| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0206 |
|
4,306 |
4,200 |
$27.30M |
| 0121 |
|
4,637 |
4,542 |
$26.49M |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
173,548 |
153,059 |
$14.97M |
| J9271 |
Injection, pembrolizumab, 1 mg |
228 |
178 |
$3.24M |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
13,058 |
13,054 |
$2.29M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
22,430 |
20,349 |
$2.21M |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,500 |
7,388 |
$1.99M |
| J9144 |
Injection, daratumumab, 10 mg and hyaluronidase-fihj |
219 |
167 |
$1.87M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
6,091 |
6,023 |
$1.86M |
| 99460 |
|
631 |
609 |
$1.83M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
29,705 |
27,021 |
$1.67M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
8,103 |
8,102 |
$1.51M |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
3,139 |
3,131 |
$1.32M |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
551 |
551 |
$1.27M |
| 95811 |
|
2,791 |
2,785 |
$1.10M |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
1,581 |
829 |
$1.08M |
| 0123 |
|
130 |
130 |
$1.02M |
| 0211 |
|
131 |
130 |
$986K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
2,609 |
2,587 |
$932K |
| 77066 |
Tomosynthesis, mammo |
4,238 |
4,214 |
$773K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
7,848 |
7,748 |
$762K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
2,918 |
2,917 |
$746K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
18,055 |
15,622 |
$727K |
| 80053 |
Comprehensive metabolic panel |
51,855 |
44,382 |
$701K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
4,610 |
4,567 |
$700K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
70,029 |
60,139 |
$696K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
7,313 |
7,203 |
$674K |
| 76642 |
|
7,656 |
7,421 |
$656K |
| 93976 |
|
1,635 |
1,607 |
$645K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,805 |
2,583 |
$579K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
7,926 |
7,672 |
$575K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
12,332 |
12,330 |
$548K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
10,132 |
9,625 |
$511K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
142,780 |
78,650 |
$472K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,654 |
4,182 |
$454K |
| 77065 |
Tomosynthesis, mammo |
3,082 |
2,910 |
$420K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
10,116 |
7,647 |
$410K |
| 71046 |
Radiologic examination, chest; 2 views |
12,272 |
12,090 |
$386K |
| J2505 |
Injection, pegfilgrastim, 6 mg |
55 |
38 |
$362K |
| 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 |
3,201 |
3,134 |
$343K |
| J2785 |
Injection, regadenoson, 0.1 mg |
1,092 |
1,090 |
$343K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,891 |
2,858 |
$309K |
| 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 |
2,901 |
2,721 |
$304K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
27,539 |
19,971 |
$303K |
| 93971 |
|
1,831 |
1,803 |
$295K |
| 71045 |
Radiologic examination, chest; single view |
20,033 |
18,998 |
$282K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
24,546 |
22,877 |
$269K |
| 84484 |
|
17,143 |
14,391 |
$262K |
| 84443 |
Thyroid stimulating hormone (TSH) |
11,936 |
11,498 |
$254K |
| Z7502 |
|
6,725 |
6,635 |
$250K |
| 0122 |
|
36 |
36 |
$242K |
| 76830 |
Ultrasound, transvaginal |
2,271 |
2,252 |
$240K |
| 76801 |
|
2,463 |
2,261 |
$233K |
| J0897 |
Injection, denosumab, 1 mg |
131 |
127 |
$230K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,329 |
2,106 |
$228K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
5,556 |
4,989 |
$221K |
| Q5107 |
Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg |
284 |
80 |
$217K |
| 93017 |
|
2,338 |
2,328 |
$215K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
20,279 |
15,248 |
$209K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
7,794 |
6,833 |
$205K |
| 71250 |
|
854 |
853 |
$203K |
| 83690 |
|
21,486 |
19,674 |
$191K |
| 0223U |
|
518 |
514 |
$189K |
| 93798 |
|
7,508 |
1,492 |
$187K |
| J1453 |
Injection, fosaprepitant, 1 mg |
1,727 |
1,051 |
$175K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
16,115 |
15,417 |
$168K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,999 |
1,859 |
$167K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
115 |
115 |
$148K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
1,408 |
1,408 |
$138K |
| 87634 |
|
1,720 |
1,678 |
$138K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,265 |
1,035 |
$132K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
627 |
398 |
$126K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
16,097 |
12,164 |
$125K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
8,740 |
8,214 |
$115K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
13,932 |
7,935 |
$110K |
| 59025 |
Fetal non-stress test |
1,698 |
698 |
$108K |
| 93970 |
|
431 |
430 |
$103K |
| 81001 |
|
24,742 |
23,474 |
$101K |
| 80061 |
Lipid panel |
5,781 |
5,754 |
$93K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
7,135 |
5,699 |
$92K |
| J7050 |
Infusion, normal saline solution, 250 cc |
11,395 |
4,682 |
$90K |
| 85027 |
|
10,696 |
9,280 |
$89K |
| 96379 |
|
17,717 |
9,348 |
$88K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
235 |
235 |
$83K |
| 87040 |
|
6,072 |
3,616 |
$81K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
199 |
199 |
$79K |
| 83605 |
|
5,435 |
4,734 |
$79K |
| 74018 |
|
2,539 |
2,360 |
$77K |
| 80076 |
|
7,306 |
7,058 |
$76K |
| 77062 |
|
3,213 |
3,207 |
$73K |
| 80305 |
|
4,409 |
4,251 |
$73K |
| 73610 |
|
1,512 |
1,505 |
$70K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,714 |
5,679 |
$69K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,803 |
1,799 |
$66K |
| 84702 |
|
3,283 |
2,601 |
$63K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,526 |
2,498 |
$63K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,523 |
2,496 |
$63K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
584 |
584 |
$61K |
| 77080 |
|
1,117 |
1,117 |
$60K |
| 83735 |
|
7,004 |
5,236 |
$60K |
| 73630 |
|
1,369 |
1,363 |
$59K |
| 87653 |
|
1,523 |
1,510 |
$59K |
| 73562 |
|
1,391 |
1,387 |
$59K |
| 84439 |
|
5,028 |
4,798 |
$57K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
4,249 |
2,997 |
$54K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
6,733 |
2,991 |
$51K |
| 85007 |
|
10,630 |
9,223 |
$51K |
| 82805 |
|
810 |
769 |
$50K |
| J1756 |
Injection, iron sucrose, 1 mg |
644 |
275 |
$50K |
| 81025 |
|
4,599 |
4,436 |
$49K |
| 85610 |
|
8,917 |
8,397 |
$48K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
5,749 |
4,529 |
$47K |
| 0127 |
|
13 |
13 |
$47K |
| 87077 |
|
5,067 |
4,910 |
$45K |
| 85730 |
|
5,644 |
5,461 |
$44K |
| 76770 |
|
384 |
383 |
$43K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
2,623 |
2,472 |
$42K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
4,493 |
3,249 |
$40K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
4,617 |
3,285 |
$40K |
| 81003 |
|
13,488 |
12,744 |
$39K |
| 73030 |
|
809 |
807 |
$38K |
| 77061 |
|
1,712 |
1,703 |
$38K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,424 |
1,407 |
$38K |
| 0450 |
Emergency room services |
9,421 |
9,034 |
$37K |
| 81329 |
|
205 |
205 |
$34K |
| 76536 |
|
419 |
418 |
$34K |
| 70491 |
|
96 |
95 |
$34K |
| 82948 |
|
5,386 |
4,486 |
$33K |
| 84703 |
|
3,459 |
3,338 |
$32K |
| 83880 |
|
857 |
834 |
$32K |
| 72100 |
|
609 |
606 |
$32K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,759 |
1,918 |
$31K |
| 82728 |
|
1,810 |
1,748 |
$31K |
| 94729 |
|
376 |
376 |
$30K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
27 |
15 |
$30K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,128 |
2,816 |
$30K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
290 |
223 |
$28K |
| 76870 |
|
251 |
246 |
$27K |
| 86480 |
|
355 |
355 |
$26K |
| 73130 |
|
560 |
558 |
$26K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
297 |
280 |
$25K |
| 94726 |
|
342 |
342 |
$25K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
874 |
725 |
$24K |
| 85379 |
|
1,854 |
1,832 |
$24K |
| 64615 |
|
755 |
753 |
$24K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
187 |
186 |
$23K |
| 86850 |
|
1,891 |
1,787 |
$23K |
| 96416 |
|
251 |
144 |
$22K |
| 80081 |
|
233 |
232 |
$21K |
| 94375 |
|
999 |
999 |
$21K |
| 86803 |
|
1,183 |
1,181 |
$21K |
| 88304 |
|
1,207 |
1,207 |
$20K |
| 84145 |
|
732 |
714 |
$20K |
| 83550 |
|
1,822 |
1,787 |
$20K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
754 |
750 |
$19K |
| 86900 |
|
4,757 |
4,057 |
$18K |
| 86140 |
|
2,701 |
2,525 |
$18K |
| 96367 |
|
729 |
532 |
$18K |
| 86901 |
|
4,470 |
4,024 |
$17K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,033 |
924 |
$17K |
| 83540 |
|
1,871 |
1,833 |
$15K |
| 82570 |
|
2,324 |
2,290 |
$15K |
| 73110 |
|
315 |
314 |
$14K |
| 86318 |
|
632 |
606 |
$14K |
| J9190 |
Injection, fluorouracil, 500 mg |
503 |
158 |
$14K |
| J1815 |
Injection, insulin, per 5 units |
1,112 |
613 |
$13K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,496 |
1,318 |
$13K |
| 82043 |
|
1,759 |
1,756 |
$13K |
| 80074 |
|
207 |
207 |
$12K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
2,625 |
1,597 |
$12K |
| J2060 |
Injection, lorazepam, 2 mg |
1,496 |
1,177 |
$12K |
| 84481 |
|
541 |
430 |
$11K |
| J9070 |
Cyclophosphamide, 100 mg |
82 |
25 |
$11K |
| 84436 |
|
1,262 |
1,239 |
$11K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
25 |
25 |
$11K |
| 93880 |
|
65 |
65 |
$10K |
| 87210 |
|
1,423 |
1,408 |
$10K |
| 87340 |
|
784 |
778 |
$10K |
| 84153 |
|
418 |
411 |
$9K |
| 82247 |
|
1,353 |
891 |
$9K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
54 |
54 |
$9K |
| 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 |
499 |
492 |
$8K |
| S0164 |
Injection, pantoprazole sodium, 40 mg |
500 |
417 |
$8K |
| 73590 |
|
215 |
214 |
$8K |
| 87070 |
|
720 |
670 |
$8K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
13 |
13 |
$8K |
| 73140 |
|
264 |
262 |
$7K |
| 86706 |
|
554 |
553 |
$7K |
| 84100 |
|
1,225 |
1,020 |
$7K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
921 |
728 |
$7K |
| 87081 |
|
853 |
838 |
$7K |
| 82378 |
|
294 |
246 |
$7K |
| 84403 |
|
258 |
250 |
$7K |
| Z7610 |
|
711 |
464 |
$7K |
| 82533 |
|
325 |
262 |
$7K |
| 73080 |
|
136 |
136 |
$7K |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
853 |
825 |
$6K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
932 |
923 |
$6K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
512 |
322 |
$6K |
| 96417 |
|
149 |
102 |
$5K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
510 |
477 |
$5K |
| 85045 |
|
1,040 |
998 |
$5K |
| 84445 |
|
65 |
65 |
$5K |
| Z9725 |
|
119 |
119 |
$5K |
| 82670 |
|
140 |
139 |
$5K |
| 82951 |
|
307 |
307 |
$5K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
82 |
78 |
$5K |
| 82746 |
|
246 |
244 |
$4K |
| 72040 |
|
93 |
93 |
$4K |
| 82550 |
|
533 |
516 |
$4K |
| 83001 |
|
191 |
191 |
$4K |
| 86704 |
|
545 |
543 |
$4K |
| 83615 |
|
562 |
509 |
$4K |
| 95816 |
|
56 |
56 |
$4K |
| 86592 |
|
794 |
776 |
$4K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
12 |
12 |
$4K |
| 88342 |
|
94 |
91 |
$4K |
| 19083 |
|
184 |
184 |
$4K |
| 87186 |
|
353 |
332 |
$4K |
| 83970 |
|
73 |
73 |
$4K |
| 82248 |
|
557 |
425 |
$4K |
| 86308 |
|
550 |
547 |
$4K |
| 86038 |
|
233 |
232 |
$3K |
| 11043 |
|
398 |
287 |
$3K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
28 |
24 |
$3K |
| 85651 |
|
651 |
540 |
$3K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
75 |
75 |
$3K |
| 85652 |
|
956 |
936 |
$3K |
| 86376 |
|
169 |
169 |
$3K |
| J9263 |
Injection, oxaliplatin, 0.5 mg |
145 |
38 |
$3K |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
281 |
138 |
$3K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
83 |
81 |
$3K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
336 |
323 |
$3K |
| 83002 |
|
120 |
120 |
$3K |
| 86235 |
|
98 |
85 |
$3K |
| 84146 |
|
104 |
104 |
$3K |
| 82784 |
|
185 |
162 |
$2K |
| 82607 |
|
130 |
129 |
$2K |
| 93356 |
|
34 |
34 |
$2K |
| 74022 |
|
27 |
27 |
$2K |
| 83521 |
|
91 |
73 |
$2K |
| 93925 |
|
27 |
27 |
$2K |
| 84460 |
|
332 |
332 |
$2K |
| 73502 |
|
42 |
40 |
$2K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
12 |
12 |
$2K |
| J0640 |
Injection, leucovorin calcium, per 50 mg |
36 |
12 |
$2K |
| 84165 |
|
138 |
129 |
$2K |
| 86787 |
|
130 |
130 |
$2K |
| 86331 |
|
108 |
95 |
$2K |
| 86696 |
|
86 |
86 |
$2K |
| A9505 |
Thallium tl-201 thallous chloride, diagnostic, per millicurie |
69 |
69 |
$2K |
| 82553 |
|
120 |
116 |
$2K |
| 84156 |
|
447 |
381 |
$2K |
| 78306 |
|
12 |
12 |
$2K |
| 84550 |
|
290 |
263 |
$2K |
| 0250 |
|
9,245 |
8,897 |
$2K |
| 96415 |
|
165 |
125 |
$2K |
| 86800 |
|
95 |
95 |
$2K |
| 86695 |
|
75 |
75 |
$2K |
| 36902 |
|
112 |
110 |
$1K |
| 86334 |
|
61 |
57 |
$1K |
| 96411 |
|
36 |
32 |
$1K |
| 84450 |
|
177 |
177 |
$1K |
| 83655 |
|
82 |
82 |
$1K |
| 76882 |
|
72 |
66 |
$1K |
| 82565 |
|
165 |
163 |
$1K |
| 86635 |
|
74 |
74 |
$1K |
| 86171 |
|
65 |
64 |
$993.28 |
| 74019 |
|
27 |
27 |
$981.87 |
| 72072 |
|
16 |
16 |
$936.08 |
| 76775 |
|
12 |
12 |
$874.78 |
| 73090 |
|
25 |
25 |
$861.04 |
| 87045 |
|
66 |
65 |
$822.76 |
| 96523 |
|
59 |
43 |
$816.04 |
| 86225 |
|
42 |
42 |
$806.84 |
| 82232 |
|
40 |
37 |
$797.71 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
114 |
95 |
$795.18 |
| C8929 |
Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography |
14 |
14 |
$774.96 |
| 86431 |
|
88 |
88 |
$773.52 |
| 90686 |
|
26 |
26 |
$767.07 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
15 |
15 |
$757.20 |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
12 |
12 |
$678.13 |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
24 |
24 |
$671.28 |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
15 |
15 |
$648.76 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
398 |
349 |
$646.59 |
| 96401 |
|
46 |
33 |
$644.49 |
| 99199 |
Unlisted special service, procedure or report |
12 |
12 |
$595.20 |
| 84480 |
|
26 |
26 |
$565.24 |
| 86039 |
|
41 |
41 |
$531.70 |
| 87075 |
|
45 |
39 |
$528.30 |
| 87205 |
|
101 |
91 |
$526.48 |
| 82950 |
|
85 |
85 |
$496.41 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
57 |
53 |
$485.97 |
| 87449 |
|
32 |
32 |
$475.52 |
| 86341 |
|
13 |
13 |
$474.89 |
| 70360 |
|
16 |
16 |
$450.49 |
| 87427 |
|
40 |
40 |
$437.60 |
| J2182 |
Injection, mepolizumab, 1 mg |
26 |
24 |
$399.55 |
| 82150 |
|
40 |
39 |
$397.90 |
| 73660 |
|
13 |
13 |
$379.73 |
| 73120 |
|
13 |
13 |
$365.88 |
| 84681 |
|
14 |
14 |
$361.20 |
| J1630 |
Injection, haloperidol, up to 5 mg |
40 |
31 |
$360.45 |
| 0270 |
|
190 |
155 |
$337.66 |
| 82785 |
|
24 |
24 |
$333.28 |
| 85018 |
|
107 |
107 |
$325.53 |
| 0272 |
|
5,479 |
5,337 |
$324.73 |
| 85014 |
|
99 |
99 |
$302.01 |
| 86762 |
|
13 |
13 |
$289.90 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
24 |
24 |
$283.50 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
15 |
15 |
$277.65 |
| 84432 |
|
12 |
12 |
$272.58 |
| 87147 |
|
41 |
40 |
$263.22 |
| 0271 |
|
7,008 |
6,821 |
$226.81 |
| 0762 |
|
177 |
175 |
$180.75 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
2,111 |
1,809 |
$180.49 |
| 87046 |
|
53 |
52 |
$171.72 |
| 82009 |
|
26 |
24 |
$170.82 |
| 80069 |
|
15 |
15 |
$161.40 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
12 |
12 |
$146.29 |
| 96402 |
|
13 |
13 |
$145.53 |
| 0301 |
|
2,616 |
2,604 |
$127.90 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
233 |
203 |
$117.89 |
| 84478 |
|
13 |
12 |
$85.44 |
| 84520 |
|
16 |
16 |
$78.40 |
| 0636 |
|
6,515 |
6,218 |
$51.96 |
| 0402 |
|
2,091 |
2,064 |
$47.26 |
| 84155 |
|
16 |
14 |
$43.20 |
| 0410 |
|
2,423 |
2,375 |
$41.68 |
| 0258 |
|
832 |
828 |
$17.80 |
| 0730 |
|
6,175 |
5,986 |
$0.00 |
| 0300 |
|
7,302 |
6,994 |
$0.00 |
| 0320 |
|
6,083 |
5,932 |
$0.00 |
| 0483 |
|
959 |
957 |
$0.00 |
| 0430 |
|
2,240 |
2,215 |
$0.00 |
| 0302 |
|
478 |
477 |
$0.00 |
| 0460 |
|
2,816 |
2,772 |
$0.00 |
| 0489 |
|
1,308 |
1,300 |
$0.00 |
| 0360 |
|
12 |
12 |
$0.00 |
| 0260 |
|
25 |
25 |
$0.00 |
| 0921 |
|
54 |
54 |
$0.00 |
| 0390 |
|
13 |
12 |
$0.00 |
| 0350 |
|
4,080 |
4,016 |
$0.00 |
| 0305 |
|
2,610 |
2,592 |
$0.00 |
| 0306 |
|
2,154 |
2,140 |
$0.00 |
| 0307 |
|
1,934 |
1,930 |
$0.00 |
| 0420 |
|
2,964 |
2,918 |
$0.00 |
| 0440 |
|
344 |
344 |
$0.00 |
| 0610 |
|
947 |
942 |
$0.00 |
| 36591 |
|
93 |
53 |
$0.00 |
| 0720 |
|
113 |
113 |
$0.00 |
| 0171 |
Inj, epinephrine (belcher) |
48 |
48 |
$0.00 |
| 93797 |
|
22 |
12 |
$0.00 |
| 0370 |
|
12 |
12 |
$0.00 |
| 0710 |
|
12 |
12 |
$0.00 |
| 0341 |
|
14 |
14 |
$0.00 |