105 |
|
506 |
464 |
$8K |
| 76770 |
|
66 |
56 |
$8K |
| 93880 |
|
118 |
106 |
$8K |
| 87631 |
|
142 |
135 |
$8K |
| 73562 |
|
148 |
144 |
$7K |
| 87480 |
|
832 |
633 |
$7K |
| 86431 |
|
347 |
285 |
$7K |
| 85610 |
|
7,134 |
5,458 |
$7K |
| 87510 |
|
832 |
633 |
$7K |
| 12001 |
|
44 |
40 |
$7K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
648 |
558 |
$7K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
151 |
51 |
$7K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,439 |
950 |
$7K |
| 84100 |
|
1,209 |
785 |
$7K |
| 87070 |
|
712 |
596 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
76 |
65 |
$6K |
| J8501 |
Aprepitant, oral, 5 mg |
485 |
321 |
$6K |
| 83874 |
|
4,884 |
3,278 |
$6K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
15 |
14 |
$6K |
| 72050 |
|
221 |
184 |
$6K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
18,827 |
14,924 |
$6K |
| 82784 |
|
503 |
417 |
$6K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
73 |
52 |
$6K |
| 76830 |
Ultrasound, transvaginal |
328 |
242 |
$6K |
| 86704 |
|
338 |
284 |
$5K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
698 |
299 |
$5K |
| 84480 |
|
137 |
98 |
$5K |
| 82043 |
|
799 |
702 |
$5K |
| 73110 |
|
374 |
320 |
$5K |
| 82565 |
|
922 |
797 |
$5K |
| 77336 |
|
30 |
12 |
$4K |
| 87449 |
|
380 |
325 |
$4K |
| 87641 |
|
290 |
217 |
$4K |
| 83880 |
|
1,479 |
1,193 |
$4K |
| 87338 |
|
236 |
200 |
$4K |
| 86376 |
|
234 |
192 |
$4K |
| 88304 |
|
431 |
307 |
$4K |
| 83993 |
|
198 |
171 |
$4K |
| 78227 |
|
19 |
12 |
$4K |
| 36591 |
|
914 |
351 |
$4K |
| 85730 |
|
5,152 |
4,186 |
$4K |
| 96376 |
|
1,668 |
930 |
$4K |
| Q3014 |
Telehealth originating site facility fee |
326 |
305 |
$4K |
| 84146 |
|
467 |
362 |
$4K |
| 0352U |
|
271 |
260 |
$4K |
| 77066 |
Tomosynthesis, mammo |
89 |
81 |
$4K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
19 |
12 |
$4K |
| 84156 |
|
1,025 |
822 |
$4K |
| 83615 |
|
673 |
504 |
$3K |
| 82947 |
|
600 |
485 |
$3K |
| 83001 |
|
228 |
195 |
$3K |
| 82248 |
|
392 |
291 |
$3K |
| 83690 |
|
7,704 |
6,136 |
$3K |
| 87420 |
|
116 |
114 |
$3K |
| 82951 |
|
173 |
154 |
$3K |
| 87324 |
|
337 |
284 |
$3K |
| 86708 |
|
134 |
109 |
$3K |
| 72072 |
|
117 |
98 |
$3K |
| 70496 |
|
90 |
78 |
$3K |
| 29580 |
|
36 |
12 |
$3K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
4,955 |
2,977 |
$3K |
| 82962 |
|
5,303 |
3,105 |
$3K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
11,908 |
8,938 |
$2K |
| J0735 |
Injection, clonidine hydrochloride, 1 mg |
255 |
235 |
$2K |
| 64633 |
|
72 |
52 |
$2K |
| 01936 |
|
180 |
161 |
$2K |
| 86705 |
|
108 |
81 |
$2K |
| 74019 |
|
43 |
36 |
$2K |
| 80074 |
|
114 |
86 |
$2K |
| 84703 |
|
2,507 |
1,923 |
$2K |
| 84520 |
|
389 |
326 |
$2K |
| 72220 |
|
89 |
81 |
$2K |
| 86480 |
|
52 |
48 |
$2K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
10,093 |
6,997 |
$2K |
| 85045 |
|
250 |
201 |
$2K |
| 83605 |
|
1,304 |
960 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
157 |
100 |
$2K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,043 |
890 |
$2K |
| 80321 |
|
2,865 |
2,157 |
$2K |
| J2805 |
Injection, sincalide, 5 micrograms |
19 |
12 |
$2K |
| 87329 |
|
121 |
107 |
$1K |
| 73590 |
|
130 |
114 |
$1K |
| 77062 |
|
89 |
81 |
$1K |
| 82670 |
|
103 |
95 |
$1K |
| 73700 |
|
14 |
14 |
$1K |
| 81025 |
|
3,952 |
2,940 |
$1K |
| 84145 |
|
566 |
430 |
$1K |
| 88341 |
|
18 |
14 |
$1K |
| 71101 |
|
69 |
57 |
$1K |
| 87328 |
|
121 |
107 |
$1K |
| 72146 |
|
13 |
12 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,538 |
1,821 |
$1K |
| 73080 |
|
98 |
80 |
$1K |
| 84481 |
|
40 |
38 |
$1K |
| 82550 |
|
387 |
252 |
$1K |
| 92523 |
|
13 |
13 |
$1K |
| 93226 |
|
12 |
12 |
$1K |
| 96415 |
|
15 |
12 |
$988.56 |
| 82378 |
|
185 |
112 |
$954.62 |
| 87209 |
|
61 |
51 |
$948.38 |
| 85379 |
|
1,101 |
876 |
$870.33 |
| 84436 |
|
581 |
481 |
$775.89 |
| 86701 |
|
70 |
64 |
$764.62 |
| 87040 |
|
725 |
478 |
$761.74 |
| J1815 |
Injection, insulin, per 5 units |
305 |
137 |
$741.77 |
| 87075 |
|
147 |
123 |
$731.19 |
| 87071 |
|
185 |
117 |
$716.88 |
| A4649 |
Surgical supply; miscellaneous |
466 |
430 |
$689.79 |
| 87177 |
|
61 |
51 |
$681.65 |
| 86200 |
|
36 |
25 |
$672.51 |
| 72040 |
|
27 |
24 |
$653.20 |
| 82375 |
|
429 |
288 |
$637.64 |
| 82247 |
|
63 |
37 |
$604.33 |
| 80349 |
|
52 |
44 |
$604.26 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
336 |
225 |
$584.66 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
751 |
354 |
$584.48 |
| 74022 |
|
148 |
104 |
$532.40 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
788 |
655 |
$524.45 |
| 86800 |
|
21 |
15 |
$517.86 |
| 83002 |
|
41 |
39 |
$509.77 |
| 93225 |
|
12 |
12 |
$489.21 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,872 |
1,248 |
$489.01 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,152 |
1,103 |
$485.82 |
| 87205 |
|
99 |
71 |
$476.92 |
| 84402 |
|
34 |
30 |
$446.78 |
| 84144 |
|
20 |
14 |
$430.15 |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
39 |
29 |
$427.38 |
| 82652 |
|
20 |
18 |
$417.36 |
| 84165 |
|
37 |
26 |
$401.28 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
1,686 |
1,407 |
$393.06 |
| 83630 |
|
22 |
18 |
$385.46 |
| 83050 |
|
421 |
286 |
$383.51 |
| 73521 |
|
12 |
12 |
$353.38 |
| J2060 |
Injection, lorazepam, 2 mg |
467 |
293 |
$351.22 |
| 86308 |
|
16 |
12 |
$339.02 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,580 |
1,333 |
$297.98 |
| 86235 |
|
27 |
13 |
$287.88 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
772 |
561 |
$285.02 |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
39 |
38 |
$270.92 |
| 85018 |
|
54 |
39 |
$267.22 |
| 73620 |
|
14 |
12 |
$264.63 |
| 83721 |
|
38 |
28 |
$257.04 |
| 99219 |
|
67 |
29 |
$241.56 |
| 82103 |
|
18 |
12 |
$222.75 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,850 |
1,839 |
$222.26 |
| A9270 |
Non-covered item or service |
3,181 |
1,161 |
$218.19 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
393 |
256 |
$200.86 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
5,537 |
4,411 |
$195.99 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,125 |
734 |
$193.71 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
9,139 |
6,033 |
$191.72 |
| 82525 |
|
17 |
14 |
$187.38 |
| 82533 |
|
15 |
12 |
$179.06 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
657 |
496 |
$174.15 |
| 84238 |
|
12 |
12 |
$172.20 |
| 86015 |
|
12 |
12 |
$168.15 |
| 85014 |
|
89 |
65 |
$136.97 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,586 |
887 |
$126.12 |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
24 |
12 |
$124.34 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
213 |
117 |
$116.51 |
| 84460 |
|
15 |
12 |
$113.69 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
901 |
833 |
$111.60 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
1,474 |
462 |
$102.52 |
| J1644 |
Injection, heparin sodium, per 1000 units |
874 |
379 |
$89.88 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
353 |
289 |
$72.84 |
| 73140 |
|
21 |
12 |
$70.40 |
| 86318 |
|
12 |
12 |
$67.70 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
596 |
544 |
$56.54 |
| 73090 |
|
46 |
39 |
$52.83 |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
137 |
85 |
$51.46 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
77 |
40 |
$49.44 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,389 |
1,087 |
$47.21 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
567 |
364 |
$46.09 |
| 82040 |
|
25 |
25 |
$44.80 |
| C9113 |
Injection, pantoprazole sodium, per vial |
27 |
19 |
$35.74 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
592 |
417 |
$30.80 |
| 82140 |
|
23 |
14 |
$30.28 |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
97 |
14 |
$28.18 |
| A6199 |
Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches |
136 |
95 |
$27.25 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
179 |
147 |
$26.47 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
72 |
41 |
$25.68 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
62 |
55 |
$20.45 |
| J2704 |
Injection, propofol, 10 mg |
4,161 |
3,036 |
$20.28 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
56 |
27 |
$18.96 |
| 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 |
188 |
153 |
$16.84 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
254 |
224 |
$12.96 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
114 |
81 |
$11.09 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
491 |
365 |
$9.12 |
| J3480 |
Injection, potassium chloride, per 2 meq |
170 |
117 |
$8.78 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
1,419 |
1,180 |
$5.71 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
717 |
542 |
$3.31 |
| J1940 |
Injection, furosemide, up to 20 mg |
17 |
12 |
$1.82 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
185 |
144 |
$0.92 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
48 |
26 |
$0.70 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
266 |
219 |
$0.09 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
2,982 |
2,599 |
$0.00 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
289 |
251 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
1,894 |
1,620 |
$0.00 |
| A9541 |
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries |
198 |
179 |
$0.00 |
| 88312 |
|
70 |
64 |
$0.00 |
| 99233 |
Prolong inpt eval add15 m |
21 |
12 |
$0.00 |
| 00840 |
|
58 |
39 |
$0.00 |
| 99408 |
|
29 |
25 |
$0.00 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
30 |
25 |
$0.00 |
| A9537 |
Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries |
39 |
25 |
$0.00 |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
108 |
99 |
$0.00 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
59 |
51 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
329 |
218 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
166 |
101 |
$0.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
17 |
15 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
117 |
82 |
$0.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
30 |
24 |
$0.00 |
| A4217 |
Sterile water/saline, 500 ml |
12 |
12 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
67 |
41 |
$0.00 |
| 00790 |
|
17 |
13 |
$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 |
12 |
12 |
$0.00 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
22 |
15 |
$0.00 |