| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0378 |
Hospital observation service, per hour |
4,174 |
3,458 |
$3.71M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
18,401 |
17,276 |
$3.14M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
16,053 |
15,027 |
$2.89M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
13,018 |
12,190 |
$2.27M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
6,808 |
6,020 |
$2.02M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
5,170 |
5,067 |
$1.68M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,740 |
4,649 |
$1.24M |
| 70450 |
Computed tomography, head or brain; without contrast material |
4,485 |
4,324 |
$1.24M |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,439 |
2,392 |
$1.20M |
| 80053 |
Comprehensive metabolic panel |
49,911 |
43,773 |
$1.04M |
| 77412 |
|
1,239 |
121 |
$962K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
4,906 |
4,555 |
$840K |
| 77336 |
|
873 |
376 |
$837K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
14,982 |
14,117 |
$772K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
3,416 |
2,815 |
$753K |
| 59025 |
Fetal non-stress test |
2,612 |
2,173 |
$730K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
7,777 |
2,252 |
$654K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
2,244 |
944 |
$612K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
939 |
926 |
$561K |
| 93017 |
|
2,691 |
2,636 |
$451K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
302 |
302 |
$437K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,685 |
1,663 |
$410K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,848 |
1,787 |
$409K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
2,218 |
1,365 |
$387K |
| 93975 |
|
833 |
815 |
$380K |
| 93970 |
|
805 |
777 |
$377K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,391 |
1,365 |
$367K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,048 |
1,045 |
$347K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
4,823 |
4,818 |
$314K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,782 |
1,735 |
$304K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
909 |
903 |
$298K |
| 76801 |
|
2,558 |
2,335 |
$238K |
| 93225 |
|
1,187 |
1,174 |
$234K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,407 |
1,277 |
$215K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
4,169 |
4,091 |
$214K |
| 86850 |
|
5,846 |
5,437 |
$211K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
3,376 |
3,303 |
$201K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,293 |
1,215 |
$201K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,564 |
1,556 |
$179K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
2,099 |
2,064 |
$164K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
4,494 |
1,489 |
$155K |
| 86901 |
|
5,845 |
5,461 |
$153K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
5,035 |
4,933 |
$141K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
846 |
825 |
$133K |
| 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 |
1,614 |
1,557 |
$118K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,735 |
3,713 |
$116K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
5,037 |
4,937 |
$115K |
| 86900 |
|
5,853 |
5,469 |
$113K |
| 83880 |
|
3,180 |
3,054 |
$106K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,688 |
2,387 |
$106K |
| 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 |
1,659 |
1,603 |
$106K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
1,534 |
1,483 |
$103K |
| 93226 |
|
1,072 |
1,061 |
$102K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,474 |
1,305 |
$98K |
| 93296 |
|
1,174 |
1,083 |
$95K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,254 |
2,144 |
$93K |
| 97161 |
|
814 |
784 |
$93K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,605 |
2,556 |
$91K |
| 36415 |
Collection of venous blood by venipuncture |
15,623 |
11,122 |
$91K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
287 |
285 |
$90K |
| 93971 |
|
1,031 |
1,008 |
$87K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
96 |
95 |
$80K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
394 |
318 |
$80K |
| 84443 |
Thyroid stimulating hormone (TSH) |
9,727 |
9,394 |
$79K |
| 76830 |
Ultrasound, transvaginal |
1,692 |
1,653 |
$78K |
| 70496 |
|
254 |
253 |
$75K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
177 |
175 |
$75K |
| 71250 |
|
851 |
843 |
$75K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
38,365 |
32,929 |
$72K |
| 99406 |
|
2,069 |
1,873 |
$71K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
70 |
70 |
$70K |
| 86618 |
|
3,177 |
2,600 |
$69K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
4,331 |
3,721 |
$69K |
| 80061 |
Lipid panel |
9,938 |
9,859 |
$68K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
2,581 |
2,540 |
$67K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
4,722 |
4,061 |
$64K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,971 |
737 |
$63K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
3,371 |
3,133 |
$63K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,232 |
1,230 |
$63K |
| 96367 |
|
477 |
344 |
$62K |
| 77065 |
Tomosynthesis, mammo |
763 |
713 |
$62K |
| 85610 |
|
14,786 |
13,654 |
$60K |
| 76641 |
|
2,268 |
2,262 |
$60K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
6,062 |
6,019 |
$59K |
| 74183 |
|
183 |
183 |
$57K |
| 96415 |
|
91 |
61 |
$54K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
816 |
709 |
$54K |
| 82607 |
|
4,271 |
4,222 |
$53K |
| 74174 |
|
166 |
166 |
$49K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
1,644 |
1,635 |
$49K |
| 76770 |
|
146 |
144 |
$47K |
| J1756 |
Injection, iron sucrose, 1 mg |
833 |
374 |
$46K |
| 77066 |
Tomosynthesis, mammo |
673 |
668 |
$44K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
342 |
339 |
$42K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,397 |
2,379 |
$40K |
| 88342 |
|
748 |
693 |
$37K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
140 |
104 |
$37K |
| 76642 |
|
1,792 |
1,779 |
$36K |
| 81025 |
|
10,359 |
9,766 |
$35K |
| 88304 |
|
719 |
692 |
$33K |
| 87634 |
|
1,375 |
1,356 |
$33K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
4,693 |
4,686 |
$33K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
612 |
603 |
$33K |
| 82728 |
|
2,403 |
2,303 |
$30K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
6,174 |
5,941 |
$28K |
| 12001 |
|
57 |
57 |
$28K |
| 77334 |
|
45 |
40 |
$28K |
| 77280 |
|
30 |
28 |
$27K |
| 76536 |
|
1,193 |
1,188 |
$27K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
908 |
803 |
$27K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
6,613 |
6,355 |
$26K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
641 |
622 |
$25K |
| 88307 |
|
278 |
252 |
$25K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
905 |
431 |
$25K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
198 |
190 |
$24K |
| 71046 |
Radiologic examination, chest; 2 views |
3,803 |
3,706 |
$24K |
| 86803 |
|
2,250 |
2,244 |
$23K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
145 |
36 |
$23K |
| 86780 |
|
1,943 |
1,889 |
$22K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
2,080 |
1,972 |
$21K |
| 70486 |
|
295 |
289 |
$21K |
| 84439 |
|
2,695 |
2,572 |
$20K |
| 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 |
1,101 |
1,083 |
$20K |
| 82746 |
|
1,631 |
1,610 |
$19K |
| 82803 |
|
1,031 |
948 |
$19K |
| 94060 |
|
681 |
676 |
$18K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
11,445 |
9,954 |
$17K |
| 72141 |
|
53 |
53 |
$16K |
| 84153 |
|
841 |
839 |
$16K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
200 |
199 |
$15K |
| 90715 |
|
508 |
504 |
$14K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
588 |
584 |
$14K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
10,054 |
8,507 |
$13K |
| 84466 |
|
1,066 |
1,036 |
$13K |
| 83735 |
|
8,558 |
6,806 |
$12K |
| 77290 |
|
15 |
15 |
$11K |
| 72197 |
|
38 |
38 |
$11K |
| 97535 |
Self-care/home management training, each 15 minutes |
202 |
103 |
$11K |
| 83540 |
|
2,221 |
2,170 |
$11K |
| 86617 |
|
491 |
414 |
$11K |
| 87486 |
|
263 |
262 |
$11K |
| 82378 |
|
720 |
672 |
$11K |
| 82565 |
|
2,346 |
2,278 |
$11K |
| 87340 |
|
988 |
983 |
$10K |
| 77300 |
|
13 |
13 |
$10K |
| 81001 |
|
7,999 |
7,329 |
$10K |
| 86666 |
|
408 |
382 |
$10K |
| 87077 |
|
1,786 |
1,722 |
$10K |
| 86769 |
|
220 |
220 |
$10K |
| 77080 |
|
183 |
183 |
$10K |
| 94726 |
|
682 |
677 |
$10K |
| 87625 |
|
355 |
355 |
$9K |
| 94729 |
|
681 |
676 |
$9K |
| 86762 |
|
577 |
575 |
$8K |
| 77049 |
|
27 |
26 |
$8K |
| 84702 |
|
1,826 |
1,560 |
$8K |
| 84481 |
|
744 |
727 |
$8K |
| 72100 |
|
1,184 |
1,175 |
$7K |
| Q9963 |
High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml |
1,273 |
1,260 |
$7K |
| 36430 |
|
18 |
12 |
$7K |
| 87081 |
|
1,350 |
1,339 |
$7K |
| 93880 |
|
56 |
55 |
$6K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
20 |
20 |
$6K |
| 85027 |
|
3,227 |
2,945 |
$6K |
| 87186 |
|
1,389 |
1,357 |
$6K |
| 86140 |
|
2,377 |
2,247 |
$6K |
| 87581 |
|
264 |
263 |
$6K |
| 71271 |
|
248 |
248 |
$5K |
| 86038 |
|
944 |
931 |
$5K |
| 87660 |
|
345 |
341 |
$5K |
| 73030 |
|
887 |
852 |
$5K |
| 80047 |
|
220 |
215 |
$5K |
| 83550 |
|
1,032 |
1,018 |
$5K |
| 87510 |
|
325 |
322 |
$5K |
| 85730 |
|
2,787 |
2,599 |
$5K |
| 97803 |
|
244 |
169 |
$5K |
| 87480 |
|
313 |
310 |
$5K |
| 82570 |
|
1,071 |
1,028 |
$4K |
| 80076 |
|
490 |
480 |
$4K |
| 97162 |
|
29 |
27 |
$4K |
| 70491 |
|
17 |
17 |
$4K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
27 |
27 |
$4K |
| 71045 |
Radiologic examination, chest; single view |
7,501 |
7,084 |
$4K |
| 88341 |
|
138 |
130 |
$4K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
417 |
409 |
$4K |
| 73562 |
|
596 |
591 |
$4K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
105 |
65 |
$4K |
| 86480 |
|
62 |
62 |
$4K |
| 88142 |
|
160 |
160 |
$4K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
8,254 |
6,311 |
$3K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,774 |
2,672 |
$3K |
| 77062 |
|
110 |
110 |
$3K |
| J1453 |
Injection, fosaprepitant, 1 mg |
22 |
12 |
$3K |
| J2785 |
Injection, regadenoson, 0.1 mg |
155 |
148 |
$3K |
| 86431 |
|
552 |
550 |
$3K |
| 29125 |
|
12 |
12 |
$3K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
122 |
90 |
$3K |
| 76937 |
|
13 |
13 |
$3K |
| 81003 |
|
4,349 |
4,157 |
$3K |
| 83690 |
|
5,478 |
5,138 |
$2K |
| 86376 |
|
163 |
162 |
$2K |
| 86300 |
|
106 |
106 |
$2K |
| 83615 |
|
679 |
593 |
$2K |
| 76775 |
|
28 |
28 |
$2K |
| 76882 |
|
62 |
61 |
$2K |
| 88141 |
|
348 |
347 |
$2K |
| 73630 |
|
401 |
395 |
$2K |
| 73610 |
|
507 |
496 |
$2K |
| 84484 |
|
8,296 |
6,537 |
$2K |
| 87070 |
|
390 |
374 |
$2K |
| 85379 |
|
2,661 |
2,584 |
$2K |
| 86787 |
|
272 |
271 |
$2K |
| 73130 |
|
366 |
359 |
$2K |
| 86706 |
|
179 |
178 |
$2K |
| 85652 |
|
1,870 |
1,772 |
$2K |
| 87484 |
|
87 |
86 |
$2K |
| 87468 |
|
87 |
86 |
$2K |
| 97116 |
|
38 |
25 |
$2K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
4,765 |
4,271 |
$2K |
| 84550 |
|
523 |
493 |
$2K |
| 97802 |
|
57 |
56 |
$2K |
| 85007 |
|
1,372 |
1,186 |
$2K |
| 82947 |
|
1,616 |
1,265 |
$2K |
| 97165 |
|
12 |
12 |
$2K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
13 |
13 |
$1K |
| 76870 |
|
27 |
26 |
$1K |
| 83001 |
|
64 |
63 |
$1K |
| 72082 |
|
92 |
92 |
$1K |
| 86753 |
|
117 |
113 |
$1K |
| 84403 |
|
39 |
39 |
$1K |
| 85651 |
|
638 |
595 |
$1K |
| 83605 |
|
3,377 |
2,833 |
$1K |
| 82784 |
|
55 |
54 |
$989.81 |
| 86800 |
|
74 |
73 |
$966.72 |
| 84703 |
|
1,458 |
1,361 |
$918.01 |
| 82550 |
|
716 |
655 |
$903.53 |
| 86765 |
|
62 |
62 |
$854.84 |
| 84100 |
|
1,738 |
1,379 |
$843.35 |
| 87205 |
|
392 |
371 |
$827.39 |
| 70498 |
|
75 |
75 |
$810.02 |
| 72040 |
|
143 |
142 |
$790.80 |
| 74018 |
|
224 |
219 |
$754.48 |
| 86235 |
|
40 |
40 |
$636.91 |
| 96402 |
|
13 |
12 |
$627.86 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
890 |
734 |
$623.12 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
5,041 |
4,247 |
$621.91 |
| 76813 |
|
41 |
41 |
$621.66 |
| 86735 |
|
74 |
74 |
$601.78 |
| 84460 |
|
153 |
150 |
$580.44 |
| 93298 |
|
261 |
248 |
$579.96 |
| 87040 |
|
1,673 |
1,084 |
$576.47 |
| 86696 |
|
45 |
45 |
$574.20 |
| 88112 |
|
14 |
12 |
$573.38 |
| 84450 |
|
141 |
138 |
$541.04 |
| 82948 |
|
2,262 |
1,453 |
$522.59 |
| 84156 |
|
195 |
170 |
$415.82 |
| 72070 |
|
57 |
57 |
$392.78 |
| 84146 |
|
15 |
15 |
$379.68 |
| 99407 |
|
32 |
29 |
$375.13 |
| 82150 |
|
196 |
195 |
$361.88 |
| 80320 |
|
1,083 |
988 |
$346.11 |
| 73502 |
|
57 |
57 |
$316.97 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,724 |
1,517 |
$285.18 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
5,255 |
4,630 |
$275.40 |
| 73560 |
|
118 |
113 |
$269.84 |
| 86304 |
|
17 |
14 |
$257.86 |
| 96376 |
|
1,544 |
1,387 |
$251.78 |
| 83002 |
|
12 |
12 |
$228.78 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
318 |
241 |
$222.40 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
545 |
535 |
$213.43 |
| 83655 |
|
14 |
14 |
$207.55 |
| 77061 |
|
12 |
12 |
$201.69 |
| 82248 |
|
69 |
61 |
$201.49 |
| 73110 |
|
43 |
42 |
$199.25 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
6,578 |
5,700 |
$195.47 |
| 82533 |
|
15 |
12 |
$184.36 |
| 73564 |
|
14 |
13 |
$180.91 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
596 |
341 |
$180.84 |
| 86039 |
|
32 |
32 |
$167.44 |
| 72050 |
|
12 |
12 |
$165.16 |
| 84520 |
|
39 |
39 |
$165.02 |
| J7050 |
Infusion, normal saline solution, 250 cc |
764 |
514 |
$161.06 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
493 |
451 |
$137.88 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
4,262 |
3,610 |
$136.41 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,019 |
697 |
$134.13 |
| 82105 |
|
15 |
15 |
$122.73 |
| J2704 |
Injection, propofol, 10 mg |
3,538 |
3,443 |
$117.47 |
| 84480 |
|
17 |
16 |
$85.36 |
| 82043 |
|
15 |
15 |
$83.78 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,610 |
1,331 |
$83.11 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
407 |
293 |
$76.47 |
| 73080 |
|
26 |
25 |
$75.75 |
| 82950 |
|
40 |
40 |
$64.75 |
| 84436 |
|
12 |
12 |
$64.41 |
| 87207 |
|
49 |
48 |
$60.81 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
599 |
473 |
$60.77 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,570 |
1,292 |
$52.41 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,594 |
1,182 |
$51.17 |
| 73140 |
|
13 |
13 |
$50.85 |
| 85014 |
|
40 |
39 |
$50.04 |
| 86141 |
|
32 |
31 |
$48.18 |
| 74019 |
|
24 |
24 |
$43.20 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
318 |
315 |
$38.60 |
| 73600 |
|
15 |
15 |
$34.20 |
| J1644 |
Injection, heparin sodium, per 1000 units |
618 |
482 |
$32.92 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,514 |
2,415 |
$25.14 |
| 85018 |
|
26 |
25 |
$24.30 |
| 83721 |
|
12 |
12 |
$18.22 |
| 73090 |
|
15 |
15 |
$17.60 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
87 |
85 |
$17.26 |
| 85384 |
|
25 |
25 |
$15.87 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
793 |
709 |
$12.80 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
599 |
499 |
$8.62 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,886 |
1,851 |
$8.25 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
13 |
13 |
$6.29 |
| C9113 |
Injection, pantoprazole sodium, per vial |
138 |
87 |
$5.34 |
| 99152 |
|
42 |
25 |
$4.91 |
| 81015 |
|
135 |
133 |
$4.24 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
147 |
147 |
$1.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
55 |
54 |
$1.00 |
| A4649 |
Surgical supply; miscellaneous |
143 |
142 |
$0.78 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
43 |
43 |
$0.45 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
141 |
122 |
$0.31 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
62 |
56 |
$0.00 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
57 |
39 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
43 |
30 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
19 |
18 |
$0.00 |
| 96417 |
|
56 |
26 |
$0.00 |
| 84145 |
|
27 |
27 |
$0.00 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
14 |
12 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
36 |
27 |
$0.00 |
| C1769 |
Guide wire |
342 |
310 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
85 |
70 |
$0.00 |
| 93297 |
|
13 |
12 |
$0.00 |
| 80329 |
|
157 |
84 |
$0.00 |
| A4648 |
Tissue marker, implantable, any type, each |
25 |
25 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
20 |
18 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
28 |
26 |
$0.00 |
| G0399 |
Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation |
43 |
43 |
$0.00 |
| 94644 |
|
12 |
12 |
$0.00 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
17 |
17 |
$0.00 |