| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
39,027 |
34,685 |
$8.75M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
45,518 |
42,017 |
$8.62M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
12,322 |
9,342 |
$6.57M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
3,704 |
3,521 |
$4.91M |
| G0378 |
Hospital observation service, per hour |
5,208 |
2,609 |
$4.55M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
14,386 |
13,599 |
$1.97M |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,633 |
3,429 |
$1.90M |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,752 |
1,697 |
$1.83M |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
14,016 |
6,275 |
$1.48M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
21,252 |
7,840 |
$1.20M |
| 36415 |
Collection of venous blood by venipuncture |
59,532 |
49,387 |
$1.08M |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,897 |
6,007 |
$1.06M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
9,231 |
8,148 |
$1.03M |
| 80053 |
Comprehensive metabolic panel |
25,920 |
22,971 |
$826K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
727 |
683 |
$803K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,442 |
2,698 |
$728K |
| 59025 |
Fetal non-stress test |
2,366 |
1,443 |
$726K |
| 71046 |
Radiologic examination, chest; 2 views |
7,860 |
7,478 |
$716K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
37,652 |
31,190 |
$639K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
459 |
371 |
$604K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
6,802 |
2,561 |
$593K |
| 80050 |
General health panel |
4,522 |
4,465 |
$584K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
13,388 |
12,315 |
$561K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
6,172 |
5,453 |
$521K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
6,840 |
6,007 |
$469K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,672 |
1,646 |
$467K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
713 |
686 |
$466K |
| 83690 |
|
6,354 |
5,785 |
$439K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
10,784 |
9,307 |
$424K |
| 84484 |
|
7,300 |
5,667 |
$422K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
3,371 |
3,249 |
$421K |
| 73630 |
|
2,966 |
2,606 |
$410K |
| 71045 |
Radiologic examination, chest; single view |
5,015 |
4,511 |
$399K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,561 |
1,489 |
$394K |
| 73030 |
|
2,493 |
2,240 |
$381K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
15,482 |
13,157 |
$380K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,740 |
2,420 |
$367K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
6,912 |
6,708 |
$353K |
| 80061 |
Lipid panel |
10,367 |
10,222 |
$346K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
6,813 |
6,606 |
$346K |
| 73130 |
|
2,054 |
1,774 |
$333K |
| 76830 |
Ultrasound, transvaginal |
1,427 |
1,408 |
$332K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,471 |
1,437 |
$329K |
| 73610 |
|
2,164 |
1,995 |
$318K |
| 76801 |
|
1,414 |
1,345 |
$317K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
11,268 |
11,073 |
$314K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
6,565 |
3,125 |
$302K |
| 81001 |
|
11,097 |
10,191 |
$300K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,271 |
1,243 |
$295K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
2,141 |
2,073 |
$277K |
| 73110 |
|
1,717 |
1,469 |
$276K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
4,004 |
3,603 |
$275K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,823 |
1,815 |
$272K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,162 |
1,967 |
$264K |
| 84443 |
Thyroid stimulating hormone (TSH) |
7,689 |
7,490 |
$241K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
4,316 |
4,209 |
$233K |
| 86850 |
|
4,257 |
4,052 |
$219K |
| 97161 |
|
3,907 |
3,732 |
$218K |
| 73560 |
|
1,690 |
1,499 |
$210K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
222 |
221 |
$200K |
| 72100 |
|
1,487 |
1,462 |
$181K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
2,049 |
1,956 |
$179K |
| 87081 |
|
5,170 |
5,066 |
$163K |
| 87070 |
|
3,763 |
3,621 |
$161K |
| 73562 |
|
979 |
884 |
$160K |
| 84702 |
|
3,170 |
2,453 |
$160K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
3,384 |
3,343 |
$158K |
| 87186 |
|
5,483 |
4,928 |
$157K |
| 86803 |
|
4,231 |
4,160 |
$152K |
| 83605 |
|
3,850 |
3,073 |
$146K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,535 |
1,245 |
$143K |
| 97533 |
|
1,649 |
804 |
$124K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
8,801 |
6,592 |
$123K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,953 |
2,609 |
$120K |
| 87040 |
|
2,467 |
1,537 |
$120K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
6,503 |
5,154 |
$117K |
| 83880 |
|
2,497 |
2,202 |
$114K |
| 73502 |
|
951 |
914 |
$110K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
116 |
114 |
$109K |
| 97162 |
|
1,366 |
1,327 |
$103K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,107 |
912 |
$103K |
| 86901 |
|
3,903 |
3,667 |
$101K |
| 86900 |
|
3,852 |
3,623 |
$99K |
| 86140 |
|
3,361 |
3,024 |
$98K |
| 85610 |
|
7,415 |
5,177 |
$93K |
| 73565 |
|
631 |
623 |
$93K |
| 86780 |
|
3,404 |
3,343 |
$90K |
| 82728 |
|
2,319 |
2,255 |
$90K |
| 85379 |
|
1,492 |
1,432 |
$89K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,901 |
2,855 |
$88K |
| 81025 |
|
4,668 |
4,484 |
$86K |
| 93971 |
|
295 |
285 |
$84K |
| 84439 |
|
2,357 |
2,299 |
$82K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
2,240 |
2,214 |
$80K |
| 87481 |
|
2,571 |
1,400 |
$80K |
| 87077 |
|
3,765 |
3,283 |
$80K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
2,313 |
2,233 |
$79K |
| 87147 |
|
3,988 |
3,518 |
$76K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
1,042 |
654 |
$76K |
| 96376 |
|
1,239 |
1,142 |
$74K |
| 82607 |
|
2,236 |
2,197 |
$74K |
| 85027 |
|
3,047 |
2,927 |
$74K |
| 76942 |
|
228 |
219 |
$73K |
| 83735 |
|
3,773 |
2,940 |
$72K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
1,760 |
1,646 |
$71K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,098 |
1,650 |
$71K |
| 82948 |
|
5,729 |
2,265 |
$69K |
| 84703 |
|
1,633 |
1,577 |
$69K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
532 |
491 |
$69K |
| 87340 |
|
3,111 |
3,052 |
$68K |
| 64450 |
|
136 |
134 |
$67K |
| 84145 |
|
1,572 |
1,283 |
$66K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
209 |
209 |
$65K |
| 87205 |
|
2,751 |
2,540 |
$62K |
| 82803 |
|
1,379 |
1,066 |
$62K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
548 |
393 |
$59K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,208 |
1,188 |
$57K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
7,172 |
6,004 |
$56K |
| 70498 |
|
50 |
49 |
$55K |
| 12001 |
|
273 |
252 |
$52K |
| 83540 |
|
1,936 |
1,889 |
$50K |
| 87480 |
|
2,046 |
1,953 |
$49K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
278 |
276 |
$49K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
642 |
375 |
$48K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
5,955 |
5,289 |
$46K |
| 87510 |
|
1,957 |
1,870 |
$46K |
| 81003 |
|
4,575 |
4,344 |
$44K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,130 |
3,088 |
$43K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
234 |
205 |
$43K |
| J1815 |
Injection, insulin, per 5 units |
1,327 |
693 |
$43K |
| 97165 |
|
470 |
452 |
$42K |
| 87660 |
|
1,670 |
1,599 |
$41K |
| 87185 |
|
2,271 |
1,650 |
$41K |
| 73140 |
|
353 |
321 |
$40K |
| J3490 |
Unclassified drugs |
5,893 |
3,523 |
$40K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
678 |
649 |
$40K |
| 82043 |
|
1,601 |
1,572 |
$40K |
| 87420 |
|
470 |
454 |
$38K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
513 |
336 |
$38K |
| 72040 |
|
242 |
235 |
$36K |
| 86762 |
|
1,881 |
1,847 |
$36K |
| 82570 |
|
2,204 |
2,072 |
$35K |
| 82746 |
|
913 |
897 |
$34K |
| 82105 |
|
1,022 |
1,013 |
$34K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,562 |
1,555 |
$34K |
| 97597 |
|
236 |
108 |
$32K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,652 |
2,122 |
$32K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,103 |
2,382 |
$32K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
555 |
430 |
$31K |
| 82950 |
|
1,542 |
1,513 |
$29K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
2,023 |
1,777 |
$29K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
38 |
24 |
$28K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
56 |
53 |
$28K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
2,197 |
2,031 |
$28K |
| 83550 |
|
1,527 |
1,489 |
$27K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,658 |
1,797 |
$27K |
| 80076 |
|
1,271 |
1,204 |
$27K |
| 99215 |
Prolong outpt/office vis |
125 |
104 |
$25K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
386 |
362 |
$25K |
| 74018 |
|
182 |
171 |
$24K |
| 90715 |
|
762 |
754 |
$24K |
| 99442 |
|
515 |
494 |
$22K |
| 85652 |
|
1,306 |
1,176 |
$22K |
| 71250 |
|
44 |
41 |
$22K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
954 |
464 |
$22K |
| 86336 |
|
378 |
376 |
$22K |
| J2704 |
Injection, propofol, 10 mg |
2,488 |
2,045 |
$22K |
| 84403 |
|
607 |
581 |
$21K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,178 |
1,970 |
$19K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,528 |
2,270 |
$18K |
| 76000 |
|
134 |
128 |
$17K |
| 85651 |
|
1,148 |
1,039 |
$17K |
| 84100 |
|
854 |
673 |
$17K |
| 73564 |
|
87 |
86 |
$16K |
| 82677 |
|
366 |
364 |
$16K |
| 76770 |
|
65 |
64 |
$16K |
| 94761 |
|
677 |
381 |
$16K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,214 |
498 |
$16K |
| 85730 |
|
600 |
530 |
$16K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,155 |
1,125 |
$15K |
| 76642 |
|
86 |
86 |
$15K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,072 |
1,935 |
$15K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
2,587 |
1,277 |
$15K |
| 82550 |
|
494 |
388 |
$14K |
| 71100 |
|
78 |
75 |
$13K |
| 10060 |
|
96 |
75 |
$12K |
| 36416 |
|
3,056 |
2,032 |
$12K |
| 84153 |
|
328 |
321 |
$11K |
| J2060 |
Injection, lorazepam, 2 mg |
1,451 |
1,217 |
$11K |
| 86701 |
|
390 |
384 |
$11K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,366 |
1,128 |
$10K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,127 |
897 |
$10K |
| 86703 |
|
406 |
392 |
$9K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
999 |
914 |
$9K |
| 72084 |
|
34 |
32 |
$9K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
12 |
12 |
$9K |
| 86038 |
|
346 |
338 |
$8K |
| 74019 |
|
50 |
50 |
$8K |
| 84156 |
|
342 |
268 |
$8K |
| 76536 |
|
37 |
37 |
$8K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
4,650 |
3,991 |
$8K |
| 86258 |
|
134 |
109 |
$8K |
| 84146 |
|
261 |
253 |
$7K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
673 |
419 |
$6K |
| 87522 |
Neg quan hep c or qual rna |
43 |
42 |
$6K |
| 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 |
12 |
$6K |
| 86706 |
|
227 |
223 |
$6K |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,215 |
750 |
$6K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,263 |
1,061 |
$6K |
| 81513 |
|
1,423 |
1,378 |
$5K |
| 94060 |
|
17 |
16 |
$5K |
| 70486 |
|
12 |
12 |
$5K |
| 51702 |
|
92 |
84 |
$4K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
161 |
155 |
$4K |
| 86704 |
|
149 |
146 |
$4K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
219 |
200 |
$4K |
| 87088 |
|
163 |
154 |
$4K |
| 73590 |
|
25 |
24 |
$4K |
| 76882 |
|
14 |
13 |
$4K |
| 77066 |
Tomosynthesis, mammo |
24 |
24 |
$3K |
| 84550 |
|
400 |
377 |
$3K |
| 73080 |
|
28 |
25 |
$3K |
| 82553 |
|
73 |
70 |
$3K |
| 76775 |
|
12 |
12 |
$3K |
| 76870 |
|
12 |
12 |
$3K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
218 |
122 |
$3K |
| 86431 |
|
133 |
133 |
$3K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
13 |
13 |
$2K |
| 81002 |
|
1,098 |
1,062 |
$2K |
| 73090 |
|
21 |
14 |
$2K |
| 86364 |
|
34 |
27 |
$2K |
| 72082 |
|
12 |
12 |
$2K |
| 83970 |
|
15 |
14 |
$2K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
22 |
20 |
$2K |
| T1015 |
Clinic visit/encounter, all-inclusive |
215 |
207 |
$2K |
| 88720 |
|
314 |
236 |
$2K |
| 87046 |
|
42 |
41 |
$2K |
| 86922 |
|
19 |
12 |
$2K |
| 82009 |
|
258 |
218 |
$2K |
| 87045 |
|
66 |
65 |
$2K |
| 97163 |
|
15 |
14 |
$2K |
| 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 |
107 |
104 |
$1K |
| 87899 |
|
74 |
39 |
$1K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,595 |
1,226 |
$1K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
235 |
209 |
$1K |
| 0003A |
|
50 |
50 |
$1K |
| 83615 |
|
46 |
41 |
$1K |
| 82565 |
|
77 |
72 |
$1K |
| 73070 |
|
14 |
12 |
$1K |
| 77065 |
Tomosynthesis, mammo |
12 |
12 |
$1K |
| 85014 |
|
73 |
66 |
$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 |
2,363 |
1,616 |
$1K |
| 96367 |
|
12 |
12 |
$978.33 |
| 83516 |
|
15 |
12 |
$950.15 |
| 86708 |
|
41 |
41 |
$950.05 |
| 83001 |
|
34 |
33 |
$924.60 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
26 |
24 |
$887.65 |
| 82140 |
|
12 |
12 |
$865.48 |
| 87075 |
|
28 |
26 |
$842.58 |
| 82951 |
|
12 |
12 |
$834.88 |
| 82784 |
|
28 |
27 |
$814.44 |
| 85018 |
|
49 |
43 |
$785.70 |
| 83002 |
|
32 |
31 |
$782.55 |
| J1940 |
Injection, furosemide, up to 20 mg |
165 |
103 |
$764.47 |
| 87427 |
|
27 |
26 |
$734.29 |
| 90686 |
|
26 |
26 |
$577.39 |
| S3620 |
Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total) |
29 |
29 |
$541.52 |
| 92134 |
|
176 |
94 |
$529.74 |
| C9113 |
Injection, pantoprazole sodium, per vial |
63 |
39 |
$484.13 |
| 86480 |
|
12 |
12 |
$464.50 |
| 0002A |
|
20 |
20 |
$460.53 |
| A4565 |
Slings |
81 |
67 |
$457.15 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
35 |
30 |
$410.82 |
| 87015 |
|
26 |
26 |
$391.07 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
12 |
12 |
$363.66 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
34 |
27 |
$353.87 |
| 82247 |
|
15 |
13 |
$340.38 |
| 83655 |
|
12 |
12 |
$336.85 |
| 0013A |
|
15 |
15 |
$321.51 |
| J3480 |
Injection, potassium chloride, per 2 meq |
27 |
12 |
$321.01 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
23 |
18 |
$293.34 |
| 86707 |
|
12 |
12 |
$278.69 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
1,257 |
954 |
$268.05 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
82 |
41 |
$260.29 |
| A9270 |
Non-covered item or service |
25,932 |
4,596 |
$260.25 |
| 82952 |
|
12 |
12 |
$249.63 |
| 82977 |
|
14 |
14 |
$245.56 |
| 84132 |
|
13 |
12 |
$162.60 |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
34 |
30 |
$144.96 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
20 |
17 |
$144.29 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
12 |
12 |
$139.04 |
| 82947 |
|
12 |
12 |
$121.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
30 |
25 |
$70.13 |
| 81015 |
|
53 |
53 |
$40.34 |
| 80349 |
|
38 |
36 |
$25.94 |
| J7999 |
Compounded drug, not otherwise classified |
57 |
57 |
$0.00 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
221 |
212 |
$0.00 |
| G8981 |
Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals |
136 |
131 |
$0.00 |
| G8982 |
Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
174 |
163 |
$0.00 |
| 99217 |
|
54 |
50 |
$0.00 |
| G8991 |
Other physical or occupational therapy primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
12 |
12 |
$0.00 |
| G9162 |
Spoken language expression functional limitation, current status at therapy episode outset and at reporting intervals |
29 |
29 |
$0.00 |
| G8985 |
Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
424 |
389 |
$0.00 |
| G8984 |
Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals |
359 |
342 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
916 |
860 |
$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 |
1,103 |
1,014 |
$0.00 |
| 99225 |
|
37 |
24 |
$0.00 |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
43 |
29 |
$0.00 |
| G9163 |
Spoken language expression functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
31 |
31 |
$0.00 |
| 99219 |
|
15 |
14 |
$0.00 |
| G8990 |
Other physical or occupational therapy primary functional limitation, current status, at therapy episode outset and at reporting intervals |
12 |
12 |
$0.00 |