| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
105,392 |
86,273 |
$55.05M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
106,844 |
92,479 |
$31.13M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
293,204 |
218,070 |
$25.72M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
403,235 |
112,061 |
$21.67M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
90,358 |
77,677 |
$18.37M |
| S9480 |
Intensive outpatient psychiatric services, per diem |
84,832 |
9,522 |
$8.62M |
| J9271 |
Injection, pembrolizumab, 1 mg |
1,678 |
1,081 |
$8.45M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
52,522 |
44,001 |
$7.40M |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
6,287 |
5,012 |
$4.31M |
| 59025 |
Fetal non-stress test |
20,020 |
8,713 |
$3.18M |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
17,326 |
8,572 |
$3.07M |
| A0431 |
Ambulance service, conventional air services, transport, one way (rotary wing) |
1,634 |
1,302 |
$3.05M |
| 97010 |
|
112,146 |
39,528 |
$2.98M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
24,061 |
16,188 |
$2.87M |
| 19318 |
|
536 |
500 |
$2.81M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
18,248 |
16,051 |
$2.73M |
| 71046 |
Radiologic examination, chest; 2 views |
45,389 |
39,703 |
$2.49M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
45,330 |
33,669 |
$2.28M |
| 58661 |
|
454 |
436 |
$2.24M |
| 90935 |
Hemodialysis procedure with single evaluation by a physician |
6,032 |
447 |
$2.20M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
5,640 |
5,188 |
$2.16M |
| 93458 |
|
1,596 |
1,414 |
$2.08M |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
3,103 |
2,875 |
$2.06M |
| H0035 |
Mental health partial hospitalization, treatment, less than 24 hours |
13,202 |
1,547 |
$2.04M |
| 72125 |
Computed tomography, cervical spine; without contrast material |
12,038 |
10,479 |
$2.03M |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
2,602 |
2,307 |
$2.00M |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
2,888 |
2,652 |
$2.00M |
| 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 |
30,136 |
23,768 |
$1.93M |
| 97161 |
|
33,865 |
31,144 |
$1.92M |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
15,069 |
11,246 |
$1.80M |
| J3380 |
Injection, vedolizumab, intravenous, 1 mg |
347 |
292 |
$1.70M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
14,005 |
12,161 |
$1.70M |
| 96375 |
Therapeutic injection; each additional sequential IV push |
42,558 |
31,542 |
$1.64M |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
2,247 |
2,011 |
$1.57M |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
2,743 |
2,566 |
$1.52M |
| 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 |
18,642 |
15,788 |
$1.46M |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
153,178 |
51,696 |
$1.42M |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
8,103 |
3,732 |
$1.39M |
| 47562 |
|
344 |
313 |
$1.37M |
| 95811 |
|
1,948 |
1,820 |
$1.35M |
| A0436 |
Rotary wing air mileage, per statute mile |
1,633 |
1,302 |
$1.31M |
| 90834 |
Psychotherapy, 45 minutes with patient |
24,689 |
11,753 |
$1.25M |
| 77386 |
|
6,537 |
358 |
$1.24M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
4,504 |
4,051 |
$1.19M |
| 93798 |
|
16,874 |
2,627 |
$1.17M |
| 77412 |
|
9,359 |
880 |
$1.16M |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
5,660 |
5,221 |
$1.16M |
| 71045 |
Radiologic examination, chest; single view |
23,761 |
20,352 |
$1.15M |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
255,395 |
75,732 |
$1.14M |
| 97035 |
|
17,758 |
6,204 |
$1.10M |
| 70450 |
Computed tomography, head or brain; without contrast material |
24,486 |
21,090 |
$1.08M |
| 27447 |
|
455 |
396 |
$972K |
| 49083 |
|
2,205 |
932 |
$962K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
4,284 |
3,693 |
$949K |
| 97162 |
|
20,733 |
18,810 |
$937K |
| J2505 |
Injection, pegfilgrastim, 6 mg |
515 |
280 |
$919K |
| 97597 |
|
10,756 |
5,234 |
$917K |
| G0121 |
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk |
1,308 |
1,254 |
$909K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
8,844 |
7,816 |
$900K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,820 |
8,295 |
$865K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
1,449 |
832 |
$859K |
| 70496 |
|
4,009 |
3,532 |
$857K |
| 77334 |
|
2,592 |
1,546 |
$856K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
1,523 |
1,358 |
$845K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
6,331 |
5,628 |
$836K |
| J9035 |
Injection, bevacizumab, 10 mg |
602 |
186 |
$828K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
7,301 |
6,986 |
$815K |
| 76801 |
|
7,505 |
6,273 |
$776K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
10,664 |
9,067 |
$752K |
| 76830 |
Ultrasound, transvaginal |
6,785 |
6,181 |
$671K |
| D7140 |
Extraction, erupted tooth or exposed root |
14,392 |
4,276 |
$635K |
| 93975 |
|
3,272 |
2,956 |
$633K |
| J0897 |
Injection, denosumab, 1 mg |
909 |
733 |
$629K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
6,535 |
5,932 |
$615K |
| Q5107 |
Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg |
578 |
199 |
$607K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
6,192 |
5,406 |
$590K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
26,266 |
19,635 |
$588K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
42,736 |
29,906 |
$582K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,515 |
8,362 |
$578K |
| 66982 |
|
698 |
579 |
$558K |
| 58558 |
|
276 |
258 |
$551K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
54,793 |
27,194 |
$549K |
| 86900 |
|
41,838 |
34,947 |
$534K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
2,104 |
1,412 |
$533K |
| 90791 |
Psychiatric diagnostic evaluation |
5,913 |
5,069 |
$521K |
| 90870 |
|
3,661 |
1,081 |
$507K |
| 64450 |
|
711 |
641 |
$470K |
| 78431 |
|
664 |
570 |
$469K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
6,185 |
5,534 |
$469K |
| 77336 |
|
6,848 |
2,382 |
$464K |
| J9299 |
Injection, nivolumab, 1 mg |
164 |
85 |
$460K |
| 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 |
22,628 |
17,616 |
$459K |
| 94060 |
|
2,655 |
2,428 |
$456K |
| 52356 |
|
137 |
123 |
$454K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
28,684 |
25,372 |
$449K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
28,724 |
25,394 |
$449K |
| 36224 |
|
103 |
87 |
$440K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
4,104 |
3,747 |
$436K |
| 97165 |
|
6,471 |
5,949 |
$425K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
3,828 |
3,324 |
$423K |
| J0882 |
Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) |
3,780 |
887 |
$415K |
| 88184 |
|
3,715 |
2,681 |
$413K |
| 20610 |
|
1,850 |
1,568 |
$412K |
| 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 |
1,140 |
1,007 |
$399K |
| 43235 |
|
936 |
882 |
$390K |
| J0185 |
Injection, aprepitant, 1 mg |
3,396 |
1,642 |
$385K |
| H0015 |
Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education |
3,124 |
455 |
$383K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
9,914 |
8,641 |
$375K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
6,021 |
2,162 |
$360K |
| 36430 |
|
2,291 |
1,412 |
$348K |
| 77300 |
|
1,891 |
1,350 |
$346K |
| 58571 |
|
68 |
50 |
$343K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
3,406 |
3,177 |
$326K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
9,753 |
5,723 |
$325K |
| 64400 |
|
1,234 |
1,090 |
$312K |
| 97014 |
|
6,007 |
2,315 |
$301K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
106,722 |
87,932 |
$299K |
| 96367 |
|
6,409 |
3,549 |
$270K |
| 96415 |
|
4,794 |
3,035 |
$265K |
| 97113 |
|
4,727 |
1,373 |
$264K |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
140 |
94 |
$262K |
| 77065 |
Tomosynthesis, mammo |
2,350 |
2,089 |
$261K |
| 93971 |
|
3,712 |
3,358 |
$256K |
| 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 |
31,713 |
22,934 |
$252K |
| 90651 |
|
1,022 |
967 |
$251K |
| 77066 |
Tomosynthesis, mammo |
1,990 |
1,882 |
$243K |
| 76813 |
|
2,640 |
2,435 |
$238K |
| 97166 |
|
4,242 |
3,867 |
$234K |
| 0002A |
|
7,333 |
6,854 |
$232K |
| 0001A |
|
7,730 |
7,170 |
$231K |
| J0485 |
Injection, belatacept, 1 mg |
1,532 |
622 |
$231K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
3,339 |
3,037 |
$231K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
577 |
506 |
$224K |
| 64405 |
|
1,010 |
937 |
$223K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
24,856 |
21,960 |
$221K |
| 97535 |
Self-care/home management training, each 15 minutes |
10,202 |
6,650 |
$220K |
| 93970 |
|
1,804 |
1,589 |
$218K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
1,531 |
1,067 |
$216K |
| 99215 |
Prolong outpt/office vis |
2,129 |
1,837 |
$215K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,995 |
1,799 |
$213K |
| 97012 |
|
4,142 |
1,398 |
$207K |
| 64615 |
|
987 |
918 |
$200K |
| 10060 |
|
1,248 |
1,154 |
$198K |
| 90746 |
|
3,475 |
3,177 |
$197K |
| 96417 |
|
4,669 |
2,404 |
$193K |
| J9144 |
Injection, daratumumab, 10 mg and hyaluronidase-fihj |
67 |
36 |
$192K |
| 95909 |
|
806 |
771 |
$190K |
| 86780 |
|
17,806 |
15,444 |
$188K |
| G0498 |
Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted living) using a portable pump provided by the office/clinic, includes follow up office/clinic visit at the conclusion of the infusion |
1,105 |
604 |
$187K |
| J9217 |
Leuprolide acetate (for depot suspension), 7.5 mg |
839 |
698 |
$181K |
| 76642 |
|
2,629 |
2,480 |
$174K |
| 90832 |
Psychotherapy, 30 minutes with patient |
7,855 |
4,552 |
$172K |
| 74174 |
|
1,275 |
1,105 |
$160K |
| G0105 |
Colorectal cancer screening; colonoscopy on individual at high risk |
264 |
253 |
$156K |
| 90677 |
|
1,022 |
894 |
$155K |
| 10061 |
|
433 |
414 |
$148K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
2,524 |
687 |
$147K |
| H2012 |
Behavioral health day treatment, per hour |
2,674 |
149 |
$146K |
| C9600 |
Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch |
32 |
31 |
$144K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
18,510 |
16,806 |
$143K |
| 95708 |
|
260 |
220 |
$141K |
| D1110 |
Prophylaxis - adult |
5,765 |
5,164 |
$140K |
| 80061 |
Lipid panel |
16,550 |
14,673 |
$139K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
243,794 |
180,187 |
$136K |
| 97163 |
|
3,299 |
3,016 |
$135K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
4,129 |
3,680 |
$135K |
| 93296 |
|
7,887 |
7,519 |
$133K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,633 |
1,062 |
$129K |
| 76825 |
|
277 |
241 |
$122K |
| 74183 |
|
595 |
548 |
$122K |
| 58300 |
|
754 |
700 |
$122K |
| 77295 |
|
174 |
129 |
$119K |
| 88342 |
|
6,068 |
4,995 |
$119K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
26,888 |
5,345 |
$117K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
6,776 |
6,070 |
$111K |
| 71250 |
|
2,201 |
1,962 |
$108K |
| 93976 |
|
1,078 |
966 |
$108K |
| 86870 |
|
723 |
662 |
$107K |
| D0210 |
Intraoral - complete series of radiographic images |
3,230 |
2,913 |
$107K |
| 76770 |
|
1,288 |
1,181 |
$106K |
| 93308 |
|
873 |
774 |
$106K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
944 |
876 |
$106K |
| 77301 |
|
176 |
144 |
$105K |
| 93460 |
|
79 |
75 |
$104K |
| 74240 |
|
754 |
705 |
$104K |
| 97116 |
|
8,685 |
4,856 |
$99K |
| 92557 |
|
984 |
887 |
$98K |
| 87536 |
|
5,489 |
4,875 |
$97K |
| 91010 |
|
303 |
285 |
$96K |
| 70491 |
|
590 |
540 |
$95K |
| G0257 |
Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility |
897 |
622 |
$94K |
| 95700 |
|
599 |
548 |
$94K |
| 95816 |
|
614 |
555 |
$89K |
| 91200 |
|
1,572 |
1,465 |
$89K |
| 92610 |
|
1,079 |
955 |
$88K |
| 43259 |
|
90 |
85 |
$88K |
| 77290 |
|
428 |
354 |
$87K |
| 96411 |
|
1,718 |
956 |
$86K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
6,834 |
6,118 |
$86K |
| 90739 |
|
754 |
724 |
$84K |
| 90686 |
|
6,094 |
5,563 |
$83K |
| D0140 |
Limited oral evaluation - problem focused |
3,604 |
3,262 |
$80K |
| 93505 |
|
55 |
37 |
$80K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
364 |
321 |
$80K |
| 74220 |
|
830 |
761 |
$78K |
| 85097 |
|
494 |
288 |
$78K |
| P9047 |
Infusion, albumin (human), 25%, 50 ml |
1,216 |
448 |
$77K |
| 97167 |
|
1,668 |
1,546 |
$77K |
| 90732 |
|
1,079 |
973 |
$77K |
| D0120 |
Periodic oral evaluation - established patient |
4,739 |
4,321 |
$76K |
| 27130 |
|
27 |
26 |
$75K |
| 0011A |
|
2,583 |
2,383 |
$72K |
| 52332 |
|
57 |
49 |
$71K |
| 76641 |
|
801 |
759 |
$71K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
4,692 |
4,547 |
$71K |
| D0330 |
Panoramic radiographic image |
2,978 |
2,652 |
$68K |
| 84443 |
Thyroid stimulating hormone (TSH) |
21,547 |
18,677 |
$68K |
| 58301 |
|
359 |
327 |
$67K |
| 0012A |
|
2,188 |
2,027 |
$66K |
| 97164 |
|
4,672 |
4,128 |
$66K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
8,745 |
7,807 |
$65K |
| 72141 |
|
487 |
451 |
$64K |
| 36415 |
Collection of venous blood by venipuncture |
280,264 |
206,087 |
$64K |
| 80053 |
Comprehensive metabolic panel |
117,670 |
92,978 |
$64K |
| 92526 |
|
1,469 |
836 |
$64K |
| 77280 |
|
713 |
505 |
$62K |
| 86480 |
|
4,275 |
3,795 |
$62K |
| 57454 |
|
244 |
222 |
$61K |
| D9310 |
|
3,993 |
3,581 |
$60K |
| 88360 |
|
1,374 |
1,115 |
$60K |
| 36591 |
|
3,180 |
2,048 |
$56K |
| 86832 |
|
1,035 |
834 |
$56K |
| 93017 |
|
4,091 |
3,598 |
$56K |
| 20553 |
|
578 |
522 |
$55K |
| 73564 |
|
9,754 |
8,792 |
$55K |
| 95806 |
|
450 |
427 |
$53K |
| 86833 |
|
1,018 |
832 |
$53K |
| J3032 |
Injection, eptinezumab-jjmr, 1 mg |
14 |
14 |
$51K |
| 0004A |
|
1,575 |
1,459 |
$51K |
| 70486 |
|
2,939 |
2,633 |
$51K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
16,766 |
10,869 |
$51K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
171 |
156 |
$49K |
| 36821 |
|
29 |
26 |
$49K |
| 73700 |
|
871 |
770 |
$49K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
55,430 |
45,476 |
$47K |
| 77338 |
|
284 |
229 |
$46K |
| 95911 |
|
107 |
107 |
$46K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
37,090 |
32,619 |
$46K |
| D0274 |
Bitewings - four radiographic images |
1,756 |
1,652 |
$45K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,320 |
1,223 |
$43K |
| 94010 |
|
556 |
502 |
$42K |
| 75561 |
|
170 |
155 |
$42K |
| 43237 |
|
41 |
36 |
$41K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
637 |
210 |
$41K |
| 97760 |
|
1,130 |
970 |
$41K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
777 |
579 |
$40K |
| 90670 |
|
588 |
505 |
$39K |
| 95910 |
|
166 |
161 |
$39K |
| 81455 |
|
413 |
270 |
$37K |
| 36561 |
|
12 |
12 |
$36K |
| 86803 |
|
10,393 |
9,181 |
$36K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
3,415 |
2,918 |
$34K |
| 96402 |
|
1,847 |
1,393 |
$34K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
4,909 |
4,364 |
$33K |
| 64721 |
|
28 |
26 |
$33K |
| 20552 |
|
271 |
261 |
$32K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
571 |
414 |
$32K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
455 |
260 |
$31K |
| 0031A |
|
1,435 |
1,032 |
$31K |
| 95912 |
|
67 |
66 |
$31K |
| 76536 |
|
482 |
454 |
$30K |
| 83880 |
|
19,575 |
15,878 |
$30K |
| 72110 |
|
1,051 |
969 |
$30K |
| 0064A |
|
936 |
865 |
$29K |
| 11982 |
|
186 |
176 |
$29K |
| 20600 |
|
140 |
102 |
$29K |
| Q5114 |
Injection, trastuzumab-dkst, biosimilar, (ogivri), 10 mg |
23 |
12 |
$29K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
100,241 |
79,668 |
$28K |
| 86361 |
|
4,814 |
4,246 |
$28K |
| 78451 |
|
81 |
62 |
$28K |
| 81003 |
|
109,369 |
79,772 |
$28K |
| 72197 |
|
88 |
84 |
$28K |
| 96116 |
|
583 |
512 |
$27K |
| Q0138 |
Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) |
146 |
82 |
$27K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
804 |
573 |
$26K |
| 88173 |
|
1,707 |
1,364 |
$26K |
| 73130 |
|
7,474 |
6,347 |
$26K |
| 81025 |
|
76,749 |
66,263 |
$25K |
| 29405 |
|
108 |
86 |
$25K |
| J1453 |
Injection, fosaprepitant, 1 mg |
206 |
79 |
$25K |
| 82947 |
|
8,254 |
6,456 |
$25K |
| 70498 |
|
4,046 |
3,565 |
$24K |
| 73030 |
|
8,022 |
6,913 |
$24K |
| 98968 |
|
1,134 |
479 |
$23K |
| 72100 |
|
4,479 |
3,984 |
$21K |
| D9222 |
|
424 |
258 |
$21K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
53 |
51 |
$21K |
| 31575 |
|
202 |
171 |
$21K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
267 |
251 |
$20K |
| 51702 |
|
965 |
748 |
$20K |
| 99205 |
Prolong outpt/office vis |
147 |
137 |
$20K |
| Q0222 |
Injection, bebtelovimab, 175 mg |
45 |
44 |
$20K |
| 96133 |
|
308 |
267 |
$19K |
| 85027 |
|
23,895 |
19,213 |
$19K |
| 98967 |
|
708 |
267 |
$19K |
| 96137 |
|
304 |
262 |
$19K |
| 87340 |
|
10,542 |
9,287 |
$18K |
| 84702 |
|
10,691 |
8,061 |
$18K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
28,058 |
24,020 |
$18K |
| 78816 |
|
14 |
14 |
$18K |
| 11043 |
|
56 |
40 |
$17K |
| 73630 |
|
6,714 |
6,009 |
$17K |
| 95715 |
|
30 |
12 |
$17K |
| 80164 |
|
3,446 |
2,687 |
$17K |
| 19083 |
|
14 |
14 |
$17K |
| G0378 |
Hospital observation service, per hour |
33,026 |
18,640 |
$17K |
| 29125 |
|
736 |
619 |
$16K |
| 92523 |
|
100 |
93 |
$16K |
| 20561 |
|
1,163 |
356 |
$16K |
| 73610 |
|
9,016 |
7,107 |
$16K |
| 90734 |
|
131 |
127 |
$16K |
| 93312 |
|
71 |
67 |
$16K |
| 19081 |
|
13 |
13 |
$16K |
| 19301 |
|
14 |
12 |
$15K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
616 |
572 |
$15K |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
42 |
40 |
$15K |
| 76818 |
|
123 |
81 |
$15K |
| 95819 |
|
168 |
150 |
$15K |
| 96132 |
|
424 |
373 |
$15K |
| 73110 |
|
5,479 |
4,421 |
$15K |
| 97168 |
|
840 |
766 |
$14K |
| D0220 |
Intraoral - periapical first radiographic image |
1,489 |
1,343 |
$14K |
| 74420 |
|
990 |
854 |
$14K |
| 90674 |
|
811 |
729 |
$14K |
| 58100 |
|
98 |
84 |
$14K |
| 97124 |
|
483 |
253 |
$14K |
| 93280 |
|
1,114 |
1,050 |
$14K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
299 |
187 |
$14K |
| 82607 |
|
5,411 |
4,795 |
$13K |
| 78492 |
|
17 |
14 |
$13K |
| 72158 |
|
47 |
39 |
$13K |
| 0054A |
|
432 |
374 |
$13K |
| 84146 |
|
1,249 |
1,075 |
$12K |
| D1206 |
Topical application of fluoride varnish |
636 |
606 |
$12K |
| M0222 |
Intravenous injection, bebtelovimab, includes injection and post administration monitoring |
45 |
44 |
$12K |
| 0003A |
|
364 |
342 |
$12K |
| 77080 |
|
121 |
116 |
$12K |
| 73502 |
|
4,253 |
3,755 |
$12K |
| 80159 |
|
934 |
645 |
$11K |
| 74230 |
|
138 |
124 |
$11K |
| 72156 |
|
68 |
65 |
$11K |
| 51701 |
|
278 |
229 |
$10K |
| 95953 |
|
25 |
25 |
$10K |
| 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 |
1,555 |
1,455 |
$10K |
| 73562 |
|
1,642 |
1,485 |
$10K |
| 75574 |
|
87 |
83 |
$10K |
| 96409 |
|
117 |
50 |
$10K |
| 84439 |
|
4,468 |
3,868 |
$10K |
| 64644 |
|
41 |
37 |
$10K |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
28 |
23 |
$9K |
| 78803 |
|
13 |
12 |
$9K |
| 88307 |
|
4,107 |
3,399 |
$9K |
| 76970 |
|
114 |
99 |
$9K |
| 72131 |
|
687 |
556 |
$9K |
| 97763 |
|
644 |
402 |
$9K |
| 71271 |
|
91 |
88 |
$9K |
| 94660 |
|
2,692 |
1,661 |
$9K |
| 51798 |
|
424 |
357 |
$9K |
| 77470 |
|
53 |
27 |
$9K |
| 91320 |
|
173 |
143 |
$9K |
| Q5103 |
Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg |
18 |
14 |
$8K |
| 96523 |
|
436 |
335 |
$8K |
| 82746 |
|
3,549 |
3,122 |
$8K |
| 0124A |
|
306 |
282 |
$8K |
| J7297 |
Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg |
96 |
93 |
$8K |
| D1120 |
Prophylaxis - child |
202 |
194 |
$8K |
| 87077 |
|
12,979 |
11,398 |
$8K |
| 97032 |
|
183 |
75 |
$8K |
| 95250 |
|
124 |
93 |
$8K |
| 74018 |
|
2,064 |
1,767 |
$8K |
| 86923 |
|
1,607 |
1,148 |
$8K |
| 82728 |
|
4,947 |
4,273 |
$7K |
| 0071A |
|
203 |
201 |
$7K |
| 43264 |
|
12 |
12 |
$7K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
17 |
13 |
$7K |
| 94618 |
|
193 |
174 |
$7K |
| 73140 |
|
2,388 |
1,911 |
$7K |
| 87522 |
Neg quan hep c or qual rna |
954 |
854 |
$7K |
| 80074 |
|
722 |
644 |
$7K |
| 78306 |
|
34 |
30 |
$7K |
| 0072A |
|
201 |
182 |
$7K |
| 86706 |
|
6,123 |
5,407 |
$6K |
| 80178 |
|
2,166 |
1,680 |
$6K |
| 74019 |
|
1,004 |
892 |
$6K |
| 80076 |
|
22,978 |
19,708 |
$6K |
| 88344 |
|
30 |
30 |
$6K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
13,654 |
9,728 |
$6K |
| D5110 |
|
17 |
13 |
$6K |
| 97018 |
|
138 |
50 |
$6K |
| 93298 |
|
283 |
266 |
$6K |
| 90747 |
|
60 |
48 |
$6K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
3,831 |
3,412 |
$6K |
| 73552 |
|
2,691 |
2,346 |
$6K |
| 73590 |
|
4,482 |
3,901 |
$6K |
| 73080 |
|
2,222 |
1,962 |
$6K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
82 |
56 |
$5K |
| 87205 |
|
12,500 |
10,147 |
$5K |
| 90694 |
|
285 |
279 |
$5K |
| 87210 |
|
6,999 |
5,117 |
$5K |
| 93282 |
|
318 |
296 |
$5K |
| 72070 |
|
499 |
447 |
$5K |
| 12001 |
|
1,830 |
1,662 |
$5K |
| 20560 |
|
563 |
138 |
$5K |
| J0885 |
Injection, epoetin alfa, (for non-esrd use), 1000 units |
69 |
37 |
$5K |
| 10022 |
|
17 |
13 |
$5K |
| 83550 |
|
4,618 |
4,047 |
$5K |
| 72170 |
|
2,270 |
2,020 |
$5K |
| 83735 |
|
54,792 |
39,407 |
$5K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
12 |
12 |
$5K |
| 87186 |
|
8,177 |
7,137 |
$4K |
| 84484 |
|
67,269 |
40,246 |
$4K |
| 95992 |
|
757 |
385 |
$4K |
| 92611 |
|
44 |
42 |
$4K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
56,435 |
43,629 |
$4K |
| 52000 |
|
12 |
12 |
$4K |
| 73560 |
|
685 |
586 |
$4K |
| D9243 |
|
73 |
39 |
$4K |
| 96136 |
|
310 |
266 |
$4K |
| 76882 |
|
135 |
127 |
$4K |
| Q3014 |
Telehealth originating site facility fee |
2,296 |
2,021 |
$4K |
| 86318 |
|
896 |
798 |
$4K |
| J2506 |
Injection, pegfilgrastim, excludes biosimilar, 0.5 mg |
15 |
12 |
$4K |
| 82374 |
|
4,968 |
3,488 |
$4K |
| 83540 |
|
5,075 |
4,424 |
$4K |
| 82962 |
|
147,472 |
74,165 |
$4K |
| 87081 |
|
5,395 |
4,968 |
$4K |
| 72040 |
|
785 |
645 |
$4K |
| 20550 |
|
18 |
12 |
$4K |
| 76870 |
|
561 |
508 |
$4K |
| 78264 |
|
18 |
13 |
$3K |
| 82570 |
|
5,334 |
4,403 |
$3K |
| 93270 |
|
563 |
430 |
$3K |
| 36592 |
|
87 |
66 |
$3K |
| 86787 |
|
4,854 |
4,366 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
32 |
32 |
$3K |
| 86704 |
|
1,941 |
1,741 |
$3K |
| 12002 |
|
1,181 |
1,071 |
$3K |
| 51729 |
|
12 |
12 |
$3K |
| 97799 |
|
797 |
205 |
$3K |
| 97810 |
|
905 |
236 |
$3K |
| 93926 |
|
66 |
55 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
29 |
28 |
$3K |
| J3300 |
Injection, triamcinolone acetonide, preservative free, 1 mg |
23 |
16 |
$3K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
26 |
16 |
$3K |
| 51784 |
|
40 |
38 |
$3K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
80 |
44 |
$3K |
| 93283 |
|
168 |
161 |
$3K |
| 86317 |
|
1,916 |
1,685 |
$3K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
130 |
117 |
$3K |
| 85610 |
|
53,763 |
40,931 |
$3K |
| 73060 |
|
1,925 |
1,566 |
$3K |
| 77307 |
|
12 |
12 |
$3K |
| 86762 |
|
4,579 |
4,119 |
$3K |
| 73090 |
|
2,405 |
2,007 |
$3K |
| J9395 |
Injection, fulvestrant, 25 mg |
31 |
26 |
$2K |
| 73120 |
|
110 |
106 |
$2K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
15 |
12 |
$2K |
| 77085 |
|
26 |
26 |
$2K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
44 |
40 |
$2K |
| 82435 |
|
4,962 |
3,496 |
$2K |
| 0034A |
|
64 |
63 |
$2K |
| 96401 |
|
363 |
131 |
$2K |
| 82565 |
|
10,839 |
8,303 |
$2K |
| 84703 |
|
4,658 |
4,116 |
$2K |
| 83690 |
|
47,904 |
40,569 |
$2K |
| 83615 |
|
7,922 |
5,464 |
$2K |
| 84156 |
|
3,918 |
3,126 |
$2K |
| 86593 |
|
647 |
570 |
$2K |
| 82140 |
|
1,677 |
1,363 |
$2K |
| 86140 |
|
7,955 |
6,730 |
$2K |
| 91122 |
|
13 |
12 |
$2K |
| 70546 |
|
19 |
16 |
$2K |
| 90715 |
|
14,134 |
12,814 |
$2K |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
347 |
134 |
$2K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
1,975 |
1,888 |
$2K |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
1,125 |
872 |
$2K |
| 99407 |
|
938 |
645 |
$2K |
| 84152 |
|
693 |
617 |
$2K |
| 82043 |
|
3,237 |
2,942 |
$2K |
| 86850 |
|
39,392 |
33,125 |
$2K |
| D2332 |
|
23 |
12 |
$2K |
| 93284 |
|
124 |
117 |
$2K |
| 80051 |
|
1,821 |
1,530 |
$2K |
| J0881 |
Injection, darbepoetin alfa, 1 microgram (non-esrd use) |
19 |
12 |
$2K |
| 88237 |
|
420 |
259 |
$2K |
| 97130 |
|
50 |
12 |
$2K |
| 86304 |
|
1,356 |
1,168 |
$1K |
| 0052A |
|
41 |
38 |
$1K |
| 87070 |
|
7,191 |
5,448 |
$1K |
| 72128 |
|
611 |
485 |
$1K |
| 82105 |
|
764 |
674 |
$1K |
| D2331 |
|
25 |
16 |
$1K |
| 82652 |
|
68 |
64 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
133 |
86 |
$1K |
| 71101 |
|
797 |
728 |
$1K |
| 85014 |
|
11,247 |
8,288 |
$1K |
| 12011 |
|
931 |
867 |
$1K |
| 90846 |
Family psychotherapy without the patient present, 50 minutes |
14 |
12 |
$1K |
| 85730 |
|
5,634 |
4,889 |
$1K |
| 87641 |
|
3,168 |
2,917 |
$1K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,150 |
2,014 |
$1K |
| 88313 |
|
2,247 |
1,642 |
$999.89 |
| 82550 |
|
22,708 |
17,964 |
$998.67 |
| 84100 |
|
15,470 |
10,436 |
$975.13 |
| J2310 |
Injection, naloxone hydrochloride, per 1 mg |
463 |
380 |
$968.67 |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
13 |
12 |
$965.69 |
| 73070 |
|
626 |
542 |
$958.05 |
| 92552 |
|
314 |
304 |
$920.88 |
| 86901 |
|
41,661 |
34,794 |
$911.14 |
| 82803 |
|
4,864 |
3,940 |
$896.65 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
21 |
13 |
$889.72 |
| 88112 |
|
727 |
573 |
$875.53 |
| 82677 |
|
340 |
298 |
$854.33 |
| 82150 |
|
2,992 |
2,543 |
$851.78 |
| 85018 |
|
8,266 |
5,955 |
$847.68 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
10,602 |
9,401 |
$835.95 |
| 88264 |
|
361 |
215 |
$833.21 |
| 87507 |
|
87 |
81 |
$796.04 |
| 88304 |
|
3,305 |
2,977 |
$791.29 |
| 83605 |
|
16,011 |
10,640 |
$786.22 |
| 84403 |
|
225 |
185 |
$772.57 |
| 86709 |
|
123 |
112 |
$763.25 |
| 73000 |
|
222 |
175 |
$739.36 |
| 86696 |
|
79 |
66 |
$702.24 |
| 86708 |
|
108 |
98 |
$688.78 |
| 81001 |
|
15,105 |
13,020 |
$677.73 |
| 84134 |
|
3,117 |
2,920 |
$630.69 |
| 95012 |
|
248 |
239 |
$618.92 |
| 84466 |
|
3,203 |
2,996 |
$600.63 |
| 82330 |
|
2,820 |
1,967 |
$580.21 |
| 86695 |
|
94 |
78 |
$579.60 |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
651 |
568 |
$559.63 |
| 86336 |
|
341 |
299 |
$550.56 |
| 85652 |
|
7,071 |
6,089 |
$544.69 |
| 70355 |
|
1,972 |
1,804 |
$532.55 |
| 0051A |
|
13 |
13 |
$520.00 |
| 83970 |
|
1,282 |
1,051 |
$519.52 |
| 20611 |
|
15 |
12 |
$512.60 |
| 87040 |
|
13,092 |
5,814 |
$492.94 |
| 88142 |
|
63 |
57 |
$489.26 |
| 73523 |
|
16 |
12 |
$483.33 |
| 0013A |
|
14 |
14 |
$480.00 |
| 83721 |
|
207 |
177 |
$446.39 |
| 83021 |
|
486 |
468 |
$413.76 |
| 84704 |
|
340 |
298 |
$412.18 |
| 81050 |
|
2,166 |
1,464 |
$408.05 |
| 82553 |
|
8,302 |
6,917 |
$405.02 |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
104 |
80 |
$398.02 |
| 93880 |
|
12 |
12 |
$393.80 |
| 84550 |
|
3,982 |
3,092 |
$391.95 |
| 92567 |
|
1,152 |
1,030 |
$379.07 |
| 85660 |
|
2,681 |
2,333 |
$362.75 |
| 76775 |
|
80 |
73 |
$355.27 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
50,133 |
40,343 |
$353.24 |
| 86920 |
|
57 |
43 |
$321.28 |
| 84450 |
|
3,106 |
2,529 |
$319.66 |
| 94727 |
|
2,315 |
2,122 |
$307.06 |
| 87493 |
|
109 |
93 |
$301.59 |
| 76000 |
|
28 |
24 |
$300.44 |
| 86922 |
|
333 |
263 |
$274.63 |
| 76820 |
|
807 |
377 |
$272.91 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
39,961 |
34,387 |
$265.67 |
| 88280 |
|
445 |
264 |
$263.67 |
| 80197 |
|
1,123 |
625 |
$262.20 |
| 87075 |
|
2,453 |
1,390 |
$261.59 |
| 84132 |
|
9,527 |
6,870 |
$250.69 |
| 84478 |
|
68 |
43 |
$246.54 |
| 85379 |
|
5,074 |
4,489 |
$242.00 |
| 82248 |
|
159 |
137 |
$210.47 |
| 96377 |
|
290 |
158 |
$210.12 |
| 82040 |
|
1,547 |
1,300 |
$206.31 |
| 85045 |
|
958 |
759 |
$205.82 |
| 70360 |
|
100 |
91 |
$203.96 |
| 84145 |
|
5,223 |
4,513 |
$202.16 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
75 |
68 |
$188.72 |
| 99406 |
|
265 |
215 |
$182.32 |
| 73600 |
|
108 |
96 |
$182.18 |
| 76937 |
|
1,090 |
889 |
$178.12 |
| 87184 |
|
677 |
615 |
$172.42 |
| J0613 |
Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg |
23 |
12 |
$170.80 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
91,039 |
59,422 |
$166.56 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
13 |
13 |
$166.00 |
| 86618 |
|
253 |
219 |
$163.01 |
| 82977 |
|
62 |
58 |
$161.00 |
| 87015 |
|
1,441 |
861 |
$159.50 |
| 82010 |
|
3,951 |
3,253 |
$155.31 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
1,223 |
584 |
$155.20 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
2,572 |
2,311 |
$154.50 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
19,565 |
13,127 |
$154.35 |
| 85007 |
|
335 |
295 |
$149.71 |
| 87206 |
|
1,550 |
732 |
$145.41 |
| 81002 |
|
8,226 |
6,676 |
$145.15 |
| 82784 |
|
69 |
65 |
$142.08 |
| 82375 |
|
291 |
249 |
$141.24 |
| 87102 |
|
1,001 |
674 |
$136.34 |
| 87529 |
|
15 |
13 |
$134.04 |
| 96368 |
|
1,474 |
933 |
$129.59 |
| J1644 |
Injection, heparin sodium, per 1000 units |
33,327 |
13,076 |
$123.75 |
| 82247 |
|
49 |
47 |
$122.74 |
| 83930 |
|
2,221 |
1,860 |
$120.56 |
| J2060 |
Injection, lorazepam, 2 mg |
5,370 |
4,125 |
$116.04 |
| 87116 |
|
641 |
421 |
$113.52 |
| 86038 |
|
75 |
66 |
$108.66 |
| 89051 |
|
2,641 |
1,211 |
$107.25 |
| 80177 |
|
440 |
364 |
$98.09 |
| 82378 |
|
21 |
19 |
$93.85 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,790 |
1,585 |
$90.47 |
| 80179 |
|
284 |
268 |
$82.20 |
| J2359 |
Injection, olanzapine, 0.5 mg |
19 |
16 |
$81.58 |
| 94729 |
|
2,655 |
2,433 |
$81.08 |
| G0010 |
Administration of hepatitis b vaccine |
1,797 |
1,655 |
$80.00 |
| 86703 |
|
43 |
39 |
$78.54 |
| 82310 |
|
1,874 |
996 |
$75.32 |
| J1953 |
Injection, levetiracetam, 10 mg |
520 |
407 |
$72.53 |
| 84165 |
|
40 |
38 |
$71.82 |
| 84520 |
|
10,107 |
6,607 |
$71.02 |
| 73650 |
|
32 |
26 |
$69.15 |
| 87106 |
|
26 |
25 |
$69.02 |
| 86705 |
|
12 |
12 |
$67.50 |
| 84075 |
|
1,918 |
1,555 |
$67.21 |
| 84295 |
|
5,663 |
3,995 |
$66.65 |
| 85041 |
|
487 |
469 |
$66.00 |
| 80143 |
|
298 |
279 |
$65.76 |
| 96376 |
|
13,545 |
9,005 |
$63.95 |
| 82077 |
|
1,225 |
1,139 |
$60.92 |
| 85520 |
|
157 |
96 |
$58.45 |
| 87088 |
|
84 |
77 |
$54.18 |
| 88185 |
|
3,698 |
2,681 |
$53.61 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
45,469 |
36,113 |
$53.44 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
25,997 |
22,215 |
$50.88 |
| 84460 |
|
3,116 |
2,533 |
$42.02 |
| 87799 |
|
31 |
27 |
$40.91 |
| 87581 |
|
104 |
80 |
$33.51 |
| 87486 |
|
104 |
80 |
$33.51 |
| 95851 |
|
154 |
139 |
$32.65 |
| 83050 |
|
100 |
81 |
$31.68 |
| 85347 |
|
2,050 |
1,251 |
$28.49 |
| 86431 |
|
44 |
42 |
$27.10 |
| 82670 |
|
14 |
14 |
$26.68 |
| J1836 |
Injection, metronidazole, 10 mg |
684 |
470 |
$26.52 |
| 82800 |
|
329 |
277 |
$25.01 |
| 86200 |
|
28 |
25 |
$24.72 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
39,709 |
32,900 |
$21.00 |
| G0009 |
Administration of pneumococcal vaccine |
1,749 |
1,580 |
$20.00 |
| J3486 |
Injection, ziprasidone mesylate, 10 mg |
106 |
80 |
$18.58 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
4,944 |
3,921 |
$18.46 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
6,817 |
5,491 |
$17.60 |
| 80069 |
|
63 |
40 |
$16.60 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
3,666 |
3,082 |
$15.93 |
| 82075 |
|
317 |
284 |
$15.84 |
| 85049 |
|
101 |
82 |
$11.22 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
11,245 |
9,340 |
$11.12 |
| J3490 |
Unclassified drugs |
830,512 |
176,255 |
$10.92 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
9,778 |
6,728 |
$10.88 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
1,806 |
1,509 |
$10.83 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,832 |
1,409 |
$10.49 |
| J1921 |
Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg |
302 |
282 |
$10.36 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
1,670 |
1,409 |
$9.60 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
31,278 |
24,259 |
$8.23 |
| 85384 |
|
45 |
41 |
$8.11 |
| 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 |
22,212 |
15,939 |
$7.23 |
| 84155 |
|
14 |
12 |
$7.00 |
| J1940 |
Injection, furosemide, up to 20 mg |
4,809 |
2,436 |
$6.87 |
| P9612 |
Catheterization for collection of specimen, single patient, all places of service |
22 |
14 |
$6.30 |
| G0008 |
Administration of influenza virus vaccine |
5,459 |
4,980 |
$6.18 |
| J7050 |
Infusion, normal saline solution, 250 cc |
26,134 |
14,789 |
$5.92 |
| 86308 |
|
142 |
121 |
$5.34 |
| J1790 |
Injection, droperidol, up to 5 mg |
2,672 |
2,148 |
$5.33 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
512 |
343 |
$4.83 |
| 82945 |
|
30 |
25 |
$3.75 |
| 90656 |
|
48 |
43 |
$3.60 |
| 84157 |
|
71 |
57 |
$3.50 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
8,494 |
7,309 |
$3.04 |
| 93325 |
|
1,021 |
930 |
$2.32 |
| G8985 |
Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
282 |
247 |
$2.19 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
59,945 |
45,292 |
$2.19 |
| G8984 |
Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals |
239 |
215 |
$1.92 |
| J0741 |
Injection, cabotegravir and rilpivirine, 2mg/3mg |
261 |
242 |
$1.86 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
2,212 |
1,828 |
$1.78 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
216 |
192 |
$1.76 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
28,938 |
18,525 |
$1.72 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
7,620 |
3,785 |
$1.53 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
10,364 |
7,749 |
$1.08 |
| G8988 |
Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
260 |
212 |
$0.95 |
| G8987 |
Self care functional limitation, current status, at therapy episode outset and at reporting intervals |
241 |
203 |
$0.88 |
| G8982 |
Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
122 |
108 |
$0.86 |
| J1630 |
Injection, haloperidol, up to 5 mg |
9,825 |
8,196 |
$0.71 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
5,706 |
3,407 |
$0.69 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
9,772 |
4,370 |
$0.62 |
| G8981 |
Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals |
84 |
77 |
$0.60 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
426 |
290 |
$0.46 |
| G8997 |
Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
203 |
162 |
$0.38 |
| G8996 |
Swallowing functional limitation, current status at therapy episode outset and at reporting intervals |
203 |
162 |
$0.38 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
9,684 |
6,802 |
$0.28 |
| J2305 |
Injection, nitroglycerin, 5 mg |
590 |
539 |
$0.26 |
| J1805 |
Injection, esmolol hydrochloride, 10 mg |
54 |
48 |
$0.20 |
| J0670 |
Injection, mepivacaine hydrochloride, per 10 ml |
3,074 |
2,677 |
$0.00 |
| C1729 |
Catheter, drainage |
3,331 |
1,793 |
$0.00 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
5,324 |
3,245 |
$0.00 |
| C1760 |
Closure device, vascular (implantable/insertable) |
806 |
682 |
$0.00 |
| C1776 |
Joint device (implantable) |
1,409 |
1,255 |
$0.00 |
| C1751 |
Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) |
99 |
79 |
$0.00 |
| 78434 |
|
339 |
302 |
$0.00 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
4,787 |
4,091 |
$0.00 |
| 76942 |
|
1,069 |
974 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
2,509 |
2,086 |
$0.00 |
| 99173 |
|
270 |
256 |
$0.00 |
| 88302 |
|
529 |
472 |
$0.00 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
2,258 |
2,009 |
$0.00 |
| 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 |
7,327 |
4,838 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
837 |
736 |
$0.00 |
| 77012 |
|
84 |
67 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
3,131 |
2,721 |
$0.00 |
| 93356 |
|
1,362 |
1,242 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,728 |
1,511 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
8,400 |
7,143 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
4,624 |
4,444 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
10,598 |
6,792 |
$0.00 |
| 90999 |
Unlisted dialysis procedure, inpatient or outpatient |
6,497 |
538 |
$0.00 |
| J9190 |
Injection, fluorouracil, 500 mg |
2,028 |
704 |
$0.00 |
| 99152 |
|
5,933 |
4,933 |
$0.00 |
| 86849 |
|
224 |
176 |
$0.00 |
| 76827 |
|
221 |
198 |
$0.00 |
| J1756 |
Injection, iron sucrose, 1 mg |
4,040 |
1,763 |
$0.00 |
| C1874 |
Stent, coated/covered, with delivery system |
513 |
429 |
$0.00 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
1,354 |
1,182 |
$0.00 |
| Q0508 |
Miscellaneous supply or accessory for use with an implanted ventricular assist device |
29 |
14 |
$0.00 |
| 82365 |
|
331 |
285 |
$0.00 |
| 82272 |
|
277 |
238 |
$0.00 |
| G0271 |
Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes |
413 |
291 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
341 |
316 |
$0.00 |
| J9263 |
Injection, oxaliplatin, 0.5 mg |
86 |
38 |
$0.00 |
| 90750 |
|
2,215 |
1,725 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
284 |
224 |
$0.00 |
| J2916 |
Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg |
1,478 |
299 |
$0.00 |
| 19281 |
|
13 |
12 |
$0.00 |
| V2630 |
Anterior chamber intraocular lens |
129 |
86 |
$0.00 |
| C1758 |
Catheter, ureteral |
1,468 |
1,275 |
$0.00 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
71 |
63 |
$0.00 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
145 |
144 |
$0.00 |
| 95874 |
|
256 |
245 |
$0.00 |
| J3260 |
Injection, tobramycin sulfate, up to 80 mg |
780 |
628 |
$0.00 |
| J0640 |
Injection, leucovorin calcium, per 50 mg |
1,027 |
284 |
$0.00 |
| G0109 |
Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes |
42 |
35 |
$0.00 |
| 93319 |
|
17 |
15 |
$0.00 |
| J1956 |
Injection, levofloxacin, 250 mg |
28 |
26 |
$0.00 |
| S0190 |
Mifepristone, oral, 200 mg |
56 |
42 |
$0.00 |
| C1757 |
Catheter, thrombectomy/embolectomy |
29 |
24 |
$0.00 |
| 87497 |
|
16 |
12 |
$0.00 |
| 97598 |
|
668 |
356 |
$0.00 |
| 97811 |
|
265 |
82 |
$0.00 |
| 91300 |
|
16,081 |
13,477 |
$0.00 |
| A9541 |
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries |
265 |
236 |
$0.00 |
| 82805 |
|
168 |
153 |
$0.00 |
| 91312 |
|
285 |
261 |
$0.00 |
| J9171 |
Injection, docetaxel, 1 mg |
53 |
36 |
$0.00 |
| 76376 |
|
210 |
195 |
$0.00 |
| 92978 |
|
95 |
83 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
376 |
295 |
$0.00 |
| 90678 |
|
87 |
86 |
$0.00 |
| J9206 |
Injection, irinotecan, 20 mg |
150 |
64 |
$0.00 |
| 73100 |
|
15 |
12 |
$0.00 |
| 76098 |
|
48 |
38 |
$0.00 |
| L3913 |
Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
31 |
27 |
$0.00 |
| 77387 |
|
161 |
27 |
$0.00 |
| 90840 |
|
118 |
103 |
$0.00 |
| 88312 |
|
31 |
26 |
$0.00 |
| Q4038 |
Cast supplies, short leg cast, adult (11 years +), fiberglass |
13 |
12 |
$0.00 |
| Q0245 |
Injection, bamlanivimab and etesevimab, 2100 mg |
41 |
39 |
$0.00 |
| 85670 |
|
15 |
15 |
$0.00 |
| J9000 |
Injection, doxorubicin hydrochloride, 10 mg |
31 |
13 |
$0.00 |
| 98966 |
|
38 |
18 |
$0.00 |
| A4566 |
Shoulder sling or vest design, abduction restrainer, with or without swathe control, prefabricated, includes fitting and adjustment |
27 |
27 |
$0.00 |
| J1643 |
Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units |
14 |
13 |
$0.00 |
| J9201 |
Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg |
187 |
49 |
$0.00 |
| Q0244 |
Injection, casirivimab and imdevimab, 1200 mg |
12 |
12 |
$0.00 |
| J2720 |
Injection, protamine sulfate, per 10 mg |
44 |
40 |
$0.00 |
| J3371 |
Injection, vancomycin hcl (mylan), not therapeutically equivalent to j3370, 500 mg |
42 |
29 |
$0.00 |
| 90653 |
|
172 |
152 |
$0.00 |
| 64643 |
|
41 |
40 |
$0.00 |
| 95957 |
|
13 |
12 |
$0.00 |
| 58340 |
|
12 |
12 |
$0.00 |
| J3489 |
Injection, zoledronic acid, 1 mg |
12 |
12 |
$0.00 |
| 86235 |
|
21 |
12 |
$0.00 |
| 82108 |
|
359 |
294 |
$0.00 |
| 59841 |
|
39 |
26 |
$0.00 |
| G0270 |
Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes |
43 |
35 |
$0.00 |
| 87400 |
|
88 |
79 |
$0.00 |
| 73020 |
|
13 |
12 |
$0.00 |
| 99495 |
|
120 |
91 |
$0.00 |
| 95886 |
|
2,070 |
1,976 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
5,952 |
3,386 |
$0.00 |
| C1781 |
Mesh (implantable) |
440 |
401 |
$0.00 |
| C1753 |
Catheter, intravascular ultrasound |
145 |
129 |
$0.00 |
| C1769 |
Guide wire |
11,794 |
9,239 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
63,265 |
43,357 |
$0.00 |
| 95885 |
|
771 |
743 |
$0.00 |
| 36000 |
|
1,391 |
1,179 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
8,173 |
6,447 |
$0.00 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
1,555 |
1,265 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
1,927 |
1,464 |
$0.00 |
| V2632 |
Posterior chamber intraocular lens |
7,613 |
6,074 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
2,782 |
2,439 |
$0.00 |
| J1815 |
Injection, insulin, per 5 units |
15,361 |
5,962 |
$0.00 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
5,043 |
2,284 |
$0.00 |
| 91301 |
|
4,583 |
4,241 |
$0.00 |
| 91305 |
|
563 |
488 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
1,863 |
1,635 |
$0.00 |
| A6213 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
446 |
383 |
$0.00 |
| 88300 |
|
14 |
13 |
$0.00 |
| 88341 |
|
3,635 |
2,853 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
1,387 |
1,249 |
$0.00 |
| 91307 |
|
403 |
382 |
$0.00 |
| 36416 |
|
23,484 |
19,844 |
$0.00 |
| C2617 |
Stent, non-coronary, temporary, without delivery system |
1,715 |
1,469 |
$0.00 |
| 80185 |
|
14 |
12 |
$0.00 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
1,558 |
1,133 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
3,886 |
1,797 |
$0.00 |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
1,010 |
730 |
$0.00 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
1,514 |
1,251 |
$0.00 |
| 90480 |
|
173 |
143 |
$0.00 |
| J7121 |
5% dextrose in lactated ringers infusion, up to 1000 cc |
229 |
171 |
$0.00 |
| J0461 |
Injection, atropine sulfate, 0.01 mg |
350 |
199 |
$0.00 |
| C1783 |
Ocular implant, aqueous drainage assist device |
53 |
38 |
$0.00 |
| 74330 |
|
324 |
288 |
$0.00 |
| A9538 |
Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries |
12 |
12 |
$0.00 |
| A9555 |
Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries |
804 |
690 |
$0.00 |
| 88331 |
|
329 |
232 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
4,547 |
3,818 |
$0.00 |
| C1889 |
Implantable/insertable device, not otherwise classified |
471 |
404 |
$0.00 |
| A6022 |
Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each |
690 |
387 |
$0.00 |
| A4648 |
Tissue marker, implantable, any type, each |
1,131 |
999 |
$0.00 |
| C1726 |
Catheter, balloon dilatation, non-vascular |
1,071 |
965 |
$0.00 |
| A9503 |
Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries |
35 |
31 |
$0.00 |
| J9267 |
Injection, paclitaxel, 1 mg |
1,487 |
598 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
174 |
151 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
6,751 |
2,802 |
$0.00 |
| Q0164 |
Prochlorperazine maleate, 5 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 |
72 |
38 |
$0.00 |
| A6214 |
Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing |
568 |
439 |
$0.00 |
| 11045 |
|
1,738 |
819 |
$0.00 |
| 96127 |
|
395 |
365 |
$0.00 |
| J3411 |
Injection, thiamine hcl, 100 mg |
261 |
190 |
$0.00 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
283 |
165 |
$0.00 |
| 88311 |
|
1,008 |
632 |
$0.00 |
| J2790 |
Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) |
28 |
27 |
$0.00 |
| 93320 |
|
14 |
12 |
$0.00 |
| J2501 |
Injection, paricalcitol, 1 mcg |
9,160 |
722 |
$0.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
172 |
95 |
$0.00 |
| J9045 |
Injection, carboplatin, 50 mg |
1,444 |
733 |
$0.00 |
| 91303 |
|
890 |
821 |
$0.00 |
| 90839 |
|
481 |
384 |
$0.00 |
| J0706 |
Injection, caffeine citrate, 5 mg |
527 |
460 |
$0.00 |
| 91306 |
|
890 |
822 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
2,280 |
1,877 |
$0.00 |
| 0352U |
|
992 |
942 |
$0.00 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
290 |
238 |
$0.00 |
| A4217 |
Sterile water/saline, 500 ml |
753 |
597 |
$0.00 |
| 94760 |
|
15 |
13 |
$0.00 |
| 99496 |
|
553 |
424 |
$0.00 |
| L8699 |
Prosthetic implant, not otherwise specified |
112 |
88 |
$0.00 |
| J0280 |
Injection, aminophyllin, up to 250 mg |
123 |
97 |
$0.00 |
| 77001 |
|
153 |
134 |
$0.00 |
| 72190 |
|
71 |
69 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
40 |
38 |
$0.00 |
| J0610 |
Injection, calcium gluconate (fresenius kabi), per 10 ml |
62 |
38 |
$0.00 |
| 76377 |
|
53 |
50 |
$0.00 |
| 97804 |
|
15 |
12 |
$0.00 |
| 89060 |
|
21 |
17 |
$0.00 |
| 36226 |
|
31 |
27 |
$0.00 |
| 99386 |
|
15 |
14 |
$0.00 |
| J0456 |
Injection, azithromycin, 500 mg |
59 |
41 |
$0.00 |
| C1768 |
Graft, vascular |
27 |
24 |
$0.00 |
| 86160 |
|
32 |
27 |
$0.00 |
| J3360 |
Injection, diazepam, up to 5 mg |
21 |
15 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
14 |
13 |
$0.00 |
| J0697 |
Injection, sterile cefuroxime sodium, per 750 mg |
329 |
229 |
$0.00 |
| 84300 |
|
12 |
12 |
$0.00 |
| Q2039 |
Influenza virus vaccine, not otherwise specified |
28 |
27 |
$0.00 |
| 86777 |
|
16 |
12 |
$0.00 |
| 99385 |
|
17 |
13 |
$0.00 |
| Q0247 |
Injection, sotrovimab, 500 mg |
28 |
23 |
$0.00 |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
26 |
26 |
$0.00 |
| L3906 |
Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
15 |
12 |
$0.00 |