| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
35,904 |
28,556 |
$21.82M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
29,183 |
25,201 |
$11.99M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
7,021 |
6,348 |
$4.43M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
12,003 |
10,841 |
$3.19M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
16,111 |
12,986 |
$2.29M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
2,166 |
1,911 |
$2.19M |
| G0378 |
Hospital observation service, per hour |
2,757 |
1,769 |
$2.06M |
| J3490 |
Unclassified drugs |
88,845 |
28,293 |
$1.95M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
13,839 |
9,530 |
$1.69M |
| 96375 |
Therapeutic injection; each additional sequential IV push |
18,051 |
14,243 |
$1.47M |
| 41899 |
Unlisted procedure, dentoalveolar structures |
729 |
667 |
$1.45M |
| 70450 |
Computed tomography, head or brain; without contrast material |
4,965 |
4,426 |
$1.40M |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
10,463 |
7,390 |
$1.20M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,774 |
8,098 |
$1.17M |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
8,709 |
7,691 |
$1.16M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
3,096 |
2,931 |
$1.03M |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
2,112 |
1,996 |
$881K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,847 |
1,710 |
$865K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
8,922 |
5,340 |
$845K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
17,994 |
14,859 |
$820K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,774 |
1,682 |
$813K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
2,020 |
1,860 |
$730K |
| 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 |
7,401 |
5,311 |
$686K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
5,186 |
4,444 |
$679K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
8,256 |
2,687 |
$535K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,404 |
2,931 |
$482K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
4,175 |
3,780 |
$442K |
| 71046 |
Radiologic examination, chest; 2 views |
9,166 |
8,477 |
$438K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,842 |
1,722 |
$438K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
9,015 |
7,966 |
$415K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
669 |
612 |
$413K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
7,026 |
2,216 |
$412K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,121 |
1,033 |
$402K |
| 71045 |
Radiologic examination, chest; single view |
9,715 |
8,296 |
$398K |
| 80053 |
Comprehensive metabolic panel |
51,207 |
41,233 |
$398K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
320 |
270 |
$397K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,582 |
2,936 |
$394K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,017 |
921 |
$388K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,112 |
5,177 |
$341K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
59,456 |
46,338 |
$338K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
897 |
850 |
$316K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,373 |
1,277 |
$284K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,472 |
1,941 |
$269K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
2,092 |
1,579 |
$241K |
| 93017 |
|
699 |
659 |
$240K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
6,930 |
5,591 |
$229K |
| 76830 |
Ultrasound, transvaginal |
1,197 |
1,111 |
$227K |
| 96376 |
|
3,718 |
3,007 |
$212K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
4,571 |
3,874 |
$212K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
12,598 |
10,162 |
$205K |
| 88312 |
|
2,049 |
1,639 |
$205K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
12,782 |
10,241 |
$203K |
| 84443 |
Thyroid stimulating hormone (TSH) |
13,304 |
12,149 |
$175K |
| 72100 |
|
1,592 |
1,515 |
$166K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,033 |
816 |
$156K |
| S0028 |
Injection, famotidine, 20 mg |
3,179 |
2,613 |
$151K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
4,632 |
4,275 |
$145K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
4,636 |
4,275 |
$145K |
| 83880 |
|
6,797 |
5,670 |
$144K |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
1,802 |
1,567 |
$137K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
2,638 |
1,020 |
$123K |
| 73610 |
|
1,872 |
1,666 |
$122K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
7,090 |
5,932 |
$121K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
9,468 |
7,039 |
$120K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
271 |
239 |
$118K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,949 |
2,593 |
$115K |
| 73630 |
|
2,062 |
1,808 |
$113K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,402 |
1,297 |
$113K |
| 71250 |
|
404 |
386 |
$112K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
189 |
176 |
$112K |
| 70486 |
|
337 |
311 |
$111K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,761 |
1,532 |
$111K |
| 73562 |
|
1,743 |
1,474 |
$109K |
| 88313 |
|
1,805 |
1,437 |
$109K |
| J7050 |
Infusion, normal saline solution, 250 cc |
3,949 |
2,879 |
$109K |
| 73030 |
|
2,011 |
1,751 |
$108K |
| J2704 |
Injection, propofol, 10 mg |
5,317 |
4,143 |
$92K |
| 73130 |
|
1,454 |
1,244 |
$91K |
| 73110 |
|
1,471 |
1,265 |
$91K |
| 94726 |
|
571 |
548 |
$91K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
220 |
160 |
$81K |
| 93971 |
|
496 |
468 |
$81K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
2,461 |
1,433 |
$80K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
943 |
655 |
$78K |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
2,895 |
2,442 |
$77K |
| 84484 |
|
10,231 |
7,686 |
$71K |
| 83690 |
|
13,721 |
11,397 |
$70K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
133 |
119 |
$66K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,601 |
4,129 |
$65K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,620 |
3,059 |
$65K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
559 |
513 |
$64K |
| 83735 |
|
14,095 |
11,037 |
$63K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
20,151 |
9,341 |
$61K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,669 |
3,085 |
$60K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,702 |
2,549 |
$58K |
| J2060 |
Injection, lorazepam, 2 mg |
3,238 |
2,674 |
$57K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,573 |
3,028 |
$57K |
| 64483 |
|
140 |
129 |
$57K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
8,156 |
7,289 |
$55K |
| 73502 |
|
868 |
801 |
$53K |
| 80061 |
Lipid panel |
5,396 |
5,072 |
$52K |
| 94729 |
|
611 |
583 |
$50K |
| 84439 |
|
6,688 |
5,998 |
$49K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,961 |
2,185 |
$49K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
234 |
220 |
$48K |
| 10060 |
|
394 |
349 |
$48K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
3,083 |
2,621 |
$48K |
| 82962 |
|
15,536 |
4,920 |
$46K |
| 97597 |
|
478 |
253 |
$45K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,076 |
1,994 |
$45K |
| 96367 |
|
1,266 |
1,048 |
$43K |
| 82077 |
|
3,667 |
2,831 |
$43K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,934 |
5,536 |
$42K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,309 |
995 |
$41K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
1,461 |
1,105 |
$41K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
7,333 |
6,036 |
$41K |
| 90715 |
|
759 |
690 |
$41K |
| 81025 |
|
5,977 |
5,280 |
$40K |
| 70496 |
|
90 |
82 |
$38K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,323 |
1,775 |
$38K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
2,072 |
1,635 |
$36K |
| 74018 |
|
639 |
583 |
$34K |
| 81001 |
|
13,585 |
11,641 |
$34K |
| 72050 |
|
342 |
326 |
$34K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,664 |
1,236 |
$33K |
| 80305 |
|
3,313 |
2,935 |
$33K |
| J3535 |
Drug administered through a metered dose inhaler |
1,287 |
792 |
$30K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
214 |
122 |
$30K |
| 76536 |
|
176 |
168 |
$29K |
| 83605 |
|
3,877 |
3,205 |
$28K |
| 12001 |
|
327 |
310 |
$28K |
| 84703 |
|
4,436 |
3,895 |
$28K |
| 87653 |
|
831 |
791 |
$28K |
| 87486 |
|
897 |
850 |
$27K |
| 87186 |
|
3,776 |
3,155 |
$27K |
| 87581 |
|
897 |
850 |
$27K |
| 86780 |
|
2,234 |
2,147 |
$27K |
| 86803 |
|
2,113 |
2,036 |
$26K |
| 86140 |
|
6,540 |
5,739 |
$25K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
68 |
65 |
$25K |
| 94010 |
|
182 |
175 |
$25K |
| 36415 |
Collection of venous blood by venipuncture |
50,468 |
40,112 |
$24K |
| 84702 |
|
1,795 |
1,333 |
$24K |
| 82728 |
|
2,338 |
2,146 |
$23K |
| 73564 |
|
408 |
338 |
$22K |
| 87077 |
|
3,089 |
2,535 |
$22K |
| 82607 |
|
2,012 |
1,884 |
$21K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,505 |
1,128 |
$21K |
| 82803 |
|
1,355 |
1,073 |
$21K |
| 76801 |
|
74 |
66 |
$20K |
| J1756 |
Injection, iron sucrose, 1 mg |
227 |
114 |
$19K |
| 86850 |
|
3,056 |
2,583 |
$19K |
| 85610 |
|
6,649 |
5,567 |
$18K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
762 |
688 |
$18K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
91 |
89 |
$17K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
139 |
124 |
$17K |
| 81003 |
|
9,703 |
8,633 |
$17K |
| 73140 |
|
361 |
326 |
$16K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,464 |
1,205 |
$16K |
| 88307 |
|
50 |
37 |
$16K |
| 87340 |
|
1,654 |
1,597 |
$15K |
| J1790 |
Injection, droperidol, up to 5 mg |
810 |
660 |
$15K |
| 87040 |
|
2,191 |
1,164 |
$15K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
51 |
51 |
$15K |
| 73080 |
|
232 |
214 |
$15K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
13 |
13 |
$15K |
| 82550 |
|
3,290 |
2,791 |
$14K |
| J1630 |
Injection, haloperidol, up to 5 mg |
726 |
530 |
$14K |
| 76775 |
|
55 |
53 |
$13K |
| 85730 |
|
3,323 |
2,912 |
$13K |
| 83655 |
|
1,000 |
973 |
$12K |
| 87070 |
|
1,631 |
1,516 |
$12K |
| 94060 |
|
54 |
51 |
$12K |
| 73560 |
|
284 |
254 |
$12K |
| 88304 |
|
300 |
231 |
$12K |
| 87081 |
|
1,855 |
1,729 |
$11K |
| J3411 |
Injection, thiamine hcl, 100 mg |
447 |
335 |
$11K |
| 83874 |
|
1,285 |
1,171 |
$11K |
| 82553 |
|
1,429 |
1,228 |
$11K |
| 85652 |
|
5,229 |
4,668 |
$11K |
| 70491 |
|
28 |
24 |
$11K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
16 |
12 |
$10K |
| 85027 |
|
1,749 |
1,610 |
$10K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,022 |
944 |
$10K |
| 84100 |
|
3,390 |
2,507 |
$10K |
| 93226 |
|
56 |
50 |
$10K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
44 |
38 |
$10K |
| 97602 |
|
61 |
27 |
$9K |
| 76642 |
|
99 |
96 |
$9K |
| 83550 |
|
1,437 |
1,317 |
$9K |
| J1940 |
Injection, furosemide, up to 20 mg |
857 |
593 |
$9K |
| 87210 |
|
1,796 |
1,669 |
$9K |
| 83540 |
|
1,841 |
1,686 |
$9K |
| 93225 |
|
69 |
63 |
$8K |
| 12002 |
|
76 |
72 |
$8K |
| 87522 |
Neg quan hep c or qual rna |
176 |
168 |
$8K |
| 84481 |
|
509 |
485 |
$8K |
| 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 |
170 |
163 |
$8K |
| 73590 |
|
140 |
121 |
$7K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
318 |
233 |
$7K |
| 86901 |
|
3,235 |
2,730 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
492 |
464 |
$7K |
| 86900 |
|
3,193 |
2,695 |
$7K |
| 85379 |
|
968 |
875 |
$7K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
269 |
258 |
$7K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
116 |
53 |
$6K |
| 82043 |
|
1,397 |
1,327 |
$6K |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
37 |
26 |
$6K |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
105 |
93 |
$6K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
16 |
14 |
$6K |
| 86706 |
|
581 |
557 |
$6K |
| 87205 |
|
1,575 |
1,383 |
$5K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,987 |
1,712 |
$5K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
176 |
165 |
$5K |
| 82746 |
|
506 |
475 |
$5K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
26 |
24 |
$5K |
| J2785 |
Injection, regadenoson, 0.1 mg |
58 |
53 |
$5K |
| 93880 |
|
17 |
16 |
$5K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
122 |
113 |
$5K |
| 93976 |
|
18 |
15 |
$5K |
| 73221 |
|
13 |
12 |
$4K |
| 97162 |
|
71 |
67 |
$4K |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
1,041 |
847 |
$4K |
| 82565 |
|
1,230 |
1,114 |
$3K |
| 86704 |
|
336 |
320 |
$3K |
| 87507 |
|
12 |
12 |
$3K |
| 86703 |
|
287 |
268 |
$3K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
14 |
12 |
$3K |
| C9113 |
Injection, pantoprazole sodium, per vial |
71 |
55 |
$3K |
| 86923 |
|
50 |
25 |
$3K |
| 94644 |
|
70 |
64 |
$3K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
79 |
77 |
$3K |
| 93296 |
|
16 |
16 |
$3K |
| 84112 |
|
31 |
26 |
$3K |
| 73090 |
|
40 |
38 |
$3K |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
303 |
262 |
$3K |
| M0222 |
Intravenous injection, bebtelovimab, includes injection and post administration monitoring |
20 |
12 |
$2K |
| 82150 |
|
455 |
412 |
$2K |
| 77066 |
Tomosynthesis, mammo |
12 |
12 |
$2K |
| 29125 |
|
39 |
36 |
$2K |
| 86003 |
|
171 |
86 |
$2K |
| 84550 |
|
688 |
572 |
$2K |
| 86038 |
|
203 |
189 |
$2K |
| 86708 |
|
191 |
186 |
$2K |
| 96368 |
|
70 |
60 |
$2K |
| G0145 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision |
35 |
25 |
$2K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
564 |
211 |
$2K |
| 80076 |
|
218 |
207 |
$2K |
| 80074 |
|
37 |
37 |
$2K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
90 |
75 |
$2K |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
151 |
130 |
$2K |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
12 |
12 |
$1K |
| 86481 |
|
15 |
15 |
$1K |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
434 |
368 |
$1K |
| 82784 |
|
172 |
140 |
$1K |
| 86762 |
|
84 |
82 |
$1K |
| J3360 |
Injection, diazepam, up to 5 mg |
30 |
28 |
$1K |
| 93922 |
|
13 |
12 |
$1K |
| 72072 |
|
13 |
12 |
$1K |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
61 |
47 |
$1K |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
154 |
146 |
$1K |
| 84145 |
|
86 |
59 |
$1K |
| 86705 |
|
84 |
81 |
$919.99 |
| 71101 |
|
15 |
12 |
$909.07 |
| C1769 |
Guide wire |
23 |
12 |
$858.58 |
| 87075 |
|
127 |
95 |
$830.18 |
| 83615 |
|
243 |
185 |
$827.11 |
| J1815 |
Injection, insulin, per 5 units |
64 |
37 |
$693.20 |
| 99152 |
|
25 |
25 |
$685.41 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
39 |
38 |
$668.16 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
227 |
195 |
$544.10 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
19 |
12 |
$543.69 |
| 82140 |
|
44 |
38 |
$542.81 |
| 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 |
627 |
570 |
$497.22 |
| 82570 |
|
122 |
104 |
$488.85 |
| 12011 |
|
15 |
13 |
$484.98 |
| 84156 |
|
157 |
130 |
$475.10 |
| J3480 |
Injection, potassium chloride, per 2 meq |
16 |
13 |
$439.85 |
| Q2039 |
Influenza virus vaccine, not otherwise specified |
13 |
12 |
$436.38 |
| 86200 |
|
39 |
38 |
$407.85 |
| 83516 |
|
31 |
24 |
$402.65 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
14 |
14 |
$368.49 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
68 |
54 |
$360.45 |
| 83970 |
|
13 |
12 |
$355.04 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
101 |
94 |
$345.83 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
98 |
79 |
$329.22 |
| 84403 |
|
17 |
16 |
$323.92 |
| 85014 |
|
211 |
163 |
$304.03 |
| 87493 |
|
13 |
12 |
$287.00 |
| 85018 |
|
187 |
154 |
$283.10 |
| 86709 |
|
29 |
29 |
$279.32 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
13 |
13 |
$270.50 |
| 88142 |
|
14 |
14 |
$232.01 |
| 82785 |
|
14 |
13 |
$192.21 |
| 83001 |
|
14 |
13 |
$162.57 |
| 82533 |
|
13 |
12 |
$157.26 |
| 86376 |
|
13 |
12 |
$125.84 |
| 86431 |
|
25 |
25 |
$114.03 |
| J2560 |
Injection, phenobarbital sodium, up to 120 mg |
420 |
357 |
$109.27 |
| 85007 |
|
26 |
25 |
$80.65 |
| 82950 |
|
14 |
13 |
$75.60 |
| 82010 |
|
15 |
14 |
$70.63 |
| 84512 |
|
19 |
13 |
$67.13 |
| 84132 |
|
13 |
12 |
$21.88 |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
334 |
321 |
$0.00 |
| 0353U |
|
287 |
272 |
$0.00 |
| J0670 |
Injection, mepivacaine hydrochloride, per 10 ml |
12 |
12 |
$0.00 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
13 |
12 |
$0.00 |
| 36416 |
|
1,602 |
1,456 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
105 |
78 |
$0.00 |
| 86364 |
|
58 |
57 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
114 |
99 |
$0.00 |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
29 |
26 |
$0.00 |