| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
67,669 |
57,253 |
$8.48M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
59,868 |
48,211 |
$6.40M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
52,170 |
45,198 |
$5.85M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
17,029 |
14,054 |
$5.43M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
22,918 |
21,630 |
$1.90M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,552 |
12,310 |
$1.50M |
| 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 |
22,059 |
20,057 |
$1.29M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
8,638 |
7,996 |
$1.25M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
9,797 |
7,431 |
$962K |
| S9485 |
Crisis intervention mental health services, per diem |
1,640 |
1,191 |
$904K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
7,977 |
6,280 |
$874K |
| 70450 |
Computed tomography, head or brain; without contrast material |
8,176 |
7,510 |
$820K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
13,761 |
4,303 |
$742K |
| 62323 |
|
2,182 |
2,026 |
$720K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
19,363 |
16,296 |
$661K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
5,154 |
4,668 |
$606K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
552 |
549 |
$600K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
101,727 |
82,759 |
$498K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
2,966 |
2,569 |
$438K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
17,861 |
15,245 |
$406K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
17,995 |
16,202 |
$369K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,976 |
1,202 |
$363K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
12,341 |
11,966 |
$339K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
12,243 |
11,871 |
$336K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
8,728 |
8,217 |
$330K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
6,694 |
6,517 |
$328K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
7,410 |
7,229 |
$327K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,374 |
2,242 |
$326K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
6,514 |
4,654 |
$325K |
| G0378 |
Hospital observation service, per hour |
8,101 |
5,973 |
$313K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,910 |
1,329 |
$309K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
3,995 |
2,621 |
$305K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
78,566 |
62,918 |
$286K |
| 93971 |
|
1,908 |
1,804 |
$265K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,564 |
1,534 |
$252K |
| 59025 |
Fetal non-stress test |
793 |
436 |
$230K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
293 |
287 |
$229K |
| 71046 |
Radiologic examination, chest; 2 views |
19,543 |
17,971 |
$219K |
| 84443 |
Thyroid stimulating hormone (TSH) |
24,754 |
23,953 |
$215K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,411 |
1,322 |
$189K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
12,044 |
11,878 |
$188K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
958 |
929 |
$184K |
| 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 |
5,013 |
4,360 |
$183K |
| 80050 |
General health panel |
9,685 |
9,440 |
$156K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
6,417 |
6,336 |
$149K |
| 97161 |
|
2,944 |
2,736 |
$149K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
27,247 |
26,515 |
$144K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
5,505 |
5,347 |
$142K |
| 76642 |
|
1,071 |
1,056 |
$138K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
2,075 |
1,104 |
$135K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
6,338 |
6,069 |
$133K |
| 87400 |
|
12,776 |
6,146 |
$132K |
| 84484 |
|
18,075 |
14,359 |
$131K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,405 |
1,399 |
$130K |
| 99215 |
Prolong outpt/office vis |
1,108 |
1,065 |
$127K |
| 93975 |
|
805 |
768 |
$125K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,044 |
1,023 |
$123K |
| 80053 |
Comprehensive metabolic panel |
31,799 |
28,429 |
$119K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
78 |
77 |
$110K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
17,866 |
13,886 |
$110K |
| 87088 |
|
19,213 |
17,474 |
$106K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
4,361 |
3,912 |
$103K |
| 80061 |
Lipid panel |
30,450 |
29,795 |
$103K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
20,293 |
17,613 |
$99K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
29,770 |
25,465 |
$98K |
| 80076 |
|
33,012 |
29,532 |
$95K |
| 83690 |
|
16,292 |
14,198 |
$95K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,085 |
1,017 |
$86K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
4,508 |
4,429 |
$84K |
| 84703 |
|
12,628 |
11,649 |
$83K |
| ATP08 |
|
13,892 |
10,838 |
$78K |
| 83735 |
|
17,435 |
12,597 |
$77K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
553 |
534 |
$74K |
| 87480 |
|
4,210 |
3,958 |
$67K |
| 87510 |
|
4,209 |
3,957 |
$67K |
| 87660 |
|
4,210 |
3,958 |
$67K |
| ATP15 |
|
8,374 |
6,619 |
$65K |
| 85027 |
|
15,853 |
13,174 |
$65K |
| 87081 |
|
11,040 |
10,384 |
$61K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
425 |
388 |
$60K |
| 87430 |
|
5,181 |
5,015 |
$59K |
| 81001 |
|
24,219 |
21,971 |
$58K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
652 |
646 |
$57K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
587 |
539 |
$56K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12,407 |
9,748 |
$56K |
| 87070 |
|
8,391 |
7,998 |
$56K |
| 36415 |
Collection of venous blood by venipuncture |
58,857 |
43,609 |
$55K |
| 12001 |
|
242 |
232 |
$52K |
| 86803 |
|
5,186 |
4,993 |
$52K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
5,181 |
2,265 |
$51K |
| Q0138 |
Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) |
135 |
92 |
$48K |
| 82728 |
|
6,291 |
5,991 |
$47K |
| 84702 |
|
3,481 |
2,637 |
$47K |
| 86780 |
|
4,214 |
4,083 |
$46K |
| 84439 |
|
7,673 |
7,426 |
$45K |
| 82607 |
|
5,475 |
5,324 |
$45K |
| 90715 |
|
1,964 |
1,887 |
$43K |
| 76830 |
Ultrasound, transvaginal |
457 |
449 |
$41K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
289 |
287 |
$40K |
| 77080 |
|
941 |
930 |
$40K |
| 87077 |
|
7,191 |
6,685 |
$38K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
561 |
208 |
$36K |
| 87186 |
|
6,103 |
5,739 |
$35K |
| 73630 |
|
2,963 |
2,824 |
$34K |
| 86140 |
|
9,468 |
8,648 |
$34K |
| 83880 |
|
2,412 |
2,160 |
$33K |
| 87040 |
|
3,731 |
2,770 |
$33K |
| 83550 |
|
6,709 |
6,451 |
$33K |
| 86850 |
|
4,639 |
4,337 |
$31K |
| 72100 |
|
1,937 |
1,834 |
$30K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
16,027 |
12,187 |
$29K |
| 85610 |
|
13,234 |
9,225 |
$28K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,693 |
707 |
$28K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
3,041 |
2,825 |
$28K |
| 70498 |
|
327 |
292 |
$28K |
| 85379 |
|
3,937 |
3,715 |
$28K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
36 |
36 |
$27K |
| 87340 |
|
3,346 |
3,291 |
$27K |
| 83540 |
|
7,098 |
6,794 |
$27K |
| 85007 |
|
10,761 |
8,933 |
$26K |
| 73130 |
|
2,473 |
2,345 |
$26K |
| 73030 |
|
2,188 |
1,974 |
$25K |
| 96415 |
|
350 |
273 |
$24K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
17,237 |
10,382 |
$24K |
| 86618 |
|
1,872 |
1,830 |
$24K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
7,427 |
4,832 |
$24K |
| 84153 |
|
1,665 |
1,642 |
$24K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
14,834 |
12,493 |
$23K |
| 81025 |
|
3,996 |
3,795 |
$23K |
| 81513 |
|
183 |
175 |
$22K |
| 81003 |
|
10,728 |
10,081 |
$21K |
| 73610 |
|
2,379 |
2,214 |
$21K |
| 71045 |
Radiologic examination, chest; single view |
7,265 |
6,506 |
$21K |
| 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 |
1,235 |
1,226 |
$20K |
| G0382 |
Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
855 |
810 |
$20K |
| 82043 |
|
7,305 |
7,174 |
$20K |
| 83605 |
|
3,175 |
2,742 |
$20K |
| 84403 |
|
900 |
881 |
$19K |
| 71250 |
|
455 |
415 |
$19K |
| 97803 |
|
310 |
288 |
$19K |
| 82105 |
|
1,253 |
1,246 |
$19K |
| 71271 |
|
391 |
386 |
$19K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,706 |
3,440 |
$18K |
| ATP14 |
|
5,850 |
4,888 |
$18K |
| 86787 |
|
1,567 |
1,537 |
$18K |
| 86901 |
|
5,339 |
4,957 |
$18K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
8,602 |
6,840 |
$18K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
13,238 |
12,147 |
$18K |
| 86900 |
|
5,339 |
4,957 |
$17K |
| 86762 |
|
1,309 |
1,298 |
$17K |
| 83021 |
|
1,012 |
1,000 |
$17K |
| 85652 |
|
8,502 |
7,893 |
$17K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
5,908 |
4,739 |
$16K |
| 85730 |
|
3,568 |
3,237 |
$15K |
| 87205 |
|
4,616 |
4,311 |
$15K |
| G0476 |
Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test |
687 |
686 |
$14K |
| 96367 |
|
299 |
225 |
$14K |
| 82570 |
|
5,057 |
4,811 |
$14K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
17 |
12 |
$14K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
97 |
96 |
$14K |
| 74018 |
|
610 |
536 |
$14K |
| 76536 |
|
83 |
83 |
$13K |
| 83516 |
|
1,048 |
973 |
$13K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
7,324 |
5,824 |
$12K |
| 86480 |
|
243 |
240 |
$12K |
| 88342 |
|
207 |
202 |
$12K |
| 84100 |
|
3,696 |
2,789 |
$12K |
| 82746 |
|
1,498 |
1,425 |
$12K |
| 94060 |
|
82 |
80 |
$12K |
| 71048 |
|
490 |
475 |
$11K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
2,044 |
2,019 |
$11K |
| 86706 |
|
1,153 |
1,139 |
$10K |
| 97802 |
|
119 |
119 |
$10K |
| 77065 |
Tomosynthesis, mammo |
114 |
107 |
$10K |
| 87420 |
|
853 |
822 |
$10K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
7,652 |
6,565 |
$10K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
375 |
339 |
$10K |
| 86039 |
|
1,037 |
1,020 |
$9K |
| J2704 |
Injection, propofol, 10 mg |
9,767 |
8,528 |
$9K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
40 |
40 |
$9K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
69 |
65 |
$9K |
| 73502 |
|
781 |
720 |
$8K |
| G0481 |
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; 8-14 drug class(es), including metabolite(s) if performed |
92 |
91 |
$8K |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
269 |
194 |
$8K |
| 73110 |
|
673 |
646 |
$8K |
| 20553 |
|
94 |
92 |
$8K |
| J3490 |
Unclassified drugs |
893 |
810 |
$7K |
| 83001 |
|
415 |
413 |
$7K |
| 82550 |
|
2,431 |
2,228 |
$7K |
| ATP17 |
|
6,193 |
5,529 |
$7K |
| 84402 |
|
295 |
289 |
$6K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
3,184 |
2,673 |
$6K |
| 90686 |
|
326 |
288 |
$6K |
| 73560 |
|
2,251 |
2,051 |
$6K |
| 77066 |
Tomosynthesis, mammo |
83 |
81 |
$6K |
| 99443 |
|
318 |
306 |
$6K |
| J7050 |
Infusion, normal saline solution, 250 cc |
3,069 |
1,635 |
$6K |
| J2060 |
Injection, lorazepam, 2 mg |
3,520 |
2,664 |
$6K |
| 84146 |
|
333 |
333 |
$6K |
| 94726 |
|
83 |
79 |
$6K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,689 |
1,557 |
$6K |
| 84550 |
|
2,398 |
2,193 |
$6K |
| 94729 |
|
67 |
66 |
$6K |
| 87481 |
|
185 |
176 |
$6K |
| 80074 |
|
138 |
138 |
$6K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
185 |
176 |
$5K |
| 82248 |
|
2,174 |
1,735 |
$5K |
| 82950 |
|
1,209 |
1,185 |
$5K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
4,879 |
4,506 |
$5K |
| 82565 |
|
4,837 |
4,565 |
$5K |
| 80179 |
|
501 |
461 |
$5K |
| 82784 |
|
688 |
650 |
$5K |
| 36591 |
|
999 |
560 |
$5K |
| 80143 |
|
589 |
482 |
$5K |
| ATP03 |
|
2,425 |
2,118 |
$5K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
7,463 |
6,710 |
$5K |
| 70496 |
|
319 |
284 |
$5K |
| 73562 |
|
81 |
81 |
$5K |
| 77061 |
|
66 |
62 |
$4K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
271 |
250 |
$4K |
| 20610 |
|
74 |
70 |
$4K |
| 83721 |
|
1,017 |
990 |
$4K |
| 73564 |
|
160 |
156 |
$4K |
| 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 |
2,154 |
1,946 |
$4K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
4,783 |
4,195 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
18 |
12 |
$4K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
22 |
18 |
$3K |
| 87210 |
|
453 |
366 |
$3K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,441 |
1,652 |
$3K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
13 |
13 |
$3K |
| 62321 |
|
12 |
12 |
$3K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,875 |
2,439 |
$3K |
| 85008 |
|
2,308 |
2,155 |
$3K |
| 83970 |
|
242 |
234 |
$3K |
| 90658 |
|
90 |
90 |
$3K |
| 97165 |
|
73 |
64 |
$3K |
| 86376 |
|
213 |
178 |
$3K |
| 86665 |
|
173 |
90 |
$3K |
| 70486 |
|
56 |
54 |
$3K |
| 84520 |
|
3,138 |
2,945 |
$3K |
| 83002 |
|
160 |
159 |
$3K |
| 74019 |
|
51 |
51 |
$2K |
| ATP09 |
|
571 |
434 |
$2K |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
31 |
31 |
$2K |
| 72110 |
|
54 |
53 |
$2K |
| J1644 |
Injection, heparin sodium, per 1000 units |
501 |
226 |
$2K |
| 80164 |
|
766 |
693 |
$2K |
| 98968 |
|
31 |
24 |
$2K |
| 88304 |
|
237 |
232 |
$2K |
| 12011 |
|
12 |
12 |
$2K |
| 70491 |
|
28 |
25 |
$2K |
| 86703 |
|
249 |
245 |
$2K |
| 82803 |
|
178 |
153 |
$2K |
| 82670 |
|
89 |
89 |
$2K |
| 76801 |
|
66 |
62 |
$2K |
| 12002 |
|
15 |
14 |
$2K |
| 84270 |
|
110 |
108 |
$2K |
| A9270 |
Non-covered item or service |
5,464 |
757 |
$2K |
| 86592 |
|
564 |
559 |
$2K |
| 84460 |
|
2,112 |
1,956 |
$2K |
| 86235 |
|
27 |
25 |
$2K |
| 86364 |
|
191 |
123 |
$2K |
| 84450 |
|
1,933 |
1,795 |
$2K |
| 83655 |
|
174 |
173 |
$2K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
260 |
221 |
$2K |
| 86431 |
|
365 |
360 |
$2K |
| ATP18 |
|
1,447 |
1,272 |
$2K |
| 72141 |
|
12 |
12 |
$2K |
| 98971 |
|
15 |
14 |
$2K |
| 99205 |
Prolong outpt/office vis |
14 |
14 |
$2K |
| Q9963 |
High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml |
254 |
250 |
$2K |
| ATP02 |
|
531 |
410 |
$2K |
| 86617 |
|
124 |
61 |
$2K |
| 73140 |
|
98 |
94 |
$2K |
| 96376 |
|
1,539 |
1,149 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,423 |
923 |
$2K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
89 |
41 |
$2K |
| 86308 |
|
308 |
302 |
$1K |
| 77062 |
|
28 |
28 |
$1K |
| 83525 |
|
124 |
124 |
$1K |
| 94664 |
|
176 |
175 |
$1K |
| 71101 |
|
191 |
172 |
$1K |
| 85651 |
|
705 |
699 |
$1K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,032 |
637 |
$1K |
| 81002 |
|
417 |
404 |
$1K |
| 93225 |
|
14 |
14 |
$1K |
| 76770 |
|
13 |
13 |
$1K |
| ATP07 |
|
389 |
352 |
$1K |
| ATP11 |
|
765 |
667 |
$1K |
| J0885 |
Injection, epoetin alfa, (for non-esrd use), 1000 units |
26 |
12 |
$1K |
| 87522 |
Neg quan hep c or qual rna |
27 |
26 |
$1K |
| C9113 |
Injection, pantoprazole sodium, per vial |
398 |
212 |
$1K |
| J1630 |
Injection, haloperidol, up to 5 mg |
429 |
353 |
$1K |
| 80178 |
|
507 |
439 |
$1K |
| 76870 |
|
12 |
12 |
$946.68 |
| 80355 |
|
59 |
58 |
$944.00 |
| 73080 |
|
144 |
140 |
$934.29 |
| 86664 |
|
63 |
62 |
$889.22 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
41 |
38 |
$859.89 |
| 97597 |
|
144 |
88 |
$804.53 |
| 86663 |
|
63 |
62 |
$788.95 |
| 99442 |
|
72 |
68 |
$722.30 |
| 86747 |
|
58 |
29 |
$689.52 |
| G0383 |
Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
66 |
63 |
$674.95 |
| ATP16 |
|
103 |
75 |
$646.26 |
| Q9953 |
Injection, iron-based magnetic resonance contrast agent, per ml |
412 |
391 |
$645.79 |
| 84481 |
|
84 |
82 |
$643.48 |
| G0381 |
Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
26 |
26 |
$641.26 |
| 86258 |
|
39 |
39 |
$624.67 |
| 93226 |
|
14 |
14 |
$582.40 |
| 86800 |
|
37 |
37 |
$520.99 |
| 96127 |
|
909 |
908 |
$481.52 |
| 86200 |
|
41 |
41 |
$457.44 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
57 |
54 |
$448.14 |
| 84156 |
|
131 |
110 |
$385.12 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
313 |
206 |
$341.21 |
| 73501 |
|
13 |
13 |
$315.32 |
| 86225 |
|
25 |
24 |
$300.96 |
| 90662 |
|
85 |
79 |
$279.87 |
| 82947 |
|
97 |
94 |
$237.50 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
2,200 |
1,862 |
$232.21 |
| Q2039 |
Influenza virus vaccine, not otherwise specified |
409 |
400 |
$202.85 |
| 86141 |
|
24 |
24 |
$188.96 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
722 |
614 |
$153.24 |
| 81015 |
|
57 |
55 |
$149.51 |
| 83020 |
|
13 |
13 |
$138.77 |
| 86705 |
|
14 |
14 |
$134.94 |
| 85384 |
|
19 |
16 |
$128.55 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
44 |
26 |
$125.71 |
| S0164 |
Injection, pantoprazole sodium, 40 mg |
72 |
38 |
$121.85 |
| 80320 |
|
386 |
147 |
$106.80 |
| 82140 |
|
30 |
26 |
$102.80 |
| G2062 |
Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 11-20 minutes |
15 |
15 |
$91.00 |
| 90732 |
|
24 |
24 |
$89.55 |
| 82465 |
|
24 |
24 |
$82.98 |
| 82009 |
|
27 |
25 |
$77.82 |
| 72202 |
|
13 |
13 |
$55.16 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
15 |
12 |
$50.40 |
| 82247 |
|
84 |
58 |
$44.30 |
| G0008 |
Administration of influenza virus vaccine |
485 |
476 |
$41.75 |
| 97116 |
|
17 |
13 |
$40.74 |
| 82977 |
|
12 |
12 |
$38.59 |
| 82378 |
|
13 |
12 |
$34.60 |
| J1020 |
Injection, methylprednisolone acetate, 20 mg |
137 |
128 |
$31.71 |
| 82150 |
|
15 |
13 |
$26.72 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
47 |
27 |
$18.73 |
| 73590 |
|
13 |
12 |
$18.39 |
| J3480 |
Injection, potassium chloride, per 2 meq |
167 |
97 |
$13.57 |
| J1790 |
Injection, droperidol, up to 5 mg |
14 |
12 |
$12.36 |
| 80177 |
|
13 |
13 |
$12.09 |
| 85018 |
|
16 |
12 |
$10.80 |
| 85014 |
|
17 |
14 |
$10.80 |
| 82310 |
|
37 |
36 |
$4.71 |
| G0384 |
Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
13 |
12 |
$4.66 |
| Q0163 |
Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen |
36 |
28 |
$1.02 |
| 80051 |
|
190 |
179 |
$0.00 |
| J1815 |
Injection, insulin, per 5 units |
19 |
12 |
$0.00 |
| G8950 |
Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
145 |
144 |
$0.00 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
25 |
12 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
12 |
12 |
$0.00 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
89 |
87 |
$0.00 |
| 36416 |
|
49 |
29 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
14 |
14 |
$0.00 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
102 |
50 |
$0.00 |
| 94760 |
|
64 |
51 |
$0.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
14 |
12 |
$0.00 |
| J2002 |
Injection, lidocaine hcl in 5% dextrose, 1 mg |
26 |
25 |
$0.00 |
| 83615 |
|
13 |
13 |
$0.00 |
| 93242 |
|
13 |
13 |
$0.00 |
| 82040 |
|
13 |
12 |
$0.00 |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
841 |
750 |
$0.00 |
| G9744 |
Patient not eligible due to active diagnosis of hypertension |
243 |
242 |
$0.00 |
| 99152 |
|
48 |
44 |
$0.00 |
| 29125 |
|
12 |
12 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
236 |
229 |
$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 |
275 |
266 |
$0.00 |